2260m and 16m groups. No significant difference in heart structure was observed between the
native Tibetan children and the Han Chinese at 3700m (p0.05). In conclusion, the heart structure
in healthy children living at 3700m was significantly different compared with those in healthy
children at middle high altitude and sea level. A high-altitude hypoxic environment did play a
major role in the change of heart structure in healthy children; the racial differences between the
Han and Tibetan children did not contribute.
70.
INTERNATIONAL HIGH ALTITUDE PULMONARY EDEMA REGISTRY: TOOLS FOR
THE NEW MILLINNEUM. Stuart Harris
1
, Stephen Thomas
1
, IHARC Investigators
3
.
Massachusetts General Hospital, Harvard Medical School, Boston, MA. USA
1
, International
High Altitude Research Collaborators
3
.
The International High Altitude Pulmonary Edema Registry is a new, multi-center
international collaborative study first conceived by physician-scientists at the 2002 Barcelona
meeting of the ISMM. The Registry seeks to combine the limited data from multiple, single-sites
into a single, large and significant cohort using a secured, web-based data instrument. The
International HAPE Registry was founded and is governed by representatives of its international
contributors, a group known as the International High Altitude Research Collaborators (IHARC).
Over the last two years, the IHARC group, working with information technology staff and
database researchers at Massachusetts General Hospital (Boston, USA), have developed the data
instrument that is the International HAPE Registry. Through multiple revisions, the Registry has
been honed to an essential 180+ data points most likely to inform future HAPE epidemiologic,
pharmacologic, genetic, treatment and outcomes research. The Registry is web-based, with entry
of data through an encrypted, secured server accessible only to participating IHARC study
physicians (www.iharc.org). All participants will have signed a written informed consent prior to
enrollment in the Registry. In mid-2004, high altitude centers across the United States and Asia
began enrolling patients. Obstacles overcome in creating and implementing the Registry have
included the disparity of sites involved (from isolated, high-altitude clinics to urban, tertiary-care
medical centers), the traditional independence of prior (single-site) altitude research projects, and
increasingly complex administrative hurdles for registry research as outlined in Dr. Engelfinger's
editorial in the April 1, 2004 New England Journal of Medicine. The IHARC researchers
continue to welcome new investigators to participate in the Registry. Our goals are simple: the
collegial and productive pursuit of world class, high altitude research.
71.
DEATHS DUE TO HIGH ALTITUDE ILLNESS AMONG TOURISTS CLIMBING MT.
KILIMANJARO . Markus Hauser
1
, Andreas Mueller
1
, Britta Swai
2
, Emma Moshi
2
, Sendui Ole
Nguyaine
3
. Medical Department, Kilimanjaro Christian Medical Centre (KCMC), Moshi,
Tanzania
1
,
3
, Pathology Department, Kilimanjaro Christian Medical Centre (KCMC), Moshi,
Tanzania
2
,
Introduction: Mt. Kilimanjaro, the highest mountain in Africa, attracts more than 20 000
climbers each year. Although climbing experience is not required, less than 70% of the tourists
reach the summit at 5895 m. Climbers who failed to reach the summit, suffer from various
symptoms of High Altitude Illness (HAI) but fatal incidences are rare. Methods: Retrospective
analysis of the autopsies of tourists who died while climbing Mt. Kilimanjaro from 01/1996 to
10/2003. Autopsy is legally required in Tanzania on all fatal incidences among tourists. Our
Pathology Department is the only one in the vicinity to perform these, so the data reflect the
actual number of fatal cases. Results: During the past 8 years, 25 tourists died while climbing Mt.
Kilimanjaro, one died after reaching KCMC due to ARDS secondary to high altitude pulmonary
oedema (HAPE). The age ranged from 29 to 74 years, 17 male, 8 female. 14/25 tourists died due
to advanced HAI: 1/14 had high altitude cerebral oedema (HACE) only, 5/14 had HAPE, and
8/14 had findings of both HAPE and HACE. Non HAI-related deaths occurred in 11/25 climbers
due to trauma (3), myocardial infarction (4), pneumonia (2), cardio-pulmonary failure of other
underlying cause (1) and acute appendicitis (1). The estimated mortality rate for HAI was 7,7 per
