Renal crystal deposits and histopathology in patients with cystine stones

We have biopsied the papillae of patients who have cystine stones asking if this stone type is associated with specific tissue changes. We studied seven cystine stone formers (SF) treated with percutaneous nephrolithotomy using digital video imaging of renal papillae for mapping and obtained papillary biopsies. Biopsies were analyzed by routine light and electron microscopy, infrared spectroscopy, electron diffraction, and micro-CT. Many ducts of Bellini (BD) had an enlarged ostium, and all such were plugged with cystine crystals, and had injured or absent lining cells with a surrounding interstitium that was inflamed to fibrotic. Crystal plugs often projected into the urinary space. Many inner medullary collecting ducts (IMCD) were dilated with or without crystal plugging. Apatite crystals were identified in the lumens of loops of Henle and IMCD. Abundance of interstitial Randall's plaque was equivalent in amount to that of non-SF. In the cortex, glomerular obsolescence and interstitial fibrosis exceeded normal. Cystine crystallizes in BD with the probable result of cell injury, interstitial reaction, nephron obstruction, and with the potential of inducing cortical change and loss of IMCD tubular fluid pH regulation, resulting in apatite formation. The pattern of IMCD dilation, and loss of medullary structures is most compatible with such obstruction, either from BD lumen plugs or urinary tract obstruction from stones themselves

Probing surfaces with thermal He atoms: scattering and microscopy with a soft touch

Helium atom scattering (HAS) is a well established technique, particularly suited for the investigation of insulating and/or fragile materials and light adsorbates including hydrogen. In contrast to other beam techniques based on Xrays or electrons, low energy (typically less than 100 meV) He atoms are scattered by the tail of the electron density distribution which spill out from a surface, therefore HAS is strictly a nonpenetrating technique without any sample damage. HAS has been used to investigate structural properties of crystalline surfaces, including precise determination of atomic step heights, for monitoring thin film growth, to study surface transitions such as surface melting and roughening and for determining the presence and properties of adsorbates. Energy resolved HAS can provide information about surface vibrations (phonons) in the meV range and surface diffusion. This chapter provides a brief introduction to HAS with an outlook on a new, promising surface science technique: Neutral Helium Microscopy