Understanding the anatomy of dermoscopy of melanocytic skin tumours: Correlation in vivo with line-field optical coherence tomography

BACKGROUND

Early melanoma detection is the main factor affecting prognosis and survival. For that reason, non-invasive technologies have been developed to provide a more accurate diagnosis. Recently, line-field confocal optical coherence tomography (LC-OCT) was developed to provide an in vivo, imaging device, with deep penetration and cellular resolution in three dimensions. Combining the advantages of conventional OCT and reflectance confocal microscopy, this tool seems to be particularly suitable for melanocytic lesions.

OBJECTIVES

The objective of this study was to identify and describe the correlation between specific dermoscopic criteria and LC-OCT features in three dimensions associated with melanocytic lesions.

METHODS

Dermoscopic and LC-OCT images of 126 melanocytic lesions were acquired in three different centres. The following dermoscopic criteria have been considered: reticular pattern, dots and globules, structureless areas, blue-whitish veil, regression structures, negative network, homogeneous pattern, streaks and blotches.

RESULTS

69 (55%) benign and 57 (45%) malignant lesions were analysed. A regular reticular pattern was found associated in the 75% of the cases with the presence of elongated rete ridges with pigmented cells along the basal layer, while atypical reticular pattern showed an irregular organization of rete ridges with melanocytic hyperplasia, broadened and fused ridges and elongated nests. Both typical and atypical dots and globules were found associated with melanocytic nests in the dermis or at the dermoepidermal junction (DEJ), as well as with keratin cysts/pseudocysts. Grey globules corresponded to the presence of melanin-containing dermal inflammatory cells (melanophages) within the papillae. Structureless brown/black areas correlated with alterations of the DEJ. We observed the same DEJ alterations, but with the presence of dermal melanophages, in 36% of the cases of blue/white/grey structureless areas. A description of each LC-OCT/dermoscopy correlation was made.

CONCLUSIONS

LC-OCT permitted for the first time to perform an in vivo, 3D correlation between dermoscopic criteria and pathological-like features of melanocytic lesions.

Line-field confocal optical coherence tomography of basal cell carcinoma: a descriptive study

BACKGROUND

Early diagnosis and subtype classification of basal cell carcinoma (BCC) are crucial to reduce morbidity and optimize treatment. Good accuracy in differentiating BCC from clinical imitators has been achieved with existing diagnostic strategies but lower performance in discriminating BCC subtypes. Line-field confocal optical coherence tomography (LC-OCT) is a new technology able to combine the technical advantages of reflectance confocal microscopy and OCT.

OBJECTIVES

To identify and describe LC-OCT criteria associated with BCC and explore their association with BCC subtypes.

METHODS

Basal cell carcinoma were imaged with a handheld LC-OCT device before surgical excision. LC-OCT images were retrospectively evaluated by three observers for presence/absence of criteria for BCC. Multivariate logistic regression models were used to find independent predictors of BCC subtypes.

RESULTS

Eighty-nine histopathologically proven BCCs were included, of which 66 (74.2%) were pure subtypes [superficial BCC (sBCC): 19/66 (28.8%); nodular BCC (nBCC): 31/66 (47.0%); infiltrative BCC (iBCC): 16/66 (24.2%)]. Lobules, blood vessels and small bright cells within epidermis/lobules were the most frequent criteria for BCC. LC-OCT criteria independently associated with sBCC were presence of hemispheric lobules, absence of lobule separation from the epidermis, absence of stretching of the stroma; with nBCC were presence of macrolobules, absence of lobule connection to the epidermis; and with iBCC were presence of branched lobules.

CONCLUSIONS

This was the first study describing the characteristics of BCC under LC-OCT examination. We proposed morphologic criteria, which could be potentially useful for diagnosis and subtype classification of BCC, as well as for its therapeutic management. Future studies are needed to assess these hypotheses.

Electronic structure, low-temperature transport and thermodynamic properties of polymorphic β-As2Te3

The first-order lattice distortion undergone by β-As₂Te₃ around 200 K results in a cycling effect on its transport properties.

