Search PubMed⌕ Search

Biomedical subjects

M Fitzmaurice

Publications and source records attributed to M Fitzmaurice.

30 records · Page 2Linked to original sources

Laser induced fluorescence spectroscopy of normal and atherosclerotic human aorta using 306-310 nm excitation.

Ultraviolet excited laser induced fluorescence (LIF) was studied in normal and atherosclerotic human arterial wall in vitro. Using excitation wavelengths from 306 to 310 nm, two distinct emission bands were observed in the LIF of both normal and pathologic aorta: a short wavelength band, peaking at 340 nm emission, which was attributed to tryptophan; and a long wavelength band, peaking at 380 nm emission, which was assigned to a combination of collagen and elastin. The intensity of the short wavelength band was quite sensitive to the choice of excitation wavelength, while the long wavelength band was not, so that the relative contributions of the bands could be controlled by the precise choice of excitation wavelength. A valley in the spectra at 418 nm was attributed to fluorescence reabsorption by oxy-hemoglobin. By using 308 nm excitation to observe emission simultaneously from both the short and long wavelength bands, normal and atherosclerotic aorta were spectrally distinct. Two LIF emission intensity ratios were defined to characterize both the relative tryptophan fluorescence content as well as the ratio of elastin to collagen fluorescence in each spectrum. The differences in these two emission ratios among the various histologic tissue types correlated qualitatively with the histologic and biochemical compositions of these tissues. By combining these parameters in a binary classification scheme, normal and atherosclerotic aorta were correctly distinguished in 56 of 60 total cases. Furthermore, atherosclerotic plaques, atheromatous plaques, and exposed calcifications could be classified individually with sensitivities/predictive values of 90%/90%, 100%/75%, and 82%/82%, respectively.

Aorta↗

Immunoglobulin deposition in atherosclerotic aortocoronary saphenous vein grafts.

Aortocoronary saphenous vein grafts develop a rapidly progressive atherosclerosis that is diffuse, concentric, and histologically distinct from that in native coronary arteries. To explore a possible role of immunologic injury in this form of atherosclerosis, frozen sections of saphenous vein grafts and normal saphenous vein controls were examined for deposits of immunoglobulins, C3, and fibrinogen by direct immunofluorescence. Immunoglobulins were found in 19 of 24 grafts, all with diffuse concentric intimal fibroplasia or atherosclerosis. No immunoglobulins were found in 5 grafts with focal eccentric atherosclerosis or organized thrombi or in the five controls. C3 and fibrinogen were also found in the majority of grafts and controls. Immunoglobulins were distributed concentrically throughout the intima or associated with atheromatous debris. The amount of immunoglobulin correlated with the amount of atheromatous debris.

Aged↗

Quadricuspid aortic valve.

A rare case of a quadricuspid aortic valve discovered incidentally at autopsy is described. A shallow raphe joined the supernumerary and adjacent cusp, possibly representing early fusion of the commissures. There was no symptomatic hemodynamic abnormality. Other than a probe-patent foramen ovale, no congenital anomalies were present. This is only the sixth example of a quadricuspid aortic valve with a raphe reported in the English language literature.

Aged↗

Argon ion laser-excited autofluorescence in normal and atherosclerotic aorta and coronary arteries: morphologic studies.

Argon ion laser-excited autofluorescence was studied in unstained frozen sections of 47 normal and atherosclerotic human aortas and coronary arteries by means of a bright-field microscope modified for fluorescence microscopy with 476 nm argon ion laser epillumination, and compared to morphology in serial sections stained with H & E, Movat pentachrome, and oil red O. Normal artery autofluorescence correlated morphologically with the structural protein fibers elastin and collagen in the intima, media, and adventitia. Atherosclerotic plaque autofluorescence correlated morphologically with lipid or calcified deposits in the atheroma core. The autofluorescence of these deposits differed from that of elastin and collagen in distribution, intensity, and color, and increased with the severity of the plaque. We conclude that argon ion laser-excited autofluorescence in normal and atherosclerotic arteries correlates with morphology and has diagnostic potential in laser angiosurgery.

Adult↗

A one-layer model of laser-induced fluorescence for diagnosis of disease in human tissue: applications to atherosclerosis.

This paper describes a general model of tissue fluorescence which can be used both to: 1) determine chemical and physical properties of the tissue, and 2) design an optimal algorithm for clinical diagnosis of tissue composition. This model is based on a picture of tissue as a single, optically thick layer, in which fluorophores and absorbing species are homogeneously distributed. As a specific example, the model is applied to the laser induced fluorescence (LIF) of normal and atherosclerotic human aorta using 476 nm excitation. Methods for determining the relevant attenuation and fluorescence lineshapes are detailed, and these lineshapes are used to apply the model to data from 148 samples. The model parameters are related to the concentrations of the major arterial chromophores: structural proteins, hemoglobin and ceroid. In addition, the model parameters are used to derive diagnostic algorithms for the presence of atherosclerosis. Utilizing a binary classification scheme, the presence or absence of pathology was determined correctly in 88 percent of cases.

Algorithms↗

Resolution of neurotoxicity with anticholinesterase therapy in death-adder envenomation.

A case of the reversal of death-adder (Acanthophis antarcticus) neurotoxicity by treatment with neostigmine methylsulphate in a Papua New Guinean villager is described. While antivenom remains the mainstay in the treatment of snake-bite envenomation, the possible role of anticholinesterase therapy for death-adder bites in Papua New Guinea is discussed. In addition, some problems with first-aid management are outlined.

