The diagnostic yield of transjugular renal biopsy. Experience in 200 cases

Renal histology remains the keystone of diagnosis in most parenchymal renal diseases and especially in glomerulopathies [1–3]. Sampling of renal tissue by percutaneous needle biopsy was described by Iversen and Brun in 1951 [4]. This procedure is usually safe, provided contraindications are respected [5–10]. Such contraindications include uncontrolled hypertension and/or bleeding disorders, which can favor severe perirenal hematoma. Even when these contraindications are heeded, systematic computerized tomography (CT) showed that the incidence of perirenal hematoma discovered by CT scan (irrespective of its clinical manifestation) is 57 to 85% [11, 12].In the absence of contraindications, there are patients in whom the slightest possibility of a complication necessitating lombotomy for hemostasis would be ethically incompatible with renal biopsy. This is the case, for instance, in patients with morbid obesity or with chronic respiratory insufficiency, in whom general anesthesia might represent a considerable hazard. Finally, there are cases where the size or the anatomical location of the kidney makes renal tissue sampling difficult or impossible. Ultrasound or CT scan-guided biopsy [13–15] does not always obviate such pitfalls. Other, more invasive methods have been proposed to sample kidney tissue, for instance by means of a short lombotomy [16–21], but this approach, which in addition necessitates the use of an operating room and several days of hospitalization, is similarly inapplicable in a patient with severe bleeding disorder or morbid obesity.We have described a novel technique of renal biopsy using the transjugular route, inspired from that used for liver biopsy in patients with clotting disorders in whom the percutaneous route would similarly be precluded [22–24]. This new technique was published in abstract form [25], and we reported our preliminary results on 50 cases [26]. The goal of this Technical Note is to analyze our present experience on 200 procedures carried out in 195 patients

Potentialités de Termitaria coronata Thaxter, 1920 (Deutéromycètes, Termitariales) pour la lutte biologique contre les Termites (Isoptera)

Potentialities of Termitaria coronata Thaxter, 1920 (Deuteromycetes, Termitariales) for biological control against Termites (Isoptera). Termitaria coronata Thaxter, 1920, is observed on the 0.95% of Nasutitermes banksi, 2.5% of N. ephratae, 2% of N. guayanae, 4.6% of N. nigriceps and 1.7% of N. surinamensis. Among 600 examined specimens of termites belonging to these five species of Nasutitermes from French Guyana, about 2,3 % were infected by T. coronata. The infected antennae have a considerable inflammation and an important deformation. The presence of T. coronata on the articulations handicapped mechanically the termite. Inflammations and malformations are more important on the head than on the other parts of the body. The degradations of the epidermal cells are considerable.Sur 600 individus examinés de cinq espèces de Nasutitermes de Guyane française, environ 2,3% sont infectés par le champignon Termitaria coronata Thaxter, 1920. Les antennes infestées ont une inflammation considérable et une déformation. L'infestation des articulations handicape souvent ces termites. L'inflammation et les malformations sont plus importantes sur la tête que sur le reste du corps. Les dégradations des cellules épidermiques sont considérables.Ensaf Alireza, Callard Patrice, Bourée Patrice. Potentialités de Termitaria coronata Thaxter, 1920 (Deutéromycètes, Termitariales) pour la lutte biologique contre les Termites (Isoptera). In: Bulletin de la Société entomologique de France, volume 111 (1), mars 2006. pp. 43-49

Potentialités de Termitaria coronata Thaxter, 1920 (Deutéromycètes, Termitariales) pour la lutte biologique contre les Termites (Isoptera)

