Hyperbaric oxygenation as a treatment for facial palsy.
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Adolescent↗
Biomedical subjects
N Konda
Publications and source records attributed to N Konda.
Radiotherapy after hyperbaric oxygenation for malignant gliomas: a pilot study.
The results of radiotherapy combined with hyperbaric oxygen in 9 patients with malignant glioma were compared with those of radiotherapy without hyperbaric O2 in 12 patients. This is the first report of a pilot study of irradiation immediately after exposure to hyperbaric O2 in humans. All patients receiving this treatment showed more than 50% regression of the tumor, and in 4 of them, the tumors disappeared completely. Only 4 out of 12 patients without hyperbaric O2 showed decreases in tumor size, and all 12 patients died within 36 months. So far, this new regimen seems to be a useful form of radiotherapy for malignant gliomas.
Adolescent↗
In situ arterial and brain tissue PCO2 responses to acetazolamide in cats.
We have studied how in situ arterial (PaCO2) and brain tissue PCO2 (PbCO2) responses to acetazolamide (AZ) are affected by respiratory patterns. Sixteen cats were anesthetized with ketamine. Group 1 cats (n = 7) breathed air spontaneously. Group 2 cats (n = 6) were paralyzed and ventilated mechanically to maintain PaCO2 at 37 +/- 1 Torr before AZ administration; the respiratory rate and depth did not change during the course of measurements. Two CO2 sensors to measure in situ PaCO2 and PbCO2 continuously were used. One was placed through a burr hole into the cerebral white matter 15 mm in depth, and another was inserted into the femoral artery. After intravenous administration of AZ (20 mg/kg), PaCO2 decreased, after a significant transient rise, and then returned gradually to the baseline in group 1, but it increased gradually and reached a new steady state in group 2. PbCO2 and the PbCO2-PaCO2 gradient increased remarkably in the two groups immediately after administration. We conclude that AZ resulted in a large increase in both PbCO2 and the PbCO2-PaCO2 gradient and that there are two distinct in situ PaCO2 responses to AZ in spontaneously breathing vs. mechanically ventilated animals. The mechanisms for these observations are discussed.
Acetazolamide↗
Hyperbaric oxygen therapy adjunctive to mild hypertensive hypervolemia for symptomatic vasospasm.
The efficacy of hyperbaric oxygen (HBO) therapy was evaluated retrospectively in 43 patients who developed symptomatic vasospasm following acute aneurysm surgery. HBO therapy was given as an adjunct to mild hypertensive hypervolemia in 24 patients. Before HBO therapy, 17 patients had no infarct (Group 1), and seven had infarcts (Group 2) caused by vasospasm. A further 19 patients received mild hypertensive hypervolemia alone (Group 3). Cerebral infarcts developed in four Group 1 and 12 Group 3 patients. A good outcome 1 month after surgery was achieved by 13 Group 1 (76%), one Group 2, and seven Group 3 patients (37%). Fifteen of the 24 patients who received HBO therapy responded to HBO exposure, and 12 responding patients (80%) had a good outcome. During HBO exposure, electroencephalographic improvements were all accompanied by neurological improvements. There were no complications related to HBO therapy. HBO therapy adjunctive to mild hypertensive hypervolemia is helpful in preventing cerebral infarction associated with symptomatic vasospasm.
Adult↗
Intracranial pressure responses during hyperbaric oxygen therapy.
