Noninvasive hemodynamic monitoring of patients sustaining severe penetrating thoracic, abdominal and thoracoabdominal injuries for early recognition and therapy of shock.
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Biomedical subjects
Publications and source records attributed to K Lu.
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The impact of a sphere with velocity u0 on a fine, loose granular system under the acceleration due to gravity has been studied by fast video photography. The behavior of the granular bed is found to be similar to a fluid during initial impact, followed by a cavity drag during projectile penetration. From the trajectory of the projectile it is found that the drag on the projectile can be well described by adding a bulk frictional force f to the hydrostatic force kappa(z) where kappa is a constant and z denotes the penetration depth. Both kappa and f are u0 dependent. This form of the drag force suggests that fluidlike viscous dissipations in the bed can be neglected in these three-dimensional (3D) experiments. However, due to the imposed boundary this hydrodynamic term of the drag force is found to be not negligible in quasi-2D granular beds.
Methods used to strengthen metals generally also cause a pronounced decrease in electrical conductivity, so that a tradeoff must be made between conductivity and mechanical strength. We synthesized pure copper samples with a high density of nanoscale growth twins. They showed a tensile strength about 10 times higher than that of conventional coarse-grained copper, while retaining an electrical conductivity comparable to that of pure copper. The ultrahigh strength originates from the effective blockage of dislocation motion by numerous coherent twin boundaries that possess an extremely low electrical resistivity, which is not the case for other types of grain boundaries.
The dilute-to-dense transition of granular flow of particle size d(0) is studied experimentally in a two-dimensional channel (width D) with confined exit (width d). Our results show that with fixed d and D there is a maximum inflow rate Q(c) above which the flow changes from dilute to dense and the outflow rate drops abruptly from Q(c) to a dense rate Q(d). A rescaled critical rate q(c) is found to be a function of a scaling variable lambda only: q(c) approximately F(lambda), where lambda identical with d/d(0) d/D-d. This form of lambda suggests that the dilute-to-dense transition is a global property of the flow, unlike the jamming transition which depends only on d/d(0). Furthermore, the transition is found to occur when the area fraction of particles near the exit exceeds a critical value which is close to 0.65+/-0.03.
The goal of this work is to study the cerebral autoregulation, brain gas exchange, and their interaction by means of a mathematical model. We have previously developed a model of the human cardiopulmonary (CP) system, which included the whole body circulatory system, lung and peripheral tissue gas exchange, and the central nervous system control of arterial pressure and ventilation. In this study, we added a more detailed description of cerebral circulation, cerebrospinal fluid (CSF) dynamics, brain gas exchange, and cerebral blood flow (CBF) autoregulation. Two CBF regulatory mechanisms are included: autoregulation and CO(2) reactivity. Central chemoreceptor control of ventilation is also included. We first established nominal operating conditions for the cerebral model in an open-loop configuration using data generated by the CP model as inputs. The cerebral model was then integrated into the larger CP model to form a new integrated CP model, which was subsequently used to study cerebral hemodynamic and gas exchange responses to test protocols commonly used in the assessment of CBF autoregulation (e.g., carotid artery compression and the thigh-cuff deflation test). The model can closely mimic the experimental findings and provide biophysically based insights into the dynamics of cerebral autoregulation and brain tissue gas exchange as well as the mechanisms of their interaction during test protocols, which are aimed at assessing the degree of autoregulation. With further refinement, our CP model may be used on measured data associated with the clinical evaluation of the cerebral autoregulation and brain oxygenation in patients.
Effects of interstitial air on the motions of a large intruder in a shaken granular bed are studied experimentally as a function of ambient air pressure, particle size of the bed, and the density of the intruder. It is found that the intruder always rises from the granular bed in the absence of air. However, the intruder can acquire both positive and negative buoyancy in the presence of air. Negative buoyancy can be observed only when both the density of the intruder and the particle size of the bed are small enough. This negative buoyancy can be explained by the unusual air pressure distribution found in the bed.
The microstructure in the surface layer of a pure iron plate was refined at the nanometer scale by means of a surface mechanical attrition treatment that generates repetitive severe plastic deformation of the surface layer. The subsequent nitriding kinetics of the treated iron with the nanostructured surface layer were greatly enhanced, so that the nitriding temperature could be as low as 300 degrees C, which is much lower than conventional nitriding temperatures (above 500 degrees C). This enhanced processing method demonstrates the technological significance of nanomaterials in improving traditional processing techniques and provides a new approach for selective surface reactions in solids.
Brachial plexus avulsion injury is one of the major complications after traffic, especially motorcycle accidents. During the past 12 years, we have encountered more than 40 brachial plexus avulsion injuries. The neurological deficits included pain and paralysis of the damaged limb. Dorsal root entry zone lesions made by thermocoagulation were performed for intractable pain in 34 cases. The pain relief rate was good in about 75%. Combined neural reconstruction was performed in 15 cases. The reconstruction included neurolysis, nerve graft, nerve transfer, and functioning muscle/tendon transfer etc. There were 13 male and 2 female patients. Age distribution was from 21 to 61 years with a mean age of 41.8 years. Eleven patients were found to have whole brachial plexus injury and 4 with upper brachial plexus injury. Twelve patients had good pain relief. Six patients showed good functional result after reconstruction. Three had no improvement. Combined pain control and reconstruction offer an early rehabilitation for brachial plexus avulsion injury.
