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At least 37 records · Page 2
All sourcesNASA NTRSDOE OSTI
NASA NTRS1980

Blood filling and flow in lungs during change in body position in space

In the horizontal position (supine and lateral), in the upright position (head up and head down) and during change of the cat body position in space, quantitative responses of regional blood volume and blood flow in the lungs (ml/100 cu cm) revealed presence of the gradient in the gravitation direction. Blood volume and blood flow of different lung portions changed qualitatively and quantitatively in different ways. These changes occurred only in the direction producing the equality of regional hydrostatical and hemodynamic loads in the lungs at either horizontal level.

Pogodin, A. S.↗
NASA NTRS2003

Microgravity alters respiratory sinus arrhythmia and short-term heart rate variability in humans

We studied heart rate (HR), heart rate variability (HRV), and respiratory sinus arrhythmia (RSA) in four male subjects before, during, and after 16 days of spaceflight. The electrocardiogram and respiration were recorded during two periods of 4 min controlled breathing at 7.5 and 15 breaths/min in standing and supine postures on the ground and in microgravity. Low (LF)- and high (HF)-frequency components of the short-term HRV (< or =3 min) were computed through Fourier spectral analysis of the R-R intervals. Early in microgravity, HR was decreased compared with both standing and supine positions and had returned to the supine value by the end of the flight. In microgravity, overall variability, the LF-to-HF ratio, and RSA amplitude and phase were similar to preflight supine values. Immediately postflight, HR increased by approximately 15% and remained elevated 15 days after landing. LF/HF was increased, suggesting an increased sympathetic control of HR standing. The overall variability and RSA amplitude in supine decreased postflight, suggesting that vagal tone decreased, which coupled with the decrease in RSA phase shift suggests that this was the result of an adaptation of autonomic control of HR to microgravity. In addition, these alterations persisted for at least 15 days after return to normal gravity (1G).

Clinical Trial↗
NASA NTRS1996

Cardiovascular effects of a fractional -Gz force during a relatively prolonged exposure

Artificial hypogravity was created by having subjects remain in a supine position while undergoing rotation in an artificial gravity simulator. Various cardiovascular variables, such as heart rate, cardiac output, thoracic electric impedance, and blood pressure were measured. Results indicated that the hypogravity force produced a headward fluid shift, as seen by a decrease in thoracic impedance, which triggers regulatory neuroendocrine mechanisms. These findings are presented and discussed.

Non-NASA Center↗
NASA NTRS1994

Cardiopulmonary adaptation to weightlessness

The lung is profoundly affected by gravity. The absence of gravity (microgravity) removes the mechanical stresses acting on the lung paranchyma itself, resulting in a reduction in the deformation of the lung due to its own weight, and consequently altering the distribution of fresh gas ventilation within the lung. There are also changes in the mechanical forces acting on the rib cage and abdomen, which alters the manner in which the lung expands. The other way in which microgravity affects the lung is through the removal of the gravitationally induced hydrostatic gradients in vascular pressures, both within the lung itself, and within the entire body. The abolition of a pressure gradient within the pulmonary circulation would be expected to result in a greater degree of uniformity of blood flow within the lung, while the removal of the hydrostatic gradient within the body should result in an increase in venous return and intra-thoracic blood volume, with attendant changes in cardiac output, stroke volume, and pulmonary diffusing capacity. During the 9 day flight of Spacelab Life Sciences-1 (SLS-1) we collected pulmonary function test data on the crew of the mission. We compared the results obtained in microgravity with those obtained on the ground in both the standing and supine positions, preflight and in the week immediately following the mission. A number of the tests in the package were aimed at studying the anticipated changes in cardiopulmonary function, and we report those in this communication.

