ELECTRON MICROSCOPY OF LIVER LESIONS IN PRIMARY BILIARY CIRRHOSIS

An 80 μm bile duct with typical features of chronic non-suppurative destructive cholangitis was examined by electron microscopy. Many inflammatory cells, including lymphocytes, macrophages and plasma cells infiltrated among epithelial cells of the bile duct. Epithelial cells were compressed and deformed by infiltrating lymphocytes. These lymphocytes were in contact with epithelial cells at small points or large areas. The intercellular distance was about 10 or 20 nm at the contact areas. The mode of contact and intercellular distance coincided with the results of in vitro experiments on lymphocyte cytotoyicity against target cells. Some epithelial cells in contact with lymphocytes showed degenerative changes. Necrotic changes were observed in bile duct epithelial cells undergoing emperipolesis. The invading lymphocyte in the epithelial cell had osmiophilic substances on the surface. These sites of emperipolesis seem to be the areas of lymphocyte cytotoxicity against epithelial cells.     

ELECTRON MICROSCOPY OF LIVER LESIONS IN PRIMARY BILIARY CIRRHOSIS

Liver biopsy specimens from a primary biliary cirrhosis (PBG) patient and two control patients with other biliary disorders were examined under the electron microscope, with special reference to intrahepatic bile ducts. The PBG patient had a bile duct with an 80 μm diameter that showed specific alterations in epithelial cells. These cells were termed oncocytes, and their main features were: the presence of a large number of swollen mitochondria with abnormal cristae, no mitochondrial bodies, small number of exocrine granules and an undulated nucleus with a large cytoplasm. The number of mitochondria per ultrathin-sectioned epithelial cell was greater by about 2 times in the oncocytic epithelial cells compared to the control cells. Fine fibrils and long-spacing collagens were present around the PBC bile duct. Periductal capillaries of the bile duct had multilayered basement membranes. These periductal changes may have induced the oncocytic changes in the epithelial cells. The basement membrane of the bile duct was meandrous and often disrupted, but not multilayered. Many lymphocytes and macrophages infiltrated among the epithelial cells.     

FLORID DUCT LESIONS AND EXTENSIVE BILE DUCT LOSS OF THE INTRAHEPATIC BILIARY TREE IN CHRONIC LIVER DISEASES OTHER THAN PRIMARY BILIARY CIRRHOSIS

Intrahepatic biliary tree with either florid duct lesions or a moderate to severe degree of the duct loss in four livers with chronic hepatic diseases other than primary biliary cirrhosis were studied with histometric and serial section observations. Florid duct lesions, distributed segmentally in the liver, were found in one case with incomplete septal cirrhosis and one case with idiopathic portal hypertension. The florid duct lesions including marked plasma cell infiltration and occasional periductal granulomas, were not associated with any bile duct loss in the two cases. The duct lesions were reversible in one case during a long clinical course. On the other hand, a moderate to severe bile duct loss with biliary epithelial degeneration and necrosis was associated with no or little periductal inflammatory cell infiltration in one other case with chronic intrahepatic cholestasis, probably drug-induced, and in one case with idiopathic portal hypertension. Although florid duct lesions and bile duct loss were important diagnostic features of primary biliary cirrhosis, one of them was observed to develop independently in severely diseased livers, not consistent with a diagnosis of primary biliary cirrhosis, sclerosing cholangitis or intrahepatic bile duct paucity syndrome.     

MORPHOLOGICAL STUDIES OF THE SPLEEN IN IDIOPATHIC PORTAL HYPERTENSION (SO-CALLED BANTI'S SYNDROME WITHOUT LIVER CIRRHOSIS) USING LIGHT MICROSCOPY, SCANNING ELECTRON MICROSCOPY AND HISTOMETRY

Morphological changes in the spleens of patients with idiopathic portal hypertension (IPH) were studied and compared with the normal spleen. The study used (1) light microscopy with histometry, (2) scanning electron microscopy (SEM) of the splenic tissue with histometry and (3) SEM of the spleen vascular replica. Histometrical studies by light microscopy showed that the volume of red pulp of IPH was increased in a unit area and to a total of 12 times the normal in the whole spleen. The white pulp was scanty of lymphocytes and decreased in a unit area but it was increased in the whole spleen. SEM of the white pulp of IPH demonstrated many channels formed by reticulum cells and running parallel with each other along the central artery. This finding presumably corresponds to periarterial fibrosis in light microscopy. SEM histometry demonstrated that the venous sinuses of IPH were small but increased in number and occupied the same percentage area in a unit red pulp area as in the normal spleen. The Billroth cord of IPH was narrowed and occupied by thickened reticulum cells, which may cause increased pooling and destruction of blood cells in the enlarged spleen (hypersplenism). SEM of the tissue and vascular replica demonstrated open arterial termination in the Billroth cord in the spleen of IPH as well as in the normal spleen. Venous sinuses in the replica of IPH ran parallel with each other forming bundles with fewer intercommunications than normal.     

