[The antagonistic function of the heart muscle sustains the autoregulation according to Frank and Starling : Part I: Structure and function of heart muscle]. / Die antagonistische Funktion des Herzmuskels unterstützt die Autoregulation nach Frank-Starling : Teil I: Struktur und Funktion des Herzmuskels.

In the tradition of Harvey and according to Otto Frank the heart muscle structure is arranged in a strictly tangential fashion hence all contractile forces act in the direction of ventricular ejection. In contrast, morphology confirms that the heart consists of a 3-dimensional network of muscle fibers with up to two fifths of the chains of aggregated myocytes deviating from a tangential alignment at variable angles. Accordingly, the myocardial systolic forces contain, in addition to a constrictive also a (albeit smaller) radially acting component. Using needle force probes we have correspondingly measured an unloading type of force in a tangential direction and an auxotonic type in dilatative transversal direction of the ventricular walls to show that the myocardial body contracts actively in a 3-dimensional pattern. This antagonism supports the autoregulation of heart muscle function according to Frank and Starling, preserving ventricular shape, enhances late systolic fast dilation and attenuates systolic constriction of the ventricle wall. Auxotonic dilating forces are particularly sensitive to inotropic medication. Low dose beta-blocker is able to attenuate the antagonistic activity. All myocardial components act against four components of afterload, the hemodynamic, the myostructural, the stromatogenic and the hydraulic component. This complex interplay critically complicates clinical diagnostics. Clinical implications are far-reaching (see Part II, https://doi.org/10.1007/s00059-018-4735-x).

[Antagonistic function of the heart muscle : Part II: Clinical implications]. / Die antagonistische Funktion des Herzmuskels : Teil II: Klinische Auswirkungen.

In the hypertrophic heart the myostructural afterload in the form of endoepicardial networks is predominant, which enhances myocardial hypertrophy. The intrinsic antagonism is derailed. Likewise, the connective tissue scaffold, i.e. the stromatogenic afterload, is enriched in the response to the derailment of antagonism in a hypertrophic heart up to regional captivation of the heart musculature. Due to the selective susceptibility of the auxotonic, contracting oblique transmural myocardial network for low dose negative inotropic medication, this promises to attenuate progress in myocardial hypertrophy. Volume reduction surgery is most effective in reducing wall stress as long as the myocardium is not critically fettered by fibrosis. The use of external mechanical circulatory support is then effective if the heart is supported in its resting mode, which means around a middle width and at minimal amplitude of motion. The takotsubo cardiomyopathy might possibly reflect an isolated, extreme stimulation of the intrinsic antagonism as a response to hormonally induced sensitization of the myocardium to catecholamine. A particular significant conclusion with respect to the diseased heart is that clinical diagnostics need new impulses with a focus on the analysis of local motion patterns and on myocardial stiffness reflecting disease-dependent antagonistic intensity. This would become a relevant diagnostic marker if corresponding (noninvasive) measurement techniques would become available.

Diastolic ventricular aspiration: a mechanism supporting the rapid filling phase of the human ventricles.

During the rapid filling phase of the heart cycle, the internal volumes of the two ventricular cavities approximately double, while the intraventricular pressures rise typically only by an amount of less than 1 kPa. Such a small pressure increase cannot be the sole driving mechanism for the large inflow of blood associated with ventricular expansion during this period. Instead, the rapid filling phase is to be interpreted as being mediated primarily by the heart recoiling elastically from its contracted state, causing blood to be aspirated rapidly into the ventricles. In order to study the role of this mechanism, elastic finite element (FE) simulations of ventricular expansion were performed, taking into account the large deformations occurring during this period and the effective compressibility of the myocardium due to intramural fluid flow. Thereby, a realistic three-dimensional geometry derived from magnetic resonance imaging (MRI) measurements of both human ventricles was used. To validate our FE analyses, the results were compared with published measurements relating to the rapid filling phase of the human left ventricle. Our study shows that, under normal physiological conditions, ventricular aspiration plays a key role in the ventricular filling process.

Leaf transmission reduction using moving jaws for dynamic MLC IMRT.

