予稿集（すべて） - 鹿児島市医師会
Contents
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69. 49 MAGNETIC RESONANCE IMAGING OF CENTRAL NERVOUS SYSTEM DECOMPRESSION SICKNESS IN SHEEP UNDERGOING HYPERBARIC EXPOSURE Sobakin ASt Hutchinson E Lehner CE Eldridge MW Diving Physiology Laboratory and the Departments of Pediatrics and Biomedical Engineering University of Wisconsin School of Medicine and Public Health Madison WI 53792 BACKGROUND We have previously demonstrated that oxygen pre breathing before drop out decompression reduces the risk of decompression sickness DCS in the UW sheep model However little is known about the incidence and mechanisms of neurological injury in these models or the effects of decompression strategies on ameliorating neurological DCS We have undertaken magnetic resonance imaging MRI studies to define the incidence and mechanism of CNS injury in a sheep model of decompression sickness MATERIALS AND METHODS Ten adult ewes 91 4 9 2 SD kg underwent dry chamber air exposure at 60 fsw 2 8 atm abs for 24 hours followed by an oxygen 88 92 pre breathe for 3 hr before dropout decompression at 30 feet min 0 9 atm min to surface Another four animals 95 6 5 8 SD kg underwent an identical decompression scenario without oxygen
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183. HBO 2ATA 1 HBO 39 40 11 4 AFAR bl ZBL HBO Hyperbaric Oxygen Therapy
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201. 4 SEP HBO 21 DE 2 0 silo 26 silo DR HBO HBO 7 46 ICU HBO
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206. pre breathing Six weeks after exposure animals were sacrificed and brain and spinal cords are fixed in formalin T2 weighted fast spin echo imaging and high resolution 3 dimensional spin echo imaging were performed on the spinal cords using a high field strength Varian 4 0 Tesla MRI scanner RESULTS Decompression without oxygen pre breathing resulted in 100 mortality All the oxygen pre breathing animals survived Six animals developed limb bends with one developing signs of respiratory DCS Thus far we have found no evidence of focal infarcts in the spinal cords of the oxygen pre breath group However patchy areas of increased T2 signal intensity are seen in white matter CONCLUSION Thus far we see no evidence of discreet spinal cord infarction as would occur with arterial gas embolism suggesting that 3 hr oxygen pre breathing may reduce the severity of neurological DCS However subtle areas of increased signal intensity may represent white matter injury Our ongoing work will use high resolution diffusion tensor MRI to further characterize the possible white matter injury 1 W
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