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Biomedical subjects

P E Roy

Publications and source records attributed to P E Roy.

At least 19 recordsLinked to original sources

Soft filamentous woven polyester arterial prosthesis from China.

Woven polyester arterial prostheses have traditionally been known for their tight construction and smooth surface which has limited their healing capacity and resulted in poor attachment of their internal and external capsules. A new woven prototype has recently been developed in the Peoples' Republic of China. Among its unique features are its high physical porosity, softness and flexibility. This study undertook a series of in vitro tests to characterize its structure and physical properties in comparison with four commercial polyester grafts of North American origin. In addition, an animal trial was completed in which the new prototype was implanted as an infrarenal aortic substitute in 20 dogs for periods ranging from 4 h to 12 month. The in vitro tests confirmed a unique lightweight, highly porous, satin weave construction. Because of its high water permeability, preclotting was necessary before implantation. Once preclotted and installed, no significant blood loss was observed, and 19 of the 20 grafts remained patent at the sacrifice. Rapid full-width healing was achieved with tightly bound capsules, and more extensive tissue ingrowth was observed. Further work is needed to evaluate its long-term durability as an arterial substitute.

Animals↗

A pathological study of arterial prostheses surgically excised after overt clinical infection.

Infection caused regarding vascular grafts in vascular surgery still remains a major problem. To reduce this problem and the complications which follow, the surgeon must be able to apply the best surgical management and also be confident with the vascular substitute used. There are two important factors to be considered: the biomaterial must have low propensity to infection and good stability if and when infected. In an attempt to verify this problem, 93 vascular grafts surgically excised for overt infection were examined. Techniques used for examinations were gross morphology, histopathology and scanning electron microscopy (SEM) evaluation. There were 23 human umbilical vein (HUV) grafts, 51 Dacron grafts and 19 expanded polytetrafluoroethylene (ePTFE) grafts. Histopathological signs of infection were absent in 57% of the ePTFE and Dacron grafts and in 17.4% of the HUV grafts. The latter were more heavily histologically infected and in some cases the walls were destructed. Histopathological signs of infection were seen on all the prosthetic walls in 36% of all the specimens and were mainly on the external portion of the grafts for the remaining prostheses. Bacteria were seen in respectively 21.7, 15.7 and 20% of the HUV, Dacron and ePTFE grafts with the Gram stain and in 86.9, 84.3 and 94.7% with SEM. The implantation period was shorter for the bioprostheses compared to that of the synthetic grafts because of the site and the indication of implantation. The stability of the bioprostheses was lower compared to that of the synthetic grafts when infected, leading to a breakdown of the wall along the length of the graft. The infection was found on the external capsule of the grafts rather than on the luminal surface.

Arteries↗

A comparative study of the spaces between the metacarpal and metatarsal heads.

The study of the spaces between the metacarpal heads on 23 cadavers, raises the question of the existence of bursae at this level. This is in line with recent studies suggesting that such bursae are present at this level in the foot. Careful dissection and histological studies revealed characteristics compatible with both of the following hypotheses: either the existence of bursae not described until now in anatomy text-books, or spaces limited by a cul-de-sac of the aponeuroses of the hand in the 2nd, 3rd and 4th digits. Tissue analyses that could determine more specifically the nature of the limiting membrane of these spaces, as well as pathological studies demonstrating the occurrence of common anomalies of bursae in these spaces, are required in order to conclude definitively the nature of the spaces between the metacarpal heads. The gross anatomical and histological characteristics of the spaces between the metacarpal and metatarsal heads and of their limiting membranes were compared and found to be analogous in our series.

Humans↗

Effect of ethane-I-hydroxy-I, I-diphosphonate on arterial calcinosis induced by hypervitaminosis D: a morphologic investigation.

