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At least 73 records · Page 4

Blood Volume: Importance and Adaptations to Exercise Training, Environmental Stresses and Trauma/Sickness

This paper reviews the influence of several perturbations (physical exercise, heat stress, terrestrial altitude, microgravity, and trauma/sickness) on adaptations of blood volume (BV), erythrocyte volume (EV), and plasma volume (PV). Exercise training can induced BV expansion; PV expansion usually occurs immediately, but EV expansion takes weeks. EV and PV expansion contribute to aerobic power improvements associated with exercise training. Repeated heat exposure induces PV expansion but does not alter EV. PV expansion does not improve thermoregulation, but EV expansion improves thermoregulation during exercise in the heat. Dehydration decreases PV (and increases plasma tonicity) which elevates heat strain and reduces exercise performance. High altitude exposure causes rapid (hours) plasma loss. During initial weeks at altitude, EV is unaffected, but a gradual expansion occurs with extended acclimatization. BV adjustments contribute, but are not key, to altitude acclimatization. Microgravity decreases PV and EV which contribute to orthostatic intolerance and decreased exercise capacity in astronauts. PV decreases may result from lower set points for total body water and central venous pressure, which EV decrease bay result form increased erythrocyte destruction. Trauma, renal disease, and chronic diseases cause anemia from hemorrhage and immune activation, which suppressions erythropoiesis. The re-establishment of EV is associated with healing, improved life quality, and exercise capabilities for these injured/sick persons.

Sawka, Michael N.↗

Noninvasive Intracranial Volume and Pressure Measurements Using Ultrasound (Head and Spinal)

Prevention of secondary brain injuries following head trauma can be accomplished most easily when intracranial pressure (ICP) is monitored. However, current measurement techniques are invasive and thus not practical in the combat environment. The Pulsed Phase Lock Loop device, which was developed and patented by consultants Drs. Yost and Cantrell, uses a unique, noninvasive ultrasonic phase comparison method to measure slight changes in cranial volume which occur with changes in ICP. Year two studies included whole body head-up and head-down tilting effects on intracranial compliance and pressure in six healthy volunteers.

Hargens, Alan R.↗

Considerations for Medical Transport from the Space Station via an Assured Crew Return Vehicle (ACRV)

In developing a permanently crewed space station, the importance of medical care has been continually reaffirmed; and the health maintenance facility (HMF) is an integral component. It has diagnostic, therapeutic, monitoring, and information management capability. It is designed to allow supportive care for: (1) non-life-threatening illnesses; e.g., headache, lacerations; (2) moderate to severe, possibly life-threatening illnesses; e.g., appendicitis, kidney stones; and (3) severe, incapacitating, life-threatening illnesses; e.g., major trauma, toxic exposure. Since the HMF will not have a general surgical capability, the need for emergency escape and recovery methods has been studied. Medical risk assessments have determined that it is impossible to accurately predict the incidence of crewmember illness/injury. A best estimate is 1:3 per work-year, with 1% of these needing an ACRV. For an eight-person crew, this means that one assured crew return vehicle (ACRV) will be used every 4 to 12 years. The ACRV would serve at least three basic objectives as: (1) a crew return if the space shuttle is unavailable; (2) an escape vehicle from a major time-critical space station emergency; and (3) a full or partial crew return vehicle for a medical emergency. The focus of this paper is the third objective for the ACRV.

Stepaniak, Philip↗

Ultrasound as a Noninvasive Method to Assess Changes of Intracranial Volume and Pressure During Simulated Microgravity

