Effects of HZE particle on the nigrostriatal dopaminergic system in a future Mars mission.

Because of long duration travel outside the Earth's magnetic field, the effect of iron-rich high charge and energy (HZE) particles in Galactic Cosmic Rays on human body is the major concern in radiation protection. Recently attention has been directed to effects on the central nervous system in addition to mutagenic effects. In particular, a reduction in striatal dopamine content on nigrostriatal dopaminergic system has been reported by investigators using accelerated iron ions in ground-based mammalian studies. In addition, studies of the pathophysiology of Parkinson's disease demonstrated that excess iron cause a reduction in the dopamine content in the substantia nigra. This suggests an intriguing possibility to explain the selective detrimental effects of HZE particles on the dopaminergic system. Should these particles have biochemical effects, possible options for countermeasures are: (1) nutritional prevention, (2) medication, and (3) surgical placement of a stimulator electrode at a specific anatomic site in the basal ganglia.

Survival at high altitudes: wheel-well passengers.

There have been 10 specific "wheel-well" passenger stowaway flights (the wheel-well area was entered just before take-off) documented in the N.Y. Times between 1947-1993. Five stowaways survived flights encompassing altitudes as high as 39,000 feet, with six dying in the process (one flight had two stowaways, one fatal, one surviving). Three Douglas DC-8 and four Boeing 707 aircraft, plus a Caravelle, an unknown jet, and a piston airliner were involved. Several of the wheel-well flight stowaways were reportedly politically motivated to attempt these international flights. This paper describes the unpressurized flight environment and the physiology that enabled human survival under conditions of extreme hypoxia and cold, inducing a virtual "hibernative" state. It is likely that similar attempts will continue, and alert airport security preventive measures are indicated.

Economy class syndrome.

A recent case of the "Economy Class Syndrome" is presented, emphasizing the syndrome's aeromedical implications and prevention. The clinical presentation, current modes of prophylaxis and therapy, plus a brief but pertinent historical background, are described. The syndrome is potentially fatal, and the authors stress that the condition needs to be recognized as a preventable hazard of air travel. Adoption of the preventive measures described herein can assist in promoting healthy air travel.

Cases from the aerospace medicine residents' teaching file. Case #58. Scrofula.

A patient presenting with dysphagia was treated for bacterial lymphadenitis with broad spectrum antibiotics by an internist and an otolaryngologist. The clinical picture, histopathology, diagnosis, aeromedical disposition, and a brief, but pertinent historical background are described. The case was unique in that the diagnosis would have been missed had it not ultimately been for the timely intervention and advice of a senior preventive medicine physician. The physician recognized the high probability of extrapulmonary tuberculosis manifesting itself as scrofula. Tuberculosis cases in the United States have begun to climb in number and alertness to this infection is warranted.