Begell House Inc.
Critical Reviews™ in Biomedical Engineering
CRB
0278-940X
25
6
1997
Biomechanics of Penetrating Trauma
485-501
10.1615/CritRevBiomedEng.v25.i6.10
Narayan
Yoganandan
Department of Neurosurgery, Medical College of Wisconsin; and the Department of Veterans Affairs Medical Center Research, Milwaukee, Wisconsin 53226
Frank A.
Pintar
Department of Neurosurgery, Medical College of Wisconsin; and the Department of Veterans Affairs Medical Center Research, Milwaukee, Wisconsin 53226
injury analysis
penetrating trauma
secondary prevention
projectile
trauma biomechanics
It is well known that injuries and deaths due to penetrating projectiles have become a national and an international epidemic in Western society. The application of biomedical engineering to solve day-to-day problems has produced considerable advances in safety and mitigation/ prevention of trauma. The study of penetrating trauma has been largely in the military domain where war-time specific applications were advanced with the use of high-velocity weapons. With the velocity and weapon caliber in the civilian population at half or less compared with the military counterpart, wound ballistics is a largely different problem in today's trauma centers. The principal goal of the study of penetrating injuries in the civilian population is secondary prevention and optimized emergency care after occurrence. A thorough understanding of the dynamic biomechanics of penetrating injuries quantifies missile type, caliber, and velocity to hard and soft tissue damage. Such information leads to a comprehensive assessment of the acute and long-term treatment of patients with penetrating injuries. A review of the relevant military research applied to the civilian domain and presentation of new technology in the biomechanical study of these injuries offer foundation to this field. Relevant issues addressed in this review article include introduction of the military literature, the need for secondary prevention, environmental factors including projectile velocity and design, experimental studies with biological tissues and physical models, and mathematical simulations and analyses. Areas of advancement are identified that enables the pursuit of biomechanics research in order to arrive at better secondary prevention strategies.
Theoretical Models for Drug Delivery to Solid Tumors
503-571
10.1615/CritRevBiomedEng.v25.i6.20
A. W.
El-Kareh
Department of Physiology, University of Arizona, Tucson, AZ 85724-5051
Timothy
Secomb
University of Arizona
blood vessel
chemotherapy
compartmental models
convection
diffusion
interstitium
mathematical model
The effectiveness of anti-cancer drug therapies is often limited by the difficulty of achieving drug delivery throughout solid tumors. Mathematical models permit an analysis of the factors leading to inadequate drug delivery to tumors and can suggest strategies for improving delivery. An overview is given of key factors that influence drug delivery and the extent to which they have been incorporated into existing theoretical models. These factors include spatial gradients of drug concentration and other variables within tumors and other parts of the body, and the relative magnitudes of the time scales involved in drug transport, tumor cell kinetics, and host toxicity. Models for both systemic and regional delivery methods are considered, including intravenous, intraarterial, intraperitoneal, intrathecal, and intratumoral delivery. Strategies for improving delivery are discussed, including use of two-step therapies, hyperthermia, liposome encapsulation, and magnetic targeting. Until now, modeling has mainly developed in separate subfields of tumor growth and cell kill kinetics, compartmental modeling of the body, spatially distributed models for single tissues, radiation dose calculations, tumor oxygenation, tumor blood flow, and cellular pharmacokinetics. In the future, models that integrate these subfields should be developed.