1. Life Sci. 2015 Jun 1;130:97-102. doi: 10.1016/j.lfs.2015.03.004. Epub 2015 Mar 25. Electric foot shock stress adaptation: Does it exist or not? Bali A(1), Jaggi AS(2). Author information: (1)Department of Pharmaceutical Sciences and Drug Research, Punjabi University, Patiala 147002, Punjab, India. Electronic address: anjubali.123@gmail.com. (2)Department of Pharmaceutical Sciences and Drug Research, Punjabi University, Patiala 147002, Punjab, India. Electronic address: amteshwarjaggi@yahoo.co.in. Stress adaptation is a protective phenomenon against repeated stress exposure and is characterized by a decreased responsiveness to a repeated stress stimulus. The adaptation is associated with a complex cascade of events, including the changes in behavior, neurotransmitter and gene expression levels. The non-adaptation or maladaptation to stress may underlie the affective disorders, such as anxiety, depression and post-traumatic stress disorder (PTSD). Electric foot shock is a complex stressor, which includes both physical and emotional components. Unlike immobilization, restraint and cold immersion stress, the phenomenon of stress adaptation is not very well defined in response to electric foot shock. A number of preclinical studies have reported the development of adaptation to electric foot shock stress. However, evidence also reveals the non-adaptive behavior in response to foot shocks. The distinct adaptive/non-adaptive responses may be possibly influenced by the type, intensity, and duration of the stress. The present review discusses the existence or non-existence of adaptation to electric foot shock stress along with possible mechanism. Copyright © 2015 Elsevier Inc. All rights reserved. PMID: 25817228 [PubMed - as supplied by publisher] 2. Wilderness Environ Med. 2015 Mar 5. pii: S1080-6032(15)00004-6. doi: 10.1016/j.wem.2014.12.026. [Epub ahead of print] Finger and Toe Temperature Responses to Cold After Freezing Cold Injury in Elite Alpinists. Morrison SA(1), Gorjanc J(2), Eiken O(3), Mekjavic IB(4). Author information: (1)Environmental Physiology and Ergonomics Laboratory, Department of Automation, Biocybernetics and Robotics, Jožef Stefan Institute, Ljubljana, Slovenia (Drs Morrison and Mekjavic). Electronic address: shawnda.morrison@zrs.upr.si. (2)Department of Surgery, Hospital of the Brothers of St. John of God, St.Veit/Glan, Austria (Dr Gorjanc). (3)Department of Environmental Physiology, School of Technology and Health, Royal Institute of Technology, Stockholm, Sweden (Dr Eiken). (4)Environmental Physiology and Ergonomics Laboratory, Department of Automation, Biocybernetics and Robotics, Jožef Stefan Institute, Ljubljana, Slovenia (Drs Morrison and Mekjavic). OBJECTIVE: To assess whether previous freezing cold injuries (FCI) would affect digit skin temperatures and rewarming rates during a follow-up cold stress test protocol. DESIGN: Nonrandomized control trial. METHODS: Twenty elite alpinists participated; alpinists with previous FCI requiring digit amputations (injured, INJ: n = 10 total, n = 8 male) were compared with ability-matched, uninjured alpinists (control, CON: n = 10, all male). Digit skin temperature was measured using infrared thermography as an index of peripheral digit perfusion after a cold stress test, which consisted of 30 minutes of immersion in 8°C water. RESULTS: The INJ alpinists' injured toes were warmer (approximately 6%) than their uninjured toes immediately after cold immersion (95% CI, 0.01°C to 1.00°C; P = .05); there were no differences between the rates of rewarming of injured and uninjured toes (INJ, 0.5° ± 0.1°C/min; CON, 0.7° ± 0.3°C/min; P = .16). Although the INJ alpinists had colder injured fingers immediately after the 35°C warm bath compared with their own uninjured fingers (32.2° ± 2.0°C vs 34.5° ± 0.5°C; P = .02), there were no differences observed between the rates of rewarming of injured and uninjured fingers after cold exposure (INJ, 1.1° ± 0.2°C/min; CON, 1.3° ± 0.5°C/min; P = .22). CONCLUSIONS: Even after FCI that requires digit amputation, there is no evidence of different tissue rates of rewarming between the injured and uninjured fingers or toes of elite alpinists. Copyright © 2015 Wilderness Medical Society. Published by Elsevier Inc. All rights reserved. PMID: 25754904 [PubMed - as supplied by publisher] 3. Cryobiology. 2014 Oct;69(2):323-32. doi: 10.1016/j.cryobiol.2014.08.007. Epub 2014 Aug 27. Intermittent whole-body cold immersion induces similar thermal stress but different motor and cognitive responses between males and females. Solianik R(1), Skurvydas A(2), Mickevičienė D(2), Brazaitis M(2). Author information: (1)Institute of Sports Science and Innovations, Lithuanian Sports University, Sporto Str. 6, LT-44221 Kaunas, Lithuania. Electronic address: rima.solianik@lsu.lt. (2)Institute of Sports Science and Innovations, Lithuanian Sports University, Sporto Str. 6, LT-44221 Kaunas, Lithuania. The main aim of this study was to compare the thermal responses and the responses of cognitive and motor functions to intermittent cold stress between males and females. The intermittent cold stress continued until rectal temperature (TRE) reached 35.5°C or for a maximum of 170 min. Thermal response and motor and cognitive performance were monitored. During intermittent cold stress, body temperature variables decreased in all subjects (P < 0.001) and did not differ between sexes. The presence of fast and slow cooling types for participants with similar effect on physiological variables were observed; thus the different rate coolers were grouped together and were attributed only sex specific responses. Overall, TRE cooling rate and cold strain index did not differ between sexes. Maximal voluntary contraction (MVC) decreased after intermittent cold exposure only in males (P < 0.001), whereas changes in muscle electromyography (EMG) activity did not differ between sexes. The effects of intermittent cold stress on electrically evoked muscle properties, spinal (H-reflex), and supraspinal (V-waves) reflexes did not differ between sexes. Intermittent cold-induced cognitive perturbation of attention and memory task performance was greater in males (P < 0.05). Contrary to our expectations, the results of the present study indicated that males and females experience similar thermal stress induced by intermittent whole-body cold immersion. Although no sex-specific differences were observed in muscle EMG activity, involuntary muscle properties, spinal and supraspinal reflexes, some of the sex differences observed (e.g., lower isometric MVC and greater cognitive perturbation in males) support the view of sex-specific physiological responses to core temperature decrease. Copyright © 2014 Elsevier Inc. All rights reserved. PMID: 25172303 [PubMed - indexed for MEDLINE] 4. Ergonomics. 2014;57(10):1499-511. doi: 10.1080/00140139.2014.934298. Epub 2014 Jul 17. The influence of cooling forearm/hand and gender on estimation of handgrip strength. Cheng CC(1), Shih YC, Tsai YJ, Chi CF. Author information: (1)a Department of Industrial Management , National Taiwan University of Science and Technology , Taipei , Taiwan. Handgrip strength is essential in manual operations and activities of daily life, but the influence of forearm/hand skin temperature on estimation of handgrip strength is not well documented. Therefore, the present study intended to investigate the effect of local cooling of the forearm/hand on estimation of handgrip strength at various target force levels (TFLs, in percentage of MVC) for both genders. A cold pressor test was used to lower and maintain the hand skin temperature at 14°C for comparison with the uncooled condition. A total of 10 male and 10 female participants were recruited. The results indicated that females had greater absolute estimation deviations. In addition, both genders had greater absolute deviations in the middle range of TFLs. Cooling caused an underestimation of grip strength. Furthermore, a power function is recommended for establishing the relationship between actual and estimated handgrip force. Statement of relevance: Manipulation with grip strength is essential in daily life and the workplace, so it is important to understand the influence of lowering the forearm/hand skin temperature on grip-strength estimation. Females and the middle range of TFL had greater deviations. Cooling the forearm/hand tended to cause underestimation, and a power function is recommended for establishing the relationship between actual and estimated handgrip force. Practitioner Summary: It is important to understand the effect of lowering the forearm/hand skin temperature on grip-strength estimation. A cold pressor was used to cool the hand. The cooling caused underestimation, and a power function is recommended for establishing the relationship between actual and estimated handgrip force.STATEMENT OF RELEVANCE: Manipulation with grip strength is essential in daily life and the workplace, so it is important to understand the influence of lowering the forearm/hand skin temperature on grip-strength estimation. Females and the middle range of TFL had greater deviations. Cooling the forearm/hand tended to cause underestimation, and a power function is recommended for establishing the relationship between actual and estimated handgrip force. PRACTITIONER SUMMARY: It is important to understand the effect of lowering the forearm/hand skin temperature on grip-strength estimation. A cold pressor was used to cool the hand. The cooling caused underestimation, and a power function is recommended for establishing the relationship between actual and estimated handgrip force PMID: 25030838 [PubMed - in process] 5. J Appl Physiol (1985). 2014 Apr 1;116(7):844-51. doi: 10.1152/japplphysiol.00637.2013. Epub 2013 Nov 21. Hyperventilation, cerebral perfusion, and syncope. Immink RV(1), Pott FC, Secher NH, van Lieshout JJ. Author information: (1)Laboratory for Clinical Cardiovascular Physiology, Department of Anatomy, Embryology, and Physiology, AMC Center for Heart Failure Research, Academic Medical Centre, University of Amsterdam, Amsterdam, the Netherlands; This review summarizes evidence in humans for an association between hyperventilation (HV)-induced hypocapnia and a reduction in cerebral perfusion leading to syncope defined as transient loss of consciousness (TLOC). The cerebral vasculature is sensitive to changes in both the arterial carbon dioxide (PaCO2) and oxygen (PaO2) partial pressures so that hypercapnia/hypoxia increases and hypocapnia/hyperoxia reduces global cerebral blood flow. Cerebral hypoperfusion and TLOC have been associated with hypocapnia related to HV. Notwithstanding pronounced cerebrovascular effects of PaCO2 the contribution of a low PaCO2 to the early postural reduction in middle cerebral artery blood velocity is transient. HV together with postural stress does not reduce cerebral perfusion to such an extent that TLOC develops. However when HV is combined with cardiovascular stressors like cold immersion or reduced cardiac output brain perfusion becomes jeopardized. Whether, in patients with cardiovascular disease and/or defect, cerebral blood flow cerebral control HV-induced hypocapnia elicits cerebral hypoperfusion, leading to TLOC, remains to be established. PMID: 24265279 [PubMed - indexed for MEDLINE] 6. J Pain. 2014 Mar;15(3):272-82. doi: 10.1016/j.jpain.2013.10.015. Epub 2013 Nov 14. Age and race effects on pain sensitivity and modulation among middle-aged and older adults. Riley JL 3rd(1), Cruz-Almeida Y(2), Glover TL(3), King CD(2), Goodin BR(4), Sibille KT(2), Bartley EJ(2), Herbert MS(4), Sotolongo A(5), Fessler BJ(5), Redden DT(6), Staud R(7), Bradley LA(5), Fillingim RB(2). Author information: (1)Pain Research and Intervention Center of Excellence, University of Florida, Gainesville, Florida. Electronic address: jriley@dental.ufl.edu. (2)Pain Research and Intervention Center of Excellence, University of Florida, Gainesville, Florida. (3)Pain Research and Intervention Center of Excellence, University of Florida, Gainesville, Florida; College of Nursing, University of Florida, Gainesville, Florida. (4)Department of Psychology, University of Alabama-Birmingham, Birmingham, Alabama. (5)Division of Clinical Immunology and Rheumatology, University of Alabama-Birmingham College of Medicine, Birmingham, Alabama. (6)Department of Biostatistics, School of Public Health, University of Alabama-Birmingham, Birmingham, Alabama. (7)College of Medicine, University of Florida, Gainesville, Florida. This study tested the effects of aging and race on responses to noxious stimuli using a wide range of stimulus modalities. The participants were 53 non-Hispanic blacks and 138 non-Hispanic white adults, ages 45 to 76 years. The participants completed a single 3-hour sensory testing session where responses to thermal, mechanical, and cold stimuli were assessed. The results suggest that there are selected age differences, with the older group less sensitive to warm and painful heat stimuli than middle-aged participants, particularly at the knee. This site effect supports the hypothesis that the greatest decrement in pain sensitivity associated with aging occurs in the lower extremities. In addition, there were several instances where age and race effects were compounded, resulting in greater race differences in pain sensitivity among the older participants. Overall, the data suggest that previously reported race differences in pain sensitivity emerged in our older samples, and this study contributes new findings in that these differences may increase with age in non-Hispanic blacks for temporal summation and both heat and cold immersion tolerance. We have added to the aging and pain literature by reporting several small to moderate differences in responses to heat stimuli between middle- and older-age adults.PERSPECTIVE: This study found that the greatest decline in pain sensitivity with aging occurs in the lower extremities. In addition, race differences in pain sensitivity observed in younger adults were also found in our older sample. Copyright © 2014 American Pain Society. Published by Elsevier Inc. All rights reserved. PMCID: PMC4005289 PMID: 24239561 [PubMed - indexed for MEDLINE] 7. Aviat Space Environ Med. 2013 Sep;84(9):921-6. Cognitive function during lower body water immersion and post-immersion afterdrop. Seo Y(1), Kim CH, Ryan EJ, Gunstad J, Glickman EL, Muller MD. Author information: (1)Exercise and Environmental Physiology Laboratory, Kent State University, Kent, OH 44242, USA. INTRODUCTION: The physiological effects of immersion hypothermia and afterdrop are well-characterized, but the psychological effects are less clear. The purpose of this study was to quantify changes in cognitive function during and after lower body water immersion. METHODS: On separate mornings, nine young healthy men participated in both neutral (35 +/- 1 degree C) and cold (13 +/- 1 degree C) water immersion. Subjects rested in neutral air for 30 min followed by 60 min water immersion to the iliac crest and 15 min of recovery in neutral air. Rectal temperature and mean skin temperature were continuously monitored. Metabolic rate, the Stroop Color Word Test (SCWT), and the Profile of Mood State (POMS) were quantified at predetermined intervals. RESULTS: During immersion in cold water, rectal temperature was reduced, but SCWT and POMS scores were unchanged relative to baseline. Despite the reduced rectal temperature, little to no shivering was observed during immersion and metabolic rate did not change. During recovery from cold immersion, rectal temperature was further reduced by approximately 0.5 degree C, shivering was noted, and metabolic rate increased. Coincident with this acute afterdrop, SCWT Color-Word performance (delta = -4 +/- 8 vs. 7 +/- 6 correct responses) and Interference score (delta = -2 +/- 7 vs. 4 +/- 8) was impaired relative to recovery from neutral immersion (i.e., when core temperature and metabolic rate did not change). CONCLUSION: These results suggest that recovery from lower body cold water immersion elicits the afterdrop phenomenon and shivering, which together impair selective attention as measured by the SCWT. PMID: 24024303 [PubMed - indexed for MEDLINE] 8. PLoS One. 2013;8(2):e56773. doi: 10.1371/journal.pone.0056773. Epub 2013 Feb 22. Mast cell dependent vascular changes associated with an acute response to cold immersion in primary contact urticaria. Meyer J(1), Gorbach AM, Liu WM, Medic N, Young M, Nelson C, Arceo S, Desai A, Metcalfe DD, Komarow HD. Author information: (1)Infrared Imaging and Thermometry Unit, National Institute of Biomedical Imaging and Bioengineering, National Institutes of Health, Bethesda, Maryland, United States of America. BACKGROUND: While a number of the consequences of mast cell degranulation within tissues have been documented including tissue-specific changes such as bronchospasm and the subsequent cellular infiltrate, there is little known about the immediate effects of mast cell degranulation on the associated vasculature, critical to understanding the evolution of mast cell dependent inflammation. OBJECTIVE: To characterize the microcirculatory events that follow mast cell degranulation. METHODOLOGY/PRINCIPAL FINDINGS: Perturbations in dermal blood flow, temperature and skin color were analyzed using laser-speckle contrast imaging, infrared and polarized-light colorimetry following cold-hand immersion (CHI) challenge in patients with cold-induced urticaria compared to the response in healthy controls. Evidence for mast cell degranulation was established by documentation of serum histamine levels and the localized release of tryptase in post-challenge urticarial biopsies. Laser-speckle contrast imaging quantified the attenuated response to cold challenge in patients on cetirizine. We found that the histamine-associated vascular response accompanying mast cell degranulation is rapid and extensive. At the tissue level, it is characterized by a uniform pattern of increased blood flow, thermal warming, vasodilation, and recruitment of collateral circulation. These vascular responses are modified by the administration of an antihistamine. CONCLUSIONS/SIGNIFICANCE: Monitoring the hemodynamic responses within tissues that are associated with mast cell degranulation provides additional insight into the evolution of the acute inflammatory response and offers a unique approach to assess the effectiveness of treatment intervention. PMCID: PMC3579929 PMID: 23451084 [PubMed - indexed for MEDLINE] 9. Eur J Appl Physiol. 2013 Mar;113(3):681-9. doi: 10.1007/s00421-012-2473-y. Epub 2012 Aug 24. Acute anxiety increases the magnitude of the cold shock response before and after habituation. Barwood MJ(1), Corbett J, Green R, Smith T, Tomlin P, Weir-Blankenstein L, Tipton MJ. Author information: (1)Department of Sport and Exercise Science, University of Portsmouth, Spinnaker Building, Cambridge Rd, Portsmouth, UK. martin.barwood@port.ac.uk Cold immersion evokes the life-threatening cold shock response (CSR). We hypothesised that anxiety may increase the magnitude of (Study 1), and diminish habituation to (Study 2), the CSR. Study 1: eleven participants completed two 7-min immersions in cold water (15 °C). On one occasion, to induce anxiety, participants were instructed that the water would be 5 °C colder (ANX); it was unchanged. The other immersion was a control (CON). Study 2: ten different participants completed seven, 7-min immersions. Immersions 1-5 induced habituation. Immersions 6 and 7 were counter-balanced to produce anxiety (ANX) or acted as a control (CON). Anxiety (20 cm scale) and cardiorespiratory responses (cardiac frequency [f(c)]), respiratory frequency [f(R)], tidal volume [V(T)], minute ventilation [V(E)]) were measured in both studies. Results of study 1: participants were more anxious in the ANX immersion (mean [SD]; CON 5.3 [3.6] and ANX 8.4 [5.0] cm). f(c) peaked at higher levels in ANX (136.4 [15.0]; CON: 124.0 [17.6] b min(-1)) and was higher pre-immersion and in minutes 3 and 5-7 by 7.2 [2.1] b min(-1). ANX [Formula: see text] was higher pre immersion and in minutes 5-6. Results of study 2: repeated immersion habituated the CSR. Anxiety was greater prior to ANX (CON 1.9 [2.3], ANX 6.6 [4.8] cm). f (c) in ANX was higher prior to immersion and in minutes 1-2, 4-6 cf CON; ANX f (c) was not different to the CSR seen in pre-habituation. f (R) was higher in minute 1 of immersion 1 (cf min 1 CON and ANX) following which it exceeded the CSR in CON. The magnitude and duration of CSR (f(c), V(E)) increased with anxiety. Anxiety diminishes CSR habituation. PMID: 22918558 [PubMed - indexed for MEDLINE] 10. Int J Biometeorol. 2012 Jul;56(4):631-7. doi: 10.1007/s00484-011-0462-1. Epub 2011 Jun 22. The effect of repeated mild cold water immersions on the adaptation of the vasomotor responses. Wakabayashi H(1), Wijayanto T, Kuroki H, Lee JY, Tochihara Y. Author information: (1)Department of Human Science, Faculty of Design, Kyushu University, Minami-ku, Fukuoka, Japan. waka78421@yahoo.co.jp There are several types of cold adaptation based on the alteration of thermoregulatory response. It has been thought that the temperature of repeated cold exposures during the adaptation period is one of the factors affecting the type of cold adaptation developed. This study tested the hypothesis that repeated mild cold immersions would induce an insulative cold adaptation but would not alter the metabolic response. Seven healthy male participants were immersed to their xiphoid process level repeatedly in 26°C water for 60 min, 3 days every week, for 4 weeks. During the first and last exposure of this cold acclimation period, the participants underwent body immersion tests measuring their thermoregulatory responses to cold. Separately, they conducted finger immersion into 5°C water for 30 min to assess their cold-induced vasodilation (CIVD) response before and after cold acclimation. During the immersion to xiphoid process, participants showed significantly lower mean skin temperature and skin blood flow in the forearm post-acclimation, while no adaptation was observed in the metabolic response. Additionally, blunted CIVD responses were observed after cold acclimation. From these results, it was considered that the participants showed an insulative-type of cold acclimation after the repeated mild cold immersions. The major finding of this study was the acceptance of the hypothesis that repeated mild cold immersion was sufficient to induce insulative cold adaptation but did not alter the metabolic response. It is suggested that the adaptation in the thermoregulatory response is specific to the response which is repeatedly stimulated during the adaptation process. PMID: 21695574 [PubMed - indexed for MEDLINE] 11. Med Sci Sports Exerc. 2011 Nov;43(11):2180-8. doi: 10.1249/MSS.0b013e31821d06d9. Sprint cycling performance is maintained with short-term contrast water immersion. Crampton D(1), Donne B, Egaña M, Warmington SA. Author information: (1)Department of Physiology, Trinity College Dublin, Dublin, Ireland. Erratum in Med Sci Sports Exerc. 