Oxidative Stress, HSP70/HSP90 and eNOS/iNOS Serum Levels in Professional Divers during Hyperbaric Exposition.

Heat shock proteins (HSPs) have protective effects against oxidative stress and decompression sickness. Nitric oxide may reduce bubble formation during decompression and its activity is regulated by HSPs. A simulated dive can cause the HSP response. The aim of this study was to describe the effect of simulated dives on the antioxidant system, HSPs, and nitric oxide synthase response and demonste the relationship between the concentration of HSPs and the intensification of oxidative stress. A total of 20 healthy professional divers took part in training, consisting of simulated dry dives in a hyperbaric chamber and split into experiment I (30 m exposure, 400 kPa) and experiment II (60 m exposure, 700 kPa) over 24 h. The activities of superoxide dismutase (SOD), catalase (CAT), and glutathione peroxidase (GPx) and the concentrations of malondialdehyde (MDA), heat shock protein 70 (HSP70), heat shock protein 90 (HSP90), endothelial (eNOS) and inducible (iNOS) nitric oxide synthase were measured. Increases in the activity of SOD and MDA concentration were demonstrated. The activity of GPx depended on the dive profile. The HSP70 serum level in both experiments was significantly lower after the dives. The mean HSP90 level was significantly higher after the simulated dive at 60 m. A significant relationship between HSP concentration and SOD/GPx activity was demonstrated. eNOS concentration increased after 60 m exposure. No change in iNOS concentration was observed. In conclusions, the simulated dive significantly affected the antioxidant system, heat shock protein expression and nitric oxide synthase; however, the changes depend on the diving conditions. There is a relationship between the expression of HSPs and the intensity of oxidative stress.

Influence of Scuba Diving on the Quality of Life of People with Physical Disabilities.

The aim of the study was to assess quality of life related to mental and physical health among divers and non-divers with physical disabilities. The examined group consisted of 240 disabled people (both genders). The SF-36 questionnaire (Short-Form Health Survey) was used to measure the overall sense of health-related quality of life. Moreover, the authors' survey was also used in the study. There was a significant difference (p < 0.05) in the self-assessment of the quality of life (physical functioning, social functioning, mental health, and vitality) between the examined diving and non-diving groups. In other areas evaluated with the use of the SF-36 questionnaire, i.e., limitation in performing roles due to emotional problems and pain, limitations in performing roles due to physical health, a tendency to a higher rating was noticed in the group of divers. Scuba diving can improve various components of the life-quality of people with disabilities, and in general can be seen as a form of physical activity and rehabilitation for people with disabilities. However, it is necessary to conduct extensive research in this area.

Analysis of the Increase of Vascular Cell Adhesion Molecule-1 (VCAM-1) Expression and the Effect of Exposure in a Hyperbaric Chamber on VCAM-1 in Human Blood Serum: A Cross-Sectional Study.

Background and Objectives: Vascular cell adhesion molecule-1 (VCAM-1) was identified as a cell adhesion molecule that helps to regulate inflammation-associated vascular adhesion and the transendothelial migration of leukocytes, such as macrophages and T cells. VCAM-1 is expressed by the vascular system and can be induced by reactive oxygen species, interleukin 1 beta (IL-1ß) or tumor necrosis factor alpha (TNFα), which are produced by many cell types. The newest data suggest that VCAM-1 is associated with the progression of numerous immunological disorders, such as rheumatoid arthritis, asthma, transplant rejection and cancer. The aim of this study was to analyze the increase in VCAM-1 expression and the impact of exposure in a hyperbaric chamber to VCAM-1 levels in human blood serum. Materials and Methods: The study included 92 volunteers. Blood for the tests was taken in the morning, from the basilic vein of fasting individuals, in accordance with the applicable procedure for blood collection for morphological tests. In both groups of volunteers, blood was collected before and after exposure, in heparinized tubes to obtain plasma and hemolysate, and in clot tubes to obtain serum. The level of VCAM-1 was determined using the immunoenzymatic ELISA method. Results: The study showed that the difference between the distribution of VCAM-1 before and after exposure corresponding to diving at a depth of 30 m was at the limit of statistical significance in the divers group and that, in most people, VCAM-1 was higher after exposure. Diving to a greater depth had a much more pronounced impact on changes in VCAM-1 values, as the changes observed in the VCAM-1 level as a result of diving to a depth of 60 m were statistically highly significant (p = 0.0002). The study showed an increase in VCAM-1 in relation to the baseline value, which reached as much as 80%, i.e., VCAM-1 after diving was almost twice as high in some people. There were statistically significant differences between the results obtained after exposure to diving conditions at a depth of 60 m and the values measured for the non-divers group. The leukocyte level increased statistically after exposure to 60 m. In contrast, hemoglobin levels decreased in most divers after exposure to diving at a depth of 30 m (p = 0.0098). Conclusions: Exposure in the hyperbaric chamber had an effect on serum VCAM-1 in the divers group and non-divers group. There is a correlation between the tested morphological parameters and the VCAM-1 level before and after exposure in the divers group and the non-divers group. Exposure may result in activation of the endothelium.