INCREASED ACIDOPHILS OF THE HYPOPHYSIS IN LIVER CIRRHOSIS

The percentage of cell number of 3 types of male anterior pituitary cells was counted in autopsy cases with liver cirrhosis and cases that died of other conditions. These cases were then compared. In liver cirrhosis, acidophils (somatotrophs and mammotrophs) showed a tendency to increase in cell percentages. Immunocytochem-istry also revealed the increase in the number of somatotrophs and mammotrophs in liver cirrhosis. Comparison of protein sythesis in cirrhotic liver and in healthy liver, in vitro, revealed that in the cirrhotic liver tissue protein synthesis was markedly depressed and GH for protein synthesis became more necessary than in a non-cirrhot-ic state. The disturbed protein synthesis and hypoproteinemia were suggested as causative factors of increased acidophils of the anterior lobe of the hypophysis.     

AFP,CA19—9联检在原发性肝癌和肝硬化鉴别诊断中的临床意义

为提高原发性肝癌的诊断率和与肝硬化，其他慢性肝病的鉴别诊断，本文采用放射免疫分析法和免疫放射分析法。对５０例健康体检者、４８例原发性肝癌、３９例肝硬化，３６例其他一肝病患者，分别检验其血清中甲胎蛋白，糖类抗原１９－９肿瘤标志物的含量，结果进行比较。     

ANATOMICAL LESIONS BEING RESPONSIBLE FOR DEVELOPMENT OF PORTAL HYPERTENSION IN CARBON TETRACHLORIDE-INDUCED RAT LIVER CIRRHOSIS

The hemodynamics of carbon tetrachloride-Induced rat liver cirrhosis were examined by means of the perfusion experiment and the anatomical lesions being responsible for the development of portal hypertension were evaluated. The portal blood flow of isolated rat liver was 3.07±0.53 ml/g/min. in intact rats, 1.94±0.24ml/g/min. In fibrosis rats and 1.75±0.23 ml/g/min. in cirrhosis rats under the condition of perfusion pressure 13.5 cmH₂O and of Ht 36%. The flbrotlc liver as well as cirrhotic liver showed marked elevation of hepatic vascular resistance, and more than 20 cmH₂O perfusion pressures were necessary for the fibrotlc liver as well as the cirrhotic liver to hold the normal level of hepatic blood flow. There was no perceptible stenosis or distortion of the Intrahepatic portal tree and of the hepatic venous tree, but there was marked constriction of the sinusoid resulting from enlargement of the hepatic cell in the fibrotlc liver as well as in the cirrhotic liver. The Intimate correlation between the hepatic blood flow reduction and the extent of sinusoidal constriction suggested that vascular resistance of cirrhotic liver was located In the sinusoidal bed.     

MORPHOLOGICAL STUDIES OF THE SPLEEN IN SPLENOMEGALIC LIVER CIRRHOSIS COMPARING WITH THE SPLEEN IN IDIOPATHIC PORTAL HYPERTENSION (SO-CALLEDBANTI'S SYNDROME WITHOUT LIVER CIRRHOSIS)

Morphological changes of the spleen in splenomegalic liver cirrhosis (SLG) were studied. Comparisons with the normal spleen and the spleen of idiopathic portal hypertension (IPH) were made by (1) light microscopy with histometry, (2) scanning electron microscopy (SEM) with histometry, and (3) SEM of the spleen vascular replica. Hlstometrical studies by light microscopy showed that in both SLG and IPH, the white pulp volume was decreased in random units of splenic tissue but increased in the whole spleen, whereas the red pulp volume was increased both in random units of splenic tissue and in the whole spleen. The increase in the total volume of the white pulp was less marked in SLG than in IPH. SEM histometry demonstrated in the red pulp an increase in small venous sinuses and narrowing of the Billroth cord in SLG and IPH. Narrowing of the Billroth cord was more marked in SLG than in IPH. SEM of the white pulp showed channels formed by reticulum cells around the central artery in SLC and IPH. The channels are thought to correspond to so-called "follikulare Fibroadenie" or periarterial fibrosis. The spleen vascular replica demonstrated open arterial termination into the tissue spaces in the Billroth cord in SLG, IPH and the normal. Venous sinuses were arranged in bundles in SLC and IPH.     

