MIT-HOL kerdes [0290]: orvostudomanyi

[Fazekas Andrea]

At 11:17 1999.11.08.=02=19=CC=B6=A4=07=0F=12 +0100, you wrote:
>Eletkor: felnott
>Hely:
>Nyelv: magyarangol
>Forras: mindegy
>Kerdes: Agyserulesek es repules (turbulencia,legnyomas kulonbseg)kozotti
osszefuggesek.
>Miert: Egy serult szemely szamara fontos informaciot jelentene.
>Hol kereste: Sehol.
>


1. A Jogtar-CD alapjan Magyarorszag es Ausztralia kozott csak adoztatas,
beruhazas es bunugyi jogsegely temakorokben van megallapodas.

2. A Medline-ban vegeztem keresest a repules kozbeni agyserules temaban es
nagyon keves irodalmat talaltam.

Udvozlettel:
Egy internet-konyvtaros

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1990-tol napjainkig a kovetkezo irodalmakat talaltam:

Cerebral arterial gas embolism in air force ground maintenance crew--a
report of two cases.
Lee-CT
Department of Diving and Hyperbaric Medicine, Lumut Armed Forces Hospital,
Royal Malaysian Naval Base. ctlee at tm.net.my
Aviat-Space-Environ-Med. 1999 Jul; 70(7): 698-700
Two cases of cerebral arterial gas embolism (CAGE) occurred after a
decompression incident involving five maintenance crew during a cabin
leakage system test of a Hercules C-130 aircraft. During the incident, the
cabin pressure increased to 8 in Hg (203.2 mm Hg, 27 kPa) above atmospheric
pressure causing intense pain in the ears of all the crew inside. The system
was rapidly depressurized to ground level. After the incident, one of the
crew reported chest discomfort and fatigue. The next morning, he developed a
sensation of numbness in the left hand, with persistence of the earlier
symptoms. A second crewmember, who only experienced earache and heaviness in
the head after the incident, developed retrosternal chest discomfort,
restlessness, fatigue and numbness in his left hand the next morning. Both
were subsequently referred to a recompression facility 4 d after the
incident. Examination by the Diving Medical Officer on duty recorded
left-sided hemianesthesia and Grade II middle ear barotrauma as the only
abnormalities in both cases. Chest X-rays did not reveal any extra-alveolar
gas. Diagnoses of Static Neurological Decompression Illness were made and
both patients recompressed on a RN 62 table. The first case recovered fully
after two treatments, and the second case after one treatment. Magnetic
resonance imaging (MRI) of the brain and bubble contrast echocardiography
performed on the first case 6 mo after the incident were reported to be
normal. The second case was lost to follow-up. Decompression illness (DCI)
generally occurs in occupational groups such as compressed air workers,
divers, aviators, and astronauts. This is believed to be the first report of
DCI occurring among aircraft's ground maintenance crew.

High-altitude medicine.
Harris-MD; Terrio-J; Miser-WF; Yetter-JF-3rd
Madigan Army Medical Center, Tacoma, Washington, USA.
Am-Fam-Physician. 1998 Apr 15; 57(8): 1907-14, 1924-6
As more people enjoy the outdoors, high-altitude illness is increasingly
becoming a problem that family physicians across the country must treat.
High-altitude illness, which usually occurs at altitudes of over 1,500 m
(4,921 ft), is caused primarily by hypoxia but is compounded by cold and
exposure. It presents as one of three forms: acute mountain sickness (AMS),
high-altitude pulmonary edema (HAPE) and high-altitude cerebral edema
(HACE). But high-altitude illness can have many other manifestations.
Cardinal symptoms include dyspnea on exertion and at rest, cough, nausea,
difficulty sleeping, headache and mental status changes. Treatment requires
descent, and gradual acclimatization provides the most effective prevention.
Acetazolimide is an effective preventive aid and can be used in certain
conditions as treatment.