2012 Mar;44(3):561. Egana, Mikel [corrected to Egaña, Mikel]. PURPOSE: Given the widespread use of water immersion during recovery from exercise, we aimed to investigate the effect of contrast water immersion on recovery of sprint cycling performance, HR and, blood lactate. METHODS: Two groups completed high-intensity sprint exercise before and after a 30-min randomized recovery. The Wingate group (n = 8) performed 3 × 30-s Wingate tests (4-min rest periods). The repeated intermittent sprint group (n = 8) cycled for alternating 30-s periods at 40% of predetermined maximum power and 120% maximum power, until exhaustion. Both groups completed three trials using a different recovery treatment for each trial (balanced randomized application). Recovery treatments were passive rest, 1:1 contrast water immersion (2.5 min of cold (8°C) to 2.5 min of hot (40°C)), and 1:4 contrast water immersion (1 min of cold to 4 min of hot). Blood lactate and HR were recorded throughout, and peak power and total work for pre- and postrecovery Wingate performance and exercise time and total work for repeated sprinting were recorded. RESULTS: Recovery of Wingate peak power was 8% greater after 1:4 contrast water immersion than after passive rest, whereas both contrast water immersion ratios provided a greater recovery of exercise time (∼ 10%) and total work (∼ 14%) for repeated sprinting than for passive rest. Blood lactate was similar between trials. Compared with passive rest, HR initially declined more slowly during contrast water immersion but increased with each transition to a cold immersion phase. CONCLUSIONS: These data support contrast water immersion being effective in maintaining performance during a short-term recovery from sprint exercise. This effect needs further investigation but is likely explained by cardiovascular mechanisms, shown here by an elevation in HR upon each cold immersion. PMID: 21502898 [PubMed - indexed for MEDLINE] 12. Neurosci Lett. 2010 Mar 19;472(2):109-13. doi: 10.1016/j.neulet.2010.01.064. Epub 2010 Feb 2. Dorsal root ganglion neurons respond with prolonged extracellular signal-regulated protein kinase phosphorylation following noxious heat and cold stimulation. Donnerer J(1), Liebmann I. Author information: (1)Institute of Experimental and Clinical Pharmacology, Medical University of Graz, Universitätsplatz 4, A-8010 Graz, Austria. josef.donnerer@medunigraz.at In the present study the time course of extracellular signal-regulated protein kinase phosphorylation (pERK1/2 appearance) in lumbar sensory dorsal root ganglia (DRG) was determined following a 5-min noxious heat or a noxious cold stimulus to the hind paw of the rat. The thermal stimuli were chosen to activate transient receptor potential (TRP) channels, but not to induce tissue damage. A quantitative analysis of phospho-ERK1/2 was performed by protein extraction and Western blot analysis. Western blot analysis showed that following the heat stimulus, phosphorylation of ERK1/2 increased 2-3-fold between 10 and 30min in the DRG on the ipsilateral side. High levels were maintained from 30min up to 16h. Following the cold stimulus to the paw, pERK1/2 immediately increased 2-fold within 2min in the DRG on the ipsilateral side, it declined within 2h and reached a second peak at 4h. In the DRGs on the contralateral side of the paw's heat or cold immersion the pERK1/2 remained low at all time points investigated. Fluorescence immunohistochemistry of the DRG following the thermal stimuli revealed an increased cytoplasmic staining for pERK1/2 in neurons. The present results show that following a 5-min nociceptive thermal stimulus sensory neurons respond with a characteristic long-lasting phosphorylation of ERK1/2. Copyright 2010 Elsevier Ireland Ltd. All rights reserved. PMID: 20132866 [PubMed - indexed for MEDLINE] 13. Pharmacol Res. 2009 Jun;59(6):385-92. doi: 10.1016/j.phrs.2009.02.001. Epub 2009 Feb 13. Ameliorative potential of rosiglitazone in tibial and sural nerve transection-induced painful neuropathy in rats. Jain V(1), Jaggi AS, Singh N. Author information: (1)Department of Pharmaceutical Sciences and Drug Research, Punjabi University, Patiala 147002, India. The present study was designed to investigate the ameliorative potential of rosiglitazone, a peroxisome proliferator-activated receptor gamma (PPAR gamma) agonist, in tibial and sural nerve transection-induced neuropathic pain in rats. The pinprick, cold immersion, hot plate and hot immersion tests were performed to assess the degree of mechanical and cold hyperalgesia; heat hyperalgesia and allodynia, respectively. The tissue thio-barbituric acid reactive species and reduced glutathione were measured as the markers of oxidative stress. Furthermore, the myeloperoxidase activity (a specific marker of inflammation) was also measured along with the determination of the calcium levels. Rosiglitazone (2.5, 5 and 10 mg/kg p.o.), was administered for 28 days after tibial and sural nerve transection. Administration of rosiglitazone (5 and 10 mg/kg p.o.) attenuated tibial and sural nerve transection-induced mechanical and cold hyperalgesia without modulating heat hyperalgesia. Rosiglitazone also attenuated tibial and sural nerve transection-induced increase in oxidative stress, myeloperoxidase activity and calcium levels. It may be concluded that rosiglitazone has ameliorative potential in attenuating the painful state associated with tibial and sural nerve transection, which may further be attributed to anti-inflammatory actions with subsequent decrease in oxidative stress and calcium levels. PMID: 19429470 [PubMed - indexed for MEDLINE] 14. Pain. 2009 Jun;143(3):172-8. doi: 10.1016/j.pain.2008.12.027. Epub 2009 Mar 10. Deficiency in endogenous modulation of prolonged heat pain in patients with Irritable Bowel Syndrome and Temporomandibular Disorder. King CD(1), Wong F, Currie T, Mauderli AP, Fillingim RB, Riley JL 3rd. Author information: (1)Department of Community Dentistry & Behavioral Science, University of Florida College of Dentistry, 1329 SW 16th Street, Suite 5180, PO Box 103628, Gainesville, FL 32610-3628, USA. cking@dental.ufl.edu Comment in Pain. 2009 Jun;143(3):161-2. Females with Irritable Bowel Syndrome (IBS) and Temporomandibular Disorder (TMD) are characterized by enhanced sensitivity to experimental pain. One possible explanation for this observation is deficiencies in pain modulation systems such as Diffuse Noxious Inhibitory Control (DNIC). In a few studies that used brief stimuli, chronic pain patients demonstrate reduced DNIC. The purpose of this study was to compare sensitivity to prolonged heat pain and the efficacy of DNIC in controls to IBS and TMD patients. Heat pain (experimental stimulus; 44.0-49.0 degrees C), which was applied to left palm, was continuously rated during three 30-s trials across three separate testing sessions under the following conditions: without a conditioning stimulus; during concurrent immersion of the right foot in a 23.0 degrees C (control); and during noxious cold immersion in a (DNIC; 8.0-16.0 degrees C) water bath. Compared to controls, IBS and TMD patients reported an increased sensitivity to heat pain and failed to demonstrate pain inhibition due to DNIC. Controls showed a significant reduction in pain during the DNIC session. These findings support the idea that chronic pain patients are not only more pain sensitive but also demonstrate reduced pain inhibition by pain, possibly because of dysfunction of endogenous pain inhibition systems. PMCID: PMC3629692 PMID: 19278784 [PubMed - indexed for MEDLINE] 15. Int Wound J. 2008 Oct;5(4):562-9. doi: 10.1111/j.1742-481X.2008.00454.x. Epub 2008 Sep 1. Cold immersion recovery responses in the diabetic foot with neuropathy. Bharara M(1), Viswanathan V, Cobb JE. Author information: (1)Southern Arizona Limb Salvage Alliance (SALSA), University of Arizona and Southern Arizona Veterans Affairs, Health Care System, University of Arizona College of Medicine, Tucson, AZ 85724-5072, USA. manish.bharara@gmail.com The aim of this article was to investigate the effectiveness of testing cold immersion recovery responses in the diabetic foot with neuropathy using a contact thermography system based on thermochromic liquid crystals. A total of 81 subjects with no history of diabetic foot ulceration were assigned to neuropathy, non neuropathy and healthy groups. Each group received prior verbal and written description of the test objectives and subsequently underwent a comprehensive foot care examination. The room temperature and humidity were consistently maintained at 24 degrees C and less than 50%, respectively, with air conditioning. The right foot for each subject was located on the measurement platform after cold immersion in water at 18-20 degrees C. Whole-field thermal images of the plantar foot were recorded for 10 minutes. Patients with diabetes with neuropathy show the highest 'delta temperature', that is difference between the temperature after 10-minute recovery period and baseline temperature measured independently at all the three sites tested, that is first metatarsal head (MTH), second MTH and heel. This clinical study showed for the first time the evidence of poor recovery times for the diabetic foot with neuropathy when assessing the foot under load. A temperature deficit (because of poor recovery to baseline temperature) suggests degeneration of thermoreceptors, leading to diminished hypothalamus-mediated activity in the diabetic neuropathic group. PMID: 18783470 [PubMed - indexed for MEDLINE] 16. Int Wound J. 2008 Oct;5(4):570-6. doi: 10.1111/j.1742-481X.2008.00455.x. Epub 2008 Sep 1. Warm immersion recovery test in assessment of diabetic neuropathy--a proof of concept study. Bharara M(1), Viswanathan V, Cobb JE. Author information: (1)Southern Arizona Limb Salvage Alliance (SALSA), University of Arizona and Southern Arizona Veterans Affairs, Health Care System, University of Arizona College of Medicine, Tucson, AZ 85724-5072, USA. manish.bharara@gmail.com The aim of this article was to present results of warm immersion recovery test in the diabetic foot with neuropathy using a liquid crystal-based contact thermography system. It is intended to provide a 'proof of concept' for promoting the role of supplementary thermal assessment techniques and evidence-based diagnosis of diabetic neuropathy. A total of 81 subjects from the outpatient department of MV Hospital for Diabetes, India, were assessed using a liquid crystal thermography system. Each subject was assigned to one of three study groups, that is diabetic neuropathy, diabetic non neuropathy and non diabetic healthy. The room temperature and humidity were consistently maintained at 24 degrees C and less than 50%, respectively, with air conditioning. The right foot for each subject was located on the measurement platform after warm immersion in water at 37 degrees C. Whole-field thermal images of the plantar foot were recorded for 10 minutes. Local measurements at the most prevalent sites of ulceration, that is metatarsal heads, great toe and heel, show highest temperature deficit after recovery for diabetic neuropathy group. The findings of the current study support the ones of a previous study by the authors, which used cold immersion recovery test for the neuropathic assessment of the diabetic foot. A temperature deficit between the recovery and the baseline temperature for the neuropathic group suggests degeneration of thermoreceptors. Thermal stimulus tests can be useful to validate the nutritional deficits' (during plantar loading and thermal stimulus) contribution in foot ulceration. PMID: 18783469 [PubMed - indexed for MEDLINE] 17. Med Sci Monit. 2007 May;13 Suppl 1:121-8. Comparison of thermography and Doppler sonography in the evaluation of the cold immersion test in women with excessive vasospastic reaction. Stefańczyk L(1), Woźniakowski B, Pietrzak P, Majos A, Grzelak P. Author information: (1)Department of Radiology and Diagnostic Imaging, Medical University of Łódź, Łódź, Poland. stefanczyk_l@wp.pl BACKGROUND: Determining the predisposition to vasospastic reactions in a function test is important at the earliest possible stage of diagnosis. Thermography is an acknowledged procedure for monitoring function tests; however, its availability is limited. The aim of this study was to compare the progression of the cold immersion test in a thermal picture and an US-CD examination with the flow assessment of the small blood vessels of the hand. MATERIAL/METHODS: A group of 16 women declaring high cold tolerance of their hands was compared with a group of 24 women reporting hand complaints when exposed to the cold. The subjects underwent a test in which they immersed their right hand in ice-cold water (0 degrees C). Then images of the temperature distribution in the hand were recorded with a thermovisory camera. At the same time, spectral waveforms were registered in the proper palmar digital artery and in the radial artery at specified time intervals. RESULTS: Data analysis comprised temperature measurements at the level of the nail plate of the middle finger and at the wrist. There were differences between the groups at all the stages of the immersion test (efficient return of temperature to initial values in the reference group, delayed return in subjects with low tolerance to thermal stimuli). Flow resistance analysis using the Doppler method in the studied arteries revealed similar differences between the groups (swift flow normalization and efficient reperfusion in the reference group, higher flow resistance and low reperfusion in subjects with low tolerance to thermal stimuli). CONCLUSIONS: Changes in the parameters of hand warmth during the immersion test assessed by thermography and changes in the flow parameters observed by Doppler sonography demonstrated similar progression, which suggests the equivalence of both methods. Doppler sonography may thus serve as a method of monitoring function tests to establish a predisposition to vasospasm. PMID: 17507897 [PubMed - indexed for MEDLINE] 18. Arch Mal Coeur Vaiss. 2006 Nov;99(11):1115-9. [The heart and underwater diving]. [Article in French] Lafay V(1). Author information: (1)Service de médecine du sport, hôpital Salvator, 249, bd de Sainte-Marguerite, 13274 Marseille 09. vincent.lafay@medecins-saint-antoine.fr Cardiovascular examination of a certain number of candidates for underwater diving raises justifiable questions of aptitude. An indicative list of contraindications has been proposed by the French Federation of Underwater Studies and Sports but a physiopathological basis gives a better understanding of what is involved. During diving, the haemodynamic changes due not only to the exercise but also to cold immersion, hyperoxaemia and decompression impose the absence of any symptomatic cardiac disease. Moreover, the vasoconstriction caused by the cold and hyperoxaemia should incite great caution in both coronary and hypertensive patients. The contraindication related to betablocker therapy is controversial and the debate has not been settled in France. The danger of drowning makes underwater diving hazardous in all pathologies carrying a risk of syncope. Pacemaker patients should be carefully assessed and the depth of diving limited. Finally, the presence of right-to-left intracardiac shunts increases the risk of complications during decompressionand contraindicates underwater diving. Patent foramen ovale is a special case but no special investigation is required for its detection. The cardiologist examining candidates for underwater diving should take all these factors into consideration because, although underwater diving is a sport associated with an increased risk, each year there are more and more people, with differing degrees of aptitude, who wish to practice it. PMID: 17181043 [PubMed - indexed for MEDLINE] 19. Med Sci Monit. 2006 Jul;12(7):CR290-5. Epub 2006 Jun 28. The influence of alterations in room temperature on skin blood flow during contrast baths in patients with diabetes. Petrofsky JS(1), Lohman E 3rd, Lee S, de la Cuesta Z, Labial L, Iouciulescu R, Moseley B, Korson R, Al Malty A. Author information: (1)Department of Physical Therapy, Loma Linda University, Loma Linda, CA 92350, USA. jpetrofsky@llu.edu BACKGROUND: Contrast baths (CB) have been used for over two thousand years. But it only was recently that CB were shown to improve limb circulation to a greater extent than that which can be seen after continuous exposure to a warm, constant temperature, bath. However, other studies show that this type of response to temperature can be impaired if the sympathetic nervous system applies vasoconstriction to the blood vessels. Therefore the purpose of the present investigation was to examine the relationship between sympathetic outflow on the magnitude of the change of blood flow (BF) during contrast baths in controls and with people diabetes. Sympathetic vasoconstriction activity was altered by global heating. MATERIAL/METHODS: Fourteen patients with type 2 diabetes were compared to 14 age-matched controls. BF was measured during 16 minutes of serial contrast baths of the foot following 3 minutes of warm water and 1 min of cold immersion at 2 different room temperatures, 19 and 32 deg C. RESULTS: When subjects were exposed to global heating (warm room) there is a greater response to CB than when subjects were initially in a cooler room. However, for both temperatures, subjects with diabetes had a response that was over 50% less than that seen in control subjects. CONCLUSIONS: Removing sympathetic vasoconstrictor tone by global heating benefits subjects with diabetes and control subjects in their response to CB. For subjects with diabetes, global heating may be necessary to increase blood flow to acceptable levels for effective therapy. PMID: 16810134 [PubMed - indexed for MEDLINE] 20. J Clin Monit Comput. 2006 Jun;20(3):175-84. Epub 2006 Apr 13. Analysis of the ear pulse oximeter waveform. Awad AA(1), Stout RG, Ghobashy MA, Rezkanna HA, Silverman DG, Shelley KH. Author information: (1)Department of Anesthesia, Yale University School of Medicine, New Haven, CT 06516, USA. OBJECTIVE: For years researchers have been attempting to understand the relationship between central hemodynamics and the resulting peripheral waveforms. This study is designed to further understanding of the relationship between ear pulse oximeter waveforms, finger pulse oximeter waveforms and cardiac output (CO). It is hoped that with appropriate analysis of the peripheral waveforms, clues can be gained to help to optimize cardiac performance. METHODS: Part 1: Studying the effect of cold immersion test on plethysmographic waveforms. Part 2: Studying the correlation between ear and finger plethysmographic waveforms and (CO) during CABG surgery. The ear and finger plethysmographic waveforms were analyzed to determine amplitude, width, area, upstroke and downslope. The CO was measured using continuous PA catheter. Using multi-linear regression, ear plethysmographic waveforms, together with heart rate (HR), were used to determine the CO Agreement between the two methods of CO determination was assessed. RESULTS: Part 1: On contralateral hand immersion, all finger plethysmographic waveforms were reduced, there was no significant change seen in ear plethysmographic waveforms, except an increase in ear plethysmographic width. Part 2: Phase 1: Significant correlation detected between the ear plethysmographic width and other ear and finger plethysmographic waveforms. Phase 2: The ear plethysmographic width had a significant correlation with the HR and CO. The correlation of the other ear plethysmographic waveforms with CO and HR are summarized (Table 5). Multi-linear regression analysis was done and the best fit equation was found to be: CO=8.084 - 14.248 x Ear width + 0.03 x HR+ 92.322 x Ear down slope+0.027 x Ear Area Using Bland & Altman, the bias was (0.05 L) but the precision (2.46) is large to be clinically accepted. CONCLUSION: The ear is relatively immune to vasoconstrictive challenges which make ear plethysmographic waveforms a suitable monitor for central hemodynamic changes. The ear plethysmographic width has a good correlation with CO. PMID: 16612551 [PubMed - indexed for MEDLINE] 21. J Card Fail. 2006 Mar;12(2):114-9. The daily incidence of acute heart failure is correlated with low minimal night temperature: cold immersion pulmonary edema revisited? Milo-Cotter O(1), Setter I, Uriel N, Kaluski E, Vered Z, Golik A, Cotter G. Author information: (1)Department of Cardiology, Assaf-harofeh Medical Center, Zerifin, Israel. Comment in J Card Fail. 2006 Mar;12(2):120-1. BACKGROUND: Previous studies suggested a higher incidence of acute heart failure (AHF) during cold months in regions with cold climate. We examined the daily incidence of AHF by same-day trough temperature and humidity in a warmer region. METHODS AND RESULTS: All admissions for AHF (340 patients) to a city hospital, providing the sole emergency medical care to a geographical region of approximately 500,000 people were recorded. Patients were followed through admission and for 6 months after discharge. Low minimal trough temperature was associated with an increase in the same-day AHF incidence. Lowest tercile trough night temperatures were associated with higher AHF incidence (3.5 +/- 2.1 versus 2.4 +/- 1.6, events/24 hours, P = .012). This association was mainly from increased AHF events in nights with the predetermined trough temperature of <7 degrees C (4 +/- 2.1 versus 2.5 +/- 1.7, events/24 hours, P = .0013). This association persisted even after excluding the coldest consecutive 30 days from the analysis. Humidity was not associated with increased AHF event rate. In a post-hoc analysis we have observed doubling of 6-month mortality in patients admitted with AHF during days with lower trough night temperature, despite no apparent worse baseline characteristics or disease severity at admission. CONCLUSIONS: AHF rate is increased during days with lower trough night temperature. If confirmed, these results may have implications on issues related to climate control in houses of the elderly or patients susceptible to heart failure. PMID: 16520258 [PubMed - indexed for MEDLINE] 22. Am J Hypertens. 2005 Sep;18(9 Pt 1):1211-7. Quantitative genetic analysis of blood pressure response during the cold pressor test. Choh AC(1), Czerwinski SA, Lee M, Demerath EW, Wilson AF, Towne B, Siervogel RM. Author information: (1)Lifespan Health Research Center, Wright State University School of Medicine, 3171 Research Boulevard, Dayton, OH 45420, USA. audrey.choh@wright.edu BACKGROUND: The genetic association between blood pressure (BP) at rest and during the cold pressor test (CPT) is not well characterized. The purpose of this study was to examine the genetic architecture of BP during the CPT, and to determine whether BP at rest and during the CPT share common genetic influences. METHODS: In 419 individuals distributed across four large families, variance components methods were used to estimate heritabilities of resting BP and CPT BP, along with genetic correlations among BP traits. The CPT consisted of immersion of the left foot in 4 degrees C water while the participant was supine. Blood pressure reactivity (DeltaBP) was defined as BP at 15 to 30 sec and 45 to 60 sec of foot immersion minus resting BP. RESULTS: Significant (P < .05) heritabilities were found for supine BP (h(2)(SBP) = 0.35), CPT BP (h(2)(SBP) = 0.27 and 0.33, h(2)(DBP) = 0.18 and 0.30), and DeltaSBP (h(2)(SBP) = 0.12 and 0.37) but not for DeltaDBP. Bivariate analyses detected significant (P < .05) genetic correlations between resting SBP and CPT SBP that were different from 0 and 1. Genetic correlations between resting DBP and CPT DBP were not significantly different from 1. Genetic correlations between resting SBP and DeltaSBP were not significant. CONCLUSIONS: Measures of BP at rest and during cold immersion are significantly influenced by additive genetic effects. These genetic influences are only partially shared between SBP at rest and SBP during cold immersion, suggesting that a somewhat different set of genes may influence SBP during cold immersion. Unique sets of genes also appear to influence DeltaSBP independent of those influencing resting SBP. PMID: 16182112 [PubMed - indexed for MEDLINE] 23. Ind Health. 