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Effect of arthroscopy and continuous cryotherapy on the intra-articular temperature of the knee.

PURPOSE: The purpose of this study was to determine "in vivo" the intra-articular temperature of the knee in baseline situation, to quantify its variation during the arthroscopic surgery and the repercussion on the body temperature, and to quantify the variation of the intra-articular temperature after the application of topic cold postoperatively. TYPE OF STUDY: Case series. Experimental study in patients who undergo arthroscopic surgery of the knee monitoring their intra-articular temperature. METHODS: An intra-articular temperature data acquisition system is used in 30 patients who undergo arthroscopic surgery of the knee using saline solution at room temperature and monitoring their body temperature with a rectal temperature probe. In 23 of these patients, after surgery, a plastic bag with 2 kg of ice is applied on the knee, and the variation of the intra-articular temperature is measured for at least 1 hour. RESULTS: The basal temperature of the knee (32.22 degrees +/- 0.28 degrees C) decreases during the intervention using saline fluid at room temperature to nearly equalize it (24.49 degrees +/- 0.97 degrees C), and it led to a drop of the body temperature of 0.14 degrees +/- 0.04 degrees C. The continuous external application of ice after the arthroscopy produces a drop of the intra-articular temperature directly related to the time, with a magnitude of almost 4 degrees C in the first hour. CONCLUSIONS: The intra-articular baseline temperature of the knee is significantly lower than that of the body, and the repercussion of its drop during arthroscopic surgery on the body temperature is insignificant. The external application of ice is an effective and sure method to diminish the intra-articular temperature of the knee. LEVEL OF EVIDENCE: Level IV, case series with no control group.

Adolescent↗

Time course of deacclimatization to cold water immersion in Korean women divers.

Seasonal basal metabolic rates (BMR), critical water temperature (Tcw), maximal body insulations (Imax), and finger blood flow during hand immersion in 6 degrees C water (Q finger) were measured periodically during the course of a 3-yr longitudinal study (1980-1982) of modern Korean diving women (ama), who have been wearing wet suits since 1977 to avoid cold stress during work. Methods and protocols were identical to previous studies of cotton-suited ama from 1961-1974. The BMR of modern ama did not undergo seasonal fluctuation (1980-1981) and was within the DuBois standard and comparable to nondivers year around Tcw of ama was still reduced by 2-3 degrees C in 1980 but increased progressively to equal that of nondivers in 1982, when compared at comparable subcutaneous fat thickness (SFT). Since modern ama and nondivers have 2.4 times thicker SFT (i.e., 4-13 mm) than in 1962 the absolute Tcw is significantly reduced. Q finger of ama was also significantly lower than controls in 1980 but in 1981-1982 was identical to controls. Imax of modern ama was identical to controls of comparable SFT in 1980-1982. The time course of cold deacclimatization thus was BMR, 3 yr; Imax, 3 yr; Q finger, 4 yr; and Tcw, 5 yr. This longitudinal study provides further evidence that acclimatization to cold did at one time exist in these diving women.

Acclimatization↗

Cyclic changes of cervical mucus enzymes related to the time of ovulation. I. Alkaline phosphatase.

The concentration of alkaline phosphatase in cervical mucus was serially determined during a menstrual cycle in five normal ovulatory women and correlated with the time of ovulation as monitored by the basal body temperature and radioimmunoassay of serum lutenizing hormone (LH), progesterone, and estradiol. The activity of alkaline phosphatase decreased significantly at midcycle just prior to the LH surge and began to rise after ovulation. Self-detection of cervical mucus alkaline phosphatase may provide a practical method of ovulation prediction.

Adult↗

[Inner ear blood flow with betahistine--an animal experiment study].

The influence of the drug Betahistin on the cochlear blood flow (CBF) was checked on 15 guinea pigs (6 controls) (Charles River, BFA 350-450 g) by means of the hydrogen clearance method. The hydrogen clearance measurements were carried out under alpha-chloralose-ethylurethane anaesthesia, artificial respiration with simultaneous control of the electrocardiogram, arterial blood pressure and body temperature. The actual arterial pH-value was checked hourly. Indirect measurement of CBF was carried out in the perilymphatic space (basal turn) before and after intravenous application of Betahistin (vena jugularis externa) (dosage: 0.11 mg/kg/min). The mean arterial blood pressure remained within the 10% range during the experiments. Under Betahistin-treatment the CBF showed an significant increase (p = 0.05). Despite this favourable pharmacological efficiency of Betahistin it must be pointed out that the general application of vasoactive drugs, especially of vasodilative drugs, in the treatment of postulated inner ear blood flow disturbances is presently controversial.

