ISSN: 1605–9204 European Journal of Underwater and … · 2015. 10. 27. · e-mail:...

Volume 2 No. 4, December 2001Volume 2 No. 4, December 2001Volume 2 No. 4, December 2001Volume 2 No. 4, December 2001 ISSN: 1605–9204ISSN: 1605–9204ISSN: 1605–9204ISSN: 1605–9204

European Journal ofEuropean Journal ofEuropean Journal ofEuropean Journal ofUnderwater andUnderwater andUnderwater andUnderwater and

Hyperbaric MedicineHyperbaric MedicineHyperbaric MedicineHyperbaric Medicine

CONTENTSEUBS Newsletter, Volume 8 No 4, Winter 2001 Impressum & EUBS Executive Committee Overleaf

Editorial 93President’s Column 93Financial Statement for 2000 94Press Release 94

Original Papers Thirty Years of Growth & Progress: EUBS RC Bornmann & Lee Greenbaum 95 What’s the UHMS doing now Don Chandler 100 Effects of Hyperbaric Oxygenation on

Mortality in Murine Polymicrobial Sepsis M Heringlake et al. 103

Meeting Reports EUBS Annual Scientific Meeting 2001 Lee Greenbaum 107 UHMS Annual Scientific Meeting 2001 Bill Hamilton 109 UHMS Workshop 2001 “Patient Safety” C Pirone & PHJ Mueller 111

Book Review Tauchtauglichkeit Manual Claus-Martin Muth 106

Instructions to Authors Inside Back Cover

DISCLAIMER: All opinions expressed are given in good faith and in all cases represent the views ofthe writer and are not necessarily representative of the policy of the EUBS.

Official NEWSLETTER

EJUHM Volume 2 No. 4, December 2001

PUBLISHED quarterly by the European Underwater and European Underwater and European Underwater and European Underwater and Baromedical Society Baromedical Society Baromedical Society Baromedical Society EUBSEUBSEUBSEUBS

EDITOR Peter HJ Mueller [email protected] Strasse 91-93, D-68163 Mannheim/Germany

ASSISTANT EDITOR Hyperbaric Medicine and Clinical Applications: Till S. MutzbauerASSISTANT EDITOR Occupational Medicine, Compressed Air Work: Birger NeubauerASSISTANT EDITOR Physiology and Medicine of Diving, Fitness to Dive: Kay Tetzlaff

Printed in Germany by Druckerei Johannes May, D-68163 Mannheim

EUBS EXECUTIVE COMMITTEEPRESIDENTDr. Ramiro Cali-CorleoHyperbaric Unit, St. Luke’s HospitalG’Mangia, MaltaTel.: +356-234765Fax: +356-372484e-mail: [email protected]

VICE PRESIDENTDr. Noemi BittermanS. Neaman InstituteTechnion, Technion CityHaifa 32000, IsraelTel.: +972-4-8347171Fax: +972-4-8346631e-mail: [email protected]

IMMEDIATE PAST PRESIDENTDr. Greta BolstadHelPro asN-7012 Trondheim, NorwayTel.: +47-73596899Fax: +47-73591005e-mail: [email protected]

PAST PRESIDENTDr. Juergen WenzelWalhallstrasse 36D-51107 Koeln, GermanyTel.: +49-2203-6013370Fax: +49-2203-68323e-mail: [email protected]

SECRETARYDr. Joerg SchmutzFoundation for Hyperbaric MedicineKleinhuningerstrasse 177CH-4057 Basel, SwitzerlandTel.: +41-61 631306Fax: +41-61-6313006e-mail: [email protected]

TREASURER & MEMBERSHIP SECRETARYMrs. Angela RandellBenview, Prospect TerracePort ElphinstoneInverurie, AB51 3UN, United KingdomTel. & Fax: +44-1467-620408e-mail: [email protected]

MEMBER AT LARGE 2001Dr. Einar ThorsenNUI, PO Box 6N-5034 Ytre Laksevag, NorwayTel.: +47-53-41600Fax: +47-53-46936e-mail: [email protected]

