Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 14 de 14
Filtrar
1.
Int J Health Geogr ; 22(1): 26, 2023 09 28.
Artículo en Inglés | MEDLINE | ID: mdl-37759295

RESUMEN

BACKGROUND: Childrens' outdoor active play is an important part of their development. Play behaviour can be predicted by a variety of physical and social environmental features. Some of these features are difficult to measure with traditional data sources. METHODS: This study investigated the viability of a machine learning method using Google Street View images for measurement of these environmental features. Models to measure natural features, pedestrian traffic, vehicle traffic, bicycle traffic, traffic signals, and sidewalks were developed in one city and tested in another. RESULTS: The models performed well for features that are time invariant, but poorly for features that change over time, especially when tested outside of the context where they were initially trained. CONCLUSION: This method provides a potential automated data source for the development of prediction models for a variety of physical and social environment features using publicly accessible street view images.


Asunto(s)
Peatones , Motor de Búsqueda , Niño , Humanos , Ambiente , Medio Social , Aprendizaje Automático
2.
Artículo en Inglés | MEDLINE | ID: mdl-33322481

RESUMEN

This paper presents an empirically grounded call for a more nuanced engagement and situatedness with placial characteristics within a spatial epidemiology frame. By using qualitative data collected through interviews and observation to parameterise standard and spatial regression models, and through a critical interpretation of their results, we present initial inroads for a situated spatial epidemiology and an analytical framework for health/medical geographers to iteratively engage with data, modelling, and the context of both the subject and process of analysis. In this study, we explore the socioeconomic factors that influence homicide rates in the Brazilian state of Alagoas from a critical public health perspective. Informed by field observation and interviews with 24 youths in low-income neighbourhoods and prisons in Alagoas, we derive and critically reflect on three regression models to predict municipal homicide rates from 2016-2020. The model results indicate significant effects for the male population, persons without elementary school completion, households with reported income, divorced persons, households without piped water, and persons working outside their home municipality. These results are situated in the broader socioeconomic context, trajectories, and cycles of inequality in the study area and underscore the need for integrative and contextually engaged mixed method study design in spatial epidemiology.


Asunto(s)
Homicidio , Violencia , Adolescente , Brasil/epidemiología , Femenino , Humanos , Renta , Masculino , Pobreza , Factores Socioeconómicos
3.
Int J Health Geogr ; 19(1): 26, 2020 07 06.
Artículo en Inglés | MEDLINE | ID: mdl-32631351

RESUMEN

BACKGROUND: Geographic masks are techniques used to protect individual privacy in published maps but are highly under-utilized in research. This leads to continual violations of individual privacy, as sensitive health records are put at risk in unmasked maps. New approaches to geographic masking are required that foster accessibility and ease of use, such that they become more widely adopted. This article describes a new geographic masking method, called street masking, that reduces the burden on users of finding supplemental population data by instead automatically retrieving OpenStreetMap data and using the road network as a basis for masking. We compare it to donut geomasking, both with and without population density taken into account, to evaluate its efficacy against geographic masks that require slightly less and slightly more supplemental data. Our analysis is performed on synthetic data in three different Canadian cities. RESULTS: Street masking performs similarly to population-based donut geomasking with regard to privacy protection, achieving comparable k-anonymity values at similar median displacement distances. As expected, distance-based donut geomasking performs worst at privacy protection. Street masking also performs very well regarding information loss, achieving far better cluster preservation and landcover agreement than population-based donut geomasking. Distance-based donut geomasking performs similarly to street masking, though at the cost of reduced privacy protection. CONCLUSION: Street masking competes with, if not out-performs population-based donut geomasking and does so without requiring any supplemental data from users. Moreover, unlike most other geographic masks, it significantly minimizes the risk of false attribution and inherently takes many geographic barriers into account. It is easily accessible for Python users and provides the foundation for interfaces to be built for non-coding users, such that privacy can be better protected in sensitive geospatial research.


