Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 50
Filtrar
1.
Proc Natl Acad Sci U S A ; 119(2)2022 01 11.
Artigo em Inglês | MEDLINE | ID: mdl-34983872

RESUMO

Deforestation affects local and regional hydroclimate through changes in heating and moistening of the atmosphere. In the tropics, deforestation leads to warming, but its impact on rainfall is more complex, as it depends on spatial scale and synoptic forcing. Most studies have focused on Amazonia, highlighting that forest edges locally enhance convective rainfall, whereas rainfall decreases over drier, more extensive, deforested regions. Here, we examine Southern West Africa (SWA), an example of "late-stage" deforestation, ongoing since 1900 within a 300-km coastal belt. From three decades of satellite data, we demonstrate that the upward trend in convective activity is strongly modulated by deforestation patterns. The frequency of afternoon storms is enhanced over and downstream of deforested patches on length scales from 16 to 196 km, with greater increases for larger patches. The results are consistent with the triggering of storms by mesoscale circulations due to landscape heterogeneity. Near the coast, where sea breeze convection dominates the diurnal cycle, storm frequency has doubled in deforested areas, attributable to enhanced land-sea thermal contrast. These areas include fast-growing cities such as Freetown and Monrovia, where enhanced storm frequency coincides with high vulnerability to flash flooding. The proximity of the ocean likely explains why ongoing deforestation across SWA continues to increase storminess, as it favors the impact of mesoscale dynamics over moisture availability. The coastal location of deforestation in SWA is typical of many tropical deforestation hotspots, and the processes highlighted here are likely to be of wider global relevance.


Assuntos
Processos Climáticos , Conservação dos Recursos Naturais/tendências , África Ocidental , Agricultura , Brasil , Inundações , Florestas , Namíbia , Chuva , Árvores
2.
Nature ; 544(7651): 475-478, 2017 04 26.
Artigo em Inglês | MEDLINE | ID: mdl-28447639

RESUMO

The hydrological cycle is expected to intensify under global warming, with studies reporting more frequent extreme rain events in many regions of the world, and predicting increases in future flood frequency. Such early, predominantly mid-latitude observations are essential because of shortcomings within climate models in their depiction of convective rainfall. A globally important group of intense storms-mesoscale convective systems (MCSs)-poses a particular challenge, because they organize dynamically on spatial scales that cannot be resolved by conventional climate models. Here, we use 35 years of satellite observations from the West African Sahel to reveal a persistent increase in the frequency of the most intense MCSs. Sahelian storms are some of the most powerful on the planet, and rain gauges in this region have recorded a rise in 'extreme' daily rainfall totals. We find that intense MCS frequency is only weakly related to the multidecadal recovery of Sahel annual rainfall, but is highly correlated with global land temperatures. Analysis of trends across Africa reveals that MCS intensification is limited to a narrow band south of the Sahara desert. During this period, wet-season Sahelian temperatures have not risen, ruling out the possibility that rainfall has intensified in response to locally warmer conditions. On the other hand, the meridional temperature gradient spanning the Sahel has increased in recent decades, consistent with anthropogenic forcing driving enhanced Saharan warming. We argue that Saharan warming intensifies convection within Sahelian MCSs through increased wind shear and changes to the Saharan air layer. The meridional gradient is projected to strengthen throughout the twenty-first century, suggesting that the Sahel will experience particularly marked increases in extreme rain. The remarkably rapid intensification of Sahelian MCSs since the 1980s sheds new light on the response of organized tropical convection to global warming, and challenges conventional projections made by general circulation models.


Assuntos
Inundações/estatística & dados numéricos , Chuva , Imagens de Satélites , África Subsaariana , África do Norte , Convecção , Aquecimento Global/estatística & dados numéricos , Modelos Teóricos , Estações do Ano , Temperatura , Ciclo Hidrológico , Vento
3.
Angew Chem Int Ed Engl ; 60(32): 17556-17563, 2021 Aug 02.
Artigo em Inglês | MEDLINE | ID: mdl-33979473

RESUMO

We report the first experimental investigation of porous organic cages (POCs) for the demanding challenge of SO2 capture. Three structurally related N-containing cage molecular materials were studied. An imine-functionalized POC (CC3) showed modest and reversible SO2 capture, while a secondary-amine POC (RCC3) exhibited high but irreversible SO2 capture. A tertiary amine POC (6FT-RCC3) demonstrated very high SO2 capture (13.78 mmol g-1 ; 16.4 SO2 molecules per cage) combined with excellent reversibility for at least 50 adsorption-desorption cycles. The adsorption behavior was investigated by FTIR spectroscopy, 13 C CP-MAS NMR experiments, and computational calculations.

