Pathogenesis and prevention of dysbaric osteonecrosis

• Autorzy: Kawashima M. , Tamura H. , Noro Y. , Takao K. , Kitano M. , Lehner Ch. E. , Taya Y. , Mano Y. , Tsunosue T.
• Języki publikacji: EN

Abstrakty

EN

Japanese diving fishermen are known to have a high prevalence of dysbaric osteonecrosis. Their typical dive practices are characterized by long exposure to high pressure and by repetitive diving. The etiology of dysbaric osteonecrosis still remains controversial. Because the development of dysbaric osteonecrosis may occur silently, the diver may be unaware of the actual ischemic event. Moreover, key etiologic evidence is often lost before the diver is examined. The early stage of dysbaric osteonecrosis was evaluated in four autopsy cases of divers who died of acute decompression sikness. Hypercoagulability of blood was present in these cases. Hypercoagulability of blood has also been observed in experimental rats after decompression. Dysbaric osteonecrosis has been experimentally induced in six sheep at the University of Wisconsin - Madison. These findings are reviewed by comparing dysbaric osteonecrosis in both divers and experimental animals. In conclusion, a bone compartment syndrome and hypercoagulability appear to be pathogenetic factors in dysbaric osteonecrosis.

Słowa kluczowe

EN

dysbaric osteonecrosis; pathogenesis; bone compartment syndrome; hypercoagulability; decompression sickness; bends

• Wydawca: Polskie Towarzystwo Medycyny i Techniki Hiperbarycznej
• Czasopismo: Polish Hyperbaric Research
• Rocznik: 2005
• Tom: Nr 3(12)
• Strony: 13--18
• Opis fizyczny: Bibliogr. 27 poz.

Twórcy

autor

Kawashima M.

• Orthopedic Hospital, Miyabu, Nakatsu-shi 879, Japan

autor

Tamura H.

• Orthopedic Hospital, Miyabu, Nakatsu-shi 879, Japan

autor

Noro Y.

• Orthopedic Hospital, Miyabu, Nakatsu-shi 879, Japan

autor

Takao K.

• Orthopedic Hospital, Miyabu, Nakatsu-shi 879, Japan

autor

Kitano M.

• Department of Oral Pathology, Kagoshima University Dental School, 8-chome Kagoshima-shi 890, Japan

autor

Lehner Ch. E.

• Department of Preventive Medicine, Medical School and Biotron, University of Wisconsin – Madison, 2115 Observatory Drive, Madison, WI 53706, USA

autor

Taya Y.

• Coastal Research Department, Japan Marine Science and Technology Center,Natsushima-cho, Yokosuka-shi 237, Japan

autor

Mano Y.

• School of Allied Health Sciences, Faculty of Medicine, Tokyo Medical and Dental University, Yushima 1-chome, Bunkyo-ku, Tokyo 113, Japan

autor

Tsunosue T.

