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Developments within the field of image-guided surgery are ever expanding, driven by collective involvement of clinicians, researchers, and industry. While the general conception of the potential of image-guided surgery is to improve surgical outcome, the specific motives and goals that drive can differ between the different expert groups. To establish the current and future role of intra-operative image guidance within the field of image-guided surgery a Delphi consensus survey was conducted during the 2'd European Congress on Image-guided surgery. This multidisciplinary survey included questions on the conceptual potential and clinical value of image-guided surgery and was aimed at defining specific areas of research and development in the field in order to stimulate further advances towards precision surgery. Obtained results based on questionnaires filled in by 56 panel experts (clinicians: N=30, researchers: N=20 and industry: N=6) were discussed during a dedicated expert discussion session during the conference. The outcome of this Delphi consensus is indicative of the potential improvements offered by image-guided surgery and of the need for further research in this emerging-field, that can be enriched by the identification of reliable molecular targets.

The integration of medical imaging technologies into diagnostic and therapeutic approaches can pro-vide a preoperative insight into both anatomical (e.g. using computed tomography, magnetic resonanceimaging, or ultrasound), as well as functional aspects (e.g. using single photon emission computedtomography, positron emission tomography, lymphoscintigraphy, or optical imaging). Moreover, someimaging modalities are also used in an interventional setting (e.g. computed tomography, ultrasound,gamma or optical imaging) where they provide the surgeon with real-time information during theprocedure. Various tools and approaches for image-guided navigation in cancer surgery are becoming feasibletoday. With the development of new tracers and portable imaging devices, these advances will reinforcethe role of interventional molecular imaging.

Das Melanom metastasiert frühzeitig in die regionalen Lymphknoten. Die Exzision des ersten drainierenden Lymphknotens (Schildwächterlymphknotenextirpation (SLNE)) dient als diagnostische Operation, um eine mögliche lymphogene Metastasierung festzustellen und das weitere Therapiekonzept[zum vollständigen Text gelangen Sie über die oben angegebene URL], 26. Fortbildungswoche für praktische Dermatologie und Venerologie

Background: Fumaric acid esters (FAEs) are a broadly used therapy option for patients suffering from moderate-to-severe plaque psoriasis. Various studies in psoriasis have already shown peripheral blood lymphopenia during oral FAE therapy. Smaller studies also documented a reduction of CD4+ and CD8+ cell counts. Up to now, there are few case reports on opportunistic infections under FAE therapy - all of them associated with lymphopenia. Objective: To examine the influence of FAEs on white blood cells with special regard to leukocytes, lymphocytes, and CD4+ and CD8+ cells during psoriasis therapy. Patients and Methods: A cohort of 105 patients with diagnosed moderate-to-severe chronic plaque psoriasis was enrolled in this single-centre observational trial. For a cohort of 36 patients, T-cell subset analyses were performed. Results: Of the total, 65 patients were male (61.9%) and 40 (38.1%) female; the mean age was 43.3 years (range 16-73 years). The median lymphocyte count was significantly reduced by about 35.8% after the first 6 months of therapy. When assessing the lymphocyte count nadir over the whole period observed, 46.7% of the patients developed lymphopenia. Severe lymphopenia (Conclusion: To the best of our knowledge this is the largest clinical investigation analysing prospectively CD4+ and CD8+ cell counts in psoriasis patients receiving FAEs. We suggest periodic monitoring of absolute lymphocyte counts as well as the establishment of the determination of T-cell subsets prior to and during therapy.

Wir berichten über eine 46-jährige Patientin mit einem seit 2 Jahren bestehenden, therapieresistenten Ulcus am rechten Fußrücken bei kongenitaler komplexer AV-Fistel. Bereits vor 12 Jahren hatte sich in der gleichen Lokalisation erstmals ein Ulcus entwickelt. Eine Coil-Embolisation führte trotz unvollständiger Okklusion der AV-Fistel zu einer Abheilung über einen Zeitraum von 10 Jahren. Aktuell imponierte um das Ulcus eine Hyperpigmentierung im Sinne eines klinischen Hinweises auf eine venöse Insuffizienz. Durch eine ausschließlich konservative Therapie der venösen Komponente der AV-Fistel konnte eine vollständige Abheilung des Ulcus erzielt werden. Wir diskutieren anhand dieses Fallberichtes die unterschiedlichen Aspekte in der Entstehung und Therapie eines Ulcus bei AV-Fistel im Rahmen eines Stewart-Bluefarb-Syndroms.