Renal involvement in type 2 diabetes mellitus: a clinicopathologic study of the Henry Ford Hospital experience.
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Aged↗
Biomedical subjects
R N Romanski
Publications and source records attributed to R N Romanski.
Neonatal kidneys: sonographic anatomic correlation.
The ultrasound appearances of the neonatal and adult kidney contrast dramatically. In the normal kidney of a newborn infant, the echogenicity of the renal cortex equals that of the liver. To determine the morphological reasons for the unique and specific sonographic findings, we performed a quantitative anatomic analysis of the components of the kidney on autopsy specimens from four neonates. Our analysis reveals that the glomeruli occupy proportionally a much greater volume of the renal cortex during the first two months of life (18% as compared with 8.6% in the adult). Other anatomic differences include the greater proportional volume of the cellular component of the glomerular tuft in the neonate, and the location of 20% of the loops of Henle within the neonatal cortex rather than in the medulla. The increased number of anatomical structures, and thus interfaces, undoubtedly accounts for the increased echogenicity. The neonatal kidney often demonstrates prominent and hypoechoic renal pyramids. This may be explained by the larger volume of medulla in the neonatal kidney, which results in a ratio of cortex to medulla of 1.64:1 in the neonate as compared with a ratio of 2.59:1 in the adult. There is also a noted lack of echogenicity in the renal sinus region in neonates. Anatomically this is secondary to the absence of renal sinus adipose tissue in the kidney of the neonate.
Adult↗
The renal sinus during allograft rejection: sonographic and histopathologic findings.
In fourteen renal allografts, the sonographic appearance of the renal sinus was correlated with the histopathologic findings. In each allograft specimen, the histologic changes in the renal sinus were compared with those in the renal cortex. Except for one case (hyperacute rejection), the histologic rejection changes were of similar severity within the cortex and renal sinus. When the renal sinus histologic changes of rejection were considered to be minimal (three patients), the sonographic appearance of the renal sinus was classified as normal. With moderate histologic changes in the renal sinus (five patients), the sonographic findings in four patients were considered moderate, with a change in spatial distribution resulting in a coarse and uneven distribution of renal sinus echoes. When the renal sinus histologic changes of rejection were interpreted as severe (six patients), the sonographic findings were similarly more advanced. Except for a very few intense echoes distributed in an irregular pattern, the area of the renal sinus blended with the adjacent parenchyma. The study demonstrated a good correlation between histology and sonography of the renal sinus during allograft rejection, and promises reliable prediction of the severity of the rejection process using a noninvasive, rapid, and relatively simple approach.
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