Asunto(s)
Confidencialidad , Privacidad , Canadá/epidemiología , Ciudades , Humanos , Densidad de Población
4.
Artículo en Inglés | MEDLINE | ID: mdl-32244976

RESUMEN

Road traffic injuries constitute a significant global health burden; the World Health Organization estimates that they result in 1.35 million deaths annually. While most pedestrian injury studies rely predominantly on statistical modelling, this paper argues for a mixed-methods approach combining spatial analysis, environmental scans, and local knowledge for assessing environmental risk factors. Using data from the Nova Scotia Trauma Registry, severe pedestrian injury cases and ten corresponding hotspots were mapped across the Halifax Regional Municipality. Using qualitative observation, quantitative environmental scans, and a socioeconomic deprivation index, we assessed hotspots over three years to identify key social- and built-environmental correlates. Injuries occurred in a range of settings; however, clear patterns were not observed based on land use, age, or socio-economic status (SES) alone. Three hotspots revealed an association between elevated pedestrian injury and a pattern of geographic, environmental, and socio-economic factors: low- to middle-SES housing separated from a roadside attraction by several lanes of traffic, and blind hills/bends. An additional generalized scenario was constructed representing common risk factors across all hotspots. This study is unique in that it moves beyond individual measures (e.g., statistical, environmental scans, or geographic information systems (GIS) mapping) to combine all three methods toward identifying environmental features associated with pedestrian motor vehicle crashes (PMVC).


Asunto(s)
Accidentes de Tránsito , Peatones , Heridas y Lesiones , Ciudades , Femenino , Humanos , Masculino , Nueva Escocia , Factores de Riesgo , Factores Socioeconómicos , Heridas y Lesiones/epidemiología
5.
J Forensic Sci ; 65(4): 1247-1259, 2020 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-32092159

RESUMEN

Aging adult skeletal material is a crucial component of building the biological profile of unknown skeletal remains, but many macro- and microscopic methods have challenges regarding accuracy, precision, and replicability. This study developed a volumetric method to visualize and quantify histological remodeling events in three dimensions, using a two-dimensional serialized approach that applied circular polarizing microscopy and geographic information systems protocols. This approach was designed as a tool to extend current histological aging methodologies. Three serial transverse sections were obtained from a human femoral midshaft. A total sample size of 6847 complete osteons from the three sections was identified; 1229 osteons connected between all sections. The volume of all connected osteons was interpolated using ArcGIS area calculations and truncated cone geometric functions. Each section was divided into octants, and two random samples of 100 and of 30 connected osteons from each octant were generated. Osteon volume was compared between the octants for each random sample using ANOVA. Results indicated that the medial aspect had relative uniformity in osteon volume, whereas the lateral aspect showed high variability. The anterolateral-lateral octant had significantly smaller osteon volume, whereas the posterior-posterolateral octant had significantly larger osteon volume. Results also indicated that a minimum of 100 osteons is statistically more robust and more representative of normal osteon distribution and volume; the use of 30 osteons is insufficient. This research has demonstrated that osteon volume can be interpolated using spatial geometry and GIS applications and may be a tool to incorporate into adult age-at-death estimation techniques.


Asunto(s)
Determinación de la Edad por el Esqueleto/métodos , Remodelación Ósea , Fémur/ultraestructura , Osteón/ultraestructura , Antropología Forense , Sistemas de Información Geográfica , Humanos , Procesamiento de Imagen Asistido por Computador , Microscopía
6.
Cryo Letters ; 28(3): 173-86, 2007.
Artículo en Inglés | MEDLINE | ID: mdl-17898905

RESUMEN

Freeze injury in BPH1(CAFTD)-2 cells frozen/thawed in suspension was studied through a two-level four-parameter (2(4)) experimental design and analysis. The four parameters considered were end temperature, hold time, TNFalpha concentration, and thawing rate. Thermal parameter values chosen were based on the approximate thermal history cells would experience in the peripheral region of a cryosurgical iceball. Cell suspensions were frozen at a constant 10 degree C/min on a directional solidification stage and viability was assessed within 1 hr post-thaw using a dye exclusion assay. The parameters affecting cell survival were determined through calculation of the individual parameter effects (E) and interactions (I) according to factorial design guidelines; data set curvature (C) was also determined. Cell viability ranged from a maximum of 87.6 percent to a minimum of 17.6 percent indicating trends in cell survival were sensitive to the parameters chosen. Survival was affected by the following parameters in order: lowering the end temperature, increasing the hold time, adding TNFalpha, and reducing the thawing rate. In addition, all 2-way parameter interactions except TNFalpha hold time were statistically significant. Curvature analysis showed that cell viability at the midpoint of the data was nearly 20 percent lower than predicted based on linear interpolation. These results were verified and extended using analysis of variance (ANOVA). We conclude that cryoinjury in this tumor line can be influenced by multiple interacting thermal parameters, most importantly end-temperature and hold time, as well as the presence of the cytokine TNFalpha. Finally, although the cell type is tumorigenic results suggest the possibility of using freezing to control benign prostatic hyperplasia (BPH) in addition to cancer within the prostate.