MEMBER AT LARGE 2000Dr. Martin Hamilton-FarrellLondon Hyperbaric Medicine Ltd.Whipps Cross University HospitalLeytonstone, London, E11 1NR, United KingdomTel.: +44-20-85395522Fax: +44-20-85391333e-mail: [email protected]

MEMBER AT LARGE 1999Dr. Mikael GennserFOA Naval MedicineNational Defence Research EstablishmentS-13061 Horsfjarden, SwedenTel.: +46-8-50263474Fax: +46-8-50034735e-mail: [email protected]

JOURNAL & NEWSLETTER EDITORDr. Peter HJ MuellerHBO-Zentrum Rhein-NeckarDiakoniekrankenhausSpeyerer Str. 91-93D-68163 Mannheim, GermanyTel.: +49-621-8102 390Fax: +49-621-8102 393e-mail: [email protected]

European Journal of Underwater and Hyperbaric Medicine, ISSN: 1605-9204 Volume 2 No. 4, December 2001

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EDITOR’S COLUMN

Dear Readers!

We have all been deeply shocked by thetragedy of the 11th September. The world haschanged thereafter and we have been forced toaccept that nothing is to be taken for granted, inparticular our safety in this world. Although wehave not learned about any losses amongst ourSociety’s membership, many of us are sufferingfrom the loss of relatives or friends indirectly.Our sympathy remains with the victims andtheir loved ones.

Dr. Einar Thorsen from Norway has beenelected by the membership for a three yeartenure as Member-at-Large. Congratulations!He replaces Dr. Peter Germonpré fromBelgium, who will remain active for the Societyas the EUBS webmaster. Peter is also theSecretary General of the next EUBS AnnualScientific Meeting which will be held in Brugge,Belgium, September 4-8, 2002. For more infovisit http://www.eubs.org/eubs2002_1.htm

This issue presents a lot of EUBS history. Withthe invited presentations made by BobBornmann and Don Chandler at the EUBSAnnual Scientific Meeting in Hamburg it createsa bridge from the past to the future of ourSociety. Therefore this issue does not leaveenough room for many scientific papers. Thiswill be different in the spring issue coming up,which will contain the Proceedings of the 3rd

Hamburg Symposium on Occupational Risks inHyperbaric Tunnelling and Commercial Diving.You can expect a highly scientific and hugeissue full of valuable material.

The winning paper of this years ZetterströmAward “NEUROPROTECTION BY THE USEOF HYPERBARIC OXYGEN AFTERPERMANENT FOCAL ISCHEMIA” by HolgerSchade et al. will hopefully be soon availablefor publication in the Journal. The authors hadsubmitted the paper to a neurology journal withsignificant impact and momentarily they arewaiting for the review. However, we havealready requested the permission to reprint thepaper in the EJUHM. You should be able to findit in the summer issue.

The Diving seminars at the World Congress onDrowning to be held in Amsterdam 27-29 June2002 will cover important topics relevant todiving medicine and diving safety! So visit:http://www.drowning.nl

At this time I would like to extend my sinceregratefulness to all those who have supportedme for the past year with the Journal in theediting, by submitting papers or by doing thereviews. Thank you very much indeed!

I wish you all a Merry Christmas and the verybest for the New Year.

Peter

MESSAGE FROM THE PRESIDENT

Dear Friends

The events of 11th September are still with usand its consequences will be with us for manyyears. Its occurrence just days before theEUBS meeting also meant that some of ourfriends from America were not able to attend.Let us hope that next year’s meeting in Belgiumwill be in a calmer and more carefree world.

I would like to congratulate Dr Uli van Laak andhis team for managing to run the meeting sowell even if he was forced to make somechanges because of what had happened.However the conference was a scientificsuccess with many interesting and thoughtprovoking papers presented. The social partwas not lacking and the casual beer night wasparticularly notable.

A new development is that discussions areunder way to set up a federation of internationalsocieties in diving and hyperbaric medicine andthis is to be spearheaded by the EUBS and theUHMS following talks we had with theExecutive Director of the UHMS, Don Chandler.