The responses of intracranial pressure (ICP) to hyperbaric oxygen (HBO) therapy and arterial gas pressures were investigated. ICP was measured through a ventricular or spinal drainage catheter in patients with brain tumor or cerebrovascular disease. Changes in ICP, heart rate (HR), arterial blood pressure (ABP), and transcutaneous partial pressure of carbon dioxide (PtcCO2) or oxygen (PtcO2) were recorded continuously during air or 100% O2 breathing at 1 and 2.5 atmospheres absolute (ATA). HR and PtcCO2 decreased and mean ABP was unchanged during HBO inhalation. ICP was reduced at the beginning and tended to increase gradually during HBO inhalation. The change from air to O2 without altering respiratory frequency and volume caused a gradual increase of ICP and PtcCO2 with a transient ICP reduction in an artificially respirated patient. Intentionally reduced respiration to maintain PtcCO2 at the value at 2.5 ATA with air caused the ICP to return to near the value at 2.5 ATA with air even during HBO inhalation. These findings suggest that reduced ICP is initially due to direct cerebral vasoconstriction caused by hyperoxia and is maintained mainly by induced hypocapnia during HBO inhalation. Care is required when giving HBO therapy to patients with a high ICP and/or who are respirated artificially.
Adult↗
Human auditory brain stem response during induced hyperthermia.
A continuous monitoring of auditory brain stem response (ABR) and esophageal (Tes) and rectal temperatures (Tre) were recorded in male undergraduate subjects to investigate a relationship between the interpeak latencies (IPLs) and core temperature. The average change of Tes (36.8-39.5 degrees C) was achieved by immersing the subjects in a temperature-controlled water bath (30-42 degrees C). The IPLs became shorter with the rise in body temperature and were correlated with both Tes and Tre. The average slopes for IPL(I-III) and IPL(I-V) were significantly higher than those for IPL(III-V). The present study of humans indicated that changes of IPL(I-III) and IPL(I-V) were 0.11 and 0.16 ms, respectively, per 1 degree C change in core temperature during induced hyperthermia.
Adult↗
Water temperature and intensity of exercise in maintenance of thermal equilibrium.
This study examined the thermal and metabolic responses of six men during exercise in water at critical temperature (Tcw, 31.2 +/- 0.5 degrees C), below Tcw (BTcw, 28.8 +/- 0.6 degrees C), at thermoneutrality (Ttn, 34 degrees C), and above Ttn (ATtn, 36 degrees C). At each water temperature (Tw) male volunteers wearing only swimming trunks completed four 1-h experiments while immersed up to the neck. During one experiment, subjects remained at rest (R), and the other three performed leg exercise (LE) at three different intensities (LE-1, 2 MET; LE-2, 3 MET; LE-3, 4 MET). In water warmer than Tcw, there was no difference in metabolic rate (M) during R. The M for each work load was independent of Tw. Esophageal temperature (Tes) remained unchanged during R in water of ATtn (36 degrees C). However, Tes significantly (P less than 0.05) declined over 1 h during R at Ttn (delta Tes = -0.39 degrees C), Tcw (delta Tes = -0.54 degrees C), and BTcw (delta Tes = -0.61 degrees C). All levels of underwater exercise elevated Tes and M compared with R at all Tw. In water colder than Tcw, the ratio of heat loss from limbs compared with the trunk became greater as LE intensity increased, indicating a preferential increase in heat loss from the limbs in cool water. Tissue insulation (Itissue) was lower during LE than at R and was inversely proportional to the increase in LE intensity. A linearly inverse relationship was established between Tw and M in maintaining thermal equilibrium.(ABSTRACT TRUNCATED AT 250 WORDS)
Adult↗
Physiological responses of aged men to head-up tilt during heat exposure.
The effects of age on cardiovascular and thermoregulatory responses to passive tilting were investigated using six old (61-73 yr) and 10 young (21-39 yr) unacclimatized men. Experiments were carried out at 26 degrees C and after exposure to 40 degrees C and 40% relative humidity for 105 min. Continuous measurements of esophageal (Tes) and mean skin (Tsk) temperatures and heart rate (HR) were recorded. Other variables studied included blood pressure (BP), forearm blood flow (FBF), and cardiac output (CO), which were measured at 4- to 5-min intervals. Measurements were made in the supine position and after 70 degrees head-up tilt for 15 min. Cardioacceleration during the tilt test was greater in the young men than in the old. Other cardiovascular responses of the old men to orthostatism were qualitatively similar to that of the young except for FBF and forearm vascular conductance. The old men did not show significant changes in FBF during tilting, suggesting a deterioration in the sympathetic nervous reflex in the aged. However, other circulatory adaptations seemed to overcome this deficiency resulting in orthostatic tolerance similar to that of the young. During head-up tilt at 26 and 40 degrees C, Tes of both age groups increased. This may reflect a decrease in conductive heat transfer presumably due to diminished blood flow to the periphery.
