A program designed to find second applications for space technology in the medical field is described. Illustrative examples and clinical test results are included for prosthetic urethral devices, ear oximeter for monitoring leukemia patients, devices for measuring low level CO effects on automobile drivers, radiation dosimeter probe for detecting radiation levels in cancerous areas, and electromyographic muscle trainer

Wooten, F. T.

English

A program designed to find ways of transferring space technology to non-space medicine is discussed. The methodology used to attack the problem and several illustrative examples of the results are given

NASA Technical Reports Server

R E S E A R C H T R I A N G L E I N S T I T U T E
ADVANCEMENTS IN MEDICINE FROM AEROSPACE RESEARCH
by
F. Thomas Wooten
c
Presented at the
Conference on
SPACE FOR MANKIND'S BENEFIT
Huntsville, Alabama
November 16-19, 1971
This work supported under Contract //NASW-2273
by the
National Aeronautics and Space Administration
R E S E A R C H T R I A N G L E P A R K , N O R T H C A R O L I N A 2 7 7 0 J
https://ntrs.nasa.gov/search.jsp?R=19720004362 2020-03-23T13:38:23+00:00Z
ADVANCEMENTS IN MEDICINE FROM AEROSPACE RESEARCH
F. Thomas Wooten
Research Triangle Institute
Research Triangle Park, North Carolina
INTRODUCTION
The world has recently viewed the dramatic successes of a space
effort which chose a difficult goal and then carefully developed the
technology necessary to reach that goal. This paper discusses a program
which is designed to find second applications in the field of medicine
for the technology developed to achieve the nation's space goals. The
program is the outgrowth of the congressional charter included in the
Space Act of 1958 which directed NASA to find second applications for
the technology which resulted from NASA's R & D programs.
For several years NASA has sponsored a program which has at its
core multidisciplinary teams of scientists and engineers called Applica-
tion Teams. Such a team is located at each of three not-for-profit
research institutes (Research Triangle Institute of North Carolina,
Southwest Research Institute of Texas, and Midwest Research Institute of
Missouri) and one medical school (Stanford University). The teams seek
to provide an interface between two diverse fields: aerospace and medi-
cine.
The medical profession has awakened in the past decade to the need
for advanced technology in medical research and health care. This
awakening alone is not enough. Some effective avenues for the flow of
information, ideas, and technology between the physical and medical
sciences have been established, but more are needed. This program pro-
vides one such avenue.
METHODOLOGY
Technology utilization is the term applied to the task of finding
second applications for technology. Many of the methods for implement-
ing the concept of technology utilization are largely passive in nature;
passive in this case means the information is provided to those who seek
it and thus, the physician must understand the information system in
order to use it. One of the unique features of the Application Team
program is that the method is active. Active, in this sense, means that
the problems and solutions are actively sought.
This search for problems is carried out by the members of the multi-
disciplinary team. Team members visit major medical centers (the
National Institutes of Health and medical schools) where suitable medi-
cal problems are identified with the aid of a consultant. The consul-
tant, a medical center staff member, helps to insure that the problems
selected meet certain minimum requirements. In general our team accepts
only those problems which (1) have no solutions available on the commer-
cial market, (2) are discrete and can be defined in specific terms,
(3) impede the progress of priority efforts of the physician, and
(4) appear amenable to solution by aerospace related technology. We
impose these requirements because this program is designed for problem
solving, not just information searching.
If a problem meets these requirements, it is defined by the physi-
cian and team member during one or more meetings. Problem definition
can probably best be explained by an example: Arthritis is a crippling
disease which can result in the destruction of the ball and socket joint
of the hip. One method of treating this disease is to replace the human
hip ball and socket joint with an artificial material. An orthopedic
surgeon asked the team to find an improved material. The team quickly
determined that the basic problem was that existing materials have
inadequate friction and wear characteristics. The team looked for im-
proved low friction bearing materials which were biocompatible and not
just for prosthetic hip joint materials. Thus, the search could be
broadened to areas unrelated to medicine.
