数字化人体喉的三维重建及其可视化

目的:构建基于PC的喉部三维可视化模型,为喉部解剖教学、虚拟喉科手术及临床喉外科手术治疗方案的选择提供数字化三维解剖学依据。方法:从第三军医大学采集的首例中同数字化可视人体数据集中提取会厌软骨上缘至环状软骨下缘的断层图像,在PC机上经数据分割、对位重建、平滑处理和三维显示等步骤,完成对喉部结构的三维重建和立体显示。结果:完整地重建了喉部各重要结构,可显示喉部各结构的空间位置和毗邻关系,重建结构可以单独或联合显示,可在在维空间位置上绕任意轴旋转任意角度。结论:该数字化可视人体数据集能够较好地重建喉的可视化模型,重建结构逼真,能展示喉的真实面貌,该结果可应用于喉外科手术辅助教学以及手术入路的辅助设计等。     

丘脑的计算机三维重建及其临床意义

目的：用计算机重建丘脑的空间形态与位置,为脑的立体定向手术解剖学基础,方法：对５０只整脑１００个丘脑作２ｍｍ厚的的连续水平切面,运用表面重建法对丘脑进行计算机三维重建;首先对各切面二维 像进行配准与校正,再采用专家辩认核团、基于廓匹配的轮廓接、非线性有理Ｂ样条插值等方法手段,精确地重建了丘脑。结果：重建后的丘脑立体图像顺滑、自然、逼真,可任意缩放、旋转、切割。结论：     

杏仁核的计算机三维重建及其临床意义

目的 探讨杏仁核的空间形态与位置的三维重建技术,为颅脑立体定向手术提供可视性的解剖学基础.方法 成年健康自愿者,男性20例,女性20例,应用1.5T MRI,在标准的脑立体定向空间做1 mm层厚的MRI轴位脑扫描,在MRI上对杏仁核进行识别、手动分割、提取和三维重建,并对其进行测量与标准化处理.结果 建立利用MPI图像...     

首例中国数字化可视人体肝门静脉系的三维重建与实时显示

目的:对中国数字化可视人体及器官的三维重建和实时显示进行技术探索,并为临床和解剖学教学提供精确的肝门静脉系实时三维图形。方法:采用Photoshop图像处理与Surfdriver三维重建相结合方法,在Dell 340工作站上对第三军医大学首例数字化人体断层进行肝门静脉系统的重建,并用Leica QwinV3图像分析系统进行血管分支角度测量。结果:精确显示了肝门静脉系1～3级分支的三维形态,从不同角度观察各分支形态及毗邻关系,前观左右干呈“Y”型夹角110°;右前观右侧三个段支呈三星状、右侧观又呈“T”型。结论:肝内血管的三维重建能立体显示肝门静脉肝内分支在肝叶中的位置,可为临床肝癌等介入治疗提供形态依据。     

Three dimensional anatomy of complete duct systems in human breast: pathological and developmental implications.

AIMS: To reconstruct the arrangement in space of all major ducts and their branches from nipple to periphery of a human breast obtained at necropsy. METHODS: Duct tracing through cleared haematoxylin stained 2 mm sub-gross coronal slices of a complete necropsy breast and computer modelling of duct territories. RESULTS: All branches were traced for 10 complete duct systems of a single breast from a 19 year old girl. Their complexity prevented comprehensive modelling of individual ducts and rami using available computer software, but the territories (catchments) drained by individual duct systems did not overlap and could be reconstructed. Catchment volume and length of the central unbranched duct draining each catchment varied greatly. Duct spacing showed non-random uniformity which is also seen in rodent mammary glands. CONCLUSIONS: These spatial relations are consistent with mutual growth inhibition between duct systems during mammary development. Although there is no clear morphological distinction between mammary duct end buds and lateral buds in women, the present study does suggest that processes of branching morphogenesis occurring during development of the breasts in women do show some analogies with the growth of end buds/lateral branches/alveoli during rodent mammary gland development. Rodent models of mammary development may usefully suggest hypotheses about human breast biology. Less laborious methods of three dimensional reconstruction of mammary ducts and their branches from sub-gross slices, allowing more specimens to be studied, would be valuable for the study of normal human breast development and mammary intraepithelial neoplasia. Increasing power and decreasing costs of high definition image processing hardware and software may make such endeavours practicable.     

