VOLUME 49 NUMBER 1

JANUARY 1978

/FIKTION SB4CE a n d

jgggl ENVIRONMENTAL MTIOIULASSOCIATIO« PIBUCÄTIONS /^EDICINE

BIDIRECTIONAL OVERADAPTATION ACHIEVED BY EXECUTING LEFTWARD OR RIGHTWARD HEAD MOVEMENTS DÜRING UNIDIRECTIONAL ROTATION—ishton G r a y b i e l and James Knepton 1

RELATIONSHIPS BETWEEN AMBIENT, PILOT, AND COCKPIT TEMPERATURES DÜRING ROUTINE AIR OPERATIONS-M . H . Harrison, C. Higenbottam, and R . A . Rigby 5

COMPARISON OF ANALYSIS TECHNIQUES FOR ELECTROMYO-GRAPHIC DATA—John C. Johnson 14

COSMIC RAY EFFECTS ON THE EYES OF RATS FLOWN ON COSMOS NO. 782, EXPERIMENT K-007—Delbert E . Phil­pott, R o b e r t C o r b e t t , Charles Turnbill, Gladys Harrison, D a v i d Leaffer, Sam Black, Walter Sapp, G l o r i a K l e i n , a n d L o y a F. Savik 19

CORIOLIS CROSS-COUPLING EFFECTS: DISORIENTING AND NAUSEOGENIC OR NOT?—Fred E . Guedry, Jr., and A l a n J. Benson 29

VISUAL COUNTERACTION OF NAUSEOGENIC AND DISORIENT­ING EFFECTS OF SO ME WHOLE-BODY MOTIONS: A PRO-POSED MECHANISM—Fred E . Guedry, Jr 36

RADIOBIOLOGICAL EXPERIMENT ABOARD THE BIOSATELLITE C0SM0S-690—O. G . G a z e n k o , B . A . A d a m o v i c h , Y u . G . G r i g o r i e v , Y u . P . D r u z h i n i n , E . A . l l y i n , and V. I. Popov 42

VITAMINS LIMITING FOR GROWTH OF SUBJECTS FED A NOR­MAL DIET UNDER HYPERBARIC He-02 CONDITIONS— C. A . Zogg, S . J. B r u m l e v e , B . D e B o e r , and T. K . A k e r s 47

INCREASED SECRETION OF GROWTH HORMONE, PROLACTIN, ANTIDIURETIC HORMONE, AND CORTISOL INDUCED BY THE STRESS OF MOTION SICKNESS—T. E v e r s m a n n , M . G o t t s m a n n , E . Uhlich, G . Ulbrecht, K . v o n Werder, and P . C. S c r i b a 53

DEPARTMENTS Questions and Answers for AMEs 90 Excerpts from the Casebook of Jason Harbro, M.D., A M E 91 President^ Page 93 Medical News 94

INCREASED URINARY EXCRETION OF TRIIODOTHYRONINE (T3) AND THYROXINE (T4) AND DECREASED SERUM THY-REOTROPIC HORMONE (TSH) INDUCED BY MOTION SICK­NESS—/. Habermann, T. E v e r s m a n n , E . Erhardt, M . G o t t s m a n n , G . Ulbrecht, and P . C. Scriba 58

EFFECTS OF 6 HOURS HYPOXIC AND COLD EXPOSURE ON URINARY ELECTROLYTE AND CATECHOLAMINE EXCRE­TION— T. P u r s h o t t a m , M . L . P a h w a , and H. D . Brahma-chari 62

ALTERATIONS IN ERYTHROCYTE SURVIVAL PARAMETERS IN RATS AFTER 19.5 DAYS ABOARD COSMOS 782—Henry A . L e o n , L u b a V. S e r o v a , Jennifer C u m m i n s , and Stephen A . L a n d o w 66

RAT LUNG HYPER-REACTIVITY TO S T R E S S - Z W L . B e c k -m a n 70

CLINICAL MEDICINE LOW ATMOSPHERIC PRESSURE EFFECTS ON WEARING

SOFT CONTACT LENSES—Weylin G. Eng, Jerry L . R a s c o , and Joseph A . Marano 73

