Primary cutaneous aggressive epidermotropic cytotoxic T-cell lymphomas: reappraisal of a provisional entity in the 2016 WHO classification of cutaneous lymphomas.

Primary cutaneous CD8-positive aggressive epidermotropic T-cell lymphoma is a rare and poorly characterized variant of cutaneous lymphoma still considered a provisional entity in the latest 2016 World Health Organization Classification of Cutaneous lymphomas. We sought to better characterize and provide diagnostic and therapeutic guidance of this rare cutaneous lymphoma. Thirty-four patients with a median age of 77 years (range 19-89 years) presented primarily with extensive annular necrotic plaques or tumor lesions with frequent mucous membrane involvement. The 5-year survival was 32% with a median survival of 12 months. A subset of 17 patients had a prodrome of chronic patches prior to the development of aggressive ulcerative lesions. We identified cases with lack of CD8 or αβ T-cell receptor expression yet with similar clinical and pathological presentation. Allogeneic stem cell transplantation provided partial or complete remissions in 5/6 patients. We recommend the term primary cutaneous aggressive epidermotropic cytotoxic T-cell lymphoma as this more broad designation better describes this clinical-pathologic presentation, which allows the inclusion of cases with CD8 negative and/or αβ/γδ T-cell receptor chain double-positive or double-negative expression. We have identified early skin signs of chronic patch/plaque lesions that are often misdiagnosed as eczema, psoriasis, or mycosis fungoides. Our experience confirms the poor prognosis of this entity and highlights the inefficacy of our standard therapies with the exception of allogeneic stem cell transplantation in selected cases

The proposition of an inexpensive chemically defined culture medium (MycoDef) for yeast studies

Chemically defined culture media (CDCMs) have their compositions qualitatively and quantitatively known. They are constituted of components able to meet the nutritional requirements of microorganisms. This study evaluated the employability of a multivitamin as the basis for the elaboration of a CDCM for experiments with yeasts. Candida albicans reference strains ATCC®90028™ and SC5314 were used. YNB® without amino acid (Difco Co.) was used as the standard in evaluations. For the preparation of the experimental culture medium (MycoDef), commercial multivitamin tablets had their coatings removed and were crushed until obtaining a fine powder; missing constituents were added. Comparisons were carried out evaluating aerobic and anaerobic planktonic growth rate, biofilm formation rate, whole-cell protein patterns by SDS-PAGE, minimum inhibitory concentrations and minimal fungicidal concentrations for clotrimazole, fluconazole, nystatin, and griseofulvin. Growth in MycoDef and YNB® did not differ between them (p>0.05) in both normoxic and anoxic conditions. Regarding employability for sensitivity testing, MycoDef showed performance like YNB®. The protein profiles of cells grown on both media did not differ in the number and positioning of bands. The results obtained allowed us to infer that MycoDef is a reliable low-cost culture medium useful for trials involving C. albicans

Multifocal pleomorphic dermal sarcoma and the role of inflammation and immunosuppression in a lung transplant patient: a case report

Background Pleomorphic dermal sarcoma is the cutaneous variant of undifferentiated pleomorphic sarcoma. It is a rare malignancy of unclear histogenesis; it is a diagnosis of exclusion that requires extensive use of immunohistochemistry to rule out other malignancies. Pleomorphic dermal sarcoma typically presents as a solitary tumor in sun-exposed areas and may have unpredictable clinical behavior, with some tumors associated with metastasis and death. Case presentation We present an unusual case of multifocal pleomorphic dermal sarcoma arising in the areas of alpha-1-antitrypsin deficiency panniculitis in a lung transplant patient. Our patient was a 58-year-old white woman whose initial presentation was consistent with alpha-1-antitrypsin deficiency panniculitis. She then developed extensive multifocal, bleeding, and ulcerated nodules in the areas of the panniculitis. A skin biopsy was consistent with a diagnosis of pleomorphic dermal sarcoma. Her immunosuppressive regimen was decreased, and she was treated with liposomal doxorubicin 40 mg/m2 every 3 weeks with some initial improvement in the size of her tumors. However, soon after beginning therapy, she developed pneumonia and septic shock and ultimately died from multi-organ failure. Conclusions We hypothesize that chronic, multifocal inflammation in the skin in the setting of immunosuppression led to simultaneous, malignant transformation in numerous skin lesions. We discuss the challenges of diagnosing pleomorphic dermal sarcoma, therapeutic options, and stress the need for multidisciplinary management of these cases

Transplantation of bone marrow mesenchymal stem cells decreases oxidative stress, apoptosis, and hippocampal damage in brain of a spontaneous stroke model

