BACKGROUND & AIMS: :Keloids are a major complication related to surgical wound healing and very challenging condition to treat. Many treatment options are available, but the efficacy of the treatment is poor in most of cases and some keloids do not respond to the treatment at all. We compared the efficacy of intralesional 5-fluorouracil (5-FU) and triamcinolone (TAC) injections in a double-blind randomized controlled trial (RCT). Forty-three patients with 50 keloid scars were treated with either intralesional TAC or 5-FU-injections over 6 months. We wanted to find out whether biological features (cell density, cell proliferation rate, vascular density, myofibroblast numbers, steroid hormone receptor expression) in keloids could be used to predict the response to therapy and define the biological changes that take place in patients receiving a response. As there was no statistically significant difference in the remission rate between TAC and 5-FU treatments, all patients were combined and analyzed as responders and nonresponders. Although responders have slightly more myofibroblasts than the nonresponders in their keloids in the pretreatment biopsy samples, we could not identify a single predictive factor that could identify those patients that respond to drug injections. The good clinical response to therapy is associated with the simultaneous reduction of myofibroblasts in the keloid. This study demonstrates that myofibroblasts are reduced in number in those keloids that were responsive to therapy, and that both 5-FU and TAC injections are useful for keloid treatment.

背景与目标： ：瘢痕are是与手术伤口愈合和非常具有挑战性的疾病相关的主要并发症。有许多治疗方法可供选择，但大多数情况下治疗效果较差，某些瘢痕loid对治疗完全无反应。在一项双盲随机对照试验（RCT）中，我们比较了病灶内5-氟尿嘧啶（5-FU）和曲安西龙（TAC）注射的疗效。对43例瘢痕les有50例的患者在6个月内进行了病灶内TAC或5-FU注射治疗。我们想找出瘢痕loid中的生物学特征（细胞密度，细胞增殖率，血管密度，成肌纤维细胞数量，类固醇激素受体表达）是否可用于预测对治疗的反应并确定接受抗癌药物的患者的生物学变化。回复。由于TAC和5-FU治疗之间的缓解率在统计学上没有显着差异，因此将所有患者合并并分析为缓解者和无缓解者。尽管在预处理活检样本中反应者的瘢痕loid中成肌纤维母细胞的数量比未反应者略多，但我们无法确定一个单一的预测因素可以识别出那些对药物注射有反应的患者。对治疗的良好临床反应与瘢痕loid中成纤维细胞的同时减少有关。这项研究表明，对治疗有反应的瘢痕loid中成纤维细胞的数量减少，并且5-FU和TAC注射均可用于瘢痕loid治疗。

BACKGROUND & AIMS: :New developments in stent technology led to the first biodegradable magnesium stents. To overcome the fundamental restrictions of conventional stent implantation, these new stents may improve interventional therapy, also in small children. What remains after complete degradation of a magnesium stent is of particular interest and concern. At the autopsy, 2 months after the projected complete degradation time of the 3.0 x 10 mm(2) stent, no solid compounds were detected, and the vessel diameter had increased slightly to 3.7 mm. Histological preparation revealed an amorphous to jelly-like substitute of the magnesium struts mainly consisting of calcium phosphate covered by fibrotic tissue. Immunological staining revealed no relevant inflammatory reaction to the stent material. Neointima proliferation was detected around the struts with some cellular infiltration of the calcium-phosphate material. These pathological and histological findings show minimal alteration of the vessel wall and an increase of the arterial diameter after stent degradation. This is an important precondition for further use of biodegradable stents in small infants. Further observations have to prove whether these findings do reproduce in other settings also.

背景与目标： ：支架技术的新发展导致了首个可生物降解的镁支架。为了克服常规支架植入的基本限制，这些新的支架可能会改善介入治疗，甚至在儿童中也是如此。镁支架完全降解后剩下的东西是特别令人关注和关注的。在尸体解剖中，在预计的3.0 x 10 mm（2）支架完全降解时间之后2个月，没有检测到固体化合物，并且血管直径略微增加到3.7 mm。组织学制备显示镁柱的无定形至果冻状替代物，其主要由被纤维化组织覆盖的磷酸钙组成。免疫染色显示与支架材料无相关的炎症反应。在细胞周围渗透了磷酸钙物质后，在支杆周围检测到了新内膜增生。这些病理学和组织学结果显示，支架降解后，血管壁的改变最小，动脉直径增加。这是在婴儿中进一步使用可生物降解支架的重要前提。进一步的观察必须证明这些发现是否也能在其他环境中重现。

