The Scoop: A Publication of the University of Texas Medical School at Houston

Produced by the Office of Communications // April 5, 2012

The “inside story” behind astronaut research

Dr. Larry Kramer takes a tour inside the space shuttle simulator at NASA.

Dr. Larry Kramer takes a tour inside the space shuttle simulator at NASA.

Research led by Dr. Larry Kramer, professor of diagnostic and interventional imaging, recently made international headlines as it revealed that extended time in space can cause problems for astronauts’ vision. Scoop sat down with Kramer for the story behind the research.

How did this research project come to be?

There is a misconception that I conducted a prospective research study—it actually began with the anticipation of scanning just one astronaut for clinical indications. By pure chance, Dr. Michael Bungo, professor of cardiology, was conducting a cardiac MRI research study on astronauts at UT’s research facility, and a volunteer astronaut for his study returning from space was having vision problems. NASA approached Dr. Bungo about tagging on ultra high-resolution MRI images of the orbits (the eye and optic nerve), and he, in turn, consulted me.

I was attracted to the challenge having previously used prototypical orbital coils in my residency program to diagnose small melanomas of the eye. This initial study ultimately revealed severe swelling of the optic nerve, distention of the optic nerve sheath, and flattening of the posterior eyeball, which suggested the possibility of elevated intracranial pressure. This information was not completely identified on routine clinical examination and likely indicated the necessity for a broader evaluation of the astronaut core. In a sense, we became a clinical site for NASA to further evaluate the vision problem in astronauts.

After we collected a number of cases, I was invited to present my findings at a small group meeting at NASA. At this time I began to look at the entire data set in detail and theorize on the possible mechanisms to explain the imaging findings. A larger summit conference convened months later with internationally recognized experts at which point I decided to submit our observations for publication.

What percentage of the astronauts are having this vision problem?

About 40% of short duration and 60% of long duration astronauts.

What do you think is causing the problem?

Microgravity is the dominant theory in my mind—blood pools to your feet on earth, yet in space blood redistributes toward your head. This phenomenon may raise intracranial pressure above normal, which over time, expands and pressurizes the optic nerve sheath. This excessive pressure surrounding the optic nerve may explain the flattening of the back of the eyeball and swelling of the optic nerve, although the exact mechanism still remains a mystery. Other theories include the high levels of radiation in space and higher than normal levels of carbon dioxide in localized environments on the international space station.

The biggest problem is the swelling of the optic nerve as it can lead to more serious visual loss. Highly functioning visual acuity is required for mission-specific tasks and for surviving emergency situations when the only available resources might be a flashlight and a guidebook.

Would this problem affect those who travel by plane frequently—such as pilots or flight attendants?

There is little change in gravitational forces while traveling in an airplane, so microgravity would not be in effect.

Could this issue be a problem for other areas of an astronaut’s body?

Other physical issues astronauts deal with have been well documented and are a result of exposure to microgravity, such as bone mineral and muscle mass loss. More obvious on entering microgravity is the appearance of “chicken legs” and “puffy face” due to shift of blood from the lower extremities to the head. Dr. Bungo is looking at changes in the heart.

After 50 years of space travel, why is this vision issue only now being discovered?

I suspect that there is probably some reluctance to convey this information by astronauts because of implications for canceling their participation in future missions. Also with short duration exposure, symptoms were less severe, correctable with specialized glasses, and for the most part reversible. The visual abnormalities with longer excursions into space have become more clinically evident and problematic and thus awareness of the problem has escalated.

Do you think this research will affect the future of the space program?

It already has. NASA was obtaining preflight MRI studies of the brain in astronauts but none included high resolution imaging of the orbits—it is now standard in their evaluation. This is information that will be needed going forward to fully establish the relationship of microgravity and visual changes. It also has spurred a lot of interest in developing new noninvasive measurement tools for measuring intracranial pressure in the astronauts while in space. High-resolution ultrasound equipment is also now being utilized on the international space station to evaluate real-time changes in the optic nerve sheath. These new tools will help monitor astronauts’ health in space and potentially allow for early treatment before symptoms occur.

How does it feel to have this research all over the news? Is this what you have been studying your whole career?

I was definitely caught off guard by the degree of public interest the study generated. It was exciting but not without concern that the rapid dissemination information would distort the actual facts before the paper made it to hard copy. I would say my focused interest in magnetic resonance imaging and my previous training in head and neck radiology intersected with the problem at the right time.

Did the public have any interesting feedback?

There was much discussion generated related to the online publication of the findings. The dominant thought by many was that the answer to this issue was already solved by the science fiction movie 2001: A Space Odyssey, in that NASA should create artificial gravity in space.

