Air Medical Transport of a 12-Year-Old Girl With Cerebral Gas Embolism Due to Helium Inhalation.

This case report describes the initial care and transport considerations of a pediatric patient who suffered from cerebral gas embolism sustained after inhalation of helium from a pressurized tank. The patient demonstrated neurologic symptoms necessitating hyperbaric oxygen therapy and required fixed wing air transport across a mountain range from a rural community hospital to a tertiary center for the treatment. We review the pathophysiology of cerebral gas embolism and strategies for transporting patients with cerebral gas embolism and other trapped gas.

Cold atmospheric pressure He-plasma jet and plasma ball interactions with the Venus flytrap: Electrophysiology and side effects.

Cold atmospheric pressure radio frequency plasma (CAPP) can play an important role in agriculture, medicine, biophysical and bioelectrochemical applications, disinfection and sterilization, synthesis of different compounds, nitrogen fixation, and treatment of surfaces. Here we found that reactive oxygen and nitrogen species, UV-Vis photons, and high-frequency strong electromagnetic fields with an amplitude of a few kV produced by a cold plasma jet can interact with bio-tissue and damage it if the plasma treatment is long enough. The electrophysiological effects of CAPP treatment of bio-tissue and electrical signals transmission were measured in the Venus flytrap. The plasma ball does not produce any visible side effects on the Venus flytrap, but induces electrical signals in bio-tissue with very high amplitude. Plasma (Kirlian) photography shows the existence of a blue aura around the plasma ball due to a corona discharge. Understanding the mechanisms of interactions between CAPP and bio-tissue and preventing side effects can contribute to the application of plasma technology in medicine and agriculture. The use of cold plasma in medicine and agriculture should be monitored for side effects from strong high-frequency electro-magnetic fields, UV photons, and reactive oxygen and nitrogen species to protect against undesirable consequences.

Localized dose delivering by ion beam irradiation for experimental trial of establishing brain necrosis model.

Localized dose delivery techniques to establish a brain radiation necrosis model are described. An irradiation field was designed by using accelerated protons or helium ions with a spread-out Bragg peak. Measurement of the designed field confirmed that a high dose can be confined to a local volume of an animal brain. The irradiation techniques described here are very useful for establishing a necrosis model without existence of extraneous complications.

Neurological oxygen toxicity.

SCUBA diving has several risks associated with it from breathing air under pressure--nitrogen narcosis, barotrauma and decompression sickness (the bends). Trimix SCUBA diving involves regulating mixtures of nitrogen, oxygen and helium in an attempt to overcome the risks of narcosis and decompression sickness during deep dives, but introduces other potential hazards such as hypoxia and oxygen toxicity convulsions. This study reports on a seizure during the ascent phase, its potential causes and management and discusses the hazards posed to the diver and his rescuer by an emergency ascent to the surface.

Effects of nitrogen and helium on CNS oxygen toxicity in the rat.

The contribution of inert gases to the risk of central nervous system (CNS) oxygen toxicity is a matter of controversy. Therefore, diving regulations apply strict rules regarding permissible oxygen pressures (Po(2)). We studied the effects of nitrogen and helium (0, 15, 25, 40, 50, and 60%) and different levels of Po(2) (507, 557, 608, and 658 kPa) on the latency to the first electrical discharge (FED) in the EEG in rats, with repeated measurements in each animal. Latency as a function of the nitrogen pressure was not homogeneous for each rat. The prolongation of latency observed in some rats at certain nitrogen pressures, mostly in the range 100 to 500 kPa, was superimposed on the general trend for a reduction in latency as nitrogen pressure increased. This pattern was an individual trait. In contrast with nitrogen, no prolongation of latency to CNS oxygen toxicity was observed with helium, where an increase in helium pressure caused a reduction in latency. This bimodal response and the variation in the response between rats, together with a possible effect of ambient temperature on metabolic rate, may explain the conflicting findings reported in the literature. The difference between the two inert gases may be related to the difference in the narcotic effect of nitrogen. Proof through further research of a correlation between individual sensitivity to nitrogen narcosis and protection by N(2) against CNS oxygen toxicity in rat may lead to a personal O(2) limit in mixed-gas diving based on the diver sensitivity to N(2) narcosis.

Cerebral arterial gas embolism by helium: an unusual case successfully treated with hyperbaric oxygen and lidocaine.