Effects of high atmospheric pressure and oxygen on middle cerebral blood
flow velocity in humans measured by transcranial Doppler.
Omae-T; Ibayashi-S; Kusuda-K; Nakamura-H; Yagi-H; Fujishima-M
Yagi Hospital, Fukuoka, Japan. omae at qmed.hosp.go.jp
Stroke. 1998 Jan; 29(1): 94-7
BACKGROUND AND PURPOSE: There are several reports that have studied the
effects of hyperbaric oxygen (HBO) on cerebral blood flow (CBF). However,
most of the reports have been of animal experiments, and human studies are
few so far. The aim of this study is to clarify the relationship between HBO
and CBF in humans. METHODS: Middle cerebral arterial blood flow velocity
(MCV) was measured using transcranial Doppler (TCD) technique in a
multiplace hyperbaric chamber. The Doppler probe was fixed on the temporal
region by a head belt, and the transcutaneous gas measurement apparatus
(tcPO2 and tcPCO2) was fixed on the chest wall. MCV and transcutaneous gas
were measured continuously in eight healthy volunteers under four various
conditions: 1 atmosphere absolute (ATA) air, 1 ATA oxygen (O2), 2 ATA air,
and 2 ATA O2. On the next step, the effect of environmental pressure was
studied in another eight healthy volunteers, in whom the tcPO2 was kept at
almost the same level under conditions of both 1 ATA and 4 ATA by inhaling
oxygen at 1 ATA. RESULTS: MCV of 1 ATA O2, 2 ATA air, and 2 ATA O2
decreased, and tcPO2 increased significantly in comparison with that of 1
ATA air. A significant difference in MCV was observed between the O2 group
and the air group under the same pressure circumstance. On the other hand,
there were no differences in MCV or tcPO2 between 4 ATA air and 1 ATA plus
O2, and the influence for the MCV of the environmental pressure was not
observed. CONCLUSIONS: We conclude that hyperoxemia caused by HBO reduces
the CBF, but the high atmospheric pressure per se does not influence the CBF
in humans.

Neurological manifestation of arterial gas embolism following standard
altitude chamber flight: a case report.
Rios-Tejada-F; Azofra-Garcia-J; Valle-Garrido-J; Pujante-Escudero-A
Centro de Instruccion de Medicina Aeroespacial (C.I.M.A.), Madrid, Spain.
Aviat-Space-Environ-Med. 1997 Nov; 68(11): 1025-8
In the course of a decompression at flight level 280 (28,000 ft) in an
altitude chamber flight, a 45-yr-old cabin air traffic controller developed
sudden numbness in his left upper and lower extremities and, soon after,
complete paralysis in the left side, dysarthria and left facial palsy. A
presumptive diagnosis of arterial gas embolism (AGE) was made and hyperbaric
oxygen therapy (HBO) was given after airevac of the patient to the closest
compression facility. Complete resolution of the symptoms was obtained after
treatment Table VI-A (extended), plus 3 consecutive HBO treatments (90 min
of Oxygen at 2.0 ATA). AGE is a rare event in the course of regular altitude
chamber flight and diagnosis should be done in the context of the barometric
pressure changes and an acute cerebral vascular injury. Risk factors and
follow-up diagnostic procedures are discussed.

Dysbarism: the medical problems from high and low atmospheric pressure [see
comments]
James-PB
Wolfson Hyperbaric Medicine Unit, Ninewells Hospital, Medical School,=
 Dundee.
J-R-Coll-Physicians-Lond. 1993 Oct; 27(4): 367-74
The most serious problems resulting from a change in ambient pressure are
pulmonary barotrauma with air embolism and decompression sickness. The small
differential pressures used in ventilators at atmospheric pressure may tear
lung tissue and, in diving, deaths have occurred from the expansion of
pulmonary gas on an ascent of less than two metres. The bubbles of respired
gas that enter the systemic circulation often occlude cerebral arteries and
may cause infarction. In decompression sickness, bubbles form in the tissues
from supersaturation of the nitrogen or helium absorbed under pressure.
Joint pain--the 'bends'--is associated with gas in particular connective
tissue. Serious decompression sickness results from the entry of
microbubbles into the systemic veins. Large numbers of bubbles trapped in
the lung cause an acute respiratory syndrome known as 'chokes'. If the lung
filter is overwhelmed, or microbubbles pass into the systemic arteries
through an atrial septal defect, they may open the blood-brain barrier,
affecting brain and spinal cord function. Untreated, demyelination with
relative preservation of axons may occur, the pathological hallmarks of
multiple sclerosis. Gas bubble disease requires urgent compression in a
hyperbaric chamber and the use of high partial pressures of oxygen.