45,506 research outputs found
Line‐field optical coherence tomography: in vivo diagnosis of basal cell carcinoma subtypes compared with histopathology
No full textBackground: Basal cell carcinoma (BCC) is the most common skin cancer in the general population. Treatments vary from Mohs surgery to topical therapy, depending on the subtype. Dermoscopy, reflectance confocal microscopy (RCM) and optical coherence tomography (OCT) have gained a foothold in daily clinical practice to optimize diagnosis and subtype-oriented treatment. The new technique of line-field confocal OCT (LC-OCT) allows imaging at high resolution and depth, but its use has not yet been investigated in larger studies. Aim: To evaluate the main LC-OCT criteria for the diagnosis and subtyping of BCC compared with histopathology, OCT and RCM. Methods: In total, 52 histopathologically confirmed BCCs were evaluated for imaging criteria. Their frequency, predictive values and ROC curves were calculated. A multinominal regression with stepwise variables selection to distinguish BCC subtypes was performed. Results: Nodular BCCs were mainly characterized by atypical keratinocytes, altered dermoepidermal junction (DEJ), tumour nests in the dermis, dark clefting, prominent vascularization and white hyper-reflective stroma. Superficial BCCs showed a thickening of the epidermis due to a series of tumour lobules with clear connection to the DEJ (string of pearls pattern). Infiltrative BCCs were characterized by elongated hyporeflective tumour strands, surrounded by bright collagen (shoal of fish pattern). The overall BCC subtype agreement between LC-OCT and conventional histology was 90.4% (95% CI 79.0–96.8). Conclusion: LC-OCT allows noninvasive, real-time identification of BCCs and their subtypes in vertical, horizontal and three-dimension mode compared with histology, RCM and OCT. Further larger studies are needed to better explore the clinical applications of this promising device
Line‐field confocal optical coherence tomography for the in‐vivo real‐time diagnosis of different stages of keratinocyte skin cancer: a preliminary study
No full textBackground: The treatment of keratinocyte cancers (KC) strictly depends on their differentiation and invasiveness. Non-invasive diagnostic techniques can support the diagnosis in real time, avoiding unnecessary biopsies. This study aimed to preliminarily define main imaging criteria and histological correlations of actinic keratosis (AK), Bowen’s disease (BD) and squamous cell carcinoma (SCC) using the novel device line-field confocal optical coherence tomography (LC-OCT). Methods: Dermoscopy and LC-OCT images of 73 histopathologically confirmed lesions (46 AKs, 11 BD and 16 SCCs) were included in the study. Exemplary lesions (10 AKs, 5 BD and 5 SCCs) were additionally investigated with optical coherence tomography and reflectance confocal microscopy. Results: Most common LC-OCT findings of KC in the descriptive statistics were hyperkeratosis/parakeratosis, disruption of stratum corneum, broadened epidermis, basal and suprabasal keratinocyte atypia, dilated vessels/neoangiogenesis and elastosis/collagen alterations. In the univariate multinomial logistic regression, a preserved DEJ was less common in SCC compared with AK and BD, BD displayed marked keratinocyte atypia involving all epidermal layers (bowenoid pattern), while SCC showed ulceration, increased epidermal thickness, keratin plugs, acantholysis, not visible/interrupted DEJ and epidermal bright particles. LC-OCT increased the diagnostic confidence by 24.7% compared with dermoscopy alone. Conclusions: Our study describes for the first time specific LC-OCT features of different stages of KC and their histopathological correlates, focusing on keratinocyte morphology and architecture of the epidermis and DEJ. LC-OCT may open new scenarios in the bedside diagnosis, treatment planning and follow-up of KC
Comparison of ex-vivo confocal micrographic surgery of basal cell carcinoma and conventional frozen section Mohs surgery (Munich method)
No full textIntroduction
A new, reliable way to confidently diagnose basal cell carcinoma (BCC) out of fresh or frozen tissue is ex vivo confocal microscopy (CLSM). BCC belongs to the most frequently occurring epithelial skin tumours in humans and its incidence is increasing year by year. The most efficient treatment of BCC is micrographic surgery on frozen sections with Mohs surgery. Using a confocal microscope based on two different lasers with varying wavelengths, images in reflectance (RM) and fluorescence mode (FM) can be generated. In addition to that, the newest generation allows creating an overlap between the earlier mentioned modes combined with a staining software, making direct comparison to conventional histologic haematoxylin & eosin (HE) staining possible. Images produced by RM are based on the natural contrast of subcellular structures, whereas FM images have an increased cell-to-stroma contrast due to fluorochromes.
