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Maggot therapy for calciphylaxis wound debridement complicated by bleeding

Calciphylaxis is a rare disease with significant morbidity and mortality. Reported 1-year mortality is up to 80%, with sepsis as the leading cause of death.1 Although most cases occur in end-stage renal disease patients on dialysis, nonuremic cases also occur. Maggot therapy for wound debridement in calciphylaxis has been reported, but the literature is limited.

Schnitzler syndrome associated with hairy cell leukemia presenting with chronic urticaria and arthralgias

Schnitzler syndrome is an underdiagnosed clinical condition characterized by 2 major criteria: chronic recurrent urticarial eruption and monoclonal IgM gammopathy, as well as at least 2 of the following minor criteria: (1) recurrent fever, (2) high C-reactive protein (CRP) levels, (3) signs of abnormal bone remodeling with or without bone pain, and (4) neutrophilic infiltrates on skin biopsy.1 We report the case of a patient with history of hairy cell leukemia who exhibited atypical clinical presentation of chronic urticaria for 2 years before the final diagnosis of Schnitzler syndrome was established.

A melanocytic cuckoo

A 32-year-old man presented with a pigmented lesion on the left dorsal foot for as long as he could remember. Having observed a gradual change in peripheral color over many years, it had become more raised and occasionally itchy in the preceding year. There was no personal or family history of cutaneous malignancy. Clinical examination found a 10-mm × 10-mm symmetrical square plaque with a peripheral tan-colored area surrounding central blue-black pigmentation (Fig 1).

An unusual case of metastatic breast carcinoma metastasizing to an antecedent rhytidectomy procedural scar

Breast carcinoma remains the most common cutaneous metastasis in women.1 Although breast carcinoma can arise within mastectomy scars as a sign of locoregional recurrence, distant metastasis in the skin is a less common event. We report the case of a 58-year-old white woman with a history of infiltrative ductal carcinoma who presented with multiple cutaneous papules and nodules on the scalp and retroauricular region. A single metastatic focus uniquely occurred in a prior rhytidectomy scar on the left postauricular sulcus.

Nevus anemicus and RASopathies

Tadini and colleagues were the first to report the correlation between anemic nevi and RASopathies.1 A retrospective study in their genodermatosis center identified anemic nevi at different anatomic sites in a cohort of neurofibromatosis type 1 (NF1) (50/565).

Spiny keratoderma exposes underlying renal cell carcinoma

Spiny keratoderma is a rare condition characterized by numerous, pinpoint, keratotic projections commonly found on the palms and soles reported in the literature to be associated with several diverse underlying conditions, including malignancy. We report an unusual case of spiny keratoderma associated with renal cell carcinoma.

Extracranial congenital malignant rhabdoid tumor in infant with disseminated disease: An uncommon entity and diagnostic challenge

Malignant rhabdoid tumors (MRTs) are uncommon and aggressive tumors that typically present during childhood. Primary MRTs most often arise from the central nervous system and kidneys; however, primary tumors from other sites are occasionally reported. We present a case of an infant born with extracranial MRTs who was found to have disseminated disease involving the abdominal viscera.

Invasive trichosporonosis treated with voriconazole

Trichosporon is a genus of yeast-like fungi. It is perhaps most widely known as the cause of white piedra, a benign superficial mycosis seen in immunocompetent individuals in tropical and subtropical regions. However, the incidence of invasive trichosporonosis has increased in immunocompromised patients, most notably those with hematologic malignancies. The following case illustrates characteristic features of trichosporonosis fungemia.

Pilomatrix carcinoma of the nose: Clinical and dermoscopic presentation

A 69-year-old man presented with a smooth dome-shaped reddish nodule, 1.4 cm in diameter, which had rapidly arisen on the nose over the previous 3 months (Fig 1).

Psoriasiform eruption on the face and extremities associated with nivolumab therapy

Nivolumab is an IgG4 anti–programmed cell death protein 1 monoclonal antibody, part of a newer class of drugs known as immune checkpoint inhibitors.1 Nivolumab has been approved for use in previously treated patients with non–small cell lung cancer, renal cell carcinoma, and metastatic melanoma and is in the advanced stages of development for the treatment of squamous cell carcinoma of the head and neck, urothelial cancer, gastric cancer, glioblastoma, and other lung cancers.1-3

Metastatic melanoma with diffuse melanosis histologically after stable response to talimogene laherparepvec therapy

Talimogene laherparepvec (T-VEC) is the first oncolytic viral immunotherapy approved for treatment of unresectable recurrent melanoma metastases involving skin, subcutaneous fat, or lymph nodes after initial surgery. T-VEC has a favorable safety profile; however, use has been limited to specialized centers because of a select eligible patient population and logistical concerns.1 A randomized phase 3 study comparing T-VEC with subcutaneous granulocyte-macrophage colony-stimulating factor in unresectable stage IIIC-IV melanoma (limited visceral disease) showed an improved durable response rate (complete and partial response ≥6 months) of 16.3% versus 2.1%.

Recurrent lupus profundus-like panniculitis associated with streptococcal throat infections in an immunocompetent child

We report the unusual case of an immunocompetent child in whom recurrent lupus profundus-like panniculitis associated with group A Streptococcus throat infections developed. Her skin findings were independent of the presence of bacterial organisms and resistant to antibiotics alone, suggesting an inflammatory, immune-mediated process. Surprisingly, histopathology testing found characteristics of lupus erythematosus profundus in an acute panniculitis stage.

Explosive bullous pemphigoid with high serum total IgE: Serum IgE as a biomarker that reflects disease activity

Bullous pemphigoid (BP) is a chronic autoimmune blistering disease characterized by pruritic, tense bullae and urticarial plaques. BP is associated with significant mortality, with 1-, 2-, and 5-year mortality rates of 19.46%, 29.13%, and 58.03%, respectively, in South Korea.1 The main pathogenesis involves IgG autoantibodies against hemidesmosomal proteins: BP 180 and BP 230. IgE autoantibodies are increasingly reported in BP.2 Herein we report a case of refractory BP with a fatal outcome and discuss the possible relationship between total serum IgE and disease activity.

Carpenter's pigmentation mimicking ashy dermatosis associated with African padauk wood dust

Various adverse cutaneous reactions may occur as a result of exposure to wood dust or exotic woods. These reactions include allergic contact dermatitis, irritant contact dermatitis, urticaria, photoallergic and phototoxic reactions, and multiformelike reactions. Exposure is also associated with nasal, eye, and respiratory symptoms.

Squamous cell carcinoma arising in a chronic perineal wound in a patient with long-standing cutaneous Crohn's disease

Cutaneous squamous cell carcinoma (SCC) is an invasive, malignant tumor with metastatic potential. This tumor can arise from various precursor lesions, including ulcers, actinic keratoses, and leukoplakia. A Marjolin ulcer is an aggressive malignancy of the skin, most commonly SCC, arising in chronic wounds or scars. Transformation from a chronic wound to SCC is rare and slow with an unknown pathogenesis, although proposed mechanisms include nonspecific or chronic antigenic stimulation.1,2 Malignantly transformed wounds are challenging to differentiate from primary chronic ulcers, so having a high suspicion for SCC and diagnosis in a timely manner is key.

Propranolol as a potentially novel treatment of arteriovenous malformations

Arteriovenous malformations (AVMs) are characterized by a snarled tangle of arteries and veins that are connected to each other through a bypass in the capillary bed.1,2 AVMs can occur anywhere on the body but are most commonly in the brain, lungs, pelvis, and extremities.1,2 AVMs can be either asymptomatic or cause intense pain or bleeding and can lead to serious medical problems.3,4 The diagnosis of an AVM involves a combination of vascular imaging studies, such as Doppler ultrasound, computerized axial tomography, magnetic resonance angiography, and histologic examination of tissue biopsies.

Pressure-induced necrosis can mimic retiform purpura

Retiform purpura most often represents pathology of medium vessels and is commonly an important sign of systemic disease. Identifying the underlying etiology is important to help prevent morbidity and mortality. We present a case in which pressure-induced necrosis (coma blister) occurred in a stellate pattern, mimicking more typical retiform purpura.

