ATW1H%ASUACAD.BITNET@oac.ucla.edu (Dr David Dodell) (06/07/89)
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Volume 2, Number 23 June 6, 1989
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Articles
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How Space Flight has Held Medical Research
IMPLANT CONNECTING WIRES
An electrical pulse can make a muscle move. Knowing this, doctors have
sometimes fitted appropriate patients with an electrical system in which nerve
endings under the skin are connected by tiny platinum wires to minaturized
power sources on the skin surface. A frequent movement of the limb to which
the connecting wire is attached would tug at the implant, damaging the skin.
This could lead to infection. NASA has solved this problem by redesigning the
connector terminal on the skin. It has connected the implant to a miniscule
grooved pin on top of the skin which accepts a fork-type connector from the
outside power source, providing secure electrical contact. However, the
connector is easily dislodged from the pin by any slight pull, preventing skin
damage.
Vital Signs Radio System
Hospital patients can move about more freely and yet provide the medical
staff with continuous readings of their heartbeats and body temperatures
because the patients wear space age wrist radios that transmit these readings
to a hospital central station. This radio system is derived from equipment
developed and used in the Mercury and Gemini mannned space flight programs.
BATTERY OPERATED 'PILL'
By swallowing a 1-inch by 1/4-inch bugged tablet, patients can keep medical
personnel continuously informed about temperatures deep within their bodies.
Local temperature increases can reveal infections. The unit, which is retained
in the body for 5 days, can be adapted to report on intestinal presssure,
stomach acidity, or chemical status of the gastrointestinal tract. After the
unit is excreted, it can be recovered, sterilized, stored, and reused. Its
battery can run for about 640 hours before needing replacement. The pill was
originally developed for NASA studies of the effects of bedrest simulating the
weightlessness of flight in space.
X-RAY COMPUTER ENHANCEMENT
NASA'S Mariner 9 mission in 1971 and 1972 showed Martian views that changed
our conception of that planet. The pictures telecast to Earth were enhanced by
computers to bring out details that would have otherwise been obscured or
lost. The same techniques applied to X-rays are revealing much about the body
that formerly could not be discerned, contributing significantly to diagnosis
and treatment of disease or injury.
NMR:NEW WINDOW INTO THE BODY
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Volume 2, Number 23 June 6, 1989
Nuclear Magnetic Resonance (NMR) employs a magnetic field and radio waves
to peer inside the body. Unlike X-rays, NMR can even see into bones. But NMR
images are more difficult to interpret than X-rays, which has limited their
usefulness. By applying the computerized image enhancement technology
developed to read Earth resources satellite photographs, NASA was able to
provide thematic "maps" of the human body, False color can be added to each
type of tissue, making such problems as tumors or blood clots stand out
sharply and clearly. NMR and image enhancement provide invaluable information
to diagnostic physicians and surgeons, enabling them to provide better care to
their patients.
Miniaturized Diagnostic System
A device developed for medical studies of astronauts who are on long space
missions is the basis for a miniaturized medical diagnostic system capable of
performing 12 different blood analyses. Another attribute of the system is
that it uses approximately one-tenth cubic centimeter of blood to do its work.
This is about a fiftieth of the blood sample required for most conventional
analyses. The system is especially attractive for use with infants, the
elderly, and emergency room cases where minimum blood samples are available.
Microorganism Detection
Many youngsters participated in a NASA space project by capturing
fireflies for the space agency. NASA researchers wanted the Luciferace found
in fireflies to develop a machine to detect possible microorganisms on other
planets. Luciferace produces light in the presence of adenosine triphosphate
(ATP), which is a biochemical found in all living things. The NASA biochemical
machine process for detection of extraterrestrial life has been adapted to
human health uses in FLASH (Fast Luciferace Automated Assay Specimens for
Hospitals), which analyzes bacteria in urine samples. In the assay, urine
glows (becomes bioluminescent) if bacteria are in it, and quantitative
information is obtained automatically by detecting and recording light given
off by the urine sample. Luciferace is now artificially synthesized and
available for widespread use.
Testing of Manipulative Skills
A machine for measuring human coordination, EPIC (Electronic Programmable
Interactive Coorditester/Trainer) is another device developed from NASA
technology. It is expected that many uses will be found, not only in
biomedicine, rehabilitation, and the physiology of muscular coordination but
also in job aptitude testing, law enforcement, and highway safety. In
rehabilitation work, for example, test results can show progress or indicate
need for remedial help.
EPIC is derived from a NASA prototype to test pilot manipulative skills and
determine effects of fatigue on their dexterity. In using EPIC, colored lights
are flashed on a display panel. The person being tested, using hand and foot
controls, tries to match the lights on his panel.
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Volume 2, Number 23 June 6, 1989
The lights are constantly changed, calling for continuous reactions from
the person being tested.
Heat Sterilization
Using space-proven high temperature-resistant polymers in a breathing
machine is expected to be of significant benefit to sufferers from asthma,
emphysema, and respiratory diseases. Spacecraft dry heat sterilization
techniques which can be used without harm to the machine prevent the possible
transfer of infectious microorganisms from one user to another. Machines
currently used have parts that cannot withstand heat sterilization. As a
result, chemical sterilizers are used.