The aim of this work is to investigate to what extent it is possible to use the secondary collimator jaws to reduce the transmitted radiation through the multileaf collimator (MLC) during an intensity modulated radiation therapy (IMRT). A method is developed and introduced where the jaws follow the open window of the MLC dynamically (dJAW method). With the aid of three academic cases (Closed MLC, Sliding-gap, and Chair) and two clinical cases (prostate and head and neck) the feasibility of the dJAW method and the influence of this method on the applied dose distributions are investigated. For this purpose the treatment planning system Eclipse and the Research-Toolbox were used as well as measurements within a solid water phantom were performed. The transmitted radiation through the closed MLC leads to an inhomogeneous dose distribution. In this case, the measured dose within a plane perpendicular to the central axis differs up to 40% (referring to the maximum dose within this plane) for 6 and 15 MV. The calculated dose with Eclipse is clearly more homogeneous. For the Sliding-gap case this difference is still up to 9%. Among other things, these differences depend on the depth of the measurement within the solid water phantom and on the application method. In the Chair case, the dose in regions where no dose is desired is locally reduced by up to 50% using the dJAW method instead of the conventional method. The dose inside the chair-shaped region decreased up to 4% if the same number of monitor units (MU) as for the conventional method was applied. The undesired dose in the volume body minus the planning target volume in the clinical cases prostate and head and neck decreased up to 1.8% and 1.5%, while the number of the applied MU increased up to 3.1% and 2.8%, respectively. The new dJAW method has the potential to enhance the optimization of the conventional IMRT to a further step.

Analysis of near-infrared spectroscopy and indocyanine green dye dilution with Monte Carlo simulation of light propagation in the adult brain.

Near-infrared spectroscopy (NIRS) combined with indocyanine green (ICG) dilution is applied externally on the head to determine the cerebral hemodynamics of neurointensive care patients. We applied Monte Carlo simulation for the analysis of a number of problems associated with this method. First, the contamination of the optical density (OD) signal due to the extracerebral tissue was assessed. Second, the measured OD signal depends essentially on the relative blood content (with respect to its absorption) in the various transilluminated tissues. To take this into account, we weighted the calculated densities of the photon distribution under baseline conditions within the different tissues with the changes and aberration of the relative blood volumes that are typically observed under healthy and pathologic conditions. Third, in case of NIRS ICG dye dilution, an ICG bolus replaces part of the blood such that a transient change of absorption in the brain tissues occurs that can be recorded in the OD signal. Our results indicate that for an exchange fraction of Delta=30% of the relative blood volume within the intracerebral tissue, the OD signal is determined from 64 to 74% by the gray matter and between 8 to 16% by the white matter maximally for a distance of d=4.5 cm.

A finite element model of the human left ventricular systole.

Local wall stress is the pivotal determinant of the heart muscle's systolic function. Under in vivo conditions, however, such stresses cannot be measured systematically and quantitatively. In contrast, imaging techniques based on magnetic resonance (MR) allow the determination of the deformation pattern of the left ventricle (LV) in vivo with high accuracy. The question arises to what extent deformation measurements are significant and might provide a possibility for future diagnostic purposes. The contractile forces cause deformation of LV myocardial tissue in terms of wall thickening, longitudinal shortening, twisting rotation and radial constriction. The myocardium is thereby understood to act as a densely interlaced mesh. Yet, whole cycle image sequences display a distribution of wall strains as function of space and time heralding a significant amount of inhomogeneity even under healthy conditions. We made similar observations previously by direct measurement of local contractile activity. The major reasons for these inhomogeneities derive from regional deviations of the ventricular walls from an ideal spheroidal shape along with marked disparities in focal fibre orientation. In response to a lack of diagnostic tools able to measure wall stress in clinical routine, this communication is aimed at an analysis and functional interpretation of the deformation pattern of an exemplary human heart at end-systole. To this end, the finite element (FE) method was used to simulate the three-dimensional deformations of the left ventricular myocardium due to contractile fibre forces at end-systole. The anisotropy associated with the fibre structure of the myocardial tissue was included in the form of a fibre orientation vector field which was reconstructed from the measured fibre trajectories in a post mortem human heart. Contraction was modelled by an additive second Piola-Kirchhoff active stress tensor. As a first conclusion, it became evident that longitudinal fibre forces, cross-fibre forces and shear along with systolic fibre rearrangement have to be taken into account for a useful modelling of systolic deformation. Second, a realistic geometry and fibre architecture lead to typical and substantially inhomogeneous deformation patterns as they are recorded in real hearts. We therefore, expect that the measurement of systolic deformation might provide useful diagnostic information.

