ALBERT

Description: Changes in leukocyte subpopulations and function after spaceflight have been observed but the mechanisms underlying these changes are not well defined. This study investigated the effects of short-term spaceflight (8-15 days) on circulating leukocyte subsets, stress hormones, immunoglobulin levels, and neutrophil function. At landing, a 1.5-fold increase in neutrophils was observed compared with preflight values; lymphocytes were slightly decreased, whereas the results were variable for monocytes. No significant changes were observed in plasma levels of immunoglobulins, cortisol, or adrenocorticotropic hormone. In contrast, urinary epinephrine, norepinephrine, and cortisol were significantly elevated at landing. Band neutrophils were observed in 9 of 16 astronauts. Neutrophil chemotactic assays showed a 10-fold decrease in the optimal dose response after landing. Neutrophil adhesion to endothelial cells was increased both before and after spaceflight. At landing, the expression of MAC-1 was significantly decreased while L-selectin was significantly increased. These functional alterations may be of clinical significance on long-duration space missions.

Description: The six domains that must be addressed in managing fatigue in operational settings are identified, and examples of how the aviation industry is dealing with the problems in each domain are given. Challenges facing healthcare providers in managing fatigue are also discussed.

Description: Promethazine (PMZ) is the antimotion sickness drug of choice in the U.S. Space Shuttle program; however, virtually nothing is known about the bioavailability and performance effects of this drug in the microgravity environment. PMZ has detrimental side effects on human performance on Earth that could affect Shuttle operations. In a recent ground-based study we examined: 1) the effects of promethazine (PMZ) on Shuttle landing performance using the portable inflight landing operations trainer (PILOT), and 2) saliva and urine samples to determine the pharmacokinetics of PMZ. The PILOT performance data is presented here.

Description: As the Russian Space Agency (RSA) and the U.S. National Aviation and Space Administration (NASA) began in the mid 1990s to plan a preliminary cooperative flight program in anticipation of the International Space Station, programmatic and philosophical differences became apparent in the technical and medical approaches of the two agencies. This paper briefly describes some of these differences and the process by which the two sides resolved differences in their approaches to the medical selection and certification of Shuttle-Mir crew members. These negotiations formed the basis for developing policies on other aspects of the medical support function for international missions, including crew training, preflight and postflight data collection, and rehabilitation protocols. The experience gained through this cooperative effort has been invaluable for developing medical care capabilities for the International Space Station.

Description: The National Aeronautics and Space Administration (NASA) has used iodination as a method of microbial disinfection of potable water systems in United States spacecraft and long-duration habitability modules. A review of the effects on the thyroid following consumption o iodinated water by NASA astronauts was conducted. Pharmacological doses of iodine consumed by astronauts transiently decreased thyroid function, as reflected in serum TSH values. Although the adverse effects of excess iodine consumption in susceptible individuals are well documented, exposure to high doses of iodine during space flight did not result in a statistically significant increase in long-term thyroid disease in the astronaut population.

Description: A report presents data on the effectiveness of each of six rehydration fluids in restoring total body water and plasma volume in human subjects during rest and exercise. One of the six fluids was water sweetened with aspartame: the others were water containing various amounts of sodium chloride and/or sodium citrate, plus various amounts of aspartame and/or other carbohydrates. In one experiment, five men who had previously dehydrated themselves for 24 hours drank one of the rehydration fluids, then sat for 70 minutes. Pretest plasma volumes were measured and changes in plasma volumes were calculated. This procedure was repeated at weekly intervals until all six rehydration fluids had been tested. Another similar experiment involved four men who exercised on a cycle ergometer for 70 minutes in the supine position after drinking the fluids.

Description: The polyamines putrescine (PUT) and spermine (SPM) were examined for their ability to protect human cell Deoxyribonucleic Acid (DNA) against the formation of radiation-induced double-strand breaks (DSBs). As observed previously, under conditions where polyamines were shown to be almost completely absent, association with nuclear matrix protein into a nucleoid, and organization into chromatin structure, protected DNA from induction of DSBs by factors of 4.5 and 95, respectively. At concentrations below 1 mM, PUT or SPM provided equivalent levels of protection to deproteinized nuclear DNA, consistent with their capacity to scavenge radiation-induced radicals. At constant ionic strength, 5 mM SPM protected deproteinized DNA and nucleoid DNA and DNA in nuclear chromatin by factors of 100 and 26, respectively. At 5 mM, SPM provided 15 times greater protection of deproteinized DNA than did PUT. Under physiologically relevant conditions, 5 mM SPM protected DNA in the intact nucleus from the induction of DSBs by a factor of 2 relative to DNA in the absence of SPM. Studies of SPM binding during cellular fractionation revealed that a significant fraction of the cellular SPM is tightly bound in the nucleus but can be removed by extended washing. Thus the association of SPM with nuclear chromatin appears to be a significant contributor to the resistance of the cell's DNA to the induction of DSBs.