• Santa Maria Neurosurgical Clinic, Shimoikenaga, Nakatsu-shi 879, Japan

Bibliografia

• 1. Amako T. and Kawashima M. 1974. Bone and joint lesions in decompression sickness. Seminars Arthr Rhenm 4: 151-190.
• 2. Behnke A. R. 1945. Decompression sickness incident to deep-sea diving and high altitude ascent Medicine 24: 381-402.
• 3. Elliot D. H. and Kindwall E. P. 1982. Manifestations of decompression disorders. In the physiology and medicine of diving (Ed. by Bennet P. B. and Elliot D. H.), Bailliere Tindall, London, pp.461-472.
• 4. Grutzmacher K. T. 1941. Veranderungen an Schultergelenk als Folge von Druckluf terkrankung. Rontgenpraxis (Leipgig) 13: 216-218.
• 5. Jones J. P. 1965. Systemic fat embolism after renal hemotransplantation and treatment with corticosteroids. N, Engl. J, Med. 273: 1453-1458.
• 6. Jones J. P. and Sakovich L. 1966. Fat embolism of bone. A roentgenographic and histological investigation, with use of intra-arterial Lipiodol, in rabbits. J, Bone Joint Surg. 48A: 149-164.
• 9. Jones J. P. Jr. 1985. Fat embolism and osteonecrosis. Orthop. Clin North Am 16: 595-633.
• 10. Jones J. P. Jr. 1992. Intravascular coagulation and osteonecrosis. Clin Orthop 277: 41-53
• 11. Kawashima M. and Kitano M. 1977. Histopathology of the early stage of osteonecrosis in divers. Undersea Biomedical Research 4: 409-417.
• 12. Kawashima M. and Kitano M. 1978. Pathological review of osteonecrosis in divers.Clin Orthop 130: 107-117.
• 13. Kawashima M. 1976. Aseptic bone necrosis in Japanese divers. The Bulletin of Tokyo Medical and Dental University 23: 71-92.
• 14. Kitano M., Kawashima M., Torisu T. and Hayashi K. 1976. Acase report of diver with multiple aseptic bone necrosis. Clin. Orthop (Japan) 11: 1092-1099.
• 15. Kitano M. and Kawashima M. 1978. Experimental studies on decompression sickness. Orthopedics and Traumatology. 27: 653-658.
• 16. Kitano M. and Hayashi K. 1981. Acute decompressio sickness. Acta Pathol. Jpn. 31: 269-276.
• 17. Kitano M., Lehner C. E., Kawashima M., Taya Y. and Lanphier E. H. 1993 Experimentally induced dysbaric osteonecrosis in sheep, a histopathological analysis.South Pacific Study 13: 173-182.
• 18. Lehner C. E. 1992. Dive profiles and adaptation: pressure profiles target specific tissues for decompression injury, in Repetitive Diving Workshop (Eds M. A. Lang and R. D. Vann),203-217, American Academy of Underwater Sciences, Costa Mesa, California.
• 19. Lehner C. E., Adler G. G., Kanikula T. M., Palta M. and Lanphier E. H. 1985. Influence of dive profile on manifestations of decompression sickness. Undersea Biomed. Res. 12 (suppl): 12.
• 20. Lehner C. E., Palta M., Adler G. G., Lightfoot E. N. and Lanphier E. H. 1985. Prediction of DCS incidence from no-stop decompression air dives. Undersea Biomed. Res.
• 21. Lehner C. E., Hei D. J., Palta M., Lightfoot E. N. and Lanphier E. H. 1986. Accelerated onset of decompression sickness in short,deep dives in sheep. In: Ninth Symposium on Underwater Physiology (program abstracts) (Kobe, Japan, September, !986). Bethesda: Undersea Medical Society.
• 22. Lehner C. E., Hei D. J., Palta M., Ives T. M. and Lanphier E. H. 1987. Dive profile selectively influences the relative frequency of decompression sikness manifestations. Undersea Biomed. Res. 14 (Suppl): 17.
• 23. Lehner C. E., Cronk B. C., Hei D. J. and Lanphier E. H. !988. Transient decompression sickness in sheep: Implications for human cases. Undersea Biomed. Res. 15 (Suppl): 68.
• 24. Lehner C. E., Hei D. J., Kang Y. and Lanphier E.H. 1989. Statistical associations of decompression sickness manifestations in sheep: implications for human cases. Undersea Biomed. Res. 16 (Suppl): 91-92.
• 25. Lehner C. E., Lanphier E. H., Lemos S. E., Adams W. M. 1990. Dysbaric osteonecrosis and elevated pressure; a proposed etiological and pathogenic model. Undersea Biomed. Res. 17 (Suppl): 29.
• 26. Lehner C. E., Lin T. F., Rhode B. A., Dubielzig R. R., Shidara F. And Lanphier E. H. 1991. Respiratory decompression sickness in sheep after prolonged hyperbaric exposure: obesity as a risk factor in chokes. Undersea Biomed. Res. 18 (Suppl): 71-72.
• 27. Lehner C. E., Lin T. F., Lanphier E. H., Wilson M. A., Markel M. D. And Dueland R. 1993. Prolonged hyperbaric exposure, persistent limb bends, and early recompression treatment in dysbaric osteonecrosis. Undersea and Hyperbaric Med. 20 (Suppl):21.