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initiatives "[Lipid rescue] is now included in the guidelines and practice advisories of a number of professional societies." The clinical crossover was accelerated in 2006 when New York anesthesiologist Meg Rosenblatt, MD, who was familiar with Weinberg's publications, intervened in an unsuccessful resuscitation attempt with the recommended lipid emulsion and saved the patient. In another case, lipid emulsion saved a patient from an extreme buproprion overdose, demonstrating for the first time that the technique also worked in cases of non-anesthetic toxicity. In that case, Archie Sirianni, MD, an anesthesiologist in Media, Pa., resuscitated a 17-year-old girl who overdosed on the drug in a suicide attempt. She went into cardiovascular collapse and had aggressive CPR for 50 minutes with her family in the room. Finally, Sirianni asked the hospital pharmacy to deliver the lipid emulsion to the ICU. The patient was so close to death the hospital was poised to harvest her organs. She survived and recovered after the lipid emulsion was given. "This is a great example of translational science. Guy had postulated and written about it," Sirianni says. "I started to call toxicologists and said they had to get the information out because it had the potential to help a lot of people. In my mind it has a broader application, including petrochemicals, agriculture chemicals, pesticides and pharmacological toxicities." A new paper in the American Journal of Cardiology reports that lipid emulsion is effective in treating severe cocaine toxicity, which will help physicians handle the approximately 400,000 emergency room visits per year for cocaine overdose. Weinberg notes that LipidRescue™ is used in combination with the primary elements of good Basic Life Support: oxygenation, Thomas Royston: The research of Thomas Royston, PhD, focuses heavily on how various diseases and injuries can be diagnosed by measuring the stiffness and damping of tissues through optical or magnetic resonance elastography. "The objective, technically, is to get a map of the mechanical properties," says Royston, head of the newly merged department of bioengineering in the College of Medicine and College of Engineering. He's using optical elastography to map the stiffness of the cornea, which can change in response to disease and then again in response to treatment. His use of magnetic resonance elastography, more applicable to internal organs, includes preliminary study of the brain and heart and a more in-depth look at the lungs, the latter of which Royston has a federal NIH R01 grant to study. The lung study is part of a broader effort called the "audible human project" to develop an acoustic model of sound and vibration transmission inside and throughout the body, Royston says. "You're measuring vibratory wave motion. Sometimes, it's easy to correlate that with stiffness properties," he says, as in the liver, because it's a large and relatively homogenous organ. "But with more complicated geometries like the heart wall or lungs, it's extremely difficult to interpret what you're measuring. The R01 project will develop a comprehensive computer model that will simulate how these organs vibrate." He's used animal models so far, but Royston anticipates translational applications. "We're looking at developing diagnostic methods that we intend to translate into human subject studies, and ultimately the clinic," he says. 30 years after leaving his position as a basic researcher at the National Institutes of Health, prompted by the near-death of a carnitine-deficit patient from a very small dose of a local anesthetic. He has discovered a lipid emulsion treatment that reverses the toxic effects and is now bedside saving lives. Photo: Lloyd DeGrane Acoustical Diagnoses Guy Weinberg, MD, has come full circle to the bench illinois medicine | 25

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