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NASA NTRS1998

Current concepts in the pathophysiology, evaluation, and diagnosis of compartment syndrome

This article reviews present knowledge of the pathophysiology and diagnosis of acute compartment syndromes. Recent results using compression of legs in normal volunteers provide objective data concerning local pressure thresholds for neuromuscular dysfunction in the anterior compartment. Results with this model indicate that a progression of neuromuscular deficits occurs when IMP increases to within 35 to 40 mm Hg of diastolic blood pressure. These findings provide useful information on the diagnosis and compression thresholds for acute compartment syndromes. Time factors are also important, however, and usually are incompletely known in most cases of acute compartment syndrome. Although the slit catheter is a very good technique for monitoring IMP during rest, these catheters and their associated extracorporeal transducer systems are not ideal. Recently developed miniature transducer-tipped catheters and, perhaps, future development of noninvasive techniques may provide accurate recordings of IMP in patients with acute compartment syndromes.

NASA Discipline Cardiopulmonary↗
NASA NTRS1998

Immune responses in space flight

Space flight has been shown to have profound effects on immunological parameters of humans, monkeys and rodents. These studies have been carried out by a number of different laboratories. Among the parameters affected are leukocyte blastogenesis, natural killer cell activity, leukocyte subset distribution, cytokine production - including interferons and interleukins, and macrophage maturation and activity. These changes start to occur only after a few days space flight, and some changes continue throughout long-term space flight. Antibody responses have received only very limited study, and total antibody levels have been shown to be increased after long-term space flight. Several factors could be involved in inducing these changes. These factors could include microgravity, lack of load-bearing, stress, acceleration forces, and radiation. The mechanism(s) for space flight-induced changes in immune responses remain(s) to be established. Certainly, there can be direct effects of microgravity, or other factors, on cells that play a fundamental role in immune responses. However, it is now clear that there are interactions between the immune system and other physiological systems that could play a major role. For example, changes occurring in calcium use in the musculoskeletal system induced by microgravity or lack of use could have great impact on the immune system. Most of the changes in immune responses have been observed using samples taken immediately after return from space flight. However, there have been two recent studies that have used in-flight testing. Delayed-type hypersensitivity responses to common recall antigens of astronauts and cosmonauts have been shown to be decreased when tested during space flights. Additionally, natural killer cell and blastogenic activities are inhibited in samples taken from rats during space flight. Therefore, it is now clear that events occurring during space flight itself can affect immune responses. The biological significance of space flight-induced changes in immune parameters remains to be established; however, as duration of flights increases, the potential for difficulties due to impaired immune responses also increases.

manned↗
NASA NTRS1998

Biotic transitions in global marine diversity

Long-term transitions in the composition of Earth's marine biota during the Phanerozoic have historically been explained in two different ways. One view is that they were mediated through biotic interactions among organisms played out over geologic time. The other is that mass extinctions transcended any such interactions and governed diversity over the long term by resetting the relative diversities of higher taxa. However, a growing body of evidence suggests that macroevolutionary processes effecting biotic transitions during background times were not fundamentally different from those operating during mass extinctions. Physical perturbations at many geographic scales combined to produce the long-term trajectory of Phanerozoic diversity.

Non-NASA Center↗
NASA NTRS1998

Future human bone research in space

Skylab crewmembers demonstrated negative calcium (Ca) balance reaching about -300 mg/day by flight day 84. Limited bone density (BMD) measurements documented that bone was not lost equally from all parts of the skeleton. Subsequent BMD studies during long duration Russian flights documented the regional extent of bone loss. These studies demonstrated mean losses in the spine, femur neck, trochanter, and pelvis of about 1%-1.6% with large differences between individuals as well as between bone sites in a given individual. Limited available data indicate postflight bone recovery occurred in some individuals, but may require several years for complete restoration. Long duration bedrest studies showed a similar pattern of bone loss and calcium balance (-180 mg/day) as spaceflight. During long duration bedrest, resorption markers were elevated, formation markers were unchanged, 1,25 vitamin D (VitD) and calcium absorption were decreased, and serum ionized Ca was increased. Although this information is a good beginning, additional spaceflight research is needed to assess architectural and subregional bone changes, elucidate mechanisms, and develop efficient as well as effective countermeasures. Space research poses a number of unique problems not encountered in ground-based laboratory research. Therefore, researchers contemplating human spaceflight research need to consider a number of unique problems related to spaceflight in their experimental design.

