Anesthesia for the parturient with pseudoxanthoma elasticum

We present our experience in the anesthetic management of two parturients with pseudoxanthoma elasticum. The first had an epidural catheter inserted for labor analgesia and ultimately had a forceps delivery. The second had a cesarean section under epidural anesthesia and had a complicated postoperative course. There were no untoward effects of regional anesthesia in either of these two women. The anesthetic implications for parturients with pseudoxanthoma elasticum are discussed.     

Coronary artery bypass in a 15-year-old girl with pseudoxanthoma elasticum

A 15-year-old girl with pseudoxanthoma elasticum and associated severe coronary artery disease underwent double coronary artery bypass using left internal mammary artery and saphenous vein. Preoperatively the patient had life-threatening syncope and positive treadmill test results. The postoperative course was uneventful, and the patient has been doing well for 3 years. Pseudoxanthoma elasticum is a rare disease that can cause premature coronary arterial obstructive disease in children and adolescents.     

Nonlinear optical microscopy of articular cartilage

OBJECTIVE: To assess the ability of nonlinear optical microscopy (NLOM) to image ex vivo healthy and degenerative bovine articular cartilage. METHOD: Fresh bovine femoral-tibial joints were obtained from an abattoir. Articular cartilage specimens were harvested from the tibial plateau. Normal and degenerative specimens were imaged by NLOM and subsequently fixed and processed for histological examination. RESULTS: NLOM provided high resolution images of articular cartilage at varying depths with high sensitivity to tissue morphology and high specificity to tissue components without fixing, sectioning or staining. Spectroscopic segmentation of nonlinear optical signals isolated the collagen matrix from the chondron (chondrocyte and non-collagen pericellular matrix). Images from the superficial zone were consistent with the presence of a matrix composed of both elastin-like and collagen fibers distributed in a depth-dependent morphological arrangement, whereas only collagen was demonstrated in the middle and deep zones. Alterations of collagen matrix associated with advanced degenerative joint disease (fibrocartilage) were observed with NLOM. Individual chondrocytes were imaged and demonstrated intracellular fluorescence consistent with the presence of products of intracellular biochemical processes. CONCLUSION: Thin images of living articular cartilage using NLOM may be obtained with (sub-)cellular resolution at varying depths without fixing, sectioning or staining. Extracellular matrical collagen and chondron may be imaged separately in native tissue using spectrally distinct, endogenous, nonlinear optical signals. NLOM was sensitive to macromolecular composition and pathologic changes in articular cartilage matrix. Advances in instrumentation may lead to the application of NLOM to study articular cartilage in vivo.     

Nonlinear optical microscopy for label-free detection of gastrointestinal neuroendocrine tumors

Neuroendocrine tumors (NETs), which are rare and slow-growing neoplasms, pose a diagnostic challenge as they are clinically silent at the time of presentation. Here, gastrointestinal neuroendocrine tumors were researched by nonlinear microscopy, and results demonstrate that this technique has the capability to identify neuroendocrine tumors in the absence of labels and can, in particular, detect rare neuroendocrine tumor cells, vascular invasion, desmoplastic reaction, and fibroelastosis induced by neuroendocrine tumors. These conclusions highlight the possibility of nonlinear optical microscopy as a diagnostic tool for label-freely differentiating neuroendocrine tumors by these histopathologic features.     

Intra‐operative radiotherapy management for breast cancer treatment in patients with pseudoxanthoma elasticum: A case report

Pseudoxanthoma elasticum is a systemic metabolic disease presenting calcifications and progressive fragmentation of elastic fibers. Actually, no targeted therapies are available for the treatment; only prevention of complications is possible. Classically, pseudoxanthoma elasticum is a “benign” disease, without cancer association. Herein, we reported a singular association of pseudoxanthoma elasticum with breast carcinoma, describing the clinical management, in particular intra‐operative treatment, focusing on intra‐operative radiotherapy since no specific guidelines are available in literature.     