BACKGROUND & AIMS: :Recently, D-limonene-based solvents are used as a safe alternative to xylene for histological and cytological application to dissolve paraffin. We report the case of a histopathology technician with a recalcitrant hand contact dermatitis strictly related to the use of a limonene-based solvent agent. Patch tests with SIDAPA (Italian Society of Allergological, Professional and Environmental Dermatology) standard series, limonene-based solvent used by the patient and D- and L-limonene (both oxidized and nonoxidized form) and with Giemsa and methylene blue stains were performed. Patch testing gave positive results to oxidized D- and L-limonene. The patient retired from work and promptly improved and healed the hand eczema. Subsequently, the potential occurrence of limonene oxidation products in the incriminated preparation was investigated using gas chromatography-mass spectrometry. While patch test showed positive reaction to oxidized limonene, chemical analysis failed to detect oxidized limonene in the preparations used by the patient. Considering the strict relation between the use of the preparations and the appearance of symptoms, we can assume that oxidized limonene may be produced during the handling of limonene-based products, especially in the presence of oxidants stains, frequently used in histological laboratories.

背景与目标： ：最近，D-柠檬烯基溶剂被用作组织学和细胞学上溶解石蜡的二甲苯的安全替代品。我们报告了一名组织病理学技术人员患有顽固性手接触性皮炎的案例，该案例与使用柠檬烯类溶剂试剂严格相关。使用SIDAPA（意大利过敏，专业和环境皮肤病学会）标准系列，患者使用的柠檬烯基溶剂以及D-和L-柠檬烯（氧化形式和非氧化形式）以及Giemsa和亚甲基蓝染色剂进行贴剂测试。补丁测试对氧化的D-和L-柠檬烯给出了积极的结果。患者从工作中退休，并迅速康复并治愈了手部湿疹。随后，使用气相色谱-质谱法研究了所述制品中柠檬烯氧化产物的潜在发生。虽然斑贴试验显示对氧化柠檬烯呈阳性反应，但化学分析未能检测出患者使用的制剂中氧化柠檬烯。考虑到制剂的使用与症状的出现之间的严格关系，我们可以假设氧化柠檬烯可能是在柠檬烯类产品的处理过程中产生的，特别是在存在组织学实验室经常使用的氧化剂污渍的情况下。

BACKGROUND & AIMS: :Ethylene glycol (EG) may be acutely toxic following ingestion. In fatal cases, microscopic examination of urine and kidney specimens can establish a post-mortem diagnosis of EG poisoning. We describe the main renal histopathologic changes during different stages of EG poisoning, which might be helpful when dating the EG poisoning itself. A single-centre retrospective study conducted on all EG poisoning cases demonstrated that in an early stage of EG poisoning, fine dust-like crystals were deposited to the tubular cell basement membrane, followed by internalisation of calcium oxalate crystals into the epithelial cells. Later, the crystals formed larger aggregates within the epithelial cells. As the changes became advanced, pronounced tubular epithelial damage occurred, with detachment of epithelial cells from the basement membrane. In the final stage, coarse calcium oxalate crystals were recognised in the tubular lumen, with cellular debris from damaged epithelial cells. Our study shows that the time-dependent histological changes described follow the clinical stages of EG poisoning and may therefore provide a rough estimate of the time of EG ingestion before death.

背景与目标： ：乙二醇（EG）摄入后可能具有剧毒。在致命的情况下，对尿液和肾脏标本进行显微镜检查可以确定死后的EG中毒诊断。我们描述了EG中毒不同阶段的主要肾脏组织病理学变化，这可能对约会EG中毒本身有帮助。对所有EG中毒病例进行的单中心回顾性研究表明，在EG中毒的早期阶段，细小的粉尘样晶体沉积在管状细胞基底膜上，然后草酸钙晶体内在化到上皮细胞中。后来，晶体在上皮细胞内形成了较大的聚集体。随着变化的进行，发生明显的肾小管上皮损伤，上皮细胞从基底膜上脱落。在最后阶段，在管状内腔中识别出草酸钙粗晶体，并有来自受损上皮细胞的细胞碎片。我们的研究表明，所描述的随时间变化的组织学变化遵循EG中毒的临床阶段，因此可能提供死亡前EG摄入时间的粗略估计。

BACKGROUND & AIMS: :Paragangliomas arise from sympathetic or parasympathetic paraganglia and should now be defined by their site and type. The term pheochromocytoma is reserved for intra-adrenal tumors. This short review discusses the gross and microscopic features, the immunohistochemical profile, the problem of recognizing malignant potential, and the rare instances where a differential diagnosis has to be considered.

