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Biomedical subjects

S Koller

Publications and source records attributed to S Koller.

At least 19 recordsLinked to original sources

The use of confocal laser-scanning microscopy in microsurgery for invasive squamous cell carcinoma.

BACKGROUND: Ex-vivo confocal laser-scanning microscopy offers rapid imaging of excised tissue specimens without conventional histotechnical procedures. As vertical sections are prepared, morphological features can be assessed according to standard criteria used in conventional histopathology. OBJECTIVES: To validate the diagnostic confocal examination of squamous cell carcinoma (SCC) in microscopy-guided surgery. METHODS: Four independent observers received standardized instructions about diagnostic confocal microscopy features of SCC. Subsequently, 120 confocal images of fresh excisions from SCC or normal skin, imaged using a commercially available, near-infrared, reflectance confocal laser-scanning microscope, were evaluated by each observer. RESULTS: General morphology, such as location, size and shape of the cancer area could be visualized by the imaging system. Furthermore, densely packed and irregularly organized nuclei and nuclear atypia could be delineated. Overall, a sensitivity of 95% and a specificity of 96.25% were achieved by the four observers (positive predictive value 96.25%, negative predictive value 95.23%). CONCLUSIONS: This study provides a set of well-described morphological criteria with obvious diagnostic impact which should be used in further investigations. In the future, confocal laser-scanning microscopy may guide microsurgery of any skin cancer.

Carcinoma, Squamous Cell↗

Adapting the fluoroscope to image-guided surgery.

Image-guided techniques have been well established in all surgical disciplines for years. To achieve an optimised work flow during image-guided surgery, the surgeon should be able to manipulate the visual feedback and therefore the imaging unit. C-arm fluoroscopy is the imaging modality routinely used for intraoperative imaging in orthopaedic surgery. The C-arm fluoroscope is positioned and handled by a radiographer on vocal commands, which means that the surgeon depends on external help to manipulate the visual feedback and the work flow is not optimised. The MEPUC interface adapts the C-arm fluoroscope to the needs of image-guided orthopaedic procedures. MEPUC is an acronym for Motorised Exact-Positioning Unit for C-arm. In the hardware component of the MEPUC a conventional C-arm fluoroscope is equipped with stepping motors. The software component allows the surgeon to control the motorised movements of the fluoroscope. The MEPUC interface enables the surgeon to position the C-arm fluoroscope independently in the operating room. Further advantages are achievable when the MEPUC interface is combined with surgical navigation, as this combination allows fully automatic reproduction of former projections. Clinical experience with the MEPUC interface suggests that the work flow for intraoperative imaging is improved and personal requirements reduced.

Fluoroscopy↗

Primary Bartholin gland carcinoma: a report of seven cases.

This study reviews our experience with 7 patients with primary Bartholin gland cancer (BGC) treated at the Queensland Gynaecological Cancer Centre (QCGC) and compares this with previously published data. A retrospective clinicopathologic review of all patients with primary BGC treated at QCGC from 1988 to 2000 was performed. Of the 7 patients treated, all underwent primary surgery and 5 of the 7 patients received radiotherapy postoperatively. All patients presented with a local swelling or a lump. Two had associated discharge and 2 had associated pain. Of the 7 patients, 2, 3 and 2 respectively were classified as having Stage IB, II or III disease. Five of the 7 patients had squamous cell carcinoma (SCC), one had adenoid-cystic carcinoma and 1 had a small-cell neuroendocrine cancer of the Bartholin gland. None of the patients with SCC developed recurrent disease. The patient with adenoid-cystic carcinoma experienced local recurrences at 4 years and again at 5 years and 3 months. Nine years after primary treatment she was diagnosed with pulmonary metastases. The patient with small-cell neuroendocrine cancer of the Bartholin gland was considered tumour-free after operation. Thorough imaging, including a CT scan of her chest, abdomen and pelvis showed no evidence of disease. She died 1 year and three months after diagnosis from disseminated pulmonary disease. We present the first report of small cell neuroendocrine cancer of the Bartholin gland. Therapeutic principles in the management of vulval cancer at other sites appear to be appropriate for management of BGC.

Adult↗

Prospective study of suspected associations between certain drugs administered during early pregnancy and congenital malformations.

From 1964 to 1976, a cohort study was performed in West Germany to study the possible influence of various factors on pregnancy and child development. Results of the evaluation of 13,643 pregnancies are given with respect to possible teratogenetic effects of antiemetic drugs and sex hormones administered in early pregnancy. There was no evidence of an increased risk of major malformations following the intake of certain antiemetic drugs and progesterone. Also, the use of a hormonal pregnancy test was not significantly associated with an increase of major malformations.

Abnormalities, Drug-Induced↗

[Chances of abortion prophylaxis in early pregnancy (author's transl)].

7870 pregnancies during the years 1964-1970 observed in a cooperative clinical study give the data basis of an exploratory statistical analysis. Here the associations of drugs taken during the first three months of pregnancy with the incidence of early spontaneous abortions before the fifth month are demonstrated. The rates are corrected for time of enrollment. Women having taken antiemetic drugs or preparations containing vitamins or minerals have less abortions than women without intake of these drugs. This is found especially in the presence of early nausea or vomiting and of bleedings in the first trimenon. It is important that these drugs have not been used for the treatment of bleedings. Therefore the takers and the non-takers are comparable. A success of the then usual treatment with female sexual hormones could not be found. The high abortion rates of women treated with tranquilizers cannot be interpreted as a failure of this treatment because of the epidemiological non-experimental character of the study.

Abortion, Spontaneous↗