Effect of Apnea-Induced Hypoxia on Cardiovascular Adaptation and Circulating Biomarkers of Oxidative Stress in Elite Breath-Hold Divers.

Given the previous evidence that breath-hold diving is a cause of physiological stress, this study aimed to determine whether a combination static and dynamic apnea would affect total oxidant status, nitric oxide, heat shock proteins and cardiovascular parameters in elite freedivers. Thirteen finalists of the World and European championships in swimming pool breath-hold diving participated in the study. Whole-body plethysmography and electrocardiography was performed to determine the cardiorespiratory variables at baseline and during the simulation static apnea. An assessment of the heart rate, blood oxygen saturation and biochemical variables was performed before and in response to a combination of a static followed by a dynamic apnea. Static and dynamic breath-holding had a significant effect on oxidative stress, as evidenced by an increase in the total oxidant status/capacity (p < 0.001). The post apnea concentrations of heat shock proteins 27 (HSP27) were significantly elevated (p < 0.03, but total antioxidant status (TAS), HSP90, HSP70, and nitric oxide (NO) changes were not significant. levels under the influence of the static and dynamic breath-hold protocol. A significant positive correlation between HSPs and TAS (r = 0.63; p < 0.05) as well as NO levels was associated with beneficial cardiovascular adaptation. An increase in serum HSP27 levels mediated in nitric oxide levels could explain its important role in improving cardiovascular functions in elite freedivers. Further studies are necessary to explain the exact mechanisms of breath holds training of cardiovascular adaptation responsible for maintaining adequate oxygen supply in elite divers.

Scuba Diving as a Form of Rehabilitation for People with Physical Disabilities.

(1) Background: The exploration of the potential therapeutic benefits of scuba diving for the mental and physical health of people with physical disabilities. (2) Methods: The research was conducted on a group of 240 people (men and women) with physical disabilities, using the survey designed by one of the authors. The subjective sense of physical and mental fitness was analyzed in retrospective and real terms. (3) Results: Significant increases in self-esteem, belief in our own abilities (self-confidence) and improvement in the ability to engage in social interactions were observed in the group of scuba divers with disabilities compared to individuals with disabilities not practicing diving. The respondents also declared an improvement in the efficiency of the respiratory system and stressed that a water environment increased their motor skills and relieved pain. (4) Conclusions: Diving can become one of the forms of rehabilitation for people with disabilities. There is a need for further research to expand our understanding of the benefits and possible health problems involved in diving. These activities have a huge impact on improving the quality of life of people with disabilities.

Rectal aberrant crypt foci (ACF) as a predictor of benign and malignant neoplastic lesions in the large intestine.