Health risk assessment of VOC emissions in laboratory rooms via a modeling approach

Abstract

One of the important agents menacing buildings' employees and residents' health is the emission of volatile organic compounds (VOCs) into the indoor environment. The present research studied the VOC emission to evaluate indoor air quality (IAQ) through studying in-laboratory processes and tasks. On account of that, three different pollutants (acetone, benzene, and toluene) were chosen as candidate VOCs, and Environmental Engineering Research Center at Sahand University of Technology was selected as a sample laboratory for each VOC. Using CFD model, concentrations of pollutants under unsteady state in a three-dimensional geometry at various temperatures were provided. To validate the considered model, the modeling results were compared to experimental data. Health risk was evaluated through the building using the OEL-C, OEL-STEL, and OEL-TWA parameters for the three pollutants. According to the mentioned parameters and the modeling results, 1 h following the emission, in order to reduce the health risk associated with short-term exposure to the emission, the staff should observe a minimum distance of 3, 2, and 1.8 m to the sources of acetone, benzene, and toluene, respectively. This is while, since average concentration of emission within the laboratory in an 8-h period is several times as large as OEL-TWA, then the laboratory staffs are strictly recommended not to work in the laboratory for long hours. Furthermore, using the results of this research, the staff can detect safe locations within the laboratory without any need to use emission monitoring equipment.

G-Spotplasty: A New Surgical Plastic Intervention—The Preliminary Study

Abstract

Background

Ostrzenski's G-pot anatomical structure discovery has been verified by the anatomy, histology, MRI in vivo, and electrovaginography in vivo studies. The objectives of this scientific-clinical investigation were to develop a new surgical reconstructive intervention (G-spotplasty); to determine the ability of G-spotplasty surgical implementation; to observe for potential complications; and to gather initial information on whether G-spotplasty improves female sexual activity, sexual behaviors, and sexual concerns.

Methods

A case series study was designed and conducted with 5-year follow-up (October 2013 and October 2017). The rehearsal of new G-spotplasty was performed on fresh female cadavers. Three consecutive live women constituted this clinical study population, and they were subjected to the newly developed G-spotplasty procedure in October 2013. Preoperatively and postoperatively, a validated, self-completion instrument of Sexual Relationships and Activities Questionnaire (SRA-Q) was used to measure female sexual activity, sexual behaviors, and sexual concerns.

Results

Three out of twelve women met inclusion criteria and were incorporated into this study. All patients were subjected to G-spotplasty, completed 5-year follow-up, and returned completed SRA-Q in a sealed envelope. New G-spotplasty was successfully implemented without surgical difficulty and without complications. All patients reported re-establishing vaginal orgasms with different degrees of difficulties, observing return of anterior vaginal wall engorgement, and were very pleased with the outcome of G-spotplasty.

Conclusions

The G-spotplasty is a simple surgical intervention, easy to implement, and improves sexual activities, sexual behaviors, and sexual concerns. The preliminary results are very promising and paved the way for additional clinical-scientific research.

Level of Evidence IV

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

Tryptophan photo-product FICZ upregulates AHR/MEK/ERK-mediated MMP1 expression: Implications in anti-fibrotic phototherapy

The amounts of extracellular matrix (ECM) components in the dermis, such as collagen, elastin, proteoglycan, and fibronectin, are regulated by control of the balance between two opposing processes: production and degradation. Transforming growth factor (TGF)-ß is a major profibrotic cytokine that transforms fibroblasts into myofibroblasts, which synthesize ECM proteins [1]. In scleroderma, fibroblasts that have been aberrantly activated through TGF-ß signaling may result in the production of abundant collagen [2].

Regulation of melanocyte stem cell behavior by the niche microenvironment

Pigment Cell &Melanoma Research, EarlyView.

Unraveling adsorption behavior and mechanism of perfluorooctane sulfonate (PFOS) on aging aquatic sediments contaminated with engineered nano-TiO 2

Abstract

Engineered nano-TiO₂ (Enano-TiO₂) have inevitably discharged into aquatic sediments that resulted from their widespread use. The physicochemical characteristics of sediments might be changed because of remarkable properties of Enano-TiO₂ and affected by the aging of sediments, thereby altering the environmental behavior and bioavailability of other pollutants such as perfluorooctane sulfonate (PFOS) in sediments. Here, adsorption behavior and mechanism of PFOS on aging aquatic sediments spiked with Enano-TiO₂ at a weight ratio of 5.0% were investigated. The results showed that Enano-TiO₂ significantly altered zero points of charge (pH_zpc) and pore surface properties of sediments, manifested as pH_zpc, the total surface area (S_BET), the micro-pore surface area (S_micro), and the external surface area (S_ext) of sediment particles contaminated with Enano-TiO₂ clearly increased, instead average pore size decreased. Rapid intra-particle diffusion processes were well fitted by the pseudo-second-order rate model with the sorption rate (K₂) following the order single (5.764 mg/(g·h)) > binary systems (3.393 mg/(g·h)). Freundlich model best described the sorption isotherm data with the larger sorption capacity (K_F) and sorption affinity (1/n) of sediments spiked with Enano-TiO₂ than that of sediments only. Additionally, Enano-TiO₂ changed the adsorption thermodynamics of PFOS on the sediments with the absolute value of ∆G⁰, ∆H⁰, and ∆S⁰ increased. Fourier transform infrared (FT-IR) spectroscopy suggested possible formation of a negative charge-assisted H-bond between PFOS and the functionalities on sediment surfaces, including O–H of carboxyl, alcohol, phenols, and chemisorbed H₂O as well as carbonyl groups (C=O) of ketone groups. Furthermore, the multilayer sorption of PFOS on sediments contaminated with Enano-TiO₂ is plausible because of bridging effect of Cu²⁺ and Pb²⁺.

Analysis of the repeatability of the exhaust pollutants emission research results for cold and hot starts under controlled driving cycle conditions

Abstract

Measurement of car engines exhaust pollutants emissions is very important because of their harmful effects on the environment. This article presents the assessment of repeatability of the passenger car engine exhaust pollutants emission research results obtained in the conditions of a chassis dynamometer. The research was conducted in a climate chamber, enabling the temperature conditions to be determined from − 20 to + 30 °C. The emission of CO, CH₄, CO₂, NO_X, THC, and NMHC was subjected to the analysis. The aim of the research is to draw attention to the accuracy of the pollutant emission research results in driving cycles, and the comparison of pollutant emission results and their repeatability obtained in successive NEDC cycles under cold and hot start conditions. The results of the analysis show that, in the case of a small number of measurements, the results repeatability analysis is necessary for a proper interpretation of the pollutant emission results on the basis of the mean value. According to the authors' judgment, it is beneficial to determine the coefficient of variation for a more complete assessment of exhaust emission result repeatability obtained from a small number of measurements. This parameter is rarely presented by the authors of papers on exhaust components emission research.

Effective nitrogen removal during different periods of a field-scale bioretention system

Abstract

Bioretention systems are designed to manage stormwater, but they are always subject to substantial nitrate leaching. In previous laboratory-scale experiments, nitrate removal was enhanced using wood chips as a medium. However, the ability of field-scale systems to transform and remove nitrogen species is not well understood. Here, we report a wood-chip bioretention system that accepts the natural runoff from an elevated highway. The transformation of different nitrogen species indicates that the field-scale system with wood chips also inhibits nitrogen leaching. Nitrate removal was mainly found during the wet period, and was affected by the hydraulic loading rate of the system. Overall, this study showed that the field performance of the wood-chip bioretention system effectively removes nitrogen. In addition, the main period associated with the nitrogen removal process was identified.

