A Novel Technique for Preparation, Staining, and Visualization of Tissue with Metal Implants and Extraskeletal Calcification Areas
The aim of the study was to evaluate the efficacy of a novel technique for preparation, staining, and visualization of tissues containing extra-skeletal mineralization areas, all-metal implants or their prototypes for their subsequent examination using scanning electron microscopy in the backscattered electron mode.
Materials and Methods. After fixation in 10% formalin (24 h), the biomaterial (a titanium nickelide plate with the surrounding tissues after subcutaneous implantation, patented titanium alloy plates with the surrounding tissues after cranioplasty, primary and secondary calcified atherosclerotic plaques) were fixed with 1% osmium tetroxide (12 h) and then stained with 2% aqueous solution of osmium tetroxide (48 h). The samples were further stained with 2% alcoholic uranyl acetate (5 h), dehydrated with isopropanol (5 h) and acetone (1 h), impregnated with a mixture of acetone and epoxy resin Epon (1:1, 6 h) and then embedded into a fresh portion of epoxy resin (24 h), which was followed by polymerization at 60°C. After grinding and polishing, epoxy blocks were counterstained with lead citrate (7 min) and sputter-coated with carbon, then the samples were visualized by scanning electron microscopy in the backscattered electron mode. The elemental composition was studied using X-ray microanalysis.
Results. The developed technique allows obtaining high-quality images at five thousand-fold magnifications, provides the possibility to identify the shape and structure of intact metal and mineral inclusions, and to type the surrounding cells, distinguishing mesenchymal and immunocompetent cells by shape and cytoplasmic content. Apart from connective tissue capsule thickness and leukocyte infiltration, this technique makes it possible to estimate the number and area of newly formed small-caliber vessels representing a surrogate marker of inflammation.
Conclusion. The proposed technique provides the possibility to investigate adequately the structure of samples when their sectioning is impossible or significantly complicated, with image quality remarkably higher than that obtained by light microscopy.
- Timmermans F.J., Otto C. Contributed review: review of integrated correlative light and electron microscopy. Rev Sci Instrum 2015; 86(1): 011501, https://doi.org/10.1063/1.4905434.
- Combs C.A., Shroff H. Fluorescence microscopy: a concise guide to current imaging methods. Curr Protoc Neurosci 2017; 79: 2.1.1–2.1.25, https://doi.org/10.1002/cpns.29.
- Ryan J., Gerhold A.R., Boudreau V., Smith L., Maddox P.S. Introduction to modern methods in light microscopy. Methods Mol Biol 2017; 1563: 1–15, https://doi.org/10.1007/978-1-4939-6810-7_1.
- Mukhamadiyarov R.A., Sevostyanova V.V., Shishkova D.K., Nokhrin A.V., Sidorova O.D., Kutikhin A.G. Grinding and polishing instead of sectioning for the tissue samples with a graft: implications for light and electron microscopy. Micron 2016; 85: 1–7, https://doi.org/10.1016/j.micron.2016.03.005.
- Sharma S.P., Dahal K., Khatra J., Rosenfeld A., Lee J. Percutaneous coronary intervention vs coronary artery bypass grafting for left main coronary artery disease? A systematic review and meta-analysis of randomized controlled trials. Cardiovasc Ther 2017; 35(3), https://doi.org/10.1111/1755-5922.12260.
- Calvet D., Mas J.L.; Carotid Stenosis Trialists’ Collaboration. Symptomatic carotid stenosis: is stenting as safe and effective as carotid endarterectomy? Curr Opin Neurol 2017; 30(1): 22–27, https://doi.org/10.1097/WCO.0000000000000409.
- Zanotti B., Zingaretti N., Verlicchi A., Robiony M., Alfieri A., Parodi P.C. Cranioplasty: review of materials. J Craniofac Surg 2016; 27(8): 2061–2072, https://doi.org/10.1097/SCS.0000000000003025.
- Rony L., Lancigu R., Hubert L. Intraosseous metal implants in orthopedics: a review. Morphologie 2018; 102(339): 231–242, https://doi.org/10.1016/j.morpho.2018.09.003.
- Lotkov A.I., Matveeva V.G., Antonova L.V., Kashin O.A., Kudryashov A.N. Surface modification of bare-metal stents for preventing restenosis (part 1). Complex Issues of Cardiovascular Diseases 2017; 6(1): 122–130, https://doi.org/10.17802/2306-1278-2017-1-122-130.
- Lotkov A.I., Matveeva V.G., Antonova L.V., Kashin O.A., Kudryashov A.N. Surface modification of bare-metal stents for preventing restenosis (part 2). Complex Issues of Cardiovascular Diseases 2017; 6(3): 131–142, https://doi.org/10.17802/2306-1278-2017-6-3-131-142.
- Wu M., Rementer C., Giachelli C.M. Vascular calcification: an update on mechanisms and challenges in treatment. Calcif Tissue Int 2013; 93(4): 365–373, https://doi.org/10.1007/s00223-013-9712-z.
- Lanzer P., Boehm M., Sorribas V., Thiriet M., Janzen J., Zeller T., St Hilaire C., Shanahan C. Medial vascular calcification revisited: review and perspectives. Eur Heart J 2014; 35(23): 1515–1525, https://doi.org/10.1093/eurheartj/ehu163.
- Kostyunin A.E., Yuzhalin A.E., Ovcharenko E.A., Kutikhin A.G. Development of calcific aortic valve disease: do we know enough for new clinical trials? J Mol Cell Cardiol 2019; 132: 189–209, https://doi.org/10.1016/j.yjmcc.2019.05.016.
- Bre L.P., McCarthy R., Wang W. Prevention of bioprosthetic heart valve calcification: strategies and outcomes. Curr Med Chem 2014; 21(22): 2553–2564, https://doi.org/10.2174/0929867321666131212151216.
- Mukhamadiyarov R.A., Kutikhin A.G. Histology and histopathology of blood vessels: backscattered scanning electron microscopy approach. Fundamental’naya i klinicheskaya meditsina 2019; 4(1): 6–14, https://doi.org/10.23946/2500-0764-2019-4-1-6-14.