RESUMO
INTRODUCTION: Since 2010, the network of rare malignant tumors of the ovary (TMRG) was developed to optimize the management of patients, also allowing a histological second opinion of rare ovarian tumors. The aim of this work was to study the contribution of second opinion to improve histological diagnostic accuracy on ovarian rare malignant tumors included in the TMRG database. MATERIAL AND METHODS: Histological data of patients diagnosed with a rare ovarian tumor included in TMRG network over a one-year period (2018) were collected. Initial diagnoses were compared with second opinion from national gynecological pathologist experts. The modalities of histological second opinion requests were studied, as well as the histological characteristics of the tumors. The discordances were classified as minor (if the modification of histological diagnosis did not change patient management) and major (if the patient management can be modified). RESULTS: Of 1185 included patients, 937 matched the inclusion criteria. Full concordance between primary diagnosis and expert second opinion was reached in 611 cases (65,3%), minor discordance was seen in 114 (12,2%) and major discordance in 209 (22,3%) of cases. In systematic review requested by the network, 26% (n = 137) of cases were reported with a change in histological diagnosis, while the change concerned 44% (n = 186) of cases for a second opinion spontaneously requested by the initial pathologist. The discrepancies concerned all categories of ovarian tumors, with a majority of mucinous tumors (43% of major discordances), followed by stromal and sex-cord tumors (13.8% of major discordances) and clear cell tumors (12,4% of major discordances). CONCLUSION: This analysis confirms the diagnostic difficulty of ovarian tumors, due to their rarity and morphological heterogeneity. French pathologists are aware of these difficulties and spontaneously refer ovarian tumors with unusual histology for a second opinion and collaborate with rare tumor networks for systematic review.
Assuntos
Neoplasias Ovarianas , Tumores do Estroma Gonadal e dos Cordões Sexuais , Feminino , Humanos , Neoplasias Ovarianas/diagnóstico , Neoplasias Ovarianas/patologia , Encaminhamento e ConsultaRESUMO
BACKGROUND: Localized myxoedema is a rare dermopathy in patients with Graves' disease. The pretibial area is the most commonly affected region but herein we present a case of myxoedema of the big toe. PATIENTS AND METHODS: A 44-year-old male with Graves' disease ongoing for seven years presented bilateral ophthalmopathy and myxoedema of the big toes. The myxoedema was treated successfully with intralesional steroids. DISCUSSION: The physiopathology of myxoedema involves fibroblast activation and glycosaminoglycan production. This activation could result from stimulation of TSH receptors at their surface by TSH receptor antibodies (TRAK) or from an inflammatory process. The pretibial topography may be related to the high frequency in this area of microtrauma, with modulation of the cytokine microenvironment. CONCLUSION: The atypical localization seems to correlate with a Koebner phenomenon. Treatment of Graves' disease is generally insufficient to resolve the cutaneous problems. Topical corticosteroid therapy generally results in rapid improvement of recent lesions.
Assuntos
Dermatoses do Pé/patologia , Doença de Graves/patologia , Mixedema/patologia , Dedos do Pé/patologia , Adulto , Biópsia , Carbimazol/uso terapêutico , Descompressão Cirúrgica , Fibroblastos/metabolismo , Fibroblastos/patologia , Dermatoses do Pé/tratamento farmacológico , Dermatoses do Pé/etiologia , Dermatoses do Pé/fisiopatologia , Glicosaminoglicanos/análise , Glicosaminoglicanos/metabolismo , Doença de Graves/complicações , Doença de Graves/tratamento farmacológico , Doença de Graves/fisiopatologia , Doença de Graves/cirurgia , Oftalmopatia de Graves/etiologia , Oftalmopatia de Graves/cirurgia , Terapia de Reposição Hormonal , Humanos , Imunoglobulinas Estimuladoras da Glândula Tireoide/imunologia , Imunossupressores/administração & dosagem , Imunossupressores/uso terapêutico , Injeções Intralesionais , Masculino , Metimazol/uso terapêutico , Mixedema/tratamento farmacológico , Mixedema/etiologia , Mixedema/fisiopatologia , Receptores da Tireotropina/imunologia , Receptores da Tireotropina/fisiologia , Tireoidectomia , Tiroxina/uso terapêutico , Triancinolona/administração & dosagem , Triancinolona/uso terapêuticoRESUMO
The conventional approach for microscopic 3D cellular imaging is based on axial through-stack image series which has some significant limitations such as anisotropic resolution and axial aberration. To overcome these drawbacks, we have recently introduced an alternative approach based on micro-rotation image series. Unfortunately, this new technique suffers from a huge burden of computation that makes its use quite difficult for current applications. To address these problems we propose a new imaging strategy called bi-protocol, which consists of coupling micro-rotation acquisition and conventional z-stack acquisition. We experimentally prove bi-protocol 3D reconstruction produces similar quality to that of pure micro-rotation, but offers the advantage of reduced computation burden because it uses the z-stack volume to accelerate the registration of the micro-rotation images.