Steam jet mill—a prospective solution to industrial exhaust steam and solid waste

Abstract

Bulk industrial solid wastes occupy a lot of our resources and release large amounts of toxic and hazardous substances to the surrounding environment, demanding innovative strategies for grinding, classification, collection, and recycling for economically ultrafine powder. A new technology for grinding, classification, collection, and recycling solid waste is proposed, using the superheated steam produced from the industrial exhaust steam to disperse, grind, classify, and collect the industrial solid waste. A large-scale steam jet mill was designed to operate at an inlet steam temperature 230–300 °C and an inlet pressure of 0.2–0.6 MPa. A kind of industrial solid waste fluidized-bed combustion ashes was used to grinding tests at different steam temperatures and inlet pressures. The total process for grinding, classification, and collection is drying. Two kinds of particle sizes are obtained. One particle size is d₅₀ = 4.785 μm, and another particle size is d₅₀ = 8.999 μm. For particle size d₅₀ = 8.999 μm, the inlet temperature is 296 °C and an inlet pressure is 0.54 MPa for the grinding chamber. The steam flow is 21.7 t/h. The yield of superfine powder is 73 t/h. The power consumption is 3.76 kW h/t. The obtained superfine powder meets the national standard S95 slag. On the basis of these results, a reproducible and sustainable industrial ecological protocol using steam produced by industrial exhaust heat coupled to solid waste recycling is proposed, providing an efficient, large-scale, low-cost, promising, and green method for both solid waste recovery and industrial exhaust heat reutilization.

RF-ablation pattern shaping employing switching channels of dual bipolar needle electrodes: ex vivo results

Abstract

Purpose

Radiofrequency (RF) ablation with mono- or bipolar electrodes is a common procedure for hepatocellular carcinoma (HCC) with a low rate of recurrence for small size tumors. For larger lesions and/or non-round/ellipsoid shapes RF ablation has some limitations and generally does not achieve comparable success rates to microwave ablation or high-intensity focused ultrasound therapies.

Materials and methods

To shape RF ablations for matching a tumor size and geometry, we have developed an electronic channel switch box for two bipolar needles that generates multiple selectable ablation patterns. The setup can be used with commercially available mono- or bipolar RF generators. The switch box provides ten selectable ablation procedures to generate different ablation patterns without a relocation of a needle. Five patterns were exemplary generated in ex vivo tissue of porcine liver and chicken breast and visually characterized.

Results

Different ablation patterns, e.g., in a L- or U-shape, were achieved. In chicken breast a maximum ablation with a diameter of \(4.3\, \hbox {cm}\) was obtained and in porcine liver \(2.8\, \hbox {cm}\) with electrodes of \(0.9\, \hbox {cm}\) length.

Conclusion

The resulting ablations with the electronic switch box and two bipolar needles show the potential ability to manage RF therapies of complex and large tumor geometries. Next steps would be to validate the actual tissue ablation volumes in further ex vivo and preclinical studies and against simulation results.

HPLC–DAD identification of polyphenols from ethyl acetate extract of Amaranthus spinosus leaves and determination of their antioxidant and antinociceptive effects

Abstract

Amaranthus spinosus has been consumed traditionally to prevent various diseases including abdominal pain. In this study, the phytochemical composition, antioxidant and analgesic activities of an ethyl acetate extract of A. spinosus leaves (ASEA) were evaluated. The ASEA had the highest concentrations of total phenols (462.2 mg GAE/g DW), condensed tannin (5.01 mg CE/g DW) and total flavonoid contents (30.07 mg CE/g DW) compared to the chloroform, n-hexane, n-butanol and water extracts. Similarly, ASEA showed the most effective total antioxidant activity (45.45 µg/mL), DPPH scavenging activity (27.32 µg/mL) and hydrogen peroxide scavenging activity (30.60 µg/mL). ASEA with the doses of 200–600 mg/kg (p.o.) clearly demonstrated antinociceptive effects by reducing acetic acid-induced abdominal contortions with a maximal inhibition of 79.57% at 600 mg/kg and increasing latencies of the hot-plate paw-licking response. The tested doses also significantly (p < 0.001) decreased the reaction time in the formalin test at the neurogenic and inflammatory phases. ASEA contained ten polyphenols with caffeic acid being the predominant polyphenol. Overall, this study gave evidence that A. spinosus is a new antioxidant and analgesic agent, and justified its traditional use for the treatment of pain.

Quantum gravity, timelessness, and the contents of thought

Abstract

A number of recent theories of quantum gravity lack a one-dimensional structure of ordered temporal instants. Instead, according to many of these views, our world is either best represented as a single three-dimensional object, or as a configuration space composed of such three-dimensional objects, none of which bear temporal relations to one another. Such theories will be empirically self-refuting unless they can accommodate the existence of conscious beings capable of representation. For if representation itself is impossible in a timeless world, then no being in such a world could entertain the thought that a timeless theory is true, let alone believe such a theory or rationally believe it. This paper investigates the options for understanding representation in a three-dimensional, timeless, world. Ultimately it concludes that the only viable option is one according to which representation is taken to be deeply non-naturalistic. Ironically then we are left with two seemingly very unattractive options. Either a very naturalistic motivation—taking seriously a live view in fundamental physics—leads us to a very non-naturalistic view of the mental, or else views in the philosophy of mind partly dictate what is an acceptable theory in physics.

Cytotoxicity and histopathological analysis of titanium nanoparticles via Artemia salina

Abstract

The consumption trend of nanoparticles by industry in this moment pays attention to titanium nanoparticles (TiNPs), due to their various applications: personal care products, household products, food industry, electronic devices, and healthcare products. Rising consumption of TiNPs without specific regulatory criteria for control safety releasing quantification leads to concern on the topic of environmental contamination and injurious effect. Therefore, this study investigates TiNP toxicities on aquatic animals representing hazardous effects to natural water resource, by determining 24-h LC₅₀ of TiNPs with histopathology investigation. We select brine shrimp (Artemia salina) as a model. Ten adults A. salina were incubated at room temperature for 24 h with various concentrations of TiNPs in triplicate. The mortality number of A. salina was recorded and LC₅₀ value was calculated. The LC₅₀ result is 1693.43 mg/L. Next, A. salina histopathology investigation was done by selecting the living ones after incubation for 24 h with 25% LC₅₀ of TiNPs. We performed tissue processing, embedding, sectioning, and H&E staining, and observed under light microscope. Histopathology reveals TiNP occlusion throughout the intestinal tract. Epithelial cells show abnormal morphology such as hyperplasia, villus deformation, disorganized arrangement, severe edema, and necrosis area. Consequently, the current study shows the severity of TiNP effects on aquatic microcrustaceans and their negative impact on the ecosystem. Furthermore, this information will aid the elucidation of TiNP toxicity effect and the risk of ecosystem disruptions.

Concurrent reduction-adsorption of chromium using m-phenylenediamine-modified magnetic chitosan: kinetics, isotherm, and mechanism

Abstract

Magnetic chitosan particles (MCS) were chemically grafted by m-phenylenediamine (mPD) forming a distinctive shell layer with abundant nitrogenous functional groups and used as an adsorbent for the effective removal of Cr(VI) from aqueous solution. By interaction among functional groups in the facile oxidative polymerization process, the grafting of mPD and its polymers on MCS surface was innovatively realized. Through Fourier-transformed infrared spectroscopy, energy dispersive spectrometer, X-ray photoelectron spectroscopy, etc., the chemical properties of MCS before and after modification were characterized and the concurrent reduction-adsorption mechanism in Cr(VI) adsorption by mPD-MCS was carefully analyzed. The maximal Cr(VI) removal performance of mPD-MCS reached 227.27 mg/g, which was significantly better than that of the original MCS. The analysis indicated that Cr(VI) could be efficiently reduced to Cr(III) and the removal of Cr(VI) and Cr(III) was through adsorption and chelation simultaneously by mPD-MCS. Results also indicated that the concurrent reduction-adsorption was enhanced by protonation of nitrogenous functional groups under low pH. The obtained results suggest that mPD-MCS has a good potential in removal and detoxication of Cr(VI) from aqueous solutions.

