Long-term decline of the Amazon carbon sink.

Atmospheric carbon dioxide records indicate that the land surface has acted as a strong global carbon sink over recent decades, with a substantial fraction of this sink probably located in the tropics, particularly in the Amazon. Nevertheless, it is unclear how the terrestrial carbon sink will evolve as climate and atmospheric composition continue to change. Here we analyse the historical evolution of the biomass dynamics of the Amazon rainforest over three decades using a distributed network of 321 plots. While this analysis confirms that Amazon forests have acted as a long-term net biomass sink, we find a long-term decreasing trend of carbon accumulation. Rates of net increase in above-ground biomass declined by one-third during the past decade compared to the 1990s. This is a consequence of growth rate increases levelling off recently, while biomass mortality persistently increased throughout, leading to a shortening of carbon residence times. Potential drivers for the mortality increase include greater climate variability, and feedbacks of faster growth on mortality, resulting in shortened tree longevity. The observed decline of the Amazon sink diverges markedly from the recent increase in terrestrial carbon uptake at the global scale, and is contrary to expectations based on models.

[Sex workers: limited access to healthcare]. / Travailleuses du sexe: un accès aux soins limité?

Sex workers constitute a heterogeneous group possessing a combination of vulnerability factors such as geographical instability, forced migration, substance addiction and lack of legal residence permit. Access to healthcare for sex workers depends on the laws governing the sex market and on migration policies in force in the host country. In this article, we review different European health strategies established for sex workers, and present preliminary results of a pilot study conducted among 50 sex workers working on the streets in Lausanne. The results are worrying: 56% have no health insurance, 96% are migrants and 66% hold no legal residence permit. These data should motivate public health departments towards improving access to healthcare for this vulnerable population.

Forest carbon sink neutralized by pervasive growth-lifespan trade-offs.

Land vegetation is currently taking up large amounts of atmospheric CO2, possibly due to tree growth stimulation. Extant models predict that this growth stimulation will continue to cause a net carbon uptake this century. However, there are indications that increased growth rates may shorten trees' lifespan and thus recent increases in forest carbon stocks may be transient due to lagged increases in mortality. Here we show that growth-lifespan trade-offs are indeed near universal, occurring across almost all species and climates. This trade-off is directly linked to faster growth reducing tree lifespan, and not due to covariance with climate or environment. Thus, current tree growth stimulation will, inevitably, result in a lagged increase in canopy tree mortality, as is indeed widely observed, and eventually neutralise carbon gains due to growth stimulation. Results from a strongly data-based forest simulator confirm these expectations. Extant Earth system model projections of global forest carbon sink persistence are likely too optimistic, increasing the need to curb greenhouse gas emissions.

Tree height strongly affects estimates of water-use efficiency responses to climate and CO2 using isotopes.

Various studies report substantial increases in intrinsic water-use efficiency (W i ), estimated using carbon isotopes in tree rings, suggesting trees are gaining increasingly more carbon per unit water lost due to increases in atmospheric CO2. Usually, reconstructions do not, however, correct for the effect of intrinsic developmental changes in W i as trees grow larger. Here we show, by comparing W i across varying tree sizes at one CO2 level, that ignoring such developmental effects can severely affect inferences of trees' W i . W i doubled or even tripled over a trees' lifespan in three broadleaf species due to changes in tree height and light availability alone, and there are also weak trends for Pine trees. Developmental trends in broadleaf species are as large as the trends previously assigned to CO2 and climate. Credible future tree ring isotope studies require explicit accounting for species-specific developmental effects before CO2 and climate effects are inferred.Intrinsic water-use efficiency (W i ) reconstructions using tree rings often disregard developmental changes in W i as trees age. Here, the authors compare W i across varying tree sizes at a fixed CO2 level and show that ignoring developmental changes impacts conclusions on trees' W i responses to CO2 or climate.

A Global Analysis of Deforestation in Moist Tropical Forest Protected Areas.