2005 Jul;43(3):548-55. Preliminary study on the assessment of peripheral vascular response to cold provocation in workers exposed to hand-arm vibration using laser Doppler perfusion imager. Miyai N(1), Terada K, Sakaguchi S, Minami Y, Tomura T, Yamamoto H, Tomida K, Miyashita K. Author information: (1)Department of Hygiene, School of Medicine, Wakayama Medical University, 811-1 Kimiidera, Wakayama 641-8509, Japan. Measurements of changes in finger skin blood flow with laser Doppler perfusion imaging (LDPI) in response to cold provocation test (10 degrees C, 10 min) were performed in 12 men suffering from vibration induced white finger (VWF) and 13 exposed controls. The mean perfusion values in both groups reduced markedly as a result of immersion of the hand in cold water. In the controls, however, the mean value increased gradually until the end of the cold provocation, while that in the VWF subjects remained at the lowest level. After removal of the hand from the cold water, the skin blood perfusion in the controls recovered rapidly and nearly reached the baseline value. In the VWF subjects, it had a slight increase immediately following the cold immersion but no tendency to rise as the time span increased. Analysis of covariance controlling for possible confounders revealed that the VWF subjects had significantly lower perfusion values compared to the controls in the last several minutes of the cold provocation and the following recovery. These findings suggest that the LDPI technique enables visualizing and quantifying the peripheral vascular effects of cold water immersion on the finger skin blood perfusion and thus has the potential of providing more detailed and a&curate information that may help detect the peripheral circulatory impairment in the fingers of vibration-exposed workers. PMID: 16100932 [PubMed - indexed for MEDLINE] 24. Neurosci Lett. 2005 Jun 3;380(3):209-13. Epub 2005 Feb 2. Homotopic and heterotopic effects of endogenous analgesia in healthy volunteers. Pud D(1), Sprecher E, Yarnitsky D. Author information: (1)Haifa Pain Research Group, Rambam Medical Centre, Haifa, Israel. doritpud@research.haifa.ac.il Although research on DNIC has revealed the inhibitory effect occurring between two remote pain stimuli, the interrelation between two adjacent painful stimuli has not yet been characterized. In the present study, we used a sample of 40 healthy volunteers to examine the effect of 30-s immersion of the fingers in water of 1 degree C, as a conditioning stimulus, on pain intensities produced by conditioned mechanical punctuate stimuli, applied both adjacent and contralateral to the cooled area. There was a significant decrease in mechanical pain intensities from 17.23+/-2.39 at baseline to 12.45+/-2.39 when stimulating immediately after the cold immersion at an adjacent site, and from 20.00+/-2.39 to 15.08+/-2.39 at remote sites (F=20.02, p<0.0001). A significant positive correlation between the extent of pain reduction in the cooled and in the uncooled hand was found (r(s)=0.59, p=0.0001). The extent of pain reduction following cooling in the cooled and in the uncooled hand was also found to be similar for males and for females (p=0.63). It is concluded that under the conditions of this experiment, EA affects heterotopic and homotopic regions similarly and without gender differences. PMID: 15862887 [PubMed - indexed for MEDLINE] 25. Int Arch Occup Environ Health. 2005 May;78(4):311-8. Epub 2005 Apr 7. Effects of waterproof covering on hand immersion tests using water at 10 degrees C, 12 degrees C and 15 degrees C for diagnosis of hand-arm vibration syndrome. Suizu K(1), Harada N. Author information: (1)Department of Hygiene, Yamaguchi University School of Medicine, Ube 755-8505, Japan. OBJECTIVES: To compare effects of waterproof covering on finger skin temperature (FST) and subjective hand pain during immersion tests using cold water at 10 degrees C, 12 degrees C and 15 degrees C. In the (Draft International Standard) of the International Organization for Standardization (ISO/DIS 14835-1), a water temperature of 12 degrees C and use of water covering are proposed. METHODS: Six healthy male subjects took part in the immersion tests and immersed both hands into water at 10 degrees C, 12 degrees C and 15 degrees C for 5 min, repeatedly, with waterproof covering (polyethylene gloves) or without (bare hands). The FST data from middle fingers and subjective pain scores for hand pain were analyzed. Furthermore, the test with water at 12 degrees C was repeated to assess the repeatability of the test. RESULTS: The glove and water temperature factors for FST were significant at every minute from 1 min during immersion up to 2 min after recovery, showing higher values for waterproof covering than for bare hands and showing lowest values for water temperature of 10 degrees C and highest for 15 degrees C. The glove and water temperature factors for subjective pain score were significant at the 1-min and 2-min points during immersion, showing lower scores for waterproof covering than for bare hands and showing highest scores for water temperature of 10 degrees C and lowest for 15 degrees C. The results of the first and second tests using water of 12 degrees C showed no systematic difference in FST and hand pain between the tests, with a few exceptions. CONCLUSIONS: Subjective pain during the cold immersion test with polyethylene gloves and water at 12 degrees C can be reduced, while the differences in FST between water temperatures of 10 degrees C and 12 degrees C were small or not apparent at some points during immersion and recovery. The test also seems to be suitable for repeatability. Further investigation on hand-arm vibration syndrome (HAVS) patients to validate the use of the immersion test with gloves to obtain sufficient data for diagnostic value is required. PMID: 15815917 [PubMed - indexed for MEDLINE] 26. Acta Physiol Scand. 2005 Apr;183(4):389-97. Effects of cold-water immersion on VEGF mRNA and protein expression in heart and skeletal muscles of rats. Kim JC(1), Yi HK, Hwang PH, Yoon JS, Kim HJ, Kawano F, Ohira Y, Kim CK. Author information: (1)Department of Physical Education, Chonbuk National University, Cheonju City, Korea. AIM: The effects of cold exposure on gene and protein expression of vascular endothelial growth factor (VEGF), in heart and skeletal muscles, were studied in male adult Wistar rats. METHODS: Cold immersion was accomplished by submerging the rats in shoulder-deep water maintained at approximately 18 degrees C, either acutely (1 h) or chronically (1 h day(-1), 5 days week(-1) for 20 weeks). The expressions of VEGF mRNA and protein in heart, gastrocnemius, and soleus muscles were examined by Northern and Western blotting and competitive-polymerase chain reaction techniques. RESULTS: The expressions of VEGF mRNA and protein were markedly increased in cardiac muscle of the cold-immersed group, particularly in the 1-hour exposure group, whereas VEGF mRNA and protein in gastrocnemius were decreased significantly after an acute exposure. Although the protein level in gastrocnemius remained low in the chronically exposed group, the expression of mRNA of VEGF(165) with chronic exposure in this group returned to the control level and that of VEGF(206) was 15% greater than that in controls. The expression of mRNA for VEGF(165) in soleus was also lowered by acute cold exposure, although that for VEGF(206) was stable. However, VEGF protein was increased by 50%. After 20 weeks, all of these parameters were increased over the levels found in the controls. CONCLUSION: These results suggest that the VEGF gene may be a major regulatory factor in cardiac and skeletal muscle adaptation to the cold environment stimulating angiogenesis and thermogenesis. PMID: 15799775 [PubMed - indexed for MEDLINE] 27. Acta Physiol Scand. 2004 Sep;182(1):3-10. Effects of immersion water temperature on whole-body fluid distribution in humans. Stocks JM(1), Patterson MJ, Hyde DE, Jenkins AB, Mittleman KD, Taylor NA. Author information: (1)Department of Biomedical Science, University of Wollongong, Wollongong, NSW, Australia. AIM: In this study, we quantified acute changes in the intracellular and extracellular fluid compartments during upright neutral- and cold-water immersion. We hypothesized that, during short-term cold immersion, fluid shifts would be wholly restricted to the extracellular space. METHODS: Seven males were immersed 30 days apart: control (33.3 degrees SD 0.6 degrees C); and cold (18.1 degrees SD 0.3 degrees C). Posture was controlled for 4 h prior to a 60-min seated immersion. RESULTS: Significant reductions in terminal oesophageal (36.9 degrees +/- 0.1 degrees -36.3 degrees +/- 0.1 degrees C) and mean skin temperatures (30.3 degrees +/- 0.3 degrees -23.0 degrees +/- 0.3 degrees C) were observed during the cold, but not the control immersion. Both immersions elicited a reduction in intracellular fluid [20.17 +/- 6.02 mL kg(-1) (control) vs. 22.72 +/- 9.90 mL kg(-1)], while total body water (TBW) remained stable. However, significant plasma volume (PV) divergence was apparent between the trials at 60 min [12.5 +/- 1.0% (control) vs. 6.1 +/- 3.1%; P < 0.05], along with a significant haemodilution in the control state (P < 0.05). Plasma atrial natriuretic peptide concentration increased from 18.0 +/- 1.6 to 58.7 +/- 15.1 ng L(-1) (P < 0.05) during cold immersion, consistent with its role in PV regulation. We observed that, regardless of the direction of the PV change, both upright immersions elicited reductions in intracellular fluid. CONCLUSION: These observations have two implications. First, one cannot assume that PV changes reflect those of the entire extracellular compartment. Second, since immersion also increases interstitial fluid pressure, fluid leaving the interstitium must have been rapidly replaced by intracellular water. PMID: 15329051 [PubMed - indexed for MEDLINE] 28. J Pain. 2004 May;5(4):233-7. Temperature and the cold pressor test. Mitchell LA(1), MacDonald RA, Brodie EE. Author information: (1)Department of Psychology, Glasgow Caledonian University, United Kingdom. l.b.mitchell@gcal.ac.uk As a method of experimental pain induction, the cold pressor test is thought to mimic the effects of chronic conditions effectively. A survey of previous studies using the cold pressor, however, revealed a lack of standardization and control of water temperature, questioning comparability and reliability. This study reports the influence of temperature on pain tolerance and intensity by using a commercially available circulating water bath. Twenty-six participants (12 men, 14 women) underwent 4 cold pressor trials with temperature order counterbalanced across 1 degrees C, 3 degrees C, 5 degrees C, and 7 degrees C, temperatures representative of the range used in previous literature. After each cold immersion participants rated pain intensity on a visual analogue scale and the McGill Pain Questionnaire. Tolerance times were recorded for each trial. Significant main effects of temperature were found for tolerance time, with higher temperatures resulting in longer times, and pain intensity, with lower temperatures resulting in higher intensities. Gender differences were found, with men tolerating the stimulus for significantly longer than women. It was concluded that small differences in water temperature have a significant effect on pain intensity and tolerance time. The use of cold pressor equipment that ensures a precise constant temperature of circulating water is necessary to ensure comparable and reliable results.PERSPECTIVE: The cold pressor method of experimental pain induction has been widely used in the evaluation of psychological and physiological pain treatments. This article highlights the need for clear methodologic guidelines for the technique and demonstrates that very minor changes in experimental protocol can produce significant differences. Copyright 2004 American Pain Society PMID: 15162346 [PubMed - indexed for MEDLINE] 29. J Athl Train. 2001 Mar;36(1):16-19. Effects of Hot or Cold Water Immersion and Modified Proprioceptive Neuromuscular Facilitation Flexibility Exercise on Hamstring Length. Burke DG(1), Holt LE, Rasmussen R, MacKinnon NC, Vossen JF, Pelham TW. Author information: (1)St Francis Xavier University, Antigonish, Nova Scotia, Canada. OBJECTIVE: To compare the changes in hamstring length resulting from modified proprioceptive neuromuscular facilitation flexibility training in combination with cold-water immersion, hot-water immersion, and stretching alone. DESIGN AND SETTING: Training-only subjects stood motionless for 10 minutes, while subjects in the cold group stood in a cold-water bath (8 degrees +/- 1 degrees C) immersed up to the gluteal fold for 10 minutes, and subjects in the hot group stood in a hot-water bath (44 degrees +/- 1 degrees C) immersed up to the gluteal fold for 10 minutes. All subjects exercised only the right lower limb using a modified proprioceptive neuromuscular facilitation flexibility protocol, consisting of 1 set of 4 repetitions. This procedure was followed for 5 consecutive days. SUBJECTS: Forty-five uninjured subjects (21 women, 24 men; age range, 18-25 years) were randomly assigned to the cold, hot, or stretching-alone group. MEASUREMENTS: Subjects were measured for maximum active hip flexion on the first and fifth days. RESULTS: Group results were assessed using a 2 x 3 analysis of variance, comparing changes in hamstring length from pretest to posttest. All 3 groups had significant improvements in hamstring length (pretest to posttest) (P <.05). However, no significant differences occurred among groups. CONCLUSIONS: No advantage was apparent in using complete hot or cold immersion to increase hamstring length in healthy subjects. PMCID: PMC155396 PMID: 12937509 [PubMed - as supplied by publisher] 30. J Strength Cond Res. 2003 Aug;17(3):509-13. Recovery of maximal isometric grip strength following cold immersion. Douris P(1), McKenna R, Madigan K, Cesarski B, Costiera R, Lu M. Author information: (1)Department of Physical Therapy, New York Institute of Technology, Old Westbury, NY 11568, USA. pdouris@nyit.edu The purpose of this study was to investigate the effects of various cold immersion durations on maximal grip strength and the subsequent recovery of grip strength. Sixteen healthy men between 20 and 42 years of age participated in this study. Maximal isometric grip strength was measured before, immediately after, and 5, 10, and 15 minutes after cold immersion. Subjects submerged their dominant elbow, forearm, and hand in a cold water whirlpool at 10 degrees C for 5, 10, 15, or 20 minutes. There was a significant decrease in isometric grip strength when the forearm was immersed in 10 degrees C water for durations between 5 and 20 minutes and no recovery of this strength loss for a period of 15 minutes following removal from the cold immersion (p = 0.0001). These findings suggest that clinicians should be aware of the alterations in isometric muscle strength that result from utilizing the temperature and time frames of cold application used in this study. PMID: 12930178 [PubMed - indexed for MEDLINE] 31. Eur J Appl Physiol. 2003 Jun;89(5):471-4. Epub 2003 Apr 24. Direct and indirect methods for determining plasma volume during thermoneutral and cold-water immersion. Gordon CJ(1), Fogarty AL, Greenleaf JE, Taylor NA, Stocks JM. Author information: (1)Faculty of Health Science, Australian Catholic University, Sydney, Australia. Plasma volume (PV), determined indirectly from changes in haematocrit (Hct) and haemoglobin concentration ([Hb]), underestimates the absolute PV change (Evans blue dye) during thermoneutral immersion. Since PV changes during cold-water immersion have only been determined indirectly, we hypothesised that a similar underestimation may occur. Therefore, we compared the indirectly-measured PV with a direct-tracer dilution method (Evans blue dye column elution) in seven healthy males, during three, 60-min exposures: air (control; 21.2 degrees C), thermoneutral immersion (34.5 degrees C) and cold-water immersion (18.6 degrees C). During thermoneutral immersion, the directly-measured PV increased by 16.2 (1.4)% (P<0.05) and the indirectly-measured by 8.5 (0.8)% (P<0.05), with the latter underestimating the former by 43 (9.1)% (P<0.05). During cold immersion, the direct PV decreased by 17.9 (3.0)% (P<0.05) and the indirect by 8.0 (1.2)% (P<0.05), with the latter representing a 52 (6.8)% (P<0.05) underestimation of the direct PV change. Directionally-equivalent underestimations of PV change occur when using the indirect method during both thermoneutral and cold-water immersion. The assumptions inherent in the indirect method (constant F-cell ratio) appear to be violated during water immersion. PMID: 12712349 [PubMed - indexed for MEDLINE] 32. Yao Xue Xue Bao. 1998 Sep;33(9):682-7. [Synthesis and antiulcer activity of 3,4-dihydro-hainanensine analogs]. [Article in Chinese] Liu R(1), Gao Y, Zhang S, Liang X. Author information: (1)Institute of Materia Medica, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100050. In order to search for new compounds with new mode of action, high antiulcer activity and lower toxicity, 26(13 pairs of diastereoisomer A and B) 3,4-dihydro-hananensine analogs were synthesized. All compounds were tested in M1 receptor combined assay and gastric ulcer induced by cold-immersion stress in rats. Most compounds showed antiulcer activity, among them IX3A, IX7A, IX8A, IX12A, IX12B and IX13A exhibited more potent antiulcer activity than the control compound cimetidine. Meanwhile, the relationship between their structures and activity was discussed. PMID: 12016872 [PubMed - indexed for MEDLINE] 33. J Neurol Neurosurg Psychiatry. 2001 May;70(5):618-23. Phenotypic variation of a Thr704Met mutation in skeletal sodium channel gene in a family with paralysis periodica paramyotonica. Kim J(1), Hahn Y, Sohn EH, Lee YJ, Yun JH, Kim JM, Chung JH. Author information: (1)Department of Neurology, College of Medicine, Chungnam National University, 640 Daesa-dong, Joong-ku, Taejon, Korea. OBJECTIVES: Patients with paralysis periodica paramyotonica exhibit a clinical syndrome with characteristics of both hyperkalaemic periodic paralysis and paramyotonia congenita. In several types of periodic paralysis associated with hyperkalaemia, mutations in the skeletal muscle sodium channel (SCN4A) gene have been previously reported. Phenotypic variations of mutations in SCN4A, however, have not been described yet. The present study aimed to evaluate genetic variations in a family with clinical and electrophysiological characteristics of paralysis periodica paramyotonia. METHODS: Seven members of a family affected with symptoms of paralysis periodica paramyotonia were studied by electrophysiological and genetic analyses. There were increased serum potassium concentrations in four members during paralytic attacks induced by hyperkalaemic periodic paralysis provocation tests. Short exercise tests before and after cold immersion were carried out in four patients to distinguish electrophysiological characteristics of hyperkalaemic periodic paralysis and paramyotonia. Sequencing analyses of SCN4A were performed on one patient and a normal control to identify polymorphisms. Restriction fragment length polymorphism (RFLP) analysis was then performed at the identified polymorphic sites. RESULTS: Electrophysiological studies showed both exercise sensitivity and temperature sensitivity. Compound motor action potential (CMAP) amplitudes were decreased (7.3%-28.6%) after short exercise tests. The CMAP amplitudes were even more severely decreased (21.7%-56.5%) in short exercise tests after cold exposure. Three polymorphic sites, Gln371Glu, Thr704Met, and Aspl376Asn were identified in SCN4A. RFLP analyses showed that all affected patients carried the Thr704Met mutation, whereas unaffected family members and a normal control did not. CONCLUSION: Phenotypic variation of the Thr704Met mutation, which was previously reported in patients with hyperkalaemic periodic paralysis, is described in a family affected with paralysis periodica paramyotonia. PMCID: PMC1737343 PMID: 11309455 [PubMed - indexed for MEDLINE] 34. Rheumatology (Oxford). 2000 Oct;39(10):1132-8. Effect of SR 49059, a V1a vasopressin receptor antagonist, in Raynaud's phenomenon. Hayoz D(1), Bizzini G, Noël B, Depairon M, Burnier M, Fauveau C, Rouillon A, Brouard R, Brunner HR. Author information: (1)Division of Hypertension and Vascular Medicine, CHUV, Lausanne, Switzerland. OBJECTIVE: To assess whether vasopressin V1a receptor blockade reduces the abnormal vasoactive response to cold in patients suffering from Raynaud's phenomenon (RP). METHODS: SR 49059, an orally active, non-peptidic vasopressin V1a receptor antagonist, was given orally (300 mg once daily) to 20 patients with RP in a single-centre, double-blind, placebo-controlled, randomized cross-over study with two 7-day periods of treatment separated by 21 days of washout. Bilateral finger systolic blood pressure and skin temperature were assessed before and after immersion of the hand in cold water for 3 min (15 degrees C) during the screening phase and three times (before and 2 and 4 h after drug intake) on days 1 and 7 of each of the two treatment periods. Recovery of digital pressure and skin temperature was measured 0, 10, 20 and 32 min after the end of the cold immersion test. RESULTS: SR 49059 significantly attenuated the cold-induced fall in systolic pressure by 14.5% (95% confidence interval 0-29; P = 0.045) on the most affected hand on day 7 compared with placebo. Temperature recovery after the end of the cold test showed a trend to enhancement 2 and 4 h after SR 49059 on day 7 (P = 0.060 and P = 0.062 respectively). The beneficial effects on finger pressure and temperature recovery were obtained without changes in supine blood pressure or in heart rate. CONCLUSION: SR 49059 given orally once a day for 7 days to patients with RP showed favourable effects compared with placebo on finger systolic pressure and temperature recovery after cold immersion, without inducing side-effects. PMID: 11035135 [PubMed - indexed for MEDLINE] 35. Transplantation. 2000 May 15;69(9):1950-3. Beneficial effect of additional cardioplegia flush during hypothermic static cardiac preservation. Hisatomi K(1), Moriyama Y, Yotsumoto G. Author information: (1)Second Department of Surgery, Faculty of Medicine, Kagoshima University, Japan. BACKGROUND: The effects of various preservative solutions and methods have been studied to prolong the safety period of cardiac preservation. In this study, we used cardioplegic solution (CS) during cardiac preservation and investigated how flush CS yields good preservation of isolated hearts compared with only cold immersion. METHODS: Male Wistar rat hearts were arrested with 4 degrees C St. Thomas crystalloid CS. All hearts were immersed for 6 hr in a 4 degrees C Euro-Collins solution. Hearts were classified into seven groups by period and number of infusions of CS (20 ml/kg) during simple immersion of hearts. Infusion of CS during preservation was not used for group I. Infusion was performed at two hours after starting immersion for group II, at 3 hr for group III, at 4 hr for group IV, at 5 hr for group V, every hour for group VI, and every 2 hr for group VII. After preservation, the hearts were reperfused with blood using a support rat. Myocardial adenosine triphosphate was measured immediately after immersion of hearts. Biochemical examination of coronary effluents was performed at 15 min after reperfusion, and cardiac function was evaluated at 40 min after reperfusion. Myocardial specimens were subsequently taken for measurement of water content. RESULTS: Percentage recovery of left ventricular developed pressure and dp/dt in groups III, VI, and VII were higher than those in group I at each balloon volume, and left ventricular end-diastolic pressure in these groups was also significantly lower than that in group I. Levels of creatine kinase-MB and lactate in groups VI and VII after reperfusion were significantly lower than those in group I. Myocardial adenosine triphosphate was significantly better preserved in groups III, IV, VI, and VII than in group I. However, no significant difference in cardiac function or myocardial adenosine triphosphate was found among groups III, IV, VI, and VII. CONCLUSIONS: The use of CS during cardiac preservation is effective in preserving cardiac function and myocardial enzymes, and infusion may be sufficient if performed once-only at 3 or 4 hr from starting immersion in 6 hr storage of isolated rat hearts. PMID: 10830237 [PubMed - indexed for MEDLINE] 36. AJR Am J Roentgenol. 