Modeling of processes of heat transfer in whole-body hyperthermia

The method of whole-body hyperthermia in which the body temperature for a short time reaches values up to 43-44 degrees C holds currently much promise. However, at body temperatures above 42 degrees C, the risks associated with the hemodynamic instability and the appearance of arrhythmia in the patient increase. A model of heat transfer has been created to increase the efficiency and safety of the immersion-convectional method of whole-body hyperthermia. This model takes into account changes in the skin blood flow and the dynamics of pulse rate depending on body temperature. The model of heat transfer adequately reflects processes of heating of the organism and can form a basis for the calculation of distribution of heat inside the organism.     

Temperature difference between the body core and arterial blood supplied to the brain during hyperthermia or hypothermia in humans

 A vascular heat transfer model is developed to simulate temperature decay along the carotid arteries in humans, and thus, to evaluate temperature differences between the body core and arterial blood supplied to the brain. Included are several factors, including the local blood perfusion rate, blood vessel bifurcation in the neck, and blood vessel pairs on both sides of the neck. The potential for cooling blood in the carotid artery by countercurrent heat exchange with the jugular veins and by radial heat conduction to the neck surface was estimated. Cooling along the common and internal carotid arteries was calculated to be up to 0.87 °C during hyperthermia by high environmental temperatures or muscular exercise. This model was also used to evaluate the feasibility of lowering the brain temperature effectively by placing ice pads on the neck and head surface or by wearing cooling garments during hypothermia treatment for brain injury or other medical conditions. It was found that a 1.1 °C temperature drop along the carotid arteries is possible when the neck surface is cooled to 0 °C. Thus, the body core temperature may not be a good indication of the brain temperature during hyperthermia or hypothermia. Received: 10 January 2002 / Accepted: 7 May 2002 This research was supported by a UMBC Summer Faculty Fellowship.     

Effects of microwave exposure and temperature on survival of mice infected with Streptococcus pneumoniae

Female CD-1 mice were injected with an LD₅₀ dose of Streptococcus pneumoniae and then exposed to 2.45 GHz (CW) microwave radiation at an incident power density of 10 mW/cm² (SAR = 6.8 W/kg), 4 h/d for 5 d at ambient temperatures of 19 °C, 22 °C, 25 °C, 28 °C, 31 °C, 34 °C, 37 °C and 40 °C. Four groups of 25 animals were exposed at each temperature with an equal number of animals concurrently sham-exposed. Survival was observed for a 10-d period after infection. Survival of the sham-exposed animals increased as ambient temperature increased from 19 °C–34 °C. At ambient temperatures at or above 37 °C the heat induced in the body exceeded the thermoregulatory capacity of the animals and deaths from hyperthermia occurred. Survival of the microwave-exposed animals was significantly greater than the shams (～20%) at each ambient temperature below 34 °C. Based on an analysis of the data it appears that the hyperthermia induced by microwave exposure may be more effective in increasing survival in infected mice than hyperthermia produced by conventional methods (ie, high ambient temperature). Microwave radiation may be beneficial to infected animals at low and moderate ambient temperatures, but it is detrimental when combined with high ambient temperatures.     

Deep body and surface temperature responses to hot and cold environments in the zebra finch

