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Biomedical subjects

F K Butler

Publications and source records attributed to F K Butler.

24 records · Page 2Linked to original sources

Central nervous system oxygen toxicity in closed circuit scuba divers II.

Central nervous system oxygen toxicity is currently the limiting factor in underwater swimming/diving operations using closed-circuit oxygen equipment. A dive series was conducted at the Navy Experimental Diving Unit in Panama City, FL, to determine whether these limits can be safely extended and also to evaluate the feasibility of making excursions to increased depth after a previous transit at a shallower depth for various lengths of time. A total of 465 man-dives were conducted on 14 different experimental profiles. In all, 33 episodes of oxygen toxicity were encountered, including 2 convulsions. Symptoms were classified as probable, definite, or convulsion. Findings were as follows: symptom classification is a useful tool in evaluating symptoms of oxygen toxicity; safe exposure limits should generally be adjusted only as a result of definite symptoms or convulsions; the following single-depth dive limits are proposed: 20 fsw (6.1 msw)--240 min, 25 fsw (7.6 msw)--240 min, 30 fsw (9.1 msw)--80 min, 35 fsw (10.7 msw)--25 min, 40 fsw (12.2 msw)--15 min, 50 fsw (15.2 msw)--10 min; a pre-exposure of up to 4 h at 20 fsw causes only a slight increase in the probability of an oxygen toxicity symptom on subsequent downward excursions; a pre-exposure depth of 25 fsw will have a more adverse effect on subsequent excursions than will 20 fsw; a return to 20 fsw for periods of 95-110 min seems to provide an adequate recovery period from an earlier excursion and enables a second excursion to be taken without additional hazard; nausea was the most commonly noted symptom of oxygen toxicity, followed by muscle twitching and dizziness; dives on which oxygen toxicity episodes were noted had a more rapid rate of core temperature cooling than dives without toxicity episodes; several divers who had passed the U.S. Navy Oxygen Tolerance Test were observed to be reproducibly more susceptible to oxygen toxicity than the other experimental divers.

Adult↗

Report of an isolated mid-frequency hearing loss following inner ear barotrauma.

A case describing an isolated mid-frequency hearing loss as a result of inner ear barotrauma is presented. The onset of symptoms was insidious but progressed to a profound total-range hearing loss in the right ear. This loss resolved rapidly with cessation of diving activity, bed rest, and head elevation, leaving only an isolated 20-dB hearing decrement at 1000 Hz. Since the diver was participating in evaluation of experimental decompression tables, differentiation had to be made between barotrauma and inner ear decompression sickness.

Adult↗

Diving and hyperbaric ophthalmology.

Exposure of the human body to ambient pressures greater than that at sea level may result in various disorders, some of which have ocular manifestations. Additionally, some eye disorders and postoperative states may be adversely affected by the underwater environment or other hyperbaric exposures. The prevalence of recreational, military, and commercial diving, as well as the medical use of hyperbaric oxygen therapy, requires that ophthalmologists be familiar with the effects of the hyperbaric environment on the normal and diseased eye. The ophthalmology and diving medical literatures were surveyed for publications relating to the ophthalmic aspects of diving and hyperbaric exposures. Underwater optics, underwater refractive correction, and ophthalmic aspects of a fitness-to-dive evaluation are summarized. The evaluation and management of ocular manifestations of decompression sickness and arterial gas embolism are reviewed and guidelines for diving after ocular surgery are proposed.

Barotrauma↗

A focal brain abnormality in panic disorder, a severe form of anxiety.

Panic disorder is characterized by recurrent anxiety attacks in the absence of a frightening stimulus. It is a common disorder, affecting 2-5% of the general population and 10-14% of patients seen in cardiology practice. Infusion of sodium (DL)lactate precipitates an anxiety attack in most persons with this disorder but rarely does so in normal controls, suggesting a neurobiological basis for the problem. Despite this observation, the pathophysiology of panic disorder remains unknown. We have now used positron emission tomography to measure cerebral blood flow (CBF) in patients with panic disorder in the absence of a panic attack. Analysis of CBF in regions thought to mediate symptoms of panic, anxiety and vigilance reveals a significant (P less than 0.005) abnormal asymmetry of CBF (left less than right) located in a region of the parahippocampal gyrus. This asymmetry was present in seven patients with panic disorder and a positive response to lactate infusion but was absent in six normal controls and in three patients with panic disorder associated with a negative response to lactate. We believe this to be the first study to identify a discrete brain abnormality in patients with this severe form of anxiety.

Anxiety Disorders↗