Rare pulmonary barotrauma after explosive decompression: a case report.

BACKGROUND: Pneumothorax as a consequence of pulmonary barotrauma during explosive decompression military crew training in a hypobaric chamber is an extremely rare and sparsely diagnosed complication. Extensive bilateral tissue damage is even more unexpected. CASE PRESENTATION: A 26-year-old active duty Air Force pilot was performing an explosive decompression simulation from 8000 ft. (2438.4 m) to 25,000 ft. (7620 m) in a 1.5 s interval. The training was interrupted due to the pilot's apparent health complications. After transfer to the emergency department, a CT scan showed bilateral lung barotrauma with emphysema. CONCLUSIONS: The case report shows extensive emphysema and pneumothorax after a rapid decompression done for training purposes. It is a possible but rare complication. The cause remains unclear, with suspicion of a predisposed lung disease.

The influence of the explosive decompression in steam-explosion pretreatment on the enzymatic digestibility of different biomasses.

For the production of second generation biofuels from lignocellulosic biomass, pretreatment of the biomass feedstock is necessary to overcome its recalcitrance in order to gain fermentable sugars. Due to many reasons, steam-explosion pretreatment is currently the most commonly used pretreatment method for lignocellulosic biomass on a commercial scale [S. Brethauer and M. H. Studer, CHIMIA, 2015, 69, 572-581]. In contrast to others, we showed that the explosive decompression at the end of this pretreatment step can have a positive influence on the enzymatic digestibility of softwood, especially in combination with high enzyme dosages [T. Pielhop, et al., Biotechnology for Biofuels, 2016, 9, 152]. In this study, the influence of the explosive decompression on the enzymatic digestibility of hardwood and herbaceous plants was systematically studied. Beech and corn stover were pretreated under different pretreatment conditions and enzymatically hydrolysed with different enzyme dosages. The maximum enhancement of the digestibility of corn stover was 16.53% after a 2.5 min pretreatment step at 15 barg steam pressure. For beech, a maximum relative enhancement of 58.29% after a 10 min pretreatment step at 15 barg steam pressure could be reached. With this, we show that the explosive decompression can also enhance the enzymatic cellulose digestibility of hardwood and herbaceous plants.

Explosive Decompression with Resultant Air Gas Embolism in a Fourth Generation Fighter at Ground Level.

BACKGROUND: Arterial gas embolism (AGE) is a rare condition in the flying community most often only ever seen in flight while operating at high altitude or incidents involving hypobaric chambers. This article describes a severe case of AGE that occurred in a pilot of a fourth generation fighter aircraft at ground level. The environmental control system (ECS) malfunctioned, causing an overpressurized cockpit and a subsequent explosive decompression when the pilot opened the canopy to egress. CASE REPORT: The ECS onboard fourth generation fighter aircraft is composed of many computer-controlled subsystems. When these components fail, the system can potentially overpressurize the cockpit. Combined with opening the canopy without prior venting, this overpressurization can lead to a situation akin to a diver surfacing too quickly. A pilot experienced this scenario and subsequently developed symptoms of arterial gas embolization-one form of decompression illness (DCI). We reviewed the design of the environmental control system and recommend that the cockpit must be slowly depressurized to decrease risk of injury from rapid decompression. DISCUSSION: Literature review showed three similar cases of ground-based overpressurization causing AGE symptoms, although these cases were maintenance personnel intentionally testing aircraft cabin integrity and not associated with aircraft intending flight.7 The lessons learned from this case can be used to identify and hopefully prevent severe DCI from ground level cockpit overpressurization and to further general understanding of aircraft ECS. Zhang JX, Berry JR, Beckstrand DP. Explosive decompression with resultant air gas embolism in a fourth generation fighter at ground level. Aerosp Med Hum Perform. 2016; 87(11):963-967.

[Microvascular decompression surgery for trigeminal neuralgia: technical review based on surgical anatomy].

To perform secure microvascular decompression for trigeminal neuralgia, it is important to perform each surgical procedure based on detailed anatomical knowledge. As for microsurgical procedure, there are two major approaches; the supracerebellar approach and the trans-horizontal fissure approach. This article reviews the advantages of each surgical approach and describes points to pay attention to, with figures which will help the surgeon to perform this surgery. The importance of real decompression or transposition of the offending vessels is stressed. The significance of preoperative imaging as well as perioperative management including the patients' positioning is also described.