Such an organization will strengthen ourspecialty through the creation of a consensuson a number of key matters such as indicationsand professional qualifications. It was alsoagreed to increase the co-operation betweenthe two societies, the UHMS and the EUBS byrunning a column in each other’s newsletter.

Well there is a lot to do before next year’smeeting, in the meantime I wish you all the bestfor the coming festivities.

R. Cali-CorleoPresident


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EUBS FINANCIAL STATEMENT FOR THE PERIOD 1ST JANUARY TO 31ST DECEMBER 2000

INCOME

Membership 4,599.50Corporate Membership 750.00Proceedings 308.00Interest on Bank Account 220.47

Total £5,877.97

EXPENDITURE

Secretarial Fees 600.00Newsletter 4,075.71Cardnet Charges 326.50Travel & Accomodation – Malta 412.92Student Grant 213.09Postage/Telephone etc 395.30

Total £6,023.52

Expenditure over Income £ 145.55

Bank Balance

Account Balance as at 1 January 2000 £13,974.41Stamp Stock and Cash in Hand at 1 January 2000 0.00

£13,974.41Less Expenditure over Income 145.55

£13,828.86

Account Balance as at 31 December 2000 £13,604.16Stamp Stock and Cash in Hand at 31 December 2000 224.70

£13,828.86

To come off for 2000

Website £250Proceedings – Malta £853

AGA LINDE HEALTHCARE HBO AWARD 2001 GRANTEDTO TWO RESEARCHERS FROM GERMANY

In co-operation with the Association of German HBOCentres (Verband Deutscher Druckkammerzentren, VDD)AGA Linde Healthcare GmbH & Co. KG(Unterschleißheim, Germany) has granted the HBOAward of the year 2001 to Dr. Claus-Martin Muth(University Hospital Ulm, Germany) and Dr. MartinKoschnick (BG Unfallklinik Ludwigshafen, Germany).In their research work both scientists investigated theapplication of hyperbaric oxygen for the treatment ofdiabetic wounds in an animal model.Dr. Muth and Dr. Koschnick could clearly demonstratethat hyperbaric oxygen can compensate for negativeeffects on wound healing which are very often linked withdiabetes mellitus as a chronic systemic disorder.Furthermore their study shows that at least in the animalmodel used for the experiments (Sprague Dawley Rats)HBO therapy is much more effective than clinically

accepted treatments like standard moist-wound therapywith or without additional application of hyaluronic acidThe HBO award for German-speaking countries which isgranted since 4 years on a yearly base honours excellentscientists active in the field of HBO therapy, from basicexperimental and theoretical research up to clinicalstudies and applications. More information as well asapplication forms for 2002 are available at AGA LindeHealthcare GmbH & Co. KG, Edisonstrasse 2, 85716Unterschleißheim, Germany, and VDD e.V., Cuno-Niggl-Strasse 3, 83278 Traunstein (Germany).

AGA Linde Healthcare GmbH & Co. KGEdisonstrasse 2

Contact: Pascal StraussD-85716 Unterschleißheim/Germany

Tel.: +49-(0)40 – 8531 21301


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EUBS MEETING 2001

Lee Greenbaum Jr.

One could very easily give credit to the meeting chairman(Secretary General) Dr Ulrich van Laak for selecting theloveliest city in Germany tohold the annual EUBS meeting.The weather god must haverecognized and approved hisselection because we wereblessed with near-perfectweather. The location of theconvention hotel (HotelIntercontinental) added to thepleasantness of the meetingsbecause it was one half blockaway from the AußenalsterLake, a lake surrounded by lovely parkland with bike andwalking paths. In late afternoon the lake was always busywith sailboats and rowing shells.

Just prior to official registration and the opening sessions,the World Trade Center in New York and the Pentagon inWashington, DC were wrecked by terrorists. Some of themembers from the United States who had planned toattend were prevented from attending because all airportsin the U.S. were closed. Those U.S. members whodeparted before tragedies had their warmed by the verysympathetic comments and concerns of our Europeanfriends. The U.S. consulate that was located an the lakefront and within easy walking distance from theconvention hotel was busy with very somber andrespectful Hamburg residents who continued to file theconsulate day and night laying flowers at the frontentrance and standing in line to sign the visitor book. AnyU.S. visitor who happened to walk by had to be deeplymoved by the loving concern.