short duration↗
NASA NTRS2003

Sympathetic responses to Valsalva's manoeuvre following bed rest

The purpose of this study was to examine whether 14 days of head-down tilt bed rest (HDBR) alters autonomic regulation during Valsalva's manoeuvre (VM) and if this would predict blood pressure control during a 60 degrees head-up tilt (HUT) test. To examine autonomic control of blood pressure, we measured the changes in systolic (delta SBP) and diastolic (delta DBP) blood pressure between baseline and the early straining (Phase IIE) period of VM (20 sec straining to 40 mmHg; N = 7) in conjunction with changes in muscle sympathetic nerve activity (MSNA; microneurography) burst frequency (B/min) and total activity (% delta) from baseline over the 20-sec straining period. MSNA data were successfully recorded from 6 of the 7 individuals. The averaged responses from three repeated VMs performed in the supine position were compared between the pre- and post-HDBR tests. Compared with the pre-HDBR test, a greater reduction in SBP, DBP, and MAP was observed during Phase IIE following HDBR, p < 0.05. The increase in MSNA burst frequency during straining was augmented in the post- compared with the pre-HDBR test, p < 0.0001, as was the Phase IV blood pressure overshoot, p < 0.05. Although all subjects completed the 20-min pre-HDBR tilt test without evidence of hypotension or orthostatic intolerance, the post-HDBR test was stopped early in 5 of the 7 subjects due to systolic hypotension. The responses during the VM suggest that acute autonomic adjustments to rapid blood pressure changes are preserved after bed rest. Furthermore, MSNA and blood pressure responses during VM did not predict blood pressure control during orthostasis following HDBR.

NASA Discipline Musculoskeletal↗
NASA NTRS2003

Lumbar spine disc heights and curvature: upright posture vs. supine compression harness

INTRODUCTION: Spinal lengthening in microgravity is thought to cause back pain in astronauts. A spinal compression harness can compress the spine to eliminate lengthening but the loading condition with harness is different than physiologic conditions. Our purpose was to compare the effect of spine compression with a harness in supine position on disk height and spinal curvature in the lumbar spine to that of upright position as measured using a vertically open magnetic resonance imaging system. METHODS: Fifteen healthy subjects volunteered. On day 1, each subject lay supine for an hour and a baseline scan of the lumbar spine was performed. After applying a load of fifty percent of body weight with the harness for thirty minutes, the lumbar spine was scanned again. On day 2, after a baseline scan, a follow up scan was performed after kneeling for thirty minutes within the gap between two vertically oriented magnetic coils. Anterior and posterior disk heights, posterior disk bulging, and spinal curvature were measured from the baseline and follow up scans. RESULTS: Anterior disk heights increased and posterior disk heights decreased compared with baseline scans both after spinal compression with harness and upright posture. The spinal curvature increased by both loading conditions of the spine. DISCUSSION: The spinal compression with specially designed harness has the same effect as the physiologic loading of the spine in the kneeling upright position. The harness shows some promise as a tool to increase the diagnostic capabilities of a conventional MR system.

Non-NASA Center↗
DOE OSTI2016

SU-F-T-536: Contra-Lateral Breast Study for Prone Versus Supine Patients

Purpose: There are several advantages to utilizing the prone technique for intact breast cancer patients. However, as the topography changes, accompanied by the influence of a supporting breast board and patient treatment couch, the question that arises is to whether there is a concern for contralateral breast dose for intact breast cancer patients being treated with this technique. Methods: An anthropomorphic phantom with breast mounds to duplicate intact breast cancer treatment was planned in prone and supine position. Two tangential beams were executed in the similar manner for as the radiotherapy planning system. For the prone setup, a breast dense foam board was used to support the phantom. A grid of 24 OSL nanodots was placed at 6cm, 4cm, and 2cm apart from the medial border for both prone and supine setups. The phantom was set up using megavoltage imaging and treated as per plan. Additional, a similar study was performed on a patient treated in prone position. Results: Overall, the contralateral breast dose was generally higher for prone setups at all locations especially when close to the medial border. The average mean dose was found to be 1.8%, 2.5% of the prescribed dose for supine respectively prone position. The average of the standard deviation is 1.04%, 1.38% for supine respectively prone position. As for patient treated in prone position average mean dose was found to be 1.165% of the prescribed dose and average of the standard deviation is 9.456%. Conclusion: There is minimal influence of scatter from the breast board. It appears that the volatility of the setup could lead to higher doses than expected from the planning system to the contralateral breast when the patient is in the prone position.

