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Biomedical subjects

F O Tio

Publications and source records attributed to F O Tio.

69 records · Page 4Linked to original sources

American mucocutaneous leishmaniasis.

Presented is a well-documented, autochthonous case of mucocutaneous leishmaniasis, a protozoan disease endemic to Asia, Africa, Southern Europe, South America, and Central America, which until recently was not found in North America. Diagnosis is made by positive culture on NNN media, positive serodiagnosis, positive Montenegro skin test, the presence of Leishman-Donovan bodies on Giemsa stain with light microscopy, and the presence of the kinetoplast within the organism on electron microscopy. The recommended treatment is sodium antimony gluconate given intramuscularly, 600 mg daily for seven to ten days.

Humans↗

Pancreatic inclusions and its relation to boric acid poisoning: review of the literature and report of a case.

It is known among forensic and pediatric pathologists that the demonstration of pancreatic inclusions is considered to have diagnostic significance in cases of boric acid poisoning. Fisher was the first to suggest a causal relationship between the inclusions and boric acid toxicity. Valdes-Dapena and Arey paid particular attention to the pancreatic inclusions in reviewing the literature of cases of boric acid poisoning. They found the inclusions in 6 of the 55 autopsies. This paper describes the finding of pancreatic inclusions in a fatal case of gastro-enteritis not associated with boric acid intoxication. The nature of the inclusion bodies was studied by light and electron microscopy. Ultrastructurally, the cytoplasmic inclusions represent a non-specific autophagic cell degenerative process. Toxicological examination of postmortem blood and viscera showed no evidence of boric acid toxicity. The desirability of toxicological analysis in cases of boric acid poisoning and the restricted value of pancreatic inclusions as a diagnostic tool are emphasised.

Boric Acids↗

Agar-screew specimen carrier for bulk processing of biopsy material for electron microscopy.

A specimen carrier for processing large numbers of biopsy materials for epoxy embedding and electron microscopy is described. Commercially available 18-mesh stainless steel or 16-mesh aluminum wire screening is used. The screening is cut into 1 x 3-inch strips. One corner is snipped off for orientation purposes. Four drops of warm 4% agar is placed on a prewarmed standard microscopic glass slide. A thin agar support film is formed on the bottom side of the horizontally held wire screen by lightly running it against the agar. Tissue blocks trimmed to 1 mm-3 are blotted on filter paper and placed in a prearranged order on the top surface of the support film. A thin top coating of agar is applied on the specimen by touching it with the tip of a pasteur pipette containing warm 4% agar. The agar-screen unit with the mounted specimens is stabilized in 4% buffered formalin and rinsed with Sorenson's phosphate buffer, pH 7.4, with 6.8% sucrose. It is then processed as a unit through routine osmium tetroxide postfixation, alcohol dehydration, and Epon 812 filtration. The tissue blocks are plucked off the agar support film with fine-tipped tweezers and embedded in individual capsules. No difficulty in thin sectioning was encountered and examination of the sections under the electron microscope showed good infiltration by the epoxy resin.

Biopsy↗

Use of stents covered with polytetrafluoroethylene in experimental abdominal aortic aneurysm.

PURPOSE: To establish the effectiveness of covered stents in the treatment of aortic aneurysms, to investigate the histopathologic healing patterns of the device, and to determine the long-term endurance and integrity of modified polytetrafluoroethylene (PTFE). MATERIALS AND METHODS: Experimental aneurysms were created in dogs by enlarging the aortic lumen with a patch of abdominal fascia. After 5 months, eight animals underwent an endoluminal bypass. The bypass device consisted of a 6-cm-long stent covered with thin PTFE. After surgery, the animals were killed at 3, 6, and 12 months in groups of three, three, and two, respectively. Specimens were processed for luminal surface studies and cross-sectional histologic study. Explanted PTFE material was analyzed for its physical characteristics and performance and was compared with retained control samples. RESULTS: Before the animals were killed, aortography showed patent bypass conduits in all animals, although two of eight had leaks into the aneurysmal sac. Endothelialized neointima largely covered the luminal surface of the PTFE stent. The percentage of prosthetic surface covered by tissue did not change from 3 months to 1 year. Physical testing of the explanted PTFE material showed no structural deterioration and no change in the internodal distance. Thickness and axial tensile strength varied 12% and 17% from controls, respectively. CONCLUSION: Thin-walled PTFE seems to have physicochemical characteristics that make this material adequate for endovascular use. Though limited, this study supports the establishment of preliminary clinical evaluation of metallic stents combined with PTFE for the treatment of abdominal aortic aneurysm.

