[Pathological diagnosis and ultrastructure features of primary pulmonary cryptococcosis: a study of 27 cases].

OBJECTIVE: To investigate diagnostic histopathology and ultrastructure features of primary pulmonary cryptococcosis (PC). METHODS: Clinical data and pathologic findings of 27 cases of PC were retrospectively reviewed, light and electron microscopic evaluations and histochemistry stain studies were performed. RESULTS: The specimens consisted of 2 fine-needle aspiration lung biopsies and 25 cases of open lung biopsies. Cryptococcosis granuloma formation was identifiable by histopathological examination in 25 of 27 cases, with gum-like lesion and fungi in the remaining 2 cases. The detection rates of cryptococcus neoformans (CN) by mucicarmine (MC), periodic acid-Schiff (PAS), alcian blue (AB) and Grocott methenamine-silver (GMS) were 87.0% (20/23), 100% (27/27), 66.7% (18/27), and 100% (23/23) respectively. Under the electron microscope, most CN had a simple structure with a few organelles. The capsule was seen in all organisms. A percentage of the organisms showed nuclei, nucleoli, mitochondria and vacuoles. The detection rate of CN by EM was 91.7% (11/12). CONCLUSIONS: The clinical manifestation and imaging of PC are nonspecific for PC. Lung biopsy is the major diagnostic modality. The detection rate by electron microscopy was quite high. Therefore, a correct diagnosis of pulmonary cyrptococcosis should rely on the combination of histopathological evaluation, histochemistry staining and/or electron microscopic examination.

[A clinicopathologic study on neoadjuvant chemotherapy in the treatment of non-small-cell lung cancer].

BACKGROUND: To explore the clinicopathological changes of non-small cell lung cancer tissues after neoadjuvant chemotherapy with MVP (MMC+VDS+DDP) regimen and its concordance with clinical evaluation, and to study the clinical value of neoadjuvant chemotherapy. METHODS: A total of 84 patients with NSCLC were randomized into combinated therapy group (42 cases) and surgical group (42 cases). The combinated therapy group were given MVP regimen for 2 cycles before operation and 2-4 cycles after operation, however, the surgical group only received surgical treatment. The efficacy of preoperative chemotherapy were determined by pathologic examination under light microscope and electron microscope and clinical evaluation. RESULTS: Combinated therapy group showed various degrees of degeneration and necrosis of tumor cells, which was not found in surgical group. The overall response rate of neoadjuvant chemotherapy was 59.5% (25/42) by both pathological and clinical evaluation. The coincidence ratio of the two evaluation methods was 71.4% (Kappa value=0.407,P < 0.01). Between the two groups, there was a significant difference in total survival rate (P=0.047). And further analysis showed that survival rate was remarkably different in patients with stage III between the two groups (P=0.037), but not in those with stage I and II (P > 0.05). CONCLUSIONS: Degeneration and necrosis with fibrosis are the main pathological phenotypes of the primary lesion after induction chemotherapy, which can be showed by clinical evaluation to chemotherapy efficacy. The preoperative and postoperative adjuvant chemotherapy may be benefical to patients with stage-III NSCLC.

L-arginine promotes the repair process of endothelium in ischemia-reperfused arteries of rats.

OBJECTIVE: To observe effects of arginine on art erial endothelium injured by ischemia-reperfusion (IR), and explore its possibl e mechanism. METHODS: Fifty-four rats were divided into 3 groups and treate d in respective ways: (1) drinking tap water as the control; (2) drinking tap wa ter containing 2.5% L-arginine; (3) drinking tap water containing 2.5% L-arginine together with intraperitoneal injection of N(G)-nitro-L-arginine methylester 5 mg/kg/d. A segment of the common carotid artery was occluded for 1 h, and then reperfused. Samples taken at different post-IR t ime from the segment were prepared for the ultrastructural and Ce-H(2)O(2) cyto chemical observation. The naked index (NI) of internal elastic lamina (IEL) was measured for comparing the endothelial injure extent and its repair process. RESULTS: Less damage of endothelial cells (EC), more platelets adhering to naked IEL and more regenerating EC were observed in Group 2. The NI values of samples taken at 1, 2, 3 d after the IR were respectively 0.92plus minus0.08, 0.88plus minus0.03 and 0.41plus minus0.02 in Group 1, and reduced to 0.52plus minus0.05, 0.19plus minus0.08 and 0.06plus minus0.01 in Grou p 2 (P<0.05-0.01). In Group 3, the endothelium da mage was not alleviated, and so were the NI. The Ce-H(2)O(2) particles deposite d on the lumen surface of endothelium were much less in Group 2 than in Groups 1 and 3. CONCLUSIONS: L-arginine promotes the repair process of IR-in jured endothelium probably through the removal of oxygen free radicals by NO.