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At least 379 records · Page 21

Tissue Engineering Using Transfected Growth-Factor Genes

A method of growing bioengineered tissues includes, as a major component, the use of mammalian cells that have been transfected with genes for secretion of regulator and growth-factor substances. In a typical application, one either seeds the cells onto an artificial matrix made of a synthetic or natural biocompatible material, or else one cultures the cells until they secrete a desired amount of an extracellular matrix. If such a bioengineered tissue construct is to be used for surgical replacement of injured tissue, then the cells should preferably be the patient s own cells or, if not, at least cells matched to the patient s cells according to a human-leucocyteantigen (HLA) test. The bioengineered tissue construct is typically implanted in the patient's injured natural tissue, wherein the growth-factor genes enhance metabolic functions that promote the in vitro development of functional tissue constructs and their integration with native tissues. If the matrix is biodegradable, then one of the results of metabolism could be absorption of the matrix and replacement of the matrix with tissue formed at least partly by the transfected cells. The method was developed for articular chondrocytes but can (at least in principle) be extended to a variety of cell types and biocompatible matrix materials, including ones that have been exploited in prior tissue-engineering methods. Examples of cell types include chondrocytes, hepatocytes, islet cells, nerve cells, muscle cells, other organ cells, bone- and cartilage-forming cells, epithelial and endothelial cells, connective- tissue stem cells, mesodermal stem cells, and cells of the liver and the pancreas. Cells can be obtained from cell-line cultures, biopsies, and tissue banks. Genes, molecules, or nucleic acids that secrete factors that influence the growth of cells, the production of extracellular matrix material, and other cell functions can be inserted in cells by any of a variety of standard transfection techniques.

Madry, Henning↗

Developing Physiologic Models for Emergency Medical Procedures Under Microgravity

Several technological enhancements have been made to METI's commercial Emergency Care Simulator (ECS) with regard to how microgravity affects human physiology. The ECS uses both a software-only lung simulation, and an integrated mannequin lung that uses a physical lung bag for creating chest excursions, and a digital simulation of lung mechanics and gas exchange. METI's patient simulators incorporate models of human physiology that simulate lung and chest wall mechanics, as well as pulmonary gas exchange. Microgravity affects how O2 and CO2 are exchanged in the lungs. Procedures were also developed to take into affect the Glasgow Coma Scale for determining levels of consciousness by varying the ECS eye-blinking function to partially indicate the level of consciousness of the patient. In addition, the ECS was modified to provide various levels of pulses from weak and thready to hyper-dynamic to assist in assessing patient conditions from the femoral, carotid, brachial, and pedal pulse locations.

Parker, Nigel↗

Developing Physiologic Models for Emergency Medical Procedures Under Microgravity

Several technological enhancements have been made to METI's commercial Emergency Care Simulator (ECS) with regard to how microgravity affects human physiology. The ECS uses both a software-only lung simulation, and an integrated mannequin lung that uses a physical lung bag for creating chest excursions, and a digital simulation of lung mechanics and gas exchange. METI s patient simulators incorporate models of human physiology that simulate lung and chest wall mechanics, as well as pulmonary gas exchange. Microgravity affects how O2 and CO2 are exchanged in the lungs. Procedures were also developed to take into affect the Glasgow Coma Scale for determining levels of consciousness by varying the ECS eye-blinking function to partially indicate the level of consciousness of the patient. In addition, the ECS was modified to provide various levels of pulses from weak and thready to hyper-dynamic to assist in assessing patient conditions from the femoral, carotid, brachial, and pedal pulse locations.

Parker, Nigel↗

Geospatial Modeling of Asthma Population in Relation to Air Pollution

Current observations indicate that asthma is growing every year in the United States, specific reasons for this are not well understood. This study stems from an ongoing research effort to investigate the spatio-temporal behavior of asthma and its relatedness to air pollution. The association between environmental variables such as air quality and asthma related health issues over Mississippi State are investigated using Geographic Information Systems (GIS) tools and applications. Health data concerning asthma obtained from Mississippi State Department of Health (MSDH) for 9-year period of 2003-2011, and data of air pollutant concentrations (PM2.5) collected from USEPA web resources, and are analyzed geospatially to establish the impacts of air quality on human health specifically related to asthma. Disease mapping using geospatial techniques provides valuable insights into the spatial nature, variability, and association of asthma to air pollution. Asthma patient hospitalization data of Mississippi has been analyzed and mapped using quantitative Choropleth techniques in ArcGIS. Patients have been geocoded to their respective zip codes. Potential air pollutant sources of Interstate highways, Industries, and other land use data have been integrated in common geospatial platform to understand their adverse contribution on human health. Existing hospitals and emergency clinics are being injected into analysis to further understand their proximity and easy access to patient locations. At the current level of analysis and understanding, spatial distribution of Asthma is observed in the populations of Zip code regions in gulf coast, along the interstates of south, and in counties of Northeast Mississippi. It is also found that asthma is prevalent in most of the urban population. This GIS based project would be useful to make health risk assessment and provide information support to the administrators and decision makers for establishing satellite clinics in future.