Animals↗

[Therapeutic effect of Chinese herbal medicines for nourishing blood and reinforcing shen in treating patients with anovulatory sterility of shen-deficiency type and its influence on the hemodynamics in ovarian and uterine arteries].

OBJECTIVE: To observe the clinical therapeutic effect of Nuzhen Yunyu Decoction (NYD, a Chinese recipe for nourishing blood and reinforcing Shen) and its influence on the hemodynamic parameters in ovarian and uterine arteries. METHODS: Sixty-eight patients were randomly divided into two groups at the ratio of 2:1, 45 in the TCM group treated with Chinese medicine and 23 in the control group treated with clomiphene citrate. Menstrual cycle were taken as the indexes for clinical observation; basal body temperature, cervical mucus, vaginal exfoliative cells, serum hormones and B ultrasonic examination were taken as the indexes for ovulation and pregnancy assessment. The hemodynamic parameters of uterus and ovary were determined by using color Doppler ultrasonography, and the growth of follicles and ovulation, thickness of uterine endometrium were also monitored continuously. RESULTS: Results of 3 cycles treatment and 1 year follow-up study showed that the ovulation promoting rate, pregnancy rate and abortion rate in the two groups were similar, but the treated group showed better effects than that of control group, in such aspects as regulating menstruation, promoting growth and development of follicle, strengthening endometrium, improving blood supply and circulation of uterine and ovary (P < 0.05, P < 0.01). CONCLUSION: NYD has the effects of ovulation promotion and holistic regulation of reproductive system.

Adult↗

The role of ultrasound in female infertility management.

Ultrasound became an important help for the diagnosis of infertility by demonstration of the pelvic organs, of growing ovarian follicles, of intrafollicular structures and of cyclic uterine endometrial changes. Ultrasonic particularities of ovaries and their landmarks such as the ovarian artery, are described. Average ovarian blood flow can be measured. In hormone stimulated cycles, the ultrasonic examination is repeated through ovulation, induction and even afterward. The average diameter of the growing follicle is measured. The results of more than 8000 scans allowed the deduction that ovulation induction would be successful if the preovulatory follicular diameter was between 18 and 24 mm. Where two or more follicles of that diameter are present, multiple pregnancy occurs. The risk of overstimulation can be assessed. The importance of ultrasound is even higher than estradiol because it is impossible to differentiate between one big, some medium or many small follicles with hormone assays. It is possible to see the cumulus oöphorus, but not earlier than 1-2 days before ovulation. Following successful ovulation the mature follicle appears to have a more solid than cystic make-up. Signs of a failure of ovulation are given. Cyclic changes in the histology of the endometrium are described and make it possible to predict ovulation within 12 hr. Ultrasound is an important aid in predicting the time of ovulation more accurately than the basal body temperature and faster and cheaper than hormone profiles. Ultrasound plays a role in egg collection and replacement of the embryo. The detection of ovulation is very important in the treatment of infertility. This was only possible for a longtime by hormone profile. Nowadays ultrasound is an accepted method in the diagnostic procedures of this field. It permits the visualization of the position and size of the uterus, Fallopian tubes and ovaries, the exclusion of genital anomalies and the demonstration of physiological changes of these organs during the menstrual cycle. The main points of ultrasound in the diagnosis of infertility are as follows: Demonstration of the pelvic organs (uterus, Fallopian tube, ovary) and vascular structures. Demonstration of growing ovarian follicles (Measurement of their numbers and sizes). Demonstration of intrafollicular structures (Cumulus oöphorus, Corpus luteum). Demonstration of cyclic uterine endometrial changes. Most of the results were first obtained with high-resolution compound scanners, but the new generation of real-time scanners are equally capable. Sector scanners are superior to linear-array-parallel scanners, especially for the demonstration of specific structural ch

Corpus Luteum↗

[A computerized information system for gynecological patients].

