Cellular digital fibromas: distinctive CD34-positive lesions that may mimic dermatofibrosarcoma protuberans

BACKGROUND: Digital fibromas are common benign acral tumors typically reported as angiofibromas (AFs) or acquired digital fibrokeratomas (ADFs). Cellular variants are not well recognized. METHODS: We collected 14 acral fibrocytic lesions showing a spindle cell morphology from our files, and evaluated CD34, Factor XIIIa, epithelial membrane antigen (EMA), and S100 protein staining of these lesions. We compared the histologic and immunohistochemical features of these cellular fibromas with five digital AFs, five ADFs, and five digital dermatofibromas. RESULTS: The 14 cellular digital fibromas showed intersecting fascicles of thin delicate bland spindle cells in the superficial reticular dermis with a fibrotic-to-slight myxoid stroma. The spindle cells in all cases stained strongly for CD34, and only scattered stromal cells stained for Factor XIIIa. Five tested cases were negative for EMA and S100 protein. The digital AFs, fibrokeratomas, and dermatofibromas stained predominately for Factor XIIIa, with no or minimal staining for CD34. CONCLUSIONS: These findings suggest that a subset of digital fibromas is characterized by a dense cellular proliferation of CD34-positive spindle cells. Awareness of this variant of digital fibroma and its staining pattern is critical in preventing misdiagnosis as dermatofibrosarcoma protuberans, particularly in superficial biopsies.     

Metals and kidney markers in adult offspring of endemic nephropathy patients and controls: a two-year follow-up study

Background  

The etiology of Balkan Endemic Nephropathy, (BEN), a tubulointerstitial kidney disease, is unknown. Although this disease is endemic in rural areas of Bosnia, Bulgaria, Croatia, Romania, and Serbia, similar manifestations are reported to occur in other regions, for instance Tunisia and Sri Lanka. A number of explanations have been stated including lignites, aristolochic acid, ochratoxin A, metals, and metalloids. Etiologic claims are often based on one or a few studies without sound scientific evidence. In this systematic study, we tested whether exposures to metals (cadmium and lead) and metalloids (arsenic and selenium) are related to Balkan Endemic Nephropathy.     

Sample conservation prior to total EDTA and Fe(III)EDTA measurements

Ethylenediamine tetraacetic acid (EDTA) is a potent chelating agent and has the potential to affect the environmental mobility of heavy metals. A reliable quantification of EDTA and its speciation is required in order to accurately estimate the actual impact of this compound on the aquatic environment. This study aimed to determine the optimal conservation conditions for samples in order to accurately measure EDTA speciation and total EDTA concentration. The results obtained by studying the effects of time elapsed between sampling, conditioning [i.e., addition of reagents to complex EDTA with Fe (III)], and analysis show that the determination of EDTA speciation needs to be carried out immediately after sampling. The measurement of total EDTA may be performed within 2 mo, as long as the sample is filtered and conditioned on the day of sampling.     

Th17 cells in Bulgarian children with chronic obstructive lung diseases

Introduction and objectives

Th17 lymphocytes are now widely believed to be critical in various chronic pulmonary diseases. However, there is still a small number of investigations regarding children. We aimed to assess the percentage of Th17 lymphocytes and IL-17A in peripheral blood of children with chronic obstructive lung diseases.

Mechanism of inhibitory effect of some pyrazole derivatives on purine biosynthesis de novo

The inhibitory effect of some pyrazole derivatives on GAR synthesis was studied. It was found that nonalkylating analogues and chloroethyltriazeno analogues inhibited GAR synthesis. A possible mechanism of action of triazeno derivatives on purine biosynthesis de novo was shown.     

Trajectories of cognitive decline and functional status in the frail older adults

This study investigates the implications of different levels of cognitive decline on functional status in frail older adults. Four cognitive trajectories, including two with catastrophic cognitive decline, were defined in a 3-year study. Participants with complete cognitive and functional status data at baseline, 12 and 36 months of follow-up were included in the study (n=456). Data were analysed with repeated measures statistics. Substantial functional deterioration over time was observed for the participants with catastrophic cognitive decline. Catastrophic cognitive decline influenced performance in instrumental activities of daily living (IADL) and activities of daily living (ADL) at 12 months, whereas basic physical and mental actions were affected at 36 months. IADL were found to deteriorate more than ADL. The results have implications on planning appropriate geriatric rehabilitation and long-term care program.