The kidney disease of diabetes mellitus (KDDM): a cell and molecular biology approach.
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Biomedical subjects
Publications and source records attributed to C M Pesce.
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Mice transgenic for bovine growth hormone (bGH) develop an increase in body weight and glomerular lesions characterized by a disproportionate increment in glomerular volume and progressive mesangial sclerosis. The relationship between glomerular size and body growth in bGH mice was further investigated by examining mice transgenic for a mutated GH gene (bGH-m11) which failed to enhance body growth. The glomeruli in bGH-m11 mice exhibited an increase in size and glomerulosclerosis comparable to those found in bGH mice. The levels of alpha 1 type IV collagen mRNA, as measured by the competitive polymerase chain reaction in isolated microdissected glomeruli, were markedly elevated in mice transgenic for both bGH and bGH-m11 genes. These data suggest that body growth on one hand, and glomerular hypertrophy and sclerosis on the other hand, are mediated by different portions of GH or different second messenger signaling systems.
The evolution of glomerulosclerosis consists of a progressive increase in mesangial matrix with gradual glomerular obliteration. The sclerotic process is thought to be irreversible and include a progressive loss of glomerular cells. To investigate this process, we selected mice transgenic for bovine growth hormone because they develop progressive glomerulosclerosis and renal failure. The sequence of histologic events in the growth hormone mice consists initially of an increase in the number of centrolobular glomerular cells, followed by an accumulation of extracellular matrix. This is accompanied by an increase in glomerular size which is disproportionate to the overall increment in kidney or body weight. The [3H]thymidine labeling index of the cells of the glomerular tuft was assessed before the development of recognizable sclerosis and at a time when the sclerosis was far advanced. The labeling index was more than five-fold increased over controls at the early time point. Contrary to what was expected, the labeling index remained at the same high levels in densely sclerotic glomeruli at the late time point. In conclusion, increased cell turnover is a significant component of the sclerotic process both at the onset and in the late stages of this model.
Detection of an elevated prolactin level in the nonpregnant patient usually directs attention to the investigation of the pituitary gland. We describe a patient with secondary amenorrhea and galactorrhea in whom such an elevated prolactin level did initially lead to the discovery of a pituitary mass that was treated first unsuccessfully with surgery, and then successfully with medical therapy. After medical therapy normal menstruation continued, galactorrhea recurred intermittently, and the prolactin level rose again and remained in the approximately 36-micrograms/L range. However, 2 years later an ovarian teratoma was discovered incidentally and was removed surgically. On pathological evaluation the teratoma was noted to include prolactin-containing tissue, and immediately after surgery the patient's prolactin level and responsiveness to stimulatory testing returned to normal. To our knowledge this is the first case report of the association of clinically evident hyperprolactinemia with an ovarian cystic teratoma that contained prolactin-producing tissue.
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The surface area per unit volume (Sv), mean thickness (T), and mean length per unit volume (Lv) of the fibrous septa were measured in 15 liver specimens with micronodular cirrhosis, and the allometric equations of Lv on T and of Lv on Sv were calculated. The results supported the view that increases in extension of the surface of the septa were mainly related to increases in their lengths, while thickening of the septa called for relatively short septa of low Lv. As a result, two growth patterns could be recognized in the fibrous septa of cirrhosis. The first one was characterized by collagen deposition around the septa, leading to their thickening; the second one was characterized by elongation of the septa, leading to slender septal branches.
A 54-year-old man had intermittent evening fever, arthralgia, transient erythematous macular eruption on the skin, and splenomegaly of two year's duration. Immunofluorescence tests for Borrelia burgdorferi serum antibodies had positive results, but G-penicillin treatment was ineffective. Splenectomy with lymph node biopsy was performed to rule out lymphoproliferative disorders. Borrelia-like spirochetes were identified histologically in the spleen; this finding was consistent with persistence of B. burgdorferi organisms in inner organs in chronic Lyme disease.
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The volume of the adenomatous mucosa (V), the area of the surface epithelium (Ss), the area of the glandular epithelium (Sg), and the Sg: Ss ratio were calculated in a series of 14 adenomatous polyps (APs) of a case of multiple polyposis of the colon. The equation of simple allometry was used to study the relative growth of the four series of values. Ss grew isometrically with size; Sg overgrew Ss and accounted for most of the increase in V. The Sg:Ss ratio increased with Sg and V.
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A testicular biopsy is often useful in male infertility to evaluate the degree of damage and the patient's prognosis. The major issues in the interpretation of the histologic specimens are the adoption of a simple reproducible classification of testicular abnormalities, and the recognition of specific causes of damage. This review is concerned with the clinical scope of testicular biopsy for infertility, the technical handling of the specimen, and a practical stepwise approach to the histologic diagnosis.
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This study was conducted to evaluate morphometrically the microscopic components of the testis in cases of varicocele, the leading cause of male infertility, with the aim to identify consistent differences from controls. In our specimens of patients with varicocele, the vascular and interstitial fractions, as well as the Leydig cell count, were significantly increased. Our data support the notion that the interstitium is the testicular compartment most consistently affected and that the damage to the tubules is erratic and probably late.
This work is concerned with new morphologic data pointing to an immune component in the pathogenesis of pseudomembranous colitis. The focal distribution of the pseudomembranes suggests selective damage induced by Clostridium difficile toxins. The sites of attachment to the mucosa correspond anatomically to the intestinal structures specialized for immune information and response. Furthermore, viable IgA production supports the view that toxins are carried to lymphoid aggregates where plasma cell proliferation takes place. A sharp increase in the mast cell population of the colon is also reported. Mast cells, whose role in the pathogenesis of intestinal diseases is still obscure, are diffusely distributed, irrespective of the focal lesions of pseudomembranous colitis.