BACKGROUND & AIMS: AIM:To investigate the dynamic alteration of telomerase expression during development of hepatocellular carcinoma (HCC) and its diagnostic implications in liver tissues or peripheral blood mononuclear cells for HCC. METHODS:Dynamic expressions of liver telomerase during malignant transformation of hepatocytes were observed in Sprague-Dawly (SD) rats fed with 0.05% of 2-fluoenyacetamide (2-FAA). Total RNA and telomerase were extracted from rat or human liver tissues. The telomerase activities in livers and in circulating blood were detected by a telomeric repeat amplification protocol-enzyme-linked immunosorbent assay (TRAP-ELISA), and its diagnostic value was investigated in patients with benign or malignant liver diseases. RESULTS:The hepatoma model displayed the dynamic expression of hepatic telomerase during HCC development. The telomerase activities were consistent with liver total RNA levels (r = 0.83, P<0.01) at the stages of degeneration, precancerosis, and cancerization of hepatocytes. In HCC patients, the telomerase levels in HCC tissues were significantly higher than in their adjacent non-cancerous tissues, but liver total RNA levels were lower in the former than in the latter. Although the circulating telomerase of HCC patients was abnormally expressed among patients with chronic liver diseases, the telomerase activity was a non-specific marker for HCC diagnosis, because the incidence was 15.7% in normal control, 25% in chronic hepatitis, 45.9% in liver cirrhosis, and 85.2% in HCC, respectively when absorbance value of telomerase activity was more than 0.2. If the value was over 0.6, the incidence was 60% in HCC group and 0% in any of the others (P<0.01) except in two cases with liver cirrhosis. However, the combination of circulating telomerase with serum alpha-fetoprotein level could increase the positive rate and the accuracy (92.6%, 125 of 135) of HCC diagnosis. CONCLUSION:The overexpression of telomerase is associated with HCC development, and its abnormality in liver tissues or in peripheral blood could be a useful marker for diagnosis and prognosis of HCC.

背景与目标： 目的：研究肝细胞癌（HCC）发生过程中端粒酶表达的动态变化及其在肝组织或外周血单核细胞中的诊断意义。
方法：在喂食0.05％2-氟乙酰胺（2-FAA）的Sprague-Dawly（SD）大鼠中观察肝细胞恶性转化过程中肝端粒酶的动态表达。从大鼠或人肝脏组织中提取总RNA和端粒酶。通过端粒重复扩增方案-酶联免疫吸附测定（TRAP-ELISA）检测肝脏和循环血液中的端粒酶活性，并对其在良性或恶性肝病患者中的诊断价值进行研究。
结果：肝癌模型在肝癌发生过程中表现出肝端粒酶的动态表达。在变性，癌前期和肝细胞癌化阶段，端粒酶活性与肝脏总RNA水平一致（r = 0.83，P <0.01）。在HCC患者中，HCC组织中的端粒酶水平显着高于其相邻的非癌性组织，但前者的肝脏总RNA水平低于后者。尽管在慢性肝病患者中HCC患者的循环端粒酶异常表达，但端粒酶活性不是HCC诊断的非特异性标志物，因为正常对照组的发生率为15.7％，慢性肝炎为25％，肝为45.9％当端粒酶活性的吸光度值大于0.2时，肝硬化和HCC中的85.2％。如果该值超过0.6，则除两名肝硬化患者外，HCC组的发生率为60％，其他任何一组的发生率为0％（P <0.01）。但是，循环端粒酶与血清甲胎蛋白水平的结合可以提高HCC诊断的阳性率和准确性（92.6％，第125页）。
结论：端粒酶高表达与肝癌的发生有关，其在肝组织或外周血中的异常可能是诊断和预后的有用标志。

BACKGROUND & AIMS: BACKGROUND:Flow cytometric basophil activation tests have been developed as cellular tests for in vitro diagnosis of IgE-mediated reactions. Different activation markers (CD63 or CD203c) with distinct ways of regulation have been used after stimulation with various allergens. OBJECTIVE:It was the aim of the present study to compare basophil activation tests by measuring both CD63 and CD203c upregulation in patients with insect venom allergy. MATERIALS AND METHODS:43 patients with a history of insect venom anaphylaxis were examined. A careful allergy history was taken, and skin tests and determination of specific IgE-antibodies were performed. Basophil activation tests (BAT) using CD63 or CD203c expression were done after stimulation with different concentrations of bee and wasp venom extracts. 25 healthy subjects with negative history of insect venom allergy were studied as controls. RESULTS:The CD203c protocol showed a slightly higher sensitivity than the CD63 protocol (97% vs. 89%) with regard to patients' history. The magnitude of basophil response was higher with CD203c in comparison to CD63 for both insect venoms. Specificity was 100% for the CD63 protocol and 89% for the CD203c protocol with regard to controls with negative history and negative RAST. CONCLUSION:These results support the reliability of basophil activation tests using either CD63 or CD203c as cellular tests in the in vitro diagnosis of patients with bee or wasp venom allergy with a slightly higher sensitivity for the CD203c protocol.