背景与目标： ：神经胶质瘤起源于交感神经节或副交感神经节，现在应根据其部位和类型进行定义。术语嗜铬细胞瘤保留用于肾上腺内肿瘤。这篇简短的评论讨论了总体和微观特征，免疫组化谱，识别恶性潜能的问题以及需要考虑鉴别诊断的罕见情况。

BACKGROUND & AIMS: PURPOSE:Precision in corneal flap cutting is essential in LASIK surgery. Current mechanical microkeratomes have a very good performance record; however, in a few cases, complications can occur during the microkeratome pass and flap cut. Femtosecond lasers offer an alternative to the mechanical cut and can provide additional features regarding the flap morphology. In this study, we analyzed femtosecond laser flaps regarding their morphology, cut accuracy, and histopathology. METHODS:Forty-five fresh porcine cadaveric eyes were prepared for femtosecond laser flap cutting with the Femtec femtosecond laser system (20/10 Perfect Vision, Heidelberg, Germany). The eyes were assigned to three different thickness groups, with 120-, 140-, or 180-microm cut depth, respectively. In addition, different flap diameters ranging from 8.0 to 9.5 mm and rim edge angulations between 60 degrees and 90 degrees were performed. After the cut, the eyes were examined under a microscope regarding accuracy and potential defects, and flap thickness and diameter were measured. In addition, flaps were prepared for further histopathologic examination. RESULTS:All flap cuts were easily performed without any intraoperative complications. Flap thickness measurements revealed a median (in micrometers) of 110.5 (intended thickness 120), 142.5 (intended 140), and 180.0 (intended 180), respectively. The flap diameter for an intended size between 8.0 and 9.5 mm was within a range of +/-0.4 mm, the median at the maximum was 0.3 mm off. Histopathology revealed very low to almost no changes in the stromal structure of the cornea and correct hinge angulations. CONCLUSIONS:LASIK flap cuts were easily performed without any complications. The accuracy and morphology were very precise and consistent. Histopathology revealed a smooth cut with hinge angulations, as expected.

背景与目标： 目的：角膜瓣切开的精确度在LASIK手术中至关重要。当前的机械微角膜刀具有非常好的性能记录；然而，在少数情况下，在微型角膜刀通过和皮瓣切割过程中可能会发生并发症。飞秒激光提供了机械切割的替代方法，并且可以提供有关皮瓣形态的其他功能。在这项研究中，我们分析了飞秒激光瓣的形态，切割精度和组织病理学。
方法：准备45只新鲜的猪尸体眼，用Femtec飞秒激光系统（20/10 Perfect Vision，德国海德堡）切割飞秒激光皮瓣。将眼睛分为三个不同的厚度组，分别具有120微米，140微米或180微米的切割深度。此外，还进行了从8.0到9.5毫米不等的襟翼直径和轮辋边缘成60度至90度的角度调整。切开后，在显微镜下检查眼睛的准确性和潜在缺陷，并测量皮瓣的厚度和直径。另外，准备皮瓣用于进一步的组织病理学检查。
结果：所有皮瓣切开都很容易，没有任何术中并发症。折翼厚度测量显示中位数（以微米为单位）分别为110.5（预期厚度120），142.5（预期厚度140）和180.0（预期厚度180）。预期尺寸在8.0到9.5毫米之间的襟翼直径在/-0.4毫米范围内，最大中值偏离0.3毫米。组织病理学显示，角膜基质结构的改变非常低甚至几乎没有改变，并且铰链角度正确。
结论：LASIK皮瓣切开很容易，没有任何并发​​症。准确性和形态非常精确且一致。如预期的那样，组织病理学显示平滑切开且铰链成角度。

BACKGROUND & AIMS: BACKGROUND:Chronic rhinosinusitis (CRS) is an inflammatory disease process with several different phenotypes. Recent data has shown that CRS phenotypes maintain distinct nasal microbiota that may predict surgical outcomes. Nasal microbiota and structured histopathologic reporting have the potential to further differentiate subtypes and provide additional insight into the pathophysiology of CRS. METHODS:Sinus swabs collected during functional endoscopic sinus surgery (FESS) were studied by polymerase chain reaction analysis of 16S ribosomal RNA. A structured histopathology report of 13 variables was utilized to analyze sinus tissue removed during FESS. Histopathology variables and relative abundance of nasal microbiota were compared among CRS patients. RESULTS:A total of 51 CRS patients who underwent FESS were included. Relative abundance of the Firmicutes phylum in nasal microbiota of CRS patients was associated with presence of neutrophilic infiltrate (27.47 ± 44.75 vs 9.21 ± 11.84, p < 0.029), presence of mucosal ulceration (47.67 ± 45.52 vs 13.27 ± 26.48, p < 0.041), presence of squamous metaplasia (5562.70 ± 2715.66 vs 3563.73 ± 2580.84, p < 0.035), and absence of Charcot-Leyden crystals (5423.00 ± 3320.57 vs 679.94 ± 1653.66, p < 0.001). Relative abundance of the Bacteroidetes phylum in nasal microbiota of CRS patients was associated with increased severity of inflammatory degree (p < 0.004) and presence of mucosal ulceration (p < 0.004). CONCLUSION:Distinct histopathologic features of CRS are associated with relative abundance of nasal microbiota phyla, specifically Firmicutes and Bacteroidetes. These findings contribute to the growing body of literature on microbiota in sinonasal disease and may have important implications for understanding pathophysiologic mechanisms of CRS subtypes and disease management.

