DIAGNOSTIC ELECTRON MICROSCOPY (EM)

透射电子显微镜（EM）被用作一种辅助程序，在广泛的肿瘤性和非肿瘤性疾病的诊断，可以是非常有用的选择诊断困境。诊断电子显微镜服务的主要目标是：(1)提供病人标本的电子显微镜诊断；(2)有助于了解各种NIH方案中研究的疾病的发病机制；(3)协助研究人员在研究方案中提出具体的电子显微镜相关问题。过去几年的成就总结如下。(1)共有118个患者组织被EM处理和诊断。(2)另外172个研究标本被EM处理和评估为研究方案。(3)EM有助于识别NIH试验中使用的药物氟尿定引起的线粒体损伤。(4)EM有助于确定NIH临床医生在IV型分枝杆菌病患者中检测到的慢性胃炎不是由于缺乏壁细胞。而是由于巨大溶酶体中储存的物质而导致功能失调的壁细胞。(5) EM很重要，因为它表明畸形Smith-Lemli-Opitz综合征患者除了在胆固醇生物合成方面的原发性缺陷外，还可能在细胞内低密度脂蛋白（LDL）的降解方面存在继发性缺陷，导致未酯化的胆固醇和溶酶体内含物的异常积累，类似于Niemann Pick病。(6)电镜在淋巴结网状细胞肿瘤的形态学表征中发挥作用。-电子显微镜，-人体组织，液体，细胞等

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 years accomplishments are summarized below. (1) A total of 118 patient tissues were processed and diagnosed by EM. (2) An additional 172 research specimens were processed and evaluated for research protocols (3) EM was instrumental in identifying the mitochondrial damage caused by the drug fialuridine that was used in NIH trials (4) EM was instrumental in defining that the achlorydric gastritis that was detected in patients with mycolipidosis type IV by NIH cllnicians was not due to lack of parietal cells, but rather to dysfunctional parietal cells because of storage material in giant lysosomes. (5) EM was important in showing that patients with the dysmorphic Smith-Lemli-Opitz syndrome, in addition to their primary defect in cholesterol biosynthesis may have a secondary defect in the degradation of intracellular low denisity lipoproteins (LDL), resulting in abnormal accumulation of unesterified sterols and lysosomal inclusions similar to those seen in Niemann Pick disease. (6) EM played a role in the morphologic characterization of reticulum cell neoplasms in lymph nodes. - Electron microscopy, - Human Tissues, Fluids, Cells, etc.