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PubMedDate not supplied

Normal reference value of hemoglobin of infant girls and altitude in China.

BACKGROUND: The aim of this study was to supply a scientific basis for uniting the normal reference value standard of hemoglobin of Chinese infant girls. METHODS: A research study was carried out concerning the relationship between the normal reference value of 3,771 examples of hemoglobin of infant girls and altitude in 40 areas of China. Normal reference values of hemoglobin of infant girls were determined by hemoglobincyanide method. RESULTS: It was found that correlation of normal reference value of hemoglobin of infant girls and altitude was quite significant (r=0.545). By using method of univariate linear regression analysis, the following regression equation is inferred: Y = 112.9 + 0.008978X +/- 20.8. CONCLUSIONS: If altitude values are obtained in certain areas, normal reference value of hemoglobin of infant girls of this area can be reckoned by using the regression equation. Furthermore, depending on altitude, China can be divided into three districts as follows: Qingzang District, Central District, and Eastern District.

Altitude↗
PubMed2006

Red blood cell senescence and neocytolysis in humans after high altitude acclimatization.

A selective lysis of relatively young erythrocytes (neocytolysis), together with a decrease of erythropoietin (EPO) production, has been described in polycythemic, high altitude acclimatized climbers, after descent to sea level, and in astronauts, soon after exposure to weightlessness (Alfrey CP, Rice L, Udden MM, Driscoll TB. Neocytolysis may represent the physiological down-regulation of red-cell mass. Lancet 349 (1997) 1389-90). To study neocytolysis, we analysed blood samples drawn from 4 mountain climbers at sea level before and after 53 days of high altitude acclimatization (> or = 4500 m). After a 6-day descent to sea level, erythropoietin (EPO) plasma levels were lower than before high altitude acclimatization (mean values: 2.5+/-3.3 versus 10+/-4.5 mIU/ml, p < 0.05). Red blood cell (RBC) populations were separated into low, middle and high density subsets, which, by physical and phenotypical criteria, were characterized as young, middle-aged and old. RBC membrane molecules CD55 and CD59 along with phosphatydylserine and CD47 were measured. The former are partially lost during RBC aging. The latter are involved in the triggering or inhibition of RBC phagocytosis by macrophages. Immunofluorescence and flow cytometry were done on each density subset. Young and middle-aged RBCs largely disappeared after descent from high altitude (from 4.50% (+/-3.10) and 66% (+/-6.90) to 0.19% (+/-0.07) and 1.90% (+/-0.50), respectively). Simultaneously, there was a dramatic increase of high density RBCs (from 29.50% (+/-7) to 97.90% (+/-2.00)). Furthermore, the remaining young and middle-aged RBCs had acquired a senescent-like phenotype, which may account for their increased susceptibility to phagocytosis.

Acclimatization↗
PubMed2005

Cosmogenic 7Be deposition in North Wales: 7Be concentrations in sheep faeces in relation to altitude and precipitation.

Beryllium-7 (7Be) is a cosmogenic radionuclide with a half-life of 53.3 days produced mostly in the stratosphere by cosmic ray spallation of nitrogen and oxygen and entering the lower troposphere by atmospheric circulation processes. Most of the nuclide is removed by rainout during precipitation, so given that rainfall generally increases with altitude, it was considered probable that 7Be deposition would also be greater at higher altitudes. The aim of this study was to determine if there is any relationship between 7Be concentrations, altitude and precipitation by measuring 7Be activity within sheep faeces. An area of North Wales and Northwest England was selected for study, extending from the Dee Estuary at sea level to Snowdon at 1065 m. The results obtained showed a significant increase in 7Be activity with increasing altitude and precipitation consistent with predictions based on the existing literature.

Altitude↗
PubMed2005

Plants at high altitude exhibit higher component of alternative respiration.

Total respiration, capacities of cytochrome (CytR) and alternative respiration (AR) were studied in two varieties of barley (Horedum vulgare) and wheat (Triticum aestivum) each and one variety of pea (Pisum sativum) at low (Palampur; 1300 m) and high altitudes (Kibber; 4200 m). Similar studies were carried out in naturally growing Rumex nepalensis and Trifoilum repenses at Palampur, Palchan (2250 m) and Marhi (3250 m). All the plants species exhibited lower CytR but significantly higher AR capacity at high altitude (HA) (72-1117% higher) as compared to those at low altitude (LA). Glycolytic product, pyruvate and tricarboxylic acid cycle intermediate, citrate increased with increase in altitude. While the role of these metabolites in relation to HA biology is discussed, significantly higher AR at HA is proposed to be an adaptive mechanism against the metabolic perturbations wherein it might act to lower reactive oxygen species and also provides metabolic homeostasis to plants under the environment of HA.

