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Schoonmaker JA, Ryan MS, Bhasin-Chhabra B. Nonalbumin Proteinuria in a Patient with Slowly Worsening Kidney Function. Kidney360 2024; 5:481-482. [PMID: 38546983 PMCID: PMC11000716 DOI: 10.34067/kid.0000000000000338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/02/2024]
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2
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Huff D, Fortin Ensign S, Ryan MS, Palmer J, Munoz J. Histiocytic Sarcoma Treated with Pembrolizumab: A Case Report and Literature Review. J Immunother Precis Oncol 2023; 6:198-202. [PMID: 38143950 PMCID: PMC10734394 DOI: 10.36401/jipo-23-11] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 06/25/2023] [Accepted: 07/24/2023] [Indexed: 12/26/2023]
Abstract
Histiocytic sarcoma (HS) is a rare hematologic malignancy that has historically been treated with lymphoma-based regimens with a median survival of 6 months. We describe a case of a 51-year-old woman who presented with acute back pain and cord compression. She was diagnosed with HS with diffuse skeletal lesions and high expression of programmed death ligand 1 (PD-L1). She was subsequently treated with chemotherapy plus off-label use of pembrolizumab followed by allogeneic stem cell transplantation. Ultimately, the patient died in the setting of progression of disease 17 months after her stem cell transplantation and 26 months after her diagnosis. This article also presents a literature review of cases of HS treated with programmed death ligand inhibition.
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Affiliation(s)
- Daniel Huff
- Department of Internal Medicine, Mayo Clinic, Phoenix, AZ, USA
| | | | | | - Jeanne Palmer
- Department of Hematology and Oncology, Mayo Clinic, Phoenix, AZ, USA
| | - Javier Munoz
- Department of Hematology and Oncology, Mayo Clinic, Phoenix, AZ, USA
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3
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Ryan MS, McIntyre J, Bramwell LD, Ojha S. Accidental lipid overdose in a preterm infant: A case report. J Neonatal Perinatal Med 2023; 16:577-586. [PMID: 37718874 DOI: 10.3233/npm-231221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/19/2023]
Abstract
BACKGROUND Intravenous lipid emulsions (ILEs) provide essential fatty acids during parenteral nutrition (PN). Serious adverse events including death can occur from overdose. We report an accidental overdose in a preterm infant. METHOD On Day 2 of life, a 29-week gestational age (GA) twin was accidentally given 47.5 mL of Intralipid20% (≈3x daily amount) in 50-minutes. RESULTS No apparent clinical deterioration occurred, although blood samples were lipaemic. Outcomes at 2 years corrected GA were similar to that of his twin. Service changes were made to infusion packaging and administration to avoid similar errors. CONCLUSIONS Medication errors in neonates are unfortunately common. Published articles usually focus on poor outcomes, which can increase the distress for parents of children where errors have occurred. Publishing the full spectrum of outcomes instead allows parents and professionals to be aware of all possibilities and lessons learnt, even if serious harm was avoided.
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Affiliation(s)
- M S Ryan
- Centre for Perinatal Research, Lifespan and Population Health, School of Medicine, University of Nottingham, Nottingham, UK
| | - J McIntyre
- Neonatal Unit, Derby Children's Hospital, University Hospitals of Derby and Burton NHS Foundation Trust, Derby, UK
| | | | - S Ojha
- Centre for Perinatal Research, Lifespan and Population Health, School of Medicine, University of Nottingham, Nottingham, UK
- Neonatal Unit, Derby Children's Hospital, University Hospitals of Derby and Burton NHS Foundation Trust, Derby, UK
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Abu Jawdeh BG, Nguyen MC, Ryan MS, Vikram HR. Case report: Emphysematous pyelonephritis associated with kidney allograft abscess formation. Front Med (Lausanne) 2022; 9:1066512. [PMID: 36619614 PMCID: PMC9812942 DOI: 10.3389/fmed.2022.1066512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Accepted: 11/30/2022] [Indexed: 12/24/2022] Open
Abstract
Emphysematous pyelonephritis (EPN) is a severe, acute necrotizing infection that is defined by the presence of gas in the kidney parenchyma. Multiple case reports have described the radiological findings and clinical course of EPN. Herein, we report on EPN including the histopathological findings in a kidney transplant recipient. Our patient presented with EPN complicated by multiorgan failure and was successfully managed with transplant nephrectomy.
