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EMA
Selected AbstractsInvestigating static and dynamic characteristics of electromechanical actuators (EMA) with MATLAB GUIsCOMPUTER APPLICATIONS IN ENGINEERING EDUCATION, Issue 2 2010Gursel Sefkat Abstract This paper deals with the design of an electromechanical device considering some prescribed performance requirements, and static and dynamic analysis of this device are carried out. In studying the transient response of such a system, as part of dynamic analysis, two methods mostly used finite element method (FEM) and finite differences method (FDM). However, these methods need much CPU time. In this work, a computer simulator program is developed for an EMA. This technique is implemented in the MATLAB-Simulink environment and tested for different design tasks such as electromagnetic valves or electromechanical brakes etc. Furthermore, by using GUIDE tools within MATLAB, a simple useful and user-friendly GUI structure is developed to provide a visual approach to design and analysis process. © 2009 Wiley Periodicals, Inc. Comput Appl Eng Educ 18: 383,396, 2010; Published online in Wiley InterScience (www.interscience.wiley.com); DOI 10.1002/cae.20279 [source] Mesothelioma Symposium 11.30,12.30 Tuesday 16 September 2003CYTOPATHOLOGY, Issue 2003Darrel Whitaker Dr The diagnosis of malignant mesothelioma on the cytology of serous effusions is a two-phase process. First is to determine that the effusion is malignant based on morphological features such as a highly cellular fluid with many large three dimensional cell aggregates, and/or the recognition of minor malignant criteria including prominent cell engulfment, uniformly present very prominent nucleoli, or the finding of very large (giant) cells. In cell block sections, strong positive staining with EMA often with cell membrane accentuation provides compelling support for a cytological diagnosis of malignancy. Second is to recognize that the malignant cells have a mesothelial phenotype and do not represent metastatic malignancy (usually adenocarcinoma). Criteria in support of mesothelioma include the lack of a ,two cell' population, that is one native (mesothelial) and one foreign (metastatic), cells with abundant dense staining cytoplasm, the presence of ,windows' where mesothelioma cells lie in close apposition and intracytoplasmic glycogen presenting either as small peripheral vacuoles on MGG stained smears or large yellow refractile crescents on Papanicolaou stained smears. In addition, mesothliomas often possess connective tissue stromal cores occurring as either well-formed collagen within papillary aggregates or lying free as pink (MGG) or light green (Pap) amorphous material in the background of the smear or in loose association with mesothelioma cells. Finally small orange staining squamous-like cells can occasionally be identified and sometimes this may be a very prominent finding and has resulted in the false impression of a squamous cell carcinoma. Almost certainly these cells represent apoptotic tumour cells. The connective tissue mucin hyaluronic acid may be found as a net-like pattern in the smear background or as large hard-edged magenta-stained vacuoles on MGG-stained smears. Cell block sections provide architectural information and it is usually possible to separate mesothelioma aggregates with their cuboidal cells, central nuclei and abundant dense cytoplasm arranged in solid, papillary or hollow clusters from those of adenocarcinoma with less dense, often foamy cytoplasm, often composed of columnar cells with elongated nuclei. Aggregate form in adenocarcinoma can be variable but true acini are a rare finding. These cell block sections provide an ideal medium for histochemistry (PAS with and without diastase digestion) and immunocytochemistry. By using a panel of antibodies (Calretinin and CK 5/6, BerEp4, CEA, B72.3) it is almost always possible to distinguish mesothelioma from metastatic adenocarcinoma. Calretinin and CK 5/6 positive staining and absent staining with BerEp4, CEA and B72.3 is considered diagnostic of mesothelioma. [source] Pulmonary non-Hodgkin's lymphoma (NHL) of diffuse large B-cell type with simultaneous humeral involvement in a young lady: An uncommon presentation with cytologic implicationsDIAGNOSTIC CYTOPATHOLOGY, Issue 3 2010C.T., Irene Ruben B.Sc. Abstract A bronchogenic carcinoma, almost invariably, presents as a lung mass. Primary pulmonary lymphomas are rare. We report an unusual case of a pulmonary non-Hodgkin's lymphoma (NHL) with simultaneous involvement of the right humerus in a 37 year old lady. Bronchial lavage smears showed atypical cells with irregular nuclear membranes raising a suspicion of a hematolymphoid tumor, over a small cell carcinoma that was the closest differential diagnosis. Biopsy from the lung mass and from the lesion in the humerus showed an identical malignant round cell tumor with prominent apoptosis. On immunohistochemistry (IHC), tumor cells were diffusely positive for leukocyte common antigen (LCA), CD20 and MIB1 (70%), while negative for cytokeratin (CK), epithelial membrane antigen (EMA) synaptophysin, chromogranin, neuron specific enolase (NSE), CD3, and CD10. Diagnosis of a pulmonary NHL of diffuse large B-cell type with involvement of the humerus was formed. The case is presented to create an index of suspicion for the possibility of a NHL on respiratory samples, while dealing with small round cells with irregular nuclear membranes. IHC is necessary to confirm he diagnosis. A simultaneous association in the humerus in our case makes it unusual. Diagn. Cytopathol. 2010. © 2009 Wiley-Liss, Inc. [source] Papillary thyroid carcinoma with metastasis to the frontal skullDIAGNOSTIC CYTOPATHOLOGY, Issue 7 2009Dian Feng M.D., Ph.D. Abstract Papillary thyroid carcinoma with metastasis to the frontal skull is extremely rare. We report a case of unsuspected papillary thyroid carcinoma with frontal skull metastasis. The patient was a 62-year-old African American woman with presentation of a 4-cm firm, painless, immobile, ill-defined mass at the right forehead. Ultrasound and computer tonography detected a hypervascular and osteolytic tumor involving the skull and overlying skin. Fine-needle aspiration was performed followed by surgical biopsy. Cytologic examination revealed the presence of hypercellular and bloody material. The neoplasm showed glandular features and was composed of clusters of round to oval cells with pinkish squamoid cytoplasm, oval nuclei and inconspicuous nucleoli on smears and sections of cell block. With immunocytochemical stain, the neoplastic cells were positive for pancytokeratin and vimentin and focally positive for EMA, while they were negative for S100, HMB45, Melan-A, CD34, GFAP, CD10, LCA, RCC and CD138. The diagnosis was a metastatic carcinoma. Clinical follow up with surgical biopsy was recommended. Surgical biopsy demonstrated histological and cytological features of papillary thyroid carcinoma including prominent papillae, nuclear overlapping, grooves, and intranuclear pseudoinclusions. Thus, a diagnosis of metastatic papillary thyroid carcinoma was rendered. Though skull metastasis of thyroid carcinoma is rare, it should be considered in the differential diagnosis when a skull mass lesion is encountered. Diagn. Cytopathol. 