Milei J, Beigelman R, Valero E, Pesce R, Quel E, Armentano R, Storino R
Hospital Fernández, Argentina.
Arch Inst Cardiol Mex. 1990 Jan-Feb;60(1):21-6.
Laser beam constitutes a potential therapy in modern cardiology. Although its myocardial effects are known, they have been insufficiently evaluated at the surviving myocytes zone surrounding the evaporated crater. In order to assess myocyte cellular and organelar damage, we studied 8 isolated canine hearts radiated with different intensities by a CO2He laser beam 2.4, 3.5, 5, 15, 25, 30 and 40 Watts, varying the exposition time from 1 to 6 sec. Color photographs from the post-radiated lesions on front and depth were obtained. Their volumes were measured applying the cylinder and the cut out-conus formulas according to the shape of the lesions and then the involved tissues were embedded in paraffin for histological studies. Previously, samples of the lesions were fixed in glutaraldehyde for ultrastructural studies. Volumes of the craters were from 0.0004 to 19.57 mm3. Three layers were observed: a) a carbonized internal lining which measured x 15 microns in thickness; b) a coagulation necrotic zone ("gruyere cheese-like"), 70 microns thickness; c) finally more peripherally, a layer consisting of myocytes with patchy homogeneous cytoplasm, and scare positivity for the Barbeito López Trichome Stain (a positive technique in cases of myocardial damage). Ultrastructurally, crater peripherical cells showed cytosol and mitochondrial edema without membrane disruptions. These findings suggest that myocytes surrounding the laser beam crater, show reversible lesions. Therefore laser beam apperrs a safe procedure to be used in myocardium.
激光束是现代心脏病学中的一种潜在治疗方法。尽管其对心肌的作用已为人所知,但在围绕蒸发弹坑的存活心肌细胞区域,其作用尚未得到充分评估。为了评估心肌细胞的细胞和细胞器损伤,我们研究了8个离体犬心,用二氧化碳氦激光束以2.4、3.5、5、15、25、30和40瓦的不同强度进行照射,照射时间从1秒到6秒不等。获取了辐射后病变正面和深度的彩色照片。根据病变形状,应用圆柱体和截头圆锥体公式测量其体积,然后将受累组织嵌入石蜡中进行组织学研究。此前,将病变样本固定在戊二醛中进行超微结构研究。弹坑体积为0.0004至19.57立方毫米。观察到三层:a)碳化内衬,厚度为x 15微米;b)凝固性坏死区(“瑞士奶酪样”),厚度70微米;c)最后在更外围,一层由细胞质呈斑驳均匀状的心肌细胞组成,对巴比托·洛佩斯三色染色呈弱阳性(这是心肌损伤情况下的一种阳性技术)。超微结构上,弹坑周边细胞显示胞质溶胶和线粒体水肿,但无膜破坏。这些发现表明,激光束弹坑周围的心肌细胞显示出可逆性损伤。因此,激光束似乎是一种可安全用于心肌的方法。