4.
Angew Chem Int Ed Engl ; 59(32): 13371-13378, 2020 Aug 03.
Artigo em Inglês | MEDLINE | ID: mdl-32383492

RESUMO

The invention of inverse vulcanization provides great opportunities for generating functional polymers directly from elemental sulfur, an industrial by-product. However, unsatisfactory mechanical properties have limited the scope for wider applications of these exciting materials. Here, we report an effective synthesis method that significantly improves mechanical properties of sulfur-polymers and allows control of performance. A linear pre-polymer containing hydroxyl functional group was produced, which could be stored at room temperature for long periods of time. This pre-polymer was then further crosslinked by difunctional isocyanate secondary crosslinker. By adjusting the molar ratio of crosslinking functional groups, the tensile strength was controlled, ranging from 0.14±0.01 MPa to 20.17±2.18 MPa, and strain was varied from 11.85±0.88 % to 51.20±5.75 %. Control of hardness, flexibility, solubility and function of the material were also demonstrated. We were able to produce materials with suitable combination of flexibility and strength, with excellent shape memory function. Combined with the unique dynamic property of S-S bonds, these polymer networks have an attractive, vitrimer-like ability for being reshaped and recycled, despite their crosslinked structures. This new synthesis method could open the door for wider applications of sustainable sulfur-polymers.

5.
Chemistry ; 25(44): 10433-10440, 2019 Aug 06.
Artigo em Inglês | MEDLINE | ID: mdl-31136036

RESUMO

Sulfur is an underused by-product of the petrochemicals industry. Recent research into inverse vulcanization has shown how this excess sulfur can be transformed into functional polymers, by stabilization with organic crosslinkers. For these interesting new materials to realize their potential for applications, more understanding and control of their physical properties is needed. Here we report four new terpolymers prepared from sulfur and two distinct alkene monomers that can be predictively tuned in glass transition, molecular weight, solubility, mechanical properties, and color.

6.
J Cutan Pathol ; 46(6): 452-454, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30811629

RESUMO

We present histologic features of a locally advanced cutaneous squamous cell carcinoma (cSCC) treated with the programmed cell death protein-1 (PD-1) antagonist, pembrolizumab, with a partial response. This contributes to a growing body of literature supporting the efficacy of pembrolizumab in treatment of surgically unresectable cSCC. We also provide a detailed description of the histologic features, particularly keratin granulomata with adjacent lymphocytic aggregates and fibrosis, observed in cSCC under treatment with a PD-1 antagonist.


Assuntos
Anticorpos Monoclonais Humanizados/administração & dosagem , Carcinoma de Células Escamosas , Neoplasias Labiais , Neoplasias Cutâneas , Carcinoma de Células Escamosas/tratamento farmacológico , Carcinoma de Células Escamosas/metabolismo , Carcinoma de Células Escamosas/patologia , Feminino , Humanos , Neoplasias Labiais/tratamento farmacológico , Neoplasias Labiais/metabolismo , Neoplasias Labiais/patologia , Pessoa de Meia-Idade , Proteínas de Neoplasias/antagonistas & inibidores , Proteínas de Neoplasias/metabolismo , Receptor de Morte Celular Programada 1/antagonistas & inibidores , Receptor de Morte Celular Programada 1/metabolismo , Neoplasias Cutâneas/tratamento farmacológico , Neoplasias Cutâneas/metabolismo , Neoplasias Cutâneas/patologia
7.
J Cutan Pathol ; 44(8): 713-721, 2017 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-28556973

