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At least 55 records · Page 3Linked to original sources

Nitrogen tensions in brachial vein blood of Korean ama divers.

Intravascular bubble formation and symptoms of decompression sickness have been reported during repetitive deep breath-hold diving. Therefore we examined the pattern of blood N2 kinetics during and after repetitive breath-hold diving. To study muscle N2 uptake and release, we measured brachial venous N2 partial pressure (PN2) in nine professional Korean breath-hold divers (ama) during a 3-h diving shift at approximately 4 m seawater depth and up to 4 h after diving. PN2 was determined with the manometric Van Slyke method. Diving time and depth were recorded using a backpack computer-assisted dive longer that allowed calculating the surface-to-depth time ratio to derive the effective depth. With the assumption that forearm muscle N2 kinetics follow the general Haldanian principles of compression and decompression, i.e., forearm muscle is a single compartment with a uniform tissue PN2 equal to venous PN2, PN2 data were fitted to monoexponential functions of time. In the early phase of the diving shift, PN2 rapidly increased to 640 Torr (half time = 6 min) and then slowly declined to baseline levels (half time = 36 min) after the work shift. Peak PN2 levels approximated the alveolar PN2 derived from the effective depth. We conclude that forearm muscle N2 kinetics are well described by a Haldanian single-compartment model. Decompression sickness is theoretically possible in the ama; it did not occur because the absolute PN2 remained low due to the shallow working depth of the ama we studied.

Diving↗

Fatal dissecting aneurysm of the aorta in a diver.

A 20-yr-old trained sports diver developed severe chest pain shortly after decompressing from a 40 m repetitive freshwater sinkhole dive, and died 6 h later. An autopsy examination showed a dissecting aneurysm of the aorta with rupture into the left pleural cavity. The relationship between the fatal event and the diving is discussed.

Adult↗

Fetal development: effects of stimulated diving and hyperbaric oxygen treatment.

Fetuses from hamsters exposed to repetitive 5.2-ATA (140 fsw) air dives during early pregnancy showed no significant differences from the control group in birth weight, frequency of malformation, or death. Also, exposure of mothers to hyperbaric oxygen as required for treatment of decompression sickness (DCS) has no adverse effect on fetal development or survival. Although the number of females who suffered and survived DCS in this study was small (n = 3), teratogenic effects were nevertheless found among the fetuses of this group. In fact, at least one fetus from each female undergoing DCS was found to have serious malformations. These results suggest that DCS during early organogenesis may have significant deleterious effects on fetal development.

Animals↗

Heart rates of northern elephant seals diving at sea and resting on the beach.

Heart rates of northern elephant seals diving at sea and during apnoea on land were monitored to test whether a cardiac response to submergence is an important factor in their ability to make repetitive, long-duration dives. Seven juvenile northern elephant seals were captured at Año Nuevo, CA, instrumented and translocated to release sites around Monterey Bay. Heart rate and dive depth were recorded using custom-designed data loggers and analogue tape monitors during the seals' return to Año Nuevo. Heart rates during apnoea and eupnoea were recorded from four of the seals after they hauled out on the beach. Diving patterns were very similar to those of naturally migrating juveniles. The heart rate response to apnoea at sea and on land was a prompt bradycardia, but only at sea was there an anticipatory tachycardia before breathing commenced. Heart rate at sea declined by 64% from the surface rate of 107 +/- 3 beats min-1 (mean +/- S.D.), while heart rate on land declined by 31% from the eupnoeic rate of 65 +/- 8 beats min-1. Diving heart rate was inversely related to dive duration in a non-linear fashion best described by a continuous, curvilinear model, while heart rate during apnoea on land was independent of the duration of apnoea. Occasionally, instantaneous heart rate fell as low as 3 beats min-1 during diving. Although bradycardia occurs in response to apnoea both at sea and on land, only at sea is heart rate apparently regulated to minimise eupnoeic time and to ration oxygen stores to ensure adequate supplies for the heart and brain not only as the dive progresses normally but also when a dive is abnormally extended.

Animals↗

Multiple cerebral infarction in Japanese breath-hold divers: two case reports.

We report on two Japanese breath-hold divers (ama) who developed neurological disturbances following more than 3 hours of consecutive dives to 15-25 meters of seawater. Their magnetic resonance images of the brain showed multiple cerebral infarcts which were consistent with their neurological symptoms. The cerebral lesions seem to have been caused by repetitive breath-hold dives for extended periods of time. Immediate recompression is required when neurological symptoms develop after such dives.

Adult↗

Converting standard air decompression tables for no-stop diving from altitude or habitat.