Protected areas (PAs) have been established to conserve tropical forests, but their effectiveness at reducing deforestation is uncertain. To explore this issue, we combined high resolution data of global forest loss over the period 2000-2012 with data on PAs. For each PA we quantified forest loss within the PA, in buffer zones 1, 5, 10 and 15 km outside the PA boundary as well as a 1 km buffer within the PA boundary. We analysed 3376 tropical and subtropical moist forest PAs in 56 countries over 4 continents. We found that 73% of PAs experienced substantial deforestation pressure, with >0.1% a(-1) forest loss in the outer 1 km buffer. Forest loss within PAs was greatest in Asia (0.25% a(-1)) compared to Africa (0.1% a(-1)), the Neotropics (0.1% a(-1)) and Australasia (Australia and Papua New Guinea; 0.03% a(-1)). We defined performance (P) of a PA as the ratio of forest loss in the inner 1 km buffer compared to the loss that would have occurred in the absence of the PA, calculated as the loss in the outer 1 km buffer corrected for any difference in deforestation pressure between the two buffers. To remove the potential bias due to terrain, we analysed a subset of PAs (n = 1804) where slope and elevation in inner and outer 1 km buffers were similar (within 1° and 100 m, respectively). We found 41% of PAs in this subset reduced forest loss in the inner buffer by at least 25% compared to the expected inner buffer forest loss (P<0.75). Median performance (P) of subset reserves was 0.87, meaning a reduction in forest loss within the PA of 13%. We found PAs were most effective in Australasia (P = 0.16), moderately successful in the Neotropics (P = 0.72) and Africa (p = 0.83), but ineffective in Asia (P = 1). We found many countries have PAs that give little or no protection to forest loss, particularly in parts of Asia, west Africa and central America. Across the tropics, the median effectiveness of PAs at the national level improved with gross domestic product per capita. Whilst tropical and subtropical moist forest PAs do reduce forest loss, widely varying performance suggests substantial opportunities for improved protection, particularly in Asia.

Müllerian adenosarcoma of the uterus. Clinicopathologic report of five cases.

The clinicopathologic features of five cases of müllerian adenosarcoma of the uterus are presented and are compared with those of previously reported cases. Four tumors were localized in the endometrium; in one case, a cervical or endometrial origin was not clear. The ages of the patients ranged from 53 to 79 years. Two died without clinical evidence of recurrence 19 and 18 years after hysterectomy. One was alive and well 10 years postoperatively and one was lost to follow-up 6 months after therapy. In one case, a first abdominal recurrence was resected 5 years and 9 months after hysterectomy; the patient died of a second abdominal recurrence 18 months later. The tumors were bulky polypoid masses producing metrorrhagia. Histologically, a sarcomatous component was intimately associated with benign epithelium of various müllerian types. The neoplasm was typically organized in papillary fronds and periglandular sarcomatous cuffs. Cystic glands were also a constant feature. Mitoses were generally fewer than 10 per 10 high-power fields, except in one case where they were 44 in a more malignant-appearing area. Adenosarcoma must be differentiated from other müllerian tumors, mainly carcinosarcoma whose prognosis is much less favorable.

Trophoblastic pseudotumor of the uterus: clinicopathologic report with immunohistochemical and ultrastructural studies.

The clinicopathologic feature of two cases of trophoblastic pseudotumor of the uterus are presented and compared with previously reported cases. In both cases, cancer was erroneously diagnosed. One patient, 27 years of age when first examined, presented metrorrhagia 10 months after a full-term delivery. The lesion was entirely removed by curettage and was no longer found in the hysterectomy specimen. The patient is alive and well more than 17 years after therapy. The other patient, 36 years of age at the initial examination, presented with metrorrhagia 23 months after a therapeutic abortion. The pseudotumor infiltrated the full thickness of the uterine wall. The patient is alive and well 3 years and 7 months after hysterectomy and radiation therapy. Histologically, the tumor consisted of large cells invading the myometrium in small clusters either as cords or as single cells. There were 2 mitoses/10 HPF of which some were atypical. Tumor cells containing chorionic gonadotropin (hCG) and a pregnancy-specific protein (SP1) were demonstrated immunohistochemically (alpha 2-PAG) and placental lactogen (hPL) in one case. Ultrastructurally, trophoblastic pseudotumor closely resembled cytotrophoblastic cells of the basal plate of the placenta.

Placental site trophoblastic tumor (trophoblastic pseudotumor) of the uterus with metastases and fatal outcome. Clinical and autopsy observations of a case.

A 41-year-old woman who 5 years earlier had a hysterectomy for a placental site trophoblastic tumor (formerly called trophoblastic pseudotumor) was readmitted to the hospital with pelvic recurrence and multiple lung metastases. Despite an initial decrease in the size of the lung metastases and concomitant lowering of the serum values of human chorionic gonadotropin (beta-HCG) from 2,200 to 40 ng/ml, combined chemotherapy became ineffective. The patient died 4 months later with widespread metastases. The clinical course and the autopsy findings of this case are reported and compared with the two similar cases reported in the literature.

