Nodular Vulvar Lesions.

A woman in her 30s presented with mildly itchy skin nodules in the vulvar region for 1 year, which occurred during pregnancy and increased gradually in size and number without any treatments. What is your diagnosis?

[Established Genital and Extragenital Lichen Sclerosus:A Clinicopathological Analysis].

Objective To investigate the clinicopathological characteristics of established genital and extragenital lichen sclerosus(LS)and compare the differences between them. Method The clinicopathological data of 55 patients with established genital and extragenital LS diagnosed by pathological examination in the Department of Dermatology of Beijing Hospital were retrospectively analyzed. Results The 55 patients included 11 males and 44 females.Among them,38,15,and 2 patients had genital lesions,extragenital lesions,and both genital and extragenital lesions,respectively.Extragenital LS mainly involved the back(14.55%)and extremities(7.27%).Among the patients,28.30% were asymptomatic,and 73.58% and 24.53% felt itchy and painful,respectively.The asymptomatic patients had a higher proportion in extragenital cases(χ2=31.224,P=0.000),and the itchy symptom was more common in genital LS cases than in extragenital LS cases(χ2=39.073,P=0.000).Vulvar pain only appeared in the patients with genital LS.A total of 57 biopsy specimens from the 55 patients were reviewed,of which 40 were from genital lesions and 17 were from extragenital lesions.In addition to papillary dermal homogenization (100%),the common pathological changes include hyperkeratosis(98.25%),atrophy(50.88%),basal cell liquefaction degeneration (52.63%),dilated blood vessels(64.91%),a perivascular lymphocytic infiltrate(100%),histiocytic infiltrate(85.96%),and lichenoid inflammatory infiltrate(54.39%).Higher proportions of acanthosis (χ2=4.402,P=0.036),dilated blood vessels (χ2=9.330,P=0.002),and eosinophilic infiltrate (χ2=4.162,P=0.041) were observed in genital LS cases.A higher proportion of follicular plugging appeared in extragenital LS cases (χ2=5.076,P=0.024). Conclusion The established genital LS and extragenital LS showed some differences in clinical symptoms and pathological changes including acanthosis,dilated blood vessels,eosinophilic infiltrate,and follicular plugging.

Diffuse Neurofibroma: An Uncommon Cause of Alopecia.

Alopecia (hair loss) is reported to be associated with infection, genetics, hormonal changes, drugs, or inflammation. The most frequent causes of hair loss in pediatric patients include tinea capitis, alopecia areata, traction alopecia, and trichotillomania. In the adult population, causes to be considered are alopecia areata and hair loss associated with systemic disease and hormonal influence. The clinician must be able to separate the types and causes of hair loss into those that reflect primary dermatologic conditions and those that represent a reaction to systemic disease. Benign cutaneous tumors have also been known to develop alopecia via occupying the place for hair follicles or tumor-induced inflammatory responses. However, the mechanism of alopecia by neurofibroma (NF) has not been well investigated. We present a 32-year-old patient who developed scalp plaque with alopecia within 6 years. He denies any itching or pain in the area, and has not tried any treatments. In this study, the unusual association between NF and alopecia is shown.

Adding nickel formate in alkali lignin to increase contents of alkylphenols and aromatics during fast pyrolysis.

The composition of pyrolysis vapors obtained from alkali lignin pyrolysis with the additive of nickel formate was examined using the pyrolysis gas chromatography-mass spectrometry (Py-GC/MS). Characterization of bio-chars was performed using X-ray diffraction (XRD). Results showed that the nickel formate significantly increased liquid yield, simplified the types of alkali lignin pyrolysis products and increased individual component contents. The additive of nickel formate increased contents of alkylphenols and aromatics from alkali lignin pyrolysis. With an increase in temperature, a greater amount of the relative contents can be achieved. The nickel formate was thermally decomposed to form hydrogen, resulting in hydrodeoxygenation of alkali lignin during pyrolysis. It was also found that Ni is in favor of producing alkylphenols. The analysis based on the experimental result provided evidences used to propose reaction mechanism for pyrolysis of nickel formate-assisted alkali lignin.

Endoscopic ultrasound elastography: Current status and future perspectives.