背景与目标： 背景：慢性鼻鼻窦炎（CRS）是一种具有多种不同表型的炎性疾病过程。最近的数据表明，CRS表型保持着独特的鼻微生物群，可以预测手术结果。鼻微生物群和结构化的组织病理学报告具有进一步区分亚型并为CRS的病理生理学提供更多见解的潜力。
方法：通过16S核糖体RNA的聚合酶链反应分析研究功能性内窥镜鼻窦手术（FESS）中收集的鼻拭子。利用13个变量的结构化组织病理学报告来分析FESS期间切除的窦组织。比较了CRS患者的组织病理学变量和鼻腔菌群的相对丰度。
结果：共纳入51例接受了FESS治疗的CRS患者。 CRS患者鼻腔菌群中门生菌的相对丰度与中性粒细胞浸润的存在有关（27.47±44.75对9.21±11.84，p <0.029），粘膜溃疡的存在（47.67±45.52对13.27±26.48，p <0.041） ，鳞状化生的存在（5562.70±2715.66 vs 3563.73±2580.84，p <0.035），以及不存在夏科特-莱登晶体（5423.00±3320.57 vs 679.94±1653.66，p <0.001）。 CRS患者鼻腔菌群中细菌杆菌的相对丰度与炎症程度的增加（p <0.004）和粘膜溃疡的存在（p <0.004）相关。
结论：CRS独特的组织病理学特征与鼻微生物群门的相对丰度有关，特别是硬毛菌和拟杆菌。这些发现促进了鼻窦疾病中微生物群的文献的增长，并且可能对理解CRS亚型的病理生理机制和疾病管理具有重要意义。

BACKGROUND & AIMS: :Cardigan Bay on the western coast of the UK is considered a pristine location with much of its coastal and marine habitats protected under various national and EC Directives. Despite this, populations of the flatfish dab (Limanda limanda) captured from Cardigan Bay display elevated levels of liver tumours relative to the background prevalence of the disease. This study describes the findings of a research cruise that took place during November 2003 to assess the prevalence of tumours in dab from selected sites in and around Cardigan Bay. In addition, potential causative mechanisms were investigated via measurement of a range of end points (including composition and abundance of benthic and phytoplankton communities, sediment toxicity and cellular biomarkers of genotoxicity) from sediment, water and biota samples. Fish captured from South Cardigan Bay displayed a relatively higher prevalence of liver tumours compared to those captured from Red Wharf Bay. Hepatocellular adenoma (8% and 2%, respectively) and hepatocellular foci of cell alteration (18% and 6%, respectively) were most prevalent in South Cardigan Bay. Analysis of the sediment failed to distinguish any differences in toxicity between the two sampling sites. However, DNA strand breaks in red blood cells of dab were significantly higher (p < 0.05) in fish collected from Red Warf Bay compared with those sampled at Cardigan Bay. The alignment of biological effects measures via such integrated cruise programs are discussed. This work was partly funded under the auspices of the 2003 Prince Madog Prize.

背景与目标： ：英国西部海岸的Cardigan湾被认为是原始地区，其许多沿海和海洋生境都受到各种国家和EC指令的保护。尽管如此，从Cardigan湾捕获的比目鱼（Limanda limanda）种群相对于本病的背景患病率仍表现出较高的肝肿瘤水平。这项研究描述了2003年11月进行的一次研究航行的结果，以评估Cardigan湾及其周边地区选定地点民建联中的肿瘤患病率。此外，还通过测量沉积物，水和生物群样品的一系列端点（包括底栖和浮游植物群落的组成和丰度，沉积物毒性和遗传毒性的细胞生物标志物）来研究潜在的致病机理。与从红码头湾捕获的鱼相比，从南卡迪根湾捕获的鱼显示出较高的肝肿瘤患病率。肝细胞腺瘤（分别为8％和2％）和细胞改变的肝细胞灶（分别为18％和6％）在南Cardigan湾中最为普遍。对沉积物的分析未能区分两个采样点之间的毒性差异。但是，与在Cardigan湾采样的鱼相比，从Red Warf湾收集的鱼的dab红细胞的DNA链断裂明显更高（p <0.05）。讨论了通过这种综合巡航程序对生物效应措施的调整。这项工作的部分资金是在2003年玛多格王子奖的赞助下获得的。

