Search

Objectives. We aim to establish whether in vivo confocal endomicroscopy (1) delivers a clear image of subcellular structures within the upper airway mucosa and (2) allows leucocytes to be identified using topical antibodies against CD45, the common leucocyte antigen. Methods. Endoscopic confocal images were captured from the supraglottic and tracheal mucosa in anaesthetised Landrace–Large white hybrid pigs using a rigid endoscope (Optiscan, Melbourne, Auctralia). 10% fluroscein was administered intravenously as contrast; 30 min later 0.05% acriflavine was applied as a topical contrast to the mucosa immediately prior to imaging of two pigs. In a further two pigs, 10% fluorescently labelled anti-CD45 antibody was applied topically immediately prior to imaging. Images were captured and reviewed on a computer screen at the time of examination. Results. High-resolution (x1000 magnification) images of the nuclei and cytoplasm of individual cells within the stratified squamous and respiratory epithelium of the supraglottis and trachea were captured using concurrent fluroscein and acriflavine staining. Intravenous fluroscein highlighted subsurface capillaries within which individual erythrocytes appeared as unstained shadows. Discrete leucocytes were clearly visible within the mucosa following topical application of anti-CD45 antibody. Conclusion. In vivo confocal endomicroscopy allows examination of the upper airway mucosa at cellular resolution in real time. We have, for the first time, combined in vivo confocal imaging with antibody targeting of specific cell markers in the upper airway in large animals. Combining confocal endomicroscopy with topical antibodies against tumour markers (e.g. EGFR and p53) may allow tumours to be diagnosed and characterised during endoscopic examination without taking a biopsy. [ABSTRACT FROM AUTHOR]

The purpose of this paper is to examine the problem of femoral neck fracture in the elderly New Zealand citizen, and to consider the prospects for prevention. Data are drawn chiefly from the Accident Compensation Corporation's claims data base, which has enabled identification of the mechanism of accident associated with such fractures. The data reveal a relative preponderance of femoral neck fracture in females of advanced age. In this group, the typical accident sequence is found to be mundane, 84% of victims falling to the ground without involvement of external agency. It is concluded that the resulting fractures are largely attributable to the heightened vulnerability of the subject as opposed to the magnitude of the blow. Hence, an appropriate intervention strategy should be aimed at strengthening the bone structure of individuals at risk. The practicability of this approach is discussed with particular reference to calcium and hormonal supplements. It is noted that cost and other factors make identification of a high risk sub-population desirable. Modern methods of bone density measurement have enhanced the feasibility of this procedure.