Three dimensional reconstruction of the fibrous frame of the rotator cuff

The authors present the methodology and the results of a trial of 3D-reconstruction of the fibrous frame of the rotator cuff taken from high resolution MRI. The acuracy of the method used is discussed. A precise reconstruction of the soft tissues is possible and provides an interesting model to study the mechanical role of the rotator cuff muscles. An example of biomechanical application of the 3D images is given.Work done in the Orthopaedic Research Laboratory Paris-South University, and in the Anatomy Institute of Paris, Paris V University, Prof. J.P. Lassau     

Correlations of breast carcinoma biomarkers and p53 tested by FASAY and immunohistochemistry

p53 status is an important predictive factor in breast cancer, but the results of many studies are ambiguous. We tested p53 by functional analysis of separated alleles in yeast (FASAY) as well as by immunohistochemistry (IHC) and evaluated correlations with main prognostic factors, proliferation, and Bcl-2. Thirty-two tumors were tested with antibodies BP53-12, DO1, DO11, DO12, and by FASAY. Spearman rank correlations were tested separately with age, tumor type, pT, grade, pN, NPI, Ki-67, S-phase, proliferation index, Bcl-2, and steroid receptor status determined by ER, PR, and pS2. FASAY showed significant correlations with ductal type, grade and proliferation, and an inverse correlation with functional estrogen receptor and Bcl-2. FASAY provided better correlations compared to p53 IHC. We conclude that FASAY shows significant correlations with main prognostic/predictive factors and provides more reliable biological information compared to p53 IHC. Apoptosis is positively linked to proliferation and is not under the control of p53, which is frequently mutated in highly proliferating carcinomas. FASAY seems to be very important in assessing the predictive significance of p53 for a specific therapy of breast cancer.     

Secretory carcinoma of the breast: a distinct variant of invasive ductal carcinoma assessed by comparative genomic hybridization and immunohistochemistry

Secretory carcinomas (SCA) are distinguished from infiltrating ductal carcinomas (IDC) of the breast by their characteristic histomorphology and more favorable prognosis and by the expression of a chimeric tyrosine kinase that is encoded by the ETV6-NTRK3 fusion gene. On this basis, we evaluated 13 SCAs (12 of them with ETV6-NTRK3 gene fusion) by molecular and immunohistochemical (IHC) methods. DNA was obtained from 8 of 13 microdissected SCAs and was analyzed for genetic alterations (GA) by comparative genomic hybridization (CGH). IHC staining was performed for estrogen receptor (ER), progesterone receptor (PR), HER2/neu, and Ki-67 (MIB1) in all 13 cases. Molecular and immunohistochemical results in SCAs were compared with previous data regarding immunohistochemical and molecular characteristics of IDCs. An average of 2.0 GAs (range: 0 to 6) were detected, including recurrent gains of chromosome 8q (37.5%) and 1q (25%) and losses of 22q (25%). Four of 13 (31%) SCAs were positive for ER, and 2 were positive for PR. The mean MIB1-labeling index was 11.4% (range: <1 to 34%). Her-2/neu protein overexpression was detected in 2 cases, including 1 with strong (score 3+) and 1 with weak HER2/neu expression (score 2+). Fluorescence in situ hybridization analysis of the latter case showed no evidence of HER-2/neu-gene amplification. Compared with previous findings in IDCs, SCAs are characterized by a relatively low number of GAs, a low proliferative rate, infrequent HER2/neu protein overexpression, decreased steroid hormone receptor expression, and expression of ETV6-NTRK3 fusion gene. These results support the hypothesis that SCAs have immunohistochemical and genetic features that distinguish them from IDCs of the usual type.     

Quantitative proteomic profiling of breast cancers using a multiplexed microfluidic platform for immunohistochemistry and immunocytochemistry

This paper describes a multiplexed microfluidic immunohistochemistry (IHC)/immunocytochemistry (ICC) platform for quantitative proteomic profiling in breast cancer samples. Proteomic profiling via ICC was examined for four breast cancer cell lines (AU-565, HCC70, MCF-7, and SK-BR-3). The microfluidic device enabled 20 ICC assays on a biological specimen at the same time and a 16-fold decrease in time consumption, and could be used to quantitatively compare the expression level of each biomarker. The immunohistochemical staining from the microfluidic system showed an accurate localization of protein and comparable quality to that of the conventional IHC method. Although AU-565 and SK-BR-3 cell lines were classified by luminal subtype and adenocarcinomas and were derived from the same patient, weak p63 expression was seen only in SK-BR-3. The HCC70 cell line showed a triple-negative (estrogen receptor-negative/progesterone receptor-negative/human epidermal growth factor receptor 2-negative) phenotype and showed only cytokeratin 5 expression, a representative basal/myoepithelial cell marker. To demonstrate the applicability of the system to clinical samples for proteomic profiling, we were also able to apply this platform to human breast cancer tissue. This result indicates that the microfluidic IHC/ICC platform is useful for accurate histopathological diagnoses using numerous specific biomarkers simultaneously, facilitating the individualization of cancer therapy.     

