Responses of the autonomic nervous system in altitude adapted and high altitude pulmonary oedema subjects

Studies were carried out to ascertain the role of sympatho-parasympathetic responses in the process of adaptation to altitude. The assessment of status of autonomic balance was carried out in a group of 20 young male subjects by recording their resting heart rate, blood pressure, oral temperature, mean skin temperature, extremity temperatures, pupillary diameter, cold pressor response, oxygen consumption, cardioacceleration during orthostasis and urinary excretion of catecholamines; in a thermoneutral laboratory. The same parameters were repeated on day 3 and at weekly intervals for a period of 3 weeks, after exposing them to 3,500 m; and also after return to sea level. At altitude, similar studies were carried out in a group of 10 acclimatized lowlanders, 10 high altitude natives and 6 patients who had recently recovered from high altitude pulmonary oedema. In another phase, similar studies were done in two groups of subjects, one representing 15 subjects who had stayed at altitude (3,500–4,000 m) without any ill effects and the other comprising of 10 subjects who had either suffered from high altitude pulmonary oedema (HAPO) or acute mountain sickness (AMS). The results revealed sympathetic overactivity on acute induction to altitude which showed gradual recovery on prolonged stay, the high altitude natives had preponderance to parasympathetic system. Sympathetic preponderance may not be an essential etiological factor for the causation of maladaptation syndromes.     

Mast cells in the human lung at high altitude

Mast cell densities in the lung were measured in five native highlanders of La Paz (3600 m) and in one lowlander dying from high-altitude pulmonary oedema (HAPO) at 3440 m. Two of the highlanders were mestizos with normal pulmonary arteries and the others were Aymara Indians with muscular remodelling of their pulmonary vasculature. The aim of the investigation was to determine if accumulation of mast cells in the lung at high altitude (HA) is related to alveolar hypoxia alone, to a combination of hypoxia and muscularization of the pulmonary arterial tree, or to oedema of the lung. The lungs of four lowlanders were used as normoxic controls. The results showed that the mast cell density of the two Mestizos was in the normal range of lowlanders (0.6–8.8 cells/mm²). In the Aymara Indians the mast cell counts were raised (25.6–26.0 cells/mm²). In the lowlander dying from HAPO the mast cell count was greatly raised to 70.1 cells/mm² lung tissue. The results show that in native highlanders an accumulation of mast cells in the lung is not related to hypoxia alone but to a combination of hypoxia and muscular remodelling of the pulmonary arteries. However, the most potent cause of increased mast cell density in the lung at high altitude appears to be high-altitude pulmonary oedema.     

Body composition in air and road inductees at high altitude during the initial days of acclimatization

 This study assesses body composition changes and their time course during the initial days of acclimatization to high altitude (HA). Comparisons were made between gradual and acute induction to HA using 60 male lowlander volunteers (24–28 years of age) divided into two equal groups for inducting them to HA. Thirty subjects were air-lifted from sea level (SL) to 3500 m HA in 1 h. These subjects were air inductees (AI). The other 30 subjects were transported in 4 days by road to the same location at 3500 m. These were road inductees (RI). After remaining for 15 days at 3500 m both groups were inducted to 4200 m by road. All the subjects could not reach the various altitudes at the same time due to logistical problems. Ultimately, data for each altitude (SL, 3500 m and 4200 m) were available for only 26 RI subjects and 10 AI subjects. Skinfold thickness (SKF) measurements for the subscapular, thigh, triceps, biceps, juxtanipple, umbilicus, suprailiac and calf regions were taken in order to calculate fat percentages. Measurements were taken at SL and on days 1 and 9 at both 3500 m and 4200 m. On day 1 at 3500 m, RI showed a significant fall in body weight (BW) with respect to SL but AI maintained it. On subsequent days at HA both groups showed a significant fall in BW and lean body mass but not in percentage fat. SKF in the biceps and triceps regions decreased significantly but in the umbilicus and suprailiac regions it significantly increased at HA in both groups. Body composition, along with other parameters, is discussed determining the acclimatization schedule for sojourners at HA. Possibly, translocation of body fat takes place from the periphery to deep body fat depots in the core/main trunk due to the cold at HA. Received: 8 May 1997 / Revised: 10 August 1997 / Accepted: 20 October 1997     

Effects of high altitudes on finger cooling test in Japanese and Tibetans at Qinghai Plateau

