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Biomedical subjects

Narayan Yoganandan

Publications and source records attributed to Narayan Yoganandan.

At least 19 recordsLinked to original sources

Experimental model for civilian ballistic brain injury biomechanics quantification.

Biomechanical quantification of projectile penetration using experimental head models can enhance the understanding of civilian ballistic brain injury and advance treatment. Two of the most commonly used handgun projectiles (25-cal, 275 m/s and 9 mm, 395 m/s) were discharged to spherical head models with gelatin and Sylgard simulants. Four ballistic pressure transducers recorded temporal pressure distributions at 308kHz, and temporal cavity dynamics were captured at 20,000 frames/second (fps) using high-speed digital video images. Pressures ranged from 644.6 to -92.8 kPa. Entry pressures in gelatin models were higher than exit pressures, whereas in Sylgard models entry pressures were lower or equivalent to exit pressures. Gelatin responded with brittle-type failure, while Sylgard demonstrated a ductile pattern through formation of micro-bubbles along projectile path. Temporary cavities in Sylgard models were 1.5-2x larger than gelatin models. Pressures in Sylgard models were more sensitive to projectile velocity and diameter increase, indicating Sylgard was more rate sensitive than gelatin. Based on failure patterns and brain tissue rate-sensitive characteristics, Sylgard was found to be an appropriate simulant. Compared with spherical projectile data, full-metal jacket (FMJ) projectiles produced different temporary cavity and pressures, demonstrating shape effects. Models using Sylgard gel and FMJ projectiles are appropriate to enhance understanding and mechanisms of ballistic brain injury.

Biomechanical Phenomena↗

Biomechanical characterization of internal layer subfailure in blunt arterial injury.

Blunt carotid artery injuries occur in 0.3% of blunt injured patients and may lead to devastating neurological consequences. However, arterial mechanics leading to internal layer subfailure have not been quantified. Twenty-two human carotid artery segments and 18 porcine thoracic aorta segments were opened to expose the intimal side and longitudinally distracted to failure. Porcine aortas were a geometrically accurate model of human carotid arteries. Internal layer subfailures were identified using videography and correlated with mechanical data. Ninety-three percent (93%) of vessels demonstrated subfailure prior to catastrophic failure. All subfailures occurred on the intimal surface. Initial subfailure occurred at 79% of the stress and 85% of the strain to catastrophic failure in younger porcine specimens, compared to 44% and 60%, respectively, in older human specimens. In most cases, multiple subfailures occurred prior to catastrophic failure. Due to limitations in human specimen quality (age, prior storage), young and fresh porcine aorta specimens are likely a more accurate model of clinical blunt carotid artery injuries. Present results indicate that vessels are acutely capable of maintaining physiologic function following initial subfailure. Delayed symptomatology commonly associated with blunt arterial injuries is explained by this mechanics-based and experimentally quantified onset of subcatastrophic failure.

Animals↗

Moment-rotation responses of the human lumbosacral spinal column.

The objective of this study was to test the hypothesis that the human lumbosacral joint behaves differently from L1-L5 joints and provides primary moment-rotation responses under pure moment flexion and extension and left and right lateral bending on a level-by-level basis. In addition, range of motion (ROM) and stiffness data were extracted from the moment-rotation responses. Ten T12-S1 column specimens with ages ranging from 27 to 68 years (mean: 50.6+/-13.2) were tested at a load level of 4.0 N m. Nonlinear flexion and extension and left and right lateral bending moment-rotation responses at each spinal level are reported in the form of a logarithmic function. The mean ROM was the greatest at the L5-S1 level under flexion (7.37+/-3.69 degrees) and extension (4.62+/-2.56 degrees) and at the L3-L4 level under lateral bending (4.04+/-1.11 degrees). The mean ROM was the least at the L1-L2 level under flexion (2.42+/-0.90 degrees), L2-L3 level under extension (1.58+/-0.63 degrees), and L1-L2 level under lateral bending (2.50+/-0.75 degrees). The present study proved the hypothesis that L5-S1 motions are significantly greater than L1-L5 motions under flexion and extension loadings, but the hypothesis was found to be untrue under the lateral bending mode. These experimental data are useful in the improved validation of FE models, which will increase the confidence of stress analysis and other modeling applications.

Adult↗

Mechanics of arterial subfailure with increasing loading rate.

