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Biomedical subjects

T J Filler

Publications and source records attributed to T J Filler.

31 records · Page 2Linked to original sources

[Possibilities of multimedia online teaching in medical education].

The local independence of students and teachers is accepted to be one of the main advantages of teleteaching. New techniques allow to use the Internet protocol similar to video conferences, thus giving premises to link specialties which have to operate in different environments. Synchronous communication can be established with students even over long-distances. In a pilot study a three-directional lecture between an operating theatre, the dissection laboratory of the institute of anatomy, and a lecture hall was given. During the lesson students discussed problems with any lecturer. We were able to demonstrate a sufficient transmission capability for this real-time application provided by the available internet technology. On the other hand, great technical and personnel effort for this computer aided MOT is necessary. However, although it is often difficult to reconcile the timetable of surgeries and lectures MOT provides new potentialities in interdisciplinary medical education.

Computer-Assisted Instruction↗

Three-dimensional reconstruction of senile plaques in Alzheimer's disease.

So far, the three-dimensional approach to senile plaques, one of the principal histopathological hallmarks in Alzheimer's disease besides neurofibrillary tangles, has been scarce. Two main problems in three-dimensional reconstruction of histological specimens are the horizontal distortion during the preparation of serial thin tissue-slides and the need for consecutive vertical readjustment. This is greatly facilitated by the reflection contrast microscope (Leica, Germany) which is a light microscopical instrument causing interference patterns and reflections along interfaces by means of circularly polarized epi-illumination. Using this technique, one can obtain distinct optical sections of a depth of 1.5 microns within specimens up to 30 microns in thickness, thus preserving the integrity of the observed object and rendering a manual alignment superfluous. We applied the reflection contrast microscope (RCM) on thick tissue-slides of the cerebral cortex of a patient suffering from Alzheimer's disease which had been dyed according to Campbell. This is a silver-based staining method detecting beta A4-amyloid, the main component of senile plaques. Under the RCM, these silver-stained extracellular amyloid deposits cause reflections which allow the assessment of their three-dimensional distribution by focusing through the specimen. The optical sections obtained in this way were digitized, and the identified senile plaques reconstructed by the grey-scale image analysis system VIDAS 2.5 (Zeiss/Kontron, Germany).

Aged↗

Different adhesion types and active sensitivity of platelet subpopulations.

Two different adhesion patterns of blood platelets with different sensitivity to adenosine were demonstrated by means of reflection contrast microscopy with consecutive image analysis and cell affinity chromatography. High-performance liquid chromatography revealed that thrombin-induced serotonin release of adenosine-sensitive platelets was lower than that of adenosine-resistant cells. Our results indicate platelet heterogeneity and suggest that the platelets with lower adenosine sensitivity may be actively involved in the early interaction between platelets and injured endothelium.

Adenosine↗

Qualitative investigations on vital blood platelets by reflection contrast microscopy.

Light-microscopic visualization of vital human blood platelets is improved by reflection contrast microscopy. The light reflected from the specimen causes interference patterns which are used for the assessment of surfaces or adhesion areas. By means of this technique we studied the activation process of unstimulated platelets. During the observation the following two features were assessed: (1) Platelet adhesion areas and their shape change: two main types of adhesion patterns were found for activated platelets. Type A was characterized by flat spreading and extensive adhesion zones, whereas type B showed only focal contacts in the center and long and sometimes dichotomously split pseudopodia. Both adhesion types coexisted in each sample but did not change into one another during the observation period of 25 min. (2) Pseudopodia formation: initially, a rapid evagination of mobile pseudopodia could be observed which lasted for approximately 2 min. After reaching their final individual length, the pseudopodia adhered to the glass and remained stationary.

Blood Platelets↗

[Adhesions and interference images of unfixed erythrocytes].

For the analysis of deformability in microcirculatory investigations an exact understanding of red blood cell (RBC) geometry is required. To extend knowledge we introduce a new morphological feature of resting unfixed erythrocytes by means of an inverted reflection contrast microscope (RCM). By assessing the interference patterns caused by RCM erythrocytes can be classified according to the depth of their central concavity which depends on the flexibility of the RBC. Moreover, the RBC adhesion can be directly observed. We found out that: 1. Five types of normocytes can be distinguished in RCM. 2. In phase contrast the size distribution of RBC without central concavity (type 5, 11.53% of all normocytes) shows peaks at 48 microns2 and 52 microns2. 3. Image analysis reveals two size categories of relative adhesion areas. One category consists of type 1 and 2 (relative adhesion area 25.63%), the other of the types 3 to 5 (relative adhesion area 39.91%). Besides, RCM allows the reliable identification of pathologic erythrocytes in unstained specimens.