Autoimmune oophoritis.

A 43-year-old para 3 woman presented with a six-year history of progressive oligomenorrhea and hypomenorrhea. A total abdominal hysterectomy with bilateral salpingo-oophorectomy was performed for the suspicion of ovarian cysts. On histologic examination, the ovaries contained lymphocytic and plasma cell infiltrates in relation to the theca interna of growing follicles, to the corpora lutea and to the endocrine hilar cells. The infiltrates increased in density with the follicular maturation and culminated against the corpora lutea. The plasma cell population was polyclonal. No antibodies to ovarian tissue components could be demonstrated in the patient's serum by means of immunohistochemistry; but antibodies to the zona glomerulosa of adrenal cortex were detected by serologic means. Although a rare disease, autoimmune oophoritis must be recognized histologically because it is a cause of ovarian failure and because it indicates that the patient is at risk of developing associated Addison's disease.

Ovarian hypoplasia with follicular calcifications.

The clinical features and the ovary biopsy findings of two cases of ovarian hypoplasia are presented. Both patients, 20 and 34 years of age, complained of primary amenorrhea. One patient presented growth retardation with genital and breast infantilism. The other patient, who received substitutive estrogen therapy, displayed normal adult secondary sexual characteristics. The chromosomal karyotype was 46,XX in both patients. The internal genital organs were hypoplastic. In the ovaries, the follicular maturation did not go beyond the secondary follicles which underwent atresia with a strange process of calcification beginning in the ova. The etiologic factors of this phenomenon are unknown. The authors found only one analogous case in the literature.

Post-operative pseudosarcoma of the vagina. A case report.

We report a case of a post-operative vaginal pseudosarcoma occurring in a 38 year old woman and we briefly review the literature.

Bronchial granular-cell tumor. Report of a case with preoperative cytologic diagnosis on bronchial brushings and immunohistochemical studies.

A 42-year-old man presented with a polypoid endobronchial mass of the right apical segmental bronchus. Bronchial brushing smears contained clusters of cells exhibiting abundant diffusely granular cytoplasm with indistinct borders. A cytologic diagnosis of granular-cell tumor was rendered. Histologic examination of the upper right lobectomy specimen provided confirmation. Immunohistochemically, the granular cells strongly reacted with the S-100 protein antibody. This case demonstrates that the cytologic diagnosis of bronchial granular-cell tumor is possible if this lesion is considered in the differential diagnosis of lung tumors.

[Ovarian carcinoid tumors: immunohistochemical and ultrastructural study of 8 cases]. / Carcinoïdes ovariens: étude immunohistochimique et ultrastructurale de 8 cas.

Eight ovarian carcinoids, 4 trabecular and 4 strumal have been studied immunohistochemically for polypeptide hormones; three of them were also examined with the electron microscope. Seven of eight cases were positive for at least one polypeptide hormone. The trabecular parts of the 4 cases of strumal carcinoid were positive for pancreatic polypeptide. As the vesicular regions of these 4 cases were positive for thyroglobulin and for pancreatic polypeptide, we suspect the existence of "hybrid" thyroid and neuroendocrine cells. The electron microscopic examination revealed: the cell in the insular carcinoid had no distinct polarization and contained electron-dense granules of varying shape; in the trabecular part of the strumal carcinoid the cells were polarized and contained round electron-dense granules.

[Sclerosing tumour of the ovarian stroma. A case history (author's transl)]. / Tumeur sclérosante du stroma ovarien. Présentation d'un cas.

An anatomo-clinical presentation of a benign sclerosing tumour of the ovarian stroma brings the number of such cases reported, as far as we can tell, in the literature to 13. Removal of this tumour from a woman of 26 years of age rapidly solved the problem of her sterility. The patient is in good health more than 6 years after the operation. From the histopathological point of view the tumour is characterised especially by a tissue arranged in intensely vasculaised lobules, which are rich in ballooned-but cells filled with lipids and followed by sclerosis.

[Blue naevus of the cervix. 3 case histories (author's transl)]. / Naevus bleu du col utérin. A propos de 3 cas.