Kethireddy, Swatantra R.↗

Evalution of a DE-Identification Process for Ocular Imaging

Medical privacy of NASA astronauts requires an organized and comprehensive approach when data are being made available outside NASA systems. A combination of factors, including the uniquely small patient population, the extensive medical testing done on these individuals, and the relative cultural popularity of the astronauts puts them at a far greater risk to potential exposure of personal information than the general public. Therefore, care must be taken to ensure that the astronauts' identities are concealed. Magnetic Resonance Imaging (MRI) medical data is a recent source of interest to researchers concerned with the development of Visual Impairment due to Intracranial Pressure (VIIP) in the astronaut population. Each vision MRI scan of an astronaut includes 176 separate sagittal images that are saved as an "image series" for clinical use. In addition to the medical information these image sets provide, they also inherently contain a substantial amount of non-medical personally identifiable information (PII) such as-name, date of birth, and date of exam. We have shown that an image set of this type can be rendered, using free software, to give an accurate representation of the patient's face. This currently restricts NASA from dispensing MRI data to researchers in a deidentified format. Automated software programs, such as the Brain Extraction Tool, are available to researchers who wish to de-identify MRI sagittal brain images by "erasing" identifying characteristics such as the nose and jaw on the image sets. However, this software is not useful to NASA for vision research because it removes the portion of the images around the eye orbits, which is the main area of interest to researchers studying the VIIP syndrome. The Lifetime Surveillance of Astronaut Health program has resolved this issue by developing a protocol to de-identify MRI sagittal brain images using Showcase Premier, a DICOM (Digital Imaging and Communications in Medicine) software package. The software allows manual editing of one image from a patient's image set to be automatically applied to the entire image series. This new approach would allow a new level of access to untapped medical imaging data relating to VIIP that can be utilized by researchers while protecting the privacy of the astronauts. In the next step toward finalizing this technique, NASA clinical radiology consultants will test the images to verify removal of all metadata and PII.

LaPelusa, Michael B.↗

Brain Gene Expression Signatures From Cerebrospinal Fluid Exosome RNA Profiling

While the Visual Impairment and Intracranial Pressure (VIIP) syndrome observations have focused on ocular symptoms, spaceflight has been also associated with a number of other performance and neurologic signs, such as headaches, cognitive changes, vertigo, nausea, sleep/circadian disruption and mood alterations, which, albeit likely multifactorial, can also result from elevation of intracranial pressure (ICP). We therefore hypothesize that these various symptoms are caused by disturbances in the neurophysiology of the brain structures and are correlated with molecular markers in the cerebrospinal fluid (CSF) as indicators of neurophysiological changes. Exosomes are 30-200 nm microvesicles shed into all biofluids, including blood, urine, and CSF, carrying a highly rich source of intact protein and RNA cargo. Exosomes have been identified in human CSF, and their proteome and RNA pool is a potential new reservoir for biomarker discovery in neurological disorders. The purpose of this study is to investigate changes in brain gene expression via exosome analysis in patients suffering from ICP elevation of varied severity (idiopathic intracranial hypertension -IIH), a condition which shares some of the neuroophthalmological features of VIIP, as a first step toward obtaining evidence suggesting that cognitive function and ICP levels can be correlated with biomarkers in the CSF. Our preliminary work, reported last year, validated the exosomal technology applicable to CSF analysis and demonstrated that it was possible to obtain gene expression evidence of inflammation processes in traumatic brain injury patients. We are now recruiting patients with suspected IIH requiring lumbar puncture at Baylor College of Medicine. Both CSF (5 ml) and human plasma (10 ml) are being collected in order to compare the pattern of differentially expressed genes observed in CSF and in blood. Since blood is much more accessible than CSF, we would like to determine whether plasma biomarkers for elevated ICP can be identified. This may eventually lead to a blood test to diagnose intracranial hypertension.

Zanello, S. B.↗

Simulating Medical Officer Occupied Time (MOOT) for Space Medical System Design, a Pilot Project

Providing and receiving medical treatment takes time away from other duties. The time is expected to vary based on the provider’s skill level, duration of the patient’s illness, specific tasks performed, and the condition’s severity. Since crew time is a limited resource, it is important to understand how MOOT will impact mission objectives. Historically, diagnostic/treatment time was estimated only for the patient by subject matter experts using a non-standard approach based on the condition as a whole. The present effort uses a Delphi approach among experts of varied training levels and based on estimates of specific medical tasks in order to more accurately assess downtime for both caregiver and patient with fewer errors.

Preston Fedor↗

Zero-g simulation system for therapeutic application

System aids in therapeutic retraining of damaged muscles or functions as walking support during therapy. Articulated harness assembly contains patient, suspension system supports harness assembly in such a way as to counterbalance exertion of external forces on patient.

