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Developments in NASA technology of possible interest to outside users are reported. Complied are descriptions of a number of instruments that have proven useful in monitoring and treating patients. Described are several diagnostic, prosthetic, and therapeutic devices as well as patent information on new innovations in aerospace medicine technology.
Two types of videoscintiscopes for performing radioisotopic angiocardiography with a scintillation camera are described, and use of these instruments in performing clinical studies is illustrated. Radionuclide angiocardiography is a simple, quick and accurate procedure recommended as a screening test for patients with a variety of congenital and acquired cardiovascular lesions. When performed in conjunction with coronary arterial catheterization, dynamic radionuclide angiography may provide useful information about regional myocardial perfusion. Quantitative capabilities greatly enhance the potential of this diagnostic tool.
The main objective of the survey reported was a quantitative comparison of different visual functions at identical retinal points of individual patients. The possibility to develop objective forms of visual-field testing was also explored, taking into account reports by Frydrychowicz and Harms (1940) and Harms (1951). These investigators had insisted that pupillary responses to light are depressed in areas of homonymous scotomata. The shapes of homonymous visual field defects are discussed together with questions regarding the association and dissociation of symptoms.
Device exercises hands of persons whose fingers are generally straight and need to be flexed inward toward palms of hands. Device is extremely simple in design, which reduces costs, and fits all hand sizes. Patient can instantly free hand from device by pulling flap free from wrist of straps.
Once reference apparatus has been located properly, and its position on chest of patient has been recorded on skin by means of indelible fiducial marks, it is simple matter at later time to reposition probe on chest over heart. In this way, signals from exact same area of heart can be re-examined.
The therapeutic effect of a constant and varying magnetic field on epicondylitis of the humerus is studied on ninety patients. Good results are obtained from the treatment (recovery of 80%, considerable improvement in 14.5%). The method is recommended for clinical application.
A system designed to collect electroencephalographic, electro-oculographic, electromyographic, and head motion data is described. The portable instrumentation provides a rapid and simple means by which neurophysiological data can be obtained by the patient in his home and the taped data returned to the laboratory for analysis. The system was designed primarily for the study of sleep.
Minimal television system requirements for medical telediagnosis were studied. The experiment was conducted with the aid of a simulated telemedicine system. The first step involved making high quality videotape recordings of actual medical examinations conducted by a skilled nurse under the direction of a physician watching on closed circuit television. These recordings formed the baseline for the study. Next, these videotape recordings were electronically degraded to simulate television systems of less than broadcast quality. Finally, the baseline and degraded video recordings were shown (via a statistically randomized procedure) to a large number of physicians who attempted to reach a correct medical diagnosis and to visually recognize key physical signs for each patient. By careful scoring and analysis of the results of these viewings, the pictorial and diagnostic limitations as a function of technical video characteristics were to be defined.
Improvements in medical care during the last two decades have resulted in the survival of an ever-increasing group of patients with severe neuro-muscular disabilities who otherwise would have succumbed to their diseases or injuries. This has created a sizeable population of severely paralyzed persons totally dependent upon society for care. It has been estimated that this population may grow beyond 5,000,000 persons by 1980. A rather fortunate confluence of complementing technologies and surgical techniques offer promise of solving this growing socially significant problem.
Five patients were studied with left ventriculography during different phases of the Valsalva manoeuvre. Small doses of contrast medium allowed adequate repetitive visualization of the left ventricle for volume calculation. During strain phase, the volume of the left ventricle decreased by nearly 50 per cent in each case, and stroke volume and cardiac output also dropped strikingly. Release of straining was attended by a sharp rebound of left ventricular volume to control levels, with a transient surge of increased cardiac output 42 per cent above that of the resting state.
A fluoroscopic tomography system capable of synthesizing body sections at a number of levels within the body has been developed. The synthesized body sections may lie either in a range of planes parallel to, tilted with respect to, skewed with respect to, or both tilted and skewed with respect to the plane of motion of the X-ray tube target. In addition, body sections can be presented which are contoured to the patient's anatomy. That is to say, they may even encompass such complex surfaces as a quadratic hyperplane. In addition, tomograms of organs in motion can be imaged.
Float valve maintains constant level of solution, providing constant drop rate as long as solution can flow into patient's vein. Second float valve allows solution to enter vein, but prevents entry of air.
A technique to quantitate total body calcium in humans is developed. Total body neutron irradiation is utilized to produce argon 37. The radio argon, which diffuses into the blood stream and is excreted through the lungs, is recovered from the exhaled breath and counted inside a proportional detector. Emphasis is placed on: (1) measurement of the rate of excretion of radio argon following total body neutron irradiation; (2) the development of the radio argon collection, purification, and counting systems; and (3) development of a patient irradiation facility using a 14 MeV neutron generator. Results and applications are discussed in detail.
The total body calcium in humans was determined by measuring expired Ar-37 after neutron irradiation. The excretion of Ar-37 from humans was found to be much slower than the excretion from rats and dogs, and to be related to the age of a person. A study of the uniformity of the Ar-37 production throughout the thickness of the body was studied using phantoms. The results indicate that it should be possible to obtain a uniformity within plus or minus 3% for the production of Ar-37 per unit of calcium by using a bilateral irradiation. New low background, large volume proportional counters were developed and constructed, for more sensitive measurement of Ar-37 in the expired air from patients. A new irradiation enclosure was developed for measuring total body calcium in rats by the Ar-37 method. With this enclosure the Ar-37 production per gram of calcium is constant with a standard deviation of plus or minus 2.8% for any size rat between 100 and 500 grams. The use of Na-22 as measure of bone replacement in the fractured femur of a dog was not successful.
The multidisciplinary care of neuromuscular disabled patients is reviewed. Described are the activities of occupational and vocational therapists, social workers, clinical psychologists and speech pathologists that are directed toward the major effects of spinal cord injuries, amputations, stroke, cerebral palsy, and rheumatoid arthritis.
Mechanical and electrical engineering devices for paralytic patient care are discussed as they are applied to medical problems. These include means of preventing bedsores, mobility aids, upper extremity orthoses, and electrical stimulation.
Possible applications are considered of a master-sleeve teleoperator arm system, developed in exoskeletal space suit technology, as therapeutic aid, orthotic device, or for therapy on patients with neurological disorders.
Control theory, including manual control theory, and a review of some previous physiological and neurological applications of control theory and associated engineering concepts are reported. The discussion includes a specially tailored battery of critical control tasks that are being developed to monitor astronaut performance in long term orbital flight. The application of these concepts and tasks to patients with various neurological disorders is considered.