Chemical sterilizers are believed to be less reliable than heat and also
may react with materials from which the machine is made to produce toxic
(poisonous) products.
PACEMAKER RECHARGEABLE BATTERY
A greatly improved pacemaker for heart patients uses many electronic and
electrical components first developed for NASA spacecraft. This pacemaker uses
a rechargeable battery rather than nuclear generated power, and therefore,
emits no radioactivity. It is made of extremely durable components and is
immune to electrical interference from such sources as car ignitions, radar.
and microwave ovens. It is also one third the size and one half the weight of
the conventional pacemaker, and it's easier to implant. The rechargeable
battery stores enough energy to last as long as eight weeks, but doctors
recommend a weekly 90-minute recharge. The wearer can readily recharge the
battery at home using a portable charging console.
The new pacemaker eliminates the need for surgery and hospitalization as is
necessary about every two years to replace conventional pacemakers. Its
smaller size and weight reduce patient discomfort. The pacemaker also does not
create a large noticeable bulge along the wearers body.
VOICE-CONTROLLED WHEELCHAIR
Based on teleoperator and robot technology developed for space-related
programs, a voice-controlled wheelchair and its manipulator have been tested
as a possible aid to paralyzed and other severely handicapped persons. The
heart of the system is a voice-command analyzer which utilizes a minicomputer.
The analyzer recognizes commands only in the patient's particular speech
pattern. The computer translates commands into electrical signals which
activate appropriate motors and cause the desired motion of chair or
manipulator. The mainpulator arm can pick up objects, open doors, turn knobs,
and perform a variety of other functions. The system responds to one word
voice commands such as "go," "stop," "up," "down," "right," "left,"
"backward," and "forward."
"READING" MACHINE FOR THE BLIND
A device which converts regular inkprint into a readable, vibrating tactile
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Volume 2, Number 23 June 6, 1989
form enables blind persons to read almost anything in print, not just braille
transcriptions. The device is called the OPTACON, or OPtical-to-TActile
CONverter. It combines optical and electronic technology developed in
aerospace research.
The blind reader moves a miniature camera across a line of print with one
hand, and with the fingers of the other hand senses a vibrating image of the
letters the camera is viewing on a tactile array screen. For school use, the
Optacon makes the instructional materials of the sighted available to the
blind. It helps the sightless to obtain jobs, win promotions, and enter
vocational areas once closed to them. A related spin-off of optical-
electronic technology is the Paper Money Identifier, a small device the size
of a cigarette pack which scans a piece of paper money, reacts to the
different colors of the bill, and generates an audible signal identifying the
denominations.
IMPLANTABLE DEFIBRILLATOR
A spinoff from miniaturized space circuitry, this AID automatic pulse
generator can save thousands of people each year from death or brain damage.
Monitoring the heartbeat continuously, the device recognizes the onset of
fibrillation--a condition in which the heart's regular contractions change to
spasmodic twitching which pumps no blood--and delivers a corrective electrical
shock to restore rhythmic beating. The generator was developed by Medrad,
Inc., and Intec Systems, Inc., both of Pittsburg.
DENTAL ARCH WIRE
Straightening teeth is a difficult process requiring months, often years,
of applying corrective pressure by means of arch wires-better known as braces-
which may have to be changed several times in the course of treatment. A new
type of arch wire material, called Nitinol, is helping to reduce the number of
brace changes, due to its exceptional elasticity. An alloy of nickel and
titanium, Nitinol was orginally developed for aerospace applications. Because
of its ability to return to its original shape after bending, antennas or
other hardware could be compacted effectively in a satellite during launch,
and later expand to full size when in orbit. This same property allows braces
made of Nitinol to exert continuous pull on teeth, reducing the frequency of
office visits to change or adjust braces and, in some cases, actually trimming
overall treatment time.
ROBOTICS
NASA designs for advanced teleoperator systems have been applied to restore
movement to the limbs of paralysis victims. They include electrically powered
robot-type arms that can be moved smoothly and with dexterity. The arms can
even be operated by tongue pressure on protruding vitamin-pill sized switches.
The devices can be tailored to individual requirements potentially assisting
thousands of paralytics or amputees. They can also be used for hazardous
operations such as servicing nuclear reactors and handling of toxic or
infectious material.
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Volume 2, Number 23 June 6, 1989
REMOTELY CONTROLLED PATIENT SYSTEMS
Advances in electronics and miniaturization made possible by the space age
have contributed much to progress in health services. A number of these were
consolidated in a test hospital room for paralyzed or severely disabled
patients. The devices permit remote control of communications systems and
appliances for the comfort and recreation of bedridden patients.
Selecting any of the several complete systems in the demonstration hospital
room, the patient can dial and answer telephones, turn the pages of books,
open and close curtains, activate and tune radios, television sets and
intercoms, and turn a variety of appliances on or off.
One of the systems uses the "sight switch" developed by NASA scientists for
possible use by astronauts.
