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Biomedical subjects

A Vogel

Publications and source records attributed to A Vogel.

At least 73 records · Page 4Linked to original sources
PubMed1994

Mechanisms of intraocular photodisruption with picosecond and nanosecond laser pulses.

Nd:YAG laser photodisruption with nanosecond (ns) pulses is an established method for intraocular surgery. In order to assess whether an increased precision can be achieved by the use of picosecond (ps) pulses, the plasma size, the shock wave characteristics, and the cavitation bubble expansion after optical breakdown with ps- and ns-laser pulses were investigated by time-resolved photography and acoustic measurements. Nd:YAG laser pulses with a duration of 30 ps and 6 ns, respectively, were focused into a water-filled glass cuvette. Frequency doubled light from the same laser pulses was optically delayed between 2 ns and 136 ns and used as illumination light source for photography. Since the individual events were well reproducible, the shock wave and bubble wall position could be determined as a function of time. From the slope of these r(t) curves, the shock wave and bubble wall velocities were determined, and the shock wave pressure was calculated from the shock velocity. The plasma size at various laser pulse energies was measured from photographs of the plasma radiation. The breakdown thresholds at 30 ps and 6 ns pulse duration were found to be 15 microJ and 200 microJ, respectively. At threshold, ps-plasmas are shorter than ns-plasmas, but at the same pulse energy they are always approximately 2.5 times longer. The initial shock pressures were 17 kbar after ps-pulses with an energy of 50 microJ, and 21 kbar after 1 mJ ns-pulses. The pressure amplitude decayed much faster after the ps-pulses. The maximum expansion velocity of the cavitation bubble was 350 m/s after a 50 microJ ps-pulse, but 1,600 m/s after a 1 mJ ns-pulse. The side effects of intraocular microsurgery associated with shock wave emission and cavitation bubble expansion can be considerably reduced by the use of ps-pulses, and new applications of photodisruption may become possible.

Eye↗
PubMed1994

Function of FGF-4 in limb development.

The apical ectodermal ridge plays a central role in limb development through its interactions with the underlying mesenchyme. Removal of the AER results in cessation of limb outgrowth and leads to truncation of the limb along the proximo-distal axis. The many functions attributed to the ridge include maintenance of the progress zone mesenchyme. Here, cells are stimulated to proliferate, are maintained in an undifferentiated state, and are assigned progressively more distal positional values as the limb grows. The AER also functions to maintain the activity of the polarizing region, a region of mesenchyme which is thought to provide the primary signal for patterning along the antero-posterior axis. We have begun to explore the function of fibroblast growth factor-4 (FGF-4) during limb development. FGF-4, which encodes an efficiently secreted protein, is expressed in the AER. We have previously demonstrated that FGF-4 protein can stimulate limb mesenchyme proliferation and can induce the expression of a downstream homeobox gene, Evx-1 (homologue of the Drosophila even-skipped gene), that is normally regulated by a signal from the AER. To determine to what extent FGF-4 protein can substitute for the AER to allow normal limb outgrowth, we performed experiments on the developing chick limb in ovo. Remarkably, we find that after AER removal, the FGF-4 protein can provide all the signals required for virtually normal outgrowth and patterning of the limb.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1994

Ultrastructural analysis of skin and aorta from a patient with Menkes disease.

Ultrastructural studies of the skin and aorta of a patient with Menkes disease, an X-linked recessive disorder of copper metabolism, are described. Dermal thickness was normal, while dermal collagen fibrils exhibited a heterogeneous size range, with a mean diameter smaller than normal. Long-spacing collagen was often observed near fibroblasts, the plasma membranes of which were decorated by aggregates of interwoven filaments. Dermal elastin fibers were scarce and consisted of thin strands of amorphous elastin associated with numerous microfibrils. In the aorta, the amount of collagen was normal, although the fibrils displayed a broader range of diameters than normal, with a slightly smaller mean. Elastin fibers showed considerable disruption, appearing fragmented and wider than normal, and displaying irregular contours. The inclusion of cationic dyes during tissue fixation gave rise to numerous electron-dense precipitates within the elastin fibers, suggesting the presence there of glycosaminoglycans or proteoglycans, among which unsulfated and sulfated chondroitins were demonstrated by immunoelectron microscopy to be prominent. Heparan sulfate, observed to be a constituent of normal elastin fibers, was much reduced in amount. Elastin was also found associated with glycosaminoglycans in the soluble matrix of the aortic wall.