Theoretical and practical aspects relating to the photothermal therapy of tumors of the retina and choroid: A review.

Photothermal treatment of tumors of the retina and choroid such as retinoblastomas, malignant melanomas, benign tumors as well as of vascular malformations can be performed by using laser radiation. A number of basic physical laws have to be taken into account in this procedure. Of particular importance thereby are: Arrhenius' law to approximate the kinetics of protein denaturation and photocoagulation, furthermore the electromagnetic radiation field, the distribution of both radiant and thermal energy induced in tumors and vascular structures, the influence of the wavelength and laser pulse duration (exposure time), as well as of the optical properties of the tissue. Strict confinement of the extent of the photothermal damage is critical since such pathological entities are frequently located close to the macula or optic nerve head.The conditions for tumor destruction are best fulfilled when using radiation in the near-infrared range of the electromagnetic spectrum such as that emitted from the diode (810 nm) and the Nd: YAG (1064 nm) laser, because of the good optical penetration properties of these radiations in tissue. Short wavelength sources of radiation, such as the argon ion (488, 514 nm) or the freqeuency-doubled Nd: YAG (532 nm) laser are less well suited for the irradiation of large vascular structures due to their poor penetration depths. However, for vascular formations with a small thickness (1 mm or less), short wavelength sources appear to be the most appropriate choice. Optical coupling of radiant energy to the eye by means of indirect ophthalmoscopic systems or positive contact lenses is furthermore of importance. Strong positive lenses may lead to severe constrictions of the laser beam within the anterior segment, that leads to high irradiance increasing the probability for structures to be damaged; with negative contact lenses, such as the -64 D Goldmann type lens, this danger is largely absent.

Pneumatic Distension of Ventricular Mural Architecture Validated Histologically.

Purpose: There are ongoing arguments as to how cardiomyocytes are aggregated together within the ventricular walls. We used pneumatic distension through the coronary arteries to exaggerate the gaps between the aggregated cardiomyocytes, analyzing the pattern revealed using computed tomography, and validating our findings by histology. Methods: We distended 10 porcine hearts, arresting 4 in diastole by infusion of cardioplegic solutions, and 4 in systole by injection of barium chloride. Mural architecture was revealed by computed tomography, measuring also the angulations of the long chains of cardiomyocytes. We prepared the remaining 2 hearts for histology by perfusion with formaldehyde. Results: Increasing pressures of pneumatic distension elongated the ventricular walls, but produced insignificant changes in mural thickness. The distension exaggerated the spaces between the aggregated cardiomyocytes, compartmenting the walls into epicardial, central, and endocardial regions, with a feathered arrangement of transitions between them. Marked variation was noted in the thicknesses of the parts in the different ventricular segments, with no visible anatomical boundaries between them. Measurements of angulations revealed intruding and extruding populations of cardiomyocytes that deviated from a surface-parallel alignment. Scrolling through the stacks of tomographic images revealed marked spiraling of the aggregated cardiomyocytes when traced from base to apex. Conclusion: Our findings call into question the current assumption that cardiomyocytes are uniformly aggregated together in a tangential fashion. There is marked heterogeneity in the architecture of the different ventricular segments, with the aggregated units never extending in a fully transmural fashion. Key Points: • Pneumographic computed tomography reveals an organized structure of the ventricular walls.• Aggregated cardiomyocytes form a structured continuum, with marked regional heterogeneity.• Global ventricular function results from antagonistic forces generated by aggregated cardiomyocytes. Citation Format: • Burg MC, Lunkenheimer P, Niederer P et al. Pneumatic Distension of Ventricular Mural Architecture Validated Histologically. Fortschr Röntgenstr 2016; 188: 1045 - 1053.