2009. © 2009 Wiley-Liss, Inc. [source] Liesegang rings in fine needle aspirate of breast cysts with predominance of apocrine cells: A study of 14 casesDIAGNOSTIC CYTOPATHOLOGY, Issue 10 2008F.I.A.C., Raj K. Gupta M.D. Abstract Fine needle aspirate (FNA) from 14 cases (age range 17,84 years), with Liesegang rings (LR's) in breast cysts seen over a period of 26 years comprised the material of this study from more than 38,000 FNA's of the breast which had been done for a variety of breast lesions. In six of the 14 cases, the aspirate was obtained under ultrasound guidance whereas in the remaining cases it was collected from a palpable lesion. The aspiration was performed using a 22 gauge needle and the syringe and needle contents were washed in a cytology container with 30% ethyl alcohol in physiologic saline. The cytologic preparations from half of the sample were made on a 5 micron Schleicher and Schuell filter and stained by Papanicolaou method whereas from the remainder of the sample a cell block was made and sections cut, stained with hematoxylin-eosin (H&E) and used for immunohistochemical study. Filter preparations and cell blocks revealed cyanophilic, spherical, ring-like structures of various sizes and shape mostly with double walls, and striations with amorphous material in the lumen and under polarized light were nonrefractile. Seen also were several apocrine cells and some macrophages and the LR's were found to be negative on immunostains for EMA and CK, and a panel of other special stains (Table I). Since LR's can be mistaken for ova, larvae, or parasites, it is important to be aware of their potential presence in aspirate samples of breast cysts to avoid a misdiagnosis. The exact mechanism of formation of LR's is not fully understood and certain views as proposed are discussed in this presentation. Diagn. Cytopathol. 2008;36:701,704. © 2008 Wiley-Liss, Inc. [source] Diagnostic effects of prolonged storage on fresh effusion samples,,DIAGNOSTIC CYTOPATHOLOGY, Issue 1 2007Frances Manosca M.D. Abstract The effects on morphology and diagnostic interpretation of delayed processing of refrigerated effusion samples have not been well documented. The potential for cellular degeneration has led many laboratories to reflexively fix samples rather than submit fresh/refrigerated samples for cytologic examination. We sought to determine if effusion specimens are suitable for morphologic, immunocytochemical, and DNA-based molecular studies after prolonged periods of refrigerated storage time. Ten fresh effusion specimens were refrigerated at 4°C; aliquots were processed at specific points in time (days 0, 3, 5, 7, 10, 14). Specimens evaluated included four pleural (3 benign, 1 breast adenocarcinoma) and six peritoneal (2 ovarian adenocarcinomas, 1 malignant melanoma, 2 mesotheliomas, 1 atypical mesothelial) effusions. The morphology of the cytologic preparations from the 10 effusions was preserved and interpretable after 14 days of storage at 4°C. The immunocytochemical profile of the samples (AE1/AE3, EMA, calretinin, and LCA) was consistent from day 0 to day 14. Amplifiable DNA was present in all samples tested on day 14. We conclude that cytopathologic interpretation of effusion samples remains reliable with refrigeration at 4°C even if processing is delayed. Diagn. Cytopathol. 2007;35:6,11. © 2006 Wiley-Liss, Inc. [source] The high post-test probability of a cytological examination renders further investigations to establish a diagnosis of epithelial malignant pleural mesothelioma redundantDIAGNOSTIC CYTOPATHOLOGY, Issue 8 2006J.G.J.V. Aerts M.D., Ph.D. Abstract The aim of the study was to establish in a prospective and blinded manner the diagnostic yield of morphology, immunocytochemistry (ICH) and electron microscopy (EM) in the cytological analysis of malignant pleural mesothelioma (MPM). Pleural fluid from consecutive patients, 14 with a histologically proven MPM, 12 with a malignant pleuritis due to adenocarcinoma (AC), and 13 with a reactive pleural effusion (RM), was separately analyzed. Smears were incubated with monoclonal antibodies (Tag72, Ber-Ep4, anti-CEA, EMA). These were considered suggestive for MPM when only EMA stained positive, for AC when three out of four markers stained positive, and for RM when no marker stained positive. The post-test probability of the morphological, ICH, and EM analysis were 92, 100, 92% or MPM, 91, 100, 86% for AC, and 88, 88, 90% for RM, respectively. We concluded that the high post-test probability of a combined morphological and ICH diagnosis of MPM warrants to cease further diagnostic procedures in these patients. Electron microscopy did not add to accuracy of diagnosis. Diagn. Cytopathol. 2006;34:523,527. © 2006 Wiley-Liss, Inc. [source] Comparison of three cytologic preparation methods and immunocytochemistries to distinguish adenocarcinoma cells from reactive mesothelial cells in serous effusionDIAGNOSTIC CYTOPATHOLOGY, Issue 1 2006(I.A.C.), Junko Ueda Ph.D. Abstract We assessed whether a panel of seven antibodies is useful in the differentiation of adenocarcinoma cells (ACCs) from reactive mesothelial cells (RMCs) in effusion samples and to determine optimal specimen preparation conditions for immunocytochemical analysis of effusion samples. Immunocytochemistry (ICC) was performed on three types of effusion preparations from the same effusion specimens: ethanol-fixed smears, ethanol-fixed cell -blocks, and formalin-fixed cell-blocks. Commercially available antibodies MOC-31, Ber-EP4, CA19-9, CEA, EMA, CA125, and HBME-1 were tested on RMCs from four samples of various etiology and 15 samples of adenocarcinoma from various primary sites. Ethanol-fixed smears showed strong immunoreactivity to all antibodies tested. The immunoreactivity of ethanol-fixed and formalin-fixed cell-blocks was significantly lower with all antibodies except CA19-9. Smear preparations are more sensitive than cell-blocks for immunocytochemical study. A panel of antibodies MOC-31, Ber-EP4, CA19-9, and CEA appears to be suitable to distinguish between ACCs and RMCs. Diagn. Cytopathol. 2006;34:6,10. © 2005 Wiley-Liss, Inc. [source] Desmoplastic round cell tumor of childhood: Can cytology with immunocytochemistry serve as an alternative for tissue diagnosis?DIAGNOSTIC CYTOPATHOLOGY, Issue 6 2005Dr Brijal Dave M.D. Abstract There are limited reports on the cytology of desmoplastic small round cell tumors (DSRCT). Fine needle aspiration biopsy (FNAB) findings in seven aspirates from four cases of histologically and immunohistochemically confirmed cases were analyzed with the main intention of ascertaining if cytological diagnosis of DSRCT is possible. Also assessed were the immunocytochemistry(ICC) findings in these cases. The basic cytological impression was that of a cohesive small round cell tumor. Nuclei showed granular chromatin with grooves, nuclear molding and inconspicuous nucleoli. Stromal fragments were noted in all four cases. In two cases, awareness of cytological features in the appropriate clinical context led to a suggestion of the diagnosis of DSRCT on cytology itself. ICC on destained smears showed positivity for cytokeratin, epithelial membrane antigen (EMA), desmin and WT-1 in two cases. In conclusion, given the right clinical setting, a cytological diagnosis of DSRCT is plausible and in conjunction with ICC may help in documenting the polyphenotypic nature and thereby confirming the diagnosis. Diagn. Cytopathol. 