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Affiliation(s)
- Bassam G. Abu Jawdeh
- Division of Nephrology, Mayo Clinic Arizona, Phoenix, AZ, United States,*Correspondence: Bassam G. Abu Jawdeh,
| | - Michelle C. Nguyen
- Division of Transplant Surgery, Mayo Clinic Arizona, Phoenix, AZ, United States
| | - Margaret S. Ryan
- Department of Pathology, Mayo Clinic Arizona, Phoenix, AZ, United States
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Ramon DS, Troop DM, Kinard TN, Jadlowiec CC, Ryan MS, Hewitt WR, Olsen LG, Jaramillo A, Taner T, Heilman RL. Alloantibodies after simultaneous liver-kidney transplant: A story of primary nonfunction, retransplantation, and antibody-mediated rejection. Am J Transplant 2022; 22:977-985. [PMID: 34882942 DOI: 10.1111/ajt.16913] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 12/02/2021] [Accepted: 12/02/2021] [Indexed: 01/25/2023]
Abstract
Simultaneous liver-kidney transplant (SLKT) in the presence of antihuman leukocyte antigen (HLA) donor-specific antibodies (DSA) is a well-accepted practice. Herein, we describe the evolution of alloantibodies in a patient who received an SLKT. The pre-SLKT serum sample showed multiple strong DSA. As expected, all DSA cleared in a sample collected 4 days after the SLKT. Because of the primary nonfunction of the liver in the SLKT, the patient had a second liver transplant 4 days later. An abrupt increase in DSA levels against the kidney was detected 10 days after the second liver transplant. These DSA were refractory to treatment, and the transplanted kidney was lost due to antibody-mediated rejection (AMR). A detailed study of the HLA epitopes recognized by DSA and, after normalization with third-party alloantibodies to address the effect of multiple transfusions and liver allograft neutralization, showed that the elimination of these antibodies depended on the HLA antigens expressed by the transplanted liver cells. The return of DSA after removal of the first transplanted liver was associated with AMR in the transplanted kidney.
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Affiliation(s)
- Daniel S Ramon
- Department of Laboratory Medicine and Pathology, Mayo Clinic Hospital, Phoenix, Arizona
| | - Danielle M Troop
- Department of Laboratory Medicine and Pathology, Mayo Clinic Hospital, Phoenix, Arizona
| | - Theresa N Kinard
- Department of Laboratory Medicine and Pathology, Mayo Clinic Hospital, Phoenix, Arizona
| | - Caroline C Jadlowiec
- Division of Transplant and Hepatobiliary Surgery, Mayo Clinic Hospital, Phoenix, Arizona.,Transplant Center, Mayo Clinic Hospital, Phoenix, Arizona
| | - Margaret S Ryan
- Department of Laboratory Medicine and Pathology, Mayo Clinic Hospital, Phoenix, Arizona
| | - Winston R Hewitt
- Division of Transplant and Hepatobiliary Surgery, Mayo Clinic Hospital, Phoenix, Arizona.,Transplant Center, Mayo Clinic Hospital, Phoenix, Arizona
| | - Linda G Olsen
- Department of Laboratory Medicine and Pathology, Mayo Clinic Hospital, Phoenix, Arizona
| | - Andrés Jaramillo
- Department of Laboratory Medicine and Pathology, Mayo Clinic Hospital, Phoenix, Arizona
| | - Timucin Taner
- Division of Transplantation Surgery, Mayo Clinic, Rochester, Minnesota.,Department of Immunology, Mayo Clinic, Rochester, Minnesota
| | - Raymond L Heilman
- Transplant Center, Mayo Clinic Hospital, Phoenix, Arizona.,Division of Nephrology, Mayo Clinic Hospital, Phoenix, Arizona
