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PubMed2006

Optical coherence tomography for experimental neuroendoscopy.

Optical coherence tomography (OCT) is a non-invasive and non-contact imaging technology that has been applied to several biomedical applications. We have recently demonstrated that OCT allows discrimination of tumor adjacent brain, diffuse and solid tumor tissue and that this technology may be used to detect residual tumor within the resection cavity during resection of intrinsic brain tumors. Here we show that an OCT integrated endoscope can image the endoventricular anatomy and other endoscopically accessible structures in a human brain specimen. A Sirius 713 optical coherence tomography device was mounted to a modified rigid endoscope. A formalin-fixed human brain specimen was used to simulate endoscopic visualization of brain anatomy and two specimens of fixed malignant tumors with endoventricular growth patterns. Simultaneous OCT imaging and endoscopic video imaging of the visible spectrum was possible using a graded index rod endoscope. OCT imaging of a human brain specimen in water allowed an in-depth view into structures like the walls of the ventricular system, the choroid plexus or the thalamostriatal vein. OCT further allowed imaging of structures beyond tissue barriers or opaque media. In this fixed specimen OCT allowed discrimination of vascular structures down to a diameter of 50 mum. In vessels larger that 100 mum the lumen could be discriminated and within larger blood vessels a layered structure of the vascular wall as well as endovascular plaques could be visualized. This in vitro pilot study has demonstrated that OCT integrated into neuroendoscopes may add information that cannot be obtained by the video imaging alone. This technology may provide an extra margin of safety by providing cross-sectional images of tissue barriers within optically opaque conditions.

Brain↗

PubMed2001

Tissue harmonic imaging: is it a benefit for bile duct sonography?

OBJECTIVE: Our purpose was to compare tissue harmonic imaging with conventional sonography of the biliary tract. SUBJECTS AND METHODS: Eighty patients with suspect biliary disease had conventional sonography and tissue harmonic imaging with an ATL 3000 or 5000 scanner in a 6-month interval. Final diagnoses included malignant biliary obstruction (n = 30), choledocholithiasis (n = 16), sclerosing cholangitis (n = 4), normal or nonobstructed ducts (n = 16), and miscellaneous conditions (n = 14). Similar images were taken with each technique in terms of projection, field of view, focal zone selection, and evidence of disease. Two separate observers blinded to patient data and technique reviewed and graded images individually for the appearance of the lumen of the bile ducts, the length of the visible duct, the appearance of the duct wall, the presence of any intraluminal masses, and the appearance of associated acoustic shadows. Images were graded from zero to 3, with 3 being the best. RESULTS: The median of the 546 tissue harmonic images was one grade higher than the median for the corresponding conventional images (p < 0.0001). Improvements with tissue harmonic imaging included better sharpness of the duct walls (p < 0.01), a clearer lumen (p < 0.0001), identification of a longer length of the common bile duct (p < 0.0001), and improved detection of intraluminal masses (p < 0.006). Acoustic shadows were better defined and blacker with tissue harmonic imaging (p < 0.007). CONCLUSION: Improvement in contrast and reduction of side lobe artifacts with tissue harmonic imaging enhance visualization of the biliary ducts. Tissue harmonic imaging is now our routine technique for bile duct examination.

Artifacts↗

PubMedDate not supplied

Morphometric analysis of the sacroiliac joint.

The sacroiliac (SI) joint is the point of articulation between the sacrum and the innominate bone of the pelvis. The anterior portion is synovial, and the posterosuperior portion is a typical syndesmosis. The SI joint may be affected by inflammatory or degenerative changes which include narrowing, minor sclerosis and erosion. Alterations in the anatomy of this joint may be involved in causing lower back pain. Radiodiagnosis of the width of the articular space is one of the tools utilized to evaluate the normal state of any joint. Scanty data is available on the morphometric characteristics of the SI joint. Therefore, the articular width space of the SI joint was measured to define its normal size in relation to age and sex. The study included 198 x-rays of the abdomen, in anteroposterior projection, of 112 males and 86 females (age range: 17 to 91 yrs). Individual films were divided into four classes according to age (< 50; 50-59; 60-69; > 70). The articular space of the SI joint is made up of a lateral and a medial part: the first representing the anterior articular space; the latter the posterior one. The anterior articular space of both the right and left joint, which was more easily visible and measurable was measured at the medium and inferior levels. Measurements were taken from the radiograms using a semiautomatic computerized system (Videoplan II, Image Analysis system-Kontron). The mean value of the articular space width a the medium and inferior levels, according to age group, was measured in both the males and females. The values obtained were studied using variance analysis. No significant differences were found in the mean values of the articular space width at the SI joint, when males and females were compared in relation to age. Moreover, the articular space width diminished with increasing the age. This fact was not always statistically significant.

