AN ELECTRON MICROSCOPIC STUDY OF ACUTE PROMYELOCYTIC LEUKEMIA WITH CHLOROMA

Tumor forming acute promyelocytic leukemia (APL) is rare and only three cases have been documented. However, there are no reports on either the chloromatous character or electron microscopical analysis. The present paper dealt with a light, electron microscopic and histochemical study of the tumor of APL in a 55-year-old Japanese male. The tumors found in the anterior mediastinum and right lower extremity. He died from respiratory disturbance and hydrothorax due to obstruction of the pulmonary truncus by the mediastinal tumor. In electron microscopy, the tumor cells showed dilatation, eolloracious pattern and honey-comb-like structure of rough endoplasmic reticula (RER) and parallel array-arrangement of smooth endoplasmic reticula (SER). These abnormalities of ER are the same as those recently recognized in leukemic cells in APL. Furthermore, the intercellular junctions composed of opposing dense patches of the cytoplasmic plasmalemma were frequently found between the more immature tumor cell of the mediastinum.     

RHABDOMYOSARCOMA WITH BONE MARROW METASTASIS SIMULATING ACUTE LEUKEMIA

Rhabdomyosarcoma manifested as a systemic disease is very rare and cases showing diffuse metastasis in the bone marrow are most unusual. Recently we encountered two cases of rhabdomyosarcoma with diffuse bone marrow metastasis which were clinically manifested as acute leukemia. The first patient was a 15-year-old female, who was admitted in 1982 with pancytopenia and many large primitive cells in bone marrow aspirates, hematological malignancy being diagnosed. Thereafter the bilateral breasts showed rapid swelling and a biopsy specimen revealed the histological features of typical alveolar rhabdomyosarcoma. The primary site of the neoplasm remained undetermined during the course. At autopsy, it was disclosed that the neoplasm originated from the left thigh and showed generalized metastasis. The second patient was a 38-year-old man, who was admitted in 1986 because of a nasal polyp obstructing the nasal cavity, and persistent nasal bleeding. Peripheral blood samples showed leucoerythroblastosis and thrombocytopenia, and large primitive cells were found In bone marrow aspirates, so that hematological malignancy was initially diagnosed. A biopsy specimen of the nasal polyp showed proliferation of large round cells and electron microscopy demonstrated the ultrastructural features of rhabdomyosarcoma.     

用PCR技术产前诊断人巨细胞病毒感染

用ＥＬＩＳＡ法筛选早孕妇女血人巨细胞病毒ＩｇＭ（ＨＣＭＶ－ＩｇＭ），在孕１２￣２０周用聚合酶链式反应（ＰＣＲ）技术检测其羊水中ＨＣＭＶ－ＤＮＡ，对胎儿巨细胞病毒感染作出产前诊断。在３８４例孕妇中，筛选出血ＨＣＭＶ－ＩｇＭ阳性２６例为实验组，其羊水ＨＣＭＶ－ＤＮＡ检出率为３４．６２％；从２５８例ＨＣＭＶ－ＩｇＭ阴性中选出２０例为对照组，其羊水ＨＣＭＶ－ＤＮＡ检出率为１０．０％，两组比较有显著性差异（     

22例慢性淋巴细胞白血病荧光原位杂交研究

为了解我国慢性淋巴细胞白血病（慢淋）１２号染色体三体（＋１２）的发生率，采用１２号染色体着丝粒特异性ＤＮＡ探针（Ｄ１２Ｚ３）对２２例慢淋患者进行荧光原位杂交（ＦＩＳＨ）研究，并将结果和细胞遗传学发现相比较。染色体检查揭示：５例有核型异常，其中３例有＋１２。ＦＩＳＨ检测除证实上述３例的＋１２外，还发现１例核型正常者有＋１２小克隆存在（５．３４％）。研究表明，ＦＩＳＨ在检测慢淋的染色体数目异常方面比常规细胞遗传学方法快速、准确和敏感；与西方国家慢淋＋１２检出率（２０％～３２．５％）相比较，本组慢淋＋１２阳性率偏低（１８．１％），提示我国慢淋和西方慢淋之间可能存在着生物学差异。     