BACKGROUND: The importance of ACF is not fully explained, however, their number may be a good predictor of synchronous and metachronic adenoma or other polyps whose removal reduces the risk of CRC. Due to the epidemiological and genetic association of ACF with pre-cancer lesions, they may be a potential CRC biomarker. The aim of our study was to show that the number and type of rectal ACF may be a good predictive factor for the presence of polyps located proximally from the splenic flexure and that the type and number of ACF can correlate with the number and specific types of polyps in the large intestine. METHODS: The study included 131 patients who underwent colonoscopy combined with rectal mucosa staining with 0.25% methylene blue. The number of rectal ACF was determined and bioptats were sampled for histopathological examination to assess the type of ACF. Endoscopic ACF assessment criteria given by L. Roncucci were used. The obtained material was subjected to statistical analysis using probability distribution, U-test, t-student test, and chi 2 as well as the Statistica 7.1 software package. RESULTS: The study population was divided into three subgroups according to the number of ACF observed, i.e. ACF < 5, 5-10 and > 10. ACF < 5 were found in 35 patients (29.41%), 5-10 ACF in 70 (58.82%) and ACF > 10 in 14 individuals (11.76%). The study revealed the presence of normal ACF (p = 0.49), hyperplastic ACF (p = 0.34), dysplastic ACF (p = 0.11), and mixed ACF (p = 0.06). A single type of ACF was most commonly observed (n = 88, p = 0.74). In the researched group a larger number of ACF is concurrent with adenomas and hyperplastic polyps. The number of ACF clearly correlates with the dysplasia advancement in the adenoma and the number of polyps found. CONCLUSIONS: Rectal ACF are a useful marker for the presence of cancerous lesions in the proximal and distal sections of the large intestine.

Dehydration of a diver during a hyperbaric chamber exposure with oxygen decompression.

Objective: An analysis of factors that may indicate both the type and degree of dehydration of a diver's body following a dry chamber hyperbaric exposure. Methods: The study was participated by 63 men - professional divers, with extensive diving experience, aged 24-51 years (average age 32.6). The subjects underwent two hyperbaric exposures, one to a pressure of 0.3 MPa and one to a pressure of 0.6 MPa, with oxygen decompression. The exposures were carried out in a hyperbaric chamber pursuant to the decompression tables of the Polish Navy, with the observance of a 24-hour interval between exposures. Blood samples were collected from the participants in order to perform a blood morphology test. Body weight was measured with the bioelectrical impedance method using the Maltron BioScan 920 device.The results were subjected to statistical analysis. The following blood morphology parameters were analyzed: hematocrit (Ht), erythrocyte size (MCV), color index (MCHC) and body weight composition: total water (TBW), extracellular water (ECW), intracellular water (ICW). Results: The studies have shown that during a hyperbaric exposure in the chamber the diver's body becomes dehydrated, with observable loss of both intracellular water as evidenced by the reduction of hematocrit content and erythrocyte size, as well as extracellular water, with the accompanying increase in the color index. Conclusions: Hyperbaric conditions are conducive to the dehydration of the diver's body, however to a degree which does not lead to an occurrence of health hazards. Good care for one's health through proper nutrition and hydration are sufficient preventive and protective measures.

Fatty acids and sphingolipids profile in the blood plasma of experienced divers in response to hyperbaric exposure.

INTRODUCTION: Hyperbaric exposure mimics air-breathing scuba diving, which is reaching enormous popularity around the world. The diver's body is subjected to a broad range of divergent effects exerted by, e.g.: an increased partial pressure of inert gases, microclotting, oxidative stress and/or production of gas bubbles. However, very little is known regarding the impact of hyperbaric exposure on plasma fatty acids content and composition, together with the body's sphingolipids profile. MATERIAL AND METHODS: The aim of this study was to investigate the contents of major fatty acids present in the plasma as well as sphingolipids, namely: sphingosine (SPH); sphingosine-1-phosphate (S1P); sphinganine (SPA); and ceramide (CER), after hyperbaric exposure corresponding to dives conducted to the depths of 30 and 60 meters of seawater. For the plasma lipids measurements, high-performance liquid chromatography together with gas-liquid chromatography were applied. RESULTS: We demonstrated that hyperbaric exposure does not affect the content and composition of plasma fatty acids of experienced divers. Similarly, the amounts of major sphingolipids fractions were not influenced, as only the content of sphingosine-1-phosphate in the plasma was significantly decreased. CONCLUSIONS: Observed lack of significant changes in plasma lipid profile after hyperbaric exposure suggests that the procedure might be considered as secure. However, decreased sphingosine-1-phosphate content in the plasma might possibly exert some adverse effects.

Influence of exposure in hyperbaric chambers on selected parametersof oxidative stress in professional divers.