60 APPLIED LIFE SCIENCES↗
NASA NTRS1984

Pulmonary artery location during microgravity activity: Potential impact for chest-mounted Doppler during space travel

Doppler, or ultrasonic, monitoring for pain manifestations of decompression sickness (the bends) is accomplished by placing a sensor on the chest over the pulmonary artery and listening for bubbles. Difficulties have arisen because the technician notes that the pulmonary artery seems to move with subject movement in a one-g field and because the sensor output is influenced by only slight degrees of sensor movement. This study used two subjects and mapped the position of the pulmonary artery in one-g, microgravity, and two-g environments using ultrasound. The results showed that the pulmonary artery is fixed in location in microgravity and not affected by subject position change. The optimal position corresponded to where the Doppler signal is best heard with the subject in a supine position in a one-g environment. The impact of this result is that a proposed multiple sensor array on the chest proposed for microgravity use may not be necessary to monitor an astronaut during extravehicular activities. Instead, a single sensor of approximately 1 inch diameter and mounted in the position described above may suffice.

Hadley, A. T., III↗
NASA NTRS1991

Pulmonary function in microgravity: KC-135 experience

We have commenced a KC-135 program that parallels and proceeds our Spacelab (SLS-1) pulmonary function experiment. Our first task was to elucidate the affect of normal gravitation on the shape of the maximum expiratory flow volume (MEFV) curve. Nine normal subjects performed multiple MEFV maneuvers at 0-G, 1-G, and approximately 1.7-G. The MEFV curves for each subject were filtered, aligned at RV, and ensemble-averaged to produce an average MEFV curve for each state, allowing differences to be studied. Most subjects showed a decrease in the FVC at 0-G, which we attribute to an increased intrathoracic blood volume. In most of these subjects, the mean lung volume associated with a given flow was lower at 0-G, over about the upper half of the vital capacity. This is similar to the change previously reported during heat out immersion and is consistent with the known affect of engorgement of the lung with blood, on elastic recoil. There were also consistent but highly individual changes in the position and magnitude of detailed features of the curve, the individual patterns being similar to those previously reported on transition from the erect to the supine position. This supports the idea that the location and motion of choke points which determine the detailed individual configuration of MEFV curves, can be significantly influenced by gravitational forces, presumably via the effects of change in longitudinal tension on local airway pressure-diameter behavior and wave speed. We have developed a flight mass spectrometer and have commenced a study of single breath gradients in gas exchange, inert gas washouts, and rebreathing cardiac outputs and lung volumes at 0-G, 1-G, and 1.7-G. Comparison of our results with those from SLS-1 should identify the opportunities and limitations of the KC-135 as an accessible microgravity resource.

Guy, Harold J.↗
NASA NTRS1992

NASA's extended duration orbiter medical program

The physiological issues involved in safely extending Shuttle flights from 10 to 16 days have been viewed by some as academic. After all, they reasoned, humans already have lived and worked in space for periods exceeding even 28 days in the United States Skylab Program and onboard the Russian space stations. The difference in the Shuttle program is in the physical position of the astronauts as they reenter the Earth's atmosphere. Crewmembers in the earlier Apollo, Skylab, and Russian programs were returned to Earth in the supine position. Space Shuttle crewmembers, in contrast, are seated upright during reentry and landing; reexperiencing the Earth's g forces in this position has far more pronounced effects on the crewmember's physiological functions. The goal of the Extended Duration Orbiter (EDO) Medical Project (EDOMP) has been to ensure that crewmembers maintain physiological reserves sufficient to perform entry, landing, and egress safely. Early in the Shuttle Program, it became clear that physiological deconditioning during space flight could produce significant symptoms upon return to Earth. The signs and symptoms observed during the entry, landing, and egress after Shuttle missions have included very high heart rates and low blood pressures upon standing. Dizziness, 'graying out,' and fainting have occurred on ambulation or shortly thereafter. Other symptoms at landing have included headache, light-headedness, nausea and vomitting, leg cramping, inability to stand for several minutes after wheel-stop, and unsteadiness of gait.