RESUMO

PEComas represent a family of uncommon mesenchymal tumors composed of "perivascular epithelioid cells" with a distinct immunophenotype that typically shows both myogenic and melanocytic differentiation. The PEComa family includes angiomyolipoma (AML), clear cell "sugar" tumor of the lung and extra pulmonary sites, lymphangioleiomyomatosis and clear cell myomelanocytic tumor of the falciform ligament/ligamentum teres. Very rarely, PEComas may arise in the skin. Primary cutaneous PEComas typically display a dermal proliferation of epithelioid cells with pale, clear, or granular pink cytoplasm arranged in nests and trabecula with an intervening arborizing network of delicate capillaries. Primary cutaneous PEComas have a lower frequency of myogenic marker expression than their deep soft tissue and visceral counterparts. They also often express strong diffuse CD10, leading to potential confusion with metastatic renal cell carcinoma. Most cases behave indolently. We report 5 additional cases of this rare entity. All showed classic histologic features and expression of either HMB-45 and/or Melan-A/MART-1. Four cases were tested for myogenic markers (2 were positive & 2 were negative). Three cases were tested for CD10 (all 3 were positive). All of our cases with clinical follow-up behaved indolently. Table 1 provides a summary of findings for all 5 cases in our series.


Assuntos
Proliferação de Células , Derme , Proteínas de Neoplasias/metabolismo , Neoplasias de Células Epitelioides Perivasculares , Neoplasias Cutâneas , Adulto , Idoso , Derme/metabolismo , Derme/patologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias de Células Epitelioides Perivasculares/metabolismo , Neoplasias de Células Epitelioides Perivasculares/patologia , Neoplasias Cutâneas/metabolismo , Neoplasias Cutâneas/patologia
8.
J Am Acad Dermatol ; 74(1): 75-80, 2016 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-26514601

RESUMO

BACKGROUND: Histopathologic analysis remains the gold standard for the diagnosis of melanoma, however previous studies have shown a substantial rate of interobserver variability in the evaluation of melanocytic lesions. OBJECTIVE: We sought to evaluate discordance in the histopathological diagnosis and microstaging parameters of melanoma and subsequent impact on clinical management. METHODS: This was a retrospective review of 588 cases of cutaneous melanoma and melanoma in situ from January 2009 to December 2014 that were referred to Emory University Hospital, Atlanta, GA, for treatment. Per institutional policy, all outside melanoma biopsy specimens were reviewed internally. Outside and institutional reports were compared. RESULTS: Disagreement between outside and internal reports resulted in a change in American Joint Committee on Cancer pathologic stage in 114/588 (19%) cases, resulting in a change in management based on National Comprehensive Cancer Network guidelines in 105/588 (18%) cases. LIMITATIONS: Given the retrospective nature of data collection and the bias of a tertiary care referral center, cases in this study may not be representative of all melanoma diagnoses. CONCLUSION: These findings confirm consistent subjectivity in the histopathologic interpretation of melanoma. This study emphasizes that a review of the primary biopsy specimen may lead to significant changes in tumor classification, resulting in meaningful changes in clinical management.


Assuntos
Erros de Diagnóstico/estatística & dados numéricos , Melanoma/patologia , Patologia Clínica/normas , Neoplasias Cutâneas/patologia , Adulto , Idoso , Biópsia por Agulha , Estudos de Coortes , Progressão da Doença , Feminino , Humanos , Imuno-Histoquímica , Masculino , Melanoma/mortalidade , Melanoma/cirurgia , Pessoa de Meia-Idade , Invasividade Neoplásica/patologia , Estadiamento de Neoplasias , Variações Dependentes do Observador , Guias de Prática Clínica como Assunto , Prognóstico , Estudos Retrospectivos , Medição de Risco , Neoplasias Cutâneas/mortalidade , Neoplasias Cutâneas/cirurgia , Análise de Sobrevida , Estados Unidos , Melanoma Maligno Cutâneo
9.
J Cutan Pathol ; 43(3): 276-9, 2016 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-26453895