BACKGROUND & AIMS: PURPOSE:To study whether placentas of singleton pregnancies conceived after fresh embryo transfer (ET) contain more histopathological lesions compared with placentas of singleton pregnancies conceived after frozen-thawed embryo transfer (FET). METHODS:A prospective cohort study of placental histopathology in 131 women with singleton IVF pregnancies who delivered at a single medical center, between December 2017 and May 2019. The prevalence of different placental histopathology lesions was compared between women who conceived after fresh ET and FET. RESULTS:Women who conceived after fresh ET (n = 74) did not differ from women who conceived after FET (n = 57) with regard to maternal age, BMI, nulliparity, or infertility diagnosis. Gestational week at delivery was lower in pregnancies conceived after fresh ET (38.5 vs. 39.2 weeks, respectively, p = 0.04), and a trend for a lower birthweight following fresh ET was noted (3040 vs. 3216 g, respectively, p = 0.053). However, placental histopathology analysis from pregnancies conceived after fresh ET was comparable to pregnancies conceived after FET, with regard to the prevalence of maternal vascular malperfusion lesions (45.9% vs. 50.9%, respectively, p = 0.57), fetal vascular malperfusion lesions (17.6% vs. 21.1, p = 0.61), acute inflammatory response lesions (28.4% vs. 28.1%, respectively, p = 0.96), and chronic inflammatory response lesions (13.5% vs. 8.8%, respectively, p = 0.48). CONCLUSION:Placental histopathology did not differ between IVF pregnancies conceived after fresh and frozen ET. These results are reassuring for clinicians and patients who wish to pursue with transferring fresh embryos.

背景与目标： 目的：研究新鲜胚胎移植（ET）后怀孕的单胎孕妇胎盘与冷冻融化胚胎移植（FET）后怀孕的单胎孕妇胎盘是否包含更多的组织病理学病变。
方法：对2017年12月至2019年5月在单个医疗中心分娩的131例单胎IVF孕妇的胎盘组织病理学进行前瞻性队列研究。比较了新鲜ET和FET后受孕的妇女的胎盘组织病理学病变发生率。
结果：新鲜ET后受孕的妇女（n = 74）与FET后受孕的妇女（n = 57）在产妇年龄，BMI，无效性或不育诊断方面没有差异。新鲜ET后怀孕的分娩妊娠周较低（分别为38.5周和39.2周，p = 0.04），并且发现新鲜ET后出生体重下降的趋势（分别为3040 vs. 3216g，p = 0.053） ）。然而，就母体血管灌注不良病变（分别为45.9％vs. 50.9％，p = 0.57），胎儿血管灌注不良病变（17.6）的患病率而言，新鲜ET后妊娠的胎盘组织病理学分析可与FET术后妊娠的胎盘组织病理学分析相媲美。 ％vs. 21.1，p = 0.61），急性炎症反应病变（分别为28.4％vs. 28.1％，p = 0.96）和慢性炎症反应病变（分别为13.5％vs. 8.8％，p = 0.48）。
结论：新鲜和冷冻ET后IVF妊娠的胎盘组织病理学无差异。这些结果使希望继续转移新鲜胚胎的临床医生和患者放心。

BACKGROUND & AIMS: The aim of this study is to demonstrate the spectrum of conditions encompassed by the term 'trachomatous cicatrization of eyelid tissue', to discuss the mechanisms of scar tissue formation and to describe sequelae in this potentially blinding condition. Specimens of eyelid tissues were taken from 27 upper eyelids of 21 patients with entropion who underwent surgical procedures and 2 post-mortem upper eyelids with severe trachomatous entropion. Upper palpebral conjunctival swabs and biopsy specimens were taken from 5 patients with active trachoma and they were examined by fluorescence microscopy and routine histopathological methods. Conjunctival impression cytology samples were collected in all patients. In specimens taken from patients with active trachoma the inflammatory infiltrate was organized as lymphoid follicles in the underlying stroma and impression cytology showed cytoplasmic elementary bodies. In specimens taken from patients with scarring trachoma light microscopy studies showed subepithelial fibrous membrane formation, squamous metaplasia and loss of goblet cells, pseudogland formation in conjunctiva, degeneration of orbicularis oculi muscle fibres, subepithelial vascular dilatation, localized perivascular amyloidosis and subepithelial lymphocytic infiltration. Accessory lachrymal glands and the ducts of glands were compromised by subepithelial infiltration and scarring. The contraction of the subepithelial fibrous tissue formed by collagen fibres and anterior surface drying are the main factors contributing to the chronic cicatrization and entropion formation.

背景与目标： 这项研究的目的是证明术语“眼睑组织的气管瘢痕化”所涵盖的条件范围，讨论疤痕组织形成的机制并描述这种潜在致盲条件下的后遗症。眼睑组织标本取自接受手术治疗的21例内斜视患者的27个上眼睑和2个严重气管内视熵的验尸上眼睑。取自5例活动性沙眼患者的上睑结膜拭子和活检标本，并通过荧光显微镜和常规组织病理学方法进行检查。在所有患者中收集结膜印象细胞学样品。在取自活动性沙眼患者的标本中，炎性浸润组织为基础间质中的淋巴滤泡，印象细胞学检查显示细胞质基本体。在取自有瘢痕性沙眼患者的标本中，光学显微镜检查显示上皮下纤维膜形成，鳞状化生和杯状细胞丢失，结膜内假腺形成，眼球眼球肌纤维变性，上皮下血管扩张，局部血管周淀粉样变性和上皮下淋巴结肿大。辅助泪腺和腺管受到上皮下浸润和瘢痕形成的损害。胶原纤维形成的上皮下纤维组织的收缩和前表面干燥是导致慢性瘢痕形成和熵形成的主要因素。