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Park WD, Kim DY, Mai ML, Reddy KS, Gonwa T, Ryan MS, Herrera Hernandez LP, Smith ML, Geiger XJ, Turkevi-Nagy S, Cornell LD, Smith BH, Kremers WK, Stegall MD. Progressive decline of function in renal allografts with normal 1-year biopsies: Gene expression studies fail to identify a classifier. Clin Transplant 2021; 35:e14456. [PMID: 34717009 DOI: 10.1111/ctr.14456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 07/23/2021] [Accepted: 08/04/2021] [Indexed: 11/29/2022]
Abstract
Histologic findings on 1-year biopsies such as inflammation with fibrosis and transplant glomerulopathy predict renal allograft loss by 5 years. However, almost half of the patients with graft loss have a 1-year biopsy that is either normal or has only interstitial fibrosis. The goal of this study was to determine if there was a gene expression profile in these relatively normal 1-year biopsies that predicted subsequent decline in renal function. Using transcriptome microarrays we measured intragraft mRNA levels in a retrospective Discovery cohort (170 patients with a normal/minimal fibrosis 1-year biopsy, 54 with progressive decline in function/graft loss and 116 with stable function) and developed a nested 10-fold cross-validated gene classifier that predicted progressive decline in renal function (positive predictive value = 38 ± 34%%; negative predictive value = 73 ± 30%, c-statistic = .59). In a prospective, multicenter Validation cohort (270 patients with Normal/Interstitial Fibrosis [IF]), the classifier had a 20% positive predictive value, 85% negative predictive value and .58 c-statistic. Importantly, the majority of patients with graft loss in the prospective study had 1-year biopsies scored as Normal or IF. We conclude predicting graft loss in many renal allograft recipients (i.e., those with a relatively normal 1-year biopsy and eGFR > 40) remains difficult.
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Affiliation(s)
| | - Dean Y Kim
- Henry Ford Hospital, Detroit, Michigan, USA
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Budhiraja P, Heilman RL, Jadlowiec CC, Smith ML, Ryan MS, Khamash HA, Kodali L, Moss AA, Mathur AK, Reddy KS. Successful outcomes with transplanting kidneys from deceased donors with acute kidney injuryon temporary renal replacement therapy. Clin Transplant 2021; 35:e14465. [PMID: 34514643 DOI: 10.1111/ctr.14465] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 08/11/2021] [Accepted: 08/13/2021] [Indexed: 02/02/2023]
Abstract
BACKGROUND AND OBJECTIVES We aimed to determine outcomes with transplanting kidneys from deceased donors with severe acute kidney injury requiring acute renal replacement therapy (RRT). MATERIALS AND METHODS A total of 172 recipients received a kidney from donors with acute kidney injury stage 3 (AKIN3) requiring RRT. We compared the study group to 528 recipients who received a kidney from donors with AKIN stage 3 not on RRT and 463 recipients who received < 85% Kidney Donor Profile Index (KDPI) AKIN stage 0 kidney. RESULTS The study group donors were younger compared to the 2 control groups. Despite higher DGF in the study group, the length of hospital stay and acute rejection were similar. Death censored graft survival (96% AKIN3-RRT vs. 97%AKIN3 no RRT vs. 96% KDPI < 85% AKIN0, P = 0.26) and patient survival with functioning graft at 1 year (95% across all groups, P = 0.402) were similar. The estimated glomerular filtration rate were similar across the 3 groups after first month. Interstitial fibrosis and tubular atrophy score ≥ 2 on protocol biopsy at time 0, 4 and 12 months were similar. Primary nonfunction was rare and associated with high KDPI. CONCLUSIONS Transplanting selected kidneys from deceased donors with AKIN3 requiring RRT is safe and has good outcomes.
