摘要:

Background: Many studies have been performed to identify prognostic factors of malignant melanoma using multivariate regression models. In these models, it is generally assumed that quantitative predictors such as age or tumor thickness enter linearly into the model, or they are categorized. Objective: The purpose of the present study is to investigate possible curvature (nonlinearity) of predictors of ‘death from MM within 5 years after diagnosis’ and ‘survival time after diagnosis’ avoiding the known shortcomings of categorizing predictors. Methods: Our analyses are based on data of 677 patients with stage I melanoma of the skin collected at the Cancer Registry of the Canton of Zurich. In order to study non-linearity of predictors, we use ‘generalized additive models’ (GAM): in a GAM the usual prognostic index is replaced in an optimal way by a more flexible form where the individual linear terms are replaced by possibly curved functions of the predictors. Plotting the corresponding curves (the ‘action profiles’) allows one to visualize easily the shape by which predictors ‘act’ over the whole range of values. Results: Essentially the same results emerged when studying ‘death from melanoma’ and ‘survival time in melanoma’: age and tumor thickness have a pronounced nonlinear association with both endpoints taking simultaneously into account effects of sex and tumor site. The action profile for age is J or U shaped. The action profile for thickness has a ‘two-phase’ pattern. It increases linearly for low thickness values and flattens for higher values. The shape of the action profiles was checked by performing a Monte Carlo simulation (‘bootstrapping’). Conclusions: The best prognosis of melanoma was found within a middle age range while younger and older patients showed a poorer prognosis. In our data, the increase in thickness in the range above 2 mm is of much less clinical relevance than in the range below 2 mm. GAMs may be of great value for clinicians in providing a visualization of the shape by which predictors act and to obtain a better understanding of the complex relationships between predictors and survival. Not considering curvature of action profiles may resu

ISSN:1018-8665    

DOI:10.1159/000246303

出版商:S. Karger AG    

年代:1996

数据来源: Karger

摘要:

Background: The autocrine motility factor receptor (AMFR), a specific receptor for AMF, is considered to be related to the metastatic potential of tumor cells. Objective: We investigated whether AMFR is expressed on cutaneous malignant melanoma cells and has any relationship to clinical stage and metastatic ability. Methods: We performed an immunohistochemical study on 20 cases of cutaneous malignant melanoma using anti-AMFR antibody. Results: AMFR was expressed in 9 cases (45%), and its expression had a tendency to correlate with the clinical stage and the presence of lymph node metastasis. Conclusions: The expression of AMFR may have a possible association with the metastatic potential of malignant melanoma.

ISSN:1018-8665    

DOI:10.1159/000246304

出版商:S. Karger AG    

年代:1996

数据来源: Karger

摘要:

Background: Verrucous carcinoma is a rare variant of well-differentiated squamous cell carcinoma which is characterized by a marked local aggressivity and a poor metastatic potential. Until now, little has been known about the oncogenic mechanisms of this tumor. Recently, extensive investigations have shown that p53 protein, a nuclear protein with oncogene-suppressing activity, may play a crucial role in cell transformation and immunoreactivity for this protein is found in a wide variety of cancers. Objective and Method: The aim of the present study is to examine the frequency of immunohistochemically detectable p53 protein by using two monoclonal antibodies (D07 and BP53-12) in 8 cases of formalin-fixed and paraffin-embedded specimens of verrucous skin carcinoma. Results: Overexpression of p53 protein was detected in 6 (75%) of the cases examined with the D07 antibody and in 5 (62.5%) cases with BP53-12. The p53 positivity was shown in a peripheral distribution affecting mainly the basal cell layers of tumoral islands. Conclusion: In a high percentage of verrucous carcinoma, p53 immunoreactivity has not been previously described in the literature and our findings suggest that abnormal expression of p53 tumor suppressor protein is a common event in the pathogenesis of this tumor.

ISSN:1018-8665    

DOI:10.1159/000246305

出版商:S. Karger AG    

年代:1996

数据来源: Karger

摘要:

Background and Objective: Eosinophilic pustular folliculitis (EPF) is a distinct inflammatory dermatosis of unknown etiology. The aim of this study is to evaluate the serum levels of cytokines in 3 patients with EPF before and after treatment with indomethacin. Results: Serum levels of interleukin 4 (IL-4) were elevated in patients with EPF. The remission of EPF was associated with increased serum concentrations of interferon γ with no essential change of serum levels of IL-4. Conclusion: These results suggest that subtle changes in serum levels of cytokines are involved in the remission of EPF and that indomethacin may provide the remission of EPF by altering cytokine production in patients with EP

ISSN:1018-8665    

DOI:10.1159/000246306

出版商:S. Karger AG    

年代:1996

数据来源: Karger

摘要:

Background: In some diabetic patients, the skin of the hands has a waxy appearance. Objective: To study subclinical skin stiffening in diabetic patients using a noninvasive, in vivo suction device measuring skin extensibility and elasticity. Skin thickness was also measured by high-resolution ultrasonography. Methods: Evaluations were made on the dorsum of the hands and on the volar aspect of the forearms. Results: In type 1 diabetic patients, the extensibility of skin was decreased while values of thickness and elasticity were increased. These alterations were most prominent on the hands. Similar modifications, although less pronounced, were also found in type 2 diabetic subjects. Conclusion: The reported biomechanical changes indicate the presence of subclinical skin stiffening in many patients with diabetes mellitus. Such noninvasive biometrological evaluations could be used for monitoring, rating and correlating some diabetes-associated disorders.

