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Ths paper describes a PC-based controller for robot-assisted minimally invasive surgery. The development is motivated by the need of reducing the exposure of operating room personnel to X-rays during surgical procedures such as percutanrous discectomy.
Integrated planning and execution of teleoperations in space with time delays is shown. The topics include: 1) The Problem; 2) Future Robot Surgery? 3) Approach Overview; 4) Robonaut; 5) Normal Planning and Execution; 6) Planner Context; 7) Implementation; 8) Use of JSHOP2; 9) Monitoring and Testing GUI; 10) Normal sequence: first the supervisor acts; 11) then the robot; 12) Robot might be late; 13) Supervisor can work ahead; 14) Deviations from Plan; 15) Robot State Change Example; 16) Accomplished goals skipped in replan; 17) Planning continuity; 18) Supervisor Deviation From Plan; 19) Intentional Deviation; and 20) Infeasible states.
Bisphosphonates are a class of pharmaceuticals used to treat diverse bone disorders such as osteoporosis, Paget's disease, and multiple myeloma. They constitute a class of drugs which adhere to bony surfaces and interfere with the resorptive activity of osteoclasts. They also represent a potential countermeasure towards the loss of bone mass experienced by astronauts during spaceflight. Recently, the medical literature has revealed cases of osteonecrosis of the jaw in individuals receiving intravenous bisphosphonate therapy with a smaller number of cases occurring in individuals receiving the oral form of the medication. Risk management for long duration missions requires consideration of mission success and lifetime health care of astronauts. We performed MEDLINE and PubMed searches (1966 December 2006) using the following keywords: osteonecrosis, jaw, bisphosphonates. Additional references were obtained from the citations of the retrieved articles. Injectable bisphosphonates such as pamidronate and zoledronic acid have been highlighted recently in the literature due to a possible link with osteonecrosis of the jaw. The mechanism of action remains unclear but may be linked to physiologic microdamage in the jawbones resulting from suppression of bone metabolism. The most predisposing factors appear to be the type and dose of bisphosphonate used, a history of dental surgery, trauma, and/or dental infection. In addition, patients diagnosed with a malignancy such as breast cancer or multiple myeloma, who have been on intravenous bisphosphonate therapy for several months seem to be at increased risk. The use of oral bisphosphonates appears to place patients more at risk from acute events such as gastrointestinal tract injury or perforation. Although some studies report little to no increase in GI events compared to placebo, we must remember that in microgravity, astronauts may be unable to comply with medication instructions. They may have difficulty remaining upright for the required 30-45 minutes post-ingestion. We are currently unaware if this inability to comply with instructions on the package insert may lead to an increased risk for GI events. There is a potential long-term complication that resides with both forms of bisphosphonate therapy. In order to repair normally occurring physiologic microdamage to bone, both osteoclastic resorption and osteoblastic bone deposition must be functional. Controversy exists in the literature regarding whether prolonged use of bisphosphonates may lead to the suppression of bone turnover and accumulation of microdamage. Bisphosphonates are a powerful class of drugs that suppress bone turnover, but may cause serious adverse clinical events such as gastrointestinal tract injury or osteonecrosis of the jaw. Unfortunately, little to no data exists currently which may help us provide answers regarding the risks of their use in a healthy astronaut cohort. While controversy exists in the literature regarding their mechanism and long-term consequences, the potential mission impact or lifetime health care impact of an adverse clinical event resulting from bisphosphonate therapy must be considered.
A totally implantable piezoelectric generator system able to harness power from electrically activated muscle could be used to augment the power systems of implanted medical devices, such as neural prostheses, by reducing the number of battery replacement surgeries or by allowing periods of untethered functionality. The features of our generator design are no moving parts and the use of a portion of the generated power for system operation and regulation. A software model of the system has been developed and simulations have been performed to predict the output power as the system parameters were varied within their constraints. Mechanical forces that mimic muscle forces have been experimentally applied to a piezoelectric generator to verify the accuracy of the simulations and to explore losses due to mechanical coupling. Depending on the selection of system parameters, software simulations predict that this generator concept can generate up to approximately 700 W of power, which is greater than the power necessary to drive the generator, conservatively estimated to be 50 W. These results suggest that this concept has the potential to be an implantable, self-replenishing power source and further investigation is underway.