Headaches are commonly experienced by astronauts in microgravity and by subjects undergoing head-down tilt (simulated microgravity on Earth). Exposure to microgravity probably elevates blood pressure and flow in the head which may increase intracranial volume (ICV) and pressure (ICP) and in turn cause headache. Due to the slightly compliant nature of the cranial vault and the encasement of brain and its vasculature within this vault, any increase of ICV will increase ICP and slightly distend the cranium. Previous studies document perivascular edema and increased ICP in rhesus monkeys during head-down tilt. Elevated ICP has also been reported in humans during head-down tilt. ICP measurements in healthy humans are rare because of the invasiveness of currently-available measurement techniques. Therefore, we proposed a noninvasive ultrasound technique to assess changes of ICV and JCP. The ultrasound principle is based on compliance of the cranial vault. A 450 kHz ultrasound stimulus is transmitted through the cranium by a transducer every 7.5-10 msec. The ultrasound wave enters the brain tissue, reflects off the opposite side of the cranium and is received by the same transducer. The detected wave is compared for phase quadrature (90 deg.to transmitted wave). Because the electronic circuitry of the device maintains a 90 deg. phase (phi), any alterations in the detected wave caused by an increase of ICV and ICP will be reflected as a change in the wave frequency. Phase shift is directly proportional to path length of the wave, DELTA x, which is expressed as DELTA x = phi lambda/2 pi where lambda is wavelength. Elevated ICV and ICP expand the cranial vault and increase path length of the wave (a measure of intracranial distance). Increased path length equals reduced frequency of the detected wave. Reduced frequency is then related to elevated ICP. This technique has potential uses for ICP studies of astronauts in space and head trauma patients on Earth.

Murthy, G.↗

High Altitude Measurements of Radiance at High Spectral and Spatial Resolution for SIMBIOS Sensor Calibration, Validation, and Intercomparisons

The successful combination of data from different ocean color sensors depends on the correct interpretation of signal from each of these sensors. Ideally, the sensor measured signals are calibrated to geophysical units of spectral radiance, and sensor artifacts are removed and corrected. The calibration process resamples the signal into a common radiometric data space so that subsequent ocean color algorithms that are applied to the data are based on physical processes and are inherently sensor independent. The objective of this project is to calibrate and validate the on-orbit radiometric characteristics of Sea-Viewing Wide Field-of-view Sensor (SeaWiFS) with underflights of NASA's calibrated Airborne Visible/Infrared Imaging Spectrometer (AVIRIS). This objective is feasible because AVIRIS measures the same spectral range as SeaWIFS at higher spectral resolution. In addition to satellite sensor underflights, the AVIRIS project has supported comparison and analysis of the radiometric calibration standards used for AVIRIS and SeaWIFS. To date, both the OCTS and SeaWIFS satellite sensors have been underflown by AVIRIS with matching spectral, spatial, geometric, radiometric, and temporal domains. The calibration and validation objective of this project is pursued for the following reasons: (1) Calibration is essential for the quantitative use of SeaWIFS and other SIMBIOS (Sensor Intercomparison and Merger for Biological and Interdisciplinary Oceanic Studies) sensor data; (2) Calibration in the laboratory of spaceborne sensors is challenging; (3) Satellite sensors are subjected aging on the ground and to trauma during launch; (4) The Earth orbit environment is significantly different than the laboratory calibration environment; (5) Through years of effort AVIRIS has been demonstrated to be well calibrated; and (6) AVIRIS can match the spectral and spatial observation characteristics near the top of the atmosphere at the time of SeaWIFS measurements.

