Begell House Inc.
Critical Reviews™ in Biomedical Engineering
CRB
0278-940X
29
5&6
2001
The State of Head Injury Biomechanics: Past, Present, and Future: Part 1
441-600
10.1615/CritRevBiomedEng.v29.i56.10
Werner
Goldsmith
Graduate School, University of California, Berkeley, Berkeley, California, USA
This article is the first of two parts of a comprehensive survey of the biomechanics of head injury since its inception in 1939 in the United States, the separation being made for temporal and spatial reasons. The second portion of this material will be published at a later time in this journal. The discussion will be almost exclusively limited to nonpenetrating events. The topics presented in the following sections include an introduction that discusses the magnitude of the problem, the basic tools of biomechanics, and significant major reference sources covering this subject. This is succeeded by a brief description of the components of the head, classification of head injuries, early experimental investigations and human tolerance considerations, measurement techniques of kinetic parameters, and head motion and head injury investigations prior to 1966. A Head Injury Conference sponsored by the National Institutes of Neurological Diseases and Stroke in 1966 changed the landscape of investigations in this area. While informal collaboration between neurosurgeons and engineers had existed prior to this time, the conference established a permanent mechanism ofsynergism between these disciplines, produced the first zero-order realistic model of biomechanical head injury investigation, and established a 4-year program of federally funded research into the mechanical properties of the tissues of the cranium. While a recession precluded a continuation of the national sponsorship of such work, this 4-year period of intensive research resulted in a nationwide individual effort to develop further knowledge in this area. The current presentation, then, covers the mechanical and structural properties of solid and fluid tissues of the head, emphasizing progress during the past 3 decades; fetal cranial properties; analytical and numerical head injury models; experimental cranial loads applied to human volunteers and cadaver heads, dynamic loading of surrogate heads; and, finally, head injury mechanisms. The future publication will encompass experimental, analytical, and some numerical and regulatory information and that will be divided into the following sections:
head injury experimentation involving translatory and rotational motion: equipment, subjects and mechanical and physiological consequences
diffuse axonal injury: production and traumatic effects; mechanical properties at the axonal and neuronal level
vehicular crash investigation and simulation: reconstruction methodologies, staging, surrogate validation, and occupant protection, including vehicular design
injury thresholds and tolerances, including skull and vessel failure and brain and brainstem damage, including consideration of loading directions
criteria for head injury: governmental and industry regulations, including effects of combined motion- and tissue-level loading
further discussions of cranial component properties and injury mechanisms
sports head injury considerations: boxing, baseball, softball, football, ice hockey, and skiing activities; protective head devices for these activities
vehicular protective devices: design, efficacy, standards, and limitations; models for helmets and experimental validation
This presentation is based on my nearly 4 decades of head injury research, continuous collaboration and discussions with prominent members of the neurosurgical and orthopedic community, and an exhaustive, 2-year search of the literature. While every effort has been made to include all relevant information, it is inevitable that some important research has not come to my attention, and I apologize for any such omissions.
It is hoped that this survey will serve as a resource for researchers and practitioners in the area of traumatic head injury and provide a roadmap for further investigations that are urgently needed. For example, this could include a determination of the rate of absorption of blood emitted from broken vessels, and, hopefully, some correlation between mechanical failure and physiological dysfunction of the various relevant tissues of the head. Although a good beginning has been initiated, additional information at the neuronal and axonal level concerning the effect of loading on function as well as age-related changes in geometry and tissue properties is also needed.
State-of-the-art Medical pH Probes
603-611
10.1615/CritRevBiomedEng.v29.i56.20
G. A.
Yakovlev
pH-probe Development and Production Department, "Istok-Sistema" State Research and Production Enterprise, Russia
This article deals with the development of reusable peroral, transnasal, and endoscopic pH probes, and it looks into the operational features of pH probes equipped with silver-chloride distal and surface reference electrodes. The results obtained revealed that pH probes with a surface reference electrode offer a number of advantages over pH probes with a distal reference electrode.