PURPOSE: This study evaluated the influence of hyperbaric exposure chambers on selected parameters of oxidative stress in divers' blood. METHODS: 25 healthy men (non-smoking experienced divers) ages 18-40 took part in the experiment. Subjects were exposed to hyperbaric conditions similar to those at 30 meters of depth while diving. A control group consisted of 20 healthy men who have never dived or been exposed to hyperbaric conditions. Blood was drawn from the cubital vein after overnight fasting. Superoxide dismutase (SOD-1) activity and malondialdehyde (MDA) concentration were marked in red blood cells (RBCs), carbonyl group concentration marked in serum proteins, and nitrate/nitrite concentrations were estimated in plasma. RESULTS: Statistically significant differences were found between the divers and the control group in MDA concentration in erythrocytes and carbonyl group concentration in serum proteins. Nitrite/nitrate concentrations in plasma plus SOD-1 activity in RBCs decreased significantly in the diver group compared with the control group. After hyperbaric exposure MDA concentration in erythrocytes increased considerably in the test group and a significant increase in SOD-1 activity was observed. A significant increase of nitrite/nitrate concentration was noted in plasma as well as an increase in the carbonyl group in serum proteins. CONCLUSION: Considerably weak enzymatic antioxidative defense was observed in the RBCs of individuals exposed to hyperbaric pressures versus those in normobary. This issue indicates that a diver's system has a larger susceptibility for negative effects from oxidative stress. The results also indicate that hyperbaric conditions can intensify reactions via free radicals.

Occurrence of colorectal aberrant crypt foci depending on age and dietary patterns of patients.

BACKGROUND: Aberrant crypt foci (ACF) are commonly considered the early pre-cancerous lesions that can progress to colorectal cancer (CRC). The available literature data reveal that age, dietary factors and lifestyle can affect the development of several dozen percentages of malignant tumours, including CRC. In the present study, an attempt was made to assess the incidence and growth dynamics of ACF and to determine whether the type of diet affected the development and number of AFC. METHODS: Colonoscopy combined with rectal mucosa staining with 0.25% methylene blue was performed in 131 patients. On the day of examination, each patient completed a questionnaire regarding epidemiological data. According to their numbers, colorectal ACF were divided into three groups. The findings were analysed statistically. The Student's t test and the U test were applied in order to determine the significance of differences of means and frequency of events in both groups. Statistica 7.1 and Excel 2010 were used. RESULTS: The single ACF occur in the youngest individuals (ACF < 5). Since the age of 38 years, the number of ACF gradually increases to show a decreasing tendency since the age of 60 years. The number of 5 < ACF < 10 occurs slightly later, since the age of 50 years, and dynamically increases reaching the maximum at the age of 62 years, subsequently the increase is proportional. ACF > 10 occur at a more advanced age (55 years) and their number gradually increases with age. The maximum number is observed at the age of 77 years. In individuals not using high-fibre diets and with high intake of red meat, the probability of higher numbers of ACF increases. The probability of higher numbers of ACF (5 < ACF10) was observed in patients with colon diverticula. In patients with higher BMI, the number of ACF is higher. CONCLUSION: Age significantly affects the number of colorectal ACF. The types of foods consumed can considerably increase the risk of colorectal ACF, which is particularly visible in individuals who do not regularly use high-fibre diets, those obese and with colon diverticula.

Immunohistochemical evaluation of the influence of L-arginine on biomarkers of environmental (cellular) stress in the kidneys of pregnant female rats.