PSYCHOGENIC G-FORCE INTOLERANCE REVISITED-^o-d o r e J. Wachs and Carlos J. G. Perry 76

HYPERTENSION IN THE CIVILIAN FLYING POPULATION: SIGNIFICANT OR Hüll—Michael A . Berry and R o b e r t L . Wiek, Jr 78

GUIDELINES FOR DEFINING AND DISPOSING OF MEDICAL WASTE—Frances S. N o r r i s and B . G. Young 81

FLIGHT NURSE COMMUNICATION

THE CHALLENGE OF A CORONARY CARE UNIT IN A SMALL HOSPITAL—Nancy A . Wagner 86

W i v e s 9 Wing News & Notes 100 Aerospace Physiologist Report 101 Space Medicine Branch Report 102 News of Members 106 In Memoriam 108

Copyright © 1978 by the Aerospace Medical Association. Printed monthly at Gibbs-Inman Co., P.O. Box 32030, Louisville, Ky. 40232. Second class postage paid at Washington, D.C. and at Additional Mailing Offices. Subscription: $35 U.S.; $38 Mexico; $39 other foreign.

m

Increased Secretion off Growth Hormone, Prolaeffin, Anffidiuretic Hormone, and Cortisol Induced by ttie Sfress off Motion Sickness

T. EVERSMANN, M. GOTTSMANN, E. UHLICH, G. ULBRECHT, K. VON WERDER, and P. C. SCRIBA

M e d i z i n i s c h e K l i n i k I n n e n s t a d t , V n i v e r s i t y of M u n i c h , a n d G e r m a n A i r F o r c e I n s t i t u t e of A v i a t i o n M e d i a n e , Fürstenfeld­b r u c k , West G e r m a n y

EVERSMANN, T., M. GOTTSMANN, E . UHLICH , G . ULBRECHT, K. VON WERDER, and P. C. SCRIBA. Increased secretion of growth Hormone, prolactin, antidiuretic Hormone, and Cortisol induced by the stress of motion sickness. Aviat. Space Environ. Med. 49(l):53-57, 1978.

The stress of motion sickness was experimentally provoked by Coriolis effect. Significant and reproducible increases from the basal serum level (A mean ± S.E.) of antidiuretic hormone A - ADH: 48.2 ± 4.6 pg/ml; p<0.0005), of growth hormone (A - hGH: 10.0 ± 1.2 ng/ml; p<0.0005), of prolactin (A -hPRL: 186.5 ± 29.9 /iU/ml; p<0.0005), and of Cortisol (A -F: 12.3 ± 0.9 ng%; p<0.0005) were observed, whereas the luteinizing hormone levels did not change significantly. The Stimulation of hormone secretion induced by different degrees of motion sickness seems to correlate with the severity of motion sickness. The secretion of antidiuretic hormones is the most sensitive indicator for the stress of motion sickness whereas growth hormone, prolactin, and cortisol responses to the stress of motion sickness are more delayed and less pronounced.

MOTION SICKNESS (ms) during the early stages of military flight training has been reported in

10-18% of pilots (8,15). Therefore, an attempt has been made to reduce the number of unsuitable candi-dates by means of tests to evaluate individual ms -susceptibility. Psychological, clinical, and physiological, but no endocrinological factors have been used to evaluate ms - susceptibility (15). Since ms represents a stress Situation, we have investigated the response of pituitary and pituitary-dependent adrenal hormone secretion to experimentally provoked ms. Results of this Stimulation test are presented in this paper.

M. Gottsmann, E. Uhlich, K. von Werder, and P. C. Scriba are with the University of Munich. T . Eversmann and G. Ul­brecht are with the G A F Institute of Aviation Medicine.

Presented in part at the 48th Annual Scientific Meeting of the Aerospace Medical Association in Las Vegas, Nv, May 9-12, 1977.

