原发性骨小细胞肿瘤的病理形态和免疫组化分析

目的：探讨免疫组化染色及病理形态在原发性骨小细胞肿瘤鉴别诊断中的意义。方法：对39例骨的小细胞肿瘤[其中尤因肉瘤/外周性原始神经外胚层肿瘤（EW/PNET瘤）22例、小细胞骨肉瘤6例、间叶性软骨肉瘤3例和恶性淋巴瘤8例]，观察其病理形态并作免疫组化分析，所用抗体O13、NSE、S-100、Actin和LCA。结果：EW/PNET瘤20/22例为O13阳性。NSE:EW/PNET瘤16/22例和1例骨肉瘤阳性。7例EW/PNET瘤、1例骨肉瘤及3例间叶性软骨肉瘤均有S-100阳性。所有恶性淋巴瘤的LCA均为阳性。骨肉瘤均见骨样基质，间叶性软骨肉瘤可见分化较好的软骨岛。结论：O13的染色对于EW/PNET瘤有诊断意义。小细胞骨肉瘤的成骨和间叶性软骨肉瘤的软骨分化为形态上的诊断要点。     

Acute peripheral arterial and graft occlusion: treatment with selective infusion of urokinase and lysyl plasminogen

Thirty-five patients hospitalized for recent angiographically documented arterial occlusion in the legs (27 femoropopliteal arteries and eight grafts) benefited from local fibrinolytic therapy delivered at the site of the occlusion with a 4- or 5-F catheter. This therapy combined a continuous urokinase (UK) infusion of 1,000 U/kg/hour and a lysyl plasminogen (LYS-PLG) infusion of 15 microkatals every 30 minutes. Angiographically confirmed lysis was obtained in 85% of the cases. Only 3% of the patients had major and 6% had minor groin hematomas. Only two patients had concentrations of fibrinogen as low as 100 mg/dl. Intravascular infusion of UK-LYS-PLG is as effective as streptokinase. Its excellent tolerance makes it a good alternative in the treatment of acute ischemia in the lower limbs.