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Biomedical subjects

B P Croker

Publications and source records attributed to B P Croker.

At least 37 records · Page 2Linked to original sources
PubMed1993

International standardization of criteria for the histologic diagnosis of renal allograft rejection: the Banff working classification of kidney transplant pathology.

A group of renal pathologists, nephrologists, and transplant surgeons met in Banff, Canada on August 2-4, 1991 to develop a schema for international standardization of nomenclature and criteria for the histologic diagnosis of renal allograft rejection. Development continued after the meeting and the schema was validated by the circulation of sets of slides for scoring by participant pathologists. In this schema intimal arteritis and tubulitis are the principal lesions indicative of acute rejection. Glomerular, interstitial, tubular, and vascular lesions of acute rejection and "chronic rejection" are defined and scored 0 to 3+, to produce an acute and/or chronic numerical coding for each biopsy. Arteriolar hyalinosis (an indication of cyclosporine toxicity) is also scored. Principal diagnostic categories, which can be used with or without the quantitative coding, are: (1) normal, (2) hyperacute rejection, (3) borderline changes, (4) acute rejection (grade I to III), (5) chronic allograft nephropathy ("chronic rejection") (grade I to III), and (6) other. The goal is to devise a schema in which a given biopsy grading would imply a prognosis for a therapeutic response or long-term function. While the clinical implications must be proven through further studies, the development of a standardized schema is a critical first step. This standardized classification should promote international uniformity in reporting of renal allograft pathology, facilitate the performance of multicenter trials of new therapies in renal transplantation, and ultimately lead to improvement in the management and care of renal transplant recipients.

Graft Rejection↗
PubMed1992

Chromatin structure changes suggest a compensatory response to c-myc gene amplification in malignant fibrous histiocytoma.

Changes in chromatin structure as determined from DNAse I hypersensitive site analysis are associated with c-myc amplification and increased transcript/protein levels in malignant fibrous histiocytoma (MFH) cell lines. A DNAse I hypersensitive site near the PO promoter region was observed in one MFH cell line (UR HCL 1), and in normal fibroblasts (HFF), but not in an MFH cell line with an amplified c-myc gene (P3C). A DNAse I hypersensitive site exclusive to P3C amplified c-myc was identified slightly 3' of exon one. No alterations in c-myc DNAse I hypersensitive site patterns were observed in HFF fibroblasts following serum release, when peak levels of c-myc transcript were induced. DNAse I hypersensitive site patterns associated with gene amplification may reflect a compensatory response by P3C cells to an abundance of c-myc transcript. Furthermore, elevated levels of protein in P3C cells provide additional evidence that amplified c-myc is an oncogene in MFHs.

Chromatin↗
PubMed1992

Background genes mediate the development of autoimmunity in (NZB x PL/J)F1 or (NZB x BIO.PL)F1 mice.

The (NZB x NZW)F1 mouse develops a lupus-like disease including anti-double-stranded DNA antibodies and renal disease. It has been demonstrated that genes linked to the H-2 locus contributed by NZW correlate with development of this disease. We investigated whether mice with identical class II molecules but different background genes could contribute to autoimmunity when crossed with NZB. We report that two strains, PL/J and BIO.PL, when crossed to NZB, do not result in F1 with autoimmunity. Therefore, background genes present in NZW but not in PL/J or BIO.PL contribute to the development of disease.

Amino Acid Sequence↗
PubMed1991

Mesenchymal specificity of three new monoclonal antibodies generated to the osteosarcoma cell line 4444T.

We have generated three murine monoclonal antibodies to the new human osteosarcoma cell line 4444T. Analysis of their binding patterns to tumor cell lines, normal human tissues, and surgical tumor specimens indicates that the antibodies recognize a subset of human sarcomas and stromal tissues but fail to react with carcinomas or normal human epithelial tissue. These mesenchyme-specific monoclonal antibodies bind to antigens in the extracellular matrix. One antibody is specific in its binding to the muscularis arteriosus. We expect these antibodies to aid in the identification of sarcomas and to extend our knowledge of the components of the extracellular matrix and its interaction with tumors.

Animals↗
PubMed1990

Gallium scan in the diagnosis and treatment of renal malacoplakia.

A middle-aged female was admitted with a presumptive diagnosis of pyelonephritis that failed to respond to conventional antibiotic therapy. Multiple investigations to define the etiology of the persistent fever and accompanying acute renal failure were negative. A gallium scan revealed intense uptake in the renal parenchyma. Percutaneous renal biopsy revealed malacoplakia. Six weeks of therapy with ciprofloxacin resulted in resolution of fever, improvement in the follow-up gallium scan, and reversal of the acute renal failure.

Ciprofloxacin↗
PubMed1988

Loss of corticomedullary demarcation on magnetic resonance imaging: an index of biopsy-proven acute renal transplant dysfunction.

