ELECTRIC INJURY--IMAGING OF THERMAL/NON-THERMAL ASPECTS

高能量电创伤仍然是职业伤害和残疾的主要原因。 尽管如此，由于其病理生理学方面的问题尚未解决，治疗方面的重大进展一直进展缓慢。 我们在实验室研究中已经表明，组织损伤的生物物理机制比以前认为的更复杂，也就是说，热和直接的电机制都可能参与其中，它们的相对贡献高度依赖于电流通过的持续时间。 骨骼肌和神经细胞最容易受到细胞膜损伤的直接电机制（电穿孔和电构象蛋白变性）的影响。 我们随后的报告表明，它可以通过使用生物相容性表面活性剂的直接电机制损伤的组织恢复活力，而热损伤（烧伤）的组织需要手术切除。在这个项目中解决的一个基本需求是确定相对贡献的热与电机制的组织损伤的职业性电创伤的特点，在一系列的曝光。 拟议项目将通过将组织单独暴露于60 Hz电创伤中涉及的等效热应力和电应力来实现这一点。 第二个基本需求是开发用于电损伤诊断的成像方法。 我们建议改进磁共振成像（MRI）分析序列，可用于普通的医院MRI机器，它可以区分热损伤的纯电损伤组织的基础上，组织蛋白质变性的程度。 这种诊断工具将具有巨大的临床价值，因为组织损伤的快速检测、鉴别和定位将加速并指导临床管理。 虽然对于最佳电损伤管理至关重要，但这些方法对于评估新的医学疗法以及对于纯热（热和冷）损伤评估也具有实际临床价值。

High-energy electrical trauma remains a major cause of occupational injury and disability. Nonetheless, major advances in therapy have been slow to develop because of the unresolved questions regarding its pathophysiology. We have shown in laboratory studies that the biophysical mechanisms of tissue injury are more complex than previously thought, that is, both thermal and direct electrical mechanisms are likely to be involved, and their relative contribution is highly dependent on the duration of electrical current passage. Skeletal muscle and nerve cells are the most vulnerable to direct electrical mechanisms of cellular membrane damage (electroporation and electroconformational protein denaturation). Our subsequent reports indicate that it may by possible to restore viability to tissues injured by direct electrical mechanisms using biocompatible surfactants, whereas thermally injured (burned) tissue requires surgical excision. One essential need addressed in this project is to determine the relative contribution of thermal versus electrical mechanisms of tissue injury over a range of exposures characteristic of occupational electrical trauma. The proposed project would accomplish this by separately exposing tissue to the equivalent thermal and electrical stresses involved in a 60 Hz electrical trauma. A second essential need is to develop an imaging method for electrical injury diagnosis. We propose to refine magnetic resonance imaging (MRI) analysis sequences, useable on common hospital MRI machines, which can distinguish heat-damaged from pure electrical-damaged tissue on the basis of extent of tissue protein denaturation. Such a diagnostic tool would be of tremendous clinical value because rapid detection, discrimination and localization of tissue injury would accelerate and guide clinical management. Although essential for optimal electrical injury management, these methods would also be of practical clinical value for assessment of new medical therapies as well as valuable for pure thermal (hot and cold) injury evaluation.