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Immersion A-scan compared with partial coherence interferometry: outcomes analysis.

PURPOSE: To compare 2 methods of axial length measurement, immersion ultrasonography and partial coherence interferometry, and to elucidate surgical outcomes based on immersion measurements. SETTING: Oregon Eye Institute, Eugene, Oregon, USA. METHODS: Axial length measurements in 50 cataractous eyes were obtained by optical biometry (IOLMaster, Zeiss Humphrey Systems) and immersion ultrasound (Axis II, Quantel Medical), and the results were compared. Intraocular lens (IOL) power calculations in the same eyes after cataract extraction and posterior chamber IOL implantation were evaluated retrospectively based on the postoperative spherical equivalent prediction error. RESULTS: Immersion ultrasonography and partial coherence interferometry measurements correlated in a highly positive manner (correlation coefficient = 0.996). Outcomes analysis demonstrated 92.0% of eyes were within +/-0.5 diopter of emmetropia based on immersion axial length measurements. CONCLUSION: Immersion ultrasonography provided highly accurate axial length measurements and permitted highly accurate IOL power calculations.

Biometry↗

Tensile mechanical properties of polyacetal after one and six months' immersion in Ringer's solution.

The engineering polymer polyacetal (also known as polyoxymethylene) has a long history of clinical use including in the femoral component of the Freeman all-polymer knee replacement. The polymer is a promising material for novel applications including the femoral component of hip resurfacing prostheses. However, no work following the effect on mechanical properties of extended immersion in the physiological environment has been reported. Samples of five grades of polyacetal were obtained and tested on an MTS Bionix 858 at 37 degrees C in physiological saline. Three groups of specimens were tested: "as received"; immersed in Ringer's solution at 37 degrees C for one month; immersed in Ringer's solution at 37 degrees C for six months'. While there were negligible reductions in the ultimate tensile strengths, the Young's moduli of all polymer grades showed significant reductions (p < 0.01) of up to 19.5% following one months' immersion. There were negligible changes in ultimate tensile strength and stiffness between one and six months' immersion, however some polymers showed a small, but significant (p < 0.05) increase in stiffness. The percentage elongation and true stress for plastic instability showed negligible changes following immersion for one and six months'. These results encourage the use of polyacetal in load-bearing orthopaedic applications.

Journal Article↗

Roles of nocturnal melatonin and the pineal gland in modulation of water-immersion restraint stress-induced gastric mucosal lesions in rats.

The roles of melatonin and the pineal gland in the circadian variation of water-immersion restraint stress-induced gastric mucosal lesions in rats were investigated. Fasted rats were subjected to water-immersion restraint stress during both the diurnal and nocturnal phases of a light:dark cycle. Pinealectomized and sham-operated rats were also subjected to water-immersion restraint stress at night. The lesion area after 4 hr of stress during the dark phase was significantly lower than in light-phase controls. Pinealectomy increased the lesion area in the dark phase, compared to the sham operation, but this effect was counteracted by intracisternal melatonin preadministration at a dose of 100 ng/rat. Melatonin concentrations in control rats during the light phase were significantly increased 4 hr after water-immersion restraint stress. In contrast, melatonin concentrations 4 hr after water-immersion restraint stress in the dark phase were significantly depressed compared with the control levels at the corresponding time. Melatonin levels after stress exposure were markedly decreased in pinealectomized rats as compared with sham-operated rats. These results suggest that circadian rhythm has an important role in the formation of stress-induced gastric mucosal lesions in rats and that melatonin responses to water-immersion restraint stress differ between day and night. The pineal gland modulates the stress response and melatonin contributes to gastric protection via a mechanism involving the central nervous system.

Animals↗

The effect of cold water immersion on the nasal mucosa.