Arterial subfailure leads to delayed symptomatology and high morbidity and mortality rates, particularly for the thoracic aorta and carotid arteries. Although arterial injuries occur during high-velocity automotive collisions, previous studies of arterial subfailure focused on quasi-static loading. This investigation subjected aortic segments to increasing loading rates to quantify effects on elastic, subfailure, and ultimate vessel mechanics. Sixty-two specimens were axially distracted, and 92% demonstrated subfailure before ultimate failure. With increasing loading rate, stress at initial subfailure and ultimate failure significantly increased, and strain at initial subfailure and ultimate failure significantly decreased. Present results indicate increased susceptibility for arterial subfailure and/or dissection under higher-rate extension. According to the present results, automotive occupants are at greater risk of arterial injury under higher velocity impacts due to greater body segment motions in addition to decreased strain tolerance to subfailure and catastrophic failure.

Animals↗

Stabilizing effect of precontracted neck musculature in whiplash.

STUDY DESIGN: This study investigated the effect of neck muscle precontraction in aware occupants in whiplash. Head angulation relative to T1 and facet joint capsular ligament distractions were compared between aware and unaware occupants. OBJECTIVE: To quantify changes in facet joint capsular ligament distractions between aware occupants with precontracted neck muscles and unaware occupants with reflex muscle contraction. SUMMARY OF BACKGROUND DATA: Clinical studies have reported that patients aware of the impending impact had decreased symptom intensity and faster recovery after whiplash. To date, no study has investigated the effects of precontracted neck musculature on localized spinal soft tissue distortions in whiplash. METHODS: Aware occupants with precontracted neck muscles and unaware occupants with reflex muscle contraction in whiplash were simulated using a validated computational model. Muscle contraction attained maximum levels before impact in the aware occupant and implemented reflex delay, electromechanical delay, and finite muscle rise time in the unaware occupant. RESULTS: Precontraction of neck muscles in aware occupants resulted in 63% decreased maximum head angles, elimination of cervical S-curvature, and up to 75% decrease in maximum facet joint capsular ligament distractions. CONCLUSIONS: Occupants aware of an impending whiplash impact with precontracted neck muscles can markedly reduce overall head-neck and spinal motions. It is our theory that this would reduce whiplash injury likelihood.

Accidents, Traffic↗

Lateral impact injuries with side airbag deployments--a descriptive study.

The present study was designed to provide descriptive data on side impact injuries in vehicles equipped with side airbags using the United States National Automotive Sampling System (NASS). The database was queried with the constraint that all vehicles must adhere to the Federal Motor Vehicle Safety Standards FMVSS 214, injured occupants be in the front outboard seats with no rollovers or ejections, and side impacts airbags be deployed in lateral crashes. Out of the 7812 crashes in the 1997-2004 weighted NASS files, AIS > or = 2 level injuries occurred to 5071 occupants. There were 3828 cases of torso-only airbags, 955 cases of torso-head bag combination, and 288 inflatable tubular structure/curtain systems. Side airbags were not attributed to be the cause of head or chest injury to any occupant at this level of severity. The predominance of torso-only airbags followed by torso-head airbag combination reflected vehicle model years and changing technology. Head and chest injuries were coupled for the vast majority of occupants with injuries to more than one body region. Comparing literature data for side impacts without side airbag deployments, the presence of a side airbag decreased AIS=2 head, chest, and extremity injuries when examining raw data incidence rates. Although this is the first study to adopt strict inclusion-exclusion criteria for side crashes with side airbag deployments, future studies are needed to assess side airbag efficacy using datasets such as matched-pair occupants in side impacts.

Abdominal Injuries↗

Validation of a clinical finite element model of the human lumbosacral spine.

Very few finite element models on the lumbosacral spine have been reported because of its unique biomechanical characteristics. In addition, most of these lumbosacral spine models have been only validated with rotation at single moment values, ignoring the inherent nonlinear nature of the moment-rotation response of the spine. Because a majority of lumbar spine surgeries are performed between L4 and S1 levels, and the confidence in the stress analysis output depends on the model validation, the objective of the present study was to develop a unique finite element model of the lumbosacral junction. The clinically applicable model was validated throughout the entire nonlinear range. It was developed using computed tomography scans, subjected to flexion and extension, and left and right lateral bending loads, and quantitatively validated with cumulative variance analyses. Validation results for each loading mode and for each motion segment (L4-L5, L5-S1) and bisegment (L4-S1) are presented in the paper.