M A T E R I A L S A N D METHODS

We rotated 35 fasting male subjects clockwise in a rotary chair at 8.00 a.m. During the rotation period, the eyes of the subjects remained covered. The entire test was performed at 22°C and completed at 12.00 noon. The angular velocity of the rotary chair was increased stepwise by 15°/s up to a maximum of 215°/s. Maxi­mal angular velocity depended on the individual number of head movements necessary to elicit frank motion sickness (fms). The latter became evident by vomiting or retching of the subject. When fms has developed, the rotary chair was stopped immediately by use of a brake, which slowed down the angular velocity by 5° / s 2 . Dur­ing the rotation period, head movements were performed rhythmically in the four cardinal directions, with 20 head movements per acceleration step. Development of ms Symptoms was registered according to a numerical score described by Miller and Graybiel (12).

Blood samples were taken 30 min (-30) and im­mediately before (O/I) and after the rotation period (O/II), as well as 15, 30, 45, 60, 90, and 120 min thereafter. In four subjects, additional samples were collected during the rotation period in fractions over a period of 4 min using a peristaltic pump.

Urine was collected over four periods:

fraction I (6 p.m. - 6 a.m.) before the test, fraction II (6 a.m. - 12 noon) including the test

period, fraction III (12 noon - 6 p.m.), and fraction IV (6 p.m. - 6 a.m.), after the test period.

Serum levels of growth hormone (hGH), prolactin (hPRL), luteinizing hormone (LH), and antidiuretic hormone (ADH) were determined by radioimmuno-assay (21,24). Serum and urine levels of cortisol were measured by competitive protein-binding assay (22). Blood glucose was measured by the hexokinase-method (Boehringer, Mannheim, FRG). Serum and urine osmolality were determined by freezing point reduciion

Aviation, Space, and Environmental Medicine • January, 197b 53

STRESS & PITUITARY SECRETION—EVERSMANN ET A L .

TABLE I. BASAL AND MAXIMAL SERUM LEVELS OF ADH, hGH, hPRL, L H , CORTISOL, AND GLUCOSE.

Maximal Basal Unitage X-fold Peak n level level Signifi- increase time

(mean±S.E.) (mean±S.E.) cance + ) (P<0.0)

++)

A D H 53.7 ± 4.6 2.2 ±6.5 pg/ml 0.0005 24.4 O/II 31 hGH 9.8 ± 1.2 0.7±0.1 ng/ml 0.0005 14 O/II

to 30' 29

hPRL 311 ± 2 6 147 ± 7 /tU/ml 0.0005 2.1 O/II to 15'

29

L H 3.1 ± 6.6 1.9±0.3 mU/ml — — — 17 cortisol 21.3± 1.4 10.1 ±1 .2 f i g % 0.0005 2.1 O/II

to 30' 29

glucose 110 ± 2.2 96 ±1 .6 mg% 0.0005 1.14 O/II to 30'

23

+) significance determined between maximal and basal level by Wilcoxon test ++) peak time is marked according to the time scale of Fig. 1, 2.

(Knauer-Osmometer). Statistical analysis was per­formed by paired and unpaired Wilcoxon-test and the student's t-test.

RESULTS

The number of ultimately performed head move­ments ranged between 94 and 300; the mean was 158.7 ± 8.2. Two subjects performed 300 head move­ments with only slight ms Symptoms and slight in-creases of hormone levels. No correlation was found between the number of head movements and the maxi­mal hormone levels when calculated for all t e s t e d s u b ­j e c t s . In contrast, the increase of hormone secretion correlated well to the increasing number of head move­

ments and the increasing degree of ms in a Single subject.

The stress of fms induced in all subjects a significant increase of A D H , hGH, hPRL, and cortisol secretion (Table I), whereas L H levels decreased slightly, but not significantly. The hGH secretion showed two separated peaks before (O/I) and after (O/II) rota­tion (Fig. 1). The first increase occurred in those sub­jects (n = 7) who were already stressed by venipunc-ture. Three of those subjects also showed an increase of hPRL, but not of A D H or cortisol, before rotation period. The hGH increase induced by fms was still significant after the rotation period (p< 0.025), though there was no significant difference between the hGH peak before and after rotation. Maximal levels of A D H

Fig. 1. Secretion of ADH, hGH, hPRL, and cortisol induced by motion sickness. A D H (closed circles), hGH (open Squares), hPRL (open triangles), cortisol (open circles), vertical bars repre-sent S.E.M. The individually dif-ferent duration of rotation period (hatched area) is indicated by the dotted line between O/I and O/II which, in turn, indicates the start and stop of the rotation.

