Renal papillary carcinoma developed in a kidney transplant recipient with late IgA-nephropathy

With improvements in immunosuppressive therapy, patient and graft survival in renal transplant recipients have been prolonged. Increasing donor age and patient survival rates have been related to an increase in the number of de novo tumors. Posttransplant malignancy in these patients is an important cause of graft loss and death in these patients. Among cancers occurring after a kidney transplant, renal cell carcinoma is the fifth most common malignancy after lymphoproliferative disorders, and skin, gastrointestinal, and lung cancers. When nonmelanoma skin cancers and in situ carcinoma of the cervix are excluded from malignancies, renal cell carcinoma accounts for 2% of all cancers in the general population, which increases to 5% in solid-organ recipients. The majority of renal cell carcinomas found in transplant recipients develop in the recipient 's native kidneys, but only 9% of tumors develop in the allograft itself. Tumors transmitted by donors represent only 0.02% to 0.2% of cases. Most de novo allograft renal cell carcinomas are single tumors. The mechanisms of development of renal cell carcinoma in renal grafts are not completely understood

A study on affect model validity : nominal vs ordinal labels

The question of representing emotion computationally remains largely unanswered: popular approaches require annotators to assign a magnitude (or a class) of some emotional dimension, while an alternative is to focus on the relationship between two or more options. Recent evidence in affective computing suggests that following a methodology of ordinal annotations and processing leads to better reliability and validity of the model. This paper compares the generality of classification methods versus preference learning methods in predicting the levels of arousal in two widely used affective datasets. Findings of this initial study further validate the hypothesis that approaching affect labels as ordinal data and building models via preference learning yields models of better validity.peer-reviewe

Preimplantation biopsy predicts delayed graft function, glomerular filtration rate and long-term graft survival of transplanted kidneys

Background The predictive value of preimplantation biopsies for long-term graft function is often limited by conflicting results. The aim of this study was to evaluate the influence of time-zero graft biopsy histological scores on early and late graft function, graft survival and patient survival, at different time points. Methods We retrospectively analyzed 284 preimplantation biopsies at a single center, in a cohort of recipients with grafts from live and deceased donors (standard and nonstandard), and their impact in posttransplant renal function after a mean follow-up of 7 years (range 1–16). Implantation biopsy score (IBS), a combination score derived from 4 histopathological aspects, was determined from each sample. The correlation with incidence of delayed graft function (DGF), creatinine clearance (1st, 3rd and 5th posttransplant year) and graft and patient survival at 1 and 5 years were evaluated. Results Preimplantation biopsies provided somewhat of a prognostic index of early function and outcome of the transplanted kidney in the short and long term. In the immediate posttransplantation period, the degree of arteriolosclerosis and interstitial fibrosis correlated better with the presence of DGF. IBS values between 4 and 6 were predictive of worst renal function at 1st and 3rd years posttransplant and 5-year graft survival. The most important histological finding, in effectively transplanted grafts, was the grade of interstitial fibrosis. Patient survival was not influenced by IBS. Conclusions Higher preimplantation biopsy scores predicted an increased risk of early graft losses, especially primary nonfunction. Graft survival (at 1st and 5th years after transplant) but not patient survival was predicted by IBS

Renal parenchymal resistance in patients with biopsy proven glomerulonephritis: correlation with histological findings

Renal Doppler ultrasound is increasingly used in nephrology for the evaluation of renovascular disease, allograft dysfunction, and chronic nephropathies. We compared intrarenal hemodynamic parameters to biopsy findings of glomerular sclerosis, tubular atrophy, interstitial fibrosis, crescents, arteriolosclerosis, and clinical variables in 100 patients. A positive correlation exists between renal function and percentage of glomerular sclerosis (P <0.01, r = 0.26), conversely a negative correlation exists between glomerular filtrate rate and percentage of glomerular sclerosis(P <0.0001, r = -0.35). The percentage of glomerular sclerosis correlate positively with pulsatile index (PI) (P <0.05, r = 0.21) and renal resistive index (RI) (P <0.05, r = 0.20). The percentage of crescents correlates positively with PI(P <0.05, r = 0.21) and RI (P <0.05, r = 0.20). Classifying arteriolosclerosis in four groups according to a severity scale, from absence to severe, PI (P <0.05) and RI (P <0.01) were significantly different. In the post hoc analysis, the median values of PI and RI are significantly different in patients with severe arteriolosclerosis than others. Ultrasound examination is a non-invasive diagnostic technique used on patients with suspected or established renal disease. Our study shows a close correlation between kidney function, ultrasound parameters, and histological findings. Measurement of renal parenchymal resistance by ultrasound could be used in association with biopsy and glomerular function for the evaluation of renal damage in patients with glomerulonephritis

