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.

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.

[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.

Epidemiologic pathology of ovarian cancer from the Vaud Cancer Registry, Switzerland.

OBJECTIVE: To provide further information on the descriptive epidemiology and survival of ovarian cancer patients by specific histologic types. STUDY DESIGN: Descriptive epidemiological study. Cases of ovarian cancer registered between 1974 and 1988 in the Vaud Cancer Registry, Switzerland (based on a population of approximately 530,000 inhabitants), were analysed. RESULTS: A total of 649 cases were registered, corresponding to an overall age-standardized (world population) incidence of 9.6/100,000. The most common histotype was serous carcinoma (41%, incidence rate 4.0/100,000), followed by endometrioid (13%), mucinous (12%), clear cell (5%), and undifferentiated carcinomas (3%); 20% of the cases were classified as 'epithelial, unspecified', and 6% were non-epithelial cancers. There was a tendency for the incidence of all epithelial types to rise up to the seventh decade of age, and to level off thereafter. The increases between the ages of 45 and 65 were, however, mostly in serous carcinomas whose proportion of total ovarian epithelial cancer peaked in middle age. Overall, 5-year relative survival was 32%. Survival rate was 32% for serous carcinomas, but was significantly higher for endometrioid (51%) and, among nonepithelial neoplasms, for germ-cell cancers (68%). Survival rates were poor for undifferentiated and 'epithelial, unspecified' carcinomas (16%). Relative survival was systematically higher below age 60 than at age 60 or over. In the two subsequent calendar periods examined (divided according to the approximate time when the use of platinum-based chemotherapy began to spread, i.e., 1982), 5-year relative survival rates were 28% and 36%, respectively (chi 1(2) = 6.1, p = 0.02). CONCLUSION: The present report is a population-based description of the epidemiologic pathology and prognosis of ovarian cancer, and provides evidence of a significant improvement of survival over the past decade. This may be due to changed diagnostic methods (e.g., ultrasonography), improved surgical approach, (platinum-based) chemotherapy, or a combination of all these factors.

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.

[Malacoplakia of the vagina. Cytological, histological and ultrastructural study of a case]. / Malacoplasie du vagin. Etude cytologique, histologique et ultrastructurale d'un cas.

A case of vaginal malakoplakia is reported in a 65 year old patient receiving prednisone for fifteen months for the treatment of collagen colitis. The macroscopic and microscopic appearance, cytological examination of the vaginal smear and ultrastructural examination were typical of malakoplakia. To our knowledge, this is the seventh detailed case of vaginal malakoplakia and the twenty-sixth case of malakoplakia of the female genital tract.

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.

[Necrotic oophoritis due to cytomegalovirus]. / Ovarite nécrosante à cytomégalovirus.

In a 54-year-old woman with malignant lymphoma, cytomegalovirus oophoritis was disclosed at autopsy. The virus, which is recognized by its typical nuclear inclusions, reaches the cortical stroma of the ovaries and causes zones of necrosis there. Its presence is confirmed by ultrastructural and immunohistochemical examination. The real frequency of ovarian involvement is difficult to evaluate since histological examination of ovaries is not routinely performed at autopsy. As far as we know the present case is the seventh detailed observation of cytomegalovirus oophoritis published in the literature.

[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.

Cervical intraepithelial glandular neoplasia (adenocarcinoma in situ and glandular dysplasia). A correlative study of 23 cases with histologic grading, histochemical analysis of mucins, and immunohistochemical determination of the affinity for four lectins.

Twenty-three cases of cervical intraepithelial glandular neoplasia (CIGN)--a term encompassing adenocarcinoma in situ and glandular dysplasia of the uterine cervix--were studied histologically, histochemically for mucins (neutral mucins, sialomucins and sulfomucins), and immunohistochemically for the affinity of four lectins (WGA, PNA, RCA, UEA). For comparison, six cases of cervical invasive adenocarcinoma and ten cases of cervices without tumor were similarly studied. Criteria for histologic grading of CIGN into three degrees were proposed according to the hyperchromasia and the stratification of nuclei, number of mitoses, and amount of intracellular mucin. Two different types of CIGN were distinguished according to their histological aspect and their mucin pattern: CIGN type A, where the mucin pattern was qualitatively similar to that of normal endocervical mucosa, i.e., neutral mucins, sulfomucins and sialomucins; and CIGN type B, where the glandular cells resembled small intestinal goblet cells and the mucins consisted of neutral mucins and sialomucins with the absence of sulfomucins. Nine cases of CIGN were of type A, 2 of type B, and 12 of both type A and B. Differences in lectin binding existed between normal columnar cells, CIGN, and invasive adenocarcinomas, as well as between CIGN of type A and B. The intensity of the positive immunochemical reaction varied, as well as the type of binded lectin and its localization in the cell. There was a great heterogeneity in the same histologic group from one case to another, and even in the same case from one cell to another.