NASA is planning now toward the day of long-duration flight-manned interplanetary missions for example-wherein routine health care and emergency treatment must be accomplished on-board the spacecraft over periods of months or perhaps even years. Since spacecraft design limits crew size, the medical assignment may be handled by a single astronaut-physician or by a crew member trained as a physician's assistant. In a space emergency demanding surgery, for instance, sophisticated communications equipment, backed by a computerized data processing system, would make it possible for a surgeon on Earth to "examine" the patient. He could study X-rays and other data, specify an in-flight surgical procedure, and guide the astronaut-medic step-by-step through the operation. Such a system is being evaluated now. It is called STARPAHC (Space Technology Applied to Rural Papago Health Care). NASA technology in space communications and data processing is being applied to remote health services for the Papago tribe. STARPAHC is administered by the NASA Life Sciences Directorate in the Office of Space Sciences. It is a joint program involving NASA's Johnson Space Center, the Indian Health Service of the Department of Health, Education & Welfare, and the Papago's Executive Health Council. Lockheed Missiles & Space Co. is NASA's systems support contractor.
The National Biocomputation Center, a joint partnership between the Stanford University School of Medicine's Department of Surgery and NASA's Ames Research Center, is the test bed for much of NASA's research in telemedicine, the remote delivery of medical care. In early 2005, researchers at the National Biocomputation Center formed a spinoff company, Intelesense Technologies, to use the telemedicine sensors to provide integrated global monitoring systems. Intelesense uses the systems to better understand how environments and people are linked, monitor and protect natural resources, predict and adapt to environmental changes, provide for sustainable development, reduce the costs and impacts of natural disasters, and provide an effective and intelligent response to such disasters. Current projects range from protecting the environment to tracking emerging infectious diseases like avian influenza (bird flu) and helping people from around the world connect and interact with each other to better understand their environment and themselves.
Atomic oxygen's unique characteristic of oxidizing primarily hydrogen, carbon, and hydrocarbon polymers at surface levels has been applied in the restoration of artwork, detection of document forgeries, and removal of bacterial contaminants from surgical implants. The Electro-Physics Branch at Glenn Research Center built on corrosion studies of long-duration coatings for use in space, and applied atomic oxygen's selectivity to instances where elements need to be removed from a surface. Atomic oxygen is able to remove organic compounds high in carbon (mostly soot) from fire-damaged artworks without causing a shift in the paint color. First successfully tested on oil paintings, the team then applied the restoration technique to acrylics, watercolors, and ink. The successful art restoration process was well-publicized, and soon a multinational, nonprofit professional organization dedicated to the art of forensic analysis of documents had successfully applied this process in the field of forgery detection. The gas has biomedical applications as well-Atomic Oxygen technology can be used to decontaminate orthopedic surgical hip and knee implants prior to surgery, and additional collaborative research between the Cleveland Clinic Foundation and the Glenn team shows that this gas's roughening of surfaces improves cell adhesion, which is important for the development of new drugs.
The challenge of human space exploration places demands on technology that push concepts and development to the leading edge. In biotechnology and biomedical equipment development, NASA science has been the seed for numerous innovations, many of which are in the commercial arena. The biotechnology effort has led to rational drug design, analytical equipment, and cell culture and tissue engineering strategies. Biomedical research and development has resulted in medical devices that enable diagnosis and treatment advances. NASA Biomedical developments are exemplified in the new laser light scattering analysis for cataracts, the axial flow left ventricular-assist device, non contact electrocardiography, and the guidance system for LASIK surgery. Many more developments are in progress. NASA will continue to advance technologies, incorporating new approaches from basic and applied research, nanotechnology, computational modeling, and database analyses.
A method and apparatus for measuring pressure buildup in a body compartment that encases muscular tissue. The method includes assessing the body compartment configuration and identifying the effect of pulsatile components on at least one compartment dimension. This process is used in preventing tissue necrosis, and in decisions of whether to perform surgery on the body compartment for prevention of Compartment Syndrome. An apparatus is used for measuring excess pressure in the body compartment having components for imparting ultrasonic waves such as a transducer, placing the transducer to impart the ultrasonic waves, capturing the reflected imparted ultrasonic waves, and converting them to electrical signals, a pulsed phase-locked loop device for assessing a body compartment configuration and producing an output signal, and means for mathematically manipulating the output signal to thereby categorize pressure build-up in the body compartment from the mathematical manipulations.
