Tag Archives: ISB

Deep research: keeping fit on the bottom of the North Sea

FatimaKiboub_Foto_NTNU_profilBlogger: Fatima Zohra Kiboub
Industrial PhD Candidate, Lead QHSE Engineer, Technip

 

 

 

Deep saturation divers

The working environment, health and safety of an offshore diver has significantly improved since the 1990s and saturation diving is today among the safest offshore occupations.

Crucial to our gas and oil industry, the offshore divers perform their work on the ocean floor of the Norwegian continental shelf. Not unlike the astronauts, these divers – the aquanauts – encounter environments that challenge the body’s capacity for adaptations. We look at how their bodies respond and what makes them fit and healthy.

Saturation diving is a very challenging job and the divers have to be extremely fit and healthy. The divers live at an elevated atmospheric pressure inside a pressure chamber, which is equal to the pressure at the water depth they will work at. They breathe a mixture of helium and oxygen called Heliox, which makes their voices sound like Mickey Mouse!

When working at depths of 50-180 metres, it is dark and the seawater is very cold – around 4-8°C. The divers are therefore dressed in neoprene wet suits where heated seawater is pumped through to keep them warm. It is like floating in a heated spa pool. They wear a helmet, wellington boots and rubber gloves, which could be mistaken for dishwashing gloves.

Many research projects have been conducted with recreational divers and also offshore air divers, but there are not many research projects on offshore saturation diving – and even less research done with real-life saturation divers in their own working environment.

New science indicates that elevated oxygen levels in the breathing gas and the formation of microbubbles in the blood stream makes the body initiate an anti-inflammation reaction by releasing stress biomarkers into the blood stream. This is of course closely linked to the function of the vascular system. This gave us the idea to not only study the effects of diving on the vascular system and how the body adapts to such conditions; but also how to improve the long-term health monitoring.

Vitamins

The main part of my PhD project is to see if the intake of antioxidants in the form of vitamin C and E will reduce the stress biomarkers found in the blood of saturation divers. The participating offshore divers will be given vitamins every day whilst living in the pressure chamber and blood samples will be taken before entering and upon leaving the chamber. The results will be compared with a control group not taking vitamins.

After obtaining the approval of my employer, Technip – which performs subsea construction work for the oil & gas industry; and after securing funding from the Norwegian Research Council and the necessary ethical authorisation to perform research on humans, I could start my PhD research at the Medical Faculty at NTNU doing data- and samples collection during the 2015 offshore season.

Testing ultrasound equipment

Here you can see my manager Morten in the improvised ultrasound testing room and Andreas in the back making sure that the FMD protocol was followed properly.

Before going offshore, one of my PhD supervisors, Andreas Møllerløkken, provided training on how to use an ultrasound machine to run a test called Flow Mediated Dilation (FMD). This test measurers how much a large artery of the arm can expand after the blood flow has been reduced for 5 minutes using an inflated blood pressure cuff. FMD is a much used indicator of vascular health. We used my office colleagues as guinea pigs in order to practice before going offshore.

We also obtained the centrifuges and cooling transportation boxes required for our mission, and on 2nd June, it was time for the fun part of the project to begin!

My main supervisor, Ingrid Eftedal, and I took all the equipment to the hospital on board the Skandi Arctic Dive Support Vessel. We received a warm welcome by all the crew, and by the end of the first day, we had already tested two divers.

The divers had joined the vessel by 6th June. They all went through the medical pre-dive check and some were also due to have their annual direct oxygen uptake (VO2max) test.

Initially, eight divers agreed to participate in the project, and we took their blood samples and ran FMD tests. It was a great relief to actually get started.

Medical tests onboard

As the blood samples also will be used in two other research projects run by the barophysiology group at NTNU, we are taking four test tubes of blood from the divers and 3 from the non-divers to study different paramenters. This has earnt me the nichname ‘The Vampire’, although it is the nurse taking the actual samples!

We centrifuge the tubes with blood and anticoagulant to separate the plasma into tubes for freezing and later analysis at the NTNU laboratory.

We also measure percentage of red blood cells onboard, and record the results in our log sheet.

