PubMed · 15012044
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J Harten, J Kinsella. 2004. Perioperative optimisation.. https://doi.org/10.1177/003693300404900102
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In the early days of manned space flight, experiments were done in which dogs and chimpanzees were exposed to near vacuum in anticipation of possible manned space flight accidents. These specimens experienced what was termed "ebullism". This syndrome involved boiling of body fluids resulting in extreme dehydration and circulatory failure. Whereas malignant tumors are typically warmer than normal tissue, it should be possible to destroy them while sparing normal tissue through this phenomenon by subjecting patients to low pressure slightly greater than that which would produce systemic ebullism.
Many types of ophthalmic instruments produce a concentrated focal irradiance in the lens. Instruments that illuminate large areas of the retina-known as "Maxwellian-view," are but one example, and there are concerns about the potential hazards associated with this optical system. The transfer of the heat generated in the human eye in Maxwellian-view illumination or similar focal-beam situations was simulated using a mathematical model to determine the temperature elevations induced in the human eye. The maximum temperature rise in the lens region was examined to quantitatively assess the potential thermal hazard to the lens. It was shown that Maxwellian-view illumination or similar focal-beam situations can cause thermal injury to the lens under certain conditions, and that this hazard is greater for incident wavelengths of about 320-420 nm than for longer wavelengths. The risk of thermal injury increases as exposure duration increases, and the risk tends to increase as the beam waist diameter or Maxwellian-view angle decreases.
AIM: To explore mechanisms by which temperature could influence the pathogenesis and symptoms of diabetic polyneuropathy. METHODS: We conducted a literature review attempting to identify mechanisms by which diabetic polyneuropathy could be affected by temperature. RESULTS: Cooling can theoretically hasten the progression of diabetic polyneuropathy through several different mechanisms. Specifically, cooling can enhance neuronal ischaemia, increase formation of reactive oxygen species, slow axonal transport, increase protein kinase C activity, and interfere with immune function. Short-term temperature fluctuations (both warming and cooling) can initiate and exacerbate neuropathic pain by causing neuronal hyperexcitability and functional deafferentation. Although normal fluctuations of distal extremity temperature may be sufficient for these effects, impaired thermoregulation may make the distal extremities more susceptible to temperature extremes. Eventually, a 'vicious cycle' may ensue, resulting in neuronal deterioration with further disruption of temperature regulation. Limited epidemiological data suggest a higher prevalence of diabetic polyneuropathy in populations living in colder locations, supporting our hypothesis. CONCLUSIONS: Variations in foot temperature may play an important but as yet unrecognized role in the development and symptoms of diabetic polyneuropathy. Further basic and clinical research exploring this concept could help elucidate the natural history of diabetic polyneuropathy and lead to novel therapeutic strategies.