Adolescent↗

PubMed1996

Food management for the aging population.

The older population is becoming more important to our society everyday. These individuals are being studied for their past, present, and potential impact on markets and marketing. Evaluated as a user of products or services in the marketplace or an employee or volunteer within the marketing system, this segment is gaining a visibility and importance. An interview was conducted with five Nutrition Project Directors to obtain an overview of Federally Funded Nutrition Programs for the Elderly. The areas which were highlighted were service delivery, site activities, management styles, barriers to service, clientele composition, food planning and preparation, staffing, USDA funding, coordination, marketing, transportation, and volunteerism. The Second Quarter Service Provider Output Reports for 1991, which are compiled by the Nutrition Projects and submitted to the Area Agency on Aging, were utilized to obtain client profile information (Reports, 1991). The analysis sought to compare the programs offered in the five counties on a number of factors which could be quantified. It was hoped that by looking at the numerical ratios, and depicting them graphically, any trends or unique characteristics of the programs could be identified. In that the percentage of Florida's present elder population (17%) far exceeds the national average (12%) these findings could be utilized by nutrition programs outside of Florida to plan for future funds. Analysis of quantitative information on the five programs yielded information on cost comparisons and on services.

Aged↗

PubMed1999

A preliminary statistical examination of the effects of uncertainty and variability on environmental regulatory criteria for ozone.

Basing the quantitative expression of environmental regulatory standards and associated compliance criteria on statistical principles has recently received attention in Europe, most visibly in a study by the UK Royal Commission on Environmental Pollution. These issues are timely for consideration in the USA, where a recent periodic review of National Ambient Air Quality Standards (NAAQS) has led to revision of the regulatory standards for ambient ozone and particulate matter. Salient statistical issues include accounting for errors of the first and second kind due to sampling and measurement error. These issues appear routine statistically and also may seem absent from regulations, but neither is necessarily the case. This paper is directed towards developing a methodology for examining the problem of dealing with uncertainty and variation in environmental regulations and compliance criteria. Our approach is illustrated through statistical analysis of the (old) 1 hour and the (new) 8 hour standards for ambient ozone, based on intensive monitoring in California's San Joaquin Valley during summer 1990 performed under the SARMAP Project. This paper presents preliminary findings based on quantifying measurement error or precision in terms of small-scale spatial and temporal variability, laying the groundwork for future work.

Air Pollutants↗

PubMed2003

Fusion of contrast-enhanced breast MR and mammographic imaging data.

Increasing use is being made of Gd-DTPA contrast-enhanced magnetic resonance imaging for breast cancer assessment since it provides 3D functional information via pharmacokinetic interaction between contrast agent and tumour vascularity, and because it is applicable to women of all ages as well as patients with post-operative scarring. Contrast-enhanced MRI (CE-MRI) is complementary to conventional X-ray mammography, since it is a relatively low-resolution functional counterpart of a comparatively high-resolution 2D structural representation. However, despite the additional information provided by MRI, mammography is still an extremely important diagnostic imaging modality, particularly for several common conditions such as ductal carcinoma in situ (DCIS) where it has been shown that there is a strong correlation between microcalcification clusters and malignancy. Pathological indicators such as calcifications and fine spiculations are not visible in CE-MRI and therefore there is clinical and diagnostic value in fusing the high-resolution structural information available from mammography with the functional data acquired from MRI imaging. This paper presents a novel data fusion technique whereby medial-lateral oblique (MLO) and cranial-caudal (CC) mammograms (2D data) are registered to 3D contrast-enhanced MRI volumes. We utilise a combination of pharmacokinetic modelling, projection geometry, wavelet-based landmark detection and thin-plate spline non-rigid 'warping' to transform the coordinates of regions of interest (ROIs) from the 2D mammograms to the spatial reference frame of the contrast-enhanced MRI volume. Of key importance is the use of a flexible wavelet-based feature extraction technique that enables feature correspondences to be robustly determined between the very different image characteristics of X-ray mammography and MRI. An evaluation of the fusion framework is demonstrated with a series of clinical cases and a total of 14 patient examples.

Adult↗

PubMed2006

The returns from cardiovascular research: the impact of the National Heart Foundation of Australia's investment.