Using the phase equilibration theory of Hills (1966), as modified by Hennessy and Hempleman (1977), it is possible to predict formulas for converting standard air decompression tables for no-stop diving at altitude or from a normoxic habitat, breathing air. For diving following equilibration at altitude, the Royal Navy, Royal Naval Physiological Laboratory, and Haldane-type rules appear to be too conservative, with the opposite result for diving after excursion to altitude. Predictions in the latter case are in fair agreement with the Swiss (Boni, Schibli, Nussberger, and Bühlmann 1976) no-stop altitude tables. In the case of habitats, close agreement is found between the Hamilton, Kenyon, Freitag, and Schreiner (1973) normoxic tables for no-stop downward excursions and indefinite dive upward-excursions on air. In the case of flying directly after no-stop diving, the US Navy rule of using repetitive group D appears to be conservative for dives less than 50 fsw, and possibly unsafe for dives over 50 fsw. It is concluded that for no-stop diving a single tissue and single safe ascent pressure formula are all that is necessary to generate equivalent air dives. This enforces the hypothesis that it is the volume of gas released on ascent that governs marginal type I bends, and that in a no-stop ascent, all excess dissolved gas is released in the worst case.

Aerospace Medicine↗

Neutrophil tolerance to oxidative stress induced by hypoxia/reoxygenation.

Repetitive episodes of hypoxia/reoxygenation induce cellular adaptations resulting in a tolerance process against oxidative stress. We studied the effects of chronic episodes of hypoxia/reoxygenation on neutrophil antioxidant defenses, neutrophil oxidative capability, and oxidative damage induced in neutrophils and plasma. Seven professional apnea divers participated in the study. Blood samples were taken under basal conditions, after a diving apnea session, and under basal conditions after five consecutive days of diving apnea sessions (basal post-diving). Chronic episodes of hypoxia/reoxygenation increased malondialdehyde (MDA), carbonyl derivates and creatine kinase (CPK) in plasma. Neutrophil catalase (CAT) levels were higher in basal post-diving. Neutrophil oxidative burst was maintained after diving, although the maximum response was delayed in basal post-diving. Neutrophil thioredoxin reductase (TR) activity increased in basal post-diving, and glutathione reductase (GR) activity was maintained. Chronic, repetitive episodes of diving apnea induce neutrophil adaptations in order to delay the oxidative burst response and to facilitate protein reduction. Diving apnea could be a good model to study tolerance to the oxidative stress generated by hypoxia/ reoxygenation.

Adaptation, Physiological↗

Neurological manifestations in Japanese Ama divers.

Repetitive breath-hold (BH) diving can lead to accumulation of nitrogen (N2) in blood and tissues, which may give rise to decompression illness (DCI). An unusual condition is "Taravana", the diving syndrome reported by Cross in the 1960s. That report generated wide discussion as to whether BH diving can cause DCI. Paulev was the first person to suggest the link between DCI and BH diving. He, a submarine medical officer developed symptoms of DCI after a series of BH dives, having proceeded the dives by spending time in a hyperbaric chamber at 20 meters for 8 minutes. Recently four professional Japanese BH divers (Ama) with histories of diving accidents were reported. Magnetic resonance imaging of these divers detected cerebral infarcts localized in the watershed areas of the brain. A survey conducted on their island revealed that many Ama divers had experienced stroke-like events. A clinical feature of DCI in BH diving is that the damage is limited to the brain. Although the mechanisms of brain damage in BH diving are unclear, N2 bubbles passing through the lungs or the heart so as to become arterialized are most likely to be the etiological factor.

Adult↗

Antioxidant enzymes in ringed seal tissues: potential protection against dive-associated ischemia/reperfusion.

Diving seals experience heart rate reduction and preferential distribution of the oxygenated blood flow to the heart and brain, widespread peripheral vasoconstriction, and selective ischemia in the most hypoxia-tolerant tissues. The first breath after the dive restores the oxygenated blood flow to all tissues and raises the potential for the production of reactive oxygen species (ROS). We hypothesized that in order to counteract the damaging effects of ROS and to tolerate repetitive cycles of ischemia/reperfusion associated with diving, ringed seal (Phoca hispida) tissues have elevated activities of antioxidant enzymes. Activities of superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GPx) and glutathione-S-transferase (GST) were measured by spectrophotometric techniques in heart, kidney, liver, lung, and muscle extracts of ringed seals and domestic pigs (Sus scrofa). The results suggest that in ringed seal heart SOD, GPx and GST activities are an efficient protective mechanism for counteracting ROS production and its deleterious effects. Apparently CAT activity in seal liver and GPx activity in seal muscle participate in the removal of hydroperoxides, while seal lung appears to be protected from oxidative damage by SOD and GPx activities.

Animals↗

Habituation of the cardiac response to involuntary diving in diving and dabbling ducks.