[Uni-axial tissular extension for covering skin defects of the limbs. A 31 cases review]

INTRODUCTION

The skin property to adapt to external constraints is widely used in plastic surgery. Tissue expansion is the most known and codified application. Tissue extension appears to be an attractive alternative. The authors propose the usage of a simplified procedure to deal with skin loss in the superior or inferior members.

MATERIAL AND METHOD

Thirty-one patients underwent uni-axial traction between February 2000 and October 2003.

RESULTS

Closure of skin loss on the upper member has been obtained in 6 days and in 8 days on the inferior member.

DISCUSSION

Efficiency, reliability and no subsequent aftermaths are strong arguments in favor of the development of a simplified extension procedure.

CONCLUSION

The tissue extension procedure, although scarcely used is an attractive procedure for the coverage of skin losses.

Generalized anxiety disorder in women

Women have a higher prevalence of GAD than do men. This ratio holds true in most clinical and general-population samples. Some variations exist, with evidence to suggest the strong impact of environment and life events. Women are sensitive to lifetime adversity and exacerbation of symptoms in conjunction with their menstrual cycle. Comorbidity is a crucial diagnostic factor when treating anyone with GAD, especially women. Most notably, high comorbidity with other anxiety disorders, MDD and alcohol-abuse disorder occurs for women. Overall, although the prevalence of women with GAD is greater than that of men with GAD, the course of illness and prognosis are not qualitatively different. Across varied methodology, data suggest gender-related differences in the metabolism and potentially in the effects and side effects of the various benzodiazepines and antidepressant psychopharmacologic treatments of GAD. Additional research is needed to better understand these differences.

Direct and crossover effects of prosocial and antisocial coping behaviors

The relationship of antisocial and prosocial coping behaviors to individual and relationship well-being was prospectively examined in a sample of fire-emergency workers (FEWs) and their marital or romantic partners (69 couples). Results of hierarchical multiple regression equations indicated that FEWs' antisocial coping was related to higher levels of depressive symptoms. Prosocial coping was related to decreased anger expression and increased relationship adjustment. Partners' prosocial coping was a significant predictor of FEWs' reports of better relationship adjustment. For partners, prosocial coping was positively related to their relationship adjustment. FEWs' coping was unrelated to partners' outcome. Results for the FEWs support the notion that coping has direct and crossover effects. Moreover, results indicate that prosocial and antisocial coping behaviors have differential effects on well-being.

Individual and crossover effects of stress on adjustment in medical student marriages

High-stress individuals may benefit from social support, although their support providers may be adversely affected via stress crossover effects. Individual and crossover effects of perceived stress within medical student marriages (n = 30) were investigated. Perceived spousal support was positively associated with individuals' own marital and emotional adjustment, attenuating stress effects. With regard to crossover effects, medical students' perceived stress was significantly associated with their spouses' emotional adjustment. Further, medical students' own emotional adjustment fully mediated this crossover effect. Results suggest that the contagion of negative affect may serve as a key mechanism through which stress crossover effects operate in marriage.

Transcriptional regulation and structural organization of the human cytosolic phospholipase A(2) gene

Cytokines are established regulators of the arachidonic acid cascade in lung cells. The levels of various arachidonic metabolites distinguish the normal and pathogenic states of the human lung. Arachidonyl-selective cytosolic phospholipase A(2) (cPLA(2)) is ubiquitously present in human lung and is most likely the rate-limiting step in eicosanoid generation. We therefore studied the regulation of this pivotal gene in human lung fibroblasts and epithelial cells by proinflammatory cytokines. We demonstrate a dose- and time-dependent induction of human cPLA(2) mRNA by interleukin-1beta, tumor necrosis factor-alpha, and interferon-gamma as well as the abrogation of this induction by glucocorticoids. Nuclear runoff studies demonstrate that de novo transcription of the cPLA(2) gene is required for cytokine induction. We have characterized the human cPLA(2) gene, which is encoded by 18 exons and spans in excess of 137 kb. Deletion analysis of a 3.4-kb fragment of the human promoter identified two regions responsible for basal expression of the cPLA(2) gene. Conversely, a CA-dinucleotide repeat in the proximal promoter appears to repress overall promoter activity. Understanding the molecular mechanisms associated with cytokine-dependent expression of the cPLA(2) gene should provide further insight into regulating the level of proinflammatory mediators in pulmonary diseases.