OBJECTIVE: To evaluate the outcomes of the research investment of the National Heart Foundation of Australia (NHF). DESIGN AND SETTING: The NHF Research Evaluation Working Group was established in 2002 to oversee evaluation of research funding and outcomes data collected over a 5-year period. The evaluation included a bibliometric analysis conducted by the Research Evaluation and Policy Project at the Australian National University. OUTCOME MEASURES: Level and leverage of research funding; funding levels across the disciplines of biomedical, clinical, and public health research; and visibility and knowledge impact of NHF-supported research in international cardiovascular journals. RESULTS: The NHF's investment in research increased by 27% from 2001 to 2005. This increase resulted from leveraged support for fellowships and scholarships of $1.5 million over this period, and $2.2 million from the pharmaceutical industry. There was an increase in fellowship and scholarship funding from 26% in 2001 to 46% in 2005. There was a 75% increase in the funding allocated to public health research from 2002 to 2004. NHF-funded research publications were found in high impact journals at levels above Australian and world averages, but received fewer citations than expected based on citation rates for all similar articles. CONCLUSIONS: The NHF has been successful in implementing a policy to allocate 50% of its research funding to people and 50% to projects. This strategy has led to an increase in funding support for public health research. NHF-funded research has performed very well in terms of knowledge impact. The NHF is now well placed to strategically fund relevant research in the future.

Australia↗

PubMed2002

Imaging skin pathology with polarized light.

Linearly polarized light that illuminates skin is backscattered by superficial layers and rapidly depolarized by birefringent collagen fibers. It is possible to distinguish such superficially backscattered light from the total diffusely reflected light that is dominated by light penetrating deeply into the dermis. The method involves acquisition of two images through an analyzing linear polarizer in front of the camera, one image (I(par)) acquired with the analyzer oriented parallel to the polarization of illumination and one image (I(per)) acquired with the analyzer oriented perpendicular to the illumination. An image based on the polarization ratio, Pol=(I(par)-I(per))/(I(par)+I(per)), is created. This paper compares normal light images, represented by I(per), and Pol images of various skin pathologies in a pilot clinical study using incoherent visible-spectrum light. Images include pigmented skin sites (freckle, tattoo, pigmented nevi) and unpigmented skin sites [nonpigmented intradermal nevus, neurofibroma, actinic keratosis, malignant basal cell carcinoma, squamous cell carcinoma, vascular abnormality (venous lake), burn scar]. Images of a shadow cast from a razor blade onto a forearm skin site illustrate the behavior of Pol values near the shadow edge. Near the shadow edge, Pol approximately doubles in value because no I(per) photons are superficially scattered into the shadow-edge pixels by the shadow region while I(par) photons are directly backscattered from the superficial layer of these pixels. This result suggests that the point spread function in skin for cross-talk between Pol pixels has a half-width-half-max of about 390 microm.

Adult↗

PubMed1995

Human demineralized freeze-dried bone: inadequate induced bone formation in athymic mice. A preliminary report.

The purpose of this study was to test the osteoinductive properties of demineralized freeze-dried bone (DFDBA) randomly purchased from four commercial bone banks. Twenty-five (25) milligrams of bone from each of the banks was implanted into the hindquarter muscles of athymic mice. Two samples from each of the banks were compared with samples from the other banks. A total of 16 implants were grafted into 8 mice. Two additional mice served as controls. One mouse received an implantation of deactived human cortical bone matrix (DBM) (negative control). The other mouse received an implant of human bone morphogenetic protein/non-collagenous proteins (hBMP/NCP) infused to surface demineralized human cortical bone (positive control). At 21 days the mice were killed, the hindquarters were photographed, and the tissues were prepared for histologic evaluation. Of the 16 commercial DFDBA implants, 12 were available for histologic evaluation. There was no radiographic evidence of bone formation for the DFDBA implanted mice or the DBM implants. Small bone ossicles were scarcely visible in the hindquarters of the mouse which received the hBMP/NCP infused bone. Histomorphometric analysis was used to determine the percentage of new and dead bone. The bone was measured in pixels. The predominant histologic feature of the DFDBA implants was non-vital bone chips with minimal amounts of new bone. The average amount of non-vital bone ranged from 78.4% to 92.5%. There was no evidence of bone formation for the DBM implants. The average amount of bone for the mouse which received hBMP/NCP was 96%. The results of this pilot study indicate that commercially-available DFDBA induced clinically insignificant amounts of bone.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

PubMed2003

Quality of digital pre-implant tomography: comparison of film-screen images with storage phosphor images at normal and low dose.

