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Biomedical subjects

J Dunmore-Buyze

Publications and source records attributed to J Dunmore-Buyze.

7 recordsLinked to original sources

A real vessel phantom for flow imaging: 3-D Doppler ultrasound of steady flow.

Vascular phantoms are used to assess the capabilities of various imaging techniques, such as x-ray CT and angiography, and B-mode, power Doppler, and colour Doppler ultrasound (US). They should, therefore, accurately mimic the vasculature, blood, and surrounding tissue, in regard to both imaging properties and vessel geometry. In the past, a variety of walled and wall-less vessel models have been used. However, these models only approximate the true vessel geometry, and generally lack pathologic features such as plaques or calcifications. To amend these deficiencies, we have developed a real vessel phantom for US and x-ray studies, which comprises a fixed human vessel specimen, cannulated onto two acrylic tubes, and embedded in agar in an acrylic box. Earlier, we demonstrated a good overall correlation between x-ray angiography, CT, and 3-D B-mode US images of this phantom. Here, we extend its use to flow imaging with 3-D power and 3-D colour Doppler US.

Humans↗

The radiographic quantitation of aortic valve calcification: implications for assessing bioprosthetic valve calcification in vitro.

Calcification of natural aortic and bioprosthetic heart valves is a poorly understood phenomenon that results in valvular obstruction and tissue failure. We describe a non-destructive quantitative computed microtomographic (QCT) technique for determining both calcium content and local calcium distribution within explanted valves. As a reference standard, a dual-energy x-ray absorptiometry (DEXA) system with an accuracy demonstrated to be within 1% of the true calcium mass of test material was used to obtain the total calcium content of 24 human aortic valve cusps recovered at autopsy from patients aged 51-80 years. These cusps were then scanned using our unique volume QCT scanner, with multiple x-ray projections acquired by rotating the explanted tissue through a single axis of rotation. A three-dimensional cross-sectional map was reconstructed for each cusp. Voxel size was 0.003 mm3 and a calibration phantom was used to calculate calcium content. The minimum detection limit for calcium mass was 1 mg within the whole cusp. The DEXA and QCT scans were compared with respect to total calcium content, which ranged from 0 to 15 mg. An excellent correlation between the two independent techniques was demonstrated with an r2 value of 0.94 (p < 0.001). Non-destructive microtomographic CT scanning provided excellent volumetric density measurements, with quantitative 3D images permitting an assessment of any individual area of the cusp for calcium content and spatial distribution. This new approach to valve tissue analysis allows for subsequent histologic assessment.

Absorptiometry, Photon↗

The pericardial bioprosthesis: altered tissue shear properties following glutaraldehyde fixation.

BACKGROUND AND AIM OF THE STUDY: Glutaraldehyde-fixed bovine pericardial tissue used in the construction of valvular bioprostheses undergoes repeated bending stress during the cardiac cycle. To bend smoothly, internal tissue shearing is required. The effect of glutaraldehyde fixation on internal shear properties of this material was examined. METHODS: Pericardium from each of 12 bovine hearts was cut into two pieces; one piece was retained as fresh tissue, the other was glutaraldehyde-fixed. Circular samples were then mounted and installed in a shear testing apparatus. For each sample, the shear stress versus shear strain characteristics were measured in circumferential and radial directions at strain rates of 1.0, 0.1 and 0.02 s(-1) while immersed in a 20 degrees C bath; similar measurements were made on six fresh and six fixed samples at 37 degrees C. In addition, the stress relaxation properties were measured by holding the tissue at maximum shear for 100 s after each of the three shear deformations, and recording force generated with time. RESULTS: The shear stress-strain test on fresh tissue (n = 12) showed non-linear behavior at the three shear rates. The shear modulus for fresh tissue increased from <1.0 kPa to 5 kPa at a shear strain approaching 1.0, and results were identical in radial or circumferential directions. For glutaraldehyde-fixed pericardium (n = 12), shear modulus increased promptly to 15-20 kPa at a strain of 0.2, and did not vary with strain rate. Shear relaxation was similar in fresh and fixed tissue. CONCLUSION: Fresh pericardium sheared easily at low shear stresses, with minimal resistance developing until the shear strain exceeded 0.5, while glutaraldehyde-fixed tissue displayed a marked resistance to shearing, with an immediate rise in shear stress at low strain. No differences were detected in shear properties between radial and circumferential directions. Such marked tissue stiffening may be a factor in collagen fiber disruption, leading to bioprosthetic heart valve failure.

Biomechanical Phenomena↗

Laser-induced fluorescence (LIF) recognition of the structural composition of porcine heart valves.