Global warming increasingly challenges thermoregulation in endothermic animals, particularly in hot and dry environments where low water availability and high temperature increase the risk of hyperthermia. In birds, un-feathered body parts such as the head and bill work as ‘thermal windows’, because heat flux is higher compared to more insulated body regions. We studied how such structures were used in different thermal environments, and if heat flux properties change with time in a given temperature. We acclimated zebra finches (Taeniopygia guttata) to two different ambient temperatures, ‘cold’ (5 °C) and ‘hot’ (35 °C), and measured the response in core body temperature using a thermometer, and head surface temperature using thermal imaging. Birds in the hot treatment had 10.3 °C higher head temperature than those in the cold treatment. Thermal acclimation also resulted in heat storage in the hot group: core body temperature was 1.1 °C higher in the 35 °C group compared to the 5 °C group. Hence, the thermal gradient from core to shell was 9.03 °C smaller in the hot treatment. Dry heat transfer rate from the head was significantly lower in the hot compared to the cold treatment after four weeks of thermal acclimation. This reflects constraints on changes to peripheral circulation and maximum body temperature. Heat dissipation capacity from the head region increased with acclimation time in the hot treatment, perhaps because angiogenesis was required to reach peak heat transfer rate. We have shown that zebra finches meet high environmental temperature by heat storage, which saves water and energy, and by peripheral vasodilation in the head, which facilitates dry heat loss. These responses will not exclude the need for evaporative cooling, but will lessen the amount of energy expend on body temperature reduction in hot environments.     

Response of mice to continuous 5-day passive hyperthermia resembles human heat acclimation

Chronic repeated exposure to hyperthermia in humans results in heat acclimation (HA), an adaptive process that is attained in humans by repeated exposure to hyperthermia and is characterized by improved heat elimination and increased exercise capacity, and acquired thermal tolerance (ATT), a cellular response characterized by increased baseline heat shock protein (HSP) expression and blunting of the acute increase in HSP expression stimulated by re-exposure to thermal stress. Epidemiologic studies in military personnel operating in hot environments and elite athletes suggest that repeated exposure to hyperthermia may also exert long-term health effects. Animal models demonstrate that coincident exposure to mild hyperthermia or prior exposure to severe hyperthermia can profoundly affect the course of experimental infection and injury, but these models do not represent HA. In this study, we demonstrate that CD-1 mice continuously exposed to mild hyperthermia (ambient temperature ~37°C causing ~2°C increase in core temperature) for 5 days and then exposed to a thermal stress (42°C ambient temperature for 40 min) exhibited some of the salient features of human HA, including (1) slower warming during thermal stress and more rapid cooling during recovery and (2) increased activity during thermal stress, as well as some of the features of ATT, including (1) increased baseline expression of HSP72 and HSP90 in lung, heart, spleen, liver, and brain; and (2) blunted incremental increase in HSP72 expression following acute thermal stress. This study suggests that continuous 5-day exposure of CD-1 mice to mild hyperthermia induces a state that resembles the physiologic and cellular responses of human HA. This model may be useful for analyzing the molecular mechanisms of HA and its consequences on host responsiveness to subsequent stresses.     

Physiological burden of hyperthermia of various etiologies in humans

The physiological burden of heat loads has been studied with regard to four types of hyperthermia. It has been found that the genesis of overheating depends on the origin of hyperthermia. Heating almost always negatively affects the body during work, causing marked physiological changes and reducing performance capacity, especially during performance of continuous physical work, which seems to be a more aggravating factor as compared to discontinuous work. However, under thermoneutral conditions, hyperthermia may be essential for efficient muscle performance. During discontinuous physical work, rectal temperature rapidly increases to a steady state (38.7°C) corresponding to the highest work capacity, both physical and mental, which decreases with further overheating of the body (39.2°C). Usually, continuous work is much harder to bear than discontinuous work under thermoneutral conditions.     

Mathematical apparatus of the circuit theory in modeling of heat transfer upon extreme heating of an organism

The mathematical model of heat transfer in whole-body hyperthermia, developed earlier by the author, has been refined using the mathematical apparatus of the circuit theory. The model can be used to calculate the temperature of each organ, which would increase the efficacy and safety of the immersion-convection technique of whole-body hyperthermia.     

Isolation and characterization of minor glycosaminoglycans in the rabbit vitreous body

Protein synthesis in the microvascular system of the rabbit brain was inhibited following the elevation of body temperature by 2?2.5°C. $\text{In}$,$\text{vivo}$ labeling studies indicated that hyperthermia also induced the synthesis of a 74K protein in cerebral microvessels which is similar in molecular weight to one of the major heat shock proteins previously reported in tissue culture systems following elevation of ambient temperature. The present results suggest that a physiologically relevant increase in body temperature, similar to that attained during fever reactions, can induce the synthesis of a heat shock protein in the cerebral microvascular system of the intact mammal.     