Strain energy density as a rupture criterion for the kidney: impact tests on porcine organs, finite element simulation, and a baseline comparison between human and porcine tissues.

High-velocity (up to 25 m/s) impact tests were performed on pig kidneys to characterize failure behavior at deformation rates associated with traumatic injury. Cylindrical tissue samples (n = 45) and whole perfused organs (n = 34) were impacted using both falling weights and a high-velocity pneumatic projectile impactor. Impact energy was incrementally increased until visible rupture occurred. The strain energy density failure threshold fell between 25 and 60 kJ/m3 for excised porcine tissue samples, and between 15 and 30 kJ/m3 for whole, perfused organs. The relationship between localized failure in whole organ impacts and tissue level failure thresholds observed in cylindrical tissue samples was explored using a detailed finite element model of the human kidney. The model showed good correlation between experimentally observed injury patterns and predicted strain energy density distributions within the renal parenchyma. Finally, to facilitate interpretation of the porcine renal impact results with regard to human trauma, quasi-static compression test results of freshly excised human kidney cortex samples (n = 30) were compared against similar tests on pig kidneys. Human tissues failed at Lagrange strain levels similar to porcine tissue (63+/-6.3%), but at 52% lower Lagrange stress (116+/-28 kPa), and 35% lower strain energy density (17.1+/-4.4 kJ/m3). Thus conservative interpretation of porcine test results is recommended.

Strain-rate dependent material properties of the porcine and human kidney capsule.

This study was performed to characterize the mechanical properties of the kidney capsular membrane at strain-rates associated with blunt abdominal trauma. Uniaxial quasi-static and dynamic tensile experiments were performed on fresh, unfrozen porcine and human renal capsules at deformation rates ranging from 0.0001 to 7 m/s (strain-rates of 0.005-250 s(-1)). Single stroke, dynamic tests were performed on samples of porcine renal capsule at strain-rates of 0.005 s(-1) (n = 33), 0.05 s(-1) (n = 17), 0.5 s(-1) (n = 38), 2 s(-1) (n = 10), 4 s(-1) (n = 10), 50 s(-1) (n = 21), 100 s(-1) (n = 18), 150 s(-1) (n = 17), 200 s(-1) (n = 10), and 250 s(-1) (n = 17). Due to limited availability of human tissues, only quasi-static tests were performed (0.005 s(-1), n = 25). Porcine renal capsule properties were found to match the material properties of human capsular tissue sufficiently well such that porcine tissue material can be used as a human test surrogate. The apparent elastic modulus and breaking stress of the porcine renal capsule were observed to increase significantly with increasing strain-rate (p < 0.01). Breaking strain was inversely related to strain-rate (p < 0.01). The effect of increasing strain-rate on material properties diminished appreciably at rates exceeding 150 s(-1). Empirically derived mathematical models of constitutive behavior were developed using a hyperelastic/viscoelastic Ogden formulation, as well as a Cowper-Symonds law material curve multiplication.

Some aspects of wave aberrations of the human eye and supervision: a review.

Supervision is defined by a visual acuity of 20/10 or 20/8 and may be attained by custom-correcting the aberrations of higher order of the human eye. Higher order aberrations are those aberrations which are left in the eye after having corrected lower order aberrations, i.e., defocus (myopia, hypermetropia) regular astigmatism, and which can be corrected by ordinary spectacle lenses or contact lenses. Higher order aberrations are found to a higher or lesser degree in normal or pathological human eyes and in eyes having undergone conventional corneal surgery. According to custom keratorefractive surgery limits, given by the neural visual apparatus and the receptor mosaic, supervision (i.e., 20/10 or even 20/8) may be attained. A number of dedicated sensors have been developed in recent years that are able to detect and measure aberrations of the wave front which is a sensitive procedure for the determination and surgical control of the optical quality of the eye. Not every custom keratorefractive procedure results in supervision, however. This is because not every "normal" eye is able to reach such limits because of its basic design (anatomy or function) and also because keratorefractive procedures neglect the plastic behaviour of the cornea. The plasticity of the central neural system may furthermore interact with corrected or non-corrected visual function.

