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At least 1,153 records · Page 64Linked to original sources
PubMed1989

[Great depth pneumatic caisson and its load work involved with the efficiency of respiratory protection].

Pneumatic caisson work in Japan has been in operation since 1924. Afterward, this technique of compressed air work has been utilized in the constructions like as foundation works, the basements, and shafts of the bottom tunnel or shields for subway and so forth. While, it means for people to be exposed to hyperbaric environment that they use compressed air work, this technique has risks to be suffered from not only decompression sickness (DCS) but toxicity of poisonous gas or oxygen deficiency. However, this technique is necessary for urban civil engineering and recent compressed air works over than 1.0 kg/cm2 has been increased in 1.5 times more than in 1970's and the higher compressed air work more than 4.0 kg/cm2 will be actually planned in near future. So unmanned caisson work is considered as a better technique for such high pressure work, even though people must enter into hyperbaric working fields for maintenance or repair of unmanned operated machinery and materials. This research is to establish the safety work under hyperbaric environment within 7 kg/cm2. It is necessary for us to establish the system not only to keep safety but to maintain working efficiency. According to obtain the purpose, the effect of respiratory protection has been investigated and work load under hyperbaric caisson work has also been studied.

Adult↗
PubMed1990

[Working ability between air and trimix breathing gas under 8 ATA air condition].

Pneumatic caisson work in Japan has come into operation since 1924. Afterward, this technique of compressed air work has been widely utilized in the construction of foundation basements, shafts of the bottom tunnel shields for subway and so forth. While using this technique of compressed air work means that workers have to be exposed to hyperbaric environment, this technique has risks of not only decompression sickness (DCS) but also toxicity of poisonous gas and/or oxygen deficiency. However, this technique is independent of city construction work and the operation of compressed air work higher than 5ATA (4.0 kg/cm2G) is actually been planning recently. Accordingly unmanned caisson work is considered as a better technique for such higher pressurized work, even though workers must enter into hyperbaric working fields for maintenance or repair of unmanned operated machinery and materials. This research is to establish the safe work under hyperbaric air environment at 8ATA.

Adult↗
PubMed2000

Research on nitrogen-oxygen saturation diving with repetitive excursions.

For some tasks of underwater operation the need for longer dive duration and more working divers necessitates the use of saturation diving techniques with excursions. Saturation diving with excursion has high working efficiency. A collaborative experiment with Chinese Underwater Technology Institute, American National Office of Research Undersea Program and Hamilton Research Ltd. was conducted at our Institute in Shanghai. The main experiment objectives were to assess the longer, deeper repetitive excursions during nitrogen-oxygen saturation situation, oxygen exposure management, nitrox saturation decompression after excursions and performance aspects. Four Chinese professional experienced divers were saturated at 25 msw for 5 days at the hyperbaric facility, where they did 15 air excursions to depths between 50 and 75 msw, for duration up to 240 min. Decompression from excursions to the storage were mostly no-stops, but 5 required stops for 3 to 116 min. Saturation decompression began with the "precursory" ascent following a brief return to 25 msw. Doppler bubble detection showed some bubbles of Spencer Grade II and occasionally III, following excursions and during saturation decompression, especially after muscle flexing. No symptoms of decompression sickness were reported: one diver was more of fatigued on one occasion than other times. Oxygen exposure reached its peak of 3103 Oxygen Toxicity Units on Day 6. The only subjective symptom of oxygen toxicity was mild and transient numb fingertips. No significant change was seen in vital capacity.

Adult↗
PubMed1988

Ductus arteriosus in pilot whales.

The ductus arteriosus (DA), connecting the aorta with the pulmonary artery in the fetus, which normally closes up just after birth in terrestrial mammals, has been claimed not to close, but to remain open in normal, adult cetaceans, just as in the adult lungfish. We have examined the hearts from two Pilot Whales. In those we found no persisting DA, but an almost totally obliterated lumen. Blood flow through the ductus of these two whales could be excluded. Instead of an anatomical shunt mammals may use a functional pulmonary shunt. To the extent diving mammals can empty their alveoli for air at depth through reinforced bronchioli, and their very compliant thorax, they block alveolar gas exchange, and thus avoid decompression sickness, nitrogen narcosis and pulmonary squeeze.