用PCR组建巨细胞病毒抗原决定簇基因的表达克隆

巨细胞病毒感染的血清学诊断方法是目前临床诊断中应用最广泛的方法之一。但由于缺少高效价、高纯度和高特异性的抗原，使各种血清学方法在其敏感性和特异性方面均不能令人满意。文献报道，通过分子生物学得到的或化学合成的单一病毒蛋白或部分成份可作为血清学诊断的良好抗原。本文报道用聚合酶链反应扩增了巨细胞病毒主要磷蛋白ｐＰＵＬ３２的一个强抗原决定簇基因，并同时在扩增产物的两端引入了相应的限制性内切酶识别位点序列，经与表达载体连接后转入相应的细菌中，得到了能够表达此抗原决定簇的克隆，其表达的融合蛋白在免疫转印检测中与人巨细胞病毒阳性血清有强特异性反应。     

ULTRASTRUCTURAL STUDY OF LYMPHOCYTIC INTERACTION WITH HEPATOCYTES AND ENDOTHELIAL CELLS IN ACUTE NON-A, NON-B HEPATITIS

In the liver biopsy specimens of all six patients with acute non-A, non-B hepatitis, the lymphocytic interaction with hepatocytes and sinusoidal endothelial cells was observed by electron microscopic study. Lymphocytes were in a close contact with damaged hepatocytes and interrupted endothelial cells, and the microvilli on the surface of these damaged hepatocytes were degenerated and lost. These findings pointed out the possibility that the lymphocyte may play one of the important roles in hepatocytic damage and endothelial cell damage in acute non-A, non-B hepatitis.     

t（8;21）白血病的若干特征及其在急性白血病分型中的地位

为了解ｔ（８；２１）白血病的特征及在急性白血病分型中的地位，对４２例ｔ（８；２１）白血病患者作了回顾性分析。患者中数年龄为２７．５岁，男女各占半数。其白血病类型有Ｍ１２例、Ｍ２，３１例、Ｍ２ｂ５例、Ｍ４２例和ＭＤＳ－ＲＡＥ８２例。骨髓细胞染色体Ｒ带核型分析揭示典型ｔ（８；２１）易位４０例，简单和复杂变异ｔ（８；２１）易位各１例。２８例（６７％）可见正常核型的细胞。２６例（６１．９％）合并其它染色体异常，其中丢失Ｙ染色体１４例，丢失Ｘ染色体、９ｑ－和＋４各３例。结果提示：本组ｔ（８；２１）白血病的临床和血液学持征和国外报道基本一致；ｔ（８；２１）白血病不但包括大多数Ｍ２ｂ，还包括部分Ｍ２ａ和少数Ｍ１、Ｍ４及ＭＤｓ；ｔ（８；２１）白血病在急性非淋巴细胞白血病中的地位，以用Ｍ２／ｔ（８；２１）来表示较为恰当。     

CHRONIC LYMPHOCYTIC LEUKEMIA SHOWING PITUITARY TUMOR WITH MASSIVE LEUKEMIC CELL INFILTRATION, AND SPECIAL REFERENCE TO CLINICOPATHOLOGICAL FINDINGS OF CLL

An autopsy case of a 33 years old doctor with chronic lymphocytic leukemia (CLL) was reported. Two remissions were noted with chemotherapy and irradiation. The special characteristic of this case was the tumor formation in the sellar fossa similating a pituitary tumor which was considered as a type of meningeal leukemia, showing visual disturbance. Leukemic cell infiltration was hardly observed in any other organs.
From the analysis of five cases of CLL, the author proposes that CLL may be classified into two types: the one is the severe type showing a short clinical course and the other is a mild one, showing a long clinical course. Details such as histopathological findings, cause of death and clinical findings were discussed.     

肺瘤坏死因子和神经肽Y与急性心肌梗塞的关系

动态测定76例临床明确诊断的急性心肌梗塞患者和15例正常对照组肿瘤坏死因子和血浆神经肽Y的水平。结果显示,正常对照组NPY为93.3±10.6ng/L,急性心肌梗塞组在发病后1天NPY异常升高,为160.2±26.3ng/L,发病后第7天为121.3±24.7ng/L,均高于正常对照组(p<0.05);与NPY不同,正常对照组的TNF为0.97±0.38μg/L,在急性心肌梗塞发病后第1天升高至2.48±0.89μg/L(p<0.01),但发病后第3天降至1.12±0.37μg/L,已接近正常(p>0.05)。提示,TNF在急性心肌梗塞的发生中有重要作用,但与患者预后无直接关系;而血浆神经肽Y的水平不仅与急性心肌梗塞患者的发生有关,而且在急性心肌梗塞的病程和预后中有重要价值。     