Adult↗

Trabecular bone density of male human cervical and lumbar vertebrae.

The objective of this study was to determine the bone mineral density (BMD) of cervical vertebrae and correlate with the lumbar spine. Fifty-seven young adult healthy male volunteers, ranging from 18 to 41 years of age, underwent quantitative computed tomography (QCT) scanning of C2-T1 and L2-L4 vertebrae. To account for correlations, repeated measures techniques were used to compare data as a function of spinal level and region. Linear regression methods were used (+/-95% CI) to compare data as a function of spinal level and region. The mean age and body height were 25.0 +/- 5.8 years and 181.0 +/- 7.6 cm. BMD decreased from the rostral to caudal direction along the spinal column. Grouped data indicated that the neck is the densest followed by the first thoracic vertebra and low back with mean BMD of 256.0 +/- 48.1, 194.3 +/- 44.2, and 172.2 +/- 28.4 mg/cm(3), respectively; differences were statistically significant. While BMD did not vary significantly between the three lumbar bodies, neck vertebrae demonstrated significant trends. The matrix of correlation coefficients between BMD and spinal level indicated that the relationship is strong in the lumbar (r = 0.92-0.96) and cervical (r = 0.73-0.92) spines. Data from the present study show that the trabecular bony architecture of the neck is significantly different from the low back. These quantitative BMD data from a controlled young adult healthy human male volunteer population may be valuable in establishing normative data specifically for the neck. From a trabecular bone density perspective, these results indicate that lumbar vertebrae cannot act as the best surrogates for neck vertebrae. Significant variations in densities among neck vertebrae, unlike the low back counterpart, may underscore the need to treat these bones as different structures.

Adolescent↗

Biomechanics of side impact: injury criteria, aging occupants, and airbag technology.

This paper presents a survey of side impact trauma-related biomedical investigations with specific reference to certain aspects of epidemiology relating to the growing elderly population, improvements in technology such as side airbags geared toward occupant safety, and development of injury criteria. The first part is devoted to the involvement of the elderly by identifying variables contributing to injury including impact severity, human factors, and national and international field data. This is followed by a survey of various experimental models used in the development of injury criteria and tolerance limits. The effects of fragility of the elderly coupled with physiological changes (e.g., visual, musculoskeletal) that may lead to an abnormal seating position (termed out-of-position) especially for the driving population are discussed. Fundamental biomechanical parameters such as thoracic, abdominal and pelvic forces; upper and lower spinal and sacrum accelerations; and upper, middle and lower chest deflections under various initial impacting conditions are evaluated. Secondary variables such as the thoracic trauma index and pelvic acceleration (currently adopted in the United States Federal Motor Vehicle Safety Standards), peak chest deflection, and viscous criteria are also included in the survey. The importance of performing research studies with specific focus on out-of-position scenarios of the elderly and using the most commonly available torso side airbag as the initial contacting condition in lateral impacts for occupant injury assessment is emphasized.

Accidents, Traffic↗

Biomechanical strength of reconstruction plates when used for medial support of MED-El cochlear implants: implications for diagnostic MRI.

PURPOSE: It is hypothesized that a mesh reconstruction plate designed to fit a cochlear implant (CI) internal device will provide immediate structural support to the site of the implant and that this strength far exceeds the forces induced by a 1.5-tesla MRI. PROCEDURES: Human calvarial specimens were drilled and plated with reconstruction mesh. Force was applied until failure was reached. RESULTS: Mean maximum force, mean force to first failure and mean displacement measures for group 1 (resorbable mesh, n = 10) were 302.9 N, 283.0 N and 3.05 mm, respectively. The mean maximum force for group 2 (0.4-mm titanium mesh, n = 10) and group 3 (0.6-mm titanium mesh, n = 8), were 121.3 and 234.0 N, respectively. Mean force of first failure was 92.0 N for group 2 and 164.8 N for group 3. CONCLUSIONS: The force required for failure of the mesh is significantly greater than the 0.17 N exerted on a CI magnet by a 1.5-tesla MRI scan.

Absorbable Implants↗

Bone mineral density of human female cervical and lumbar spines from quantitative computed tomography.

