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Biomedical subjects

J S Nelson

Publications and source records attributed to J S Nelson.

At least 127 records · Page 7Linked to original sources
PubMed1989

Mid-infrared erbium:YAG laser ablation of bone: the effect of laser osteotomy on bone healing.

A comparative study was undertaken in rabbit tibiae to assess the healing of bone in response to osteotomies by a mid-infrared erbium: YAG (2.94 microns) laser or a mechanical saw. Laser parameters necessary for osteotomy were shown to produce deep cuts with sharp edges and no gross charring or burning of adjacent bone. However, it was noted histologically that there was a delay in healing of the laser osteotomies as compared to saw osteotomies. This delay was caused by a microscopic zone of damage to bone adjacent to the laser cuts. It is concluded that, although the erbium: YAG laser may be a useful tool in orthopaedic surgery to ablate bone, under the conditions used in this study, there will be a delay in the healing process after laser osteotomy.

Animals↗
PubMed1989

Colonic mucosectomy using laser photodynamic therapy.

Photodynamic therapy (PDT) involves photosensitizing tissue and then activating it with monochromatic light, causing necrosis. Precise control of the extent of injury should be possible by varying the energy density of the light applied to the target tissue. We tested the sensitivity of colonic tissue to PDT by injecting 10 mg/kg Photofrin II intraperitoneally in 10 rats. After 24 hr the left colon was opened and cleansed. A 1.0-cm2 area of mucosa was exposed to 630 nm (red) light produced by an argon-pumped dye laser. Pairs of rats were treated with energy densities of either 10, 20, 40, 60, or 80 J/cm2, controlled by varying exposure times. After 48 hr, we sacrificed the rats and fixed, sectioned, and stained the left colons. The depth of injury was measured with an ocular micrometer and expressed as a percentage of normal bowel wall thickness. A curve was fit to the data points by computerized nonlinear regression. The relationship between depth of injury (Y) and energy density (X) was found to fit the equation Y = 1 - aebx, where constants a = 1.15 and b = -0.0353, (R2 = 0.93, P less than 0.001). The relationship between injury and energy density is biphasic, rising rapidly from 0 to 40 J/cm2 and more slowly after this point, suggesting that colonic mucosa is more sensitive to PDT than muscularis, providing a margin of safety against perforation. Bowel perforation did not occur in this study but is predicted by extrapolation for energy densities of 100 J/cm2 or greater. These data indicate that photodynamic colonic mucosectomy is possible.

Animals↗
PubMed1989

Radiation Therapy Oncology Group (RTOG) survival data on anaplastic astrocytomas of the brain: does a more aggressive form of treatment adversely impact survival?

The RTOG has sponsored several studies for malignant gliomas of the brain that have included tumors classified as either glioblastoma multiforme (GBM) or anaplastic-atypical astrocytoma (AAF) under the Nelson schema. Glioblastoma multiforme, the more aggressive histology, has done poorly under all forms of treatment having a typical median survival of 8-11 months. The less common and less aggressive anaplastic-atypical astrocytoma seems to show a survival that worsens with treatment more aggressive than standard radiotherapy. All patients in this report have had their tumors centrally reviewed by a RTOG neuropathologist and have had the diagnosis of anaplastic-atypical astrocytoma confirmed. We compare three patient groups: standard photon radiotherapy from the 60 and 70 Gy arms of RTOG 74-01/ECOG 1374 and from the 65 Gy control arm of RTOG 76-11; radiation therapy and chemotherapy from RTOG 74-01/ECOG 1374 (60 Gy + BCNU and 60 Gy + MeCCNU + DTIC) and from RTOG 79-18 (60 Gy + BCNU); and photon irradiation plus a neutron boost from RTOG 76-11 and RTOG 80-07. There are 47 analyzable cases treated with photons alone, 78 analyzable cases treated with photons + chemotherapy, and 38 analyzable cases treated with photons + neutron boost. Median survival for the three groups of patients is, respectively, 3.0 years, 2.3 years, and 1.7 years. Actuarial survival curves are presented for each subgroup of patients and then for the patient subgroups further broken down by major prognostic variables--age and Karnofsky performance status. In each "better prognostic category," the median survival decreased as the "aggressiveness" of the treatment increased. The implications of these findings for future clinical trials is discussed.

