Ex-vivo Fluorescence Confocal Microscopy: The First Application For Real-Time Pathologic Examination of Prostatic Tissue

Prostate cancer "real time" intra-operative pathological examination currently utilizes frozen section, despite the many inherent limitations of this procedure. Ex vivo Fluorescence Confocal Microscopy (FCM) is a novel technology, which provides fast microscopic fluorescence and reflectance tissue imaging. FCM has been proven beneficial in colorectal, breast, thyroid and skin lesions. However, it was never applied in urology. The aim of our study is to report the first application of FCM in the urologic field assessing its diagnostic accuracy for non-neoplastic and cancerous prostate tissue (prostatic adenocarcinoma) compared to the gold standard histopathological diagnoses.Objective: To report the first application of ex vivo fluorescence confocal microscopy (FCM) - a novel optical technology that is capable of providing fast microscopic imaging of unfixed tissue specimens- in the urological field assessing its diagnostic accuracy for non neoplastic and cancerous prostate tissue (prostatic adenocarcinoma) compared to the 'gold standard' histopathological diagnoses. Patients and methods: In all, 89 specimens from 13 patients with clinically localised prostate cancer were enrolled into the study. All patients underwent robot-assisted laparoscopic radical prostatectomy with fresh prostatic tissue biopsies taken at the end of each intervention using an 18-G biopsy punch. Specimens were randomly assigned to the three collaborating pathologists for evaluation. Intra- and inter-observer agreement was tested by the means of Cohen's κ. The diagnostic performance was evaluated on receiver operating characteristic curve analysis. Results: The overall diagnostic agreement between FCM and histopathological diagnoses was substantial with a 91% correct diagnosis (κ = 0.75) and an area under the curve of 0.884 (95% confidence interval 0.840–0.920), 83.33% sensitivity, and 93.53% specificity. Conclusion: FCM seems to be a promising tool for enhanced specimens' reporting performance, given its simple application and very rapid microscopic image generation (<5 min/specimen). This technique may potentially be used for intraoperative pathological specimens' analysis

Complete high-intensity focused ultrasound in prostate cancer: outcome from the @-Registry

n/

Robotic-assisted laparoscopic prostatectomy

Prostate cancer remains a significant health problem worldwide and is the second highest cause of cancer-related death in men. While there is uncertainty over which men will benefit from radical treatment, considerable efforts are being made to reduce treatment related side-effects and in optimising outcomes. This article reviews the development and introduction of robotic-assisted laparoscopic radical prostatectomy (RALP), the results to date, and the possible future directions of RALP

Quasi-static cyclic tests on seismic-resistant beam-to-column and column-to-foundation subassemblies using Laminated Veneer Lumber (LVL)

This paper describes part of an extensive experimental programme in progress at the University of Canterbury to develop Laminated Veneer Lumber (LVL) structural systems and connections for multistorey timber buildings in earthquake-prone areas. The higher mechanical properties of LVL, when compared to sawn timber, in addition to its low mass, flexibility of design and rapidity of construction, create the potential for increased use of LVL in multi-storey buildings. The development of these innovative ductile connections in LVL, proposed here for frame systems, have been based on the successful implementation of jointed ductile connections for precast concrete systems, started in the early 1990s with the PRESSS Program at the University of California, San Diego, further developed in Italy and currently under further refinement at the University of Canterbury. This paper investigates the seismic behaviour of the so-called “hybrid” connection, characterised by the combination of unbonded post-tensioned tendons and either external or internal energy dissipaters passing through the critical contact surface between the structural elements. Experimental results on hybrid exterior beam-to-column and column-to-foundation subassemblies under cyclic quasi-static unidirectional loading are presented. The proposed innovative solutions exhibit a very satisfactory seismic performance characterised by an appreciable energy dissipation capacity (provided by the dissipaters) combined with self-centring properties (provided by the unbonded tendons) and negligible damage of the LVL structural elements