A prospective study of 19 cadaveric renal allograft recipients with suspected graft rejection was undertaken to compare the histological findings of the renal transplant biopsy with the results of magnetic resonance imaging (MRI). All 19 patients underwent a biopsy of the transplant allograft. Biopsy results included acute cellular rejection, acute vascular rejection, chronic vascular rejection (CVR), and acute tubular necrosis (ATN). Recipients of cadaveric renal allografts with normal function served as controls. The control showed distinct corticomedullary demarcation (CMD) on T1-weighted imaging. In contrast, CMD was absent or diminished in all the patients with suspected allograft rejection. Unfortunately, the loss of CMD did not correlate with a specific biopsy diagnosis. Patients with biopsy evidence of acute and chronic rejection or ATN demonstrated loss of CMD with similar image patterns. In conclusion, MRI is capable of detecting renal allograft dysfunction, but does not permit the determination of a specific cause.

Adult↗
PubMed1988

The histopathology of vulvar vestibulitis syndrome.

Forty-one cases of vulvar vestibulitis syndrome are presented. All cases were studied to provide a histopathological description of this condition in terms of location, intensity, and characterization of the inflammatory response. Alterations of the normal histology of minor vestibular glands forming vestibular clefts are described. The association of this condition with other disease processes, and special studies done to elucidate an etiology, are discussed.

Dyspareunia↗
PubMed1988

Two distinct pathologic types of giant cell tumor of the vulva. A report of two cases.

Giant cell carcinoma of the vulva has been described as a distinctive primary tumor of the vulva associated with multinucleated tumor giant cells and nuclear pleomorphism. These tumors have been reported to have a poorer prognosis than does squamous cell carcinoma, to which they are thought to be related. Two women were treated for primary vulvar malignancies possessing the morphologic features of giant cell tumor. Electron microscopy was not beneficial in distinguishing the tumors. A panel of immunoperoxidase procedures, including AE 1/3, 35 beta H-11, carcinoembryonic antigen, epithelial membrane antigen, HMB-45, S-100, leukocyte common antigen, placentalike alkaline phosphatase, alpha-1-antichymotrypsin and vimentin made it possible to distinguish the two tumors and characterized one as a nodular amelanotic melanoma with multinucleate tumor giant cells and the second as a squamous cell carcinoma with tumor giant cells. The latter term should replace the term giant cell carcinoma. Histologic criteria can help define this tumor.

Aged↗
PubMed1987

Clinical and pathologic features of polyarteritis nodosa and its renal-limited variant: primary crescentic and necrotizing glomerulonephritis.

This study supports the concept that primary necrotizing and crescentic glomerulonephritis is a kidney-limited form of polyarteritis nodosa. Thirty-four patients with necrotizing and crescentic glomerulonephritis were divided into three groups based on the presence or absence of systemic vasculitis as determined by clinical or histologic criteria. Laboratory studies demonstrated elevated erythrocyte sedimentation rates, anemia, mild eosinophilia, hematuria, and proteinuria in patients in each group; there were no significant differences in these data between the groups, however. Complement levels and antinuclear antibody screens were normal. Mean serum creatinine levels were markedly elevated but fell by a factor of two following therapy. There was a higher morbidity in the patients with kidney-limited disease. This was attributable to a higher percentage of these patients' having no symptoms and presenting for medical care only after they were in chronic renal failure. Most patients not experiencing chronic renal failure were treated with cyclophosphamide and prednisone, which seemed effective in this retrospective study.

Biopsy↗
PubMed1987

Polypoid tumor of the esophagus.

Five cases of an uncommon esophageal tumor consisting of a mucosal squamous cell carcinoma that surrounds a polypoid mass of spindle cells were examined. The spindle cell component was composed of elongated cells with blunt nuclei, admixed with multinucleated giant cells. Reticulin fibers enveloped individual cells, and abundant collagen was present. Thirteen to 69 mitotic figures occurred per 10 high-power fields. Electron microscopy showed dilated cisternae of rough endoplasmic reticulum and peripheral intermediate filaments within the cytoplasm. Intermediate-type junctions (zonulae adherens) and subplasmalemmal linear densities connected some cells. No tonofibrillar bundles or desmosomes (maculae adherens) were present. Immunoperoxidase stains detected no keratin in the spindle cells. Alpha-1-antichymotrypsin and alpha-1-antitrypsin were in the spindle cells in five of five and three of five cases, respectively. The absence of desmosomes, tonofibrillar bundles, and keratin and the presence of alpha-1-antitrypsin and alpha-1-antichymotrypsin favor fibrohistiocytic differentiation of the spindle cell component.

Carcinoma, Squamous Cell↗
PubMed1984

Thrombotic microangiopathy in anti-glomerular basement membrane glomerulonephritis.

