• Journal of Korean Neurosurgical Society
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• 제30권sup2호
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• pp.316-321
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• 2001

Objectives : The goal of this study is to evaluate the usefulness of mild hypothermia treatment in patients with increased intracranial pressure(ICP). Material and Method : From November 1999 to May 2001, 11 patients were treated with mild hypothermia ($32-34^{\circ}C$) in whom ICP maintained at higher than 20mmHg in spite of decompressive surgery and high dose barbiturate therapy. The patient's rectal temperature were lowered by external cooling. Hypothermia was maintained for not more than 7 days and then the patients were rewarmed slowly for 24 hours. If increased ICP persisted for 2 days of hypothermia, this treatment was continued for several days. The functional outcome of each patient was assessed according to Glasgow Outcome Scale(GOS). Results : All cases except two cases showed decrease of ICP after hypothermia therapy. In 1 case which was right middle cerebral artery(MCA) infarct, ICP re-increased after 24 hours and in another 1 case, ICP was not controlled initially. Among 11 cases, 3 cases showed favorable outcome. Conclusion : Mild hypothermia treatment in patients with increased ICP was effective in controlling ICP and mortality was so decreased. More clinical experience and controlled study was need to determine the effectiveness.

• The Korean Journal of Physiology and Pharmacology
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• 제3권4호
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• pp.383-391
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• 1999

This study was carried out to determine whether the effects of an ${\alpha}_2-adrenoceptor$ agonist, clonidine, on mean arterial pressure (MAP) and heart rate (HR) are influenced by mild hypothermia. Experiments were performed in respiration-controlled and spontaneously breathing pentobarbital-anesthetized rats. Rectal temperature was maintained at $37.5{\pm}0.3^{circ}C$ for normothermic groups or at $35.2{\pm}0.3^{circ}C$ for mild hypothermic groups. Intravenous injection of clonidine (1 and 2 ${\mu}g/kg)$ produced depressor and bradycardic responses in spontaneously breathing rats under both normothermic and mild hypothermic condition: a decrease in MAP was not altered but bradycardic response was significantly augmented in the mild hypothermic group as compared with the normothermic group. Under the respiration-controlled condition, the hypotensive effect of clonidine $(2\;{\mu}g/kg)$ was reduced, whereas the bradycardic effect was increased in mild hypothermic rats as compared with normothermic rats. Both hypotensive and bradycardic effects of clondine $(2\;{\mu}g/kg)$ were blocked by pretreatment with an ${\alpha}_2-adrenoceptor$ antagonist, yohimbine (0.5 mg/kg), in both thermal conditions. Yohimbine (0.5 mg/kg, i.v.) alone produced signifcantly an increase in heart rate in the mild hypothermic group than in the normothermic group. Pretreatment with a muscarinic receptor antagonist, atropine methylnitrate (1 mg/kg, i.v.), attenuated the bradycardic effect of clonidine in the mild hypothermic group but not in the normothermic group. These results suggest that clonidine- induced bradycardia is amplified by mild hypothermia probably through an increased parasympathetic activity.

• 한국콘텐츠학회논문지
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• 제10권4호
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• pp.206-215
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• 2010

본 연구는 백서의 척수손상 후 중강도 저체온법과 수중운동이 운동기능에 미치는 영향을 알아보기 위해 신경학적 운동행동 검사와 면역조직화학적 평가를 실시하였다. 실험대상은 척수손상 유발 후 아무런 처치를 하지 않은 대조군(n=12), 척수손상 유발 직후 저체온법을 적용한 실험군 I(n=12), 척수손상 유발 후 수중운동을 실시한 실험군 II(n=12), 척수손상 유발 직후 저체온법을 적용한 후 수중운동을 실시한 실험군 III(n=12)으로 나누었다. 모든 실험군은 3일, 7일, 14일, 21일에 신경학적 운동행동 검사를 실시하였고, 3일, 7일, 21일에는 면역조직화학적 평가를 실시하였다. BBB 척도에서 14일에 대조군과 비교하여 실험군 II와 III이 통계학적으로 매우 유의한 차이를 보였으며(p<.001), 격자걷기 검사에서 대조군과 비교하여 실험군 III이 통학적으로 유의한 차이를 보였다(p<.05). 면역조직화학적 평가에서, BDNF의 발현량은 실험군 III에서 가장 많이 관찰되었다. 이와 같은 결과를 통해 중강도 저체온법과 수중운동이 척수손상 후 운동기능에 긍정적인 효과가 있음을 알 수 있었다.