Mutagenic assessment of Lithobates catesbeianus tadpoles exposed to the 2,4-D herbicide in a simulated realistic scenario

Abstract

The aim of the current study is to assess possible erythrocyte mutagenic effects on Lithobates catesbeianus tadpoles exposed to water contaminated with 2,4-D. In order to do so, tadpoles were exposed to a predictive and environmentally relevant herbicide concentration (1.97 mg/L), which is likely to be found in lentic environments formed by superficial water runoffs in pasture areas where the herbicide was applied. The micronucleus test, as well as tests for other nuclear abnormalities, was conducted after 3, 5, and 9 days of exposure (d.e.). Changes in the biomass and mouth-cloaca length or interference in the larval development of the animals (in the three evaluated times) were not recorded. However, tadpoles exposed to 2,4-D showed the highest total number of nuclear abnormalities, as well as the highest frequency of binucleated erythrocytes and kidney-shaped nuclei (shortly after 3 d.e.). The micronucleus frequency was also higher in animals exposed to 2,4-D (in the 3rd, 5th, and 9th d.e.), as well as the frequency of binucleated cells (3rd, 5th, and 9th d.e.) presenting notched (9th d.e.) and blebbled (9th d.e.) nuclei in comparison to those of the control, after 5 and 9 days of exposure. Therefore, the current study is a pioneer in showing that 2,4-D has a mutagenic effect on L. catesbeianus tadpoles, even at low concentrations (environmentally relevant) and for a short period of time, a fact that may lead to direct losses in anuran populations living in areas adjacent to those subjected to 2,4-D herbicide application.

The field experiments and model of the natural dust deposition effects on photovoltaic module efficiency

Abstract

The maximisation of the efficiency of the photovoltaic system is crucial in order to increase the competitiveness of this technology. Unfortunately, several environmental factors in addition to many alterable and unalterable factors can significantly influence the performance of the PV system. Some of the environmental factors that depend on the site have to do with dust, soiling and pollutants. In this study conducted in the city centre of Kraków, Poland, characterised by high pollution and low wind speed, the focus is on the evaluation of the degradation of efficiency of polycrystalline photovoltaic modules due to natural dust deposition. The experimental results that were obtained demonstrated that deposited dust-related efficiency loss gradually increased with the mass and that it follows the exponential. The maximum dust deposition density observed for rainless exposure periods of 1 week exceeds 300 mg/m² and the results in efficiency loss were about 2.1%. It was observed that efficiency loss is not only mass-dependent but that it also depends on the dust properties. The small positive effect of the tiny dust layer which slightly increases in surface roughness on the module performance was also observed. The results that were obtained enable the development of a reliable model for the degradation of the efficiency of the PV module caused by dust deposition. The novelty consists in the model, which is easy to apply and which is dependent on the dust mass, for low and moderate naturally deposited dust concentration (up to 1 and 5 g/m² and representative for many geographical regions) and which is applicable to the majority of cases met in an urban and non-urban polluted area can be used to evaluate the dust deposition-related derating factor (efficiency loss), which is very much sought after by the system designers, and tools used for computer modelling and system malfunction detection.

Absorption characteristics of compound heavy metals vanadium, chromium, and cadmium in water by emergent macrophytes and its combinations

Abstract

The aim of the present study was to investigate three kinds of emergent macrophytes, i.e., Acorus calamus L., Phragmites communis Trin., and Alternanthera philoxeroides (Mart.) Griseb and their combination patterns on their removal efficiency of compound heavy metals (vanadium, chromium, and cadmium) from synthetic aqueous. The results showed that the optimal single-species for compound heavy metals removal was Acorus calamus L. and during experiment period, the average removal efficiency of V⁵⁺, Cr⁶⁺, and Cd²⁺ was 52.4, 46.8, and 90.0%, respectively. Combination C (the quality ratio of Acorus calamus L., Phragmites communis Trin., and Alternanthera philoxeroides (Mart.) Griseb is 2:1:1) had the highest removal efficiency on compound heavy metals among three groups and the average removal efficiency of V⁵⁺, Cr⁶⁺, and Cd²⁺ was 18.0, 70.0, and 95.1%, respectively. The highest efficiency of combination C on V⁵⁺ removal was lower than single Alternanthera philoxeroides (Mart.) Griseb group; this may be an existing antagonism in different plants. Heavy metals of V⁵⁺, Cr⁶⁺, and Cd²⁺ had an obviously positive effect on SOD, CAT, and POD of emergent macrophytes. From these results, we conclude that in a phytoremediation for the removal of compound heavy metals where V was dominated pollution in water, the use of Acorus calamus L. species rather than a mixture of several plants should be suggested. When heavy metal pollution was dominated by Cr and Cd, group C rather than a single plant species should be used.

Lymphoprolifération cutanée primitive CD30+ sous fingolimod : un cas et revue systématique de la littérature

Publication date: Available online 17 April 2018
Source:Annales de Dermatologie et de Vénéréologie
Author(s): E. Cesbron, J.-B. Monfort, C. Giannesini, P. Duriez, P. Moguelet, P. Senet, C. Francès, A. Barbaud, F. Chasset
IntroductionLe fingolimod est un traitement immunomodulateur oral, indiqué dans la sclérose en plaques (SEP) de forme récurrente-rémittente. Nous rapportons un cas de lymphoprolifération cutanée primitive CD30+ survenue sous ce traitement. Nous avons également réalisé une revue systématique des cas publiés dans la littérature médicale, afin de préciser les caractéristiques des lymphoproliférations associées à ce traitement.ObservationUne femme de 56 ans, suivie pour une SEP récurrente-rémittente, développait 6 mois après l'introduction du fingolimod des nodules ulcérés des aisselles et du dos, asymptomatiques. La biopsie cutanée trouvait un infiltrat inflammatoire dermique polymorphe, riche en grandes cellules CD30+. La confrontation anatomoclinique permettait de retenir le diagnostic de lymphome T cutané CD30+ anaplasique. Le bilan d'extension éliminait une localisation cutanée d'un lymphome systémique. L'évolution était marquée par une régression spontanée des nodules malgré la poursuite du fingolimod. Après évaluation du rapport bénéfice–risque, le fingolimod était poursuivi sous surveillance cutanée rapprochée, sans rechute après 18 mois de traitement.DiscussionUne revue systématique de la littérature dans PUBMED/Medline et Embase a trouvé 7 autres cas de lymphoprolifération survenue sous fingolimod, dont deux autres cas de lymphoprolifération cutanée primitive CD30+, également spontanément régressifs mais en arrêtant l'immunomodulateur.ConclusionMême si la survenue d'une lymphoprolifération CD30+ sous fingolimod semble rare et l'imputabilité de ce dernier dans leur survenue incertaine, cette association doit être connue des dermatologues qui sont appelés à effectuer la surveillance cutanée des patients traités par cet immunomodulateur. Soulignons que dans notre observation, les lésions ont régressé spontanément malgré la poursuite du traitement par fingolimod.BackgroundFingolimod is an oral immunomodulator approved for relapsing-remitting multiple sclerosis. We report a case of a primary cutaneous CD30+ T-cell lymphoproliferation occurring 6 months after initiation of fingolimod. Based on a systematic literature review, the characteristics of these fingolimod-induced lymphoproliferative disorders are described.Patients and methodsA 56-year-old woman developed cutaneous indurated and ulcerated nodular lesions 6 months after starting fingolimod for active relapsing–remitting multiple sclerosis. Histological examination of a punch biopsy sample demonstrated a polymorphous dermal infiltrate containing large atypical CD30+ cells, leading to diagnosis of primary cutaneous CD30+ anaplastic large-cell lymphoma. Chest-abdomen-pelvis CT scans were performed to rule out secondary cutaneous anaplastic large-cell lymphoma. Spontaneous clinical regression was observed and after assessing the benefit/risk ratio, it was decided to continue fingolimod under strict surveillance, with no relapse occurring by month 18.DiscussionA systematic review of PUBMED/Medline and Embase identified seven other cases of lymphoproliferative disorders occurring during fingolimod treatment, including two other cases of primitive cutaneous CD30+ lymphoproliferative disorders.ConclusionEven if cutaneous CD30+ lymphoproliferative disorders occur only rarely during fingolimod treatment, dermatologists should nevertheless be aware of this association for which strict dermatological surveillance is required. We would also stress that these CD30+ lymphoproliferative disorders can disappear spontaneously, as in our case, even if treatment by fingolimod is continued.