The present study was undertaken to examine changes in vascular ultrastructure of rats subjected to hypervitaminosis D with or without treatment with ethane-I-hydroxy-I, I-diphosphonate (EHDP). Five groups of rats were studied. Untreated rats were given 0.9% NaCl i.p. Sham-treated rats were given vehicle (corn oil). Treated rats were given ergocalciferol (75,000 IU i.p.) dissolved in vehicle with or without EHDP (5 mM/100 g body-weight i.p.). Rats which had been given ergocalciferol without EHDP developed hypercalcemia and demonstrated significant arterial calcinosis. A similar degree of calcinosis was not observed in rats given ergocalciferol with EHDP. EHDP appeared to inhibit arterial calcinosis; however, it did not affect plasma calcium levels. This suggests that EHDP might delay calcium influx into the cell and thereby prevent calcium overload. Our findings support the suggestion that EHDP therapy can be an effective treatment for the inhibition of dystrophic arterial calcinosis.

Animals↗

[Contents of the transversal foramen of the seventh cervical vertebra].

The purpose of our study was to evaluate the individual variations of the foramen sometimes has the same dimensions as the foramen of the other cervical vertebrae, but it can also be smaller, or absent. In cases where the foramen is present in the seventh cervical vertebra, vascular or nerve structures (or both) can be occasionally observed within. When the transverse foramina are found to contain none of the above structures, what then is to be found within this space? According to our results, the transverse foramina of the seventh cervical vertebra almost universally contain vascular and nerve branches as well as fibrous and adipose tissue. This report concerns the results of the macroscopic and microscopic studies concerning the contents of the transverse foramina of the seventh cervical vertebra.

Cervical Vertebrae↗

An histo-morphological evaluation of ninety surgically excised human umbilical vein grafts.

Morphological, histological, and scanning electron microscopy examinations were performed on 90 surgically excised human umbilical vein grafts. Most of the explanted grafts were removed because of thrombosis or infection and were removed typically from a patient in the mid 60s and after an average duration of implantation of 11 months. Multiple structural defects were found including deep folds, breaks on the luminal surface, and delamination. These areas as well as anastomotic sites represented potential areas for thrombotic accumulation. A higher incidence of infection was observed in grafts composed of 2 or 3 segments. Bacteria were often found in folds and could be seen invading the wall of the prosthesis. In addition, bacteremic colonization was often seen in noninfected grafts. The late aneurysmal formations were also of particular concern. The biodegradation of the wall and the disruption of the polyester mesh were the probable causes. The second generation Dardik Biograft aimed at reducing these formations. The success of this new processing remains to be evaluated.

Adult↗

In vivo biostability of four types of arterial grafts with impervious walls; their haemodynamic and pathological characteristics.

We describe the haemodynamic and pathological characteristics of four types of four impervious arterial prostheses, two alloplastic (Mitrathane and Gore-Tex), and two chemically processed bovine heterografts (Solcograft and Solco P). They were implanted in the thoracic aortae of dogs for durations of 24 hours, 48 hours, one week, two weeks, one month, three months and six months. Haemodynamic analyses showed no relation between the shear rate index, I.gamma, and compliance, CD. The observed shear rates are 6.5 times lower than those likely to damage the endothelial cell layer. Macroscopic and microscopic observations of explanted grafts showed the presence of obstructive thrombi at the anastomoses of Mitrathane grafts as early as one week. Gore-Tex grafts develop in the area of anastomoses parietal-thrombi which reorganize and become covered with pseudo-endothelial cells. The bovine heterografts show a similar behaviour. However, whereas Solcograft has an irregular thin wall, Solco P had improved characteristics except in the graft implanted for three months which demonstrated, some manufacturing weaknesses. Both types showed the development of anastomotic pannus covered with endothelial-like cells. All grafts, whether alloplastic or chemically processed, suffered from an absence of healing of the middle part of the prosthesis. The cause of this problem will be found in the analysis of the biochemical and enzymatic reactations between the material used and its physiological surrounding.

Anastomosis, Surgical↗

Collagen coatings as biological sealants for textile arterial prostheses.