54 A v i a t i o n , Space, and E n v i r o n m e n t a l M e d i c i n e • J a n u a r y , 1 9 7 8

STRESS & PITUITARY SECRETION—EVERSMANN ET A L .

occurred practically always after cessation of rotation, whereas levels of hGH, hPRL, and cortisol rose to a maximum from immediately after (O/II) to 30 min after rotation. In four subjects, A D H secretion showed two peaks—shortly before fms became obvious and after rotation stopped (Fig. 2). In two of those subjects, the first peak was higher than the second; in the other two, this pattern was reversed. Serum osmolality was not in-fluenced by A D H secretion. The volume of urine frac­tion II collected during the test period was reduced significantly (p<0.1- n = 29) compared with the previous nocturnal fraction I. Urine osmolality of fraction I (618 ± 70 mosmol/1) increased to 788 ± 102 mosmol/ 1 in fraction II (mean ± S.E.).

Cortisol secretion (Fig. 1) induced by fms was as-sociated with changes of the white blood cell count. The leucocytes increased significantly (p< 0.005) from 2406 ± 557 to 3602 ± 819 (x • 10 3/mm 3, mean ± S.E.) from the end of the rotation period until 120 min thereafter. The eosinophiles were reduced correspond-ingly.

The levels of blood glucose increased significantly up to 110 ± 2.2 mg% (p< 0.0005; n = 23) after rotation stopped compared with the basal level (96 ± 1 . 5 mg%, mean ± S.E.).

Urinary excretion of cortisol was not increased significantly by the Stimulation test when compared to the normal diurnal cortisol excretion (22).

The reproducibility of fms-induced hormone secretion was demonstrated in four subjects, who were tested again by the described method after an interval of 3 months. A D H , hGH, hPRL, and cortisol levels in both tests showed a similar secretion pattern with similar maximal levels (Table II). Grading ms Symptoms demonstrated a nearly identical development of ms Symptoms in each subject retested. The number of per-

T A B L E II. TEST R E T E S T R E P R O D U C I B I L I T Y O F S E R U M L E V E L S O F A D H , h G H , hPRL, A N D CORTISOL (n - 4) .

Correlation Correlation of secretion profile of maximal levels

(n = 32) ( n - 4 ) r* r * D**

A D H 0.96 1.06 0.95 1.12 h G H 0.81 0.70 0.70 0.89 h P R L 0.82 1.05 0.61 0.64 cortisol 0.76 0.56 0.74 1.19

* r = correlation coefficient ** b = regression coefficient (slope of the line y = a + bx)

formed head movements correlated well (r = 0.75, b = 0.97) when test and repeated test were analyzed.

Hormone secretion during the rotation period induced by fms was investigated in eight subjects (Fig. 2). In all subjects, hormone secretion was stimulated before fms occurred and increased parallel with the develop­ment of ms Symptoms. Excessively high hormone levels were observed in those subjects demonstrating not only vomiting or retching but also pallor, sweating, and in­creased salivation. The stress of rotation without Per­formance of head movements elicited in one of three subjects (Fig. 3) only slight Symptoms of ms associated with an increase of hGH levels up to 12 ng/ml, whereas the other two subjects showed neither Stimulation of hormone secretion nor ms Symptoms. The hGH secre­tion in this one subject was stimulated up to 30 ng/ml in the previous test with head movements.

DISCUSSION

Increased secretion of hGH, hPRL, and cortisol in­duced by surgical or physical stress is well docu-mented (4,9,10,13,16). Similar responses of these

Fig. 2. Secretion of A D H , h G H , hPRL, and cortisol in a single sub­ject during the rotation period. A D H (closed circles), h G H (open Squares), h P R L (open triangles), c o r t i s o l (open circles). The hatched area represents develop­ment of motion sickness Symptoms, graded on the right y-axis. The ro­tation period, O/I-O/II , is out of Proportion in comparison with the pre- and postperiod.

hGH • o (ng/ml)

hPRLA A (pU/ml)

15

10

500

400

300 -30

200

100

0

A D H « -(pg/ml)

50

40

-20

IC

- 0

CORTISOL o-tpg'M

25

MOTION SICKNESS GRADING

30

20

15

10

0 -30 0/1

_ L _ _ L _

0/11 15 30 45 60 90 120 t(Mm ) J

0 32 65 98 130 162 176 head movements i — — - i

0 30 Min.