Altitude↗
PubMed2004

Effects of altitude, distance and waves of movement on the dispersal in Australia of the arbovirus vector, Culicoides brevitarsis Kieffer (Diptera: Ceratopogonidae).

The dispersal of the biting midge and arbovirus vector Culicoides brevitarsis in the Bellinger, Macleay and Hastings river valleys and up the escarpment of the great dividing range (GDR) of mid-northern coastal New South Wales, Australia, from 1995 to 2003 was studied. The midge moved up these valleys from the endemic coastal plain in at least two waves between October and May, and both waves were modelled. Dispersal time can be explained by direct distance from the coast and the altitude of the sites. Dispersal times due to distance were similar at 18.2 +/- 2.2 (S.D.) and 15.9 +/- 2.6 weeks per 100 km for first- and second-occurrences at fixed altitude. Time of the first wave was extended 0.48 +/- 0.22 weeks for every 100-m rise in altitude and the second by 1.14 +/- 0.24 weeks for every 100-m rise for a set distance. Although C. brevitarsis can move up the escarpment of the GDR (and possibly transmit virus), vector dispersal, survival and establishment at and beyond the top of the range are limited. A third model showed that previously described slower movement of C. brevitarsis up the more-southerly Hunter valley relative to movements down the coastal plain also was related to increasing altitude.

Altitude↗
PubMed2005

Heterogeneous pulmonary blood flow in response to hypoxia: a risk factor for high altitude pulmonary edema?

High altitude pulmonary edema (HAPE) is a rapidly reversible hydrostatic edema that occurs in individuals who travel to high altitude. The difficulties associated with making physiologic measurements in humans who are ill or at high altitude, along with the idiosyncratic nature of the disease and lack of appropriate animal models, has meant that our understanding of the mechanism of HAPE is incomplete, despite considerable effort. Bronchoalveolar lavage studies at altitude in HAPE-susceptible subjects have shown that mechanical stress-related damage to the pulmonary blood gas barrier likely precedes the development of edema. Although HAPE-susceptible individuals have increased pulmonary arterial pressure in hypoxia, how this high pressure is transmitted to the capillaries has been uncertain. Using functional magnetic resonance imaging of pulmonary blood flow, we have been able to show that regional pulmonary blood flow in HAPE-susceptible subjects becomes more heterogeneous when they are exposed to normobaric hypoxia. This is not observed in individuals who have not had HAPE, providing novel data supporting earlier suggestions by Hultgren that uneven hypoxic pulmonary vasoconstriction is an important feature of those who develop HAPE. This brief review discusses how uneven hypoxic pulmonary vasoconstriction increases regional pulmonary capillary pressure leading to stress failure of pulmonary capillaries and HAPE. We hypothesize that, in addition to the well-documented increase in pulmonary vascular pressure in HAPE-susceptible individuals, increased perfusion heterogeneity in hypoxia results in lung regions that are vulnerable to increased mechanical stress.

Altitude Sickness↗
PubMed2005

Active trachoma in children in central Ethiopia: association with altitude.

A cross-sectional study was conducted in the dry month of February 2000 in the Gurage Zone of Ethiopia (population over 1.5 million) to determine the magnitude of trachoma and blindness. A multistage cluster sampling was applied to identify the study subjects. Pre-school children (1-6 years) were examined for active trachoma by trained ophthalmic nurses. The prevalence of active trachoma in the 1-6-year-old age group was 56.5%, ranging from 5.7% (altitude > 3000 m) to 73.4% (altitude less than 2000 m) (P < 0.001). Active trachoma was more common in male children than in female children and peaked in the 3-year-old age group (63.2%), declining with age. The distance to a source of water for 45% of these households was only 15 min. Only 6% of the households had latrines. Confirmation of the association between active disease and altitude may assist with mapping of trachoma in Ethiopia and elsewhere. It is possible that fly density, higher in villages at low altitudes, contributed to the differences seen.

Age Distribution↗
PubMed1996

Increased incidence of placental chorioangioma in high-altitude pregnancies: hypobaric hypoxia as a possible etiologic factor.