After a problem is defined, a solution is sought using several
approaches. First, a computer search of the NASA document bank is per-
formed which covers approximately 700,000 documents. The bibliography
and related documents are analyzed by the physician and the team member
to determine whether an adequate solution is available.
A second approach used in finding solutions is to request sugges-
tions from NASA personnel by circulating concise written problem state-
ments to the NASA field centers. These documents are circulated by the
Technology Utilization Officers (TUO) who are located at each center and
who have a detailed knowledge of the research activities at their
centers. The TUO provides a vital link between the teams and key NASA
personnel.
A third approach is to contact field center personnel or NASA
contractor personnel directly when the teams are aware that these per-
sonnel have knowledge about particular problems. These contacts, co-
ordinated with each TUO, allow the teams to rapidly obtain advanced
technological information.
After an idea or individual has been identified by these searching
procedures, both direct and indirect contacts between physicians and
NASA personnel are arranged. In the former case, physicians have
visited NASA centers for discussions; in the latter case, the team
members have provided the contact by visits and correspondence. Always
the idea is to provide the physician with fresh insight into his problem
from a discipline he does not normally encounter.
The team then acts as a catalyst to provide implementation of the
ideas. Although the primary responsibility for implementation of the
technology lies with the physician, the team assists in engineering
consultation and in recommendations for ways of applying the technology.
In addition, in a few instances NASA has initiated feasibility studies
directly when it is clear that no other avenues are open to the physi-
cian and when the necessary expertise is available only within NASA.
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has occurred.
PROGRAM ANALYSIS
Because the transfer of technology in this active mode is a unique
venture, significant efforts are made to analyze the transfer process so
that improvements in transfer methodology can occur. The analysis phase
of the program has disclosed several important facts about the problem
of finding second applications for space technology. First, although
the searching of document files is one key aspect of the program, it is
not the most important aspect. Most information systems are designed to
retrieve information directly related to a subject. Information that is
indirectly related to a subject cannot be easily retrieved unless the
searcher has some initial clues. As an example, a search for methods of
rapidly heating blood would probably not include semiconductor fabrica-
tion as a search term unless the searchers were aware that microwave
heating is a vital aspect of semiconductor fabrication processes.
Thus, search results are limited by the experience of the searcher.
The second important lesson learned from this program is that per-
sonal interaction is vital when two diverse disciplines are attempting
to interact. In fact, disciplines do not really interact, but people
do. The "interaction" between two diverse disciplines really results
when two people sit down to talk. If we simply give a physician an
engineering document, the results are usually quite low. Consider two
examples: (1) The physician cannot begin to realize the significance
of modern communications technology to his method of dispensing health
care, and (2) the engineer cannot recognize the significance of his
cryogenic technology to leukemia therapy until face-to-face and repeated
interaction occurs. Personal interaction between all elements of the
team program (physician, team member, and aerospace engineer) has been
found to be of major importance for success.
EXAMPLES OF RESULTS
In order to illustrate both the methodology and the results of the
Application Team, examples of particular problems will now be discussed.
In Figure 1, a prototype of a prosthetic urethral valve is shown.
This valve is designed to meet the needs of patients with urinary
incontinence or the inability to voluntarily control urination. In
addition to the obvious social and hygienic implications of inconti-
nence, this inability to control urination can result in tissue
deterioration, infection, kidney damage, and eventually death. Previous
attempts to solve this problem using electrical stimulation have not
been satisfactory.
Figure 1. Prototype Prosthetic Urinary Valve
One problem in attempting to use a valve in the urinary system is
that urine causes an incrustation that fouls most valves. This problem
was posed to NASA engineers at Lewis Research Center who proposed the
use of a flexible membrane valve. A team engineer proposed a check
valve that together with the bulb shown in Figure 1, forms a bistable
valve which controls the urine flow. This device is now undergoing
testing in experimental animals, and if it is perfected, an estimated
15,000 patients per year could benefit from this device.
