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Needle-like inclusions have been found, by electron microscopy, in the livers of two unrelated patients with erythropoietic protoporphyria. Since they have not been noted in other hepatic conditions but do occur in the livers of protoporphyric mice it is suggested that they represent markers for protoporphyric liver disease. Paracrystalline inclusions that have been previously described in Wilson's disease and porphyria cutanea tarda were also present in the hepatocytes of one of these patients.

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Some trends in electron microscopy of skin have emerged and should be pursued in the future. The fine structure and some basic cellular reaction patterns of epidermal cells are discussed to illustrate the interplay of morphologic, cytochemical, and tracer studies. Intracytoplasmic membranes and secretory granules, lysosomes and endocytic mechanisms, cytomembranes and cell surface specialization are discussed to show how these can be used to arrive at a more meaningful interpretation of structure. Despite all advances, however, a great deal more needs to be done before the details of skin structure are completely elucidated.