Aviation, Space, and E n v i r o n m e n t a l M e d i c i n e • January, 1978 55

STRESS & PITUITARY SECRETION—EVERSMANN ET A L .

hGH I n g / m l ]

1 2 r

10-

8-

6-

4-

2 -

0-

Cortisol Ipg'/.l

12r 10-8-6-4-2-

hPRL I j j U / m l ]

300 r

250

200

150

100

, 50 3

, 0

ADH [ p g / m l ]

30

-30 Ö7l Ö / I I 15 ~ 3 0 45 90 120 t [ M i n ]

Fig. 3. Secretion of A D H , hGH, hPRL, and cortisol induced by ro­tation without head movements. The three subjects are indicated by different symbols (Squares, circles, triangles). The individually differ­ent duration of rotation period is marked by the dotted line between O/I and O/II.

-30 0/1 0/11 15 30 45 60 90 120 tIMin.1

hormones to acceleration (11), aerobatic flight (18), parachute jumping (17), and rotation (1,5) have been observed. Increased serum levels of A D H in response to rotation have been described by Keil (7) using the A D H radioimmunoassay (ADH-RIA). The recent de-velopment of the ADH-RIA led to the evaluation of the role of A D H as a stress hormone. Previously, Taylor (20) had suggested an enhanced secretion of A D H lead­ing to a decrease of urine flow in experimentally pro­voked motion sickness (ms). In contrast, inhibition of A D H secretion, and therefore increased urinary Output, was found in weightlessness (10). Measuring A D H by bioassay, Rogge (19) reported 1967 increased A D H levels in response to acceleration. These studies suggest that A D H secretion, especially, is influenced, respec-tively, by the functional State of the vestibulär organ and by the vestibulär nuclei. The mechanism leading to A D H Stimulation or suppression still remains unclear.

As shown in this study, the stress of frank motion sickness (fms) leads to a 21-fold increase of A D H levels compared with basal levels. This Stimulation can-not be due to a fluid shift from the upper to the lower part of the body caused by rotation since A D H levels remain unaltered during the identical test but without head movements. Furthermore, changes in body Posi­tion from a supine to an upright position provoke only slight increase of A D H levels (21). It cari be con-cluded therefore that A D H secretion depends on the stress of ms.

In agreement with other studies (5,20,21), ms-induced A D H secretion causes a decreased urine flow associated with increased urine osmolality but un-changed serum osmolality and hematocrit. AU subjects tested had no fluid intake during the test period. Thus,

acute changes in A D H secretion seem to have no in-fluence on serum osmolality, but do on urine osmolality and urine flow. But both urine parameters are indirect indicators of stress-induced secretion of A D H , since maximal urine osmolality is already reached at the presence of 5 pg A D H / m l (21).

In four subjects, A D H secretion showed two sepa-rated peaks shortly before and after cessation or rota­tion. The biphasic secretion seems to depend on a sec-ond stress effect induced by the acute stop of the rotary chair at O/II, following the first stress of fms. This stop effect can cause a substantial Stimulation of hormone secretion alone, particularly of A D H and hGH, if the subjects develop evidence of ms Symptoms after halting the rotary chair.

The fms-induced increase of hormone secretion seems to depend on the severity of fms. Those subjects wfao demonstrated other characteristic ms Symptoms, such as pallor, sweating, increased salivation, or dizziness, before vomiting or retching had much higher hormone levels compared to those subjects demonstrating only vomiting or retching. The latter subjects seemed to be less stressed. This indicates the possibility of quantitatirag stress by determining hormone secretion, since subjecits showing slight increases of hormone secretion experi-enced only slight ms Symptoms. However, the hormonal response to different degrees of ms has to be im-vestigated further to assess the reliability of individual stress quantitation by determining the secretion pattern of the different stress hormones.