With a reported sensitivity of 88% and a specificity of 99% for the diagnose of BCC on fresh tissue, CLSM has shown to be an attractive alternative to conventional frozen histology for detecting margins in freshly excised tissues. Furthermore CLSM can be applied during surgery as a so-called “bedside histology” and since there is no tissue damaged during the ex-vivo CLSM examination the analyzed samples can still undergo the process of standard histopathological evaluation.
Material and Methods
In this ongoing study, fifty-seven BCCs 35 microns thick horizontal frozen sections of primary BCCs stained with acridine orange were analysed with ex vivo CLSM. Complete or partial resection, histological subtype, as well as presence of adnexal structures and artefacts were evaluated. Features were compared with conventional H&E of the same sample.
Results
Ex-vivo CLSM reached a sensitivity of 90% and a specificity of 95% in the diagnosis of BCC on frozen sections, being able to recognize the presence of the tumour and its margins. Following features were correctly recognized in CLSM on frozen sections: palisading, clefting, stromal reaction, adnexal structures, fat tissue, muscle, scars. The tumour subtype was correctly defined. The most common artefact was a blurred margin, probably due to acridine orange accumulation.
Discussion
Our preliminary results confirm the high potential of CLSM for perioperative BCC diagnosis as well as margin assessment on frozen sections. The new generation device adds overlap images and digital staining, for a more accurate comparison to conventional histopathological H&E staining. This brings to a better definition not only of BCCs but also of other structures such as adnexa. Time sparing in comparison to standard frozen sections, CLSM allows bedside surgery, immediate reoperations or one-step wound closures. As a consequence, the economic burden of multiple operations can be decreased.
We believe in CLSM will gain importance in dermato-surgery in the next future, with its use not only narrowed to micrographic surgery of BCCs but also of other skin tumours. The new digital staining tool can improve the diagnostic accuracy thanks to the intuitive comparison with H&E staining in conventional histopathology
In vivo examination of healthy human skin after short-time treatment with moisturizers using confocal Raman spectroscopy and optical coherence tomography: Preliminary observations
No full textSkin is our barrier against environmental damage. Moisturizers are widely used to increase hydration and barrier integrity of the skin; however, there are contrasting observations on their in vivo effects in real-life settings. In cosmetic studies, cor- neometers and tewameters are traditionally used to assess skin hydration. In this study, two novel noninvasive diagnostic techniques, optical coherence tomography (OCT) and confocal Raman spectroscopy, were used to analyze stratum corneum and epidermal thickness (ET), water content, blood flow in function of depth, skin roughness, attenuation coefficient, natural moisturizing factor, ceramides and free fatty acids, cholesterol, urea, and lactates in 20 female subjects aged between 30 and 45 before and after 2 weeks application of a commercially available mois- turizing lotion on one forearm. The untreated forearm served as control. A third measurement was conducted 1 week after cessation of moisturizing to verify whether the changes in the analyzed parameters persisted. We noticed a reduction in skin roughness, an increase in ceramides and free fatty acids and a not statistically sig- nificant increase in ET. As a conclusion, short time moisturizing appears insufficient to provide significant changes in skin morphology and composition, as assessed by OCT and RS. Novel noninvasive imaging methods are suitable for the evalu- ation of skin response to topical moisturizers. Further studies on larger sample size and longer treatment schedules are needed to analyze changes under treat- ment with moisturizers and to standardize the use of novel noninvasive diagnostic techniques
Erratum to: Effect of moderate red wine intake on cardiac prognosis after recent acute myocardial infarction of subjects with Type 2 diabetes mellitus (Diabetic Medicine, (2006), 23, 9, (974-981), 10.1111/j.1464-5491.2006.01886.x)
No full textIn an article by Marfella et al, the author name C. Saron is incorrect and should be listed as C. Sardu. Therefore the correct author list is: R. Marfella, F. Cacciapuoti, M. Siniscalchi, F. C. Sasso, F. Marchese, F. Cinone, E. Musacchio, M. A. Marfella, L. Ruggiero, G. Chiorazzo, D. Liberti, G. Chiorazzo, G. F. Nicoletti, C. Sardu, F. D'Andrea, C. Ammendola, M. Verza and L. Coppola.In an article by Marfella et al, the author name C. Saron is incorrect and should be listed as C. Sardu. Therefore the correct author list is: R. Marfella, F. Cacciapuoti, M. Siniscalchi, F. C. Sasso, F. Marchese, F. Cinone, E. Musacchio, M. A. Marfella, L. Ruggiero, G. Chiorazzo, D. Liberti, G. Chiorazzo, G. F. Nicoletti, C. Sardu, F. D'Andrea, C. Ammendola, M. Verza and L. Coppola
Going Beyond Counting First Authors in Author Co-citation Analysis
No full textThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
De Maiestate / Praeside M. Jacobo Thomasio, Moralis Philosoph. P. P., publice disputabit Johannes Dunte, R. L. Author & Respon: ad diem 9. Septembr. H L. Q. C.
