Patient page. Extreme cold: an outdoor prevention guide for your personal health and safety.
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OBJECTIVE: To investigate the role of cell junction in the hypothermal impairment of tissue without any cryoprotectant. METHODS: Epithelial MDCK cell line which is able to form well-defined cell junctions after confluency, and fibroblast V79 cell line which is unable to be used for graded freezing experiments, either in suspension, single tough attached to flasks or as monolayers on flasks. Then the viability was assessed by WST-1 and MT, respectively. RESULTS: The results of viability of the two types of cells assessed by WST-1 were well-fitted with that of MTT. The recovery of the two types of cells in suspension was higher than that of single tough group and monolayer group. The single tough group of MDCK had a higher recovery than did the monolayer group. At the same time, such tendency was not observed on V79 cells. As compared with V79 monolayers, lower recovery was found on MDCK monolayers. CONCLUSIONS: The junction between cells and the adhesion between cell and matrix have important roles in the hypothermic impairment of tissue. Their existence affect the recovery of cells under hypothermia. The cytoskeleton system may contribute to the impairment caused by junctions.
Possibility of the formation of anterio-lateral composite femoral cutaneous flaps on three different vascular pedicles was proved by topographic-+-anatomical studies on 53 lower extremities. A method of determination of zones of localization of the corresponding cutaneous vessels is proposed. An experience with 12 operations has confirmed that anterio-lateral femoral flaps may be used for autotransplantation independently and in combination with lateral cutaneous femoral flaps as well as for transposition of a permanent vascular pedicle.
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Biochemical and immunological indexes of peripheral blood were compiled in military sanatorium "Divnomorskoe" in seamen who have suffered from general supercooling in the result of "Komsomolets" atomic submarine breakdown. The patients had the symptoms of metabolic disturbance, immunodepression, a great concentration of proteins in acute phase and activity of MB-fraction of creatine phosphokinase. Immunodepression after the general supercooling was mainly conditioned by oppression of differentiation, metabolic changes and functional activity of T-lymphocytes. A course of immunocorrective therapy was employed using "thymogen"--synthetic peptide of thymus. In the process of rehabilitation there was a gradual functional recovery, normalization of metabolism and immunological indexes.
The series comprises 40 soldiers who sustained 49 local cold injuries during their service in The Norwegian Army. Twenty-one cold injuries were classified as first degree, 15 as second degree and 13 as third degree. No difference in ambient temperature at the time of injury was observed between the three categories of injuries, but the duration of cold exposure was significantly longer in those suffering third degree injury. Thirty-eight of the 40 soldiers experienced sequelae. The trend was that the severity of sequelae was most pronounced in third degree injuries. However, soldiers with first degree injury may suffer from significant sequelae, while those with third degree injury may exhibit a more benign clinical course. Overall degree of distress from sequelae was mild to moderate with exacerbation of symptoms and signs upon cold exposure. Although the influence on civilian occupational activity was minor, a substantial negative impact on performance in the field or combat setting may be anticipated. Soldiers as well as commanders must be thoroughly informed about prophylactic measures, symptoms and signs of an impending cold injury. Rewarming of the skin must be initiated without delay.
The use of cutaneous and musculocutaneous flaps has been greatly enhanced by a better understanding of vascular anatomy. Cutaneous vessels reach the skin by three basic pathways: over the muscle layer, through the muscles, and between the muscles. The authors' anatomic investigation of each of these three types of vessels and the clinical application of this information is presented.
One December morning the naked bodies of two alcoholics were found on an open place in the center of the city of Essen. The phenomenon of paradoxical undressing due to vital hypothermia is described and the significant influence of alcohol on hypothermia and confusion in connection with hypothermia is pointed out. Compared to the results of other authors, external and internal signs of lethal hypothermia were analysed in a retrospective series of 30 cases (autopsy material in the region of Essen, investigation period from 1979-1989).
An experience with 137 microsurgical transplantations enabled the authors to consider questions of rational organization of these complex, and severe operations. Different variants of work of the second team of surgeons are analyzed aimed at shortening the duration of the operation and getting less load by its participants.
Frost-bite was produced in five Hanford Miniature Swine by exposure to -75 degrees C air for 1, 3, 5, 10 or 20 min. Biopsies were taken at 0, 3, 6, 12, 24 and 48 h and 1, 2 and 15 weeks. Sweat glands were evaluated microscopically and graded: 0, no change to 5, severe change. Sweat gland changes were mild by 1 h and moderate by 24 h for all freeze groups, except the 1-min freeze group. Severe morphological changes were of two types: degeneration/necrosis and squamous metaplasia. These changes suggest that hyperhidrosis, as a sequel to frost-bite, may be more subjective than real and that squamous cell carcinoma, as a delayed sequel to frost-bite, could originate from sweat glands as well as from the epidermis.
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