This meeting, as with most EUBS annual meetingsincluded a special scientific symposium. This symposium,The Third Symposium on Occupational Risks inHyperbaric Tunneling and Commercial Diving wasorganized by Dr Birger Neubauer of Hamburg. Thesymposium was held in the lecture hall of the famousBernhard-Nocht-Institute for Tropical Medicine whichoverlooked the port of Hamburg near the site of the firstElbe tunnel that was constructed in 1910. The topicscovered were wide ranging, including discussions onhyperbaric tunneling in contaminated grounds, breathinggas contaminants, welding fumes, diving in chemicallycontaminated waters and contaminations resulting frompyrolysis. It is our hope that this very informativesymposium will be published and made available to thosepeople who were unable to attend.

The diving physiology session was opened by a paper byNossum and Brubakk from Trondheim, Norway. Theinvestigators developed a technique that employed tissuesilver staining combined with image processing toquantify the precise amount of mechanical damage in theendothelial layer of blood vessels following exposure tointravascular bubbles. This exciting new method mayserve as a major contribution when attempting to

determine the mechanism(s) that lead to a reduction in theendothelial response when exposed to intravascularbubbles. Investigators (Leni, Menu, Laforest, Zouani andMeliet) from Toulon exposed male rabbits to pressurizedair atmospheres (500 kPa and 100kPa) for 25 minutes.One group of rabbits were given furosemide (5 mg/kg,im) prior to compression. Evoked potentials were used torecord immediate changes in neural transmission. Theauthors were able to demonstrate a preexisting iso-osmotic dehydration that coincided with evoked potentiallatencies following rapid decompression. It was felt thatdehydration may be a major contributing factor but notthe sole cause of the altered nervous system. It waspointed out that a major weakness in the study was thelack of pathologic data.

A study in which recreational divers were exposed to wetand dry atmospheres at 50 meters (0.6 Mpa), Mutzbauer,Gruenes, Neubauer, Lorenz, Weiss, Schneider andTetzlaff were able to demonstrate the there was no effecton erythropoietin levels in plasma. There was no evidencethat water immersion played any role as a co-factor forerythropoietin production.

The recent loss of the Russian submarine in which therewere no survivors has tended to highlight the need formore useful data on safe escape procedures for the captivecrews. Using goats, Gennser, Blogg, Loveman, Seddon,Thacker and White compressed the animals to 25 ATA.The goats were allowed to breath air or gas mix of 60/40oxygen/nitrogen through an oro-nasal mask during therapid decompression. Immediately following the return toatmospheric pressure, they were given air to breathe. Noconvulsions were seen in any of the oxygen/nitrogen mixanimals and no changes in breathing frequency werenoted. Bubble scores from precordial Doppler wereidentical in both animal groups. Bubbles disappearedmore quickly after the ascent in the hyperoxic animals.Schabana, Hamich, Radermacher, Muth and Paulatmodified an ultrasound device (Smart Dop, DWLElektronische Systeme GmbH) that is employed tomeasure cerebral blood flow but in this instance it wasused to record bubble presence and blood flow in thesubmerged diver. It was thought that the equipment mightbe used to evaluate diver safety during decompression, inaddition, to gain some insight about the role of a patentforamen ovale during diving.

It is interesting to note that in thirteen experiencedrecreational divers, five of whom had patent foramenovales, no increased incidence of changes in cerebralwhite matter was seen. Farkas and collaboratorsemployed MRI to evaluate any possible cerebralabnormalities. No subjects were older than 40 and therewas no evidence of cardiovascular disease anddecompression illness prior to the initiation of the study.

The possible relationship of patent foramen ovales (PFO)and changes in the central nervous system continues toperplex the diving community. Another study by Koch,


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Wie, Kampen, Bettinghausen, Rieckert and Tetzlaff inwhich they studied fifty healthy professional and well-trained recreational divers with no history of DCI, strokeor cardiac failure, PFOs per se did not indicate that therewas an increased incidence of cerebral lesions in healthydivers who never experienced symptomatic DCI II.However, the study did demonstrate an age related effect,as influenced by the number of dives, on the incidence ofbrain lesions. The presence of brain lesions were detectedwith MRI and independent evaluators were employed inthe PFO and MRI recordings.

