冰冻切片与石蜡切片对乳腺肿瘤的诊断价值研究

目的:分析和比较冰冻切片与石蜡切片对乳腺肿瘤的诊断价值。方法:选取480例新鲜乳腺标本,将其制成冰冻切片以及石蜡切片,根据诊断结果进行对比分析,评价乳腺肿瘤的冰冻切片与石蜡切片的对乳腺肿瘤的诊断价值。结果:经石蜡切片诊断乳腺良性肿瘤277例,占57.71%,良性肿瘤中以乳腺纤维瘤诊断居多;经石蜡切片诊断乳腺恶性肿瘤203例,占42.29%,以乳腺浸润性导管癌居多。冰冻切片诊断乳腺良性肿瘤279例,占58.13%;恶性肿瘤195例,占40.62%;延迟诊断6例,占1.25%。以石蜡切片诊断结果为金标准,冰冻切片诊断乳腺良性肿瘤的准确率为98.56%(273/277),诊断恶性肿瘤的准确率为95.07%(193/203),假阳性率为0.72%(2/277),假阴性率为2.96%(6/203),冰冻切片与石蜡切片诊断乳腺肿瘤的结果具有显著一致性,K值为0.965(P0.05)。结论:冰冻切片与石蜡切片诊断乳腺肿瘤的符合率较高,可作为术中快速病理检测的手段,但该种切片方式存在少量延迟诊断,多与术者操作经验有关,故术中应注重制片过程,提高冰冻切片质量。     

Utility of Intraoperative Frozen Section in the Diagnosis of Periprosthetic Joint Infection

Purpose

Intraoperative frozen section (FS) is an effective diagnostic test for periprosthetic joint infection (PJI). We evaluated the diagnostic characteristics of single- and multiplex-site intraoperative FS, and evaluated the results of single-site FS combined with those of C-reactive protein (CRP) level and erythrocyte sedimentation rate (ESR) for assessing PJI.

Methods

We studied 156 painful joint arthroplasties in 152 consecutive patients presenting for revision total joint arthroplasty due to PJI. Receiver operating characteristic analysis was used to determine the optimal cutoff values for CRP level, ESR, and intraoperative FS histopathology. Sensitivity, specificity, positive and negative predictive values, and accuracy of the diagnostic tests were assessed using a 2×2 table.

Results

We investigated the diagnostic utility of polymorphonuclear leukocyte number (PMN) per high-power field (HPF) on FS. Our data showed that 5 PMNs per HPF is a suitable diagnostic threshold, with a high accuracy in single- and multiplex-site FS. Five PMNs in any 1 of 5 sites had the highest sensitivity of 0.86 and a specificity of 0.96. Five PMNs in every 1 of 5 sites had greater diagnostic utility, with a specificity of 1; however, the sensitivity of this measure fell to 0.62. Five PMNs in single-site FS had a sensitivity of 0.70 and a specificity of 0.94. Five PMNs in single-site FS or CRP level ≥15 mg/L increased the sensitivity to 0.92; however, the specificity decreased to 0.79.

Conclusion

Compared with single-site FS, any 1 positive site on multiplex-site FS may improve sensitivity, while every 1 positive site on multiplex-site FS may improve specificity. Five PMNs in any 1 of 5 sites on FS has excellent utility for the diagnosis of PJI. Additional systematic large-scale studies are needed to verify this result.     

小鼠海马神经元冰冻切片和脑片培养方法的比较

目的:通过冰冻切片和脑片培养方式比较获得更适合脑片实验研究的方法。方法:分别运用急性切片和脑片培养方法,结合全细胞膜片钳技术比较两种脑片处理方法对小鼠海马神经元细胞形态、细胞膜封接难易程度、细胞电生理特性等的差异,获得更适合细胞研究的脑片获取方法。结果:冰冻切片方法切断部分神经纤维,脑片表层出现肿胀或坏死细胞,2-3层细胞可用于膜片钳记录,但不易封接破膜。脑片培养后可使纤维再生,整个脑片细胞形态清晰可见,容易封接破膜,电生理记录波形及基本特性与冰冻切片一致,但脑片培养方法的细胞突触后电流幅度更大、频率更高。结论:脑片培养可修复受损纤维和细胞膜柔韧性,且不改变膜特性,但脑片培养重建了一定数量的细胞间信号连接,使细胞反应性增强,脑片培养方法更适合脑片神经元研究。     

Survival of Frozen Mycoplasmas

Cooling to -70 C killed a higher percentage of Acholeplasma laidlawii and Mycoplasma mycoides var. capri cells than cooling to -20 C. However, to preserve cell viability for prolonged periods storage at -70 C was much more preferable. The percentage of cells surviving freezing could be increased by increasing the initial cell concentration or by the addition of dimethyl sulfoxide or glycerol as cryoprotective agents. In the presence of 1.5 M of any one of these agents survival rates of up to 100% could be obtained. The optimal cooling rates for maximal survival of A. laidlawii under the experimental conditions tested were 11 C/min for cooling to -20 C and about 15 C/min for cooling to -70 C. Increasing the warming rate during thawing from 0.6 to 67 C/min increased survival by 3 log. Oleic acid enrichment of A. laidlawii membrane lipids, or reduction in the cholesterol content of M. mycoides var. capri membranes, increased the percentage of organisms surviving freezing. Hence, the composition of membrane lipids appears to have a marked influence on the susceptibility of mycoplasmas to freezing injury.     

Bacteriological Survey of the Frozen Prepared Foods Industry: IV. Frozen Breaded Fish

During sanitation-inspections of 23 breaded-fish processors, 573 finished product units and 604 line samples were collected and analyzed bacteriologically. Data for finished product units processed on the same data are presented in groups; most of the groups consisted of 10 units. Groups of frozen, raw-breaded fish produced under good and poor conditions of sanitation were studied. No more than 20% of the units in each group produced under good conditions of sanitation were positive for Escherichia coli or coagulase-positive staphylococci. Groups of frozen, fried-breaded fish produced under good and poor sanitary conditions were also studied. No more than 10% of the units in each good-sanitation group were positive for E. coli or coagulase-positive staphylococci. However, approximately 30% of the groups processed under poor sanitary conditions also did not exceed these viable bacterial counts because of the lethal effect of the terminal fry to which the product is subjected. It was found that line samples collected from the processing lines reflected the sanitary conditions of the plant and provided bacteriological support for inspectional evidence of plant insanitation.     

Mounting Frozen Sections with Gelatin

Frozen sections, 15-50 µ thick, are soaked for 5 minutes or longer in a mixture of equal parts of 1.5% aqueous gelatin and 80% alcohol, and teased onto a slide. After allowing excess fluid to evaporate, sections will be moist and can be blotted with filter paper that may require dampening with 95% alcohol. Immersed in 95% alcohol, the remaining gelatin will congeal, anchoring the section to the slide. If necessary, the sections can subsequently be coated with celloidin.     

Metabolic Injury in Frozen Bacteria

S ummary : Aerobacter aerogenes populations, partly killed by freezing and thawing, usually showed more viable bacteria when plated on a rich medium than on a poor one. This 'metabolic injury' was not due to osmotic sensitivity or to toxic materials in the agar. Freezing and thawing was not significantly mutagenic and mutation to nutritional exigence did not account for the phenomenon. The survivors of freezing and thawing showed long lag phases in the recovery media, during which lag periods further mortality occurred.