Clinical, histopathological and immunohistochemical assessment of human skin field cancerization before and after photodynamic therapy

O conceito de campo de cancerização, em dermatologia, sugere que a pele fotodanificada tem maior potencial para o desenvolvimento de neoplasias cutâneas. A terapia fotodinâmica (TFD) é um método não invasivo para o tratamento de queratoses actínicas (QA) múltiplas, possibilitando a abordagem de todo o campo. Vinte e seis pacientes com múltiplas QAs na face foram submetidos a três sessões de TFD com metilaminolevulinato 16% (MAL) e luz vermelha, com intervalo de um mês. Biópsias foram realizadas antes e após três meses da última sessão e o material corado para hematoxilina-eosina e Weigert. O estudo imunohistoquímico foi feito para os marcadores: TP-53, pró-colageno I, Metaloproteinase-1 e Tenascina-C. A avaliação do fotoenvelhecimento global melhorou consideravelmente (p < 0,001) e a cura clínica das QAs foi de 89,5% ao final do estudo. Duas sessões mostraram ser equivalentes a três sessões de TFD. Diminuição significante do grau e extensão da atipia celular (p < 0,001), aumento das fibras colágenas (p = 0,001) e melhora do grau de elastose (p = 0,002) foram observadas. O estudo imunohistoquímico mostrou diminuição da expressão da TP-53 (p = 0,580), aumento de pró-colágeno I (p = 0,477) e de MMP-1 (p = 0,08), embora não houvesse diferença estatisticamente significante. Aumento significativo foi observado para Tenascina-C (p = 0,024). Múltiplas sessões de TFD com MAL induziram melhora clínica e histológica do campo de cancerização. A diminuição da severidade e extensão da atipia celular associada à menor expressão de TP-53 sugerem redução do potencial carcinogênico do campoThe field cancerization concept suggests that photodamaged skin has an increased risk for the development of malignant lesions. Topical photodynamic therapy (PDT) is a non-invasive therapeutic method for multiple actinic keratosis (AK), allowing the possibility of treating the entire surface. Twenty-six patients with photodamaged skin and multiple AKs on the face were submitted to three consecutive sessions of PDT with mehtylaminolevulinate 16% (MAL) and red light, one month apart. Biopsies were performed before and three months after the last treatment session, and stained for hematoxilin-eosin and Weigert. Immunohistochemestry study was performed for TP-53, pro-collagen I, Metalloproteinase-1 and Tenascin-C. The global score for photodamage improved considerably in all patients (p < 0.001). The AK clearance rate was 89.5% at the end of the study. Two treatments were similar to three MAL-PDT sessions. A significant decrease in keratinocytes atypia grade and amount was observed (p < 0.001). A significant increase in collagen deposition (p = 0.001) and improvement of solar elastosis (p = 0.002) were noticed. Immunohistochemical study showed decreased TP-53 expression although not statistically significant (p = 0.580), increased pro-collagen I and MMP-1 expressions (p = 0.477 and p = 0.08) again not statistically significant and a increased expression of Tenascin-C (p = 0.024), which was statistically significant. In conclusion, multiple sessions of MAL-PDT induced clinical and histological improvement of field cancerization. The decrease in severity and extension of keratinocytes atypia associated with a decreased expression of TP-53 suggest a reduced carcinogenic potential of the altered fiel

Angioma em tufos: relato de um caso tratado com laser corante pulsado

O angioma em tufos é quadro raro, benigno, de proliferação cutânea angiomatosa. Acomete mais crianças e clinicamente caracteriza-se por lesões em placas, vermelho-violáceas, dolorosas e mais freqüentes no tronco. Quando não regride espontaneamente, os tratamentos propostos (cirurgia convencional, corticoterapia, interferon e laser) alcançam pouco sucesso. Descreve-se o caso de uma menina de 11 anos, com angioma em tufos no tronco, tratada com laser corante pulsado que mostrou alívio importante da dor local e redução discreta do tamanho da lesão. A raridade de casos relatados no Brasil e a tentativa terapêutica com laser corante pulsado motivaram a divulgação do caso

Estimation of biomass and carbon stocks: the case of the Atlantic Forest

The main objective of this paper is to present and discuss the best methods to estimate live above ground biomass in the Atlantic Forest. The methods presented and conclusions are the products of a workshop entitled "Estimation of Biomass and Carbon Stocks: the Case of Atlantic Rain Forest". Aboveground biomass (AGB) in tropical forests is mainly contained in trees. Tree biomass is a function of wood volume, obtained from the diameter and height, architecture and wood density (dry weight per unit volume of fresh wood). It can be quantified by the direct (destructive) or indirect method where the biomass quantification is estimated using mathematical models. The allometric model can be site specific when elaborated to a particular ecosystem or general that can be used in different sites. For the Atlantic Forest, despite the importance of it, there are only two direct measurements of tree biomass, resulting in allometric models specific for this ecosystem. To select one or other of the available models in the literature to estimate AGB it is necessary take into account what is the main question to be answered and the ease with which it is possible to measure the independent variables in the model. Models that present more accurate estimates should be preferred. However, more simple models (those with one independent variable, usually DBH) can be used when the focus is monitoring the variation in carbon storage through the time. Our observations in the Atlantic Forest suggest that pan-tropical relations proposed by Chave et al. (2005) can be confidently used to estimated tree biomass across biomes as long as tree diameter (DBH), height, and wood density are accounted for in the model. In Atlantic Forest, we recommend the quantification of biomass of lianas, bamboo, palms, tree ferns and epiphytes, which are an important component in this ecosystem. This paper is an outcome of the workshop entitled "Estimation of Biomass and Carbon Stocks: the Case of Atlantic Rain Forest", that was conducted at Ubatuba, São Paulo, Brazil, between 4 and 8 December 2006 as part of the Brazilian project "Ombrophylus Dense Forest floristic composition, structure and function at the Núcleos Picinguaba and Santa Virginia of the Serra do Mar State Park", BIOTA Gradiente