Prediction of human core body temperature using non-invasive measurement methods

The measurement of core body temperature is an efficient method for monitoring heat stress amongst workers in hot conditions. However, invasive measurement of core body temperature (e.g. rectal, intestinal, oesophageal temperature) is impractical for such applications. Therefore, the aim of this study was to define relevant non-invasive measures to predict core body temperature under various conditions. We conducted two human subject studies with different experimental protocols, different environmental temperatures (10 °C, 30 °C) and different subjects. In both studies the same non-invasive measurement methods (skin temperature, skin heat flux, heart rate) were applied. A principle component analysis was conducted to extract independent factors, which were then used in a linear regression model. We identified six parameters (three skin temperatures, two skin heat fluxes and heart rate), which were included for the calculation of two factors. The predictive value of these factors for core body temperature was evaluated by a multiple regression analysis. The calculated root mean square deviation (rmsd) was in the range from 0.28 °C to 0.34 °C for all environmental conditions. These errors are similar to previous models using non-invasive measures to predict core body temperature. The results from this study illustrate that multiple physiological parameters (e.g. skin temperature and skin heat fluxes) are needed to predict core body temperature. In addition, the physiological measurements chosen in this study and the algorithm defined in this work are potentially applicable as real-time core body temperature monitoring to assess health risk in broad range of working conditions.     

The role of energy in hyperthermia-induced mammalian cell inactivation: A study of the effects of glucose starvation and an uncoupler of oxidative phosphorylation

When cultured Chinese hamster cells were exposed to 43°C hyperthermia, effects due to glucose deprivation and to the presence of the uncoupler of oxidative phosphorylation, carbonylcyanide-3-chlorophenylhydrazone, during the 43°C treatment proved to be strongly accelerated compared to the effects at normal temperature (37°C). This strongly indicates that the availability of energy plays an important role in the response of these cells to hyperthermia. One of the reasons cells die after hyperthermia may be a lethal lack of energy. Cells heated before glucose deprivation were able to maintain viability for a longer period during deprivation than cells without the preheat treatment. As the cells might develop thermotolerance after the heat exposure, this suggests that cells in the thermotolerant state use energy in a more economical way.     

Heat shock increases levels of reactive oxygen species,autophagy and apoptosis

Hyperthermia is a promising anticancer treatment used in combination with radiotherapy and chemotherapy. Temperatures above 41.5 °C are cytotoxic and hyperthermia treatments can target a localized area of the body that has been invaded by a tumor. However, non-lethal temperatures (39–41 °C) can increase cellular defenses, such as heat shock proteins. This adaptive survival response, thermotolerance, can protect cells against subsequent cytotoxic stress such as anticancer treatments and heat shock (>41.5 °C). Autophagy is another survival process that is activated by stress. This study aims to determine whether autophagy can be activated by heat shock at 42 °C, and if this response is mediated by reactive oxygen species (ROS). Autophagy was increased during shorter heating times (<60 min) at 42 °C in cells. Levels of acidic vesicular organelles (AVO) and autophagy proteins Beclin-1, LC3-II/LC-3I, Atg7 and Atg12-Atg5 were increased. Heat shock at 42 °C increased levels of ROS. Increased levels of LC3 and AVOs at 42 °C were inhibited by antioxidants. Therefore, increased autophagy during heat shock at 42 °C (<60 min) was mediated by ROS. Conversely, heat shock at 42 °C for longer times (1?3 h) caused apoptosis and activation of caspases in the mitochondrial, death receptor and endoplasmic reticulum (ER) pathways. Thermotolerant cells, which were developed at 40 °C, were resistant to activation of apoptosis at 42 °C. Autophagy inhibitors 3-methyladenine and bafilomycin sensitized cells to activation of apoptosis by heat shock (42 °C). Improved understanding of autophagy in cellular responses to heat shock could be useful for optimizing the efficacy of hyperthermia in the clinic.     

