Effects of Varying Amount of Reward in Free Operant Conditioning of Humans on a Fixed-Ratio Schedule

38 Ss were divided into 4 groups, each group being placed on a 21:1 fixed-ratio schedule. Group I received an increase in magnitude of reward at a late stage of learning; Group II received a decrease in magnitude of reward at the same point in learning. Group III received an increase in reward-size at an early point in learning, while Group IV received a decrease in magnitude of reward at an early stage of learning. As predicted, shifts in reward significantly influenced running time in Groups III and IV but not in Groups I and II. These results are discussed as relevant to secondary reinforcement and learned expectancy.

Altitude Decompression Sickness Risk and Physical Activity During Exposure

INTRODUCTION

Earlier research described a linear relationship between the highest 1 min of oxygen consumption (Vo2) during a recurring physical activity and incidence of decompression sickness (DCS) during research chamber exposures to high altitude. The current effort was designed to determine if that relationship holds true at a lower altitude.

METHODS

Male subjects (20) were exposed without prebreathe to 22,500 ft (6858 m; 314 mmHg; 6.1 psi) for 4 h while seated, nonambulatory the entire time, with echo-imaging at 16-min intervals (Non-Amb Echo), breathing 100% oxygen. Average highest 1 min of Vo2 and level of activity was determined. Results during Non-Amb Echo were compared with earlier research data acquired under identical conditions except for higher levels of activity.

RESULTS

No DCS was reported or observed and no venous gas emboli were observed. Combined with earlier data, a strong linear relationship (r > 0.99) was observed between DCS incidence and level of activity.

DISCUSSION

These results suggest physiological envelopes might be expanded or prebreathe time reduced for some high-altitude aircraft operations that involve very low levels of physical activity. They may also help to explain the higher DCS risk for inside observers vs. trainees during altitude chamber training. The data imply potential for update of altitude DCS risk prediction models by adjustment with quantified level of activity during exposure.

Recollection of hypoxia symptoms between training events

INTRODUCTION

The well-established technique of mask-off hypoxia training in a hypobaric training environment elicits symptoms that are correlated with in-flight symptoms reported by aircrew. Aircrew receive training on recognition of symptoms and response early in their flying career and accomplish refresher training on a 5-yr cycle. The symptoms reported after acute hypoxia represent cognitive and psychomotor impairment. The purpose of this study was to evaluate the correlation of symptoms experienced during hypoxia training and recall of symptoms S from the training sessions 5 yr previously.

METHODS

A survey listing 18 symptoms of hypoxia and severity of condition was presented to 1123 aircrew attending refresher training at 10 U.S. Air Force Aerospace Physiology Training Units prior to and immediately following hypoxia training in the hypobaric chamber.

RESULTS

The five symptoms most commonly reported following hypoxia training are: lightheaded/dizzy, dizziness, mental confusion, visual impairment, and tingling. The hypoxia symptom "lightheaded/dizzy" recorded the highest frequency of all 18 symptoms. Lightheaded/dizzy frequencies for both previous and current hypoxia training were 67.2% and 72.3%, respectively. This symptom remained consistent throughout all data analysis, retaining the highest frequency in all levels of severity (mild, moderate, and extreme) for both the previous hypoxia training and current hypoxia training.

DISCUSSION

The similarity of symptoms recalled between hypoxia training events provides strong evidence that hypoxia training is an effective method of establishing recognized decrements that may influence performance in flight.

Fifty years of decompression sickness research at Brooks AFB, TX: 1960-2010

INTRODUCTION, FACILITIES, AND METHODS: Decompression sickness (DCS) occurring in hypobaric environments related to aviation or spaceflight was a major focus of research at Brooks AFB/City-Base, TX, throughout the period 1960-2010. Multiple hypobaric chambers and extensive support facilities were built for research on altitude DCS using both human subjects and animal models. Areas of study included symptomatology, incidence, prediction, and prevention of DCS. High-altitude aviation, spacecraft atmospheres, and pressure suits were evaluated with various decompression and prebreathing schedules to reduce DCS risk. FACTORS AFFECTING DCS INCIDENCE: The results from these efforts were recorded in an extensive Altitude DCS Research Database which served as a resource for developing reports and exploring relationships of various parameters such as altitude, time at altitude, prebreathe time, and mode of activity while decompressed. PREVENTION AND PREDICTION OF DCS: Individual susceptibility to DCS was also evaluated in an effort to tailor preventive measures and predict susceptibility. Completion of the 26 human-use protocols provided information which was incorporated into NASA and USAF operational practices to reduce DCS risk.

DOCUMENTATION

DCS researchers working at Brooks throughout this period produced 177 papers documenting results of thousands of subject-exposures and other experiments. An Altitude DCS Risk Assessment Computer Model was fielded in 2005. This review centers on the results of research at Brooks and notes questions about operational DCS risk that have not yet been answered.

Aerospace medicine at Brooks AFB, TX: hail and farewell

With the impending termination of USAF operations at Brooks Air Force Base (AFB) in San Antonio, TX, it is time to consider its historic role in Aerospace Medicine. The base was established in 1917 as a flight training center for the U.S. Army Air Service and in 1926 became home to its School of Aviation Medicine. The school moved to San Antonio's Randolph Field in 1931, but in 1959 it returned to Brooks where it occupied new facilities to support its role as a national center for U.S. Air Force aerospace medicine, including teaching, clinical medicine, and research. The mission was then expanded to encompass support of U.S. military and civilian space programs. With the abrupt termination of the military space program in 1969, research at Brooks focused on clinical aviation medicine and support of advanced military aircraft while continuing close cooperation with NASA in support of orbital spaceflight and the journey to the Moon. Reorganization in the 1990s assigned all research functions at Brooks to the Human Systems Division and its successors, leaving to USAFSAM the missions related to clinical work and teaching. In 2002 the USAF and the city of San Antonio implemented shared operation of Brooks as a "City-Base" in the hope of deflecting threatened closure. Nevertheless, under continuing pressure to consolidate military facilities in the United States, the 2005 Base Closure and Realignment Commission ordered Brooks closed by 2011, with its aerospace medicine functions relocated to new facilities at Wright-Patterson AFB in Dayton, OH.

Air break during preoxygenation and risk of altitude decompression sickness

INTRODUCTION

To reduce the risk of decompression sickness (DCS), current USAF U-2 operations require a 1-h preoxygenation (PreOx). An interruption of oxygen breathing with air breathing currently requires significant extension of the PreOx time. The purpose of this study was to evaluate the relationship between air breaks during PreOx and subsequent DCS and venous gas emboli (VGE) incidence, and to determine safe air break limits for operational activities.

