The thalamic pain is an unfamiliar, intensely disagreeable sensation and resistant to analgesics. The purpose of this study is to determine the usefulness of digital infrared thermographic imaging for objective diagnosis of thalamic pain syndrome after cerebrovascular stroke. Twenty-seven patients with thalamic pain syndrome who had mild or no disability after cerebrovascular stroke were examined. Digital Infrared thermographic imaging study of these patients revealed hypothermia on the involved trunk, upper and lower extremities. The meaningful differences of the skin temperature between painful side and contralateral side were 0.89degreesC in trunk, 1.02degreesC in upper extremity and 1.37degreesC in lower extremity. Digital infrared thermographic imaging seems to be an useful diagnostic modality in thalamic pain syndrome after cerebrovascular stroke.
Analgesics ; Diagnosis ; Humans ; Hypothermia ; Lower Extremity ; Sensation ; Skin Temperature ; Stroke* ; Upper Extremity

Adult ; Circulatory Arrest, Deep Hypothermia Induced ; adverse effects ; Humans ; Male ; Rhabdomyolysis ; diagnosis ; etiology

Female ; Hand-Arm Vibration Syndrome ; diagnosis ; Humans ; Hypothermia ; diagnosis ; Male ; Reference Standards ; Skin Temperature ; physiology ; Young Adult

Essential palmar hyperhidrosis is a disease characterized by excessive sweating on palms and hands due to hyperaction of sympathetic nervous discharge. It develops severe hypothermia on both hands because of loss of surface heat by evaporation of the sweating. Numerous tests including starch-iodine test were used to detect sweating status. But they were complicated and unpleasant to patients. Digital infrared Thermographic Imaging(DITI) can show a thermal difference very clearly. We have used DITI not only for the diagnosis, but for planning of the operation and operative follow up of the disease since 1990. 343 cases of bilateral upper thoracic(T2 & T3) sympathetic ganglionectomy were performed from Mar. 1989 to Dec. 1996 in our spine center. Among them, open surgery with posterior midline approach were initially carried out in 54 cases and recently percutaneous endoscopic sympathectomy were carried out in 289 additional cases. Digital Infrared Thermographic Imaging has been taken pre and postoperatively in 339 cases. Preoperatively, severe hypothermia is noted in 96.2% in both hands and feet. Immediately after operation, the sweating ceased in all cases and marked hyperthermia was noted in both hands compared to preoperative status due to sympathetic denervation. DITI is more accurate and easier than any other method for diagnosis and evaluation of treatment effect in hyperhidrosis. DITI is simple, accurate, comfortable and objective diagnostic tool for hyperhidrosis patient.
Diagnosis ; Fever ; Follow-Up Studies ; Foot ; Ganglionectomy ; Hand ; Hot Temperature ; Humans ; Hyperhidrosis* ; Hypothermia ; Spine ; Sweat ; Sweating ; Sympathectomy

BACKGROUND: Acute thoracic aortic dissections involving the aortic arch differ in diagnosis, surgical procedures, and operative results compared to those that do not involve the aortic arch. In general cerebral perfusion under deep hypothermic circulatory arrest (HCA) is performed during the repair of the aortic arch dissection. Here, we report our surgical results of the aortic arch dissection repair using retrograde cerebral perfusion (RCP) and its safety. MATERIAL AND METHOD: Between January 1996 and June 2002, 22 consecutive patients with aortic arch dissection underwent aortic arch repair. In 20 of them RCP was performed under HCA. RCP was done through superior vena cava in 19 patients and by systemic retrograde venous perfusion in 1, in whom it was difficult to reach the SVC. When the patient's rectal temperature reached 16 to 18oC, systemic circulation was arrested, and the amount of RCP amount was 481.1+/-292.9 ml/min with perfusion pressure of 20~30 mm Hg. RESULT: There were two in-hospital deaths (4.5%) and one late death (9.1%). Mean circulatory arrest time (RCP time) was 54.0+/-13.4 minutes (range, 7 to 145 minutes). RCP time has no correlation with the appearance of consciousness, recovery of orientation, or ventilator weaning time (p=0.35, 0.86, and 0.92, respectively). Ventilator weaning was faster in patients with earlier recovery of consciousness and orientation (r=0.850, r=926; p=0.000, respectively). RCP of more than 70 minutes did not affect the appearance of consciousness, recovery of orientation, ventilator weaning time, exercise time, or hospital stay (p= 0.42, 0.57, 0.60, 0.83, and 0.51, respectively). CONCLUSION: Retrograde cerebral perfusion time under hypothermic circulatory arrest during repair of aortic arch dissection may not affect recovery of orientation, ventilator weaning time, neurologic complications, and postoperative recovery.
Aorta, Thoracic* ; Circulatory Arrest, Deep Hypothermia Induced ; Consciousness ; Diagnosis ; Humans ; Length of Stay ; Perfusion* ; Vena Cava, Superior ; Ventilator Weaning

Asphyxia Neonatorum ; complications ; Humans ; Hypothermia, Induced ; methods ; trends ; Hypoxia-Ischemia, Brain ; diagnosis ; therapy ; Infant, Newborn ; Neurologic Examination