Pool, Sam Lee↗
NASA NTRS1981

Effects of antiorthostatic bedrest on the cardiorespiratory responses to exercise

The cardiorespiratory changes in exercise performance induced by horizontal and antiorthostatic bed rest are compared in order to determine the physiological changes occurring in the antiorthostatic position and their degree of similarity to those observed in weightlessness. Systolic and diastolic pressures, heart rates, maximum oxygen uptake, ventilation volume during and following 5 min of submaximal exercise in the supine position and body weight and composition were determined in subjects before and following 7 days of bed rest in the horizontal or 6-deg head-down positions. Bed rest is found to result in a general decrease in exercise tolerance as indicated by cardiorespiratory parameters in both groups, with the 6-deg head-down treatment causing greater cardiovascular deconditioning. When compared with space flight data, the antiorthostatic position is shown to simulate the effects of weightlessness more effectively than horizontal bed rest

Convertino, V. A.↗
DOE OSTI2016

TU-H-CAMPUS-TeP1-02: Seated Treatment: Setup Uncertainty Comparable to Supine

Purpose: For some head and neck patients, positioning in the supine position is not well tolerated. For these patients, treatment in a seated position would be preferred. We have evaluated inter- and intra- fraction uncertainty of patient set-up in a novel treatment chair which is compatible with modern linac designs. Methods: Five head-and-neck cancer patients were positioned in the chair, fitted with immobilization devices, and imaged with orthogonal X-rays. The couch (with chair attached) was rotated to simulate delivery (without actual treatment), another set of images were acquired, providing a measure of intra-fraction displacement. The patient then got off of and back onto the chair and the process was repeated, thus providing a measure of inter-fraction set-up uncertainty. Six sub-regions in the head-and-neck were rigidly registered to evaluate local intra- and interfraction displacement. Image guidance was simulated by first registering one sub-region; the residual displacement of other sub-regions was then measured. Additionally, a patient questionnaire was administered to evaluate tolerance of the seated position. Results: The chair design is such that all advantages of couch motions may be utilized. Average inter- and intrafraction displacements of all sub-regions in the seated position were less than 2 and 3 mm, respectively. When image guidance was simulated, interfraction displacements were reduced by an average of 4 mm, providing comparable setup to the supine position. The enrolled patients, who had no indication for a seated treatment position, reported no preference for the seated or the supine position. Conclusion: The novel chair design provides acceptable inter- and intra-fraction displacement, with reproducibility similar to that observed for patients in the supine position. Such a chair will be utilized for patients who cannot tolerate the supine position and use with CBCT images for planning, in a fixed-beam linac system, and for other treatment sites is under investigation. Funding: Varian Medical Systems.

60 APPLIED LIFE SCIENCES↗
NASA NTRS1994

Exercise with prebreathe appears to increase protection from decompression sickness: Preliminary findings

Extravehicular activity (EVA) from the Space Shuttle involves one hour of prebreath with 100% oxygen, decompression of the entire Shuttle to 10.2 psia for at least 12 hours, and another prebreath for 40 minutes before decompression to the 4.3 psia suit pressure. We are investigating the use of a one-hour prebreathe with 100% oxygen beginning with a ten-minute strenuous exercise period as an alternative for the staged decompression schedule described above. The 10-minute exercise consists of dual-cycle ergometry performed at 75% of the subject's peak oxygen uptake to increase denitrogenation efficiency by increasing ventilation and perfusion. The control exposures were preceded by a one-hour prebreathe with 100% oxygen while resting in a supine position. The twenty-two male subjects were exposed to 4.3 psia for 4 hours while performing light to moderate exercise. Preliminary results from 22 of the planned 26 subjects indicate 76% DCS following supine, resting prebreathe and 38% following prebreathe with exercise. The staged decompression schedule has been shown to result in 23% DCS which is not significantly different from the exercise-enhanced prebreathe results. Prebreathe including exercise appears to be comparable to the protection afforded by the more lengthy staged decompression schedule. Completion of the study later this year will enable planned statistical analysis of the results.