In addition to ‘normal’ health check such as taking the blood pressure, we ran FMD test using an ultrasound machine in combination with an electro cardiogram (ECG). This test shows how much the brachial artery in the arm can expand after 5 minutes of pressure in the forearm. It is a good indicator of artery elasticity reflecting vascular health.

The divers who were due to take their annual VO2max test, measuring the maximum oxygen uptake in the blood, were running on the onboard treadmill placed within the vessel’s hospital.

I have to say it is not easy to work when the ‘ground’ is moving in all directions all the time, but when the sea calmed down enough, it was safe for the divers to run on the treadmill. All our non-divers also passed the test with extremely good results – it is amasing how fit these guys are despite varying lifestyles and age groups!

In fact there is a bit of jovial competition around the VO2max tests. And the vessel has several provisions for staying active with half a basketball pitch, golf course simulator, boxing gym, table-tennis room and a darts board in addition to the two gyms.

Sports halls onboard

On 9th June there was a crew change, another four of the divers agreed to participate in the project. As one of my biggest concerns has been to get enough divers to participate and to be able to do the tests as planned, I was very pleased about this.

By the 14th June, the campaign was completed and we headed back to Stavanger. Here I did a full handover to the new nurse, who would perform the tests on the batch of divers coming out of decompression on the 15th. The day after, a new team of divers arrived, and most of them agreed to participate thanks to the efforts of our crewing office in Aberdeen.

The Skandi and its divers control room

The diving chambers control room onboard the Skandi is there to keep the divers safe inside the pressurised chambers until they are decompressed back to surface pressure again – a process that can take 2-10 days depending on the depth the divers have been working at

In July I will sign on again, and if all goes well, I will be done with all the sampling and diver testing by mid-July, just in time to spend Ramadhan in Stavanger. In the autumn I will analyse the blood samples and test results, and hopefuly we will be able to share some early results with the Skandi Arctic crew presenting the results to those that partcipated or otherwise have shown an interest in our work.

Working offshore has its challenges including seasickness and a working environment in constant motion. Although phone signals were patchy I managed to get in touch with my family in Algeria and tell them their Saharan girl was having a blast in the middle of the North Sea!

Fatima Zohra Kiboub is a Lead QHSE Engineer at Technip and is doing an industrial PhD with the barophysiology group at the Deparment of circulation and medical imaging (ISB) at NTNU.

Want to know more about life onboard the Skandi Arctic? Check out this video.

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Planning the direction for CIUS

CIUS-people

Photo: Kristina Jones/NTNU

45 people from both academia and the industry were present at the first meeting discussing the direction for half the different work packages at NTNUs new centre CIUS, a Centre for Innovative Ultrasound Solutions for health care, maritime, and oil & gas.

- At this point, before we can start the work, it is important for us to point out the further direction for the research in some of the work packages at the centre. Work packages 1-4, in ultrasound knowledge and technology, and no 7, in clinical feasibility, are the fundament onto which all the other work packages will build, Asta Håberg, the head of CIUS, says.

CIUS is a Norwegian Research Council appointed centre for research-based innovation (SFI) and is located at Department of Medical Imaging and Circulation at Norwegian University of Science and Technology (NTNU) in Trondheim.

- CIUS will deliver novel ultrasound technology solutions for the benefit of the involved partners, new diagnostic tools for the benefit of patients and the Norwegian healthcare system, important knowledge disseminated in highly recognized scientific journals, and skilled personnel to further exploit the future potential of ultrasound imaging in Norwegian industries, healthcare and academia, Håberg says.

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Shutting off blood supply to an extremity to protect the heart

på operasjonssal

Foto: Geir Mogen

In a study just published in the International Journal of Cardiology, researchers from CERG and the Department of Cardiothoracic Surgery at the St. Olav’s Hospital have shown that shutting off the blood supply to an arm or leg before cardiac surgery protects the heart during the operation.

We wanted to see how the muscle of the left chamber of the heart was affected by a technique, called RIPC (remote ischemic preconditioning), during cardiac surgery. RIPC works by shutting off the blood supply to an arm or a leg before heart surgery. The goal is to reduce risk during cardiac surgery in the future.