CA-549: immunohistochemistry and serum levels in breast carcinoma and other neoplasms

CA-549 is a high molecular weight acidic glycoprotein found in the serum of breast cancer patients. Detection of CA-549 in serum using an immunoradiometric assay has [1] correlated with disease course in breast cancer patients and [2] aided in establishing the diagnosis of breast cancer in patients with metastatic disease. This study examines the expression of CA-549 using immunohistochemistry in normal breast, benign breast disease, breast carcinoma, and a variety of other carcinomas. In addition, in 29 patients both serum and tissue samples were available for correlation. CA-549 was constitutively expressed in normal breast tissue, but immunohistochemical positivity was restricted either to the luminal aspect or entire cell membrane. All patients with benign breast disease had normal levels of CA-549 despite immunohistochemical positivity. Nearly all (98 percent) of breast carcinomas showed reactivity for CA-549, with a majority (82 percent) of the cases showing cytoplasmic positivity. In patients with both serum and tissue studied, those with cytoplasmic staining of the breast carcinomas had mean serum level of 174 U per ml (range 1.9 to 785), compared to 37.3 U per ml (range 2.1 to 86.8) in those with only membrane or luminal staining of tumor (p = 0.0578). Immunoreactive CA-549 was found in many normal epithelia and in other types of carcinomas. CA-549 is [1] constitutively expressed on the cell membrane of normal breast epithelium, [2] commonly present in the cytoplasm of breast carcinomas, and [3] found often in a variety of carcinomas.     

成人盆腔血管多层螺旋CT三维重建初步研究

目的：探讨多层螺旋CT应用于正常人体盆腔血管形态学研究的可行性，重建盆腔血管，观察正常人体盆腔血管一般形态。方法：经肘正中静脉为16名正常受试者注射造影剂后，使用16排多层螺旋CT进行盆腔扫描，图像采集后经遮盖容积重建（SVR）和最大密度投影（MIP）技术重建盆腔动、静脉，鉴别显影血管及各血管分（属）支。结果：全部受试者中均显示出3-4级血管，平均显影时间为30s时可以清晰的显示动脉系统，90～130s之间为二者共同显示，并且在130s时静脉系统显影最为清晰，而230s后由于组织强化作用显著增强，静脉边缘显示不够清晰，但是相对独立。结论：多层螺旋CT可以作为解剖学手段，应用于正常人体盆腔血管形态学研究，并且随软件的升级可以更加清晰、准确地分离动静脉，对于今后临床盆腔血管疾病研究具有重要意义。     

人分化抗原5C5蛋白分子的三维结构预测

蛋白质三维结构的预测问题一直是当今生物学领域的一个重大课题。其中用THREADING法来构建无明显序列同源性的蛋白质的三维结构是一个行之有效的方法。本文通过对一种含有亮氨酸拉链的蛋白质5C5用THREADING法进行结构预测，展示了该方法的有效性，同时结合其他信息分析，初步探讨了5C5蛋白质可能的生物学意义。     

HNF4A immunohistochemistry facilitates distinction between primary and metastatic breast and gastric carcinoma

The distinction between primary gastric adenocarcinoma and gastric metastatic breast carcinoma can be difficult. Expression of hepatocyte nuclear factor 4A (HNF4A) has been described as being specific to distinguish between neoplastic gastric and breast epithelial cells. The aim of this study was to validate the use of HNF4A with immunohistochemistry in discriminating gastric from breast carcinomas. Immunohistochemical expressions of HNF4A, estrogen receptor (ER), progesterone receptor (PR), and BRST-2 were determined in primary sporadic gastric adenocarcinomas (n?=?107) and breast carcinomas (n?=?105). The same markers and clinicopathological features were studied in 1 patient with breast metastasis of gastric cancer, 6 patients with gastric metastases of breast cancer, and 13 patients with both primary gastric and breast carcinomas. HNF4A expression was seen in 106 of 107 primary gastric adenocarcinomas and was absent in all 105 primary breast carcinomas (sensitivity 99 %, specificity 100 %). ER, PR, and BRST-2 were 100 % specific for breast carcinomas with sensitivities of 77, 58, and 38 %, respectively. The metastasis of gastric carcinoma to the breast showed strong expression of HNF4A. None of the metastases of breast carcinomas to the stomach showed expression of HNF4A. Tissues of patients with two primary carcinomas showed strong expression of HNF4A in all gastric carcinomas and no expression in breast carcinomas. Our results indicate that HNF4A is a very good marker to discriminate between primary and metastatic gastric and breast carcinomas.     