Asunto(s)
Congelación , Neoplasias de la Próstata/fisiopatología , Análisis de Varianza , Línea Celular Tumoral/efectos de los fármacos , Supervivencia Celular , Criocirugía , Esquema de Medicación , Humanos , Masculino , Neoplasias de la Próstata/patología , Temperatura , Factores de Tiempo , Factor de Necrosis Tumoral alfa/administración & dosificación , Factor de Necrosis Tumoral alfa/farmacología
7.
Mol Cancer Ther ; 6(7): 2039-47, 2007 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-17620433

RESUMEN

Cryosurgery is a minimally invasive cancer treatment using cryogenic temperatures. Intraoperative monitoring of iceball growth is an advantage of the treatment. However, whereas the iceball can be easily visualized, destruction within the iceball is incomplete and the means to monitor the "kill zone" are urgently needed. Recently, we have shown the ability of tumor necrosis factor-alpha (TNF-alpha) to enhance destruction within an iceball. To avoid systemic toxicity, we delivered TNF-alpha selectively to the tumor by a gold nanoparticle of 30-nm diameter (CYT-6091) tagged with TNF-alpha and thiol-derivatized polyethylene glycol. Using a dorsal skin fold chamber (DSFC) in a nude mouse, both normal skin and human prostate carcinoma (LNCaP Pro 5) were pretreated with soluble TNF-alpha (topically or i.v.) or CYT-6091 (i.v.) and frozen after 4 h. The cryolesion was assessed after 3 days by comparing histologic necrosis with perfusion defects. Hind limb tumors were also treated by visibly encompassing the tumor with an iceball and assessing gross changes over time. A 5-mug dose of soluble TNF-alpha or CYT-6091 increased the temperature threshold of necrosis in the tumor in the DSFC from -14.0 +/- 1.6 degrees C (n = 6) to 0.9 +/- 1.5 degrees C (n = 6) and -1.5 +/- 3.7 degrees C (n = 6), respectively. In hind limb tumors, the same dose resulted in significant tumor shrinkage and remission in 2 of 8 (for soluble TNF-alpha) and in 3 of 8 (for CYT-6091). The nanoparticle alone group without TNF-alpha increased the temperature threshold of necrosis to -7.0 +/- 2.3 degrees C in the tumor in the DSFC and more shrinkage of the tumor in the hind limb when compared with cryo alone treatment. Systemic toxicity was noted in all soluble TNF-alpha groups but none with CYT-6091. These results suggest that it is possible to destroy all of a tumor within an iceball by preincubation with TNF-alpha and systemic toxicity can be avoided by CYT-6091.


Asunto(s)
Criocirugía/métodos , Factor de Necrosis Tumoral alfa/administración & dosificación , Factor de Necrosis Tumoral alfa/farmacología , Animales , Crioterapia , Relación Dosis-Respuesta a Droga , Miembro Posterior/patología , Humanos , Masculino , Ratones , Ratones Desnudos , Necrosis , Neoplasias de la Próstata/patología , Temperatura , Células Tumorales Cultivadas
8.
J Androl ; 27(6): 826-36, 2006.
Artículo en Inglés | MEDLINE | ID: mdl-16837732

