Heart rate and blood pressure responses to +Gz following varied-duration -Gz.

BACKGROUND: The push-pull effect has been defined previously as decreased +Gz tolerance caused by previous baseline zero or -Gz exposure. Earlier work indicates that the delay in BP (BP) recovery during +Gz is a function of time at -G7, and is due to the lengthened time-course of sympathetically mediated peripheral vasoconstriction. HYPOTHESIS: The purpose of this study was to retrospectively determine whether heart rate (HR) varies with BP as duration at preceding -Gz increased. METHODS: Continuous ECG R-R interval data from 15 s of +2.25Gz after preceding 2, 5, 10, or 15 s at 2Gz obtained from previous experiments were analyzed and compared with the previously reported BP data. Repeated measures ANOVA and regression analyses were used to compare +2.25Gz HR responses after the four -Gz conditions and one control +2.25Gz condition. RESULTS: An initial rapid rise in HR was observed for all conditions with a consistent steady-state plateau achieved after the first 7 s of +2.25Gz. However, there were significant differences in mean HR attained during the +2.25Gz plateau for preceding 15 s -2.0 Gz vs. the control, 2, 5, and 10s -Gz conditions (109+/-1.1 vs. 102+/-1.8, 100+/-2.0, 97+/-1.1 and 101+/-1.1, bpm, respectively; p<0.05). CONCLUSIONS: HR, unlike BP, increases briskly across all preceding -Gz time conditions, adapting within the initial baroreflex-compensatory time frame typically expected for +Gz exposures. These results suggest there may be a threshold effect for HR response. Consequently, vasoconstrictor response is a critical adaptive mechanism during +Gz when preceded by long (>10 s) -Gz exposures.

Proposed algorithm to aid the diagnosis of cerebellopontine angle tumors.

Hearing and/or balance disorders are symptoms that may be associated with tumors of the cerebellopontine angle (CPA). Between March 1988 and May 1995, 22 patients had diagnosis or evaluation of CPA tumors at Cleveland Clinic Florida. The most common presenting signs or symptoms included unilateral low-frequency tinnitus, unsteadiness, and/or asymmetric hearing loss. On the basis of our experience, we have constructed an algorithm to help identify and manage acoustic nerve dysfunction. We compare our findings with national epidemiologic data and current medical reports.

The effect of varying time at -Gz on subsequent +Gz physiological tolerance (push-pull effect).

INTRODUCTION: Previous studies have demonstrated decreased +Gz tolerance when preceded by 0 Gz or -Gz, referred to as the "push-pull effect." The purpose of this experiment was to observe the effect of varying time duration at -Gz on the push-pull effect. METHODS: During single sessions, six subjects (three men, three women) were subjected to five relaxed exposures to +2.25 Gz on the NAMRL Coriolis Acceleration Platform (CAP). The first and last exposures were control runs that were preceded by +1 Gz. Each experimental run was preceded by -2 Gz for 2, 5, or 15 s. Blood pressure (BP) was monitored using the Finapres at the level of the clavicle. Visual light loss was assessed at +2.25 Gz using a light bar. RESULTS: Mean BP was significantly reduced when the +2.25 Gz exposures were preceded by -2 Gz. Following 15 s of -2 Gz, mean BP decreased more and was slower to recover than for 2 and 5 s of -2 Gz. Reported incidents of visual light loss were: 1 following 2 s, 2 following 5 s, and 4 following 15 s at -2 Gz. There were no reports of visual light loss during control runs. CONCLUSION: During relaxed conditions, the push-pull effect is augmented by increasing duration of the preceding -Gz.

The "push-pull effect".

The purpose of this study was to prove or refute previous authors' suggestions that tolerance to +Gz is reduced when preceded by 0 Gz or -Gz. Six men and six women were subjected to one session of acceleration stresses that varied between -2 and +2.25 Gz on the NAMRL Coriolis Acceleration Platform (CAP). At the beginning and end of each session, we exposed the relaxed subjects to identical control segments that were comprised of +1 Gz for 30 s, followed by +2.25 Gz for 15 s, and then return to +1 Gz. Subjects were also exposed to three experimental segments that were comprised of 0, -1, or -2 Gz for 10 s, followed by +2.25 Gz for 15 s, and then return to +1 Gz. Subjects verbally reported any decrements in peripheral vision during exposure to +2.25 Gz. Blood pressure (BP) was reduced during each 15-s period at +2.25 Gz. The minimum BP was progressively lower during the 15-s period as the preexposure experimental conditions became more negative (+1, 0, -1, and -2 Gz). Episodes of peripheral vision loss increased as the preceding -Gz became more negative. BP during exposure to +Gz was significantly affected by the preceding 10-s exposure to -Gz, and is indicative of reduced +Gz tolerance. As this "push-pull effect" may result in unexpected incapacitation, it has important implications for aviation safety.

"Bunt bradycardia": two cases of slowing of heart rate inflight during negative Gz.

Two cases are presented of Canadian Forces pilots who experienced inflight bradycardia during 15 s of -1 Gz acceleration. The bradycardia was characterized by rapid cardio-deceleration, stable bradycardia, then cardio-acceleration during recovery following the -Gz exposure that was slower than the cardio-deceleration. Vagally mediated bradycardia in humans subjected to -Gz acceleration stress has been previously documented in laboratory studies. This bradycardia may be operationally significant since it signifies the presence of other physiological effects that predispose aviators to reduced subsequent +Gz tolerance. Research to investigate the implications of reduced +Gz tolerance following -Gz acceleration is warranted.

The Canadian Forces Airsickness Rehabilitation Program, 1981-1991.

Airsickness is a significant obstacle in the training of some student pilots. When conventional therapy fails, desensitization therapy may be indicated. Using experience gained by the RAF and USAF, the Canadian Forces (CF) began such a program in 1981. This paper reports program results from 1981-1991. Following subject identification, treatment consists of three phases: biofeedback relaxation therapy, ground-based desensitization training and in-flight desensitization therapy with a pilot-flight surgeon. Employing a definition of cure used by the RAF, success was compared with that of the RAF and USAF programs. A total of 22 student pilots have undergone rehabilitation, 17 of whom have been successfully treated for a success rate of 77%. This is comparable to success rates of other programs. It is reaffirmed that desensitization is a valid clinical tool in treatment of airsickness.

Sequence, structure and activity of phosphoglycerate kinase: a possible hinge-bending enzyme.

The fitting of sequenced peptides to a high-resolution X-ray map of phosphoglycerate kinase has yielded the complete sequence and structure of the horse muscle enzyme. Metal ADP and ATP substrates are bound to one of the two widely separated domains in an environment that seems unsuitable for phosphoglycerate binding. The most plausible binding site for the phosphoglycerate substrate is on the other domain about 10 A from the ATP, which implies the possibility of a large scale hinge-bending of the domains to bring the two substrates together in a water-free environment for catalysis.