Potentialities of Termitaria coronata Thaxter, 1920 (Deuteromycetes, Termitariales) for biological control against Termites (Isoptera). Termitaria coronata Thaxter, 1920, is observed on the 0.95% of Nasutitermes banksi, 2.5% of N. ephratae, 2% of N. guayanae, 4.6% of N. nigriceps and 1.7% of N. surinamensis. Among 600 examined specimens of termites belonging to these five species of Nasutitermes from French Guyana, about 2,3 % were infected by T. coronata. The infected antennae have a considerable inflammation and an important deformation. The presence of T. coronata on the articulations handicapped mechanically the termite. Inflammations and malformations are more important on the head than on the other parts of the body. The degradations of the epidermal cells are considerable.Sur 600 individus examinés de cinq espèces de Nasutitermes de Guyane française, environ 2,3% sont infectés par le champignon Termitaria coronata Thaxter, 1920. Les antennes infestées ont une inflammation considérable et une déformation. L'infestation des articulations handicape souvent ces termites. L'inflammation et les malformations sont plus importantes sur la tête que sur le reste du corps. Les dégradations des cellules épidermiques sont considérables.Ensaf Alireza, Callard Patrice, Bourée Patrice. Potentialités de Termitaria coronata Thaxter, 1920 (Deutéromycètes, Termitariales) pour la lutte biologique contre les Termites (Isoptera). In: Bulletin de la Société entomologique de France, volume 111 (1), mars 2006. pp. 43-49

Etude de la vascularisation dans les cancers bronchiques non-à petites cellules (CBNPC) et ses conséquences sur l' expression génique intratumorale

PARIS-BIUSJ-Thèses (751052125) / SudocPARIS-BIUSJ-Physique recherche (751052113) / SudocSudocFranceF

Etude phénotypique des cellules myoépithéliales des glandes salivaires normales et tumorales

Nous rapportons les résultats de 3 études consacrées à la caractérisation des cellules myoépithéliales (CM) des glandes salivaires et à leur fonction éventuelle dans le développement tumoral. Nous avons d abord démontré par double marquage (68 tumeurs des glandes salivaires, 6 tissus contrôles) l existence dans 92% des tumeurs testées, d une immunoréactivité nucléaire de la p63 dans les compartiments cellulaires CM, et les cellules basales canalaires (CB), et une absence de réactivité au niveau des cellules luminales (adénomes pléomorphes, adénomes à cellules basales, carcinomes adénoïdes kystiques, carcinomes à cellules myoépithéliales). En ce qui concerne les carcinomes mucoépidermoïdes (CME), CB, cellules squameuses et intermédiaires expriment la p63. Il en est de même pour les CB des tumeurs de Whartin et des oncocytomes. Nous avons ensuite analysé l activation de la voie ERK-1/ERK-2 dans les CME (57 CME, et 37 tissus contrôles,) et étudier son expression au niveau du contingent CM. La voie ERK-1/ERK-2 est activée dans les CME, et significativement corrélée de façon indépendante à l agressivité tumorale. Il existe une expression de l ERK-1/ERK-2 phosporylés au niveau des cellules intermédiaires des CME, considérées comme des CM modifiées. Nous avons enfin, à partir de la constitution de tissue arrays testé au niveau de 150 adénomes pléomorphes et leurs tissus contrôles, l expression de : PS100, actine, p63, des CK : AE1/AE3, 7, 5/6, 10/13, 8, 18, 19, 34 beta E12, MIB-1, MUC-1, Notch1, jagged1 et le bleu alcian. L analyse par classification hiérarchique a permis de définir des profils d expression des différents compartiments normaux de l arbre salivaire et au niveau des tumeurs de distinguer deux grands clusters sans corrélation significative (p=0,1) avec l indice de prolifération mesuré par MIB-1. La comparaison des profils d expression des compartiments normaux et des clusters rencontrés, laisse à penser que la fonction de la CM dans le développement des adénomes pléomorphes est probablement surestimée par rapport à celle des CB des canaux striés.In order to characterize the salivary gland (SG) myoepithelial cells (MC) and their tumor development relationship, we reported 3 consecutive studies. First we demonstrated by immunostaining (68 SG tumors, and 6 normal samples) a p63 nuclear staining in MC and in duct basal cells (BC) among 63/68 tumors, and the absence of staining in luminal cells (pleomorphic adenomas, basal cell adenomas, adenoid cystic carcinomas, epithelial-myoepithelial carcinomas). Moreover, in mucoepidermoid carcinomas (MEC), BC, squamous and intermediate cells express p63. Likewise, BCs are reactive in Warthin tumors and oncocytomas. Next we analyzed ERK-1/ERK-2 pathway activation in MEC (57 MEC, and 37 normal samples) and examined its expression at the MC level. ERK-1/ERK-2 pathway is activated in MEC, and significantly correlated to aggressive tumor behavior. Phosphorylated ERK-1/ERK-2 is noted in MEC intermediate cells, considered as modified MCs. Finally, we studied on tissue arrays (150 pleomorphic adenomas and their normal counterpart) the expression of: PS100, actin, p63, cytokeratins: AE1/AE3, 5/6, 7, 8, 10/13, 18, 19 and 34bE12, MIB-1, MUC-1, Notch1, Jagged1 and alcian blue. Hierarchical classification-analyses allowed us to define expression profiles of the different salivary gland compartments and clustered the tumors in 2 major categories, not significantly (p=0.1) associated with the labeling tumor index (MIB-1). Comparative study of normal compartment s and tumor s profile questioned MC versus BC of striated ducts function.PARIS-BIUSJ-Thèses (751052125) / SudocPARIS-BIUSJ-Physique recherche (751052113) / SudocSudocFranceF