Animals↗
PubMed2004

Patent foramen ovale and stroke.

A patent foramen ovale (PFO) is a frequent remnant of embryological development with clinical importance in thromboembolism, paradoxical embolism, stroke, platypnea-orthodeoxia, decompression sickness, and migraine headache. The proposed mechanisms of stroke with PFO include paradoxical embolization, in situ thrombosis within the canal of the PFO, associated atrial arrhythmias, and concomitant hypercoagulable states. Prospective trials using aspirin treatment to reduce recurrent stroke showed a significant recurrence of neurologic events in patients with a PFO and atrial septal aneurysm. Use of warfarin anticoagulation does not further reduce recurrent stroke rates compared with antiplatelet therapy. Both surgical and catheter-based modes of closure have been shown to decrease the rate of subsequent embolic events substantially. Successful closure, defined by transesophageal echocardiography, appears to predict freedom from subsequent embolic events. To our knowledge, no randomized trials comparing anticoagulation with surgical or catheter-based closure have been performed.

Echocardiography, Transesophageal↗
PubMed1999

[New approaches in neurosurgery and hyperbaric medicine--the importance of preventive and industrial medicine].

Neurosurgical patients have been mainly treated by surgical procedures over the past decades. In addition, hyperbaric oxygen (HBO) therapy in neurosurgery has been used in patients with ischemic cerebrovascular diseases, head trauma, spinal damage, postoperative brain edema and others. However, the main therapeutic methods for neurosurgical diseases have changed dramatically due to developments in radiological techniques, such as radiosurgery and intravascular surgery. With changes in therapeutic methods, HBO therapy may become a very important treatment option for neurosurgical patients. For example, HBO therapy combined with radiotherapy (UOEH regimen) and anticoagulant therapy appear to be very effective in the treatments of malignant brain tumors and ischemic cerebrovascular diseases, respectively. On the other hand, medical examinations under hyper- and hypobaric environments have not yet been fully studied in the central nervous system compared to those in the cardiopulmonary systems. Moreover, the mechanisms of cerebral lesions in decompression sickness and acute mountain sickness remain unclear. Clinical neurologic approaches are very important in these fields. Hence, clinicians and researchers skilled in both neurosurgery and hyperbaric medicine will be required for advanced treatment and preventive and industrial medicine.

Anticoagulants↗
PubMed1976

South African underwater diving accidents, 1969-1976.

Since 1969 a survey of diving accidents involving South African amateur divers was undertaken. The South African Underwater Union diving accident report form was used, and various State agents (SA Police and inquest courts) and individual divers and club instructors were questioned. This survey covers the period up to the end of June 1976. Data acquired during the 8-year period 1969 - 1976 are compared. A conservative estimate from the number of certificates issued to club divers indicates a 25% increase in diver population, while the number of fatilities has decreased from 0,1% in 1971 to 0,016% in 1976, indicating the importance of accident reporting in determining safety trends. In general, a change in pattern is observed during the last 4 years, showing more SCUBA than breath-hold fatalities. The formation of the Decompression Sickness and Diving Accidents Investigation Panel as a further measure to decrease fatal diving accidents is discussed.

Accidents↗
PubMed1999

Medical advice for commercial air travelers.

Family physicians are often asked to advise patients who are preparing to travel. The Air Carrier Access Act of 1986 has enabled more passengers with medical disabilities to choose air travel. All domestic U.S. airlines are required to carry basic (but often limited) medical equipment, although several physiologic stresses associated with flight may predispose travelers with underlying medical conditions to require emergency care. Recommendations for passengers with respiratory, cardiac or postsurgical conditions must be individualized and should be based on objective testing measures. Specific advice for patients with diabetes, postsurgical or otolaryngologic conditions may make air travel less hazardous for these persons. Air travel should be delayed after scuba diving to minimize the chance of developing decompression sickness. Although no quick cure for jet lag exists, several simple suggestions may make travel across time zones more comfortable.

Aerospace Medicine↗
PubMed1999

[Aviation physiology].

