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Development of device for holding anatomical tissues during operations is discussed. Device consists of plastic dish with hemispherical recess in center to hold excised eyes. Low vacuum applied to underside of recess insures holding of part.
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The need to develop a systems approach to the management of trauma and other major clinical medical events in space along with appropriate development and evaluation of surgical techniques and required hardware was investigated. A prototype zero gravity surgical module was constructed and tested aboard a KC-135 aircraft during parabolic arc zero G flight. To insure parity of quality care to that available on Earth, it was recommended that a clinical medical and bioengineering advisory committee define and help develop the necessary components of the clinical medical care system for the space station and lunar base. Key components of the system are aerospace surgical training, medical equipment development, including support hardware and software, rapid access to a network of specialty expertise, and continued research and development.
A method for tracking an object in a sequence of images is described. Such sequence of images may, for example, be a sequence of television frames. The object in the current frame is correlated with the object in the previous frame to obtain the relative location of the object in the two frames. An optical joint transform correlator apparatus is provided to carry out the process. Such joint transform correlator apparatus forms the basis for laser eye surgical apparatus where an image of the fundus of an eyeball is stabilized and forms the basis for the correlator apparatus to track the position of the eyeball caused by involuntary movement. With knowledge of the eyeball position, a surgical laser can be precisely pointed toward a position on the retina.
Prototype hardware and procedures which could be applied to a surgical support system on SSF are realistically evaluated in microgravity using an animal model. Particular attention is given to the behavior of bleeding in a surgical scenario and techniques for hemostasis and fluid management.
With a concentration on Fourier optics pattern recognition, we have developed several methods of tracking objects in dynamic imagery to automate certain space applications such as orbital rendezvous and spacecraft capture, or planetary landing. We are developing two of these techniques for Earth applications in real-time medical image processing. The first is warping of a video image, developed to evoke shift invariance to scale and rotation in correlation pattern recognition. The technology is being applied to compensation for certain field defects in low vision humans. The second is using the optical joint Fourier transform to track the translation of unmodeled scenes. Developed as an image fixation tool to assist in calculating shape from motion, it is being applied to tracking motions of the eyeball quickly enough to keep a laser photocoagulation spot fixed on the retina, thus avoiding collateral damage.
With a concentration on Fourier optics pattern recognition, we have developed several methods of tracking objects in dynamic imagery to automate certain space applications such as orbital rendezvous and spacecraft capture, or planetary landing. We are developing two of these techniques for Earth applications in real-time medical image processing. The first is warping of a video image, developed to evoke shift invariance to scale and rotation in correlation pattern recognition. The technology is being applied to compensation for certain field defects in low vision humans. The second is using the optical joint Fourier transform to track the translation of unmodeled scenes. Developed as an image fixation tool to assist in calculating shape from motion, it is being applied to tracking motions of the eyeball quickly enough to keep a laser photocoagulation spot fixed on the retina, thus avoiding collateral damage.
The objectives of this ground based research is to measure the liquid/vapor interfacial surface energies of succinonitrile (SCN) and alloys of succinonitrile and acetone using Surface Light Scattering Spectrometer. Liquid/vapor interfacial energy measurements will be made near and above the melting point and are the primary goal of this proposal. A measurement of viscosity also results from the Surface Light Scattering technique employed. Interfacial free energies between the phases enters into many analysis of phase transformation and flow, including nucleation, dendritic growth, interface stability, Ostwald ripening, and Marangoni flow. Succirionitrile (SCN) is useful as a model for the study of metal solidification, although it is an organic material, it has a BCC crystal structure and solidifies dendriticly like a metal. It is also transparent and has a low melting point (58.08 C). Succinonitrile has been and is being used extensively in NASAs Microgravity Materials Science and Fluid Physics programs and as well as in several ground-based and microgravity studies including the Isothermal Dendritic Growth Experiment (IDGE) due to Glicksman and coworkers and subsequently in several theoretical and numerical studies of dendritic growth. Previous measurements of succinonitrile (SCN) and alloys of succinonitrile and acetone surface tensions are extremely limited. We believe the data sought through this proposal have significant basic physical property data value and thus the work proposed will provide needed data in support of NASAs Microgravity program research.