PHYSIOLOGICAL SIGNIFICANCE OF APOPTOSIS DURING ANIMAL VIRUS INFECTION

Apoptosis has been considered to be a host defense mechanism against viral infection in multicellular organisms. This is based on the findings that apoptogenic mutants of insect viruses cannot grow because infected host cells die by apoptosis. This suggests that the apoptotic response of host cells has a deleterious effect on virus infection. Thus, apoptosis is an important host defense mechanism that is capable of inhibiting viral replication during infection. However, in vitro studies indicated that apoptosis alone does not provide the same protection against viral infection in animal cells as it does in the insect cells. Still, most animal viruses have acquired a strategy to overcome host cell apoptosis. In addition, a varying degree of necrosis usually accompanies apoptosis, suggesting a possible contribution of necrosis to the host reactions against virus. To understand the physiological significance of apoptosis during animal virus infection, we have characterized viral growth and the cellular responses against virus infection in a wide variety of virus-cell interaction systems. Mainly based on our own works, we discuss the nature of apoptosis in the animal virus infection and verify its role as a host defense mechanism against virus infection.     

ACUTE LEUKEMIA OF MEGAKARYOCYTE LINEAGE WITH TUMOR FORMATION: An Autopsy Case of Patient with Down's Syndrome

In this report we present the autopsy findings of acute megakaryoblastic leukemia with tumor formation in a 2-year-old female infant with Down's syndrome. Chromosomal analysis of blast cells revealed constitutional anomaly of trisomy 21 and two other related types of abnormal clones. Flow cytometric examination revealed blast cells expressing Ia-like or HLA-DR antigens. Postmortem examination showed extensive inffltration of leukemic cells in most of the examined organs, including the bone marrow with myelofibrosis. Tumor masses in the maxillary, frontal and femoral bones and the atria of the heart had undergone massive infiltration of atypical blast cells with an increase in the reticulin network. The final diagnosis was confirmed by ultrastructural cytochemistry of the platelet peroxidase reaction as well as by immunological staining utilizing anti-platelet glycoprotein IIb/IIIa, anti-platelet factor 4 and anti- β -thromboglobulin antibodies for the blast cells. It seems likely that platelet-derived growth factor, secondary to an increase in the reticulin network, plays a major role in myelofibrosis of acute megakaryoblastic leukemia with tumor formation. ACTA PATHOL JPN 38: 193–207, 1988.     

缺血性脑血管病急性期REG改变及其与伴随高血压的关系

本文应用ＲＥＧ（脑阻抗血流图）法、检测缺血性脑血管病发病急性期伴随、不伴随高血压的脑血管功能变化，结果显示；伴随高血压未病侧脑血流量指标较健康对照组有显著下降，各缺血性血管病的弹性指标病侧、未病侧较健康对照组有不同程度下降，表明脑血管病后伴有高血压的脑血管功能减退更为显著。上述结果与临床表现相一致、故用ＲＥＧ０这一简单、重复性较好的方法检测脑血管功能、特别是病后伴随高血压的检测，对指导预防再复发是有一定意义的。     

密质骨的滑动界面细观力学模型

本文将粘合线作为骨单元和间板之间的粘弹性界面,建立了密质骨的细观力学模型,并给出了该模型在滑骨的轴线方向载荷作用下的应力响应和某些密质骨的宏观等效模量。还发现骨单元和间板的泊松比之差对密质骨的等效模量和内部横向应力的分布具有重要影响。     

急性髓系白血病细胞遗传学的分型诊断意义

为探讨细胞遗传学在急性髓系白血病（ＡＭＬ）分型诊断中的意义，回顾性分析了１６７例原发性初诊ＡＭＬ患者的核型与ＡＭＬ亚型之间的关系。结果表明：６７．７％的患者有克隆性染色体异常，ｔ（８；２１）、ｔ（１５；１７）、ｉｎｖ（１６）／ｄｅｌ（１６）分别与Ｍ２ｂ、Ｍ３、Ｍ４Ｅｏ特异性相关，１１号染色体异常常见于Ｍ４、Ｍ５。细胞遗传学可作为ＡＭＬ亚型的分型诊断手段之一。     