OBJECTIVES: Our purpose was to determine the effects of pregnancy at high altitude on the human placental structure. STUDY DESIGN: Histologic material from 22 term placentas delivered at altitudes above 3600 m was examined and compared with control material from 760 m. RESULTS: Intraplacental chorioangiomas were identified in 5 of the 22 high-altitude placentas but in none of the 59 controls. The lesions were not visible on the external surface of the placentas and were not encapsulated. The state of differentiation varied; some contained numerous capillaries that showed sinusoidal dilations, whereas in others at the opposite extreme mesenchymal cells predominated. The presence of chorioangiomas was frequently associated with threatened premature delivery, a circumvallate placenta, and multiple infarction. The lesions represented only a small percentage of the overall placental volume (<10%). CONCLUSIONS: The increased incidence of placental chorioangioma observed at high altitude (above 3600 m) may be due to the prevailing hypobaric hypoxia. Overexpression of angiogenic cytokines such as vascular endothelial growth factor, which is known to be up-regulated by this factor in vitro, may mediate this effect.

Adult↗
PubMedDate not supplied

The refractive changes and long-term (3 years) results of radial keratotomy performed at high altitude.

PURPOSE: To evaluate the development of regression or progression following radial keratotomy (RK) performed at high altitude (1,720 meters) at long-term follow-up (3 years). METHODS: Thirty-nine eyes of 21 myopia patients (between -3.25 D and -11.00 D) whose ages were 19-32 years were included in the study. The RK procedures were performed in standard Russian style. RESULTS: The average spherical equivalent cycloplegic refractions were -5.49 D +/- 2.08 (SD) preoperatively, -1.64 +/- 1.59 D in the short-term (3.41 +/- 1.46 months) and -1.40 +/- 1.71 D in the long-term (30.72 +/- 4.36 months) follow-up period. There was no statistically significant difference between these values at the short- and long-term follow-up measurements (t = -1.57, P =.12). CONCLUSIONS: The refractive changes following RK performed at high altitude occur through a combination of both the direct effect of reduced barometric pressure and the edematous corneal expansion because of hypoxia. An ophthalmologist performing RK surgery at high altitude must consider the long-lasting therapeutic effects of high altitude surgery compared to surgery at sea level.

Adult↗
PubMed1988

Altitude and childhood growth.

To assess the possible influence of altitude on childhood growth in the United States, we used data collected by the Centers for Disease Control Pediatric Nutrition. Surveillance System from eight mountain states to determine the height and weight status of children aged 5 years or younger enrolled in various public health programs between 1982 and 1984. The mean birth weight, height-for-age, weight-for-age, and weight-for-height indicators were found to decline significantly with increasing altitude, starting at an elevation greater than 1500 m (p less than 0.001, ANOVA). The reduction in growth was observed for all age groups and all birth weight groups studied. Part of the observed reduction in growth could be attributed to the lower birth weight of children born at higher altitude. However, the reduced growth status persisted after controlling for birth weight, suggesting the presence of an extrauterine growth retardation effect related to altitude.

Altitude↗
PubMed2000

Reduced maximal cardiac output at altitude--mechanisms and significance.

When a lowlander ascends to altitude and acclimatizes over days to weeks, both maximal exercise capacity and maximal cardiac output are reduced compared to sea level. Of the several possible mechanisms underlying this reduction of maximal cardiac output, the available data are interpreted as supporting the simplest hypothesis--that this merely reflects the reduced requirement for muscle blood flow that results from the arterial hypoxemia of altitude (which reduces muscle O2 availability and thus maximal muscle function). The competing hypotheses, that increased blood viscosity, reduced blood volume, autonomic nervous system changes or myocardial hypoxic dysfunction reduce maximal cardiac output, are not well supported by existing data. However, critical tests of some of these hypotheses remain to be devised and undertaken. When it comes to the question of the importance of reduced maximal cardiac output to V(O2) MAX at altitude, the available evidence suggests that cardiac output is not a major limiting variable. This is because as cardiac output rises, gains in convective flow of O2 in the circulation are offset by losses from greater diffusion impairment of O2 transfer in the lungs and muscles, and vice versa. However, just as with the mechanism of cardiac output reduction itself, clear-cut experimental tests of its role in limiting exercise at altitude remain to be conducted.

Adaptation, Physiological↗
PubMed2002

Angiotensin-converting-enzyme inhibition therapy in altitude polycythaemia: a prospective randomised trial.