Der Einfluß der Umgebungstemperatur auf Motilität,Körpertemperatur und Sauerstoffverbrauch von normalen und Pervitin-behandelten Mäusen

Single mice were kept in various ambient temperatures (15° to 35° C) and motility, oxygen consumption, and body temperature were recorded. Untreated animals: Motility was least at 25° C room temperature. Relations between motility and body temperature were linear at all ambient temperatures. The body temperatures of very agile mice did not vary at ambient temperatures from 15° to 30° C whereas that of quiet mice was strongly influenced by the milieu. The relations between oxygen consumption and body weight were also linear at all ambient temperatures; the corresponding regression coefficients decreased progressively with rising ambient temperatures. Oxygen consumption increased at a constant rate with motility, independent of ambient temperatures. Animals treated with methamphetamine: The LD₅₀ of methamphetamine decreased considerably with rising ambient temperature. The influence on body temperature of methamphetamine was very variable and depended on both dose and ambient temperature. Toxic doses of methamphetamine induced hyperthermia in warm surroundings and hypothermia in a cool milieu. Under the influence of methamphetamine, oxygen consumption increased or decreased considerably with the body temperature. Ambient temperatures exerted an essential influence on the cause of death after toxic doses of methamphetamine.     

Neue Ergebnisse über die Arbeitshyperthermie des Menschen

Nielsen (1938) demonstrated that hypothermia during exercise is independent of room temperature within a range from 5° to 32° C. Subsequently, other investigators confirmed this observation. From these results,Asmussen &Nielsen (1947) concluded that a resetting of the thermoregulatory centre brought about by impulses reaching the brain from the working muscles or from the motor centres takes place. In order to find out whether impulses from motor centres really affect the thermoregulatory centres, we tried, by administration of curare in human beings, to increase the frequency of impulses necessary to bring about a certain amount of mechanical work. However, in 2 series of experiments at room temperatures of 23° and 34° C respectively and at a constant work output of 3 mkp/sec, no significant differences in body temperature (measured in the lower esophagus) before and during curare infusion could be detected. In the resting conditions, curare exerts no influence on body temperature. In normal subjects performing low work (3 mkp/sec) the body temperature decreases at a room temperature of 23° C but increases at a room temperature of 32° C. In conclusion, the hyperthermia during exercise cannot be due to a resetting of thermoregulatory centres. It works rather like a proportional closed loop control system. The relative independence of the hyperthermia from the environmental temperature suggests a considerable influence of the latter parameter via the thermoreceptors of the skin on the thermoregulation during work.     

Temperature measurements in a capacitive system of deep loco-regional hyperthermia

Hyperthermia has been shown to be a medically useful procedure applicable for different indications. For the connection between clinical effects and heat, it is important to understand the actual temperatures achieved in the tissue. There are limited temperature data available when using capacitive hyperthermia devices even though this is worldwide the most widespread method for loco-regional heating. Hence, this study examines temperature measurements using capacitive heating. Bioequivalent phantoms were used for the measurements, which, however, do not consider perfusion in live tissue. In general, the required temperature impact for an effective cancer therapy should need an increase of 0.2°C/min, which has been achieved. In the described tests on the non-perfused dummy, on average, the temperature increases by approximately 2°C in the first 12 min. The temperature difference relative to the starting temperature was 10–12°C within a therapy time of 60 min (rising from the initial room temperature between 20–24°C and 32–34°C). The average deviation with three individual measurements each on different days in a specified localization was 2°C. The minimum temperature difference was 4.2°C, and the maximum value was reached in the liver with 10.5°C. These values were achieved with a moderate energy input of 60–150 watts, with much higher performance outputs still available.

These results show that the tested capacitive device is capable of achieving quick temperature increase with a sufficient impact into the depth of a body.     