背景与目标： 背景：流式细胞仪嗜碱性粒细胞活化测试已发展为用于体外诊断IgE介导的反应的细胞测试。在用各种变应原刺激后，已使用具有不同调节方式的不同激活标记（CD63或CD203c）。
目的：本研究的目的是通过测量昆虫毒液过敏患者中的CD63和CD203c上调来比较嗜碱性粒细胞活化测试。
材料与方法：检查43例有虫毒过敏史的患者。仔细记录过敏史，并进行皮肤测试和特定IgE抗体的测定。在用不同浓度的蜜蜂和黄蜂毒液提取物刺激后，进行了使用CD63或CD203c表达的嗜碱性粒细胞活化测试（BAT）。以25名昆虫毒液过敏史为阴性的健康受试者作为对照。
结果：就患者病史而言，CD203c方案显示出比CD63方案更高的敏感性（97％比89％）。与两种昆虫毒液的CD63相比，CD203c的嗜碱性粒细胞反应程度更高。对于具有阴性历史和阴性RAST的对照，CD63方案的特异性为100％，CD203c方案的特异性为89％。
结论：这些结果支持使用CD63或CD203c作为细胞测试的嗜碱性粒细胞活化测试在对蜜蜂或黄蜂毒液过敏患者进行体外诊断时的可靠性，对CD203c协议的敏感性稍高。

BACKGROUND & AIMS: OBJECTIVE:Use of the image-guided stereotactic brain biopsy has facilitated the diagnosis of previously inaccessible lesions with both safety and reliability. However, few studies have assessed the diagnostic yield of frozen section evaluation of the initial stereotactic target (FS-0). We describe our experience with 188 stereotactic brain biopsies in order to evaluate the diagnostic yield of FS-0.

DESIGN:Retrospective study of 188 stereotactic brain biopsies from 185 patients.

SETTING:Tertiary referral center with a high volume of neurosurgical cases including image-guided stereotactic brain biopsies.

PATIENTS:One hundred eighty-five patients who underwent imaged-guided stereotactic brain biopsy over a 58-month period.

RESULTS:The patients studied included 107 males and 78 females (mean age 48 years). Eleven (6%) biopsies were nondiagnostic. Diagnoses from FS-0 included a neoplastic condition in 96 (73%) of 131 cases and a nonneoplastic condition in 23 (50%) of 46 cases. In 119 (67%) of 177 cases, a diagnosis was reached at FS-0. A correct diagnosis was made on subsequent frozen section in 28 (16%) of cases, including 21 (16%) of 131 neoplasms and 7 (15%) of nonneoplastic conditions. In 15 (54%) of 28 cases, the correct diagnosis was made on the second frozen section; in 25 (89%) of 28, the correct diagnosis was made by the fourth frozen section. In 14 (11%) of 131 neoplastic cases, a sampling error relative to the lesion resulted in an inaccurate diagnosis at FS-0. A significant error in diagnosis occurred in three cases (1.7%).

CONCLUSIONS:We conclude that (1) because 58 (33%) of 177 diagnosed cases in our series would have been potentially misdiagnosed if only one biopsy had been taken at the stereotactic target, frozen section evaluation or cytologic examination of material at the time of surgery should be performed routinely to ensure that adequate tissue has been obtained for purposes of diagnosis; (2) taking up to four biopsies increases the diagnostic yield (from 67% to 89% in this series); and (3) neoplastic lesions are more likely to be definitively diagnosed at FS-0 than non-neoplastic lesions.

背景与目标： 目标：使用图像引导的立体定向脑活检技术，既安全又可靠，有助于诊断先前难以接近的病变。但是，很少有研究评估初始立体定位目标（FS-0）的冷冻切片评估的诊断率。为了描述FS-0的诊断结果，我们描述了188例立体定向脑活检的经验。

DESIGN ：对185例患者的188例立体定向脑活检进行了回顾性研究。
设置：拥有大量神经外科病例的三级转诊中心，包括图像引导的立体定向脑活检。

患者：一百八十五

结果：接受影像引导的立体定向脑活检的患者。研究的患者包括107例男性和78例女性（平均年龄48岁）。 11例（6％）活检未确诊。 FS-0的诊断包括131例中的96例（73％）为肿瘤性疾病和46例中23例（50％）为非肿瘤性疾病。在177例病例中，有119例（67％）达到了FS-0的诊断。在随后的冰冻切片中，有28例（16％）做出了正确的诊断，包括131例肿瘤中的21例（16％）和7例（15％）的非肿瘤性疾病。在28例病例中，有15例（54％）对第二个冷冻切片做出了正确的诊断。 28例中有25例（89％）通过第四次冰冻切片做出了正确的诊断。在131例肿瘤病例中，有14例（11％）相对于病变的采样错误导致FS-0诊断不准确。结论3例诊断错误（1.7％）。

结论：我们得出结论：（1）因为本系列177例诊断病例中有58例（33％）如果仅在立体定向目标上进行了一次活检，可能会被误诊，在手术时应常规进行冰冻切片评估或材料的细胞学检查，以确保获得足够的组织用于诊断； （2）最多进行四次活检可以提高诊断率（在本系列中从67％增至89％）； （3）FS-0比非肿瘤性病变更有可能明确诊断出肿瘤性病变。