Nouvel apport à la morphologie d'un champignon ecto-parasite et pathogène : <I>Termitaria coronata</I> Thaxter (Termitariales, Deuteromycetes)

The morphology of Termitaria coronata Thaxter was studied by scanning and transmission electron microscopy. The plates of T. coronata can be found on all parts of the body of the termite, particularly on the antenna, on the head and the legs. The sub-base consists of thousands of independent chlamydospores (haustorium mother cell), the majority showing a haustorium, able to perfore the cuticle of the termite. At the base of haustorium the chlamydospore presents two concentric valves. Their three-dimensional morphological structure is shown for the first time by this study.La morphologie du Termitaria coronata Thaxter a été étudiée en microscopies électroniques à balayage et à transmission. Les plaques de T. coronata peuvent se situer sur la totalité du corps du termite, particulièrement sur les antennes, la tête et les pattes. En coupe, la couche inférieure apparaît constituée de milliers de chlamydospores (cellules mères de l\u27haustorium) indépendantes les unes des autres, chacune produisant à son extrémité un haustorium capable de traverser la cuticule du termite. À la base de cet haustorium, la chlamydospore présente deux valves concentriques. Leur structure morphologique tridimensionnelle est décrite pour la première fois dans cette étude.</p

Altered Pattern of Major Histocompatibility Complex Expression in Renal Carcinoma : Tumor-Specific Expression of the Nonclassical Human Leukocyte Antigen-G Molecule Is Restricted to Clear Cell Carcinoma While Up-Regulation of Other Major Histocompatibility Complex Antigens Is Primarily Distributed in All Subtypes of Renal Carcinoma

Renal epithelial cancers represent a heterogeneous group of neoplasms arising from the malignant transformation of presumed diverse cell lineages. We recently demonstrated that tumor-specific up-regulation of human leukocyte antigen (HLA)-G, a nonclassical HLA class Ib molecule that might be involved in immune evasion by tumor cells, frequently occurs in conventional (clear cell) renal carcinoma. We here examined whether HLA-G activation is a common process affecting all types of renal epithelial tumors. We analyzed a series of 38 paraffin-embedded tumors including clear cell, papillary, chromophobe, collecting duct carcinoma, and oncocytoma. Seven of 12 (58%) clear cell tumors were positive by immunohistochemistry, whereas all of the other subtypes of renal carcinoma were negative for HLA-G expression. Developing or adult normal renal tissue were devoid of HLA-G expression. We also observed that ectopic expression of HLA class II antigens occurs more frequently in clear cell renal carcinoma than in other subtypes of renal tumors. Moreover, in contrast to the common observation of a down-regulation of major histocompatibility complex class Ia antigens reported in various tumors, the concomitant study of the same biopsies for classical HLA class Ia antigen expression revealed a general increase of HLA class Ia expression, regardless of histological subtypes. These results provide evidence for the heterogeneity of major histocompatibility complex expression patterns in renal carcinoma and support the hypothesis that specific mechanisms underlying the malignant transformation into clear cell renal carcinoma up-regulate expression of HLA-G and to a lesser extent HLA class II molecule expression. Considering the immunotolerant role of HLA-G toward the immune response, these mechanisms may thus provide renal cell carcinoma tumor cells with additional means to escape immune surveillance