Two collagen-coated grafts were studied: Hemashield (bovine collagen cross-linked with formaldehyde vapours and softened by exposure to glycerol) and Tascon (collagen fibres cross-linked with glutaraldehyde solution). The weight of the coating was 310 +/- 5 mg/g for Hemashield and 45 +/- 2.5 mg/g for Tascon. However, notwithstanding these differences, both coatings were efficient in making the walls of the grafts impervious to blood. The water permeabilities for the Hemashield and the Tascon were 8.7 and 5.9 ml.min-1.cm-2 at 120 mmHg respectively. The Hemashield collagen coating was rapidly eroded in vitro (4 h) after exposure to buffer, trypsin or pancreatin solutions, whereas the Tascon collagen coating remained well preserved after 7 d incubation. Both coatings were safe and did not interfere with the physical properties of the graft which was used as a skeleton. The healing properties of the Hemashield were similar to that observed with preclotted polyester prostheses, except in the early hours following graft implantation. On the other hand, the absence of erosion in the coating of the Tascon seemed to contribute to early antithrombogenicity. It also induced marked inflammatory reactions in the surrounding tissues and thus the healing appeared to be delayed.

Animals↗

In vivo evaluation of four chemically processed biological grafts implanted as infrarenal arterial substitutes in dogs.

Four chemically processed grafts implanted as arterial substitutes in dogs were evaluated as blood conduits in terms of patency rates, healing characteristics and biostability. Omniflow, Biopolymeric, Dardik-Biograft of the second generation and BIMA grafts were implanted as infrarenal aortic substitutes for 4, 24 and 48 h (short-term), 1, 2 and 4 wk (medium-term), 3 and 6 month (long-term), each type of graft being implanted for a complete series. The explanted grafts were evaluated macroscopically and processed for light and scanning electron microscopy. One Omniflow graft was occluded at 6 months and two Dardik-Biografts were thrombosed, one at 24 h and one at 1 month. All explanted grafts in the Biopolymeric series and in the BIMA were patent at the animals' death. Histological studies revealed frequent subintimal fibrosis in the Biopolymeric and Omniflow grafts. A peripheral inflammatory reaction was present in most grafts explanted. Scanning electron microscopy showed an aggravation of flow surface irregularities, after implantation of Omniflow, Biopolymeric and Dardik-Biograft, compared to virgin prostheses. These grafts presented an internal capsulae on the graft flow surface along the anastomoses. The capsulae slightly extended towards the centre of the graft after long-term implantation, (6 month) and corresponded to the pannus. Endothelial-like cells covered this pannus. The BIMA graft performed the most satisfactorily and retained its blood compatibility best, that is, the luminal surface was smooth with only minor thrombotic deposits and a thin pannus along the anastomotic lines.

Animals↗

Regression of white adipose tissue in diabetic rats.

The effects of long-term diabetes (4 wk) on the development of parametrial (PWAT) and retroperitoneal (RWAT) white adipose tissues were studied in young Sprague-Dawley rats (170-200 g) injected with a single dose of streptozotocin (75 mg/kg). Diabetes stopped animal growth and totally abolished the normal increases in the wet weight, total protein content, and cellularity (estimated by DNA content) of PWAT and RWAT. Remarkably, the prolonged lack of insulin induced a progressive decrease of the cellularity of RWAT to levels that were lower than those of the initial controls. It also resulted in a marked reduction of adipocyte size. The tiny adipocytes seen in diabetic animals were characterized by the presence of multilocular triglyceride droplets. In general, the decreases in cell number, cell size, and protein content were more pronounced in RWAT than in PWAT. Quantitative cellular frequency studies revealed that adipocytes, and possibly also endothelial cells, contribute to the decrease in RWAT cellularity. The results demonstrate that 1) diabetes inhibits proliferative activity in adipose tissue, 2) total cell number reduction may occur in adipose depot of young growing rats, 3) this effect is depot dependent, and 4) the turnover of adipocytes and endothelial cells is relatively slow (several weeks).

Adipose Tissue↗

Expanded polytetrafluoroethylene prostheses as secondary blood access sites for hemodialysis: pathological findings in 29 excised grafts.