Pseudo-kyste mucoïde

Publication date: Available online 17 April 2018
Source:Annales de Dermatologie et de Vénéréologie
Author(s): T. Deschamps, M. Perier-Muzet, L. Thomas, S. Dalle

Angiœdème bradykinique par déficit en C1 Inhibiteur acquis : quatre cas

Publication date: Available online 17 April 2018
Source:Annales de Dermatologie et de Vénéréologie
Author(s): C. Jacquin-Porretaz, F. Castelain, E. Daguindau, E. Seilles, C. Nardin, F. Aubin, F. Pelletier
IntroductionL'angiœdème bradykinique par déficit en C1 Inhibiteur acquis (AOA) est une forme rare d'angiœdème bradykinique. Il se caractérise cliniquement par une survenue tardive après l'âge de 40 ans, l'absence d'antécédents familiaux d'angiœdème et une moindre fréquence des crises abdominales par rapport aux angiœdèmes héréditaires (AOH). Ses caractéristiques biologiques sont un dosage pondéral et une activité fonctionnelle de la protéine C1 inhibiteur (C1 Inh) abaissés ; il se distingue de l'AOH par une diminution du taux de C1q. Une majorité des cas d'AOA ont également des anticorps anti-C1 Inh. Le pronostic à long terme est déterminé par la présence d'une hémopathie sous-jacente, qui s'associe fréquemment aux AOA.ObservationsNous rapportons les cas de quatre patients atteints d'AOA, âgés de 60 à 77 ans, vus dans le centre de compétences du centre de référence des angiœdèmes du CHRU de Besançon. Les manifestations cliniques d'angiœdème étaient déclenchées chez trois patients par l'introduction d'un inhibiteur de l'enzyme de conversion (IEC) ou d'un sartan (ARA2). Trois patients sur quatre avaient des anticorps anti-C1 Inh. Le bilan étiologique a mis en évidence un lymphome indolent de la zone marginale chez un patient, une gammapathie monoclonale chez deux autres et enfin un patient avait une leucémie lymphoïde chronique connue.DiscussionL'apparition d'un angiœdème après introduction d'un IEC ou d'un ARA 2 peut révéler un AOA par déficit en C1 Inh. Ce mode de révélation ne doit pas faire porter à tort le diagnostic d'angiœdème aux IEC ou aux sartans ; un dosage du C1 Inh et du C1q est nécessaire dans cette situation. La recherche d'une hémopathie sous-jacente est systématique et détermine le pronostic à long terme.BackgroundAcquired C1-esterase inhibitor (C1-INH) deficiency angioedema (C1-INH-AAE) is a form of bradykinin-mediated angioedema. This rare disorder is due to acquired consumption of C1-INH, hyperactivation of the classic pathway of human complement, and potentially fatal recurrent angioedema symptoms. Clinical symptoms of C1-INH-AAE are very similar to those of hereditary angioedema (HAE) but usually appear after the fourth decade of life and induce abdominal pain less frequently. Laboratory tests are essential in establishing the diagnosis with low levels or abnormal structure and function of C1-INH. Most patients present C1-INH autoantibodies. Furthermore, C1q is reduced in AAE, contrary to HAE. The long-term prognosis is determined by associated hematologic malignancies.Patients and methodsWe report 4 cases of C1-INH-AAE associated with lymphoproliferative disorders referred to the Reference Centre for Angioedema of Besançon, France. The patients were aged between 60 and 77 years. C1 INH antibodies were found in three patients. Symptoms were triggered by angiotensin-converting enzyme (ACE) inhibitors or angiotensin II receptor blockers (ARBs) in 3 patients. Hematologic malignancy was present at diagnosis (one case of chronic lymphoid leukemia) or was diagnosed during follow-up (one case of indolent marginal zone non-Hodgkin lymphoma and two cases of monoclonal gammopathy).DiscussionC1-INH-AAE induced by ACE inhibitors or ARBs may be associated with hematologic malignancies. This form of revelation does not necessarily indicate a diagnosis of ACE or ARBs angioedema, and screening should therefore be performed for C1 Inh and C1q. An underlying hematologic malignancy should be routinely sought and the long-term prognosis determined.

Fréquence des sensibilisations de contact aux pansements modernes utilisés sur les ulcères de jambe

Publication date: Available online 17 April 2018
Source:Annales de Dermatologie et de Vénéréologie
Author(s): E. Garval, J. Plee, C. Lesage, A. Grange-Prunier, P. Bernard, G. Perceau
IntroductionL'eczéma de contact allergique péri-ulcéreux est une complication fréquente des ulcères de jambe (UDJ), retardant leur cicatrisation. Le but de l'étude était de décrire la fréquence de sensibilisation aux pansements utilisés chez ces malades et d'évaluer s'il existait une relation entre le nombre de sensibilisations et l'étiologie de l'ulcère, sa durée d'évolution, l'âge ou le sexe des malades.Malades et méthodesCette étude rétrospective menée au CHU de Reims de 2010 à 2014 incluait tous les malades porteurs d'un UDJ d'étiologie vasculaire compliqué de dermite eczématiforme péri-ulcéreuse et ayant eu des tests allergologiques parmi une des trois batteries suivantes : standard européenne, UDJ, corticoïdes.RésultatsParmi les 73 malades inclus, 43 % étaient polysensibilisés. Trente-trois (45 %) étaient sensibilisés aux pansements (38 % aux hydrocolloïdes, 18 % aux hydrogels, 7 % aux hydrocellulaires, 7 % aux hydrofibres, 5 % aux interfaces, 3 % aux alginates). L'âge médian et le sexe des malades ne différaient selon qu'ils étaient polysensibilisés ou non (p=0,84 et p=0,25, respectivement). Les malades étaient plus souvent polysensibilisés lorsque l'ulcère évoluait depuis plus de 5 ans (p=0,032).ConclusionPrès d'un malade sur deux présentant une dermite eczématiforme autour d'un UDJ est sensibilisé aux pansements, notamment hydrocolloïdes et hydrogels. Le risque de sensibilisation est d'autant plus important que la durée de la maladie ulcéreuse est plus longue.IntroductionAllergic contact dermatitis around chronic leg ulcers (CLU) is a common complication in patients presenting CLU and prolongs healing times. The aim of this study was to describe the rate of sensitization to modern dressings (MD) used in these patients and to assess whether there is a relation between the number of sensitizations and ulcer type, the time from onset of the ulcer, and patient age and gender.Patients and methodsWe conducted a retrospective study at Reims University Hospital between 2010 and 2014 that included all patients with CLU of vascular etiology surrounded by eczematous lesions, and who had one of the patch-tests in the following 3 series: European baseline±leg ulcers±corticosteroids.ResultsAmong the 73 patients included, 43 % were polysensitized. Thirty-three patients (45 %) were sensitized to MD (38 % to hydrocolloids, 18 % to hydrogels, 7 % to hydrocellular dressings, 7 % to hydrofiber dressings, 5 % to contact layers and 3 % to alginates).Median age and sex did not differ between "polysensitized" patients and "non-polysensitized" patients (P=0.84 and P=0.25, respectively). Polysensitization was more frequent among patients presenting ulcers for more than 5 years (P=0.032).ConclusionPractically half of all patients presenting CLU with surrounding contact dermatitis had sensitization to modern dressings (mostly hydrocolloids and hydrogels). The rate of sensitization increased with the length of presence of CLU.

Phénomènes de Köbner, Renbök, Wolf et Cie… est-il temps de simplifier ?