BACKGROUND: Angiotensin-converting-enzyme (ACE) inhibitors reduce packed cell volume and haemoglobin concentration in polycythaemia that follows renal transplantation, which, like altitude polycythaemia, is an erythropoietin-dependent form of polycythaemia. We aimed to establish the effect of ACE-inhibitor treatment in people with altitude polycythaemia. METHODS: We did a prospective randomised study in 26 people with altitude polycythaemia (packed cell volume > or = 55%) and 24-h rate of urinary protein excretion greater than 150 mg, who had been referred to the Renal Disease Project in La Paz, Bolivia. 13 participants were assigned 5 mg/day enalapril for 2 years (study group), and 13 no treatment (controls). Blood pressure, packed cell volume and haemoglobin concentration, proteinuria, and renal function were compared by intention-to-treat analyses. FINDINGS: Baseline packed cell volume and haemoglobin concentration were positively correlated with bodyweight (p=0.02), systolic (p=0.01) and diastolic (p=0.04) blood pressure, serum creatinine (p=0.009), blood urea (p=0.008), and proteinuria (p=0.003). Systolic and diastolic blood pressure remained stable in the study group, but increased in controls. In study patients, mean (SD) packed cell volume, haemoglobin concentration, and proteinuria fell from 63.5% (4.9) to 56.8% (4.1), p<0.0001; 207 (18) to 164 g/L (13), p<0,0001; and from 358.6 (260.3) to 247.7 mg/24-h (208.2), p<0.002, respectively, but did not change significantly in controls. At 12 and 24 months of follow-up, packed cell volume, haemoglobin concentration, and proteinuria differed significantly between the groups (p<0.0001 for each comparison). In study patients, follow-up changes in packed cell volume (r=0.88, p<0.0001) or haemoglobin concentration (r=0.83, p<0.0001) and proteinuria were strongly correlated. Enalapril was well tolerated by all patients. INTERPRETATION: ACE-inhibition therapy effectively and safely ameliorates altitude polycythaemia and reduces proteinuria.

Adult↗
PubMed1985

Positive airway pressure for high-altitude pulmonary oedema.

Expiratory positive airway pressure was studied on Mount McKinley, Alaska, at an altitude of 4400 m, in three climbers with high-altitude pulmonary oedema and five climbers without evidence of this disorder. In the subjects with high-altitude pulmonary oedema oxygen saturation improved from 53.3 +/- 10.1% to 72.0 +/- 5.7% with expiratory positive airway pressure of 10 cm water. Oxygen saturation, heart rate, and respiratory rate did not change in healthy climbers. No adverse effects were noted. Improved oxygen saturation did not persist when expiratory positive airway pressure was discontinued. This procedure may be useful as a temporary first-aid measure in high-altitude pulmonary oedema.

Adult↗
PubMed1996

Effects of simulated high altitude on patients who have had radial keratotomy.

BACKGROUND: Previous studies documented diurnal myopic shifts in patients who have had radial keratotomy (RK). Recently, hyperopic shifts in these patients exposed to high altitude have been reported. A direct mechanical effect of reduced barometric pressure on surgically altered corneas has been theorized to cause this hyperopic shift. Another hypothesis implicates the effect of hypobaric hypoxia on the RK incisions. The authors examined the effect of a 6-hour exposure to decreased barometric pressure on 14 normal and 18 RK corneas. METHODS: Cycloplegic refraction, keratometry, corneal pachymetry, and tonometry were performed on seven control subjects and nine patients who have had RK. Measurements were obtained over 8 hours at sea level on day 1 of the study. Measurements were repeated on day 2 which included a 6-hour exposure to 12,000 feet simulated altitude in a hypobaric chamber. Results were compared between subjects and control subjects to determine the effect of a 6-hour exposure to decreased barometric pressure. RESULTS: There was no statistically significant difference in refraction or keratometry readings between control subjects and subjects who have had RK. Central corneal thickness decreased in the afternoon in RK eyes compared with control eyes. There was no clinically significant difference in intraocular pressure between subjects who have had RK and control subjects. CONCLUSIONS: A measurable hyperopic shift in RK corneas exposed to high altitude requires more than 6 hours to develop. A direct effect on corneal shape due to barometric pressure alone should produce a sudden change in refractive error. This study supports the hypothesis that a slow metabolic process is responsible for the previously documented hyperopic shifts induced by altitude. However, a barometric pressure effect requiring more than 6 hours to occur cannot be ruled out with the methodology used in this study.

Adult↗
PubMedDate not supplied

The influence of altitude in bronchial asthma.

BACKGROUND: Some asthmatic children living in mountain areas experience significant improvement in daily symptoms and in the degree of bronchial obstruction. The aim of this study is to investigate the effect of altitude on the prevalence and morbidity of childhood bronchial asthma. METHODS: A questionnaire regarding the history and symptoms of asthma was distributed to 874 children aged 6-12 years, to be completed by their parents with the help of their pediatrician. A total of 583 children lived at sea level, 180 at an altitude between 501 and 800 meters, and 111 at an altitude between 801 and 1,200 meters. All children with recurrent cough, shortness of breath, wheezing, and a history of bronchial asthma were considered to have bronchial asthma. RESULTS: The prevalence of childhood bronchial asthma in the mountains (800-1,200 meters) was twice as low as that at sea level (15.8% of children) (p <0.01). Parental smoking was more frequent in children who lived at sea level than in the mountains. Additionally, consumption of fish and oranges was more frequent at sea level. Children with asthma who lived in the mountains were absent fewer days from school per year (0.2) and had fewer nights with dyspnea per year (0.5) than asthmatic children who lived at sea level (1.6 days and 25 nights, respectively). CONCLUSIONS: Bronchial asthma in children who live at high altitudes is characterized by low prevalence and low morbidity.