RESUMO

There are few reported cases of cutaneous intestinal metaplasia or primary adenocarcinoma arising at the ileostomy site following panproctocolectomy. These complications have been seen almost exclusively in patients with familial adenomatous polyposis and inflammatory bowel disease (IBD). However, benign intraepidermal colonic mucosa at a reversed ileostomy site in a patient without familial adenomatous polyposis or IBD has not been documented. We report a case of a 51-year-old female with a history of colonic adenocarcinoma who presented with pruritic, erythematous, scaly plaques on the right lower abdomen, present since reversal of her ileostomy in 2007. Skin biopsy revealed benign foci of colonic epithelium with no evidence of adenomatous change. Benign intraepidermal colonic mucosa was diagnosed based on histopathologic findings and immunohistochemistry. To our knowledge, this is the first case of intraepidermal benign colonic metaplasia forming in a patient following ostomy reversal. The case emphasizes the importance of patient education and physical examination of the stoma or stoma remnants for detection of unusual or changing lesions due to the risk for malignant transformation. It also demonstrates that benign colonic mucosa should be considered in the differential diagnosis when evaluating lesions near ileostomy sites, regardless of whether the patient has a history of familial adenomatous polyposis or IBD.


Assuntos
Colo/patologia , Neoplasias do Colo/patologia , Mucosa Intestinal/patologia , Pele/patologia , Polipose Adenomatosa do Colo , Colo/cirurgia , Neoplasias do Colo/cirurgia , Feminino , Humanos , Metaplasia , Pessoa de Meia-Idade
10.
J Cutan Pathol ; 41(2): 134-8, 2014 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-24188507

RESUMO

Low-grade fibromyxoid sarcoma (LGFMS) represents a rare soft tissue tumor that was first characterized in 1987. LGFMS usually presents as a large, deeply situated mass in adults and is characterized by deceptively bland histopathologic features. LFGMS is less common in superficial soft tissue and in children. It is distinctly uncommon for LGFMS to exhibit nuclear pleomorphism. Herein, we present a case of a 10-year-old male who presented with a subcutaneous back mass that displayed features typical for LGFMS as well as scattered large, hyperchromatic and pleomorphic nuclei. The constellation of clinicopathologic features, including the young age of the patient, the small size and superficial location of the tumor and the presence of scattered nuclear pleomorphism are all unusual features for LGFMS. Fluorescent in situ hybridization (FISH) with a break-apart probe for FUS revealed the presence of a FUS gene rearrangement confirming the diagnosis of LGFMS. This case highlights the importance of maintaining a high index of suspicion for LGFMS even in the context of small, superficially-located tumors, pediatric patients or tumors with scattered nuclear pleomorphism.


Assuntos
Núcleo Celular , Fibroma , Rearranjo Gênico , Proteína FUS de Ligação a RNA , Sarcoma , Neoplasias Cutâneas , Núcleo Celular/genética , Núcleo Celular/metabolismo , Núcleo Celular/patologia , Criança , Fibroma/genética , Fibroma/metabolismo , Fibroma/patologia , Humanos , Hibridização in Situ Fluorescente , Masculino , Proteína FUS de Ligação a RNA/genética , Proteína FUS de Ligação a RNA/metabolismo , Sarcoma/genética , Sarcoma/metabolismo , Sarcoma/patologia , Neoplasias Cutâneas/genética , Neoplasias Cutâneas/metabolismo , Neoplasias Cutâneas/patologia
11.
J Cutan Pathol ; 41(2): 81-7, 2014 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-24251693

RESUMO

BACKGROUND: As histopathologic assessment is subject to sampling error, some institutions 'preorder' deeper sections on some or all cases (hereafter referred to as prospective deeper sections), while others order additional sections only when needed (hereafter referred to as retrospective deeper sections). We investigated how often additional sections changed a diagnosis and/or clinical management. Given the recent decrease in reimbursement for CPT-code 88305, we also considered the financial implications of ordering additional sections. METHODS: Cases (n = 204) were assigned a preliminary diagnosis, based on review of the initial slide, and a final diagnosis, after reviewing additional sections. Cases with discordant diagnoses were assessed by two dermatologists, who indicated whether the change in diagnosis altered clinical management. Expenses were estimated for three scenarios: (a) no additional sections, (b) prospective deeper sections and (c) retrospective deeper sections. RESULTS: Diagnoses were modified in 9% of cases, which changed clinical management in 56% of these cases. Lesions obtained by punch-biopsy and inflammatory lesions were disproportionately overrepresented amongst cases with changed diagnoses (p < 0.001, p = 0.12, respectively). The cost of prospective deeper sections and retrospective deeper sections represented a 56% and 115% increase over base costs, respectively. Labor costs, particularly the cost of dermatopathologist evaluation, were the most significant cost-drivers. CONCLUSIONS: While additional sections improve diagnostic accuracy, they delay turn-around-time and increase expenditures. In our practice, prospective deeper sections are cost effective, however, this may vary by institution.