Aviation physiology should be known at least in parts by the physicians advising air travellers. Due to reducing atmospheric pressure at altitude gas volume in body cavities expands (Boyle's law). This might not be a problem during ascend since air can disappear easily through natural ways. However, air must return to body cavities during descend and a person with a cold may suffer from painful barotitis. Hypoxia is mostly due to a reduced pO2 in high altitude (Daltons's Law). This may be prevented by an aircraft cabin or supplemented oxygen. Decompression sickness is very rare in aviation but divers should comply to a dive free interval before flying.

Aerospace Medicine↗
PubMed2000

[Macular functions in professional divers].

PURPOSE: Air diving is frequently practiced by professionals or sportsmen. Controversial data exist in the literature on the existence of retinal abnormalities in divers. PATIENTS AND METHODS: 18 divers (aged: 27-58y) who dived around 2000 times in their life were studied: half of them dived only with air while the others used an O2-enriched gas mixture (40 to 60%). None of them had presented a bend (decompression sickness). Visual acuity and ocular fundus examination have been explored. A quantification of color vision and central visual field, so as a fluorescein angiography have been performed. RESULTS: No alteration of visual acuity was noted; abnormalities in the color vision and the visual field are reported; however the angiographic lesions described in the literature have not been observed. DISCUSSION: The alterations of color vision were quite severe but not very frequent. No correlation was found with any characteristics or type of diving. CONCLUSION: These observations are comforting for sportive divers who do not dive very often nor very deep but an individual predisposition is suspected.

Adult↗
PubMed1976

The effects of body position and a vasodilator on xenon133 elimination from human subcutaneous fat.

The elimination of Xe133 from a deposit in the subcutaneous adipose tissue adjacent to the anterior tibial muscle was recorded by an external scintillation detector in 16 human subjects in sitting and in supine body position in a neutral environmental temperature (28 degrees C). The xenon clearance rate was increased in supine compared to sitting body position by a mean of 33%. I also studied the effect of a sympathomimetic beta 2-receptor stimulating agent using the same technique in 16 supine subjects. A perorally administered ester of terbutaline increased the xenon-elimination rate by a mean of 103%. The increased xenon-elimination rates in the supine body position and after the drug administration may reflect corresponding increases in adipose-tissue blood flow. The findings are in accordance with earlier measurements of an increase in central and peripheral blood flow and an increased whole-body, nitrogen-elimination rate during supine body position. The results might be of importance in decompression routines and in the treatment of decompression sickness.

Adipose Tissue↗
PubMed1996

Hearing loss in diving--a study amongst Navy divers.

Despite the commonly observed condition of middle and inner ear barotrauma among divers, there is little evidence of insidious and permanent development of sensorineural hearing loss associated with diving. An audiometric survey was performed on a group of 120 divers and 166 non divers from the Royal Malaysian Naval Base in Lumut, West Malaysia between July to December 1991. The results of this survey revealed that insidious development of high frequency sensorineural hearing loss may be associated with diving. At frequencies 4000, 6000 and 8000 Hz the divers had higher mean hearing levels than non divers and their hearing at those frequencies seemed to deteriorate faster. The etiology of this insidious hearing loss is multifactorial and may be related to inner ear barotrauma, decompression sickness or noise-induced deafness.

Adolescent↗
PubMed2001

[Iatrogenic gas embolism].

BACKGROUND: Gas embolism may occur as a consequence of lung injury, decompression sickness, surgery or as accidental infusion of gas during various diagnostic procedures. Iatrogenic gas embolism is often not recognised, but can lead to severe morbidity or even death. MATERIAL AND METHODS: We present a case of iatrogenic paradoxical air embolism caused by a defect in a central venous catheter. A review of the literature is given. RESULTS: The patient recovered gradually, but suffered significant neurological deficits. INTERPRETATION: Gas embolism must be considered as a differential diagnosis when a patient presents with unexplained neurological symptoms. Prompt treatment using oxygen at increased pressures (hyperbaric oxygen treatment) may be lifesaving and prevent serious sequelae.

Adult↗
PubMed2001

Orbital hemorrhage following face-mask barotrauma.

A 41-yr-old female recreational diver suffered an orbital hemorrhage following face-mask barotrauma This case illustrates the potential for significant orbital injury to occur as a result of face-mask barotrauma Barotraumatic orbital hemorrhage is an unusual disorder, but recognition of this entity is important for diving physicians. The signs and symptoms should not be mistaken for decompression sickness or arterial gas embolism. Patients with barotraumatic orbital hemorrhage require emergency referral to an ophthalmologist so that potentially vision-threatening ocular complications may be identified and treated. Barotrauma may result in several different types of cranial neuropathies and should be recognized as another possible cause for neurologic deficits following a dive.