Adolescent↗
PubMed1989

Treatment of facial vascular lesions with a 100-mu spot 577-nm pulsed continuous wave dye laser.

The present study documents the treatment and follow-up of 25 patients treated for four different types of superficial facial vascular lesions with the continuous wave, mechanically pulsed, yellow (577-nm wavelength) tunable dye laser using a 100-mu spot diameter handpiece and pulse durations of 0.05 to 0.10 s. When absorbed, this wavelength generates heat specifically within superficial blood vessels and, if delivered in a brief, intense pulse to a small, focused spot, can cause selective damage without destruction of the adjacent epidermis or surrounding dermis. The results indicate that the physician can attain an excellent clinical outcome while significantly reducing potential adverse side effects seen in treating these lesions with more conventional laser systems.

Adolescent↗
PubMed1989

Does an extraocular proprioceptive signal reach the superior colliculus?

1. The primary functions of the superior colliculus (SC) are thought to include both the spatial localization of sensory stimuli and the initiation of an orienting response. It has been hypothesized that, in cat, both of these SC functions may be influenced by feedback from the extraocular muscles. The present investigation was initiated to determine which SC cells receive this extraocular muscle feedback and how this feedback influences the discharge properties of SC cells and their ability to integrate input from other sensory modalities. These questions were addressed in cats prepared with various anesthetic agents. 2. During the course of these experiments it became apparent that responses of SC cells to extraocular muscle stimulation could be elicited only under very specific conditions, and these observations questioned the existence of functional extraocular inputs to SC cells. 3. Rotating the eye or stretching the extraocular muscles was never found to be effective in activating SC cells unless the drug chloralose was used in the experimental preparation. In these chloralose-anesthetized animals, responses to eye rotation or muscle stretch were long and variable in latency, the discharge did not reflect the metrics of the stimulus, and the velocity and amplitude thresholds of these cells usually exceeded the cat's oculomotor range. Responses usually consisted of one to three impulses and, in appropriate conditions, could be inhibited by responses to visual or auditory stimuli. 4. The origin of this SC response to eye rotation/extraocular-muscle stretch could not be localized to the extraocular muscles. Responses to passive stretch of extraocular muscles were not eliminated by anesthetizing the muscles with injections of lidocaine. Active contraction of the extraocular muscles induced by electrical stimulation of the oculomotor nerve was never observed to evoke SC responses. Furthermore, transection of the muscle nerves, which isolated the extraocular-muscle receptors from the CNS, did not affect the response initiated by stretching the extraocular muscles. However, in the absence of intact muscle nerves, pulling the periorbital tissue elicited responses very much like those produced by stretching the muscles in the intact preparation, suggesting the periorbita as the source of responses in intact preparations as well. 5. These data are not consistent with the hypothesis that feedback from extraocular-muscle receptors influences the activity of SC cells.

Action Potentials↗
PubMed1988

Mechanism of tumor destruction following photodynamic therapy with hematoporphyrin derivative, chlorin, and phthalocyanine.

The effect of photodynamic therapy on the tumor microvasculature in the first few hours after treatment was studied at the light and electron microscopy levels. BALB/c mice with EMT-6 tumor received ip injections of hematoporphyrin derivative, chlorin, or phthalocyanine, and 24 hours later, the tumors were treated with light at 100 J/cm2 at the appropriate therapeutic wavelength for each photosensitizer. Animals were killed and their tumors removed at time 0, 30 minutes, 1 hour, and 2, 4, 6, 8, 12, 16, and 24 hours after treatment. The results indicate that for all three sensitizers the effects of photodynamic therapy leading to rapid necrosis of tumor tissue are not the result of direct tumor cell kill but are secondary to destruction of the tumor microvasculature. The first observable signs of destruction occur in the subendothelial zone of the tumor capillary wall. This zone, composed of dense collagen fibers and other connective tissue elements, is destroyed in the first few hours after phototherapy. However, the ultrastructural changes seen in this zone are different for the hematoporphyrin derivative, compared with chlorin and phthalocyanine. Binding of photosensitizers to the elements in this zone as well as altered permeability and transport through the endothelial cell layer because of the increased intraluminal pressure may be key features of tumor destruction.

Animals↗
PubMed1988

In vitro characterization of monoaspartyl chlorin e6 and diaspartyl chlorin e6 for photodynamic therapy.