RESUMEN

Persistent infertility after apparently successful vasectomy reversal is common. One possible etiology is epididymal epithelial dysfunction resulting in improper sperm maturation after vasectomy reversal. The epididymal epithelium secretes a number of proteins that are thought to be required for the maturation of sperm. Ligation of the vas deferens during vasectomy may affect the synthesis of some of these proteins. In the present study, the function of the epididymal epithelium was assessed at early times after vasectomy (1, 4, and 7 days) by measuring the level of mRNA of 4 secreted proteins: Crisp-1, clusterin, osteopontin, and transferrin. In addition, the site of synthesis of these proteins was determined by immunocytochemistry. The results demonstrated that the expression of Crisp-1 and clusterin, representative epididymal secretory proteins, was largely unaffected by vasectomy. However, osteopontin mRNA increased in the vas deferens in response to vasectomy. Immunocytochemical localization of osteopontin suggested that both infiltrating immune cells and deferential luminal epithelium were responsible for this up-regulation. Transferrin expression was viewed as a marker for immune cells at the site of injury. However, both the caput epididymis and deferential epithelia were found to express transferrin, in addition to immune cells. In conclusion, there appear to be only minor changes in expression of genes encoding epididymal secretory proteins acutely after vasectomy, but, not surprisingly, there was evidence of an inflammatory response after vasectomy.


Asunto(s)
Epidídimo/fisiología , Conducto Deferente/fisiología , Vasectomía , Animales , Northern Blotting , Clusterina/biosíntesis , Epitelio/fisiología , Inmunohistoquímica , Masculino , Glicoproteínas de Membrana/biosíntesis , Osteopontina/biosíntesis , ARN Mensajero/metabolismo , Ratas , Ratas Sprague-Dawley , Transferrina/biosíntesis
9.
Ann Biomed Eng ; 32(10): 1384-98, 2004 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-15535056

RESUMEN

The in situ thermal protein denaturation and its correlation with direct hyperthermic cell injury in Dunning AT-1 prostate tumor cells were investigated in this study. The in situ thermal protein denaturation was studied using both Fourier transform infrared spectroscopy (FTIR) and differential scanning calorimetry (DSC). The FTIR spectra at different temperatures show changes in protein secondary structure (from alpha helix to extended beta sheet) during in situ thermal protein denaturation within AT-1 cells. Calorimetric studies using DSC show that endothermic heat release is associated with the in situ thermal protein denaturation. Furthermore, both the secondary structure changes detected by FTIR and the calorimetric changes detected by DSC were quantified and the kinetics of the overall in situ thermal protein denaturation was derived under different heating conditions. The onset temperature where the overall in situ thermal protein denaturation is first detectable was found to be scanning rate dependent (approximately 41 degrees C at 2 degrees C min(-1) and approximately 44 degrees C at 5 degrees C min(-1)). The kinetics of the overall in situ thermal protein denaturation was derived from both DSC and FTIR measurements and was fit using kinetic and statistical models. The kinetic data determined by FTIR and DSC under the same heating conditions match well with each other. The activation energy of the overall in situ thermal protein denaturation is found to be strongly dependent on the temperature range considered (the activation energy ranges from approximately 110 kJ mol(-1) between 44 and 90 degrees C to approximately 750 kJ mol(-1) between 44 and 50 degrees C). However, its dependence on heating rate is negligible. Several denaturation peaks, including a dominant one between approximately 62 and 65 degrees C, are identifiable from both the DSC and the FTIR results. To investigate directly the relationship between thermally induced cell injury and the in situ thermal protein denaturation, both acute (propidium iodide dye exclusion, assessed 3-h postthermal treatment) and chronic (clonogenics, assessed 7-day postthermal treatment) cell injury were quantified using AT-1 cells prepared under the same conditions as for the DSC protein studies. Comparisons of the results from the cell injury studies and the DSC protein denaturation studies show that the overall in situ thermal protein denaturation correlates well with both the acute and the chronic cell injury, which suggests that overall in situ thermal protein denaturation is an important mechanism of direct hyperthermic cell injury in AT-1 cells at the macromolecular level.