The next example concerns the need for careful monitoring of
leukemia patients who, not uncommonly, die because of shock—as opposed
to some cause more directly related to the proliferation of white blood
cell forming tissue. In order to prevent these deaths, the National
Cancer Institute asked the team to find a means of monitoring blood
pressure without significantly disturbing the patient. Conventional
blood pressure measurements require an occlusive cuff which is clearly
unsuitable for frequent, round-the-clock monitoring.
A direct contact with NASA's Ames Research Center revealed *~ha
ear oximeter had been developed for measuring oxygen content of the
blood of astronauts in ground testing. This device, shown in Figure 2,
was also sensitive to relative changes in blood pressure. Although
previous ear oximeters required that blood flow in the ear be occluded
in order to measure blood pressure, this new NASA development removed
this requirement and the resulting discomfort. At the present time,
the NASA ear oximeter is undergoing clinical trials at the National
Cancer Institute. Successful conclusion of these trials could result in
savings of hundreds of lives annually.
Figure 2. Ear Oximeter
A third example of an application of aerospace technology resulted
when the Environmental Protection Agency (EPA) wanted to study the effects
of low levels of carbon monoxide on automobile drivers. A search revealed
that a NASA scientist at Langley Research Center had developed an instru-
ment, shown in Figure 3, which measured the coordination and reaction time
of astronauts exposed to contaminants in spacecraft. This instrument was
loaned to EPA and is now being used for the planned study. Although the
new application of the equipment is not significantly different from the
basic NASA use, it is interesting to note that EPA had planned to develop
<-iiinVi •-»••-» -!•«"» •"••!- -viiffVK-tv* •
OI_ll~Ll Gill J.J.1O U JL U.1U«-1.1
dollars resulted.
Figure 3. Complex Coordinator
A fourth example is shown in Figure 4. This is a radiation dosimeter
probe developed under NASA sponsorship for nonmedical purposes and is now
being used to measure the radiation level absorbed around cancerous areas
in order to determine the position of administered radioisotopes. This
allows more precise definition of cancerous areas and prevents damage to
surrounding healthy tissue.
The final example of a transfer concerns the need for an improved
electromyographic muscle trainer. When muscles of the hand become damaged
or atrophied, an electromyographic muscle trainer is employed to determine
whether or not a specific muscle is being used. The trainer consists of
two electrodes, an amplifier, and a speaker which allows the patient to
hear when a specific muscle is being used, but the bulky electrodes pre-
viously employed were too large for proper results.
Figure 4. Radiation Dosimeter
Figure 5 shows the use of small electrodes devised from NASA-
developed spray-on electrode formulations. With these electrodes no
further attachment mechanism is needed for the wires, and the electrodes
provide extremely satisfactory results. The improved access to the
muscle being exercised permits improved rehabilitation procedures for a
significant number of patients. The technique is already in use in
several rehabilitation centers.
Figure 5. Electromyographic Electrodes
CONCLUSIONS
This paper has described a new and exciting approach to the process
of finding new applications for space technology. NASA has taken the lead
in implementing the concept of technology utilization, and the Technology
Utilization Program is the first vital step in the goal of a technological
society to insure maximum benefit from the costs of technology. Experi-
ence has shown that the active approach to technology transfer is unique
and is well received in the medical profession when appropriate problems
are tackled. The problem solving approach is a useful one at the precise
time when medicine is recognizing the need for new technology.
It is significant that the decade which heralded the space age is
also the decade that signaled the awakening of medicine to the need for
technology. Whether the coincidence is directly related, indirectly
related, or unrelated can be argued by philosophers. But this simulta-
neous occurrence cannot be ignored, and this program is one step in the many
that are needed to fulfill medicine's needs. Thus, the Application Team
program clearly fits the purpose of this conference which is to discuss
"Space for Mankind's Benefit."


Advancements in medicine from aerospace research

PRECEDING PAGE BLANK NOT FTT,?T 
ADVANCEMENTS IN MEDICINE FROM AEROSPACE RESEARCH 
By Dr. F. Thomas Wooten 
Director, RTI Biomedical Application Team 
Research Triangle Institute 
Research Triangle Park, North Carolina 
Ackn ow I edg men t 
This work supported under NASW-2273. 