OBJECTIVES: This study was conducted to evaluate follow-up results in patients with hypertrophic obstructive cardiomyopathy (HOCM) who underwent either percutaneous transluminal septal myocardial ablation (PTSMA) or septal myectomy. BACKGROUND: Controversy exists with regard to these two forms of treatment for patients with HOCM. METHODS: Of 51 patients with HOCM treated, 25 were treated by PTSMA and 26 patients via myectomy. Two-dimensional echocardiograms were performed before both procedures, immediately afterwards and at a three-month follow-up. The New York Heart Association (NYHA) functional class was obtained before the procedures and at follow-up. RESULTS: Interventricular septal thickness was significantly reduced at follow-up in both groups (2.3 +/- 0.4 cm vs. 1.9 +/- 0.4 cm for septal ablation and 2.4 +/- 0.6 cm vs. 1.7 +/- 0.2 cm for myectomy, both p < 0.001). Estimated by continuous-wave Doppler, the resting pressure gradient (PG) across the left ventricular outflow tract (LVOT) significantly decreased immediately after the procedures in both groups (64 +/- 39 mm Hg vs. 28 +/- 29 mm Hg for PTSMA, 62 +/- 43 mm Hg vs. 7 +/- 7 mm Hg for myectomy, both p < 0.0001). At three-month follow-up, the resting PG remained lower in the PTSMA and myectomy groups (24 +/- 19 mm Hg and 11 +/- 6 mm Hg, respectively, vs. those before procedures, both p < 0.0001). The NYHA functional class was also significantly improved in both groups (3.5 +/- 0.5 vs. 1.9 +/- 0.7 for PTSMA, 3.3 +/- 0.5 vs. 1.5 +/- 0.7 for myectomy, both p < 0.0001). CONCLUSIONS: Both myectomy and PTSMA reduce LVOT obstruction and significantly improve NYHA functional class in patients with HOCM. However, there are benefits and drawbacks for each therapeutic method that must be counterbalanced when deciding on treatment for LVOT obstruction.
Vestibular function in cochlear implant candidates varies from normal to total absence of function. In patients with intact vestibular function preoperatively, invasion of the otic capsule places residual vestibular function at risk. Speech-processing strategies that result in large amplitude electrical transients or strategies that employ high amplitude broad frequency carrier signals have the potential for disrupting vestibular function. Five patients were tested with and without electrical stimulation via cochlear electrodes. Two patients experienced subjective vestibular effects that were quickly resolved. No long-term vestibular effects were noted for the two types of second generation cochlear implants evaluated. Histopathological findings from another patient, who had electrically generated vestibular reflex responses to intramodiolar electrodes, indicated that responses elicited were a function of several variables including electrode location, stimulus intensity, stimulus amplitude, and stimulus frequency. Differential auditory, vestibulocolic, and vestibulospinal reflexes were demonstrated from the same electrode as a function of stimulus amplitude, frequency, and duration.
OBJECTIVES: The risk of a urinary calculus during an extended duration mission into the reduced gravity environment of space is significant. For medical operations to develop a comprehensive strategy for the spaceflight stone risk, both preventive countermeasures and contingency management (CM) plans must be included. METHODS: A feasibility study was conducted to demonstrate the potential CM technique of endoscopic ureteral stenting with ultrasound guidance for the possible in-flight urinary calculus contingency. The procedure employed the International Space Station/Human Research Facility ultrasound unit for guide wire and stent localization, a flexible cystoscope for visual guidance, and banded, biocompatible soft ureteral stents to successfully stent porcine ureters bilaterally in zero gravity (0g). RESULTS: The study demonstrated that downlinked endoscopic surgical and ultrasound images obtained in 0g are comparable in quality to 1g images, and therefore are useful for diagnostic clinical utility via telemedicine transmission. CONCLUSIONS: In order to be successful, surgical procedures in 0g require excellent positional stability of the operating surgeon, assistant, and patient, relative to one another. The technological development of medical procedures for long-duration spaceflight contingencies may lead to improved terrestrial patient care methodology and subsequently reduced morbidity.
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One of the main components of NASA's vision for the future of space exploration will actually have a keen eye for the past. The James Webb Space Telescope (JWST), scheduled to launch in 2018, will have spectacular sight, after it reaches orbit, one of its main goals is to observe the first galaxies that formed in the early universe. "JWST offers new capabilities in the infrared well beyond what we can see from current telescopes, either on the ground or in space. It will let us explore the early universe, extrasolar planets, and really, all branches of astrophysics," says Lee Feinberg, optical telescope element manager for the JWST at Goddard Space Flight Center. Building such a keen space telescope is an astronomic task. Because JWST will gaze over such incredible distances, it requires very large mirrors. In fact, the primary mirror will be more than two stories in diameter and consists of 18 separate segments. Each segment must be perfectly smooth, flat, and scratch-free in order to deliver a view 13 billion light years away. Construction of the 18 mirror segments involved measuring, grinding, polishing, and testing - and more measuring, grinding, polishing, and testing - and more measuring, grinding, polishing, and testing (you get the idea). One of the most time consuming steps of the mirror development process, the grinding phase, can take years.