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Affiliation(s)
- Pooja Budhiraja
- Division of Nephrology, Mayo Clinic Hospital, Phoenix, Arizona, USA
| | | | | | - Maxwell L Smith
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Phoenix, Arizona, USA
| | - Margaret S Ryan
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Phoenix, Arizona, USA
| | - Hasan A Khamash
- Division of Nephrology, Mayo Clinic Hospital, Phoenix, Arizona, USA
| | - Lavanya Kodali
- Division of Nephrology, Mayo Clinic Hospital, Phoenix, Arizona, USA
| | - Adyr A Moss
- Department of Surgery, Mayo Clinic, Phoenix, Arizona, USA
| | - Amit K Mathur
- Department of Surgery, Mayo Clinic, Phoenix, Arizona, USA
| | - Kunam S Reddy
- Department of Surgery, Mayo Clinic, Phoenix, Arizona, USA
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Jadlowiec CC, Hanna WA, Ninan J, Ryan MS, Das DM, Smith M, Khamash H, Mathur AK, Singer A, Moss A, Reddy KS, Heilman RL. Transplant outcomes using kidneys from high KDPI acute kidney injury donors. Clin Transplant 2021; 35:e14279. [PMID: 33690907 DOI: 10.1111/ctr.14279] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Revised: 02/11/2021] [Accepted: 02/27/2021] [Indexed: 11/28/2022]
Abstract
Kidney transplant (KT) outcomes from high kidney donor profile index (KDPI ≥85%) donors with acute kidney injury (AKI) remain underreported. KT from 172 high KDPI Acute Kidney Injury Network (AKIN) stage 0-1 donors and 76 high KDPI AKIN stage 2-3 donors from a single center were retrospectively assessed. The AKIN 2-3 cohort had more delayed graft function (71% vs. 37%, p < .001). At one year, there were no differences in the estimated glomerular filtration rate (44 ± 17 vs. 46 ± 18, p = .42) or fibrosis on protocol biopsy (ci, p = .85). Donor terminal creatinine (p = .59) and length of delayed graft function (p = .39) did not impact one-year eGFR. There were more primary nonfunction (PNF) events in the high KDPI AKIN 2-3 group (5.3% vs. 0.6%, p = .02). With a median follow-up of 3.8 years, one-year death-censored graft failure was 3.5% for AKIN 0-1 and 14.5% for AKIN 2-3 (HR 2.40, 95% CI 1.24-4.63, p = .01). Although AKIN stage 2-3 high KDPI kidneys had comparable one-year eGFR to AKIN stage 0-1 high KDPI kidneys, there were more PNF occurrences and one-year death-censored graft survival was reduced. Given these findings, additional precautions should be undertaken when assessing and utilizing kidneys from severe AKI high KDPI donors.
