14你小汗腺汗孔瘤的临床病理分析

分析小汗腺汗孔瘤的临床病理表现。方法：对１４例小汗腺汗孔瘤进行光镜观察，并对部分病例作免疫组化染色，结果：发现汗孔瘤是一种特异性的肿瘤类型：１．肿瘤发生于表皮，部分累及真皮。２．肿瘤细胞和周围棘细胞境界较清楚。３．肿瘤细胞巢仙可见有护膜的小孔，小管状结构。４．肿瘤以宽带方式向下延５．宽带之间的间质水肿，疏松。６．部分肿瘤延伸达真皮深层者，下方形成有少许透明细胞成分的结节。７．瘤细胞较棘细胞小，镶嵌     

透明细胞汗腺瘤1例

患者女性,36岁,右手掌皮下无痛性包块1年。病理检查：带皮肤组织1．5cm×1．0cm大小,切面见真皮层1．0cm×0．5cm灰白色结节,无包膜,切面质韧,未见明显囊腔。镜下：可见类圆形、梭形肿瘤细胞呈小叶状及带状分布,并可见空泡样透明细胞区域及腺管状结构。腺管状结构可见由双层细胞组成。瘤细胞之间可见淡嗜伊红物质,未见角化物。间质中可见数量不等的纤维结缔组织穿插于肿瘤细胞间。PAS（＋＋）．Foot瘤细胞无嗜银纤维。免疫织化,keratin（＋＋）,EMA（＋＋）,vimentin（＋＋）。病理诊断：右手掌皮肤透明细胞汗腺瘤。讨论透明…     

汗腺粘液腺癌伴小汗腺螺旋腺瘤一例

患者男,84岁。因面部肿物3年,近半年来生长较快于1999年6月15日行肿物切除术。肿物局部有破溃,无疼痛瘙痒,周围皮肤正常。病理检查:梭形皮肤1块,面积1.5ｃｍ×1.2ｃｍ。皮肤表面呈结节状,有破溃,切面可见一直径1.2ｃｍ肿物,灰红灰白,部分区域半透明,有灶状出血,质软,界较清,但无包膜。镜下观察:表皮大部分完整,中心部有浅溃疡形成。真皮层内可见到2种肿瘤结构:(1)小汗腺粘液腺癌结构:真皮浅层可见大小较一致肿瘤细胞组成的小巢、条索状或腺样结构,这些上皮成分结构周围有大量浅染的粘液形成,肿瘤细胞漂浮于粘液池中,形成典型的汗腺型粘液腺…     

伴有显著血管平滑肌瘤样增生的肾细胞癌

肾透明细胞癌通常具有丰富的窦状血管网，这一特点有助于与其它脏器发生的透明细胞肿瘤鉴别，同时有研究提示肿瘤的血管形成与瘤细胞分泌的血管生长因子有关。作者报道了5例伴有显著血管平滑肌瘤样增生的肾透明细胞癌，并认为这种增生可能是伴随肾透明细胞癌出现的非肿瘤性血管增生的另一种表现形式。此组患者年龄37～75岁（平均53岁），4例为女性。均无结节性硬化。5例肿瘤均为孤立性，直径1．8-4cm。肿瘤界限清楚，具有厚而不规则的包膜。2例肿瘤中央可见纤维瘢痕，并有白色条索与包膜相连。肿瘤切面呈多彩状，可见红褐色、黄色和半透明白色区域及囊性变、坏死灶和局灶钙化。组织学观察：肿瘤最具特点的表现是两种不同成分混合存在：上皮性透明细胞肿瘤成分和具有血管平滑肌瘤样外观的间质成分。[第一段]     

多囊性肾细胞癌1例报道及文献复习

目的：阐明多囊性肾细胞癌的病理形态学特征及鉴别诊断要点。方法：报道1例多囊性肾细胞癌,结合文献对本病的临床病理特征进行探讨。结果：肿瘤由厚的假纤维被膜环绕,瘤体全部由大小不等的囊腔及无膨胀性实性结节的薄的间隔构成,囊腔被覆透明细胞,异形性小,间隔内含聚集的透明细胞上皮巢,结论：多囊性肾细胞癌是一种罕见的有低度恶性倾向的肿瘤,术前影像学,细胞学检查及术后的肉眼特征均与囊性肾瘤,囊性部分分化性肾母细胞瘤相似,最重要的是本瘤缺乏肉眼所见的膨胀性实性结节,显微镜下的关键特征是间隔内可见聚集的透明细胞巢。     