1999 Jun;172(6):1605-9. Doppler spectral waveform analysis of arteries of the hand in patients with Raynaud's phenomenon as compared with healthy subjects. Chikui T(1), Izumi M, Eguchi K, Kawabe Y, Nakamura T. Author information: (1)Department of Radiology and Cancer Biology, Nagasaki University School of Dentistry, Japan. OBJECTIVE: We sought to characterize and compare the blood flow patterns of peripheral arteries of the hand in patients with Raynaud's phenomenon and in healthy subjects. SUBJECTS AND METHODS: We used Doppler sonography to assess the blood flow pattern of the proper palmar digital artery and the deep radial arch in the hands of 79 healthy subjects and 24 patients with primary and secondary Raynaud's phenomenon. We determined the resistive index, pulsatility index, peak systolic velocity, and end-diastolic velocity of these peripheral arteries at rest and after cold immersion. RESULTS: The proper palmar digital artery of healthy subjects showed higher end-diastolic velocities and lower resistive indexes than did the deep radial arch. Compared with healthy subjects, patients with Raynaud's phenomenon had higher resistive and pulsatility indexes but lower peak systolic and end-diastolic velocities in these arteries. Accordingly, the differences in end-diastolic velocity and resistive index seen in the two peripheral arteries of healthy subjects were not seen in patients with Raynaud's phenomenon. Analysis of receiver operating characteristic curves showed high diagnostic accuracy in detecting the disease. Cold-immersion studies revealed that for the proper palmar digital arteries throughout the time after immersion, all these Doppler parameters were significantly lower for the velocities and higher for the indexes in patients with Raynaud's phenomenon than in healthy subjects. CONCLUSION: Taken together, these results suggest a legitimate role for Doppler sonography in the assessment of Raynaud's phenomenon. PMID: 10350298 [PubMed - indexed for MEDLINE] 37. Ophthalmologica. 1999;213(3):150-3. Blood flow velocity in the peripheral circulation of glaucoma patients. O'Brien C(1), Butt Z. Author information: (1)Princess Alexandra Eye Pavilion, Edinburgh, UK. Using the laser Doppler technique we measured finger blood flow velocity in 25 untreated primary open-angle glaucoma (POAG), 22 untreated low-tension glaucoma (LTG) and 19 age-matched normal subjects. Four blood flow measurements were recorded: baseline flow, after immersion in warm water for 2 min (40 degrees C maximum flow), after 10 s exposure to cold water (4 degrees C minimum flow) and time to recover to baseline flow after cold immersion. Significant differences between the LTG group and both the normal and POAG groups were found in a greater maximum flow (p = 0.03 and p = 0.01, respectively), a lower minimum flow (p = 0.04 and p = 0.03, respectively) and a longer recovery time to baseline flow (p = 0. 0001 for both the normal and POAG groups). A longer recovery time to baseline flow (p = 0.008) in POAG was the only difference between the normal and POAG groups. Both glaucoma groups had more systemic vascular disease than normal, and there were more smokers in the POAG group than normals. Subgroup assessment performed with migraine, vascular disease and smoking subjects excluded from the analysis did not alter the overall results. We conclude that systemic vasospasm is a strong feature of low-tension glaucoma. PMID: 10202286 [PubMed - indexed for MEDLINE] 38. Ind Health. 1998 Apr;36(2):171-8. Finger skin temperature and laser-Doppler finger blood flow in subjects exposed to hand-arm vibration. Mirbod SM(1), Yoshida H, Jamali M, Miyashita K, Takada H, Inaba R, Iwata H. Author information: (1)Department of Hygiene, Gifu University School of Medicine, Japan. OBJECTIVES: This study was aimed to assess the peripheral circulatory functions of forestry workers exposed to hand-arm vibration, using simultaneous measurements of finger skin temperature (FST) and finger blood flow (FBF). METHODS: The subjects were five men with vibration-induced white finger (VWF), four subjects with numbness in their hands and five exposed controls without any signs or symptoms related to vibration syndrome. Simultaneous measurements of FST and laser-Doppler FBF were performed before, during and following a 10-min recovery period after the hand was immersed in cold water (10 degrees C, 10 min). Partitional measurements of finger blood flows could be made between the capillaries and deeply located vessels using two laser-Doppler flow probes having narrower and wider optic fiber separations. RESULTS: The FST as well as the FBF of the capillary and deeply located vessels during and following the cold immersion test in those with VWF and in the subjects with numbness had a slight increase immediately following the cold immersion and no tendency to be augmented as the time span increased. After the cold immersion test, the control group had significantly greater FST and FBF compared to other groups. Particularly, from the 5th to the 10th min after the cold provocation, the values of FBF of the deeply located vessels in those with VWF were significantly lower than the controls. During the course of observation, the FST had significantly linear relationship with the recorded capillary and deep FBF values, and that was much closely correlated with the deep FBF (i.e., P < 0.01 in each selected condition). The slope of the regression lines in the capillary were steeper and shallow in the deep FBF. CONCLUSIONS: In addition to the measurement of capillary FBF, more detailed and accurate information on the peripheral circulatory functions of vibration-exposed subjects can be obtained by including the assessment of the deep FBF. PMID: 9583315 [PubMed - indexed for MEDLINE] 39. Clin Auton Res. 1997 Oct;7(5):223-6. Postural hypotension in a patient with cervical myelopathy due to craniovertebral anomaly. Misra UK(1), Kalita J, Kapoor R. Author information: (1)Department of Neurology, Sanjay Gandhi PGIMS, Lucknow, India. ukmisra@sgpgi.ren.nic.in We report a patient with craniovertebral anomaly leading to cervical cord compression who presented with disabling postural hypotension. A 60-year-old electrician presented with progressive weakness of the upper and lower limbs, which had started 7 years previously. He had difficulty in holding urine for the previous year and had blacked out on standing for the past 3 months. He had upper limb wasting and lower limb spasticity, with impaired joint position sense. Autonomic dysfunctions included postural hypotension, absence of sinus arrhythmia, impaired Valsalva ratio, and lack of increase in blood pressure on cold immersion and isometric contraction. Cervical spine radiograph and magnetic resonance imaging revealed atlantoaxial dislocation, Klippel-Feil syndrome and osteophytes, resulting in cord compression at C2-C4. Partial and selective damage to the descending autonomic fibres may be responsible for postural hypotension in this patient. PMID: 9370068 [PubMed - indexed for MEDLINE] 40. Am J Cardiol. 1997 Sep 1;80(5):637-40. Serum endothelin levels and pain perception in patients with cardiac syndrome X and in healthy controls. Cox ID(1), Salomone O, Brown SJ, Hann C, Kaski JC. Author information: (1)Department of Cardiological Sciences, St. George's Hospital Medical School, London, England. The possible algogenic effects of elevated serum endothelin levels in cardiac syndrome X were investigated in a case-control study that examined somatic pain perception in the forearm during submaximal effort tourniquet and cold immersion tests. Pain threshold to both ischemic and cold stimulation of the forearm was demonstrated to be significantly lower in patients with syndrome X than in matched healthy controls, and a negative correlation between ischemic pain threshold and endothelin levels was demonstrated. PMID: 9294999 [PubMed - indexed for MEDLINE] 41. Med Sci Sports Exerc. 1997 Mar;29(3):320-5. Facial cooling-induced bradycardia: attenuating effect of central command at exercise onset. Smith JC(1), Stephens DP, Winchester PK, Williamson JW. Author information: (1)Southwestern University, Department of Kinesiology, Georgetown, TX 78626, USA. smithj@southwestern.edu Facial cooling (FC) elicits a marked bradycardia at rest that appears to be reduced during exercise. This study was done to delineate the effects of exercise mediated central command from those of muscle afferent feedback and sympathetic stimulation on the attenuation of the bradycardic effect of FC during the onset of exercise. Ten healthy subjects (26 +/- 2 yr) were exposed to FC under five different conditions: 1) seated rest on the cycle ergometer, 2) onset of mild exercise (resting HR + 20 beats.min-1), 3) onset of moderate exercise (resting HR + 50 beats.min-1), 4) seated rest on the ergometer during electrical stimulation, and 5) seated rest on the ergometer during a cold immersion test (CT) (one hand immersed in an ice slurry at 0 degree C). The two exercise intensities were presumed to provide different degrees of central command. Electrical stimulation of the quadriceps was assumed to provide isolated muscle afferent feedback, while the CT served as a sympathetic stimulus. Beat-by-beat data were recorded for HR and mean arterial blood pressure for the duration of each test (50 s), and a rating of perceived pain was taken after each FC. FC elicited significant increases in mean arterial pressure during mild and moderate exercise compared with resting control (P < 0.05) and during moderate exercise compared to exercise without FC (P < 0.05). Mean decreases in HR during FC were similar for resting control (-12 +/- 3 beats.min-1), electrical stimulation (-10 +/- 3 beats.min-1), and CT (-9 +/- 3 beats.min-1). The HR response to FC during mild exercise (-7 +/- 2 beats.min-1) was significantly different (P < 0.05) from the rest condition; however, there was no significant bradycardia (-2 +/- 2 beats.min-1; P > 0.05) during onset of moderate exercise. These findings suggest that the magnitude of cold face-induced bradycardia may be attenuated at exercise onset by neural signals related to the higher levels of central motor command associated with heavier exercise. PMID: 9139170 [PubMed - indexed for MEDLINE] 42. Exp Brain Res. 1997 Jan;113(1):81-7. Effect of intrathecal serotonin on nociception in rats: influence of the pain test used. Bardin L(1), Bardin M, Lavarenne J, Eschalier A. Author information: (1)Laboratoire de Pharmacologie Médicale, Faculté de Médecine, Clermont-Ferrand, France. The involvement of serotonin (5-HT) in the modulation of nociceptive impulse in the spinal cord has been widely studied. However, its activity, considering the nature of noxious stimuli and the type of 5-HT receptors involved, merits to be further elucidated. The present behavioural study was performed to compare the dose-antinociceptive effect relationship of 5-HT in rats, after intrathecal (i.t.) injection (10 microliters/rat), using mechanical (paw pressure), thermal (tail immersion and tail-flick) and chemical (formalin) pain tests. In rats submitted to the paw pressure test, 5-HT was found to possess a dose-dependent antinociceptive activity (0.01, 0.1, 1, 10 and 20 micrograms/rat) when vocalization threshold was assessed as a pain parameter. A peak effect occurred 5 min after the injection and the effect was maintained for 45 min. The lowest active dose was 0.1 microgram (maximum increase in vocalization thresholds, 23 +/- 3%) and a plateau was observed for 10 micrograms and 20 micrograms (maximum increase in vocalization thresholds, 72 +/- 7% and 71 +/- 6%, respectively). When paw withdrawal was assessed, 5-HT induced a weak hyperalgesic effect for the highest dose (60 micrograms), while other doses were ineffective. In the tail-immersion (warmth and cold) and tail-flick tests, different doses (0.01, 0.1, 1, 10, 30, 60 and 100 micrograms/rat) were studied. In the two immersion tests, only the highest doses (60 micrograms and 100 micrograms) significantly increased the withdrawal thresholds from 5 to 45 min after the injection. The maximum effect was observed at 5 min (23 +/- 4% and 21 +/- 6% for 60 micrograms; 27 +/- 3% and 30 +/- 6% for 100 micrograms in the warmth and cold immersion test, respectively). In the tail-flick test, the doses of 30, 60 and 100 micrograms/rat dose-dependently and significantly increased the withdrawal thresholds from 5 to 45 min after the injection, with a maximum effect at 5 min (30 +/- 5% for 30 micrograms; 37 +/- 6% for 60 micrograms; and 45 +/- 4% for 100 micrograms). In the formalin test, 5-HT (10, 25, 50, 75 and 100 micrograms/rat) produced dose-related antinociception. The nociceptive response (licking of the injected paw) was significantly reduced from 25 micrograms (-59 +/- 11%) in the early phase, whereas the lowest active dose in the late phase was 50 micrograms (-46 +/- 17%). For both phases, a total inhibition was obtained with 100 micrograms. It is concluded that the effect of 5-HT on pain tests may differ according to the applied stimulus and the parameter assessed; unspecific effects of 5-HT may modify motor reactions to noxious stimuli. Mechanical test (assessment of vocalization) was the most sensitive to 5-HT. These observations are of importance in order to further study the pharmacological mechanisms involved in 5-HT spinally induced antinociception. PMID: 9028777 [PubMed - indexed for MEDLINE] 43. Transplantation. 1996 Oct 15;62(7):884-8. Rat whole-limb viability after cold immersion using University of Wisconsin and Euro-Collins solutions. Yokoyama K(1), Kimura M, Itoman M. Author information: (1)Department of Orthopedic Surgery, Kitasato University School of Medicine, Kanagawa, Japan. The purpose of this study was to compare University of Wisconsin (UW) solution with Euro-Collins (EC) solution in their cold preservation effects on rat limbs. Thirty-six Lewis rat limbs were preserved in EC solution (n=18) or UW solution (n=18) at 4 degrees C for 72 hr, and grafted orthotopically to a syngeneic rat using microsurgical techniques. The surgeon was blinded to the solution used. We evaluated the vascular patency rate and death rate of both groups at day 7 after surgery and performed histological evaluations of bone, muscle, growth plate, and articular cartilage for each specimen of successful grafts in both groups. The vascular patency rates of the EC and UW groups were 27.7% (5/18) and 11% (2/18), respectively, and showed no significant difference. The death rates of the EC and UW groups were 50% (9/18) and 60% (10/18), which were not significantly different. There were no clear differences in histological viability between both groups, in all tissues exclusive of bone marrow and muscle tissue. Our results showed that in comparing EC and UW solutions, one was not significantly superior to the other as a cold immersion storage medium after a 72 hr ischemia-induced reperfusion injury. PMID: 8878378 [PubMed - indexed for MEDLINE] 44. Pflugers Arch. 1996 Jul;432(3):368-72. Changes in thermal homeostasis in humans due to repeated cold water immersions. Janský L(1), Janáková H, Ulicný B, Srámek P, Hosek V, Heller J, Parízková J. Author information: (1)Department of Comparative Physiology, Faculty of Science, Charles University, Vinicná 7, CZ-12800 Prague 2, Czech Republic. The purpose of this study was to monitor changes in body and skin temperatures, heat production, subjective shivering, cold sensation and body fat content in humans after intermittent cold water immersion. Repeated exposures of young sportsmen to cold water (head out, 14 degrees C, 1 h, 3 times per week for 4-6 weeks) induced changes in regulation of thermal homeostasis. "Cold acclimated" subjects exhibited an hypothermic type of adaptation. Central and peripheral body temperatures at rest and during cold immersion were lowered. The metabolic response to cold was delayed and subjective shivering was attenuated. The observed hypothermia was due to the shift of the threshold for induction of cold thermogenesis to lower body temperatures. "Cold acclimated" subjects also showed a lowered cold sensation. Because of the observed physiological changes, about 20% of the total heat production was saved during one cold water immersion of "cold acclimated" subjects. Maximal aerobic and anaerobic performances were not altered. No change in the thermosensitivity of the body temperature controller, as assessed from the unchanged slope of the relation between the deep body temperature and total heat production, was observed. Changes in cold sensation and regulation of cold thermogenesis were noticed first after four cold water immersions and persisted for at least 2 weeks after termination of the adaptation procedure. A trend towards a small increase in the body fat content was also observed. This finding, as well as the increased vasoconstriction, evidenced by the lowered skin temperature, indicate that slight changes in body insulation may also occur after "cold acclimation" in humans. PMID: 8765994 [PubMed - indexed for MEDLINE] 45. Ann R Coll Surg Engl. 1996 Jul;78(4):372-9. Nature and mechanism of peripheral nerve damage in an experimental model of non-freezing cold injury. Irwin MS(1). Author information: (1)Blond McIndoe Centre, Queen Victoria Hospital, East Grinstead. Non-freezing cold injury (NFCI), so called trench foot, is a condition characterised by a peripheral neuropathy, developing when the extremities are exposed for prolonged periods to wet conditions at temperatures just above freezing. Classically, military personnel are affected, with 14% of casualties in the Falklands conflict afflicted. Clinically, NFCI is characterised by a well-defined acute clinical picture and chronic sequelae. Little is known regarding the pathophysiology and treatment of this condition. Opinions vary as to the type of nerve fibres most susceptible to damage and proposed mechanisms of injury include direct axonal damage, ischaemia and ischaemia/reperfusion. A series of investigations has been performed to clarify which populations of nerve fibres are more susceptible to damage, and to elucidate the exact mechanism of nerve injury. An in vivo rabbit hind limb model, subjected to 16 h of cold immersion (1-2 degrees C), provided the basis of this study. Nerve specimens were examined by semi-thin sectioning for myelin fibre counts, by electron microscopy to assess the unmyelinated fibre population, and fine nerve terminals in plantar skin were assessed immunohistochemically. The results showed that large myelinated fibres were preferentially damaged, while small myelinated and unmyelinated fibres were relatively spared. Nerve damage was found to start proximally and extend distally with time. Serial temperature measurements identified a warm-cold interface in the upper tibial region of immersed limbs. As this was the initial site of injury, this suggested that a dynamic balance exists in the cold immersed limb between the protective effects of cooling and the damaging effects of ischaemia. The non-invasive technique of near infrared spectroscopy was used to measure changes in tissue oxygen supply and utilisation and blood volume. The findings supported the hypothesis that an interface is created at the site of initial nerve damage in the upper tibia, where cyclical ischaemia-reperfusion injury occurs. PMCID: PMC2502597 PMID: 8712655 [PubMed - indexed for MEDLINE] 46. Ann Thorac Surg. 1996 Jul;62(1):78-82. Effect of triiodothyronine on graft function in a model of heart transplantation. Votapka TV(1), Canvasser DA, Pennington DG, Koga M, Swartz MT. Author information: (1)Department of Surgery, Saint Louis University Health Sciences Center, Missouri, USA. BACKGROUND: Brain death is associated with neuroendocrine changes that result in impaired metabolism, reduced myocardial energy stores, and deteriorating cardiac function. As a result of these changes, a substantial number of normal human hearts are not considered suitable for transplantation. In the hope of preventing these complications and stabilizing the condition of cardiac donors, we compared the function of transplanted hearts from brain-dead rats that received triiodothyronine (T3) (n = 6) with that of hearts from a group that received a placebo (n = 5). METHODS: This experiment was designed to be both blinded and randomized. Brain death was achieved by bilateral carotid ligation and inflation of an intracranial balloon. Triiodothyronine or placebo was administered in a blinded, randomized fashion. The brain-dead donors were then supported with conventional techniques for 2 hours after which time heterotopic transplantation was performed using hypothermic preservation and a working heart model. Hemodynamics of the transplanted hearts were assessed 48 hours postoperatively. RESULTS: The hearts from donors that had been pretreated with T3 were found to have a significantly higher (p < 0.005) peak left ventricular pressure than the hearts from the placebo-treated group (137 +/- 17 mm Hg versus 115 +/- 15 mm Hg). Left ventricular end-diastolic pressure was significantly lower (p < 0.01) in the T3-treated group (5.2 +/- 2.2 mm Hg) compared with the placebo-treated group (6.9 +/- 0.5 mm Hg). There was also a significantly higher (p = 0.03) maximal first derivative of left ventricular pressure in the T3-treated group compared with the placebo-treated group (4,876 +/- 1,348 mm Hg/s versus 3,344 +/- 1,016 mm Hg/s). Finally, the cardiac output in the group given T3 was 93 +/- 16 mL/min compared with 61 +/- 22 mL/min in the group given the placebo (p < 0.01). CONCLUSIONS: Hearts from brain-dead rats that had received T3 before transplantation showed improved postoperative function. The experimental design of predonation brain death, cold immersion storage, and transplantation in a working heart model should make these data more relevant clinically than those previously reported. PMID: 8678689 [PubMed - indexed for MEDLINE] 47. Neurosci Lett. 1996 Jun 14;211(1):65-7. Sciatic nerve section induces mechanical hyperalgesia in skin adjacent to the deafferented region in rats: lack of correlation with autotomy behavior. Kauppila T(1), Xu XJ. Author information: (1)Department of Physiology, University of Helsinki, Finland. We have studied the development of cutaneous hypersensitivity in the innervation area of the saphenous nerve and autotomy behavior in rats after unilateral sciatic nerve section. Hypersensitivity was assessed by stimulating the saphenous area with mechanical (von Frey hairs and analgesimeter), cold (immersion) or heat (immersion or radiant heat) stimuli 10 days after sciatic nerve section. We did not observe any hypersensitivity to thermal stimulation or weak mechanical stimulation produced by von Frey hairs. A significant decrease in withdrawal threshold to intense mechanical pressure produced by analgesimeter was observed, indicating the possible presence of mechanical hyperalgesia. Eleven of 17 rats had started autotomy at this time, but there was no correlation between the presence of autotomy and mechanical hyperalgesia. It is concluded that in our experimental setting, only mechanical hyperalgesia was present 10 days after axotomy. Moreover, autotomy behavior and adjacent hyperalgesia may be triggered by different mechanisms. PMID: 8809849 [PubMed - indexed for MEDLINE] 48. J Heart Lung Transplant. 