OBJECTIVE: Clinical experiences in the fields of general gynecology, gynecological oncology and reproductive endocrinology had been accumulated over a long period of time. All of the recorded information was written on various kinds of sheets that could easily be damaged and lost with frequent reading. Statistical works were done manually. This is the situation may encountered by all of the hospitals in China, so a computerized information system for gynecological patients is eagerly needed. METHODS: The program was designed on the basis of Foxpro 2.6 for Windows. RESULTS: The interfaces were specially designed for every of 72 databases to be like the style of patient's records which can be easily operated with mouse pressing buttons. Some of the databases such as basal body temperature, metastasis of lymph nodes and classification of endometriosis were carefully designed. Because the program will be used in China, the interfaces were all in Chinese. A dictionary was used to simplify the importing of the data. When import, one can easily press the line with the appropriate meaning in the dictionary. A strong statistical function was attached to the program. With its friendly interface, statistical work can be done with ease. This system is capable of further development and fit into needs of various hospitals and departments. CONCLUSION: This program is very useful for clinical doctors as well as scientific research personnel. With the help of this program, efficacy of our medical work can be raised, clinical experiences can be summarized in time and the clinical level can thus be improved.

Female↗

Medroxyprogesterone increases basal temperature: a placebo-controlled crossover trial in postmenopausal women.

OBJECTIVE: To assess whether temperature is increased by medroxyprogesterone (MPA) and thus whether basal temperature records could be used to determine ovulation during cyclic MPA therapy. DESIGN: A 2-month double-blind placebo-controlled crossover trial in which oral basal temperature was measured daily. SETTING: Normal human volunteers in an academic medical environment. SUBJECTS: Eleven postmenopausal women not taking gonadal hormones. INTERVENTION: Medroxyprogesterone acetate (10 mg/d) or placebo, calendar days 16 to 25, with crossover. MAIN OUTCOME MEASURES: Comparison of mean temperature days 17 to 26 during MPA versus placebo; comparison of differences between temperatures days 7 to 16 and 17 to 26 in MPA versus placebo months; and analysis for a significant monthly thermal shift. RESULTS: The mean temperatures during MPA treatment averaged 0.27 degrees C higher than during the placebo phase and showed a significant change from pretreatment to "treatment" phases during MPA but not during placebo cycles. Eight of the MPA and one of the placebo cycles showed a shift from lower to higher temperatures days 16 to 25. CONCLUSIONS: Medroxyprogesterone acetate has a physiological progesterone-like thermal effect. Therefore basal temperature data cannot reliably indicate ovulation during cyclic MPA administration.

Adult↗

The significance of serum oestradiol and progesterone levels in evaluating the response to clomiphene citrate.

In practice, the prediction of ovulation after the administration of clomiphene citrate (Clomid) has been based on measurement of biphasic basal body temperature and menstrual changes. In this article a protocol is presented to gauge adequately the extent of the response to the drug and to monitor reliably the occurrence of ovulation. The measurement of oestradiol levels at two different times, coupled with a single progesterone estimation, has proved the method of choice in monitoring Clomid response. These assays may provide reliable criteria for establishing suitable doses for individual patients.

Adolescent↗

Immunoglobulins, proteinase inhibitors, albumin, and lysozyme in human cervical mucus. I. Communication: hormonal profiles and cervical mucus changes--methods and results.

The serum levels of luteinizing hormone (LH), estradiol-17beta, and progesterone were determined simultaneously with the concentrations of immunoglobulin (Ig) G, IgA, C'3, alpha1-antitrypsin, inter-alpha-trypsin inhibitor, alpha1x-antichymotrypsin, albumin, and lysozyme in cervical mucus during nine ovulatory cycles. Spinnbarkeit and ferning were also assessed, and the basal body temperature was measured and recorded during these cycles. The profiles were synchronized according to the LH peak. The midcycle period, characterized by the rapid increase and decline of estrogen and the beginning rise of progesterone, shows a prounced minimum of immunoglobulins, C'3, proteinase inhibitors, albumin, and lysozyme in cervical mucus, which is known to be most receptive to sperm penetration at this time. Although the variation of cervical mucus values is considerable during the early proliferative and the luteal phases, the midcycle values appear to be constantly low, showing slight differences among the profiles of the different parameters. The statistical evaluation and the assessment of the significance of parameters for ovulation detection and the assessment of the fertile period as well as the correlation of these parameters with basal body temperature will be the subject of the second communication of this series.

Adult↗

[Kangaroo mother care: bibliographical review on the current attitudes, their interests and their limits].

