Rats were exposed to 100% oxygen at 3 ATA for two hours a day. On the second, third, seventh or fourteenth day, alveolar macrophages（AMP）were collected by bronchoalveolar lavage.
Immunological functions of alveolar macrophages were evaluated by chemiluminescence and chemotaxis. Chemiluminescence, which indicates the production of active oxygen by macrophages, increased significantly after three, seven and fourteen days exposure to OHP. Chemotaxis increased also but not significantly after two, three and seven days exposure.
These results indicate that the OHP（100% Oxygen, 3 ATA, 2 hours）enhanced the immunological activity of rat AMP. The present findings imply that the activation of AMP due to repeated OHP causes alveoli damages.

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Hyperbaric oxygen therapy（OHP）was used to improve the viability of grafted skin, mucous membrane and skin pedicle flap, in reconstructive surgery for oromaxillo-facial defects. Subjects were twenty eight patients who received thirty two graft surgery during eight years from 1977 to 1985 and resulted in disturbed circulation. Types of flaps were; twelve Abbe flaps, one palatal mucoperiostal flap, one tongue flap, one dermis fat flap, one auricular composite graft, one nasolabial flap, one temporal forehead flap, one myocutaneous flap, two myocutaneous flaps of pectoralis major and three delto-pectoral flaps.
During OHP, ischemic flaps turned into fresh pink and OHP was continued twice or once a day under 2 and/or 3 ATA for one hour respectively. Early employment of OHP brought favorable result. Survival effect of flaps. was excellent in fifteen cases（53.5%）, fair in five cases（17.9%） and poor in remaining eight cases（28. 6%）. Major complication was otalgia, which occured in five cases. Through these facts, OHP was proved to be useful to improve disturbed blood circulation of grafted flaps.

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The number of reports on fat embolism has increased recently, however, it is still a rare disease in Japan. The prognosis of severe fat embolism falling into coma within twenty four hours after injury is generally poor and early diagnosis and treatment are required strongly.
Five cases of fat embolism were experienced which occurred within twenty four hours after multiple fractures of long bone. All the cases showed sudden confusion as initial symptom and three cases went into drawsiness to coma within a few hours after onset. In order to prevent the release of fat particles from the lesion, surgical reposition of fractured bone was performed as early as possible. Furthermore, hyperbaric oxygen therapy was introduced to improve hypoxic disorder observed in early stages. All showed complete relief from the trouble.

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To elucidate the mechanism of the effect of OHP upon endotoxin-induced lung injury, biochemical effects of oxidant upon metabolism and also the morphological changes of lung tissue were studied using guinea pigs.
After administration of endotoxin, remarkable decrease of leucocytes in right atrium, decrease of SOD activity and elevation of MDA in lung tissue were observed. Degeneration of type Ⅱ alveolar cells and alveolar capillaries, edema in stroma were noted microscopically in endotoxin treated lung. Contrary to these findings, these changes were not observed in OHP treated animals.
From these results, it is suggested that OHP is effective to reduce lung injury by improving oxidant metabolism in endotoxin shock.

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The sole effect of HBO on multiple organ failure, particularly on toxic acute hepatic failure （AHF）, has not yet been clarified. The effects of HBO were studied by pathohistological observation, using rabbits which were experimentally induced into AHF by i.v. injection of D-galactosamine and the findings were compared with those of control animals.
In liver, centro-acinar degeneration, necrosis with karyorrhexis and poor leucocytic infiltration were noted in control animals. While in HBO animals, cellular structure was well preserved and many basophilic fine globular substances were seen in cytoplasma, which were identified as “Ring-mitochondria” through electron-microscopy. In control animals, cellular damage was so severe that no mitochondria could be seen. In HBO animals, degenerative changes of hepatic cell were very few and poly-nucleation suggested regeneration of damaged cell. in kidney, vacuolar degeneration was also minimal in HBO animals.
In conclusion, HBO is considered to be indicated for toxic hepato-renal failure.

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A case of 32-year-old man was reported who showed prolonged hepatic and renal failure treated by hyperbaric oxygen therapy（OHP）.
These disorders followed severe hemorrhagic shock due to contusions of left-side chest and upper arm. As his progress was poor, so, three months after the accident, he received OHP（2 ATA for two hours with pure oxygen）for ten days continuously.
After the beginnig of OHP, hepatic（GOT, PT, T-Bil, P-Ammonia）and renal（sCr, BUN, Ccr, FENa）functions improved significantly. Within the same day, FENa, u-BMG, TmG, PT and p-Ammonia during OHP were improved compared with those data before OHP.
This result suggests OHP is effective for hepatic and renal failure following hemorrhagic shock not only in acute but also in chronic phases.

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To establish a more effective treatment table for initial recompression, a modified long-term air table combined with HBO was examined for serious DCS cases（spinal cord and brain type）and got excellent results. This table consists of 100ft initial recompression with air for one to two hours, followed by safe decompression considering upon the symptoms of patients and also upon nitrogen gas eliminating rate from involved tissue, and HBO which is introduced after envirorunental pressure reaches 40ft.

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Blood gasmetry under hyperbaric oxygenated condition was studied clinically in relation to the difference of masks, calibration gases and the effect of heparin in sampling syringe. Subjects were 197 patients of cerebrovascular disease. IL #813 model（Instrumentation Laboratory Inc.） was employed as blood gas analyzer. During inhalation of pure oxygen, two kinds of low calibration gases were used as follows; gas A（O₂ 50%, CO₂ 2.5%, N₂ balance）and gas B（O₂ 95%, CO₂ 2.5%, N₂ balance）.
When gas B was used, PaO₂ at 2 ATA was 725±125mmHg in patients using oxygen mask （lnspiron）, and 1088±147mmHg with anesthetic mask（Acoma）. But, when gas A was used, PaO₂ showed apparently lower value than that of gas B （p<0.001）.
To study the influence of heparin upon PaO₂, two kinds of heparin were used in sampling syringe; powdered and liquid heparin. Under 1 ATA O₂ and 1 ATA air condition, the property of heparin had no influence upon PaO₂. However, under 2 ATA O₂ condition, when liquid heparin was used, PaO₂ was significantly lower than those utilized powdered heparin（p<0.01）.
When extremely high PaO₂ can be expected, calibration gas should be selected which has approximate properties to the sampled blood gas, and powdered heparin should be also prefered.

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The effects of short-term and long-term hyperbaric oxygen therapy（HBO）for multiple sclerosis were studied. Three patients in chronic stage were exposed to compressed air everyday, in a hyperbaric chamber at 1.9 ATA for ninety minutes a day until total numbers of treatment reached twenty times. In other three patients, treatment at 1.8 ATA was administered one to four times a week until total exposures for each patient reached 117, 158 and 194 respectively during one year. In each treatment, 100% oxygen was given for ten minutes during air compression by mask.
In all the short-term patients, objective improvement was recognized. IgG synthesis in CSF and the cell ratio of OKT⁴⁺ to OKT⁸⁺ decreased in two patients after the treatment. In the long-term Patients, the number of relapse reduced. Clinical symptoms and disability scales remained unchanged. These results suggest that HBO can ameliorate the symptoms in chronic stage and it can also reduce the lumber of relapses of multiple sclerosis.

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