猪卵巢卵母细胞体外成熟及体外受精过程中皮质颗粒变化的研究

目的　研究猪皮质颗粒在体外成熟及体外受精过程中的变化 ,以及皮质颗粒与多精受精的关系。　方法　用异硫氰荧光素联接的花生四烯酸 (FITC- PNA)标记体外成熟不同时间及体外受精不同时间皮质颗粒。　结果　皮质颗粒在猪卵母细胞体外成熟过程中逐渐由皮质部向卵质膜下迁移 ,并在质膜下排布成单层。体外成熟过程中所排出的第 1极体也被 FITC- PNA所标记 ,说明第 1极体中含有皮质颗粒。在对不同体外成熟时间的卵母细胞进行授精时发现 ,皮质颗粒的释放速度与体外成熟时间呈正比例关系。为进一步证实皮质颗粒的排放速度与多精受精之间的关系 ,还进行了精子穿透实验。结果显示 ,体外成熟 48h的卵母细胞其多精受精率为 73% ,比体外成熟36 h(83% )、2 4h(80 % )的卵母细胞要低。并且进入卵子的精子数目 (1.7)比后两者 (分别为 3.1和 2 .9)的少。　结论　多精受精率与皮质颗粒释放的速度和数量的大小有关     

用点突变的方法组建巨细胞病毒抗原决定簇基因的表达克隆

研究资料表明，人巨细胞病毒（ＨＣＭｖ）单一蛋白的单一抗原决定簇只能被部分患者阳性血清识别。组建在血清学诊断中能够替代全病毒抗原的基因工程抗原，需要含有病毒多种主要抗原蛋白的抗原决定簇。为搞清在表达载体中重复插入某一抗原决定簇基因是否能表达出更高抗原效价的融会蛋白，我们用点突变的方法，在表达载体中分别插入了人ＨＣＭｖ的ｐｐＵＬ３２蛋白羧基端一个抗原决定簇基因的１个、２个和３个拷贝。在免疫转印检测中，这些克隆表达的融合蛋白与特异性阳性血清的反应性差别不明显。这表明，插入表达载体中目的基因的多寡对表达蛋白的抗原效价没有显著影响。     

抗B-CLL Id x抗CD3双特异性抗体的制备及其特性研究

应用无筛选标记细胞株杂交瘤·杂交瘤细胞直接融合法制备了２株分泌抗慢性Ｂ淋巴细胞白血病（Ｂ－ＣＬＬ）Ｉｄｘ抗ＣＤ３双特异性抗体（ＢｓＡｂ）的四价体瘤细胞株。采用间接ＥＬＩＳＡ试验与间接免疫荧光试验证明了该ＢｓＡｂ能分别与Ｂ－ＣＬＬ患者血清及带ＣＤ３标记的细胞特异性结合,经细胞结合试验证明该ＢｓＡｂ同时具备与Ｉｄ及ＣＤ３两种抗原结合能力,经酶桥联法证明该ＢｓＡｂ亚类为ＩｇＧ１×ＩｇＧ２ａ,用ＭＴＴ法证实ＢｓＡｂ能诱导Ｔ细胞活化增殖     

600例慢性粒细胞白血病的细胞遗传学分析

目的为了探讨我国慢性粒细胞白血病（慢粒）中Ｐｈ染色体的有关特点及其意义。方法染色体制备采用骨髓细胞直接法和／或短期培养法，应用Ｒ显带技术对６００例慢粒患者的细胞遗传学资料进行了回顾性分析。结果３０例（５％）为Ｐｈ（－），５７０例（９５％）为Ｐｈ（＋）；５３５例（９３．８％）有典型Ｐｈ易位，３４例（５．９％）有变异易位，包括简单变异易位和复杂变异易位各１３例（２．２％），隐匿Ｐｈ易位８例（１．４％）；５２６例（９２．２％）的Ｐｈ（＋）细胞为１００％，４４例（７．７％）经异基因骨髓移植、干扰素和脉冲羟基脲等治疗后有部分或全部细胞转为正常核型；５０．６％的慢粒急变患者有额外的染色体异常，其中以＋８、２Ｐｈ和ｉ（１７ｑ）最多见。结论染色体检查不但有助于慢粒的诊断和鉴别诊断，而且有助于预测急变、判断疗效和进行细胞遗传学分型