The response of the nasal mucosa to cold water immersion is not well known. We have attempted to document this response in normal individuals. Seventeen individuals with no history of nasal disease or allergy were studied. All subjects were asked to perform sustained cold water (15 degrees C) immersion of their hand and forearm on the side of the obstructed nostril for a period of 5 min. The nasal cross-sectional area was measured on both sides of the nose using an acoustic rhinometer. The individuals were then rested for at least 30 min and the test repeated with immersion of the opposite hand. There was a significant fall in nasal cross-sectional area on the side of immersion (median change = 0.32 cm2, P = 0.0003) with a significant rise in nasal cross-sectional area on the none test side (median change = 0.35 cm2, P = 0.0003). There were no significant differences between these results and those obtained by immersion on the opposite side. The results indicate that cold water immersion produces nasal obstruction and that both afferent and efferent arms of this reflex are side-specific.

Blood Pressure↗

Core temperature response to immersed bicycle ergometer exercise at water temperatures of 21 degrees, 25 degrees, and 29 degrees C.

A bicycle ergometer modified for aquatic exercise was used to determine the effects of immersion on core temperature during submaximal exercise at different water temperatures. An exercise intensity (60% of maximal oxygen consumption) and duration (30 minutes) considered appropriate for cardiovascular conditioning were used. These data will be useful in cardiovascular and leg-strengthening hydrotherapy programs. Rectal temperature, skin temperature, and a rating of thermal comfort were studied in five normal men (14.8% +/- 5.6% fat) during headout immersion at water temperatures of 21.1 degrees, 25.3 degrees, and 29.4 degrees C and exercise in air of 21.1 degrees C. Subjects were immersed for 30 minutes during static and exercise (63% +/- 0.6% maximal oxygen consumption) conditions. Data were collected every 5 minutes and analyzed by repeated measured analysis of variance. At water temperatures, rectal temperature fell from control during static immersion (p less than or equal to 0.05) and was lower than control at the end of the 30-minute recovery period (p less than or equal to 0.05). During exercise there was no change in rectal temperature at water temperatures of 21.1 degrees and 25.3 degrees C; however, rectal temperature rose at water temperatures of 29.4 degrees (p less than or equal to 0.05) and air 21.1 degrees C (p less than or equal to 0.05). At the end of recovery rectal temperature was lower than control at water temperatures 21.1 degrees C (p less than or equal to 0.05) and greater than control at water temperatures 29.4 degrees C (p less than or equal to 0.05). There was no change from control in rectal temperatures at water temperatures 25.3 degrees C and air at 21.1 degrees C. These results indicate that immersion in 25.3 degrees and 21.1 degrees C water effectively attenuates the rise in rectal temperature during exercise at 63% of maximal oxygen consumption, whereas immersion in 29.4 degrees C water does not. In addition, both skin and rectal temperatures affect perception of thermal state but do not give the subjects an accurate estimation of thermal balance.

Adult↗

The influence of bicycle exercise, with or without hand immersion in cold water, on forearm sweating in young and middle-aged women.

Forearm sweat production rate (SPR) and external auditory meatal temperature (TEAM) were examined in five young and five middle-aged women in response to intermittent exercise, on three separate occasions. The first experiment was a control study, while in the second study the left hand was immersed in cold water at the onset of sweating during each exercise bout, and in the third study this immersion was accompanied by venous occlusion of the upper left arm. TEAM increased by 0.5 degrees C during exercise with no significant differences between the groups on any occasion. The young women displayed a greater peak SPR during exercise in the control than the middle-aged women (52.5 +/- 23.9 vs. 16.7 +/- 6.5 mg cm2 h-1, P less than 0.001). With hand immersion, peak SPR was depressed to 14.0 +/- 4.6 mg cm2 h-1 (P less than 0.001) in the young women and to 13.1 +/- 4.5 mg cm2 h-1 in the middle-aged (P less than 0.05). With hand immersion and venous occlusion the peak SPR in young women increased (43.0 +/- 9.2 mg cm2 h-1). In the older women SPR was 14.9 +/- 6.1 mg cm2 h-1, which was not different from either control or cold-immersed values. Thus, forearm SPR during low-intensity intermittent exercise is greater in young compared with middle-aged women, despite similar changes in TEAM. The response to hand immersion in cold water was more marked in the young subjects.

Adult↗

Effect of immersion solutions containing enterocin AS-48 on Listeria monocytogenes in vegetable foods.