1. Bradycardia in response to forced submergence was habituated in dabbling (Anas platyrhynchos, Linnaeus) and diving (Aythya americana, Eyton) ducks by repetitively submerging the animals, each day for several days, for periods of 40 and 20 s, respectively. The onset of pronounced bradycardia was delayed with each successive trial, until little or no bradycardia occurred during submergence. Diving bradycardia is driven by chemoreceptors in the dabbler and caused by stimulation of narial receptors in the diver. 2. Mean arterial blood pressure in dives was unchanged from pre-dive levels in both naive and trained dabbling ducks. PaO2, PaCO2 and pHa at the end of a dive were similar before and after habituation training. 3. Bradycardia occurred in dives by habituated dabbling ducks if the animal breathed 15% O2 before submergence. The ventilatory responses to breathing high and low levels of oxygen were unaffected by habituation training. 4. The changes in blood gases during dives by naive and habituated dabbling ducks were the same: therefore, in the absence of a demonstrated decrement in receptor chemosensitivity or efferent potency, the locus of habituation must reside in the central nervous system.

Animals↗

Human Sleep Apneas and Animal Diving Reflexes: The Comparative Link.

Adaptations to survive periods of limited access to oxygen should have been favored along the evolution of vertebrates. Paradigmatic examples of this adaptation are the diving animals, which can sustain prolonged and repetitive periods of anoxia. These animals support what would be considered a severe gas imbalance in their internal environment thanks to three main strategies: increased oxygen stores, resistance to asphyxia, and reduced metabolic expenditure during the apneic intervals. However, diving animals developed their abilities from very old life-sustaining responses that should have been used on many other occasions. Humans with sleep apneas perhaps share many physiological adaptations with diving animals. We review here the extent of such similarities and offer clear evidence of its existence and suggest possible research lines that could improve the clinical knowledge about this condition.

Journal Article↗

Does competitive apnea diving have a long-term risk? Cardiopulmonary findings in breath-hold divers.

STUDY PURPOSE: The aim of this study was to investigate the cardiopulmonary status in a competitive apnea diving team. DESIGN: This study was conducted with a cross-sectional study design in which subjects had to undergo a predefined series of cardiopulmonary examinations. SUBJECTS: Eight competitive apnea divers (mean age, 26.9 +/- 5.3 years) who were participating in international apnea diving contests. METHODS: Electrocardiographic, 2-dimensional echocardiographic, Doppler-echocardiographic, and oxymetric examinations were performed in each subject during an apnea test. RESULTS: Apnea diving experience was 2.5 +/- 0.58 years, with a training frequency of 8.9 +/- 6.0 dives per week. During an apnea test, mean apnea time was 4.5 +/- 0.96 minutes. While 2-dimensional echocardiography showed normal morphologic findings of cardiac dimensions and function, electrocardiography, and Doppler echocardiography revealed indicators suggesting the beginning of right ventricular strain. CONCLUSIONS: We interpret the findings of our study as the onset of pulmonary hypertension resulting from repetitive pulmonary vasoconstriction together with severe hypoxia during apnea diving. We conclude that regular competitive apnea diving over a period of >2 to 3 years might carry a chronic cardiopulmonary risk that may lead from early functional changes to manifestation of pulmonary hypertension.

Adult↗

Low-back pain in athletes.

While most occurrences of low-back pain in athletes are self-limited sprains or strains, persistent, chronic, or recurrent symptoms are frequently associated with degenerative lumbar disc disease or spondylolytic stress lesions. The prevalence of radiographic evidence of disc degeneration is higher in athletes than it is in nonathletes; however, it remains unclear whether this correlates with a higher rate of back pain. Although there is little peer-reviewed clinical information on the subject, it is possible that chronic pain from degenerative disc disease that is recalcitrant after intensive and continuous nonoperative care can be successfully treated with interbody fusion in selected athletes. In general, the prevalence of spondylolysis is not higher in athletes than it is in nonathletes, although participation in sports involving repetitive hyperextension maneuvers, such as gymnastics, wrestling, and diving, appears to be associated with disproportionately higher rates of spondylolysis. Nonoperative treatment of spondylolysis results in successful pain relief in approximately 80% of athletes, independent of radiographic evidence of defect healing. In recalcitrant cases, direct surgical repair of the pars interarticularis with internal fixation and bone-grafting can yield high rates of pain relief in competitive athletes and allow a high percentage to return to play. Sacral stress fractures occur almost exclusively in individuals participating in high-level running sports, such as track or marathon. Treatment includes a brief period of limited weight-bearing followed by progressive mobilization, physical therapy, and return to sports in one to two months, when the pain has resolved.