Green, Robert O.↗

Non-Invasive Measurement of Pulsatile Intracranial Pressures Using Ultrasound

Early detection of elevated intracranial pressure (ICP) will aid clinical decision-making for head trauma, brain tumor and other cerebrovascular diseases. Conventional methods, however, require surgical procedures which take time and are accompanied by increased risk of infection. Accordingly we have developed and refined a new ultrasound device to measure skull movements which are known to occur in conjunction with altered ICP. The principle of this device is based upon pulse phase locked loop (PPLL), which enables us to detect changes in distance on the order of microns between an ultrasound transducer on one side of the skull and the opposite inner surface of the cranium. The present study was designed to verify this measurement technique in cadavera. Transcranial distance was increased in steps of 10 mmHg from zero to 50 mmHg by saline infusion into the lateral ventricle of two cadavera. In separate experiments, pulsations of ICP with the amplitudes of zero to 2 mmHg were generated by rhythmic injections of saline using a syringe. When the ICP was stepwise increased from zero to 50 mmHg, transcranial distance increased in proportion with the ICP increase (y=12 x - 76, r=0.938), where y is changes in transcranial distance in microns and x is ICP in mmHg. In the data recorded while ICP pulsations were generated, fast Fourier transform analysis demonstrated that cranial pulsations were clearly associated with ICP pulsations. The results indicate that changes in transcranial distance is linearly correlated with those in ICP, and also that the PPLL device has sufficient sensitivity to detect transcranial pulsations which occur in association with the cardiac cycle. By analyzing the magnitude of cranial pulsations, we may be able to estimate the pressure-volume index in the cranium. As a result, estimates of intracranial compliance may be possible by using the PPLL device. Further studies are necessary in normal subjects and patients.

Ueno, Toshiaki↗

Airline Chair-rest Deconditioning: Induction of Immobilization Thromboemboli?

Air passenger miles will likely double by year 2020. The altered and restrictive environment in an airliner cabin can influence hematological homeostasis in passengers and crew. Flight-related deep various thromboemboli (DVT) have been associated with at least 577 deaths on 42 of 120 airlines from 1977 to 1984 (25 deaths/million departures), whereas many such cases go unreported. However, there are four major factors that could influence formation of possible flight-induced DVT: sleeping accomodations (via sitting immobilization), travelers' medical history (via tissue injury), cabin environmental factors (via lower partial pressure of oxygen and lower relative humidity), and the more encompassing chair-rest deconditioning (C-RD) syndrome. There is ample evidence that recent injury and surgery (especially in deconditioned hospitalized patients) facilitate thrombophlebitis and formation of DVT that may be exacerbated by the immobilization of prolonged air travel. In the healthy flying population immobilization factors associated with prolonged (> 5 hr) C-RID such as total body dehydration, hypovolemia and increased blood viscosity, and reduced various blood flow (pooling) in the legs may facilitate formation of DVT. However, data from at least four case-controlled epidemiological studies did not confirm a direct causative relationship between air travel and DART, but factors such as history of vascular thromboemboli, various insufficiency, chronic heart failure, obesity, immobile standing position, more than 3 pregnancies, infectious disease, long-distance travel, muscular trauma and violent physical effort were significantly more frequent in DVT patients than in controls. Thus, there is no clear, direct evidence yet that prolonged sitting in airliner seats, or prolonged experimental chair-rest- or bed- rest-deconditioning treatments cause deep various thromboemboli in healthy people.

Greenleaf, J. E.↗

Mechanical injury and repair of cells

OBJECTIVE: To concisely review the field of cell plasma membrane disruption (torn cell surface) and repair. MAIN POINTS: Plasma membrane disruption is a common form of cell injury under physiologic conditions, after trauma, in certain muscular dystrophies, and during certain forms of clinical intervention. Rapid repair of a disruption is essential to cell survival and involves a complex and active cell response that includes membrane fusion and cytoskeletal activation. Tissues, such as cardiac and skeletal muscle, adapt to a disruption injury by hypertrophying. Cells adapt by increasing the efficiency of their resealing response. CONCLUSION: Plasma membrane disruption is an important cellular event in both health and disease. The disruption repair mechanism is now well understood at the cellular level, but much remains to be learned at the molecular level. Cell and tissue level adaptational responses to the disruption either prevent its further occurrence or facilitate future repairs. Therapeutically useful drugs might result if, using this accumulating knowledge, chemical agents can be developed that can enhance repair or adaptive responses.

