scholarly journals Confocal Microscopy and Lentigo Maligna: An in vivo Pilot Study for the Assessment of Response to Imiquimod Therapy

Dermatology ◽  
2018 ◽  
Vol 235 (2) ◽  
pp. 150-155 ◽  
Author(s):  
Flurin L. Brand ◽  
S. Morteza Seyed Jafari ◽  
Robert E. Hunger
Keyword(s):  
Confocal Microscopy ◽  
Histopathological Examination ◽  
Surgical Excision ◽  
Lentigo Maligna ◽  
Noninvasive Technique ◽  
Important Benefit ◽  
Before And After ◽  
Atypical Cells

Background: Reflectance confocal microscopy (RCM) is a noninvasive technique that provides real-time in vivo images of the epidermal layer. Imiquimod has been recommended as an alternative treatment in lentigo maligna (LM) when surgical excision is not the treatment of choice. In the present study we compare the results of in vivo RCM to the histopathological examination before and after treatment of LM with topical imiquimod. Methods: Thirty-four patients with confirmed LM were included. Imiquimod 5% was applied until a weeping erosion appeared in the LM-affected skin. Evaluation was performed by clinical examination, dermatoscopy, histopathology and RCM. Results: During the follow-up, 27 of 34 patients (79.42%) demonstrated a total tumor clearance by imiquimod treatment. In the treated area, a significant decrease of atypical cells was detected using RCM (p < 0.0001). Furthermore, a significant positive correlation in the detected atypical cells was shown using confocal microscopy and histology (p = 0.0001, r = 0.7335, respectively). Conclusion: In patients not suitable for surgical intervention imiquimod treatment is an appropriate treatment alternative. Thereby, in vivo RCM was demonstrated to be an excellent examining device, which not only allows diagnosis of LM, but also therapy and follow-up examinations. An important benefit of RCM, in contrast to conventional histopathology, is the simple handling with in vivo examination of epidermal skin without any pain for the patient.

scholarly journals Comparing preoperative mapping with reflectance confocal microscopy to surgical markings in lentigo maligna excision of the face: a pilot study

2020 ◽  
Vol 3 (2) ◽  
Author(s):  
Lipi Shukla ◽  
Louise Photiou ◽  
Alan Pham ◽  
Catriona McLean ◽  
Raquel Ruiz ◽  
...  
Keyword(s):  
Pilot Study ◽  
Confocal Microscopy ◽  
Surgical Margin ◽  
Surgical Excision ◽  
Reflectance Confocal Microscopy ◽  
Histopathological Analysis ◽  
Lentigo Maligna ◽  
Complete Excision ◽  
Preoperative Mapping

Background: Lentigo maligna (LM) characteristically has an ill-defined margin and may require multiple excisions to achieve complete excision with 5mm margins. In vivo reflectance confocal microscopy (RCM) is a non-invasive tool recognised as useful in the management of LM. The authors aimed to determine whether the use of RCM prior to surgical excision reliably increased the rate of complete excision when compared with standard surgical excision. Methods: This prospective pilot study included patients with biopsy-proven LM of head and neck region who sought consultation for surgical management from May 2017 to May 2019 at the Victorian Melanoma Service, Melbourne. Patients were randomised to two groups based on the availability of RCM — Group 1, RCM-guided surgical excision, and Group 2, standard surgical excision. Outcomes were measured based on clinical markings and histopathological margins achieved and reported as RCM or surgical margin excess or deficit. Ethics approval for the study was obtained from the Research Governance Unit of The Alfred Hospital, Melbourne. Results: Results demonstrated that RCM marking of lesion margins was in excess in 69 percent of cases, in deficit in 22 per cent and accurate in nine per cent after histopathological analysis of the specimens. In comparison, lesions that were surgically marked were removed with margins in excess in 43 per cent of cases, in deficit in 11 per cent and accurate in 46 per cent. Conclusion: This pilot study demonstrates that RCM did not increase the accuracy of LM surgical excision in comparison with standard surgically marked excisions.

scholarly journals In vivo comparison of braided (Accero) and laser-cut intracranial stents (Acclino, Credo): evaluation of vessel responses at subacute and mid-term follow-up in a rabbit model

2020 ◽  
Vol 31 (12) ◽  
Author(s):  
Mühl-Benninghaus Ruben ◽  
Tomori Toshiki ◽  
Krajewski Stefanie ◽  
Dietrich Philipp ◽  
Simgen Andreas ◽  
...  
Keyword(s):  
Histopathological Examination ◽  
Rabbit Model ◽  
Vessel Diameter ◽  
Progressive Increase ◽  
In Vivo Model ◽  
Antiplatelet Medication ◽  
Significant Difference ◽  
Before And After