Publication date: Available online 17 April 2018
Source:Annales de Dermatologie et de Vénéréologie
Author(s): N. Kluger
Depuis la fin du XIX^e siècle, les dermatologues savent par observations que les dermatoses peuvent interagir (ou bien éviter d'interagir) avec une grande variété d'agressions cutanées ou bien même avec une autre dermatose préexistante. Des tentatives pour nommer et classer ces phénomènes ont été faites : phénomène de Köbner, réaction isotopique de Wolf, phénomène Renbök etc. Cependant, avec le temps, ces phénomènes se sont enrichis en nuances et subtilités, tandis que des phénomènes similaires ont été décrits sous différents termes, ajoutant une confusion certaine dans la littérature. Nous faisons ici une mise au point historique, sémantique et nosologique de ces différents phénomènes. Nous prônons l'utilisation de classifications plus simples avec des termes universels distinguant les phénomènes d'affinité et d'épargne, qu'ils soient isomorphiques ou isotopiques et selon les lésions sous-jacentes (post-traumatique, post-herpétique, post-vaccination, post-radiothérapie, territoire neurologique déficitaire, mosaïcisme génétique ou autre).Since the end of the 19th century, dermatologists have observed that skin conditions may respond (or not) to a wide variety of skin injuries or even to other existing skin conditions. Attempts were made to name and classify such phenomena: Köbner phenomenon, Wolf's isotopic response, Renbök phenomenon, etc. However, over time, further subtleties and nuances came to be grafted onto the initial descriptions, while comparable phenomena were described using different terms, all of which resulted in considerable confusion in the literature. Herein we review the history, semantics and nosology of these different phenomena. We also propose the use of a simpler, more homogenous and universal nomenclature that distinguishes between affinity and sparing phenomena, whether isomorphic or isotopic and which is based on the lesions involved (trauma, vaccination, radiotherapy, neurologic defect, herpes, genetic mosaicism and so on).

Toxicités dermatologiques des inhibiteurs de checkpoint immunologiques

Publication date: Available online 18 April 2018
Source:Annales de Dermatologie et de Vénéréologie
Author(s): V. Sibaud, S. Boulinguez, C. Pagès, L. Riffaud, L. Lamant, C. Chira, S. Boyrie, E. Vigarios, E. Tournier, N. Meyer
Le développement des inhibiteurs de checkpoints immunologiques (anticorps monoclonaux anti-PD-1/PD-L1, anti-CTLA-4) représente une avancée considérable dans la prise en charge de nombreux cancers. Étant donné leur mécanisme d'action particulier qui induit l'activation et la prolifération des lymphocytes T CD4+/CD8+, ils s'associent à un profil de tolérance tout à fait spécifique. Leurs effets indésirables sont avant tout d'ordre immunologique (immune-related adverse events) et peuvent concerner l'ensemble des organes. Dans ce cadre, la toxicité dermatologique est la plus fréquente, même si elle reste le plus souvent d'intensité légère à modérée et ne limite habituellement pas la poursuite de l'immunothérapie. Plus d'un tiers des patients traités peuvent développer des symptômes dermatologiques, le plus souvent sous la forme d'un exanthème maculo-papuleux, d'un prurit ou d'un vitiligo (ce dernier uniquement chez les patients traités pour mélanome). Des dermatoses beaucoup plus spécifiques peuvent cependant apparaître : réactions lichénoïdes, psoriasis induit, sarcoïdose, maladies auto-immunes (pemphigoïde bulleuse, dermatomyosite, pelade), lésions acnéiformes, xérostomie…Il est donc nécessaire de systématiquement caractériser cliniquement et histologiquement ces lésions en cas de formes atypiques, persistantes ou sévères. Cet article synthétise les principales toxicités dermatologiques rapportées avec les inhibiteurs de checkpoints immunologiques ainsi que leur incidence et décrit les principes de leur prise en charge.The development of immune checkpoint inhibitors (monoclonal antibodies targeting PD-1/PD-L1 or CTLA-4) represents a significant advance in the treatment of multiple cancers. Given their particular mechanism of action, which involves triggering CD4+/CD8+ T-cell activation and proliferation, they are associated with a specific safety profile. Their adverse events are primarily immune-related, and can affect practically all organs. In this context, dermatological toxicity is the most common, though it mostly remains mild to moderate and does not require discontinuation of treatment. More than a third of patients are faced with cutaneous adverse events, usually in the form of a maculopapular rash, pruritus or vitiligo (only in patients treated for melanoma). Much more specific dermatologic disorders, however, may occur such as lichenoid reactions, induced psoriasis, sarcoidosis, auto-immune diseases (bullous pemphigoid, dermatomyositis, alopecia areata), acne-like rash, xerostomia, etc. Rigorous dermatological evaluation is thus mandatory in the case of atypical, persistent/recurrent or severe lesions. In this article, we review the incidence and spectrum of dermatologic adverse events reported with immune checkpoint inhibitors. Finally, a management algorithm is proposed.

Granulome de Lever extra-facial sur cicatrice de zona : une réaction isotopique de Wolf

Publication date: Available online 17 April 2018
Source:Annales de Dermatologie et de Vénéréologie
Author(s): E. Melgar, J. Henry, A. Valois, M.-B. Dubois-Lacour, F. Truchetet, B. Cribier, J.-F. Cuny
IntroductionLe granulome de Lever est une affection dermatologique rare qui se localise classiquement sur le visage. Nous rapportons l'observation d'un granulome de Lever extra-facial apparu sur des cicatrices de zona du tronc, ce qui constitue une réaction isotopique particulière.ObservationUn homme de 60 ans consultait pour une lésion cutanée prurigineuse évoluant depuis deux mois. Il avait comme unique antécédent un zona lombaire gauche. À l'examen, nous constations une plaque érythémateuse infiltrée de 2,5cm de diamètre dans la région para-vertébrale lombaire gauche. Le bilan biologique était normal. L'examen histologique révélait un processus inflammatoire sans néovaisseaux, riche en éosinophiles, avec vasculite chronique et infiltrat polymorphe, permettant de retenir le diagnostic de granulome de Lever.DiscussionLe granulome de Lever est une forme localisée de vasculite des petits vaisseaux du derme. Bien qu'il touche généralement le visage, les atteintes extra-faciales existent. Le caractère original de cette présentation, hormis sa localisation, réside dans le fait que le granulome s'était développé sur une cicatrice de zona, ce qui correspond à une réaction isotopique de Wolf. Ce phénomène, décrit par R. Wolf, est l'apparition d'une nouvelle dermatose sur le lieu d'une ancienne dermatose guérie, le plus souvent herpétique. La physiopathologie est encore incertaine. Cette réaction est différente des réactions isomorphiques de type Koebner, où il s'agit de l'apparition d'une dermatose déjà connue sur le lieu d'un traumatisme, et non d'une nouvelle dermatose.ConclusionNous décrivons un cas, à notre connaissance jamais rapporté dans la littérature, de réaction isotopique de Wolf avec un granulome de Lever extra-facial.BackgroundGranuloma faciale (GF), or facial granuloma of Lever, is an uncommon dermatosis occurring classically on the face. We report a case of a GF on zoster scars located on the trunk, which is a highly particular isotopic response.Patients and methodsA 60-year-old man with a sole history of left lumbar zoster presented with a skin lesion present for two months. Clinical examination revealed a 2.5-cm papular erythematous lesion that was both infiltrated and pruritic. This lesion was situated precisely on zoster scars. Lab tests revealed no abnormalities. Histopathologic examination showed an inflammatory process without neovessels but rich in eosinophils with chronic vasculitis and polymorphic infiltrate, on which basis GF was diagnosed.DiscussionGF is a localized form of cutaneous small-vessel vasculitis. Although it usually affects the face, extra-facial locations also exist. The original character of this presentation, aside from the location, is the occurrence of this GF on a zoster scar, which corresponds to Wolf's isotopic response. This phenomenon, described by R. Wolf, comprises the occurrence of a new skin disorder at the site of another unrelated and already healed skin disease, usually herpes. The physiopathology is still unclear. This differs from isomorphic reactions such as Koebner's reaction, which consists of the appearance at an injury site of skin lesions typical of an existing dermatosis but not a new disorder.ConclusionThis is a rare case of Wolf's isotopic response with GF, of which, to our knowledge, there are no reports in the literature.

