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At least 19 recordsLinked to original sources
PubMed1986

Frostbite and bone scanning: the use of 99m-labeled phosphates in demarcating the line of viability in frostbite victims.

Early diagnosis of the extent of bone and soft tissue damage is a very important step in treating a frostbite victim. The diagnostic use of Tc-99m-phosphates in assessing the viability of soft tissue and bone in frostbite was evaluated in the early post-thaw period. Four patients were treated with a combination of warm baths, rehydration, vasodilators, epidural block, fasciotomy, and debridement. Six scans were done to stage involvement. In three of the four cases, final involvement could be determined as early as the third day. When a specific level of soft tissue or bone uptake was determined, future scanning showed either improvement, or no change in three of the four patients. In our experience, Tc-99m-phosphate scans represent an improvement over other diagnostic tests for viability of tissues.

Adult↗
PubMed1977

[Oxyproline excretion in the urine in frostbite].

Hyperoxyprolinuria associated with the processes occuring in frostbitten tissues is observed in frostbites of II--III degree. In frostbites of I--II and III--IV degree the level of urine oxyproline excretion does not differ from the normal one throughout the posttraumatic period. In frostbites of I--II degree this is due to a limited volume of tissue injury, in frostbites of III--IV degree-to the fixation of decay products in the pathological focus, resulting from blood circulation disorders in the frostbitten zone. Differences in oxyprolinuria level may serve as a useful tool for differential diagnosis of frostbites.

Adult↗
PubMed1991

Evidence for an early free radical-mediated reperfusion injury in frostbite.

Frostbite is characterized by acute tissue injury induced by freezing and thawing. Initial complete ischemia is followed by reperfusion and later, tissue necrosis. These vascular events support the hypothesis that free radical-mediated reperfusion injury at thawing might contribute to tissue necrosis after frostbite in a manner similar to that seen after normothermic ischemia. To test this hypothesis, rabbit ears were frozen at -21 degrees C for 30, 60, 90, or 120 s and rewarmed at room temperature (22 degrees C). Rabbits were treated "blindly" with saline alone, highly purified, pharmaceutical grade superoxide dismutase (SOD), allopurinol, or deferoxamine. The area of ear necrosis was determined 3 weeks after frostbite by "blinded" morphometry. The administration of SOD at the time of thawing significantly improved viability in ears frozen for 60 and 90 s, but not in those frozen for 30 or 120 s. Deferoxamine also improved viability in ears frozen for 60 s. Allopurinol did not significantly affect ear survival. Electron micrographs showed the appearance of severe endothelial cell injury beginning during freezing and extending through early reperfusion. Later, neutrophil adhesion, erythrocyte aggregation, and microvascular stasis were seen. These findings suggest that free radical-mediated reperfusion injury has a role in frostbite, and quantitate the proportion of the injury that is due to this mechanism.

Allopurinol↗
PubMed1990

Frostbite: predisposing factors and predictors of poor outcome.

A retrospective review of 79 frostbite cases over a 10-year period at a major Northern Canadian hospital was performed. Factors predisposing to frostbite injury and predictors of a poor outcome were sought. Impaired cerebral function was found to be the major predisposing factor to frostbite injury. At the time of injury, 53% of patients were under the influence of alcohol and 16% were suffering from psychiatric illnesses. Lower extremity frostbite, infection, and delay in seeking medical attention were factors found to be associated with a poor outcome.

Adolescent↗
PubMed1992

[A case of extra-adrenal pheochromocytoma with frostbite in extremities].

We describe a patient who presented frostbite in extremities in addition to characteristic symptoms, such as severe hypertension, sweating attacks, palpitations and headache. The patient was eventually diagnosed as having single extra-adrenal pheochromocytoma. The frostbite in extremities rapidly resolved after the removal of the tumor as well as other characteristic clinical symptoms. It is speculated that this frostbite might have been induced by severe continuous constriction of peripheral artery and loss of heat by frequent sweating attacks. Regarding cutaneous symptoms in this disease, pallor, acrocyanosis and cold extremities are commonly found. However, it seems that typical frostbite associated with pheochromocytoma has not been reported so far.

Adult↗
PubMed1992

Enzyme histochemical reactions at the demarcation line in frostbite: an experimental study on rabbits.