Renal arterial resistive index is associated with severe histological changes and poor renal outcome during chronic kidney disease.

International audienceUNLABELLED: ABSTRACT: BACKGROUND: Chronic kidney disease (CKD) is a growing public health problem and end stage renal disease (ESRD) represents a large human and economic burden. It is important to identify patients at high risk of ESRD. In order to determine whether renal Doppler resistive index (RI) may discriminate those patients, we analyzed whether RI was associated with identified prognosis factors of CKD, in particular histological findings, and with renal outcome. METHODS: RI was measured in the 48 hours before renal biopsy in 58 CKD patients. Clinical and biological data were collected prospectively at inclusion. Arteriosclerosis, interstitial fibrosis and glomerulosclerosis were quantitatively assessed on renal biopsy in a blinded fashion. MDRD eGFR at 18 months was collected for 35 (60%) patients. Renal function decline was defined as a decrease in eGFR from baseline of at least 5 mL/min/ 1.73 m2/year or need for chronic renal replacement therapy. Pearson's correlation, Mann-Whitney and Chi-square tests were used for analysis of quantitative and qualitative variables respectively. Kaplan Meier analysis was realized to determine renal survival according to RI value using the log-rank test. Multiple logistic regression was performed including variables with p 20% (p = 0.014) and renal function decline (p = 0.0023) had higher RI. Patients with baseline RI ≥ 0.65 had a poorer renal outcome than those with baseline RI < 0.65 (p = 0.0005). In multiple logistic regression, RI≥0.65 was associated with accelerated renal function decline independently of baseline eGFR and proteinuria/creatininuria ratio (OR=13.04 [1.984-85.727], p = 0.0075). Sensitivity, specificity, predictive positive and predictive negative values of RI ≥ 0.65 for renal function decline at 18 months were respectively 77%, 86%, 71% and 82%. CONCLUSIONS: Our results suggest that RI ≥ 0.65 is associated with severe interstitial fibrosis and arteriosclerosis and renal function decline. Thus, RI may contribute to identify patients at high risk of ESRD who may benefit from nephroprotective treatments

Immunoglobulin deposition disease with a membranous pattern and a circulating monoclonal immunoglobulin G with charge-dependent aggregation properties

A 62-year-old woman presented with nephrotic syndrome, monoclonal gammopathy, and membranous-like nephropathy with nonorganized deposits composed of monoisotypic immunoglobulin G1 lambda protein. Nephrotic syndrome remitted after a brief course of treatment with melphalan despite ongoing production of the monoclonal protein. The circulating monoclonal immunoglobulin G1 lambda showed unusual in vitro aggregation properties, including dependence on low ionic strength and neutral pH, suggesting that electrostatic interactions had a role in the precipitation process. This case illustrates the importance of looking for monoclonal immunoglobulin deposits when kidney biopsy findings are suggestive of membranous nephropathy. In addition, our in vitro demonstrations of the role of physicochemical factors in immunoglobulin precipitation help elucidate the pathogenesis of immunoglobulin deposition disorders. Although binding to podocyte antigens is a well-recognized determinant of subepithelial immunoglobulin deposition, proneness to aggregation as described in this case also might be nephritogenic