Fluorescence spectroscopy for identification of atherosclerotic tissue.

OBJECTIVE: Vessel perforation and limited steerability of the laser light are the major limitations of laser angioplasty. To improve steerability fluorescence spectroscopy has been proposed for identification of atherosclerotic plaques. The aim was to investigate this. METHODS: Fluorescence spectroscopy with three different excitation wavelengths (325 nm, 380 nm, 450 nm) was tested in an emission range of 400 nm to 600 nm. Intensity ratios at 480/420 nm were determined in different types of blood vessels. Necropsy material from 40 patients (punch biopsies of 4 mm diameter from the coronary and carotid artery as well as from the ascending and descending aorta) was studied spectroscopically. Histological alterations of the vessel wall were assessed by a semiquantitative score (0 to 10 points): (a) normal tissue, 0 to 2 points (mean = 0.25; n = 38); (b) mild atherosclerotic lesions, 3 to 5 points (mean = 3.35; n = 39); (c) severe atherosclerotic lesions, greater than or equal to 6 points (mean = 6.75; n = 43). RESULTS: Best spectroscopic results were obtained with an excitation wavelength of 325 nm. In samples with severe atherosclerotic lesions the fluorescence spectra showed a significant reduction of the emitted wavelength intensities when compared to normal tissue. There was a clear separation of the fluorescence spectra between normal and mild as well as between normal and severe atherosclerotic lesions; normal tissue showed an increased intensity in the range from 420 nm to 540 nm, whereas atherosclerotic lesions had no or only a small peak at 480 nm. There was a significant correlation between the semiquantitative score (n = 120) and the fluorescence ratio at 480/420 nm (excitation wavelength 325 nm) with a correlation coefficient of 0.87. The spectroscopic results showed no differences between the samples taken from different types of vessels. CONCLUSIONS: Fluorescence spectroscopy allows a reliable identification of normal and atherosclerotic lesions. The close correlation between the emitted light intensity ratio at 480/420 nm and the histological alterations of the vessel wall suggests a relationship between vessel wall fluorescence and the atherosclerotic alterations of the wall.

In vivo tracer transport through the lacunocanalicular system of rat bone in an environment devoid of mechanical loading.

Although diffusion has been shown to be the major contributing mechanism for molecular transport in the extravascular spaces of organs and soft tissues, it is unlikely that diffusion alone can account for molecular transport in the porous, yet relatively impermeable matrix of bone. Rather, it has been proposed that fluid flow induced by the deformations that bone is subjected to during daily activities may promote molecular transport through convective mixing of fluids or enhancement of molecular transport from the capillaries to the outermost osteocytes within a given osteon. As the relative contribution of diffusive and convective transport in the bone matrix has not yet been elucidated, we conducted experiments to study the primary role of diffusion for molecular transport within bone and to establish a baseline for fluid transport whereby mechanical loading effects are negligible. Procion red and microperoxidase were utilized as short-term (i.e., low MW, transported on the order of minutes) and long-term (i.e., comparatively high MW, transported on the order of hours) molecular tracers, respectively, to elucidate in vivo the pathways and extent of transport in the metacarpus and tibia of 60-day-old (i.e., skeletally immature) and 180-day-old (i.e., skeletally mature) animals. The tracers were introduced intravenously and the animals were maintained in an anesthetized state for the duration of the experiment to prevent physiological loading. In short-term studies, procion red tracer distribution was highly dependent on bone structure, demarcating spaces apposing the vascular pathways in the trabecular bone of immature animals and vascular and extravascular pathways (i.e., specifically, the lacunocanalicular system) within compact bone of mature animals. In longer term studies using microperoxidase, reaction product was concentrated in soft tissues as well as along a subperiosteal and subendosteal band of bone. In contrast, little peroxidase reaction product was observed in the metacarpal and tibial cortices of either immature or mature animals. Based on the results of these studies, diffusive transport mechanisms may suffice to insure an adequate supply of small molecules, such as amino acids, to osteocytes in the midcortex within minutes. In contrast, diffusion alone may not be efficient for transport of larger molecules. Thus, another mechanism of transport, such as convective transport by means of load-induced fluid flow, may be necessary to provide a sufficient supply of larger molecules, such as proteins to osteocytes for the maintenance of metabolic activity, as well as for activation or suppression of modeling processes.