Cell Adhesion↗

Adhesion of washed blood platelets in vitro is advanced, accelerated, and enlarged by oxidized low-density lipoprotein.

In order to study the influence of oxidized low-density lipoprotein (Ox-LDL) on platelet functional morphology at an early activation stage, washed human blood platelets were stimulated by 100 micrograms/ml Ox-LDL at 37 degrees C. The settling and spreading process of stimulated and unstimulated platelets on Formvar-coated glass was observed for approximately 20 min by reflection contrast microscopy (RCM) and quantified by image analysis. Each group consisted of at least 250 platelets. The results show that incubation with Ox-LDL causes platelet shape change and pseudopodia formation. The sedimentation of stimulated platelets precedes that of unstimulated platelets by approximately 3 min. The increase of the total adhesion area of all Ox-LDL treated platelets is significantly accelerated in comparison to normal platelets (20.45 microns2/min vs. 15.45 microns2/min; P < 0.01). The mean total adhesion area of Ox-LDL-treated platelets was generally larger than that of untreated platelets (189.7 microns2 vs. 144.7 microns2; P < 0.01). The disappearance of intracellular granules after platelet activation, observed by RCM, is supported by transmission electron microscopy. Our results suggest that Ox-LDL activates platelets and advances and accelerates their adhesion and thereby may contribute to pathological thrombosis and arteriosclerosis.

Blood Platelets↗

Decreased adhesion of oxidized LDL-stimulated platelets caused by cytochalasin D.

The adhesion of human blood platelets is studied with an in vitro model using reflection contrast microscopy and an image analysis system. The adhesive feature is promoted by oxidatively modified low density lipoprotein, which also induces functional morphological changes of platelets. However, when washed platelets are pretreated with 0.05 mM cytochalasin D, oxidized low density lipoprotein (100 micrograms/ml) causes a slower increase of the adhesion area (11.6 microns 2/min) compared to untreated platelets (15.7 microns 2/min) or platelets treated by oxidized low density lipoprotein alone (20.5 microns 2/min, P < 0.01). These results are supported by light transmission analysis and by transmission electron microscopy. Our experiments suggest that cytochalasin D inhibits the change of platelets in shape induced by oxidized low density lipoprotein, hinders the adhesion, but does not prevent the adhesion entirely.

Blood Platelets↗

Evaluation on blood platelets by the image analysis system VIDAS 2.5.

This paper introduces a program written on the image analysis system VIDAS 2.5. It enables the automatic quantification of high numbers of adhesion areas of vital human platelets, thus allowing statistical analysis. These adhesion areas were observed by reflection contrast microscopy (RCM), which generates images of an intense contrast and serves as a prerequisite for an evaluation by image analysis. However, RCM-photographs of the observed platelets have highly varying mean greyvalues and greyranges. These common problems for self-operating identification are excluded by two procedures within the program: 1. calibration of the scanning process for an optimal use of the available greyvalues provided by the negative, camera, and the image analysis system; and 2. relation of the threshold for discrimination of adhesion areas to the statistic parameters of the histogram within each individual digitized image. Images processed according to these prerequisites were transferred to the VIDAS implemented routines for identification and measurement of areas. Thus, image analysis combined with RCM offers a tool for basic and clinical platelet research, which is shown by an example of stimulation and inhibited stimulation of platelet activation.

Blood Platelets↗

Morphologic quantification of blood platelets by image analysis.