2005;32:330,335. © 2005 Wiley-Liss, Inc. [source] Role of immunocytochemistry and DNA flow cytometry in the fine-needle aspiration diagnosis of malignant small round-cell tumorsDIAGNOSTIC CYTOPATHOLOGY, Issue 4 2001Urmil Brahmi M.Sc. Abstract In the present study, DNA flow cytometry (FCM) and immunocytochemistry (ICC) with a selected panel of antibodies were performed on 51 cases of malignant tumors which were referred for fine-needle aspiration biopsy (FNAB) to our Department of Cytology for the last 2 yr. Twelve cases were diagnosed as neuroblastoma, 16 as Ewing's sarcoma, 2 as retinoblastoma, 5 as non-Hodgkin's lymphoma (NHL), 5 as rhabdomyosarcoma, 2 as peripheral neuroectodermal tumors (PNETs), and 8 as Wilms' tumor. Eleven of 12 neuroblastomas were diploid by FCM, and 1 was aneuploid, with an S-phase fraction (SPF) of 8.3%. Neuron-specific enolase (NSE) was negative in 3 and positive in 8 cases of neuroblastoma, whereas neuroblastoma marker was positive in 3/11. Sixteen of 17 Ewing's sarcomas were diploid, and 1 showed tetraploid aneuploidy, with an SPF of 10.06%. Eight of 13 Ewing's sarcomas were positive for Mic-2 gene product (Ewing's marker). All 5 NHL were positive for leukocyte-common antigen (LCA). Three of 5 rhabdomyosarcomas were diploid, and 2 cases showed aneuploidy. Rhabdomyosarcoma showed muscle-specific actin positivity in 4 and desmin positivity in 3 cases. All 3 cases of PNET were diploid and positive for the Mic-2 gene product, whereas NSE and vimentin were positive in 2 cases. Both cases of retinoblastoma were diploid. Immunostaining was noncontributory in 1 case, and the other showed positivity for the retinoblastoma gene product, NSE, and chromogranin. Seven of 8 Wilms' tumors were diploid, and 1 showed aneuploid, with an SPF of 11.13%. Seven of 8 Wilms' tumors were positive for cytokeratin (CK), 5 were positive for NSE, 6 were positive for epithelial membrane antigen (EMA), and 5 were positive for vimentin. FNAB diagnosis of malignant round-cell tumors is difficult only by light microscopy. Due to the availability of specific markers for subgrouping tumors, ICC has proved to be more useful these days, while DNA FCM has little diagnostic value, as most of them are diploid. Further ancillary studies, e.g., electron microscopy, image analysis, and other molecular investigations, are required to further categorize these tumors more precisely for better clinical management of these cases. Diagn. Cytopathol. 24:233,239, 2001. © 2001 Wiley-Liss, Inc. [source] Modeling mood variation associated with smoking: an application of a heterogeneous mixed-effects model for analysis of ecological momentary assessment (EMA) dataADDICTION, Issue 2 2009Donald Hedeker ABSTRACT Aims Mixed models are used increasingly for analysis of ecological momentary assessment (EMA) data. The variance parameters of the random effects, which indicate the degree of heterogeneity in the population of subjects, are considered usually to be homogeneous across subjects. Modeling these variances can shed light on interesting hypotheses in substance abuse research. Design We describe how these variances can be modeled in terms of covariates to examine the covariate effects on between-subjects variation, focusing on positive and negative mood and the degree to which these moods change as a function of smoking. Setting The data are drawn from an EMA study of adolescent smoking. Participants Participants were 234 adolescents, either in 9th or 10th grades, who provided EMA mood reports from both random prompts and following smoking events. Measurements We focused on two mood outcomes: measures of the subject's negative and positive affect and several covariates: gender, grade, negative mood regulation and smoking level. Findings and conclusions Following smoking, adolescents experienced higher positive affect and lower negative affect than they did at random, non-smoking times. Our analyses also indicated an increased consistency of subjective mood responses as smoking experience increased and a diminishing of mood change. [source] Sulfate-reducing bacteria in marine sediment (Aarhus Bay, Denmark): abundance and diversity related to geochemical zonationENVIRONMENTAL MICROBIOLOGY, Issue 5 2009Julie Leloup Summary In order to better understand the main factors that influence the distribution of sulfate-reducing bacteria (SRB), their population size and their metabolic activity in high- and low-sulfate zones, we studied the SRB diversity in 3- to 5-m-deep sediment cores, which comprised the entire sulfate reduction zone and the upper methanogenic zone. By combining EMA (ethidium monoazide that can only enter damaged/dead cells and may also bind to free DNA) treatment with real-time PCR, we determined the distributions of total intact bacteria (16S rDNA genes) and intact SRB (dsrAB gene), their relative population sizes, and the proportion of dead cells or free DNA with depth. The abundance of SRB corresponded in average to 13% of the total bacterial community in the sulfate zone, 22% in the sulfate,methane transition zone and 8% in the methane zone. Compared with the total bacterial community, there were relatively less dead/damaged cells and free DNA present than among the SRB and this fraction did not change systematically with depth. By DGGE analysis, based on the amplification of the dsrA gene (400 bp), we found that the richness of SRB did not change with depth through the geochemical zones; but the clustering was related to the chemical zonation. A full-length clone library of the dsrAB gene (1900 bp) was constructed from four different depths (20, 110, 280 and 500 cm), and showed that the dsrAB genes in the near-surface sediment (20 cm) was mainly composed of sequences close to the Desulfobacteraceae, including marine complete and incomplete oxidizers such as Desulfosarcina, Desulfobacterium and Desulfococcus. The three other libraries were predominantly composed of Gram-positive SRB. [source] Absence Epilepsy with Onset before Age Three Years: A Heterogeneous and Often Severe ConditionEPILEPSIA, Issue 7 2003Yves Chaix Summary: Purpose: The classification of epilepsies and epileptic syndromes recognizes three syndromes with typical absences [TA, i.e., childhood and juvenile absence epilepsies (CAE and JAE), and epilepsy with myoclonic absences (EMA), none of which is characterized by onset in early childhood]. Although several other forms of absence epilepsies have been described recently, none concerns infants and very young children, and little is known about the nosology and prognosis of early-onset absences. Methods: We retrospectively selected all cases with onset of absences as the only or major seizure type before age 3 years and ,2 years of follow-up among cases newly referred between 1986 and 2002. Neurospychological assessments (generally IQ measure), behavior patterns, and schooling situations were reviewed for each child. Results: We found 10 patients (7 F, 3 M). No child had sensory or motor deficits: neuroimaging was performed in nine and was normal in eight, with aspecfic findings in one. Only two could be characterized as CAE and EMA, respectively, both with seizure control and a good cognitive outcome. Among