Evolution of multilevel order in supramolecular assemblies.

The process of self-assembly at multiple length scales of bis-urea substituted toluene on a Au(111) surface was studied by low temperature scanning tunneling microscopy. Pattern formation is controlled by specific hydrogen bonds between these molecules but also by significantly weaker lateral coupling between the resulting supramolecular polymers and a quasiepitaxial interlocking with the substrate. The ordered assemblies exhibit a tunnel transparency. Our experiments indicate the necessity of multiple interactions of different strengths for obtaining ordered structures with hierarchical levels of organization.

Local brain surface temperature compared to temperatures measured at standard extracranial monitoring sites during posterior fossa surgery.

Mild hypothermia is assumed to protect against secondary brain injury. However, the accuracy of brain temperature estimation remains debatable if direct measurement in the target area is to be avoided or is impossible. Furthermore, intracerebral temperature gradients exist, especially under intraoperative conditions. We aimed to establish how brain surface temperatures (TBrain) relate to temperatures taken at standard sites in posterior fossa surgery. Ten patients undergoing cerebellopontine angle tumor removal were monitored for TBrain, esophageal temperature (TEso), bladder temperature (TBlad), ipsi- and contralateral tympanic membrane (TTymp-I, TTymp-C), and scalp temperatures (TScalp). During monitoring, TEso increased from 35.3+/-0.2 degrees C to 36.0+/-0.3 degrees C. After dura opening, TBrain was -0.14+/-0.1 degrees C below TEso. At the end of tumor removal, this difference increased to -0.43+/-0.31 degrees C (P < 0.05). TTymp-C was -0.29+/-0.18 degrees C below TBrain at dura opening. TTymp-C reflected the behavior of TEso adequately (r = 0.938), however, with a mean difference of -0.39+/-0.04 degrees C. In contrast, TTymp-I readings closely followed temperature changes in the area of surgery. TBlad reflected TEso except in periods of rapid temperature changes. In posterior fossa (PF) surgery, local TBrain is most accurately reflected by TEso. For clinical use TBlad and TTymp-C are also sufficient to assess brain surface temperature in the PF. Intraoperative surface cooling of the brainstem is less than the previously described cooling rate of exposed cerebral cortex.

Bioeffects of diagnostic ultrasound in vitro.

Biological effects induced by ultrasound were frequently reported for continuous wave (cw) mode. Thresholds for the onset of bioeffects of pulsed ultrasound, starting from diagnostic conditions, have not yet been defined by standardized in vitro models. We therefore investigated the effects of pulsed ultrasound on cultured cells using diagnostic ultrasound devices, a selfmade transducer and a sonochemical laboratory reactor tunable from pulsed diagnostic conditions to cw ultrasound. Additionally, we determined physical parameters of the ultrasonic field by different types of hydrophones. Sonochemical reactions and the effects induced by the ultrasonic fields in cultured cells indicated a threshold for bioeffects.

Disturbance of cellular calcium homeostasis by in vitro application of shock waves.

Extracorporeally generated shock waves used in lithotripsy of urinary and biliary stones exhibit tissue lesions in vivo and destroy or damage cells in vitro. The involvement of cavitation-generated free radicals in these harmful effects is discussed controversially. We investigated changes in cytoplasmic calcium concentration and intracellular calcium localization after shock-wave treatment of suspended cell cultures using flow cytometry and electron microscopy and present evidence for the disturbance of mitochondrial Ca2+ a sequestration and, therefore, for a chemically induced cell injury.

Reduced cavitation-induced cellular damage by the antioxidative effect of vitamin E.

Fragmentation of human urinary and biliary stones by shock waves in extracorporeal lithotripsy is accompanied by tissue damage. Both the fragmentation as well as the side effects are often attributed to cavitation. The hazardous potential of cavitation is not only of a physical nature but also of a chemical nature, because of the generation of free radicals, e.g. .OH, .H and .O2. After the application of shock waves, we have demonstrated cavitation-generated free radicals in cell-free solutions and also in the surviving and intact suspended MGH-U1 cells by hydroethidine measurements. Under electron microscopical inspection, the same cells exhibited perinuclear cisternae, damaged mitochondria and numerous intracellular vacuoles. The contribution of free radicals to cell damage was investigated by reducing the vitamin E level in rats by a tocopherol free diet and by incubating L1210 cells in a tocopherol enriched medium. After 250 shock waves, ex vivo erythrocytes revealed a 75% increase in total cell disruption over cells from non-depleted rats. The in vitro experiments with L1210 cells exhibited a moderate protection by the addition of this scavenger of free radicals.

Sensitivity of normal and malignant cells to shock waves.

We examined the cytotoxic effect of shock waves for primary (embryonic chick kidney and thigh muscle) and permanently growing normal and malignant cells (human, rat, and mouse) in suspension. To avoid the influence of different media, the cells were suspended in phosphate buffered saline and shock wave treated. In all cases the acute cytotoxic effect (measured by flow cytometry) was a function of the applied shock waves. The investigated cells differed in their LD 50 values which, however, do not reveal a general difference in sensitivity to shock waves for normal and malignant cells.

The lounging position for posterior fossa surgery: anesthesiological considerations regarding air embolism.

The sitting position for operations in the posterior fossa remains controversial in both adults and children, primarily because of the risk of air embolism. The reports on the incidence of this complication are varied. We retrospectively reviewed the data on 704 patients (age range 1-82 years) operated on in a lounging position for varied posterior fossa pathology from January 1984 up to December 1989. As diagnostic monitoring, we uniformly employed a Doppler ultrasound device, an atrial catheter, and capnometry. In 37 adults (5.5%) and 9 children (9/34) air embolism was diagnosed, without either morbidity or mortality. A lounging position, together with adequate infusion therapy and ventilation with PEEP, considerably reduces the risk of air embolism.

Cavitation-generated free radicals during shock wave exposure: investigations with cell-free solutions and suspended cells.

Extracorporeally generated shock waves as used in lithotripsy of urinary and biliary stones exhibit side effects in vivo. Furthermore, these shock waves destroy eukaryotic cells during in vitro treatment in suspension. A possible cause of these damaging effects might be cavitation, the growth and collapse of bubbles in liquids exposed to tensile stresses. During the collapse, temperature inside these cavitation bubbles rises up to several thousand K, leading to the formation of free radicals. We demonstrated the occurrence of cavitation-generated free radicals by direct reaction with fluorescent dyes in solution after shock wave treatment and investigated the resulting cell killing by variation of the cellular antioxidative defense status. We present evidence for the generation of intracellular free radicals during shock wave treatment of suspended cells.