Reconstruction and replacement of heart valves with grafts fro pig tissue is a common procedure. However, bioprosthetic valves wear out in a shorter time span than mechanical valves. Bioprosthetic valve structure may contribute to degenerative changes that lead to valve failure. There is, at present, no method to examine the structure of a tissue valve prior to implant. Laser-induced fluorescence (LIF) of natural fluorophores is an elegant method developed for the detection of tumors, dermal lesions and atherosclerosis. We have studied LIF as a potential diagnostic technique for analysis of valvular tissue. Using excimer laser excitation, we examined natural fluorescence recorded from porcine aortic, mitral and pulmonary valves. All three valve outflow surface tissue layers are less fluorescent at 390-450 nm than the inflow layers. Immunohistochemical analysis of collagen I and elastin content in inflow and outflow surface layers of all three valves correlated well with LIF intensities and dI/d lambda values at selected wavelengths. In conclusion, the differences observed in emitted LIF from valve surface layers are found to correlate well with diversity in the structural protein content. The LIF spectroscopic measurements may provide an appropriate tool for examination of tissue valve structure prior to use for implantation.

Animals↗

A real vessel phantom for imaging experimentation.

Vascular phantoms are used to evaluate imaging techniques such as ultrasound (US), CT, and angiography. They are expected to mimic the vasculature, surrounding tissue, and blood, and therefore must meet specific requirements on the mimicking materials, with respect to x-ray attenuation and acoustic properties (velocity, attenuation). In the past, researchers have used a variety of vessel models, including walled (typically latex tube) and wall-less phantoms (obtained by moulding a lumen in a block of agar). These models lacked the exact geometry of human vessels as well as pathologic features such as plaques and calcifications. To overcome these disadvantages, this paper describes a real vessel phantom for US and x-ray studies. The phantom consists of an agar-filled acrylic box containing a formaldehyde fixed section of a real human vessel (obtained at autopsy) cannulated onto two acrylic tubes. This phantom was evaluated by comparing the images obtained with x-ray angiography, CT, and 3-D B-mode US. The images show good overall correlation based on the location of the geometrical features within the phantom, such as lumen, plaques, and calcifications. Discrepancies, artifacts, and difficulties were minor, and are discussed. The use of a real vessel, with its natural geometry and pathology, makes this phantom attractive for evaluation of imaging techniques including projection radiography, CT and US, and for extending its use to MR and US based flow studies.

Angiography↗

A comparison of macroscopic lipid content within porcine pulmonary and aortic valves. Implications for bioprosthetic valves.

Lipid droplets have been demonstrated within both explanted porcine bioprostheses and normal porcine aortic valves. Because of the increasing interest in pulmonary valves as an allograft or xenograft aortic valve substitute, we examined the incidence and distribution of such lipid deposits in 50 porcine aortic valves and 50 matched porcine pulmonary valves. All 300 cusps were removed with surgical scissors and, under a dissecting microscope, the ventricularis layer was removed to expose the spongiosal layer. Macroscopic extracellular lipid droplets analyzed by means of a dissecting microscope with an eyepiece grid and stereology point-counting techniques to provide an area-density average spatial probability map for each cusp. Only 8% of porcine aortic valves were free of lipid, with the distribution of the lipids being 52% +/- 14% right coronary cusp, 90% +/- 8% left coronary cusp, and 68% +/- 13% noncoronary cusp. Of the pulmonary valves, 60% were free of lipid, with the incidence of lipids being 26% +/- 12% left cusp, 6% +/- 7% right cusp, and 12% +/- 9% anterior cusp. Subsequently, lipid cluster samples underwent thin-layer chromatography, which showed them to be phospholipids, oleic acid (fatty acid), triglycerides, and unesterified cholesterol. One primary mode of bioprosthetic valve failure is leaflet calcification. The similarity of distribution within the spongiosal layer between leaflet calcification and intrinsic cusp lipids suggests that the observed lipids might act as a nucleation site for calcification. The substantially lower incidence of lipid in pulmonary valves therefore may represent a potential benefit when these valves are considered for use as aortic valve replacements.

Animals↗

Enhanced detection of cardiac myocyte damage by polarized light microscopy. Use in a model of coxsackievirus B3-induced myocarditis.

Although accurate detection of cardiac muscle damage is critical in the diagnosis of acute myocarditis or acute cellular rejection in both clinical and experimental settings, the histologic evaluation is frequently uncertain without specialized stains. In a study of adult male A/J mice infected with 2x10(5) plaque-forming units of myocarditic coxsackievirus B3, cardiac muscle injury causing myofibrillar disruption was detected as a loss of muscle birefringence by polarized light microscopy. The technique was corroborated by comparison with Masson's trichrome stain and was helpful for histologic examination especially at the early preinflammatory stages of lesion development or in fringe territories of focal lesions. Polarized light microscopy is thus an available means to enhance the histologic determination of cardiac myocyte damage and has specific advantage in an absence of specialized stains.

Animals↗