the remaining eight cases, four had a fairly homogeneous presentation with predominantly brief absences and clearly asymmetric interictal EEGs. All eight had neuropsychological and/or behavioral difficulties. Three had full seizure control, and five, persisting absences, with a follow-up ranging beetween 2 years 8 months to 9 years 4 months; only one child was older than 12 years. Conclusions: Great heterogeneity exists among absence epilepsies of early onset, which are rare conditions. Only a few patients can be categorized into well-known syndromes. The overall prognosis is poor. Early onset of absences is uncommon, and multicenter studies should help clarify the nosology and prognosis. [source] Our Common European Model of AgricultureEUROCHOICES, Issue 3 2006Juha Korkeaoja Our Common European Model of Agriculture Future internal and external forces on European agriculture mean that the CAP may look very different after 2013. However large these changes, the CAP will need to retain its common principles based on the European Model of Agriculture (EMA). This became clear in an informal September meeting of EU agriculture ministers in Oulu, arranged by the Finnish Presidency. A strong CAP will be needed in the future but it will have to evolve to meet upcoming challenges. Work on the future CAP will need to start soon and the Oulu meeting may become known as the starting point for those discussions. The CAP will have to provide a reasonable environment for practicing agriculture for very different farmers in very diverse conditions, and facilitate the supply of a wide variety of goods and services to consumers and taxpayers as only truly multifunctional agriculture can. If the CAP can maintain these characteristics it has an important role to play in a future Europe. The meeting in Oulu was also an important milestone for a very special reason: for the first time, all ten New Member States took an active part in the EMA-debate with full rights and responsibilities as part of the Union. Once again this underlines the central role of our common European Model of Agriculture. Unser gemeinsames Europäisches Land wirts chafts modell Die zukünftigen internen und externen Einflüsse auf die europäische Landwirtschaft könnten zur Folge haben, dass die GAP nach dem Jahr 2013 ganz anders aussieht. Wie umwälzend diese Veränderungen auch sein mögen, die GAP wird ihre allgemeinen, auf dem Europäischen Landwirtschaftsmodell (EMA) beruhenden Grundsätze beibehalten müssen. Dies wurde im September bei einem von der finnischen Präsidentschaft arrangierten informellen Treffen der EU-Landwirtschaftsminister in Oulu deutlich. In der Zukunft brauchen wir eine starke GAP, die jedoch weiterentwickelt werden muss, um den kommenden Herausforderungen gerecht zu werden. Die Arbeit an der zukünftigen GAP muss in nächster Zeit beginnen, und das Treffen in Oulu könnte möglicherweise als Ausgangspunkt dieser Diskussionen gelten. Die GAP wird ein angemessenes Umfeld schaffen müssen, um sehr unterschiedlichen Landwirten mit sehr unterschiedlichen Arbeitsbedingungen die Ausübung der Landwirtschaft sowie Verbrauchern und Steuerzahlern die Versorgung mit einer großen Vielfalt an Waren und Dienstleistungen zu ermöglichen, wie es nur eine wirklich multifunktionale Landwirtschaft zu leisten vermag. Wenn es der GAP gelingt, diese Merkmale beizubehalten, wird ihr im zukünftigen Europa eine wichtige Rolle zukommen. Bei dem Treffen in Oulu handelt es sich auch aus einem ganz besonderen Grund um einen bedeutenden Meilenstein: Zum ersten Mal beteiligte sich jeder der zehn neuen Mitgliedsstaaten mit allen Rechten und voller Verantwortung als Teil der Union aktiv an der Debatte zum Europäischen Landwirtschaftsmodell. Wieder einmal unterstreicht dies die zentrale Rolle unseres gemeinsamen Europäischen Landwirtschaftsmodells. Ce modèle agricole européen qui nous est commun Du fait des forces internes et externes qui vont bientôt s'exercer sur l'agriculture européenne, la physionomie de la PAC après 2013 pourrait bien être très différente de ce qu'elle est maintenant. Quelque soit cependant l'importance de ces changements, la PAC devra conserver sa base commune actuelle, qui repose sur le « modèle agricole européen » (MAE). La chose est apparue clairement lors d'une réunion informelle des ministres de l'agriculture européens organisée par la présidence finnoise à Oulu, en septembre dernier. Une politique agricole musclée sera nécessaire à l'avenir, mais elle devra évoluer pour répondre à de nouveaux défis. Il va bientôt falloir commencer à travailler cette nouvelle PAC, et la réunion d'Oulu restera peut être comme le point de départ des discussions sur le sujet. La PAC devra fournir un environnement convenable pour la pratique d'agricultures diverses, par des agriculteurs différents les uns des autres, dans un vaste éventail de conditions. Elle devra permettre la production d'une grande variété de biens et de services financés par le consommateur ou le contribuable, comme seule une agriculture multifonctionnelle peut le faire. Si la PAC arrive à conserver ces caractéristiques, elle aura un grand rôle à jouer dans l'Europe de demain. Il y a encore une raison plus spécifique pour marquer d'une pierre blanche la réunion d'Oulu : pour la première fois, les dix nouveaux membres de l'Union ont activement participé et de plein droit aux discussions sur le MAE. Cela, une fois de plus, souligne le rôle essentiel du « modèle agricole européen » qui nous est commun. [source] Does ecological momentary assessment improve cognitive behavioural therapy for binge eating disorder?EUROPEAN EATING DISORDERS REVIEW, Issue 5 2002A pilot study Abstract The purpose of this pilot study was to test whether self-monitoring in CBT could be enhanced in order to improve the identification of proximal antecedents of binge eating in binge eating disorder (BED). CBT was modified by asking participants to monitor all eating intensively through ecological momentary assessment (EMA). A total of 41 females (mean BMI,=,37.9; SD,=,8.2) meeting DSM-IV criteria for BED were randomly assigned to one of two group treatments; CBT (n,=,22) or CBT with EMA (n,=,19). CBT with EMA differed from CBT in that for the first 2 weeks of treatment, participants completed detailed pocket diaries about mood, events, etc., when signalled at random by programmable wristwatches, as well as at all times when eating. All participants completed measures of eating (EDE-Q, TFEQ, EES) and general psychopathology (BDI, RSE) before treatment, at the end of treatment, and at 1-year follow-up. While both treatment groups showed improvement on the outcome variables of interest, the individual data gained via EMA did not significantly enhance standard CBT. Therefore, it is unlikely that further research incorporating EMA as a therapeutic technique within CBT for BED will be compelling. Copyright © 2002 John Wiley & Sons, Ltd and Eating Disorders Association. [source] The expression pattern of MUC1 (EMA) is related to tumour characteristics and clinical outcome in ,pure' ductal carcinoma in situ of the breastHISTOPATHOLOGY, Issue 2 2007M A J De Roos Aims:, To classify MUC1 according to five predefined expression patterns in ductal carcinoma in situ (DCIS) and related clinicopathological parameters, coexpression of other biological markers and