METHODS

Volunteers performed 30 min of PreOx, followed by either a 10-min, 20-min, or 60-min air break, then completed another 30 min of PreOx, and began a 4-h altitude chamber exposure to 9144 m (30,000 ft). Subjects were monitored for VGE using echocardiography. Altitude exposure was terminated if DCS symptoms developed. Control data (uninterrupted 60-min PreOx) to compare against air break data were taken from the AFRL DCS database.

RESULTS

At 1 h of altitude exposure, DCS rates were significantly higher in all three break in prebreathe (BiP) profiles compared to control (40%, 45%, and 47% vs. 24%). At 2 h, the 20-min and 60-min BiP DCS rates remained higher than control (70% and 69% vs. 52%), but no differences were found at 4 h. No differences in VGE rates were found between the BiP profiles and control.

DISCUSSION

Increased DCS risk in the BiP profiles is likely due to tissue renitrogenation during air breaks not totally compensated for by the remaining PreOx following the air breaks. Air breaks of 10 min or more occurring in the middle of 1 h of PreOx may significantly increase DCS risk during the first 2 h of exposure to 9144 m when compared to uninterrupted PreOx exposures.

Decompression sickness during simulated extravehicular activity: ambulation vs. non-ambulation

BACKGROUND

Extravehicular activity (EVA) is required from the International Space Station on a regular basis. Because of the weightless environment during EVA, physical activity is performed using mostly upper-body movements since the lower body is anchored for stability. The adynamic model (restricted lower-body activity; non-ambulation) was designed to simulate this environment during earthbound studies of decompression sickness (DCS) risk. DCS symptoms during ambulatory (walking) and non-ambulatory high altitude exposure activity were compared. The objective was to determine if symptom incidences during ambulatory and non-ambulatory exposures are comparable and provide analogous estimates of risk under otherwise identical conditions.

METHODS

A retrospective analysis was accomplished on DCS symptoms from 2010 ambulatory and 330 non-ambulatory exposures.

RESULTS

There was no significant difference between the overall incidence of DCS or joint-pain DCS in the ambulatory (49% and 40%) vs. the non-ambulatory exposures (53% and 36%; p > 0.1). DCS involving joint pain only in the lower body was higher during ambulatory exposures (28%) than non-ambulatory exposures (18%; p < 0.01). Non-ambulatory exposures terminated more frequently with non-joint-pain DCS (17%) or upper-body-only joint pain (18%) as compared with ambulatory exposures, 9% and 11% (p < 0.01), respectively.

DISCUSSION

These findings show that lower-body, weight-bearing activity shifts the incidence of joint-pain DCS from the upper body to the lower body without altering the total incidence of DCS or joint-pain DCS.

CONCLUSIONS

Use of data from previous and future subject exposures involving ambulatory activity while decompressed appears to be a valid analogue of non-ambulatory activity in determining DCS risk during simulated EVA studies.

Partial pressure of nitrogen in breathing mixtures and risk of altitude decompression sickness

BACKGROUND

Many aircraft oxygen systems do not deliver 100% O2. Inert gases can be present at various levels. The purpose of this study was to determine the effect of these inert gas levels on decompression sickness (DCS).

METHODS

Subjects were exposed for 4 h to 5486 m (18,000 ft) with zero prebreathe, using either mild (Test A) or strenuous exercise (Test B), and breathing 60%N2/40%O2. Test C used a breathing mixture of 40%N2/60%O2 at 6858 m (22,500 ft) with zero prebreathe and mild exercise. Test D investigated a breathing mixture of 2.8%N2/4.2%argon/93%O2 with 4 h exposures to 7620 m (25,000 ft), mild exercise, and 90 min of preoxygenation. The controls were from previous studies using similar conditions and 100% O2.

RESULTS

The DCS risk for Tests A and B and the Control for B was 7%; the Control for Test A was 0% (n.s.). Breathing the 40%N2/60%O2 mixture (Test C) resulted in 43% DCS compared with 53% DCS with 100% O2 (n.s.). When the 2.8%N2/4.2%argon/93%O2 mixture was used, the results showed 25% DCS compared with 31% DCS with 100% O2 (n.s.).

CONCLUSIONS

The increased nitrogen and argon levels in the breathing gas while at altitudes of 5486 m to 7620 m did not increase DCS risk. These results support the concept of using the partial pressure gradient of inert gases instead of the percentage of N2 or argon in a breathing gas mixture to determine the risk of DCS during altitude exposure.

Depressurization in military aircraft: rates, rapidity, and health effects for 1055 incidents

INTRODUCTION

Aircraft cabin depressurization is a rare event but one which demands attention because of the grave potential for aircrew incapacity in flight. The purpose of the current study was to determine rates of depressurization incidents for U.S. military aircraft, to examine their causes, and to evaluate the medical importance of these incidents.

METHODS

The U.S. Navy and U.S. Air Force safety center databases were searched for decompression incidents during FY1981-FY2003. A total of 1055 incidents were analyzed as to the cause, speed of onset, and adverse health effects (hypoxia, barotrauma, DCS, or any combination of these). The causes of each incident were identified and classified by aircraft type.

RESULTS

The number of incidents per airframe varied from 1 (in many airframes) to 276 in the T-38. The number of total hours flown ranged from 16,332 in the T-6 to 8,101,607 in the C-130. The number of sorties flown ranged from 8800 in the B-2 to 3,543,061 in the C-130. Of 35 common airframes, 30 showed rates between 0 and 20 incidents per million flying hours. Depressurization was "slow" in 83% of incidents. Of the 1055 incidents, only 350 (33.2%) involved adverse health effects. Hypoxia occurred in 221 incidents, DCS in 83, and barotrauma in 71. Only 4 (0.4%) resulted in a fatality. Of the 199 incidents involving hypoxia, 12 (6%) occurred below 4267 m (14,000 ft).

CONCLUSION

Most reported military aircraft depressurization incidents are slow and do not affect aircrew health. Rates have decreased dramatically since the 1980s. Still, this study lends support to continuing hypobaric chamber training for military pilots.

Altitude decompression sickness susceptibility: influence of anthropometric and physiologic variables

INTRODUCTION

There is considerable variability in individual susceptibility to altitude decompression sickness (DCS). The Air Force Research Laboratory Altitude DCS Research Database consists of extensive information on 2980 altitude exposures conducted with consistent procedures and endpoint criteria. We used this database to quantify the variation in susceptibility and determine if anthropometric and/or physiologic variables could be used to predict DCS risk.

METHODS

There were 240 subjects who participated in at least 4 of 70 exposure profiles in which between 5 and 95% of all subjects tested developed DCS symptoms. A subject/study ratio (SSR) was calculated by dividing the DCS experienced by a subject during all their exposures by the DCS incidence for all subjects who participated in the identical exposures. The SSR was used to identify the relative susceptibility of subjects for use in analyzing possible relationships between DCS susceptibility and the variables of height, weight, body mass index, age, percent body fat, and aerobic capacity.