Maladie de Paget sur sein surnuméraire

Publication date: Available online 16 April 2018
Source:Annales de Dermatologie et de Vénéréologie
Author(s): M.-H. Jegou, E. Lorier-Roy
IntroductionLa maladie de Paget mammaire est rare. Elle est exceptionnelle sur sein surnuméraire, où son diagnostic est retardé par méconnaissance de la pathologie du sein ectopique et défaut d'explorations. À partir d'un cas clinique original, nous faisons le point clinique sur le sein ectopique et ses carcinomes, dont la maladie de Paget.ObservationUne femme de 44 ans signalait depuis quelques mois une douleur dans la zone d'un sein surnuméraire. Une exploration par échographie était normale, mais la symptomatologie inexpliquée conduisait à proposer une exérèse. Celle ci était en faveur d'une maladie de Paget strictement intra-épidermique de 2 millimètres, non associée à un carcinome sous-jacent. La patiente était traitée par exérèse élargie. Une surveillance à un an ne montrait pas de récidive.DiscussionLe sein ectopique, présent dans 6 % de la population, est un « laissé pour compte », alors qu'il peut avoir les mêmes pathologies que le sein anatomique : il est à l'origine de 0,6 % des cancers mammaires. La maladie de Paget est un adénocarcinome in situ rare, représentant moins de 3 % des cancers mammaires. Elle est exceptionnelle sur sein ectopique ; nous en rapportons ici le quatrième cas publié. L'originalité de notre observation tient à l'absence de signe clinique objectif à l'inspection. Des symptômes subjectifs localisés au sein surnuméraire, tels que douleur, picotements, sensations de brûlure ou de prurit, doivent être pris en compte pour permettre un diagnostic précoce de la maladie de Paget. L'échographie et la mammographie sont souvent pris en défaut. L'imagerie en résonance magnétique (IRM) peut être une bonne indication, mais n'est pas un examen de routine. L'avenir pourrait être au dépistage par microscopie confocale sur les seins ectopiques avec plaque aréolo-mamelonnaire, car cette technique peut permettre de visualiser les cellules de Paget et leur organisation.BackgroundPaget's disease of the breast is rare, even more so when it occurs in a supernumerary breast since diagnosis is delayed due to lack of exploration and ignorance of the pathology of ectopic breast. Based on an original clinical case, we provide a clinical update concerning ectopic breast and ectopic carcinoma, including Paget's disease.Patients and methodsA 44-year-old woman had complained of pain in the area of her supernumerary breast for several months. The ultrasound examination was normal but the unexplained symptoms led to performance of an excision biopsy of the lesion. This showed strictly intra-epidermal Paget's disease measuring 2mm, without any underlying carcinoma. A wider excision was performed. Follow-up at one year showed no recurrence.DiscussionAn ectopic breast, present in 6 % of the population, is often ignored, despite being subject to the same diseases as anatomical breasts: it is at the origin of 0.6 % of breast cancers. Paget's disease is a rare in situ adenocarcinoma comprising fewer than 3 % of cases of breast cancer. It is extremely rare in ectopic breast. Ours is only the fourth reported case in the literature. This case is original because of the lack of objective clinical signs. Subjective symptoms such as pain, tingling, burning sensation and pruritus related to the supernumerary breast must be taken into consideration in order to enable early diagnosis of Paget's disease. Exploration by ultrasound and mammography generally appears flawed. Breast MRI may be useful but is not performed routinely. A promising future approach may consist of confocal microscopy screening of all ectopic breasts with areola or nipple patches, since this method enables the visualization of Paget cells and their organization.

Dermatite lichénoïde annulaire du sujet jeune : un cas et revue de la littérature

Publication date: Available online 16 April 2018
Source:Annales de Dermatologie et de Vénéréologie
Author(s): D. Debois, J.-L. Dargent, P. Ngendahayo, P.-P. Roquet-Gravy
IntroductionNous rapportons un cas de dermatite lichénoïde annulaire du sujet jeune (DLAJ). Il s'agit d'une dermatose lichénoïde rare affectant principalement la population pédiatrique et présentant des caractéristiques histocliniques stéréotypées. C'est à notre connaissance le premier cas publié dans la littérature francophone.ObservationUne fille de 5 ans présentait une lésion abdominale isolée persistant depuis plus d'un an. Il s'agissait d'une lésion annulaire constituée d'une bordure érythémateuse légèrement surélevée et d'un centre hypopigmenté. L'utilisation de dermocorticoïdes et de pimécrolimus 1 % topique ne permettait qu'une amélioration clinique transitoire, la lésion récidivant systématiquement dès leur arrêt.DiscussionUne soixantaine de cas de dermatite lichénoïde annulaire du sujet jeune ont été décrits dans la littérature anglophone. Le diagnostic différentiel principal est le mycosis fongoïde de l'enfant, dans sa variante hypopigmentée. La biopsie est nécessaire au diagnostic et montre des signes histologiques caractéristiques. Il s'agit d'une réaction inflammatoire de type lichénoïde constituée de lymphocytes polyclonaux CD4+ et CD8+, en l'absence de lymphocytes atypiques ou d'épidermotropisme. La réaction inflammatoire prédomine au sommet des crêtes épidermiques et est associée à une nécrose des kératinocytes. De manière caractéristique, les crêtes épidermiques prennent ainsi une forme particulière, quadrangulaire.ConclusionLa DLAJ constitue une entité méconnue parmi les dermatoses lichénoïdes. La corrélation anatomoclinique est essentielle au diagnostic. L'étiologie n'est pas connue et l'évolution est chronique dans la majorité des cas.BackgroundAnnular lichenoid dermatitis of youth (ALDY) is a rare form of dermatitis mainly affecting children and young people. All cases reported show a consistent clinical and histological picture. This is the first case described in the French literature.Patients and methodsA 5-year-old girl presented an annular isolated patch of the lower abdomen with an erythematosquamous border and central hypopigmentation for one year. Topical corticosteroids and pimecrolimus proved effective but relapse occurred after treatment withdrawal.DiscussionOver sixty cases of ALDY are described in the English-language medical literature. The main differential diagnosis is childhood mycosis fungoides, particularly the hypopigmented variant. Biopsy is necessary for diagnosis since it can reveal typical histological features. Histopathology in all cases shows lichenoid reaction with CD4+ and CD8+ polyclonal lymphocytes. It is limited to the tips of rete ridges and associated with apoptosis of keratinocytes resulting in quadrangular-shaped rete ridges. Our case does not demonstrate either epidermotropism or atypical lymphocytes.ConclusionAnnular lichenoid dermatitis of youth (ALDY) is a poorly known distinctive entity within the lichenoid dermatitis family. Clinical-histological correlation is essential to diagnosis. The etiology is still unknown and the course is mostly chronic.

Drogues et peau : ce qu’il faut savoir. L’exemple du cannabis

Publication date: Available online 16 April 2018
Source:Annales de Dermatologie et de Vénéréologie
Author(s): D. Tennstedt

Éditorial

Publication date: Available online 16 April 2018
Source:Annales de Dermatologie et de Vénéréologie
Author(s): C. Dangoisse

Editorial board

Publication date: March 2018
Source:Annales de Dermatologie et de Vénéréologie, Volume 145, Supplement 1

Pentachlorophenol dechlorination with zero valent iron: a Raman and GCMS study of the complex role of surficial iron oxides

Abstract

The dechlorination of chlorinated organic pollutants by zero valent iron (ZVI) is an important water treatment process with a complex dependence on many variables. This complexity means that there are reported inconsistencies in terms of dechlorination with ZVI and the effect of ZVI acid treatment, which are significant and are as yet unexplained. This study aims to decipher some of this complexity by combining Raman spectroscopy with gas chromatography-mass spectrometry (GC-MS) to investigate the influence of the mineralogy of the iron oxide phases on the surface of ZVI on the reductive dechlorination of pentachlorophenol (PCP). Two electrolytic iron samples (ZVI-T and ZVI-H) were found to have quite different PCP dechlorination reactivity in batch reactors under anoxic conditions. Raman analysis of the "as-received" ZVI-T indicated the iron was mainly covered with the ferrous oxide (FeO) wustite, which is non-conducting and led to a low rate of PCP dechlorination. In contrast, the dominant oxide on the "as-received" ZVI-H was magnetite which is conducting and, compared to ZVI-T, the ZVI-H rate of PCP dechlorination was four times faster. Treating the ZVI-H sample with 1 N H₂SO₄ made small change to the composition of the oxide layers and also minute change to the rate of PCP dechlorination. However, treating the ZVI-T sample with H₂SO₄ led to the loss of wustite so that magnetite became the dominant oxide and the rate of PCP dechlorination increased to that of the ZVI-H material. In conclusion, this study clearly shows that iron oxide mineralogy can be a contributing factor to apparent inconsistencies in the literature related to ZVI performance towards dechlorination and the effect of acid treatment on ZVI reactivity.