Assuntos
Imageamento Tridimensional/métodos , Microscopia Confocal , Algoritmos , Linhagem Celular Tumoral , Humanos , Processamento de Imagem Assistida por Computador , Reprodutibilidade dos Testes , RotaçãoRESUMO
Recently, micro-rotation confocal microscopy has enabled the acquisition of a sequence of micro-rotated images of nonadherent living cells obtained during a partially controlled rotation movement of the cell through the focal plane. Although we are now able to estimate the three-dimensional position of every optical section with respect to the cell frame, the reconstruction of the cell from the positioned micro-rotated images remains a last task that this paper addresses. This is not strictly an interpolation problem since a micro-rotated image is a convoluted two-dimensional map of a three-dimensional reality. It is rather a 'reconstruction from projection' problem where the term projection is associated to the PSF of the deconvolution process. Micro-rotation microscopy has a specific difficulty. It does not yield a complete coverage of the volume. In this paper, experiments illustrate the ability of the classical EM algorithm to deconvolve efficiently cell volume despite of the incomplete coverage. This cell reconstruction method is compared to a kernel-based method of interpolation, which does not take account explicitly the point-spread-function (PSF). It is also compared to the standard volume obtained from a conventional z-stack. Our results suggest that deconvolution of micro-rotation image series opens some exciting new avenues for further analysis, ultimately laying the way towards establishing an enhanced resolution 3D light microscopy.
Assuntos
Processamento de Imagem Assistida por Computador/métodos , Microscopia Confocal/métodos , Rotação , Algoritmos , Adesão Celular , Linhagem Celular Tumoral , Núcleo Celular/ultraestrutura , Humanos , Aumento da Imagem , Laminas/ultraestruturaRESUMO
X chromosome inactivation is a remarkable example of chromosome-wide gene silencing and facultative heterochromatin formation. Numerous histone posttranslational modifications, including H3K9me2 and H3K27me3, accompany this process, although our understanding of the enzymes that lay down these marks and the factors that bind to them is still incomplete. Here we identify Cdyl, a chromodomain-containing transcriptional corepressor, as a new chromatin-associated protein partner of the inactive X chromosome (Xi). Using mouse embryonic stem cell lines with mutated histone methyltransferase activities, we show that Cdyl relies on H3K9me2 for its general association with chromatin in vivo. For its association with Xi, Cdyl requires the process of differentiation and the presence of H3K9me2 and H3K27me3, which both become chromosomally enriched following Xist RNA coating. We further show that the removal of the PRC2 component Eed and subsequent loss of H3K27me3 lead to a reduction of both Cdyl and H3K9me2 enrichment on inactive Xi. Finally, we show that Cdyl associates with the H3K9 histone methyltransferase G9a and the MGA protein, both of which are also found on Xi. We propose that the combination of H3K9me2 and H3K27me3 recruits Cdyl to Xi, and this, in turn, may facilitate propagation of the H3K9me2 mark by anchoring G9a.