Webb, James T.↗
DOE OSTI2016

SU-G-JeP3-02: Comparison of Magnitude and Frequency of Patient Positioning Errors in Breast Irradiation Using AlignRT 3D Optical Surface Imaging and Skin Mark Techniques

Purpose: To evaluate clinical usefulness of AlignRT (Vision RT Ltd., London, UK) in reducing patient positioning errors in breast irradiation. Methods: 60 patients undergoing whole breast irradiation were selected for this study. Patients were treated to the left or right breast lying on Qfix Access breast board (Qfix, Avondale, PA) in supine position for 28 fractions using tangential fields. 30 patients were aligned using AlignRT by aligning a breast surface region of interest (ROI) to the same area from a reference surface image extracted from planning CT. When the patient’s surface image deviated from the reference by more than 3mm on one or more translational and rotational directions, a new reference was acquired using AlignRT in-room cameras. The other 30 patients were aligned to the skin marks with room lasers. On-Board MV portal images of medial field were taken daily and matched to the DRRs. The magnitude and frequency of positioning errors were determined from measured translational shifts. Kolmogorov-Smirnov test was used to evaluate statistical differences of positional accuracy and precision between AlignRT and non-AlignRT patients. Results: The percentage of port images with no shift required was 46.5% and 27.0% in vertical, 49.8% and 25.8% in longitudinal, 47.6% and 28.5% in lateral for AlignRT and non-AlignRT patients, respectively. The percentage of port images requiring more than 3mm shifts was 18.1% and 35.1% in vertical, 28.6% and 50.8% in longitudinal, 11.3% and 24.2% in lateral for AlignRT and non-AlignRT patients, respectively. Kolmogorov-Smirnov test showed that there were significant differences between the frequency distributions of AlignRT and non-AlignRT in vertical, longitudinal, and lateral shifts. Conclusion: As confirmed by port images, AlignRT-assisted patient positioning can significantly reduce the frequency and magnitude of patient setup errors in breast irradiation compared to the use of lasers and skin marks.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2016

SU-F-J-131: Reproducibility of Positioning Error Due to Temporarily Indwelled Urethral Catheter for Urethra-Sparing Prostate IMRT

Purpose: The purpose of this study was to prospectively assess the reproducibility of positioning errors due to temporarily indwelled catheter in urethra-sparing image-guided (IG) IMRT. Methods: Ten patients received urethra-sparing prostate IG-IMRT with implanted fiducials. After the first CT scan was performed in supine position, 6-Fr catheter was indwelled into urethra, and the second CT images were taken for planning. While the PTV received 80 Gy, 5% dose reduction was applied for the urethral PRV along the catheter. Additional CT scans were also performed at 5th and 30th fraction. Positions of interests (POIs) were set on posterior edge of prostate at beam isocenter level (POI1) and cranial and caudal edge of prostatic urethra on the post-indwelled CT images. POIs were copied into the pre-indwelled, 5th and 30th fraction’s CT images after fiducial matching on these CT images. The deviation of each POI between pre- and post-indwelled CT and the reproducibility of prostate displacement due to catheter were evaluated. Results: The deviation of POI1 caused by the indwelled catheter to the directions of RL/AP/SI (mm) was 0.20±0.27/−0.64±2.43/1.02±2.31, respectively, and the absolute distances (mm) were 3.15±1.41. The deviation tends to be larger if closer to the caudal edge of prostate. Compared with the pre-indwelled CT scan, a median displacement of all POIs (mm) were 0.3±0.2/2.2±1.1/2.0±2.6 in the post-indwelled, 0.4±0.4/3.4±2.1/2.3±2.6 in 5th, and 0.5±0.5/1.7±2.2/1.9±3.1 in 30th fraction’s CT scan with a similar data distribution. There were 6 patients with 5-mm-over displacement in AP and/or CC directions. Conclusion: Reproducibility of positioning errors due to temporarily indwelling catheter was observed. Especially in case of patients with unusually large shifts by indwelling catheter at the planning process, treatment planning should be performed by using the pre-indwelled CT images with transferred contour of the urethra identified by post-indwelled CT images.