• Journal of Korean Neurosurgical Society
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• 제29권2호
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• pp.167-179
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• 2000

Objective : We studied to clarify the effective time zone of mild hypothermic neural protection during ischemia and/or reperfusion after middle cerebral artery occlusion. Methods : In a reversible cerebral infarct model which maintained reperfusion of blood flow after middle cerebral artery occlusion for two hours, the size of cerebral infarction, cerebral edema and the extent of neurological deficit were observed and analyzed for comparison between the control and the experimental groups under hypothermia($33.5^{\circ}C$). The temporalis muscle temperature was reduced to $33.5^{\circ}C$ by surface cooling for two hours during middle cerebral artery occlusion for study group I. The following groups applied hypothermia for two-hour periods after reperfusion : group II(0-2 hours), group III(2-4 hours), and group IV(4-6 hours). They were rewarmed to $36.5^{\circ}C$ until sacrified at 2, 4, 6, 12, and 24 hours after reperfusion. Control group was maintained at normothermia without hypothermia. Results : In the experimental groups with hypothermia, the average value of the size of cerebral infarction($mean{\pm}SD$) was $1.97{\pm}1.65%$, which was a remarkable reduction over that of the control, $4.93{\pm}3.79%$. In the control, a progressive increase was shown in the size of infarction from point of reperfusion to 6 hours after reperfusion without further changes in size afterward. Intra-ischemic hypothermia(group I) prevented ischemic injury but did not prevent reperfusion injury. Group II examplified the most neural protective effect in comparison to the control group and group IV(p<0.05). The cortex was more vulnerable to reperfusion injury than the subcortex. Mild hypothermia showed more neural protective effects on the cortex than subcortex. Conclusion : The most appropriate time zone for application of mild hypothermia was defined to be within four hours following reperfusion.

• 대한수의학회지
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• 제38권4호
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• pp.867-881
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• 1998

The studies were carried out to investigate the phygiological changes in deep hypothermia in rabbits. Sixty rabbits were continuously cooled with femoral arterio-venous bypass circulation to rectal temperatures of $34.0{\pm}0.3^{\circ}C$(mild hypothermia), $30.0{\pm}0.3^{\circ}C$(moderate hypothermia), and $25.0{\pm}0.3^{\circ}C$(deep hypothermia). The results obtained in these experiments were summarized as follows : In mild, moderate, and deep hypothermia, MAP, HR, RR, pH, $pCO_2$, $pO_2$, $Na^+$, $K^+$, HCT, PLT, glucose, L-lactate, BUN, and creatinine were analyzed. During hypothermia, a statistically significant decrease of MAP occurred between $30^{\circ}C$ and early $25^{\circ}C$(Start) of rectal temperature while significant increases occurred between baseline($38.7^{\circ}C$) and $30^{\circ}C$. Significant decreases of HR and RR were observed in the rabbits, particularly those changes appeared to similar patterns in proportion to hypothermia. Significant decreases of pH occurred between $34^{\circ}C$ and $25^{\circ}C$, and significant increases of $pO_2$ and $pCO_2$ were observed continuously in the hypothermic rabbits. The hypothermia had no significant effect on blood $Na^+$ and serum creatinine. Blood $K^+$ significantly decreased from $3.1{\pm}0.5$(baseline) to $2.6{\pm}0.6mmol/l$($34^{\circ}C$) with the hypothermia for about 30 minutes, and significantly increased from $2.4{\pm}0.6$($25^{\circ}C$(S)) to $2.7{\pm}0.5mmol/l$($25^{\circ}C$(E)) with the hypothermia for 2 hrs. HCT significantly increased to $34^{\circ}C$, thereafter, continuously increased to $25^{\circ}C$(Start, End). PLT increased to $34^{\circ}C$, thereafter, continuously decreased to $25^{\circ}C$(Start, End). Also PLT decreased significantly from 414.3($30^{\circ}C$) to $308.8{\times}103/mm^3$($25^{\circ}C$, Start). Significant increases of blood glucose and L-lactate occurred between $30^{\circ}C$ and $25^{\circ}C$ (Start, End). Slight increase of serum BUN continuously appeared with the hypothermia. These results, such as characteristic changes of the significant decrease of pH and PLT at $34^{\circ}C$, the significant decrease of MAP at $30^{\circ}C$, and the significant increase of glucose and l-lactate at $30^{\circ}C$, suggest that homeostasis of rabbits to hypothermia rapidly decreases at $34{\sim}30^{\circ}C$ of rectal temperature. Therefore, we suggest that, during the period with the rapidly decreased homeostasis, the very carefully control and treatment need to recover hypothermic animals under the circumstances of the various hypothermic experiments and emergency medicine.