1996 May;15(5):475-84. Efficacy of oxygenated University of Wisconsin solution containing endothelin-A receptor antagonist in twenty-four-hour heart preservation. Okada K(1), Yamashita C, Okada M, Okada M. Author information: (1)Department of Surgery, Kobe University School of Medicine, Japan. BACKGROUND: The University of Wisconsin solution has been proven to be effective for prolonged heart preservation. However, 24-hour heart preservation by simple cold immersion in University of Wisconsin solution has been disappointing. We have performed hypothermic low-pressure continuous coronary perfusion with oxygenated University of Wisconsin solution for experimental prolonged heart preservation. However, the high potassium concentration of University of Wisconsin solution combined with prolonged ischemia has detrimental effects on endothelial function, which increases coronary tone during preservation and after reperfusion. The severe vasoconstriction and tissue edema result in damage to the coronary microcirculation. The purpose of this study was to determine whether hypothermic low-pressure continuous coronary perfusion technique with oxygenated University of Wisconsin solution containing a selective endothelin-A receptor antagonist (FR139317) would increase the effectiveness of the perfusion technique and improve postischemic cardiac function, both minimizing tissue edema and suppressing vasoconstriction. METHODS AND RESULTS: Preischemic and postischemic cardiac function of isolated rabbit hearts was evaluated with a Langendorff apparatus. The hearts were divided into three groups (n = 7 each): group I (hypothermic low-pressure continuous coronary perfusion with University of Wisconsin solution), group II (hypothermic low-pressure continuous coronary perfusion with oxygenated University of Wisconsin solution), and group III (hypothermic low-pressure continuous coronary perfusion with oxygenated University of Wisconsin solution containing 10 mg/L of FR139317). Preservation was performed for 24 hours. The initial perfusion pressure for continuous coronary perfusion was set at 5 mm Hg. Measurement of percentage of tissue water content and ultrastructural examination of the myocardium was then performed. In groups I, II, and III, the perfusion pressures at the end of the 24-hour preservation period increased from 5 mm Hg to 12.2 +/- 2.5, 8.1 +/- 1.3, and 5.4 +/- 0.8 mm Hg (p < 0.05), respectively. Percent recovery rate of cardiac output was 56.6 +/- 2.8, 82.3 +/- 8.2, and 93.3 +/- 6.0 (p < 0.05), respectively. And percent recovery rate of coronary flow was 55.5 +/- 8.1, 80.0 +/- 8.0, and 94.3 +/- 9.4 (p < 0.05), respectively. A significant inverse correlation was found between continuous coronary perfusion pressure at the end of preservation and the recovery rate of cardiac output (r = 0.85, p < 0.05). Tissue water content was significantly higher in group I than in groups II and III. These effects were inhibited by oxygenation of the University of Wisconsin solution (group II) and by the addition of the selective endothelin-A receptor antagonist (FR139317) (group III). Damage to coronary circulation was reduced by oxygenation and the addition of endothelin-A receptor antagonist during prolonged heart preservation. CONCLUSIONS: We concluded that hypothermic low-pressure continuous coronary perfusion technique with oxygenated UW solution containing endothelin-A receptor antagonist (FR139317) maintained coronary circulation by suppressing tissue edema and vasoconstriction during preservation, which improved postischemic functional recovery. PMID: 8771503 [PubMed - indexed for MEDLINE] 49. Clin Auton Res. 1996 Apr;6(2):83-9. Cardiovascular adjustments and pain during repeated cold pressor test. Stancák A Jr(1), Yamamotová A, Kulls IP, Sekyra IV. Author information: (1)Department of Physiology and Clinical Physiology, 3rd Medical Faculty, Charles University, Prague, Czech Republic. Andrej.Stancak@lf3.cuni.cz The cold pressor test is used in the clinical testing of the autonomic nervous system. However, little is known about changes in the autonomic control of the cardiovascular system during repeated challenge with cold. Heart rate (HR), respiratory sinus arrhythmia (RSA), T-wave amplitude of ECG (TWA), blood pressure, body temperature and perceived pain were recorded in 18 male subjects during three CPTs which consisted of four minutes immersion of the left hand into cold water at 1 degree C. Breathing during CPT was either spontaneous or paced at 0.23 Hz or 0.1 Hz. Pain intensity and HR decreased and TWA increased during the cold immersion and in the resting period preceding cold in the second and third trials. Systolic and pulse blood pressure increased in resting periods in the third trial. RSA increased in the second and third cold challenge during paced breathing at 0.1 Hz only. A decrease in body temperature (0.48 degree C) at the end of the experiment correlated marginally with HR changes. Our study shows that sustained cardiovascular changes are induced by the first challenge with cold, and persist or increase with repeated cold pressor tests. PMID: 8726092 [PubMed - indexed for MEDLINE] 50. Kurume Med J. 1996;43(1):11-5. A revised cold water immersion test for assessing peripheral circulatory function. Ishitake T(1), Kihara T, Matoba T. Author information: (1)Department of Environmental Medicine, Kurume University School of Medicine, Japan. To improve the conventional cold water immersion test for assessing peripheral circulatory function, the immersed area of the hand was changed in this study. Twenty-seven healthy medical students with a mean age of 24 years participated in the study. The cold water immersion tests were carried out using two methods (in 5 degree C water for 1 min), in which the immersed area was up to the metacarpophalangeal (MP) joints (hereafter, MP-method) which is a new method, or to the wrist (hereafter, W-method) which is a conventional method. The recovery of skin temperature, vibratory perception threshold and complaints of finger pain were determined during cold immersion tests with the two methods. The mean skin temperature for the MP-method after immersion recovered more quickly than that for the W-method. However, the time courses of recovering were parallel for the two methods. Significant differences were noted at 3 min, 5 min and 10 min after cessation of immersion. There was a significant positive correlation in the recovery rates at 5 min after immersion between the two methods (correlation coefficient = 0.65, p < 0.01). The mean vibratory thresholds for the W-method were higher than those for the MP-method, and the difference was significant (p < 0.01). All subjects preferred the MP-method to the W-method because there was less finger pain. These results indicate that the MP-method, immersion up to the MP joint of a hand, for assessing peripheral circulatory function is better than the W-method. PMID: 8709554 [PubMed - indexed for MEDLINE] 51. Br J Sports Med. 1995 Dec;29(4):218-20. Heart or lung failure: what causes exertional, high altitude, and cold immersion pulmonary oedema? Pedoe DT. PMCID: PMC1332228 PMID: 8808531 [PubMed - indexed for MEDLINE] 52. J Athl Train. 1995 Oct;30(4):293-6. Sensory information can decrease cold-induced pain perception. Streator S(1), Ingersoll CD, Knight KL. Author information: (1)Stephen Streator is Graduate Assistant at Indiana State University, Terre Haute, IN 47809. Specific terms are often used to describe the pain athletes typically experience during cold treatments. It is not clear whether providing athletes with such descriptive sensory information will decrease their perceived pain during treatments. The purpose of this study was to determine if subjects' perceptions of cold-induced pain could be influenced by the type of information provided before treatment, such as "pain will be cursing" or "pain will be flickering." Ninety Division I intercollegiate athletes were randomly assigned to one of five groups: traditional terms (cold, burning, aching, numbness), high-level terms (freezing, crushing, pounding, heavy), moderate-level terms (cold, gnawing, pulsing, aching), or low-level terms (cool, pinching, flickering, dull) from the McGill Pain Questionnaire, or no terms at all (control). The four groups that received a set of terms were told that those terms described the sensations they would feel during cold immersion of the ankle. Pain was measured with the McGill Pain Questionnaire every 3 minutes during a 21-minute immersion (1 degrees C) of the foot and ankle. Sensory, affective, evaluative, and miscellaneous pain measures were derived. The control group experienced greater sensory and affective pain than did any of the other groups and experienced greater evaluative pain than did the groups receiving low-level or traditional terms. We conclude that providing athletes with some type of sensory information to describe their cold-pain experience will decrease their perceived pain during cold immersion, although it does not seem to matter what terms are used. PMCID: PMC1317996 PMID: 16558350 [PubMed] 53. Neuroscience. 1995 Aug;67(4):941-51. Influence of the sympathetic nervous system in the development of abnormal pain-related behaviours in a rat model of neuropathic pain. Desmeules JA(1), Kayser V, Weil-Fuggaza J, Bertrand A, Guilbaud G. Author information: (1)INSERM U 161, Unité de Recherches de Physiopharmacologie du Système Nerveux, Paris, France. This study evaluated the effect of surgical sympathectomy on pain-related behaviours in a well established model of peripheral mononeuropathy produced by loose ligatures around the common sciatic nerve in the rat. Behavioural abnormalities include spontaneous abnormal position of the hindpaw after the nerve constriction, indicative of "spontaneous pain", and changes in responses to mechanical or thermal stimuli applied to this paw. These changes are usually maximal at week 2 after the surgery, stable until weeks 3-4, and disappear between weeks 8 and 12. To assess the role of the sympathetic nervous system in the development and persistence of these abnormalities, four groups of rats were behaviourally tested: (i) rats receiving a complete sham surgery, (ii) rats with a sciatic nerve constriction produced by loose ligatures around the common nerve trunk plus a sham sympathectomy, (iii) rats receiving a lumbar sympathectomy with a sham nerve ligature, and (iv) rats receiving a simultaneous surgical lumbar sympathectomy and a sciatic nerve constriction. The efficacy of the sympathectomy was assessed by the measure of the noradrenaline level in the sciatic nerve. Sympathectomy reduced selectively or even prevented the abnormal reaction to cold temperature and to heat (45 degrees C) in rats with a peripheral mononeuropathy. In contrast, the abnormal reaction to mechanical pressure was not influenced, and the behavioural abnormalities indicating spontaneous pain were still present. Sympathectomy alone resulted in a reduction of the vocalization threshold to pressure on both hindpaws, but also a short-lasting increased tolerance to cold immersion. This study confirms the selective role of the sympathetic nervous system in affecting the development and maintenance of some abnormal pain-related behaviours to thermal stimuli in rats with a moderate, but persistent, constriction of one sciatic nerve. PMID: 7675215 [PubMed - indexed for MEDLINE] 54. Int J Biometeorol. 1995 Aug;39(1):40-5. Cardiac output variations in supine resting subjects during head-out cold water immersion. Vogelaere P(1), Deklunder G, Lecroart J. Author information: (1)Hoger Instituut V. Lichamelijke Opvoeding, Vrije Universiteit Brussel, Belgium. Five men, aged 31.2 years (SD 2.3), under semi-nude conditions and resting in a dorsal reclining position, were exposed to thermoneutral air for 30 min, followed immediately by a cold water (15 degrees C) immersion for 60 min. Cardiac output was measured using a dual-beam Doppler flow meter. During immersion in cold water, cardiac frequency (fc) showed an initial bradycardia. The lowest values were reached at about 10 min after immersion, 58.3 (SD 2.5) to 48.3 (SD 7.8) beats min-1 (P < 0.05). By the 20th min of exposure, fc had gradually risen to 70.0 beats min-1 (SD 6.6, P < 0.05). This change could be due to the inhibition of the initial vagal reflex by increased catecholamine concentration. Stroke volume (Vs) was significantly increased (P < 0.05) during the whole cold immersion period. Cardiac output, increased from 3.57 (SD 0.50) to 6.26 (SD 1.33) l min-1 (P < 0.05) and its change with time was a function of both Vs and fc. On the other hand, systolic flow acceleration was unchanged during the period of immersion. The changes in the respiratory variables (ventilation, oxygen uptake, carbon dioxide output and respiratory exchange ratio) during immersion showed an initial hyperventilation followed, as immersion proceeded, by a slower metabolic increase due to shivering. PMID: 7558407 [PubMed - indexed for MEDLINE] 55. J Athl Train. 1995 Mar;30(1):49-52. The effect of a toe cap and bias on perceived pain during cold water immersion. Misasi S(1), Morin G, Kemler D, Olmstead PS, Pryzgocki K. Author information: (1)Sharon Misasi is Program Coordinator of Athletic Training and Assistant Professor at Department of Physical Education, Southern Connecticut State University, New Haven, CT 06515. Cold water immersion is an integral part of acute injury care. Despite tremendous success, the treatment causes discomfort, which may result in noncompliance. Two variables, including use of a neoprene toe cap and prior knowledge of the perceived sensations of pain gained through a therapeutic modalities class, were examined for their effects on the perception of cold. Thirty four subjects were recruited and underwent two 21-minute cold water immersion treatments (14 degrees C). During this time, each subject completed a McGill Pain Questionnaire every 3 minutes. The results from the questionnaire were analyzed using a Stepwise Discriminant Analysis Function with factored categories undergoing multivariate analysis. Factors distinguishing between the perceptions of cold for both variables were identified. The toe cap does reduce pain sensation during cold immersion. Taking a therapeutic modalities class resulted in a higher perception of the sensory component of pain. Those who had not taken such a class tended to score higher in responses to the affective pain component and the categories that represented a combination of pain components. By providing athletes with a greater understanding of perceived pain associated with cold treatments, compliance with treatments should be greater. PMCID: PMC1317828 PMID: 16558308 [PubMed] 56. Yao Xue Xue Bao. 1995;30(2):103-6. [Antiulcer effect of polycyclicamine compound HH01 on experimental gastric ulcer in rats]. [Article in Chinese] Zhang SR(1), Cui GJ, Xu RM, Han C, Guo JY. Author information: (1)Institute of Materia Medica, Chinese Academy of Medical Sciences, Beijing. HH01(1-methyl-3,4,5,6,9,10-hexahydro-7H-cyclopenta [j,k]-1,3-dioxolo [4,5-h]-pyrrolo[2,1-b] [3]-benzazepine) A and B in doses 30 mg.kg-1 and 60 mg.kg-1 were shown to protect gastric mucosa of rats from damage induced by absolute ethanol, cold-immersion stress and pylorus ligation. No effect was found in indomethacin model in mice. HH01 was found to decrease secretion of gastric juice and HCl in pylorus ligated rats. The content of DNA in gastric juice of animals treated with HH01 was lower than in control. The results suggest that HH01 is effective as an anti-ulcer agent, but its mechanism of action is yet unknown. PMID: 7785432 [PubMed - indexed for MEDLINE] 57. Clin Auton Res. 1994 Oct;4(5):257-61. Reflex cutaneous vasoconstriction during cold pressor test is mediated through alpha-adrenoceptors. Frank SM(1), Raja SN. Author information: (1)Department of Anesthesiology and Critical Care Medicine, Johns Hopkins Medical Institutions, Baltimore, MD 21287. The effects of the cold pressor test on the coronary circulation have been clearly defined but the effects on the peripheral vasculature are less well understood. To measure the peripheral vasomotor response during cold pressor test perfusion in the upper extremity contralateral to the cold immersion was assessed by laser Doppler flowmetry and skin-surface temperature gradients. To identify the mechanism of vasoconstriction, cold pressor test was performed before and after the administration of phentolamine, an alpha-adrenoceptor antagonist. Vasoconstriction during cold pressor test was demonstrated by both skin-surface temperature gradients and by laser Doppler flowmetry. This vasoconstrictor response was significantly attenuated by the administration of phentolamine. The results demonstrate that the cold pressor test induces an alpha-adrenoceptor mediated vasoconstriction in the peripheral vasculature. PMID: 7888745 [PubMed - indexed for MEDLINE] 58. J Allergy Clin Immunol. 1994 Feb;93(2):501-9. Tumor necrosis factor-alpha release during systemic reaction in cold urticaria. Tillie-Leblond I(1), Gosset P, Janin A, Dalenne R, Joseph M, Wallaert B, Tonnel AB. Author information: (1)INSERM, CJF 90.06, Institut Pasteur, Lille, France. Primary cold urticaria (PCU) characterized by the association of urticaria, angioedema, and sometimes a shock-like reaction after cold exposure, is usually considered to be linked with histamine and prostaglandin D2 release by mast cells. To determine the involvement of cytokines, we studied the release of tumor necrosis factor-alpha (TNF-alpha) in the blood of the efferent vein after immersion of the hand in chilled water. Five patients with PCU were compared with a control population (three patients with nonphysical urticaria and three healthy subjects). Among patients with PCU who underwent the cold immersion test, two exhibited a shock-like reaction with a large urticarial plaque (patients 1 and 2), one had only a mild cutaneous reaction, and two had no reaction. Patient 1 was reevaluated after 6 months of treatment with H1 and H2 antihistamines: he did not respond to this challenge. All controls were strictly negative. Histamine was released within the first minute after the challenge in the three patients with PCU, but at a higher level for the two patients who had a systemic reaction. TNF-alpha was undetectable in the blood of the patient with only a mild cutaneous reaction, whereas TNF-alpha release was observed for the two patients with a systemic reaction, 2 and 6 minutes after the end of the cold immersion test. The two other patients and the control subjects released neither histamine nor TNF-alpha. In parallel, pathologic and immunohistochemical (with a rabbit anti-TNF-alpha antibody) studies were performed on skin biopsy specimens collected 10 minutes after ice-cube test.(ABSTRACT TRUNCATED AT 250 WORDS) PMID: 7509821 [PubMed - indexed for MEDLINE] 59. Eur J Appl Physiol Occup Physiol. 1994;68(2):134-8. Digital and brachial artery blood pressure measurements during peripheral, cold-induced vasoconstriction. Stroud MA(1), James DP, Railton D, Sowood PJ. Author information: (1)RAF Institute of Aviation Medicine, Farnborough, Hants, England. Measurements of digital artery blood pressure made using an automated photoplethysmographic method (Finapres), in the middle finger of the left hands of nine male subjects, were compared with pressure measures in the right brachial artery using a method relying on the abolition of Karotkoff sounds during occlusion of the upper arm by a pressure cuff (Dinamap), during a 40-min immersion of the hand in cold (4 degrees C) and thermoneutral (32 degrees C) water. Blood flow in the left index finger was assessed and temperatures of the left and right ring fingers were also measured. Before immersion, systolic pressures in the digital artery were higher than systolic pressures in the brachial artery (P < 0.05), whereas the corresponding diastolic measurements were similar. However, both systolic (P < 0.01) and diastolic (P < 0.05) digital artery measurements increased with time. During cold immersion both systolic and diastolic pressures increased at both sites (P < 0.01), although the digital artery systolic readings rose sharply and then declined, whereas the brachial artery readings were stable. The cold-immersed digital artery diastolic measurements were greater than the brachial artery measurements (P < 0.01) and showed a continuation of the upward trend noted prior to immersion (P < 0.01). Thermoneutral diastolic digital artery measurements also showed this continued trend (P < 0.001). Some individual photoplethysmograph assessments of index finger blood flows showed intermittent vasodilatation, but cold immersion caused a decline in mean flow to 22% of pre-immersion value at 15 min, followed by an increase to 40%.(ABSTRACT TRUNCATED AT 250 WORDS) PMID: 8194542 [PubMed - indexed for MEDLINE] 60. Zhen Ci Yan Jiu. 1994;19(2):72-4. [Influence of stress on gastroenteric electric activity and modulated effect of acupuncture on it in rats]. [Article in Chinese] Xu G(1). Author information: (1)Institute of Acupuncture and Meridian, Anhui College of TCM. Experiments were performed in SD rats. Three pairs of bipolar electrode were implanted surgically on the antrum, ascending and descending colon of rats. The stress model was induced by restraint cold immersion (4 degrees C Water, 30-40 min.). The modulating effect of Zusanli ST36 acupuncture on gastroenteric electric activity was investigated. The inhibitory effects of gastro-colon electric activity were obviously displayed in stress rats, such as the frequency and amplitude of slow wave were reduced, rhythmic disorder, degree of dispersion was enlarged, fast wave was decreased and the IDMEC phase III was prolonged or disturbed. Acupuncture of Zusanli could effectively reduce the inhibition effect of gastro-colon electric activity induced by stress in rats. PMID: 7750183 [PubMed - indexed for MEDLINE] 61. Int J Biometeorol. 