Aorta↗
PubMed1994

Lens refilling and endocapsular polymerization of an injectable intraocular lens: in vitro and in vivo study of potential risks and benefits.

Endocapsular cataract removal and injection of a liquid artificial lens has several advantages, including restitution of accommodation, small corneoscleral incision, a more physiological position of the intraocular lens, and a reduced rate of secondary opacification. Our technique consists of bimanual phacofragmentation followed by injection of a fluid monomeric material that can be polymerized inside the capsular bag by short light exposure. Our study assessed the potential risks of the technique (e.g., heat damage to ocular tissue, light damage to the retina) and investigated the technique in vivo. We performed in vitro experiments on porcine cadaver eyes and an in vivo study on 15 rabbits. After a clinical follow-up of at least 12 weeks, the eyes were investigated histopathologically. During the polymerization process, the highest temperature measured at the posterior lens capsule was 45.1 degrees Celsius for a few seconds. The measured irradiance (0.065 watts per cm2) and the risk of photochemical damage to the retina during 20 seconds of polymerization were comparable to that caused by 1.5 minutes of standard coaxial illumination with the operating microscope. In vivo there were no serious inflammatory reactions except in four cases in which there had been intraoperative problems. The rate of secondary opacification appeared less than in conventional intraocular lens implantation in rabbits, especially when the capsule refilled completely. Retinal damage could not be detected histopathologically. In conclusion, refilling techniques may be successful once appropriate refilling materials become available.

Animals↗
PubMed1994

[Intrastromal refractive corneal surgery with pico-second Nd:YAG laser pulses].

Intrastromal laser surgery with picosecond pulses aims to achieve refractive changes of the cornea without damaging the epithelium, Bowman's membrane, or the endothelium. For that, a tissue layer with well-defined thickness has to be evaporated by creating laser plasmas within the corneal stroma. We investigated the plasma formation and the plasma-induced shock wave emission and bubble generation (cavitation) in the cornea, as well as the tissue effects and the range for endothelial damage. The laser light source used was an Nd:YAG laser emitting pulses with a duration of 30 ps at a repetition rate of 10 Hz. Intrastromal plasma formation and cavitation were investigated in sheep eyes in vitro by means of time-resolved macro-photography with 20 ns exposure time. Photographs were taken at various delay times (3 microseconds-2 min) after the release of the Nd:YAG laser pulse. The morphology of the laser effects and the incidence of endothelial damage was investigated by light-microscopic inspection of histological cross sections of the irradiated corneas. The minimal plasma size at energies close to the breakdown threshold was about 40 microns. Using a laser effects could be created without causing microscopically detectable damage to the epithelium, endothelium, or Bowman's membrane. To avoid damage, the distance between endothelium and laser focus had to be larger than 150 microns. Shock wave-induced tissue damage was not observed, although the maximum shock wave pressure was up to 13 kbar. The laser-generated intrastromal cavities are at least 10 times larger than the plasma volume.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1994

[Preparation of critical point dried specimens of mouse embryos with a laser scalpel].

We investigated the use of a laser scalpel for tissue sparing demonstration of the deep structures of critical point dried specimens. A Nd:YAG-Laser emitted pico-second pulses (wavelength 1064 nm, pulse width 30 ps) at pulse energies varying from 1 microJ to 6 mJ was used. Differences in the effects on sputtered and unsputtered specimens were found. We separate the floor of the mouth and pharyngeal fornix in mouse embryos (10. developmental day). It was concluded the laser scalpel is superior to conventional mechanical dissecting methods when applied to small dried specimens. The advantages and disadvantages of the laser scalpel are discussed.

Animals↗
PubMed1994

Intraocular photodisruption with picosecond and nanosecond laser pulses: tissue effects in cornea, lens, and retina.