The influences of both hypobaric hypoxia and cold on peripheral circulation were studied using the finger cooling test (measurement of the decrease in finger temperature, measured at the dorsal surface of the finger, during immersion of the hand in 0° C water for 20 min) at Qinghai Plateau. The same test was carried out at simulated altitudes in a 25° C climatic chamber to separate the hypobaric hypoxia influence from that of cold. In Japanese subjects at Qinghai Plateau there was a significant difference between finger skin temperatures (FSTs) during 20 min of 0° C water immersion at altitudes of 2260 m and 4860 m by ANOVA. Mean finger skin temperature during the 20-min immersion (5–20 min, MST) measured at 4860 m was significantly lower than that at 2260 m. In Tibetan subjects, there was also a significant difference between FSTs at 2260 m and at 4860 m by ANOVA. MST at 4860 m tended to be lower than that at 2260 m. In the 25° C climatic chamber, there was a significant difference between FSTs of Japanese expedition members at 2000 m and at 4000 m by ANOVA. MST was higher at 4000 m than at 2000 m, contrary to the data obtained in Qinghai. In conclusion, the higher skin temperature in response to local cold immersion, which would have been caused by stronger hypobaric hypoxia, must have been masked by the lower ambient temperature.     

The effect of low temperatures on the photosynthetic apparatus of Quercus ilex subsp. ballota at its lower and upper altitudinal limits in the Iberian peninsula and during a single freezing-thawing cycle

We investigated the response of the photosynthetic apparatus during an episode of extreme low winter temperature in Quercus ilex subsp. ballota (Desf.) Samp., a typical Mediterranean evergreen species in the Iberian peninsula. Both plants in a woodland located at high altitude (1,177 m. a.s.l.) and potted plants obtained from acorns of the same populations grown at low altitude (225 m. a.s.l.) were analyzed. Net CO₂ assimilation rate was negative and there was a marked decrease in photosystem II (PSII) efficiency during winter in leaves of the woodland population (high altitude individuals). These processes were accompanied by increases in non-photochemical quenching (NPQ) and in the de-epoxidated carotenoids within the xanthophyll cycle, mechanisms aimed to dissipate excess energy. In addition, these de-epoxidated carotenoids were largely preserved during the night. There was no chlorophyll bleaching during the winter, which suggests that leaves were not experiencing photoinhibitory damage. In fact, the net photosynthetic rate and the PSII efficiency recovered in spring. These changes were not observed, or were much more reduced, in individuals located at lower altitude after a few frosts. When the response to rapid temperature changes (from 20°C to –5°C and from –5°C to 20°C) was studied, it was found that the maximum potential PSII efficiency was fairly stable, ranging from 0.70 to 0.75. The rest of the photosynthetic parameters measured, actual and intrinsic PSII efficiency, photochemical and NPQ, responded immediately to the changes in temperature and, also, the recovery after cold events was practically immediate.     

Changes in body fluid compartments on re-induction to high altitude and effect of diuretics

Studies were carried out in 29 healthy young adults in the Indian Army stationed in the plains and posted at an elevation of 3500 m for more than 6 months. After exposure to a low elevation in Delhi (260 m) for 3 weeks they were reinduced to a height of 3500 m. The subjects were divided into three groups, each of which was treated with either placebo or acetazolamide or spironolactone. The drug treatment was started immediately after their landing at high altitude and continued for 2 days only. Total body water, extracellular fluid, intracellular fluid, plasma volume, blood pH, PaO₂, PaCO₂ and blood viscosity were determined on exposure at Delhi and on re-induction to high altitude. Plasma volume was increased after the descent from high altitude and remained high for up to 21 day's study. This increased plasma volume may have some significance in the pathogenesis of pulmonary oedema. Total body water and intracellular fluid content were increased at 260 m elevation, while extracellular fluid decreased. On re-induction there was a decrease in total body water with no change in the extracellular fluid content.This paper was presented in part at the 17th annual conference of the Society of Nuclear Medicine, India held at Bangalore, January 2–4, 1986     

Prevalence of acute mountain sickness in the Swiss Alps.