Escherichia coli-induced alterations of human spermatozoa. An electron microscopy analysis

This study evaluated if the negative influence of Escherichia coli on the motility of human spermatozoa is a consequence of E. coli-induced ultrastructural alterations. Suspensions of spermatozoa were artificially infected with E. coli from a serotyped, pathogenic strain and incubated at 37 degrees C for 6 h. After incubation, spermatozoa were fixed in glutaraldehyde, stained with osmium tetroxide and ruthenium red and embedded in Spurr(R)-resin followed by ultramicrotomy. The sections were analysed subsequently by use of transmission electron microscopy. Uninfected suspensions of spermatozoa in medium and bacterial suspensions served as controls. Negative contrast technique was performed to facilitate visualization of ultrastructural details of the bacterial capsule after experimental exposure to spermatozoa. Electron microscopic evaluation revealed multiple and profound alterations in the ultrastructure of spermatozoa such as membrane defects and cytoplasmic vacuoles exclusively in spermatozoa of infected samples (> 90%). Morphological alterations involved all superficial structures of spermatozoa, in particular the plasma membrane of the mid-piece and neck as well as the inner and outer acrosomal membrane of the acrosome, indicating that morphological defects account for the immobilization of spermatozoa by E. coli. The results suggest that E. coli infection of ejaculates results in immobilization and impaired acrosomal function in human spermatozoa, findings that support the indication for antimicrobial chemotherapy in symptomatic and silent infections that affect the ejaculate.     

Noninvasive assessment of cutaneous alterations in mice exposed to whole body gamma irradiation using optical imaging techniques

We report the results of a study carried out to investigate the potential of optical techniques such as optical coherence tomography, Mueller matrix spectroscopy, and cross-polarization imaging for noninvasive monitoring of the ionizing radiation exposure-induced alterations in cutaneous tissue of mice. Radiation dose-dependent changes were observed in tissue microvasculature and tissue optical parameters like retardance and depolarization as early as 1 h post radiation exposure. Results suggest that these optical techniques may allow early detection of radiation dose-dependent alterations which could help in screening of population exposed to radiation.     

Electron microscopy as a diagnostic tool in pathology.

As pathologists begin to examine increasing numbers of tumors under the electron microscope and the biochemistry begins to characterize molecular change associated with disease states, electron microscopy will gain wider acceptance in clinical practice. The clinician is admonished not to rely on electron microscopy as a sole diagnostic tool, but to use it as an integral part of the available diagnostic armamentarium.     

Atomic force microscopy as a tool for biomedical and biotechnological studies

This work presents different applications in progress with the aid of the atomic force microscopy (AFM) technique for biomedical and biotechnological applications, comprising both the acquisition of three-dimensional images and spectroscopic force measurements, in the following systems: first, low-density lipoprotein (LDL)-glycosaminoglycans; second, lectins-polysaccharides; third, mycobacterium leprae cellular wall and Vesicular Stomatites Virus (VSV) with fibronectin laminin, and lipidic membranes; fourth, DNA-complex; and fifth, actin, as well as the development of surface functionalizing protocols and image restoration by means of mathematical techniques.     

Automation of human semen analysis using a novel artificial intelligence optical microscopic technology

Current semen analysis still commonly depends on a manual microscopy method in clinical laboratories worldwide. However, some of the major disadvantages of this technique are that it is labour‐intensive, subjective, laboratory‐based and time‐consuming. Although computer‐assisted semen analysers (CASAs) have enabled partial automation of routine semen analysis, they lack wider acceptance due to their complicated operation. Therefore, the development of an accessible, rapid and standardised method for semen analysis is urgently needed. Here, we describe the development and clinical testing of a novel, automated, artificial intelligence optical microscopic (AIOM)‐based technology, LensHooke? X1 PRO (X1 PRO), designed for the quantitative measurement of sperm concentration, motility and seminal pH. We observed high degree of correlation in the results of concentration, progressive motility and progressively motile sperm concentration between the X1 PRO semen analyser and manual method using 135 clinical semen samples. In addition, the seminal pH results obtained by X1 PRO and manual methods were comparable (p = .12). In summary, our results showed that new X1 PRO semen analyser is a reliable diagnostic tool for routine semen analysis providing clinically acceptable results based on World Health Organization (WHO) 5th Edition guidelines.     