Anatomo-pathological features of 3 cases of blue naevi of the cervix are presented and discussed together with the literature. Blue naevi of the cervix are localised in the chorion of the endocervical mucus and sometimes even in a polyp, and can be multiple. They are different from benign melanosis or melanocytes which are found in the basal portion of the malpighian epithelium of the exocervix or the vagina. The blue naevus and benign melanosis can rarely give rise to primitive malignant melanomas of the cervix.

[The endolymphatic myosis: a low grad stromal endometrial sarcoma. I. Pathology (author's transl)]. / La myose endolymphatique, sarcome "low grade" du stroma endométrial. I. Anatomie pathologique.

The authors present 6 cases of endolymphatic myosis of endometrial stroma. All patients with known evolutions were alive between 4 months and 17 years after treatment in spite of 2 relapses. Pathological aspect of this rare lesion is characterized by penetration of stromal endometrial tumoral tissue without glands in both lymphatic and venous myonatrial vessels. In certain cases, the presence of polypes of this structure allows the diagnostic by dilatation and analogy Progestine induces a predecidual transformation of this lesion. The myosis belongs to the endometrial stromal sarcoma. The lesion is however different by its low mitotic index.

[Endolymphatic myosis low grade sarcoma of the endometrical stroma. II. Clinical (author's transl)]. / La myose endolymphatique, sarcome "low grade" du stroma endométrial. II. Clinique.

Various clinical parameters of myosis have been reviewed in the light of the literature. This is a rare tumour which manifests itself generally by metrorrhagia in the pre- or perimenopausal age groups. The first treatment which among other operative forms of treatment offers the best prognostic chances is total hysterectomy with bilateral salpingo-oophorectomy. Radiotherapy and endocrine therapy with progestogens have their place in cases of relapse of metastases. There are several anatomo-pathological and clinical features which point to the fact that stromal myosis is hormone-dependent.

[Chylous ascites: apropos of a case of endometrial adenocarcinoma associated with homologous carcinosarcoma of a fallopian tube]. / Ascite chyleuse: à propos d'un cas d'adénocarcinome de l'endomètre associé à un carcinosarcome homologue d'une trompe.

A patient who was 61 years of age had obstruction of the thoracic duct by metastases from an adenocarcinoma of the endometrium together with a carcinosarcoma of the tube. She developed chylous ascite. The diagnostic approach and the treatment has been reviewed by the authors.

[Giant cell arteritis affecting the female genital tract. 2 case reports]. / Artérite à cellules géantes à localisation gynécologique. Présentation de 2 cas.

Localisation of giant cell arteritis in the female genital organs is very rarely found in sections removed at operation, although this kind of arteritis is a systemic condition. This article reports two new cases to add to the seven cases that have already been reported in the literature. The first case was that of a woman of 78 year of age who was investigated because she had fever, dyspnoea, pains in her chest, pronounced debility and loss of weight. A salpingo-oophorectomy was carried out because she had a parovarian cyst which proved to be benign. Unexpectedly however histological examination revealed that she had giant cell arteritis in the ovary and in the tube, and this diagnosis explained the clinical picture. The second case was that of a 75 years old woman treated intermittently over two years with Prednisone for vague arthralgia. When she had had a sub-total hysterectomy with bilateral salpingo-oophorectomy because of fibroids the organs were removed in order to improve her urinary incontinence and the giant cell arteritis was discovered histologically in the uterus, the ovaries and the tubes. In this second case the unexpected diagnosis clarified the clinical picture.

[Early diagnosis of premalignant and malignant lesions of the endometrium. Evaluation of a device for collecting intrauterine samples (the Inocurette) compared with exploratory curettage]. / Le diagnostic précoce des lésions prémalignes et malignes de l'endomètre. Evaluation d'un dispositif de prélèvement intra-utérin (Inocurette) par comparaison avec le curetage explorateur.

Screening methods for detecting more accurately carcinoma of the endometrium is becoming increasingly important because of the rising incidence of the condition. Inocurette has recently been invented to combine a scraping action with suction. This study investigates 385 patients who were admitted for diagnostic curettage or hysterectomy to which were added a series of 120 patients who were examined as out patients. Inocurette has a sensitivity of 86% and a specificity of 99%. It therefore can be considered as a reliable method of screening for the limits within which fractional diagnostic curettage should be used. Marked pain and great difficulty in introducing the apparatus made its use limited in respectively 15% and 14.5% of cases. So, the method is acceptable and useful within these limits. The results could be improved if on the one hand a thinner apparatus could be designed and on the other hand a substance could be found to soften the cervix so that it became easier to introduce the apparatus.