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Affiliation(s)
| | - Wael A Hanna
- Division of Nephrology, Mayo Clinic, Phoenix, AZ, USA
| | - Jacob Ninan
- Division of Nephrology, Mayo Clinic, Phoenix, AZ, USA
| | - Margaret S Ryan
- Division of Anatomic Pathology, Mayo Clinic, Phoenix, AZ, USA
| | - Devika M Das
- Alix School of Medicine, Mayo Clinic, Scottsdale, AZ, USA
| | - Maxwell Smith
- Division of Anatomic Pathology, Mayo Clinic, Phoenix, AZ, USA
| | - Hasan Khamash
- Division of Nephrology, Mayo Clinic, Phoenix, AZ, USA
| | - Amit K Mathur
- Division of Transplant Surgery, Mayo Clinic, Phoenix, AZ, USA
| | - Andrew Singer
- Division of Transplant Surgery, Mayo Clinic, Phoenix, AZ, USA
| | - Adyr Moss
- Division of Transplant Surgery, Mayo Clinic, Phoenix, AZ, USA
| | - Kunam S Reddy
- Division of Transplant Surgery, Mayo Clinic, Phoenix, AZ, USA
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Nguyen BD, Ryan MS. Gastrointestinal: Positron emission tomography-computed tomography imaging of multifocal intestinal metastasis from primary lung cancer. J Gastroenterol Hepatol 2019; 34:814. [PMID: 30693593 DOI: 10.1111/jgh.14591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Accepted: 12/28/2018] [Indexed: 12/09/2022]
Affiliation(s)
- B D Nguyen
- Department of Radiology, Mayo Clinic, Scottsdale, Arizona, USA
| | - M S Ryan
- Department of Laboratory Medicine, Mayo Clinic, Scottsdale, Arizona, USA
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Brodsky SV, Satoskar A, Hemminger J, Rovin B, Hebert L, Ryan MS, Nadasdy T. Anticoagulant-Related Nephropathy in Kidney Biopsy: A Single-Center Report of 41 Cases. Kidney Med 2019; 1:51-56. [PMID: 32715287 PMCID: PMC7380361 DOI: 10.1016/j.xkme.2019.03.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Abstract
Rationale & Objective In 2009, the first case of acute kidney injury and occlusive red blood cell (RBC) tubular casts associated with a high international normalized ratio in a patient receiving warfarin was identified. This entity, named warfarin-related nephropathy, was later renamed anticoagulant-related nephropathy (ARN) after similar cases with other anticoagulants were described. We provide our 10-year experience with ARN based on a single-center kidney biopsy laboratory. Study Design The kidney pathology database at the Ohio State University Wexner Medical Center (OSUWMC) was searched for native kidney biopsy cases consistent with ARN. Clinical data were obtained from patient medical records. Setting & Participants Native kidney biopsies evaluated between January 1, 2009, and December 31, 2017 at OSUWMC. Results Among 8,636 native kidney biopsies reviewed at the OSUWMC, there were 41 (0.5%) patients for whom deterioration in kidney function could not be explained by kidney biopsy findings alone if anticoagulation was not considered. There were 63% men and 95% were white; average age was 62 ± 14 years. Most were on warfarin therapy (N = 28), although cases were also attributed to direct-acting anticoagulants (N = 2), antiplatelet medications (N = 1), heparin or enoxaparin (N = 4), and disseminated intravascular coagulopathy (N = 6). Morphologically, there was acute tubular necrosis and RBC casts. The majority of biopsies had an underlying glomerular disease and many patients had positive serologic test results. In all these cases, the severity of kidney failure, RBC tubular casts, and hematuria were disproportionate to glomerular morphologic changes. Limitations Selection bias in the decision to perform a kidney biopsy. Conclusions ARN is an uncommon diagnosis in kidney pathology practice, but it should be considered when the number of RBC tubular casts is disproportionate to the severity of glomerular changes in a kidney biopsy in patients either receiving anticoagulation therapy or who presented with acute coagulopathy. Our data suggest that anticoagulation aggravates underlying glomerular diseases rather than directly affecting the glomerular filtration barrier.