人胎视网膜发生的光镜和电镜观察

本文在光镜下观察40例人胎视网膜的发生,在电镜下观察15例人胎视网膜视细胞、双极细胞、节细胞的发育。结果表明:胚胎第9周时神经上皮可分内、外成神经细胞层。第10周时内、外成神经细胞层之间的Chievitz带消失;第11周时节细胞从内成神经细胞层内迁;第13周节细胞与内成神经细胞之间出现内网层;第16周始双极细胞从外成神经细胞层中内迁形成外网层和内核层。第20周后视网膜各层形成。而视细胞、双极细胞、节细胞的超微结构于胎儿8个月后才发育完善。其结构与成人基本相同。     

ELECTRON MICROSCOPY OF INTRADUCTAL PAPILLOMA OF THE BREAST

Intaductal papillomas, papillary carcinomas, and normal mammary large ducts were studied by electron microscopy. The intraductal papillomas were divided into two subtypes: fibrous and glandular. Comparative ultrastructural analysis of these two subtypes revealed definitive differences in the nucleus, chromatin, and presence of myoepithelial cells. An irregularly shaped nucleus, aggregated heterochromatin, and prominent myoepithelial cells were the conspicuous features of the fibrous type which appeared to be almost absent in the glandular type. Moreover, the fibrous type possessed intact basal laminae, various differentiations of the cell surface, desmosomes, terminal bar, intrastromal projections of crab-finger-like appearance of the myoepithelial cells, and a two cell layer arrangement of epithelial cells. In these features, the ultrastructural appearance of the fibrous type closely resembled that of the cells of the normal mammary large duct. The glandular type, on the other hand, more or less lacked myoepithelial cells, well-developed organelles and showed a euchromatin pattern in the nucleus. This type resembled the papillary carcinoma in its histological characters. An absence of basal laminae (infiltrating carcinoma only) and the presence of intracytoplasmic lumina were characteristic of papillary carcinomas, and these two features were not found in the intraductal papillomas.     

小鼠晶状体纤维的扫描电镜观察

用扫描电镜观察了小鼠平行于晶体前后轴不同断裂面的晶体纤维,发现纤维表面超微结构与其他一些动物基本一致,但在赤道部存在一种陡峭的,两侧凹凸不平的条形隆起,在晶体断裂面上象放射状条纹分布在赤道部纤维上,文内对该联系经晶体的生理功能进行了探讨;由于在平行于前后轴的不同断裂面上均可见到不同层次的板层样结构,因此提出晶体纤维板层的概念,并对其形成、连接、在晶体内的排列及意义进行了探讨.     

PATHOLOGY OF LIVER CIRRHOSIS IN EXPERIMENTAL SCHISTOSOMIASIS JAPONICA

Rabbits were experimentally infected with Scbistosoma japonicum to observe morphological alterations of the liver to the 60th week of infection in chronological sequence. In the present report, the developing process of liver cirrhosis due to Schistosoma japonicum was elucidated together with the repairing process occurring after its cirrhotic state. It is concluded that the experimental liver cirrhosis due to Schistosoma japonicum is repairable. Consequently, in the persistence and progress of a cirrhotic state in the liver, repeated infections appear to play an important role.     

人鼻粘膜微血管管壁的扫描电镜观察

用胰蛋白酶消化-盐酸水解结缔组织法处理成人下鼻甲粘膜标本,然后在扫描电镜下观察了鼻粘膜微血管的管壁结构.毛细血管前微动脉的管壁为分枝平滑肌细胞;在毛细血管前微动脉的末端观察到毛细血管前括约肌;肌性微静脉的中膜由几层环形排列的平滑肌细胞构成.本文还讨论了粘膜微血管管壁结构的机能意义.     

EXPRESSION OF β2-MICROGLOBULIN ON INTERLOBULAR BILE DUCTS IN PRIMARY BILIARY CIRRHOSIS AND OTHER HEPATOBILIARY DISEASES

Expression of β-microglobulin, a reliable marker of HLA Glass I, on the interlobular bile ducts (bile ducts) was surveyed using an immunoperoxidase method in paraffin sections of specimens from patients with a variety of hepatobiliary diseases. Normal bile ducts showed negativity or weak cytoplasmic positivity in normal as well as diseased livers. On the other hand, abnormal bile ducts showing degenerative or proliferative changes in primary biliary cirrhosis and graft-versus-host disease revealed enhanced expression of this protein, suggesting that these damaged bile ducts might be more susceptible to T cell-mediated immune attack in these immunologic diseases. However, enhanced expression of this protein was also similarly found on abnormal bile ducts in several nonimmunologic biliary diseases Including extrahepatic biliary obstruction. Enhanced expression of this protein on the interlobular bile ducts may therefore be an epiphenomenon secondary to different primary pathologic events in the biliary tree, such as immunologic and nonimmunologic processes. ACTA PATHOL JPN 38 : 853∼860, 1988.     

