Biomedical subjects
J Churg
Publications and source records attributed to J Churg.
Nomenclature of vasculitic syndromes: a historical perspective.
Since the original description of periarteritis nodosa (PAN) in 1866, the number of recognized forms of so-called idiopathic vasculitis has risen to about a dozen. Their relation to each other and their nature remain unclear, although the recent discovery of antineutrophil cytoplasmic autoantibodies (ANCA) promises a clue to the origin of at least some of them, particularly Wegener's granulomatosis (WG) and perhaps also Churg-Strauss syndrome (CSS). On the other hand, PAN appears to be a nonspecific syndrome of various etiologies.
Mesangiocapillary glomerulonephritis in Down's syndrome.
The clinical and pathologic features of progressive renal disease in 4 patients with Down's syndrome are described. All patients were male, between 20 and 30 years of age at the time of clinical presentation. Three out of 4 had proteinuria, and 2 had hematuria. Serologic tests for hepatitis B virus infection and antinuclear antibodies performed in 2 patients were negative. Examination of renal tissue from biopsy and/or from autopsy revealed mesangiocapillary glomerulonephritis (MCGN), type 1. While an increased incidence of congenital heart disease and acute leukemias has been documented in Down's syndrome, an association with MCGN has not been reported previously to our knowledge. This probably represents a form of idiopathic MCGN and may be related to the long survival of these individuals.
Histopathology and ultrastructure of ovarian hilus cell tumor: report of two cases.
Explore the source record for details and available documents.
Glomerular microfibrils in renal disease: a comparative electron microscopic study.
Microfibrils are a common component of connective tissue that have been described only rarely in the renal glomerulus. Structurally, microfibrils are fibrotubules with an average diameter of 12 nm, a lucid core, and a dark periphery. High resolution electron microscopy, including stereo microscopy performed on renal biopsy tissues, demonstrated the presence of microfibrils under the endothelium of the capillary walls and in the mesangium in several glomerular diseases. These diseases were characterized by widening of lamina rara interna or separation of the endothelium from the basement membrane, among them transplant glomerulopathy, focal segmental glomerulosclerosis (including a case associated with Marfan syndrome), preeclamptic toxemia, and less frequently hemolytic-uremic syndrome and malignant hypertension. The number of microfibrils generally correlated with the degree of subendothelial widening.
Functions of mesothelioma panels.
Explore the source record for details and available documents.
Hemolytic-uremic syndrome.
Explore the source record for details and available documents.
Coagulation and the kidney.
Explore the source record for details and available documents.
Identification of dense deposit disease: a report for the International Study of Kidney Diseases in Children.
The fluorescent dye thioflavin T stains intensely the deposits in dense deposit disease and can be used for identification purposes. Comparison of thioflavin T staining with electron microscopy was carried out in 25 patients and showed excellent congruity. Thioflavin T is much easier to use, but is less specific than electron microscopy. Cases of light chain disease and of some gammopathies can be a source of confusion. In nearly all other instances, the pattern of staining helps to differentiate dense deposits from other types of deposits and from amyloid.
Ultrastructure of hematoxylin bodies in systemic lupus erythematosus.
Two specimens, the first from a percutaneous renal biopsy and the second autopsy tissue of ovary, from two subjects with active systemic lupus erythematosus were found to contain many striking hematoxylin bodies in the walls of several small arteries. The specimens were reprocessed for electron microscopy; in one case, corresponding plastic embedded sections were also stained with hematoxylin-eosin and Feulgen stain. Hematoxylin bodies were easily identified on electron microscopy. They were found to be dense, homogeneous structures, approximately the size of a nucleus. They probably represent mainly altered nuclear material with occasional small chromatin remnants or minor cytoplasmic inclusions.
Glomerular injury in malignant nephrosclerosis.