RESULTS

The DCS incidence was 46.5% during 1879 subject-exposures by subjects exposed at least 4 times. A significant relationship existed between higher DCS susceptibility and the combination of lower aerobic capacity and greater weight (p < 0.05).

DISCUSSION

Despite a correlation, less than 13% of the variation in DCS susceptibility was accounted for by the best combination of variables, weight and VO2max.

CONCLUSION

Differences in DCS susceptibility cover a wide range and appear to be related to some anthropometric and physiologic variables. However, there was insufficient correlation to allow prediction of an individual's susceptibility.

Altitude decompression sickness between 6858 and 9144 m following a 1-h prebreathe

INTRODUCTION

The zero prebreathe altitude threshold for developing 5% decompression sickness (DCS) symptoms in men has been reported to be 6248 m (20,500 ft). However, such an altitude threshold when 1 h of oxygen prebreathe is used has not been well documented and was the primary purpose of this study.

METHODS

The 51 male human subjects were exposed to 9144 m (30,000 ft), 8382 m (27,500 ft), 7620 m (25,000 ft), and/or 6858 m (22,500 ft) for 8 h. They were monitored for symptoms of DCS and venous gas emboli (VGE).

RESULTS

DCS symptom incidence after 4 h of exposure decreased with exposure altitude from 87% at 9144 m to 26% at 6858 m. VGE were lower during the 4-h 6858-m exposures (32%) than at the higher altitudes (76-85%). The symptom incidences during the first 4 h of exposure were lower at 6858 m and 7620 m following a 1-h prebreathe as compared with analogous zero-prebreathe exposures. There were no differences between incidences of VGE or DCS at any of the four altitudes after 8 vs. 4 h of exposure.

CONCLUSION

The altitude threshold for 5% DCS symptoms is below 6858 m after 1 h of prebreathe. However, during 6858-m and 7620-m exposures, a 1-h prebreathe is highly beneficial in reducing DCS incidence and delaying the onset of DCS, keeping the incidence to less than 6% during the first 90 min of exposure. Use of 4-h vs. 8-h exposures does not appear to underestimate DCS risk at or above 7620 m.

Central nervous system decompression sickness and venous gas emboli in hypobaric conditions

INTRODUCTION

Altitude decompression sickness (DCS) that involves the central nervous system (CNS) is a rare but potentially serious condition. Identification of early symptoms and signs of this condition might improve treatment.

METHODS

We studied data from 26 protocols carried out in our laboratory over the period 1983-2003; all were designed to provoke DCS in a substantial proportion of subjects. The data set included 2843 cases. We classified subject-exposures that resulted in DCS as: 1) neurological DCS of peripheral and/or central origin (NEURO); 2) a subset of those that involved only the CNS (CNS); and 3) all other cases, i.e., DCS cases that did not have a neurological component (OTHER). For each case, echo imaging data were used to document whether venous gas emboli (VGE) were present, and their level was classified as: 1) any level, i.e., Grade 1 or higher (VGE-1); and 2) high level, Grade 4 (VGE-4).

RESULTS

There were 1108 cases of altitude DCS in the database; 218 were classified as NEURO and 49 of those as CNS. VGE-1 were recorded in 83.8% of OTHER compared with 58.7% of NEURO and 55.1% of CNS (both p < 0.001 compared with OTHER). The corresponding values for VGE-4 were 48.8%, 37.0%, and 34.7% (p < 0.001, compared to OTHER). Hyperbaric oxygen (HBO) was used to treat about half of the CNS cases, while all other cases were treated with 2 h breathing 100% oxygen at ground level.

DISCUSSION

Since only about half of the rare cases of hypobaric CNS DCS cases were accompanied by any level of VGE, echo imaging for bubbles may have limited application for use as a predictor of such cases.

Altitude decompression sickness at 7620 m following prebreathe enhanced with exercise periods

INTRODUCTION

Over 80% altitude decompression sickness (DCS) was reported during a 4-h exposure with mild exercise to 7620 m (25,000 ft) without prebreathe. Prebreathe for more than 1 h would be necessary to reduce the DCS risk below 40%. Use of a single period of exercise to enhance prebreathe effectiveness has been successfully tested and used during some U-2 operations. The current tests used multiple exercise sessions to enhance prebreathe (MEEP) as a means of improving denitrogenation efficiency.

METHODS

Two MEEP profiles, 30 or 60 min, preceded 4-h exposures to 7620 m with mild, upper-body exercise while breathing 100% oxygen. Resting prebreathe controls were from published studies at the same laboratory. Both MEEP profiles involved 10 min of strenuous dual-cycle ergometry (75% of maximal oxygen uptake) at the beginning of prebreathe. After a 15-min rest period during the 60-min prebreathe, an additional 5 min of strenuous ergometry was performed. Mild exercise was performed during 15 of the last 20 min of both prebreathe profiles.

RESULTS

The 60-min MEEP resulted in 25% DCS and the 30-min MEEP 40% DCS (N.S.). The 25% incidence of DCS following the 60-min MEEP profile was significantly less than the 63% DCS following an equal-time, resting prebreathe control. Following the 30-min MEEP, DCS incidence was not greater than the incidence following a 60-min, resting prebreathe control. There was a lower incidence of venous gas emboli during the MEEP exposures than during resting control exposures.

CONCLUSION

Denitrogenation with multiple periods of exercise provides a shorter alternative to resting prebreathe for reducing DCS risk during exposure to 7620 m.

Decompression sickness risk model: development and validation by 150 prospective hypobaric exposures

INTRODUCTION

High altitude exposure has an inherent risk of altitude decompression sickness (DCS). A predictive DCS model was needed to reduce operational risk. To be operationally acceptable, such a theoretical model would need to be validated in the laboratory using human subjects.

METHODS

The Air Force Research Laboratory (AFRL) has conducted numerous studies on human subjects exposed to simulated altitudes in hypobaric chambers. The database from those studies was used to develop a statistical altitude DCS model. In addition, a bubble growth model was developed using a finite difference method to solve for bubble radius as a function of time. The bubble growth model, integrated with the statistical model, constitutes the AFRL DCS Risk Assessment Model. Validation of the model was accomplished by comparing computer predictions of DCS risk with results from subsequent prospective human subject exposures. There were five exposure profiles, not previously found in the database, covering a wide parameter of ranges of altitude (18,000-35,000 ft), exposure time (180-360 min), prebreathe time (0-90 min), and activity level (rest-strenuous) that were used. The subjects were monitored for DCS symptoms and venous gas emboli.

RESULTS

There were 30 subjects who were exposed to each of the 5 altitude profiles. The DCS incidence onset curves predicted by the model were not significantly different from the experimental values for all scenarios tested and were generally within +/- 5% of the actual values.

CONCLUSION

A predictive altitude DCS model was successfully developed and validated.