Adult↗

Pemphigus and pemphigoid antibody production by pokeweed mitogen-stimulated peripheral blood mononuclear cell cultures in vitro.

Peripheral blood mononuclear cells from pemphigus vulgaris and bullous pemphigoid patients produced antiepithelial antibodies in a pokeweed mitogen-stimulated in vitro cell culture system. Antiintercellular substance (ICS) antibodies were detected in supernatants of cell cultures from four of four pemphigus vulgaris patients by indirect immunofluorescence. Similarly, antibasement membrane (BM) antibodies were detected in supernatants of cell cultures from three of four bullous pemphigoid patients. No anti-ICS or anti-BM antibodies were detected in supernatants of cell cultures of six normal controls, although antinuclear antibodies were detected occasionally. This pokeweed mitogen-stimulated in vitro cell culture system is suggested as a model to study the role of defects in immunoregulation in the pathogenesis of pemphigus vulgaris and bullous pemphigoid.

Adult↗

Gastrointestinal tissue diagnosis by laser-induced fluorescence spectroscopy at endoscopy.

An endoscope-compatible, optical fiber system has been developed which can be used to obtain laser-induced fluorescence spectra of mucosal abnormalities during endoscopy in real time. The results of our previous in vitro studies have suggested that laser-induced fluorescence tissue spectra are sufficiently unique that they can be used to accurately diagnose mucosal abnormalities in some systems. To test this hypothesis in vivo, laser-induced fluorescence spectra were obtained during colonoscopy from 31 colonic adenomas, 4 hyperplastic polyps, and 32 examples of normal mucosa in 20 patients. The resulting spectra could be used to correctly differentiate adenomas from normal colonic mucosa and hyperplastic polyps in 97% of the specimens studied with the resulting sensitivity, specificity, and positive predictive value of 100%, 97%, and 94%, respectively. These results, although preliminary in nature, suggest that laser-induced fluorescence spectra can be used in the recognition and differential diagnosis of mucosal abnormalities at endoscopy.

Adenoma↗

Diagnosis of human coronary atherosclerosis by morphology-based Raman spectroscopy.

BACKGROUND: Recent studies have shown that chemical composition and morphology, rather than anatomy (degree of stenosis), determine atherosclerotic plaque instability and predict disease progression. Current clinical diagnostic techniques provide accurate assessment of plaque anatomy, but have limited capability to assess plaque morphology in vivo. Here we describe a technique for a morphology-based diagnosis of atherosclerosis in the coronary arteries using Raman spectroscopy that can potentially be performed in vivo using optical fiber technology. METHODS: Raman tissue spectra were collected from normal and atherosclerotic coronary artery samples in different stages of disease progression (n=165) from explanted transplant recipient hearts (n=16). Raman spectra from the elastic laminae (EL), collagen fibers (CF), smooth muscle cells (SMC), adventitial adipocytes (AA) or fat cells, foam cells (FC), necrotic core (NC), cholesterol crystals (CC), beta-carotene containing crystals (beta-C), and calcium mineralizations (CM) were used as basis spectra in a linear least squares-minimization (LSM) model to calculate the contribution of these morphologic structures to the coronary artery tissue spectra. RESULTS: We developed a diagnostic algorithm that used the fit-contributions of the various morphologic structures to classify 97 coronary artery samples in an initial calibration data set as either nonatherosclerotic, calcified plaque, or noncalcified atheromatous plaque. The algorithm was subsequently tested prospectively in a second validation data set, and correctly classified 64 (94%) of 68 coronary artery samples. CONCLUSIONS: Raman spectroscopy provides information about the morphologic composition of intact human coronary artery without the need for excision and microscopic examination. In the future, it may be possible to use this technique to analyze the morphologic composition of atherosclerotic coronary artery lesions and assess plaque instability and disease progression in vivo.

Adipocytes↗

Raman microspectroscopy of human coronary atherosclerosis: biochemical assessment of cellular and extracellular morphologic structures in situ.

BACKGROUND: We have previously shown that Raman spectroscopy can be used for chemical analysis of intact human coronary artery atherosclerotic lesions ex vivo without tissue homogenization or extraction. Here, we report the chemical analysis of individual cellular and extracellular components of atherosclerotic lesions in different stages of disease progression in situ using Raman microspectroscopy. METHODS: Thirty-five coronary artery samples were taken from 16 explanted transplant recipient hearts, and thin sections were prepared. Using a high-resolution confocal Raman microspectrometer system with an 830-nm laser light, high signal-to-noise Raman spectra were obtained from the following morphologic structures: internal and external elastic lamina, collagen fibers, fat, foam cells, smooth muscle cells, necrotic core, beta-carotene, cholesterol crystals, and calcium mineralizations. Their Raman spectra were modeled by using a linear combination of basis Raman spectra from the major biochemicals present in arterial tissue, including collagen, elastin, actin, myosin, tropomyosin, cholesterol monohydrate, cholesterol linoleate, phosphatidyl choline, triolein, calcium hydroxyapatite, calcium carbonate, and beta-carotene. RESULTS: The results show that the various morphologic structures have characteristic Raman spectra, which vary little from structure to structure and from artery to artery. The biochemical model described the spectrum of each morphologic structure quite well, indicating that the most essential biochemical components were included in the model. Furthermore, the biochemical composition of each structure, indicated by the fit contributions of the biochemical basis spectra of the morphologic structure spectrum, was very consistent. CONCLUSIONS: The Raman spectra of various morphologic structures in normal and atherosclerotic coronary artery may be used as basis spectra in a linear combination model to analyze the morphologic composition of atherosclerotic coronary artery lesions.

Biomarkers↗