Trichoblastic Carcinoma: A Report of Two Cases of a Deeply Infiltrative Trichoblastic Neoplasm

BACKGROUND: Trichoblastoma is a benign neoplasm with primitive hair follicle differentiation. The tumor is characterized by nests and cords of epithelial cells in an organized relationship with stroma. Some of the epithelial cells resemble follicular germ and other cells show follicular sheath differentiation. The neoplasm is symmetrical and well circumscribed. In addition, cytologic examination shows no atypia. Concept of its malignant counterpart is poorly understood. OBJECTIVE: We report two trichoblastic neoplasms that show histologic features of malignancy. METHODS: Skin biopsies from the lip region of a 53-year-old female and a 74-year-old male who had presented with the neoplasms in that location for several years were reviewed. Excised specimens measured 2 x 1 x 1 cm and 1.6 x 0.7 x 0.8 cm respectively. RESULTS: The histologic sections revealed locally aggressive neoplasms showing prominent differentiation towards hair germ and follicular sheath with formation of papillary mesenchymal bodies, follicular bulb-like structures, small keratin cysts and rare malformed hair shaft. The neoplasm showed asymmetry of architecture and massive subcutaneous and muscular infiltration. CONCLUSION: With demonstration of these two cases and references of few other reported cases we raise the possibility of existence of trichoblastic carcinoma that is distinct from basal cell carcinoma.     

天津地区G6PD缺陷患者常见基因突变分析

目的研究北方地区葡萄糖－６－磷酸脱氢酶（ｇｌｕｃｏｓｅ－６－ｐｈｏｓｐｈａｔｅｄｅｈｙｄｒｏｇｅｎａｓｅ,Ｇ６ＰＤ）基因突变类型、基因突变与人口变迁。方法采用“错配引物”介导的聚合酶链反应／限制性酶切分析法和双脱氧核苷酸指纹印迹检测法,对天津地区２２例Ｇ６ＰＤ缺陷患者进行３种中国南方人群常见的Ｇ６ＰＤ基因突变的分析。结果８例患者（８／２２,３６．４％）有Ｒ４５９Ｌ（１３７６Ｇ→Ｔ）突变;７例患者（７／２２,３１．８％）有Ｒ４６３Ｈ（１３８８Ｇ→Ａ）突变;７例（７／２２）无１３７６和１３８８位点突变病例中,有３例做了Ｈ３２Ｒ（９５Ａ→Ｇ）突变分析,提示１例有该位点突变。结论北方地区也存在中国南方人群常见的３种Ｇ６ＰＤ基因突变,大多数中国北方Ｇ６ＰＤ缺陷患者是由于中国南方移民迁移造成的。     

Hepatocellular carcinoma: US evolution in the early stage

To study the sonographic evolution of hepatocellular carcinoma (HCC) in its early stage, 26 HCCs in 24 patients were observed regularly with real-time ultrasound for a period of 90 to 691 days. In the beginning, 21 tumors were hypoechoic, two isoechoic, and three diffusely hyperechoic. On follow-up, two of the 21 initially hypoechoic HCCs remained the same echodensity, 12 increased in internal echoes but were still hypoechoic, one became isoechoic, four changed to hyperechoic, and the remaining two shifted from hypoechoic to isoechoic and then to hyperechoic. The two initially isoechoic HCCs also gained echogenicity and became hyperechoic. By contrast, the three initially hyperechoic HCCs kept the same echo patterns. The "acquired" hyperechoic HCCs were inhomogeneous in echodensity and larger in size whereas the three originally hyperechoic HCCs were homogeneous and smaller. It is concluded that most small HCCs evolve progressively from hypoechoic to isoechoic and then to inhomogeneously hyperechoic patterns as they grow; a few HCCs have diffusely high echogenicity from the beginning and retain the same features thereafter.     