Altitude decompression sickness symptom resolution during descent to ground level

INTRODUCTION

Altitude decompression sickness (DCS) is a health risk associated with the conduct of high altitude airdrop operations, high altitude reconnaissance, future fighter operations, hypobaric chamber training, unpressurized flight, and extravehicular activity (EVA) in space. The treatment for DCS includes the provision of 100% oxygen (O2) at ground level (GLO) and/or hyperbaric oxygen therapy (HBO). In this paper we examine the effect of repressurization to ground level from hypobaric conditions on DCS symptoms. Timely recompression (descent at first recognition of any DCS symptom) may be a safe, effective treatment for the large majority of DCS symptoms.

METHODS

Data from altitude chamber exposures recorded in the Air Force Research Laboratory (AFRL) Altitude DCS Database were reviewed to determine the level of recompression required for complete resolution of 1,699 observed symptoms.

RESULTS

Of the 1,699 DCS symptoms reviewed, 66 (3.9%) resolved at altitude, 117 (6.9%) resolved at ground level, and 1,433 (84.3%) resolved during descent. Increasing the pressure by 138 mmHg from the altitude of exposure where symptoms occurred resolved roughly 50% of symptoms. Little resolution of symptoms was noted with recompressions of < 50 mmHg. The greatest rate of symptom resolution occurred with recompressions of 50-250 mmHg.

CONCLUSION

These findings support the concept that descent and postflight, ground-level oxygen may be sufficient to relieve the majority of altitude DCS symptoms. HBO may be reserved for serious, recurring, delayed, or refractory symptoms. The findings also suggest a need for further study of DCS symptom resolution.

Staged decompression to 3.5 psi using argon-oxygen and 100% oxygen breathing mixtures

INTRODUCTION

The current extravehicular activity (EVA) space suit at 4.3 psia causes hand and arm fatigue and is too heavy for Martian EVA. A 3.5 psia EVA pressure suit requires increased preoxygenation time but would reduce structural complexity, leak rate, and weight while increasing mobility, comfort, and maintainability. On Mars, nitrogen and argon are available to provide the inert gas necessary for a fire-resistant habitat atmosphere, eliminating need for transport. This study investigated breathing argon/oxygen and 100% oxygen gas mixtures during staged decompression prior to exposure to 3.5 psia.

METHOD

During this study, 40 subjects each completed 3 hypobaric exposures to 3.5 psia for 3 h in a reclined position: (A) a 4-h 25-min 14.7-psia (ground level) denitrogenation (100% oxygen breathing) prior to exposure to 3.5 psia; (B) the same as A, utilizing a 7.3-psia stage denitrogenation; and (C) the same as B, with 62% argon-38% oxygen (ARGOX) during the stage. Venous gas emboli (VGE) were monitored with echocardiography.

RESULTS

Decompression sickness (DCS) incidence at 3.5 psia with ARGOX at 7.3 psia (C) was significantly higher than with oxygen breathing with or without staged decompression: there was 78% DCS for C compared with 33% and 55% DCS, respectively, for A and B. The corresponding VGE incidences were 73% (C) compared with 33% (A) and 45% (B).

CONCLUSION

Preoxygenation at a 7.3-psia stage resulted in a higher DCS risk at 3.5 psia than ground level preoxygenation. It is suggested that an 8.0-psia stage pressure could eliminate this difference. Unfavorable results after preoxygenation with ARGOX indicate argon on-gassing was significant.

The risk of altitude decompression sickness at 12,000 m and the effect of ascent rate

INTRODUCTION

Loss of aircraft cabin pressurization can result in very rapid decompression rates. The literature contains reports of increased or unchanged levels of altitude decompression sickness (DCS) resulting from increasing the rate of decompression. We conducted two prospective exposure profiles to quantify the DCS risk at 12,192 m (40,000 ft), and to determine if there was a greater DCS hazard associated with a much higher rate of decompression than typically used during past DCS studies.

METHODS

The 63 human subjects participated in 80 altitude chamber decompression exposures to a simulated altitude of 12,192 m (2.72 psia; 18.75 kPa) for 90 min, following preoxygenation with 100% oxygen for 90 min. Half of the subject-exposures involved an 8-min decompression (1,524 mpm; 5,000 fpm) and the other half experienced a 30-s decompression (mean of 24,384 mpm; 80,000 fpm). Throughout each ascent and exposure, subjects were seated at rest and breathed 100% oxygen. At altitude, they were monitored for precordial venous gas emboli (VGE) and DCS symptoms.

RESULTS

The higher decompression rate yielded 55.0% DCS and 72.5% VGE and the lower rate produced 47.5% DCS and 65.0% VGE. Chi square and log rank tests based on the Kaplan-Meier analyses indicated no difference in the incidence or onset rate of DCS or VGE observed during the two profiles.

CONCLUSION

Decompression rate to altitude up to 24,384 mpm was found not to have an effect on DCS risk at altitude. However, research is needed to define the DCS risk with decompression rates greater than 24,384 mpm. It was also found that the onset time to DCS symptoms decreases as altitude increases.

Gender not a factor for altitude decompression sickness risk

INTRODUCTION

Early, retrospective reports of the incidence of altitude decompression sickness (DCS) during altitude chamber training exposures indicated that women were more susceptible than men. We hypothesized that a controlled, prospective study would show no significant difference.

METHODS

We conducted 25 altitude chamber decompression exposure profiles. A total of 291 human subjects, 197 men and 94 women, underwent 961 exposures to simulated altitude for up to 8 h, using zero to 4 h of preoxygenation. Throughout the exposures, subjects breathed 100% oxygen, rested or performed mild or strenuous exercise, and were monitored for precordial venous gas emboli (VGE) and DCS symptoms.

RESULTS

No significant differences in DCS incidence were observed between men (49.5%) and women (45.3%). However, VGE occurred at significantly higher rates among men than women under the same exposure conditions, 69.3% and 55.0% respectively. Women using hormonal contraception showed significantly greater susceptibility to DCS than those not using hormonal contraception during the latter two weeks of the menstrual cycle. Significantly higher DCS incidence was observed in the heaviest men, in women with the highest body fat, and in subjects with the highest body mass indices and lowest levels of fitness.

CONCLUSION

No differences in altitude DCS incidence were observed between the sexes under our test conditions, although men developed VGE more often than women. Age and height showed no significant influence on DCS incidence, but persons of either sex with higher body mass index and lower physical fitness developed DCS more frequently.

Enhancement of preoxygenation for decompression sickness protection: effect of exercise duration

INTRODUCTION

Since strenuous exercise for 10 min during preoxygenation was shown to provide better protection from decompression sickness (DCS) incidence than resting preoxygenation, a logical question was: would a longer period of strenuous exercise improve protection even further?

HYPOTHESIS

Increased strenuous exercise duration during preoxygenation increases DCS protection.