ISSN:1018-8665    

DOI:10.1159/000246307

出版商:S. Karger AG    

年代:1996

数据来源: Karger

摘要:

Background: We examined an 18-month-old girl with typical clinical features of X-linked dominant chondrodysplasia punctata (CDPX2) with decreased activity of dihydroxyacetone phosphate acyltransferase (DHAP-AT), previously reported in CDPX2. On the other hand, steroid sulfatase, whose activity is deficient or decreased in X-linked ichthyosis and X-linked recessive chondrodysplasia punctata, has been reported to be normal in CDPX2, although all of these diseases have ichthyotic skin changes. Objective: We measured the activity of DHAP-AT and steroid sulfatase of the patient’s fibroblasts to confirm the DHAP-AT abnormality in CDPX2. Results: The DHAP-AT activity was remarkably reduced, but steroid sulfatase activity was within normal levels when compared with those of 2 healthy controls. Conclusion: The abnormal metabolism in plasmalogen synthesis in CDPX2 was confirmed. It is, however, unknown how the decreased DHAP-AT activity is related to the skin change

ISSN:1018-8665    

DOI:10.1159/000246308

出版商:S. Karger AG    

年代:1996

数据来源: Karger

摘要:

Background: Male baldness develops because of an increased duration of the lag phase. Objective and Methods: To assess if this occurs also in balding women we studied 2 women with Ludwig type I–II patterned baldness for 2 years with monthly phototrichograms. Hairs were identified as thick anagen hairs, thin anagen hairs and telogen hairs. Results and Conclusions: Most of the hairs followed the expected development, namely they remained thick anagen hairs or they became thick from thin anagen, telogen from thick anagen or thin anagen from telogen hairs. Other hairs, though, became thin from thick anagen or telogen from thin anagen or thick anagen from telogen hairs. Still others did not regrow immediately after being in the telogen phase, leaving an empty space. Some empty spaces were not refilled for a long time. As in men, in balding women tiny bald spots develop corresponding to telogen hairs not replaced in due tim

ISSN:1018-8665    

DOI:10.1159/000246309

出版商:S. Karger AG    

年代:1996

数据来源: Karger

摘要:

Background: Juvenile temporal arteritis has been proposed as an entity but remains controversial. Case Report: A 39-year-old male, who was otherwise asymptomatic, developed painless bilateral nodules in the temporal areas. His eosinophil blood count was 2,660/mm3 (31%), while the erythrocyte sedimentation rate was normal. Histologic examination of the lesion revealed non-giant-cell granulomatous inflammation with abundant eosinophil infiltration. The clinical and pathologic manifestations in our patient were different from those in classic temporal arteritis, which occurs almost exclusively in individuals over the age of 50 years, allergic granulomatosis and angiitis, and thromboangiitis obliterans. Eight cases of this disease have previously been reported in the literature. Conclusion: We consider that ‘juvenile temporal arteritis with eosinophilia’ is a distinct clinical and pathologic entity. The prognosis of the diseases is considered to be g

ISSN:1018-8665    

DOI:10.1159/000246310

出版商:S. Karger AG    

年代:1996

数据来源: Karger

摘要:

Background: Malignant cellular blue nevus (MCBN) is a rare entity due to the malignant transformation of a preexisting cellular blue nevus (CBN). Objective and Methods: The clinical and pathologic features of 6 patients with MCBN are described. Results: Three tumors were located on the scalp, 2 on the trunk and 1 on the neck. The lesions, present from birth or childhood, had enlarged rapidly in the last months before excision. Histologically, there was a dermal proliferation of spindle and epithelioid atypical melanocytic cells. Some of them were heavily pigmented. Numerous atypical mitoses were seen. In 2 cases, foci of necrosis were detected. In 2 cases, remnants of CBN were also noted. MCBN has a poor prognosis and may be difficult to differentiate from so-called atypical blue nevus, metastasis of malignant melanoma and malignant transformation of combined nevus. Conclusions: CBN may represent a precursor of malignant melanoma. In MCBN, malignant changes seem to occur in clear cells.

ISSN:1018-8665    

DOI:10.1159/000246311

出版商:S. Karger AG    

年代:1996

数据来源: Karger

摘要:

Background: Reticular erythematous mucinosis (REM) syndrome is characterized by an accumulation of mucin in the dermis. Objective: To elucidate the mechanism of mucin deposition, the response of REM syndrome fibroblasts to various exogenous factors was studied. Method: REM and control fibroblasts were treated with potent modulators including tumor necrosis factor-α, basic fibroblast growth factor, interferon-γ, transforming growth factor-β1 and interleukin-1α (IL-1α) and -4. Results: IL-1β failed to stimulate glycosaminoglycan synthesis in REM fibroblasts whereas it stimulated glycosaminoglycan synthesis up to 6-fold in control fibroblasts. The stimulation of glycosaminoglycan was caused largely by a comparable increase in hyaluronic acid. Conclusion: These results suggest that the patient fibroblasts exhibit an abnormal response to stimulation by exogenous IL-1β and that IL-1β may be involved in the abnormal hyaluronic acid metabolism in REM s

ISSN:1018-8665    

DOI:10.1159/000246312

出版商:S. Karger AG    

年代:1996

数据来源: Karger