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Affiliation(s)
- Sergey V Brodsky
- Departments of Pathology (SVB, AS, JH, TN) and Medicine (BR, LH), Ohio State University, Columbus, OH; and Department of Pathology, Mayo Clinic, Scottsdale, AZ (MSR)
| | - Anjali Satoskar
- Departments of Pathology (SVB, AS, JH, TN) and Medicine (BR, LH), Ohio State University, Columbus, OH; and Department of Pathology, Mayo Clinic, Scottsdale, AZ (MSR)
| | - Jessica Hemminger
- Departments of Pathology (SVB, AS, JH, TN) and Medicine (BR, LH), Ohio State University, Columbus, OH; and Department of Pathology, Mayo Clinic, Scottsdale, AZ (MSR)
| | - Brad Rovin
- Departments of Pathology (SVB, AS, JH, TN) and Medicine (BR, LH), Ohio State University, Columbus, OH; and Department of Pathology, Mayo Clinic, Scottsdale, AZ (MSR)
| | - Lee Hebert
- Departments of Pathology (SVB, AS, JH, TN) and Medicine (BR, LH), Ohio State University, Columbus, OH; and Department of Pathology, Mayo Clinic, Scottsdale, AZ (MSR)
| | - Margaret S Ryan
- Departments of Pathology (SVB, AS, JH, TN) and Medicine (BR, LH), Ohio State University, Columbus, OH; and Department of Pathology, Mayo Clinic, Scottsdale, AZ (MSR)
| | - Tibor Nadasdy
- Departments of Pathology (SVB, AS, JH, TN) and Medicine (BR, LH), Ohio State University, Columbus, OH; and Department of Pathology, Mayo Clinic, Scottsdale, AZ (MSR)
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Ryan MS, Satoskar AA, Nadasdy GM, Brodsky SV, Hemminger JA, Nadasdy T. Phospholipase A2 receptor staining is absent in many kidney biopsies with early-stage membranous glomerulonephritis. Kidney Int 2016; 89:1402-3. [DOI: 10.1016/j.kint.2015.12.057] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2015] [Accepted: 12/30/2015] [Indexed: 11/27/2022]
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Abstract
INTRODUCTION In the USA, most anatomical pathology residency training is based on an apprenticeship model in which residents learn directly by watching more senior personnel and then performing the examination. The level and the effect of the standardisation of resident trainee gross tissue examination practices have not been extensively evaluated. METHODS In this apprenticeship-based training programme, a retrospective report review was performed to measure the level of standardisation of gross description (for 11 mandatory descriptors) and tissue submission (for four mandatory sections) practices for uterine specimens removed for benign conditions (n=78). Practices were examined for significant relationships with error, turnaround time (TAT), resource utilisation and postgraduate year of resident (n=25) training. RESULTS Residents provided mandatory descriptors from 23.1% to 93.6% of the time and submitted mandatory sections from 82.1% to 96.2% of the time. Cases submitted by less experienced residents had a longer TAT and were associated with more errors, measured by the necessity to submit additional tissues. Less experienced residents used greater resources (submitting 9.5 tissue cassettes per case) compared with more experienced residents (7.3 cassettes per case), and a statistically significant correlation was found between the number of cassettes submitted and TAT. CONCLUSIONS In this training programme, the model of apprenticeship training leads to less than optimal standardisation of gross examination practices, inefficiency, active errors and a high frequency of latent conditions leading to error.
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Affiliation(s)
- Margaret S Ryan
- Department of Pathology, University of Colorado, Aurora, Colorado, USA
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Saubermann LJ, Beck P, De Jong YP, Pitman RS, Ryan MS, Kim HS, Exley M, Snapper S, Balk SP, Hagen SJ, Kanauchi O, Motoki K, Sakai T, Terhorst C, Koezuka Y, Podolsky DK, Blumberg RS. Activation of natural killer T cells by alpha-galactosylceramide in the presence of CD1d provides protection against colitis in mice. Gastroenterology 2000; 119:119-28. [PMID: 10889161 DOI: 10.1053/gast.2000.9114] [Citation(s) in RCA: 162] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND & AIMS CD1d is a major histocompatibility complex class I-like molecule that presents glycolipid antigens to a subset of natural killer (NK)1.1(+) T cells. These NK T cells exhibit important immunoregulatory functions in several autoimmune disease models. METHODS To investigate whether CD1d and NK T cells have a similar role in intestinal inflammation, the effects of the glycolipid, alpha-galactosylceramide (alpha-GalCer), on dextran sodium sulfate (DSS)-induced colitis were examined. Wild-type (WT), CD1d(-/-), and RAG(-/-) mice were examined for their response to either alpha-GalCer or the control analogue, alpha-mannosylceramide (alpha-ManCer). RESULTS WT mice, but not CD1d(-/-) and RAG(-/-) mice, receiving alpha-GalCer had a significant improvement in DSS-induced colitis based on body weight, bleeding, diarrhea, and survival when compared with those receiving alpha-ManCer. Elimination of NK T cells through antibody-mediated depletion resulted in a reduction of the effect of alpha-GalCer. Furthermore, adoptive transfer of NK T cells preactivated by alpha-GalCer, but not alpha-ManCer, resulted in diminished colitis. Using a fluorescent-labeled analogue of alpha-GalCer, confocal microscopy localized alpha-GalCer to the colonic surface epithelium of WT but not CD1d(-/-) mice, indicating alpha-GalCer binds CD1d in the intestinal epithelium and may be functionally active at this site. CONCLUSIONS These results show an important functional role for NK T cells, activated by alpha-GalCer in a CD1d-restricted manner, in regulating intestinal inflammation.