NASA Center JSC↗
NASA NTRS1998

Perspective on the impact of weightlessness on calcium and bone metabolism

As humans venture into space to colonize the moon and travel to distant planets in the 21st century, they will be confronted with a bone disease that could potentially limit their space exploration activities or put them at risk for fracture when they return to earth. It is now recognized that an unloading of the skeleton, either due to strict bed rest or in zero gravity, leads on average to a 1%-2% reduction in bone mineral density at selected skeletal sites each month. The mechanism by which unloading of the skeleton results in rapid mobilization of calcium stores from the skeleton is not fully understood, but it is thought to be related to down regulation in PTH and 1,25-dihydroxyvitamin D3 production. Bone modeling and mineralization in chick embryos is not affected by microgravity, suggesting that bone cells adapt and ultimately become addicted to gravity in order to maintain a structurally sound skeleton. Strategies need to be developed to decrease microgravity-induced bone resorption by either mimicking gravity's effect on bone metabolism, or enhancing physically or pharmacologically bone formation in order to preserve astronauts' bone health.

short duration↗
NASA NTRS1998

Hindlimb unloading of growing rats: a model for predicting skeletal changes during space flight

A model that uses hindlimb unloading of rats was developed to study the consequences of skeletal unloading and reloading as occurs during and following space flight. Studies using the model were initiated two decades ago and further developed at National Aeronautics and Space Administration (NASA)-Ames Research Center. The model mimics some aspects of exposure to microgravity by removing weightbearing loads from the hindquarters and producing a cephalic fluid shift. Unlike space flight, the forelimbs remain loaded in the model, providing a useful internal control to distinguish between the local and systemic effects of hindlimb unloading. Rats that are hindlimb unloaded by tail traction gain weight at the same rate as pairfed controls, and glucocorticoid levels are not different from controls, suggesting that systemic stress is minimal. Unloaded bones display reductions in cancellous osteoblast number, cancellous mineral apposition rate, trabecular bone volume, cortical periosteal mineralization rate, total bone mass, calcium content, and maturation of bone mineral relative to controls. Subsequent studies reveal that these changes also occur in rats exposed to space flight. In hindlimb unloaded rats, bone formation rates and masses of unloaded bones decline relative to controls, while loaded bones do not change despite a transient reduction in serum 1,25-dihydroxyvitamin D (1,25D) concentrations. Studies using the model to evaluate potential countermeasures show that 1,25D, growth hormone, dietary calcium, alendronate, and muscle stimulation modify, but do not completely correct, the suppression of bone growth caused by unloading, whereas continuous infusion of transforming growth factor-beta2 or insulin-like growth factor-1 appears to protect against some of the bone changes caused by unloading. These results emphasize the importance of local as opposed to systemic factors in the skeletal response to unloading, and reveal the pivotal role that osteoblasts play in the response to gravitational loading. The hindlimb unloading model provides a unique opportunity to evaluate in detail the physiological and cellular mechanisms of the skeletal response to weightbearing loads, and has proven to be an effective model for space flight.

Non-NASA Center↗
NASA NTRS1998

Applications of telemedicine in the United States space program

Since the beginning of human space flight, NASA has been placing humans in extreme and remote environments. There are many challenges in maintaining humans in outer space, including the provision of life-support systems, radiation shielding, and countermeasures for minimizing the effect of microgravity. Because astronauts are selected for their health, among other factors, disease and illness are minimized. However, it is still of great importance to have appropriate medical care systems in place to address illness and injury should they occur. With the exception of the Apollo program, exploration of space has been limited to missions that are within several hundred miles of the surface of the Earth. At the drawn of the 21st century and the new millennium, human exploration will be focused on operation of the International Space Station (ISS) and preparation for human missions to Mars. These missions will present inherent risks to human health, and, therefore, appropriate plans must be established to address these challenges and risks. Crews of long-duration missions must become more independent from ground controllers. New systems, protocols, and procedures are currently being perfected. Application of emerging technologies in information systems and telecommunications will be critical to inflight medical care. Application of these technologies through telemedicine will provide crew members access to information, noninvasive procedures for assessing health status, and guidance through the integration of sensors, holography, decision-support systems, and virtual environments. These technologies will also serve as a basis to enhance training and medical education. The design of medical care for space flight should lead to a redesign of the practice of medicine on Earth.