Introduction 
m. ine world has recentiy viewed the dramatic 
successes of a space effort, which chose a difficult 
goal and then carefully developed the technology 
necessary to reach that goal. This paper discusses 
a program which is designed to find second applica- 
tions in the field of medicine for the technology de- 
veloped to achieve the nation's space goals. The 
program is the outgrowth of the congressional char- 
ter included in the Space Act of 1958, which direct- 
ed NASA to find second applications for .the technol- 
ogy which resulted from NASA's Research and 
Development ( R&D) programs. 
For several years NASA has sponsored a pro- 
gram which has, at i t s  core, multidisciplinary 
teams of scientists and engineers called Applica- 
tion Teams. Such a team is located at each of three 
not-for-profit research institutes (the Research 
Triangle Institute of North Carolina, the Southwest 
Research Institute of Texas, and the Midwest Re- 
search Institute of Missouri) and one medical school 
(Stanford University). The teams seek to provide 
an interface between two diverse fields: aerospace 
and medicine. 
The medical profession has awakened in the 
past decade to the need for advanced technology in 
medical research and health care. This awakening 
alone is not enough. Some effective avenues for 
the flow of information, ideas, and technology be- 
tween the physical and medical sciences have been 
established, but more a re  needed. This program 
provides one such avenue. 
Methodology 
"Technology utilization" is the term applied to the 
task of finding second applications for technology. 
Many of the methods for implementing the concept 
of technology utilization are largely passive in na- 
ture; passive, in this case, means the information 
is provided to those who seek it and thus the phy- 
sician must understand the information system in 
order to use it. One of the unique features of the 
Application Team program is that the method is 
active. Active, in this sense, means that the prob- 
Icms aiid s~hiiioiis ar*e autiveiy sought. 
This search for problems is  carried out by the 
members of the multidisciplinary team. Team mem- 
bers visit major medical centers (the National Insti- 
tutes of Health and medical schools) where suitable 
medical problems a re  identified with the aid of a 
consultant. The consultant, a medical center staff 
member, helps to ensure that the problems selected 
meet certain minimum requirements. In general, 
our team accepts only those problems which (1) have 
no solutions available on the commercial market, 
(2) are  discrete and can be defined in specific 
terms, (3) impede the progress of priority efforts 
of the physician, and (4) appear amenable to solu- 
tion by aerospace-related technology. We impose 
these requirements because this program is designed 
for problem solving, not just for information search- 
ing. 
If a problem meets these requirements, it is 
defined by the physician and team member during 
one o r  more meetings. Problem definition can 
probably best be explained by an example: arthritis 
is a crippling disease which can result in the de- 
struction of the ball-and-socket joint of the hip. One 
method of treating this disease is to replace the 
human hip ball-and- socket joint with an artificial 
material. An orthopedic surgeon asked the team to 
find an improved material. The team quickly deter- 
mined that the basic problem was that existing mate- 
rials have inadequate friction and wear character- 
istics. The team looked for improved low friction- 
bearing materials which were biocompatible and not 
just for prosthetic hip joint materials. Thus, the 
search could be broadened to areas unrelated to 
medicine. 
Af t e r  a problem is defined, a solution is sought 
using several approaches. First, a computer search 
https://ntrs.nasa.gov/search.jsp?R=19730005121 2020-03-17T07:53:06+00:00Z
of the NASA document bank is performed, which cov- 
ers approximately 700 000 documents. The bibliog- 
raphy and related documents a re  analyzed by the 
physician and the team member to determine whether 
an adequate solution is available. 
A second approach used in finding solutions is 
to request suggestions from NASA personnel by cir- 
culating concise written problem statements to the 
NASA field centers. These documents a re  circu- 
lated by the Technology Utilization Officers (TUO) 
who are located at each center and who have a de- 
tailed knowledge of the research activities at their 
centers, The TU0 provides a vital link between the 
teams and key NASA personnel. 