OBJECTIVES: The aim of this pilot study was to compare the image quality of a storage phosphor system with that of conventional film-screen in pre-implant conventional tomography, and to test the influence of radiation dose on image quality in the storage phosphor system. METHODS: Cross-sectional conventional tomographic images (Scanora) technique) were obtained on 11 patients with film-screen and with storage phosphor image plates (Digora) PCT) at normal and low doses. Ten observers graded the visibility of anatomical structures of importance for implant planning. A three-step rating scale was used, where -1 =worse, 0=equal and 1=better than the reference image. RESULTS: Although image quality was graded as equally good in the majority (59%) of images, the storage phosphor system scored significantly lower than film-screen (-0.37 vs 0.00, respectively) for all the images. Low dose storage phosphor images were rated significantly lower (-0.21) than normal dose images (0.00). CONCLUSIONS: In the majority of patients, anatomic structures of importance for implant planning are visualized equally well on storage phosphor and film-screen images. However, where differences do exist, storage phosphor images score lower than film-screen images. Dose reduction in the storage phosphor system had a negative influence on image quality.

Adult↗

PubMed2002

Assessment of response by breast helical computed tomography to neoadjuvant chemotherapy in large inflammatory breast cancer.

Breast helical computed tomography (CT) was evaluated for use in assessing response to neoadjuvant chemotherapy and residual tumor volume. Forty-three patients with large, inflammatory breast cancers (stage IIA, 12; IIB, 13; IIIA, 9; IIIB, 9), all histologically confirmed by core biopsy, were evaluated prior to and following neoadjuvant chemotherapy. The breast helical CT procedure involved patients in the prone position using single acquisition during quiet respiration following intravenous injection of nonionic contrast material. Helical CT results (3.2-mm slices and maximum intensity projections) were compared to clinical and mammographic evaluations, as well as to pathologic findings. All tumors were clearly visible by breast helical CT, showing important tumor enhancement. Helical CT evaluation of response to chemotherapy (using World Health Organization criteria) corresponded better with mammography (78%, Cohen's kappa statistic (kappa) = 0.65) than with clinical examination (53%, kappa = 0.30). Helical CT measurement of residual tumor volume after neoadjuvant chemotherapy and correlation with pathologic findings were globally satisfactory. The intraclass correlation coefficient was 0.69 (excellent for rounded opacities [0.97], but not as good for diffuse, scattered or multinodular opacities [0.60]). By contrast, clinical and mammographic correlations were globally unsatisfactory (0.49 and 0.28, respectively). Breast helical CT can be very useful in the quantitative assessment of response to neoadjuvant chemotherapy and preoperative determination of residual tumor volume. For this reason, it can be considered an alternative to breast magnetic resonance imaging because of its simplicity, rapidity, and accessibility.

Adult↗

PubMed1997

[Identification of the central sulcus using the scanner and MRI].

Methods to directly and indirectly identify the central sulcus are presented. In the axial plan, direct method is remarkable but obviously requires good visualization of the sulci in the central region. Sulci are readily visible in 90% of the cases on CT scans and in 50% of the cases on MRI. The method can also be applied when tumoral development erases the cerebral sulci by direct lecture of the controlateral rolandic region and right-left transfer. Within the precision limits of the method, it can be considered that the central sulci are symmetrical. The main signs are: the relative morphologies of the superior frontal sulcus and the precentral sulcus, the hook-shaped aspect of the middle part of the central sulcus, the internal end of the central sulcus projection anteriorly to the pars marginalis, the bifid nature of the internal end of the posterior central sulcus contouring the pars marginalis, and the lesser thickness of the posterior central gyrus compared with the precentral gyrus. The indirect method is less precise and is used when the direct method is unsuccessful. The central sulcus is identified on the sagittal images and, using the lateral view of the skull as a reference image, the topographic information is transferred to the axial images.

Brain↗

PubMed1993

Have the invisible children become visible?

Over the past 30 years much information has been collected on children whose parents suffer from psychiatric illness. Research has shown that many of these children are at high risk for significant psychopathology but there have been few investigations examining whether or not they are being identified and are receiving mental health care. The purpose of this pilot study was to investigate to what extent the children of psychiatrically ill adult patients are identified and referred to the mental health services. Results of structured interviews with the patients indicate that a considerable number had school-aged children and that in many instances no inquiry had been made concerning the children's psychological health. Although some of the children were reported to have received treatment, few had been referred by their parent's psychiatrists. Recommendations to improve the identification and treatment of such children are outlined in this study.