The popularity of expanded polytetrafluoroethylene (PTFE) arteriovenous fistulas for hemodialysis access is increasing. The low infection rate, low thrombogenicity and low body reactivity make it an important blood access for patients on routine hemodialysis. The authors examined 29 PTFE graft fistulas surgically excised from patients on hemodialysis for one or more of the following complications: infection 7, 2 with associated hemorrhage; thrombosis 9; aneurysm 11, 3 with associated thrombosis; stenosis 5, 3 with associated thrombosis; hemorrhage 4 and arterial steal 2. The explanted prostheses were reinforced Gore-tex in 20, Gore-tex thin wall in 1, Impra I in 4, Impra II in 3 and Vitagraft in 1. It was also noted that the implants failed in the short term mainly because of infection, in the medium term mainly because of thrombosis and stenosis, and in the long term usually because of aneurysm.

Adult↗

Biologic and structural evaluation of 80 surgically excised human umbilical vein grafts.

Human umbilical vein is a valuable alternative to autogenous saphenous vein in lower-limb revascularization. However, the long-term patency is not as good. To understand better the reasons for this, the authors studied the biologic and structural changes occurring in 80 segments of human umbilical vein (HUV) grafts excised from 70 patients. Morphologic, histologic and scanning electron microscopy examinations were performed on each specimen. It was noted that increasing duration of implantation was associated with greater encapsulation and less surrounding inflammatory reaction. Twenty-six percent of clinically noninfected grafts were found to harbour bacteria. Bacteremic colonization was often in the folds of the luminal surface. As a result of these findings, the authors emphasize the need for complete excision of clinically infected grafts. Anastomoses between HUV segments are discouraged because they are associated with a high frequency of infection and a corresponding decrease in duration of implantation. Delamination of the wall was common, and such sites may represent areas at risk for further degradation. Continued surveillance of the biologic and structural changes occurring in excised grafts remains an important method in increasing our understanding of the evolutive complications of HUV grafts.

Adult↗

Generation of monoclonal antibodies reactive with nuclear proteins of human primary breast tumors.

Nuclear proteins were extracted from purified nuclei of human primary breast tumors (BrT) and bladder tumors and of human normal breast, kidney and lymphocytes by enzymatic treatment. SDS-Polyacrylamide gel electrophoresis of nuclear proteins from breast tumors showed different bands in the molecular weight zones from 25 to 220 kDa which were absent or present only as traces in normal breast tissue. Murine monoclonal antibodies (MAbs) have been produced using nuclear extracts of human primary breast tumors as immunogens. Approximately 2,000 hybridomas were generated from 5 hybridizations. According to their reactivity to BrT nuclear extracts and mammary carcinoma cell line MCF-7, seven hybridomas were selected and cloned. They were further characterized with histological immunoperoxidase assays of formaldehyde-fixed BrT paraffin tissue sections. MAb 6A3 particularly gave strong nuclear staining with all BrT specimens while MAb 1D8 showed both nuclear and cytoplasmic staining with only some of them. Specimens from mammoplasty did not react with these MAbs. Immunoblotting of BrT nuclear extracts as developed with MAbs 6A3 and 1D8 revealed major protein bands with molecular weight of 120 and 130 kDa. The potential use of these MAb-defined BrT-related nuclear proteins as markers for human breast cancer was suggested.

Antibodies, Monoclonal↗

Effects of litter size and light regimen imposed during lactation on ovarian follicular population at weaning in third-parity sows.

Sixteen third-parity sows maintained under two photoperiod treatments (16 h light: 8 h dark [16 h] or 4 h light: 20 h dark [4 h]) were assigned to be unilaterally ovariectomized (left ovary) at weaning on d 28 after farrowing a small litter (12 or fewer piglets; S) or a large litter (more than 12 piglets; L). Antral follicles were classified as atretic or nonatretic and divided into six size classes. The right ovary was obtained at slaughter, 16 d after estrus was detected. Number of antral follicles in the left ovary was greater (P less than .05) for L sows (540) than for S sows (427). Sows exposed to 16 h of light with large litters had a higher number of atretic follicles than all other groups (litter size x photoperiod interaction, P less than .05). Number of nonatretic follicles were similar between groups. However, when nonatretic follicles were classed by size (1 = smallest; 6 = largest), their distribution differed. In Class 1, L sows had more follicles than S sows (P less than .05). For Classes 3 and 4, photoperiod interacted with litter size to decrease the number of follicles in L 16 h sows (litter size x photoperiod interaction, P less than .05). These lower numbers of nonatretic follicles were related to a higher rate of follicular atresia in L 16 h sows. In Classes 2, 3 and 4, L 16 h sows had more atretic follicles than any other group (litter size x photoperiod interaction, P less than .05).(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

Ultrastructural study of hypervitaminosis D induced arterial calcification in Wistar rats.

