Hyperbaric oxygen therapy in idiopathic sudden sensorineural hearing loss (ISSNHL) in association with combined treatment.

The main basic effect of hyperbaric oxygenation (HBO2) on the human body, in our study, was an increased partial pressure of oxygen resulting from an increased amount of oxygen dissolved in plasma. Thus the plasma can become capable of carrying enough oxygen to meet the needs of the body's tissues. From 1 January 2004 to 31 December 2007, a total of 61 patients (62 ears) received medical treatment at the ENT clinic of the 3rd Faculty of Medicine, Charles University, and at the Central Military Hospital in Prague. Treatment consisted of a combination of vasodilatation infusion treatment and HBO2 therapy. The results were evaluated in a retrospective study. The overall percentage of patients showing improvement was 59.7%. However, for those patients who started HBO2 treatment within 10 days of onset, complete recovery, or significant improvement was noted in 65.9%. In contrast, patients who started treatment after 10 days of onset, improvement was noted in only 38.9%. NMR examination revealed that two patients had vestibular schwannoma (also known as acoustic neuroma).

LBNP and push-pull effect.

The high level of the long lasting acceleration with both an extensive gradient of the acceleration onset and vector alterations belong to the flight specificity in a cockpit of agile aircraft with high manoeuvring capabilities. In these cases the so-called push-pull (PP) effect has its particular significance. This means the tolerance decrease to the plus gravitational acceleration turns up after an exposure to the microgravity on the acceleration level between zero and +0.8 Gz or after previous action of negative acceleration values. The resulting activation of the sympathicus during plus gravitational acceleration process is up to several seconds behind time and pilot's performance is reduced. At the same time both an impairment of the threshold of the vision failure and G-LOC occur. The gravitational acceleration fatigue effect escalates, too.

Testing method of plus and minus Gz tolerance at Czech Air Force pilots.

Pilots' physiological measurement in conditions of alternating plus and minus Gz (gravitational acceleration) has been done during real flights. The comparison of physiological responses during flights at the safe altitude of 7000 ft and low level flights at the altitude of 900 ft over ground bears on the evaluation of changes of the continuous blood pressure and the heart rate. High level of pilots' plus-minus Gz tolerance is essential requirement to cope with low level flights in agile aircraft. It was proved that the sinusoidal profile during real flights is possible to use for pilots' tolerance to plus and minus Gz load evaluation. A system for the physiological signal acquisition in a cockpit of combat aircraft was developed for this purpose.

[131I meta-iodobenzylguanidine in combination with hyperbaric oxygen therapy in the treatment of prognostically high-risk forms of neuroblastoma]. / 131I metajodobenzylguanidin v kombinaci s hyperbarickou oxygenoterapií v lécbe prognosticky vysoce nepríznivých forem neuroblastomu.

BACKGROUND: Despite of improving diagnostics, development of new drugs and treatment strategies, patients with biologically unfavourable, advanced or relapsed neuroblastoma remain practically incurable. Treatment related toxicity, requirement for personnel and financial costs have became limiting. Tumor specific therapy represented by 131I-meta-iodobenzylguanidine (MIBG) administration could become an alternative improving the overall survival. In comparison with standard external radiotherapy the targeted therapy enables to achieve radiation 5 to 10 times higher with lower organ toxicity. Data published by European and American colleagues brought evidence of high efficacy of this method. It motivated us to set and develop the method at our department. TYPE OF STUDY: Retrospective analysis of therapeutic results and side effects of the administration of 131I-meta-iodobenzylguanidine in high-risk neuroblastoma patients cured at the Department of Pediatric Oncology in Prague since 1997 till 2000. METHOD AND RESULTS: 131I-meta-iodobenzylguanidine was fourteen times therapeutically administered in seven high-risk relapsed neuroblastoma patients. Four children received a single dose of 131I-meta-iodobenzylguanidine, three patients were treated repeatedly. The first dose represented 5.5 GBq, repeated dose 3.7 GBq, irrespective to the body weight. Each MIBG administration was followed by four days hyperbaric oxygen therapy. The treatment was well tolerated, acute and late side effects were not serious and only rarely reached grade 3 or 4 according to the International North American Children's Cancer Group Classification. Three of the seven children have survived with no evidence of the disease. Four children died of the disease progress. CONCLUSIONS: 131I-meta-iodobenzylguanidine treatment combined with hyperbaric oxygen therapy becomes a well-tolerated therapy for high-risk neuroblastoma patients non-responding to the conventional treatment. Though the 131I-meta-iodobenzylguanidine administration probably cannot cure these patients, the repeated administration can bring long lasting remission.

Physiological response of pilots to the LBNP-, flight-, and centrifuge load.

The possibility of the LBNP method's utilization at persons with low resistance of the cardiovascular system to the orthostatic load is a matter one of the research projects of IAM. We concentrated in previous stages our effort on an evaluation of basic physiological responses of the organism to this type of a load and on determination of reliable markers of the precollapse state. After analysis of results of examinations of 64 probands' set we defined qualifying criteria to the prediction for selection of individuals with the insufficient orthostatic resistance. Verification of experimental results by the comparison with well-established examination methods, during a real flight load and at the examination in a human centrifuge, is a goal of the following research activity. In current period of the task's solution the physiological response to an LBNP load has been compared with the physiological response to the load during real flight in an aircraft.

Physiological response of pilots to the load of lower body negative pressure.

The Czech Air-Force prepares an introduction of a new generation of aircraft with high maneuvering possibilities. The possibility of making full use of the aircraft flight properties assumes sufficient pilot's +Gz tolerance and also its improvement during the new flight training system. The optimal method to achieve this purpose is the human centrifuge utilization. For the Czech Republic, the building or the renting of a human centrifuge for the pilot's selection is unfortunately very expensive. In our institute we are interested in the analysis of the possibilities of the lower body negative pressure (LBNP) technique for the basic pilot's selection with low level of +Gz tolerance, using the examination of the orthostatic cardiovascular reactions of the pilot's organism.