We describe aortic arch endarterectomy performed concomitantly with on-pump cardiac surgery in 2 patients with grade V arch atherosclerosis. In both patients, transesophageal echocardiographic findings led to the diagnosis of severe arch atherosclerosis associated with a mobile atheromatous plaque in the aortic arch. The severe arch atherosclerosis was managed with endarterectomy under deep hypothermic circulatory arrest. In patients with severe grade V atherosclerosis in the aortic arch, performing endarterectomy simultaneously with primary cardiac surgery may be justified as a way to reduce the risk of peripheral embolism, including cerebrovascular accidents, with minimal additional surgical risk.
Aorta ; Aorta, Thoracic ; Atherosclerosis ; Circulatory Arrest, Deep Hypothermia Induced ; Diagnosis ; Echocardiography ; Embolism ; Endarterectomy ; Humans ; Plaque, Atherosclerotic ; Stroke ; Thoracic Surgery

Wischnewski spots (WS) are multiple black spots observed in the gastric mucosa at autopsy that are considered a reliable and important feature of hypothermia. Nonetheless, the frequency of WS varies widely. WS were discovered in 20 cases out of 3,493 autopsies (0.57%) conducted between 2001 and 2017 in the Department of Forensic Medicine of the School of Medicine, Kyungpook National University in Korea. This study aimed to investigate the distribution and size of WS in these cases and analyze the respective causes of death. Nine cases that occurred in winter were the same as the nine cases with hypothermia as the cause of death or contributory cause. The post-mortem blood alcohol test was positive in eight cases, with acute or chronic alcoholism determined as the cause of death in two of these cases. There were two cases of acute poisoning by pesticides. Putrefaction was noted in six cases (30%). WS presented in various sizes ranging from pinpoint to more than 5 mm in diameter, and the number of WS varied from 5 to 100. WS distribution was diffuse in four cases (20%) and localized in 13 cases (65%). Microscopic examination showed brown to black pigmentation but no neutrophil infiltration or vital reactions in the WS. Thus, WS are associated with hypothermia and are considered post-mortem alterations with variable appearance, size, and distribution. Hypothermia is an exclusive diagnosis at autopsy that should result from a combined assessment of toxicological tests, circumstance of death, and autopsy findings.
Alcoholism ; Autopsy ; Cause of Death ; Diagnosis ; Forensic Medicine ; Gastric Mucosa ; Gyeongsangbuk-do ; Humans ; Hypothermia ; Korea ; Neutrophil Infiltration ; Pesticides ; Pigmentation ; Poisoning

Systemic lupus erythematosus(SLE) is a prototypic autoimmune disease affecting various organ systems. Hypothermia is a rare manifestation of SLE. We experienced a case of SLE combined with hypothermia. A 36-year-old woman, who had been diagnosed as SLE 3 days before admission, admitted complaining of mental confusion. After admission, her body temperature, initially 36.1 degree C, became 32.6 degree C. Her core body temperature was less than 35.0 degree C. Despite of warming with heating lamp and blankets, her core temperature did not reach 35.0 degree C during 18 hours. Ten days later, her temperature exceeded 36.0 degree C.
Adrenal Cortex Hormones/administration & dosage ; Adult ; Atrial Fibrillation/diagnosis ; Atrial Fibrillation/complications* ; Body Temperature/physiology ; Case Report ; Cyclophosphamide/administration & dosage ; Drug Therapy, Combination ; Electrocardiography ; Female ; Follow-Up Studies ; Human ; Hypothermia/therapy ; Hypothermia/diagnosis ; Hypothermia/complications* ; Lupus Erythematosus, Systemic/drug therapy ; Lupus Erythematosus, Systemic/diagnosis ; Lupus Erythematosus, Systemic/complications*

BACKGROUND: Deep hypothermic circulatory arrest during repair of aortic arch anomalies may induce neurological complications or myocardial injury. So we surveyed if the regional cerebral and myocardial perfusion might eliminate those potential side effects. MATERIAL AND METHOD: From March 2000 to December 2004, 62 neonates or infants with aortic arch anomaly underwent one stage biventricular repair using the regional perfusion technique by single surgeon. Preoperative diagnosis of the arch anomaly consisted of coarctation (n=46), interruption of the aorta (n=12), hypoplastic left heart syndrome (n=2) and truncus areteriosus (n=2). Combined anomalies were ventricular septal defect (n=51), TAPVR (n=1), PAPVR (n=1) and atrioventricular septal defect (n=2). Arterial cannula was inserted at the innominate artery. RESULT: The mean regional perfusion time of brain was 28+/-10 min. Operative mortality rates was 0 (0/62). Late death was 1 (1/62) during 11+/-7 months of follow-up. Neurologic complications consisted of transient chorea in 1 case. There was no reoperation associated with arch anolamy. Pulmonary complication associated with arch repair occurred in 1 case which was managed by aortopexy. CONCLUSION: One-stage arch repair using the regional prefusion is safe and effective in minimizing the neurologic and myocardial complications.
Aorta ; Aorta, Thoracic* ; Brachiocephalic Trunk ; Brain ; Catheters ; Chorea ; Circulatory Arrest, Deep Hypothermia Induced ; Diagnosis ; Follow-Up Studies ; Heart Septal Defects, Ventricular ; Humans ; Hypoplastic Left Heart Syndrome ; Hypothermia ; Infant ; Infant, Newborn ; Mortality ; Perfusion* ; Regional Blood Flow ; Reoperation ; Scimitar Syndrome