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Affiliation(s)
- L J Saubermann
- Division of Gastroenterology and the Harvard Digestive Diseases Center, Brigham and Women's Hospital, Boston, Massachusetts 02115, USA
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Ryan MS, Griffin F, Mahon B, Mills KH. The role of the S-1 and B-oligomer components of pertussis toxin in its adjuvant properties for Th1 and Th2 cells. Biochem Soc Trans 1997; 25:126S. [PMID: 9057024 DOI: 10.1042/bst025126s] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Affiliation(s)
- M S Ryan
- Department of Biology, St Patrick's College, Maynooth, Co. Kildare, Ireland
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Mahon BP, Ryan MS, Griffin F, Mills KH. Interleukin-12 is produced by macrophages in response to live or killed Bordetella pertussis and enhances the efficacy of an acellular pertussis vaccine by promoting induction of Th1 cells. Infect Immun 1996; 64:5295-301. [PMID: 8945580 PMCID: PMC174522 DOI: 10.1128/iai.64.12.5295-5301.1996] [Citation(s) in RCA: 99] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
Using a murine respiratory infection model, we have demonstrated previously that infection with Bordetella pertussis or immunization with a whole-cell pertussis vaccine induced antigen-specific Th1 cells, which conferred a high level of protection against aerosol challenge. In contrast, immunization with an acellular vaccine, consisting of the B. pertussis components detoxified pertussis toxin, filamentous hemagglutinin, and pertactin adsorbed to alum, generated Th2 cells and was associated with delayed bacterial clearance following challenge. In this study, we demonstrated that addition of interleukin-12 (IL-12) either in vitro or in vivo enhanced type 1 T-cell cytokine responses induced with an acellular vaccine. Furthermore, the rate of bacterial clearance in mice coinjected with IL-12 and the acellular vaccine was similar to that observed following immunization with a potent whole-cell vaccine. Analysis of IL-12 secretion by murine macrophages suggested that this cytokine is produced in vivo following B. pertussis infection or immunization with the whole-cell vaccine. IL-12 was detected in the supernatants of lung, splenic, and peritoneal macrophages infected with live B. pertussis or stimulated with heat-killed whole B. pertussis or B. pertussis lipopolysaccharide. In contrast, IL-12 could not be detected following stimulation of macrophages with the bacterial antigens filamentous hemagglutinin, detoxified pertussis toxin, and pertactin, the components of acellular vaccines. Our findings suggest that induction of endogenous IL-12 may contribute to the high efficacy of pertussis whole-cell vaccines and also demonstrate that it is possible to attain these high levels of protection with a less reactogenic acellular vaccine incorporating IL-12 as an adjuvant.
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Affiliation(s)
- B P Mahon
- Department of Biology, St. Patrick's College, Maynooth, County Kildare, Ireland
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Ryan MS. Neglected survivors. Am J Nurs 1988; 88:1070. [PMID: 3400743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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Kramer M, Roth T, Goldstein S, Ryan MS, Blackwell B. A double-blind evaluation of metiapine in hospitalized acute schizophrenics. Curr Ther Res Clin Exp 1975; 18:839-48. [PMID: 2450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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