Asunto(s)
Supervivencia Celular/efectos de la radiación , Calor , Hipertermia Inducida/métodos , Modelos Biológicos , Proteínas de Neoplasias/efectos de la radiación , Neoplasias de la Próstata/patología , Neoplasias de la Próstata/fisiopatología , Desnaturalización Proteica/efectos de la radiación , Adenocarcinoma/patología , Adenocarcinoma/fisiopatología , Animales , Apoptosis/efectos de la radiación , Línea Celular Tumoral , Proliferación Celular/efectos de la radiación , Simulación por Computador , Relación Dosis-Respuesta en la Radiación , Masculino , Dosis de Radiación , Ratas
10.
Am J Hematol ; 77(2): 117-25, 2004 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-15389823

RESUMEN

Vascular inflammation, secondary to ischemia-reperfusion injury, may play an essential role in vaso-occlusion in sickle cell disease (SCD). To investigate this hypothesis, dorsal skin fold chambers (DSFCs) were implanted on normal and transgenic sickle mice expressing human alpha and beta(s)/beta(s-Antilles) globin chains. Microvessels in the DSFC were visualized by intravital microscopy at baseline in ambient air and after exposure to hypoxia-reoxygenation. The mean venule diameter decreased 9% (P < 0.01) in sickle mice after hypoxia-reoxygenation but remained constant in normal mice. The mean RBC velocity and wall shear rate decreased 55% (P < 0.001) in sickle but not normal mice after hypoxia-reoxygenation. None of the venules in normal mice became static at any time during hypoxia-reoxygenation; however, after 1 hr of hypoxia and 1 hr of reoxygenation, 11.9% of the venules in sickle mice became static (P < 0.001). After 1 hr of hypoxia and 4 hr of reoxygenation, most of the stasis had resolved; only 3.6% of the subcutaneous venules in sickle mice remained static (P = 0.01). All of the venules were flowing again after 24 hr of reoxygenation. Vascular stasis could not be induced in the subcutaneous venules of sickle mice by tumor necrosis factor alpha (TNF-alpha). Leukocyte rolling flux and firm adhesion, manifestations of vascular inflammation, were significantly higher at baseline in sickle mice compared to normal (P < 0.01) and increased 3-fold in sickle (P < 0.01), but not in normal mice, after hypoxia-reoxygenation. Plugs of adherent leukocytes were seen at bifurcations at the beginning of static venules. Misshapen RBCs were also seen in subcutaneous venules.


Asunto(s)
Anemia de Células Falciformes/fisiopatología , Daño por Reperfusión/fisiopatología , Piel/irrigación sanguínea , Anemia de Células Falciformes/sangre , Anemia de Células Falciformes/complicaciones , Anemia de Células Falciformes/genética , Animales , Recuento de Células Sanguíneas , Adhesión Celular/fisiología , Femenino , Hematócrito , Rodamiento de Leucocito , Leucocitos/citología , Ratones , Ratones Endogámicos C57BL , Ratones Transgénicos , Microcirculación/fisiología , Microscopía/instrumentación , Microscopía/métodos , Daño por Reperfusión/sangre , Daño por Reperfusión/complicaciones , Reticulocitos/citología
11.
Technol Cancer Res Treat ; 3(3): 245-51, 2004 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-15161317

RESUMEN

The microenvironmental pH and oxygenation is known to influence tumor cell response to heat, radiation, photodynamic and even chemotherapy. We have studied the previously untested influence of acidity and hypoxia on tumor and endothelial cell sensitivity to freezing. In addition, we have measured changes in oxygenation in vivo in murine FSaII fibrosarcomas after freeze injury. A low pH or low oxygenation environment was found to increase the sensitivity of tumor and endothelial cells to freezing at -20 degrees C or -40 degrees C in vitro. However, low pH and low oxygenation combined did not further increase cryosensitivity of the cells. In vivo, tumor oxygenation after freeze injury was studied immediately or 1-3 days after a standard freezing protocol was applied to FSaII tumors ranging from 250-500 mm3 grown in the rear-limb of C3H mice. Tumor oxygenation at the edge of the iceball was found to transiently increase 1-2 hours after freezing. At 1-3 days after freezing, a treatment that delayed FSaII tumor growth by approximately 1.5-fold, the mean tumor oxygenation was significantly increased by up to 2.5-fold from a control level of 5 mmHg partial pressure of oxygen (pO2), especially at the periphery of the tumor. We conclude that manipulation of pH or oxygenation has potential to increase the anti-tumor effects of minimally invasive cryosurgical techniques. Furthermore, the dynamic changes in oxygenation after freeze injury in vivo suggests value in combining cryotherapy with treatments dependent on oxygenation levels. Ultimately, these may be routes to more reliable treatment response with fewer recurrences.