Eleven frostbites were induced on the ears of seven New Zealand White rabbits and specimens were taken from the lesion after 1, 4 and 8 hours, and from ten further frostbites on the ears of six rabbits for examination 1, 3 and 7 days later. The specimens were taken at the border between the frozen and non-frozen skin. NADH-diaphorase, alkaline phosphatase and esterase were demonstrated histochemically in the sample, which was also studied by haematoxylin and eosin staining. Five ears served as controls. Some granulocytes could be seen accumulating in the vessels and in the dermis at the border of the frostbite area after only 1 hour, and other enzyme rich cells (macrophages) also began to appear. After 4 hours the inflammation was quite obvious with the enzyme reactions clearly observable in the sections. After 8 hours there was no marked difference compared with the 4-hour picture. It was only after 3 days that the line of demarcation between the normal and frostbite tissue could be seen clearly. This was oblique in some specimens and vertical in others. The degeneration in the lesion could best be demonstrated by the NADH-diaphorase and esterase reactions and the early inflammation by the alkaline phosphatase reaction.

Alkaline Phosphatase↗
PubMed1991

Frostbite in reindeer herders.

The aim of this study was to determine the prevalence of frostbite among reindeer herders and to clarify the co-factors that may relate to these injuries. 2081 (60%) male reindeer herders in Finland were asked information on frostbite. Logistic regression analysis was used for studying the effect of potential co-factors. 453 men (22% of the respondents) reported frostbites during the last twelve months, the areas most affected being the face, fingers and toes. The amount of time spent in snowmobile driving, white finger symptom and the area of reindeer herding proved to be significant explanatory factors. Since the majority of frostbites were associated with snowmobile driving in spite of protection and adaptation to cold, it seems that new technology has not solved all the problems of the working conditions in a cold environment.

Adult↗
PubMed1977

Studies on heat output from the hand of frostbite subjects.

We studied 12 subjects, who had suffered first- to third-degree frostbite at high altitude during winter, at Delhi, India. At normal sea level pressure there (PB 740 mm Hg) and in a decompression chamber at a simulated altitude of 4085 m, the studies were at both 26 degrees C and 6.8 degrees C. A group of control (non-frostbite) subjects of comparable age were also studied for their heat output at 26 degrees C, PB 740 mm Hg. Heat output from the hands of a group of mountaineers from the sea level was also studied at 2121 m at 25 degrees C and 4485 m at 7 degrees C. The results indicated that the frostbite subjects had a significantly higher heat ouput at PB 740 mm Hg and 26 degrees C than the non-frostbite subjects. When the former were tested at sea level (PB 740 mm Hg) at 6.8 degrees C, the hand heat output showed a marked and significant decrease. On testing them at a simulated altitude of 4085 m at 26 degrees C and at 6.8 degrees C, a very highly significant reduction in hand heat output was observed compared to their initial value at sea level (740 mm Hg) and 26 degrees C. Their hand heat output also showed a very highly significant decrease compared to mountaineers at 4485 m and 7 degrees C.

Adult↗
PubMed1990

Vital reactions to frostbite of the ear and paw skin in guinea pigs exposed to the cold.

Vital reactions to frostbite in the paw and ear skin of guinea pigs were studied in order to find an animal model for frostbite in cases of accidental hypothermia. One group of animals was rendered hypothermic (rectal temperature, 30 degrees C) by exposure to an ambient temperature of -20 degrees C, and samples were taken from the frozen skin. A second group was rendered hypothermic and rewarmed in warm air at 45 degrees C, and samples were taken from the thawed skin. The only vital reaction in the first group (freezing time, 4-5 h) was mild initial inflammation, which was expressed in granulocyte adhesion to the vessel wall and the migration of a few cells into the dermis. The inflammatory reaction was more distinct in the second group (freezing and thawing together 5-7 h), with a large number of granulocytes being present in the dermis. Oedema and hyperaemia were also present in the frostbitten tissue after thawing, but no signs of necrosis developed. The alkaline-phosphatase reaction demonstrated the presence of granulocytes more clearly than H & E or Masson trichrome staining. Vital reactions were more advanced in the ear skin. It is concluded that vital reactions are very scarce in cases of frostbite, even after several hours' exposure, unless the tissue is allowed to thaw.

