Interstitial rejection, vascular rejection, and diffuse thrombosis of renal allografts. Predisposing factors, histology, immunohistochemistry, and relation to outcome.

Histological and immunohistochemical analyses were made of biopsy specimens from 50 consecutive patients who experienced putative graft rejection. The mean age of the patients was 44.5 years (range, 17-69 years) and 26 were men.

Isolation of cDNAs encoding immunogenic regions of gp330, the autoantigen involved in Heymann nephritis.

Active Heymann nephritis is an organ-specific autoimmune disease of the rat kidney, characterized by the formation of immune complexes located subepithelially in the glomerulus. The T cell-mediated humoral immune response is directed to gp330, a large renal epithelial glycoprotein which is expressed both in the proximal tubule and on glomerular podocytes. In this study polyclonal rabbit antibodies raised against affinity-purified rat gp330 were used to screen a lambda-gt11 expression library of the rat kidney.

Effects of high glucose on the production of heparan sulfate proteoglycan by mesangial and epithelial cells.

Changes in heparan sulfate metabolism may be important in the pathogenesis of diabetic nephropathy. Recent studies performed on renal biopsies from patients with diabetic nephropathy revealed a decrease in heparan sulfate glycosaminoglycan staining in the glomerular basement membrane without changes in staining for heparan sulfate proteoglycan-core protein. To understand this phenomenon at the cellular level, we investigated the effect of high glucose conditions on the synthesis of heparan sulfate proteoglycan by glomerular cells in vitro.

Cloning of the mouse fibronectin V-region and variation of its splicing pattern in experimental immune complex glomerulonephritis.

Increased mRNA and protein expression of extracellular matrix (ECM) components, including fibronectin, occurs during the development of glomerulonephritis and glomerulosclerosis in immunologically mediated kidney diseases. However, in addition to these quantitative changes in ECM expression, qualitative changes in these molecules may contribute to malformations in the composition of the glomerular matrix. These qualitative changes may include alterations in the splicing pattern of the V-region of fibronectin, since this region plays a role in its accumulation.

Cardiovascular variability in major depressive disorder and effects of imipramine or mirtazapine (Org 3770).

Spectral analysis of fluctuations in heart rate (HR) and blood pressure (BP) was applied to assess sympathetic and parasympathetic cardiovascular control mechanisms in patients with unipolar affective disorder before and after treatment with imipramine (IMI) or mirtazapine (MIR). In a double-blind randomized study, 10 patients received treatment with IMI and 10 patients received treatment with MIR. Cardiovascular parameters were studied before and after 4 weeks of treatment: HR and BP (Finapres) were recorded continuously during supine rest (SR) and orthostatic challenge (OC; 60-degrees head-up tilting).

High failure rate of cementless threaded acetabular cups: a radiographic and histologic study in the goat.

We studied the fixation of the Mecron cementless titanium screw cup radiographically and histologically in 20 dwarf-goats after periods of 0, 6, 26 and 52 weeks. In only 3 goats did histology show good bone-implant contact, whereas in the other 17 goats a fibrous membrane interface was seen. This high failure rate is caused by the poor primary fixation and should be a warning against the use of this implant.

Characterization of reactivity of monoclonal autoantibodies with renal antigens in experimental lupus nephritis.

Mice with chronic graft-versus-host disease (GvHD), induced by injection of DBA/2 lymphocytes into (C57BL10*DBA/2)F1 hybrids, develop a lupus-like syndrome with immune complex glomerulonephritis. Circulating autoantibodies are reactive with various self-antigens, including DNA, renal tubular epithelium (RTE), and laminin-1. To elucidate the reactivity of autoantibodies with renal antigens in experimental lupus nephritis further, the reactivity of the autoantibodies was studied in more detail by generating hybridomas from GvHD spleen cells.

Longterm low dose cyclosporine in patients with rheumatoid arthritis: renal function loss without structural nephropathy.

Objective: To investigate whether administration of low dose cyclosporine for 2 years induces structural changes in the kidneys of patients with rheumatoid arthritis (RA).

Methods: Renal biopsies were performed in 11 patients with RA who had been treated with cyclosporine [mean dose 3.3 mg/kg/day; mean maximum dose 4.

Function and survival of intrasplenic islet autografts in dogs.

Successful transplantation of isolated islets of Langerhans has been reported in large mammals, including man, but metabolic control has not been well-established. We studied the glucose and islet hormone response to fasting, i.v.

Production and cytokine-mediated regulation of monocyte chemoattractant protein-1 by human proximal tubular epithelial cells.

Impairment of renal function in various types of glomerular disease is associated with tubulointerstitial changes. The mechanism of mononuclear cell infiltration in the interstitium is not fully understood. Recently, monocyte chemoattractant protein-1 (MCP-1) has been identified as a monocyte-specific chemotactic factor.

Role of the extracellular matrix in the development of glomerulosclerosis in experimental chronic serum sickness.

Glomerulosclerosis is a severe complication of many immunologically mediated kidney diseases and is associated with a poor prognosis with respect to renal function. The aim of this study was to elucidate the role of the extracellular matrix (ECM) in the development of glomerulosclerosis in experimental immune complex glomerulonephritis. Induction of chronic serum sickness by repetitive injections of human IgG into preimmunized Wistar rats leads to the development of immune complex nephritis and glomerulosclerosis.

Progression of chronic renal disease in humans is associated with the deposition of basement membrane components and decorin in the interstitial extracellular matrix.