A third approach is to contact field center per- 
sonnel or NASA contractor personnel directly when 
the teams a re  aware that these personnel have knowl- 
edge about particular problems. These contacts, 
coordinated with each TUO, allow the teams to rap- 
idly obtain advanced technological information. 
After an idea o r  individual has been identified 
by these searching procedures, both direct and in- 
direct contacts between physicians and NASA per- 
sonnel are arranged. In the former case, physicians 
have visited NASA centers for discussions; in the 
latter case, the team members have provided the 
contact by visits and correspondence. Always the 
idea is to provide the physician with fresh insight 
into his problem from a discipline he does not nor- 
mally encounter. 
The team then acts as  a catalyst to provide im- 
plementation of the ideas. Although the primary 
responsibility for implementation of the technology 
lies with the physician, the team assists in engineer- 
ing consultation and in recommendations for ways of 
applying the technology. In addition, in a few in- 
stances, NASA has initiated feasibility studies di- 
rectly when it is clear that no other avenues a re  
open to the physician and when the necessary exper- 
tise is available only within NASA. At all times, 
the team feels that success comes only when utili- 
zation has occurred. 
Program Analysis 
Because the transfer of technology in this active 
mode is a unique venture, significant efforts a re  
made to analyze the transfer process so that im- 
provements in transfer methodology can occur. The 
analysis phase of the program has disclosed several 
important facts about the problem of finding second 
applications for space technology. First, although 
the searching of document files is one key aspect of 
the program, i t  is not the most important aspect. 
Most information systems are  designed to retrieve 
information directly related to a subject. Informa- 
tion that is indirectly related to a subject cannot be 
easily retrieved unless the searcher has some ini- 
tial clues. A search for methods of rapidly heating 
blood, a s  an example, would probably not include 
semiconductor fabrication as a search term unless 
the searchers were aware that microwave heating 
is a vital aspect of semiconductor fabrication proc- 
esses. Thus, search results a re  limited by the 
experience of the searcher. 
The second important lesson learned from this 
program is that personal interaction is vital when 
two diverse disciplines a re  attempting to interact. 
In fact, disciplines do not really interact, but people 
do. This interaction between two diverse disciplines 
really results when two people si t  down to talk. If 
we simply give a physician an engineering document, 
the results a re  usually quite low. Consider two ex- 
amples: (1) The physician cannot begin to realize 
the significance of modern communications technol- 
ogy to his method of dispensing health care, and ( 2 )  
the engineer cannot recognize the significance of his 
cryogenic technology to leukemia therapy until face- 
to-face and repeated interaction occurs. Personal 
interaction between ‘all elements of the team program 
(physician, team member, and aerospace engineer) 
has been found to be of major importance for 
success. 
Examples of Resul ts 
In order to illustrate both the methodology and 
the results of the Application Team, examples of 
particular problems will now be discussed. 
A prototype of a prosthetic urethral valve is 
shown in Figure 1. This valve is designed to meet 
the needs of patients with urinary incontinence or 
the inability to voluntarily control urination. In 
addition to the obvious social and hygienic implica- 
tions of incontinence, this inability to control urina- 
tion can result in tissue deterioration, infection, 
kidney damage, and eventually death. 
tempts to solve this problem using electrical stimu- 
lation have not been satisfactory. 
Previous at- 
One problem in attempting to use a valve in the 
urinary system is that urine causes an incrustation 
that fouls most valves. This problem was posed to 
NASA engineers at Lewis Research Center who pro- 
posed the use of a flexible membrane valve. A team 
engineer proposed a check valve that, together with 
the bulb shown in Figure 1, forms a bistable valve 
which controls the urine flow. This device is now 
undergoing testing in experimental animals, and if 
i t  is perfected, an estimated 15 000 patients per 
year could benefit from this device. 