Review, Tutorial↗

The impact of the new biology on radiation risks in space

Radiation is considered to be one of three or four major hazards for personnel in space and has emerged as the most critical issue to be resolved for long-term missions, both orbital and interplanetary. Space habitats are stressful and dangerous environments. Health and medical consequences arising from microgravity, stress, and trauma include weakened immune systems, increased viral activity, and loss of bone mass. The greatest risks from radiation are generally assumed to be cancers and possibly damage to the central nervous system. Synergistic effects arising from the other environmental hazards along with abscopal and exogenic factors are likely. Space programs represent an exceptional opportunity for examining the biological consequences of low-dose exposures of humans to radiation at every level of progression. Although astronauts are a relatively small population, they are healthy, physically active volunteers who undergo extensive testing and medical examinations before, during, and after protracted exposures with periodic follow-up examinations. The radiation environments along with other hazards are likewise monitored and documented. Extensive international research programs are in progress. Seven years ago the U.S. National Aeronautics and Space Administration established the National Space Biomedical Research Institute through a cooperative agreement with a consortium of research and academic institutions in order to address radiation issues through a concerted, programmatic effort. Advanced technologies are rapidly being incorporated into these programs to determine the significance of new biological data and to evaluate the interplay among the different medical hazards. Programmatic in vivo and in vitro studies of the processes leading to carcinogenesis are in progress. Drugs and dietary supplements are being examined at the cellular and in vivo levels to assess their potential as dose-modifying agents. The infrastructure of this new approach, recent results, and research in progress are reviewed and discussed.

NASA Discipline Radiation Health↗

Caspase inhibitors promote vestibular hair cell survival and function after aminoglycoside treatment in vivo

The sensory hair cells of the inner ear undergo apoptosis after acoustic trauma or aminoglycoside antibiotic treatment, causing permanent auditory and vestibular deficits in humans. Previous studies have demonstrated a role for caspase activation in hair cell death and ototoxic injury that can be reduced by concurrent treatment with caspase inhibitors in vitro. In this study, we examined the protective effects of caspase inhibition on hair cell death in vivo after systemic injections of aminoglycosides. In one series of experiments, chickens were implanted with osmotic pumps that administrated the pan-caspase inhibitor z-Val-Ala-Asp(Ome)-fluoromethylketone (zVAD) into inner ear fluids. One day after the surgery, the animals received a 5 d course of treatment with streptomycin, a vestibulotoxic aminoglycoside. Direct infusion of zVAD into the vestibule significantly increased hair cell survival after streptomycin treatment. A second series of experiments determined whether rescued hair cells could function as sensory receptors. Animals treated with streptomycin displayed vestibular system impairment as measured by a greatly reduced vestibulo-ocular response (VOR). In contrast, animals that received concurrent systemic administration of zVAD with streptomycin had both significantly greater hair cell survival and significantly increased VOR responses, as compared with animals treated with streptomycin alone. These findings suggest that inhibiting the activation of caspases promotes the survival of hair cells and protects against vestibular function deficits after aminoglycoside treatment.

NASA Discipline Neuroscience↗

Inhibition of caspases prevents ototoxic and ongoing hair cell death

Sensory hair cells die after acoustic trauma or ototoxic insults, but the signal transduction pathways that mediate hair cell death are not known. Here we identify several important signaling events that regulate the death of vestibular hair cells. Chick utricles were cultured in media supplemented with the ototoxic antibiotic neomycin and selected pharmacological agents that influence signaling molecules in cell death pathways. Hair cells that were treated with neomycin exhibited classically defined apoptotic morphologies such as condensed nuclei and fragmented DNA. Inhibition of protein synthesis (via treatment with cycloheximide) increased hair cell survival after treatment with neomycin, suggesting that hair cell death requires de novo protein synthesis. Finally, the inhibition of caspases promoted hair cell survival after neomycin treatment. Sensory hair cells in avian vestibular organs also undergo continual cell death and replacement throughout mature life. It is unclear whether the loss of hair cells stimulates the proliferation of supporting cells or whether the production of new cells triggers the death of hair cells. We examined the effects of caspase inhibition on spontaneous hair cell death in the chick utricle. Caspase inhibitors reduced the amount of ongoing hair cell death and ongoing supporting cell proliferation in a dose-dependent manner. In isolated sensory epithelia, however, caspase inhibitors did not affect supporting cell proliferation directly. Our data indicate that ongoing hair cell death stimulates supporting cell proliferation in the mature utricle.