Arterial blood gases during breathhold diving wererecorded by Calcia, Pittner, Schabana, Hamich,Radermacher and Muth. The blood gases were sampled at20 msw. Descent and ascent times were one minute andthe bottom times were two and 3 minutes. The arterialpO2 was equal or the same as theoretical values. Theincrease of pCO2 was less pronounced than might havebeen expected from measurement of alveolar gases. Thecombined influences of breathhold, valsalva maneuverand intensive exercise on heart rate were studied byHoffmann, Smerecnik, Buttgereit and Leyk. Sixteenathletic students exercised on a cycle ergometer in thesupine position and breathhold and the valsalva maneuverwere performed during exercise. The heart rate decreasedwithin the last seconds of the exercise with a minimumimmediately during recovery. This was then followed bya second maximum and minimum heart rate. Theinvestigators speculated that vasoconstriction led to meanblood pressure increase which was compensated for by adecreased heart rate.

Naraki and Mohri from Yokosuka investigated the riskthat divers face following diving by flying or driving tohypobaric environments. Rats were allowed to saturate ata pressure equivalent to 30 meters, viz 150 minutes andwere then decompressed at a rate of ten meters perminute. Time intervals of 1, 5, 10, 20 and 30 minuteswere allowed to elapse before decompression to varyinghypobaric environments equivalent to 500, 1000, 1500,2000, 2500 and 3000 meters. The rats were kept in theseenvironments for 30 minutes. Following recompression,they were observed for signs and symptoms of DCI. Ahigh level of incidence of DCI was noted followingresidence at 1500 meters for short surface exposures butno DCI for surface intervals longer than 20 minutes.

Based on previous studies by Marroni, et al., thatdemonstrated that post dive high bubble grades may bedirectly to fast to medium half time tissues, computedvenous pN2 greater than 1100mbar and leading tissuepN2 greater than 80% of the allowed M value, theinvestigators attempted to identify bubble-safe profiles.Three square dive profiles were selected: a single dive to20m for 60 minutes with ascent times that ranged from 17minutes 50 seconds to 35 minutes 25 seconds. The secondgroup included single dives to 40m for 10 minutes withascent times varying from 4 minutes to 17 minutes 15seconds. The remaining group included a series ofrepetitive dives to 30m for 16 minutes with a surfaceinterval of 75 minutes. Doppler recording was carried outevery 15 minutes post dive and all dives were madeaccording to the original Zh-L8 ADT model. Theintroduction of the Proportional M-Value Reduction

Concept (PMRC) to the fast and medium-slow HATtissue compartiments eliminated the occurrence ofsignificant post dive detectable gas emboli in the fourteenvolunteers.

In another study by Marroni and coworkers on 575volunteer divers in which Doppler recordings was used tomonitor venous gas emboli where about 33% of the diveswere in the range of 20 to 30 meters. However, overalldepth range varied from 5 to 65 meters. In an unexpectedfinding, high bubble grade recordings appeared to berelated to skin cooling with higher signals fro skintemperatures 0f 26.5 – 27°C and low or absent signals forskin temperatures of 29°C.

As in previous meetings, there has been a paucity ofexperimental papers in the hyperbaric oxygen sections ofthe meetings. However, the first paper to be presented inthe session was an excellent experimental study byHjelde, Hjelstuen, Thom and Brubakk on the effect ofhyperbaric oxygen (HBO2) on neutrophil accumulation inischemic cerebral tissue. Permanent ischemia in the ratswas produced by middle artery occlusion for four hours.In one group of rats HBO2 (100% O2 at 2 ATA for 230minutes) was administered ten minutes after MCAocclusion. The other group of rats were not exposed toHBO2 and served as controls. MRI was used to assess theefficiency of HBO2 treatment. Destructive neutrophil(PMN) levels were determined with the enzymemyeloperoxidase (MPO). The investigators found anincrease in MPO levels in the HBO2 treated rats leadingthem to conclude that in the clinical area, HBO2 cannotbe recommended for the treatment of permanent brainischemia.