Aged↗
Cardiovascular responses of aged men to orthostatism during heat exposure.
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Adult↗
Seadragon VI: a 7-day dry saturation dive at 31 ATA. II. Characteristics of diuresis and nocturia.
Four male divers were exposed to a dry, 31 ATA, He-O2 environment for 7 d (Seadragon VI). Urine was collected diurnally (0700-2200 h) and nocturnally (2200-0700 h) before (predive 1 ATA air), during, and after (decompression and postdive 1 ATA air) exposure to 31 ATA. A typical hyperbaric diuresis associated with a reduction in urine osmolality was observed in the face of a constant creatinine clearance. A significant increase (P less than 0.05) in osmolal clearance (COSM) was observed with concomitant decrease (P less than 0.05) in negative free water clearance, indicating that the diuresis has both osmotic and free water components. Although urine flow increased at pressure during both day and night, its magnitude was twofold greater at night as compared to daytime. Moreover, the diurnal diuresis was entirely due to an increase in free water excretion, whereas the nocturnal diuresis was largely due to an increased COSM. These results indicate that hyperbaric diuresis is induced by inhibition of tubular reabsorption of free water during daytime and of certain solutes during the night. Approximately 80% of the nocturnal increase in the excretion of osmotic substances was accounted for by Na, K, Cl, and urea.
Adult↗
Seadragon VI: a 7-day dry saturation dive at 31 ATA. IV. Circadian analysis of body temperature and renal functions.
Circadian rhythms of body temperature and daytime rhythms of urine flow and urinary excretion of electrolytes were investigated in 4 male subjects before, during, and after a 7-d stay in a dry heliox 31 ATA environment. The chamber temperature was maintained at about 28 degrees C during pre- and postdive 1 ATA periods and was raised to 31.5 degrees C at 31 ATA. The circadian rhythm of the rectal temperature, as analyzed by the cosinor fitting method, showed the same mesor (the mean level of fluctuation) and the amplitude at 31 and 1 ATA. However, a reversible phase shift was noted at 31 ATA in which the acrophase shifted to 1435 h at 31 ATA from 1540 h (predive) or 1610 h (postdive) at 1 ATA. This shift was attributed to an early rise of rectal temperature during night at 31 ATA. A similar phase shift was observed at 31 ATA for the skin temperature of the forehead, a region not covered by clothing or blanket. The daytime rhythms of urinary excretion of water, Na, Cl, urea, and total osmotic substances were similar, with the acrophase at 1300-1500 h at both 1 and 31 ATA. On the other hand, the daytime rhythm for urinary excretion of K, which was similar to the above at 1 ATA, disappeared at 31 ATA. The urinary excretion of endogenous creatinine remained constant during both daytime and nighttime at both 1 and 31 ATA. These results suggest that exposure to 31 ATA may alter the underlying pattern of circadian or daytime rhythms for thermoregulatory and certain renal functions.
Adult↗
Cardiorenal-endocrine responses to head-out immersion at night.