Assuntos
Microtomia/economia , Microtomia/métodos , Dermatopatias/patologia , Custos e Análise de Custo , Humanos , Patologia Clínica/economia , Patologia Clínica/métodos
12.
Am J Dermatopathol ; 36(9): e163-6, 2014 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-25062259

RESUMO

INTRODUCTION: Adenoid cystic carcinoma (ACC) is a rare carcinoma that typically arises in salivary glands but can also occur in other sites including skin. Primary salivary ACC is a locally aggressive tumor characterized by local recurrence and late metastasis. Primary cutaneous ACC is found predominately on the scalp and is more indolent than salivary ACC; and, despite a high incidence of local recurrence, metastases are exceedingly rare. METHODS: A 62-year-old white male presented with a 6-mm mobile, blue-tinted nodule on the left mid scalp unchanged for several years. RESULTS: The histopathological findings of an excisional biopsy were diagnostic for a primary cutaneous ACC. Immunohistochemistry demonstrated focal positivity for p16. CONCLUSIONS: Primary cutaneous ACC is a rare malignancy that should be considered in the differential diagnosis of adnexal neoplasms and, when occurring on the head and neck, must be distinguished from cutaneous involvement by salivary ACC. The majority of reported salivary ACC with p16 protein expression were not positive for high-risk human papilloma virus by in situ hybridization. Immunostaining for p16 has previously been reported in salivary gland ACC. This is the first report in the English literature of p16 immunoexpression in primary cutaneous ACC.


Assuntos
Carcinoma Adenoide Cístico/patologia , Neoplasias de Cabeça e Pescoço/patologia , Proteínas de Neoplasias/biossíntese , Couro Cabeludo/patologia , Neoplasias Cutâneas/patologia , Biomarcadores Tumorais/análise , Inibidor p16 de Quinase Dependente de Ciclina , Humanos , Masculino , Pessoa de Meia-Idade , Proteínas de Neoplasias/análise
13.
Am J Surg Pathol ; 48(5): 538-545, 2024 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-38525831

RESUMO

Drivers of Spitz neoplasms include activating point mutations in HRAS and Spitz-associated genomic fusions. It has become evident that some BRAF -mutated melanocytic neoplasms can morphologically mimic Spitz tumors (STs). These have been termed BRAF mutated and morphologically spitzoid (BAMS). In this study, 17 experts from the International Melanoma Pathology Study Group assessed 54 cases which included 40 BAMS and 14 true STs. The participants reviewed the cases blinded to the genomic data and selected among several diagnostic options, including BAMS, ST, melanoma, and other. A total of 38% of all diagnostic selections in the BAMS cases were for BAMS, whereas 32% were for ST. In 22 of the BAMS cases, the favored diagnosis was BAMS, whereas in 17 of the BAMS cases, the favored diagnosis was ST. Among the 20 cases in the total group of 54 with the highest number of votes for ST, half were BAMS. Of BAMS, 75% had a number of votes for ST that was within the SD of votes for ST seen among true ST cases. There was poor interobserver agreement for the precise diagnosis of the BAMS (kappa = 0.16) but good agreement that these cases were not melanoma (kappa = 0.7). BAMS nevi/tumors can closely mimic Spitz neoplasms. Expert melanoma pathologists in this study favored a diagnosis of ST in nearly half of the BAMS cases. There are BAMS cases that even experts cannot morphologically distinguish from true Spitz neoplasms.