1993 Dec;37(4):218-21. Effect of local cooling on skin temperature and blood flow of men in Antarctica. Naidu M(1), Sachdeva U. Author information: (1)Department of Physiology, All India, Institute of Medical Sciences, Ansari Nagar, New Delhi. Alterations to the finger skin temperature (Tsk) and blood flow (FBF) before and after cold immersion on exposure to an Antarctic environment for 8 weeks were studied in 64 subjects. There was a significant fall in Tsk and increase in finger blood flow after 1 week of Antarctic exposure. The Tsk did not further change even after 8 weeks of stay in Antarctica but a significant increase in FBF was obtained after 8 weeks. The cold immersion test was performed at non-Antarctic and Antarctic conditions by immersing the hand for 2 min in 0-4 degrees C cold water. In the non-Antarctic environment the Tsk and FBF dropped significantly (P < 0.001) indicating a vasoconstriction response. Interestingly after 8 weeks of stay in Antarctic conditions, the skin temperature dropped (P < 0.001) but the cold induced fall in FBF was inhibited. Based on these observations it may be hypothesized that continuous cold exposure in Antarctica results in vasodilatation, which overrides the stronger vasoactive response of acute cold exposure and thus prevents cold injuries. PMID: 8112880 [PubMed - indexed for MEDLINE] 62. J Thorac Cardiovasc Surg. 1993 May;105(5):805-14; discussion 814-5. Bless the babies: one hundred fifteen late survivors of heart transplantation during the first year of life. The Loma Linda University Pediatric Heart Transplant Group. Bailey LL(1), Gundry SR, Razzouk AJ, Wang N, Sciolaro CM, Chiavarelli M. Author information: (1)Department of Surgery, Loma Linda University and Medical Center, CA 92354. There is a rapid growth of interest in heart transplantation therapy during early infancy. From 10% to 25% of the infants who are listed for transplantation annually have died while awaiting a donor heart. There has been no significant trend in this variable. Since November 1985, 140 consecutive orthotopic transplantation procedures were performed in 139 infants who were from 3 hours to 12 months of age. Indications for transplantation included hypoplastic left heart syndrome (63%), other complex structural anomalies (29%), myopathy (6.5%), and tumors (1.5%). Most recipients had ductus-dependent circulation and received continuous infusion of prostaglandin E1. Heart donors were usually victims of trauma, sudden infant death, or birth asphyxia. A donor-recipient weight ratio of 4.0 or less was found to be acceptable. The amount of time the graft underwent cold ischemia, ranged from 64 to 576 minutes. The procurement process was facilitated by a single dose of cold crystalloid cardioplegic solution and cold immersion transport. Profound hypothermic circulatory arrest was used for graft implantation. One hundred twenty-four (89%) recipients survived transplantation and were discharged from the hospital. There were 9 late deaths, which resulted in an 83% overall survival. The 5-year actuarial survival is 80%. The survival among newborn recipients (n = 60) at 5 years is 84%. Chronic immunomodulation was cyclosporine-based and steroid-free. Surveillance was noninvasive and relied heavily on echocardiography, electrocardiography, and clinical intuition. There was one documented late lethal infection, tumor was not encountered, and coronary occlusive disease was known to exist in only one long-term survivor. We concluded that transplantation results in excellent life quality and is a highly effective and durable therapy when applied during early infancy. PMID: 8487560 [PubMed - indexed for MEDLINE] 63. Plast Reconstr Surg. 1993 Apr;91(5):865-70; discussion 871. The radial forearm flap donor site: should we vein graft the artery? A comparative study. Meland NB(1), Core GB, Hoverman VR. Author information: (1)Section of Plastic and Reconstructive Surgery, Mayo Clinic, Rochester, Minn. Controversy exists in the literature regarding reconstruction of the radial artery after elevation of the radial forearm flap. The literature suggests that reconstructing the radial artery with a vein graft is an important aspect in the use of this flap. In our experience, this has never been performed with no sequela. We examined 13 consecutive patients who underwent radial forearm flaps for head and neck reconstruction over a 28-month period. The patients were examined and questioned about the function of their upper extremities in hope of evaluating the postoperative vascular status in each. Median follow-up was 6 months, with a range of 1 month to 24 months. No patient had preexisting trauma or congenital abnormality of either arm, so that the nondonor arm could be considered as a control for each patient. Evaluation consisted of history and physical examination. The following parameters in each patient were carefully accumulated: grip strength, cutaneous blood flow measured by using a laser Doppler flowmeter, transcutaneous oxygen levels, digital/brachial blood pressure ratios, cutaneous temperature from thumb/index and thumb/small pinch, and rapid rewarming at 1-minute and 5-minute intervals after cold immersion for 2 minutes. The radial forearm flap was elevated in each patient in the nondominant extremity. Grip strengths ranged from 19 to 77 kg, with a median of 30 kg. Early rewarming of the thumb/index was also an average of 1.5 degrees less than the temperature in the control arm and was statistically significant to (p = .01).(ABSTRACT TRUNCATED AT 250 WORDS) PMID: 8460190 [PubMed - indexed for MEDLINE] 64. Clin Physiol. 1993 Mar;13(2):209-16. Chloroquine reduces blood pressure and forearm vascular resistance and increases forearm blood flow in healthy young adults. Anigbogu CN(1), Adigun SA, Inyang I, Adegunloye BJ. Author information: (1)Department of Physiology, College of Medicine, University of Lagos, Idi-Araba, Nigeria. The effects of chloroquine on resting blood pressure, forearm blood flow (FBF), and forearm vascular resistance (FVR) and on the responses to cold stimulation were studied in healthy young adults. Chloroquine sulphate (800 mg) reduced systolic pressure and increased FBF (P < 0.05) but had no effect on resting FVR. Cold immersion increased systolic pressure (from 108.8 +/- 1.7 mmHg to 127.8 +/- 6.9 mmHg; P < 0.05) diastolic pressure (from 73.4 +/- 2.7 to 95.2 +/- 6.2 mmHg; P < 0.01) and FVR (from 5.9 +/- 0.9 to 13.0 +/- 1.9 a.u.; P < 0.001) but reduced FBF (from 14.3 +/- 1.64 to 10.1 +/- 1.29 ml min-1; P < 0.05). Chloroquine reduced the increase in FVR reduced by cold stimulation (P < 0.01), but had little effect on the BF and FBF responses to cold stimulation. The hypotensive effect of chloroquine could be attributed, at least in part, to the observed fall in vascular resistance. PMID: 8453873 [PubMed - indexed for MEDLINE] 65. Int J Biometeorol. 1993 Feb;37(1):27-31. Effects of high altitudes on finger cooling test in Japanese and Tibetans at Qinghai Plateau. Takeoka M(1), Yanagidaira Y, Sakai A, Asano K, Fujiwara T, Yanagisawa K, Kashimura O, Ueda G, Wu TY, Zhang Y. Author information: (1)Department of Environmental Physiology, Shinshu University School of Medicine, Matsumoto, Japan. The influences of both hypobaric hypoxia and cold on peripheral circulation were studied using the finger cooling test (measurement of the decrease in finger temperature, measured at the dorsal surface of the finger, during immersion of the hand in 0 degrees C water for 20 min) at Qinghai Plateau. The same test was carried out at simulated altitudes in a 25 degrees C climatic chamber to separate the hypobaric hypoxia influence from that of cold. In Japanese subjects at Qinghai Plateau there was a significant difference between finger skin temperatures (FSTs) during 20 min of 0 degrees C water immersion at altitudes of 2260 m and 4860 m by ANOVA. Mean finger skin temperature during the 20-min immersion (5-20 min, MST) measured at 4860 m was significantly lower than that at 2260 m. In Tibetan subjects, there was also a significant difference between FSTs at 2260 m and at 4860 m by ANOVA. MST at 4860 m tended to be lower than that at 2260 m. In the 25 degrees C climatic chamber, there was a significant difference between FSTs of Japanese expedition members at 2000 m and at 4000 m by ANOVA. MST was higher at 4000 m than at 2000 m, contrary to the data obtained in Qinghai. In conclusion, the higher skin temperature in response to local cold immersion, which would have been caused by stronger hypobaric hypoxia, must have been masked by the lower ambient temperature. PMID: 8468096 [PubMed - indexed for MEDLINE] 66. Aviat Space Environ Med. 1992 Dec;63(12):1077-81. Decrement in manual arm performance during whole body cooling. Giesbrecht GG(1), Bristow GK. Author information: (1)Laboratory for Exercise and Environmental Medicine, Faculty of Physical Education and Recreation Studies, University of Manitoba, Winnipeg, Canada. Six subjects performed three manual arm tasks: 1) prior to immersion in 8 degrees C water; 2) soon after immersion to the neck, but prior to any decrease in core temperature; and 3) every 15 min until core temperatures decreased 2-4.5 degrees C. The tasks were speed of flexion and extension of the fingers, handgrip strength and manual dexterity. There was no immediate effect of cold immersion; however, all scores decreased significantly after core temperature decreased 0.5 degrees C. Further decrease in core temperature was associated with a progressive impairment of performance, although at a slower rate than during the first 0.5 degrees C decrease. Flexion and extension of the fingers was affected relatively more than handgrip strength or manual dexterity. Decrement in performance is a result of peripheral cooling on sensorimotor function with a probable additional effect of central cooling on cerebral function. PMID: 1456919 [PubMed - indexed for MEDLINE] 67. Sangyo Igaku. 1992 Nov;34(6):560-4. [A 4 degrees C-1 min method of cold water immersion test for peripheral circulatory function in fingers]. [Article in Japanese] Ishitake T(1), Nakagawa K, Iwamoto J, Mori C, Matoba T. Author information: (1)Department of Environmental Medicine, Kurume University School of Medicine. To assess the validity of a new simplified cold water immersion test (4 degrees C-1 min method) for peripheral circulatory function, comparison was made with the conventional method (10 degrees C-10 min method). These two different methods of cold immersion test were applied to 23 patients with vibration disease and 24 healthy men. Observation was made on finger skin temperature by a thermistor and complaints in the hand by a 5-step self-reported scale method every minute during the test. The patterns of recovery of skin temperature after cold immersion in each group were similar in both methods. Pain in the hand in the 4 degrees C-1 min method was less than that in the 10 degrees C-10 min method. The recovery rate at 5 min in the patients with Raynaud's phenomenon was lower than that in those without Raynaud's phenomenon in the 4 degrees C-1 min method (p < 0.01). However, no significant differences were noted in 10 degrees C-10 min method. The results suggest that the new method is feasible in detecting the response of vasodilation after immersion. In the recovery rate at 5 min after immersion, near values of the sensitivity and specificity were observed between 50% cut-off values in the 4 degrees C-1 min method and 30% value in the 10 degrees C-10 min method. Thus, the 4 degrees C-1 min method is considered to be more useful to evaluate the physiological response after cold immersion than the 10 degrees C-10 min method. PMID: 1460787 [PubMed - indexed for MEDLINE] 68. J Athl Train. 1992;27(3):231-4. Sensory perception of the foot and ankle following therapeutic applications of heat and cold. Ingersoll CD, Knight KL, Merrick MA. Many athletes are treated with hot and cold modalities prior to therapeutic exercise, but the effects of these treatments on sensory perception are not clear. The purpose of this study was to examine the effects of hot and cold treatments on sensory perception. We recruited 21 volunteer subjects, who reported for testing on three separate occasions. One of three treatments was applied to the left ankle and foot each day for 20 minutes: cold immersion, hot immersion, or quiet sitting (control). Three variables were measured following treatment: topagnosis, two-point discrimination, and one-legged balance. We assigned treatments and the testing order according to a Greco Latin square. Data were analyzed using a multivariate analysis of variance (MANOVA). No significant differences were detected for the three dependent measures, suggesting that therapeutic applications of heat and cold do not affect sensory perception. These findings indicate that heat and cold applications can be used prior to therapeutic exercise programs without interfering with normal sensory perception as do other analgesic and anesthetic agents. For example, the hypalgesic effect of cold, which is essential to cryokinetics, can be realized without fear of altered sensory perception. PMCID: PMC1317251 PMID: 16558166 [PubMed] 69. J Athl Train. 1992;27(3):218-22. Habituation to the perception of the qualities of cold-induced pain. Ingersoll CD, Mangus BC. This study was conducted in order to measure the reported pain caused by cold immersions over a 5-day period to determine if habituation to the perception of cold pain occurs. Numerous authors have described a habituation phenomenon to therapeutic ice bath immersions. Athletic trainers often explain to athletes that their perceptions of the pain induced by a therapeutic ice bath will decrease each day as they proceed through therapy. Essentially, it is assumed that there is a habituation to the perception of cold-induced pain shortly after initiation of the treatment regime. The subjects were 22 male and female college students who had limited experience with cold immersion. The subjects' right feet and ankles were immersed in an ice bath for 21 minutes on 5 consecutive days followed by a 21-minute recovery period. The McGill Pain Questionnaire (MPQ) was used to measure pain during the immersions. Sensory, affective, evaluative, and miscellaneous qualities of pain were determined from the MPQ. During the testing session, each subject completed the MPQ 30 seconds following immersion and then every 3 minutes until completion of the test. Repeated measures analyses of variance (ANOVAs) adjusted according to the Bonferroni correction revealed no significant differences for any of the qualities of pain over a 5-day period. The subjects' perception of cold-induced pain did appear to decrease during the immersion and there was a trend towards decreasing pain during day five, but a habituation effect was not documented in this study. PMCID: PMC1317249 PMID: 16558164 [PubMed] 70. Eur J Appl Physiol Occup Physiol. 1992;64(2):127-33. Blood flow and muscle bio-energetics by 31P-nuclear magnetic resonance after local cold acclimation. Savourey G(1), Clerc L, Vallerand AL, Leftheriotis G, Mehier H, Bittel JH. Author information: (1)Centre de Recherches, Service de Santé des Armées, Unité de Thermophysiologie, La Tronche, France. To clarify the origin of local cold adaptation and to define precisely its influence on muscle bio-energetics during local exercise, five subjects were subjected to repeated 5 degrees C cold water immersion of the right hand and forearm. The first aim of our investigation was therefore carried out by measuring local skin temperatures and peripheral blood flow during a cold hand test (5 degrees C, 5 min) followed by a 10-min recovery period. The 31P by nuclear magnetic resonance (31PNMR) muscle bio-energetic changes, indicating possible heat production changes, were measured during the recovery period. The second aim of our investigation was carried out by measuring 31PNMR muscle bioenergetics during handgrip exercise (10% of the maximal voluntary contraction for 5 min followed by a 10-min recovery period) performed both at a comfortable ambient temperature (22 degrees C; E) and after a cold hand test (EC), before and after local cold adaptation. Local cold adaptation, confirmed by warmer skin temperatures of the extremities (+30%, P less than 0.05), was related more to an increased peripheral blood flow, as shown by the smaller decrease in systolic peak [-245 (SEM 30) Hz vs -382 (SEM 95) Hz, P less than 0.05] than to a change in local heat production, because muscle bioenergetics did not vary. Acute local cold immersion decreased the inorganic phosphate:phosphocreatine (PC) ratio during EC compared to E [+0.006 (SEM 0.010) vs +0.078 (SEM 0.002) before acclimation and +0.029 (SEM 0.002) vs +0.090 (SEM 0.002) after acclimation respectively, P less than 0.05] without significant change in the PC:beta-adenosine triphosphate ratio and pH. Local adaptation did not modify these results statistically. The recovery of PC during E increased after acclimation [9.0 (SEM 0.2) min vs 3.0 (SEM 0.4) min, P less than 0.05]. These results suggested that local cold adaptation is related more to peripheral blood flow changes than to increased metabolic heat production in the muscle. PMID: 1555558 [PubMed - indexed for MEDLINE] 71. J Pediatr Surg. 1991 Apr;26(4):429-32; discussion 432-3. Living-related lobar lung transplantation in beagle puppies. Backer CL(1), Ohtake S, Zales VR, LoCicero J 3rd, Michaelis LL, Idriss FS. Author information: (1)Division of Cardiovascular-Thoracic Surgery, Children's Memorial Hospital, Chicago, IL 60614. Unilateral lung transplantation has provided effective short-term therapy in adults with end-stage lung disease. Rejection continues to be the most common cause of transplant failure. Living-related lung transplantation may decrease the recipient immune response. The purpose of this study is to test the technical and physiological feasibility of living-related lobar lung transplantation from adult beagles into beagle puppies in a chronic model. Twenty purebred adult beagle donors underwent left thoracotomy with harvest of the left lower lobe using cold perfusion of the pulmonary artery and cold immersion. Twenty recipient purebred beagle puppies from the same colony underwent left thoracotomy, left pneumonectomy, and implantation of the donor adult lobe. Anastomoses were performed in sequence: pulmonary vein to left atrium, bronchus, pulmonary artery. Postoperative immunosuppression was with Cyclosporine. Respiratory function of the implanted lobe was evaluated by pulmonary angiography and during balloon occlusion of the right pulmonary artery with arterial blood gases 1 month after transplantation. Ten recipient puppies died of rejection (4), infection (3), or bronchial dehiscence (3) prior to angiography. Seventeen pulmonary angiograms in 10 surviving animals showed normal left pulmonary arterial blood flow (2), diminished left pulmonary arterial flow (5), and occluded left pulmonary artery (3). In two recipients balloon occlusion of the right pulmonary artery was performed and respiratory function was maintained solely by the transplanted lobe for 2 days in one recipient and for 30 minutes at 1 month and 2 months postimplant in a second recipient. Living-related lung transplantation of adult beagle lobes into pneumonectomized beagle puppies is technically feasible. High mortality rates in a chronic model are related to infection and rejection.(ABSTRACT TRUNCATED AT 250 WORDS) PMID: 2056403 [PubMed - indexed for MEDLINE] 72. Eur J Appl Physiol Occup Physiol. 1991;62(2):135-9. Effect of cold stress on gallbladder contractility in humans. Jonderko G(1), Jonderko K, Końca A, Gałaszek M, Koterla W, Gałaszek Z. Author information: (1)Fourth Department of Internal Diseases, Silesian School of Medicine, Tychy, Poland. The effect of cold stress in the form of repeated hand immersion in ice cold water or repeated application to a hand of extremely cold - nitrogen gas, at a temperature of -180 degrees C (93 K), on the emptying of a meal-stimulated gallbladder was examined in seven healthy volunteers of both sexes. The control procedure consisted of repeated application to a hand of air at neutral temperatures (+35 degrees(-)+37 degrees C). Each subject underwent three examinations on separate days, the procedures being applied in random order. Gallbladder volume was measured by means of real-time ultrasonography. Measurements of volumes of the fasted gallbladder were also made on the three study days and gave similar values: 20.3 cm3, SEM 2.7 (control), 22.1 cm3, SEM 2.5 (cryotherapy), and 20.0 cm3, SEM 2.5 (cold immersion), F(2, 12) = 2.47, P greater than 0.1. A significant delaying effect of cold stress on postprandial gallbladder contractility was observed: F(2, 72) = 7.44, P less than 0.005, and F(2, 72) = 4.45, P less than 0.025 for gallbladder volume and ejection fraction, respectively. A significant difference was detected between the local application of cold gas and the control procedure (P less than 0.005) and local cryotherapy and the cold pressor test (P less than 0.05) in the case of the postprandial gallbladder volume, as well as between the local application of cold gas and the control procedure (P less than 0.025) for the ejection fraction.(ABSTRACT TRUNCATED AT 250 WORDS) PMID: 2022202 [PubMed - indexed for MEDLINE] 73. Eur J Appl Physiol Occup Physiol. 1991;62(6):445-9. The combined effect of the cold pressor test and isometric exercise on heart rate and blood pressure. Peikert D(1), Smolander J. Author information: (1)Bundesanstalt für Arbeitsmedizin, Berlin, Federal Republic of Germany. The purpose of this study was to determine if the cold pressor test during isometric knee extension [15% of maximal voluntary contraction (MVC)] could have an additive effect on cardiovascular responses. Systolic and diastolic blood pressures, heart rate and pressure rate product were measured in eight healthy male subjects. The subjects performed the cold pressor tests and isometric leg extensions singly and in combination. The increases of systolic and diastolic blood pressure during isometric exercise were of almost the same magnitude as those during the cold pressor test. The responses of arterial blood pressure, and heart rate to a combination of the cold pressor test and isometric knee extension were greater than for each test separately. It is suggested that this additional effect of cold immersion of one hand during isometric exercise may have been due to vasoconstriction effects in the contralateral unstressed limb. In summary, the circulatory effects of the local application of cold during static exercise at 15% MVC were additive. PMID: 1893909 [PubMed - indexed for MEDLINE] 74. Minerva Endocrinol. 