AbstractThis study aimed to investigate in vivo two stent technologies, with particular emphasis on thrombogenicity and inflammatory vessel remodeling processes. The micro-stents tested in this study were developed for intracranial aneurysm treatment. In our study twelve, New Zealand white rabbits were divided into two groups: 18 laser-cut stents (LCS) and 18 braided stents (BS) were impanated without admiration of antiplatelet medication. Three stents were implanted into each animal in the common carotid artery, subclavian artery, and abdominal aorta. Digital subtraction angiography was performed before and after stent implantation and at follow-up for the visualization of occurring In-stent thromboembolism or stenosis. The Stents were explanted for histopathological examination at two different timepoints, after 3 and 28 days. Angiographically neither in-stent thrombosis nor stenosis for both groups was seen. There was a progressive increase in the vessel diameter, which was more pronounced for BS than for LCS. We detected a higher number of thrombi adherent to the foreign material on day 3 for BS. On day 3, the neointima was absent, whereas the complete formation observed was on day 28. There was no significant difference between both groups regarding the thickness of the neointima. The in vivo model of our study enabled the evaluation of blood and vessel reactions for two different stent technologies. Differences in vessel dimension and tissue around the stents were observed on day 28. Histological analysis on day 3 enabled the assessment of thrombotic reactions, representing an important complementary result in long-term studies.

scholarly journals Pigmented actinic lichen planus (PALP) mimicking lentigo maligna melanoma: Usefulness of in vivo reflectance confocal microscopy in diagnosis and follow-up

2018 ◽  
Vol 4 (6) ◽  
pp. 568-572 ◽  
Author(s):  
Marina Venturini ◽  
Ausilia Maria Manganoni ◽  
Arianna Zanca ◽  
Stefania Bassissi ◽  
Laura Pavoni ◽  
...  
Keyword(s):  
Confocal Microscopy ◽  
Lichen Planus ◽  
Reflectance Confocal Microscopy ◽  
Lentigo Maligna ◽  
Lentigo Maligna Melanoma

scholarly journals The Effect of Q-Switched Nd:YAG 1064 nm/532 nm Laser in the Treatment of Onychomycosis In Vivo

2013 ◽  
Vol 2013 ◽  
pp. 1-10 ◽  
Author(s):  
Kostas Kalokasidis ◽  
Meltem Onder ◽  
Myrto-Georgia Trakatelli ◽  
Bertrand Richert ◽  
Klaus Fritz
Keyword(s):  
Clinical Study ◽  
Treatment Time ◽  
Prospective Clinical Study ◽  
Self Evaluation ◽  
Time Period ◽  
Level Of Satisfaction ◽  
Before And After ◽  
532 Nm

In this prospective clinical study, the Q-Switched Nd:YAG 1064 nm/532 nm laser (Light Age, Inc., Somerset, NJ, USA) was used on 131 onychomycosis subjects (94 females, 37 males; ages 18 to 68 years). Mycotic cultures were taken and fungus types were detected. The laser protocol included two sessions with a one-month interval. Treatment duration was approximately 15 minutes per session and patients were observed over a 3-month time period. Laser fluencies of 14 J/cm2were applied at 9 billionths of a second pulse duration and at 5 Hz frequency. Follow-up was performed at 3 months with mycological cultures. Before and after digital photographs were taken. Adverse effects were recorded and all participants completed “self-evaluation questionnaires” rating their level of satisfaction. All subjects were well satisfied with the treatments, there were no noticeable side effects, and no significant differences were found treating men versus women. At the 3-month follow-up 95.42% of the patients were laboratory mycologically cured of fungal infection. This clinical study demonstrates that fungal nail infections can be effectively and safely treated with Q-Switched Nd:YAG 1064 nm/532 nm laser. It can also be combined with systemic oral antifungals providing more limited treatment time.

scholarly journals Clinical and in Vivo Response Following Surgery or Surgery Plus Adjuvant Chemotherapy or Immunotherapy for Colorectal Carcinoma in a Rat Model

1983 ◽  
Vol 76 (10) ◽  
pp. 833-840 ◽  
Author(s):  
A K House ◽  
M A L Maley
Keyword(s):  
Body Weight ◽  
Adjuvant Chemotherapy ◽  
Surgical Excision ◽  
The Body ◽  
Recurrent Tumour ◽  
Mesenteric Node ◽  
And Control ◽  
Tumour Weight

Two cohorts of rats, 240 with colon cancer and 150 controls, were assessed clinically and immunologically for their response to tumour and its management which was either by surgical excision alone or by surgical excision combined with either adjuvant chemotherapy or immunotherapy. The histology and invasion characteristics were observed for similarity with those of human lesions. Metastases were found in liver, lymph nodes, the peritoneum or lungs in 27% of animals during follow up. Significantly fewer adjuvant-treated rats had metastases than those receiving surgery alone ( P < 0.05), and less total tumour weight was found in the adjuvant-treated rats at four ( P < 0.03) and six ( P < 0.001) weeks postoperatively. Animals in the adjuvant immunotherapy group survived longer than in either other group ( P < 0.001). The crude parameters of host response to tumour, body, spleen and mesenteric lymph node weight were recorded and the latter two indexed to body weight. The body weight of tumour and control rats increased significantly with time ( P < 0.04). The spleen and mesenteric node indices were significantly ( P < 0.04) greater in tumour than control rats and were varied by recurrent tumour growth and by the adjuvant treatment administered postoperatively.