OBJECTIVE--To assess the prevalence of symptoms and signs of acute mountain sickness of the Swiss Alps. DESIGN--A study using an interview and clinical examination in a representative population of mountaineers. Positive symptoms and signs were assigned scores to quantify the severity of acute mountain sickness. SETTING--Four huts in the Swiss Alps at 2850 m, 3050 m, 3650 m, and 4559 m. SUBJECTS--466 Climbers, mostly recreational: 47 at 2850 m, 128 at 3050 m, 82 at 3650, and 209 at 4559 m. RESULTS--In all, 117 of the subjects were entirely free of symptoms and clinical signs of acute mountain sickness; 191 had one or two symptoms and signs; and 158 had more than two. Those with more than two symptoms and signs were defined as suffering from acute mountain sickness. At 4559 m 11 climbers presented with high altitude pulmonary oedema or cerebral oedema, or both. Men and women were equally affected. The prevalence of acute mountain sickness correlated with altitude: it was 9% at 2850 m, 13% at 3050 m, 34% at 3650 m, and 53% at 4559 m. The most frequent symptoms and signs were insomnia, headache, peripheral oedema, and scanty pulmonary rales. Severe headache, vomiting, dizziness, tachypnoea, and pronounced pulmonary rales were associated with other symptoms and signs and therefore characteristic of acute mountain sickness. CONCLUSION--Acute mountain sickness is not an uncommon disease at moderately high altitude--that is, above 2800 m. Severe headache, vomiting, dizziness, tachypnoea, and pronounced pulmonary rales indicate severe acute mountain sickness, and subjects who suffer these should immediately descend to lower altitudes.     

Heart rate biofeedback and cold pressor pain: Effects of expectancy

The study investigated the effects of expectancy on the reduction of cold pressor test pain using heart rate biofeedback training. Thirty-six male subjects were given an initial 45-sec cold pressor test, 25 heart rate decrease feedback training trials, and a final cold pressor test in which they were told to decrease their heart rate, but without the aid of feedback. Two levels of outcome expectancy (increase pain, decrease pain) and two levels of cold pressor water temperature (0°C, 5°C), resulting in four groups (N=9 per group), were used to assess the interaction between expectancy and aversive stimulus intensity. Immediately prior to the final cold pressor test, the increase pain expectancy subjects were told that decreasing their heart rate during the ice water immersion would cause more pain. Decrease pain subjects were told that decreasing their heart rate would cause less pain. Expectancy was found to be the major determinant of pain reports. The decrease pain subjects consistently reported less pain on the final cold pressor, whereas the increase pain subjects consistently reported more pain. Contrary to prediction, expectancy effects were greater for the colder water. The findings indicate the importance of expectancy in the clinical use of biofeedback to control pain.This research was supported by National Institute of Mental Health Research Grant MH-26923. Computing assistance was provided by the Office of Academic Computing, UCLA. We would like to thank Lisa Greenstadt, John Richards, John Reeves, and Barbara Smith for their assistance.     

Cold-sensitive expression of cytokinin habituation by tobacco pith cells in culture

Cloned, cytokinin-habituated tissues of Nicotiana tobacum L. cv. Havana 425 are able to grow in culture at 25° C without added cytokinin. These tissues vary in their expression of the habituated phenotype at 16° C. When cytokinin-requiring pith tissues are converted to the habituated state by 35° C treatment, all of the habituated cells are cold sensitive. After several transfers in culture, some of these habituated cells give rise to stable, cold resistant variants. Both phenotypes are inherited by individual cells. Cold sensitive clones at 16° C and non-habituated clones at 16° C as well as 25° C show the same dose response to the cytokinin, kinetin. This suggests that at the physiological level, cold sensitivity results from a decreased production of cell division factors rather than from a decreased affinity of cellular receptors for these factors.Abbreviations CDF Cell division factor(s) - NAA -naphthalencacetic acid     

Physiological characteristics of cold acclimatization in man

Studies were conducted on 15 healthy young soldiers to evaluate the effect of a cold acclimatization schedule on the thermoregulatory and metabolic activity on exposure to acute cold stress. These men were exposed to cold (10C) for 4 h daily wearing only shorts for 21 days, in a cold chamber. They were subjected to a standard cold test at 10 ± 1C the day 1, 6, 11 and 21. The subjects were made to relax in a thermoneutral room (26–28C) for 1 h and their heart rate, blood pressure, oxygen consumption, oral temperature, mean skin temperature, mean body temperature, peripheral temperatures, and shivering activity were recorded. Then they were exposed to 10C and measurements were repeated at 30 min intervals, for 2 h. The cold induced vasodilatation (CIVD), cold pressor response and thermoregulatory efficiency tests were measured initially and at the end of acclimatization schedule. The data show that the procedure resulted in elevated resting metabolism, less fall in body temperature during acute cold stress, reduction in shivering, improvement in CIVD and thermoregulatory efficiency and less rise in BP and HR during cold pressor response. The data suggest the possibility of cold acclimatization in man by repeated exposure to moderately severe cold stress.     