Millimeter Waves in the Treatment of Neurological Manifestations of Vertebral Osteochondrosis
613-621
10.1615/CritRevBiomedEng.v29.i56.30
N. F.
Miryutova
Research Institute of Balneology and Physiotherapy, Moscow, Russia
E. F.
Levitskii
Research Institute of Balneology and Physiotherapy, Moscow, Russia
A. M.
Kozhemyakin
"Spinor" Joint-stock Company, Tomsk, Russia
I. M.
Mavlyautdinova
"Spinor" Joint-stock Company, Tomsk, Russia
A new millimeter-wave therapeutic technique, which combines pulsed electromagnetic radiation with noise, was developed. This technique produces analgesic and trophic effects, and it also produces an effect on the functional activity of electrically excitable regions of nerve fibers. It can therefore be employed for treating affected nerves and muscles. Hence, it may broaden the range of optimal combinations of biotropic parameters of millimeter-wave methods used in neurological practice.
Model of a Biological Cell Exposed to Extremely Small Doses (Discussed)
623-633
10.1615/CritRevBiomedEng.v29.i56.40
V. I.
Gvozdev
Moscow State Institute of Electronics and Mathematics, The Russian Federation and Higher Education Committee Prize Winner, Moscow, Russia
V. V.
Gerasyov
Department for Tumor Chemotherapy at Moscow State Clinical Hospital No. 62, Moscow, Russia
B. Ya.
Klimov
Radiology Department, Moscow State Clinical Hospital No. 62, Moscow, Russia
This article considers the physical properties of cells. On the basis of these properties, an electrodynamic model was constructed in terms of equivalent networks. This model makes it possible to study how external influences act upon a cell. For example, it can be employed to analyze cell behavior at different doses of pharmaceuticals, alpha emission, beta radiation, gamma rays, and electromagnetic fields.
Experimental Clinical Study of the Effect of Millimeter Waves on Microbial and Inflammatory Renal Diseases
635-643
10.1615/CritRevBiomedEng.v29.i56.50
I. V.
Bagdasarova
Urology and Nephrology Institute of the Ukraine Academy of Sciences, Kiev, Ukraine
A. V.
Rudenko
Urology and Nephrology Institute of the Ukraine Academy of Sciences, Kiev, Ukraine
E. N.
Tumanyants
Urology and Nephrology Institute of the Ukraine Academy of Sciences, Kiev, Ukraine
An investigation is made of the effect of low-intensity millimeter waves on the development of acute and chronic pyelonephritis. It is shown that the application of millimeter waves diminishes the rate of pyelonephritis recurrence and reduces the probability of chronic pyelonephritis. Furthermore, these waves normalize lipid peroxidation, stimulate antioxidant protection, and improve blood rheology. Experimental investigations performed on animals provided evidence for the positive effect of millimeter waves on the morphofunctional state of organs and tissues as well as on blood circulation. This especially concerns pyelonephritis of mycoplasmic etiology.
Novel Approaches to the Diagnostics and Treatment of Chronic Prostatic Diseases
645-659
10.1615/CritRevBiomedEng.v29.i56.60
Yu. M.
Esilevskii
Clinical Electrophysiological Research Laboratory of the I. M. Sechenov Moscow Medical Academy, Full Member of the Russian Academy of Medical and Technical Sciences, Russia
This article presents a modified technique for investigating the prostatic blood flow—rheoprostatography (impedance electroplethysmography of the prostate gland). It also gives some averaged rheographic parameters typical of most prevalent prostatic diseases (such as prostatitis, benign prostatic hyperplasia, and prostate cancer). These parameters were measured both under normal conditions and during functional tests. Furthermore, this article classifies prostatic blood-flow insufficiency into several stages. It is recommended that the combined therapy of chronic prostatic diseases should involve endorectal procedures of pulsed fluctuating stimulation (PFS), with rheographic monitoring being used as a feedback loop of such procedures.
Ultrasonic Diagnostic Techniques
661-674
10.1615/CritRevBiomedEng.v29.i56.70
E. B.
Khomak
Laboratory of Clinical and Electrophysiological Investigations, I. M. Sechenov Moscow Medical Academy, Moscow, Russia
I. M.
Tsybin
"Bioss" Research and Production Firm, Russia
This article deals with the physical principles of the Doppler ultrasonography. It also describes the performance specification of present-day ultrasonic devices used in clinical practice to diagnose cerebral vessel disorders, to addition, this article presents typical blood-flow indices for different regions of extra- and intracranial vessels under normal or stenotic conditions.