No full textDE MAIESTATE / PRAESIDE M. JACOBO THOMASIO, MORALIS PHILOSOPH. P. P., PUBLICE DISPUTABIT JOHANNES DUNTE, R. L. AUTHOR & RESPON: AD DIEM 9. SEPTEMBR. H L. Q. C.
De Maiestate / Praeside M. Jacobo Thomasio, Moralis Philosoph. P. P., publice disputabit Johannes Dunte, R. L. Author & Respon: ad diem 9. Septembr. H L. Q. C. (1)
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Ex-vivo fluorescence confocal microscopy with digital staining for characterizing basal cell carcinoma on frozen sections: A comparison with histology
No full textEx-vivo fluorescence confocal microscopy (FCM) has been used on fresh tissue, but there is little experience on frozen sections. We evaluated the applicability of FCM on frozen sections of basal cell carcinomas (BCCs), stained with acridine orange and digitally colored to simulate hematoxylin and eosin (H&E) dyes. We compared our diagnostic accuracy in detecting and subtyping BCCs with FCM to our gold standard (H&E stained frozen sections used in 3D horizontal micrographic surgery). Fourty-six primary BCCs were analyzed for free margins as well as histological subtype with all FCM modes and conventional H&E staining. Adnexa, artifacts and diagnostic confidence were evaluated. Free margins were identified with a sensitivity and specificity of 92% and 91%. Concordance for tumor subtype was 88%. FCM may be used on both fresh tissue and frozen samples, although with reduced performance and different artifacts. The device is useful for the intraoperative diagnosis, subtyping and margin-mapping of BCCs
Survival of Salmonella typhimurium, Listeria monocytogenes and indicator bacteria on cooked uncured turkey loaf stored under vacuum at 3°C
No full textSterile slices of cooked uncured turkey loaf were inoculated with 106 CFU of either Salmonella typhimurium, Listeria monocytogenes, Escherichia coli, Enterococcus faecalis, Citrobacter freundii, Klebsiella pneumoniae, or Enterobacter cloacae. Inoculated samples were vacuum‐packaged and stored at 3 ± 1°C. Microorganisms were enumerated at 0, 3, 6, 9, 12, and 15 days on nonselective media. K. pneumoniae exhibited the least cold‐tolerance with a log10 1.70 decrease in numbers. The coliforms E. cloacae, E. coli, and C. freundii had a survival pattern similar to that of S. typhimurium, with population decreases of log10 0.65, 0.82, 1.13, and 0.79, respectively. E. faecalis and L. monocytogenes were significantly more cold‐resistant, with a decrease of log10 0.20 and no significant change in numbers, respectively. Survival of E. faecalis was not significantly (p < 0.01) different than that of L. monocytogenes, suggesting the use of enterococci as indicators of L. monocytogenes contamination of processed meats.Peer reviewedfinal article publishe
Dispelling the Myths Behind First-author Citation Counts
No full textWe conducted a full-scale evaluative citation analysis study of scholars in the XML research field to explore just how different from each other author rankings resulting from different citation counting methods actually are, and to demonstrate the capability of emerging data and tools on the Web in supporting more realistic citation counting methods. Our results contest some common arguments for the continued
use of first-author citation counts in the evaluation of scholars, such as high correlations between author rankings by first-author citation counts and other citation
counting methods, and high costs of using more realistic citation counting methods that are not well-supported by the ISI databases. It is argued that increasingly available digital full text research papers make it possible for citation analysis studies to go beyond what the ISI databases have directly supported and to employ more
sophisticated methods
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