The sight switch is actually two switches mounted on a pair of eyeglass
frames--on the bows, near the eyes. Each switch has a small infrared source
and a sensor which detects the difference in reflectivity between the iris and
the white of the eye. To activitate the switch, the patient rotates his eye
upward and sideways-to look at the sensor near the corner of his eye. Once
adjusted for a specific individual, the switches are not operated by blinking
or normal eye movement. It takes a pronounced oblique motion of the eye to
trip the switch.
Other devices incorporated in the demonstration room include a foot-
operated switch, a panel switch, a breath switch, and a pneumatically operated
switch. The ultra sensitive foot switch responds easily to very slight
pressures.
A patient retaining only the most limited body movement can often use a
foot switch or a panel switch--two panels, one on each side of the patient's
head. By rolling his head slightly to one side or the other, he operates one
of the panel switches which are two air bags, one behind each ear.
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Volume 2, Number 23 June 6, 1989
HEART AND HEART/LUNG TRANSPLANTS INCREASINGLY POPULAR, SUCCESSFUL WORLDWIDE;
2,200 REPORTED PERFORMED IN 1988 BY REGISTRY REPORT
from the American Council on Transplantation
Reproduced with Permission
Heart and heart/lung transplantation, considered by many physicians to be
a suspect experimental procedure just a few short years ago, is enjoying
increasing popularity, and success, worldwide, according to The Registry of
the International Society for Heart Transplantation's Fifth Official Report -
1988.
The Registry reports 6,800 hearts or combined heart-lung (HL) allografts
had been performed worldwide by March of 1988. Nearly one-third of the total
(2200) were performed in 1987, reflecting the rapid growth of the procedure
over the past two years.
More than half of the 1987 transplants were performed in 109 transplant
centers in the United States. The remainder were transplanted in 79 centers
elsewhere in the world. The Registry revealed that the average age of cardiac
recipients was 43 years (range, newborn to 68 years) and of HL recipients 33
years. Males comprised 83 percent of the cardiac recipients; however, females
received a majority, 58 percent, of HL transplants. The increasing success of
the procedure was underscored by the actuarial five year survival rate of
cardiac recipients of 73 percent, and the report noted that "percentage was
about the same at 10 years posttransplantation." The major factor in the
improved success appeared to be better immunosuppressive treatment. The best
immunosuppressive regimen, according to the Report, was a combination of
cyclosporine, azathioprine, and steroids, which showed an 84 percent five year
success rate. The age of the recipient continued to play less of a role in
success. In fact, older patients did well after heart transplantation with
the best survival, 78 percent at five years, achieved in patients aged 55 to
68 years old. Heart/lung survival continued to improve with 62 percent
actuarial patient survival after one year and 61 percent after two years. Not
surprisingly, the Report, concludes that donor availability remains the single
biggest obstacle to more transplants. The average donor age was 25 (range 0
to 53) and 58 percent were obtained from "distant sites." The Report also
highlighted the importance of recent breakthroughs in increasing the ischemic
time (i.e. after the removal of the donor heart). "The relationship between
ischemic time and the 30-day mortality is reflected by an increased mortality
with duration of ischemia. The greatest mortality occurred when ischemia
exceeded four hours," the Report noted. (The Registry of the International
Society for Heart Transplantation: Fifth Official Report - 1988 was compiled
by LS Fragomeni and MP Kaye and appeared in the Journal of Heart
Transplantation 1988;7:249-253)
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Volume 2, Number 23 June 6, 1989
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Grants Available
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NIH Grant: Children's Knowledge About HIV Infection
The National Institute of Child Health and Human Development, The National
Institute of Mental Health, and the National Institute on Drug Abuse are
soliciting applications for developmental research on knowledge, attitudes,
and feelings of 6 to 12 year-old children regarding HIV infection and
transmission, AIDS as an illness and its health consequences, human sexuality,
and drug abuse. The results of this research are intended to direct AIDS-
related educational programs. The institutes seek an examination of
relationships among cognitive development, psychological development, and
AIDS-relevant knowledge. Research is needed to explore how
developmental/maturational variables interact with knowledge about sexuality
and substance abuse. Proposed reseaerch designs may employ both cross-
sectional and longitudinal methods. Applicants are invited to develop new
methods and tasks, and are encouraged to address a subset of research problems
relevant to the request.
It is anticipated that up to 9 proposals will be funded, funding levels
have not been determined yet. Deadline for proposals: July 31, 1989. Further
information should be requested in writing from one of the contacts listed
below. Inquiries should include a self-addressed mailing label. Contact:
Sarah L. Friedman, Human Learning and Behavior Branch NICHD, Room 633,
Executive Plaza North, 9000 Rockville Pike, Bethesda, MD 20892; or Rodney
Cocking, Behavioral Sciences Research Branch NIMH, Room 11C10, Parklawn
Building 5600 Fishers Lane, Rockville MD 20857; or Zili Amsel, Clinical
Medicine Branch NIDA, Room 10A08 Parklawn Building, 5600 Fishers Lane,
Rockville, MD 20857.
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