Ultrasound mapping of lymph node and subcutaneous metastases in patients with cutaneous melanoma: Results of a prospective multicenter study

Background: Ultrasound (sonography, B-mode sonography, ultrasonography) examination improves the sensitivity in more than 25% compared to the clinical palpation, especially after surgery on the regional lymph node area. Objective: To evaluate the distribution of metastases during follow-up in the draining lymph node areas from the scar of primary to regional lymph nodes ( head and neck, supraclavicular, axilla, infraclavicular, groin) in patients with cutaneous melanoma with or without sentinel lymph node biopsy (SLNB) or former elective or consecutive complete lymph node dissection in case of positive sentinel lymph node (CLND). Methods: Prospective multicenter study of the Departments of Dermatology of the Universities of Homburg/Saar, Tubingen and Munich (Germany) in which the distribution of lymph node and subcutaneous metastases were mapped from the scar of primary to the lymphatic drainage region in 53 melanoma patients ( 23 women, 30 men; median age: 64 years; median tumor thickness: 1.99 mm) with known primary, visible lymph nodes or subcutaneous metastases proven by ultrasound and histopathology during the follow-up. Results: Especially in the axilla, infraclavicular region and groin the metastases were not limited to the anatomic lymph node regions. In 5 patients (9.4%) ( 4 of them were in stage IV) lymph node metastases were not located in the corresponding lymph node area. 32 patients without former SLNB had a time range between melanoma excision and lymph node metastases of 31 months ( median), 21 patients with SLNB had 18 months ( p < 0.005). In 11 patients with positive SLNB the time range was 17 months, in 10 patients with negative SLNB 21 months ( p < 0.005); in 32 patients with CLND the time range was 31 m< 0.005). In thinner melanomas lymph node metastases occurred later ( p < 0.05). Conclusions: After surgery of cutaneous melanoma, SLNB and CLND the lymphatic drainage can show significant changes which should be considered in clinical and ultrasound follow-up examinations. Especially for high-risk melanoma patients follow-up examinations should be performed at intervals of 3 months in the first years. Patients at stage IV should be examined in all regional lymph node areas clinically and by ultrasound. Copyright (c) 2006 S. Karger AG, Basel

Diagnosis of inflammatory demyelination in biopsy specimens: a practical approach

Multiple sclerosis is the most frequent demyelinating disease in adults. It is characterized by demyelination, inflammation, gliosis and a variable loss of axons. Clinically and histologically, it shares features with other demyelinating and/or inflammatory CNS diseases. Diagnosis of an inflammatory demyelinating disease can be challenging, especially in small biopsy specimens. Here, we summarize the histological hallmarks and most important neuropathological differential diagnoses of early MS, and provide practical guidelines for the diagnosis of inflammatory demyelinating diseases

Amnesia Atlas VR

A prototype 3D browser for the viewing of images taken by SenseCam- a wearable, automatic, life-logging camera. The same technology is used by Claire as a memory-aide, and features heavily in the development of Shona Illingworth’s Lesions in the Landscape.SenseCam photo-sequences have proven to be highly effective memory cues. They provide us with another way to think about how we experience memory, and how we might construct it with the use of new technologies.Amnesia Atlas explores Sydney Harbour in a very located way. Photographs are placed back into the scenery in the position in which they were taken, using geotagging technology. Similar to our use of social media, the user is able to navigate the harbour through the lens of someone else's memory; seeing (and in some way creating their own memory of) a place as experienced by another

First manifestation of lambda positive plasmacytoma in the orbital apex with acute unilateral loss of vision

Introduction: An intracranial plasmacytoma is a rare form, which can involve the calvarium, dura or the cranial base. Only few case reports describe the manifestation of plasmacytoma of the skull base with affection of visual acuity. Case Report: We describe the case of a 43-year-old woman, presenting with an acute unilateral loss of vision. The presumption diagnosis was retrobulbar neuritis as first manifestation of multiple sclerosis. MR imaging disclosed a tumour in the left orbital region and a meningeoma was suspected. After complete resection with decompression of the optic nerve, the neuropathological examination revealed a lambda positive plasmacytoma. Additional work-up disclosed an involvement of multiple vertebral bodies. Due to the diagnosis of multiple myeloma, oncological therapy had been initiated. Conclusion: Skull base plasmacytoma is a rare disease. Solitary lesions causing neurological deficits should be treated aggressively including surgery for histological diagnosis and decompression of neural structures. Prognosis and further therapy depends on the systemic stage of disease, which has to be defined by diagnostic work-up

Being Debra

Being Debra, 2019Virtual Reality on headsetDuration, 12 minsEmploying Virtual Reality (VR), Being Debra offers the audience a taste of the embodied experience of being a dwarf in contemporary Australian society (with all its challenges, ugliness and triumphs). Shot from a first-person perspective with a 180 degree camera, the project was initiated by artist Debra Keenahan who lives with achondroplasia dwarfism. The VR experience includes flashbacks to Debra’s memories of school, dating, and engaging with authority figures, including doctors, as well as her routine daily encounters in a park.Over 70 years ago psychologist Alfred Adler described empathy as “seeing with the eyes of another, listening with the ears of another, and feeling with the heart of another”. This project explores how technology can help promote empathy by affording the viewer an embodied experience of disability and its public reception. But Keenahan’s research also takes a critical view. The notion of VR as the ultimate Empathy Machine, as proclaimed by Chris Milk in 2015, remains contentious. As Wendy Chun suggests, “If you walk in someone else’s shoes, then you’ve taken their shoes”. Is the empathy machine a mechanism of cultural appropriation or is it the means to respectful mutual understanding? VR of course cannot enable us to “be” Debra — but in this work Keenhan reveals in a powerful way what it is like to be the object of looks, glances, abuse and stigma each time she walks in public. By experiencing each of these events through VR, all of which have happened, and many of them much more than once, you will come to an understanding of what it is like to be Debra. That is, how those who are a different kind of different can be treated in this society which ironically places great value on individuality.CreditsArtistic Director: Debra KeenahanArt Director and Production Design: Volker KuchelmeisterScreenplay: Debra Keenahan, Katrina Douglas, Sarah KeenahanDirector and Casting Director: Katrina DouglasProducer and script consultant: Jill BennettAudio Recording, Sound Engineer, Production Assistant: Louis PrattSound Track: Damien EverettA fEEL production for The Big Anxiety‘Being Debra’ has been created with the support of funding from: The Australia Council for the Arts; Western Sydney University