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Out of Thin Air: The Evolving Enigma of Erythropoietin and Neocytolysis

Bernard A. Harris Jr., MD; and Paul E. Epstein, MD
[+] Article, Author, and Disclosure Information

Dr. Harris: The Harris Foundation, Inc.; Houston, TX 77289-0907 Dr. Epstein: University of Pennsylvania; Radnor, PA 19087

Requests for Single Reprints: Bernard A. Harris, Jr., MD, The Harris Foundation, Inc., PO Box 890907, Houston, TX 77289-0907; e-mail, bharris@theharrisfoundation.org.

Current Author Addresses: Dr. Harris: The Harris Foundation, Inc., PO Box 890907, Houston, TX 77289-0907.

Dr. Epstein: Penn Medicine at Radnor, 250 King of Prussia Road, Radnor, PA 19087.

Ann Intern Med. 2001;134(8):710-712. doi:10.7326/0003-4819-134-8-200104170-00015
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In this issue, Rice and colleagues (1) explore the mechanisms underlying a rapid decrease in red cell mass that occurs during descent from high altitude to sea level, a process known as neocytolysis. The sequence of events that they describe is instructive not only for its physiologic implications but also for its demonstration of how keen observation in one setting can be translated into useful knowledge in another. While it seems logical at first to think of altitude on mountains as analogous to altitude in a spacecraft, in reality the environments could not be more dissimilar. Mountainous altitude is characterized by greatly diminished oxygen availability but gravity conditions that are essentially the same as those at sea level, whereas space travel is characterized by the same oxygen availability as at sea level but in a setting of greatly diminished gravity. How, then, can one condition shed light on the other?

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