METHODS

There were 60 subjects, 30 men and 30 women, who were exposed to 9,144 m (4.3 psia) for 4 h while performing mild, upper body exercise. Before the exposures, each subject performed three preoxygenation profiles on different days in balanced order: a 90-min resting preoxygenation control; a 240-min resting preoxygenation control; and a 90-min preoxygenation including exercise during the first 15 min. The subjects were monitored at altitude for venous gas emboli (VGE) with an echo-imaging system and observed for signs and symptoms of DCS.

RESULTS

There were no significant differences in occurrence of DCS following any of the three preoxygenation procedures. Results were also comparable to an earlier report of 42% DCS with a 60-min preoxygenation including a 10-min exercise. There was no difference between VGE incidence in the comparison of protection offered by a 90-min preoxygenation with or without 13 min of strenuous exercise. The DCS incidence following a 240-min resting preoxygenation, 40%, was higher than observed during NASA studies and nearly identical with the earlier 42% DCS after a 60-min preoxygenation including exercise during the first 10 min.

CONCLUSION

The protection offered by a 10 min exercise in a 60-min preoxygenation was not increased with extension of the preoxygenation exercise period to 15 min in a 90-min preoxygenation, indicating an upper time limit to the beneficial effects of strenuous exercise.

Pulmonary decompression sickness at altitude: early symptoms and circulating gas emboli

INTRODUCTION

Pulmonary altitude decompression sickness (DCS) is a rare condition. 'Chokes' which are characterized by the triad of substernal pain, cough, and dyspnea, are considered to be associated with severe accumulation of gas bubbles in the pulmonary capillaries and may rapidly develop into a life-threatening medical emergency. This study was aimed at characterizing early symptomatology and the appearance of venous gas emboli (VGE).

METHODS

Symptoms of simulated-altitude DCS and VGE (with echo-imaging ultrasound) were analyzed in 468 subjects who participated in 22 high altitude hypobaric chamber research protocols from 1983 to 2001 at Brooks Air Force Base, TX.

RESULTS

Of 2525 subject-exposures to simulated altitude, 1030 (41%) had symptoms of DCS. Only 29 of those included DCS-related pulmonary symptoms. Of these, only 3 subjects had all three pulmonary symptoms of chokes; 9 subjects had two of the pulmonary symptoms; and 17 subjects had only one. Of the 29 subject-exposures with pulmonary symptoms, 27 had VGE and 21 had severe VGE. The mean onset times of VGE and symptoms in the 29 subject-exposures were 42 +/- 30 min and 109 +/- 61 min, respectively. In 15 subjects, the symptoms disappeared during recompression to ground level followed by 2 h of oxygen breathing. In the remaining 14 cases, the symptoms disappeared with immediate hyperbaric oxygen treatment.

CONCLUSIONS

Pulmonary altitude DCS or chokes is confirmed to be a rare condition. Our data showed that when diagnosed early, recompression to ground level pressure and/or hyperbaric oxygen treatment was 100% successful in resolving the symptoms.

Moderate exercise after altitude exposure fails to induce decompression sickness

INTRODUCTION

The objective of this study was to determine the effect of exercise after altitude exposure (post-exposure exercise) on subsequent altitude decompression sickness (DCS) incidence. Existing USAF prohibition of exercise following altitude chamber training exposures and interest from operational personnel prompted our evaluation of post-exposure exercise as a DCS-inducing stressor.

METHODS

After a 1-h resting preoxygenation, 67 subjects were exposed to 30,000 ft for 2-h while performing mild, upper body exercise. The subjects were monitored for venous gas emboli (VGE) with an echo-imaging system and observed for signs and symptoms of DCS. Subjects without DCS (n = 31) or with DCS which resolved during recompression (n = 29) were randomly assigned to post-exposure rest (control, n = 29) or moderate exercise (50% of peak oxygen uptake, dual-cycle ergometry; n = 31) and both groups were monitored for delayed or recurring DCS.

RESULTS

The altitude exposure resulted in 48.3% DCS in the 60 volunteers serving as test or control subjects. Of 31 subjects assigned to the post-exposure exercise group, 15 had developed DCS which resolved during descent. No cases of DCS were observed or reported during or following post-exposure exercise.

CONCLUSION

The results show that moderate exercise after exposure did not result in either delayed-onset or recurring DCS.

The effect of simulated weightlessness on hypobaric decompression sickness

BACKGROUND

A discrepancy exists between the incidence of ground-based decompression sickness (DCS) during simulated extravehicular activity (EVA) at hypobaric space suit pressure (20-40%) and crewmember reports during actual EVA (zero reports). This could be due to the effect of gravity during ground-based DCS studies.

HYPOTHESIS

At EVA suit pressures of 29.6 kPa (4.3 psia), there is no difference in the incidence of hypobaric DCS between a control group and group exposed to simulated weightlessness (supine body position).

METHODS

Male subjects were exposed to a hypobaric pressure of 29.6 kPa (4.3 psi) for up to 4 h. The control group (n = 26) pre-oxygenated for 60 min (first 10 min exercising) before hypobaric exposure and walking around in the altitude chamber. The test group (n = 39) remained supine for a 3 h prior to and during the 60-min pre-oxygenation (also including exercise) and at hypobaric pressure. DCS symptoms and venous gas emboli (VGE) at hypobaric pressure were registered.

RESULTS

DCS occurred in 42% in the control and in 44% in simulated weightlessness group (n.s.). The mean time for DCS to develop was 112 min (SD +/- 61) and 123 min (+/- 67), respectively. VGE occurred in 81% of the control group subjects and in 51% of the simulated weightlessness subjects (p = 0.02), while severe VGE occurred in 58% and 33%, respectively (p = 0.08). VGE started after 113 min (+/- 43) in the control and after 76 min (+/- 64) in the simulated weightlessness group.

CONCLUSIONS

No difference in incidence of DCS was shown between control and simulated weightlessness conditions. VGE occurred more frequently during the control condition with bubble-releasing arm and leg movements.

The effect of repeated altitude exposures on the incidence of decompression sickness

INTRODUCTION

Repeated altitude exposures in a single day occur during special operations parachute training, hypobaric chamber training, unpressurized flight, and extravehicular space activity. Inconsistent and contradictory information exists regarding the risk of decompression sickness (DCS) during such hypobaric exposures.

HYPOTHESIS

We hypothesized that four short exposures to altitude with and without ground intervals would result in a lower incidence of DCS than a single exposure of equal duration.

METHODS

The 32 subjects were exposed to 3 different hypobaric exposures--condition A: 2 h continuous exposure (control); condition B: four 30-min exposures with descent/ascent but no ground interval between the exposures; condition C: four 30-min exposures with descent/ascent and 60 min of ground interval breathing air between exposures. All exposures were to 25,000 ft with 100% oxygen breathing. Subjects were observed for symptoms of DCS, and precordial monitoring of venous gas emboli (VGE) was accomplished with a SONOS 1000 echo-imaging system.