The degree of impairment of renal function in patients with chronic renal failure correlates closely with the extent of fibrosis in the tubulointerstitium, i.e. of interstitial extracellular matrix (ECM) accumulation.

Radiographic loosening of cementless threaded acetabular cups. No additional diagnostic value of arthrography in 30 patients.

We compared arthrography with plain radiographs in 30 consecutive patients having a clinical diagnosis of loosening of a smooth-threaded acetabular prosthesis (Mecron, Berlin). Leakage of contrast at the interface between the ring and the bone on the medial side of the prosthesis was seen in 21 patients. Loosening of the cup was also visible on the plane radiographs and loosening was confirmed in all these patients at revision surgery.

Monocyte chemoattractant protein-1 in normal and diseased human kidneys: an immunohistochemical analysis.

We conducted an immunohistochemical analysis to investigate the presence of monocyte chemoattractant protein-1 (MCP-1) in normal and diseased human kidneys and the correlation with infiltration of macrophages. A total of 50 renal biopsies were classified according to pathologic diagnosis. The distribution as well as the intensity of MCP-1 staining, and infiltration by CD68+ macrophages were evaluated in diseased versus normal kidneys.

Lymph node staging standards in gastric cancer.

Purpose: In tumor-node-metastasis (TNM) staging, no recommendations are provided on the number of lymph nodes to examine per N level. We investigated the relationship between number of nodes examined and probability of detecting metastases, and ultimately staging accuracy.

Patients And Methods: Data from 473 curatively resected gastric cancer patients, from a randomized trial that compared the Western resection with limited and the Japanese resection with extended lymphadenectomy, were used.

Radiographic evaluation of developing instability of the Mecron cementless, threaded acetabular prostheses.

Purpose: To evaluate radiographically the history of the Mecron acetabular prosthesis.

Material And Methods: The pelvic radiographs of 350 consecutive patients with a smooth threaded acetabular prosthesis type Mecron were retrospectively evaluated (follow-up 1 to 6 years, mean 4 years). A demarcation zone seen at the medial side of the prosthesis was graded from 0 (absent) to 3 (severe).

Immunoglobulin production in vitro in major depression: a pilot study on the modulating action of endogenous cortisol.

To investigate the possible differential sensitivity of hydrocortisone (HCO) on immunoglobulin (Ig) production in depression in relation to endogenous cortisol levels, blood was obtained at 8 AM and 4 PM from 10 inpatients with major depression according to DSM-III-R criteria and 10 age- and sex-matched healthy subjects. Peripheral blood lymphocytes were cultured in the presence of graded concentrations (10(-9)-10(-5) M) of HCO to study the effect on immunoglobulin (IgG and IgM) synthesis. In addition, peripheral blood lymphocytes were cultured in the presence of pokeweed mitogen (PWM) to study any additional effect of graded concentrations of HCO (10(-9)-10(-5) M) on IgG and IgM synthesis.

Cortical tissue of patients with hereditary cerebral hemorrhage with amyloidosis (Dutch) contains various extracellular matrix deposits.

Background: Hereditary cerebral hemorrhage with amyloidosis (Dutch) (HCHWA-D) and Alzheimer's disease (AD) have certain clinical and histopathologic features in common; both are characterized by cerebral amyloid beta deposits. Extracellular matrix (ECM) components have been demonstrated in plaques and in vascular amyloid of AD, suggesting a causative relation.

Experimental Design: We studied the immunohistochemical expression of the ECM components collagen type I, III, and IV, heparan sulfate proteoglycan (HSPG), laminin, and fibronectin in cortical tissue of six HCHWA-D patients, two AD patients, and five controls.

Qualitative alterations in laminin expression in experimental lupus nephritis.

Previous studies have revealed quantitative alterations in laminin-1 expression at the mRNA and protein levels during the development of glomerulonephritis and glomerulosclerosis in chronic graft-versus-host disease in mice, a model for lupus nephritis. We have now studied the qualitative alterations in laminin expression with two monoclonal antibodies that recognize epitopes on either the E8 or the P1 fragment of laminin-1. Both of these fragments are involved in cell-matrix and matrix-matrix interactions.

Specific accumulation of exogenous fibronectin in experimental glomerulosclerosis.

The prognosis of patients showing glomerulosclerosis as a complication of an immunologically mediated kidney disease is poor. To improve the diagnosis and treatment of these patients, it is important to understand the processes involved in the development of glomerulosclerosis. In this study, we investigated the molecular composition of experimental end-stage glomerular sclerotic lesions and their pathogenesis in chronic graft-versus-host disease (GvHD) in the mouse and chronic serum sickness in the rat.

Compassionate treatment of Wegener's granulomatosis with rabbit anti-thymocyte globulin.

Unlabelled: The purpose of this study was to evaluate the effect of treatment with anti-thymocyte globulin in patients with Wegener's granulomatosis, untreatable with cyclophosphamide and steroids.

Materials And Methods: Five patients with active Wegener's granulomatosis, either not responsive to standard therapy, or who could not tolerate alkylating agents received a single course of rabbit anti-thymocyte globulin (ATG).

Results: Four patients showed a favourable response to treatment with partial or complete remission of disease activity, during a follow-up period of five to twelve months.

The relation between acute vascular and interstitial renal allograft rejection and subsequent chronic rejection.

Chronic rejection of renal allografts is a major cause of late graft loss. However, time of onset, relation with acute early rejection episodes, and risk factors are largely unknown. We undertook a cohort study of 482 consecutive patients from a single center who received a cadaveric renal allograft between January 1983 and April 1991.