Assuntos
Células-Tronco Embrionárias/fisiologia , Histonas/metabolismo , Proteínas/metabolismo , Inativação do Cromossomo X , Cromossomo X/metabolismo , Animais , Diferenciação Celular , Núcleo Celular/metabolismo , Proteínas Correpressoras , Epigênese Genética , Feminino , Regulação da Expressão Gênica no Desenvolvimento , Células HEK293 , Histona Acetiltransferases , Histona-Lisina N-Metiltransferase/metabolismo , Humanos , Hidroliases , Metilação , Camundongos , Complexo Repressor Polycomb 1/metabolismo , Isoformas de Proteínas/metabolismo , Processamento de Proteína Pós-Traducional , Estabilidade Proteica , Tretinoína/fisiologia , Cromossomo X/genéticaAssuntos
Antineoplásicos/uso terapêutico , Arsenicais/uso terapêutico , Neoplasias/tratamento farmacológico , Adulto , Neoplasias da Mama/tratamento farmacológico , Carcinoma Broncogênico/tratamento farmacológico , Carcinoma de Células Escamosas/tratamento farmacológico , Coriocarcinoma/tratamento farmacológico , Neoplasias do Colo/tratamento farmacológico , Sinergismo Farmacológico , Feminino , Fluoretos/uso terapêutico , Heparina/uso terapêutico , Humanos , Neoplasias Pulmonares/tratamento farmacológico , Masculino , Malonatos/uso terapêutico , Melanoma/tratamento farmacológico , Neoplasias Ovarianas/tratamento farmacológico , Neoplasias Faríngeas/tratamento farmacológico , Gravidez , Neoplasias Retais/tratamento farmacológico , Sarcoma/tratamento farmacológico , Neoplasias Gástricas/tratamento farmacológico , Neoplasias Testiculares/tratamento farmacológico , Neoplasias da Glândula Tireoide/tratamento farmacológico , Fatores de Tempo , Vitamina K/uso terapêuticoAssuntos
Antineoplásicos/uso terapêutico , Neoplasias/cirurgia , Ágar , Alquilantes/uso terapêutico , Técnicas de Cultura , DNA de Neoplasias/metabolismo , Fluoruracila/farmacologia , Humanos , Mecloretamina/farmacologia , Métodos , Metotrexato/farmacologia , Neoplasias/metabolismo , Células Neoplásicas Circulantes/tratamento farmacológico , Radioisótopos , Compostos de Sulfidrila/antagonistas & inibidoresAssuntos
Idoso/psicologia , Comportamento Sexual/psicologia , Disfunções Sexuais Fisiológicas/psicologia , Disfunções Sexuais Psicogênicas/psicologia , Idoso de 80 Anos ou mais , Atitude do Pessoal de Saúde , Feminino , Enfermagem Geriátrica , Humanos , Institucionalização , Masculino , Preconceito , Aconselhamento Sexual , Disfunções Sexuais Fisiológicas/prevenção & controle , Disfunções Sexuais Psicogênicas/prevenção & controleAssuntos
Alcoolismo/enfermagem , Alcoolismo/reabilitação , Diagnóstico de Enfermagem , Assistência ao Convalescente , Alcoolismo/psicologia , Assistência Ambulatorial , Ansiedade/etiologia , Negação em Psicologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Diagnóstico de Enfermagem/classificação , Planejamento de Assistência ao Paciente/organização & administração , Equipe de Assistência ao Paciente/organização & administraçãoRESUMO
A simple phenomenological model that describes capillary condensation and evaporation of pure fluids confined in cylindrical mesopores is presented. Following the work of Celestini (Celestini, F. Phys. Lett. A 1997, 228, 84), the free energy density of the system is derived using interfacial tensions and a corrective term that accounts for the interaction coupling between the vapor/adsorbed liquid and the adsorbed liquid/adsorbent interfaces. This corrective term is shown to be consistent with the Gibbs adsorption isotherm and assessed by standard adsorption tests. This model reveals that capillary condensation and evaporation are metastable and equilibrium processes, respectively, hence exhibiting the existence of a hysteresis loop inadsorption/desorption isotherm that is well-known in experiment. We extend the phenomenological model of Celestini to give a quantitative description of adsorption on the pore wall and hysteresis width evolution with temperature and confinement. Direct quantitative comparison is made with experimental data for confined argon. Used as a characterizing tool, this integrated model allows in a single fit of an experimental adsorption/desorption isotherm assessing essential characterization data such as the specific surface area, pore volume, and mean pore size.
