ABSTRACT
BACKGROUND: It is unclear if amianthoid transformation (AT) of costal cartilage extracellular matrix (ECM) has an impact on the development of pectus excavatum (PE) and pectus carinatum (PC). METHODS: AT foci were examined in intrasurgical biopsy specimens of costal cartilages of children (8-17 years old) with PE (n = 12) and PC (n = 12) and in age-matching autopsy control samples (n = 10) using histological and immunohistochemical staining, atomic force and nonlinear optical microscopy, transmission and scanning electron microscopy, morphometry and statistics. RESULTS: AT areas were identified in the costal cartilage ECM in children with normal chest, PE and PC. Each type of the AT areas ("canonical", "intertwined", "fine-fibred" and "intralacunary") had a unique morphological pattern of thickness and alignment of amianthoid fibers (AFs). AFs were formed via lateral aggregation of collagen type II fibrils in the intact ECM. Foci of the AT were observed significantly more frequently in the PE and PC groups. The AT areas had unique quantitative features in each study group. CONCLUSION: AT is a structurally diverse form of ECM alteration present in healthy and pathological costal cartilage. PE and PC are associated with specific AT disorders.
Subject(s)
Cartilage , Extracellular Matrix , Funnel Chest , Pectus Carinatum , Adolescent , Cartilage/metabolism , Cartilage/ultrastructure , Child , Extracellular Matrix/metabolism , Extracellular Matrix/ultrastructure , Female , Funnel Chest/metabolism , Funnel Chest/pathology , Humans , Male , Pectus Carinatum/metabolism , Pectus Carinatum/pathologyABSTRACT
BACKGROUND AND OBJECTIVE: To examine the possibilities of laser thermoplasty of whole costal cartilages for correction the human congenital chest wall deformities. STUDY DESIGN/MATERIALS AND METHODS: Ex vivo the samples of porcine costal cartilages were heated with lasers of differing wavelengths, including a 0.97-µm diode laser, a 1.56-µm erbium-doped quartz fiber laser, and a 1.68-µm fiber Raman laser. The dynamics of the temperature fields and the degradation of collagen in the laser-affected regions of samples were determined by using, respectively, thermometry, trypsin treatment, and light microscopy. Ex vivo the whole mechanically deformed costal cartilages of pigs were treated by laser radiation with wavelength 1.68-µm. The changes of cartilage shape were recorded at certain intervals over a 24-hour period by photographing them in a fixed position with a digital camera. RESULTS: Treatment of costal cartilage samples from 5 to 11 mm in thickness by laser radiation with 0.97, 1.56, and 1.68 µm wavelengths showed that the 1.68-µm radiation could produce the necessary nonuniform bulk heating of the exposed sample. The altered shape of costal cartilage proved to remain stable after treatment when the laser irradiation settings used provided for the heating of a broad region within the tissue to temperatures about 80°C. CONCLUSION: This study demonstrates the possibilities of laser thermoplasty of whole costal cartilages for treatment of human congenital chest wall deformities. The development of novel approaches based on laser cartilage engineering techniques will enable to treat the human congenital chest wall deformities.