1990 Oct-Dec;15(4):231-3. [Cardiovascular response to the cold test in obese subjects. Effect of a hypocaloric, normal sodium diet]. [Article in Italian] De Simone G(1), Mancini M, Turco S, Marotta T, Gaeta I, Iannuzzi R, Ferrara LA, Mancini M. Author information: (1)Istituto di Medicina Interna e Malattie Dismetaboliche, II Facoltà di Medicina e Chirurgia, Università di Napoli. Loss of weight in obese patients, both hypertensive and normotensive, causes a fall in blood pressure (BP) through a mechanism which is still not fully understood. The effects of a low-sodium low-energy diet on BP were assessed in 20 obese subjects (15 M and 5 F; age 26-65 years), 11 of whom were normotensive and 9 hypertensive. Following a period of normocaloric diet, a diet of 600 kcal was prescribed for 6 months. BP and heart rate (HR) were measured at the start and end of hypocaloric diet in resting conditions and during stimulation of the adrenergic nervous system (ANS) obtained by exposure to cold (immersion of the hand in water and ice). A reduction of resting BP (from 137/81 +/- 5/4 to 122/74 +/- 4/4 mmHg, p less than 0.05) was observed in 8 patients who lost at least 30% of excess weight (from kg 107 +/- 6 to 91 +/- 4, p less than 0.001) together with an increase in BP during exposure to cold (from 140/82 +/- 3/3 to 156/95 +/- 7/4 mmHg before and from 120/78 +/- 3/4 to 140/88 +/- 3/3 after the diet, p less than 0.05). No changes were found in the daily urinary excretion of Na during the course of diet therapy. These results demonstrate that a hypocaloric diet, independent of saline restriction, is able to reduce resting BP and pressure peaks during adrenergic stimulation. PMID: 2099990 [PubMed - indexed for MEDLINE] 75. Aviat Space Environ Med. 1989 Aug;60(8):769-73. Protection provided against the initial responses to cold immersion by a partial coverage wet suit. Tipton MJ(1), Vincent MJ. Author information: (1)Institute of Naval Medicine, Gosport, Hampshire, England. The protection provided against the initial responses to cold water immersion by a partial coverage wet suit was assessed. Eighteen subjects performed three 2-min immersions into water at 5 degrees C. During each immersion, the subjects wore either: a) cotton overall, b) trunk and arms "wet" immersion suit, or c) "dry" immersion suit. Results showed that the dry suit provided significantly (p less than 0.05) greater protection against the initial cardiac and ventilatory responses to immersion than either the wet suit or cotton overall assemblies. The responses recorded in the wet suit were similar to, and in some cases did not differ from, the cotton overall. We conclude that immersion suit design and tests should consider all of the responses associated with accidental cold water immersion and not just those resulting in a fall in core temperature. PMID: 2775133 [PubMed - indexed for MEDLINE] 76. Aviat Space Environ Med. 1989 Jul;60(7):715. Cold weather or cold immersion induced reduction of circulation within the distal extremities. Morey WA, Blackwell OG. PMID: 2764854 [PubMed - indexed for MEDLINE] 77. Br Heart J. 1989 Apr;61(4):344-7. Transmitral velocities measured by pulsed Doppler in healthy volunteers: effects of acute changes in blood pressure and heart rate. Smith SA(1), Stoner JE, Russell AE, Sheppard JM, Aylward PE. Author information: (1)Department of Medicine, Flinders Medical Centre, Bedford Park, South Australia. Comment in Br Heart J. 1989 Nov;62(5):415. The effect of a two minute cold pressor test on transmitral velocities measured by pulsed Doppler was studied in 11 healthy volunteers. Blood pressure increased significantly during cold immersion but peak atrial and peak early diastolic transmitral velocities and their ratio (A:E) were unchanged. There was no correlation between changes in Doppler variables and changes in calculated mean arterial blood pressure during the test. Heart rate changes were variable and not related to changes in blood pressure. In individual people the change in pulse interval during cold immersion was significantly and inversely correlated with the change in the A:E ratio. The large acute increase in arterial pressure seen during the cold pressor test in normal volunteers had no consistent effect on the transmitral velocity profile although small changes in heart rate were associated with large changes in A:E ratio. The effect of small changes in heart rate may be of considerable importance in determining transmitral velocity profiles. Thus in clinical and experimental studies in which the heart rate is not controlled, Doppler data on transmitral flow should be interpreted with caution. PMCID: PMC1216674 PMID: 2653392 [PubMed - indexed for MEDLINE] 78. J Vasc Surg. 1989 Feb;9(2):317-27. Upper extremity arterial injury in athletes. McCarthy WJ(1), Yao JS, Schafer MF, Nuber G, Flinn WR, Blackburn D, Suker JR. Author information: (1)Department of Surgery, Northwestern University Medical School, Chicago, IL 60611. Between 1983 and 1986, 23 athletes were evaluated for arm and hand complaints. Eleven players had symptoms of thoracic outlet compression. Severe arm fatigue (eight patients) and finger ischemia (three patients) were the presenting symptoms. In the remaining 12 athletes, symptoms of hand ischemia were predominant. Noninvasive testing with Doppler ultrasonography and duplex scanning (positional testing and finger systolic pressure recording) and cold immersion were used to aid in diagnosis. In the 11 athletes with thoracic outlet compression, arteriography confirmed the finding with compression of the subclavian artery in five, the axillary artery in one, both subclavian and axillary arteries in two, posterior humeral circumflex artery in one, and subclavian aneurysm in two. Compression of the suprascapular artery was identified in four, the subscapular artery in two, and the posterior humeral circumflex artery in one. Thrombosis of a first baseman's ulnar artery and occlusion of the palmar arch in a frisbee player were documented by arteriography. Decompression of the thoracic outlet consisted of anterior scalenectomy in five, pectoralis minor muscle division in one, and resection of both muscles in two. Removal of cervical rib with interposed vein graft was performed in the two players with arterial aneurysm. Hand ischemia in the remaining athletes was treated conservatively with Dextran-heparin infusion for acute ischemia. Repeat noninvasive study of all players demonstrated absence of compression in their playing position, and all have resumed their playing careers. Hand ischemia in athletes can be evaluated noninvasively and treated conservatively. Resection of hypertrophied muscles to decompress the thoracic outlet together with release of branch artery compression in selected athletes promotes perfusion to arm and shoulder muscles and helps to avoid the catastrophic complication of repetitive trauma leading to sudden arterial thrombosis. PMID: 2918627 [PubMed - indexed for MEDLINE] 79. Aviat Space Environ Med. 1988 Aug;59(8):738-41. The effects of cold immersion and hand protection on grip strength. Vincent MJ(1), Tipton MJ. Author information: (1)Institute of Naval Medicine, Gosport, Hants, England. The maximal voluntary grip strength (MVGS) of male volunteers was examined following a series of five intermittent 2 min cold water (5 degrees C) immersions of the unprotected hand or forearm. MVGS changes due to wearing a protective glove were also investigated. The surface electrical activity over the hand flexor muscles was recorded, as was the skin temperature of the hand and forearm. MVGS decreased significantly (p less than 0.01) following hand immersions (16%) and forearm immersion (13%). The majority of these reductions occurred during the first 2-min period of immersion. The effect of wearing a glove after unprotected hand cooling also produced significant (p less than 0.01) MVGS reductions which averaged 14%. These reductions were in addition to those caused by hand cooling. We conclude that both hand and forearm protection are important for the maintenance of hand-grip strength following cold water immersion. PMID: 3178622 [PubMed - indexed for MEDLINE] 80. Am J Med. 1988 Mar 11;84(3A):148-51. Influence of sublingual captopril on plasma catecholamine levels during hypertensive emergencies and cold immersion. Polonia JJ(1), Monteiro A, Esteves A, Cunha ME, Santos ML, Coutinho J, Coelho JL, Brandao FA, Cerqueira-Gomes M. Author information: (1)Unidade de Farmacologia Clinica, Hospital de S. Joao, Faculdade de Medicina, Porto, Portugal. Experimental evidence of captopril-induced inhibition of sympathetic activity, mediated by decrease in angiotensin II production, is presented. The blood pressure, plasma catecholamine, plasma renin activity, and plasma aldosterone responses to a single dose of sublingual captopril in 23 patients with hypertensive emergencies were evaluated. The major correlation found was between the captopril-induced decrease in blood pressure and the decrease in plasma norepinephrine levels (r = 0.57, p less than 0.01). In another 11 hypertensive patients with normal or high renin levels, captopril lowered by 65 percent the increase in plasma norepinephrine induced by cold immersion of the forearm. In both circumstances, plasma renin and aldosterone levels changed in accordance with the expected inhibition of angiotensin converting enzyme activity. These data suggest that, in selected circumstances in hypertensive patients, captopril exhibits a depressive influence on sympathetic activity along with the inhibition of the renin-angiotensin system. PMID: 3064593 [PubMed - indexed for MEDLINE] 81. Aviat Space Environ Med. 1987 Dec;58(12):1192-6. The influence of regional insulation on the initial responses to cold immersion. Tipton MJ(1), Golden FS. Author information: (1)Institute of Naval Medicine, Gosport, Hampshire, England. Twelve healthy male subjects performed three 10-min head-out immersions in water at 10 degrees C. The responses of the subjects to immersion were recorded under three conditions: a) Control condition (CC)--torso and limbs exposed; b) Torso protected/limbs exposed condition (TPC); and c) Limbs protected/torso exposed condition (LPC). Results showed that the LPC significantly reduced the heart rate (p less than 0.01), minute ventilation (p less than 0.05), and respiratory frequency (p less than 0.05) during the first minute of immersion compared to the CC. Subjects also found the LPC the most comfortable. The TPC significantly reduced minute ventilation (p less than 0.01) and respiratory frequency (p less than 0.01) on immersion compared to the CC, but did not significantly lower the heart rate response. A comparison of the LPC and TPC revealed no significant difference in minute ventilation and respiratory frequency recorded on immersion. The LPC however, produced significantly lower heart rates on immersion (p less than 0.05) than the TPC. It was concluded that the limbs may be more important than the torso for the initiation of cardiac response to cold water immersion. PMID: 3426494 [PubMed - indexed for MEDLINE] 82. Br J Clin Pharmacol. 1987 Dec;24(6):823-6. Dipipanone and nifedipine in cold induced pain; analgesia not due to skin warming. Holland RL(1), Harkin NE, Coleshaw SR, Jones DA, Peck AW, Telekes A. Author information: (1)Wellcome Research Laboratories, Beckenham, Kent. The mechanism of the pain relief produced by opiates in normal volunteers in the cold induced pain test has been investigated. In a double-blind placebo controlled study, hand skin temperature during a 3 min immersion in water at 1 degree C was not affected by either the opioid dipipanone 8 mg or the vasodilator nifedipine 10 and 20 mg. During this immersion, dipipanone produced significant pain relief. Nifedipine reduced pre-immersion blood pressures and raised heart rates, however, it did not significantly alter pain scores. It is concluded that vasodilatation and local warming do not play a role in the relief of pain by opiates in the cold immersion test. PMCID: PMC1386411 PMID: 2894219 [PubMed - indexed for MEDLINE] 83. Microvasc Res. 1985 Jul;30(1):56-62. Inhibition of cold-induced vasoconstriction with ketanserin. Hechtman DH, Jageneau A. The role of serotonin, thromboxane A2, and prostacyclin in cold-stimulated vasoconstriction was studied in 11 volunteers randomly pretreated with placebo, antagonists to serotonin (ketanserin, 40 mg), cyclooxygenase (ibuprofen, 800 mg), or thromboxane synthetase (ketoconazole, 400 mg). With an ambient temperature of 27 degrees, the hand and distal arm of one side were immersed in iced slush for 2 min. At the end of this time there was a fall in skin temperature from 31.2 to 12.2 degrees. Six minutes later with ketanserin treatment, temperature rose 4.5 degrees above placebo (P less than 0.05). In the noncooled side, ketanserin led to a rise in baseline temperature of 2.3 degrees (P less than 0.05), and increased plethysmographic finger flow to 2.08% delta vol/sec contrasted with 1.00% delta vol/sec in the placebo group (P less than 0.05). During cold immersion, temperature of this side fell 0.5 degrees, and flow decreased to 0.17% delta vol/sec. With ketanserin, temperature did not fall and flow was 0.85% delta vol/sec (P less than 0.05). Ketanserin accelerated recovery of temperature and flow (P less than 0.05). Plasma serotonin levels were constant. Ibuprofen and ketoconazole reduced baseline thromboxane B2 levels from 30 pg to 18 and 20 pg/ml (P less than 0.05), respectively, but did not influence temperature or flow. Results show that serotonin and perhaps alpha-adrenoreceptors, but not prostanoids, modulate resting skin flow and cold-induced vasoconstriction. PMID: 3160915 [PubMed - indexed for MEDLINE] 84. Aviat Space Environ Med. 1985 Feb;56(2):165-70. Rapid changes in rate-corrected and uncorrected systolic time intervals during cold pressor test. Mäntysaari M, Antila K, Peltonen T. The changes in heart rate and systolic time intervals were studied in a group of 10 young healthy male volunteers during immersion of their hand in ice water for 1 min. The heart rate and systolic time intervals were measured from electro-, phono-, and impedance cardiograms in the standard way. When the cold immersion was done in the supine position the left ventricular ejection time (LVET) and the electromechanic systole (Q-S2Tc) shortened, and when corrected for the heart rate the Q-S2Tc lengthened in the beginning of the immersion. In the head-up position the Q-S2T shortened in the beginning of the immersion while the rate-corrected systolic time intervals remained unchanged. Most of the changes in the systolic time intervals disappeared before the last quarter of the cold immersion. It was observed that during the cold immersion the linear regression coefficients between the heart rate and the Q-S2T in the supine position as well as between the heart rate and the LVET, Q-S2T and the PEP in the head-up position were greater than the regression coefficients used in the rate correction. PMID: 3985895 [PubMed - indexed for MEDLINE] 85. J Auton Nerv Syst. 1985 Jan;12(1):15-22. Sympathetic-adrenal medullary and cardiovascular responses to acute cold stress in adult and aged rats. McCarty R. In this study, adult (5 months) and aged (22 months) Fischer 344 (F-344) male rats were surgically prepared with chronic tail artery cannulae. Two days after surgery, rats were stressed by immersion in 12 degrees C water for 10 min. Blood samples (0.5 ml) were collected before and at timed intervals after cold immersion (0, 15 and 60 min) and were later assayed for content of norepinephrine and epinephrine. Consistent with earlier studies from this laboratory, there were no differences between ages in basal plasma levels of either catecholamine or in mean arterial pressure or core temperature. However, basal heart rates of aged rats were approximately 10% greater than values for adult rats. During cold immersion, aged rats had greater decrements in heart rate compared to adults but there were no age-related differences in mean arterial pressure or core temperature. Immediately following cold immersion, increments above basal values for plasma norepinephrine and epinephrine (4.2-4.6 and 11.8-14.1-fold, respectively) were similar for 5- and 22-month-old rats. However, in aged rats plasma norepinephrine was greater at 60 min post-immersion and plasma epinephrine was greater at 15 and 60 min post-immersion compared to values for adults.(ABSTRACT TRUNCATED AT 250 WORDS) PMID: 3980919 [PubMed - indexed for MEDLINE] 86. J Allergy Clin Immunol. 1984 Sep;74(3 Pt 1):275-9. Release of platelet factor 4 into the blood after cold challenge of patients with cold urticaria. Wasserman SI, Ginsberg MH. Five individuals with idiopathic cold urticaria but not normal volunteers released platelet factor 4 (PF4) detected by radioimmunoassay into the circulation after cold challenge. In three patients, a biphasic rise in PF4 was noted with increases at 1 and 10 to 20 min after immersion, whereas in two others only the later rise was detected. Peak levels of PF4 were detected in all five patients 20 min after cold immersion, whereas peak levels of other mediators such as histamine and eosinophil and neutrophil chemotactic activity occurred earlier at 10, 3 to 10, and 5 to 10 min, respectively. The identification of PF4 in the circulation of patients with cold urticaria after cold challenge provides further evidence for the activation of platelets in mast cell-dependent disorders and suggests new potential mechanisms for the expression of cold urticaria. PMID: 6470362 [PubMed - indexed for MEDLINE] 87. Clin Exp Pharmacol Physiol. 1984 Mar-Apr;11(2):171-9. Acute effects of cold on blood pressure, renin-angiotensin-aldosterone system, catecholamines and adrenal steroids in man. Hiramatsu K, Yamada T, Katakura M. In an attempt to study effects of cold on blood pressure and the renin-angiotensin-aldosterone system, 34 healthy young subjects with or without a family history of essential hypertension were exposed to moderate cold (4 degrees C for 1 h) or severe cold (immersion of the hands to 0 degrees C for 10 min). Moderate cold elevated blood pressure, aldosterone, cortisol and noradrenaline when the subjects wore summer clothing but not when the subjects wore winter clothing. Regardless of the clothing worn, skin blood flow and plasma renin activity decreased significantly in response to moderate cold but angiotensin II decreased insignificantly. Severe cold elevated blood pressure, cortisol, aldosterone and noradrenaline. Administration of dexamethasone significantly depressed an increase of aldosterone and cortisol in response to cold but failed to effect an elevation of blood pressure and noradrenaline. Plasma renin activity and angiotensin II concentration were not affected at all during and after cold exposure. It is suggested that, among the various hormones studied, noradrenaline is the only hormone responsible for an elevation of blood pressure in response to cold. PMID: 6378465 [PubMed - indexed for MEDLINE] 88. Scand J Clin Lab Invest Suppl. 1984;170:1-112. Hemodynamic reactions to circulatory stress tests in patients with neurocirculatory dystonia. Mäntysaari M. The hemodynamic reactions of 30 patients with neurocirculatory dystonia (NCD, DaCosta's syndrome) were compared to those of 30 healthy controls during the isometric handgrip test, orthostatic test, Valsalva test and the cold pressor test. The effects of hyperventilation on the ability to hold the breath were studied in both groups using the hyperventilation test. The patients and controls were young men, who were doing their conscript service, and the average age was 20 years in both groups. The diagnosis of NCD was made using the criteria described by Friedman (1947). The patients had several symptoms related to the cardiorespiratory system, the intensity of which varied from time to time and were not closely related to physical effort. In order to exclude organic diseases that could have caused the symptoms the patients were required to have no history of chronic organic diseases. They were also required to have no infectious diseases nor to be convalescents when participating in this study and to have a normal ECG and a normal thorax x-ray. The controls were anamnestically free from chronic diseases. The changes in the blood pressure, heart rate, stroke volume, cardiac index, peripheral vascular resistance and the systolic time intervals during the four tests were measured noninvasively using sphygmomanometry, electro-, phono- and impedance cardiography. The ability to hold the breath after a deep inspiration was similar in the two groups. Immediately after hyperventilation the ability to hold the breath did not improve in the NCD group as much as in the control group. In the orthostatic test the rise in the mean blood pressure was only momentarily greater in the control group than in the NCD group, and the heart rate increased about equally in the two groups. The transthoracic impedance increased significantly more in the controls than in the patients in the head-up position. The alterations in the systolic time intervals immediately after the changes of posture were more rapid in the control group that in the NCD group. During the expiratory strain of the Valsalva maneuver the hemodynamic changes in the two groups did not clearly differ from each other, but after the end of the strain the blood pressure overshoot lasted longer in the NCD group than in the control group. During the cold immersion the stroke volume decreased significantly more in the NCD group than in the control group. The stroke work index increased significantly in the control group, but did not change in the NCD group during the immersion.(ABSTRACT TRUNCATED AT 400 WORDS) PMID: 6592740 [PubMed - indexed for MEDLINE] 89. J Physiol (Paris). 1984;79(1):3-10. [Hormonal response to cold during maximum oxygen consumption in the dog]. [Article in French] Therminarias A. In dogs, acute exposure to severe cold (immersion 8-13 degrees C) induced a sustained shivering, a rapid increase in oxygen consumption (VO2) and a progressive colonic temperature fall. With a colonic temperature fall rate of 2-6 degrees C/h, VO2 reached a maximum value (VO2 max), which remained steady for more than 30 min. Under these conditions, we studied time-courses of plasma catecholamine, cortisol, insulin, T4, T3 and TSH concentrations, as well as of plasma glucose, FFA, lactic acid and K+ concentrations which can be considered to reflect the metabolic effects of these hormones. 15 min after the start of immersion, plasma epinephrine and norepinephrine were largely increased, plasma cortisol was moderately enhanced, while no change was observed in plasma insulin, T4, T3 and TSH concentrations. Plasma FFA, glucose, lactic acid and K+ were increased. 30 min after the start of immersion there was a change in evolution of plasma hormone concentrations whereas VO2 level remained steady. T4 concentration was decreased, cortisol did not change, noradrenaline tended to be higher, and epinephrine was increased. Simultaneously, a further rise was observed in glycemia and plasma K+ concentration. Negative correlations were found between colonic temperature and plasma epinephrine and between colonic temperature and plasma norepinephrine. Other plasma hormone concentrations did not seem to be affected directly by the colonic temperature fall. Each of these hormones may be involved in the mechanisms involved during exposure to a severe cold, but our data suggest that catecholamines play a major role. PMID: 6392506 [PubMed - indexed for MEDLINE] 90. J Psychosom Res. 1984;28(4):301-8. Effects of acupuncture and transcutaneous electrical nerve stimulation on cold-induced pain in normal subjects. Ashton H, Ebenezer I, Golding JF, Thompson JW. The effects of acupuncture, transcutaneous electrical nerve stimulation (TENS) at high (100 Hz) and low (8 Hz) frequency and placebo on pain induced by cold immersion of the hand were studied in 46 young healthy male and female volunteers. Acupuncture produced significant elevations of pain threshold, while 100 Hz TENS or placebo had no effect. Eight Hertz TENS produced elevation of pain threshold with significant variation in response between individuals. There was some evidence that the L scale score of the Eysenck Personality Questionnaire predicted analgesic outcome for 8 Hz TENS. No significant relationship was found between baseline pain threshold or tolerance and personality variables. PMID: 6332903 [PubMed - indexed for MEDLINE] 91. J Auton Nerv Syst. 1983 May;8(1):33-43. Autonomic dysfunction in palmar hyperhidrosis. Shih CJ, Wu JJ, Lin MT. The autonomic (including sudomotor, baroreceptor, and vasomotor) functions were assessed in 3 groups of individuals, comprising normal, hyperhidrotic, and denervated subjects. The normal group had no palmar hyperhidrosis, with intact T2-3 ganglia, the hyperhidrotic group had palmar hyperhidrosis with intact T2-3 ganglia, and the denervated group had palmar hyperhidrosis treated with T2-3 ganglionectomy. Compared with both the normal and hyperhidrotic subjects, the denervated subjects had a much smaller sweating response of both the forehead, the upper chest region and the upper extremities, and a much greater sweating response of both the lateral lumbar and ventral thigh regions in response to body exercise. In addition, cardiovascular responses to either the Valsalva manoeuver, face immersion, or finger immersion were evaluated in these groups of subjects. When compared with those of either the normal or the denervated subjects, the hyperhidrotic subjects had less reflex bradycardia in response to either Valsalva manoeuver or face immersion. In contrast, when compared with those of either the normal or the denervated subjects, the hyperhidrotic subjects had a higher degree of cutaneous vasoconstriction in response to finger (or cold) immersion. The data indicate that the sympathetic fibers passing through the T2-3 ganglia play an important role in the elaboration or modulation of autonomic function elsewhere. Probably, the hyperhidrotic subjects have an over-functioning of the sympathetic nervous fibers which pass through the T2-3 ganglia, which leads to autonomic dysfunction. The autonomic dysfunctions observed in the hyperhidrotic subjects could be eliminated after the interruption of the excessive sympathetic activities passing through the T2-3 ganglia level. A preliminary report of this work was delivered at the 15th Congress of the Pan-Pacific Surgical Association, January 12-18, 1980 and the 12th World Congress of Neurology, September 20-25, 1981. PMID: 6875200 [PubMed - indexed for MEDLINE] 92. Gastroenterol Jpn. 1982 Oct;17(5):409-14. Different mode of action of cimetidine and prostaglandin on the rat gastric mucosa under stress loading by restrain and water-immersion. Hasegawa Y, Ohsawa H, Kawahara H, Mine T. Gastric mucosal blood flow and oxygen tension in the corporal mucosa gradually declined after water immersion in the control animals. Neither cimetidine nor prostaglandin E2 had any influence on the decrease of the corporal mucosal blood flow or mucosal oxygen tension during seven hours of stress loading. The stress ulceration began to occur starting three hours after cold immersion in the control rats, and the deficit of energy metabolism was attributed to reduced oxidative phosphorylation from tissue hypoxia resulting from lowered blood flow and oxygen tension under stress. Cimetidine (4 mg/kg) maintained aerobic glycolysis, continued to produce high-energy phosphates and kept the energy charge unchanged in the gastric mucosa. In addition, PG E2-Me (100 micrograms/kg) showed similar, but less marked and shorter-lived effects on aerobic glycolysis and ATP production, whereas the energy charge of the adenosine pool decreased significantly from that produced by cimetidine. These results indicated that cimetidine significantly reduced energy requirements as compared with the control and PG E2 groups due to marked inhibition of gastric secretion and produced inhibition of mucosal ulceration by water immersion. On the other hand, increased energy requirements due to the rise of cytoprotective mucoprotein production and a resultant decrease of the energy charge were seen with PG E2 as compared with cimetidine. PMID: 7173568 [PubMed - indexed for MEDLINE] 93. J Allergy Clin Immunol. 