Comparison of the stability of press-fit hip prosthesis femoral stems using a synthetic model femur.

The motion of three different press-fit hip prosthesis femoral components was compared with that of a cemented stem and an Austin Moore noncemented hemiarthroplasty. Synthetic composite femurs were used as an experimental model to reduce the variations in shape and quality typical among cadaver femurs. Motion was measured under axial and rotational loading approximating a walking load. On the initial application of load, axial subsidence was as much as several millimeters for the noncemented stems. Considerable tightening occurred during the 5,000 walking cycles, such that the motion of the noncemented stems in some directions eventually was as small as that of the cemented stem, on the order of tens of microns.

Motion patterns of pedestrian surrogates in simulated vehicle-pedestrian collisions.

In about 80-85% of all vehicle-pedestrian collisions, a pedestrian is hit by the frontal area of a vehicle. Thereby, an enormous variety of spatial motion patterns of the impacted pedestrian is observed. The analysis of injury mechanisms and injury prevention measures depends largely on a sufficient knowledge of the relevant impact-induced motions. Accordingly, the investigation and classification of these motions is an important task in accident biomechanics. To this end, about 150 collision experiments with the aid of a catapult and several types of pedestrian surrogates were performed. Also, extensive use of a mathematical gross motion analysis model was made. The experimental impacts were analysed with the aid of automated high-speed cinephotogrammetry and acceleration measurements while the mathematical model was validated and calibrated for a number of impact configurations chosen strategically. Results of the experimental and theoretical impact simulations are presented which are related to the observed motion characteristics. In particular, a method is discussed which allows the assessment of the sensitivity of a given motion with respect to the impact parameters. An attempt is made to classify these parameters according to the significance of their influence, whereby pedestrian-related and vehicle-related parameters are discerned. It was found, that such a classification is necessary and possible and results are shown.

Material characterization of the pig kidney in relation with the biomechanical analysis of renal trauma.

The objective of this study was an investigation of the material properties of the fresh pig kidney and parametric characterization of its elastic and inelastic material behavior. The material investigation included density measurements, uniaxial as well as three-dimensional compression tests, tensile tests. and shear tests on the samples extracted from the fresh pig kidney. For comparison, density measurements on a number of soft synthetic materials were also performed. Compression tests on the radial and the tangential specimens from the cortex tissue were performed at various loading rates. Three-axial compression tests were performed on the cortex tissues placed in a compression chamber. Shear tests were performed by punching a cylinder into a slice of the cortex. Tensile tests were carried out on the outer capsule. For characterization of the material behavior, a non-linear theoretical simulation based on a two parameter Blatz model was used. For characterization of the time-dependent behavior of the pig kidney cortex, a four-parameter linear viscoelastic model was employed. From the present experimental and theoretical studies, a number of conclusions were derived: (1) The general behavior of the pig kidney cortex samples under compression showed the general non-linear features typical of the soft tissues; the stress strain diagram was composed of a very flat part at very low stress level to about 30% relative deformation which was followed by a steeply rising stiffening leading to the radial rupture of samples marked by a maximum nominal rupture strain of about 50%. (2) The uniaxial compression tests on the radial and the tangential samples from the cortex tissue showed an increase of the rupture stress with the increase in the loading rate, but a decrease in the related rupture strain. (3) The long-term uniaxial compression tests on the cortex specimens under sustained constant load showed an instantaneous deformation followed by a creep response which eventually approached an asymptote. (4) Simulation of the non-linear material behavior of the cortex tissue under uniaxial compression by the Blatz model gave two pairs of material parameters for the cortex in the radial and the tangential directions. Furthermore, fitting of the assumed four-parameter linear viscoelastic model with the experimental data resulted in the viscoelastic material parameters.

Experimental elucidation of mechanical load-induced fluid flow and its potential role in bone metabolism and functional adaptation.