Assuntos
Melanoma , Nevo de Células Epitelioides e Fusiformes , Nevo , Neoplasias Cutâneas , Humanos , Melanoma/diagnóstico , Melanoma/genética , Melanoma/patologia , Neoplasias Cutâneas/diagnóstico , Neoplasias Cutâneas/genética , Neoplasias Cutâneas/patologia , Proteínas Proto-Oncogênicas B-raf/genética , Nevo de Células Epitelioides e Fusiformes/diagnóstico , Nevo de Células Epitelioides e Fusiformes/genética , Nevo/diagnóstico , Diagnóstico Diferencial
14.
Am J Surg Pathol ; 48(6): 708-718, 2024 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-38590014

RESUMO

Next-generation sequencing (NGS) is increasingly being utilized as an ancillary tool for diagnostically challenging melanocytic neoplasms. It is incumbent upon the pathology community to perform studies assessing the benefits and limitations of these tools in specific diagnostic scenarios. One of the most challenging diagnostic scenarios faced by skin pathologists involves accurate diagnosis of desmoplastic melanocytic neoplasms (DMNs). In this study, 20 expert melanoma pathologists rendered a diagnosis on 47 DMNs based on hematoxylin and eosin sections with demographic information. After submitting their diagnosis, the experts were given the same cases, but this time with comprehensive genomic sequencing results, and asked to render a diagnosis again. Identification of desmoplastic melanoma (DM) improved by 7%, and this difference was statistically significant ( P <0.05). In addition, among the 15 melanoma cases, in the pregenomic assessment, only 12 were favored to be DM by the experts, while after genomics, this improved to 14 of the cases being favored to be DM. In fact, some cases resulting in metastatic disease had a substantial increase in the number of experts recognizing them as DM after genomics. The impact of the genomic findings was less dramatic among benign and intermediate-grade desmoplastic tumors (BIDTs). Interobserver agreement also improved, with the Fleiss multirater Kappa being 0.36 before genomics to 0.4 after genomics. NGS has the potential to improve diagnostic accuracy in the assessment of desmoplastic melanocytic tumors. The degree of improvement will be most substantial among pathologists with some background and experience in bioinformatics and melanoma genetics.


Assuntos
Sequenciamento de Nucleotídeos em Larga Escala , Melanoma , Variações Dependentes do Observador , Neoplasias Cutâneas , Humanos , Melanoma/genética , Melanoma/diagnóstico , Melanoma/patologia , Neoplasias Cutâneas/genética , Neoplasias Cutâneas/patologia , Neoplasias Cutâneas/diagnóstico , Feminino , Masculino , Reprodutibilidade dos Testes , Valor Preditivo dos Testes , Pessoa de Meia-Idade , Adulto , Idoso , Patologistas , Biomarcadores Tumorais/genética
15.
J Refract Surg ; 29(2): 133-9, 2013 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-23380415

RESUMO

PURPOSE: Objective evaluation of accommodation with a bilateral accommodating intraocular lens (IOL) versus monofocal IOLs. METHODS: Patients received accommodating IOL (Crystalens HD; Bausch & Lomb, Rochester, NY) bilaterally after cataract surgery. These were compared to a matched group receiving monofocal IOLs. Preoperative and postoperative distance corrected distance, intermediate, and near vision were evaluated. Objective accommodation was measured with the WAM-5500 Binocular Autorefractor/Keratometer (Grand Seiko, Pty Ltd., Hiroshima, Japan). RESULTS: Nineteen patients were included. Ten received the Crystalens HD in both eyes and nine received one of three monofocal lenses in each eye. Mean postoperative distance corrected distance visual acuity was not statistically different between the two groups. Mean distance corrected intermediate vision was better in the Crystalens HD group (logMAR 0.24 ± 0.11 [control], logMAR 0.11 ± 0.10 [Crystalens HD], P = .033). The groups did not differ significantly for mean distance corrected near vision (logMAR 0.54 ± 0.12 [control], logMAR 0.42 ± 0.15 [Crystalens HD], P = .087). However, a significantly greater proportion of Crystalens HD eyes achieved 0.4 or 0.3 logMAR for near wearing their distance correction (P = .013). With distance correction, the mean spherical equivalent failed to show any myopia with accommodative effort in either group. Low contrast and low luminance contrast acuity were not significantly different. CONCLUSION: The Crystalens HD showed some benefit for intermediate visual function compared to the monofocal IOLs with both groups wearing full correction for distance. There were no significant signs of accommodation in either group.