RESUMO
The role of scabrous (sca) in the evenly spaced bristle pattern of Drosophila is explored. Loss-of-function of sca results in development of an excess of bristles. Segregation of alternately spaced bristle precursors and epidermal cells from a group of equipotential cells relies on lateral inhibition mediated by Notch and Delta (Dl). In this process, presumptive bristle precursors inhibit the neural fate of neighbouring cells, causing them to adopt the epidermal fate. We show that Dl, a membrane-bound ligand for Notch, can inhibit adjacent cells, in direct contact with the precursor, in the absence of Sca. In contrast, inhibition of cells not adjacent to the precursor requires, in addition, Sca, a secreted molecule with a fibrinogen-related domain. Over-expression of Sca in a wild-type background, leads to increased spacing between bristles, suggesting that the range of signalling has been increased. scabrous acts nonautonomously, and we present evidence that, during bristle precursor segregation, Sca is required to maintain the normal adhesive properties of epithelial cells. The possible effects of such changes on the range of signalling are discussed. We also show that the sensory organ precursors extend numerous fine cytoplasmic extensions bearing Dl molecules, and speculate on a possible role for these structures during signalling.
Assuntos
Proteínas de Drosophila , Drosophila/crescimento & desenvolvimento , Drosophila/fisiologia , Glicoproteínas/fisiologia , Proteínas de Insetos/fisiologia , Animais , Animais Geneticamente Modificados , Padronização Corporal/fisiologia , Caderinas/fisiologia , Adesão Celular/fisiologia , Drosophila/citologia , Drosophila/genética , Células Epiteliais/fisiologia , Feminino , Regulação da Expressão Gênica no Desenvolvimento , Genes de Insetos , Glicoproteínas/genética , Proteínas de Insetos/genética , Peptídeos e Proteínas de Sinalização Intracelular , Masculino , Proteínas de Membrana/genética , Proteínas de Membrana/fisiologia , Microscopia Eletrônica , Mutação , Fenótipo , Receptores Notch , Transdução de Sinais/fisiologiaRESUMO
Since human papillomavirus (HPV) is the central causal factor in cervical cancer, understanding the epidemiology of this infection constitutes an important step towards development of strategies for prevention. Six hundred and fifty seven cervical samples were tested for HPV using PCR with consensus primers (MY09/MY11), by genotyping (restriction and sequencing analyses) and by cervical cytology, from women who attended a Health Examination Center of the French social security. Women with no cervical smear as well as women with cytological abnormalities within the last 3 years were recruited. HPV DNA was detected in 7.3% of the women (5.3% for high-risk, 2.4% for low-risk, and 0.5% for unknown risk types) including 6 (0.9%) mixed infections. Fifteen different genotypes were detected, of which genotypes 16 (22.2%), 58 (13.0%), 18 (11.1%), 30 (9.2%), and 33 (9.2%) were the most prevalent. In age group 17-25 years, we found the highest frequencies for both any (22.1%) and high-risk (14.7%) HPV, and prevalences gradually decreased with age. 5.2% of low-grade squamous intraepithelial lesion, 0.3% of high-grade squamous intraepithelial lesion, and 1.2% of atypical squamous cells of undetermined significance were found. The frequencies of high risk and all HPV types were significantly higher in squamous intraepithelial lesions than in those with normal and reactive/reparative changes (P < 0.0001). The prevalence of high-risk HPV in the atypical squamous cells of undetermined significance/low-grade squamous intraepithelial lesion group (28.6%) was significantly higher than in the normal and reactive/reparative changes groups (3.4%) (P < 0.0001). HPV detection was associated with younger age, single marital and non-pregnant status (P < 0.0001), premenopausal status (P = 0.0004), and contraception (P = 0.0008). Marital status (OR 4.5; 95% CI = 2.3-9.0) and tobacco consumption (OR 3.0; 95% CI = 1.6-5.7) were predictive independent factors of HPV infection. The French system of Health Examination Centers might be of interest for following women regularly, especially those with a low socioeconomic status.