STUDY DESIGN: This study determined bone mineral density (BMD) of cervical, thoracic, and lumbar vertebrae in healthy asymptomatic human subjects. OBJECTIVES: To test the hypothesis that BMD of neck vertebrae (C2-C7) is equivalent to BMD of lumbar vertebrae (L2-L4). SUMMARY OF BACKGROUND DATA: BMD of lumbar vertebrae is correlated to their strength. Although numerous studies exist quantifying BMD of the human lumbar spine, such information for the cervical spine is extremely limited. In addition, BMD correlations are not established between the two regions of the spinal column. METHODS: Adult healthy human female volunteers with ages ranging from 18 to 40 years underwent quantitative computed tomography (CT) scanning of the neck and back. All BMD data were statistically analyzed using paired nonrepeating measures ANOVA techniques. Significance was assigned at a P < 0.05. Linear regression analyses were used to compare BMD as a function of level and region; +/-95% confidence intervals were determined. RESULTS: When data were grouped by cervical (C2-C7), thoracic (T1), and lumbar (L2-L4) spines, mean BMD was 260.8 +/- 42.5, 206.9 +/- 33.5, and 179.7 +/- 23.4 mg/mL. Average BMD of cervical vertebrae was higher than (P < 0.0001) thoracic and lumbar spines. Correlations between BMD and level indicated the lowest r value for T1 (0.42); in general, the association was the strongest in the lumbar spine (r = 0.89-0.95). The cervical spine also responded with good correlations among cervical vertebrae (r ranging from 0.66 to 0.87). CONCLUSIONS: The present study failed to support the hypothesis that BMD of lumbar spine vertebrae is equivalent to its cranial counterparts. The lack of differences in BMD among the three lumbar vertebral bodies confirms the appropriateness of using L2, L3, or L4 in clinical or biomechanical situations. However, significant differences were found among different regions of the vertebral column, with the cervical spine demonstrating higher trabecular densities than the thoracic and lumbar spines. In addition, the present study found statistically significant variations in densities even among neck vertebrae.

Adolescent↗

Tapered cages in anterior lumbar interbody fusion: biomechanics of segmental reactions.

OBJECT: The aim of this study was to determine the in vitro biomechanical responses of lumbar spinal segments after implantation of tapered cages. METHODS: Range of motion (ROM)- and stiffness-related data were determined in 10 human cadaveric T12-S1 columns subjected to flexion, extension, and lateral bending modes before and after anterior lumbar interbody fusion in which stand-alone LT-CAGE devices were used. The overall column showed no significant changes in ROM or stiffness. At the instrumented level, stiffness increased significantly (p < 0.05) in flexion and lateral bending modes. Indications of instability in extension were present, but these values were not statistically significant. There was no evidence of adjacent-level instability at any level in any mode, except for the segment superior to the fixation level in flexion; here there was a significant increase in ROM (p < 0.05) and a decrease in stiffness. CONCLUSIONS: The anatomical conformity and bilateral placement of cages provide ample stability and rigidity at the treated level, comparable to that of other cage systems. Because hypermobility is traditionally related to early degenerative changes, the present results appear to suggest that cages do not significantly contribute to such alterations.

Adult↗

Biomechanics of the aging spine.

Experimental studies indicate age and degeneration affect spinal biomechanics. In vitro biomechanical experimentation is used to validate finite element cervical spine models. A high percentage of experimental studies have utilized older specimens. Computer models based on these experimental studies may not accurately represent the normal population. Younger full-column and C5-C6 motion segments were tested under pure sagittal plane moments. A review of literature was conducted, and results from previous studies were compared to present data to determine whether age was an influencing factor in spinal biomechanics. Findings indicate younger specimens under equivalent pure moment loading magnitudes underwent greater ranges of motion between 0.5 and 2.5 Nm. Based on these preliminary findings, validation of finite element modeling to ensure biofidelity should consider age as a factor that may affect biomechanics.

Aging↗

Interface parameters of impact-induced mild traumatic brain injury.