Description: Seventeen healthy supine subjects performed graded Valsalva maneuvers. In four subjects, transesophageal echographic aortic cross-sectional areas decreased during and increased after straining. During the first seconds of straining, when aortic cross-sectional area was declining and peripheral arterial pressure was rising, peroneal sympathetic muscle neurons were nearly silent. Then, as aortic cross-sectional area and peripheral pressure both declined, sympathetic muscle nerve activity increased, in proportion to the intensity of straining. Poststraining arterial pressure elevations were proportional to preceding increases of sympathetic activity. Sympathetic inhibition after straining persisted much longer than arterial and right atrial pressure elevations. Similarly, R-R intervals changed in parallel with peripheral arterial pressure, until approximately 45 s after the onset of straining, when R-R intervals were greater and arterial pressures were smaller than prestraining levels. Our conclusions are as follows: opposing changes of carotid and aortic baroreceptor inputs reduce sympathetic muscle and increase vagal cardiac motor neuronal firing; parallel changes of barorsensory inputs provoke reciprocal changes of sympathetic and direct changes of vagal firing; and pressure transients lasting only seconds reset arterial pressure-sympathetic and -vagal response relations.

Description: OBJECTIVE: To test whether unloading increases vulnerability to eccentric exercise-induced dysfunction and muscle injury. DESIGN: Before-after trial. SETTING: General community. PATIENTS OR OTHER PARTICIPANTS: Two women and 5 men (73 +/- 3kg [mean +/- SE]) who were active college students but were not trained in lower body resistance exercise volunteered. INTERVENTION: Five weeks of unilateral lower limb suspension (ULLS), which has been shown to decrease strength and size of the unloaded, left, but not load-bearing, right quadriceps femoris muscle group (QF) by 20% and 14%, respectively; performance of 10 sets of ten eccentric actions with each QF immediately after the ULLS strength tests with a load equivalent to 65% of the post-ULLS eccentric 1-repetition maximum. MAIN OUTCOME MEASURE(S): Concentric and eccentric 1-repetition maximum for the left, unloaded and the right, load-bearing QF measured immediately after ULLS and 1,4,7,9, and 11 days later; cross-sectional area and spin-spin relaxation time (T2) of each QF as determined by magnetic resonance imaging and measured the last day of ULLS and 3 days later. RESULTS: The mean load used for eccentric exercise was 23 +/- 2 and 30 +/- 3kg for the left, unloaded and right, load-bearing QF, respectively. The concentric and eccentric 1-repetition maximum for the unloaded and already weakened left QF was further decreased by 18% (p = .000) and 27% (p = .000), respectively, 1 day after eccentric exercise. Strength did not return to post-ULLS levels until 7 days of recovery. The right, load-bearing QF showed a 4% decrease (p = .002) in the eccentric 1-repetition maximum 1 day after eccentric exercise. The left, unloaded QF showed an increase in T2 (p = .002) in 18% of its cross-sectional area 3 days after the eccentric exercise, thus indicating muscle injury. The right, load-bearing QF showed no elevation in T2 (p = .280). CONCLUSION: Unloading increases vulnerability to eccentric exercise-induced dysfunction and muscle injury, even at relatively light loads.

Description: Calculations suggest that exercise in space to date has lacked sufficient loads to maintain musculoskeletal mass. Lower body negative pressure (LBNP) produces a force at the feet equal to the product of the LBNP and body cross-sectional area at the waist. Supine exercise within 50-60 mm Hg LBNP improves tolerance to LBNP and produces forces similar to those occurring during upright posture on Earth. Thus, exercise within LBNP may help prevent deconditioning of astronauts by stressing tissues of the lower body in a manner similar to gravity and also, may provide a safe and effective alternative to centrifugation in terms of cost, mass, volume, and power usage. We hypothesize that supine treadmill exercise during LBNP at one body weight (50-60 mm Hg LBNP) will provide cardiovascular and musculoskeletal loads similar to those experienced while upright in lg. Also, daily supine treadmill running in a LBNP chamber will maintain aerobic fitness, orthostatic tolerance, and musculoskeletal structure and function during bed rest (simulated microgravity).