Review, Tutorial↗
NASA NTRS1998

The origin and evolution of oxygenic photosynthesis

The evolutionary developments that led to the ability of photosynthetic organisms to oxidize water to molecular oxygen are discussed. Two major changes from a more primitive non-oxygen-evolving reaction center are required: a charge-accumulating system and a reaction center pigment with a greater oxidizing potential. Intermediate stages are proposed in which hydrogen peroxide was oxidized by the reaction center, and an intermediate pigment, similar to chlorophyll d, was present.

Review, Tutorial↗
NASA NTRS1998

Regulation of skeletal muscle perfusion during exercise

For exercise to be sustained, it is essential that adequate blood flow be provided to skeletal muscle. The local vascular control mechanisms involved in regulating muscle perfusion during exercise include metabolic control, endothelium-mediated control, propagated responses, myogenic control, and the muscle pump. The primary determinant of muscle perfusion during sustained exercise is the metabolic rate of the muscle. Metabolites from contracting muscle diffuse to resistance arterioles and act directly to induce vasodilation, or indirectly to inhibit noradrenaline release from sympathetic nerve endings and oppose alpha-adrenoreceptor-mediated vasoconstriction. The vascular endothelium also releases vasodilator substances (e.g., prostacyclin and nitric oxide) that are prominent in establishing basal vascular tone, but these substances do not appear to contribute to the exercise hyperemia in muscle. Endothelial and smooth muscle cells may also be involved in propagating vasodilator signals along arterioles to parent and daughter vessels. Myogenic autoregulation does not appear to be involved in the exercise hyperemia in muscle, but the rhythmic propulsion of blood from skeletal muscle veins facilitates venous return to the heart and muscle perfusion. It appears that the primary determinants of sustained exercise hyperemia in skeletal muscle are metabolic vasodilation and increased vascular conductance via the muscle pump. Additionally, sympathetic neural control is important in regulating muscle blood flow during exercise.

Non-NASA Center↗
NASA NTRS1998

Cellular control lies in the balance of forces

Mechanical tension generated within the cytoskeleton of living cells is emerging as a critical regulator of biological function in diverse situations ranging from the control of chromosome movement to the morphogenesis of the vertebrate brain. In this article, we review recent advances that have been made in terms of understanding how cells generate, transmit and sense mechanical tension, as well as how they use these forces to control their shape and behavior. An integrated view of cell regulation that incorporates mechanics and structure as well as chemistry is beginning to emerge.

Review, Tutorial↗
NASA NTRS1998

The bearable lightness of being: bones, muscles, and spaceflight

Bones and muscles support and move the body. Tendons link the two tissues and serve as a mechanism for transfer of forces from muscle to bone. These three tissues interact and respond to periods of activity or inactivity with appropriate alterations in structure and strength. There is substantial evidence that an environment devoid of mechanical stress on the skeleton (such as reduced gravitational forces during spaceflight, a "microgravity environment") produces direct effects on bone structure and function. There is little agreement concerning the biologic mechanisms for these atrophic changes. Changes in fluid balance and distribution coincident to spaceflight also affect muscles and bones by an unknown mechanism. Tendon-bone junctions are presumed to be spared from the effects of spaceflight. However, recent evidence from rodents suggests that spaceflight profoundly effects both the skeleton and the tendon-bone junctions. These effects include cortical bone resorption, which undermines the Sharpey's fibers that anchor the tendon to the bone matrix. The challenge to biomedical scientists is to devise methods for protecting spaceflight crews from these atrophic changes; such protection would allow for longer and more extensive spaceflights.

manned↗
NASA NTRS1998

Calcium signals and calcium channels in osteoblastic cells

Calcium (Ca2+) channels are present in non-excitable as well as in excitable cells. In bone cells of the osteoblast lineage, Ca2+ channels play fundamental roles in cellular responses to external stimuli including both mechanical forces and hormonal signals. They are also proposed to modulate paracrine signaling between bone-forming osteoblasts and bone-resorbing osteoclasts at local sites of bone remodeling. Calcium signals are characterized by transient increases in intracellular Ca2+ levels that are associated with activation of intracellular signaling pathways that control cell behavior and phenotype, including patterns of gene expression. Development of Ca2+ signals is a tightly regulated cellular process that involves the concerted actions of plasma membrane and intracellular Ca2+ channels, along with Ca2+ pumps and exchangers. This review summarizes the current state of knowledge concerning the structure, function, and role of Ca2+ channels and Ca2+ signals in bone cells, focusing on the osteoblast.

