PubMed · 6898998
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L H Hawkins. 1980. Circadian rhythms and shiftworking.. https://pubmed.ncbi.nlm.nih.gov/6898998/
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BACKGROUND: Early cytomegalovirus (CMV) reactivation infections have been found to be associated with a number of stress responses such as severe bacterial infection. Intraoperative hypothermia is known to be a significant physiological stressor. Hence, we sought to evaluate a relationship between intraoperative hypothermia during liver transplantation and early CMV infection. METHODS: Relationships between intraoperative hypothermia and early CMV infection were assessed using univariate and multivariate analysis. RESULTS: There were 11 of 100 patients who had CMV infection detected within the first 30 days after the transplant and 16 of 100 in the next 3 months after the transplant. The median intraoperative temperature (34.4 degrees C) of those who subsequently developed early CMV infection was significantly lower than that in patients who did not develop early CMV infection (35.3 degrees C; P = 0.032). Multivariate analysis showed that only hypothermia was an independent predictor of early CMV infection (odds ratio 2.8, 95% confidence intervals 1.2-6.4; P = 0.047). CONCLUSIONS: Intraoperative hypothermia during liver transplantation increases the risk of CMV infection in the 1st month postoperatively and active warming seems to reduce this risk.
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BACKGROUND AND OBJECTIVE: Interstitial Laser Photocoagulation (ILP) is a minimally invasive cancer treatment technique, whereby optical energy from implanted optical fibers is used to therapeutically heat small, solid tumors. In this work, the potential of ILP without tissue charring is investigated. STUDY DESIGN/MATERIALS AND METHODS: Optical diffusion and bio-heat transfer equations were used to develop dynamic models of interstitial laser heating in liver in vivo. Modifications in the optical properties due to tissue coagulation (T > or = 60 degrees C) were incorporated into the physical description. In addition, the effect of three different blood perfusion patterns on temperature distributions was explored. Model-predicted temperatures were used as an index for thermal damage based on an accumulated temperature injury (Arrhenius) model. Thermal damage dimensions were determined with tissue temperatures constrained to remain below 100 degrees C, so as to minimize the potential for tissue charring and smoke production. RESULTS: The model predicts that increases in scattering due to coagulation and choice of perfusion pattern affect substantially thermal damage dimensions. The results indicate that, for single fiber ILP at 2.55 W for 600 s, the maximum achievable thermal damage diameter in liver, without charring, is 9.6 mm. In addition, ILP performed with high-low power ramping may have an advantage over constant power treatments, in that, larger volumes of thermal damage can be realized earlier in an irradiation. CONCLUSIONS: For ILP performed with a single spherical emitting fiber, optimal irradiation parameters exist such that thermal lesions in liver up to approximately 10 mm in diameter can be induced while the maximum tissue temperature remains below 100 degrees C, avoiding tissue charring.