缺氧条件下冻伤对大鼠微循环液血灌流量的影响

本文采用体重２００±２０ｇ健康雄性Ｗｉｓｔａｒ大鼠,随机分为平原冻伤（ＦＮ）组,急性缺氧冻伤（ＦＡＨ）组和缺氧习服缺氧冻伤（ＦＨＡＣ）组,实验观察了大鼠右后肢重度冻伤前后各组大鼠双后肢皮肤微循环灌流量的改变,结果表明,平原冻伤使大鼠以后肢微循环灌流量明显减少,提示局部重度冻伤对微循环的影响不只局限于冻区也涉及到对侧肢体,冻冻前ＦＡＨ组大鼠微循环灌流量已明显低于ＦＮ组,表明生缺氧时血容量进行代偿性的     

Responses to whole body and finger cooling before and after an Antarctic expedition

Eight subjects, who were indoor workers and not habitually exposed to cold, spent 53 days in Antarctica. They did mainly geological field work often requiring the use of bare hands. The effects of the expedition on responses to a whole body cold exposure test, a finger blood flow test and a cold pressor test were studied. After the expedition, during whole-body cooling the time for the onset of shivering was delayed by 36 min (P<0.001) and forearm and thigh temperatures were 1.5°C higher (P<0.05) at the end of exposure. During local cooling of the finger with 10°C perfusion, finger vascular resistance was 14.9 (SEM 6.6) mmHg · ml^–1 · min · 100 ml (P<0.05) lower and finger temperature 3.9 (SEM 0.8) °C higher (P< 0.01). However, the decrease in rectal temperature during wholebody cooling was unaltered and the response to a cold pressor test was unchanged. The data would indicate that partial acclimatization to cold had been developed. Changes in forearm temperature were correlated with the duration of cold exposure of the hands (P < 0.05) and finger vascular resistance and finger temperature were correlated with responses to cooling before the expedition (P<0.001 and P<0.01, respectively). Because the ambient temperature was not clearly lower in Antarctica in comparison to Finland, the reason for the changes developed seems to be the increased exposure to the outdoor climate in Antarctica.     

Cardiovascular and metabolic responses to noradrenaline in men acclimatized to cold baths

The purpose of this study was to see whether artificial acclimatization to cold would reduce the pressor response to noradrenaline (NA) as natural acclimatization has been shown to do, and whether it would induce nonshivering thermogenesis. Three white men were infused with NA at four dosage levels between 0.038 and 0.300 g·kg^–1·min^–1 (2–23 g·min^–1), before and after artificial acclimatization to cold and again 4 months later when acclimatization had decayed. Acclimatization was induced by ten daily cold (15°Q baths of 30–60 min followed by rapid rewarming in hot (38–42°C) water, and was confirmed by tests of the subjects responses to whole-body cooling in air. Three control subjects also underwent the first and third tests. Acclimatization substantially reduced the pressor response to NA at 0.150 and 0.300 g·kg^–1·min^–1, confirming earlier findings by the same technique in naturally acclimatized men, and its decay increased this response to beyond its initial levels (P<0.05 for both changes). Acclimatization did not change the response to NA of heart rate, subjective impressions, skin temperature of finger and toe, pulmonary ventilation, or plasma free fatty acids and ketone bodies. At no time did NA increase oxygen consumption, or increase skin temperature or heat flow over reported sites of brown fat. These findings would seem to show that acclimatization to cold reduces sensitivity to the pressor effect of NA but does not induce nonshivering thermogenesis, and that the reduced sensitivity is replaced by a hypersensitivity to NA when acclimatization decays.     

Correlation of acute with chronic hypoxic pulmonary hypertension in cattle.

We investigated acute and chronic hypoxic pulmonary pressor responses in two groups of calves, one bred to be susceptible, the other resistant to high-altitude pulmonary hypertension. Twelve 5-mo-old susceptible calves residing at 1,524 m increased their mean pulmonary arterial pressure from 26 +/- 2 (SE) to 55 +/- 4 mmHg during 2 h at a simulated altitude of 4,572 m. In 10 resistant calves pressure increased from 22 +/- 1 to 37 +/- 2 mmHg. Five calves were selected from each group for further study. When 9 mo old, the 5 susceptible calves again showed a greater pressor response to acute hypoxia (27 +/- 1 to 55 +/- 4 mmHg) than did 5 resistant calves (23 +/- 1 to 41 +/- 3 mmHg). When 12 mo old, the 5 susceptible calves also developed a greater increase in pulmonary arterial pressure (21 +/- 2 to 9 +/- 4 mmHg) during 18 days at 4,572 m than did the 5 resistant calves (21 +/- 1 to 64 +/- 4 mmHg). Acute and chronic hypoxic pulmonary pressor responses were highly correlated (r = 0.91; P less than 0.001) indicating that they were probably produced through a common mechanism.     