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AGPA names Lluberes Wilkenfeld Scholar

Dr. Nubia Lluberes

Dr. Nubia Lluberes

Dr. Nubia Lluberes, a resident in the Department of Psychiatry and Behavioral Sciences, has been selected to receive a Group Psychotherapy Foundation Byron Wilkenfeld Psychiatric Resident Scholarship to attend the American Group Psychotherapy Association's Annual Meeting in New York. She is the first UT recipient of this award.

The competitive scholarship covers tuition for the two-day institute and three-day conference, March 5–10, an 18-month membership in the American Group Psychotherapy Association, and a $500 travel stipend.

“I was surprise by being selected given that I had done a little research about prior awardees and it appeared to me that it was very competitive,” Lluberes said. “But I was even more surprised after being in the meeting. The environment was very warm. Dr. Byron Wilkenfeld, the sponsor of my scholarship, and his wife were very welcoming.”

Lluberes said she learned a lot about Junganian interpretation of dreams, leadership, individual therapy within a group, re-decision strategies, gestalt and system-centered therapy.

“I also had the opportunity to mingle with colleagues in the small special interest groups and network with really great thinkers,” she added.

A program year four resident, Lluberes graduated from the Instituto Tecnológico de Santo Domingo in the Dominican Republic, her home country. She completed an internal medicine residency program in the Dominican Republic before coming to UT to pursue psychiatry studies.

Last year she received the nationally competitive American Psychiatric Association Diversity leadership Fellow award.

— Darla Brown, Office of Communications, Medical School

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MS clinic named “Company on the Move”

Dr. Jerry Wolinsky celebrates the Company on the Move honor with Katie Brass, honorary chairman, from left; Franelle Rogers, luncheon chairman; and Lesha Elsenbrook, Person on the Move Honoree.

Dr. Jerry Wolinsky celebrates the Company on the Move honor with Katie Brass, honorary chairman, from left; Franelle Rogers, luncheon chairman; and Lesha Elsenbrook, Person on the Move Honoree.

The Medical School’s Multiple Sclerosis Clinic was honored as the 2012 Company on the Move by the Houston Chapter of the National Multiple Sclerosis Society at its annual Women on the Move Luncheon March 7 at the Hotel ZaZa.

The UT Physicians clinic, which is located at the UT Professional Building, is part of the Department of Neurology and led by Dr. Jerry Wolinsky, the Bartels Family and Opal C. Rankin Professor of Neurology and director of the Multiple Sclerosis Research Group.

The center was honored for its “track record of cutting-edge care through the use of state-of-the-art techniques in the diagnosis, evaluation, management, and treatment of adult patients with demyelinating disorders in Houston.”

The center conducts investigator-initiated and pharmaceutical-company sponsored clinical trials on novel agents for the treatment of multiple sclerosis (MS) and clinical research using imaging studies to investigate the evolution of MS pathology.

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HHMI biomedical competition seeks 30 researchers

Howard Hughes Medical Institute logo

The Howard Hughes Medical Institute (HHMI) will appoint up to 30 new biomedical researchers through a national open competition for researchers who study significant biological problems in all of the biomedical disciplines as well as in adjacent fields such as biophysics, chemical biology, biomedical engineering, and computational biology. Patient-oriented researchers are also welcome to apply.

Those selected will receive a five-year appointment to HHMI, which is renewable pending favorable scientific review. Applications must be submitted by June 13, 2012.

To learn more, visit the website.


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Spring scholars

New inductees in the Alpha Omega Alpha Honor Medical Society are shown during the annual AOA Spring Banquet March 14 at the Marriott Houston in the Texas Medical Center.

New inductees in the Alpha Omega Alpha Honor Medical Society gather during the annual AOA Spring Banquet March 14 at the Marriott Houston in the Texas Medical Center.

— Dwight C. Andrews, Office of Communications, Medical School






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Events to know

April 9

Center for Membrane Biology Seminar Series: Dr. Yizhi Jane Tao (Rice University) presents, “Astrovirus Structure and Replication.”
Noon–1 p.m., MSB 2.135.

Department of Integrative Biology and Pharmacology Seminar Series: Dr. Mikhail Kolonin, associate professor in the center for stem cell research, presents, “Depletion of adipose progenitors as an approach to obesity prevention.”
4–5 p.m., MSB 2.135.

John P. McGovern Endowed Lecture in Family, Health and Human Values: Dr. Alexandra Stern (University of Michigan) presents, “Don’t Reduce Me to a Label: Disability Rights, Genetic Diagnosis, and Social Values.”
7 p.m., Rockwell Pavilion in the M.D. Anderson Library, University of Houston.