Adult↗
PubMed2002

Rabbitfish ("aras"): an unusual source of ciguatera poisoning.

BACKGROUND: Ciguatera poisoning is the commonest fish-borne seafood intoxication. It is endemic to warm water tropical areas and is caused by consumption of bottom-dwelling shore reef fish, mostly during spring and summer. The causative agent, ciguatoxin, is a heat-stable ester complex that becomes concentrated in fish feeding on toxic dinoflagellates. The common clinical manifestations are a combination of gastrointestinal and neurologic symptoms. Severe poisoning may be associated with seizures and respiratory paralysis. OBJECTIVE: To describe a series of patients who sustained ciguatera poisoning in an uncommon region and from an unexpected source. PATIENTS: Two families complained of a sensation of "electrical currents," tremors, muscle cramps, nightmares, hallucinations, agitation, anxiety and nausea of varying severity several hours after consuming rabbitfish ("aras"). These symptoms lasted between 12 and 30 hours and resolved completely. The temporal relationship to a summer fish meal, the typical clinical manifestations along with the known feeding pattern of the rabbitfish suggested ciguatera poisoning. CONCLUSIONS: The Eastern Mediterranean basin is an unusual region and the rabbitfish an unusual source for ciguatera poisoning. There are no readily available and reliable means for detecting ciguatoxin in humans. A high index of suspicion is needed for diagnosis and a thorough differential diagnosis is essential to eliminate other poisonings, decompression sickness and encephalitis. Supportive therapy is the mainstay of treatment.

Adult↗
PubMed1975

Rupture of the round window membrane.

Considerable interest has been displayed in sudden sensori-neural deafness in recent years, and especially since Blair Simmons postulated that this could be caused by mechanical disruption of the membranes in the inner ear. The literature concerning such reports is reviewed briefly and two cases of rupture of the round window membrane resulting from inner ear barotrauma are reported in detail. Both these cases were experienced divers who had had little difficulty in auto-inflation whilst diving. The first case had progressive sensori-neural deafness with mild vertigo, and tympanotomy revealed rupture of the round window membrane in both ears. These ruptures were repaired with plugs of fat, following which his hearing was restored. The second case developed marked vertigo following a dive and was thought to be suffering from decompression sickness. When the appropriate treatment did not help him, tympanotomy was performed and a rupture of the round membrane was found. This was plugged with fat with a most satisfactory result. Both of these cases had difficulty with autoinflation, and had been aware of such difficulties for some time. Nasal problems were responsible for this, and it is strongly recommended that all divers should have normal nasal function and that they should be educated in the technique of autoinflation, and, in particular, in the importance of avoiding forceful autoinflation at all times. A third case of rupture of the round membrane following an injury to the head is also reported.

Adult↗
PubMed2002

Microdialysis in cisterna magna during cerebral air embolism in swine.

Arterial gas embolism may occur as a consequence of lung rupture, decompression sickness, following operative procedures or as accidental infusion of gas during various diagnostic procedures. It can lead to severe morbidity or even death. Microdialysis is a technique that has been extensively used for evaluating localized changes in the brain. The microdialysis probe is only capable of measuring changes in the immediate adjacent tissue. In arterial gas embolism the changes are multifocal. Thus a probe located in the cerebral cortex will not detect the total amount of damage. We used microdialysis in the cisterna magna of 9 anaesthetized pigs to study the diffuse injury following arterial gas embolism. After injection of 5.0 mL of air in the internal carotid artery, we found a significantly increased lactate-pyruvate ratio in the cerebrospinal fluid, lasting for 2 hours. This indicates anaerobic metabolism. Mean levels of glycerol were significantly increased, indicating membrane disruption. Glutamate levels were also elevated, although not significantly. The injection of air affected carotid flow. Flow in the carotid artery of the side of injection decreased significantly, but returned to baseline in 1 hour. Flow in the contralateral carotid was increased, but not significantly. We conclude that massive air embolism causes ischemia and reduced blood flow in the brain that can be detected in the cisterna magna.

Animals↗