Applications of laser scanning cytometry in immunohistochemistry and routine histopathology

Laser scanning cytometry (LSC) is a powerful tool for qualitative and quantitative analysis of tissue sections in preclinical drug development. LSC combines the strengths of flow cytometry with tissue architecture retention. This technology has been used predominantly with immunofluorescent techniques on cell culture and tissue sections, but recently LSC has shown promise in evaluating chromogenic immunohistochemistry (IHC) and histochemical products in paraffin-embedded and/or frozen tissue sections. Inverted light scatter measurements or a combination of inverted scatter and fluorescence allows automated determination of cell/nuclear counts (e.g., proliferation labeling indices), cell area (e.g., cellular hypertrophy), stromal elements, and labeling intensity (e.g., cytoplasmic/organellar proteins) in chromogen-labeled IHC or histochemical stained sections that correlates well with standard manual quantification methods. Segmentation with autofluorescence or dual immunolabeling facilitates capture of labeling data from specific cell populations. LSC evaluation of HE-stained sections is accomplished using autofluorescence/eosin fluorescence and inverse scatter. A standardized fluorescent approach with archivability, a lack of fluorescence quenching (photobleaching), and amenability to evaluation of multiple markers in a section has been demonstrated using Qdot nanocrystals. Examples of LSC use in chromogenic IHC, routine histopathology, and Qdot labeling will be reviewed, and advantages and disadvantages of this technology will be discussed.     

Estrogen and progesterone hormone receptor status in breast carcinoma: comparison of immunocytochemistry and immunohistochemistry

We evaluated the correlation between histologic and cytologic specimens in the determination of estrogen receptor (ER) and progesterone receptor (PR) status in breast carcinoma and investigated the causes of clinically significant discrepancies. We analyzed 70 immunoassays for ER and 60 for PR from 71 patients with breast carcinoma. Concordance between cytology and histology was 89% for ER and 63% for PR using scores from pathology reports. Concordance between cytology and histology was 98% for ER and 91% for PR using consensus scores (obtained after reevaluation by the team of pathologists). Thirty of 130 (23%) tests had clinically relevant discrepancies, 53% of which were caused by wrong interpretation of cytologic findings, 10% by wrong interpretation of histologic findings, 17% by sampling error and 20% were not available for reevaluation. Wrong interpretation of the results for ER and PR status in cytology was a far more frequent cause of clinically relevant discrepancies than sampling errors. The use of strict criteria is recommended.     

Current standards for the diagnosis of breast carcinoma in routine practice

Every pathologist in active practice must be aware of and follow, set standards and recommendations for the diagnosis of breast carcinoma in order to ensure that the patient has the preconditions for an adequate therapy, regardless of the particular hospital setting. According to present-day knowledge, the standard obligatory examinations include conventional morphology (staging, typing and grading of the tumour) and the analysis of the steroid hormone receptor status (estrogen and progesterone). The immunohistochemical determination of tumour growth fraction with the Ki-67 antibody is economically justifiable, since it serves as an adjunct for histological/cytological tumour grading, a method that has a poor level of reproducibility. Since the introduction of herceptin immunotherapy, the determination HER-2/neu overexpression has gained a practical role and should now be included as an obligatory component of the diagnostic testing. Additional tumour markers are not components of routine diagnosis and these should be limited to clinical studies as long as their prognostic and therapeutic value have not been proven.     

Secretory carcinoma of breast demonstrates nuclear or cytoplasmic expression in p63 immunohistochemistry

The aim of this study was to evaluate the pattern of p63 expression and its implication in secretory carcinoma of the breast. Immunohistochemical staining for p63, p53, MDM2, and smooth muscle actin was performed in 7 cases of secretory carcinomas. Nuclear expression of p63 was observed in 3 cases, whereas staining against cytoplasmic and intraluminal secretory material were observed in 4 cases. p53 was expressed in 3 cases and MDM2 in 2 cases. The loss of myoepithelial cells was confirmed by immunohistochemical stain for smooth muscle actin in invasive secretory carcinomas. The pattern of expression of p63 in secretory carcinoma of the breast was revealed in nuclei or cytoplasm/secretory materials.     

Three dimensional analysis of microaneurysms in the human diabetic retina

The retinal vasculature of postmortem normal human and diabetic eyes was studied using an immunohistochemical technique in conjunction with confocal laser scanning microscopy. The technique, which stained for von Willebrand factor, allowed both large areas of the retinal vasculature to be visualised and abnormalities to be studied in detail without disturbing the tissue architecture. Only one microaneurysm, defined as any focal capillary dilation, was observed in 10 normal eyes but numerous microaneurysms were seen in 4 out of 5 diabetic retinas; counts varied between 0 and 26 per 0.41 mm² sample area. Microaneurysms were classified into 3 categories according to morphology: saccular, fusiform and focal bulges. Most were saccular, these having no preferred orientation. The majority of microaneurysms were associated with just 2 vessels suggesting they were unlikely to develop at vascular junctions. The majority were observed to originate from the inner nuclear layer and were therefore in the deeper part of the inner retinal capillary plexus. Variation in the staining of microaneurysms may correlate with endothelial dysfunction seen clinically as dye leakage during fluorescein angiography.