BACKGROUND & AIMS: PURPOSE:To describe the histopathologic findings and relevant clinical details of 3 patients undergoing penetrating keratoplasty (PK) after failure of posterior lamellar endothelial keratoplasty (EK). METHODS:Retrospective clinicopathologic case series. Patients 1 and 2 underwent EK for pseudophakic bullous keratopathy. Patient 3 underwent EK for persistent corneal edema secondary to a Descemet membrane (DM) detachment after cataract extraction. Patient 1 had persistent diffuse corneal edema and broad, long-standing iridocorneal adhesions that precluded repeat EK. Patient 2 had high intraocular pressure and severe anterior chamber inflammation 1 day postoperatively with subsequent noncorneal clearing and elected PK over repeat EK. Progressive corneal edema with resultant poor visual acuity after EK was the reason for PK in patient 3. RESULTS:Histopathologic examination disclosed thickened, edematous corneas with attenuated endothelium consistent with graft failure caused by endothelial decompensation in all 3 cases. Although various degrees of posterior lamellar graft detachment were observed in each instance, significant parts of each graft remained adherent to the host stroma or to segments of residual host DM. The wounds in the adherent areas, although discernible, were relatively inconspicuous, resembling those seen at the flap-stromal interface after laser in situ keratomileusis. The donor graft endothelium was atrophic in all cases, and a delicate retrocorneal fibrous membrane was present in 2 cases. Most of the graft in cases 1 and 2 remained adherent, with small areas of peripheral detachment. In contrast, the graft in case 3 adhered peripherally but had separated from the stroma centrally, forming a thin cleft. CONCLUSIONS:Histopathology suggests endothelial decompensation, incomplete graft adherence, and the formation of retrocorneal fibrous membranes as possible etiologies for EK failure. The adherence of endothelial grafts to residual host DM suggests that it may not be necessary to remove optically clear DM before endothelial graft placement. The inconspicuous nature of the EK interface suggests that it may not play a large role in image degradation, although more study is needed.

背景与目标： 目的：描述3例后板状内皮细胞成形术（EK）失败后进行穿透性角膜成形术（PK）的患者的组织病理学发现和相关临床细节。
方法：回顾性临床病理病例系列。患者1和2因假晶状体大疱性角膜病变而接受EK。患者3在白内障摘除后因Descemet膜（DM）脱离继发了持续性角膜水肿的EK。患者1具有持续的弥漫性角膜水肿和广泛的，长期存在的虹膜角膜粘连，因此无法进行重复EK。病人2术后1天有高眼压和严重的前房炎症，随后发生非角膜清除，并选择PK超过重复EK。 EK后进行性角膜水肿导致视力较差是3号患者PK的原因。
结果：所有3例患者的病理组织学检查均显示增厚的水肿性角膜伴内皮减弱，这与内皮失代偿引起的移植失败有关。尽管在每种情况下均观察到不同程度的后板状移植物分离，但每个移植物的重要部分仍粘附于宿主基质或残余宿主DM的节段。粘附区域的伤口虽然可以辨认，但是相对不明显，类似于在激光原位角膜磨镶术后在皮瓣-基质界面看到的伤口。在所有情况下，供体移植物内皮均萎缩，2例存在脆弱的角膜后纤维膜。在案例1和案例2中，大多数移植物保持粘附性，周围脱离区域很小。相反，情况3中的移植物在外周粘附，但在中心与基质分开，形成薄裂口。
结论：组织病理学提示内皮功能失代偿，移植物粘附不完全以及角膜后纤维膜的形成可能是导致EK失败的原因。内皮移植物对残余宿主DM的粘附表明，在放置内皮移植物之前，可能没有必要去除光学透明的DM。 EK接口的不起眼的性质表明，尽管需要进行更多研究，但它在图像质量下降中可能不会发挥重要作用。