Asunto(s)
Crioterapia/métodos , Células Endoteliales/metabolismo , Fibrosarcoma/terapia , Congelación , Miembro Posterior , Consumo de Oxígeno , Animales , Hipoxia de la Célula , Línea Celular Tumoral , Supervivencia Celular , Células Cultivadas , Células Endoteliales/patología , Femenino , Fibrosarcoma/metabolismo , Fibrosarcoma/patología , Concentración de Iones de Hidrógeno , Ratones , Ratones Endogámicos C3H , Trasplante de Neoplasias , Oxígeno/análisis , Oxígeno/metabolismo , Presión Parcial , Factores de Tiempo , Carga Tumoral
12.
J Surg Oncol ; 82(3): 160-9, 2003 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-12619059

RESUMEN

BACKGROUND AND OBJECTIVES: During cryosurgery, cells frozen slowly at the outer part of the ice ball undergo severe dehydration and are subject to solute effects injury, which may be caused in part by protein denaturation. This study was undertaken to determine whether heat shock proteins (HSPs), the molecular chaperones that stabilize proteins against denaturation, have a protective effect on cells during slow freezing. In addition, we aimed to determine whether acidic conditions, similar to those found in many solid tumors, would effect this protection. METHODS: SCK cells were frozen at 5 degrees C/min to -10 degrees C or -20 degrees C before or after induction of thermotolerance, and at neutral or low pH conditions. Lethal damage was determined by clonogenics. RESULTS: Clonogenic survival was decreased by 50% in thermotolerant cells frozen to -10 degrees C after culture in acidic conditions (pH 6.6) compared with non-thermotolerant cells cultured at neutral pH. Induction of thermotolerance alone or low pH alone did not significantly sensitize SCK cells to freezing. All treatment groups were equally susceptible to killing when frozen to -20 degrees C. CONCLUSIONS: Our results show that induction of thermal tolerance does not protect SCK cells against subsequent freezing injury and that a low pH environment actually sensitizes these cells to freeze injury.


Asunto(s)
Supervivencia Celular , Criocirugía , Congelación , Neoplasias Mamarias Animales/patología , Animales , Femenino , Proteínas de Choque Térmico/análisis , Concentración de Iones de Hidrógeno , Ratones , Células Tumorales Cultivadas
13.
J Am Assoc Gynecol Laparosc ; 10(1): 90-8, 2003 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-12555001

RESUMEN

STUDY OBJECTIVE: To evaluate the effects and feasibility of direct cryothermic and hyperthermic therapy on leiomyomata and adjacent myometrium, and to contribute to evidence-based treatment thresholds based on measurements of direct cell injury. DESIGN: Experimental study (Canadian Task Force classification II-2). SETTING: University hospital. SUBJECTS: Leiomyoma and myometrium tissue from 10 women undergoing total abdominal hysterectomy with or without bilateral salpingo-oophorectomy. INTERVENTION: In vitro cryothermic or hyperthermic therapy was performed with representative leiomyoma and myometrium tissue samples. Using a directional solidification stage to simulate cryothermic therapy, 10 leiomyoma and 6 myometrium specimens were cooled in vitro at a rate of -5 degrees C/minute to end temperatures of -20 degrees, -40 degrees, -60 degrees, and -80 degrees C with a 15-minute hold period and then rapidly thawed to 21 degrees C. Hyperthermic therapy was simulated using a preheated 45 degrees, 55 degrees, 60 degrees, 65 degrees, 70 degrees, 75 degrees, and 80 degrees C constant temperature copper heating block with a 10-minute treatment period. In conjunction with tissue culturing and control tissues, cell death was assessed with routine histology and viability dyes (ethidium homodimer/Hoechst). MEASUREMENTS AND MAIN RESULTS: In cryothermic results, leiomyomata cell death (LCD) increased from 12% to 27% by histology and 26% to 38% by viability dye assay over the thermal range from -20 degrees to -80 degrees C, respectively. Myometrial cell death (MCD) increased from 10% to 12% and 4% to 20% for the same measurements, respectively. Whereas MCD appeared relatively stable from -40 degrees to -80 degrees C, it was significantly less than LCD over this range (p <0.05). For hyperthermic results, LCD increased from 17% to 88% by histology with progressive temperature increase from 45 degrees to 80 degrees C, respectively. The MCD showed a similar increase from 16% to 91% by histology over this temperature range. Hyperthermic histology and dye assay results were similar for LCD and MCD. CONCLUSIONS: In comparison with myometrium, leiomyomata showed greater direct cryothermic and equal hyperthermic cell injury. Whereas cell death increased up to 70 degrees C and down to -80 degrees C, the interval increases in cell injury diminished with more extreme temperatures. In vivo studies of combined direct and ischemic vascular injury thresholds have yet to be performed, but direct LCD matrixes determined in this study will help provide guidelines for minimally invasive surgical techniques for the treatment of leiomyomata.