The characteristics of two new chlorin photosensitizers were studied in cell culture by determining phototoxicity, subcellular localization, and photophysical properties. Monoaspartyl chlorin e6 (MACE) and diaspartyl chlorin e6 (DACE) are new photosensitizers that show promise for use in photodynamic therapy. These chlorins are pure, monomeric compounds as determined by high-pressure liquid chromatography. Both compounds absorb substantially at a longer wavelength (664 nm) than does dihematoporphyrin ether-ester (DHE). Tumor diagnosis with the use of fluorescence should be facilitated due to the purity of the compounds and the single fluorescence emission peak. Phototoxicity dose-response curves of the sensitizers were completed using a standard clonogenic assay to determine cell viability. The chlorins showed good sensitizing capabilities with light. In addition, subcellular localization of MACE, DACE, and DHE was studied using fluorescence microscopy. Whereas DHE was located throughout the cytoplasm, the primary site of localization of the chlorins appeared to be in the lysosome. The results demonstrate that MACE and DACE are effective photosensitizing agents in vitro and compare favorably to DHE.

Cell Line↗
PubMed1988

Photodynamic therapy of human malignant melanoma xenografts in athymic nude mice.

While photodynamic therapy (PDT) for cutaneous malignancies including dermal recurrences of breast cancer and basal cell carcinomas has shown great promise, PDT of malignant melanoma has remained incompletely understood. A comparison study of the effects of PDT on human xenograft amelanotic and melanotic malignant melanoma in the athymic nude mouse model was performed. Twenty-four hours after ip administration of Photofrin II, the responses to total laser light doses of 25-300 J/cm2 were evaluated by histologic examination. Animals were also sacrificed 24 hours after administration of Photofrin II without light, and their uptake and localization of hematoporphyrin derivative (HpD) for each tumor were measured and compared. The results indicate that human xenograft melanotic melanoma, despite the fact that it contains more HpD than does amelanotic melanoma, is far less responsive to PDT. This result appears to be due to the competing chromophore melanin, which may inhibit the photochemical reaction at several key points.

Animals↗
PubMed1988

Ablation of bone and methacrylate by a prototype mid-infrared erbium:YAG laser.

An erbium:YAG laser was used to generate 200-microseconds pulses of mid-infrared 2.94-microns light in both the single and multimode configurations. Laser pulses were focused on the surfaces of both rabbit long bones and methacrylate blocks, and the tissue response was examined histologically. The depth of thermal injury was determined by ocular micrometry. Over all energy levels tested, the erbium:YAG laser produced ablation of bone and methacrylate with minimal thermal damage to adjacent tissue. Increasing the laser energy per pulse produced increasingly wider and deeper grooves in both bone and methacrylate. However, such increase in laser energy produced a proportionately greater increase in the zone of thermal injury in methacrylate as compared with bone. These studies suggest the feasibility of a surgical erbium:YAG laser in orthopaedics and other forms of ablative surgery.

Animals↗
PubMed1988

Randomized neutron dose searching study for malignant gliomas of the brain: results of an RTOG study. Radiation Therapy Oncology Group.

From September 1980 through January 1985, the Radiation Therapy Oncology Group (RTOG) conducted a randomized, dose-searching study testing the efficacy of a concomitant neutron boost along with whole brain photon irradiation in the treatment of malignant gliomas of the brain. Patients had to have biopsy-proven, supratentorial, anaplastic astrocytoma or glioblastoma multiforme (Nelson schema) to be eligible for the study. The whole brain photon irradiation was given at 1.5 Gy per treatment, 5 days-a-week to a total dose of 45 Gy. Two days-a-week the patients were to receive neutron boost irradiation to the tumor volume as determined on CT scans. The neutron irradiation was to be given prior to and within 3 hours of the photon irradiation on that day. The rationale for this particular treatment regime is discussed. A total of 190 evaluable patients were randomized among 6 different neutron dose levels: 3.6, 4.2, 4.8, 5.2, 5.6 and 6.0 Gyn gamma. There was no difference in overall survival among the 6 different dose levels, but for patients having less aggressive tumor histology (anaplastic astrocytoma), there was a suggestion that patients on the higher dose levels had poorer overall survival than patients on the lower dose levels and also did worse than historical photon controls. Important prognostic factors were identified using a Cox stepwise regression analysis. Tumor histology, Karnofsky performance status, and patient age were found to be related to survival while extent of surgery and neutron dose had no significant impact. Autopsies were performed on 35 patients and the results correlated with the actual neutron dose as determined by central-axis isodose calculations. At all dose levels there were some patients with both radiation damage to normal brain tissue and evidence of viable tumor. No evidence was found for a therapeutic window using this particular treatment regimen.