Altitude↗
PubMed2003

Calculations and observations of solar particle enhancements to the radiation environment at aircraft altitudes.

Solar particle events can give greatly enhanced radiation at aircraft altitudes, but are both difficult to predict and to calculate retrospectively. This enhanced radiation can give significant dose to aircrew and greatly increase the rate of single event effects in avionics. Validation of calculations is required but only very few events have been measured in flight. The CREAM detector on Concorde detected the event of 29 September 1989 and also four periods of enhancement during the events of 19-24 October 1989. Instantaneous rates were enhanced by up to a factor ten compared with quiet-time cosmic rays, while flight-averages were enhanced by up to a factor six. Calculations are described for increases in radiation at aircraft altitudes using solar particle spectra in conjunction with Monte Carlo radiation transport codes. In order to obtain solar particle spectra with sufficient accuracy over the required energy range it is necessary to combine space data with measurements from a wide range of geomagnetically dispersed, ground-level neutron monitors. Such spectra have been obtained for 29 September 1989 and 24 October 1989 and these are used to calculate enhancements that are compared with the data from CREAM on Concorde. The effect of cut-off rigidity suppression by geomagnetic activity is shown to be significant. For the largest event on record on 23 February 1956, there are no space data but there are data from a number of ground-level cosmic-ray detectors. Predictions for all events show very steep dependencies on both latitude and altitude. At high latitude and altitude (17 km) calculated increases with respect to cosmic rays are a factor 70 and 500 respectively for 29 September 1989 and 23 February 1956. The levels of radiation for high latitude, subsonic routes are calculated, using London to Los Angeles as an example, and can exceed 1 mSv, which is significantly higher than for Concorde routes from Europe to New York. The sensitivity of the calculations to spectral fitting, geomagnetic activity and other assumptions demonstrates the requirement for widespread carriage of radiation monitors on aircraft.

Aircraft↗
PubMed2003

Oxidative DNA damage and repair in skeletal muscle of humans exposed to high-altitude hypoxia.

Recent research suggests that high-altitude hypoxia may serve as a model for prolonged oxidative stress in healthy humans. In this study, we investigated the consequences of prolonged high-altitude hypoxia on the basal level of oxidative damage to nuclear DNA in muscle cells, a major oxygen-consuming tissue. Muscle biopsies from seven healthy humans were obtained at sea level and after 2 and 8 weeks of hypoxia at 4100 m.a.s.l. We found increased levels of strand breaks and endonuclease III-sensitive sites after 2 weeks of hypoxia, whereas oxidative DNA damage detected by formamidopyrimidine DNA glycosylase (FPG) protein was unaltered. The expression of 8-oxoguanine DNA glycosylase 1 (OGG1), determined by quantitative RT-PCR of mRNA levels did not significantly change during high-altitude hypoxia, although the data could not exclude a minor upregulation. The expression of heme oxygenase-1 (HO-1) was unaltered by prolonged hypoxia, in accordance with the notion that HO-1 is an acute stress response protein. In conclusion, our data indicate high-altitude hypoxia may serve as a good model for oxidative stress and that antioxidant genes are not upregulated in muscle tissue by prolonged hypoxia despite increased generation of oxidative DNA damage.

Adaptation, Physiological↗
PubMed2000

Response of epiplexus cells associated with the choroid plexus in the lateral ventricles of adult rats to high altitude exposure.

The present study examined effects of high altitude exposure, which leads to development of hypoxia, on epiplexus cells associated with the choroid plexus in adult rats. At 2-5 h following exposure, epiplexus cells expressing inducible nitric oxide synthase (iNOS) were commonly observed. Increased expression of complement type 3 receptors (CR3) and major histocompatibility complex class II (MHC II) antigens was also observed 4-14 days after altitude exposure. It is suggested that the early expression of iNOS in epiplexus cells following an altitude exposure may protect the choroid plexus and ventricles from damage caused by reactive oxygen species during reoxygenation. The enhanced expression of CR3 receptors and MHC II antigens at later time intervals may be involved in protection of cerebral ventricular system from any infection that may accompany or follow altitude exposure.

Altitude↗