Non-NASA Center↗
NASA NTRS1998

Vestibulospinal adaptation to microgravity

Human balance control is known to be transiently disrupted after spaceflight; however, the mechanisms responsible for postflight postural ataxia are still under investigation. In this report, we propose a conceptual model of vestibulospinal adaptation based on theoretical adaptive control concepts and supported by the results from a comprehensive study of balance control recovery after spaceflight. The conceptual model predicts that immediately after spaceflight the balance control system of a returning astronaut does not expect to receive gravity-induced afferent inputs and that descending vestibulospinal control of balance is disrupted until the central nervous system is able to cope with the newly available vestibular otolith information. Predictions of the model are tested using data from a study of the neurosensory control of balance in astronauts immediately after landing. In that study, the mechanisms of sensorimotor balance control were assessed under normal, reduced, and/or altered (sway-referenced) visual and somatosensory input conditions. We conclude that the adaptive control model accurately describes the neurobehavioral responses to spaceflight and that similar models of altered sensory, motor, or environmental constraints are needed clinically to predict responses that patients with sensorimotor pathologies may have to various visual-vestibular or changing stimulus environments.

manned↗
NASA NTRS1998

Spaceflight influences on ocular counterrolling and other neurovestibular reactions

Exposure to extended periods of weightlessness in orbital flight has profound effects on the neurovestibular system and influences head and eye movements, postural control, and spatial orientation. The associated space motion sickness is among the earliest of the signs of adaptation to this new environment. This report both reviews the prominent neurovestibular phenomena associated with going into space and returning to earth and relates the issues to vestibular compensation and rehabilitation. New results from the Spacelab SLS-2 mission are included, showing significant reductions in postflight ocular counterrolling and changes in ocular counterrolling left/right asymmetries after 2 weeks in space.

Review↗
NASA NTRS1998

Physiological principles of vestibular function on earth and in space

Physiological mechanisms underlying vestibular function have important implications for our ability to understand, predict, and modify balance processes during and after spaceflight. The microgravity environment of space provides many unique opportunities for studying the effects of changes in gravitoinertial force on structure and function of the vestibular system. Investigations of basic vestibular physiology and of changes in reflexes occurring as a consequence of exposure to microgravity have important implications for diagnosis and treatment of vestibular disorders in human beings. This report reviews physiological principles underlying control of vestibular processes on earth and in space. Information is presented from a functional perspective with emphasis on signals arising from labyrinthine receptors. Changes induced by microgravity in linear acceleration detected by the vestibulo-ocular reflexes. Alterations of the functional requirements for postural control in space are described. Areas of direct correlation between studies of vestibular reflexes in microgravity and vestibular disorders in human beings are discussed.

Non-NASA Center↗
NASA NTRS1998

Functional and structural mapping of human cerebral cortex: solutions are in the surfaces

The human cerebral cortex is notorious for the depth and irregularity of its convolutions and for its variability from one individual to the next. These complexities of cortical geography have been a chronic impediment to studies of functional specialization in the cortex. In this report, we discuss ways to compensate for the convolutions by using a combination of strategies whose common denominator involves explicit reconstructions of the cortical surface. Surface-based visualization involves reconstructing cortical surfaces and displaying them, along with associated experimental data, in various complementary formats (including three-dimensional native configurations, two-dimensional slices, extensively smoothed surfaces, ellipsoidal representations, and cortical flat maps). Generating these representations for the cortex of the Visible Man leads to a surface-based atlas that has important advantages over conventional stereotaxic atlases as a substrate for displaying and analyzing large amounts of experimental data. We illustrate this by showing the relationship between functionally specialized regions and topographically organized areas in human visual cortex. Surface-based warping allows data to be mapped from individual hemispheres to a surface-based atlas while respecting surface topology, improving registration of identifiable landmarks, and minimizing unwanted distortions. Surface-based warping also can aid in comparisons between species, which we illustrate by warping a macaque flat map to match the shape of a human flat map. Collectively, these approaches will allow more refined analyses of commonalities as well as individual differences in the functional organization of primate cerebral cortex.

Review↗