Our results with experimentally induced ms demom-strate that A D H secretion is the most sensitive indicator for ms stress, whereas hGH, hPRL, and cortisol show a more delayed and less striking rise. The delay of cortisol

56 A v i a t i o n , Space, and E n v i r o n m e n t a l M e d i c i n e • J a n u a r y , 1 9 7 8

STRESS & PITUITARY SECRETION—EVERSMANN ET A L .

secretion can be explained by its dependence on A C T H . The ms-induced increase of urinary cortisol excretion was not significant. Maybe the rise of urinary cortisol was obscured by the diurnal Variation of cortisol excre­tion. Cortisol excretion is, therefore, a less suitable Parameter for stress quantitation as is the urinary excretion of catecholamines. The ms-induced changes of catecholamine excretion and of thyroid function investigated in this study have been reported separate-ly (6). Serum levels of L H seem to be unchanged by the stress of fms. The different stress hormones respond differently to different stress Stimuli (25). In our study, the effect of fms on five different endocrine Systems was investigated demonstrating a characteristic pattern of pituitary hormone secretion.

The Coriolis effect is not the only Stimulus for the vestibulär organ leading to secretion of stress hormones. Optokinetic Stimulation (3) seems to provoke the same effect. Preliminary results from our laboratory show that A D H increases slightly (A ADH:2.68 ± 0.68 pg/ml) after mild optokinetic Stimulation with slight ms Symptoms. Düring this test, cortisol levels increased slightly but not significantly, whereas hGH and hPRL levels did not change. In order to investigate the hormonal response to psychological stress, five subjects performed an arithmetic computation test. No differ-ences were seen in serum A D H , hGH, and hPRL levels before and after the test. Only slight increases of A D H , hGH, and hPRL have been reported in response to other psychological test methods (15,23).

The secretion of hGH, hRPL, A D H , and cortisol induced by ms was investigated primarily to find a new test for evaluation of individual ms susceptibility. Our data indicate that the secretion of hormones depends on the individually different susceptibilitv for ms since the stimulated secretion correlates well with the duration of the rotation period in the individual and with the severity of his Symptoms. The reoroducibility of these results has been demonstrated. Thus, it is concluded that the determination of hormone secretion may prove to be helpful in predicting motion sickness susceptibility.

A C K N O W L E D G M E N T S The technical assistance of Miss R. Rothenfußer, G . Weidl,

B. Glöckner, J. Felsl, and Mr . J. Ettinger is acknowledged. We are indebted to Dipl . Math. M . Bauer for his assistance in the Statistical analysis.

R E F E R E N C E S 1. Colehour, J. K. , and A . Graybiel. 1966. Biochemical changes

occuring with adaptation to accelerative forces during rotation. A e r o s p a c e M e d . 37:1205-1207.

2. von Dahl, M . E., J. J. Franks, M . J. R. Prigmore, and R. L . Cramer. 1963. Adrenal corticai response to motion sick­ness. A r c h . E n v i r o n . H e a l t h 7:92-97.

3. Dichgans, J., and T. Brandt. 1973. Optokinetic motion sick­ness and pseudo-coriolis effects induced by moving visual Stimuli. A c t a O t o l a r y n g . 76:339-348.

4. Estep, H . L . , D . P. Island, R. L . Ney, and G . W. Liddle. 1963. Pituitary-adrenal dynamics during surgical stress. 7. C l i n . E n d o c r i n o l . 13:419-425.

5. Graybiel, A . , R. S. Kennedy, E . C. Knobloch, F . E. Guedry, W. Mertz, M . E . McLeod, J . R. Colehour, E . F . Miller,

II, and A . R. Fregly. 1965. Effects of exposure to a rotat-ing environment (10 R P M ) on four aviators for a period of twelve days. A e r o s p a c e M e d . 36:733-754.

6. Habermann, J., T. Eversmann, F. Erhardt, M . Gottsmann, G . Ulbrecht, and P. C. Scriba. 1978. Increased urinary excretion of triiodothyronine (T : i ) and thyroxine ( T 4 ) and decreased serum thyreotropic hormone (TSH) in­duced by motion sickness. A v i a t . Space E n v i r o n . M e d . 49:58-61.