Topics covered include: Nanotip Carpets as Antireflection Surfaces; Nano-Engineered Catalysts for Direct Methanol Fuel Cells; Capillography of Mats of Nanofibers; Directed Growth of Carbon Nanotubes Across Gaps; High-Voltage, Asymmetric-Waveform Generator; Magic-T Junction Using Microstrip/Slotline Transitions; On-Wafer Measurement of a Silicon-Based CMOS VCO at 324 GHz; Group-III Nitride Field Emitters; HEMT Amplifiers and Equipment for their On-Wafer Testing; Thermal Spray Formation of Polymer Coatings; Improved Gas Filling and Sealing of an HC-PCF; Making More-Complex Molecules Using Superthermal Atom/Molecule Collisions; Nematic Cells for Digital Light Deflection; Improved Silica Aerogel Composite Materials; Microgravity, Mesh-Crawling Legged Robots; Advanced Active-Magnetic-Bearing Thrust- Measurement System; Thermally Actuated Hydraulic Pumps; A New, Highly Improved Two-Cycle Engine; Flexible Structural-Health-Monitoring Sheets; Alignment Pins for Assembling and Disassembling Structures; Purifying Nucleic Acids from Samples of Extremely Low Biomass; Adjustable-Viewing-Angle Endoscopic Tool for Skull Base and Brain Surgery; UV-Resistant Non-Spore-Forming Bacteria From Spacecraft-Assembly Facilities; Hard-X-Ray/Soft-Gamma-Ray Imaging Sensor Assembly for Astronomy; Simplified Modeling of Oxidation of Hydrocarbons; Near-Field Spectroscopy with Nanoparticles Deposited by AFM; Light Collimator and Monitor for a Spectroradiometer; Hyperspectral Fluorescence and Reflectance Imaging Instrument; Improving the Optical Quality Factor of the WGM Resonator; Ultra-Stable Beacon Source for Laboratory Testing of Optical Tracking; Transmissive Diffractive Optical Element Solar Concentrators; Delaying Trains of Short Light Pulses in WGM Resonators; Toward Better Modeling of Supercritical Turbulent Mixing; JPEG 2000 Encoding with Perceptual Distortion Control; Intelligent Integrated Health Management for a System of Systems; Delay Banking for Managing Air Traffic; and Spline-Based Smoothing of Airfoil Curvatures.
Barrett Technology Inc., of Cambridge, Massachusetts, completed three Phase II Small Business Innovation Research (SBIR) contracts with Johnson Space Center, during which the company developed and commercialized three core technologies: a robotic arm, a hand that functions atop the arm, and a motor driver to operate the robotics. Among many industry uses, recently, an adaptation of the arm has been cleared by the U.S. Food and Drug Administration (FDA) for use in a minimally invasive knee surgery procedure, where its precision control makes it ideal for inserting a very small implant.
In the increasingly sophisticated world of high-definition flat screen monitors and television screens, image clarity and the elimination of distortion are paramount concerns. As the devices that reproduce images become more and more sophisticated, so do the technologies that verify their accuracy. By simulating the manner in which a human eye perceives and interprets a visual stimulus, NASA scientists have found ways to automatically and accurately test new monitors and displays. The Spatial Standard Observer (SSO) software metric, developed by Dr. Andrew B. Watson at Ames Research Center, measures visibility and defects in screens, displays, and interfaces. In the design of such a software tool, a central challenge is determining which aspects of visual function to include while accuracy and generality are important, relative simplicity of the software module is also a key virtue. Based on data collected in ModelFest, a large cooperative multi-lab project hosted by the Optical Society of America, the SSO simulates a simplified model of human spatial vision, operating on a pair of images that are viewed at a specific viewing distance with pixels having a known relation to luminance. The SSO measures the visibility of foveal spatial patterns, or the discriminability of two patterns, by incorporating only a few essential components of vision. These components include local contrast transformation, a contrast sensitivity function, local masking, and local pooling. By this construction, the SSO provides output in units of "just noticeable differences" (JND) a unit of measure based on the assumed smallest difference of sensory input detectable by a human being. Herein is the truly amazing ability of the SSO, while conventional methods can manipulate images, the SSO models human perception. This set of equations actually defines a mathematical way of working with an image that accurately reflects the way in which the human eye and mind behold a stimulus. The SSO is intended for a wide variety of applications, such as evaluating vision from unmanned aerial vehicles, measuring visibility of damage to aircraft and to the space shuttles, predicting outcomes of corrective laser eye surgery, inspecting displays during the manufacturing process, estimating the quality of compressed digital video, evaluating legibility of text, and predicting discriminability of icons or symbols in a graphical user interface.