The flow of granular nickel particles moving down vertical pipes from a hopper in the presence of a local, horizontal ac electric field is studied experimentally. The flow is initiated by opening the bottom outlet of the pipe after the pipe is fully filled with particles from the hopper. The mass of particles flowing out of the pipe is measured as a function of time by an electronic balance. The time dependence of the steady-state flow rate Q, under each fixed voltage V, is obtained. Depending on the magnitude of V, two types of flow behaviors are observed. For low V ( or =V(c)), no interface exists and the whole region between the hopper and the electrodes are densely filled; only one constant flow rate Q(A2) is observed. (The precise meaning of Q(A2) and Q(B) are defined in the text.) The steady-state flow rates Q(A2) and Q(B) measured for each V, are plotted as a function of V. The flow rate Q(A2) is a monotonically decreasing function of V, which can be approximately fitted by a power law, with an exponent of -0.8, while Q(B) is found to be voltage independent. These features result from a competition between the blocking effect of the electric-field region and the gravity-driven pushing effect from the hopper outlet. The local electric field is able to retard the downward movement of a dense column existing above it, but is ineffective in doing so when the column above is dilute in density.
Twenty-five patients (20 men and 5 women) with the chief complaint of facial hyperhidrosis were treated by transthoracic endoscopic T-2, 3 sympathectomy. All patients were essentially in good health except the embarrassment of facial sweating. Fifteen of them also suffered from distressing palmar hyperhidrosis. The ages ranged from 18 to 40 years (mean age 25 years). All of them except two obtained a satisfactory improvement of facial hyperhidrosis after 3 months to 2 years of follow-up. One man demonstrated very mild ptosis in the right eye. Pre- and postoperative sympathetic skin response (SSR) revealed the absence rate from 20% to 72% with electrical stimulation (p < 0.05). This study shows that T-2, 3 sympathectomy is a choice of treatment for facial hyperhidrosis and sympathetic supply to the face may at least partly be from T-2, 3 level.
In the United States, ovarian cancer is the fourth most common cause of cancer-related deaths among women. The most important prognostic factor for this cancer is tumor stage, or extent of disease at diagnosis. Although women with low-stage tumors have a relatively good prognosis, most women diagnosed with late-stage disease eventually succumb to their cancer. In an attempt to understand early events in ovarian carcinogenesis, and to explore steps in its progression, we have applied multiple molecular genetic techniques to the analysis of 21 early-stage (stage I/II) and 17 advanced-stage (stage III/IV) ovarian tumors. These techniques included expression profiling with cDNA microarrays containing approximately 18,000 expressed sequences, and comparative genomic hybridization to address the chromosomal locations of copy number gains as well as losses. Results from the analysis indicate that early-stage ovarian cancers exhibit profound alterations in gene expression, many of which are similar to those identified in late-stage tumors. However, differences observed at the genomic level suggest differences between the early- and late-stage tumors and provide support for a progression model for ovarian cancer development.
The atomic-scale details during melting of a surface-free Lennard-Jones crystal were monitored using molecular dynamics simulations. Melting occurs when the superheated crystal spontaneously generates a sufficiently large number of spatially correlated destabilized particles that simultaneously satisfy the Lindemann and Born instability criteria. The accumulation and coalescence of these internal local lattice instabilities constitute the primary mechanism for homogeneous melt nucleation inside the crystal, in lieu of surface nucleation for equilibrium melting. The vibrational and elastic lattice instability criteria as well as the homogeneous nucleation theory all coincide in determining the superheating limit.
Sitosterolemia is a rare autosomal recessive disorder characterized by (a) intestinal hyperabsorption of all sterols, including cholesterol and plant and shellfish sterols, and (b) impaired ability to excrete sterols into bile. Patients with this disease have expanded body pools of cholesterol and very elevated plasma plant-sterol species and frequently develop tendon and tuberous xanthomas, accelerated atherosclerosis, and premature coronary artery disease. In previous studies, we have mapped the STSL locus to human chromosome 2p21. Recently, we reported that a novel member of the ABC-transporter family, named "sterolin-1" and encoded by ABCG5, is mutated in 9 unrelated families with sitosterolemia; in the remaining 25 families, no mutations in sterolin-1 could be identified. We identified another ABC transporter, located <400 bp upstream of sterolin-1, in the opposite orientation. Mutational analyses revealed that this highly homologous protein, termed "sterolin-2" and encoded by ABCG8, is mutated in the remaining pedigrees. Thus, two highly homologous genes, located in a head-to-head configuration on chromosome 2p21, are involved as causes of sitosterolemia. These studies indicate that both sterolin-1 and sterolin-2 are indispensable for the regulation of sterol absorption and excretion. Identification of sterolin-1 and sterolin-2 as critical players in the regulation of dietary-sterol absorption and excretion identifies a new pathway of sterol transport.