[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.

[Detectability of glaucomatous visual field defects with the Octopus automatic perimeter. A comparison between program G-1 and programs 31 and 32 and their combinations]. / Die Erfassbarkeit glaukomatöser Gesichtsfeldausfälle mit dem automatischen Perimeter Oktopus. Ein Vergleich zwischen Programm G-1 und den Programmen 31 und 32 und deren Kombination.

Twenty-three patients between 31 and 76 years of age suffering from either hypertension or glaucoma underwent automatic perimetry with Octopus programs 31 or 32, followed by program G-1. This was done to compare the information content of the latter, new program with that of the former two, long-used in different combinations. Only one eye of any one patient was considered in this study. Using an evaluation program, the G-1 program calculates the so-called "field indices" which help to interpret the results. These field indices are the mean differential light sensitivity threshold (mDLS), the mean defect (MD), the loss variance (LV), and the corrected loss variance (corrected for short-term fluctuations (CLV)). In order to compare programs 31, 32, and their combination 31 + 32, with the field indices of program G-1, the mean DLS was taken from the Delta evaluation program, while the mean defect, the loss variance, and the corrected loss variance were calculated on the basis of programs 31, 32, and the combination of them. The mDLS and mean defect determined with program G-1 were significantly different from those found with programs 31, 32, and the combination of them. On the one hand, this was due to the difference in test patterns, that of G-1 being more centrally weighted; on the other hand, this is indicative of the precision and discrimination capability of Octopus measurements. Calculation of loss variance and corrected loss variance reveals no significant difference between the examination methods as regards these field indices, that is, between G-1 and 31, 32, or 31 + 32.(ABSTRACT TRUNCATED AT 250 WORDS)

[Prevalence of infectious diseases at the Vaud University Hospital Center]. / Prévalence des maladies infectieuses au Centre hospitalier universitaire vaudois.

The prevalence of infectious diseases at our hospital (Centre hospitalier universitaire vaudois, Lausanne [CHUV], 900 beds) was studied retrospectively over a two years period (1980-1981). The medical diagnosis of 30203 patients recorded in the computerized medical archives, representing 93% of the patients admitted during the period of observation, was reviewed. To assess the reliability of the computerized data, quality control was carried out through detailed analysis of all the histologically proven appendicitis recorded during 1981. 88% of the histologically proven appendicitis were registered in the computer and the diagnosis was specific in 87% of cases. An infectious disease was the primary reason for admission in 12.8% of the patients (3873) during the study period. Altogether, 20.2% of patients presented with an infection during their hospital stay. Because of the retrospective nature of the study it was not possible to determine whether these additional infections were nosocomially acquired. The organ systems most frequently infected were the respiratory tract (28.5% of all infections), the digestive tract (20.5%), the skin and osteoarticular system (16%) and the urogenital tract (11.6%). An infection was the primary reason for admission of 40.2% of the patients hospitalized in the dermatology service, of 19.7% of patients admitted in internal medicine, of 15-17% of the patients admitted in pediatrics, ENT and general surgery, and of 1-2% of the patients admitted in neurosurgery and radiotherapy. These observations highlight the continuing importance of infectious diseases in a modern hospital, in spite of high socio-economic levels, stringent hygiene and epidemiologic measures, and modern antibiotic availability.

Adenocarcinoma in situ and invasive adenocarcinoma of the uterine cervix. An immunohistologic study with antibodies specific for several epithelial markers.

The distribution of carcinoembryonic antigen (CEA), secretory component (SC), fat globule membrane antigens ( FGMA ), and keratin was determined immunohistochemically in 22 invasive adenocarcinomas of various types and in 9 adenocarcinomas in situ of the uterine cervix. In the invasive adenocarcinomas 77% were positive for CEA, 47% for SC, 89% for keratin, and 77% for FGMA . In adenocarcinomas in situ 67% were positive for CEA, 11% for SC, and 44% for keratin. The location of the markers was variable in the cells, and the cells in a tumor were irregularly positive. For a given histologic type there were several phenotypes. No correlation was found between histologic types of invasive adenocarcinomas and the various phenotypes. It remains to be shown whether a particular phenotype has a particular biological behavior. The detection in the serum of the markers shown in histologic preparations could be useful in the postsurgical monitoring.

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.

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.

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.