Electron microscopic analysis of subendothelial and mesangial alterations in the glomeruli was performed in 15 cases of malignant nephrosclerosis (MNS). 8 cases showed segmental or diffuse subendothelial accumulation of proteinaceous 'fibrinoid' material associated with thickening of glomerular basement membranes. 2 of these cases also showed similar deposits in the mesangium. When severe, this mesangial insudation resulted in almost complete replacement and destruction of the mesangial matrix. Endothelial injury with alteration of glomerular microcirculation and secondary intravascular coagulation is believed to play a role in the development of the glomerular lesions in MNS.
Asbestos and mesothelioma: a review.
Explore the source record for details and available documents.
Papillary tumors of the peritoneum in women: mesothelioma or papillary carcinoma.
It has been urged recently that the surface tumors of the ovary be classified as mesotheliomas because both of these neoplasms have a common ancestry. It was suggested also that the rare extragonadal peritoneal tumor of a microscopic morphology similar to that of the ovarian tumor be considered as a mesothelioma. In the present report, objections to this classification are offered. Fifteen cases of diffuse and/or localized peritoneal tumors interpreted as papillary carcinoma arising from extraovarian tissue of Müllerian potentiality are described, and distinctions from mesothelioma are pointed out. Reasons for opposing the grouping of ovarian carcinoma or extragonadal papillary carcinoma of the peritoneum with mesothelioma include the need for categorizing the latter separately in order to monitor its association with asbestos exposure and the possibility that biological differences between these tumors may lead to the development of different modes of therapy.
Immunosuppression in nephrotic syndrome.
Explore the source record for details and available documents.
Resolution of renal amyloidosis.
A patient with renal amyloidosis and the nephrotic syndrome consequent to extensive infected burns demonstrated both clinical resolution of the nephrotic syndrome and morphologic regression of the renal amyloid deposits over a six year period. The regression of the amyloid deposits was associated with several changes in the glomerular capillary wall resulting in a double capillary wall contour. This case indicates that deposits of amyloid in the kidney may regress and suggests a sequence of events in this resolution.
Membranous nephropathy following exposure to volatile hydrocarbons.
Explore the source record for details and available documents.
Peritoneal mesothelioma.
The cytohistology in 82 cases diagnosed as malignant peritoneal mesothelioma was correlated with available clinical and gross pathologic information. The cases were then evaluated as to ceratainty of diagnosis. The material had come from a large number of sources, most of it having been traced by a history of occupational exposure to asbestos. A relatively short interval of significant symptoms, with already existent diffuse peritoneal involvement and ascites, and an average survival time of less than a year characterized the group. The microscopic morphology formed a spectrum from highly characteristic, pure epithelial and mixed epithelial and sarcomatoid types, through nonspecific although relatively differentiated appearances, to pleomorphic analplatic proliferations. Local invasion and metastasis were common but much more limited than with tumors of other histogenesis showing comparable serous membrane involvement. Autopsy was of considerable exclusionary value although not in itself always determinative, and mucopolysaccharide histochemistry was occasionally decisive in diagnosis. Because of the microscopic versatlity of mesothelioma and the clinical and gross morphologic overlap with other neoplasms, all available data must be taken into consideration in arriving at a diagnosis. We believe that the dgree of certainty of diagnosis should be indicated by a succinct but reasonably explicit terminology.
Electron microscopy of a feminizing Leydig cell tumor of the testis.
The ultrastructural characteristics of a feminizing interstitial (Leydig) cell tumor of the testis were compared with those of normal Leydig cells and with the findings described in 10 published cases of Leydig cell tumor. The neoplastic Leydig cells superficially resembled normal Leydig cells. Similarities included abundant smooth endoplasmic reticulum, lipid, and microbodies. Contrastingly, Reinke crystalloids and paracrystalline inclusions were absent and lipochrome pigment and lysosomes very rare. The nuclei were large and contained enlarged, often multiple, nucleoli. The nuclear membranes tended to be irregular and undulating. Cytoplasmic membranous whorls and myelin figures were conspicuous. Fairly homogeneous fibrous septa were evident between single and grouped tumor cells. Despite several individual variations, there is a general resemblance between the neoplastic Leydig cells in this patient and those previously reported. No distinguishing ultrastructural characteristics were discerned between feminizing and virilizing Leydig cell tumors.