Hypervitaminosis D produces extensive vascular alterations which are similar to Monckeberg's calcinosis. The present study was undertaken to examine early changes in vascular ultrastructure of rats receiving tap water supplemented with either calcium chloride or a relatively low dosage of irradiated ergocalciferol ad libitum for 21 days. Untreated rats received normal tap water ad libitum. A significant increase in serum calcium levels was obtained in hypervitaminosis D treated rats. Calcium deposits were seen near the internal elastic lamina, within new elastic elements and around degenerating smooth muscle cell fragments in the extracellular organic matrix of hypervitaminosis D treated rats. Calcium deposits were not detected in vascular sections from untreated rats or those receiving calcium chloride. A complex pathogenesis of vascular lesions produced by hypervitaminosis is suggested. One possible pathogenic mechanism for calcification of elastic matrix may be via altered microfibrils. Our data support this hypothesis and indicate that much lower levels of vitamin D administration, compared to other reports, produce considerable vascular calcinosis in this experimental preparation. Several hypotheses regarding possible mechanisms of pathologic calcification are discussed.

Animals↗

In vitro and in vivo characterization of an impervious polyester arterial prosthesis: the Gelseal Triaxial graft.

Over the years, textile polyester arterial prostheses have acquired an excellent reputation for easy handling and good healing characteristics. Until recently, the main drawback in using them was the need for preclotting. This, however, is no longer true. Nonporous polyester grafts which have been coated with an impervious bioerodible layer during manufacture are now commercially available. The Gelseal Triaxial prosthesis is one of this new generation of grafts. It is manufactured by impregnating a Triaxial prosthesis with a gelatin coating. An in vivo and in vitro evaluation of this new device has found that its water permeability is almost zero. It has good handling and conformability characteristics, and its bursting strength is slightly greater than that of the uncoated prosthesis due, no doubt, to the presence of the gel. The rates of degradation of the gelatin coating have proven to be rapid under both in vitro and in vivo conditions. In fact, only a few traces of the gel were found remaining on the graft after 2 wk in the canine thoracic aorta. In addition, this study has demonstrated that the use of a bioerodible gelatin coating, with its ability to promote cellular regeneration, is a feasible approach with which to achieve earlier and more complete biological healing.

Animals↗

Pulmonary barotrauma in congenital diaphragmatic hernia: experimental study in lambs.

A left diaphragmatic hernia was created surgically in 20 fetal lambs between 93 and 110 days of gestation. Ten animals were alive with defects at cesarean section near term (135 to 140 days). These animals and two controls were submitted to various transpulmonary pressure gradients (inspiratory pressure minus pleural pressure). Hemodynamic and ventilatory studies were performed after the correction of the hernia. Morphometric analysis of the lung was carried out in all cases. The results showed a highly significant linear correlation between the transpulmonary pressure gradient employed and the pulmonary interstitial emphysema found at morphometry. Our data suggest that using low ventilatory pressures and not draining the pleural cavity results in less trauma to both lungs and may prevent one of the components of the pulmonary hypertension so often seen in newborns with congenital diaphragmatic hernia.

Animals↗

Per-operative uncontrollable bleeding at polyester (Dacron) arterial prosthesis implantation.

An aortobifemoral knitted polyester graft was placed in a 58-year-old woman with aorto-iliac occlusive disease. Although the prosthesis was preclotted in the usual manner, it never became impervious to blood under normal intra-arterial pressure. Examination of the graft showed lipid infiltration not ordinarily seen. We recommend that when a knitted prosthesis fails to preclot a woven graft should be used instead.

Blood Coagulation↗