Read more at CERG’s blog

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To treat or not to treat? The role of PET/MRI in prostate cancer

Mattijs ElschotBlog by: Mattijs Elschot
Postdoctoral Fellow at MR Cancer Group

Some prostate cancer patients need radical surgery to survive, whereas others can do without any form of treatment. The urologist determines to which group a patient belongs. Researchers at NTNU/St. Olavs Hospital investigate whether a PET/MRI scan can help making the correct decision.

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Early markers of a potentially dangerous type of prostate cancer

Morten Beck RyeBloggers: May-Britt Tessemansattebilde.may-britt.tessem and Morten Beck Rye

As we speak there are no accurate methods to diagnose potentially dangerous prostate cancer in an early stage of cancer.

From a pathologist’s point of view, aggressive cancers look totally similar to harmless subtypes in the beginning of development. As a consequence, the patients will be at high risk of overtreatment in the majority of cases where prostate cancer is detected. We urgently need new tools and markers to sort out the potentially dangerous types of prostate cancer from the non-dangerous in early disease. Most importantly, this will save the patients from reduced quality of life due to unnecessary surgical interventions, and also be economically beneficial for society.

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New method for characterizing brain tumors

Blogger: Morteza EsmaeiliMortezaE
Postdoctoral Fellow at MR Cancer Group, NTNU

 

A new non-invasive method can identify a special mutation in a type of brain tumor called gliomas. This unique test can assist in research towards new treatments that target cancer cells in glioma patients carrying this mutation. The new method is developed by my colleagues and me at MR Cancer Group at NTNU and researchers at the Departments of Radiology and Pathology of Radboud University Medical Center in Nijmegen. We believe it is an important step towards improved tools for the diagnosis and treatment evaluation of brain tumor patients.

Gliomas are common subtypes of primary brain tumors that originate from glial cells in the brain. There are different grades of gliomas, indicating their degree of aggressiveness; however, they are most often classified as “low-grade” or “high-grade” gliomas. Glioblastomas are the most aggressive type of gliomas. Various types of gliomas have been identified, and they have different clinical behavior and response to treatment. This means there is an urgent need for more accurate and precise diagnosis, prognosis, and therapy monitoring tools.

MR-bilde av en hjerne

Gliomas are common subtypes of primary brain tumors that originate from glial cells in the brain. A new non-invasive method can identify a special mutation in gliomas. (Photo: Geir Mogen/NTNU)

Conventional anatomical imaging methods, such as magnetic resonance imaging (MRI) (Figure 1), provide limited information on tumor characterization and prognosis. Advances in personalized patient management and new drug treatments for brain tumors have generated increasing demand for reproducible, non-invasive, quantitative imaging biomarkers.

Recent developments have concentrated on the role of physiological and metabolic MRI, such as magnetic resonance spectroscopy (MRS, see an example in Figure 2), and other molecular imaging methods in understanding the metabolic processes associated with tumor growth and progression. These studies have indicated that cancer cell metabolism, contrary to the metabolism in normal cells, is modulated and reprogrammed to facilitate additional/excessive demands for biomass generation and rapid cellular growth and proliferation. This particular characteristic of cancer cells can be targeted as a “weak point” to kill these cells.

This particular characteristic of cancer cells can be targeted as a “weak point” to kill these cells.

Furthermore, the utility of various techniques in distinguishing between aggressive and benign tumors, tumor grading, and treatment response evaluation and monitoring are also of interest.

Conventional MR imaging of glioblastoma

Figure 1: Conventional MR imaging of glioblastoma. Tumor regions can be identified by different MR contrasts; For example, (A) T1-weighted pre-contrast exhibit a low-intensity lesion in the left frontal lobe region (yellow arrow), (B) post-contrast MR image demonstrates a focus of enhancement in that area, (C) and T2-weighted MR image shows increased-intensity at the same region. These MR techniques enable non-invasive imaging and diagnosis of tumor lesions in the brain. Illustration is adapted from Ahmed R. et al. Cancer Manag Res, 2014 (with permission).

During our study, we uncovered a new imaging biomarker to identify glioma subtypes with different prognosis and therefore this biomarker may be used for a better clinical management, avoiding extra cost for patients and communities. More specifically the biomarker concerns metabolite levels associated with a mutated IDH gene found in more than 70% of the brain tumors classified as low-grade gliomas and secondary gliomas. Glioma patients with this mutation actually have a better prognosis.

