准分子激光原位角膜磨镶术创面愈合机制的免疫组化实验

[目的]研究准分子激光原位角膜磨镶术(1aser in situ keratomileusis,LASIK)后角膜创面的愈合机制.[方法]对10只兔右眼施行IASIK手术,分别于术后1 d、1周、1个月、3个月和6个月取标本,应用病理学和免疫组化的方法研究及观察角膜基质成分的变化.[结果]LASIK后1周中央区角膜有少量的角膜细胞出现及产生少许Ⅲ型胶原及纤维连接蛋白,术后1～3个月时达高峰,6个月时明显减少.[结论]LASIK后,角膜愈合反应极轻,因而较少引起角膜混浊的发生.     

Osteofibrous dysplasia-like adamantinoma versus osteofibrous dysplasia in children: A case report of challenging diagnosis

IntroductionOsteofibrous dysplasia (OFD) and Osteofibrous dysplasia-like Adamantinoma have a similar appearance both in clinical and radiography, but different in its histopathology. Despite this similarity, the treatment and prognosis are different, therefore the diagnosis should be established precisely.Case illustrationA three-year-old boy was admitted to hospital after falling on his lower leg. A bead size lump appeared on his tibia with pain and swelling, which later became enlarged. Diagnosis of osteofibrous dysplasia and adamantinoma was considered. We performed limb-salvage procedure by curretage, bone grafting, and internal fixation application. The histology section showed woven bone rimmed by polygonal osteoblast cell with intervening fibrous stroma and small nests of tumour cells raised the possibility of epithelial differentiation. The positivity for cytokeratin immunostaining confirmed the diagnosis as osteofibrous dysplasia-like adamantinoma. In this case it is a very rare spectrum of malignancy in children.DiscussionThese two tumor entities have identical radiographic characteristics, histopathology features the distinction between classic adamantinoma and OFD-like adamantinoma based on the predominant epithelial component. The relationship of osteofibrous dysplasia with adamantinoma is unclear. Several authors considered possible calling relationship osteofibrous dysplasia as “juvenile adamantinoma”. However, does not rule out the possible existence of de novo osteofibrous dysplasia not related to adamantinoma.ConclusionsOFD-like adamantinoma and Osteofibrous Dysplasia had similar histopathology pattern, a pathologist must be aware of this feature and perform immunohistochemical staining for keratin particularly when the histopathological feature of osteofibrous dysplasia showed small nests of tumor cells within the fibrous stroma. diagnostic challenging and require multidisciplinary approach.     

Osteosarcoma occurring in osteogenesis imperfecta

We describe a case history of a 24-year-old male with osteogenesis imperfecta (OI) who developed osteosarcoma of the left thigh. High-dose ifosfamide therapy caused marked tumor regression of multiple lung metastases. Immunohistochemically, the tumor cells were diffusely positive for the p53 protein. Mutation of the p53 gene was not detected by direct genomic sequencing of exons 4–8. The radiographic characteristics, including irregularly distributed osteolytic lesions and cortical discontinuity, should not be confused with hyperplastic callus formation, a benign process. A biopsy is critical to establish the differential diagnosis between osteosarcoma and common hyperplastic callus formation in OI; however, it must be applied with great care.     

Golgi-like demonstration of “dark” neurons with an argyrophil III method for experimental neuropathology

Summary A silver method is proposed for the selective, well-contrasted and reproducible demonstration of dark neurons in frozen, vibratome and paraffin sections cut at a thickness of 5 to 200 m from aldehyde-fixed brains. The Golgi-like staining of the dendrites enables asorting of dark neurons according to characteristic neuron classifications. The staining procedure includes an esterification with 1-propanol, a treatment with diluted acetic acid and development. The esterification strongly increases the argyrophilia of both dark neurons and mitochondria. Unwanted co-staining of mitochondria is suppressed by the acetic acid treatment, while a special developer is used to render the staining controllable. The applicability of the method to experimental neuropathology is demonstrated by Golgi-like staining of dark neurons in rat brains exposed, before transcardial perfusion-fixation and delayed autopsy, to various pathological conditions including ischemia, hypoglycemia, trauma, status epilepticus, deafferentation and poisoning with kainic acid, colchicine and sodium azide, respectively.     

203例幽门螺杆菌相关性胃病的临床病理诊断分析

目的:探讨基层医院胃、十二指肠疾病幽门螺杆菌(HP)感染情况,检测方法及HP感染性胃病的临床病理形态特点。方法:采用北京同仁医院消化内科刘宾等提供的改良胃镜下HP感染的可视化诊断和Giemsa染色的HP形态学病理诊断方法,对203例上胃肠道疾病患者进行检测,并对其胃粘膜进行组织形态观察。结果:改良胃镜下HP的可视化诊断阳性率为96.55％,Giemsa染色病理诊断阳性率为95.07％,改良胃镜下HP感染的可视化诊断与病理诊断符合率为98.47％。HP感染胃粘膜有特征性组织形态改变。结论:改良胃镜下HP感染的可视化诊断及Giemsa染色HP形态学病理诊断相结合运用于胃、十二脂肠疾病的HP检测,适合普通基层医院采用。HP感染胃粘膜有特征性组织形态改变。     

