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J Churg

Publications and source records attributed to J Churg.

At least 37 records · Page 2Linked to original sources
PubMed1990

Morphometric analysis of glomerular basement membranes (GBM) in thin basement membrane disease (TBMD).

We measured the thickness of glomerular basement membrane in 46 patients with thin basement membrane disease (TBMD), (age range 15-50 years, almost equal M:F ratio), and compared with that in a control group of 5 patients (age range 5-38 years) with normal glomerular morphology. The measurements of glomerular basement membrane taken from electron micrographs (magnification x 12,500) were analyzed using an interactive image analysis system assembled around an INTEL 10 microcomputer, with a high resolution touch sensitive screen as the interactive peripheral. Calculation was done by printing on an electron micrograph a grating replica (21,600 lines/cm), with the same magnification as the electron micrographs of the glomeruli and calibrating the arithmetic (AM) and harmonic (HM) mean for each case. Comparing the results of TBMD cases (AM 129-202 nm; HM 128-213 nm) with those of the control group consisting of 5 cases of "minimal change nephrotic syndrome" (AM 287-317 nm; HM 300-333 nm) it was found that GBM in TBMD is remarkably thin. The thinning was caused mainly by the decreased width of the lamina densa (TBMD group: 71.4-147.0 nm; HM 72.4-154.4 nm in comparison with the control group: AM 174.4-235.5 nm; HM 184.2-249.6 nm). This finding allows us to differentiate thin basement membrane disease from other glomerulopathies presenting primarily with isolated or recurrent hematuria.

Adolescent↗
PubMed1989

Kidney biopsy in SLE. I. A clinical-morphologic evaluation.

The relationship between renal morphology and clinical disease was analysed in 148 patients with SLE attending a lupus clinic. Patients were not selected for renal disease. Renal tissue was assessed according to the World Health Organization classification of lupus nephritis, the presence of active and chronic lesions was recorded and disease activity was measured according to a standard protocol. All sections of the classification were represented in this group of patients. Active and chronic lesions were more likely to occur among patients with Class III/IV (proliferative glomerulonephritis), than in any other category. Patients with Class III/IV biopsy were more likely to have evidence of clinical renal disease than patients in Class II (mesangial). However, almost half of the Class II patients had some evidence of renal disease, including elevated serum creatinine, as well as important non-glomerular lesions. Without biopsy they might have been thought to have proliferative lesions and been treated more aggressively. Two patients with proliferative glomerulonephritis had no clinical evidence of renal disease. Thus, at the time of biopsy results renal histological examination did not uniformly correlate with clinical renal disease.

Adolescent↗
PubMed1988

Immunohistochemical localization of renin in end-stage kidneys.

Hypertension in chronic renal failure is usually due to excessive accumulation of salt and water. In some cases, sodium and volume depletion by dialysis fail to reduce the high BP, and plasma renin activity tends to be higher. We performed a semiquantitative analysis of the immunohistochemical distribution of renin in the kidneys of ten patients with end-stage renal disease and hypertension using a specific antihuman renin antibody and a peroxidase-antiperoxidase technique on paraffin sections of nephrectomy and/or autopsy specimens. In five cases with severe, dialysis-resistant hypertension, the degree of immunoreactivity was most striking, exceeding that found in renovascular hypertension and present in arterioles at a distance from the glomeruli. Three cases of advanced diabetic glomerulosclerosis consistently showed minimal immunoreactivity. We conclude that renin often can be detected immunologically in the kidney of patients with chronic renal failure and hypertension, but its pathophysiological role will require further study.

Adolescent↗
PubMed1988

Nephropathy after combination chemotherapy of lymphoma.

Two patients with malignant (Hodgkin's and non-Hodgkin's lymphoblastic type) lymphoma developed chronic renal failure following prolonged combination chemotherapy and a course of radiotherapy to the para-aortic lymph nodes. The individual drugs used in both patients are believed to have very low or no nephrotoxic potential. The kidneys were shielded in a standard manner and no more than 200 rads reached the organs. On biopsy (1 patient) and at autopsy (both patients), the kidneys demonstrated diffuse tubular atrophy, extensive interstitial fibrosis and focal glomerular changes with crescents. There were also severe sclerotic changes in the arteries. The changes bore some similarity to, but were not identical with those seen with radiation nephritis. They probably represent a radiomimetic effect produced by prolonged and repeated combination chemotherapy, perhaps potentiated by the small amount of ionizing radiation.

Adult↗
PubMed1987

Case 18-1987.

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Diagnosis, Differential↗
PubMed1986

Renal papillary necrosis: relapsing form associated with alcoholism.

Described is a patient with recurrent renal papillary necrosis and chronic alcoholism as a possible precipitating factor. The case also demonstrates excellent recovery of renal function, despite considerable scarring of the parenchyma secondary to repeated episodes of sloughing of the papillae.

Alcoholism↗
PubMed1985

Use of lectins in the study of histogenesis of renal cysts.

Two peroxidase-labeled lectins, from Tetragonolobus lotus and from peanut (Arachis hypogaea), were used in the study of five cases of polycystic kidney of different types. The two lectins bind with high selectivity of proximal tubules and collecting ducts, respectively. It was found that in infantile polycystic kidneys the cyst walls consistently stained with peanut lectin but not with Tetragonolobus lectin, confirming their origin from collecting ducts only. In adult polycystic kidneys there was mixture of two types of cysts: one positive for peanut, the other positive for Tetragonolobus. The two lectins were, however, mutually exclusive. Moreover, some cysts did not stain for either lectin. The findings suggest that in this type of disease a cyst can originate from any portion of the nephron. The data are also consistent with reports in the literature which used microdissection techniques or chemical analysis of the cyst content. The use of lectins will probably be useful in investigating other types of cystic kidneys, such as dysplastic kidneys and experimental models. The technique is relatively easy to use, but must be applied under strictly controlled conditions, especially when using surgical or postmortem material.

Adult↗
PubMed1984

Active and chronic phases of Berger's disease (IgA nephropathy).

Berger's disease, or IgA nephropathy, is generally considered as pursuing a chronic course, often with recurrent attacks of gross hematuria or persistent microscopic hematuria. However, little attention has been paid to the acute changes that may accompany this nephropathy, and there are few reports of follow-up renal biopsy studies in these patients. We have had the opportunity to study two patients with Berger's disease (IgA nephropathy) in whom initial and follow-up renal biopsy studies were available. Both of these patients presented clinically with gross hematuria and moderately heavy proteinuria. In both cases, the initial renal biopsy disclosed diffuse mesangial proliferation associated with crescent formation, while follow-up biopsy disclosed only mild mesangial proliferation and no crescents. In one case electron microscopy revealed prominent subendothelial and small mesangial deposits in the initial biopsy, which became almost solely large mesangial in the second biopsy. The other case demonstrated only mesangial deposits in both biopsies.

Acute Disease↗
PubMed1984

Renal biopsies in cystic fibrosis.

Pharmacokinetic studies on antibiotics as well as other studies on renal function indicate renal malfunction in cystic fibrosis. Renal biopsies from two children, and post mortem examination from one child, with this disorder were normal by light microscopy and close to normal by immunofluorescence examination and transmission and scanning electron microscopy, even in cases with advanced disease and marked renal malfunction. Renal biopsy interpretation thus seems to be of little value in the evaluation of renal malfunction in this disorder, and this suggests that the functional abnormalities are caused by metabolic/biochemical defects.

Adolescent↗
PubMed1983

Mesangiolysis.

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Aneurysm↗