Asunto(s)
Crioterapia/efectos adversos , Hipertermia Inducida/efectos adversos , Laparoscopía/efectos adversos , Leiomioma/patología , Miometrio/patología , Neoplasias Uterinas/patología , Adulto , Anciano , Supervivencia Celular , Crioterapia/métodos , Técnicas de Cultivo , Femenino , Humanos , Hipertermia Inducida/métodos , Histerectomía/métodos , Inmunohistoquímica , Laparoscopía/métodos , Leiomioma/cirugía , Persona de Mediana Edad , Miometrio/cirugía , Probabilidad , Valores de Referencia , Sensibilidad y Especificidad , Neoplasias Uterinas/cirugía
14.
Cryobiology ; 45(2): 167-82, 2002 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-12482382

RESUMEN

Advances in minimally invasive renal cryosurgery have renewed interest in the relative contributions of direct cryothermic and secondary vascular injury-associated ischemic cell injury. Prior studies have evaluated renal cryolesions seven or more days post-ablation and postulated that vascular injury is the primary cell injury mechanism; however, the contributions of direct versus secondary cell injury are not morphologically distinguishable during the healing/repair stage of a cryolesion. While more optimal to evaluate this issue, minimal acute (< or = 3 days) post-ablation histologic data with thermal history correlation exists. This study evaluates three groups of porcine renal cryolesions: Group (1) in vitro non-perfused (n = 5); Group (2) in vivo 2-h post-ablation perfused (n = 5); and Group (3) in vivo 3-day post-ablation perfused (n = 6). The 3.4 mm argon-cooled cryoprobe's thermal history included a 75 degrees C/min cooling rate, -130 degrees C end temperature, 60 degrees C/min thawing rate, and 15-min freeze time. An enthalpy-based mathematical model with a 2-D transient axisymmetric numerical solution with blood flow consideration was used to determine the thermal history within the ice ball. All three groups of cryolesions showed histologically similar central regions of complete cell death (CD) and transition zones of incomplete cell death (TZ). The CD had radii of 1.4, 1.1, and 1.0 cm in the non-perfused, 2-h and 3-day lesions, respectively. Capillary thrombosis was present in the 2-h perfused cryolesions with the addition of TZ arteriolar/venous thrombosis in the 3-day perfused lesions. Thermal modeling revealed the outer CD boundary in all three groups experienced similar thermal histories with an approximately -20 degrees C end temperature and 2 degrees C/min cooling and thawing rates. The presence of similar CD histology and in vitro/in vivo thermal histories in each group suggests that direct cryothermic cell injury, prior to or synchronous with vascular thrombosis, is a primary mediator of cell death in renal cryolesions.


Asunto(s)
Criocirugía , Riñón/cirugía , Animales , Vasos Sanguíneos/patología , Muerte Celular , Técnicas In Vitro , Riñón/irrigación sanguínea , Riñón/patología , Masculino , Modelos Biológicos , Necrosis , Perfusión , Sus scrofa , Procedimientos Quirúrgicos Vasculares
SELECCIÓN DE REFERENCIAS
DETALLE DE LA BÚSQUEDA
...