头皮鳞样小汗腺导管癌临床病理学分析

目的探讨头皮鳞样小汗腺导管癌的临床病理和免疫表型特征及诊断与鉴别诊断。方法通过HE及免疫组化染色观察1例鳞样小汗腺导管癌,并结合文献讨论。结果肿瘤位于头皮,实性真皮结节,组织学表现为小汗腺分化合并鳞状上皮成分,后者呈显著的不典型增生伴角质囊肿形成和鳞状旋涡。免疫表型：CK7、GCDFP-15阳性,34βE12、CD10阴性。结论鳞样小汗腺导管癌是一种非常罕见的低度恶性肿瘤,局部切除后可复发,未见转移报道。组织学上主要应与具有鳞状上皮或导管分化的皮肤附属器肿瘤相鉴别。肿瘤广泛切除是首选治疗方法。     

分泌粒细胞-巨噬细胞集落刺激因子的重组痘苗病毒转染的瘤苗裂解物抗肿瘤作用

将小鼠粒细胞－巨噬细胞集落刺激因子（ＧＭ－ＣＳＦ）基因经过同源重组得到表达ＧＭ－ＣＳＦ的重组痘苗病毒，用此痘苗病毒转染小鼠黑色素瘤细胞，制备黑色素瘤瘤苗裂解物（ＧＭ－ＣＳＦＶＭＯ），Ｃ５７ＢＬ／６小鼠皮下接种Ｂ１６－Ｆ１０细胞３天后在注射部位注射瘤苗裂解物，一周后再注射一次。结果发现ＧＭ－ＣＳＦＶＭＯ能够显著地抑制荷瘤小鼠肿瘤结节的生长并明显延长荷瘤小鼠的存活期。用此瘤苗裂解物免疫小鼠两次，间隔一周，免疫一周后给Ｃ５７ＢＬ／６小鼠皮下接种Ｂ１６－Ｆ１０细胞，结果肿瘤结节出现时间明显延长，部分小鼠肿瘤不再生长。经ＧＭ－ＣＳＦＶＭＯ治疗或免疫后小鼠的外周血和脾淋巴细胞对肿瘤细胞杀伤活性明显升高，ＮＫ活性变化不明显。本结果提示，诱导机体特异性细胞免疫可能是瘤苗裂解物的抗肿瘤作用机理之一。     

卵巢黏液性囊性肿瘤伴实性附壁结节

目的：探讨卵巢黏液性囊性肿瘤伴实性附壁结节的临床病理学特点。方法：对2例卵巢黏液性囊性肿瘤进行光镜观察和免疫组化染色并复习文献。结果：1例卵巢黏液性交界性乳头状囊腺瘤伴实性附壁恶性纤维组织细胞瘤结节，结节内瘤细胞呈多形性。1例卵巢黏液性囊腺瘤伴实性附壁间变性癌结节；间变性癌结节内瘤细胞体积较大，胞质丰富，嗜酸，少数胞质透明，排列呈巢或索状；免疫表型：EMA和cytokeratin阳性。恶纤组结节中肿瘤细胞AACT和vimentin阳性。结论：免疫组化有助于卵巢黏液性囊性肿瘤伴实性附壁结节的诊断及鉴别诊断。     

反复发作的皮肤T细胞淋巴瘤一例

患者女，５０岁。因躯干散在多发性皮下结节伴疼痛于１９９７年４月入院。体检：躯干部多个皮下结节，直径０．４～１．０ｃｍ，结节表面皮肤无颜色改变。初步印象为皮肤多发性神经纤维瘤，遂行结节活检。病理检查：皮下结节直径０．５ｃｍ，淡粉红色。显微镜检查：表皮无著变，真皮较深层及皮下组织肿瘤细胞灶状或弥漫分布，无特殊排列。细胞大小不等，核圆形、卵圆形或不规则形，核仁不明显，病理性核分裂象多见，可见吞噬现象。肿瘤组织中还可见较多厚壁小血管。肿瘤组织内及其周围可见成熟的脂肪组织（图１）。免疫组化结果：白细胞共同…     