BACKGROUND & AIMS: :Prior studies have investigated sperm retrieval rates in men with nonobstructive azoospermia (NOA) secondary to specific etiologies, yet most cases of NOA are idiopathic. We compared sperm retrieval rates and testicular histopathology in idiopathic NOA (iNOA) and nonidiopathic NOA (niNOA). We performed a retrospective review of men with NOA who underwent microdissection testicular sperm extraction (microTESE) between 2000 and 2016. Men with no history of malignancy or cryptorchidism and negative genetic evaluation were considered idiopathic. Multivariable regression determined the association between idiopathic etiology and primary outcomes of sperm retrieval and active spermatogenesis on histopathology. Among 224 men, 86 (38.4%) were idiopathic, 75 (33.5%) were nonidiopathic, and 63 (28.1%) did not undergo genetic testing. Median age and serum testosterone were higher among iNOA or no testing versus niNOA. Median follicle-stimulating hormone (FSH) was lower among iNOA or no testing versus niNOA. A higher proportion of iNOA or no testing versus niNOA had a clinical varicocele. Sperm retrieval rates were similar between iNOA, niNOA, and no testing (41.8% vs 48.0% vs 55.6%, respectively; P = 0.255). Active spermatogenesis was seen in a higher proportion of iNOA or no testing versus niNOA (31.4% and 27.0% vs 16.0%, P = 0.073). On multivariaile analysis, iNOA was not associated with sperm retrieval or spermatogenesis (P = 0.430 and P = 0.078, respectively). Rates of sperm retrieval and spermatogenesis on testis pathology were similar in men with iNOA and niNOA. These data will be useful to clinicians in preoperative counseling for men with NOA and negative genetic evaluation.

背景与目标： ：先前的研究调查了继发于特定病因的非阻塞性无精子症（NOA）男性的精子回收率，但大多数NOA病例是特发性的。我们比较了特发性NOA（iNOA）和非特发性NOA（niNOA）的精子回收率和睾丸组织病理学。我们对2000年至2016年间进行了显微解剖睾丸精子提取术（microTESE）的NOA男性进行了回顾性研究。无恶性或隐睾病史和阴性基因评估的男性被认为是特发性的。多变量回归确定了特发性病因与精子取回的主要结果以及组织病理学上活跃的精子发生之间的关系。在224名男性中，有86名（38.4％）是特发性的，有75名（33.5％）是非特发性的，有63名（28.1％）没有接受基因测试。在iNOA或未进行检测的患者中，年龄中位数和血清睾丸激素水平高于niNOA。与niNOA相比，iNOA或未经测试的中位卵泡刺激素（FSH）较低。与niNOA相比，iNOA较高或未进行测试的患者有临床精索静脉曲张。 iNOA，niNOA和未检测的精子回收率相似（分别为41.8％和48.0％和55.6％； P = 0.255）。与niNOA相比，在iNOA或未进行测试的情况下，活跃的精子发生比例更高（31.4％和27.0％对16.0％，P = 0.073）。在多变量分析中，iNOA与精子获取或精子生成无关（分别为P = 0.430和P = 0.078）。 iNOA和niNOA男性的精子取精率和精子发生率对睾丸病理学的影响相似。这些数据将为临床医生在NOA和阴性基因评估的男性的术前咨询中提供帮助。

BACKGROUND & AIMS: :The frequency of biopsies with different types of mastitis among all patients with benign breast diseases in twenty years was 3%. About 2/3 of the patients were younger than 50 years, the average age was 46.7 years. Comparing the frequency of the different types of mastitis the puerperal mastitis is very rare in contrast to the increasing non-puerperal and granulomatous inflammatory breast lesions. The diagnosis "granulomatous mastitis" is one of exclusion. Both non-infectious and infectious causes must be considered. The origin of the granulomatous mastitis often is unknown, but it is supposed to be an autoimmune localized response due to the retained and extravasated fat and protein rich secretions in the ducts in cases of hyperprolactinemia (drug induced or by microprolactinomas) or hormonal imbalances characterized by epitheloid cell granulomas with giant cells microabscesses around lipid drops, but without necroses. An idiopathic type of granulomatous mastitis concerns young women in relationship to parturition with a similar histological pattern predominantly of the lobules. Special types of mastitis are the B-lymphocytic autoimmune mastitis associated with a longstanding insulin-dependent diabetes mellitus type I, the sarcoidosis, panniculitis and the rare but very different infectious diseases with breast involvement. Particularly in cases without features of secretory activity a carefully bacterioscopic and microbiologic work-up of fresh material from the surgical specimens is necessary for a final diagnostic report.

背景与目标： ：二十年来，所有乳腺良性疾病患者的不同类型乳腺炎活检的频率为3％。约2/3的患者年龄小于50岁，平均年龄为46.7岁。比较不同类型的乳腺炎的发生频率，与非褥疮性和肉芽肿性炎性乳腺病变的增加相比，产褥期乳腺炎非常罕见。诊断为“肉芽肿性乳腺炎”是排除之一。非传染性和传染性原因都必须考虑。肉芽肿性乳腺炎的起源通常是未知的，但是由于高泌乳素血症（药物诱发或微泌乳素瘤）或荷尔蒙失调，其特征是由于导管中脂肪和蛋白质丰富的保留和外溢，因此肉芽肿性乳腺炎的起源可能是自身免疫性局部反应。上皮细胞肉芽肿，脂质滴周围有巨大的细胞微脓肿，但无坏死。特发性肉芽肿性乳腺炎涉及与分娩相关的年轻女性，其组织学模式相似，主要是小叶。乳腺炎的特殊类型是B淋巴细胞自身免疫性乳腺炎，与长期存在的I型胰岛素依赖型糖尿病，结节病，脂膜炎以及罕见的但非常不同的与乳房受累的传染病有关。特别是在没有分泌活性特征的情况下，为最终诊断报告需要对来自手术标本的新鲜材料进行仔细的细菌学和微生物学检查。