INTRODUCTION: Kidney damage during pregnancy constitutes a diagnostic and therapeutic challenge. However, it is not entirely known whether a kidney condition recognised before the pregnancy releases an organism's response to pregnancy, or whether pregnancy itself worsens kidney function. OBJECTIVE: The aim of the study was immunohistochemical evaluation of cells of kidneys of pregnant rats under the influence of nitric oxide (NO), with measurement of the immunoexpression of cellular stress markers (p-53, HSP 70). The dose of administered L-arginine (NO substrate) was approximated to that applied in obstetrics in gestosis prevention and treatment in pregnant women. MATERIALS AND METHOD: 60 female rats used in experiment were divided into 6 groups: 3 experimental and 3 control. The females from experimental groups were administered L-arginine (40g/kg, per os) every other day starting from the seventh day or pregnancy. The animals were decapitated on the 10th, 20th day of pregnancy, and 10 days after the delivery. Kidneys taken from decapitated rats were evaluated using the immunohistochemical three step method. HSP 70 and p-53 proteins were detected. CONCLUSIONS: L-arginine increased the expression of p-53 protein - on the 10th day of pregnancy, which increased at the end of pregnancy; however, 10 days after delivery the level dropped below that observable during physiological pregnancy. Hormonal changes in physiological pregnancy cause an increase in expression of the p-53 (cell stress marker) in the epithelial cells of renal tubules, mainly at the end of pregnancy (20th day). 10 days after the delivery, this expression decreases. The expression of HSP-70 protein increases already on the 10th day of pregnancy and maintains a similar level throughout the pregnancy, but is reduced after the puerperium.

Chromoendoscopy with a Standard-Resolution Colonoscope for Evaluation of Rectal Aberrant Crypt Foci.

Colorectal cancer (CRC) is the second most common cause of death worldwide. According to the theory by Vogelstein, colorectal carcinogenesis involves a series of successive changes in the normal colonic mucosa, starting with excessive proliferation and focal disorders of intestinal crypts, followed by adenoma and its subsequent malignant transformation. The first identifiable changes in CRC carcinogenesis are aberrant crypt foci (ACF). ACF are invisible during routine colonoscopy yet are well identifiable in chromoendoscopy using methylene blue or indigo carmine. High-resolution colonoscopes are used for assessment of ACF. The aim of the present study was to evaluate the usefulness of standard-resolution colonoscopy for identification of rectal ACF. The following parameters were evaluated: duration of chromoendoscopy of a given rectal segment, type of ACF, sensitivity and specificity of endoscopy combined with histopathological evaluation. The mean duration of colonoscopy and chromoendoscopy was 26.8 min. In the study population, typical ACF were found in 73 patients (p = 0.489), hyperplastic ACF in 49 (p = 0.328), and dysplastic ACF in 16 patients (p = 0.107). Mixed ACF were observed in 11 individuals (p = 0.073). The sensitivity of the method was found to be 0.96 whereas its specificity 0.99. Identification of rectal ACF using standard-resolution colonoscopy combined with rectal mucosa staining with 0.25% methylene blue is characterised by high sensitivity and specificity.

Knowledge of the Disease, Perceived Social Support, and Cognitive Appraisals in Women with Urinary Incontinence.

Social support and knowledge of the disease have been shown to facilitate adaptation to a chronic disease. However, the adaptation process is not fully understood. We hypothesized that these factors can contribute to better adaptation to the disease through their impact on disease-related cognitive appraisal. To analyze the links between social support and the knowledge of the disease, on one hand, and disease-related appraisals, on the other hand, one hundred fifty-eight women with stress UI, aged 32 to 79, took part in the study. Questionnaire measures of knowledge of UI, social support, and disease-related appraisals were used in the study. The level of knowledge correlated significantly negatively with the appraisal of the disease as Harm. The global level of social support correlated significantly positively with three disease-related appraisals: Profit, Challenge, and Value. Four subgroups of patients with different constellations of social support and knowledge of the disease were identified in cluster analysis and were demonstrated to differ significantly on four disease-related appraisals: Profit, Challenge, Harm, and Value. Different cognitive appraisals of UI may be specifically related to social support and knowledge of the disease, with social support affective positive disease-related appraisals, and the knowledge affecting the appraisal of Harm.

Experimental modeling of pulmonary barotrauma.

The main causes of pulmonary barotrauma include loss of consciousness or panic attack of a diver and emergence from underwater with a constricted glottis. However, numerous publications and our observations indicate that the majority of fully symptomatic cases of pulmonary barotrauma develop without any evident errors in the ascending technique. Therefore, an attempt was made to examine such cases using the experimental model of pulmonary barotrauma designed by the authors. The experiment was conducted on 32 rabbits divided into three groups: Group C--not subjected to any treatment; Group E--with induced pulmonary barotrauma; and Group CT--subjected only to compression followed by quick decompression. In Groups E and CT, the same morphological markers of pulmonary barotrauma were detected in the lungs, although their severity varied. Morphological markers of pulmonary barotrauma were observed both in the group where the tube was not ob-structed (E) and in animals exposed only to rapid decompression (CT)

Risk factors increasing health hazards after air dives.