A 27-year-old man inhaled helium from an unregulated pressurized cylinder and underwent cerebral arterial gas embolism (CAGE), leaving him blind and with radiologic evidence initially suggesting cortical infarction. There was complete recovery of vision and substantial regression of the radiologic changes after 4 hyperbaric oxygen treatments and a 54-hour lidocaine infusion, which began 6 hours after the accident. This is the second reported case of CAGE occurring by this mechanism and the first case of unequivocal CAGE in which lidocaine has been used as an adjunctive treatment with hyperbaric oxygen.

Investigation of lipid peroxidation in liposomes induced by heavy ion irradiation.

Lipid peroxidation induced by heavy ion irradiation was investigated in 1,2-dilinoleoyl-sn-glycero-3-phosphocholine (DLPC) liposomes. Lipid peroxidation was induced using accelerated heavy ions that exhibit linear energy transfer (LET) values between 30 and 15000 keV/microm and doses up to 100 kGy. With increasing LET, the formation of lipid peroxidation products such as conjugated dienes, lipid hydroperoxides, and thiobarbituric acid-reactive substances decreased. When comparing differential absorption spectra and membrane fluidity following irradiation with heavy ions and x-rays (3 Gy/min), respectively, it is obvious that there are significant differences between the influences of densely and sparsely ionizing radiation on liposomal membranes. Indications for lipid fragmentation could be detected after heavy ion irradiation.

Electromyographic study of respiratory muscles during human diving at 46 ATA.

Electromyographic (EMG) recordings of the 6th to 7th intercostal space (thoracic EMG) and abdominal muscles, ventilatory pattern, and the work of breathing were studied in 4 human subjects exposed for 12 days to 46 ATA of helium-oxygen (density = 8.7 g.liter-1) then of nitrogen-helium-oxygen gas mixture (ternary mixture) (density = 11.1 g.liter-1). We found that the respiratory muscle work necessary for eupneic ventilation was multiplied by 4 at 46 ATA. During quiet breathing as well as during forced inspiratory maneuvers, the power spectrum of thoracic EMG shifted to the left in three individuals during the sojourn at maximal pressure, whichever gas mixture was inhaled. This was corroborated by the decreased ratio of EMG power in a high to that in a low band of frequencies. These alterations disappeared at the end of the decompression period, suggesting the existence of inspiratory muscle fatigue at high pressure. Hyperbaric tremor was recorded on the thoracic EMG and was maximal with He-O2 inhalation. It disappeared at the end of the period at 46 ATA (He-N2-O2).

[Helium-oxygen mixture and the body (the hyperbaric aspect)]. / Geliokislorodnaia smes' i organizm (giperbaricheskii aspekt).

A review of publications discussing the effect of hyperbaric He-O2 atmosphere demonstrates that its effect on the human body depends primarily on its physical parameters, density and heat conductance. Another specific effect of the atmosphere--its narcotic effect at increased pressures used in diving--still remains poorly documented. However, it appears a well recognized fact that the specific effect can be seen only in the transition period, i. e. during compression.

Quantification of high pressure nervous syndrome (HPNS) tremor in the guinea pig.

Previous studies have demonstrated two tremorgenic systems that involve separate brain mechanisms and exhibit different peak frequencies. One system (the thalamo-cortical) generates low frequency (4--8 Hz) tremor; the other (the olivo-cerebellar) produces high frequency (10--18 Hz) tremor. Based on this evidence, the present study focused on determining whether one or both of these tremor systems is involved in the high pressure nervous syndrome (HPNS). Specifically, the concern was to identify and to quantify amplitude and frequency characteristics of HPNS tremor in 8 guinea pigs breathing helium-oxygen during compression (40 ft/min) in a chamber dive to 61.6 ATA (2000 fsw) with a bottom time of 1 h. Rectal temperature was recorded and maintained at 39 degrees C +/- 1 degree. Leg tremor was recorded by magnetic inductance and stored on magnetic tape for power spectral analysis. Frequency histograms of the tremor data revealed development of a biphasic response. From surface to about 31.3 ATA (1000 fsw), a low-power, single, 4- to 6-Hz component was evident, which resembled fine or moderate tremor. Between 34.3 ATA (1100 fsw) and 61.6 ATA, a 12- to 18-Hz component emerged abruptly with a dramatic increase in power, which reflected coarse, uncontrollable tremors. In the first 5 to 10 min after the animals arrived at maximum pressure, relative power of the high frequency component dropped to and remained near base-line levels. These results support the hypothesis that HPNS tremor consists of two components and possibly two separate tremor systems.