The effect of immersion solutions containing enterocin AS-48 alone or in combination with chemical preservatives on survival and proliferation of Listeria monocytogenes CECT 4032 inoculated on fresh alfalfa sprouts, soybean sprouts, and green asparagus was tested. Immersion treatments (5 min at room temperature) with AS-48 solutions (25 microg/ml) reduced listeria counts of artificially contaminated alfalfa and soybean sprouts by approximately 2.0 to 2.4 log CFU/g compared to a control immersion treatment in distilled water. The same bacteriocin immersion treatment applied on green asparagus had a very limited effect. During storage of vegetable samples treated with immersion solutions of 12.5 and 25 microg of AS-48/ml, viable listeria counts were reduced below detection limits at days 1 to 7 for alfalfa and soybean sprouts at 6 and 15 degrees C, as well as green asparagus at 15 degrees C. Only a limited inhibition of listeria proliferation was detected during storage of bacteriocin-treated alfalfa sprouts and green asparagus at 22 degrees C. Treatment with solutions containing AS-48 plus lactic acid, sodium lactate, sodium nitrite, sodium nitrate, trisodium phosphate, trisodium trimetaphosphate, sodium thiosulphate, n-propyl p-hydroxybenzoate, p-hydoxybenzoic acid methyl ester, hexadecylpyridinium chloride, peracetic acid, or sodium hypochlorite reduced viable counts of listeria below detection limits (by approximately 2.6 to 2.7 log CFU/g) upon application of the immersion treatment and/or further storage for 24 h, depending of the chemical preservative concentration. Significant increases of antimicrobial activity were also detected for AS-48 plus potassium permanganate and in some combinations with acetic acid, citric acid, sodium propionate, and potassium sorbate.

Bacteriocins↗

Renal calcium and magnesium handling in water immersion in nephrotic patients.

The effect of water immersion to the neck on renal calcium and magnesium handling was studied in 11 nephrotic patients. There was an increase in the urinary excretion of both calcium and magnesium on immersion, and a return towards preimmersion control values in the hour following immersion. Clearances of calcium and magnesium, and fractional excretion of calcium and of magnesium all increased significantly during water immersion, and decreased in the postimmersion hour. However, magnesium excretion was 10-50 times greater than calcium excretion. Fractional excretion of sodium was highly significantly related to fractional excretion of calcium (p less than 0.001) and magnesium (p less than 0.001). The relationship between fractional excretion of phosphate and fractional excretion of calcium was statistically significant (p less than 0.05), as was that between fractional excretion of phosphate and that of magnesium (p less than 0.01). Magnesium and calcium fractional excretions were significantly correlated (p less than 0.01). It was concluded that the increase in calcium and magnesium excretion on immersion is likely to be related to the sodium diuresis caused by central hypervolemia due to immersion.

Adolescent↗

Contribution of vagal pathways to the renal responses to head-out immersion in the nonhuman primate.

Studies were carried out to determine the contribution of cardiopulmonary receptors to the renal responses to head-out water immersion in the nonhuman primate. Immersion to the suprasternal notch was associated with significant increases in central venous pressure, urine flow, and sodium excretion. The increased sodium excretion was due primarily to a significant increase in the percent of the filtered sodium excreted. Deoxycorticosterone acetate (DOCA) and antiduretic hormone (ADH) had no substantial effects on these responses. The finding of a vasopressin-resistant hyposthenuria is consistent with the natriuresis of immersion being due, at least in part, to a decrease in sodium reabsorption proximal to the diluting segment, possibly the proximal tubule. Bilateral cervical vagotomy had no substantial influence on the renal responses to immersion, demonstrating that cardiopulmonary receptors whose axons traverse the vagus nerves are not necessary for the homeostatic adjustments to central hypervolemia in the primate. Since the renal and cardiovascular responses of the primate to immersion are essentially the same as those seen in man, it is probable that vagal pathways also are not necessary in man. However, it is possible that sympathetic afferents are involved in the natriuresis observed in the primate during immersion.

Animals↗

Effects of hot bath immersion on autonomic activity and hemodynamics: comparison of the elderly patient and the healthy young.

