Diagnostic Electron Microscopy (EM)

在多种肿瘤和非肿瘤疾病的诊断中，透射式电子显微镜(EM)被用作一种辅助程序，在精心选择的诊断难题中，它是非常有用的。诊断EM服务的主要目标是：(1)在患者标本中提供EM诊断；(2)有助于理解NIH各种方案中研究的疾病的发病机制；以及(3)协助研究人员解决特定EM相关问题的研究方案。一年来的研究成果总结如下：(1)共对122例患者组织进行了EM处理和诊断。CAP检查于2/15/00成功进行，从而获得CAP认证。(2)另外对117个研究标本进行了处理和评估，每个样本有多个样本，共发表了5篇论文。(3)探讨了在超微结构水平上应用非放射性同位素原位聚合酶链式反应检测癌基因的可能性。1999年3月提交给USCAP病理学会会议的摘要(Lab Invest 2000；80：225a(第1325))获得了超微结构病理学会的荣誉称号(4)引入免疫EM以帮助NIH研究人员解决与临床相关的问题。例子和出版物如下：(A)免疫EM标记显示人类免疫缺陷病毒(HIV)包膜蛋白GP4在HIV感染痴呆患者的大脑中作为细胞外聚集体积累-Caffrey，M.等人：J Biol Chem 2000；275：19877-19882。(B)免疫EM标记显示在易患异氟醚诱导的肝炎的患者中，异氟烷代谢产物与肝脏蛋白结合并定位于线粒体-Njoku，D.等人：(提交)。(C)免疫EM标记显示瘦素在培养的前脂肪细胞和成熟组织脂肪细胞中定位的位置-Bornstein，S.R.等人。糖尿病2000；49：532-538。

Transmission electron microscopy (EM) is used as an adjunct procedure in the diagnosis of a wide range of neoplastic and non neoplastic diseases and can be extremely useful in well chosen diagnostic dilemmas. The main objectives of the diagnostic EM service are: (1) to provide EM diagnosis in patient specimens (2) to contribute to the understanding of the pathogenesis of diseases studied in various NIH protocols and (3) to assist investigators in research protocols with specific EM-related questions. The last year's accomplishments are summarized below:(1) A total of 122 patient tissues were processed and diagnosed by EM. Successful CAP inspection occurred on 2/15/00 leading to CAP certification (2) An additional 117 research specimens with multiple samples per specimen were processed and evaluated, resulting in 5 publications. (3) We explored the possibility to use a non radioisotopic in situ polymerase chain reaction at the ultrastrucutral level for the detection of oncogenes. An abstract submitted to the USCAP Academy of Pathology meeting in March of 1999 (Lab Invest 2000; 80:225A (1325)) won honorary mention from the Society of Ultrastructural Pathology (4) Immuno EM was introduced to assist NIH investigators in resolving questions with clinical relevance. Examples and puplications are shown below: (a) Immuno EM labeling showed the human immunodeficiency virus (HIV) envelope protein gp4 to accumulate as an extracellular aggregate in the brains of HIV-infected patients with dementia - Caffrey, M. et al: J Biol Chem 2000; 275:19877-19882 .(b) Immuno EM labeling showed that in patients susceptible to isoflurane-induced hepatitis, isufluorane metabolites bind to liver proteins and are localized in mitochondria- Njoku, D. et al: (Submitted).(c) Immuno EM labeling showed sites of leptin localization in cultured preadipocytes and mature tissue adipocytes- Bornstein, S.R. et al. Diabetes 2000; 49:532-538 .