OBJECTIVE: For morphologic and functional investigations on the physiology and pathology of human blood platelets, their adhesion plays an important role. This feature is normally assessed concerning qualitative aspects, but there is a lack of quantitative investigations. STUDY DESIGN: We developed a model to quantify in vitro manipulations on thrombocytes by measuring their adhesion areas automatically. This was achieved by combining the VIDAS 2.5 image analysis system with reflection contrast microscopy (RCM). The evaluation was performed independent of the position of the grey value histogram by analyzing each digitized image corresponding to its individual mean grey value. RESULTS: The applicability and validity were verified from the example of a pharmacologic experiment administering the platelet stimulant oxidized low density lipoprotein (ox-LDL) to thrombocyte suspensions and confirming it by aggregometry. We assessed the temporal increase in adhesion area and mean total adhesion area of activated platelets, comparing unstimulated to stimulated ones. Ox-LDL accelerated the adhesion process and increased the adhesion area. CONCLUSION: The combination of RCM with consecutive image analysis provides useful parameters for in vitro examination on vital human platelets. Large amounts of data can be accumulated in a short time for an evaluation of influences of and on blood platelets.

Blood Platelets↗

Reflection contrast microscopy within chrome-alum haematoxylin stained thick tissue-sections.

This paper introduces two innovations in reflection contrast microscopy (RCM): (1) an extended application for qualitative light microscopic investigations; and (2) a novel method for quantification in cytochemistry. (1) We found out that RCM cannot only be used for surface characterizations and in thin sections but also within thick tissue-sections. The use of the RCM technique is demonstrated on slides of the supraoptic nucleus (SON) of the rat stained with chrome-alum haematoxylin: Among all the stained structures only neurosecretory granules are found to cause reflections. The visualization of the neurosecretion and its distribution is more distinct and of sharper contrast than in bright field microscopy. (2) The improved differentiation allows the quantification of neurosecretion in tissue-sections by combining RCM with grey-scale image analysis.

Animals↗

Traumatic complications of acupuncture. Therapists need to know human anatomy.

OBJECTIVES: To review the traumatic injuries that have been associated with acupuncture and to discuss how these adverse effects may be reduced by increased awareness of normal anatomy and anatomical variations. METHODS: Literature search accompanied by postmortem anatomical studies. RESULTS: Traumatic lesions after acupuncture have been described in thoracic and abdominal viscera, in the peripheral and central nervous systems, and in blood vessels. Deaths have been recorded from pneumothorax and cardiac tamponade. The anatomical structure of the body at several acupuncture points is such that needles can reach vulnerable structures. CONCLUSION: While the frequency of adverse effects of acupuncture is unknown and they may be rare, knowledge of normal anatomy and anatomical variations is essential for safe practice and should be reviewed by regulatory bodies and those responsible for training courses.

Acupuncture Therapy↗

The posterior subdeltoid approach: a modified access to the posterior glenohumeral joint.

A modified surgical approach to the posterior aspect of the glenohumeral joint and/or the dorsal glenoid is described. This access does not alter any muscle insertion or neuromuscular planes. After the skin incision is made, the inferior border of the spinal part of the deltoid is identified and the deltoid muscle is mobilized and retracted, thus offering an excellent approach to the interval between the infraspinatus and teres minor muscles. This interval is split parallel to the muscle fibers. This surgical approach was first established in 10 cadaverous shoulders and then performed in 12 patients with posterior shoulder pathology. In the cadaver study, the closest distance to the axillary nerve with this approach was 22 mm. In all 12 cases, the surgical procedure could be performed without any problems.

Arm↗

[Percutaneous vertebral augmentation (PVA) in osteoporosis of the vertebrae--an experimental study].

The present study was conducted with the aim of establishing whether minimally invasive percutaneous techniques used to stabilize osteoporotic vertebrae are technically feasible. Two different methods were investigated in human thoracolumbar cadaveric vertebrae. In the first technique, special titanium implants were placed via a postero-lateral approach. With the second method, the vertebrae were filled with different types of cement of different viscosities. After each procedure, the vertebrae were examined with conventional X-ray and CT scans. The first technique proved quite unsuccessful--the insertion of the titanium implants proving difficult despite the use of special instruments. The results achieved with the second method were much better. The use of low-viscosity bone cement produced the best results. Despite a single lateral point of entry, the vertebrae were almost completely filled right into the contralateral side. Lumbar vertebrae required an average volume of cement of 7 ml (range: 6.5-10 ml) and thoracic vertebrae 5.5 ml (range: 4-7 ml). Specially developed cement application devices made possible problem-free, controlled introduction of the cement.

Aged↗