肾脏黏液样小管状和梭形细胞癌临床病理分析

目的探讨肾脏黏液样小管状和梭形细胞癌（mucinous tubular and spindle cell carcinoma, MTSCCa）的临床病理特征和鉴别诊断要点及生物学行为。方法对4例MTSCCa标本进行组织病理学和免疫组化染色观察,并复习临床资料及相关文献。结果该肿瘤好发于女性,发病年龄17～82岁（平均53岁）,临床症状不明显。组织学：肿瘤与周围肾组织分界清楚,切面实性、灰白色,肿瘤细胞形态呈双相（小管状和梭形细胞）或三相（小管状、梭形和脊索瘤样或黏液样）。其他组织学表现：泡沫样巨噬细胞聚集、典型的透明细胞和乳头状或乳头结构。免疫组化显示复合性免疫表型。结论MTSCCa是一种罕见的低级别多形性肿瘤,组织学谱系在不断扩大,免疫组化表型及组织学形态与乳头状肾细胞癌（PRCCa）有重叠。     

Schizophrenia in a North Swedish geographical isolate, 1900–1977. Epidemiology, genetics and biochemistry

Over 200 schizophrenic patients belonging to three major and interrelated pedigree complexes have been investigated over the past 30 years in a North Swedish geographically isolated population, presently numbering about 6,000. An intensive investigation of a number of biochemical correlates and genetic markers in a few selected families belonging to one of the major pedigrees has indicated new strategies for the current research program.
Schizophrenia, as defined operationally, is significantly associated with decreased activities of two enzymes (1) blood platelet monoamine oxidase, (2) plasma dopamine-β-hydroxylase, and (3) with the genetic marker Gc² (group specific antigen). Both enzymes are subject to genetic variation. A positive score for linkage between schizophrenia and low plasma DBH activity has been calculated, but, so far, available data are insufficient for discrimination between linkage and partial contribution of genetically controlled low plasma DBH to the pathogenesis of the disease. Alternatively, both mechanisms could be involved.
As a model for continued research, schizophrenia is explained as based on a double dominant-recessive genotype (Aabb), representing a vulnerability which in about 50 % of cases develops into clinical schizophrenia. It is suggested that the dominant mutation (A) operates on or affects MAO activity, and that the recessive genotype (bb) is instrumental in low variates of DBH activity and very likely such variates within the normal range of physiological variation. Moreover, it is suggested that the combined effects of MAO- and DBH-reduced efficiency on the metabolism of e.g. dopamine could be an essential pathogenic mechanism for the schizophrenic illness which is segregating in this population.     

Renal dysplasia and asplenia in two sibs

A family is reported in which two sibs, one male and the other female, both died within 24 hours of birth with enlarged polycystic kidneys. Postmortem histology in the second child showed gross renal dysplasia. In both children the pancreas was enlarged, nodular and cystic but the liver appeared macroscopically normal. In the second child, histological examination confirmed pancreatic fibrosis with cystic dilation of ducts, but showed portal fibrosis with bile duct proliferation in the liver.
This combination of findings is very reminiscent of those in a girl and her brother reported by Ivemark et al. (1959). The children reported here also showed absence or hypoplasia of the spleen, cardiac anomalies and other features of the Ivemark syndrome (Ivemark 1955), a quite different, usually sporadic, congenital disorder. It is suggested that the children described here have a distinct lethal congenital disorder, probably inherited in an autosomal recessive manner.     

