Dermatofibrosarcoma protuberans (DFSP) is an uncommon, low-grade, dermal soft-tissue neoplasm with high recurrence, but low metastatic potential. It mainly occurs on the trunk, proximal extremity, ...head and neck, but rarely on the toes. Herein we report a case of DFSP on the right hallux.
A 39-year-old male presented with a mass in the right great toe of 3.5 years. After surgical excision, histopathological evaluation of the mass showed elongated monomorphic spindle cells arranged in a storiform pattern. The tumor cells infiltrated into adjacent adipose tissue in a honeycomb formation. Immunostaining for CD34 showed diffuse and strong cytoplasmic expression in neoplastic cells, whereas that for alpha smooth muscle actin, factor XIIIa, S-100 and melan-A were negative. The tumor was diagnosed as DFSP. We further reviewed the literature of DFSP on the toes with the aim to reveal, for the first time as far as we are aware, its clinical presentations, histopathology, differential diagnosis and treatment options.
DFSP on adult toes is a rare neoplasm characterized by monomorphic spindle cells arranged in storiform pattern, and can be treated with partial or total toe amputation, or wide local excision after primary excision, with excellent prognosis.
Our previous studies revealed that a single Wilms' tumor 1 (WT-1) immunohistochemistry can be used to elucidate both the myoepithelial cells and blood vessels of human breast tumors. As the human ...ovary is rich in blood vessels, and WT-1 has been used as a biomarker for ovarian tumors, our current study attempted to assess if a single WT-1 immunohistochemistry has dual usages in evaluation of ovarian tumor and endothelial cells. Paraffin-embedded tissue sections were prepared from 20 cases of ovarian tumors. A set of four consecutive sections from each case were subjected to immunohistochemistry with a mouse monoclonal antibody against the human WT-1 protein, a well defined ovarian tumor marker, CA-125, and a endothelial cell phenotypic marker, CD34, respectively. From each case, 4-5 randomly selected fields were photographed, and expression of these molecules in the same structures were compared. Distinct WT-1 immunoreactivities were seen in both ovarian tumor and endothelial cells. Over 90% of WT-1 positive tumor and endothelial cells were positive for CA-125 and CD34, respectively. Similarly, over 90% of CA-125 or CD34 positive cells co-express WT-1 in tumor or endothelial cells, respectively. Our findings suggest that a single WT-1 immunohistochemistry can be used to assess both the tumor cells and micro-vascular density in ovarian tumors. Our findings also suggest that as WT-1 is expressed in both tumor and endothelial cells, the development of therapeutic agents to target WT-1 may provide an effective treatment option for ovarian cancer.
A fibro-osseous pseudotumor (FOPT) is a rare, rapidly enlarging, benign soft-tissue neoplasm that presents with localized pain, swelling, and redness. It typically presents in the hands and much less ...frequently in the feet. FOPT is characterized histologically by foci of osseous differentiation within the proliferated fibroblasts. This must be differentiated from other benign and malignant lesions. FOPT of the toes has been described in a few reports, but recurrence, following surgical excision, is extremely rare. Here we report a young, healthy female patient who presented with a rapidly growing FOPT of the left great toe. This unusual case had recurred twice following surgical excision, all within a 2-month period of time. The lesion was again completely excised, with no recurrences at follow-ups of 18 and 36 months. In conclusion, FOPT is a rare soft tissue lesion of the toes. It features fibroblastic proliferation and osseous differentiation, which needs to be differentiated from other benign and malignant tumors. The standard treatment is complete surgical excision with an excellent prognosis.
Onychomycosis is a common world-wide health issue. Accurate detection is essential for treatment. Multiple studies have shown that PAS-stain based histological visualization of fungal elements is ...superior to either direct microscopy with 20% potassium hydroxide, or fungal culture. However, PAS stain based histological classification and severity grading of onychomycosis are lacking in the literature. Here we reported a fungal detection rate of 47.87% based on an analysis of 13,805 toenails processed for H&E and PAS stains over a three year period. Based on the analysis of fungal density, distribution and infiltrating depth level in 858 PAS-positive toenails, we created a novel PAS stain based histological classification system to classify onychomycosis as occult onychomycosis (OO), focal or diffuse subungual onychomycosis (FSO or DSO), focal or diffuse plate onychomycosis (FPO or DPO), focal or diffuse subungual and plate onychomycosis (FSPO or DSPO) and superficial onychomycosis (SO). The severities of OO, FSO and FPO were graded as mild, DSO and DPO as moderate, FSPO and DSPO as severe infections, which revealed that more than 75% PAS positive toenails were severe infections. Evaluation of 97 paired toenails biopsied pre- and post-treatment from 47 patients demonstrated that the severity of infection was significantly reduced from severe to mild and moderate levels. These data indicate that the current histological classification evaluates not only the severity of the fungal infection but also the response to treatment. We further propose a guideline for treatment of onychomycosis based on the histological classification and severity.