Animals↗

Patency and tissue response related to two types of polytetrafluoroethylene-covered stents in the dog.

PURPOSE: A canine model was used to determine tissue response related to placement of two different designs of polytetrafluoroethylene (PTFE) covered stents in the peripheral vascular system. MATERIALS AND METHODS: Two types of PTFE covered stents were implanted in the iliac arteries of 15 mongrel dogs. The tissue response within and beneath these endoprostheses was studied and compared to that for control Palmaz stents with angiographic and histologic examination at 1, 3, and 6 months. RESULTS: The bare Palmaz stent endothelialized faster and with a thinner neointima than either covered stent design. Neointima formation proceeds from the ends toward the center of PTFE-covered stents regardless of design, with minimal transgraft tissue penetration. However, the pattern of neointimal response differed for the two designs and suggests that early thrombus formation at the stent-graft interface promotes neointimal development. CONCLUSION: The bare Palmaz stent showed the least amount of luminal encroachment at all time points compared with either covered stent. Regarding the covered stents, the different patterns of tissue response with the covered stents may provide insight into the design of stent-grafts for human use.

Animals↗

Measurement of density and calcium in human atherosclerotic plaque and implications for arterial brachytherapy.

PURPOSE: To measure density of arterial plaque specimens for purposes of improving calculation of intravascular radiation dose. METHODS AND MATERIALS: In the described technique, the mass of the specimen submerged in water is compared with its mass in air. Thirty-three plaque specimens harvested from cadavers and subsequently histologically classified (18 coronary, 15 noncoronary) were subjected to density measurement, and were also assayed for calcium using inductively coupled plasma optical emission spectroscopy (ICPOES). A dose point kernel (DPK) computer model extended to heterogeneous media is used to determine delivered dose to tissues for stents labeled with 32P, 103Pd, and 131Cs, based on measured density values. RESULTS: Plaque specimens identified histologically as noncalcified (non-class VII) had an average density of 1.22 +/- 0.03 g/cm3 (n = 19). Plaque specimens identified as calcified (Class VII) had an average density of 1.45 +/- 0.06 g/cm3 (n = 13). Density of calcified portions of plaque may be even higher because plaque specimens are heterogeneous. Plaque density was found to be correlated with calcium weight percentage (R2 = 0.67) and histologic percent area calcification (R2 = 0.58). Significant variations in calculated dose were found according to isotope, plaque density, and plaque thickness. The assumption of an "all water density" dose model overestimates dose to tissues. For 1-mm thick calcified (class VII) plaque, computed dose to tissues (via DPK model) are decreased by 29%, 34%, and 15%, for 32P, 103Pd, and 131Cs stents, respectively, compared with an "all water density" assumption model, when density is taken into account. Similar decreases are expected for catheter-based brachytherapy systems using beta or low energy (< 100 keV) gamma sources. CONCLUSIONS: This work has importance for radioactive stents and catheter-based brachytherapy due to dependence of dose on density at distances between 0.1 mm and 3 mm away from the radiation source. This dependence is important for both beta- and gamma-based systems.

Aged↗

Dose-response study of intracoronary beta-radiation with 32P in balloon- and stent-injured coronary arteries in swine.

PURPOSE: A dose-response study was performed in swine to investigate the vascular effects of 32P over a broad range of doses in order to define the therapeutic window of intracoronary radiotherapy (ICR) with 32P. METHODS AND MATERIALS: A total of 131 porcine arteries were subjected to balloon injury or stenting followed by 0-36 Gy of ICR from a centered 32P source wire to 1 mm beyond lumen surface or a sham ICR procedure. Animals were euthanized at 4 weeks, and vessels were harvested for histomorphometry. RESULTS: In the balloon-injured arteries, doses of 7 and 9 Gy did not impact restenosis. At doses of 14-36 Gy, neointima was markedly reduced, with mild dilatation at the highest dose, 36 Gy. In the stent-injured arteries, the lowest dose of 9 Gy failed to reduce neointimal growth, while 14-26 Gy showed the most favorable response. CONCLUSIONS: ICR with 32P features a broad therapeutic window. Doses of 14-26 Gy to 1 mm beyond lumen surface provided an optimal combination of efficacy and safety. Doses of 7 and 9 Gy were generally ineffective, suggesting a minimum threshold for ICR with 32P to effectively inhibit restenosis.