Alterations of arterial blood gases after HBOT incritically ill patients was monitored by Ratzenhofer-Komenda and associates at the Univerity Medical Schoolin Graz, Austria. The study was based on the clinicalobservation of a decline in oxygenation after hyperbaricoxygen therapy. The patients either were being treated fornecrotizing fasciitis, burn injury, CO poisoning and majorabdominal surgery. All subjects were mechanicallyventilated and received analgesic medication or weresedated. HBOT was administered at 2.2 ATA for 50minutes. Arterial blood gases were monitored along withheart rate and body temperature. Median arterial oxygentension decreased by 23% in hour one and by 15% in thesecond hour. Arterial oxygen tension decreased andalveoloarterial tension difference increased in the earlyperiod of HO2 exposure. The authors suggest that theremay be ventilation-perfusion inequality which seemed tobe reversible as the movement to baseline continued. Itwas suggested that because the subjects were ventilated,carbon dioxide was unable to regulate the ventilation.

A study from the Duke University (Demchenko, Oury,Crapo and Piantadosi) investigated the possibility tha NOreleased from cells may be responsible for the increasedsensitivity of the CNS to oxygen toxicity. Mutant micewere used and recording electrodes were stereotacticallyplaced in the substantia nigra, caudate putamen,hippocampus and the parietal cortex. A microdialysisprobe was placed in the caudate and was continuouslyperfused with artificial CSF. The mice were compressed


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to 5 ATA and breathed 100% oxygen. CBF was measuredevery 15 minutes along with EEGs. In addition samplesof the dialysate were also collected. The collected datasuggested that SOD3 plays a unique role in thevasculature to efficiently scavenge superoxide in veryspecific extracellular regions. Vascular SOD3 is locatedstrategically between the endothelium and smoothmuscle. NO becomes effective by exerting its influencethrough the red cells and endothelium to stimulate smoothmuscle relaxation. SOD3 appears to be involved insensitivity to CNS oxygen toxicity by inhibiting oxygenmediated inactivation of NO and CBF.

In the clinical area of hyperbaric medicine, most of thepresented papers were case reports ranging from thetreatment of cerebral palsy, Crohn disease, iatrogenic airembolism, faecal incontinence and necrotizing fasciitis.The presentation by Neubauer from Florida on thetreatment of cerebral palsy with hyperbaric was in essencea repeat of a presentation that was made in Malta. Thegeneral focus of the paper was on the use of sequentialSPECT imaging in brain injured children. In addition to abrief discussion on the use of SPECT, a film was shownon six cerebral palsyied children who were treated withhyperbaric oxygen, cases that were selected from a largevolume of treated patients. A treatment protocol was notgiven, viz standardized performance measures before andafter treatment. Independent evaluators were not used andthere was no presentation of statistically analyzed data.The use of SPECT alone is valueless unless supported bydata on brain metabolism. This would have requiredsimultaneous sampling of arterial and jugular blood. Theflows may have been altered during or just followingHBO2 treatment but were there concomitant changes inbrain metabolism? SPECT provides relative measures ofblood flow (perfusion) but cannot give information onabsolute blood flow, i.e. the level of perfusion. Thereforeit cannot be used to measure cerebral metabolic rate,changes of which would be crucial for an understandingof the effects of HBOT. It was felt by the reviewer that if

the plaguing issue of success or failure of treating braininjured children with hyperbaric oxygen is to be honestlysettled, a large multicenter clinical trial with a rigidprotocol will be required.

There were a number of wonderful social events toentertain the members and their spouses but the finalbanquet aboard the steel hull windjammer RickmerRickmers was the most memorable event. It is a statelythree master, 97 meters in length and at one time shecarried 3,500 square meters of sail. Her hull was laid in1896 in Bremerhaven and a lot water passed under herhull over the years with passages around Africa andeastern Asia. A wide range of wonderful food and wineswere served in the very bright and comfortable lounge orship’s wardroom.