A review was made of the clinical histories, treatment, and renal histologic features of 12 patients with anti-glomerular basement membrane antibody-induced glomerulonephritis (anti-GBM disease). Two patients had milder histopathologic changes in their kidney biopsy specimens and achieved clinical remission. The other ten patients with severe lesions in their biopsy specimens progressed to renal failure. In addition, vascular lesions of thrombotic microangiopathy were present in six of 12 patients. Six patients had clinical laboratory evidence of microangiopathic hemolytic anemia. There are two important points to be noted from this study. First, the kidney biopsy specimen may be a useful indicator of disease severity and prognosis. Second, clinical laboratory or histologic evidence of thrombotic microangiopathy may occur in 75% of patients with anti-GBM disease.

Adolescent↗
PubMed1983

Immunohistochemical detection of Trypanosoma cruzi in tissues of mice with experimental Chagas' disease.

We compared two immunoperoxidase procedures for the identification of Trypanosoma cruzi antigens in wax sections of infected mouse tissues. Both an indirect immunoperoxidase and an avidin-biotinated horseradish peroxidase complex (ABC) procedure gave identical patterns of localization. The ABC procedure could be used with greater dilutions of antisera than the indirect procedure. Individual organisms were clearly identified in the absence of inflammation at scanning magnifications. In addition, fragments of parasites were identified in inflammatory lesions. Therefore, this technique should be valuable in experimental and clinical situations when the identification of few organisms or fragments of organisms is required.

Animals↗
PubMed1983

Lymphoblastic lymphoma with the phenotype of common acute lymphoblastic leukemia.

Immunologic phenotyping of lymphoblastic lymphomas has shown that most of these are tumors of T-cell origin. In this report, we describe two patients with biopsy-proven lymphoblastic lymphoma whose tumors had no T-cell markers when tested by immunoperoxidase with a large panel of monoclonal antibodies. However, the tumor cells did express the common ALL antigen (CALLA), Ia antigen, and a 24,000 dalton ALL-associated antigen defined by monoclonal antibody DU-ALL-1. The tumor cells also lacked surface immunoglobulin. Although this phenotype is that seen in most cases of acute lymphoblastic leukemia, the patients were never leukemic at any time during their clinical course. Our results support the overall similarity between lymphoblastic lymphoma and acute lymphoblastic leukemia. Further, they suggest that it may be possible to identify prognostically significant immunologic subtypes of lymphoblastic lymphoma.

Adult↗
PubMed1983

Systemic kappa light-chain deposition. An ultrastructural and immunohistochemical study.

This report describes the pathology of kappa light-chain deposition in a 55-year-old patient who presented with respiratory insufficiency and hepatomegaly. Biopsies of lung and liver showed PAS-positive deposits which did not stain with congo red, crystal violet, or thioflavin-T. By indirect immunoperoxidase techniques, the deposits were composed of kappa light-chain immunoglobin. Electron microscopy revealed granular and fibrillar electron-dense material which lacked the characteristics of amyloid. Subsequent clinical studies showed this patient had a plasma cell dyscrasia. These data show that kappa light-chain deposition is not limited to the kidney, and that the first manifestation of a plasma cell dyscrasia may be systemic deposits of light chain. These deposits can be distinguished from amyloid by their immunochemical, tinctorial, and ultrastructural appearance.

Amyloidosis↗
PubMed1983

The possible occurrence of staphylococcal postinfectious glomerulonephritis in a renal allograft.

A 38-year-old male with a 5-year history of dialysis-dependent renal failure secondary to membranoproliferative glomerulonephritis, type I, received a cadaveric renal allograft from a 51-year-old male dying from acute trauma. A pretransplant biopsy of the donor kidney revealed no glomerular disease. One month after transplantation, the patient was discharged with a stable creatinine of less than 2.0 mg/dl, but subsequently developed positive urine cultures for Staphylococcus aureus and Escherichia coli and eventually underwent transplant nephrectomy. Blood cultures were positive postoperatively for S. aureus, and examination of the transplant nephrectomy showed ultrastructural, histological, and immunofluorescent findings characteristic of postinfectious glomerulonephritis. While numerous types of glomerular disease have been reported in kidney transplants, this report represents the first case suggestive of bacterial postinfectious type glomerulonephritis we have seen occurring de novo in a renal allograft.

Adult↗
PubMed1983

A fixative for use in muscle histochemistry.

A fixative solution that preserves the activity of some relevant enzymes in muscle histochemistry is described. Portions of human muscle biopsy specimens and selected murine muscles were fresh frozen or placed in the fixative at room temperature for up to 1 month before freezing. Cryostat sections of fresh frozen and fixed frozen tissue were assayed for nicotinamide adenine dinucleotide phosphate (NADH)-tetrazolium reductase (NADH), several adenosine triphosphatases (ATPases), myoadenylate deaminase (MD), and phosphorylase. NADH, ATPase, and MD activity were preserved following fixation but phosphorylase was not preserved. Murine spleen and kidney were similarly tested for acid phosphatase (acid phos), alkaline phosphatase (alk phos), and nonspecific esterase (NSE). Alk phos activity was preserved but acid phos and NSE activity were significantly reduced following fixation. This fixative is useful in some circumstances for processing or shipping human muscle biopsy specimens and experimental tissues.

Alkaline Phosphatase↗