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PubMed1976

Xe133 elimination from human fat during negative- and positive-pressure breathing.

The elimination of Xe133 from a deposit in the subcutaneous adipose tissue outside the anterior tibial muscle was recorded by an external scintillation detector in 16 human subjects during normal breathing, negative-pressure breathing (-20 cm H2o), and positive-pressure breathing (+20 cm H2O). The ambient temperature was kept at 28.0 degrees C +/- 0.1 degrees, which can be considered a neutral temperature. The xenon clearance rate was increased during negative-pressure breathing by a mean of 68% and decreased during positive-pressure breathing by a mean of 73% when compared to normal breathing. The xenon-elimination rates during the different conditions may reflect corresponding changes in adipose-tissue blood flow. Because both negative- and positive-pressure breathing may occur during diving, the uptake and elimination of inert gases in adipose tissue of a diver may be influenced; thus, the risk of decompression sickness might also be affected. The results may therefore be of importance in diving routines and in the construction of breathing apparatus for divers.

Adipose Tissue↗

PubMed1994

A histopathologic and immunocytochemical study of the spinal cord in amateur and professional divers.

To clarify the influence of diving activity on the central nervous system, we studied 10 amateur and 10 professional deceased divers with emphasis on the presence of subacute or chronic pathologic changes in the spinal cord. Of the 10 professional divers (median age 38 yr; range 29-52; median experience in excess of 13 yr), 7 were experienced saturation divers. Five had dived to a maximum depth of 150 meters of seawater, the 2 others to 300 and 500 msw, respectively. Five of the professional divers had experienced decompression sickness. The experience of the amateur divers (median age 29 yr; range 17-51) varied from a few dives to many years of recreational diving. The spinal cords were formalin-fixated and routinely processed for neuropathologic examination, which included light microscopy after immunostaining for glial fibrillary acidic protein and monocyte-macrophage-microglial markers. The microscopic examination did not reveal previous spinal cord damage. Thus, diving activity, saturation diving to extreme depths included, does not in itself seem to lead to necrosis, degeneration, or scar formation in the human spinal cord.

Adolescent↗

PubMed1994

Baromedicine today--rational uses of hyperbaric oxygen therapy.

Compressed air, and more recently hyperbaric oxygen, have been used and misused in medical treatment for more than 300 years. Advances in physiology have led to rational protocols for hyperbaric oxygen use. Hyperbaric oxygen will enhance wound healing by fibroblast and capillary proliferation, suppress infection, reduce edema, reverse CNS damage from carbon monoxide and cyanide poisoning, and reduce clostridial alpha toxins. Monoplace and multiplace chambers are used for treatment during which EKG and oxygen tissue monitoring, as well as hemodynamic and respiratory support, can be continued, iatrogenic air embolism and diving decompression sickness demand immediate treatment. Investigative uses of adjunct therapy for several other clinical problems include treatment of MS, acute spinal cord injuries, and acute MI. Specific indications agreed on by the Undersea and Hyperbaric Medicine Society are recognized by most third-party payers including Medicare, Champus, and HMSA. Hyperbaric medicine remains a fertile area for basic physiologic investigation and outcomes research.

Barotrauma↗

PubMed1994

Pupil cycle time in the long-term neurologic assessment of divers.

Pupil cycle time (PCT) is an ophthalmologic technique that measures the speed of nerve conduction throughout the pupil reflex arc. An abnormally prolonged measurement may reveal subtle lesions to the autonomic nervous system. This procedure was applied to the detection of lesions in 10 experienced professional divers and three control groups: 20 non-divers, 20 sport divers, and 10 trainee professional divers. The professional group demonstrated a prolonged mean pupil cycle time compared to other groups (F = 9.732, P < 0.001). Professional divers were significantly older than other subjects, reporting longer diving histories and a higher incidence of decompression sickness. Only professional divers had saturation or trimix experience. Two divers reported long-term visual or cognitive disturbances, but all subjects demonstrated normal visual acuity. Multiple regression analysis indicated that one variable had a predominant (P < 0.01) effect on PCT: the maximum depth attained using mixed gas breathing mixtures. The utility of the technique as a component of long-term neurologic examination is discussed.

Adult↗

PubMed1996

[Indications for hyperbaric oxygen therapy. Organization of the treatment unit. Training of personnel].

Pathophysiologic mechanisms involved in the application of HBO therapy are poorly understood that may limit its clinical use. However, useful indications are well standardized in the setting of critical care medicine, CO poisoning, decompression sickness, gas gangrene and soft tissue anaerobic infections, crush syndrome, burns, sudden deafness... HBO therapy is also indicated in the management of chronic limb ischemia, diabetic foot lesion, osteomyelitis, osteoradionecrosis. These clinical indications have been evaluated in a Consensus Conference on Hyperbaric Medicine that has classified its application according to its efficiency. Indications were classified as strongly recommended (positively affects the patient's survival), recommended (does not influence the patient's survival but is important for the prevention of serious disorders) and optional (regarded as a additional treatment modality). Clinical application of HBO therapy requires specific equipment including a multiplace hyperbaric chamber and specific educational program and training for personnel employed in the clinical hyperbaric center. Lastly, HBO therapy is related to accurate rules defining its indications as well as its evaluation that are minimal prerequisites for safety and clinical results.

Atmosphere Exposure Chambers↗

PubMed1976

Dysbaric osteonecrosis in mice.

The histopathology of dysbaric osteonecrosis and the influence of the number of exposures, compression rate, and obesity on the incidence and latency of the lesion were studied in 438 mice (2505 bones were examined). The animals were subjected to 75 psig air pressure for 2-6 hours (single or multiple exposures). Compression was rapid or stage. Decompression was safe. Osteonecrosis developed in the epiphysis of the tibia and/or femur in 34.1% of obese and in 5.8% of thin animals after a latent period of 2 to at least 12 months. It was concluded that: 1. dysbaric osteonecrosis appears to be independent of decompression sickness; 2. in obese mice the incidence is higher and the latent period shorter; 3. multiple exposures result in higher incidence and earlier lesions than single exposure; 4. the incidence is lower with stage than with rapid compression; 5. the pathogenesis of osteonecrosis may involve several factors (circulatory impairment by extravascular or intravascular bubbles, emboli, thrombi, vasoactive substances, gas-induced osmosis, autoimmunity) acting in concert or in sequence.

Animals↗

PubMed1976

[Barotrauma].

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Altitude Sickness↗

PubMed1997

Surface tension of blood.

The surface tension of blood assessed in a group of 71 healthy subjects (24 men and 47 women) by the drop method at a temperature of 22 degrees C was 55.89 x 10(-3) N x m(-1), S.D.=3.57 x 10(-3) N x m(-1). It did not correlate with age or sex of the examined subjects nor with any of the following variables: red cell sedimentation rate, blood haemoglobin levels, number of erythrocytes, total serum cholesterol, total serum triacylglycerols, creatinine blood levels, ALT and AST activity. The surface tension of blood and other body fluids can play an important part not only in the genesis and development of decompression sickness but also in other processes in the organism.

Adolescent↗

PubMed1976

Injectable agent for the treatment of air emboli-induced paraplegia in rats.

Rats with air emboli-induced paraplegia were treated with dialy levodopa injections (intra-arterially or intraperitoneally). Of the control animals, 20% fully recovered from paraplegia during a period of 7 d. Of the levodopa treated animals, 85% fully recovered during the same period. It appears, therefore, that levodopa might be one of the few injectable agents enhancing recovery from air-induced paraplegia, suggesting its possible use in decompression sickness.

Animals↗

PubMed1952