RESULTS

DCS occurred in 19 subjects during A (mean onset 70+/-29 min), 7 subjects in B (60+/-34 min), and 2 subjects in C (40+/-18 min). There was a significant difference in DCS incidence between B and A (p = 0.0015) and C and A (p = 0.0002), but no significant difference between B and C. There were 28 cases of VGE in A (mean onset 30+/-23 min), 21 in B (41+/-35 min), and 21 in C (41+/-32 min) with a significant onset curve difference between B and A and between C and A, but not between B and C. Exposure A resulted in four cases of serious respiratory/neurological symptoms, while B had one and C had none. All symptoms resolved during recompression to ground level.

CONCLUSION

Data indicate that repeated simulated altitude exposures to 25,000 ft significantly reduce DCS and VGE incidence compared with a single continuous altitude exposure.

Preoxygenation time versus decompression sickness incidence

Preoxygenation, breathing 100% oxygen prior to decompression, has been used for well over half of this century to reduce decompression sickness (DCS) incidence. Duration of preoxygenation has been reported to be inversely related to subsequent DCS incidence. A direct comparison of DCS incidence at 30,000 ft versus preoxygenation time is needed to allow better-informed decisions regarding the cost vs. benefit of increasing preoxygenation time to prevent DCS. To obtain such a comparison, we accomplished a retrospective study of exposures to 30,000 ft (226 mm Hg; 4.37 psia) while performing mild exercise. The 86 male exposures were preceded by preoxygenation times of one to four hours. Venous gas emboli (VGE) and DCS symptom development were monitored and recorded. Although more protection was demonstrated with increasing preoxygenation time, the cost-to-benefit ratio also increases with each additional increment of preoxygenation time. The diminishing return of increasing preoxygenation to reduce DCS would eventually impact mission planning and crew duty limitations. Alteration in the physiology of denitrogenation, such as inclusion of exercise during preoxygenation, may provide better and more cost-effective DCS protection than simply increasing preoxygenation time.

The effect of exposure to 35,000 ft on incidence of altitude decompression sickness

INTRODUCTION

Exposure to 35,000 ft without preoxygenation (breathing 100% oxygen prior to decompression) can result in severe decompression sickness (DCS). Exercise while decompressed increases the incidence and severity of symptoms. Clarification of the level of activity vs. time to symptom onset is needed to refine recommendations for current operations requiring 35,000-ft exposures. Currently, the U.S. Air Force limits these operations to 30 min following 75 min of preoxygenation. The objective of this study was to determine the effect of exercise intensity on DCS incidence and severity at 35,000 ft.

METHODS

Following 75 or 90 min of ground-level preoxygenation, 54 male and 38 female subjects were exposed to 35,000 ft for 3 h while performing strenuous exercise, mild exercise, or seated rest. The subjects were monitored for venous gas emboli (VGE) with an echo-imaging system and observed for signs and symptoms of DCS.

RESULTS

Exposures involving strenuous and mild exercise resulted in higher incidence (p < 0.05) and earlier onset of symptoms (p < 0.05) of DCS than exposure at rest. Mild and strenuous exercise during exposure did not differ in incidence or rate of onset. Incidence at 30 min of exposure was 8% at rest and 23% while exercising.

CONCLUSION

The results showed that current guidelines for 35,000-ft exposures keep DCS risk below 10% at rest. Exercise, even at mild levels, greatly increases the incidence and rate of onset of DCS.

Test and evaluation of exercise-enhanced preoxygenation in U-2 operations

BACKGROUND

Preoxygenation to prevent decompression sickness (DCS) during U-2 reconnaissance flights requires considerable time and occasionally does not provide adequate protection. Increasing preoxygenation within a practical period of time provides marginally increased protection and is not always operationally feasible. Including exercise during preoxygenation to increase muscle tissue perfusion, cardiac output, and ventilation can improve the quality of the denitrogenation.

METHODS

A pilot, who reported two cases of DCS during his first 25 U-2 high flights involving cabin altitudes of 29,000-30,000 ft, volunteered to test exercise-enhanced preoxygenation. He performed 10 min of strenuous upper and lower body exercise at the beginning of preoxygenation prior to subsequent high flights without increasing total preoxygenation time.

RESULTS

The exercise was performed at 75% of maximal oxygen uptake based on the estimated maximal oxygen uptake determined during an Air Force aerobic fitness test and heart rate. The pilot's next 36 high flights, using exercise-enhanced preoxygenation, were completed with no reports of DCS.

CONCLUSIONS

This statistically significant operational test reinforced the laboratory studies. Implementation of this procedure for reducing DCS in susceptible U-2 pilots and collecting additional data from the U-2 pilot population is recommended.

The effect of staged decompression while breathing 100% oxygen on altitude decompression sickness

INTRODUCTION

Space Shuttle extravehicular activity (EVA) requires decompression from sea level pressure (14.7 psia) to a 4.3 psia (30,300 ft) pressure suit. The transition currently involves altering the shuttle atmosphere to allow shirt-sleeve denitrogenation to occur during a 12 to 36-h staged decompression (SD) at 10.2 psia (9,800 ft) with an oxygen-enriched breathing gas (26.5% oxygen, 73.5% nitrogen). The denitrogenation provides protection from decompression sickness (DCS) during EVA in a 4.3 psia pressure suit. Our goal was to determine the highest altitude at which SD while breathing 100% oxygen (SD100) could provide effective protection from development of DCS symptoms after further decompression to 29,500 ft (4.5 psia).

METHODS

There were 30 male subjects exposed to at least 6 of 11 conditions in random order on successive months to 29,500 ft for 4 h while performing mild exercise and being monitored for venous gas emboli (VGE) with an echo-imaging system. The subjects received 15 min of ground-level (GL) preoxygenation and an additional 60 or 120 min of SD100 at one of four altitudes between 8,000 ft (10.9 psia) and 18,000 ft (7.3 psia). Control exposures followed a 75- or 135-min ground-level preoxygenation.

RESULTS

During SD100, one case of DCS occurred at 18,000 ft, but not at lower staging altitudes. Higher levels of VGE were observed during SD100 at 18,000 ft than during SD100 at any lower altitude.

CONCLUSION

Staged decompression at 16,000 ft and below results in decompression risk during subsequent decompression to 29,500 ft similar to that following equivalent periods of ground-level preoxygenation.

Exercise-induced altitude decompression sickness

BACKGROUND

It has been known since World War II that exercise at altitude increases incidence of decompression sickness (DCS). However, data on the effects of specific exercise types at altitude are lacking. This research focused on the relative hazards of exercise without motion (isometric, straining) vs. dynamic exercise involving motion. The study also compared arm vs. leg exercise.