Dane, D. H.↗

Design of a specialized computer for on-line monitoring of cardiac stroke volume

The design of a specialized analog computer for on-line determination of cardiac stroke volume by means of a modified version of the pressure pulse contour method is presented. The design consists of an analog circuit for computation and a timing circuit for detecting necessary events on the pressure waveform. Readouts of arterial pressures, systolic duration, heart rate, percent change in stroke volume, and percent change in cardiac output are provided for monitoring cardiac patients. Laboratory results showed that computational accuracy was within 3 percent, while animal experiments verified the operational capability of the computer. Patient safety considerations are also discussed.

Webb, J. A., Jr.↗

The first derivative of the carotid displacement pulse.

The amplitude and time relationships of the carotid derivative in normal individuals and unselected cardiac patients is investigated together with the effects of different contraction strengths in patients with pulsus alternans and subjects challenged with isoproterenol and propranolol. Data regarding the relationship between the preejection period (PEP) and the ratio of peak to total amplitude of the carotid displacement pulse derivative are presented. It is found that cardiac abnormality tends to reduce the rate of rise of the carotid displacement pulse. The results obtained show that the PEP is a somewhat more sensitive index of the changes studied than the carotid displacement derivative.

Khan, A. H.↗

Electroshock protection circuit

Circuit was developed to prevent accidental shock through electrodes used to test subjects as part of Skylab program. This circuit is placed between electrical apparatus and electrode that is attached to patient's body. Thus, patient is effectively protected from dangerous electrical shock that might be caused by failure in electrical apparatus.

Heskett, H.↗

Pseudotachometer for mobile metabolic analyzer

Metabolic analyzer determines a patient's walking or ambulation speed and simultaneously measures his metabolic parameters. Analyzer is designed to move at some preselected human ambulation speed. During test, patient is connected to system and follows analyzer closely while his metabolic data is being monitored.

Currie, J. R.↗

The use of a battery of tracking tests in the quantitative evaluation of neurological function

A tracking test battery has been applied in a drug trail designed to compare the efficacy of L-DOPA and amantadine to that of L-DOPA and placebo in the treatment of 28 patients with Parkinson's disease. The drug trial provided an ideal opportunity for objectively evaluating the usefulness of tracking tests in assessing changes in neurologic function. Evaluating changes in patient performance resulting from disease progression and controlled clinical trials is of great importance in establishing effective treatment programs.

Repa, B. S.↗

Parathyroid Hormone, Calcitonin, and Vitamin D

Analyses of secretion of parathyroid hormone during tests of stimulation and suppression of hormone-secretory activity using infusions of EDTA and calcium, respectively, have established that, in contrast to previous views, secretion of the hormone is not autonomous in many patients that have adenomatous hyperparathyroidism, but is responsive to changes in blood-calcium concentration. These findings have led to a new understanding of the pathophysiology of hormone production in hyperparathy-roidism. A related application of the diagnostic use of the radioimmunoassay is the preoperative localization of parathyroid tumors and the distinction between adenomas and chief-cell hyperplasia. Work involving catheterization and radioimmunoassay of blood samples obtained from the subclavin and innominate veins and the venae cavae, led to localization in a high percentage of patients. However, this procedure has been adopted recently to detect hormone concentration in the small veins directly draining the parathyroid glands.

Potts, J. T.↗

Visual examination apparatus

An automated visual examination apparatus for measuring visual sensitivity and mapping blind spot location is described. The apparatus includes a projection system for displaying to a patient a series of visual stimuli, a response switch enabling him to indicate his reaction to the stimuli, and a recording system responsive to both the visual stimuli per se and the patient's response. The recording system provides a correlated permanent record of both stimuli and response from which a substantive and readily apparent visual evaluation can be made.

Haines, R. F.↗

Systolic and diastolic time intervals in pulsus alternans - Significance of alternating isovolumic relaxation

Systolic and diastolic time intervals in 14 cardiac patients with pulsus alternans revealed significant alternation of preinjection period (PEP), isovolumic contraction time (IVCT), left ventricular ejection time (LVET), ejection time index (ETI), PEP/LVET, and carotid dD/dt with better functional values in the strong beats. Cycle length, duration of electromechanical systole (EMS) and total diastole, i.e., isovolumic relaxation period (IRP) and diastolic filling period (DFP) occurred in 7 out of 8 patients. These diastolic intervals alternated reciprocally such that the IRP of the strong beats encroached upon the DFP of the next (weak) beats.

Spodick, D. H.↗

Clinical applications of angiocardiography

Several tables are presented giving left ventricular (LV) data for normal patients and patients with heart disease of varied etiologies, pointing out the salient features. Graphs showing LV pressure-volume relationships (compliance) are presented and discussed. The method developed by Rackley et al. (1964) for determining left ventricular mass in man is described, and limitations to the method are discussed. Some clinical methods for determining LV oxygen consumption are briefly described, and the relation of various abnormalities of ventricular performance to coronary artery disease and ischemic heart disease is characterized.

Dodge, H. T.↗