Elastography is a new ultrasound modality that provides images and measurements related to tissue stiffness. Endoscopic ultrasound (EUS) has played an important role in the diagnosis and management of numerous abdominal and mediastinal diseases. Elastography by means of EUS examination can assess the elasticity of tumors in the proximity of the digestive tract that are hard to reach with conventional transcutaneous ultrasound probes, such as pancreatic masses and mediastinal or abdominal lymph nodes, thus improving the diagnostic yield of the procedure. Results from previous studies have promised benefits for EUS elastography in the differential diagnosis of lymph nodes, as well as for assessing masses with pancreatic or gastrointestinal (GI) tract locations. It is important to mention that EUS elastography is not considered a modality that can replace biopsy. However, it may be a useful adjunct, improving the accuracy of EUS-fine needle aspiration biopsy (EUS-FNAB) by selecting the most suspicious area to be targeted. Even more, it may be useful for guiding further clinical management when EUS-FNAB is negative or inconclusive. In the present paper we will discuss the current knowledge of EUS elastography, including the technical aspects, along with its applications in the differential diagnosis between benign and malignant solid pancreatic masses and lymph nodes, as well as its aid in the differentiation between normal pancreatic tissues and chronic pancreatitis. Moreover, the emergent indication and future perspectives are summarized, such as the benefit of EUS elastography in EUS-guided fine needle aspiration biopsy, and its uses for characterization of lesions in liver, biliary tract, adrenal glands and GI tract.

Benign liver tumors in pediatric patients - Review with emphasis on imaging features.

Benign hepatic tumors are commonly observed in adults, but rarely reported in children. The reasons for this remain speculative and the exact data concerning the incidence of these lesions are lacking. Benign hepatic tumors represent a diverse group of epithelial and mesenchymal tumors. In pediatric patients, most benign focal liver lesions are inborn and may grow like the rest of the body. Knowledge of pediatric liver diseases and their imaging appearances is essential in order to make an appropriate differential diagnosis. Selection of the appropriate imaging test is challenging, since it depends on a number of age-related factors. This paper will discuss the most frequently encountered benign liver tumors in children (infantile hepatic hemangioendothelioma, mesenchymal hamartoma, focal nodular hyperplasia, nodular regenerative hyperplasia, and hepatocellular adenoma), as well as a comparison to the current knowledge regarding such tumors in adult patients. The current emphasis is on imaging features, which are helpful not only for the initial diagnosis, but also for pre- and post-treatment evaluation and follow-up. In addition, future perspectives of contrast-enhanced ultrasound (CEUS) in pediatric patients are highlighted, with descriptions of enhancement patterns for each lesion being discussed. The role of advanced imaging tests such as CEUS and magnetic resonance imaging, which allow for non-invasive assessment of liver tumors, is of utmost importance in pediatric patients, especially when repeated imaging tests are needed and radiation exposure should be avoided.

Ultrasonographic imaging of inflammatory bowel disease in pediatric patients.

Inflammatory bowel disease (IBD) is one of the most common chronic gastrointestinal diseases in pediatric patients. Choosing the optimal imaging modality for the assessment of gastrointestinal disease in pediatric patients can be challenging. The invasiveness and patient acceptance, the radiation exposure and the quality performance of the diagnostic test need to be considered. By reviewing the literature regarding imaging in inflammatory bowel disease the value of ultrasound in the clinical management of pediatric patients is highlighted. Transabdominal ultrasound is a useful, noninvasive method for the initial diagnosis of IBD in children; it also provides guidance for therapeutic decisions and helps to characterize and predict the course of the disease in individual patients. Ultrasound techniques including color Doppler imaging and contrast-enhanced ultrasound are promising imaging tools to determine disease activity and complications. Comparative studies between different imaging methods are needed.

Quality improvement of pyrolysis oil from waste rubber by adding sawdust.