The next example concerns the need for careful 
monitoring of leukemia patients who, not uncom- 
monly, die of shock - as  opposed to some cause 
more directly related to the proliferation of white 
blood cell forming tissue. In order to prevent these 
deaths, the National Cancer Institute asked the team 
to find 3 mcms cf monitoring blcm! prcssiire with- 
out significantly disturbing the patient. Conventional 
blood pressure measurements require an occlusive 
cuff which is clearly unsuitable for frequent, round- 
the-clock monitoring. 
A direct contact with NASA's Ames Research 
Center revealed that an ear  oximeter had been de- 
veloped for measuring oxygen content of the blood 
of astronauts in ground testing. This device, shown 
in Figure 2, was also sensitive to relative changes 
in blood pressure. Although previous ear  oximeters 
required that blood flow in the ear  be occluded in 
order to measure blood pressure, this new NASA 
development removed this requirement and the re- 
sulting discomfort. At the present time, the NASA 
ear  oximeter is undergoing clinical trials at the 
National Cancer Institute. Successful conclusion 
of these trials could result in savings of hundreds 
of lives annually. 
A third example of an application of aerospace 
technology resulted when the Environmental Pro- 
tection Agency ( E P A )  wanted to study the effects of 
low levels of carbon monoxide on automobile driv- 
ers. A search revealed that a NASA scientist at 
Langley Research Center had developed an instru- 
ment, shown in Figure 3, which measured the coor- 
dination and reaction time of astronauts exposed to 
contaminants in spacecraft. This instrument was 
loaned to EPA and is now being used for the planned 
study. Although the new application of the equipment 
is  not significantly different from the basic NASA 
use, it is interesting to note that E P A  had planned 
to develop such an instrument on contract so that a 
significant savings in tax dollars resulted. 
A fourth example is shown in Figure 4. This is  
a radiation dosimeter probe, developed under NASA 
sponsorship for nonmedical purposes, and is now 
being used to measure the radiation level absorbed 
around cancerous areas in order to determine the 
position of administered radioisotopes. This 
allows more precise definition of cancerous areas 
and prevents damage to surrounding healthy tissue. 
The final example of a transfer concerns the 
need for an improved electromyographic muscle 
trainer. When muscles of the hand become damaged 
or atrophied, an electromyographic muscle trainer 
is employed to determine whether or not a specific 
muscle is being used. The trainer consists of two 
electrodes, an amplifier, and a speaker which al- 
lows the patient to hear when a specific muscle is  
being used, but the bulky electrodes previously 
employed were too large for proper results. 
Figure 5 shows the use of small electrodes 
devised from NASA-developed spray-on electrode 
formulations. With these electrodes no further 
attachment mechanism is needed for the wires, and 
the electrodes provide extremely satisfactory re- 
sults. The improved access to the muscle being 
exercised permits improved rehabilitation pro- 
cedures for a significant number of patients. The 
technique is already in use in several rehabilitation 
centers. 
Conclusion 
This paper has described a new and exciting 
approach to the process of finding new applications 
for space technology. NASA has taken the lead in 
implementing the concept of technology utilization, 
and the Technology Utilization program is the first 
vital step in the goal of a technological society to 
insure maximum benefit from the costs of technol- 
ogy. Experience has shown that the active approach 
to technology transfer is unique and i s  well received 
in the medical profession when appropriate problems 
are tackled. The problem-solving approach is a 
useful one at the precise time when medicine is rec- 
ognizing the need for new technology. 
It is significant that the decade which heralded 
the space age is also the decade that signaled the 
awakening of medicine to the need for technology. 
Whether the coincidence is directly related, indirect- 
ly  related, o r  unrelated can be argued by philoso- 
phers. But this simultaneous occurrence cannot be 
ignored, and this program is one step in the many 
that a r e  needed to fulfill medicine's needs. Thus, 
the Application Team program clearly fits the pur- 
pose of this conference which is to discuss "Space 
for Mankind's Benefit.'' 
Figure 1. Prototype prosthetic urinary valve. 
m - -w,u., * * 
c 
Figure 3. Complex coordinator. 
2 iY 
Figure 4. Radiation dosimeter. 
Figure 5. Electromyographic electrodes. 
220 


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