Assuntos
Acomodação Ocular/fisiologia , Implante de Lente Intraocular , Lentes Intraoculares , Facoemulsificação , Pseudofacia/fisiopatologia , Idoso , Idoso de 80 Anos ou mais , Estudos de Casos e Controles , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Desenho de Prótese , Refração Ocular/fisiologia , Acuidade Visual/fisiologia
16.
J Cutan Pathol ; 40(10): 909-13, 2013 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-24033835

RESUMO

Epithelioid sarcoma-like (pseudomyogenic) hemangioendothelioma (ESHE) represents a rare soft tissue and bone tumor that typically presents as nodule(s) in the distal extremities of young adults. The nodules traverse several tissue planes simultaneously and can involve the dermis, subcutis, skeletal muscle and bone. ESHE shares clinical and microscopic features with epithelioid sarcoma (ES), and, accordingly, is commonly misdiagnosed as ES. However, unlike ES, which has a poor prognosis, ESHE commonly follows an indolent course. Herein, we report a case of ESHE diagnosed by skin biopsy that clinically mimicked a dermatofibroma. We also provide clinical photographs of the lesions in various stages of development, representing information that has not been previously published, to our knowledge.


Assuntos
Hemangioendotelioma/patologia , Histiocitoma Fibroso Benigno/patologia , Sarcoma/patologia , Neoplasias Cutâneas/patologia , Adulto , Biópsia , Diagnóstico Diferencial , Humanos , Masculino
17.
Head Neck Pathol ; 17(3): 673-678, 2023 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-37420145

RESUMO

BACKGROUND: Verruciform xanthoma (VX) is an uncommon, benign epithelial lesion of the oral mucosa. While this entity can also present extraorally, including on the skin and in anogenital areas, the variation in its histologic features in extraoral sites is not yet well defined. Differences in the demographics and morphologic features of oral versus extraoral VX were assessed to help facilitate the accurate diagnosis and management of this lesion. METHODS: After obtaining IRB approval, 110 cases of diagnosed VX were retrospectively collected from our institutional archives spanning from 2000 to 2022. Patient age, gender, available medical history, lesion appearance, and duration were obtained for each case. RESULTS: The median age was 55 years (range 13-86) with a male-to-female ratio of 1.2:1. The most common oral sites, in descending order, were the palate (n = 24, 22%), buccal mucosa (n = 18, 16%), gingiva (n = 16, 15%), and tongue (n = 13, 12%). Extraoral sites comprised 9% of all lesions, including the scrotum (9), vulva (2), cheek (1), wrist (1), gluteal region (1), and abdominal wall (1). The median size for all lesions was 6.0 mm, and extraoral lesions were associated with a 6.7 mm larger size compared to oral lesions (B ± SE: 6.7 ± 2.5 cm, p = 0.01). The lesions were most frequently pink or white in color and often described as papillary, pedunculated, verrucous, and/or exophytic. Microscopically, the presence of wedge-shaped parakeratosis, keratin projections above the epithelium/epidermis, and associated inflammation significantly differed between oral and extraoral lesions. Prominent wedge-shaped parakeratosis (p = 0.04) and keratin projections above the epithelium/epidermis (p < 0.001) were more prevalent in extraoral lesions. There was no significant link between keratin projections and epithelial atypia (p = 0.44). CONCLUSIONS: Familiarity with the broad morphological spectrum of VX, including the presence and degree of wedge-shaped parakeratosis, keratin projections above the epithelium/epidermis, and associated underlying inflammation, will be helpful in diagnosing it in unusual locations.


