林醫師
------------
Sinus fat
Papilla
pelvis
Pyramid
Gerota's fascia
T12-L3
Perirenal,
pararenal fat
------------
Endothelial
fenestrae 70-100nm
Mesangial
GBM
Lamina
rara interna
Lamina
densa
Lamina
rara externa
Podocytes
foot process 20-30nm visceral epithelium
Parietal
epithelium
------------
Macula
densa of distal tubule chemoreceptor
JGA
baroreceptor
------------
90% renal cortex composes tubules
Proximal
tubule, brush border 比較紅
Shock
segments
Toxin
continuous
------------
Interstitium
Ccr, BUN
Per min
1000cc renal
artery
900cc renal
vein
GFR 100
Urine 1
------------
Renal artery
Seg
Interlobar
Arcuate
Intralobar
------------
Percutaneous biopsy
------------
HE
Silver
Masson
Trichrome
PAS
3um
Immunofluorescence
IgG, IgM,
IgA, C3, C1q, kappa, lambda
Tubules
deposition nonspecific
------------
Subepi. Membrane
Mesengial IgA
Subendo lupus, MPGN
DIf
Cryo
Acetone
PBS
FITC
PBS
PermaFluor
Dark
------------
Goodpasture disease
Goodpasture
syndrome (GPS; also known as Goodpasture’s disease, antiglomerular basement
antibody disease, or anti-GBM disease) is a rare autoimmune disease in which
antibodies attack the basement membrane in lungs and kidneys, leading to
bleeding from the lungs and kidney failure. It is thought to attack the alpha-3
subunit of type IV collagen, which has therefore been referred to as
Goodpasture's antigen.[1] Goodpasture syndrome may quickly result in permanent
lung and kidney damage, often leading to death. It is treated with
immunosuppressant drugs such as corticosteroids and cyclophosphamide, and with
plasmapheresis, in which the antibodies are removed from the blood.
------------
EM
Glutaraldehyde
1um, 50-70nm
for EM
Thin basement
disease
------------
RPGN Ccr兩倍
in 3 month. Crescent
Type 1
Goodpasture
Linear deposition of IgG in GBM
NC1
domain
Type 2
Immune
complex
SLE, IgA,
type MPGN
Type 3
Pauci
immune
------------
MPGN
Type 2 DDD, dense deposit
disease
Lamina densa, Bowman's capsule, renal tubules
Recurrence
after transportation
C3 glomerular
deposition atypical HUS
------------
Thin basement disease
400 →200
nm
Type 4
collagen
Alpha 3,4
subunit defect
Deafness
------------
Alport syndrome
X linked
Alpha 5
subunit
------------
15% AR type
------------
DM nephropathy
------------
Myeloma
Kappa 多
Light chain
Bence Jones
protein
Cast
nephropathy
------------
Amyloid
Beta
birefringence
AA, AL type
most common
Inflammation AA 未開發
Light chain AL 已開發 lambda
------------
ATIN, AIN
Chinese herb
nephropathy
------------
Granular kidney
Hypertension
Compensatory
hypertrophy
------------
Rejection
器官經濟學
Endothelial
double contour
C4d
------------
RCC 70%
Clear cell
70%
------------
UC
------------
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