The dominant diseases of modernized societies as omega-3 essential fatty acid deficiency syndrome: Substrate beriberi

About 1900, modern food selection and processing caused widespread $\text{epidemics}$ of the B vitamin deficiency diseases of beriberi and pellagra which, for genetic reasons, often expressed as different diseases ranging from bowel and heart disease to dermatoses and psychoses. But the B vitamins merely help convert essential fatty acids (EFA) into the prostaglandin (PG) tissue regulators and it now turns out that, through hydrogenation, milling and selection of w3-poor southern foods, we have also been systematically depleting, by as much as 90%, a newly discovered trace Nordic EFA (w3) of special importance to primates and sole precursor of the PG3(4) series, even as a concurrent fiber deficiency increases body demand for EFA. Since substrate EFA is processed by many B vitamin catalysts, an EFA deficiency will mimic a $\text{panh}$ypovitaminosis B, i.e., a mixture of $\text{substrate}$ beriberi and $\text{substrate}$ pellagra resembling vitamin beriberi and pellagra but exhibiting as even more diverse $\text{endemic}$ disease. This would consitute a second stage of the Modern Malnutrition and explain why some workers now hold the dominant diseases of modermized societies to be new, nutritionally based, pellagraform yet lipid-related and to range, once again, from heart disease to psychosis. It is an assumption that our dominant diseases are unrelated to each other or are merely revealed by our diagnostic acumen and therapeutic success; and that hydrogenating millions of tons of food oils annually, to destroy the rancidity producing w3-EFA, is safe for $\text{primates}$. Extensive beriberiform disease is reported here in 32 typical cases taken from medical practice which responds strikingly to linseed oil supplements (60% w3-EFA) in confirmation of identical results in Capuchins.     

'Very sore nights and days': the child's experience of illness in early modern England, c.1580-1720

Sick children were ubiquitous in early modern England, and yet they have received very little attention from historians. Taking the elusive perspective of the child, this article explores the physical, emotional, and spiritual experience of illness in England between approximately 1580 and 1720. What was it like being ill and suffering pain? How did the young respond emotionally to the anticipation of death? It is argued that children’s experiences were characterised by profound ambivalence: illness could be terrifying and distressing, but also a source of emotional and spiritual fulfilment and joy. This interpretation challenges the common assumption amongst medical historians that the experiences of early modern patients were utterly miserable. It also sheds light on children’s emotional feelings for their parents, a subject often overlooked in the historiography of childhood. The primary sources used in this article include diaries, autobiographies, letters, the biographies of pious children, printed possession cases, doctors’ casebooks, and theological treatises concerning the afterlife.     

Guidelines for the Validation and Use of Immunoassays for Determination of Introduced Proteins in Biotechnology Enhanced Crops and Derived Food Ingredients

Recent advancements in agricultural biotechnology have created a need for analytical techniques to determine introduced proteins in crops enhanced through modern biotechnology techniques. These proteins are expressed in plant tissues and may be present in food ingredients. Immunoassays are ideally suited for protein detection and may be used as both quantitative and threshold methods. Microplate ELISA and lateral flow devices are two of the most commonly used immunoassay formats for agricultural biotechnology applications. This paper provides general background information and a discussion of criteria for the validation and application of immunochemical methods to the analysis of proteins introduced into plants and food ingredients using biotechnology methods. It is the result of a collaborative effort of members of the Analytical Environmental Immunochemical Consortium. This collaborative effort represents the combined expertise of several organizations to reach consensus on establishing guidelines for the validation and use of immunoassays. Further, the paper offers developers and users a consistent approach to adopting the technology as well as aid in producing accurate and meaningful results.     

HLA in North Colombia Chimila Amerindians

HLA-A,-B,-C,-DRB1 and -DQB1 alleles have been studied in Chimila Amerindians from Sabana de San Angel (North Colombian Coast) by using high resolution molecular typing. A frequent extended haplotype was found:HLA-A*24:02-B*51:10-C*15:02-BRB1*04:07-DQB1*03:02 (28.7%) which has also been described in Amerinndian Mayos Mexican population (Mexico, California Gulf, Pacific Ocean). Other haplotypes had already been found in Amerindians from Mexico (Pacific and Atlantic Coast), Peru (highlands and Amazon Basin), Bolivia and North USA. A geographic pattern according to HLA allele or haplotype frequencies is lacking in Amerindians, as already known. Also, five new extended haplotypes were found in Chimila Amerindians. Their HLA-A*24:02 high frequencies characteristic is shared with aboriginal populations of Taiwan; also, HLA-C*01:02 high frequencies are found in New Zealand Maoris, New Caledonians and Kimberly Aborigines from Australia. Finally, this study may show a model of evolutionary factors acting and rising one HLA allele frequency (-A*24:02), but not in others that belong to the same or different HLA loci.     