Changes in plasma cortisol,blood antidiuretic hormone and urinary catecholamines in high—altitude pulmonary oedema

In 10 subjects susceptible to high altitude pulmonary oedema (HAPO) plasma cortisol and antidiuretic hormone (ADH) and urinary catecholamines were estimated both at sea level and daily during their stay at 3, 500 m (Leh). At high altitude 4 of the subjects developed HAPO, 2 got acute mountain sickness (AMS) and 4 remained unaffected. Plasma cortisol showed a sharp rise on the first day at high altitude in all the subjects. Thereafter, it declined gradually in the unaffected subjects. In the HAPO patients there was a sharp fall in the plasma cortisol level combined with antidiuresis. Changes in plasma ADH and urinary catecholamines were not consistent. It appears that failure in the normal adrenocortical response to altitude stress in susceptible subjects is a factor in precipitating HAPO.     

Interaction between cold and altitude exposure on pulmonary circulation of cattle

Hereford calves were exposed in a temperature-controlled hypobaric chamber to environmental temperatures of -2 to 1 degree C (cold) at altitudes of 1,524 m (resident altitude) and 3,048 m 1) to characterize the effects of cold exposure on the pulmonary circulation; 2) to examine the role of cold-induced hypoventilation on the pulmonary circulation; and 3) to examine the interaction between cold and hypoxia on the pulmonary circulation. Cold exposure produced a significant increase in pulmonary arterial pressure (Ppa), pulmonary arterial wedge pressure (Ppaw), and pulmonary vascular resistance (PVR) at both 1,524 and 3,048 m without affecting cardiac output. Concomitantly, cold exposure caused reductions in minute ventilation, respiratory rate, end-tidal O2 tension (PETO2), and arterial O2 tension (PaO2). Tidal volume, end-tidal CO2 tension, and arterial CO2 tension increased. Neither arterial pH nor O2 consumption changed during cold exposure. These results indicated that both pulmonary arterial and venous vasoconstriction were responsible for the pulmonary hypertension associated with cold exposure. Acute exposure to 3,048 m during cold exposure produced increases in Ppa and PVR that were similar to those elicited by cold exposure at 1,524. It was concluded that altitude exposure neither attenuated nor potentiated the effect of cold exposure on the pulmonary circulation; rather, altitude and cold exposure interacted additively. O2 administered during cold exposure to restore PETO2 and PaO2 to control values partially restored Ppa and PVR to control values. This suggested that a portion of the pulmonary hypertension associated with cold exposure was due to hypoxic pulmonary vasoconstriction elicited by the cold-induced alveolar hypoventilation.     

Face cooling by cold wind in walking subjects

The effects of low to moderate wind speeds on face temperature, thermal and pain sensations while subjects walked on a treadmill during cold exposure were studied in eight healthy men. The purpose of the study was to evaluate further the risk of frostbite at different activity levels. The walking speed was 2.8 km h(-1) and two inclination levels were used, 0 degrees and 6 degrees. The subjects were exposed to -10 degrees C and 0, 1 or 5 m s(-1) wind for 60 min dressed in cold-protective clothing with only the face unprotected. Results from previous experiments with the same subjects standing for 30 min were included in the analysis of the data. Each individual was exposed to all combinations of air velocity and activity level. The exposure to -10 degrees C and the highest wind speed used would carry no risk of frostbite according to the wind chill index. Cold lowered the skin temperature of the face significantly and wind further increased skin cooling. The activity level did not affect forehead and cheek temperatures, but the average nose skin temperature was higher and pain sensations were reduced at a higher work rate. The predicted risk of frostbite in the nose, based on average responses, would thus be less at a higher work rate. However, the results indicate that exercise does not necessarily protect all individuals from frostbite at moderate air speeds, since the nose skin temperature of 25% of the subjects dropped to 0 degrees C at 5 m s(-1) during both standing and walking. Thus the potential individual risk of frostbite in the nose is similar during light exercise and standing. Moreover, the risk of frostbite seems to be underestimated by the wind chill index under the conditions tested in this study.     