The Secretary General and President of Gesellschaft fürTauch- und Überdruckmedizin, Dr Ulrich van Laakdeserves a lot of credit for arranging and then overseeingthe twenty seventh meeting (30 anniversary) of theEuropean Underwater and Baromedical Society. Onecould easily say that the meetings were “smooth”, everydetail was considered. The Proceedings were superblydone; the printing was uniform throughout and there wasa direct correlation of the meeting agenda (table ofcontents) and the papers as presented. It certainly is amodel for the future production of meeting proceedings.Thank you Uli.

Leon Jack Greenbaum, Jr., Ph.D.396 Germantown Road

Edgewater, MD 21037 U.S.A.e-mail: [email protected]

Further copies of the Proceedings (ISBN 3-88312-132-0) of the EUBS meeting in Hamburg are availablefrom: Verlag Schmidt&Klaunig, Ringstr. 19, D-24114Kiel, Fax: +49-(0)431-6606424. Price is € 85,- incl. S&H.

UHMS holds successful new style meeting in San Antonio

R.W. Bill Hamilton

The Undersea and Hyperbaric Medical Society had a hardact to follow in picking a venue to follow the greatmeeting in Stockholm in 2000, and San Antonio did agood job. This year’s meeting, 2001 June 13-16, drew animpressive 500 attendees. The quality of a meeting is notonly how many choose to attend, but whether thoseattending are the leaders, the “movers and shakers” in thecommunity; in my opinion this year they were.

There were several things unique about this year’smeeting. One was that it was done by a totally newUHMS staff. Following the retirement of ExecutiveDirector Lee Greenbaum and his replacement by DonChandler, the Society’s experienced meeting planner JaneDunne also left, and this was followed shortly by thedeparture of Denyse Spence, the principal secretary andpivot point of the UHMS office. And three others not somuch involved in the Meeting have left UHMS as well;

Hilda Auricchio retired, Ann Barker our chief editor wentinto a semi-retirement contract status, and Nancy RuftySchandelmeier has stepped down as Editor of Pressure.Don’s right hand woman is now Rosana Enamorado, andled by the two of them the new staff put together a wellorganized meeting. A very useful organizational tidbitwas an up-to-date listing of all the committee meetingsand their locations, making it easier to for participants tojuggle all these times and places.

San Antonio was a nice place for the meeting, andalthough it was warm and somewhat humid outside, therewas a delightful Mexican color and rhythm that was partof the town, the food, the many great restaurants, and theentertainment. Add to that some sheer Texas characterexemplified by the artifact-and trophy-laden BuckhornSaloon where the Associates held their “roast” of PaulBaker; actually they had Texas barbecue, not roast. I


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remember being completely awed by the Buckhorn whenit was a downtown saloon and I was much too young toeven consider buying a beer there. The UHMS Associatesalong with the Baromedical Nurses Association had agreat pre-program also, and their ongoing sessionsafforded stiff competition to the main program.

This year’s pre-program on the Mechanisms ofDecompression Illness carried on a fine tradition, startedby David Elliott and now organized by James Francis,addressing several DCS topics not covered previously.These included hypotheses for limb bends and skin bends,cardiopulmonary DCS (chokes), and spinal DCS withproponents of the 3 leading hypotheses, and variousmodes of ear barotrauma and “squeeze.”

Another great pre-program was that on Patient Safetyorganized by Paul Barach and Peter Mueller. In coveringthe “safety” topic it provided many useful aspects ofchamber operation. Those who attended learned a lotabout how to operate a chamber, safely.

The presentation format was very different this time. Allpapers were presented as posters distributed around theroom, and then after about an hour each presenter (or insome cases selected presenters, by vote or otherwiseselected by the chairmen) gave a short oral discussion ofthe paper, with questions. Although a few seemed willingto give this method a chance, my assessment of the crowdwas that very few of us really liked it. (From thepublished plans for the next meeting we had better learnto live with it.) A major complaint was that it was notpossible to determine when a given paper was going to bediscussed, making it nearly impossible to “session hop”and hear selected papers from the three sessions going onat the same time.