prognosis. Methods and results:, With a manual tissue arrayer, 92% (n = 80) of the 87 DCIS samples were successfully targeted. Immunohistochemistry was carried out for MUC1, oestrogen receptor (ER), progesterone receptor (PR), Her2/Neu, p53 and cyclin D1. Entire membrane expression was related to Her2/neu negativity (P =0.042). Apical membrane expression was associated with low grade (P = 0.027), Her2/neu negativity (P = 0.014) and PR positivity (P = 0.005). Focal cytoplasmic expression was related to high grade (P = 0.006). Diffuse cytoplasmic expression was associated with high grade (P = 0.004), large tumour size (P = 0.046), Her2/neu positivity (P =0.042) and cyclin D1 positivity (P = 0.002). On the basis of these analyses the four patterns were reclassified as membranous or cytoplasmic expression. On multivariate analysis, cytoplasmic MUC1 expression (hazard ratio 8.5, 95% confidence interval 1.0, 73.0; P = 0.04) was the only independent predictor of local recurrence. Conclusions:, Four patterns of MUC1 expression are recognized in DCIS that suggest a relationship to functional differentiation and can be simplified into two types that are clinically relevant and could therefore be helpful in the distinction between different subgroups of DCIS. [source] Sensitivity and specificity of immunohistochemical antibodies used to distinguish between benign and malignant pleural disease: a systematic review of published reportsHISTOPATHOLOGY, Issue 6 2006J King Aims:, A systematic review of published reports that have evaluated the ability of immunohistochemistry and argyrophil nucleolar organizing region (AgNOR) staining to distinguish between benign and malignant pleural disease. Methods:, Nineteen relevant papers published during the period 1979,2005 were identified. Individual results of immunohistochemistry for five diagnostic antibodies were extracted to calculate diagnostic sensitivity and specificity. Results from five of these studies that had evaluated proliferation markers or AgNOR staining techniques were also summarized. Results:, Most antibodies demonstrated poor to moderate diagnostic ability. Desmin and epithelial membrane antigen (EMA) were the most useful, with sensitivity and specificity both above 74%. The combination of EMA and AgNOR was reported as having 95% diagnostic sensitivity. A high MCM2 labelling index also differentiated between benign and malignant pleural disease. Conclusions:, Immunohistochemistry is of limited value, but newer diagnostic methods may be useful additions in this area of pathology. The diagnostic importance of histological features seen on plain tissue sections is emphasized as vital for correctly differentiating between benign pleural disease and malignant pleural mesothelioma. [source] Cutaneous sclerosing perineurioma of the digitINTERNATIONAL JOURNAL OF DERMATOLOGY, Issue 9 2006Toshitsugu Nakamura MD An 11-year-old Japanese girl noticed a small nodule, with mild tenderness, on the right index finger 5 years before visiting our outpatient clinic. She had no familial history of neurofibromatosis or past history of traumatic injury at the site of the tumor. Physical examination revealed a slightly elevated, subcutaneous, nodular tumor in the volar aspect between the proximal and distal interphalangeal joints of the digit (Fig. 1A). By magnetic resonance imaging examination, the tumor showed low density on both T1- and T2-weighted images, and was located just adjacent to the tendon with no invasive signs. The tumor was extirpated; at operation, it was well circumscribed and mobile without adhesion to adjacent tendon or nerve, and was easily removed. Figure 1. (a) Slightly elevated subcutaneous tumor (arrow) on the volar aspect of the right index finger. (b) gross appearance of the extirpated tumor, showing a well-circumscribed, whitish solid nodule Grossly, the tumor was a well-circumscribed, firm nodule (10 mm × 8 mm × 5 mm in size) (Fig. 1B). The cut surface was whitish, homogeneous, and solid without cystic lesions. Histologically, it was an unencapsulated, paucicellular dense, fibrous nodule with a concentric circular arrangement of collagen bundles (Fig. 2A). Amongst the fibrous bundles, a small number of ovoid/epithelioid or plump spindle cells were arranged in a corded, trabecular, or whorled (onion bulb-like) pattern (Fig. 2B); a storiform pattern was not noted. These cells were relatively uniform and had a somewhat elongated, slightly hyperchromatic nucleus with fine granular chromatin. Neither nuclear pleomorphism nor multinucleated cells were evident, and necrosis and mitotic figures were not observed. Periodic acid,Schiff (PAS) stain after diastase digestion highlighted the corded or whorled pattern of the tumor cells by encasing them. For immunohistochemical examination, formalin-fixed, paraffin-embedded serial tissue sections were stained by a labeled streptavidin,biotin method. The tumor cells were positive for vimentin and epithelial membrane antigen (EMA) (Fig. 3A), and negative for pan-cytokeratin, carcinoembryonic antigen (CEA), CD34, ,-smooth muscle actin, desmin, and CD68. Type IV collagen and laminin (Fig. 3B) were detected along the cords or whorls of the tumor cells, similar to the staining pattern of the diastase-PAS reaction. Schwann cells and axonal components, immunoreactive for S100 protein and neurofilament, respectively, were focally detected just adjacent to the cords or whorls, although the tumor cells per se did not express these proteins. Consequently, the tumor was found to be perineurial in origin and was diagnosed as cutaneous sclerosing perineurioma. Figure 2. (a) Low-power view of the tumor, showing an unencapsulated, paucicellular, dense, fibrous nodule with a concentric circular arrangement of collagen bundles (hematoxylin and eosin stain: original magnification, ×15). (b) Higher magnification of the tumor, showing ovoid or epithelioid cells arranged in cords or whorls in the abundant collagen bundles (hematoxylin and eosin stain: original magnification, ×150) Figure 3. Immunohistochemical profiles of the tumor. The tumor cells are positive for epithelial membrane antigen (a) and are surrounded by laminin (b) (original magnification, ×150) [source] Acral lentiginous melanoma: an immunohistochemical study of 20 casesINTERNATIONAL JOURNAL OF DERMATOLOGY, Issue 2 2003You Chan Kim MD Background Though acral lentiginous melanoma (ALM) is a major type of malignant melanoma, no immunohistochemical study on this type of melanoma has been reported. Objective The purpose of this study is to analysis the immunohistochemical findings of ALM using routinely used immune markers. Methods An immunohistochemical study was performed on paraffin sections of 20 ALMs using S-100 protein, HMB-45, MART-1, vimentin, epithelial membrane antigen (EMA) and CAM 5.2. Results S-100 protein (95%) was found to be a more sensitive marker than either HMB-45 (80%) or MART-1 (70%) for recognizing ALM. Melanin bleaching was useful for recognizing heavily pigmented ALM using both S-100 protein and HMB-45. The intensity of HMB-45 correlated well with the melanin content. However, there was no significant correlation between the intensity of S-100 protein and the melanin content. One and two out of 20 cases stained focally with EMA and CAM5.2, respectively, but these cases stained