Patent foramen ovale was detected in 37 patients (32%). Mean age was similar in those with (60 years) and those without (64 years) PFO. Patent foramen ovale was more frequent among men (39%) than women (20%, P=.03). Patients with PFO had a lower frequency of atrial fibrillation, diabetes me!litus, hypertension, and peripheral vascular disease compared with those without PFO. There was no difference in frequency of the following characteristics in patients with PFO compared with those without PFO: pulmonary embolus, chronic obstructive pulmonary disease, pulmonary hypertension, peripheral embolism, prior cerebral infarction, nosocomial cerebral infarction, Valsalva maneuver at the time of cerebral infarction, recent surgery, or hemorrhagic transformation of cerebral infarction. Patent foramen ovale was found in 22 (40%) of 55 patients with infarcts of uncertain cause and in 15 (25%) of 61 with infarcts of known cause (cardioembolic, 21%; large vessel atherostenosis, 25%; lacune, 40%) (P=.08). When the analysis was restricted to patients who underwent Valsalva maneuver, PFO with right to left or bidirectional shunt was found in 19 (50%) of 38 patients with infarcts of uncertain cause and in 6 (20%) of 30 with infarcts of known cause (P=.Ol). Conclusion: Although PFO was over-represented in patients with infarcts of uncertain cause in our and other studies, it has a high frequency among patients with cerebral infarction of all types. The relation between PFO and stroke requires further study.
The Rock Baller is a sample acquisition tool that improves sample retention. The basic elements of the Rock Baller are the tool rotation axis, the hub, the two jaws, and the cutting blades, which are located on each of the jaws. The entire device rotates about the tool rotation axis, which is aligned parallel to the nominal normal direction of the parent rock surface. Both jaws also rotate about the jaw axis, which is perpendicular to the tool rotation axis, at a rate much slower than the rotation about the tool rotation axis. This movement gradually closes the jaws into a nearly continuous hemispherical shell that encloses the sample as it is cut from the parent rock. When required the jaws are opened to release the sample. The hemispherical cutting method eliminates the sample retention problems associated with existing sample acquisition methods that employ conventional cylindrical cutting. The resulting samples are hemispherical, or nearly hemispherical, and as a result the aspect ratio (sample depth relative to sample radius) is essentially fixed. This fixed sample aspect ratio may be considered a drawback of the Rock Baller method, as samples with a higher aspect ratio (more depth, less width) may be considered more scientifically valuable because such samples would allow for a broader inspection of the geological record. This aspect ratio issue can be ameliorated if the Rock Baller is paired with a device similar to the Rock Abrasion Tool (RAT) used on the Mars Exploration Rovers. The RAT could be used to first grind into the surface of the parent rock, after which the Rock Baller would extract a sample from a depth inside the rock that would not have been possible without first using the RAT. Other potential applications for this technology include medical applications such as the removal of tissue samples or tumors from the body, particularly during endoscopic, laparoscopic, or thoracoscopic surgeries.
A process and apparatus for measuring pressure buildup in a body compartment that encases muscular tissue. The method includes assessing the body compartment configuration and identifying the effect of pulsatible components on compartment dimensions and muscle tissue characteristics. This process is used in preventing tissue necrosis, and in decisions of whether to perform surgery on the body compartment for prevention of Compartment Syndrome. An apparatus is used for measuring pressure build-up in the body compartment having components for imparting ultrasonic waves such as a transducer, placing the transducer to impart the ultrasonic waves, capturing the imparted ultrasonic waves, mathematically manipulating the captured ultrasonic waves and categorizing pressure build-up in the body compartment from the mathematical manipulations.