Adolescent↗

PubMed2003

[High resolution contrast-enhanced 3D MR-angiography of renal arteries using parallel imaging (SENSE)].

PURPOSE: To compare three dimensional contrast enhanced MR angiography with parallel imaging technique (sensitivity encoding) to standard MR angiography technique. MATERIAL AND METHODS: CE-3D MRA of renal arteries was performed in 22 patients (23 examinations) on a 1.5 T MR- scanner (Gyroscan Intera, Philips, Netherlands). For contrast enhanced MRA a single dose of Gd-DTPA (0.1 mmol/kg b.w.) was administered. Group I: The following standard 3D gradient echo (GE) sequence was performed in 9 of the 22 patients: TR: 4.3 ms, TE: 1.5 ms, flip angle: 40, 40 slices, scan duration: 19 seconds. A spatial resolution of 1.96 x 1.76 x 3.0 mm (3) (1.76 x 1.76 x 1.5 mm (3) interpolated) was obtained. Group II: 14 examinations were acquired in 13 patients: TR, TE and flip angle were equal compared to the first protocol. The k-space lines were acquired with CENTRA (contrast-enhanced time robust angiography) and parallel imaging technique (SENSE). 60 slices were acquired, scan duration was 24 seconds. The spatial resolution of this sequence was 1.19 x 1.08 x 2.0 mm (3) (0,84 x 0,84 x 1,0 mm (3) interpolated). Original images and calculated maximum intensity projection (MIP) images were analysed by two radiologists. Image quality and the visibility of renal arteries were rated on a four-point scale. RESULTS: In the first group the image quality was rated "good" in 8/9 patients. The renal arteries were detected in all cases and rated "good". The anterior and posterior segments were rated "good" in only 5/9 and the lobar arteries were detectable only in 3 of 9 cases. The interlobar arteries could not be seen in these patients. In the second group the image quality was rated excellent in 5 examinations and good in 9 of 14 examinations. The rating for the renal arteries was excellent in all examinations (14/14). The results of the anterior and posterior segment were as followed: excellent 5/14, good 7/14, insufficient 2/14; the lobar arteries: good 6/14, insufficient 6/14 and not detectable 2/14. Interlobar arteries could be seen in 7/14 examinations, but the quality was insufficient. In 7/14 the interlobar arteries could not be detected. CONCLUSION: The use of parallel imaging technique improves image quality and the delineation of small vessels in renal MRA.

Aneurysm↗

PubMed1991

Three-dimensional presentation of cardiac morphology.

The results of a research project aiming to visualize cardiac anatomy in a 3-dimensional form for surgical planning are presented. Based on electronic data processing within a local area network environment, serial slices of CT- and MRI-machines were used to construct a 3-dimensional data cube that was illuminated by calculated sources of light. Light rays were traced through the entire "data volume". Mathematically following each pathway of light through the space, the intensity of changes along this path were calculated. The results of applying this "Heidelberg Ray-tracing Technique" to cardiac anatomy are 3-dimensional "computer movies" that appear on any workstation within a computer network. Using special software, the surgeon can "walk" in any direction through the heart or he can break it into two or more parts in order to analyze regions of interest in detail. Even small structures such as papillary muscles, bifurcations, coronary arteries and cusps of cardiac valves become visible. This new technique may enable the surgeon to open the heart prior to surgery on the computer monitor working with a visualized model that corresponds to the visual experience of his daily intraoperative practice.

Cardiac Surgical Procedures↗

PubMed1985

Non-selective intra-arterial digital subtraction angiography for the assessment of coronary artery bypass grafts.