April 11

Department of Psychiatry & Behavioral Sciences Grand Rounds: Dr. Kirti Saxena, associate professor of psychiatry and behavioral sciences, presents, “Treatment of Pediatric Bipolar Disorder: Current State of Affairs.”
Noon–1 p.m., HCPC Auditorium.

Family & Community Medicine Grand Rounds: Dr. Maureen Mayes, professor of rheumatology, presents, “Approach to Evaluation in Raynaud's & Scleroderma for the Primary Care Physician.”
1–2 p.m., MSB 2.135.

April 12

Department of Surgery’s Annual Duke Day of Trauma: Dr. A. Brent Eastman, president elect of the American College of Surgeons and chief medical officer and senior vice president of ScrippsHealth, presents, “Trauma: A Global Endemic.”
7 a.m., MSB 3.001.
CME credit is available.

Combined Neurology/ Neurosurgery Conference: Dr. George Lopez, associate professor of neurology, presents, “Hypothermia.”
8 a.m., MSB G.100.

Microbiology and Molecular Genetics Seminar Series: Dr. Dominique Missiakas (University of Chicago) presents, Staphylococcus aureus: Portrait of a pathogen.”
10:45 a.m., MSB 2.135.

April 13

Special Public Lecture: Dr. James McGaugh (University of California, Irvine) presents, “Making Lasting Memories.”
7 p.m., Herring Hall 100, Rice University Campus.
Sponsored by UTHealth, BCM, RICE, Susanne M. Glasscock SOM, SEP.

April 15

Microbiology and Molecular Genetics Seminar Series: Dr. John Taylor (University of California, Berkeley) presents, “Population genomics, natural selection and adaptive evolution of fungi.”
10:45 a.m., MSB 2.135.

April 16

Department of Integrative Biology and Pharmacology Seminar Series: Dr. Channing Der (University of North Carolina, Chapel Hill) presents, “Aberrant Ras and Rho signaling and cancer treatment.”
4–5 p.m., MSB 2.135.

April 18

Department of Psychiatry & Behavioral Sciences Grand Rounds: Dr. Andrea Stolar (Baylor College of Medicine) presents, “The Insanity Defense.”
Noon–1 p.m., HCPC Auditorium.

Family & Community Medicine Grand Rounds: Dr. Shervin Assassi, assistant professor of rheumatology, presents, “Vasculitis.”
1–2 p.m., MSB 2.135.

April 19

Department of Integrative Biology and Pharmacology Seminar Series: Dr. A. Mark Evans (University of Edinburgh) presents, “The Lkb1-AMPK signalling pathway is required for carotid body activation and thus the regulation of breathing by hypoxia.”
2 p.m., MSB 2.135.

The First Year Medical Class Silent Auction to Build Mgaraganza, Tanzania's First Secondary School.
5:30–7 p.m., Fifth Floor Gallery.
Learn more and/or contribute.

April 23

Department of Integrative Biology and Pharmacology Seminar Series: Dr. Brian Wadzinski (Vanderbilt University) presents, “Novel regulatory mechanisms for PP2A family members, key regulators of the cell.”
4–5 p.m., MSB 2.135.

April 25

Department of Psychiatry & Behavioral Sciences Grand Rounds: Dr. Nubia Lluberes, resident, presents, “Psychiatry and the Media.”
Noon–1 p.m., HCPC Auditorium.

Family & Community Medicine Grand Rounds: Dr. Nicolas Martinez presents, “PGY III Case Presentation.”
1–2 p.m., MSB 2.135.

April 25–27

Clinical Research Education— Basic: “Facilitating Excellence in Clinical Trial Management.”
Visit the website for information, fee schedule, and registration.

April 26

Achieving Communication Excellence (ACE) Lecture Series: Dr. Harvey Max Chochinov (University of Manitoba) presents, “What’s Dignity Got To Do with It? Emerging Opportunities in Palliative Care.”
Noon–1 p.m., Hickey Auditorium, R11.1400, MD Anderson Cancer Center.
Lunch will be provided to the first 150 attendees.

April 27

Physical Medicine & Rehabilitation Alliance hosts the 10th Annual William P. Blocker, MD Distinguished Lectureship: presented by Dr. Daniel Dumitru, UT Health Science Center at San Antonio.
8 a.m.–noon, Baylor College of Medicine, Kleberg Auditorium.


Dr. Heinrich Taegtmeyer, professor of internal medicine, recently was named a Top Reviewer in 2011 by the Journal of Molecular and Cellular Cardiology for “exceptional contributions to the quality.” JMCC is the official journal of the International Society for Heart Research and has an Impact Factor of 5.49. Taegtmeyer has served on its editorial board since 1993.

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