BACKGROUND & AIMS: :In this study we evaluated the indications, complications, and the spectrum of histopathological results of percutaneous renal needle biopsy (PRNB) performed in our clinic. Between June 1990 and December 2006, 679 PRNBs were performed on native kidneys of 614 children (304 boys, 310 girls) with a mean age of 10.4 years. Most frequent indications for PRNB were nephrotic syndrome (47%), hematuria, and/or proteinuria (15.9%), acute renal failure (14.6%) and complex renal manifestations (18.9%). The overall complication rate was 15.2%. The most common complications were perirenal hematoma (12.4%) and macroscopic hematuria (2.6%). The most frequent histopathological group of diseases were glomerulopathies; these were diagnosed in 376 patients (61.2%) and included membranoproliferative glomerulonephritis (11.1%), mesangial proliferation (10.7%), diffuse proliferative glomerulonephritis (7.7%), and focal segmental glomerulosclerosis (7.3%) as the most frequent. The second most frequent group of histopathology was manifestations secondary to systemic diseases; these were shown in 195 patients (31.8%). Amyloidosis (11.4%) and Henoch-Schönlein nephritis (9.9%) made the majority of this group. In conclusion, our study demonstrated that PRNB is a safe procedure with usually transient complications showing the most frequent renal diseases that cause diagnostic and therapeutic difficulties for pediatric nephrologists.

背景与目标： ：在这项研究中，我们评估了在我们诊所中进行的经皮肾穿刺活检（PRNB）的适应症，并发症和组织病理学结果的范围。在1990年6月至2006年12月期间，对平均年龄为10.4岁的614名儿童（304名男孩，310名女孩）的天然肾脏进行了679次PRNB。 PRNB最常见的适应症是肾病综合征（47％），血尿和/或蛋白尿（15.9％），急性肾衰竭（14.6％）和复杂的肾脏表现（18.9％）。总体并发症发生率为15.2％。最常见的并发症是肾周血肿（12.4％）和肉眼血尿（2.6％）。最常见的组织病理学疾病是肾小球病。这些被诊断为376例患者（61.2％），其中最常见的包括膜增生性肾小球肾炎（11.1％），肾小球膜增生（10.7％），弥漫性增生性肾小球肾炎（7.7％）和局灶性节段性肾小球硬化（7.3％）。第二类最常见的组织病理学是继发于全身性疾病的表现。 195例患者中占31.8％（31.8％）。淀粉样变性病（11.4％）和过敏性肾炎（9.9％）占该组的大多数。总而言之，我们的研究表明PRNB是一种安全的方法，通常具有短暂的并发症，显示出最常见的肾脏疾病，给儿科肾脏病医生造成诊断和治疗困难。

BACKGROUND & AIMS: OBJECTIVE:To describe a new surgical approach to rectovaginal endometriosis. Rectovaginal endometriosis can be infiltrative or superficial involving the bowel. Only infiltrative disease should be treated by intestinal resection. However, infiltration of endometriosis cannot be confirmed by preoperative imaging techniques. METHODS:A total of 48 women with infiltrative rectovaginal endometriosis were included in this prospective study. Surgery was performed using a newly developed technique. All bowel resections were indicated according to operative findings and not on the basis of preoperative imaging technique results. RESULTS:The decision for rectosigmoidal resection was based on the results of the intraoperative dissection of the rectovaginal septum. Histologically, infiltration of the ventral bowel wall was confirmed in all cases. CONCLUSION:This new surgical technique for the treatment of rectovaginal endometriosis allows precise diagnosis and treatment with low morbidity. A resection of the mesorectum is not necessary because the endometriotic nodules are always located on the antimesenteric surface of the bowel.

背景与目标： 目的：描述一种治疗直肠阴道子宫内膜异位症的新手术方法。直肠阴道子宫内膜异位可以浸润或浅表累及肠。肠切除术只能治疗浸润性疾病。但是，子宫内膜异位的浸润不能通过术前成像技术来确认。
方法：本研究共纳入48名浸润性直肠阴道子宫内膜异位症女性。使用新开发的技术进行手术。所有肠切除均根据手术发现而不是术前影像学检查结果进行。
结果：直肠乙状结肠切除术的决定是基于术中切除直肠阴道隔的结果。从组织学上来说，在所有情况下都证实了腹腔肠壁的浸润。
结论：这种治疗直肠阴道子宫内膜异位症的新外科手术技术可进行准确的诊断和治疗，且发病率低。不需要切除直肠系膜，因为子宫内膜异位结节始终位于肠的肛门周围。