Non-NASA Center↗

Do no harm--normal tissue effects

Radiation therapy confers enormous benefits that must be balanced against the possibilities for harm including late toxicity in normal tissues and radiation-induced second malignancies. A small percentage of patients experience severe late complications. The question is, do these late sequelae occur randomly, or are they confined to individuals who are genetically predisposed to radiosensitivity. Experiments with knockout mice and with patients demonstrate that individuals heterozygous for a number of genes appear to be radiosensitive. If radiosensitive patients were identified prospectively by genetic analysis, they could be spared the trauma of late sequelae. Several large studies have shown a statistically significant excess of radiation-induced malignancies in radiotherapy patients. Most second cancers are carcinomas, developing in the lining cells of the body often remote from the treatment site. Radiation-induced sarcomas appear only in the heavily irradiated areas. These are small in number but appear with a very high relative risk.

NASA Discipline Radiation Health↗

Temporary arterial shunts to maintain limb perfusion after arterial injury: an animal study

BACKGROUND: Temporary shunt placement can quickly restore perfusion after extremity arterial injury. This study examined the adequacy of limb blood flow with shunt use, non-heparin-bonded shunt patency over prolonged periods, and the safety of this technique. METHODS: Common iliac arteries were divided and 4.0-mm Silastic Sundt shunts placed in 16 anesthetized pigs. Eight (group I) had shunts placed immediately; eight others (group II) were shunted after an hour of limb ischemia and hemorrhagic shock. Physiologic parameters and femoral artery blood flow in both hindlimbs were continuously monitored. Limb lactic acid generation, oxygen utilization, and hematologic and metabolic effects were serially evaluated for 24 hours. RESULTS: Shunts remained patent in 13 of 16 pigs. Shunts thrombosed in two group I animals because of technical errors, but functioned well after thrombectomy and repositioning. Patency could not be maintained in one animal that died from shock. Flow in group I shunted limbs was 57 (+/-11 SD) % of control. For group II animals in shock, shunted limb flow initially averaged 46 +/- 15% of control, but 4 hours after shunt placement, the mean limb blood flow was the same as in group I. Increased oxygen extraction compensated for the lower flow. Lactic acid production was not increased in comparison to control limbs. CONCLUSION: Shunts provided adequate flow in this model of extremity trauma. Correctly placed shunts stayed patent for 24 hours, without anticoagulation, if shunt placement followed resuscitation.

Hindlimb/blood supply/injuries↗

[Clinical and physiological evaluation of bone changes among astronauts after long-term space flights]

Results of the joint Russian/US studies of the effect of microgravity on bone tissues in 18 cosmonauts on return from 4.5- to 14.5-month long missions are presented. Dual-energy x-ray gamma-absorbtiometry (QDR-1000 W, Hologic, USA) was used to measure bone mineral density (BMD, g/cm2) and mineral content (BMC, g) in the whole body, the scalp including cervical vertebra, arms, ribs, sternal and lumbar regions of the spinal column, pelvis and legs. A clearly defined dependence of topography of changes upon the position of a skeletal segment in the gravity vector was established. The greatest BMD losses have been observed in the skeleton of the lower body, i.e. in pelvic bones (-11.99 +/- 1.22%), lumbar vertebra (-5.63 +/- 0.817%), and in proximal femur, particularly in the femoral neck (-8.17 +/- 1.24%). Bones of the upper skeleton were either unchanged (insignificant) or showed a positive trend. Overall changes in bone mass of the whole skeleton of male cosmonauts during the period of about 6 months on mission made up -1.41 +/- 0.406% and suggest the mean balance of calcium over flight equal to -227 +/- 62.8 mg/day. Reasoning is given to qualify these states of cosmonauts' bone tissues as local osteopenia. On the literature and results of authors' clinical evidence, discussed is availability of the densitometric data for predicting risk of trauma. A biological nature of the changes under observation is hypothesized.