Hot bathing has been associated with sudden death and so the present study investigated its effects on autonomic activity and hemodynamics in the elderly patient and the healthy young by analyzing heart rate variability (HRV). Subjects were 9 elderly men (mean age, 75 years) and 9 young men (mean age, 27 years), who were immersed up to shoulder level while in a sitting position for 10min with the bath temperature at 40 degrees C. Blood pressure (BP) and heart rate (HR) were monitored. BP in the young decreased during bathing (p<0.01), whereas in the elderly BP had a maximum value just at the start of immersion (p<0.05) with a slight decline at 4 min after the start of immersion. Although HR in the young increased (p<0.01), in the elderly there was an abrupt increase in HR just at the start of immersion (p<0.05), followed by a decrease in HR. With regard to HRV, the high-frequency (HF) component in the young men was suppressed during immersion (p<0.01), but was unaffected in the elderly. The LF (low frequency)/HF ratio in the elderly decreased at 4 min (p<0.05). In conclusion, hypotensive syncope may cause sudden death by drowning during hot bathing, and is a consequence of the decrease in sympathetic tone that develops approximately 4min after immersion.

Adolescent↗

[Seasonal variation of circulatory and sensory functions during immersion test in cold water].

For early diagnosis of vibration syndrome, peripheral circulation and sensory tests after cold water immersion of the upper extremities are being performed widely in Japan. The authors studied the seasonal effect on the immersion test and its influence on diagnosis of vibration syndrome. Eight healthy male subjects, aged from 28 to 39, were examined. The immersion tests were conducted in winter (February), spring (May), summer (August) and autumn (November) in Ube city, Japan (Table 1). The room temperatures were maintained at 10 degrees C, 20 degrees C and 30 degrees C during the tests at each season. As to the exposure-to-cold test, the left hand of subject was immersed in stirred water at 10 degrees C for ten minutes, and the changes of peripheral circulatory function and sensory function were measured. Peripheral circulatory function was assessed by the skin temperature of middle finger and the value of the nail press test on the index finger. Sensory function was assessed by 125 Hz vibratory sense threshold and pain threshold of the middle finger. The finger skin temperature was lower in autumn and winter, followed by spring, and highest in summer. In particular, the finger skin temperature in autumn was lower than that in winter at the condition of room temperature at 30 degrees C, which is considered to be less effected by heat content in the body (Fig. 1, Table 3). The frequency of the appearance of cold induced vasodilation was also lower in autumn than that in winter (Table 2). These findings suggest that the tonus of the vasoconstrictor in the skin vessels of finger is strongest in autumn, followed by winter. It is also suggested that the tonus remains slightly strong in spring and is weakest in summer. Furthermore, the seasonal variations in the value of the nail press test, vibratory sense threshold and pain threshold were observed at some points of measuring time during immersion test (Figs. 2-4). Of these, the variations in the value of the nail press test and vibratory sense threshold were considered to be secondary to the seasonal variation of peripheral circulatory function (Fig.6). The variation in pain threshold was considered to result from paresthesia developing in the lower room temperature at 10 degrees C. The pain of finger during immersion test was also effected by season but the range of variation was not significant (Fig.5).(ABSTRACT TRUNCATED AT 400 WORDS)

Adult↗

Prolonged whole body immersion in cold water: hormonal and metabolic changes.

To characterize metabolic and hormonal responses during prolonged whole body immersion, 16 divers wearing dry suits completed four immersions in 5 degrees C water during each of two 5-day air saturation dives at 6.1 meters of sea water. One immersion began in the AM (1000 h) and one began in the PM (2200 h) to evaluate diurnal variations. Venous blood samples were obtained before and after completion of each immersion. Cortisol and ACTH levels demonstrated diurnal variation, with larger increases occurring after PM immersions. A greater than three-fold postimmersion increase occurred in norepinephrine (NE). There were significant increases in triiodothyronine (T3) uptake and epinephrine, but no change in T3, thyroxine, thyrotrophic hormone, and dopamine. Postimmersion free fatty acid levels increased 409% from preimmersion levels; glucose levels declined, and lactate increased significantly. Only changes in NE correlated significantly with changes in rectal temperature. In summary, when subjects are immersed in cold water for prolonged periods, with a slow rate of body cooling afforded by thermal protection and intermittent exercise, hormonal and metabolic changes occur that are similar in direction and magnitude to short-duration unprotected exposures. Except for cortisol and ACTH, none of the other measured variables exhibited diurnal alterations.