METHODS

There were 32 healthy male subjects exposed, while resting, to 29,500 ft (8992 m) for 4 h or until DCS occurred, at which time they were brought to ground level. If the subject developed DCS on this exposure, he was exposed in successive months to lower altitudes, using the same procedure, until the subject was free of symptoms for the 4-h exposure. At this symptom-free altitude, as low as 20,000 ft (6096 m), the subject performed isometric arm, isometric leg, dynamic arm and dynamic leg exercises at less than 10% of maximal oxygen consumption, each during separate exposure months. Precordial venous gas emboli (VGE) were monitored every 20 min during each exposure with a Hewlett-Packard SONOS 1000 Echo Imaging System.

RESULTS

Dynamic arm, dynamic leg, isometric arm, and isometric leg exercise induced DCS in 50%, 38%, 41% and 31% of the subjects, respectively. VGE incidence varied from 47-66%. No significant differences in DCS or VGE were found.

CONCLUSIONS

Under our test conditions, there was no difference between dynamic and isometric exercise in eliciting DCS. Exercise during exposure to the symptom-free altitude for 4 h produced a 40% incidence DCS.

An abrupt zero-preoxygenation altitude threshold for decompression sickness symptoms

INTRODUCTION

The altitude threshold for decompression sickness (DCS) symptoms has been variously described as being 18,000 ft (5,487 m) to above 25,000 ft (7,620 m). Safety and efficiency of aerospace operations require more precise determination of the DCS threshold.

METHODS

Subjects were 124 males who were exposed to simulated altitudes (11 at 11,500 ft; 10 at 15,000 ft; 8 at 16,500 ft; 10 at 18,100 ft; 10 at 19,800 ft; 20 at 21,200 ft; 20 at 22,500 ft; 10 at 23,800 ft, and 25 at 25,000 ft) for 4 to 8 h. All breathed 100% oxygen beginning with ascent. Subjects were monitored for precordial venous gas emboli (VGE) and DCS symptoms. Probit curves representing altitude vs. incidence of DCS symptoms and VGE allowed estimation of respective risk.

RESULTS

VGE were first observed at 15,000 ft with increasing incidence at higher altitudes; over 50% at 21,200 ft and 70% or higher at 22,500 ft and above. The lowest altitude occurrence of DCS was a 5% incidence at 21,200 ft. At 22,500 ft, the DCS incidence abruptly climbed to 55%.

CONCLUSION

A 5% threshold for DCS symptoms was concluded to be 20,500 ft under the conditions of this study. The abrupt increase in DCS symptoms, with zero-preoxygenation exposure above 21,200 ft implies a need for reconsideration of current USAF and FAA altitude exposure guidance.

A new preoxygenation procedure for extravehicular activity (EVA)

A 10.2 psi staged-decompression schedule or a 4-hour preoxygenation at 14.7 psi is required prior to extravehicular activity (EVA) to reduce decompression sickness (DCS) risk. Results of recent research at the Air Force Research Laboratory (AFRL) showed that a 1-hour resting preoxygenation followed by a 4-hour, 4.3 psi exposure resulted in 77% DCS risk (N=26), while the same profile beginning with 10 min of exercise at 75% of VO2peak during preoxygenation reduced the DCS risk to 42% (P<.03; N=26). A 4-hour preoxygenation without exercise followed by the 4.3 psi exposure resulted in 47% DCS risk (N=30). The 1-hour preoxygenation with exercise and the 4-hour preoxygenation without exercise results were not significantly different. Elimination of either 3 hours of preoxygenation or 12 hours of staged-decompression are compelling reasons to consider incorporation of exercise-enhanced preoxygenation.

Exercise-enhanced preoxygenation increases protection from decompression sickness

INTRODUCTION

Prevention of decompression sickness (DCS) during exposure to altitude equivalents of 30,000 ft (9144 m) requires extensive denitrogenation. In preparation for extravehicular activity (EVA), present NASA policy is to denitrogenate using a 10.2 psia staged decompression of the entire shuttle for at least 12 h, including 100 min of preoxygenation (breathing 100% oxygen at 14.7 psia prior to decompression), before decompression to the 4.3 psia (30,000 ft; 9144 m) suit pressure. This staged decompression provides the same or better protection from DCS as a 3.5- or 4-h preoxygenation used on earlier Shuttle EVA's. For high altitude reconnaissance flights at similar cockpit altitudes, a 1-h preoxygenation is currently required.

METHODS

We have investigated the use of a 1-h and a 15-min preoxygenation period, each beginning with 10 min of dual-cycle ergometry performed at 75% of each subject's peak oxygen consumption (VO2peak) to enhance preoxygenation efficiency by increasing perfusion and ventilation. Male subjects accomplished a 1-h preoxygenation with exercise, a 15-min preoxygenation with exercise, or a 1-h resting preoxygenation before exposure to 4.3 psia for 4 h while performing light to moderate exercise.

RESULTS

Incidence of DCS following the 1-h preoxygenation with exercise (42%; n = 26) was significantly less than that following the 1-h resting preoxygenation (77%; n = 26). Incidence and onset of DCS following the 15-min preoxygenation with exercise (64%; n = 22) was not significantly different from the incidence following the 1-h resting control.

CONCLUSION

Preoxygenation with exercise has been shown to provide significantly improved DCS protection when compared with resting preoxygenation.

Graying of the critical items: effects of aging on responding to MMPI-2 critical items

The relation between age and several critical item sets on the revised Minnesota Multiphasic Personality Inventory (MMPI-2; Butcher, Dahlstrom, Graham, Tellegen, & Kaemmer, 1989) was examined. MMPI-2 protocols from veterans entering a Veterans Affairs domiciliary were obtained, and the number of Grayson critical items, Koss-Butcher critical items. Lachar-Wrobel critical items, and Caldwell critical items were tabulated. Another critical item set consisting of all items of the previously mentioned sets was also tabulated. This composite set was divided into a set that has items scored on Scales 1, 2, and 3, and a second set of items that were not scored on those three scales. The effect of age on Scales L and K was also studied. A one-way analysis of variance confirmed that the number of endorsed critical items was significantly less in older age groups, and L and K increased. The implication is that endorsement of a critical item may have increased clinical significance as a person ages.