Athletic Injuries↗

Numerical phase algorithm for decompression computers and application.

Present generation decompression computers employ a simplified algorithm, limiting dissolved gas build-up in tissue and blood according to a method proposed by Haldane 80 years ago. Such a model works well for single dives, but is usually liberal and theoretically incomplete for multiple exposures within 24 hr spans. Using the critical phase hypothesis in a bubble model, we have extended the classical model of Haldane to multi-exposures. This model is discussed, and a decomputer algorithm described for multi-diving. The focus is permissible bubble excess, not just dissolved gas per se, with phase constraints affecting all tissues, fast and slow, and requiring a systematic lowering of repetitive tissue tensions. Deep repetitive and shallow multi-day exposures are impacted most by the procedure. Within nucleation theory deeper-than-first dives are also treated. A set of multi-diving fractions, xi, accounting for micronuclei excitation and regeneration, reduced bubble elimination in repetitive activity, and coupled effects on tissue tension, are proposed, with xi representing a set of multiplicative factors (less than one) applied to critical tissue tensions for multi-exposures. These factors affect repetitive activity over short time spans, deeper-than-previous and continuous multi-day activities, compared to standard computer software, and are easily encoded into existing decompression meters, potentially extending their range and flexibility over exposure regimes.

Algorithms↗

Stress fracture of the clavicle in a collegiate diver.

PURPOSE: This is the first reported case of a stress fracture of the clavicle in a collegiate diver. CASE SURVEY: A 20-year-old collegiate platform diver developed left clavicular pain after training for several months. Radiographs and radionuclide bone scan supported a diagnosis of a stress fracture of the left midclavicle. Complete fracture healing followed a period of active rest. DISCUSSION: A literature review of clavicle stress fractures is discussed. The open-hand diving technique used by this diver for water penetration may have caused repetitive stresses to radiate up the arm to the clavicle. RELEVANCE: Stress fractures should be considered in the differential diagnosis of clavicular pain in a diver.

Adult↗

Modeling dissolved and free phase gas dynamics under decompression.

Dissolved and free gases do not behave the same way in tissue under pressure, and their interaction is complex. Differences are highlighted, particularly with respect to time scales, gradients and transport. Impacts of free phases on diving are described, contrasting increased off-gassing pressures, slower ascent rates, safety stops and reduced repetitive exposures as consistent practical measures within Haldane models (limited supersaturation) which can be played off against buildup of dissolved gas. Simple computations illustrate the points.

Algorithms↗

Effect of mental task load on fronto-central theta activity in a deep saturation dive to 450 msw.

The increase of theta activity (4-7 Hz) in the electroencephalogram (EEG) during deep diving is commonly attributed to pathophysiologic mechanisms underlying the high pressure neurologic syndrome. The aim of this study was to clarify whether more precise cognitive aspects of the condition may be described in which theta activity occurs during a deep dive. Among 4 divers who were repeatedly examined during the GUSI 14 dive to 450 msw, 3 divers exhibited a pronounced correlation between short-term memory load, as varied by the memory set size of Sternberg's memory search task (MST), and the size of a distinct peak in the theta band of the EEG-power spectrum. The power of this peak was greatest in the fronto-central electrode position (Fz), increased dramatically during MST-performance at pressure, and failed to subside fully 1 day before surfacing. Despite the close dependency of observed theta activity on cognitive demands, no consistent correlation with performance measures (mean reaction time and errors) was found. In one diver, theta waves of similar morphology appeared in the resting EEG and increased significantly during the dive. We suggest two alternative explanations for the positive interaction of memory load and hyperbaric exposure on Fz-theta: a) Both factors induce a state of increased mental effort or selectivity of attention, known to be accompanied by frontal theta activity from normobaric studies. b) Pressure abnormally facilitates or patterns rhythmical excitations underlying theta activity that would occur naturally to a lesser extent during certain mental activities, learning, or repetitive short-term memory operations.

Adult↗

Screening test for decompression sickness.

The fibrin-fibrinogen degradation products (FDP) tests were studied in 18 patients having a history of illness associated with diving. FDP tests were performed prior to hyperbaric oxygen therapy (OHP). Eight patients were serious neurologic signs had positive FDP tests and required repetitive therapy. Six patients had negative FDP tests with local musculoskeletal complaints and all were asymptomatic following the first OHP treatment. Three patients were found to be suffering from other diseases. These three patients had normal levels of FDP. One patient treated at another facility 3 months earlier and having paraplegia had a positive FDP test. Serious decompression sickness with neurologic complaints appear to have some degree of disseminated intravascular coagulation (DIC) as reflected by the FDP tests. The FDP test appears to be a useful screening test that may be able to delineate therapy.

Adolescent↗