Adult↗

[Hemorheologic and blood cell changes in humans during partial immersion, with a therapeutic method, in 38 C water].

This research was carried out to define the effects on man during head-out water immersion in a bath at 38.41 +/- 0.04 degrees C (mean +/- S.E.) with a method similar to that used for therapeutical rehabilitation and time of immersion of 30 minutes. Hemorheological, hematic and hemodynamic parameters were analysed. Seventeen healthy subjects (fourteen males and three females), between the ages of 21-65 years and mean age of 29.8 +/- 2.6 years were studied. Head-out water immersion resulted in: 1) decrease in blood viscosity, red blood cells count, C-Hct and M-Hct, without significant changes in leukocytes and platelets count, MCV, plasma viscosity, erythrocyte filtration time and RCDI; 2) an increase in heart rate and a decrease in systolic and diastolic blood pressure. Thirty minutes after the end of immersion, heart rate, diastolic blood pressure and blood viscosity, measured at 0.512 sec-1 shear rate, returned to pre-immersion values; systolic blood pressure showed a slight increase but was still significantly below the basal levels; erythrocytes count, C-Hct, M-Cct and blood viscosity, measured at 94.5 sec-1 shear rate, significantly exceeded pre-immersion values. The probable pathogenesis of these observations is suggested. A matter of great interest is the study of the same parameters in elderly subjects, with or without cardiovascular diseases, or in patients using drugs affecting blood pressure, blood viscosity or hemocoagulation process.

Adult↗

Catecholamine levels in divers subjected to stresses of immersion and hyperbaric exposure.

The study was undertaken to determine the changes in plasma catecholamine levels in response to the combined stresses of cool water immersion and hyperbaric exposure. Plasma catecholamines were measured in seven thermally unprotected trained male U.S. Navy divers immersed in water at 25 degrees C and 35 degrees C at 1 ATA and 4 ATA. All measurements were made prior to any decompression procedures. Plasma norepinephrine (NE) levels were higher during cool immersions at both 1 ATA and 4 ATA. Hyperbaric exposure during warm immersion was associated with a small but significant increase in plasma NE levels. Hyperbaric exposure during cool immersion was associated with an increase in plasma NE levels, but this increase was not statistically significant. Hyperbaric exposure in both the cool and warm immersions was associated with a moderate degree of hypoventilation and carbon dioxide retention. Plasma NE levels reflect the overall stress imposed on an individual. This study indicates that plasma NE levels may be too variable to be useful as indicators of specific stress.

Atmosphere Exposure Chambers↗

[Effect of 3-day immersion on calf blood flow during physical loading test].

The effect of simulated gravitational unloading (dry immersion) on blood flow in the calf during upright locomotion was studied. Six subjects performed graded exercise before and after 3-day immersion. Arterial inflow to the calf was evaluated during abrupt cessation of treadmill walking/running on the phase of changing the leg with the plethysmographic technique of determining the haemodynamic effect of muscle pump. Before immersion, testing increased the calf blood flow on transition from walking to running and stayed at plateau or decreased with further speed rise. After immersion, the calf blood flow tended to decrease during running. At maximal running speed and heart rate > 185 beats/min, calf blood flow was significantly lower post than prior to immersion. We believe that immersion enhances the competitive interaction of local operational mechanisms of hyperemia and central vasoconstrictive influences directed at maintaining "the circulatory homeostasis".

Adult↗

The time course of topical PUVA erythema following 15- and 5-minute methoxsalen immersion.