also with HMB-45 and/or S-100 protein. Conclusions S-100 protein and HMB-45 were relatively sensitive markers for recognizing ALM. Despite the occasional positivity for the epithelial markers in ALM, all epithelial marker-positive cases stained also with HMB-45 and/or S-100 protein. Therefore, we recommend that the panel of antibodies used for recognizing ALM should contain at least S-100 protein and HMB-45. [source] A clonal cutaneous CD30+ lymphoproliferative eruption in a patient with evidence of past exposure to hepatitis EINTERNATIONAL JOURNAL OF DERMATOLOGY, Issue 7 2000Freddye M. Lemons-Estes CDR, MC USN The patient was a 52-year-old white man who had worked in remote areas of the world during the past 2 years, including an extended period in rural areas of Central Africa and in Central and South America. He had no acute illnesses during the 2-year period except for rare, mild, upper respiratory tract infections. For approximately 1 year, however, he had developed recurrent, papular-vesicular, slightly painful lesions on the fingers and palms, that spontaneously healed over weeks to months ( Fig. 1). The patient had no other concurrent illnesses and no abnormal laboratory findings, except for positive enzyme-linked immunoabsorbent assay (ELISA) for immunoglobulin G (IgG) antibodies for hepatitis E virus (HEV) using a recombinant expressed HEV antigen (Genelabs Technologies, Inc., San Antonio). Prolonged treatment with minocycline did not appear to moderate the lesions. At approximately 2.5 years after the development of his first cutaneous lesion, however, the patient reported that he had had no new lesions for over 3 months. Figure 1. Vesicular ,lesion on the finger which regressed over a period of weeks A biopsy specimen showed an intraepidermal vesicle with prominent epidermal necrosis and reticular degeneration ( Fig. 2). Within the epidermis, there was a dense infiltrate of lymphoid cells. The majority of these cells were pleomorphic with prominent nucleoli and frequent mitotic figures ( Fig. 3). Sheets of atypical cells were found in the subjacent dermis. The infiltrate extended down into the reticular dermis. With extension into the dermis, the infiltrate became more polymorphous with more small lymphoid cells, large numbers of eosinophils, and some plasma cells located more deeply. Figure 2. Intraepidermal ,blister showing reticular degeneration and marked epidermotrophism of large atypical cells with extension into the dermis with a mixed infiltrate containing eosinophils and plasma cells (30×) Figure 3. Intraepidermal ,infiltrate of large atypical cells with extension into the dermis with a mixed infiltrate containing eosinophils and plasma cells (400×) Immunohistochemical stains for CD3 (DAKO), CD4 (Becton Dickinson), CD8 (Becton Dickinson), CD15 (LeuM1, Becton Dickinson), CD20 (L-26, DAKO), CD30 (Ber-H2, DAKO), CD45RO (UCHL1, DAKO), S-100 protein (DAKO), T-cell intracellular antigen (TIA) (Coulter), epithelial membrane antigen (EMA) (DAKO), KP-1 (CD68, DAKO), MAC-387 (DAKO), Epstein,Barr virus (EBV) latent membrane antigen-1 (LMP-1, DAKO), and EBV-encoded nuclear antigen 2 (EBNA2, DAKO) were performed on formalin-fixed tissue using the ABC method with DABA as the chromagen. CD3 showed diffuse membrane staining of the large atypical lymphoid cells, as well as the majority of the small lymphoid cells ( Fig. 4). CD4 showed positive membrane staining of the large atypical lymphoid cells and the majority of the small lymphoid cells. CD8 showed only scattered light membrane staining of small lymphoid cells. CD15 was negative, and CD20 showed foci of groups of small lymphoid cells mainly within the reticular dermis. CD30 showed positive membrane and paranuclear staining of the large atypical cells, most abundant within the epidermis and papillary dermis ( Fig. 5). CD45RO showed positive membrane staining of the large atypical cells and the majority of the small lymphoid cells. S-100 protein showed increased dendritic cells within the surrounding viable epidermis and the subjacent papillary dermis ( Fig. 6). TIA showed granular staining in the large atypical lymphoid cells and only rare staining in small lymphoid cells ( Fig. 7). EMA staining was essentially negative. KP-1 showed only scattered positive cells mainly in the lower papillary and the reticular dermis. MAC-387 showed membrane staining in the viable epidermis ( Fig. 8). LMP-1 and EBNA2 for EBV were negative within the lymphoid cells as well as within the overlying epidermis. Figure 4. Immunohistochemical ,staining for CD3 showing diffuse staining of lymphoid cells within the epidermis and dermis (150×) Figure 5. Immunohistochemical ,staining for CD30 showing membrane and paranuclear staining of large atypical lymphoid cells within the epidermis and papillary dermis (a, 150× b, 400×) Figure 6. Immunohistochemical ,staining for S-100 protein within the epidermis and in the papillary dermis (a, 150× b, 300×) Figure 7. Immunohistochemical ,granular staining of large atypical lymphoid cells for TIA (200×) Figure 8. Immunohistochemical ,staining for MAC-387 showing epidermal staining (100×) Gene rearrangement studies showed a ,-T-cell receptor gene rearrangement. The monoclonal band was detected with VJ1, VJ2, and D1J2 primer sets. The T-cell receptor , rearrangement assay has a sensitivity of 61% and a specificity of 94% for the detection of a monoclonal rearrangement in T-cell lymphomas for which amplifiable DNA can be recovered. Electron microscopy was performed on formalin-fixed material, positive-fixed with 2.5% phosphate-buffered glutaraldehyde and further with 1% osmium tetroxide by standard techniques. Intracellular, 50,60-nm, cytoplasmic, spherical, viral-like particles were identified ( Fig. 9). Figure 9. Electron ,microscopy showing 50,60-nm diameter, intracellular, viral-like particles (arrows) (70,000×) [source] Evaluation of eosin-5-maleimide flow cytometric test in diagnosis of hereditary spherocytosisINTERNATIONAL JOURNAL OF LABORATORY HEMATOLOGY, Issue 1p2 2010R. KAR Summary A flow cytometry-based test using eosin-5-maleimide (EMA) dye was used for diagnosis of hereditary spherocytosis (HS). The mean fluorescence intensiy (MFI) of EMA tagged erythrocytes is lower in HS than that in other hemolytic and nonhemolytic anemias. We enrolled 114 subjects comprising 20 confirmed HS, 20 suspected HS/hemolytic anemia (HA), 20 normal controls, 20 other hemolytic anemias [13 autoimmune hemolytic anemia, three congenital dyserythropoietic anemia (CDA), one pyruvate kinase deficiency, two microangiopathic hemolytic anemia], 18 microcytic anemia and 16 macrocytic anemia cases. All samples were subjected to flow cytometry as per standard protocol. The mean MFI of normal control subjects was 11 861.5 (SD 883.5) and of confirmed HS was 7949.3 (SD 1304.1). Using this test, of 20 patients suspected to be HS/HA but with no confirmatory diagnosis, eight patients were diagnosed as HS. Using logistic regression analysis, the optimum cut-off MFI value between HS and normal controls was 10126. The area under the ROC curve was 0.99. The statistical significance of MFI values was obtained by t -test or Wilcoxon rank sum test as applicable. Compared with normal controls, the MFI values in HS were lower and in megaloblastic anemia were higher which was statistically highly