Climate Change Dependence in Ex Situ Conservation of Wild Medicinal Plants in Crete, Greece

Over 80% of the global population addresses their primary healthcare needs using traditional medicine based on medicinal plants. Consequently, there’s a rising demand for these plants for both household and industrial use at local, regional, national, and international levels. However, wild harvesting has negatively impacted natural ecosystems. Cultivating medicinal species has been proposed as a conservation strategy to alleviate this pressure. Yet, in this age of global climate change concerns, smallholder farmers’ views on the benefits of such cultivation clash with the uncertainties of climate change impacts, amplifying their anxieties. In this context, the climate change dependence of ex situ cultivation of ten wild medicinal taxa with significant ethnopharmacological interest in Crete, Greece, were studied, projecting their potential habitat suitability under various future climate scenarios. The results demonstrated species-specific effects. Based on the potential cultivation area gains and losses, these effects can be categorized into three groups. We also outlined the spatial patterns of these gains and losses, offering valuable insights for regional management strategies benefiting individual practitioners

The renal pathology in light chain deposition disease

Light Chain Deposition Disease (LCDD) is a relatively frequent renal disease associated with dysproteinemia. Although the light chain deposits can be widespread, the kidney is the most frequently involved organ, and renal involvement can dominate the clinical condition. The morphological features of LCDD can be recognized by light microscopy; however, the diagnosis can be made certain only by immunofluorescence microscopy, using antisera to kappa and lambda chains, and by electron microscop

Glomerulosclerosis: pathogenetic mechanisms and possibility of regression

Glomerular sclerosis means an increase in the extracellular matrix of the glomerulus. It is a complex, heterogeneous phenomenon with multiple cellular and biochemical mechanisms and different morphological patterns, depending on a variety of local and systemic factors. The term as such does not indicate the quantity nor the type of components of the deposited matrix. The amount of extracellular matrix increases in three types of events: - matrix deposition in areas that were destroyed by a necrotizing process (scars following glomerular necrosis); - matrix deposition in glomerular regions where matrix is normally found (mesangium, glomerular basement membranes) as seen in diabetic nephropathy; - matrix deposition inside or around collapsing capillaries involving the entire glomerulus or a segment of it (focal segmental glomerular sclerosis with nephrotic syndrome). Knowledge of the diverse morphological patterns producing glomerular sclerosis and the cellular and molecular mechanisms involved is essential for obvious reasons: they represent the rationale for any therapy aimed at preventing or reducing the progression of sclerosis and can provide a starting point to determine which forms are, at least potentially, reversible

Histopathology of Lupus Nephritis

The spectrum of morphologic changes in lupus nephritis, either microscopic, ultrastructural, or immunohistological, closely reflects the great variety of immune complexes that are produced in the course of the disease. Every tissue component of the kidney can be affected, but glomeruli are the target structure in most patients. Several attempts have been made to correlate the clinical severity and the outcome of the nephritis with the pathologic features; the current classification and the six classes that resulted from an international study group are entirely based on glomerular changes. Major criteria of classification include the focal or diffuse involvement of the glomerulus, the site of hypercellularity, the site of immune complex deposition and the presence of active and/or sclerotic lesions. Even if less thoroughly investigated than the glomerulus, the interstitial compartment has revealed many interesting features as are vascular lesions, a common and often underestimated feature. Typing of subpopulation of lymphoid infiltrates supports the emerging evidence indicating that B cells are promoting autoimmunity in mechanisms other than autoAb secretion. Many aspects are still debated and/or poorly understood, such as the interpretation of the so-called "full house nephropathy" that closely mimic lupus nephritis in seronegative patients

Blocking glomerular immunoglobulin deposits in a mouse model of lupus nephritis on indirect immunofluorescence with the use of Fab fragments

One of the most characterized models of murine lupus nephritis is the [NZB x NZW] F1 female hybrid. Extended glomerular IgG deposits may pose an obstacle in studying molecules of interest via indirect immunofluorescence due to secondary antibodies non-specific binding to deposited IgG molecules. Application of Fab fragments may mitigate non-specific interactions in this mouse model. Specifically we provide evidence that blocking paratopic interactions of secondary antibodies with indigenous glomerular IgG deposits is possible. However the blocking effect seems to be related to the species used for secondary antibody production. Increased secondary antibody host species homology with the mouse could make blocking of non-specific binding via the use of Fab fragments impossible in this mouse model. (c) 2011 Elsevier B.V. All rights reserved