PURPOSE: Nd:YAG laser photodisruption with nanosecond (ns) pulses in the millijoule range is an established tool for intraocular surgery. This study investigates tissue effects in cornea, lens, and retina to assess whether picosecond (ps) pulses with energies in the microjoule range can increase the surgical precision, reduce collateral damage, and allow applications requiring more localized tissue effects than can be achieved with ns pulses. METHODS: Both ps and ns Nd:YAG laser effects on Descemet's membrane, in the corneal stroma, in the lens, and at the retina were investigated in vitro in bovine and sheep eyes and in cataractous human lens nuclei. For each tissue, the optical breakdown threshold was determined. The morphology of the tissue effects and the damage range of the laser pulses were examined by light and scanning electron microscopy. The cavitation bubble dynamics during the formation of corneal intrastromal laser effects were documented by time-resolved photography. RESULTS: The optical breakdown threshold for ps pulses in clear cornea, lens, and vitreous is, on average, 12 times lower than that for ns pulses. In cataractous lens nuclei, it is lower by a factor of 7. Using ps pulses, Descemet's membrane could be dissected with fewer disruptive side effects than with ns pulses, whereby the damage range decreased by a factor of 3. The range for retinal damage was only 0.5 mm when 200 microJ ps pulses were focused into the vitreous. Picosecond pulses could be used for corneal intrastromal tissue evaporation without damaging the corneal epithelium or endothelium, when the pulses were applied in the anterior part of the stroma. The range for endothelial damage was 150 microns at 80 microJ pulse energy. Intrastromal corneal refractive surgery is compromised by the laser-induced cavitation effects. Tissue displacement during bubble expansion is more pronounced than tissue evaporation, and irregular bubble formation creates difficulties in producing predictable refractive changes. CONCLUSIONS: The use of ps pulses improves the precision of intraocular Nd:YAG laser surgery and diminishes unwanted disruptive side effects, thereby widening the field of potential applications. Promising fields for further studies are intrastromal corneal refractive surgery, cataract fragmentation, membrane cutting, and vitreolysis close to the retina.

Animals↗
PubMed1993

FGF-4 replaces the apical ectodermal ridge and directs outgrowth and patterning of the limb.

The apical ectodermal ridge plays a key role in limb development. We show that recombinant FGF-4 can substitute for the ridge to provide all the signals necessary for virtually complete outgrowth and patterning of the chick limb. FGF-4 stimulates proliferation of cells in the distal mesenchyme and maintains a signal from the posterior to the distal mesenchyme that appears to be required for elaboration of skeletal elements in the normal proximodistal sequence. Moreover, retinoic acid, which is capable of providing polarizing activity, can supply this signal. This suggests that polarizing activity plays a role in patterning along the proximodistal axis, in addition to its well-established role in anteroposterior patterning. Taken together, the data suggest a simple mechanism whereby FGF-4 links growth and pattern formation during limb development.

Animals↗
PubMed1993

FGF-4 maintains polarizing activity of posterior limb bud cells in vivo and in vitro.

The polarizing region is a major signalling tissue involved in patterning the tissues of the vertebrate limb. The polarizing region is located at the posterior margin of the limb bud and can be recognized by its ability to induce additional digits when grafted to the anterior margin of a chick limb bud. The signal from the polarizing region operates at the tip of the bud in the progress zone, a zone of undifferentiated mesenchymal cells, maintained by interactions with the apical ectodermal ridge. A number of observations have pointed to a link between the apical ectodermal ridge and signalling by the polarizing region. To test this possibility, we removed the posterior apical ectodermal ridge of chick wing buds and assayed posterior mesenchyme for polarizing activity. When the apical ectodermal ridge is removed, there is a marked decrease in polarizing activity of posterior cells. The posterior apical ectodermal ridge is known to express FGF-4 and we show that the decrease in polarizing activity of posterior cells of wing buds that normally follows ridge removal can be prevented by implanting a FGF-4-soaked bead. Furthermore, we show that both ectoderm and FGF-4 maintain polarizing activity of limb bud cells in culture.

Animals↗
PubMed1993

[Spatial confinement of intraocular picoseconds-photodisruption effects].