scholarly journals Computed Tomography and Bronchoscopy in Endobronchial Tuberculosis

2003 ◽  
Vol 10 (8) ◽  
pp. 445-448 ◽  
Author(s):  
Halil Yanardag ◽  
Cüneyt Tetikkurt ◽  
Seza Tetikkurt ◽  
Sabriye Demirci ◽  
Tuncer Karayel
Keyword(s):  
Computed Tomography ◽  
Retrospective Study ◽  
Therapeutic Response ◽  
Histopathological Examination ◽  
Computed Tomographic ◽  
Before And After ◽  
Endobronchial Tuberculosis ◽  
Age Range

BACKGROUND: The therapeutic response to endobronchial tuberculosis is usually evaluated by bronchoscopy. Currently, there are no published studies investigating the use of computed tomography for the evaluation of therapeutic response in endobronchial tuberculosis.OBJECTIVE: A retrospective study was performed to evaluate the bronchoscopic and computed tomographic features of endobronchial tuberculosis before and after treatment. The aim of this study was to investigate the usefulness of computed tomography for the assessment of treatment.METHODS: The clinical, pathological and bronchoscopic features of endobronchial tuberculosis were evaluated in 55 patients. The age range of the patients was 21 to 52 years. Computed tomography and bronchoscopy were performed before and after treatment.RESULTS: Diagnosis of tuberculosis was confirmed by culture and histopathological examination. Bronchoscopic examination revealed 89 endobronchial lesions of various types in 55 patients. The exudative type was the most common. Follow-up bronchoscopy revealed that exudative-, ulcerative- and granular-type lesions healed completely. Computed tomography performed after treatment correlated well with the follow-up bronchoscopic findings.CONCLUSION: The results suggest that follow-up computed tomography is useful for the evaluation of therapeutic response and complications associated with endobronchial tuberculosis, and may replace bronchoscopy.

Cryosurgical management of basal cell carcinoma: in vivo follow-up using reflectance confocal microscopy

2018 ◽  
Vol 58 (2) ◽  
pp. e30-e32 ◽  
Author(s):  
Paola Pasquali ◽  
Gonzalo Segurado-Miravalles ◽  
Azael Freites-Martínez ◽  
Salvador González-Rodriguez
Keyword(s):  
Confocal Microscopy ◽  
Basal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Basal Cell ◽  
Reflectance Confocal Microscopy

ATTENTIONAL FOCUS AND FEAR OF BLUSHING: A CASE STUDY

1999 ◽  
Vol 27 (2) ◽  
pp. 153-164 ◽  
Author(s):  
Sandra Mulkens ◽  
Susan M. Bögelts ◽  
Peter J. de Jong
Keyword(s):  
Single Case ◽  
Attentional Focus ◽  
Single Case Study ◽  
Fear Avoidance ◽  
Differential Effects ◽  
Before And After ◽  
Fear Of Blushing

By means of a single case study, the effects of redirecting attention above exposure only on fear of blushing, avoidance, and idiosyncratic dysfunctional beliefs were tested. A social phobic patient with fear of blushing as the predominant complaint received sessions of Task Concentration Training (TCT) and Exposure in Vivo (EXP) alternately, after a steady baseline had been established. The treatment consisted of 14 individual sessions. Assessments were held before and after baseline, after treatment, after 4 weeks follow-up, and after 1-year follow-up. Continuous measurements were held throughout the treatment in order to measure the differential effects of TCT and EXP on fear, avoidance and beliefs. TCT and EXP together, turned out to be an effective treatment for fear of blushing: large effects were observed on all three outcome measurements. When differential effects are closely looked at, EXP seemed more effective in decreasing fear of blushing. However, the patient appeared to have used TCT strategies as well during the EXP weeks, which may have contributed to the favourable effects of EXP.

Retained presumed intraocular cotton fiber after cataract operation: Long-term follow-up with in vivo confocal microscopy

2005 ◽  
Vol 31 (8) ◽  
pp. 1582-1587 ◽  
Author(s):  
Hunter K.L. Yuen ◽  
Robert F. Lam ◽  
Yolanda Y.Y. Kwong ◽  
Srinivas K. Rao ◽  
Ben N.M. Lam ◽  
...  
Keyword(s):  
Confocal Microscopy ◽  
Cotton Fiber ◽  
Cataract Operation ◽  
In Vivo Confocal Microscopy ◽  
Long Term Follow Up
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