Thermal salivation in rats anesthetized with barbiturates,chloralose, urethane and ketamine

1. The relationship between thermal salivation (TS) and thermoregulation was studied in anesthetized rats.2. Of the 6 anesthetics used, ketamine-anesthetized rats secreted the largest amount of saliva. Salivation, however, was thermal and not induced by ketamine itself.3. Ketamine-anesthetized rats readily secreted saliva at core temperatures less than 40°C but TS was remarkably enhanced by hyperthermia of 40–42.5°C.4. The equilibrium phase in the triphasic heat response of core temperature was a consequence of equilibrium between heat gain and heat loss by salivation.     

THE PERMISSIVE ROLE OF HYPERTHERMIA IN THE DISAGGREGATION OF BRAIN POLYSOMES BY l-DOPA OR d-AMPHETAMINE1

Abstract— l -DOPA or d -amphetamine administration disaggregates brain polyribosomes in animals maintained in an environment warm enough (26°C) so that the drugs concurrently elevate their body temperatures to above 39°C. The production of equivalent hyperthermia (by keeping control rats at ambient temperatures of 40–44° C) does not cause similar disaggregation of brain polysomes. Hence, the role of hyperthermia in the drug-induced disaggregation is permissive.     

Physical exercise-induced changes in the core body temperature of mice depend more on ambient temperature than on exercise protocol or intensity

The mechanisms underlying physical exercise-induced hyperthermia may be species specific. Therefore, the present study aimed to investigate the effects of exercise intensity and ambient temperature on the core body temperature (T _core) of running mice, which provide an important experimental model for advancing the understanding of thermal physiology. We evaluated the influence of different protocols (constant- or incremental-speed exercises), treadmill speeds and ambient temperatures (T _a) on the magnitude of exercise-induced hyperthermia. To measure T _core, a telemetric sensor was implanted in the abdominal cavity of male adult Swiss mice under anesthesia. After recovering from the surgery, the animals were familiarized to running on a treadmill and then subjected to the different running protocols and speeds at two T _a: 24 °C or 34 °C. All of the experimental trials resulted in marked increases in T _core. As expected, the higher-temperature environment increased the magnitude of running-induced hyperthermia. For example, during incremental exercise at 34 °C, the maximal T _core achieved was increased by 1.2 °C relative to the value reached at 24 °C. However, at the same T _a, neither treadmill speed nor exercise protocol altered the magnitude of exercise-induced hyperthermia. We conclude that T _core of running mice is influenced greatly by T _a, but not by the exercise protocols or intensities examined in the present report. These findings suggest that the magnitude of hyperthermia in running mice may be regulated centrally, independently of exercise intensity.     

Effect of exercise-induced hyperthermia on serum iron concentration

Serum iron levels have been shown to decline both with fever and with strenuous exercise, leading to the supposition that the decrease might be the result of a rise in core body temperature. To evaluate this hypothesis, the serum iron response to an exercise-induced 1.5°C rise in core body temperature was measured. To increase core temperature, five females and two males exercised in an environmental chamber heated to 41°C with a relative humidity of 40%. Blood samples were taken before exercise and immediately after body temperature increased approximately 1.5°C. Blood was also collected 1 h, 6 h, and 24 h postexercise. Results showed that the core body temperature significantly increased (p<0.001) from a mean baseline value of 36.5±0.1°C to 38.1±0.1°C following exercise. A one-way repeated measures analysis of variance was used to examine the effect of increased core body temperature on serum iron levels over the five time periods: preexercise, immediate postexercise, and 1 h, 6 h, and 24 h postexercise. The results indicated that there were no significant differences in serum iron levels among time periods. This suggests that the previously reported depression of serum iron levels that occurs with fever and after prolonged exercise is not the result of hyperthermia. Rather, the change in serum iron occurs in response to biological or physiological stressors, such as bacterial infection, muscle damage, or unusual trauma. Further studies are needed to explicate the mechanisms responsible for these changes.