Animals↗
PubMed1989

An evaluation of the ability of the peripheral vasodilator buflomedil to improve vascular patency after acute frostbite.

The extent of microvascular damage from frostbite can be accurately demonstrated by vascular microcorrosion casting techniques (P. S. Daum, W. D. Bowers, Jr., J. Tejada, and M. P. Hamlet, Cryobiology 24, 65-73, 1987). In the present investigation, the peripheral vasodilator buflomedil was evaluated for its ability to ameliorate microcirculatory damage from acute experimentally induced freeze injury. This drug has been reported to decrease tissue loss in human frostbite patients when given intravenously during thawing (J. Foray, P. E. Baisse, J. P. Mont, and Cl. Cahen, Sem. Hop. Paris 56, 490-497, 1980). In seven groups of anesthetized rats, left hindpaws were cooled to heat of fusion; cooling continued until the temperature in the footpads fell to -15 degrees C. Prior to cooling, group 1 received a tail vein injection of 1 ml saline/kg, while group 2 received 10 mg buflomedil/kg. Immediately following cooling, group 3 received an injection of 10 mg buflomedil/kg. Hindpaws were rapidly rewarmed in a 40 degree C bath. During rewarming, left hindpaws from group 4 were immersed in deionized water, from group 5 in 24 mg buflomedil in deionized water, from group 6 in 30% dimethyl sulfoxide (Me2SO), and from group 7 in 24 mg buflomedil in 30% Me2SO. Right hindpaws served as controls. Vascular microcorrosion casts were made from left and right hindpaws of all groups. There was no significant difference in mean cast weights when frozen hindpaws of the seven groups were compared, although treatment with buflomedil increased the mean cast weight of control hindpaws from groups 3 and 7. It therefore appears that, in this acute model for frostbite, buflomedil does not improve vascular patency.

Animals↗
PubMed1989

Treatment of frostbite with the calmodulin antagonists thioridazine and trifluoperazine.

1. Thioridazine and trifluoperazine, which have been previously found in this laboratory to be the most effective calmodulin antagonists in treatment of burns, are shown here to be also effective in the treatment of frostbite. 2. Electron microscopic studies have revealed a complete reversal of both the vascular and skin tissue damage induced by frostbite. 3. The reversal of the vascular damage was also demonstrated by the ability of these compounds to abolish the increase in hemoglobin content in the skin. 4. The reversal of the skin tissue damage was also revealed by the ability of these compounds to raise the decreased ATP level and the reduced activities of 6-phosphogluconate dehydrogenase and mitochondrial and soluble hexokinase in skin, induced by frostbite, to normal control levels.

Adenosine Triphosphate↗
PubMed1992

Assessment of tissue viability in frostbite by 99Tcm-HDP scintigraphy: an experimental study in New Zealand white rabbits.

Since the appearance of superficial tissue is often an unreliable indicator of deep tissue viability in cases of frostbite, radionuclide scintigraphy with 99Tcm-disodium oxidronate (HDP) was used to assess changes in tissue viability after experimental freezing and thawing of the rabbit ear. One shaved ear, left or right, of each of eight New Zealand white rabbits was frozen with a glass bottle (diameter of bottom 2 cm) filled with liquid nitrogen (-180 degrees C) for 5 min under Ketalar-Rompun anesthesia, the other ear serving as a control. Radionuclide scintigraphy was performed by giving a bolus intravenous injection of 130-170 MBq (3.5-4.5 mCi) 99Tcm-HDP. Radionuclide imaging was used to follow the development of the demarcation line. Scintigraphy was performed 2 h after frostbite and then after 24 h, 48 h, 1 week and 3 weeks. The frostbitten area seemed macroscopically to be warm and swollen immediately after the induction of frostbite. Scintigraphy showed the frostbitten area to be much warmer than the surrounding tissue for the first week and it was not until after that the first cold spots appeared in the middle of the frostbitten area. The necrotic and vital tissue could easily be distinguished after 3 weeks.

Animals↗
PubMed1990

Severe frostbite of the upper extremities--a psychosocial problem mostly associated with alcohol abuse.