Astrocytoma↗
PubMed1988

Combined modality approach to treatment of malignant gliomas--re-evaluation of RTOG 7401/ECOG 1374 with long-term follow-up: a joint study of the Radiation Therapy Oncology Group and the Eastern Cooperative Oncology Group.

The Radiation Therapy Oncology Group (RTOG) and the Eastern Cooperative Oncology Group (ECOG) conducted a phase III trial in patients with malignant gliomas to evaluate 4 treatment arms: 1) 60 Gy to the whole brain; 2) 60 Gy plus 10-Gy boost; 3) 60 Gy plus carmustine (BCNU); and 4) 60 Gy plus semustine plus dacarbazine. Between September 1974 and March 1979, 626 patients with malignant gliomas were treated on protocol RTOG 7401/ECOG 1374. Each institution chose a subset of the treatments to which the patients would be randomized. Patients were stratified according to subset and randomized to the 4 treatment arms. There were no differences in survival among treatment arms. For patients greater than 60 years of age, the addition of chemotherapy to radiation therapy did not improve survival. For patients aged 40-60 years, there was a statistically significant increase in overall survival when BCNU was added to 60 Gy (P less than .01), with an increase in 2-year survival from 8% to 23%. This beneficial effect of BCNU is apparent in both histological groups (astrocytoma with atypical or anaplastic foci and glioblastoma multiforme). Although few confirmatory autopsies are available, long-term survival in patients with astrocytomas with atypical and anaplastic foci who were treated with 60 Gy plus BCNU (5-yr survival, 22%) suggests no significant late CNS toxicity, compared to 60 Gy alone (5-yr survival, 15%). This is confirmed by comparable neurological function in long-term survivors.

Adult↗
PubMed1987

In vivo studies on the utilization of mono-L-aspartyl chlorin (NPe6) for photodynamic therapy.

The in vivo photosensitizing efficacy of mono-L-aspartyl chlorin has been studied by determining the percentage of BALB/c mice cured at varying doses of drug. Using an EMT-6 tumor model, animals received i.p. injections of mono-L-aspartyl chlorin (0.5-100 mg/kg) and then were subsequently exposed to light at 664 nm. Tumor biopsies were taken from selected animals sacrificed at 24 h after treatment and routine histopathological sections made. The other animals remained in the dark for a period of 6 weeks to determine the cure rate. Our results show that mono-L-aspartyl chlorin is an effective tumor localizer that brings about the selective degradation of tumor tissue following light exposure.

Animals↗
PubMed1987

Biological studies on the main fractions of hematoporphyrin derivative.

The four main fractions of hematoporphyrin derivative were separated by high-pressure liquid chromatography. Each fraction was studied with respect to photosensitizing capabilities, fluorescence, and tumor tissue uptake in mice bearing EMT-6 tumors. Animals received i.p. injections of 10 mg/kg of each fraction, and 24 h later tumors either were treated with 100 J/cm2 of light (630 nm) to evaluate photosensitizing capabilities, or the animals were sacrificed and tumors removed for fluorescence and fraction uptake determination. The results indicate that the fraction responsible for photosensitization has the highest tumor tissue uptake and retention. Furthermore, this fraction demonstrates the highest overall fluorescence localization in neoplastic tissue. The other poorly photosensitizing fractions have a lower overall fluorescence in vivo due to their poor tumor tissue localization.

Animals↗
PubMed1987

Adaptive decreases in amino acids (taurine in particular), creatine, and electrolytes prevent cerebral edema in chronically hyponatremic mice: rapid correction (experimental model of central pontine myelinolysis) causes dehydration and shrinkage of brain.