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BACKGROUND: Left ventricular (LV) reconstruction surgery leads to early improvement in LV function in ischemic cardiomyopathy (ICM) patients. This study was designed to evaluate the impact of mitral valve (MV) repair associated with LV reconstruction on LV function 1-year after surgery in ICM patients assessed by real-time 3-dimensional echocardiography (3DE). METHODS AND RESULTS: Sixty ICM patients who underwent the combination surgery (LV reconstruction in 60, MV repair in 30, and revascularization in 52 patients) were studied. Real-time 3DE was performed and LV volumes were obtained at baseline, discharge, 6-month and >or=12-month follow-up. Reduction in end-diastolic volumes (EDV) by 29% and in end-systolic volumes by 38% were demonstrated immediately after surgery and remained at subsequent follow-up (P<0.0001). The LV ejection fraction significantly increased by about 10% at discharge and was maintained >or=12-month (P<0.0001). Although the LV volumes were significantly larger in patients with MV repair before surgery (EDV, 235+/-87 mL versus 193+/-67 mL, P<0.05), they were similar to LV volumes of the patients without MV repair at subsequent follow-ups. However, the EDV increased from 139+/-24 mL to 227+/-79 mL (P<0.01) in 7 patients with recurrent mitral regurgitation (MR). Improvement in New York Heart Association functional class occurred in 81% patients during late follow-up. CONCLUSIONS: Real-time 3DE demonstrates that LV reconstruction provides significant reduction in LV volumes and improvement in LV function which is sustained throughout the 1-year follow-up with 84% cardiac event free survival. If successful, MV repair may prevent LV redilation, while recurrent MR is associated with increased LV volumes.
There are many advantages to minimally invasive surgery (MIS). An endoscope is the optical system of choice by the surgeon for MIS. The smaller the incision or opening made to perform the surgery, the smaller the optical system needed. For minimally invasive neurological and skull base surgeries the openings are typically 10-mm in diameter (dime sized) or less. The largest outside diameter (OD) endoscope used is 4mm. A significant drawback to endoscopic MIS is that it only provides a monocular view of the surgical site thereby lacking depth information for the surgeon. A stereo view would provide the surgeon instantaneous depth information of the surroundings within the field of view, a significant advantage especially during brain surgery. Providing 3D imaging in an endoscopic objective lens system presents significant challenges because of the tight packaging constraints. This paper presents a promising new technique for endoscopic 3D imaging that uses a single lens system with complementary multi-bandpass filters (CMBFs), and describes the proof-of-concept demonstrations performed to date validating the technique. These demonstrations of the technique have utilized many commercial off-the-shelf (COTS) components including the ones used in the endoscope objective.
Sensors 2000! is developing pill-shaped biotelemeters for measuring physiological parameters during space flight life sciences experiments using rodents aboard the ISS Gravitational Biology Facility, with the additional capability for monitoring the health of astronauts in the Human Research Facility. The first "pill transmitter" is capable of measuring pressure and temperature for up to 10 months. The NASA objective is to utilize these devices. The pill-transmitters can also be used by non-NASA users for medical applications. One application is fetal surgery. The 44pill" is small enough to be endoscopically placed into the womb through a tube used during surgeries to correct fetal defects before birth. After surgery, the pill-transmitter will continue to monitor body temperature, pressure and other vital signs in the womb, radioing results to physicians. It will help them to detect preterm-labor, a serious problem after fetal surgery. The pill is about one-third-of-an-inch across and one-and-one-third-inches long. Future pill-versions will include pH, heartrate, and ECG. A pH-pill prototype is currently being tested. Sensors 2000! has also designed and built a 2-channel biotelemetry receiver and has developed data acquisition software to display and record the measured physiological parameters. A DSP-base hand-held receiver (trisponder) is currently under development.
The detection of tissue interface (e.g., normal tissue, cancer, tumor) has been limited clinically to tactile feedback, temperature monitoring, and the use of a miniature ultrasound probe for tissue differentiation during surgical operations. In neurosurgery, the needle used in the standard stereotactic CT (Computational Tomography) or MRI (Magnetic Resonance Imaging) guided brain biopsy provides no information about the tissue being sampled. The tissue sampled depends entirely upon the accuracy with which the localization provided by the preoperative CT or MRI scan is translated to the intracranial biopsy site. In addition, no information about the tissue being traversed by the needle (e.g., a blood vessel) is provided. Hemorrhage due to the biopsy needle tearing a blood vessel within the brain is the most devastating complication of stereotactic CT/MRI guided brain biopsy. A robotic neurosurgery testbed has been developed at NASA Ames Research Center as a spin-off of technologies from space, aeronautics and medical programs. The invention entitled 'Robotic Neurosurgery Leading to Multimodality Devices for Tissue Identification' is nearing a state ready for commercialization. The devices will: 1) improve diagnostic accuracy and precision of general surgery, with near term emphasis on stereotactic brain biopsy, 2) automate tissue identification, with near term emphasis on stereotactic brain biopsy, to permit remote control of the procedure, and 3) reduce morbidity for stereotactic brain biopsy. The commercial impact from this work is the potential development of a whole new generation of smart surgical tools to increase the safety, accuracy and efficiency of surgical procedures. Other potential markets include smart surgical tools for tumor ablation in neurosurgery, general exploratory surgery, prostate cancer surgery, and breast cancer surgery.