食管粘膜活检取样误差的发生机制及对策

目的：探讨食管粘膜活检取样误差的发生机制及对策。方法：对来自河南食管癌高发区２８例患者行食管内镜检查和中、下段粘膜活检组织病理检查,１０天短期随访后对同一人群作重复检查;并对８８位无症状受检者进行碘染与活检相结合的方法。结果：第二次粘膜活检组织中,食管中段２４％的患者病变减轻,２８％的患者病变加重,４８％的患者病变维持不变。食管下段粘膜活检中,４８％的患者病变减轻,１６％的患者病变加重,３２％的患者病变维持不变;碘染受检者的食管粘膜中染色正常和染色异常的粘膜组织在癌前病变各阶段的构成比无明显差异。组织形态学测量显示：各级癌前组织与正常上皮组织的厚度无明显差异。结论：粘膜活检取样误差可严重影响组织病理学检查随访结果。食管粘膜癌前病变,特别是较轻度病变的厚度与同期正常上皮无明显改变,造成内镜下识别困难,是造成取样误差的重要因素。碘染可明显提高内镜下病变与同期正常组织的识别,但对小范围病变的活检准确度仍需改进。肿瘤抑制基因ｐ５３蛋白聚集的重复性检出率较高,可能是食管癌变过程中的有效指标。     

单宁酸——氯化铁法媒染心脏微血管的研究

应用单宁酸－氯化铁法媒染大鼠心脏微血管,光镜下观察其形态学特点。结果：左、右心室及空间隔、心房的微血管得到了良好的显示。左、右冠状动脉细小分支在心外膜层、心肌层及心内膜层形成了三层血管网,内、外两层微血管互相吻合成网;心肌层微血管则与心肌纤维平行,很少吻合。各级微血管的形态自然真实,有明显立体感。因此,单宁酸－氯化铁法是显示心脏微血管的理想方法。     

锥兰联合茜素红活细胞染色法观察角膜中央碱烧伤内皮细胞愈合过程

目的:研究角膜碱烧伤内皮细胞的愈合过程。方法:锥兰联合茜素红内皮细胞染色法对角膜中央碱烧伤内皮细胞形态学变化进行观察。结果:伤后20分钟内皮细胞已破坏。72小时,损伤区的周边内皮细胞变形向创面内迁移。第7天后缺损区大部分范围均可见梭形细胞覆盖。结论:兔碱烧伤损伤区内皮细胞的修复由邻近内皮细胞变形,增殖和移行长入创面内完成,修复的内皮细胞具有纤维细胞特征。眼科学报1999;15:218-220。     

A prospective study to evaluate the efficacy of modified swim-up preparation for male sex selection

A previously published study reporting the use of a modifiedswim-up technique for sperm preparation prior to inseminationwhich resulted in a high percentage of male births has beencriticized for its lack of controls. The present prospectivestudy was initiated to investigate further the efficacy of modifiedswim-up preparation for male sex-selection when applied in aproperly defined control group. Our results showed that theproportion of males born in singleton pregnancies was 50% inthe group inseminated following sperm preparation with Percolland in the control group with no sperm preparation comparedwith 88.5% in the group treated with the modified method ofswim-up sperm preparation prior to insemination. This high rateof males in the group treated with modified swim-up was alsoobserved in singleton pregnancies of women taking ovulationinducing drugs (primarily clomiphene citrate). This contrastswith previous publications in which a higher rate of femaleswas found in clomiphene citrate patients using the albumin separationtechnique. How the mechanism of the swim-up procedure may resultin a high male birth rate remains unclear. A high percentageof y enriched semen was found using fluorochrome quinacrinemustard staining but this procedure may falsely stain autosomalchromosomes. If analysis using sensitive DNA probes fails toconfirm the y enrichment of the spermatozoa, one must hypothesizethat the modified swim-up procedure damages the x-spermatozoa.     

α-Smooth-muscle actin expression in normal and fibrotic human livers

To determine the significance of the expression of -smooth-muscle actin in the fibrotic human liver, normal and diseased livers were stained with anti--smooth-muscle-actin antibody by an immunoperoxidase method. Vitamin A-containing lipocytes were also identified by the modified Kupffer's gold chloride method. In the normal human liver, lipocytes as well as vascular smooth muscle cells expressed -smooth-muscle actin. In alcoholic liver disease, there was an increase in the cells positive for -smooth-muscle actin adjacent to the fibrotic areas, but the response of lipocytes to the gold chloride reaction diminished. In chronic hepatitis, the cells positive for -smooth-muscle actin increased around the enlarged portal areas, and the response to the gold chloride reaction did not change appreciably. An increase in the cells positive for -smooth-muscle actin was associated with the progression of hepatic fibrosis in the liver of patients with alcoholic liver disease and chronic hepatitis.