Non-selective intra-arterial digital subtraction angiography (DSA) was performed immediately before selective coronary and bypass angiography in 33 consecutive symptomatic patients 48 +/- 30 months after coronary surgery, for the assessment of 75 coronary bypass grafts. Forty ml of non-ionic, low-iodine content contrast medium (iohexol) were injected into the ascending aorta at 10-20 ml/sec through a 7 or 8 F femoral pigtail catheter. Electrocardiogram-triggered images were acquired on a Siemens Digitron II apparatus in multiple projections in 24 patients and in a single projection in 9 patients. The results of this technique were compared by two independent angiographers with those of selective graft angiography in the same patients. Patency was shown by DSA in 45 of 54 grafts confirmed to be open by selective angiography (sensitivity 83%). Of 21 occluded grafts, stumps were clearly visible at selective angiography in 18 and at DSA in 9 (sensitivity for graft stumps = 50%, p less than 0.01). Of 54 patent grafts with selective angiography, the distal anastomosis could be visualized by DSA in 28 (52%), but the resolution was comparable to selective angiography in 20 grafts (37%) only. A non-significant difference in the sensitivity of DSA was observed between patent saphenous grafts to the left anterior descending coronary artery versus all other coronary arteries (95 vs 85%, respectively), while only 1 of 5 patent left internal mammary artery grafts to the left anterior descending coronary artery was visualized. In 16 of 50 grafts (32%) visualized in a second projection substantial additional diagnostic information was obtained. In conclusion, non-selective intra-arterial electrocardiogram-triggered DSA can visualize patent saphenous grafts with a high sensitivity and may be a useful screening tool for bypass grafts patency; false negatives, however, and poor visualization of distal anastomoses limit its routine clinical use.

Adult↗

PubMed1991

Inability of coronary blood flow reserve measurements to assess the efficacy of coronary angioplasty in the first 24 hours in unselected patients.

To determine functional and anatomic changes in the first 24 hours after coronary angioplasty, we studied at random 15 patients (9 men, mean age 60 years) who underwent coronary angioplasty of 16 coronary arteries. Quantitative coronary angiography and coronary flow reserve measurements from digitized coronary angiograms were performed before, immediately after, and 24 hours after coronary angioplasty. Calculated were the minimal luminal diameter, obstruction area, and percentage diameter stenosis from two preferably orthogonal projections. Prior myocardial infarction in the myocardial region of interest was present in four patients. Seven patients had multivessel disease. Collateral vessels supplying the compromised flow region were observed in three patients. Six patients had refractory unstable angina pectoris. After coronary angioplasty, angiographically visible dissection was noted in six patients, whereas side branch occlusion was observed in one. Minimal luminal diameter before, immediately after, and 24 hours after was 0.93 +/- 0.18 mm, 1.53 +/- 28 mm, and 1.53 +/- 0.21 mm, respectively; obstruction area was 0.70 +/- 0.26 mm2, 1.92 +/- 0.69 mm2, and 1.87 +/- 0.51 mm2, respectively; diameter stenosis was 60.4 +/- 8.0%, 36.8 +/- 11.4%, and 37.6 +/- 5.3%, respectively. The coronary flow reserve (lower limit of normal with this technique 3.4) was essentially the same before and immediately after coronary angioplasty (1.26 +/- 0.59 vs 1.30 +/- 0.42, p = NS) with a slight improvement to 1.78 +/- 0.90 (p less than 0.05) 1 day later. Coronary artery dimensions correlated poorly with coronary blood flow reserve before and after angioplasty.(ABSTRACT TRUNCATED AT 250 WORDS)

Angiography, Digital Subtraction↗

PubMed1987

Structural and morphometric analysis of parakeratotic and dyskeratotic cells exfoliated from various vulvar lesions. Correlation with data from cervical cytology.

Smears were taken from the vulvar skin of 123 patients (21 with normal-appearing skin and 12 with dystrophic, 29 with benign, 20 with precancerous and 53 with malignant conditions). In each case, 20 nucleated horny squames with the highest visible degree of abnormality were identified in the smear. The cytoplasmic and nuclear structures of these cells were analyzed, and the cytoplasmic and nuclear perimeters were measured by a graphics tablet (digitizing board) equipped with a camera lucida system. Five cytomorphometric parameters were calculated: cytoplasmic and nuclear areas and shape factors and the relative nuclear area. A stepwise multivariate discriminant analysis was used to evaluate the statistical significance of the parameters. Structurally, the cells from different vulvar conditions did not differ much from each other except in the formation of small cellular projections ("pseudopodia"), which were found significantly more frequently in precancerous and cancerous lesions than in others. Nuclear degeneration was a general finding in all examined cases of all conditions. Morphometric analysis revealed cytoplasmic pleomorphism to be the predominant feature associated with increasing degrees of malignancy. There was no significant increase in the relative nuclear area with increasing malignancy because the cytoplasmic and nuclear areas enlarged almost simultaneously. The cellular features found in nucleated horny cells exfoliated from various vulvar lesions are quite different from the well-known attributes of squamous epithelial cells originating from comparable conditions of the uterine cervix.

Cytoplasm↗