Browsing by Author "Rosenberg, H"
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- ItemCatastrophic antiphospholipid syndrome associated with crescentic glomerulonephritis(2000) Cisternas, M; Gutiérrez, MA; Rosenberg, H; Jara, A; Jacobelli, SThe association of renal failure with catastrophic antiphospholipid syndrome has been reported in the context of microvascular occlusions and/or malignant hypertension. We describe a 36-year-old woman who died of multiorgan failure with the laboratory, clinical and histopathological characteristics of catastrophic antiphospholipid syndrome associated with a crescentic glomerulonephritis and renal failure.
- ItemClinicopathologic implications of hMSH2 gene expression and microsatellite instability in prostate cancer(2002) Velasco, A; Albert, PS; Rosenberg, H; Martinez, C; Leach, FSHuman mismatch repair (MMR) genes encode highly conserved interacting proteins that correct replication errors predisposing to hereditary gastrointestinal and genitourinary malignancies. We previously investigated expression of the prototype MMR gene hMSH2 in normal, benign prostatic hyperplasia and malignant prostate tissues (Velasco et al., Cancer 94:690-699, 2002). An association was detected between reduced. hMSH2 staining and favorable outcome as determined by undetectable serum prostate specific antigen (PSA) after radical prostatectomy. We now investigate the association between clinicopathological variables and hMSH2 expression or microsatellite instability (MSI). A statistically significant association was found between tumors exhibiting MSI (MSI+ tumors) and lower preoperative serum PSA values, smaller tumor volumes and lower frequency of surgical specimens with extracapsular extension of tumor. No statistically of significant association (P value less than or equal to 0.05) was found between hMSH2 staining and these clinicopathologic variables. Based on our analysis, we conclude that MMR deficiency has important clinicopathologic implications in prostate cancer. Furthermore, specific MMR genes may have different effects on prostate cancer biology.
- ItemDifferential expression of the mismatch repair gene hMSH2 in malignant prostate tissue is associated with cancer recurrence(2002) Velasco, A; Hewitt, SM; Albert, PS; Saboorian, MH; Rosenberg, H; Martinez, C; Sagalowsky, AI; McConnell, JD; Linehan, WM; Leach, FSBACKGROUND. Mismatch repair (MMR) genes are responsible for coordinated correction of misincorporated nucleotides formed during DNA replication. Inactivating mutations in MMR genes have been described in sporadic cancers and a hereditary cancer predisposition syndrome. Mismatch repair deficiency causes instability at microsatellites and increased mutation rates. Although microsatellite instability (MSI) has been described in high-grade and lymph node positive prostate carcinoma specimens, an analysis comparing hMSH2 expression, MSI, and outcome in clinically organ confined prostate carcinoma has not been reported.
- ItemLong-Term outcome of type V lupus membranous glomerulonephritis(SOC MEDICA SANTIAGO, 2005) Pasten, R; Massardo, L; Rosenberg, H; Radrigan, F; Roessler, E; Valdivieso, A; Jacobelli, SBackground: The long-term outcome of the pure form of WHO type V lupus membranous glomerulonephritis is apparently more benign than that of other forms of lupus glomerulonepbritis. However 12% of such patients progress to terminal renal failure. The presence of proteinuria may be an indication of cytotoxic agents. Aim: To study the clinical long-term outcome of WHO type V Inpus membranous glomerulonepbritis. Material and methods: A retrospective analysis of all kidney biopsies of a University Pathology Department, with the diagnosis of WHO type V lupus membranous glomerulonephritis. Review of medical records of patients with the disease and one clinical assessment of all living patients. Results: Between 1973 and 2000, 703 kidney biopsies were done to patients with systemic lupus erytbematosus. Of these, 40 were membranous glomerulonepbritis and in 33 patients (28 women, age range 6-71 years), data on the evolution and survival was obtained. Nineteen bad type Va and the rest type Vb nephritis. Two presented with renal failure and I I with proteinuria over 3.5 g/24h. The median follow-up since the renal biopsy was 63 months (range 1-316). At the end of follow-up, four bad a creatinine clearance of less then 15 ml/h and four a clearance between 15 and 29 ml/h (one of these received a renal allograft). Eleven (33016) patients had died, mostly due to infections. Life expectancy at five years with a creatinine clearance over 15 ml/h was 75%. Bad prognostic factors were an elevated creatinine clearance over 15 ml/h was 75%. Bad prognostic factors were an elevated creatinine and high blood pressure at the moment of the biopsy. Conclusions: The clinical outcome of these patients was bad. Twelve percent reached a stage of terminal renal failure. This is in contrast with the 3% progression to a similar stage of proliferalive glomerulonephritis treated with the 3% cycloposphamide. New tberapies for this condition must be sought.
- ItemOutcome of Chilean patients with lupus nephritis and response to intravenous cyclophosphamide(2003) Velásquez, X; Verdejo, U; Massardo, L; Martínez, ME; Arriagada, S; Rosenberg, H; Valdivieso, A; Jacobelli, SSeveral recent open studies suggest that the response rates of lupus nephritis to intravenous (IV) cyclophosphamide are lower than those observed in clinical trials. One explanation could be ethnic differences; for example, black patients more frequently have treatment-resistant lupus nephritis. Another could be the inclusion of patients who are noncompliant with therapy. From our register of 268 systemic lupus erythematosus (SLE) patients examined between 1973 and 1996, 61 patients were treated for proliferative lupus nephritis (17 had World Health Organization [WHO] type III and 43 had WHO type IV) and were followed through to 2001. Exclusion criteria included a serum creatinine level >3 mg/dL. In this retrospective study, we assessed renal outcome and survival with an endpoint of end-stage renal disease (ESRD) or death (Kaplan-Meier). In the univariate analysis, worse prognostic factors for survival were serum creatinine >1.3 mg/dL (p < 0.001), age <30 years (p < 0.001), class 2 renal function stage (p < 0.03), and renal biopsy activity index >7 (p < 0.02). In the subgroup of 26 patients treated with IV cyclophosphamide, survival at 5 and 10 years was 82% and 73%, respectively. The dosage of IV cyclophosphamide was slightly lower than usual and used for a shorter period (median = 23 months) than what is usually recommended because of the high frequency of complications. Renal outcome of the IV cyclophosphamide-treated patients was poorer than that reported in the National Institutes of Health series (ESRD: 15% versus 3%). This low survival rate could reflect the short course and lower doses of IV cyclophosphamide used or ethnic differences. These data emphasize the need for continuous research for better-tolerated drug schemes for treatment of our lupus nephritis patients.
- ItemSimple intratesticular cysts in children: preoperative sonographic diagnosis and histological correlation(SPRINGER VERLAG, 1999) Garcia, CJ; Zuniga, S; Rosenberg, H; Arce, JD; Zuniga, FBackground. Simple intratesticular cysts are rare in children and have been considered the most uncommon cause of scrotal cystic masses in this age group. The exact etiology of these lesions is still unclear. High-resolution ultrasonography has been proved to be a reliable and accurate imaging modality in the evaluation of scrotal abnormalities in children.