In particular, with our MRS technique we observe the indirect effect of the mutation in the IDH1 gene on the level of some phospholipid metabolites, which can be considered a molecular “finger print” for this mutation. These metabolites are major components of phospholipid metabolism in the synthesis of cancer cell membranes.

MR spectroscopy provides information additional to conventional MRI

Figure 2: MR spectroscopy provides information additional to conventional MRI. T2-weighted MR images of a mouse brain with glioma tumor (top, A) and a healthy mouse brain (bottom, B), and corresponding MRS data from area of interest (blue circles, C and D). MRS detects signals for different metabolites in normal brain and tumor tissue. In particular phospholipid metabolites are of interest to characterize brain tumors. (from left to right); PE, phosphoethanolamine; PC, phosphocholine; GPE, glycerophosphoethanolamine; GPC, glycerophosphocholine. Adapted from Esmaeili M. et al. Cancer Res. 2014 (with permission).

To be a bit technical: IDH1 acts in an energy-generating pathway known as the citric-acid cycle, and the IDH1 mutations associated with cancer causes a metabolite called 2-hydroxyglutarate to accumulate. IDH1 catalyzes the conversion of isocitrate into α-ketoglutarate, a reaction that takes place in energy-generating metabolic pathways. Most remarkable is that the mutated IDH1 enzyme has acquired the capacity to produce 2-hydroxyglutarate, which can accumulate in high concentrations in gliomas with the mutation. 2-hydroxyglutarate is commonly called an oncometabolite. Our finding shows that the mutation also alters lipogenesis in brain cancer cells. Phospholipid metabolism is a major network supporting cellular lipogenesis and cell membrane turnover.

The discovery of the IDH1 mutation has generated such intense interest that pharmaceutical companies are keen to find drugs that target mutant IDH1 gliomas

The discovery of the IDH1 mutation has generated such intense interest that pharmaceutical companies are keen to find drugs that target mutant IDH1 gliomas, with some companies focusing exclusively on targeting cancer metabolism. The findings of this study and those published recently on IDH related metabolism could be used in the development of drugs for cancers with these mutations. In addition, these findings enable the detection through non-invasive imaging of the direct metabolic consequence of a genetic mutation in a cancer cell. This offers a potential new tool in the management of brain tumor patients.

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Spectacular images of tumor blood vessels

Jana CebullaBlogger: Jana Cebulla
PhD Candidate at MR Cancer group

 

Angiogenesis is the formation of new blood vessels from pre-existing vessels. This process takes place during wound healing, but is also essential during the development of certain diseases, such as cancer.

In order to grow beyond a size of 1-2mm, tumors send out chemical signals telling nearby blood vessels to send new vessels in the direction of the tumor. This way, the cancer cells can get sufficient supplies of oxygen and nutrients. Angiogenesis has also been found to help cancer spread to other parts of the body (i.e. metastasize).

Blood vessels that are recruited by a tumor

Blood vessels (orange) that are recruited by a tumor (white) which was grown on the leg of a mouse (surrounding “healthy” tissue in blue). Photo: Jana Cebulla

Hopefully, in the future the worldwide research on angiogenesis can help put together all the pieces in the puzzle and describe how angiogenesis in cancer is regulated and how we can influence it with drugs in order to treat cancer patients more effectively.

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Copenhagen next!

We’re off to Copenhagen! You can meet us at the Science in The City festival from tomorrow until Thursday 26. July.

This is what we are doing there: http://scienceinthecity.dk/en/event/6-can-u-hear-u-sound

On Saturday at 17:00 our researcher Garrett Newton Andersen will demonstrate a hand-held ultrasound machine (Vscan) on stage: http://scienceinthecity.dk/en/event/103-scan-your-heart-stage-can-u-hear-u-sound

ScienceintheCity

 

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Applied Human Physiology in Extreme Environments

Blogger: Andreas Møllerløkken Andreas Møllerløkken

 

 

 

The NTNU Barophysiology Group aims to promote safety and minimize the acute and long-term harmful effects of diving and other extreme environmental exposures. Our work covers the topics of both basic and applied research. Through a translational approach, we study animal models to provide novel and comprehensive knowledge of pathophysiological mechanisms. We also use human field and laboratory studies to obtain physiologically relevant data.