单侧睁眼闭眼引起的全脑脑电图差异研究

目的脑电图(electroencephalogram,EEG)是通过脑电描记仪将脑自身微弱的生物电放大记录成为一种脑电谱图,以帮助诊断疾病的一种现代辅助检查方法。早期对闭眼和睁眼差异的研究结果多集中在位于枕叶-顶叶的α波的幅度的变化,闭眼幅度大于睁眼。本文主要探讨单侧眼睛(左眼和右眼)分别睁开和闭合时所引起的七波段脑电图谱:Delta(0.5～3.5 Hz),Theta(4～7Hz),Alpha-1(7.5～9.5 Hz),Alpha-2(10～12 Hz),Beta-1(13～23 Hz),Beta-2(24～34 Hz)and Gamma(35～45 Hz)的差异。方法受试者为15名健康男性(年龄19～27岁),静息状态下,在安静舒适的室内环境中,将随机单侧睁眼闭眼(左开/左闭,右开/右闭)作为刺激,采用电脑自动记录七波段脑电图(128-导EEG)。结果静息状态下的脑电区域能量:中间频率波段alpha-1与alpha-2闭眼时明显高于睁眼时(alpha-1,P=0.038;alpha-2,P=0.02),而比较单侧睁眼闭眼alpha-1与alpha-2时,差异无统计学意义(alpha-1,P=0.502;alpha-2,P=0.984),其他波段差异无统计学意义。结论闭眼情况下α波功率显著高于睁眼,而在比较七波段单侧眼睛睁闭时,差异无统计学意义,说明单侧外界光线刺激引起的对侧大脑半球及视觉皮质的变化,经过视交叉传入,胼胝体整合两边的头脑反应是一种持续性变化(2 min),从而使两侧EEG区域能量图一致。     

同型半胱氨酸水平、MTHFR基因突变与原发性高血压的病例对照研究

目的:探讨升高的同型半胱氨酸水平、MTHFR基因突变与原发性高血压的关系.方法:从上海一个社区中随机选取127例35～75岁的原发性高血压病人和170例正常血压者.采用聚合酶链反应-限制性片段长度多态性分析MTHFR基因多态性.使用高效液相色谱结合电化学方法检测血清中同型半胱氨酸总浓度,使用放射免疫法同时测定血清中叶酸和B12浓度.结果:调整年龄和性别后,病例和对照组同型半胱氨酸水平分别为10.56 μmol /L 和 10.34 μmol/L,差异无显著性 (P=0.63).在未服降压药的对象中同型半胱氨酸浓度与收缩压和舒张压亦无关联.该人群MTHFR不耐热性基因突变频率为13.1%,突变等位基因频率为38.7%.病例组与对照组基因型分布和突变等位基因频率无显著性差异.然而,病例组叶酸和B12浓度高于对照组.结论:本研究未发现升高的同型半胱氨酸水平、MTHFR基因突变是原发性高血压的独立危险因素.高血压病人较高的叶酸和B12水平可能降低了同型半胱氨酸的危险性.     

铅对肾上腺皮质细胞线粒体的氧化损伤

目的】 研究铅对肾上腺皮质细胞氧化应激和线粒体功能的 影响,为了解其肾上腺皮质毒作用机制提供依据。【方法】 原代分离培养豚鼠肾上腺皮质 细胞,以0、6.25、12.5、25、50、100 μmol/L醋酸铅(PbAc)处理细胞,观察PbAc诱导肾 上腺皮质细胞活性氧(ROS)产生和线粒体损伤作用。ROS检测采用荧光分光光度法,线粒体膜 电位(MMP)和细胞存活状态采用Rh123和PI双标记、流式细胞术检测,细胞ATP水平采用化学 发光法测定。【结果】 PbAc染毒后肾上腺皮质细胞ROS形成水平随剂量增加而增加,具有剂 量效应关系[y=4.16+10.21×1g(x+1),P<0.01,R2=0.64 1］;线 粒体膜电位呈剂量依赖性降低,Rh123的平均荧光强度(MFI)在6.25～100 μmol/L各剂量组 依次为1.01,0.94,0.96,0.95和0.91,与对照组(1.35)比较具有显著性差异(P<0 .01);染毒后细胞死亡率轻度增加,与对照组(1.02%)比较,50 μmol/L和100 μmol/L的 PbAc组分别为3.16%和3.40%,差异具有显著性(P<0.05);ATP水平降低与PbAc剂量之 间存在剂量效应关系[y=212965.7-51592.5×1g(x+1),P<0.01,R2= 0.568］,剂量和时间对ATP水平的影响呈协同抑制作用(P<0.01)。【结论】 线粒体 氧化应激介导肾上腺皮质细胞毒性可能是PbAc毒作用机制之一,线粒体损伤是铅致肾上腺皮 质毒作用的早期细胞和分子事件。