Stroke is the most common cause of motor disabilities and is a major cause of mortality worldwide. Adult stem cells have been shown to be effective against neuronal degeneration through mechanisms that include both the recovery of neurotransmitter activity and a decrease in apoptosis and oxidative stress. We chose the lineage stroke-prone spontaneously hypertensive rat (SHRSP) as a model for stem cell therapy. SHRSP rats can develop such severe hypertension that they generally suffer a stroke at approximately 1 year of age. the aim of this study was to evaluate whether mesenchymal stem cells (MSCs) decrease apoptotic death and oxidative stress in existing SHRSP brain tissue. the results of qRT-PCR assays showed higher levels of the antiapoptotic BcI-2 gene in the MSC-treated animals, compared with untreated. Our study also showed that superoxide, apoptotic cells, and by-products of lipid peroxidation decreased in MSC-treated SHRSP to levels similar those found in the animal controls, Wistar Kyoto rats. in addition, we saw a repair of morphological damage at the hippocampal region after MSC transplantation. These data suggest that MSCs have neuroprotective and antioxidant potential in stroke-prone spontaneously hypertensive rats. (c) 2014 the Authors. Published by Elsevier Inc.Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)Universidade Federal de São Paulo, Dept Biofis, BR-04023062 São Paulo, BrazilUniversidade Federal de São Paulo, Ctr Desenvolvimento Modelos Expt Med & Biol, BR-04023062 São Paulo, BrazilUniversidade Federal de São Paulo, Dept Morfol, BR-04023062 São Paulo, BrazilUniversidade Federal de São Paulo, Dept Fisiol, BR-04023062 São Paulo, BrazilUniv Santa Cecilia, Dept Odontol, Santos, SP, BrazilUniversidade Federal de São Paulo, Dept Nefrol, BR-04023062 São Paulo, BrazilUniversidade Federal de São Paulo, Dept Biofis, BR-04023062 São Paulo, BrazilUniversidade Federal de São Paulo, Ctr Desenvolvimento Modelos Expt Med & Biol, BR-04023062 São Paulo, BrazilUniversidade Federal de São Paulo, Dept Morfol, BR-04023062 São Paulo, BrazilUniversidade Federal de São Paulo, Dept Fisiol, BR-04023062 São Paulo, BrazilUniversidade Federal de São Paulo, Dept Nefrol, BR-04023062 São Paulo, BrazilFAPESP: 05/60630-1FAPESP: 10/00106-5Web of Scienc

Association between Lactobacillus species and bacterial vaginosis-related bacteria, and bacterial vaginosis scores in pregnant Japanese women

<p>Abstract</p> <p>Background</p> <p>Bacterial vaginosis (BV), the etiology of which is still uncertain, increases the risk of preterm birth. Recent PCR-based studies suggested that BV is associated with complex vaginal bacterial communities, including many newly recognized bacterial species in non-pregnant women.</p> <p>Methods</p> <p>To examine whether these bacteria are also involved in BV in pregnant Japanese women, vaginal fluid samples were taken from 132 women, classified as normal (n = 98), intermediate (n = 21), or BV (n = 13) using the Nugent gram stain criteria, and studied. DNA extracted from these samples was analyzed for bacterial sequences of any <it>Lactobacillus</it>, four <it>Lactobacillus </it>species, and four BV-related bacteria by PCR with primers for 16S ribosomal DNA including a universal <it>Lactobacillus </it>primer, <it>Lactobacillus </it>species-specific primers for <it>L. crispatus</it>, <it>L. jensenii</it>, <it>L. gasseri</it>, and <it>L. iners</it>, and BV-related bacterium-specific primers for BVAB2, <it>Megasphaera</it>, <it>Leptotrichia</it>, and <it>Eggerthella</it>-like bacterium.</p> <p>Results</p> <p>The prevalences of <it>L. crispatus</it>, <it>L. jensenii</it>, and <it>L. gasseri </it>were significantly higher, while those of BVAB2, <it>Megasphaera</it>, <it>Leptotrichia</it>, and <it>Eggerthella</it>-like bacterium were significantly lower in the normal group than in the BV group. Unlike other <it>Lactobacillus </it>species, the prevalence of <it>L. iners </it>did not differ between the three groups and women with <it>L. iners </it>were significantly more likely to have BVAB2, <it>Megasphaera, Leptotrichia</it>, and <it>Eggerthella</it>-like bacterium. Linear regression analysis revealed associations of BVAB2 and <it>Megasphaera </it>with Nugent score, and multivariate regression analyses suggested a close relationship between <it>Eggerthella</it>-like bacterium and BV.</p> <p>Conclusion</p> <p>The BV-related bacteria, including BVAB2, <it>Megasphaera</it>, <it>Leptotrichia</it>, and <it>Eggerthella</it>-like bacterium, are common in the vagina of pregnant Japanese women with BV. The presence of <it>L. iners </it>may be correlated with vaginal colonization by these BV-related bacteria.</p

Appropriate use criteria in dermatopathology: Initial recommendations from the American Society of Dermatopathology

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/145218/1/cup13142.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/145218/2/cup13142_am.pd

A methodological contribution for assessing the equipments criticality in maintenance management

This work aimed to develop an alternative methodology to determine the criticality of equipments in factories, in order to contribute in guiding managers involved in the activities of planning and control systems maintenance (PCM). The methodology consisted in considering modifications of existing models and procedures found in the literature, as well as consideration of new criteria for assessing criticality, aiming its calculation of quantitative and qualitative minor deviations from the information collected. The new procedure was applied and tested in two Brazilian companies, one dedicated to mining and other to foods activities, getting more results adjusted to the reality of companies under study when compared with those presented from the previously existing methods. Regarding the authors analyzed the model presented greater concordance with the criteria already used in the business of the food industry. Finally, aiming at further improvements, the new procedure was analyzed to compile their practical demands and vulnerabilities.Esta dissertação teve como propósito desenvolver uma metodologia alternativa para determinar a criticidade de equipamentos industriais nas empresas, a fim de contribuir na orientação dos gestores envolvidos nas atividades dos sistemas de planejamento e controle da manutenção (PCM). A metodologia proposta consistiu na adequação de modelos e procedimentos já existentes na literatura, bem como na consideração de novos critérios de avaliação da criticidade, visando o seu cálculo de forma quantitativa e qualitativa com menores desvios em relação às informações coletadas em campo. O novo procedimento foi aplicado e testado em duas empresas nacionais, uma de mineração e outra de alimentos, obtendo-se resultados mais ajustados à realidade das empresas sob estudo quando comparado com os apresentados a partir das metodologias previamente existentes. Especificamente, o modelo proposto apresentou maior concordância com os critérios já utilizados na empresa do setor alimentício. Finalmente, visando futuras melhoras, o novo procedimento foi submetido a análise para o levantamento das suas demandas práticas e vulnerabilidades