The experimental model of central pontine myelinolysis--chronic (4-day) hyponatremia induced by daily injections of hypotonic dextrose solutions and vasopressin followed by rapid correction with saline--was used in young fasted and thirsted mice. In normal controls chronic fasting and thirsting lowered plasma and brain glucose levels and cerebral glycolytic and tricarboxylic acid cyclic metabolic fluxes. The fasting state had little effect on brain amino acids. Clinically, the animals became semistuporous; about one-third died. Chronic hyponatremia in fasted mice almost tripled the plasma glucose concentrations and increased the brain carbohydrate reserve. Levels of other brain glycolytic and Krebs citric acid cycle intermediates were similar to those of controls. Severe hyponatremia and hypoosmolality induced profound decreases in levels of brain electrolytes, amino acids (especially taurine), and creatine. These changes permitted a new osmotic balance between blood and brain and a normal brain water content. The behavior and mortality of the hyponatremic animals were not different from those of the fasted control mice. Correction of hyponatremia to normonatremic levels over a 9-hr period returned brain Na+ and K+ levels to normal but the contents of the measured amino acids and creatine were still reduced one-third or more. As a result, treatment produced a significant degree of dehydration and shrinkage of the brain. The findings stress the importance of amino acids (taurine in particular) and creatine levels, as well as electrolytes, in brain osmoregulation and suggest a role for an osmotic disequilibrium--blood osmolality higher than brain--in the production of brain lesions following rapid correction of chronic hyponatremia in animals and possibly in humans. Replenishment of depleted brain K+ and amino acid levels, as well as slow elevation of the chronically depressed level of plasma Na+, is recommended.

Acclimatization↗
PubMed1986

Sickle cell anemia and central nervous system infarction: a neuropathological study.

CNS infarcts were demonstrated in 12 of 24 autopsied patients with sickle cell anemia. The infarcts occurred most extensively in the territory supplied by the distal branches of the internal carotid artery, especially the anterior-middle cerebral artery boundary zone. They were regularly associated with organizing and recanalizing thrombi involving the distal cervical and proximal intracranial divisions of the internal carotid system. On the basis of these findings, we infer that the pathogenesis of the infarction involves perfusion failure or intraarterial embolization in addition to intravascular sickling.

Adolescent↗
PubMed1986

Study of the in vivo and in vitro photosensitizing capabilities of uroporphyrin I compared to photofrin II.

The in vivo biological activity of uroporphyrin I has been studied by determining the amount of necrosis produced in murine tumors exposed to various total doses of light at 615 nm. Similarly, the in vitro photosensitizing activity of uroporphyrin I was examined by measuring the percentage of cells killed in a cell culture system. Light doses used were 25-400 J/cm2. Mice that received uroporphyrin I at 40 mg/kg had only minimal superficial necrosis upon histological examination at doses of 400 J/cm2 (615 nm). Those tumors that received 300 J/cm2 or less showed no histological evidence of necrosis. Mice that received hematoporphyrin derivative (Photofrin II) at 10 mg/kg were completely necrotic at total doses of 100 J/cm2 (630 nm). PTK2 epithelial cells incubated with uroporphyrin I at either 40 micrograms/ml or 80 mu/ml and 10 J/cm2 (615 nm) showed no apparent damage and had 100% cell survival. By contrast, those cells treated with hematoporphyrin derivative (Photofrin II) at 25 micrograms/ml and 10 J/cm2 (630 nm) exhibited 100% cell kill. It is concluded that uroporphyrin I is a poor photosensitizer in both in vivo and in vitro systems compared to hematoporphyrin derivative (Photofrin II).

Animals↗
PubMed1986

Fast neutron therapy for malignant astrocytomas. A review.

The treatment of supratentorial malignant gliomas has continued to be a major problem for neurosurgeons and oncologists. Post-operative conventional radiotherapy is known to prolong survival and to enhance the quality of life. Local persistence of tumor kills the majority of patients. Fast neutron irradiation is being utilized to treat malignant gliomas based on its reputed radiobiological advantages for treatment of large tumors and the encouraging preliminary reports showing tumor eradication in post-radiation biopsy and autopsy specimens. This paper reviews the results of fast neutron irradiation alone and in combination with photons and hypoxic cell sensitizers. Survival comparisons do not show any superiority for neutrons compared to conventional radiation. However, post-neutron radiation tissue samples have shown less aggressive and minimal residual tumor in many instances. At the same time radiation necrosis has emerged as a significant problem. In summary, even though neutron irradiation can eradicate malignant gliomas a therapeutic window has yet to be identified.

Astrocytoma↗