Several researchers have developed theories implicating some manifestation of mechanical forces such as stress, strain, and strain energy density for the initiation of cellular processes associated with functional adaptation. The mechanisms underlying dynamic bone growth and repair in response to mechanical stimuli, however, are not fully understood. Load-induced fluid flow has been postulated to provide a mechanism for the transmission of mechanical signals (eg, via shear stresses, enhancement of molecular transport, or electrical effects) and the subsequent elicitation of a functional adaptation response in bone. Although indirect evidence for such fluid flow phenomena can be found in the literature pertaining to strain-generated potentials, experimental studies are inherently difficult. This motivated the authors to develop theoretical as well as ex vivo, in vitro, and in vivo experimental methods for the study of transport processes and fluid flow within bone under well-controlled mechanical loading conditions. By introducing tracer substances such as disulphine blue, procion red, and microperoxidase into the experimental system, transport and fluid flow could be visualized at tissue, cellular, and subcellular levels, respectively. Based on these studies, it could be shown that load-induced fluid flow represents a powerful mechanism to enhance molecular transport within compact bone tissue. Furthermore, the distribution of transport-elucidating tracers is a function of mechanical loading parameters as well as the location within the cross-section of the bone cortex.

Compatibility considerations for low-mass rigid-belt vehicles.

A number of staged impacts performed by our group with the aid of a test device representing a low-mass vehicle (LMV) indicates that a rigid-belt body (RBB) is a valid means for providing adequate occupant safety also for LMVs in the strict sense (curb mass less than 600 kg). The RBB concept raises the problem of compatibility, however. Ideally, the deformability of car front structures should increase with increasing vehicle weight in order to ascertain compatibility. Published data on frontal deformation characteristics substantiate in contrast that conventional cars today exhibit an opposite behaviour. To evaluate the compatibility properties of ultrastiff LMVs, two crash experiments were performed along with a theoretical model analysis. An LMV with a mass of 680 kg (including batteries, 50% mass of two dummies, instrumentation) designed according to the RBB concept and a conventional care of 1320 kg--(equivalent loading conditions as LMV)--were crashed at 56 km/h in a frontal direction against a deformable barrier (FMVSS 214). Furthermore, a mathematical model was based on estimated deformation characteristics of conventional vehicles to predict intrusion distances into the FMVSS barrier in hypothetical frontal crashes with 56 km/h. The results indicate that due to its low mass an LMV does not represent an excessive compatibility problem for other car occupants in spite of the stiff RBB characteristics.

On the significance of fiber branching in the human myocardium.

Myocardial tissue exhibits a high degree of organization in that the cardiac muscle fibers are both systematically aligned and highly branched. In this study, the influence and significance of fiber branching is analyzed mathematically. In order to allow for analytic solutions, a regular geometry and simplified constitutive relations are considered. It is found that branching is necessary to stabilize the ventricular wall.

New methods for monitoring cerebral oxygenation and hemodynamics in patients with subarachnoid hemorrhage.

Radiographic cerebral vasospasm (CVS) after subarachnoid hemorrhage (SAH) do not reflect cerebral hemodynamics and oxygenation and may occur in the absence of clinical deficit and vice-versa. This report is to describe preliminary findings in further development of a non invasive method to estimate regional cerebral oxygenation and perfusion. Measurements were performed with a technique combining near infrared spectroscopy (NIRS) and indocyaningreen (ICG) dye dilution. Successful data analysis has been performed based on the decomposition in pulsatile and non-pulsatile components of NIRS absorption data collected before and during the passage of ICG through the vascular bed under the NIRS-detector. First measurements in patients with CVS suggest that the technique could become a powerful tool in the detection and treatment of CVS. This non invasive technique can be done at the bedside, it seems to be safe, easy to perform and less time-consuming compared to conventional techniques. The influence of extracerebral bone and surface tissue on cerebral NIRS signal has not been clarified yet. Therefore a new subdural NIRS probe has been developed, which gives the opportunity to measure directly the concentration of the chromophores in the brain without the influence of extracerebral contamination. In future comparative measurements with conventional NIRS probes on the scalp will allow to quantify and eliminate extracerebral contamination from the NIRS signal.