The spectrum of renal diseases with lupus-like features: a single-center study.

BACKGROUND: A subset of patients without overt systemic lupus erythematosus (SLE) present with biopsy findings typically seen in lupus nephritis (LN). Although a minority eventually develops SLE, many do not. It remains unclear how to classify or treat these patients. Our study attempted to further understand the clinical and pathological characteristics of cases with lupus-like nephritis (LLN). METHODS: Among 2700 native kidney biopsies interpreted at University of Rochester Medical Center (URMC) from 2010 to 2019, we identified 27 patients with biopsies showing lupus-like features (LL-fx) and 96 with LN. Of those with LL-fx, 17 were idiopathic LLN and 10 were associated with a secondary etiology (e.g., infection/drugs). RESULTS: At the time of biopsy, the LLN-group tended to be slightly older (44 vs. 35), male (58.8 vs. 17.7%, p = .041), and Caucasian (47.0 vs. 28.1%, p = .005). Chronic kidney disease was the most common biopsy indication in LLN (21.4 vs. 2.8%, p = .001). Both LN and LLN presented with nephrotic-range proteinuria (mean 5.73 vs. 4.40 g/d), and elevated serum creatinine (mean 1.66 vs. 1.47 mg/dL). Tubuloreticular inclusions (TRIs; p < .001) and fibrous crescents (p = .04) were more often seen in LN, while more tubulointerstitial scarring was seen in LLN (p = .011). At mean follow-up of 1684 d (range: 31-4323), none of the LLN patients developed ESRD. A subset of both LN and cases with LL-fx overlapped with other autoimmune diseases. CONCLUSIONS: Lupus-like pathologic features are seen in a wide array of disease processes. The findings suggest that LLN may be a manifestation of an autoimmune process that overlaps with SLE.

Intracranial Mycoplasma hominis infection following emergent craniectomy.

We present a case of a young healthy female who developed recurrent cranial wound infections after a traumatic injury, the etiologic organism finally identified as Mycoplasma hominis, an uncommon and difficult to isolate bacterium.

Superior Vena Cava Syndrome in Conjunction with Pulmonary Vasculature Compromise: A Case Study and Literature Review.

BACKGROUND Superior vena cava (SVC) syndrome can result from external compression or invasion of the vessel from structural pathology within the mediastinum. Here we present a case of a patient that had no airway compromise, but who had hemodynamic instability due to pulmonary vasculature compression requiring urgent intervention. CASE REPORT A 61-year-old male who presented with severe dyspnea was found to have newly diagnosed small cell carcinoma of the right lung. The carcinoma compressed the SVC as well as the right pulmonary artery (PA) as seen on computed tomography scanning. He became critically hypoxic and was emergently intubated. Due to the lack of airway compromise, this instance of SVC syndrome was not emergently treated with radiation or chemotherapy. However, he received appropriate treatment while on mechanical ventilatory support and eventually recovered. CONCLUSIONS SVC syndrome is considered an emergent condition in the setting of airway compromise. With the addition of PA compression, a case's acuity should be reconsidered. Our case highlights the fact that SVC syndrome can be associated with compression of the right PA, due to its close proximity to the SVC. This can lead to rapid hemodynamic deterioration, thereby increasing the acuity when evaluating a patient with SVC syndrome. We recommend emergent intervention to be taken when a patient develops this combination of SVC syndrome and PA compromise.

Catalytic Role of Thermostable Metalloproteases from Bacillus subtilis KT004404 as Dehairing and Destaining Agent.

Proteases with characteristic stabilities are considered attractive candidates for industrial catalysis. In the present study, a potent bacterial strain KT004404, an inhabitant of hydrothermal vents, was isolated and characterized for protease production. Initial screening indicated that this strain produced a hydrolytic zone of 30 mm 16S rRNA-based identification revealed that our isolate was a strain of Bacillus subtilis. Optimum reaction condition for maximum protease production was determined as 55 °C, pH 6, 1 % inoculum size and malt extract as primary growth substrate supplemented with 1 % dextrose. Yield of the enzyme was increased up to 7.53 folds with a specific activity of 55.125 U/mg after gel filtration chromatography. SDS-PAGE analysis confirmed the size of protease as 28.24 kDa. Purified enzyme retained its catalytic activity over a broad range of temperature (5 to 65 °C) and pH [5-8]. Addition of metal ions shown to have a stimulatory effect on catalytic properties while EDTA inhibited the efficiency of the enzyme confirming it as a metalloprotease. Protease exhibited excellent stability and activity in the presence of anionic surfactants, solvents, and detergents. The results of dehairing and destaining experiments suggested that the protease produced by B. subtilis KT004404 could be used in leather and textile industries with ecological benefits.