Angioplasty, Balloon, Coronary↗

Yttrium-90 delivered via a centering catheter and afterloader, given both before and after stent implantation, inhibits neointima formation in porcine coronary arteries.

BACKGROUND: Intracoronary radiation (IR) studies have shown reduction of neointima formation (NF). Extrapolation of animal studies with beta-radiation to clinical trials have shown variable results, which may be related to dosimetry, centering issues, and/or shielding of beta-rays by the stent metal. We examined the effect of yttrium-90 (90Y), a pure beta-emitter delivered via an automatic afterloader to a centering catheter, on the inhibition of NF in balloon-injured (BI) porcine coronary arteries as well as in arteries receiving 90Y either prior to or following stent implantation (SI). METHODS: Twenty-three swine (44 coronary arteries) were studied. In the first study, IR (18 Gy at 1.2 mm from the balloon surface) was administered in 17 arteries following BI, while eight control arteries were subjected to BI only. In the second study, 10 swine (19 coronary arteries) underwent SI. IR (18 Gy) was administered in six arteries before and in eight arteries after SI, while five control arteries received SI only. The animals were sacrificed 2 weeks after BI and 4 weeks after SI. Their coronaries were perfusion fixed and stained, and vessel parameters (intimal area [IA] and medial fracture length [FL]) were analyzed by computer-aided histomorphometry. RESULTS: Arteries subjected to IR following BI had less NF compared to controls (IA/FL = 0.14 +/- 0.2 mm vs. 0.49 +/- 0.2 mm; P = 0.003). IA was reduced significantly in the arteries receiving radiation before and after SI compared to controls (0.92 +/- 0.98 and 0.00 +/- 0/00 vs. 2.72 +/- 1.2 mm2; P = 0.014), despite similar SI in all groups. CONCLUSIONS: IR with 90Y delivered via a centering catheter is safe and effective with complete and homogenous inhibition of NF in the context of BI or SI in the porcine coronary model.

Animals↗

Intrastromal photorefractive keratectomy with a new optically coupled laser probe.

BACKGROUND: Intrastromal photorefractive keratectomy is a new procedure in which compact linear or area regions of the corneal stroma can be vacuolized, yielding changes in corneal curvature. METHODS: Diffraction-limited 1064-nanometer light pulses from a high rep rate Q-switched Nd-YAG laser were coupled through novel means into a probe with index-matched optical contact with the cornea. The resulting extremely reduced focal region initiated a plasma point that was free of shock front effects where tissue was reduced to liquid. This probe process was applied to the corneas of eye-bank eyes, and to living rabbit and primate eyes. The refractive effects were evaluated with slit-lamp microscopy, keratoscopy light and electron microscopy. RESULTS: Refractive effects similar to refractive keratotomy were observed immediately after treatment. Intrastromal highly localized vacuolized regions were observed at the depth of focus with variability of only 20 microns. The plasma point vacuoles were about 100 microns in diameter. Stromal material that occupied the vacuole space appeared completely reduced to liquid. The transition region between vacuole and normal tissue was less than 0.5 microns. The treatment vacuoles disappeared to the unaided eye 24 to 48 hours after treatment. CONCLUSIONS: Corneal refractive power can be achieved with intrastromal keratectomy.

Animals↗

Metastatic spindle-cell carcinoma. Cytologic features and differential diagnosis.

Fine needle aspiration biopsies of tumors can yield a variety of spindle cells derived from several types of neoplasms. Among these is a rare lesion known as a "spindle-cell carcinoma" or "pseudosarcoma," which may represent a transformation of a preexisting squamous-cell carcinoma that has been subjected to radiotherapy or solar damage. The cytologic, histologic and ultrastructural features of a case of metastatic spindle-cell carcinoma of the rib subjected to fine needle aspiration are presented, and other spindle-cell tumors that should be considered in the differential diagnosis are discussed.

Biopsy, Needle↗