Myocardial ER chaperone activation and protein degradation occurs due to synergistic,not individual,cold and hypoxic stress

Environmental stress at high altitude affects the myocardium at the physiological and molecular level. Characterized by hypobaric hypoxia and low temperatures, the cumulative impact of these stressors on the protein folding homeostasis in the heart is yet unexplored. The present study evaluates the collective effect of cold and hypoxia on the myocardial protein oxidation and activation of the endoplasmic reticulum (ER) stress response. Adult rats were exposed to either a singular acute stress of cold (10 °C; C), hypobaric hypoxia (7620 m; H) or simultaneously to both cold and hypobaric hypoxia (CH) for 6 h. Hypoxic stress amplified the free radical generation in H and CH groups, leading to enhanced HIF-1α expression. Coupled to cold stress, reduced oxygen availability caused substantial protein oxidative modifications, as well as cardiac tissue injury and matrix remodeling, evident in the histological staining. Presence of oxidized proteins caused a significant upregulation in expression of ER chaperones GRP78 and PDI in the cold hypoxia exposed animals. Enhanced proteolytic activity signaled the removal of misfolded proteins. Linked intricately to cellular stress response, cell survival kinases were expressed higher in CH group; however apoptotic CHOP (C/EBP homologous protein) expression remained unaltered. Administration of ER stress inducer, tunicamycin along with cold hypoxic stress, caused a discernible increase in protein oxidation and GRP78 expression, along with a significant elevation in proteasome and apoptotic activity. Highlighting the significance of a synergistic, rather than individual, effect of low oxygen and temperature on the protein folding machinery, our study provides evidence for the activation of ER stress response in the myocardium under acute high altitude stress.     

Evolution of pulmonary diffusing capacity in man during high altitude acclimatization]

Pulmonary diffusing capacity (DLCO) has been measured at 3500 m in highlander and lowlander subjects. DLCO is more elevated in highlanders than in lowlanders. In these subjects, a transient increase of DLCO is observed during the first hours of hypoxia which is related to transient changes in pulmonary circulation.     

The effect of altitude and cold on body temperature during acclimatization of man at 3,300 m

The oral temperature of 20 healthy subjects of 22–28 years of age at sea level (Delhi) was recorded between 08:00–09:00 hr daily for a period of one week. Then they were flown to an altitude of 3,300 m where they were divided into two equal groups. One group was exposed to hypoxia and cold (6° to 11°C) simultaneously, while the other group to only hypoxia (25° to 28°C). At the end of three weeks, the groups were interchanged and studied for a further period of three weeks, after which they were flown back and re-tested at sea level for another week. The chronic hypoxia existing at this altitude produced a significant fall in body temperature irrespective of imposition or withdrawal of cold stress.

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Zusammenfassung Die Mundtemperatur von 20 gesunden Personen (22–28 Jahre alt) wurde auf Seehöhe (Delhi) täglich zwischen 08:00–09:00 hr morgens während einer Woche gemessen. Danach wurden die 20 Personen auf 3.300 m Höhe geflogen und davon 10 Personen 3 Wochen bei 25° bis 28°C und 10 bei 6° bis 11°C exponiert. Nach 3 Wochen wurden die Gruppen aus der Wärme in die Kälte und umgekehrt ausgetauscht. Nach 6 Wochen wurden alle Personen ins Tiefland zurückgeflogen und eine weitere Woche lang beobachtet. Die chronische Hypoxie in dieser Höhe führte mit und ohne Kältebelastung zu einer signifikanten Senkung der Körpertemperatur.

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Resume Pendant une semaine, on a mesuré tous les jours entre 8 et 9 heures du matin la température bucale de 20 personnes en bonne santé âgées de 22 à 29 ans. Ceci a eu lieu à Dehli, c'est-à-dire au niveau de la mer. Ces 20 individus ont été ensuite transportés par avion à 3.300 m d'altitude. 10 d'entre eux furent alors soumis à des températures de 25° à 28°C, les 10 autres à des températures de 6° à 11°C. Après 3 semaines de ce régime, on a interverti les 2 groupes. Après 3 nouvelles semaines de séjour en altitude, ces 20 personnes furent ramenées en plaine — également par avion — et soumises durant une semaine à de nouveaux examens. L'hypoxie chronique due à l'altitude a eu pour conséquence un abaissement de la température du corps, que celui-ci ait été soumis à une contrainte de froid ou non.