Cardiorenal-endocrine responses to 3-h head-out immersion (HOI) (water temperature = 34.5 +/- 0.5 degrees C) were studied during day (0900-1400 h) and night (2300-0400 h) in six hydropenic male human subjects. Although HOI induced a reversible increase in urine flow in all subjects, the response was faster and greater in magnitude during the day compared with night (P less than 0.05). Na excretion and osmolal clearance (Cosm) also followed the identical response pattern as urine flow, and in fact, the HOI-induced diuresis was entirely accounted for by the increased Cosm. Endogenous creatinine clearance was not different between the day and the night and remained unchanged during HOI. Both plasma renin activity and aldosterone concentration and urinary aldosterone excretion were nearly twofold greater during the day compared with night before HOI but decreased to the same level during HOI in both daytime and the nighttime series (P less than 0.05). There was no correlation between the Na excretion rate and renin-aldosterone levels either before or during HOI. Plasma antidiuretic hormone (ADH) level was comparable between day and night before HOI and decreased to a similar level during HOI in both daytime and nighttime series (P less than 0.05 for nighttime HOI). Cardiac output increased from 3.3 1/min before HOI to 5-6 1/min during HOI without showing any significant circadian difference. Hematocrit, hemoglobin, and plasma concentrations remained unchanged under all conditions. It is concluded that the renal response to HOI is subject to nocturnal inhibition, which cannot be attributed to circadian differences in the degree of HOI-induced central blood pooling, renin-aldosterone, or ADH responses.
Adult↗
Cutaneous vascular responses to heat simulated at a high altitude of 5,600 m.
Six healthy young men were studied in a high-altitude chamber during a 60-min heat exposure at a simulated altitude of 5,600 m or 0.5 atmosphere absolute (ATA). The heat load was provided by increasing the chamber temperature to 38 degrees C at the rate of 1 degree C/min after a 60-min equilibrium period at thermoneutrality (28 degrees C). Our question was whether or not hypoxia causes differential changes in regional cutaneous circulation during heat exposure. Skin blood flow in the forearm (FBF) and the finger (FiBF), temperatures of the esophagus (Tes) and of the skin, and cardiac output (CO) were measured during the heat exposure at 0.5 ATA and at the sea level (1 ATA). During the equilibrium period, hypoxia increased the mean skin temperature and mean heat transfer coefficient, as well as FBF and forearm vascular conductance. The increased blood flow in the cutaneous circulation during the hypoxic exposure may reflect cutaneous vasodilation and vasoconstriction in other regions of the body, since there was no alteration in CO and total peripheral resistance. During heat exposure, Tes rose faster at high altitude than at sea level. However, at the end of the 60-min heat exposure, all thermal as well as circulatory parameters showed no difference between the two altitudes, except for the FiBF. An attenuated vasodilation in the fingers during heat exposure at high altitude suggests differential vascular controls and possible impairment of thermoregulation when additional stress, such as heat, is imposed. The data suggest that cutaneous blood flow during heat exposure is not uniform throughout the entire skin in a hypoxic environment.
Adult↗
Esophageal and tympanic temperature responses to core blood temperature changes during hyperthermia.
Esophageal, rectal, tympanic, and central blood temperature, i.e., pulmonary artery and aortic arch, were recorded in three patients during iatrogenic whole-body hyperthermia for the treatment of advanced malignant metastatic cancer. Aortic temperature closely followed changes in pulmonary arterial temperature, with an average delay time of 27 s. Esophageal temperature reflected quantitatively and more quickly (avg lag time, 80 s) the temperature changes in the pulmonary artery than tympanic membrane temperature. Tympanic temperature was consistently lower than the blood temperature of the heart during steady state. Therefore it is suggested that esophageal temperature is a preferable index of central blood temperature. Additionally, measurement of esophageal temperature can be made more easily and safely than tympanic membrane temperature.
Adult↗
Energetics of wet-suit diving in Japanese male breath-hold divers.