Ultracryotomy: development and application (with examples from the yeast cytology) (author's transl)

The preparation steps usually necessary for obtaining ultrathin frozen sections of biological material (chemical prefixation, enclosing, cryoprotective treatment, freezing, sectioning, and post-staining the sections for transmission electron microscopy) are submitted to a critical analysis. The application of cryo-ultramicrotomy, in particularly for cytochemical purposes, is reviewed. Fundamental considerations of chemical prefixation and poststaining are supported by examples from yeast cytology. Furthermore, the efficiency of the cryo-ultramicrotomy (electron optical resolution of ultrastructural details) is demonstrated on yeast cells and protoplasts.     

The universal muscular chamber. A basic unit of the genitourinary, cardiovascular, gastro-intestinal, skeletal, cutaneous, respiratory and other systems, endocameral hypertension; and spasm, the key to their idiopathic diseases and arthropathies

Starting with the integument, we see many organs are contractile sacs or multiples thereof, which tubes or bags constitute the major part of the entire body. Recognition of this basic unit and its characteristics sheds new light, individually and collectively, on many disorders previously considered unrelated. Muscular tears and perforations develop in the walls of these chambers, being no way peculiar to those organs, wherein, hydrochloric acid occurs. So, it is not necessary to explain the absence of excessive acid from patients who exhibit holes in the gastric, uterine, aortic, duodenal, rectal, pulmonary, retina, and other walls. Muscle, not acid is the great common factor relating idiopathic disorders in the gastrointestinal tract to each other and to similar diseases in other systems. When the units are linked together, the lesions tend to appear as arthropathies, i.e. at the joints. Rephrasing common-place observations, frees us from conventional, conceptual cul-de-sacs. An observation is only as good as its interpretation, so all possibilities must be considered, otherwise, we will remain blinded by our misconceptions.     

Der Einfluß von Nahrungsmitteln und Rauchen auf die klinisch-chemische Diagnostik von Phäochromozytom,Neuroblastom und Karzinoid-Syndrom

Zusammenfassung Der Einfluß von verschiedenen Nahrungsmitteln auf Methoden zur Bestimmung von Adrenalin (AD), Noradrenalin (NA), Vanillinmandelsäure (VMS), Metanephrinen (MN), Homovanillinsäure (HVS) und 5-Hydroxyindolessigsäure (5-HIE) im 24 h-Harn zur Diagnose des Phäochromozytoms bzw. Karzinoid-Syndroms wurde untersucht. Die in die Untersuchung einbezogenen Nahrungsmittel waren: Tee, Kaffee, Mandeln, Ananas, Käse, Walnüsse, Vanillepudding, Bananen, Tomaten und Milchschokolade. Außerdem wurde der Einfluß des Zigarettenrauchens auf die Bestimmung von AD, NA, VMS und MN untersucht.Walnüsse führten zu einer starken Erhöhung der 5-HIE-Ausscheidung. Bananen erhöhten die Ausscheidung von AD, NA, VMS, MN und 5-HIE. Kaffee und Ananas bewirkten eine geringe Zunahme der MN-Werte. Rauchen von 20–30 Zigaretten/Tag beeinflußte keine der vier Variablen.Wenn die beschriebenen Methoden benutzt werden, sollte lediglich auf den Verzehr von Bananen und Walnüssen vor und während der Harnsammelperioden verzichtet werden, da die oberen Normgrenzen im Harn überschritten werden könnten. Ein Verzicht auf Kaffee und Ananas in normalen Mengen ist nicht erforderlich. Es besteht kein Anlaß, weiterhin die bisherigen umfangreichen Restriktionen der übrigen Nahrungsmittel beizubehalten.