Types of advanced optical microscopy techniques for breast cancer research: a review

A cancerous cell is characterized by morphological and metabolic changes which are the key features of carcinogenesis. Adenosine triphosphate (ATP) in cancer cells is primarily produced by aerobic glycolysis rather than oxidative phosphorylation. In normal cellular metabolism, nicotinamide adenine dinucleotide (NADH) is considered as a principle electron donor and flavin adenine dinucleotide (FAD) as an electron acceptor. During metabolism in a cancerous cell, a net increase in NADH is found as the pathway switched from oxidative phosphorylation to aerobic glycolysis. Often during initiation and progression of cancer, the developmental regulation of extracellular matrix (ECM) is restricted and becomes disorganized. Tumor cell behavior is regulated by the ECM in the tumor micro environment. Collagen, which forms the scaffold of tumor micro-environment also influences its behavior. Advanced optical microscopy techniques are useful for determining the metabolic characteristics of cancerous, normal cells and tissues. They can be used to identify the collagen microstructure and the function of NADH, FAD, and lipids in living system. In this review article, various optical microscopy techniques applied for breast cancer research are discussed including fluorescence, confocal, second harmonic generation (SHG), coherent anti-Stokes Raman scattering (CARS), and fluorescence lifetime imaging (FLIM).     

Inherently distorted heme as a novel tool for myoglobin-based oxygen carrier

The two types of artificial myoglobins (Mbs) containing inherently distorted α-ethyl-2,4-dimethyldeuteroheme and undistorted 2,4-dimethyldeuteroheme were prepared to examine the influence of nonplanar heme deformation on the reactivity of Mb. In ferrous deoxy proteins, the paramagnetic proton nuclear magnetic resonance spectra showed that the deformed heme caused a 3.2-ppm lower-field shift of the proximal histidine signal, indicating a larger iron displacement from the heme plane upon the nonplanar deformation. The Mb with the nonplanar heme exhibited a markedly lower oxygen affinity as compared with the Mb containing the planar heme. The result suggests the utility of heme distortion to design the Mb-based oxygen carrier.     

MR is/is not a useful diagnostic tool for breast cancer management

Aim: To assess the feasibility of percutaneous pulmonary radiofrequency ablation (RFA) executed by a single surgeon.

Materials and Methods: Between 2007 and 2010, 15 procedures were performed in 11 patients during 13 sessions. Sex, age, pulmonary localisation and tumor diameter are discussed. Metastatic lesions as well as pulmonary primitive malignancies were treated. For metastatic lesions, the primitive tumor was considered as completely treated. Surgery was refused because of impaired pulmonary function or due to patient’s refusal. All interventions were carried out by a single thoracic surgeon under CT-guidance in the department of radiology.

Results: RFA was completed in all patients without perprocedural complications. There was no significant perioperative morbidity. Pneumothorax was the most frequent complication but none of the patients needed thoracic drainage. Hospital stay decreased progressively since the start of this series. Follow-up was complete. Most lesions were stable or diminishing in size.

Conclusion: These early results show that pulmonary RFA is a safe and feasible technique in the hands of the surgeon. Longer follow-up and larger series will be welcome to confirm the results and position of this procedure which might become an important tool for the surgeon and not only for radiologists.     

Orthogonal polarization spectral imaging: a novel tool for examination of microcirculatory changes in the testis

Testicular torsion is a surgical emergency in urologic practice. Many models have demonstrated the relationship between the degree and duration of the torsion and the subsequent damages of the testis, but there are as yet no suitable methods for visualization of the testicular microcirculation in this condition. We aimed to use orthogonal polarization spectral (OPS) imaging to observe the microcirculatory changes in the testis after ischemia-reperfusion (I/R) challenge, and to compare this technique with that of fluorescence intravital video microscopy (IVM). Twelve rats subjected to 60-minute ischemia following 720° testicular torsion were divided into two groups for IVM or OPS imaging examinations of the microcirculatory network of the testis at 60, 120, 180, and 240 minutes after reestablishment of perfusion. Significant microcirculatory failure was demonstrated after I/R in both groups. The absolute values of the microcirculatory parameters recorded with the OPS and IVM imaging methods did not differ statistically. The microcirculatory disturbances are present during the later phases of testicular torsion. OPS imaging technique represents an accurate noninvasive method to detect physiologic and pathophysiologic changes in the microcirculation of the testis.