significant (P < 0.01), and the MFI values in CDA were lower which was statistically significant (P < 0.05). False-positive values were obtained in three cases of AIHA and two cases of CDA. The sensitivity and specificity was 96.4% and 94.2% respectively. The EMA-based flow cytometry test is a highly sensitive and specific method for the diagnosis of HS. [source] Detection of viable Escherichia coli O157:H7 by ethidium monoazide real-time PCRJOURNAL OF APPLIED MICROBIOLOGY, Issue 5 2009L. Wang Abstract Aims:, The aim of this study was to develop and optimize a novel method that combines ethidium bromide monoazide (EMA) staining with real-time PCR for the detection of viable Escherichia coli O157:H7 in ground beef. EMA can penetrate dead cells and bind to intracellular DNA, preventing its amplification via PCR. Methods and Results:, Samples were stained with EMA for 5 min, iced for 1 min and exposed to bright visible light for 10 min prior to DNA extraction, to allow EMA binding of the DNA from dead cells. DNA was then extracted and amplified by TaqMan® real-time PCR to detect only viable E. coli O157:H7 cells. The primers and TaqMan® probe used in this study target the uidA gene in E. coli O157:H7. An internal amplification control (IAC), consisting of 0·25 pg of plasmid pUC19, was added in each reaction to prevent the occurrence of false-negative results. Results showed a reproducible application of this technique to detect viable cells in both broth culture and ground beef. EMA, at a final concentration of 10 ,g ml,1, was demonstrated to effectively bind DNA from 108 CFU ml,1 dead cells, and the optimized method could detect as low as 104 CFU g,1 of viable E. coli O157:H7 cells in ground beef without interference from 108 CFU g,1 of dead cells. Conclusions:, EMA real-time PCR with IAC can effectively separate dead cells from viable E. coli O157:H7 and prevent amplification of DNA in the dead cells. Significance and Impact of the Study:, The EMA real-time PCR has the potential to be a highly sensitive quantitative detection technique to assess the contamination of viable E. coli O157:H7 in ground beef and other meat or food products. [source] Morphology and electrical properties of carbon black filled LLDPE/EMA compositesJOURNAL OF APPLIED POLYMER SCIENCE, Issue 1 2007Ping Zhou Abstract The morphology and electrical properties of linear low density polyethylene (LLDPE)/poly (ethylene-methyl arylate) (EMA) blends filled with carbon black (CB) are investigated in this work. Comparing to LLDPE/CB composite, the higher percolation threshold of EMA/CB composite is attributed to the good interaction between EMA and CB. However, carbon black is found to locate preferentially in the LLDPE phase of LLDPE/EMA immiscible blends from the characterization of SEM and electrical properties, which greatly decreases the percolation threshold of the composites. The viscosity of the two polymers is the key factor to determine the distribution of CB instead of interfacial energy in this system. This suggests a method to control the distribution of CB in the immiscible blends by choosing the viscosity ratio of polymer blend. © 2006 Wiley Periodicals, Inc. J Appl Polym Sci 103: 487,492, 2007 [source] Giant clear cell hidradenoma of the kneeJOURNAL OF CUTANEOUS PATHOLOGY, Issue 9 2010Gengsheng Yu Hidradenomas, also referred to as nodular hidradenomas or clear cell hidradenomas (CCH), are benign cutaneous eccrine tumors usually 2,3 cm in dimension. Hidradenomas are relatively common; however, giant forms are rare. We report a case of an 8.0 × 6.0 × 3.0 cm clear cell hidradenoma of the left knee in a 43-year-old man. The tumor was mobile, located above the patellar tendon and was without bony involvement on imaging studies. Grossly, the resected tumor was unencapsulated and tan, with a solid and cystic cut surface showing papillary excrescences on the cyst wall. Microscopically, the tumor cells showed an infiltrative growth pattern at the periphery, however, the tumor cytology was bland and no necrosis or mitoses were identified. The overlying dermis contained hemosiderin pigment deposition and infiltration with eosinophils. Immunohistochemically, tumor cells were positive for cytokeratin, CAM5.2, p53, carcino-embryonic antigen (CEA) and epithelial membrane antigen (EMA), and negative for CD10 and Ki-67. The cytological features of hidradenomas can present diagnostic challenges, as other ,clear cell' tumors such as metastatic renal cell carcinoma should be considered. Immunohistochemical studies and differential diagnoses are discussed. Yu G, Goodloe S, D'Angelis CA, McGrath BE, Chen F. Giant clear cell hidradenoma of the knee. [source] Fibroblastic rheumatism: fibromatosis rather than non-Langerhans cell histiocytosisJOURNAL OF CUTANEOUS PATHOLOGY, Issue 5 2010Nicolas Kluger Background: Fibroblastic rheumatism is a unique fibro-proliferative disease affecting the skin and joints. It is characterized by distinctive clinical and histological features related to benign spindle-shaped cells proliferation. Pediatric reports are scarce in the literature. Objective: We describe here a new case in a 10-year-old boy and discuss the potential origin of the cell proliferation. Methods: Clinical findings, radiology, microscopic examination and outcome are reviewed. Histopathology and immunochemistry studies were performed on skin biospies using CD68, CD163, desmin, factor XIIIa, CD34, smooth muscle actin, PS100, epithelial membrane antigen, and calponin. Results: Histological sections disclosed a rather circumscribed nonencapsulated nodular infiltrate, invading the dermis and the upper subcutaneous tissue, consisted of a proliferation of spindle or stellate-shaped cells and thickened collagen fibers. Orcein staining showed disappearance of the elastic network. Aponeurosis and muscle were normal. A mild perivascular lymphohistiocytic infiltrate was noted. Calponin-staining was less strongly expressed as SMA, and some of them but not all were CD68 positive, as well. On the other hand, all were CD34, CD163, FXIIIa, PS100, EMA and desmin-negative. Conclusion: The true origin of these cells remains unclear. Some authors have speculated a histiocytic origin. However, immuno-chemical staining in our case failed to confirm this hypothesis and instead supported a fibroblastic/myofibroblastic origin. Given the clinical course and the histological and immunohistochemical results, we suggest that FR should be added to the group of fibromatoses. Kluger N, Dumas-Tesici A, Hamel D, Brousse N, Fraitag S. Fibroblastic rheumatism: fibromatosis rather than non-Langerhans cell histiocytosis. [source] Morphological and immunohistochemical characteristics of atypical fibroxanthoma with a special emphasis on potential diagnostic pitfalls: a reviewJOURNAL OF CUTANEOUS PATHOLOGY, Issue 3 2010tjan Luzar The present manuscript gives emphasis on recognizing different morphological variants of atypical fibroxanthoma (AFX), on validation of immunohistochemical markers and on discussing potential diagnostic pitfalls. Material and methods: Histological features analyzed in 66 AFXs were: ulceration, morphological variants, growth pattern, location in the skin and vascular/perineural invasion. The antibodies used were CK-MNF116, CK-AE1/AE3, S100, smooth muscle actin, desmin, CD31 and EMA. Results: The study included 59 males, 7 females, aged 55,95 years, mean 77 years. All developed on sun damaged skin. Ulceration was present in 50%. Morphological patterns were pleomorphic spindle and epithelioid cells (60.6%), predominantly spindle cells (19.7%), purely spindle-cells (13.6%), and predominantly epithelioid cells (6.1%). Most were localized in the dermis (57.6%). An expansile (36.4%) rather than infiltrative (6.1%) growth into superficial subcutis was also noted. No vascular/perineural invasion was seen. Additional changes were hemorrhagic and pseudoangiomatous areas (24.2%), granular cell change (22.7%), keloid-like areas (9.1%), myxoid change (7.6%), osteoclast-like giant cells (6.1%) and clear cell change (4.6%). AFXs were consistently negative for S100, CK-MNF116, CK-AE1/AE3 and desmin. Focal positivity for SMA (45.2%), EMA (24.4%) and CD 31 (9.5%) was seen. Conclusions: A diagnosis of AFX is still made by exclusion of other malignant neoplasms with similar morphology. Immunohistochemistry plays a crucial role in this distinction, but can also be misleading. This study expands the spectrum of non-vascular CD31 positive tumors. Luzar B, Calonje E. Morphological and immunohistochemical characteristics of atypical fibroxanthoma with a special emphasis on potential diagnostic pitfalls. [source] Epithelioid sarcoma with angiomatoid features: report of an unusual case arising in an elderly patient within a burn scarJOURNAL OF CUTANEOUS PATHOLOGY, Issue 3 2008Steven Kaddu Epithelioid sarcoma (ES) is a rare, aggressive soft tissue tumor with a characteristic predilection for adolescents and young adults, and a tendency to occur on distal extremities. We report a case of ES arising in an 80-year-old woman within a burn scar that histopathologically showed unusual ,angiomatoid' features. The patient presented initially with a solitary nodule on her right wrist arising at the site of a burn scar. Histopathologically, the tumor was composed of a proliferation of relatively bland, epithelioid and spindle cells focally arranged in a nodular pattern around areas of ,geographic' necrosis. In addition, there were prominent foci of hemorrhage and blood-filled spaces as well as tumor cells with intracytoplasmic vacuoles, features suggestive of an angiomatous process. Immunohistochemistry showed positivity of tumor cells for cytokeratins and epithelial membrane antigen (EMA) whereas all vascular markers tested were negative. The overall histopathologic features were consistent with a diagnosis of ES. Follow up showed multiple recurrences arising proximally along the right upper extremity. Our case underlines the clinical and histopathological heterogeneity of ES, emphasizing the unusual occurrence of ES with ,angiomatoid' features in the elderly. In this uncommon setting, this tumor should be especially distinguished from epithelioid hemangioendothelioma and epithelioid angiosarcoma. The significance of development of ES on a healed burn scar is uncertain, but may suggest a possible causal relationship. [source] Soft-tissue perineurioma in a 20-year-old patient with neurofibromatosis type 1 (NF1): report of a case and review of the literatureJOURNAL OF CUTANEOUS PATHOLOGY, Issue 9 2007Gregory G. Ausmus Background:, Perineurioma is a rare benign soft-tissue tumor composed of cells showing differentiation toward the perineurial cells of the nerve sheath. Although mutations in the neurofibromatosis 2 (NF2) gene have been documented in this tumor, there is no known association between perineuriomas and type 1 or 2 NF. Methods:, This is the first report of a case of soft-tissue perineurioma occurring in a patient with NF1. Results:, Histopathologic examination revealed a 2.0-cm well-circumscribed, spindle-cell neoplasm with slender, elongated, bipolar, wavy cytoplasmic processes and wavy, elongated nuclei in a hyalinized stroma with focal myxoid areas. The architecture was composed predominantly of short fascicles with areas exhibiting a storiform pattern. Immunohistochemistry showed positive labeling for epithelial membrane antigen (EMA) but no staining for S-100 and smooth muscle actin (SMA). Conclusion:, This case illustrates that perineurioma can occur in association with NF1. Perineuriomas can be confused with other spindle-cell neoplasms, and relevant features and immunohistochemistry of these lesions are outlined. The patient has not had a recurrence with limited follow-up. [source] Hidradenocarcinoma: Criteria for Malignancy and Hypothesis of an Apoeccrine OriginJOURNAL OF CUTANEOUS PATHOLOGY, Issue 1 2005C. Ko The immunohistochemical profile of hidradenocarcinoma, defined here as the malignant counterpart of hidradenoma, has not been well characterised. We evaluated the staining pattern of six cases of hidradenocarcinoma using antibodies to gross cystic disease fluid protein-15 (GCDFP-15), carcino-embryonic antigen (CEA), epithelial membrane antigen (EMA), S-100 protein, keratin AE1/3, cytokeratin 5/6, p53, bcl-1, bcl-2, and Ki67. All tumours were poorly circumscribed with clefting between tumour and stroma, evidence of poroid cells and cuticular cells, decapitation secretion, and increased mitoses with cords of tumour infiltrating through the adjacent desmoplastic stroma. The tumours stained with antibodies to CEA, S-100 protein, GCDFP-15, and EMA in no consistent pattern. All tumours studied stained positively for keratin AE1/3 and cytokeratin 5/6. Ki67 and p53 staining were strongly positive in 5 of 6 tumours. Bcl-1 and bcl-2 staining were variable. Our study demonstrates that hidradenocarcinomas may have both apocrine and eccrine features within the same tumour and suggests that it may be most accurate to consider that these tumours originate from apoeccrine structures or stem cells with the capacity for pluripotential differentiation. [source] Myoepithelioma of the Skin with P63 ExpressionJOURNAL OF CUTANEOUS PATHOLOGY, Issue 1 2005M.J. Smith-Zagone A case of cutaneous myoepithelioma is reported. A 37 year-old woman presented with a 2 cm well-circumscribed dermal nodule of the forehead. The tumor was enucleated with the clinical diagnosis of an epidermal inclusion cyst. Histologically, the tumor was located within the dermis and was well circumscribed. It was composed of spindle-shaped and epithelioid cells arranged in organoid nests. Focal areas of extracellular hyalinized stroma were present. Well-defined glandular structures, chondroid matrix, and significant nuclear pleomorphism were absent. The tumor expressed widespread cytoplasmic positivity for cytokeratin (using AE1/AE3) and nuclear positivity for p63. Variable reactivity was noted with EMA and S-100. The tumor was negative for smooth muscle actin, GFAP, chromogranin, synaptophysin, and CEA. These immunohistochemical results supported myoepithelial differentiation. Myoepitheliomas of the skin are rare neoplasms that have only recently been recognized in the skin. A single publication has reported the diagnostic utility of p63 in the diagnosis of myoepithelial tumors of the skin. Myoepitheliomas often display variable expression of myoepithelial markers, with no single marker that is 100% sensitive. The current case highlights the need for a battery of markers, including p63, to detect myoepithelial differentiation. [source] | |||||||||||||||||||||||||||||||||||||||||||