Commonly considered a continuum of injuries, diffuse brain injury (DBI) ranges from mild concussion to severe diffuse axonal injury. The lower end of the spectrum is generally referred to as mild traumatic brain injury (MTBI). More severe forms of DBI have garnered extensive experimentation while these milder cases are considerably less explored. Recently, a new device was designed to generate DBI in the rodent using impact-induced angular acceleration. This device is modifiable so the entire spectrum of DBI can be investigated. Severity of DBI is critically dependent on magnitude of angular acceleration. A small animal surrogate like a rodent has a relatively small brain mass. This constraint poses a unique problem because the angular acceleration necessary for DBI is inversely related to brain mass. Prior experimentation estimated an angular acceleration of approximately 350 krad/s2 is necessary for the induction of mild traumatic brain injury (MTBI) in the rodent. To induce these magnitudes of angular acceleration in a repeatable manner, the impacting interface must be critically analyzed. This investigation uses a mathematical model based on parameters of a previously developed experimental model to assess the impacting interface such that angular accelerations are sufficient to produce MTBI in the rodent.

Acceleration↗

Automating 3D meshing method for patient-specific modeling.

The purpose of this study was to develop an automating meshing method for patient-specific modeling. Three-dimensional geometries of two six-month-old infant heads were reconstructed from the CT data. Finite element meshes including cranial bone of skull, brain, and suture were generated. Both static and dynamic analyses were performed to verify the models. The study for blunt impact of infant head was performed by using these patient-specific models.

Acceleration↗

Role of translational and rotational accelerations on brain strain in lateral head impact.

Translational and rotational accelerations from blunt head impact can induce excessive brain strain and cause traumatic brain injuries. However, it is not clear which acceleration plays a major role in the mechanism. The current study used the SIMon human finite element head model (FEHM) and delineated the contributions of these accelerations using post mortem human subject (PMHS) lateral head impact experimental data. Results indicated that rotational acceleration contributes more than 90% of total strain, and translational acceleration produces minimal strain. Therefore, the rotational component is a more important biomechanical metric in this study.

Acceleration↗

Brain strains in vehicle impact tests.

The purpose of this research was to use vehicle impact test data and parametric finite element analysis to study the contribution of translational accelerations (TransAcc) and rotational accelerations (RotAcc) on strain-induced head injuries. Acceleration data were extracted from 33 non-contact vehicle crash tests conducted by the US Department of Transportation, National Highway Traffic Safety Administration. A human finite element head model was exercised using head accelerations from the nine accelerometer package placed inside the driver dummy in these tests. Three scenarios were parameterized: both TransAcc and RotAcc, only TransAcc, and only RotAcc to demonstrate the contribution of these accelerations on brain injury. Brain strains at multiple elements, cumulative strain damage, dilatation damage, and relative motion damage data were compared. Rotational accelerations contributed to more than 80% of the brain strain. Other injury metrics also supported this finding. These findings did not depend on the crash mode, peak amplitude of translational acceleration (29 to 120 g), peak amplitude of rotational acceleration (1.3 to 9.4 krad/s ( 2 ) ) or HIC (68-778). Rotational accelerations appeared to be the major cause of strain-induced brain injury.

Acceleration↗

Worldsid assessment of far side impact countermeasures.

Far side impact trauma has been demonstrated as a significant portion of the total trauma in side impacts. The objective of the study was to assess the potential usefulness of countermeasures and assess the trade-offs associated with generic countermeasure design. Because the WorldSID dummy has demonstrated promise as a potential far side impact dummy, it was chosen to assess countermeasures in this mode. A unique far side impact buck was designed for a sled test system that included, as a standard configuration, a center console and outboard three-point belt system. This configuration assumed a left side driver with a right side impact. The buck allowed for additional options of generic restraints including shoulder or thorax plates or an inboard shoulder belt. The entire buck could be mounted on the sled in either a 90-degree (3-o'clock PDOF) or a 60-degree (2-o'clock PDOF) orientation. A total of 19 WorldSID tests were completed. The inboard shoulder belt configuration produced high shear forces in the lower neck (2430 N) when the belt position was placed over the mid portion of the neck. Shear forces were reduced and of opposite sign when the inboard belt position was horizontal and over the shoulder; forces were similar to the standard outboard belt configuration (830 - 1100 N). A shoulder or thorax restraint was effective in limiting the head excursion, but each caused significant displacement at the corresponding region on the dummy. A shoulder restraint resulted in shoulder displacements of 30 - 43 mm. A thorax restraint caused thorax deflections of 39 - 64 mm. Inboard restraints for far side impacts can be effective in reducing head excursion but the specific design and placement of these restraints determine their overall injury mitigating characteristics.

Accidents, Traffic↗