Integrated effect of nutrients from a recirculation aquaponic system and foliar nutrition on the yield of tomatoes Solanum lycopersicum L. and Solanum pimpinellifolium

Abstract

The objective of this study was to evaluate the potential of tomato plants to efficiently use the nitrogen (N) of a recirculation aquaponic system (RAS) and to evaluate the effects of foliar fertilization as a complement to the water nutrition on the growth of the two tomato cultivars. The significant effect of six macro- and seven micronutrients was evaluated on the plant growth and on the fruit yield. Two experiments were performed in a nutrient film aquaponic unit. The first experiment was designed to study the effects of foliar fertilization on the seedlings of two tomato cultivars Costoluto Genovese (CG) (Solanum lycopersicum L.) and Currant tomato (Ct) (Solanum pimpinellifolium) with 8% of weekly water exchange (WE8%-RAS). The foliar fertilizer was formulated with N restriction in the last 11 weeks (TF1). In the second experiment, two other foliar fertilization treatments (TF2 and TF3) were applied with a concentration of nutrients twice and triple that in TF1, but with a lower proportion of NPK ratio. These treatments were tested on the cultivar CG in a RAS with zero water exchange (WE0%-RAS). The data from the 1st experiment showed a positive effect of the foliar fertilization on the yield of both cultivars. The fertilization markedly influenced the dry matter weight of the CG; however, this effect was not observed in the Ct. The root length of both cultivars was positively influenced by the P content, whereas the plant height was affected by the excess of Co and S. According to the results from the 2nd experiment, the TF2 plants had the highest number of fruits with a high mean weight. The system was efficient in utilizing N from fish tank; the water K favored the yield of the CG fruit and the foliar K favored the growth of the TF2 plants. With a decrease in the foliar N, the CG plants were able to absorb 27.5% of the NO₃⁻ and 7.06% of total ammonia nitrogen from water. The absolute and relative growth rate of Nile tilapia was not affected by the rate of water exchange. Fulton's condition factor of the total length and weight curve indicated that fish from WE8%-RAS had wider bodies than the fish from WE0%-RAS at the same length range. Nitrate and P in the final effluent were lower than the maximum reference values allowed for the discharged water.

Performance and emission characteristics of a bio-lubricated two-stroke gasoline engine

Abstract

Two-stroke petrol engines find wide applications in the areas like chain saws, weed cutters, and power sprayers because of their compactness and higher power to weight ratio. In the present study, the feasibility of using vegetable-based lubricant instead of ordinary mineral 2 T oil is investigated. M15 (85% petrol + 15% methanol) and E15 (85% petrol + 15% ethanol) blend with gasoline are used as the fuel. Experiments were carried out in a two-stroke air-cooled engine equipped with a rope brake dynamometer. It is observed that the vegetable-based lubricant (sunflower oil) is miscible with the tested fuels. The frictional power for the vegetable-based lubricant was found to be less than that of mineral 2 T oil. The brake thermal efficiency improved and the brake-specific fuel consumption decreased for the sunflower oil-based lubricant. The combination of E15 + sunflower oil lubricant exhibited the greatest benefits, raising the brake thermal efficiency by 3.4% and reducing the brake-specific fuel consumption by 1.4%. Hydrocarbon and carbon monoxide emissions were lower for the vegetable-based lubricant than the 2 T mineral oil.

A new approach for the agglomeration and subsequent removal of polyethylene, polypropylene, and mixtures of both from freshwater systems – a case study

Abstract

Based on a new concept for the sustainable removal of microplastics from freshwater systems, a case study for a pH-induced agglomeration and subsequent removal of polyethylene and polypropylene particles from water is presented. The two-step-based process includes firstly a localization and secondly an aggregation of microplastic particles (250–350 μM) in a physicochemical process. The research describes a strong increase in the particle size independent of pH of the aquatic milieu induced by the addition of trichlorosilane-substituted Si derivatives. The resulting Si-based microplastic aggregates (particle size after aggregation is 2–3 cm) could be easily removed by use of, e.g., sand traps. Due to the effect that microplastic particles form agglomeration products under every kind of process conditions (e.g., various pH, various polymer concentrations), the study shows a high potential for the sustainable removal of particles from wastewater.

BRC4Env, a network of Biological Resource Centres for research in environmental and agricultural sciences

Abstract

The Biological Resource Centre for the Environment BRC4Env is a network of Biological Resource Centres (BRCs) and collections whose leading objectives are to improve the visibility of genetic and biological resources maintained by its BRCs and collections and to facilitate their use by a large research community, from agriculture research to life sciences and environmental sciences. Its added value relies on sharing skills, harmonizing practices, triggering projects in comparative biology, and ultimately proposing a single-entry portal to facilitate access to documented samples, taking into account the partnership policies of research institutions as well as the legal frame which varies with the biological nature of resources. BRC4Env currently includes three BRCs: the Centre for Soil Genetic Resources of the platform GenoSol, in partnership with the European Conservatory of Soil Samples; the Egg Parasitoids Collection (EP-Coll); and the collection of ichthyological samples, Colisa. BRC4Env is also associated to several biological collections: microbial consortia (entomopathogenic bacteria, freshwater microalgae…), terrestrial arthropods, nematodes (plant parasitic, entomopathogenic, animal parasitic...), and small mammals. The BRCs and collections of BRC4Env are involved in partnership with academic scientists, as well as private companies, in the fields of medicinal mining, biocontrol, sustainable agriculture, and additional sectors. Moreover, the staff of the BRCs is involved in many training courses for students from French licence degree to Ph.D, engineers, as well as ongoing training.

Combined acute ecotoxicity of malathion and deltamethrin to Daphnia magna (Crustacea, Cladocera): comparison of different data analysis approaches

Abstract

We studied the combined acute effect (i.e., after 48 h) of deltamethrin (a pyrethroid insecticide) and malathion (an organophosphate insecticide) on Daphnia magna. Two approaches were used to examine the potential interaction effects of eight mixtures of deltamethrin and malathion: (i) calculation of mixture toxicity index (MTI) and safety factor index (SFI) and (ii) response surface methodology coupled with isobole-based statistical model (using generalized linear model). According to the calculation of MTI and SFI, one tested mixture was found additive while the two other tested mixtures were found no additive (MTI) or antagonistic (SFI), but these differences between index responses are only due to differences in terminology related to these two indexes. Through the surface response approach and isobologram analysis, we concluded that there was a significant antagonistic effect of the binary mixtures of deltamethrin and malathion that occurs on D. magna immobilization, after 48 h of exposure. Index approaches and surface response approach with isobologram analysis are complementary. Calculation of mixture toxicity index and safety factor index allows identifying punctually the type of interaction for several tested mixtures, while the surface response approach with isobologram analysis integrates all the data providing a global outcome about the type of interactive effect. Only the surface response approach and isobologram analysis allowed the statistical assessment of the ecotoxicological interaction. Nevertheless, we recommend the use of both approaches (i) to identify the combined effects of contaminants and (ii) to improve risk assessment and environmental management.

Efficacy and safety of extracorporeal shock wave therapy for acute and chronic soft tissue wounds: A systematic review and meta‐analysis

International Wound Journal, EarlyView.

Beyond JAAD July 2018

Keeping an eye on atopic dermatitis