NASA Discipline Musculoskeletal↗

Gearing Up for the Big Game...and More

Bill Elkins, a member of the U.S. Space Foundation's Space Technology Hall of Fame, is using his experience in developing cooling garments for use in sports and medicine. His company, CoolSystems, has developed the Game Ready[TM] Accelerated Recovery System. Game Ready[TM] ergonomic wraps are designed to custom fit the ankle, knee, back, torso, shoulder, elbow, and wrist and provide deep tissue cooling therapy with intermittent compression to reduce pain, swelling, and tissue damage. Recharge[TM] cooling garments have been developed to lower core body temperature in people with heat-sensitive multiple sclerosis, reducing symptoms such as fatigue, decreased balance, impaired vision, and decreased endurance. The company currently is collaborating with Stanford University Medical Center's Stanford Stroke Center to investigate the effectiveness of discrete hypothermia in stroke and head trauma patients.

Source record↗

Airline chair-rest deconditioning: induction of immobilisation thromboemboli?

Air passenger miles will likely double by year 2020. The altered and restrictive environment in an airliner cabin can influence haematological homeostasis in passengers and crew. Flight-related deep venous thromboemboli (DVT) have been associated with at least 577 deaths on 42 of 120 airlines from 1977 to 1984 (25 deaths/million departures), whereas many such cases go unreported. However, there are four major factors that could influence formation of possible flight-induced DVT: sleeping accommodations (via sitting immobilisation); travellers' medical history (via tissue injury); cabin environmental factors (via lower partial pressure of oxygen and lower relative humidity); and the more encompassing chair-rest deconditioning (C-RD) syndrome. There is ample evidence that recent injury and surgery (especially in deconditioned hospitalised patients) facilitate thrombophlebitis and formation of DVT that may be exacerbated by the immobilisation of prolonged air travel.In the healthy flying population, immobilisation factors associated with prolonged (>5 hours) C-RD such as total body dehydration, hypovolaemia and increased blood viscosity, and reduced venous blood flow (pooling) in the legs may facilitate formation of DVT. However, data from at least four case-controlled epidemiological studies did not confirm a direct causative relationship between air travel and DVT, but factors such as a history of vascular thromboemboli, venous insufficiency, chronic heart failure, obesity, immobile standing position, more than three pregnancies, infectious disease, long-distance travel, muscular trauma and violent physical effort were significantly more frequent in DVT patients than in controls. Thus, there is no clear, direct evidence yet that prolonged sitting in airliner seats, or prolonged experimental chair-rest or bed-rest deconditioning treatments cause DVT in healthy people.

Review, Tutorial↗

Goal-directed ultrasound in the detection of long-bone fractures

BACKGROUND: New portable ultrasound (US) systems are capable of detecting fractures in the remote setting. However, the accuracy of ultrasound by physicians with minimal ultrasound training is unknown. METHODS: After one hour of standardized training, physicians with minimal US experience clinically evaluated patients presenting with pain and trauma to the upper arm or leg. The investigators then performed a long-bone US evaluation, recording their impression of fracture presence or absence. Results of the examination were compared with routine plain or computer aided radiography (CT). RESULTS: 58 patients were examined. The sensitivity and specificity of US were 92.9% and 83.3%, and of the physical examination were 78.6% and 90.0%, respectively. US provided improved sensitivity with less specificity compared with physical examination in the detection of fractures in long bones. CONCLUSION: Ultrasound scans by minimally trained clinicians may be used to rule out a long-bone fracture in patients with a medium to low probability of fracture.

Validation Studies↗

RTO Technical Publications: A Quarterly Listing

A quarterly listing of RTO technical publications is presented. The topics include: Handbook on the Analysis of Smaller-Scale Contingency Operations in Long Term Defence Planning; 2) Radar Polarimetry and Interferometry; 3) Combat Casualty Care in Ground-Based Tactical Situations: Trauma Technology and Emergency Medical Procedures; and 4) RTO Technical Publications: A Quarterly Listing

Source record↗