General Information
The Yale Electron Microscopy and Renal Pathology Laboratory is a nationally recognized center for diagnostic electron microscopy and renal pathology. It provides the most effective methodologies available for ultrastructural and immunological diagnosis. These include transmission electron microscopy, negative staining, immunocytochemistry, and standard and confocal immunofluorescence techniques. There is special emphasis on the diagnosis of glomerular, tubulointerstitial, and vascular kidney diseases. Electron microscopy is also of value in the diagnosis of ciliary abnormalities, metabolic disorders, microbial identification, and tumor diagnosis. As one of the few such comprehensive electron microscopy services with digital imaging capability in the nation, it is well positioned to serve a wide geographic area with rapid turnaround combined with expert consultative services.
Highlights
- Provides high quality electron micrographs/digital images for analysis of ultrastructural aspects of disease
- Maintains the highest level of diagnostic accuracy coupled with rapid turnaround time for renal diseases, ciliary abnormalities, metabolic disorders, microbial identification, and tumor diagnosis
- Assists in developing new programs, such as a comprehensive program for diagnosis of immunologic diseases and a center for excellence in transplantation
People
Dr. Michael Kashgarian is the Emeritus Director of the laboratory. Dr. Gilbert Moeckel (starting July 1, 2008) is Director and Dr. Jan Czyzyk is an Associate Research Scientist in Pathology and Renal Fellow. The laboratory is staffed by two full-time electron microscopists: Margaret Ianniello, Manager, and Judith Mitnick Ph.D. Administrative support is provided by Pamela Clark.
Facility
IThe laboratory is located in the Medical School, Lauder Hall LB20. Facilities include a cutting room with two Reichert Ultramicrotomes - Ultracut E and Ultracut S. An embedding area includes the Reichert Lynx Tissue Processor and the Leica EMStain automatic stainer. The Zeiss LIBRA 120 Electron Microscope is used to scan the specimens. Images are digitized from the electron microscope using the Advanced Microscopy Techniques (AMT) CCD Camera system and software.
Frequently Asked Questions
for physicians:
What are the indications for a renal biopsy?
Although patients with all varieties of renal parenchymal disease have undergone renal biopsy, the biopsy is of greatest value in patients with large amounts of proteinuria or changes in renal function, patients with systemic disease, certain patients with acute renal failure, and patients with an active urinary sediment. Important clinical information such as serum creatinine, serologic studies, and the degree of proteinuria are useful in assisting the interpretation of the renal biopsy.
Can the biopsy assess the risk of progression and the potential for response to therapy?
The renal biopsy provides significant information relative to the risk of progression by examining the degree of tubulointerstitial scarring. The potential to respond to therapy is generally based on the presence or absence of acute inflammatory changes in the glomerulus and in the tubulointerstitial compartment.
What types of infectious diseases are identified by electron microscopy?
Electron microscopy has proven useful in the diagnosis of a wide range of viral diseases and in the diagnosis of unusual infectious agents such as spirochetes, microsporidia, and protozoa mechanisms.
What clinical information will assist in the evaluation of the renal biopsy?
Important clinical information such as serum creatinine, serological studies for hepatitis and lupus, and the degree of proteinuria are generally useful in assisting in the interpretation of the renal biopsy.
Does a needle biopsy provide an adequate sampling?
It is generally felt that needle biopsy of the kidney gives a sufficient sampling for most processes that involve the glomerular or tubulointerstitial compartments.
for patients:
Why do I need a renal biopsy?
While your doctor may be able to tell you that you have a disease which affects your kidneys, laboratory tests and physical examination are generally insufficient to give the accurate diagnosis your doctor needs to plan your therapy and management.
What are the potential complications of a needle biopsy?
The technique of a renal biopsy has been improved so that complications are very uncommon. It is relatively rare to have a serious complication, although it is not uncommon to have blood in the urine following a biopsy.
Consult Services
Complete electron microscopy and renal biopsy consultation services are
available to departments and physicians within YNHH, as well as outside
hospitals and groups.
More information is available by contacting:
Electron Microscopy Laboratory
Department of Pathology
Yale University School of Medicine
P.O. Box 208023
310 Cedar Street, LH B20
New Haven, CT 06520-8023
Phone: (203) 785-2750
Fax: (203) 785-3348