蟾蜍胰腺间介细胞的电镜及免疫电镜研究

本实验应用常规电镜及A蛋白胶体金(PAG)免疫电镜技术对蟾蜍胰腺间介细胞进行了研究。间介细胞位于靠近胰岛的腺泡细胞之间或胰岛周边,胞浆内同时含有内外分泌颗粒。用PAG免疫电镜方法证实,间介细胞的β样颗粒呈抗胰岛素血清阳性反应。本文还对腺泡——胰岛转化学说进行了探讨。     

ELECTRON MICROSCOPIC STUDIES OF THE SPLEEN AND LIVER IN HEREDITARY SPHEROCYTOSIS

Electron microscopic findings of the red pulp of the spleen and liver from three patients with hereditary spherocytosis have been reported.
The sinus lumen of the spleen contained various amounts of red cell with reduced deformability. Pronounced engorgement of erythrocytes in the cordal space and various stages of erythrophagocytosis by the cordal macrophages were characteristic findings. The sinus lining cells also showed erythrophagocytosis and contained numerous dense bodies. Cordal macrophages and fibrous elements seemed to be more increased in the older patient.
Acid phosphatase activity of varied intensity was demonstrated in the erythrophagocytic vacuoles of cordal macrophages. As the intracellular degradation progressed, more intense activity of this enzyme was noted, indicating their lysosomal origin.
Splenic conditioning and enhanced destruction of defective red cells in the spleen were the main cause of hemolysis in hereditary spherocytosis.
In the liver, erythrophagocytosis by the Kupffer cells was also not infrequently noted, but the liver was estimated to play a minor role in HS.
The mechanism of hemolysis and the role of the spleen and liver in elimination of hereditary spherocytes have been discussed.     

HEPATIC MICROCIRCULATION OF LIVER CIRRHOSIS STUDIED BY CORROSION CAST/SCANNING ELECTRON MICROSCOPE EXAMINATION

Changes of hepatic microcirculations in 22 autopsy cases of liver cirrhosis were analyzed by corrosion cast/scanning electron microscope (SEM) examination. By this method, the site of arterioportal (A-P) communication in liver cirrhosis was clearly demonstrated between proliferated portal venules and arterial capillaries. The communications were observed at the same site as in the normal liver and were not at larger arterial and portal vein branches. The findings indicate that the increase of A-P communication in liver cirrhosis may be called "capillary shunting". On the basis of the findings, it was postulated that the A-P shunt could not assist in the development of portal hypertension by the transmission of high arterial pressure to the portal vein but could only compensate for decreased portal flow and/or elevate the oxygen concentration in the sinusoids to improve the hypoxic state of the liver parenchyma. It was also demonstrated that the arterial capillarization of the interstitial septa in micronodular wide septal cirrhosis was more prominent than that in macronodular thin septal cirrhosis. A grade of portal vein reduction and compensatory arterialization in a fibrous septum have been regarded as an index to estimate the advancement of liver cirrhosis. Therefere, if alcoholic micronodular cirrhosis could change into macronodular, the process should have occurred at least before the establishment of micronodular wide septal cirrhosis.     

PRIMARY FIBROSARCOMA OF THE LIVER WITH HYPOGLYCEMIA

An autopsy case of primary hepatic fibrosarcoma with severe hypoglycemia is reported. Only two cases have been previously reported. Histological features were well differentiated and partly indistinguishable from those of fibrous mesothelioma.     

家兔空肠淋巴管铸型的扫描电镜观察

为了探究空肠各层淋巴管的三维结构，将Ｍｅｒｃｏｘ注入家兔空肠壁内，制成淋巴管铸型后，在扫描电镜下观察。同时做半薄切片，以配合观察铸型标本。在空肠的粘膜层、粘膜下层、肌层等都存有毛细淋巴管、淋巴管。在小肠绒毛内可见到中央乳糜管，其三维结构在铸型标本上显示非常清楚；该管注入粘膜层和粘膜下层的毛细淋巴管网，从网发出淋巴管穿肌层，入浆膜层，离开空肠。还可见到淋巴管铸型呈串珠状外观；铸型表面存有双凹切迹，此处相当于瓣膜的部位。铸型表面还呈现出淋巴管内皮细胞核的压迹