Regulation of the manganese superoxide dismutase and inducible nitric oxide synthase gene in rat neuronal and glial cells

Bidirectional communication occurs between neuroendocrine and immune systems through the action of various cytokines. Responses to various inflammatory mediators include increases in intracellular reactive oxygen species (ROS), notably, superoxide anion (O2-) and nitric oxide (NO.). Neurotoxicity mediated by NO. may result from the reaction of NO. with O2, leading to formation of peroxynitrite (ONOO-). ROS are highly toxic, potentially contributing to extensive neuronal damage. We, therefore, evaluated the effects of a variety of inflammatory mediators on the regulation of mRNA levels for manganese superoxide dismutase (MnSOD) and inducible nitric oxide synthase (iNOS) in primary cultures of rat neuronal and glial cells. To determine age-dependent variation of mRNA expression, we used glial cells derived from newborn, 3-, 21-, and 95-day-old rat brains. Interleukin-1 beta, interferon-gamma (IFN-gamma), bacterial lipopolysaccharide (LPS), and tumor necrosis factor-alpha showed significant induction of MnSOD in both glial and neuronal cells. However, only LPS and IFN-gamma increased iNOS mRNA. These data demonstrate that these two genes are similarly regulated in two cells of the nervous system, further suggesting that the oxidative state of a cell may dictate a neurotoxic or neuroprotective outcome.

Regulation of inducible nitric oxide synthase mRNA levels by LPS, INF-gamma, TGF-beta, and IL-10 in murine macrophage cell lines and rat peritoneal macrophages

The molecular mechanisms of LPS, INF-gamma, TGF-beta, and IL-10 regulation of inducible nitric oxide synthase (iNOS) mRNA expression were evaluated. In murine macrophage cell lines, LPS-induced increases in iNOS mRNA were blocked by either cycloheximide or actinomycin D. Neither TGF-beta nor IL-10 alone had any effect on basal expression, and each only slightly reduced LPS induction of iNOS mRNA. However, IL-10 augmented INF-gamma induction of iNOS mRNA to very high levels, while TGF-beta inhibited INF-gamma induction. Human monocytes expressed no detectable iNOS mRNA with any stimuli, though Southern analysis on human genomic DNA revealed a specific human iNOS gene. In human macrophages, the iNOS gene may have become inoperative during evolution.

Gender and coping: the dual-axis model of coping

Examined a dual-axis model of coping that included both action (active vs. passive) and social dimensions (prosocial vs. antisocial) of coping strategies among a combined sample of students and community residents. We developed an assessment device to represent the model and allow investigation. Mixed support for the model and instrument were noted. Women were more prosocial than men in their coping, but no less active. Men were more likely to use antisocial and aggressive, but less assertive coping strategies than women. More prosocial, action coping strategies were also more likely to be related to greater sense of mastery and more liberal gender-role orientation. Antisocial and passive strategies tended to be related to lower mastery and more traditional gender-role orientation. Active coping was related to lower emotional distress for men and women, but both prosocial and antisocial coping were related to greater emotional distress for men, suggesting that men may have a narrower band of beneficial coping strategies than do women.

Regulation of manganese superoxide dismutase: IL-1 and TNF induction in pulmonary artery and microvascular endothelial cells

IL-1 and TNF are important mediators in the inflammatory response, and have been associated with endothelial cell damage in the lung. TNF and IL-1 cell-mediated injury has been proposed to occur through an increase in intracellular oxygen free radical production. However, these cytokines have also been shown to protect the lung from hyperoxia-mediated oxidant injury. In this paper we evaluated the response of the antioxidant enzymes, MnSOD and Cu/ZnSOD to IL-1, TNF, and LPS in both rat pulmonary artery and microvascular endothelial cells. These mediators produced an increase in MnSOD but not Cu/ZnSOD expression in both rat pulmonary endothelial cells. An additive effect was observed with co-treatment by the cytokines with LPS. The MnSOD mRNA induction is dependent upon a transcriptional event, but did not require de novo protein synthesis.