Laser photodisruption is a routinely performed clinical procedure in intraocular microsurgery of post-cataract membranes, anterior synechies and iridectomies. Damage ranges of several millimeters in diameter, however, limit the use of nanosecond photodisruption close to delicate structures, e.g., in the posterior vitreous. Multiple ps-laser pulses of about 100 microJ pulse energy were used to produce disruptive effects in the anterior lens capsule in rabbit eyes in vivo. Ophthalmoscopical and morphological investigations of these effects were compared with those of minimal ns-disruptions. The direct tissue separation effects as well as the collateral damage zones are about one order of magnitude smaller if ps-laser pulses are used. Minimal sizes of disruptive effects are about 50 microns to 150 microns and 500 microns to 1000 microns for ps- and ns-pulses, respectively. The substantial improvement of spatial confinement of ps-photodisruption enables increased precision of intraocular laser microsurgery and opens up new areas of clinical application in structures like the cornea, anterior chamber angle, and crystalline lens.

Animals↗
PubMed1992

[The importance of 201-thallium myocardial scintigraphy in the hypertensive patient].

Thallium-201 exercise myocardial scintigraphy was performed in 57 patients (37 males, 20 females; mean age 55.4 [43-78] years) with angina and systemic hypertension after exclusion by coronary angiography of any coronary macroangiopathy. The exercise ECG of 32 patients could not be used in the diagnosis of ischaemia because of the presence of left ventricular hypertrophy with abnormal repolarization or left bundle branch block. Abnormal haemodynamics were demonstrated at cardiac catheterization in 23 patients (Swan-Ganz). Only 10 of the studied hypertensives with normal coronary angiograms had a myocardial scintigram within normal limits, while 12 had extensive ischaemic zones in the left ventricle. All patients with left bundle branch block had evidence of exercise-dependent apical "ischaemia". Thallium-201 myocardial scintigraphy should not be used as a screening method in hypertensives with angina, because the high proportion of "false-positive" findings, in the sense of a macroangiopathy, will nevertheless require early invasive diagnosis.

Adult↗
PubMed1992

[Plasma formation in Nd:YAG laser surgery].

Plasma formation with nanosecond and picosecond Nd:YAG laser pulses was investigated as a function of laser pulse energy to find possibilities for a spatial reduction of the laser effects. The threshold for plasma formation (optical breakdown) in distilled water is 200 microJ for ns pulses and 15 microJ for ps pulses. At a pulse energy of 1 mJ, the plasma length is 80 microns for ns pulses and 250 microns for ps pulses. For the same pulse energy, ps plasmas are on average three times larger than ns plasmas. The plasma length is approximately proportional to the cube root of the laser pulse energy for both ns and ps laser pulses. The decrease in the breakdown threshold achieved by using ps pulses renders photodisruption with a smaller pulse energy (in the microJ range) possible, and therefore a reduction in the side effects. The results are compared with the "moving breakdown" model.

Endothelium, Corneal↗
PubMed1991

Glycosphingolipid specificity of the human sulfatide activator protein.

The interaction of the sulfatide activator protein with different glycosphingolipids have been studied in detail. The following findings were made. 1. The sulfatide activator protein forms water-soluble complexes with sulfatides [Fischer, G. and Jatzkewitz, H. (1977) Hoppe-Seyler's Z. Physiol. Chem. 356, 6588-6591] and various other glycospingolipids. 2. In the absence of degrading enzymes the activator protein acts in vitro as a glycosphingolipid transfer protein, transporting glycosphingolipids from donor to acceptor liposomes. Lipids having less than three hexoses, e.g. galactosylceramide, sulfatide and ganglioside GM3 were transferred at very slow rates, whereas complex lipids such as gangliosides GM2, GM1 and GD1a were transferred much faster than the former. The transfer rate increased with increasing length of the carbohydrate chain of the lipid molecules. 3. Both the acyl residue in the ceramide moiety and the nature of the carbohydrate chain are significant for recognition of the glycosphingolipids by the sulfatide activator protein. Apparently, both residues serve as an anchor and the longer they are the better they are recognized by the protein. 4. In the absence of activator protein, degradation rates of sulfatide derivatives by arylsulfatase A, and of ganglioside GM1 derivatives by beta-galactosidase, increase with decreasing length of acyl residues in their hydrophobic ceramide moiety. Addition of activator protein stimulates the degradation of only those GM1 and sulfatide derivatives that have long-chain fatty acids in their hydrophobic ceramide anchor.

Ceramides↗
PubMed1991

[Communal housing for the mentally ill. A supplement or an alternative to the existing psychiatric institutions].