7. Kei l , L . D. , and S. Elfis. 1976. Plasma Vasopressin and renin activity in woman exposed to bedrest and G 7 acceleration. J. A p p l . P h y s i o l . 40:911-914.

8. Kennedy, R. S. 1975. Motion sickness questionnaire and field independence scores as predictors of success in naval aviation training. A v i a t . Space E n v i r o n . M e d . 46:1349-1352.

9. Leach, C. S., P. C. Rambaut, and D . C. Johnson. 1974. Adrenocortical responses of the Apollo 17 crew members. A e r o s p a c e M e d . 45:529-534.

10. Leach, C. S., P. C. Johnson, and P. C. Rambaut. 1976. Metabolie and endocrine studies. The second manned skylab mission. A v i a t . Space E n v i r o n . M e d . 47:402-410.

11. Lipman, R. L . , F . Ulvedal, W. K . Brown, S. D . Leverett, F. R. Lecocq, and J. J. Schnure. 1970. Metabolie re­sponse to acceleration in man. A e r o s p a c e M e d . 41:905-908.

12. Miller, E. F., II, and A . Graybiel* 1970. A provocative test for grading susceptibility to motion sickness yielding a Single numerical score. A c t a O t o - L a r y n g o l . Sappl. 274: 1-15.

13. Miller, R. G . 1968. Secretion of 17-hydroxy-corticosteroids (17-OHCS) in military aviators as an index of response to stress: A review. A e r o s p a c e M e d . 39:498-501.

14. Miyabo, S., T. Asato, and N . Mizushima. 1977. Prolactin and growth hormone responses to a psycological stress in normal and neurotic subjects. J . C l i n . E n d o c r i n o l . M e t a b . 44:947-951.

15. Money, K . E . 1970. Motion sickness. P h y s i o l . Rev. 50:1-49. 16. Ney, R. L . , N . Shimizu, and W. E. Nicholson. 1963. Cor-

relation of plasma A C T H concentration with adreno­cortical response in normal human subjects, surgical pa-tients and patients with Cushing's disease. J . C l i n . Invest. 42:1669-1677.

17. Noel, G . L . , R. C. Dimond, J. M . Earll, and A . G . Frantz. 1976. Prolactin, thyrotropin, and growth hormone re-lease during stress associated with parachute jumping. A v i a t . Space E n v i r o n . M e d . 47:543-547.

18. Pinter, E . J. 1974. Metabolie and endocrine changes in aero-batic flight. A e r o s p a c e M e d . 45:1159-1163.

19. Rogge, J. D. , W. W. Moore, W. E . Segar, and A . F. Fasola. 1967. Effect of + G Z and + G X acceleration on peripheral venous A D H levels in human. / . A p p l . P h y s i o l . 23:870-874.

20. Taylor, N . B. G. , J. Hunter, and W. H . Johnson. 1957. Anti-diuresis as a measurement of laboratory induced motion sickness. C a n . J . B i o c h e m . P h y s i o l . 35:1017-1027.

21. Uhlich, E . 1976. Vasopressin. Copythek Thieme Stuttgart. 22. Ulbrecht, G. , E. Meier, R. Rotenfu/Ser, and K . von Werder.

1974. Time dependence of the flight induced increase of free urinary cortisol secretion in jet pilots. A G A R D - C P P 146, A 11-1.

23. Wagner, H . , V . Maier, H.-J. Herrmann, and H . E . Franz. 1975. Direct measurement of arginine-vasopressin in hu­man serum without extraction procedure. A c t a E n d o e r . (Kbh.) Suppl. 193:130.

24. von Werder, K . 1975. Wachstumshormone und Prolaktinsek­retion des Menschen. US-Manuskript, Urban & Schwar­zenberg, München-Berlin-Wien.

25. Yalow, R. S., N . Varsano-Aharon, E . Echemendia, and S. A . Berson. 1969. h G H and A C T H secretory responses to stress. H o r m . M e t a b . Res. 1:3-8.

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