Synthesis of some ring-substituted ruthenocenes and their use in the preparation of Ru/ZSM-5 catalysts

A method is proposed for the preparation of Ru/ZSM-5 catalysts using substituted and non-substituted ruthenocenes. To this end, the following complexes have been synthesized and characterized: dimethyl-1,1′; diphenyl-1,1′; dibenzoyl-1,1′, and monobenzoyl ruthenocene. Results of ESC A intensity ratio and ir of adsorbed pyridine show differences in the surface segregation of Ru as well as in the cationic exchange of Ru with Brønsted acid sites of the zeolite, when the catalyst is prepared using ring-substituted ruthenocene instead of ruthenocene itself. The binding energies of Ru 3d5/2 measured by ESCA are discussed.

Centrifugal analyzer used for enzyme immunoassay of progesterone and choriomammotropin

Recently we developed an enzyme immunoassay involving the use of steroid delta-isomerase (EC 5.3.3.1) as enzyme label and exclusion-affinity chromatography for rapid separation of free antigen-enzyme conjugate that bound to antibodies (J. Immunol. Methods 35: 267-284, 1980). Here we describe an automated version of this procedure, for immunoassay of progesterone and choriomammotropin (human placental lactogen) in serum with the use of a centrifugal analyzer. After incubation, suitable dilutions of sera or extract plus antiserum, conjugate, and double antibody were filtered on an estradiol affinity gel-filtration column; the enzyme activity of the filtrates was determined with the centrifugal analyzer. Results correlate well with those obtained by radioimmunoassay: r (progesterone) = 0.980, r (choriomammotropin) = 0.940. The within-run and between-run precision, specificity, sensitivity, accuracy, and speed of this system make it a useful tool for immunoassay.

Centrifugal analyzer used for enzyme immunoassay of progesterone and choriomammotropin

Recently we developed an enzyme immunoassay involving the use of steroid delta-isomerase (EC 5.3.3.1) as enzyme label and exclusion-affinity chromatography for rapid separation of free antigen-enzyme conjugate that bound to antibodies (J. Immunol. Methods 35: 267-284, 1980). Here we describe an automated version of this procedure, for immunoassay of progesterone and choriomammotropin (human placental lactogen) in serum with the use of a centrifugal analyzer. After incubation, suitable dilutions of sera or extract plus antiserum, conjugate, and double antibody were filtered on an estradiol affinity gel-filtration column; the enzyme activity of the filtrates was determined with the centrifugal analyzer. Results correlate well with those obtained by radioimmunoassay: r (progesterone) = 0.980, r (choriomammotropin) = 0.940. The within-run and between-run precision, specificity, sensitivity, accuracy, and speed of this system make it a useful tool for immunoassay.

[Meningoencephalic and chorioretinal manifestations of toxoplasmosis in an immunodeficient patient]

With reference to a case of malignant toxoplasmosis in a patient with angioimmunoblastic lymphadenopathy, the following features are recalled: in compromised hosts, clinical manifestations of malignant toxoplasmosis are highly variable, with neurologic signs and fever being predominant; the occurrence of lesions of the fundus, such as chorioretinitis, is an essential clue to the diagnosis; serologic tests for toxoplasmosis should be performed routinely at each stage of the disease in order to ascertain seroconversion through comparison with baseline results.

[Comparative study of cefotaxime serum and lung concentrations in 6 patients with thoracotomy (author's transl)]

This study was performed on samples obtained from 6 patients undergoing pulmonary surgery. Cefotaxime was administered by the i.m. route at a dose of 1 g twice daily and assays were performed on simultaneously obtained lung biopsies and serum. The comparison of tissue levels to the peak serum concentrations obtained at 30 minutes after injection provided evidence of the excellent tissue penetration of this cephalosporin in the human lungs.