The aim of the present study was to determine the effect of postprandial hypertriglyceridemia on the risk of decompression stress following hyperbaric air exposures. The study involved 55 male individuals aged 20-48 years (31.47 ± 5.49 years), body mass index 20.3-33.2 kg/m2 (25.5 ± 2.58 kg/m2). Blood was sampled two hours after a meal each participant had in accordance with individual dietary preferences to determine the following parameters: blood cell counts, activity of aspartate aminotransferase (AST) and alanine ammotransterase (ALT), concentrations of total cholesterol and triglycerides. After each hyperbaric exposure, the presence and intensity of decompression stress were assessed using the Doppler method. Decompression stress was found in 30 individuals. Postprandial hypertriglyceridemia and hypercholesterolemia increased the risk of decompression stress after hyperbaric air exposures.

Influence of L-arginine on expression of HSP70 and p-53 proteins - early biomarkers of cellular danger in renal tubular cells. Immunohistochemical assessment.

INTRODUCTION: The aim of the present study was to investigate expression of HSP70 and p-53 proteins as mechanisms of protection of the renal tubular epithelial cells from l-arginine that induces cellular stress. MATERIAL AND METHODS: The study material consisted of 16 white Wistar female rats. The rats were divided into 2 equal groups. The rats in the experimental group received L-arginine 40 mg/kg body weight per capita every other day for 2 weeks and were decapitated after 3 weeks of the experiment. After decapitation, specimens from the kidney were collected, fixed in 10% formalin, and then embedded in paraffin blocks. Proteins HSP70 and p-53 on slides were detected using the standard three-step immunohistochemical method. RESULTS: The quantitative evaluation of HSP70 and p-53 expression showed that the area occupied with positive HSP70 and p-53 reaction in the rat renal tubular cells of the experimental group (p-53: 2835.44 ±254.72 µm(2); HSP70: 24111.42 ±4290.88 µm(2)) was more statistically significant than the control group (p-53: 1882.05 ±466.43 µm(2); HSP70: 11388.63 ±1455.24 µm(2)). In the present study, the dose of L-arginine was similar to the one that was used in the gestosis treatment of pregnant women. CONCLUSIONS: The renal epithelial cells responded to L-arginine therapy, increasing expression of HSP70 and p-53 proteins. The study showed that L-arginine as a donor of exogenous nitric oxide has a disruptive effect on the renal tubular cells of rat kidneys. Thus it is going to be a subject of the author's future investigations.

The influence of high-fat diets on the occurrence of decompression stress after air dives.

INTRODUCTION: In hyperbaric air exposures, the diver's body is subjected to an increased gas pressure, which simulates a real dive performed in water with the presence of hydrostatic pressure. The hyperbaric effect depends on pressure, its dynamics and exposure time. During compression, physical dissolution of inert gas in body fluids and tissues takes place. The decompression process should result in safe physiological disposal of excess gas from the body. However, despite the correct application of decompression tables we observe cases of decompression sickness. The study aim was to find factors affecting the safety of diving, with a particular emphasis on the diet, which thus far has not been taken into account. METHODS: The study subjects were 56 divers. Before hyperbaric exposure, the following data were collected: age, height and weight; plus each divers filled out a questionnaire about their diet. The data from the questionnaires allowed us to calculate the approximate fat intake with the daily food for each diver. Moreover, blood samples were collected from each diver for analysis of cholesterol and triglycerides. Hyperbaric exposures corresponded to dives conducted to depths of 30 and 60 meters. After exposures each diver was examined via the Doppler method to determine the possible presence of microbubbles in the venous blood. RESULTS AND DISCUSSION: Decompression stress was observed in 29 subjects. A high-fat diet has a direct impact on increasing levels of cholesterol and triglycerides in the blood serum. A high-fat diet significantly increases the severity of decompression stress in hyperbaric air exposures and creates a threat of pressure disease.