Automated User's Training Operations Facility Utilization Request (AutoFUR) is prototype software that administers a Web-based system for requesting and allocating facilities and equipment for astronaut-training classes in conjunction with scheduling the classes. AutoFUR also has potential for similar use in such applications as scheduling flight-simulation equipment and instructors in commercial airplane-pilot training, managing preventive- maintenance facilities, and scheduling operating rooms, doctors, nurses, and medical equipment for surgery. Whereas requesting and allocation of facilities was previously a manual process that entailed examination of documents (including paper drawings) from different sources, AutoFUR partly automates the process and makes all of the relevant information available via the requester s computer. By use of AutoFUR, an instructor can fill out a facility-utilization request (FUR) form on line, consult the applicable flight manifest(s) to determine what equipment is needed and where it should be placed in the training facility, reserve the corresponding hardware listed in a training-hardware inventory database, search for alternative hardware if necessary, submit the FUR for processing, and cause paper forms to be printed. Auto-FUR also maintains a searchable archive of prior FURs.
Hurricane Katrina was responsible for trapping 25,000 people in the New Orleans Superdome and isolating many others throughout Louisiana and Mississippi. The transport of these evacuees to the Reliant Park (Houston, Texas) used 500 buses each containing about 55 people. Processing the arriving evacuees included addressing their health status and medical needs as follows: an initial triage at disembarkation, a secondary triage in the Reliant Astrodome and Center, and definitive clinical care in the Reliant Arena "Katrina" Clinic. Baylor College of Medicine (BCM) physicians boarded buses and identified the sickest for emergency transport to Harris County Hospital District (HCHD) hospitals. BCM departments represented included pediatrics, family and community medicine, internal medicine, radiology, obstetrics and gynecology, orthopedics, surgery, and psychiatry. Astrodome and Center triage was managed by BCM physicians and staffed by HCHD Nurses and volunteers from Texas and beyond. The Reliant Astrodome, Center and Arena reached peak headcounts of 15,000,4500, and 2500, respectively Most evacuees visiting the triage sites in the Astrodome and Center were treated using "over-the-counter" medications with the remaining being transported to the "Katrina" clinic. The clinic was equipped with a lab, pharmacy, digital X-ray, and ultrasound machines in addition to electronic patient records created using 80 computer terminals. The Katrina clinic saw more than 15,000 patients during 15 days of operations (2,000 on the first full day), administered 10,000 tetanus shots, and filled thousands of prescriptions. At the peak of operations, the clinic saw 150 patients/hour with 25 physicians scheduled for each 12-hour shift. Approximately 900 people were transported to hospital emergency rooms. Within 3 weeks of arriving at the Reliant Park facilities, more than 90% of the families found permanent housing, enrolled children in schools, and found work. Using data obtained from manual and electronic medical records, this presentation will document the major milestones and lessons learned from this extraordinary project to help the Katrina evacuees.
Stereo imaging requires two different perspectives of the same object and, traditionally, a pair of side-by-side cameras would be used but are not feasible for something as tiny as a less than 4-mm-diameter endoscope that could be used for minimally invasive surgeries or geoexploration through tiny fissures or bores. The proposed solution here is to employ a single lens, and a pair of conjugated, multiple-bandpass filters (CMBFs) to separate stereo images. When a CMBF is placed in front of each of the stereo channels, only one wavelength of the visible spectrum that falls within the passbands of the CMBF is transmitted through at a time when illuminated. Because the passbands are conjugated, only one of the two channels will see a particular wavelength. These time-multiplexed images are then mixed and reconstructed to display as stereo images. The basic principle of stereo imaging involves an object that is illuminated at specific wavelengths, and a range of illumination wavelengths is time multiplexed. The light reflected from the object selectively passes through one of the two CMBFs integrated with two pupils separated by a baseline distance, and is focused onto the imaging plane through an objective lens. The passband range of CMBFs and the illumination wavelengths are synchronized such that each of the CMBFs allows transmission of only the alternate illumination wavelength bands. And the transmission bandwidths of CMBFs are complementary to each other, so that when one transmits, the other one blocks. This can be clearly understood if the wavelength bands are divided broadly into red, green, and blue, then the illumination wavelengths contain two bands in red (R1, R2), two bands in green (G1, G2), and two bands in blue (B1, B2). Therefore, when the objective is illuminated by R1, the reflected light enters through only the left-CMBF as the R1 band corresponds to the transmission window of the left CMBF at the left pupil. This is blocked by the right CMBF. The transmitted band is focused on the focal plane array (FPA).