60 APPLIED LIFE SCIENCES↗
NASA NTRS2000

Oscillatory patterns in sympathetic neural discharge and cardiovascular variables during orthostatic stimulus

BACKGROUND: We tested the hypothesis that a common oscillatory pattern might characterize the rhythmic discharge of muscle sympathetic nerve activity (MSNA) and the spontaneous variability of heart rate and systolic arterial pressure (SAP) during a physiological increase of sympathetic activity induced by the head-up tilt maneuver. METHODS AND RESULTS: Ten healthy subjects underwent continuous recordings of ECG, intra-arterial pressure, respiratory activity, central venous pressure, and MSNA, both in the recumbent position and during 75 degrees head-up tilt. Venous samplings for catecholamine assessment were obtained at rest and during the fifth minute of tilt. Spectrum and cross-spectrum analyses of R-R interval, SAP, and MSNA variabilities and of respiratory activity provided the low (LF, 0.1 Hz) and high frequency (HF, 0.27 Hz) rhythmic components of each signal and assessed their linear relationships. Compared with the recumbent position, tilt reduced central venous pressure, but blood pressure was unchanged. Heart rate, MSNA, and plasma epinephrine and norepinephrine levels increased, suggesting a marked enhancement of overall sympathetic activity. During tilt, LF(MSNA) increased compared with the level in the supine position; this mirrored similar changes observed in the LF components of R-R interval and SAP variabilities. The increase of LF(MSNA) was proportional to the amount of the sympathetic discharge. The coupling between LF components of MSNA and R-R interval and SAP variabilities was enhanced during tilt compared with rest. CONCLUSIONS: During the sympathetic activation induced by tilt, a similar oscillatory pattern based on an increased LF rhythmicity characterized the spontaneous variability of neural sympathetic discharge, R-R interval, and arterial pressure.

NASA Program Biomedical Research and Countermeasur↗
DOE OSTI2016

Poster - 46: Intra-fraction tumor position assessment for lung SBRT in patients treated without customized immobilization devices

Purpose: To assess intra-fraction positional stability of lung cancer tumours in patients treated by kilo-voltage cone-beam computed tomography (CBCT)-guided stereotactic body radiotherapy (SBRT) without the use of customized immobilization devices. Material and Methods: Twenty-two patients underwent 4D-CT in the supine position with the arms in a wing board but without customized immobilization. The PTV was the internal target volume based on maximum intensity projections and a 5mm symmetric setup margin. Treatments were planned using 7–9 static fields or two volumetric modulated arcs. At treatment, the patient position was adjusted using pre-treatment CBCT. A post-treatment CBCT was taken immediately after the treatment ended. The 41 CBCT pairs were automatically matched and the transitional shifts between the two CBCTs recorded. The mean values and standard deviations were calculated for these displacements. Results and conclusions: The mean time between CBCTs (treatment time) was 16.5 ± 6 minutes (range: 10 to 34 minutes). In all cases the tumour remained inside the PTV in the post-treatment CBCT. The mean shifts between pre and post-treatment CBCTs were −0.7 ± 1.6 mm (range −5.0 to 3.0 mm) vertically, −0.3 ± 1.7 mm (range −4.8 to 3.0 mm) longitudinally, and −0.4 ± 1.5 mm (range −4.0 to 2.0 mm) laterally. Our results suggest little systematic shifting during treatment, and standard deviations that are consistent with another published report for treatments where customized immobilization was used. This result is encouraging for SBRT programs in clinics with limited resources.

60 APPLIED LIFE SCIENCES↗