• Journal of Chest Surgery
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• 제10권1호
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• pp.124-132
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• 1977

A experimental study of deep hypothermia for open heart surgery in 5 dogs was reviewed. Surface hypothermia in combination with limited cardiopulmonary bypass was employed. Circulatory dynamics were well maintained following cardiac arrest during one hour at $20^{\circ}C$. Some degree of acidosis usually developed after the arrest period but was gradually corrected during. rewarming Total circulatory occlusion could be maintained for at least one hour at $20^{\circ}C$ without evidence of cerebral damage in the dogs. Potassium in the serum after deep hypothermia was moderately decreased and it was the most severe change in the electrolyte. Free hemoglobin of serum was mild increased and it was one of advantages of combined hypothermia with limited cardiopulmonary bypass.

• Journal of Korean Neurosurgical Society
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• 제39권3호
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• pp.228-230
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• 2006

Hypothermia is relatively a common condition and most cases involve mild hypothermia. But severe hypothermia below $30^{\circ}C$ is medical an emergency condition. We report the case of a 41-year-old man who had been left in a manhole for more than 9 hours on a freezing cold water. He was transported to our emergency room in semicomatose state with a body temperature $26.5^{\circ}C$. The patient was warmed with active rewarming. After initial stabilization, the patient was taken for a brain computed tomography and found to have large fronto-temporo-parietal[FTP] subdural hemorrhage. The patient underwent an emergent decompressive craniectomy and hematoma evacuation. After surgery, he recovered to drowsy mentation and vital signs were stable.

• The Korean Journal of Physiology and Pharmacology
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• 제8권4호
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• pp.187-194
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• 2004

Middle cerebral artery occlusion (MCAO) results in cell death by activation of complex signal pathways for cell death and survival. Hypothermia is a robust neuroprotectant, and its effect has often been attributed to various mechanisms, but it is not yet clear. Upstream from the cell death promoters and executioners are several enzymes that may activate several transcription factors involved in cell death and survival. In this study, we immunohistochemically examined the phosphorylation of mitogen-activated protein kinase, extracellular signal-regulated kinase (ERK), c-Jun N-terminal kinase (JNK) and p38 kinase during early period of the ischemic injury, following 2 hours (h) of transient MCAO. Increased phosphorylation of ERK and p38 was observed in the vessels at 3 h, neuron-like cells at 6 and 12 h and glia-like cells at 12 h. Activation of JNK was not remarkable, and a few cells showed active JNK following ischemia. Phosphorylation of Elk-1, a transcription factor, was reduced by ischemic insult. Hypothermia attenuated the activation of ERK, p38 and JNK, and inhibited reduction of Elk-1. These data suggest that signals via different MAPK family members converge on the cell damage process and hypothermia protects the brain by interfering with these pathways.

• Child Health Nursing Research
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• 제23권4호
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• pp.505-514
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• 2017

Purpose: Maintaining body temperature is a key vital function of human beings, but little is known about how body temperature of highrisk infants is sustained during early life after birth. The aim of this study was to describe hypothermia in high-risk infants during their first week of life and examine demographic, environmental, and clinical attributors of hypothermia. Methods: A retrospective longitudinal study was done from January 1, 2013 to December 31, 2015. Medical records of 570 high-risk infants hospitalized at Neonatal Intensive Care Units (NICU) of a university affiliated hospital were examined. Body temperature and related factors were assessed for seven days after birth. Results: A total of 336 events of hypothermia (212 mild and 124 moderate) occurred in 280 neonates (49.1%) and most events (84.5%) occurred within 24 hours after birth. Logistic regression analysis revealed that phototherapy (aOR=0.28, 95% CI=0.10-0.78), Apgar score at 5 minute (aOR=2.20, 95% CI=1.17-4.12), and intra-uterine growth retardation or small for gestational age (aOR=3.58, 95% CI=1.69-7.58) were statistically significant contributors to hypothermia. Conclusion: Findings indicate that high-risk infants are at risk for hypothermia even when in the NICU. More advanced nursing interventions are necessary to prevent hypothermia of high-risk infants.

• Journal of Chest Surgery
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• 제13권3호
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• pp.186-197
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• 1980

We attempted to evaluate the effectiveness of cold blood potassium cardioplegia [Group B] compared with that of intermittent aortic cross clamp with topical hypothermia [Group A] in each six dogs. The studies were performed under the extracorporeal circulation with moderate hypothermia by using Mongrel dogs. 1. In Group A [6], it was difficult to maintain the temperature below 20?. but in Group B [6], it was possible to maintain the temperature. 2. In blood pressure and myocardial recovery ability, Group B was more excellent than Group A. 3. There was no significant difference in Na+, Ca++ and Cl- between both groups, but in K+ level, Group A was mild decreased and Group B was nearly normal level. 4. In serum LDH level, Group A was higher than Group B, but in SGOT level there was no significance between both groups. 5. On electromicroscopical study, Group A showed severe change in mitochondria, but Group B was nearly normal view. Thus we suggest that cold blood potassium cardioplegia would be more effective than intermittent aortic cross clamp with topical hypothermia for myocardial protection in open heart surgery.