This week we arrange a course, “Enjoy the Cold – Health, Protection and Survival in the Cold – Adaptation and risk assessment of human activities in cold environments” in Ny-Ålesund, Svalbard. This course aims at giving people who are working and participating in activities related to cold environments proper training and insights on different equipment that exists which can be used to manage the different challenges one faces in the cold environment. Through a combination of lectures, discussions, practical work and use of equipment, the participants will gain an intimate knowledge on how to handle work situations as well as accidents.

Measuring oxygen consumption during field work

Measuring oxygen consumption during field work

The Arctic areas have become regions of global importance because of their enormous natural resources and their strategic position. These northern areas are cold, harsh and hostile to man. Working in them is difficult, expensive and demands high levels of technical, scientific, and physiological expertise. Cold weather exposure can cause immediate health problems. For people with ailments, cold exposure can lead to new symptoms, or aggravate those existing. Cold exposure may also cause pain and disease in healthy subjects.

A number of climatic factors are known to increase challenges related to work in the northern areas, such as temperature, wind, icing, the polar low, uncertain weather forecasts and polar night. In addition to climatic factors, regulation of body temperature is affected by activity, technical protective actions/systems and clothing. The climatic problems connected with activity in the arctic areas are not only limited to equipment and equipment function. Cold is one of the most dangerous environmental risk factors for man. Not only does the cold challenge day to day function in those prepared for such an environment, but if conditions become more extreme, then it may also challenge survival. Although the human body has a physiological control mechanism, homeostasis, to maintain a stable and optimal internal environment independent of a changing external environment, this mechanism is not protection enough in the sub-arctic areas. Man is totally dependent on personal protective equipment, established working procedures and training to perform the work within specified safety and efficiency limits.

 Man is totally dependent on personal protective equipment, established working procedures and training

Increasing development and human activity in the Arctic environment calls for increased research focus on the appropriate applied human physiology in order to increase our knowledge on how the organism adapts to extreme environments.

It is well recognized that cold environments have negative health effects on the human body, but an important question is are there any increased health risks due to the physiological stress and decreased performance associated with survival requirements, for example having to wear heavy protective clothing constantly?

The course participants gets to experience field testing of immersion suits

The course participants gets to experience field testing of immersion suits

As diving is likely to be an important activity in these regions, the long-term health effects for divers who undertake the majority of their work in cold water should also be considered. More knowledge is needed to understand which processes come into play when the body’s ability to adaptation is exceeded, why one human reacts differently to another when exposed to the same environments and stressors, and how we can prepare ourselves to be protected against adverse health effects of exposures to extreme environments both in the short and long term.

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In 1990 the course “Health, Protection and Survival in the Cold” was arranged at Svea, and this was the first course in a series of courses that have been held throughout the years since then. All in all, some 250 persons have participated the course since its beginning in 1990, to get a better understanding of the different elements one meets in extreme environments and how they influence our own physiology.

With the increasing activity in the arctic regions, research within the human physiology and its response in the cold environment is necessary and give bases for our course.

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Are you at PhD student or Supervisor within Cardiovascular Disease in Norway?

Blogger: Øivind RognmoØivind Rognmo2

Are you at PhD student or Supervisor within Cardiovascular Disease in Norway?

I will recommend you to be members of the Norwegian PhD School of Cardiovascular Research (NORHEART) as it may offer you a lot of benefits.

 Foto: Geir Mogen, Istockphoto.com

NORHEART members comprise PhD students in Norwegian cardiovascular research, their supervisors, as well as lecturers from Norway and abroad. Sign up today to be a part of the number one education network for cardiovascular scientists in Norway!

Who can become member of NORHEART? All students from PhD programs or Medical Students Research programs at Norwegian Universities with projects focused on cardiovascular research. Supervisors, postdocs and other researchers within the field of cardiovascular research are also encouraged to register as members. Previous student members are listed as NORHEART alumnis.

What are the benefits for NORHEART members?

  • Priority at NORHEART events
  • Opportunities for travel and exchange grants
  • Automatic e-mail updates on key NORHEART events

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