Initiated in 1978 by a Colombian team, then largely adapted in industrialized countries as well as in poor developed countries, the kangaroo mother care (KMC) are known to ensure for low birth weight newborn, a thermoregulation, a good physiological stability and a better relational comfort with their parents. The goal of this work is to make a bibliographical review on current concepts, interests and limits of this method. We re-examined impact of the KMC on the basal metabolism, thermoregulation, growth and evolution of these children. They are helpful in the developing countries but medical safety should not be forgotten. In these countries where there's high frequentation of the services, they are able to regulate body temperature and metabolic adaptation of the newborn. In developed countries, KMC contribute to decrease anxiety of parents and improve the relations with their child. However, it is difficult to recommend their use in current practice. Rigorous randomised studies are necessary to argue their establishment in full safety, to know the neuropsychological development and the real somatic growth on the long term of the children and to known their true economic cost.

Attitude↗

[Current possibilities in reproduction medicine. 1. Diagnosis].

The methods employed by assisted conception, presuppose a rational diagnostic evaluation. The endocrine work-up concentrates on demonstrating adequate ovulation. Today, apart from vaginal ultrasonography, this largely means LH determination in the urine in the middle of the cycle, together with progesterone measurements in the luteal phase. Recording the basal body temperature can offer no more than an orientation. The clarification of tubal patency is ideally served by laparoscopy with pertubation. With the aid of new sonographically visible contrast media, tubal flow can also be investigated using sonography. For the male work-up, classical evaluation of the ejaculate has declined in importance. As a means of establishing a fertility prognosis, forward progression, lateral movements of the head of the sperm, and functional sperm analysis (hamster oocyte penetration test) would appear most suitable.

Fallopian Tube Patency Tests↗

Sudomotor function in sympathetic reflex dystrophy.

Sudomotor functions were studied in 27 patients suffering from reflex sympathetic dystrophy (RSD) according to the criteria established by Bonica (18 women, 9 men; mean age 50 +/- 12.3 years; median duration of disease 8 weeks, range 2-468 weeks). To measure local sweating rates, two small chambers (5 cm2) were affixed to corresponding areas of hairy skin on the affected and unaffected limbs. Dry nitrogen gas was passed through the chambers (270 ml/min) and evaporation was recorded at both devices with hygrometers. Thermoregulatory sweating (TST) was induced by raising body temperature (intake of 0.5 1 hot tea and infra-red irradiation). Local sweating was also induced through an axon reflex (QSART) by transcutaneous iontophoretic application of carbachol (5 min, 1 mA). In addition, skin temperature was measured on the affected and unaffected side by infra-red thermography. Mean skin temperature was significantly higher on the affected side (P < 0.003). In spite of the temperature differences, there was no difference in basal sweating on the affected and unaffected side. However, both methods of sudomotor stimulation lead to significantly greater sweating responses on the affected compared to the unaffected side (TST: P < 0.05, QSART: P < 0.004). Latency to onset of sweating was significantly shorter on the affected side under both test conditions (P < 0.04 and P < 0.003, respectively). Sweat responses were not correlated to absolute skin temperature but were probably related to the increased blood flow on the affected side. Our findings imply a differential disturbance of vasomotor and sudomotor mechanisms in affected skin. Whereas vasoconstrictor activity is apparently lowered, sudomotor output is either unaltered or may even be enhanced.

Axons↗

Core body temperature is normal in chronic fatigue syndrome.

BACKGROUND: Subjects with chronic fatigue syndrome (CFS) frequently report symptoms of subnormal body temperature and low-grade fever. We conducted a study to determine whether CFS subjects manifest any abnormality of core body temperature (CBT) that might help explain their fatigue. METHODS: Continuous 24-hour recordings of CBT measured every 5 min were performed in 7 subjects meeting the Centers for Disease Control definition of CFS. Three additional groups were studied: normal controls, subjects with seasonal allergy, and subjects with major depression. Subjects (n = 7) in each group were age-, sex-, and weight-matched to the CFS group and had normal basal metabolic rates, thyroid function, and 24-hour urinary free cortisol excretions. CBT was measured with an ingestible radio frequency transmitter pill and a belt-worn receiver-logger. Each pill was factory-calibrated to +/- 0.1 degree C and field-calibrated with a water bath calibration prior to use. RESULTS: The 24-hour mean calibration-adjusted CBTs of each group were not significantly different (control: 37.00 +/- 0.17 degrees C; CFS: 37.04 +/- 0.31 degrees C; allergy: 37.15 +/- 0.18 degrees C; depression: 37.16 +/- 0.18 degrees C). Similarly, the mean peak and trough circadian temperatures were not statistically different. The mean 24-hour profile of CBT for each group showed a similar circadian rhythm. In simultaneously collected blood samples, each group showed a similar circadian profile of serum cortisol with a peak occurring at 08:00. CONCLUSIONS: Subjects with CFS have normal CBT despite frequent self-reports of subnormal body temperature and low-grade fever.