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X-ray absorption fine structure (XAFS) was used to investigate the local structures around Ga atoms in the hexagonal nanocrystalline and crystalline GaN under 78 and 300 K. For the first nearest neighbor coordination shell of Ga-N. the average bond length R (0.194 nm), coordination number N (4.0), thermal disorder sigma (0.0052 nm) and static disorder sigmaS (0.0007 nm) are neatly independent of the measured temperature and crystalline state. This indicates that the Ga-N covalent bond is much stronger, and the 4 nitrogen atoms in first nearest neighbor around Ga atoms keep the tetrahedral structure (Td). For the second nearest neighbor coordination shell of Ga-Ga, their bond lengths are about 0.318 nm. However, the sigmaS (0.0057 nm) of nanocrystalline GaN is 0.0047 nm larger than that of crystalline GaN (0.001 nm), and the sigmaT of nanocrystalline is 0.0053 nm and 0.0085 nm at the temperature of 78 and 300 K, respectively. The result indicates that the difference of local structure around Ga atoms between nanocrystalline and crystalline GaN occurs mainly at the Ga-Ga second nearest-neighbor coordination shell. The reason is explained as the local lattice distortion and unsaturated surface atoms existing in nanocrystalline GaN.
STUDY DESIGN: This study compared the effects of isoflurane and nicardipine on regional blood flow of the lumbar paraspinal muscles. OBJECTIVES: The purpose of this study was to determine whether treatment with hypotensive agents result in ischemia of the lumbar paraspinal muscles, thereby facilitating surgical procedures. SUMMARY OF BACKGROUND DATA: Despite the general acceptance of controlled hypotension as effective in reducing blood loss during spinal surgery, the changes of blood flow that occur at the lumbar paraspinal muscles when this technique is applied remain unclear. The use of laser Doppler flowmetry allows changes of muscle blood flow to be easily detected in real time with minimal invasion, thereby allowing differences among distinct pharmacological approaches for induction and maintenance of controlled hypotension to be evaluated. METHODS: The prehypotensive and hypotensive (reduction of mean arterial pressure by 20 mm Hg) blood flow of the lumbar paraspinal muscles were assessed with a laser Doppler flowmeter in 40 patients undergoing lumbar spinal surgery. The first half of the patients (n = 20) received isoflurane, whereas the second half received nicardipine to achieve arterial hypotension. RESULTS: Compared with the prehypotensive state, during the hypotensive state, patients in the isoflurane group exhibited a 17% to 46% (mean, 33.7%) decrease in lumbar paraspinal muscle blood flow, whereas patients in the nicardipine group exhibited a 24% to 177% (mean, 82.5%) increase in lumbar paraspinal muscle blood flow. Statistical analysis showed a significant difference in the changes of flux after induced hypotension between the isoflurane and nicardipine group (P < 0.001). CONCLUSIONS: Depending on the pharmacological treatment used to achieve arterial hypotension in spine surgery, there will be either a reduction in paraspinal muscle blood flow (ischemia) or an enhancement of this blood flow (hyperemia).
Bcl-2 has been described as a factor that can protect from apoptosis. The protective effect of Bcl-2 may be lost if the protein is phosphorylated. Bcl-2 phosphorylation can be induced by agents that affect microtubule depolymerization or prevent microtubule assembly. In 13 human tumor cell lines there was a high degree of heterogeneity in Bcl-2 protein expression. Human H460 non-small-cell lung carcinoma (NSCLC) cells expressed high levels of Bcl-2 and were selected for study. Western blot analysis for Bcl-2 phosphorylation was carried out after 4 h and 24 h of exposure to cryptophycin 52, cryptophycin 55, paclitaxel or vinblastine. Cryptophycin 52 and cryptophycin 55 were very potent inducers of Bcl-2 phosphorylation. After 4 h of exposure, Bcl-2 phosphorylation was evident with 0.05 nM cryptophycin 52, 0.25 nM cryptophycin 55, 5 nM vinblastine and 50 nM paclitaxel. The hyperphosphorylated form of Bcl-2 was evident after 24 h exposure of H460 cells to 0.25 nM cryptophycin 52 or cryptophycin 55 and 50 nM vinblastine or paclitaxel. The effects of the compounds on the cell cycle paralleled those on Bcl-2 phosphorylation. In H460 cells 90% cell killing was obtained with 0.13 nM cryptophycin 52, 0.2 nM cryptophycin 55, 20 nM paclitaxel and > 100 nM vinblastine after 24 h of exposure as determined by colony formation. In Bcl-2-negative Calu-6 NSCLC cells, 90% cell killing was obtained with 0.03 nM cryptophycin 52, 0.1 nM cryptophycin 55, 11 nM paclitaxel and 0.5 nM vinblastine using the same experimental design. Thus, cryptophycins are potent inducers of Bcl-2 phosphorylation. The cryptophycins were more potent cytotoxic agents in Bcl-2-negative Calu-6 cells than in Bcl-2-positive H460 cells indicating that pathways triggered by Bcl-2 phosphorylation are involved in cryptophycin-induced lethality.
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