Morphologic features of extrahepatic manifestations of hepatitis C virus infection.

Cirrhosis and hepatocellular carcinoma are the prototypic complications of chronic hepatitis C virus infection in the liver. However, hepatitis C virus also affects a variety of other organs that may lead to significant morbidity and mortality. Extrahepatic manifestations of hepatitis C infection include a multitude of disease processes affecting the small vessels, skin, kidneys, salivary gland, eyes, thyroid, and immunologic system.

Identifying risk factors in renal allografts before transplant: machine-measured renal resistance and posttransplant allograft survival.

Enhancement of renal allograft function and survival in an era where expanded criteria donors are increasingly used requires validated selection criteria. The goal of this retrospective study was to evaluate the significance of pretransplant donor and allograft parameters to identify risk factors that can be used in a model to predict 1-year allograft outcomes. Donor demographic factors, donor type, and allograft parameters such as biopsy results and machine-measured renal resistance were correlated with 1-year graft outcome.

Kruppel-like factor 15 (KLF15) is a key regulator of podocyte differentiation.

Podocyte injury resulting from a loss of differentiation is the hallmark of many glomerular diseases. We previously showed that retinoic acid (RA) induces podocyte differentiation via stimulation of the cAMP pathway. However, many podocyte maturity markers lack binding sites for RA-response element or cAMP-response element (CREB) in their promoter regions.

Histopathology of renal failure after heart transplantation: a diverse spectrum.

Background: Chronic kidney disease occurs frequently after heart transplantation and is associated with significant morbidity and mortality. Herein we describe the histopathology associated with renal failure in a cohort of heart transplant recipients.

Methods: Over a 4-year period all patients with an estimated GFR <30 ml/min/1.

Optimized technique in needle biopsy protocol shown to be of greater sensitivity and accuracy compared to wedge biopsy.

Background: Kidney biopsy is an important tool in determining allograft suitability for transplantation. Most deceased-donor renal biopsies performed today in the United States are wedge biopsies (WBs), with core needle biopsies being performed only by a minority of organ procurement organizations (OPOs). The lack of a gold standard in tissue sampling and tissue evaluation has prompted our OPO to find a more sensitive biopsy method as well as a more accurate pathology evaluation protocol to reassess expanded-criteria donor kidneys.

Paraneoplastic glomerulopathy secondary to retroperitoneal sarcoma: a case report.

Glomerulopathy is a rare form of paraneoplastic disease. We present the second reported case of paraneoplastic glomerulopathy due to a retroperitoneal sarcoma. The patient presented with generalized edema and nephrotic syndrome.

Segmentation and thickness measurement of glomerular basement membranes from electron microscopy images.

An algorithm for segmentation and thickness measurement of the glomerular basement membranes (GBM) in electron microscopy kidney images is presented. Differences in intensities and variations between GBM and other components in the image are employed. Regions of extreme intensities such as the black area of blood cells and white areas of urinary spaces are pre-excluded.

The variable pathology of kidney disease after liver transplantation.

Background: Chronic kidney disease is a frequent complication in orthotopic liver transplant (OLT) recipients, observed in 10% to 60% after 5 years.

Patients And Methods: We analyzed clinical and pathological data from 81 OLT recipients who developed impaired kidney function with a serum creatinine greater than or equal to 1.5 mg/dL or new proteinuria on dipstick urinalysis.

BRCA1 protein and nucleolin colocalize in breast carcinoma tissue and cancer cell lines.

The breast and ovarian cancer susceptibility gene BRCA1 encodes a tumor suppressor. BRCA1 protein, which is involved in DNA damage response, has been thought to be found primarily in cell nuclei. In the present investigation, immunohistological studies of BRCA1 protein in frozen breast cancer tissue and MCF7 and HeLa cell lines revealed BRCA1 expression in both nucleoli and nucleoplasmic foci.

A semi-automatic algorithm for measurement of basement membrane thickness in kidneys in electron microscopy images.

In this paper, we present a semi-automatic algorithm for measurement of the glomerular basement membrane thickness in electron microscopy kidney images. A string of sparsely spaced points are manually inputted along the central line of the basement membrane (lamina densa) to be measured. The gaps between successive input points are lineally interpolated.

Renal gene and protein expression signatures for prediction of kidney disease progression.

Although chronic kidney disease (CKD) is common, only a fraction of CKD patients progress to end-stage renal disease. Molecular predictors to stratify CKD populations according to their risk of progression remain undiscovered. Here we applied transcriptional profiling of kidneys from transforming growth factor-beta1 transgenic (Tg) mice, characterized by heterogeneity of kidney disease progression, to identify 43 genes that discriminate kidneys by severity of glomerular apoptosis before the onset of tubulointerstitial fibrosis in 2-week-old animals.

[The significance of Goodpasture antigen in hereditary nephritis].

Introduction: Two types of hereditary nephritis, nonprogressive and progressive, clinically present as asymptomatic haematuria, sometimes combined with proteinuria. At the onset, in both types, light microscopic changes are minimal, immunofluorescence findings are negative, and diagnosis can be made only upon electron microscopic findings that are considered to be specific.