In 1980-1981, two communal housing schemes for young psychiatric patients in the Municipality of Copenhagen were established. The object was to offer these persons a home for a limited period (maximum three years). The object of this investigation is to describe the patients who lived in these communal homes during the period 1.3.1980-28.2.1989, to investigate the duration of hospitalization in psychiatric departments two years before and two years after they stay in the communal home and, on the basis of the experience gained, to discuss the possibilities and limitations of this form of housing. The investigation is retrospective and based on hospital case records. It includes 56 persons: 37 men and 19 women. The average age was 28.7 years. 92% of the residents had a chronic psychiatric disease. They had received psychiatric treatment early and had long histories with prolonged periods of hospitalization. The average duration of hospitalization was 17 months. At the conclusion of the investigation, 33 residents had moved out two or more years ago. The average duration of hospitalization for this group was reduced to approximately 1/3 of the duration of hospitalization prior to the stay in the communal home. The structure outlined here may be employed for a number of the chronic psychiatric patients but a communal psychiatric offer should include a greater spectrum of possibilities for chronic patients to cover their requirements. Establishing an offer of this type demands multidisciplinary cooperation.

Adult↗
PubMed1991

Optical properties of human sclera, and their consequences for transscleral laser applications.

The spectral dependence of the optical properties of human sclera adjacent to the limbus was investigated and related to the potentials of transscleral photocoagulation. The total transmission, absorption, and reflection, as well as the angular distribution of the transmitted and reflected light were measured at five laser wavelengths (442 nm, 514 nm, 633 nm, 804 nm, and 1,064 nm), both for noncontact and contact applications. Absorption and scattering coefficients were determined using the Kubelka-Munk model for light propagation through a scattering tissue. The scleral transmission is only 6% at 442 nm but increases to 35% at 804 nm and to 53% at 1,064 nm. The absorption is high at short wavelengths with 40% at 442 nm but it is only 6% at 804 nm and 1,064 nm. The reflection is generally higher than 40% and shows little wavelength dependence. The transmitted light is scattered diffusely at short wavelengths, but at 804 nm and 1,064 nm it exhibits a fairly narrow angular distribution in forward direction. Fiber contact leads to an increase of transmission, with a factor of 3.5 at 442 nm, of 2.0 at 804 nm, and 1.5 at 1,064 nm. Our results indicate that the diode laser (804 nm) and the Nd:YAG laser (1,064 nm) with contact delivery are best suited for transscleral photocoagulation.

Absorption↗
PubMed1991

Trisomy 8 in primary esthesioneuroblastoma.

Esthesioneuroblastoma is a rare malignancy believed to be derived from neuroectodermal stem cells within the olfactory epithelium. We have obtained the karyotype of a primary esthesioneuroblastoma following brief (7-day) in vitro culture, and have determined that the only observable cytogenetic anomaly is the presence of an additional chromosome 8. Previously, the karyotypes of two cell lines established from metastatic esthesioneuroblastomas have been reported to contain the equivalent of three copies of chromosome 8, in addition to other chromosomal aberrations, including the reciprocal translocation, t(11;22)(q24;q12). Examination of the cytogenetic literature suggests that an extra copy of chromosome 8 is a common occurrence in undifferentiated small round cell tumors frequently observed to carry the t(11;22), including esthesioneuroblastoma, Ewing's sarcoma, peripheral neuroepithelioma, Askin's tumor, and rhabdomyosarcoma. These data, combined with our report of a small round cell tumor with the karyotype 47,XY, +8, indicate that trisomy 8 may be a common phenomenon in these tumors, and may also provide some sort of selective advantage to these tumor types.

Chromosome Aberrations↗
PubMed1991

The St Croix disaster and the National Disaster Medical System.

The National Disaster Medical System was designed to respond to a catastrophic disaster by creating a group of specially trained civilian disaster medical assistance teams. The teams would be transported to the periphery of the event to triage, stabilize, and then prepare victims for evacuation to facilities elsewhere in the United States that have agreed in advance to accept such patients. Hurricane Hugo's devastation in St Croix offered the first opportunity to test the system. The event was an example of a type of medical disaster that resulted in a sudden reduction in medical resources without a great increase in casualties. Background information and operation of the New Mexico disaster medical assistance team are presented with a clinical profile of the patients seen during the disaster. We describe the first actual deployment of a disaster medical assistance team and the issues that must be addressed before future deployments.

Disaster Planning↗