BACKGROUND: Limited data exist in the literature concerning the characteristics of erythema following psoralen UV-A (PUVA) treatment using topical methoxsalen. To optimize the phototherapeutic regimen and reduce short- and long-term risks, knowledge of such basic information is essential. OBSERVATIONS: The characteristics of PUVA erythema following 15- and 5-minute immersion in methoxsalen was determined. The PUVA erythema after 15-minute methoxsalen immersion exhibited a broad peak, with the lowest median minimal phototoxic dose (MPD) at 96, 120, and 144 hours after UV-A irradiation. Seventy-three percent of subjects experienced peak erythema at 120 hours compared with only 45% at 72 hours. From the dose-response data, an increase in the erythema index of 0.025 (equivalent to the MPD) was significantly lower when determined at 120 hours after UV-A irradiation than at 72 hours (P =.03). The median maximum slope of the dose-response curve occurred at 144 hours. After 5-minute immersion, PUVA erythema displayed a broad peak from 72 hours. Erythema summation scores followed a trend similar to that of 15-minute immersion, but the intensity was significantly reduced. CONCLUSIONS: Methoxsalen-UV-A erythema exhibited a broad plateau between 96 and 144 hours, with most subjects at peak erythema at 120 hours. Reduction of methoxsalen immersion time significantly lowered the erythemal intensity. Minimum phototoxic dose reading at 72 hours underestimates the phototoxic effect of topical methoxsalen PUVA, and a change in the MPD assessment time should be considered.

Administration, Cutaneous↗

Does ice immersion influence ankle joint position sense?

The purpose of this study was to determine whether a fifteen minute ice immersion treatment influenced the normal ankle joint position sense at 40% and 80% range of inversion and to establish the length of treatment effect through monitoring the rewarming process. Forty nine healthy volunteers between the ages of 17 and 28 were tested. Subjects were screened to exclude those with a history of ankle injuries. The subject's skin temperature over antero-lateral aspect of the ankle was measured using a thermocouple device during the fifteen minutes ice intervention and thirty minutes post-intervention. Testing of ankle joint position sense using the pedal goniometer was performed before and after a clinical application of ice immersion. The testing required the subject to actively reposition their ankle at 40% and 80% of their total range of inversion. The majority of subjects experienced numbness of the foot and ankle by the fifth or sixth minute during ice immersion. One minute after immersion skin temperatures averaged 15 degrees C + 1.7 degrees C. Skin temperature was seen to rise relatively rapidly for the first ten minutes and then slowed considerably. Subjects had not returned to the pre-test skin temperatures by thirty minutes. A significant difference in ankle joint position sense (p < 0.0499) following fifteen minutes of ice immersion was found. However, the magnitude of this difference (0.5 degree) would not be deemed significant in clinical practice. The research found no significant difference in joint position sense between 40% and 80% of the range of inversion both before and after cryotherapy. These findings suggest that the clinical application of cryotherapy is not deleterious to joint position sense and assuming normal joint integrity patients may resume exercise without increased risk of injury.

Adult↗

Cyclic intramuscular temperature fluctuations in the human forearm during cold-water immersion.

The purpose of the present study was to investigate the intramuscular temperature fluctuations in the human forearm immersed in water at 15 degrees C. Tissue temperature (Tt) was continuously monitored by a calibrated multicouple probe during 3 h immersion of the forearm. The probe was implanted approximately 90 mm distal from the olecranon process along the ulnar ridge. Tt was measured every 5 mm, from the longitudinal axis of the forearm (determined from computed tomography scanning) to the skin surface. Along with Tt, rectal temperature, skin temperature and heat loss of the forearm were measured during the immersions. Five of the six subjects tested showed evidence of cyclic temperature fluctuations in the forearm limited to the muscle tissue. The first increase of the muscle temperature was observed 75 (SE 6) min after the onset of the immersion, and the duration of the cycle averaged 36 (SE 3) min. The maximum increase of the muscle temperature, which ranged between 0.4 degrees C and 1.0 degrees C, was measured at the axis of the forearm, and was inversely correlated to the circumference of the subject's forearm (P less than 0.05). No corresponding increases of the skin temperature and heat loss of the forearm were observed for the complete duration of the immersion. These data support the hypothesis of a significant contribution of the muscle vessels during cold-induced vasodilatation in the forearm.

Adolescent↗