The present study was undertaken to investigate energy balance in professional male breath-hold divers in Tsushima Island, Japan. In 4 divers, rectal (Tre) and mean skin (Tsk) temperatures and rate of O2 consumption (VO2) were measured during diving work in summer (27 degrees C water) and winter (14 degrees C water). Thermal insulation and energy costs of diving work were estimated. In summer, comparisons were made of subjects clad either in wet suits (protected) or in swimming trunks (unprotected), and in winter, they wore wet suits. The average Tre in unprotected divers decreased to 36.4 +/- 0.2 degrees C at the end of 1-h diving work, but in protected divers it decreased to 37.2 +/- 0.3 degrees C in 2 h in summer and to 36.9 +/- 0.1 degree C in 1.5 h in winter. The average Tsk of unprotected divers decreased to 28.0 +/- 0.6 degrees C in summer and that of protected divers decreased to 32.9 +/- 0.5 degrees C in summer and 28.0 +/- 0.3 degrees C in winter. Average VO2 increased 190% (from 370 ml/min before diving to 1,070 ml/min) in unprotected divers in summer, but in protected divers it rose 120% (from 360 to 780 ml/min) in summer and 110% (from 330 to 690 ml/min) in winter. Overall thermal insulation (tissue and wet suit) calculated for protected divers was 0.065 +/- 0.006 degree C X kcal-1 X m-2 X h-1 in summer and 0.135 +/- 0.019 degree C X kcal-1 X m-2 X h-1 in winter.(ABSTRACT TRUNCATED AT 250 WORDS)
Acclimatization↗
Cardiac output by impedance cardiography during head-out water immersion.
This study was undertaken to ascertain the suitability of impedance cardiography for qualifying cardiac output during water immersion where the electrodes were wet. The cardiac output was compared during wet and dry immersion with the head above water by breath holding briefly at 3 lung volumes. For dry immersion, the subjects were protected from contacting water during immersion by enveloping the whole body in a thin plastic bag. For wet immersion, the subject went into the water wearing only trunks. Eleven healthy males served as subjects. Both basal thoracic impedance and the minimum rate of impedance change decreased during wet immersion. These changes were specific, which insignificantly influenced the computation of stroke volume as compared to dry immersion. Our results showed no statistical differences between wet and dry immersions, and between measurements made at total lung capacity functional residual capacity, or residual volume. It is concluded that impedance cardiography is applicable directly in wet conditions without having to protect the subject from getting wet.
Adult↗
Hyperbaric diuresis and nocturia--a review.
Human divers are now able to engage in a multi-day dive to a considerable depth using the mixed gas saturation diving technique, however their daily activities are somewhat limited in the depth. One of the major problems that has not been generally appreciated is the potential for body fluid disturbances at high pressure due to the development of a sustained diuresis. In addition, a marked nocturia has been observed in recent saturation dives at 26-31 atmospheres absolute (ATA), which disturbs divers' sleep during the night. In this review, we will briefly discuss the basic characteristics and mechanisms of these disturbances of renal functions observed during hyperbaric exposure.
Adult↗
Diving pattern of Tsushima male breath-hold divers (Katsugi).
The present study was undertaken to investigate the diving pattern, buoyancy-mass relationship, and some respiratory functions in professional male breath-hold divers in Tsushima Island, Japan. These divers always wear neoprene wet suits and use fins and 4-kg counterweights. They usually dive to 3-10 m depths. The rate of descent was 1.12 m/s for deeper dives (greater than 10 m), which is nearly twofold greater than that of Korean female divers also wearing wet suits and fins. However, the rate of ascent (0.8 m/s) was comparable to that of Korean women divers. On a typical summer day, they spend nearly 4 h in the water and perform 175 dives. The average dive and surface time were 39 and 42 s, respectively. The total bottom time was estimated to be 67 min/d, nearly twice that of Korean women divers. These divers do not adjust the counterweight and all are using a 4-kg weight. Nevertheless, the buoyancy-mass relationship revealed that they maintain the same degree of positive buoyancy (approximately 10% above the neutral level) at surface as do Korean women divers who adjust counterweights. The vital capacity was significantly greater in the diver than in the control (P less than 0.05), which was largely due to the greater expiratory reserve volume in the diver. The end-tidal O2 and CO2 pressures of the diver resting in air were not different from those of the control. These results indicate that, while the basic diving pattern is similar in both male and female breath-hold divers, the overall efficiency of diving (in terms of the rate of descent and the bottom time) appears to be superior in male divers.
Adult↗