Looking forward to doing this again, it would be a lotmore effective if the oral presentation times could bescheduled specifically (of course the chairmen will needklaxon horns or big long shepherd’s crooks to maintainthe schedule), and if all sessions could follow the samepattern. Since all rooms will have LCD projectors theschedule could be posted on the screen and kept updated.It will work better if the chairs are clustered in the middleof the room but accessible, leaving room in front of theposters. Lighting has to be planned well, ensuring thatboth posters and screen can be seen. The method doeshave the advantage that one can study the papers ofgreatest interest in more detail, talk to the authorspersonally, but still perform the “peer review” function oforal presentations by asking incisive questions in thepublic forum. For next year we will have to prepare ourpapers more carefully, with a good poster and a few well-designed summary slides.

Perhaps the most unusual poster was one on "BOWLINGAFTER DIVING: ARE THERE SAFE LIMITS?PROJECT BOWLING SAFETY"; it was not on theofficial abstract list or schedule but was interestingnonetheless. Neil B. Hampson and Richard G. Dunforddescribed a case of thumb bends that occurred on bowlingafter diving; whether this could be attributed to bowlingwas not certain but their analysis was interesting. It's timebowling got its own poster!

One of my duties in writing up the annual meeting is toprovide some critique. The format is discussed above. Amajor glitch in my eyes (and heavy eyelids) was a severedeficit of coffee. There was a nice spread of sweet rolls,fruit, etc., early in the morning, but when that coffee ranout it seems that’s all there was. None was provided in theafternoon. Meeting Planners take note! We like coffee inthe afternoon!! In fact, since most folks get a little sleepyafter lunch, an ample supply of coffee hits the spot fromthen until the end of the program. Another planning glitchis that we lost most of the cocktail hour before thebanquet. Just after the bars started operating the doors tothe banquet room were opened and the crowd dispersed toclaim the best seats, putting an abrupt end to mostconversations. This is easy to fix: the doors to thebanquet room should stay closed until the appointed hour.This was even worse at the Boston meeting, by the way,because that time there was the additional problem thatthe bar service was inadequately matched to the thirst ofthe crowd.

An important aspect of each meeting is to recognizeaccomplishments of our colleagues. This year the AlbertR. Behnke Award went to Mike Bennett of Australia, theCraig Hoffman Award to Tom Workman, the Charles W.Shilling Award to Oskar Ehm, and the Paul Bert Award toJohn Feldmeier, among several others. It might be notedthat Mike Bennett had an awesome cheering section offellow members from Down Under. The service of LeeGreenbaum as Executive Director was recognized; Leewas at the controls when the Society went from a cigarbox accounting system to a computerized one, and into abuilding owned by the UHMS (Lee sweated this hugemortgage, but it was a good call). The Borema Award,which is actually not a UHMS award, went to MichaelStrauss. Appropriately, Dr. Strauss had 16 papers in thismeeting, far more than anyone else.

The meeting had good international representation,especially from East Asia and South and Central America,with the usual good northern European participation.About half the papers were from U.S. labs. Consideringthe general lack of research support, diving is almostholding it’s own, with 75 diving to 96 HBO2 papers bymy count. It seems to me that the HBO2 papers aredigging more into fundamental science than before, itselfa good sign for the Society. I was glad to see a couple ofpapers dealing with iatrogenic embolism, a condition thatis not treated nearly often enough.

We cannot finish without mentioning the First UHMSInternational Golf Classic, which deserves mention herebecause of our Editor Peter Mueller’s distinguishedachievement of taking the most strokes for a single hole;the actual number is classified, but it is distinguished.That’s encouraging: I may play next time.

R. W. “Bill” Hamilton, Ph. D.Hamilton Research Ltd.

80 Grove StreetTarrytown, NY, 10591-4138 U.S.A.

e-mail: [email protected]

Dear Bill, I’m looking forward to playing with yousoon! � Peter

ISSN: 1605–9204 European Journal of Underwater and … · 2015. 10. 27. · e-mail:...

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Transcript of ISSN: 1605–9204 European Journal of Underwater and … · 2015. 10. 27. · e-mail:...