This work was aimed at improving the pyrolysis oil quality of waste rubber by adding larch sawdust. Using a 1 kg/h stainless pyrolysis reactor, the contents of sawdust in rubber were gradually increased from 0%, 50%, 100% and 200% (wt%) during the pyrolysis process. Using a thermo-gravimetric (TG) analyzer coupled with Fourier transform infrared (FTIR) analysis of evolving products (TG-FTIR), the weight loss characteristics of the heat under different mixtures of sawdust/rubber were observed. Using the pyrolysis-gas chromatography (GC)-mass spectrometry (Py-GC/MS), the vapors from the pyrolysis processes were collected and the compositions of the vapors were examined. During the pyrolysis process, the recovery of the pyrolysis gas and its composition were measured in-situ at a reaction temperature of 450 °C and a retaining time of 1.2s. The results indicated that the efficiency of pyrolysis was increased and the residual carbon was reduced as the percentage of sawdust increased. The adding of sawdust significantly improved the pyrolysis oil quality by reducing the polycyclic aromatic hydrocarbons (PAHs) and nitrogen and sulfur compounds contents, resulting in an improvement in the combustion efficiency of the pyrolysis oil.

Clinical and histopathological characteristics of basal cell carcinoma in Chinese patients.

BACKGROUND: The clinical and histopathological characteristics of basal cell carcinoma (BCC) have been relatively well studied in Caucasian population. To characterize BCC in Chinese population, we analyzed the association of the histopathological subtypes with gender, age and anatomical location in this study. METHODS: The clinical and histopathological data of 243 BCC cases diagnosed at three hospitals in Beijing from January 2000 to April 2009 were reviewed retrospectively. Gender, age, location and histopathological subtype were analyzed. RESULTS: Among 243 patients enrolled, 118 were males and 125 were females. The male/female ratio was 0.94:1. The mean age was (65.16 ± 12.62) years old. The head and neck were the most common sites of BCC (77.4%). Of the BCCs, 53.9% were nodular, 18.9% superficial and 18.5% infiltrative-morphoeic. The nodular, infiltrative-morphoeic and micronodular subtypes were predominant located on the head and neck, whereas the trunk was the most common location for the superficial subtype (P < 0.05). The age at first presentation for females was lower than that for males (P < 0.05). The age at first presentation for the superficial BCCs was younger than the non-superficial subtypes (P < 0.05). Women with superficial BCC subtype visited hospital earlier than men (P < 0.05). CONCLUSIONS: Consistent with previous reports in Caucasian patient, our study find that different histopathological subtypes of BCC has distinct clinical features. It is speculated that the mechanisms underlining the pathogenesis of the superficial BCC may be different than those of non-superficial subtypes of BCC.

[Analysis of pyrolysis process and gas evolution rule of larch wood by TG-FTIR].

The weight-loss character and gas evolution rule of larch wood at different heating rates were investigated by TG-FTIR (thermogravimetric analyzer coupled to a Fourier transform infrared spectrometer), and the results were compared with those of larch wood model-component mixture. The main weight-loss area of larch wood was wider than larch wood model-component mixture, and the residual char yield of larch wood (18.97%) was lower than larch wood model-component mixture (29.83%). During the pyrolysis process, the activation energy of larch wood model-component mixture was higher than the larch wood's in the low-temperature region, but there was little difference between the two segments in high temperature region. Larch wood came through several stages of water extraction, main component decomposition, charring during its pyrolysis process, and gas precipitation mainly happening at near 375 degrees C. The order of main gas products generated from the larch wood pyrolysis reaction was CO2 > H2O > CH4 > CO, and the gas product yield was significantly increased when the heating rate increased. The larch wood model-component mixture had the similar basic rules of producing gas to larch wood, but the former had relatively higher precipitation density than the latter.

[Histopathological findings of primary cutaneous lichenoid and macular amyloidosis].

OBJECTIVE: To investigate the histopathological findings of primary cutaneous lichenoid amyloidosis (LA) and macular amyloidosis (MA). METHODS: The pathological features of 82 patients with primary cutaneous amyloidosis (PCA) admitted from 2003 to 2008 were summarized. RESULTS: There were 52 cases (63%) of LA and 30 cases (37%) of MA, among which 49 cases (60%) presented with pyknotic nucleus of the basal keratinocytes above the amyloid in the upper dermis and 18 cases (22%) presented with pagetoid dyskeratosis (PD) cells among their prickle cells. More amyloid in LA and more severe incontinent of pigment in MA. The deposition level of amyloid protein was significantly higher in patients with LA and the incontinent of pigment was significantly higher in patients with MA (P < 0.01). CONCLUSION: The amyloid protein may be derived from the apoptotic keratinocytes.