[In vivo differentiation of pigmented skin tumors with laser Doppler perfusion imaging]. / In-vivo-Differenzierung von pigmentierten Hauttumoren mittels Laser-Doppler-Perfusion-Imaging.

BACKGROUND AND OBJECTIVE: Malignant melanomas show a higher heterogeneity in their architecture and a higher vessel density because of neovascularization compared to benign melanocytic skin tumours. In this study the validity of the newly developed Laser Doppler Perfusion Imager (LDPI) with a lateral resolution of 100 microns in the differential diagnosis of pigmented skin tumours was investigated. PATIENTS/METHODS: The perfusion of 116 pigmented skin tumours was s measured with LDPI; 44 malignant melanomas, five melanoma metastases, 59 dysplastic nevi and eight basal cell carcinomas were studied before excision for precise histological diagnosis. RESULTS: There is a significantly higher perfusion of the malignant melanomas (3.15 +/- 1.87 AU) compared to dysplastic nevi (1.14 +/- 0.97 AU) (p < 0.01). By calculating a ratio of the mean perfusion in the tumour and the mean perfusion in adjacent healthy skin, the potential source of error because of regional differences in perfusion is eliminated. The ratio of malignant melanomas (10.78 +/- 9.18) is significantly higher than these of melanoma metastases (4.20 +/- 1.66), basal cell carcinomas (3.24 +/- 1.32) and dysplastic nevi (2.85 +/- 1.32). CONCLUSIONS: The high resolution LDPI has the potential to be a non-invasive screening method for preoperative differential diagnosis of pigmented skin tumours. Besides the epiluminescence microscopy and sonographic determination of the tumour thickness, we have now the possibility to get preoperative information about tumour vascularization.

[Quality of whole blood as a result of storage and preparation (inline-leukocyte depletion). Evidence for autologous predeposit]. / Die Qualität von Vollblut in Abhängigkeit von Herstellungsverfahren (Leukozytendepletion) und Lagerungsdauer. Bedeutung für die operationsvorbereitende Eigenblutspende.

AIM OF THE STUDY: Investigation of various laboratory parameters in stored whole blood, with respect to duration of storage and kind of product. METHODS: Whole blood was donated by 12 healthy volunteers using CPDA1 stabilisator. Six units were filtered with the Leukotrap A1-System (PALL Comp., Dreieich, Germany) for leukocyte depletion. The twelve units were stored for 49 days. Several hematological, biochemical and coagulatory parameters were analysed during storage. RESULTS: There was an adequate reduction of lycocytes by filtration (< 3 x 10(6) white cells per unit). ATP decreased during storage to 45% of initial value at the 49th day, without any influence of the kind of preparation. The course of other parameters such as lactate and free haemoglobin (increase), PH-value (decrease), antithrombin III (decrease), prothrombin, protein C, thrombin-antithrombin-complex, alpha-2-Anti-plasmin (decrease or indifferent) did not show any influence of the kind of preparation. Coagulation factors V and VIII decreased in both preparations, which was significantly less pronounced in whole blood with leukocyte depletion. In contrast parameters of activated coagulation such as D-Dimere and fibrinmonomeric did not change during storage after leukocyte reduction but increased at the end of storage time in CPDA1-blood. CONCLUSIONS: Several parameters indicating quality of stored blood were constant in whole blood independent of the kind of preparation during a storage of 49 days. This is in contrast to the main part of specific scientific communications. A beneficial influence of leukocyte depletion was observed for some coagulation parameters whereas increasing characteristics of activated coagulation in CPDA1-stored whole blood at the end of storage time had to be observed. The preparation of whole CPDA1-blood is recommended for autologous predonation, if storage time does not exceed 30 days. Storage time of > 40 days seems to be possible for autologous whole blood after filtration for leucocyte depletion.