1982 Aug;70(2):82-7. Measurement of plasma histamine: description of an improved method and normal values. Dyer J, Warren K, Merlin S, Metcalfe DD, Kaliner M. The single isotopic-enzymatic assay of histamine was modified to increase its sensitivity and to facilitate measurement of plasma histamine levels. The modification involved extracting 3H-1-methylhistamine (generated by the enzyme N-methyltransferase acting on histamine in the presence of S-[methyl-3H]-adenosyl-L-methionine) into chloroform and isolating the 3H-1-methylhistamine by thin-layer chromatography (TLC). The TLC was developed in acetone:ammonium hydroxide (95:10), and the methylhistamine spot (Rf = 0.50) was identified with an o-phthalaldehyde spray, scraped from the plate, and assayed in a scintillation counter. The assay in plasma demonstrated a linear relationship from 200 to 5000 pg histamine/ml. Plasma always had higher readings than buffer, and dialysis of plasma returned these values to the same level as buffer, suggesting that the baseline elevations might be attributable to histamine. However, all histamine standard curves were run in dialyzed plasma to negate any additional influences plasma might exert on the assay. The arithmetic mean (+/- SEM) in normal plasma histamine was 318.4 +/- 25 pg/ml (n = 51), and the geometric mean was 280 +/- 35 pg/ml. Plasma histamine was significantly elevated by infusion of histamine at 0.05 to 1.0 micrograms/kg/min or by cold immersion of the hand of a cold-urticaria patient. Therefore this modified isotopic-enzymatic assay of histamine is extremely sensitive, capable of measuring fluctuations in plasma histamine levels within the normal range, and potentially useful in analysis of the role histamine plays in human physiology. PMID: 7096824 [PubMed - indexed for MEDLINE] 94. Clin Sci (Lond). 1982 Aug;63(2):127-35. Influence of respiratory heat transfer on thermogenesis and heat storage after cold immersion. Morrison JB, Conn ML, Hayes PA. 1. Ten male subjects were cooled on three occasions to a rectal temperature of 35 degrees C by immersion to the neck in water at 11.3 degrees C. The subjects were rewarmed for 60 min, once by metabolic heat production alone (shivering), once by inhalation rewarming with spontaneous breathing of saturated air at 47 degrees C (control) and once by inhalation rewarming with ventilation regulated at 40 litres/min by respiring a controlled fraction of CO2 (hyperventilation). 2. Metabolic heat production was substantially reduced by inhalation rewarming (P less than 0.05), from 913 kJ when shivering to 766 kJ (control) and 613 kJ when hyperventilating. The fall in metabolic heat production was greater than the corresponding respiratory heat gain, which increased from a loss of 41 kJ when shivering to gains of 85 kJ (control) and 169 kJ (hyperventilation). 3. As differences in mean skin temperatures were small (less than 1.0 degrees C), it is concluded that the lower metabolic heat production in response to increased respiratory heat input must result from more rapid central temperature gains. This conclusion is supported by the relative values of rectal and tympanic temperatures. It was calculated that the percentage of the total heat supply which was donated to the core increased from 13% during shivering to 16% for the control and 23% in hyperventilation. Results imply that respiratory heat input is more efficient than metabolic heat production in elevating central temperature. PMID: 7083774 [PubMed - indexed for MEDLINE] 95. J Appl Physiol Respir Environ Exerc Physiol. 1982 May;52(5):1167-71. Finger temperature after a finger-cooling test: influence of air temperature and smoking. Cleophas TJ, Fennis JF, van't Laar A. Skin temperature of one finger was measured before and after immersion of the gloved fingers of both hands in 16 degrees C water for 5 min [room temperature (Ta) 24 or 20 degrees C]. At Ta 24 degrees C, 23 of 25 normal nonsmokers (92%) had finger rewarming to above 24 degrees C in 12 min after cold immersion, at Ta 20 degrees C, only 1 of 12 (8%) had similar rewarming. Among 12 habitual smokers only 4 (33%) rewarmed above 24 degrees C (Ta 24 degrees C) following a 1-h abstinence from smoking, but 8 (67%) did so after a 24-h abstinence. Only 2 of these 8, however, did so in a retest 10 min after smoking a cigarette. The smokers were not tested at Ta 20 degrees C. We conclude that air temperature and cigarette smoking are important determinants of finger rewarming following a finger-cooling test. PMID: 7096140 [PubMed - indexed for MEDLINE] 96. Sangyo Igaku. 1982 May;24(3):284-93. [Studies of peripheral nerve conduction velocities in vibrating tool operators]. [Article in Japanese] Hisanaga H. Vibrating tools such as chain-saws, rock-drills, grinders and tie-tampers have been widely used in many kinds of industries in Japan, causing vibration syndrome among the operators. As is well-known, the syndrome includes disorders of the peripheral circulation in the hands, e.g. Raynaud's phenomenon, and of the peripheral and central nervous systems. As the result of preventive countermeasures to the syndrome during the last decade, the picture of the syndrome has been partly changing especially for the patients among the state forestry workers; for example, the prevalence of the peripheral nerve disorders has been relatively increasing compared with that of Raynaud's phenomenon. Peripheral nerve disorders such as numbness, paresthesia and hypesthesia in the upper limbs tend to be usually cumulative and irreversible. The disorders are very important problem of vibration syndrome from the standpoint of treatment and prevention, though there are only a few reports of the study on the disorders using electrophysiological methods. In order to make objectively clear the peripheral nerve disorders, 236 male vibrating tool operators (= Group V) were examined. The following nerve conduction velocities were measured: (1) Maximal motor nerve conduction velocities (MCV) of the median and ulnar nerves in the forearm. (2) Sensory nerve conduction velocities (SCV) of the median and ulnar nerves in the forearm and palm. (3) Residual latency (RL) of the median and ulnar nerves. Besides, working conditions and complaints relevant to vibration syndrome were examined by using questionnaires. MCVs, SCVs and RLs that were outside of mean +/- 2 S.D. of the control group (= Group C), consisting of 30 healthy men, were evaluated as abnormal. The obtained results led to the following conclusions: (1) All MCVs, SCVs and RLs of Group V were significantly less than those of the control group. In Group V, prevalence of the abnormality in each of forearm SCVs was higher than that in each of MCVs of the corresponding nerves. (2) The difference between the median and ulnar SCV in the palm and the respective SCV in the forearm of each subject was significantly greater for Group V than Group C. (Palm-forearm difference) (3) The difference between the forearm and palmar SCV of the ulnar nerve and the respective velocities of the median nerve was statistically greater for Group V than for Group C. (Ulnar-median difference) (4) Ulnar SCV in the palm of Group V was significantly related to the total operating hours of vibrating tools. (5) There was no significant relation between all the nerve conduction velocities and the white finger attack. But a significant relation was noticed between the prevalence of the abnormal values of ulnar SCV in the palm and the peripheral circulatory function score computed from the data of nail press test and cold immersion test. PMID: 6292556 [PubMed - indexed for MEDLINE] 97. Life Sci. 1982 Feb 1;30(5):447-54. Plasma free and sulfate conjugated catecholamine levels during acute physiological stimulation in man. Joyce DA, Beilin LJ, Vandongen R, Davidson L. The responses of plasma free and sulfate-conjugated catecholamines to acute physiological stimulation was examined in normal male subjects. Catecholamines were measured with a sensitive radioenzymatic assay incorporating simultaneous hydrolysis of sulfate conjugates and O-methylation of free norepinephrine and epinephrine. Following 20 minutes recumbency after venepuncture 30 +/- 3% of norepinephrine and 16 +/- 5% of epinephrine was in thr free form. Free catecholamines generally increased during standing, cold immersion and isometric handgrip, but sulfates did not change. Bicycle ergometry markedly increased free catecholamines which rapidly returned to basal levels at the end of exercise. In contrast, sulfated norepinephrine decreased substantially with exercise in all subjects but returned to basal levels 3 minutes after stopping exercise. Epinephrine sulfate varied considerably between subjects but showed a similar, although smaller, fall with exercise. Thus, during physiological stimulation, which caused increases in free norepinephrine and epinephrine levels in plasma, the only consistent change in sulfated catecholamines was a marked fall in norepinephrine sulfate after bicycle exercise. This may indicate saturation of sulfotransferase activity, substrate inhibition or impaired tissue conjugation. PMID: 6895925 [PubMed - indexed for MEDLINE] 98. Z Lymphol. 1981 Dec;5(2):100-6. [Hydrotherapy in swellings with special reference to lymphedema]. [Article in German] Gehrke A, Hussain M, Kleinschmidt J, Rachor B, Drexel H. Is is to be stated in summary that the majority of positive arguments in the literature publications so far for the application of hydrotherapy in swellings there are weighty counter-arguments especially in lymphatic edema in the narrow sense. The present study (which is only preliminary because of the small number of cases) appears to indicate that these arguments are evidently not so weighty as was assumed hitherto. Even though unfortunately few clinically relevant alterations occurred with hydrotherapy alone, on the other hand, study indicates that we would have to prohibit patients with lymphatic edema from taking cold immersion baths. Hydrotherapy tends to have if anything a favorable influence on the basic psychological condition and according to the data available can be recommended as an additional measure. PMID: 7331405 [PubMed - indexed for MEDLINE] 99. J Allergy Clin Immunol. 1981 Dec;68(6):438-41. Identification of a new physically induced urticaria: cold-induced cholinergic urticaria. Kaplan AP, Garofalo J. Four patients with symptoms suggestive of either cold urticaria or a combination of cold and cholinergic urticaria were studied. However, all patients were negative to an ice-cube test or cold-immersion test and had no urticaria after exercise in a warm environment. When each patient was seated in a cold room (4 degree C) for 5 to 15 min, generalized urticaria appeared, consisting of puncture wheals and surrounding erythema as seen in cholinergic urticaria. Two patients had weakly positive methacholine skin tests and the other two had completely negative tests. When serial venous blood samples were obtained to test for mediator release, three of four patients had evidence of histamine release and the time course was similar to that previously reported for patients with cholinergic urticaria. These four cases represent a new syndrome with features suggestive of cold and/or cholinergic urticaria, but the results of all the tests usually utilized to diagnose these conditions were negative. We have called this disorder cold-induced cholinergic urticaria to indicate that it is cold dependent and visually indistinguishable from cholinergic urticaria. PMID: 7310011 [PubMed - indexed for MEDLINE] 100. J Occup Med. 1981 Sep;23(9):643-6. A peripheral vascular insufficiency test using photocell plethysmography. Samueloff S, Miday R, Wasserman D, Behrens V, Hornung R, Asburry W, Doyle T, Dukes-Dobos F, Badger D. A preliminary laboratory study seeking an objective test for vascular insufficiency of the fingertips (Raynaud's syndrome) is described. In a limited number of subjects, circulatory changes in the vascular bed of one hand were examined by photocell plethysmography while the opposite had was immersed in ice water. The time to complete recovery after cessation of the cold stimulus was significantly longer with primary Raynaud's patients than with the control subjects (p = 0.0045). The analysis of another parameter, the relative change in pulse amplitude during cold immersion, was confounded by age and sex differences between the Raynaud's and the control group. A follow-up investigation of the application of this technique to a population of vibration-exposed chipper and grinder and control workers is in progress. PMID: 7277056 [PubMed - indexed for MEDLINE] 101. Br J Sports Med. 1981 Jun;15(2):111-5. Canoeists' disorientation following cold immersion. Baker S, Atha J. PMCID: PMC1858744 PMID: 7272652 [PubMed - indexed for MEDLINE] 102. Jpn J Physiol. 1981;31(5):657-65. Enhancement of calorigenic response to cold and to norepinephrine in physically trained rats. Hirata K, Nagasaka T. Calorigenic response to cold and to norepinephrine (NE: 4 microgram . kg-1 . min-1) in physically fit (SW) rats was compared with control (CT) and cold-acclimated (CA) rats. Physical fitness was obtained by daily 3-hr swimming in water at 36 degree C for 6-8 weeks. Resting heart rate (HR) was significantly less in SW rats. Cold immersion (in water at 18 degree C up to the neck) increased oxygen consumption (VO2) significantly in CA and SW compared to CT rats (p less than 0.01). Cold immersion decreased colonic temperature (Tco1) in all groups. Despite the increased calorigenic response, SW rats cooled as quickly as CT rats in cold water. Body weight and skinfold thickness were significantly less in SW than in CT rats (p less than 0.01). Compared with CT rats, average weight of the interscapular BAT was significantly less in SW rats (p less than 0.05). Infusion of NE significantly increased VO2, Tco1, HR and mean aortic pressure in anesthetized rats. The increase in VO2 was significantly greater in CA (p less than 0.01) and SW (p less than 0.05) than in CT rats. Tco1 increased significantly in CA (p less than 0.05) and slightly in SW compared to CT animals. PMID: 7328915 [PubMed - indexed for MEDLINE] 103. J Anat. 1980 Jun;130(Pt 4):789-800. Innervation of the trachealis muscle in the guinea-pig: a quantitative ultrastructural study. Hoyes AD, Barber P. The fine structure and composition of the nerve plexuses associated with the cervical and the thoracic parts of the trachealis muscle were studied in two groups of six guinea-pigs. One group of animals was perfused with fixative before removal of the specimens. In the second, the specimens were incubated in 5-hydroxydopamine before cold immersion fixation. In both the cervical and the thoracic trachea, plexuses of nerves were found within and between the fascicles of muscle cells. The number of intrafascicular nerves/1000 micrometer 2 was low, and only a small proportion of the nerves contained more than five axons. Interfascicular nerves were more numerous and the mean number of axons/nerve was significantly higher than within the muscle. The number of efferent terminal profiles/100 axonal profiles was higher in the intrafascicular than in the interfascicular plexus, but in neither case was there evidence of a very close approximation of exposed terminal membranes to the membranes of adjacent muscle cells. Terminals classified as those of autonomic efferent axons were present in much greater numbers in the nerves than any other type of terminal. Examination of 5-hydroxydopamine-incubated specimens showed that less than half of these terminals were the terminals of adrenergic axons. Terminals of the type considered to represent the terminals of purinergic axons were also found in the nerves but were present in much smaller numbers than in the nerves of the submucous plexuses. The presence in the nerves of mitochondria-containing terminals with features similar to those of mechanosensitive nerve endings was related to physiological evidence of the location of stretch receptors in the muscle. PMCID: PMC1233202 PMID: 7429967 [PubMed - indexed for MEDLINE] 104. Scand J Work Environ Health. 1980 Mar;6(1):58-65. Reactions to hand cooling in workers occupationally exposed to cold. Enander A, Sköldström B, Holmér I. Ten men occupationally exposed to cold and ten office workers participated in the study. Reactions to immersion of the hands in cold water (+ 10 degrees C) for 2 min were studied during the following 30 min at two different ambient temperatures, 10 and 20 degrees C. Hand skin temperature was recorded in thermograms, and the subjects rated cold sensation and pain. Considerable interindividual differences in hand skin temperature reaction were found in both groups. On the average the occupationally exposed workers had a somewhat higher hand skin temperature than the office workers during the recovery period in the 10 degrees C ambient temperature, although the difference did not reach significance. The office workers rated significantly greater cold sensation as a result of the cold immersion, especially during an ambient temperature of 10 degrees C, and the frequency of pain ratings was higher for this group. The results suggest that cooling among the occupationally exposed workers at work was not severe enough to produce physiological adaptations, although some psychological adaptation was indicated. PMID: 7384768 [PubMed - indexed for MEDLINE] 105. Can J Physiol Pharmacol. 1980 Mar;58(3):319-21. Effect of cold water immersion and its combination with alcohol intoxication on urine flow rate of man. Cupples WA, Fox GR, Hayward JS. Urine flow rate was determined for man before and after immersion in either thermoneutral (33 degrees C) or cold (10 degrees C) water. The effect of alcohol intoxication of a level of approximately 80 mg dL-1 was also evaluated for the cold water immersion. Immersion and cold were additive in their effect, resulting in a mean urine flow rate of 4.25 mL min-1, approximately 3.5 times the preimmersion level. Alcohol intoxication in conjunction with cold water immersion caused a further large increase in urine flow to 8.03 mL min-1. These results permit better evaluation of the importance of volume diuresis as it relates to the reduction of insulative performance of dry-type immersion suits for cold water survival, and to the possible enhancement of "rewarming shock" during therapy for hypothermia victims. The increased urine production observed when alcohol treatment was added to cold immersion provides information for speculation on mechanisms of volume diuresis. PMID: 7378935 [PubMed - indexed for MEDLINE] 106. J Trauma. 1979 Jan;19(1):56-60. The effect of immediate and delayed cold immersion on burn edema formation and resorption. Demling RH, Mazess RB, Wolberg W. Massive wound edema after a burn may impair healing and help to convert partial to full-thickness injury. Cold treatment (usually by immersion) has been reported to decrease wound edema and is useful in first-aid treatment of burns. Reliable quantitative data have been lacking and frequently a superficial burn has been studied. Since cold by decreasing peripheral blood flow could actually be harmful to a deep burn, especially if applied late, we measured the effect of cold immediately and 2 minutes postburn on edema formation and resorption in a deep second-degree burn in sheep hindlimbs. We used Dichromatic Absorptiometry, a noninvasive, reliable method for measuring tissue fluid, to quantitate edema. Immediate application of cold by immersion in 15 degrees C saline for 30 minutes reduced the edema of a deep second-degree burn and did not impair resorption rate compared with control limbs, fluid content returning to baseline after 1 week. Cold treatment beginning 2 minutes after the burn did not decrease edema formation and did impair resorption. Fifteen per cent of the edema fluid was still present 1 week postburn, suggesting further injury to the burn wound vasculature with use of cold immersion 2 minutes postburn. PMID: 762717 [PubMed - indexed for MEDLINE] 107. Surg Forum. 1977;28:29-30. Effect of heparin and cold immersion on burn edema. Demling R, Wolberg WH. PMID: 617449 [PubMed - indexed for MEDLINE] 108. N Engl J Med. 1976 Mar 25;294(13):687-90. Cold urticaria: release into the circulation of histamine and eosinophil chemotactic factor of anaphylaxis during cold challenge. Soter NA, Wasserman SI, Austen KF. Patients with idiopathic acquired cold-induced urticaria were evaluated for the release of the preformed mast-cell mediators of immediate-type hypersensitivity during a study in which one arm was immersed in ice water while the other arm remained as a control. Blood specimens were obtained from each arm serially over a one-hour interval, and serum speciments were assessed for histamine, eosinophil chemotactic factor of anaphylaxis, and complement components. Levels of histamine and eosinophil chemotactic factor rose in the arm subjected to cold immersion for three minutes, with peak values occurring between two and five minutes and returning to base line by 30 minutes. No changes occurred in the control arm or in the immersed arm of normal subjects. Assessment of the classical and alternative complement pathways showed no abnormalities. This initial observation of release of eosinophil chemotactic factor of anaphylaxis in vivo along with histamine assigns the mast cell a central role in cold urticaria. PMID: 55969 [PubMed - indexed for MEDLINE] 109. J R Nav Med Serv. 1972 Winter;58(3):171-6. Cold immersion and swimming. Keatinge WR. PMID: 4647866 [PubMed - indexed for MEDLINE] 110. Br Med J. 1964 May 9;1(5392):1202. DANGERS OF COLD IMMERSION. [No authors listed] PMCID: PMC1814339 PMID: 14120824 [PubMed - OLDMEDLINE] 111. Invest Urol. 1963 Nov;1:282-97. THE EFFECTS OF RADIATION AND COLD IMMERSION UPON EXPERIMENTAL UROLITHIASIS, RENAL FUNCTION, AND MORPHOLOGY. MURPHY GP, SHARP JC. PMID: 14102159 [PubMed - indexed for MEDLINE] 112. J R Nav Med Serv. 1963;49:88-92. Cold immersion. CANNON P. PMID: 14018330 [PubMed - indexed for MEDLINE] 113. Am J Physiol. 1948 Dec;155(3):378-87. Lethal limits of cold immersion in adult rats. ADOLPH EF. PMID: 18113177 [PubMed - OLDMEDLINE] 114. Fed Proc. 1948 Mar;7(1 Pt 1):1. Lethality of cold immersion in rats. ADOLPH EF. PMID: 18932420 [PubMed - OLDMEDLINE] 115. Fed Proc. 1948 Mar;7(1 Pt 1):1. Cold tolerance and cold immersion in infant rats. ADOLPH EF. PMID: 18915310 [PubMed - OLDMEDLINE]