In the catchment area of Helsinki University Central Hospital (in total 16 surgical hospitals) amputation was performed on 9 patients with frostbite in the upper extremities during 1984-1985. The population during the study period in this area was 1.165,000 inhabitants, corresponding to 24% of the whole population in Finland. All 9 patients were male and the mean age was 49 years (range 31-75). All amputations performed were of the fingers, the third, fourth and fifth fingers most frequently affected. Alcohol was a marked etiologic or contributing factor in most of the frostbites. Two patients were chronic schizophrenics showing no signs of alcohol abuse, but the remaining 7 were either acutely or chronically alcohol intoxicated: 5 patients were chronic alcoholics, one was an alcohol abuser without a definite diagnosis of alcoholism, and one patient with no previous history of alcohol abuse was alcohol intoxicated. Based on the present study it is clear that, in addition to the cold winters in Finland, other factors contribute to severe frostbite. These include many psychosocial factors such as alcoholism or mental disease, unbalanced marital status, occupation handicap and lack of regular residence.

Adult↗
PubMed1988

Effect of a butter-rich diet on murine frostbite.

A simple reproducible, humane model for producing frostbite in rodents is desirable. We have developed such a model and have investigated the effects of a butter-rich diet on severe cold injury. Mice (25 +/- 2 g) were randomly divided into two groups (n = 10). One group was given a standard rodent diet and the other group a butter-enriched (25%) rodent diet for 1 month. Under pentobarbital sodium anesthesia the mice were placed in a plastic funnel with the stem removed so that the entire tail protruded. The tails were submerged in a freezing solution (-18 degrees C) for 8 min. The mice received no further treatment. Tail lengths were measured 2 weeks after freezing to determine the amount of tail surviving from cold injury after autoamputation. Mean tail lengths (cm +/- SD) for the two groups were as follows: butter-rich diet, 4.3 +/- 1.8; standard diet, 7.3 +/- 2.0 (P less than 0.002). A high saturated-fat diet has a deleterious effect in murine frostbite. This simple model can be employed to test various modalities in the treatment of frostbite.

Animals↗
PubMed1991

[Severe frostbites of the limbs. Apropos of 4 cases. A new approach of early prognosis].

The statistics of frostbites of the Chamonix Hospital surgical service include 1232 cases, 587 of them having been treated at the hospital. As regard four cases of severe frostbites having led to an amputation, the author reviews the complementary examinations that make possible an early prognosis. Among them, the bony scintigraphy must be privileged. It is nowadays a routine examination as it is technically easy and not difficult to interpret. Two spectroscopic examinations of living cells in NMR are reported, however no definitive conclusions could be reacted. A certain number of fundamental notions are assorted regarding the validity of the physiological mechanism what enables to reaffirm the three pillars of the treatment that must be often reduced to the simple limitation of the lesions. Two examinations show that in 1991, infection of frostbites can be always so redoutable.

Adult↗
PubMed1979

[Creatine kinase test in frostbite].

The activity of blood serum creatine kinase was studied in 37 cases with various degree of frostbites and in healthy individuals. The dynamic study of blood serum creatine kinase in frostbites cases during the first week allows for the differentiation between deep and superficial frostbites.

Adult↗
PubMed1977

Carcinoma on old frostbites.

Two cases of carcinoma developing on old frostbite scars of the heel are presented. A short review of the subject follows, stressing the rarity of these "secondary" tumors and their general context within the skin cancers and the tragic experience of Greece with frostbite in the campaign of 1940-1941.

Aged↗
PubMed1988

Treatment of experimental frostbite with urokinase.

An experimental model of frostbite using a standard cold injury in rats was used to test the therapeutic usefulness of the fibrinolytic agent urokinase. Control groups included rapid rewarming, slow rewarming, and slow rewarming followed by saline infusion. Urokinase was administered through an intra-arterial catheter 30 minutes after cold injury and slow rewarming. Optimum results were obtained with rapid rewarming of the extremity at 43 degrees C. However, with rewarming at room temperature eventual tissue loss was significantly decreased with the infusion of urokinase compared with either no treatment or saline infusion. In the clinical situation where the patient with frostbite is seen after slow rewarming, we believe that clinical trials of the use of a fibrinolytic agent are warranted.

Animals↗