The effect of head and body position on +Gz acceleration tolerance

It has been suggested there is a relationship between acceleration-induced loss of consciousness (G-LOC) and head/body position. A two-part investigation was conducted to determine whether head and body position affects acceleration tolerance. A retrospective analysis of high-G training data (N = 1,914) compared G-LOC occurrence during straight-ahead exposure to a "check-6" exposure [10 s at +9 Gz; 6 G/s onset rate; G-suit inflated; anti-G straining maneuver (AGSM) performed]. A prospective study (N = 12) was conducted with acceleration exposures using light loss criteria with subjects in straight-ahead, above, over-the-right shoulder, or over-the-left shoulder positions. Profiles consisted of 0.1 G/s onset-rate runs (no G-suit inflation; relaxed) to a maximum of +9 Gz and 0.5 G/s onset-rate runs (G-suit inflated; AGSM performed) to +9 Gz for up to 26 s. In the retrospective study, no significant difference existed between G-LOC occurrence during straight-ahead (22/1914) and check-6 (32/1914) positions. During the prospective study with AGSM runs, there was no significant difference in the time at maximum G among any of the positions. During the relaxed runs, several comparisons yielded significant differences in peak G attained. These results indicate there may be an underlying physiologic effect of head and body position on acceleration tolerance; however, the AGSM and the G-suit overcame this effect. Although task saturation and distraction may compromise performance of the AGSM and subsequently predispose acceleration-related hazards, a proper AGSM, combined with effective protective systems, remains essential components of a protection strategy.

Prevention of decompression sickness in current and future fighter aircraft

United States Air Force oxygen regulators set to "NORMAL OXYGEN" deliver up to 60% nitrogen to the pilot at cockpit altitudes of 15,000 to 20,000 ft (4573-6096 m). Research chamber exposure to these altitudes while breathing 50% nitrogen has resulted in high grades of venous gas emboli. Expansion of existing gas emboli following an unplanned decompression to ambient aircraft altitude (e.g., loss of canopy) could result in rapid development of decompression sickness (DCS) symptoms. To reduce this potential problem, regulators in current fighters should be set to "100% OXYGEN" until descent from cruise to increase denitrogenation. The United States' Advanced Tactical Fighter and the European Fighter Aircraft may be designed to cruise above 50,000 ft (15,240 m), where cockpit altitudes exceed 20,000 ft with a 5-psi differential (psid) cockpit pressurization schedule. Increasing cockpit differential pressure to 7 psid while breathing 100% oxygen would greatly reduce the chance of significant emboli formation and the potential for DCS, but would slightly elevate the risks associated with pulmonary overpressure during rapid decompression.

Breathing 100% oxygen compared with 50% oxygen: 50% nitrogen reduces altitude-induced venous gas emboli

The risk of venous gas emboli (VGE) and decompression sickness (DCS) must be determined before selection of the lowest pressure for an extravehicular activity (EVA) pressure suit which eliminates the requirement for prebreathing. In earlier studies, use of a 50% oxygen:50% nitrogen breathing mixture (50:50 mix) during 139 zero-prebreathe decompressions of male subjects to 8.3-7.8 psia resulted in 51 instances of severe VGE and one case of DCS. Our current study investigated effects of 40 zero-prebreathe decompressions of male subjects to 8.3-6.8 psia for 6 h while breathing 100% oxygen and performing moderate exercise. No DCS symptoms were observed. Severe VGE were not detected at 8.3 psia, but were present during 10%, 20%, and 40% of the exposures at 7.8, 7.3, and 6.8 psia, respectively. Zero-prebreathe decompression while breathing 100% oxygen results in significantly lower VGE and DCS risk levels than while breathing a 50:50 mix. Our results show that 7.3 psia EVA pressure suits with 100% oxygen should be safer than 8.3 psia suits with a 50:50 mix.

Unpredictability of fighter pilot G tolerance using anthropometric and physiologic variables

Correlation and regression analyses were used to study relationships between centrifuge G tolerances of 1,434 fighter pilots during High-G Training (HGT) and anthropometric and physiologic variables. Multiple regression analyses yielded a four-variable model in which gradual onset run (GOR) relaxed-G tolerance was inversely correlated with height and directly correlated with age, weight, and diastolic blood pressure. Although the four-variable model was able to predict more of the variation in G tolerance than any single variable, neither method showed a correlation (r) of greater than 0.35 with GOR relaxed or straining G tolerance. No subject variable was significantly different between the pilot groups that did and did not experience G-induced loss of consciousness. We conclude that prediction of G tolerance during centrifuge HGT is unreliable using anthropometric and physiologic variables. The anti-G straining maneuver remains the major determinant of an individual's G tolerance.

Human tolerance to 100% oxygen at 9.5 psia during five daily simulated 8-hour EVA exposures

Extravehicular activity (EVA) currently involves decompression to 4.3 psia. This degree of decompression carries a significant potential for decompression sickness (DCS) which could be alleviated if a pressure of 9.5 psia could be maintained in the pressure suit. Previous studies have not evaluated the potential for oxygen toxicity at 9.5 psia. Twenty-one subjects were exposed to 100% oxygen at 9.5 psia for 5 consecutive days, 8 h.d-1 while performing moderate exercise to simulate a typical work-week in the proposed pressure suit environment. No DCS or venous gas bubbles were detected. Pulmonary function tests, physical exams, blood analyses, arterial oxygen saturation monitoring, and X-rays showed no evidence of oxygen toxicity under these conditions. These results suggest that a 100% oxygen, 9.5 psia pressure suit environment could avoid both DCS and oxygen toxicity during EVAs of comparable duration and physical activity.

Blood factors and venous gas emboli: surface to 429 mmHg (8.3 psi)

Analyses of 43 parameters were performed on blood obtained from 30 volunteer subjects before and after a 6-h chamber decompression from the surface to 429 mmHg. Eight subjects (5 male, 3 female) were bubble-prone (bubble grades 3 and 4), and 22 (15 male, 7 female) were resistant (bubble grade 0) to forming bubbles as detected with precordial Doppler. Significant (P less than 0.05) differences include the following: higher levels of cholesterol in the bubble-prone males and combined subjects (males and females) than in their resistant counterparts; higher magnesium in the bubble-prone males; shorter preexposure prothrombin time in bubble-prone males and combined subjects; increased partial thromboplastin time in bubble-prone females vs. the resistant females, who showed a decrease during exposure; higher preexposure hemoglobin, hematocrit, and red blood cell count in the bubble-prone females; and significant reduction in hemoglobin, red blood cell count, and serum osmolality in the bubble-prone females during the exposure relative to changes in the resistant females. In this study, high cholesterol and hemoconcentration seem to be characteristics of bubble-prone subjects.

Glutamine synthetase activity in subdivisions of brain of the shark, Squalus acanthias

Specific activity of glutamine synthetase in Squalus acanthias (spiny dogfish) central nervous system regions was highest in the cerebellum and lowest in the spinal cord. The levels of activity may relate to the excitability of each region by regulating the glutamate pool.

Glutamine synthetase: assimilatory role in liver as related to urea retention in marine chondrichthyes

The levels of gluatmine synthetase specific activity in hepatic and renal tissue are higher in fish that are ureosmoregulators than in those that are not. Enzyme activities in the liver and kidney of 18 species of fish correlated directly with the ureosmoregulatory adaptation of each species.