There is limited evidence surrounding oral health in emerging adult, sexual minority men of color. This study examined the association between sociodemographic factors, health literacy, cigarette, ...e-cigarette, and alcohol use on oral health outcomes. Secondary data analysis was conducted with 322 sexual minority men ages 18-34 in the United States. Between-group, mean-level, and multivariable logistic regression analyses examined differences on oral health outcomes. Increased cigarette (aOR = 1.84,
= 0.03), e-cigarette (aOR = 1.40,
= 0.03), and alcohol use (aOR = 2.07,
= 0.05) were associated with extended time away from the dentist. Health literacy (aOR = 0.93,
= 0.05) was negatively associated. Increased cigarette (aOR = 1.17,
= 0.04) and cigarette use (aOR = 1.26,
= 0.04) were associated with tooth loss. Health literacy was negatively associated (aOR = 0.65,
= 0.03). Increased e-cigarette (aOR = 1.74,
= 0.04) and cigarette use (aOR = 4.37,
< 0.001) were associated with dental affordability issues. Lower health literacy and racial identification as Black were associated with dental affordability issues; demonstrating an urgent need to address these factors to improve oral health in emerging adult sexual minority men of color.
The tolerance mechanism of mangrove species (Avicennia marina(Forsk.) andRhizophora mucronata Lamk) was studied by inducing multiple heavy metal stress in roots and leaves of the plants. Mangrove ...seedlings were treated with different concentrations of heavy metal solution (Cr, Cd, Pb and Hg) for a period of 2 months. Scavenging antioxidant enzymes like Polyphenol Oxidase (PPO), Glutathione-S-transferase (GSTs) and Guaiacol Peroxidase (POD) were analyzed in both species afterappropriate intervals of 15 days. Results revealed that activities of these antioxidative enzymes were altereddue tomultiple heavy metals exposure in both mangrove species, whereas leaves exhibited the higher valuesas compared to the roots. In the leaves of both mangrove plants GSTs exhibited an increased trend throughout the investigated period whereas, PPO activity initially showed an increasing trend, but gradually decreased with the passage of time in response to heavy metal stress. Furthermore, an increased level of antioxidants was also observed in A. marina thanR. mucronatawhich proves that the former is a strong candidate for heavy metals phyto-remediation with its viable survival strategies
LD50 and LD90 values were determined by bioassay of topical and stomach poison applications for lindane, fenitrothion and permethrin. At equivalent dosage rates fenitrothion was generally the most ...and permethrin the least, effective. Permethrin and fenitrothion were more toxic as contact poisons whereas lindane was more effective as a stomach poison. Using LD50 and LD90 values and sucrose treated tissue paper as a substrate, the persistence of three insecticides as stomach poison was determined at various temperature regimes with light excluded. Both lindane dosages had a short persistence (3 - 7 days) at 5°C and 15°C; fenitrothion had a similar persistence at 15°C and a moderate persistence at 5°C (LD50 for 7 - 14 days and LD90 for 14 days) but permethrin retained its toxicity for at least 21 days at 5°C, 15°C and 30°C. No additional degradation was obtained at 5°C with a continuous light intensity of 2415.6 lux for any of the insecticides and permethrin retained its toxicity for at least 56 days. Persistence of fenitrothion (LD90) and permethrin (LD50) were evaluated on wheat, privet and Brussels sprout plants growing under the same light and temperature regimes referred to above. The plants had no effect on the persistence of fenitrothion. Permethrin retained its toxicity for more than 40 days but slightly higher levels of activity were retained on wheat than on the other two plants. Rain fastness on growing plants was only evaluated for permethrin; there was little loss in wheat, a greater loss on privet and Brussels sprouts.
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