A 58-year-old white woman came to our observation in April 1992 presenting an 8 mm thick, Clarke's level V nodular malignant melanoma of the pretibial region of the left leg. Inguinal iymphnodes were excised in January 1993. Widespread metastases of malignant melanoma were diagnosed. Ten days after the nodal excision, she observed hypopigmented areas of the skin on the lower extremities. In the subsequent days, these progressed symmetrically towards the trunk, back, face, and arms. Within a few months, about 70% of the body surface was depigmented. A careful ophthalmologic examination did not disclose any signs of uveal involvement. At present (January, 1995), the patient is alive and well 27 months after the diagnosis and 19 months after the nodal excision. The clinical follow-up allowed us to exclude a relapse ofthe disease.Skin biopsies taken from depigmented areas showed a marked reduction of the numbers of melanocytes. Melanin granules were practically absent in the basal keratinocytes. Adjacent hyperpigmented areas showed a normal amount of melanocytes with an increase of melanin granules in the basal layer of the epidermis. No architectural and/or cytologic abnormalities were detected in the epidermis or in the dermis.On electron microscopy, different findings were observed in hypopigmented and hyperpigmented areas. In the former (Figs. 1, 2), small melanocytes were observed occasionally in the basal layer of the epidermis. Their cytoplasm was scanty and the rough endoplasmic reticulum, mitochondria, and mature melanosomes were markedly reduced. Intracytoplasmic filaments, 10 nm thick, were abundant. The shapes of the nuclei were irregular, with small chromatin masses lining the nuclear wall, and with inconsistent nucleoli. Except for the almost complete depletion of melanosomes, no ultrastructural alterations and/or maturational disorders were observed in basal keratinocytes. Langerhans cells were frequently observed. Lymphocytes with heavily indented nuclei were seen among the basal keratinocytes. Enlarged intercellular spaces and acantholysis were also frequently observed in these instances.The hyperpigmented regions showed an apparently in-From creased number of melanocytes with enlarged cytoplasm. The number of melanocytic elongations among the keratinocytes were also increased. Subcellular organelles were abundant (i.e., the rough endoplasmic reticulum and mature subplasmalemmal melanosomes were prominant) ( Fig. 3). Mature melanosomes in normal or increased numbers were shown in keratinocytes. Mild regressive changes were observed in keratinocytes, such as vacuolization and acantholysis, especially near lymphocyte processes. Macrophages containing vacuoles with multiple melanosomes were observed in the dermis.Skin biopsies from five vitiligo patients without melanoma were examined as controls. A reduction in the number of melanocytes with an almost complete lack of melanosomes in the basal keratinocytes was demonstrated in all cases. Lymphocytes with heavily indented nuclei were observed in the epid...
We report the second infant of nonconsanguineous parents with epidermolysis bullosa junctionalis associated with urinary bladder exstrophy, epispadias, anteriorized anus, and bilateral inguinal hernias. The family history also included the death of a maternal cousin due to epidermolysis bullosa. Our diagnosis was based on electron microscopy and immunofluorescence evidence. This patient is reported because of the rarity of this constellation of findings.
Background The management of melanoma patients with metastatic melanoma in the sentinel nodes (SN) is evolving based on the results of trials questioning the impact of completion lymph node dissection (CLND) and demonstrating the efficacy of new adjuvant treatments. In this landscape, new prognostic tools for fine risk stratification are eagerly sought to optimize the therapeutic path of these patients. Methods A retrospective cohort of 2,086 patients treated with CLND after a positive SN biopsy in thirteen Italian Melanoma Centers was reviewed. Overall survival (OS) was the outcome of interest; included independent variables were the following: age, gender, primary melanoma site, Breslow thickness, ulceration, sentinel node tumor burden (SNTB), number of positive SN, non-sentinel lymph nodes (NSN) status. Univariate and multivariate survival analyses were performed using the Cox proportional hazard regression model. Results The 3-year, 5-year and 10-year OS rates were 79%, 70% and 54%, respectively. At univariate analysis, all variables, except for primary melanoma body site, were found to be statistically significant prognostic factors. Multivariate Cox regression analysis indicated that older age (P < 0.0001), male gender (P = 0.04), increasing Breslow thickness (P < 0.0001), presence of ulceration (P = 0.004), SNTB size (P < 0.0001) and metastatic NSN (P < 0.0001) were independent negative predictors of OS. Conclusion The above results were utilized to build a nomogram in order to ease the practical implementation of our prognostic model, which might improve treatment personalization.
We are glad to introduce CLiC-it 2014 (http://clic.humnet.unipi.it), the first edition of the Italian Conference on Computational Linguistics, a new event aiming to establish a reference forum for research on Computational Linguistics of the Italian community. CLiC-it covers all aspects of automatic language understanding, both written and spoken, and targets state-of-art theoretical results, experimental methodologies, technologies, as well as application perspectives, which may contribute to advance the field.CLiC-it 2014 is held in Pisa on December 9-10 2014, and it is co-located with EVALITA-2014 (http://www.evalita.it), the fourth edition of the evaluation campaign of Natural Language Processing and Speech tools for Italian and with the XIII Symposium on Artificial Intelligence (Pisa, 10-12 December 2014, http://aiia2014.di.unipi.it/).Pisa is a special place in the history of Italian Computational Linguistics. Here, Padre Roberto Busa carried out his pioneering research on automatic text processing in the late '60s with Antonio Zampolli, who then founded the Istituto di Linguistica Computazionale of CNR in Pisa, the first research center thoroughly devoted to Computational Linguistics and Natural Language Processing. The University of Pisa also hosted the first professorship in Computational Linguistics held by Antonio Zampolli until his death in 2003.It is therefore highly symbolic that the Italian community on Computational Linguistics gathers for the first time in Pisa, there where its roots lie. Italian Computational Linguistics has come a long way. Research groups and centers are now spread nationwide and play an active role on the international scene. The large number of researchers that have decided to present their work to CLiC-it is the best proof of the maturity of our community, strongly committed to shape the future of Computational Linguistics.The spirit of CLiC-it is inclusive. In the conviction that the complexity of language phenomena needs cross-disciplinary competences, CLiC-it intends to bring together researchers of related disciplines such as
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