Adult↗

The prediction of ovulation and monitoring of the fertile period.

Simple and reliable methods have been sought for both predicting and confirming ovulation. Application of these methods could include management of infertile couples to aid in conception and for increasing the reliability of natural family planning (NFP) as a method of birth control. With the advent of specific hormone assays, serial measurements of estrogens, progesterone (and metabolites), and luteinizing hormone have been the gold standard of monitoring ovarian function in women. However, newer and simpler methodologies have been described and are currently either in use or being tested. These include the measurement of basal body temperature (BBT), the evaluation of the volume, consistency and electro-conductivity of cervicovaginal fluid, salivary steroid content and cellular enzymatic activity, the use of enzyme-linked immunosorbent assays applied to solid-phase formats, and the investigation of new hormonal molecules as markers of reproductive state and function. These new technologies are described herein and their potential for monitoring ovarian function is discussed.

Body Temperature↗

Periovulatory beta-endorphin levels in premenstrual syndrome.

OBJECTIVE: To determine whether changes in peripheral beta-endorphin levels during the periovulatory phase are associated with symptoms of premenstrual syndrome (PMS). METHODS: Twenty-one PMS patients and ten controls were studied. All were in general good health and had no history of psychiatric disorders. They were between 21-44 years of age, had had regular menses for at least six previous cycles, and were carefully selected by charting the Visual Linear Analogue Scale and basal body temperature daily for 1 month. After an overnight fast, the subjects had blood drawn between 8:00 and 10:00 AM daily for 8 days, starting on the tenth day of the menstrual cycle, for one cycle. Beta-endorphin and LH were measured by radioimmunoassay. The day of the LH peak was defined as day LH 0. The beta-endorphin levels were expressed as the number of days before or after the LH surge. RESULTS: Beta-endorphin levels throughout the periovulatory phase were lower in PMS patients than in controls, and the differences were more remarkable on LH days 0 and 4. CONCLUSION: Our data suggest that an aberration of normal changes in beta-endorphin activity in PMS patients may occur around the time of ovulation.

Adult↗

[The psychological effect of clinical examination on women with tubal infertility].

OBJECTIVE: To comprehend the psychological effects in the course of diagnosis and treatment of infertility on the sexuality, emotional feeling and marriage of women with tubal infertility. METHODS: The study involved 180 hospitalized patients who were awaiting tube operation from May to September in the year 2000. A survey was made by using questionnaire about sexuality, emotional feeling and marriage after infertility examinations. RESULTS: The sexual intercourse frequency of 46.2% infertile women decreased and no influences on sexual living satisfaction were confirmed during basal body temperature (BBT) examination. 92.3% to 93.2% of the infertile women were sad after hysterosalpingography(HSG) and laparoscopy. 78.9% of them felt remorse when the result of semen examination was normal. 56.6% of them would choose in vitro fertilization and embryo transfer(IVF-ET); 38.9% of the infertile couples' wedlock would not be stable and 10.5% of them would be divorced in the case of continuing infertility 2 years after tube operation. CONCLUSION: Sexual intercourse in almost half of the infertile couples decreased during BBT examination. Most infertile women became sad when they were informed of the abnormal results of HSG and laparoscopy and the normal results of semen analysis.

Adult↗

Heat balance of the human body: influence of variations of locally distributed parameters.

Human body temperature control is characterized by a local dependence of system variables and parameters. Essential properties regarding inhomogeneity of the passive system have been investigated using mathematical methods. The general diffusion-equation has been solved using implicit finite difference methods with nonlinear boundary conditions. In order to allow comparison with experimental results, a simple ideal controller has been defined. On the basis of an inhomogeneous cylinder model with four concentric layers, influences of variations due to differences between tissues and individuals or measurements of parameters such as basal metabolism and conductivity have been studied. Stationary temperature profiles calculated for homogeneous and inhomogeneous conditions have been compared. Finally, the influence of blood flow has been discussed, as well as the stationary behaviour of profiles due to blood flow and blood flow control. The change of sign of curvature of temperature profile is possible only if blood flow mechanisms and the local distribution of metabolism are taken into account.

Air↗