Objective: The aim of this study was to determine the significance of Goodpasture antigen detection in diagnosis of progressive and nonprogressive hereditary nephritis in its early phase.

Loss of polycystin-1 causes centrosome amplification and genomic instability.

Autosomal dominant polycystic kidney disease (ADPKD) is the most common monogenetic disease predominantly caused by alteration or dysregulation of the PKD1 gene, which encodes polycystin-1 (PC1). The disease is characterized by the progressive expansion of bilateral fluid-filled renal cysts that ultimately lead to renal failure. Individual cysts, even within patients with germline mutations, are genetically heterogeneous, displaying diverse chromosomal abnormalities.

A case of autoimmune thyroiditis and membranoproliferative glomerulonephritis.

Thyroid hormones play an important role in the growth of the kidney and maintenance of its functions. Prolonged hypothyroidism is known to be accompanied by changes in renal morphology such as thickening of the glomerular and tubular basement membranes as well as increased mesangial matrix. Increased transcapillary leakage of plasma proteins leading to proteinuria and generalized edema is also a known complication of hypothyroidism.

Transplant glomerulopathy may occur in the absence of donor-specific antibody and C4d staining.

Background And Objectives: Transplant glomerulopathy (TGP) has been proposed to be a component of chronic antibody-mediated rejection (AMR). We have studied 36 patients with TGP and 51 patients with chronic allograft nephropathy (CAN) but without TGP for C4d staining and donor-specific anti-HLA antibodies (DSA) to investigate the alloantibody-mediated mechanisms.

Design, Setting, Participants, & Measurements: Allograft biopsies were stained with C4d staining and DSAs were studied by Luminex Flow Beads.

Aspergillus infection limited to renal allograft: case report and review of literature.

We report a case of a 28-year-old recipient of a cadaveric renal transplant who developed Aspergillus infection in the allograft without having disseminated disease. We review the previously reported cases of isolated Aspergillus in kidney transplant recipients and discuss the possible route of transmission in our patient. We also discuss the alternate but successful treatment that our patient received.

Renal transplant patient with polyoma virus bladder infection and subsequent polyoma virus nephropathy.

Polyoma virus nephropathy (PVN) is a significant cause of renal allograft dysfunction in transplant patients. A 58-year-old male received a cadaveric renal transplant and 12 weeks later presented with fever, diarrhea, and dysuria. He was diagnosed with a polyoma virus infection of the bladder by a transurethral bladder biopsy.

Expression of p53 in virally infected tubular cells in renal transplant patients with polyomavirus nephropathy.

Polyomavirus (PV) infection is associated with ureteral stenosis, hemorrhagic cystitis, and interstitial nephritis in renal transplant patients. The 3 PVs detected in human beings-BK virus, JC virus, and simian virus 40-each encode highly homologous forms of a large T antigen, a transcriptional and replicational regulatory protein. We describe immunohistochemical findings in 5 renal transplant patients who developed PV nephropathy (PVN) and a sixth patient with both PVN and PV infection of the bladder mucosa.

Later-onset Fabry disease: an adult variant presenting with the cramp-fasciculation syndrome.

Background: Classic Fabry disease, an X-linked recessive lysosomal storage disease due to the deficient activity of alpha-galactosidase A, typically presents in early childhood with acroparesthesias, angiokeratomas, hypohidrosis, and corneal dystrophy. The neuropathic pain presumably results from glycosphingolipid accumulation in the vascular endothelium and in small-caliber nerve fibers, and is treatable by enzyme replacement therapy. Later-onset variants with residual alpha-galactosidase A activity lack vascular endothelial involvement and classic symptoms, which lead to the development of cardiac and/or renal disease after the fourth decade of life.

Laparoscopic management of gastrointestinal stromal tumors.

Background: Surgery remains the standard for nonmetastatic gastrointestinal stromal tumors (GISTs). Laparoscopic surgery should be considered for these tumors as their biologic behavior lends them to curative resection without requiring large margins or extensive lymphadenectomies.

Methods: A retrospective review was performed of patients who underwent laparoscopic treatment of GISTs by surgeons at the Mount Sinai Medical Center from 2000-2005.

Differential expression of profibrotic and growth factors in chronic allograft nephropathy.

Background: Chronic allograft nephropathy (CAN) is a multifactorial process, where both immunological and nonimmunological factors play roles. Microarrays detect thousands of genes simultaneously.

Methods: We have analyzed gene expression profiles of 16 kidney transplant biopsy samples with CAN by high-density oligonucleotide microarrays, comparing to six normal transplant biopsies.

[HIV infection and the kidneys (Part II): Morphologic changes and their diagnostic significance].

HIV-infected patients may be faced with a variety of renal problem patterns. HIV-associated nephropathy is a unique pattern of sclerosing glomerulopathy and represents the most rapidly progressive form of focal segmental glomerulosclerosis. This study involved the examination of 32 renal biopsies: by light, immunofluorescence, and electron microscopy, in order to determine the most accurate and reliable diagnostic procedure.