Assuntos
Doenças da Boca , Paraceratose , Xantomatose , Humanos , Masculino , Feminino , Adolescente , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Estudos Retrospectivos , Doenças da Boca/patologia , Xantomatose/patologia , Queratinas , Genitália/patologia
18.
JAMA Netw Open ; 6(1): e2250613, 2023 01 03.
Artigo em Inglês | MEDLINE | ID: mdl-36630138

RESUMO

Importance: A standardized pathology classification system for melanocytic lesions is needed to aid both pathologists and clinicians in cataloging currently existing diverse terminologies and in the diagnosis and treatment of patients. The Melanocytic Pathology Assessment Tool and Hierarchy for Diagnosis (MPATH-Dx) has been developed for this purpose. Objective: To revise the MPATH-Dx version 1.0 classification tool, using feedback from dermatopathologists participating in the National Institutes of Health-funded Reducing Errors in Melanocytic Interpretations (REMI) Study and from members of the International Melanoma Pathology Study Group (IMPSG). Evidence Review: Practicing dermatopathologists recruited from 40 US states participated in the 2-year REMI study and provided feedback on the MPATH-Dx version 1.0 tool. Independently, member dermatopathologists participating in an IMPSG workshop dedicated to the MPATH-Dx schema provided additional input for refining the MPATH-Dx tool. A reference panel of 3 dermatopathologists, the original authors of the MPATH-Dx version 1.0 tool, integrated all feedback into an updated and refined MPATH-Dx version 2.0. Findings: The new MPATH-Dx version 2.0 schema simplifies the original 5-class hierarchy into 4 classes to improve diagnostic concordance and to provide more explicit guidance in the treatment of patients. This new version also has clearly defined histopathological criteria for classification of classes I and II lesions; has specific provisions for the most frequently encountered low-cumulative sun damage pathway of melanoma progression, as well as other, less common World Health Organization pathways to melanoma; provides guidance for classifying intermediate class II tumors vs melanoma; and recognizes a subset of pT1a melanomas with very low risk and possible eventual reclassification as neoplasms lacking criteria for melanoma. Conclusions and Relevance: The implementation of the newly revised MPATH-Dx version 2.0 schema into clinical practice is anticipated to provide a robust tool and adjunct for standardized diagnostic reporting of melanocytic lesions and management of patients to the benefit of both health care practitioners and patients.


Assuntos
Melanoma , Neoplasias Cutâneas , Humanos , Neoplasias Cutâneas/diagnóstico , Neoplasias Cutâneas/patologia , Melanoma/diagnóstico , Melanoma/patologia , Patologistas , Consenso , Instalações de Saúde
19.
Open Forum Infect Dis ; 9(11): ofac608, 2022 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-36447606

RESUMO

Cryptococcoid Sweet syndrome is a rare histologic variant of the neutrophilic dermatosis presenting clinically with skin lesions typical of classical Sweet syndrome but with yeast-like structures suggestive of Cryptococcus on histopathology. Histochemical stains for fungus and cultures are negative whereas staining for myeloperoxidase is positive. We present 2 cases of cryptococcoid Sweet syndrome with atypical skin manifestations, including hemorrhagic bullae and plaques, and provide a brief review of the literature. Clinicians should be aware that this variant of Sweet syndrome can present with uncommon clinical findings and has histopathologic findings suggestive of Cryptococcus species.

20.
J Colloid Interface Sci ; 603: 728-737, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34229116

RESUMO

Mercury pollution is a significant threat to the environment and health worldwide. Therefore, effective and low-cost absorbents that are easily scalable are needed for real-world applications. Enlarging the surface area of the materials and doping with heteroatoms are two of the most common strategies to cope with this problem. Sulfur-doped activated carbon synthesized from the carbonization of inverse vulcanized thiopolymers makes it possible to combine both large specific surface area and doping of heteroatoms, resulting in outperformance in mercury uptake against commercial activated carbons. Convenient recovery of mercury absorbents after treatment should be beneficial in mercury collecting and recycling. Therefore, magnetic sulfur-doped carbons (MSCs) were prepared by functionalizing sulfur doped carbons through chemical precipitation with magnetic iron oxides. Besides the characterisations of materials, mercury uptake experiments, such as stactic test, capacity test, impact of solution pH, and mixed ions interferences were performed. These MSCs exhibit high specific surface area (1,329 m2/g), high sulfur content (up to 14.8 wt%), porous structure, low cost, and are convenient for retrieval. MSCs are demonstrated high uptake capacity (187 mg g-1) and efficiency in mercury solution and multifunctional absorption in mixed ions solution, showing their potential to be applied in water purification and environmental remediation.


Assuntos
Mercúrio , Adsorção , Carvão Vegetal , Fenômenos Magnéticos , Enxofre
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA