Barnert Hospital was a 236-bed hospital at 680 Broadway in the Eastside section of Paterson, New Jersey that operated for 99 years. The hospital was named for Nathan Barnert, a philanthropist and former mayor of Paterson who founded the hospital. In 1914, Barnert donated a site at East 30th Street and Broadway and provided an endowment. The original building was designed by Fred Wesley Wentworth in the classical revival style, constructed of a pink granite base and yellow brick with extensive detailing and other elaborate materials. it stood until the mid 1960s when it was demolished for a more modern structure.The hospital was a full-service facility offering perinatal care, family care services and an outpatient infusion unit treating high risk pregnancies and hematology-oncology patients. Its operations were drastically scaled back in its last years of operation due to serious financial difficulties. The hospital sought Chapter 11 Bankruptcy protection in August, 2007. The hospital initially intended to close on September 28, 2007 due to a lack of funds. However soon after the announcement both the State and Federal governments appropriated $3.5 million to keep the hospital open while a buyer was sought. Several groups attempted unsuccessfully to raise $3.5 million in order to purchase the facility and convert it into a multi-use specialty hospital. The bankruptcy court reviewed bids, however these plans did not materialize and the hospital announced its closure on February 1, 2008. The hospital closed officially on May 30, 2008.Following Barnert's bankruptcy, the facility was purchased by Community Healthcare Associates and reorganized as a 'medical arts complex.' As of September 17, 2009, Barnert is at over 90% capacity with tenants that include pharmacists, hospice care, an adult day-care center, a sub-acute rehabilitation center and group practices that provide primary care. The $15 million renovation by CHA included a new heating and cooling system, with the building being completely retrofitted with new floors installed. The Barnert Medical Arts Complex is now flourishing and serves as a model for struggling acute care hospitals around New Jersey.
OBJECTIVES:To study the tertiary-stem villi vessel lumen and wall thickness of placenta in pregnancy complicated with placental insufficiency and intrauterine growth retardation (IUGR), its correlation with the umbilical artery Doppler flow study, and compare with normal and non-IUGR pregnancies.METHODS:Placentas from 45 deliveries (between 28 and 38 weeks) were collected for morphometric study of the tertiary-stem villi vessels. Each pregnancy had clinical suspicion of IUGR and was confirmed by serial ultrasound biometry, HC/AC ratio, and had abnormal umbilical artery Doppler velocimetry (RI). Each placenta was weighed after trimming of the membrane and the cord. Sections of the placenta (4 micron) were stained with hematoxylin and eosin and periodic acid-Schiff reagents. Tertiary-stem villi vessels were identified under a microscope (x40) and morphometric study was performed. Inner and outer circumferences (2.pi.r) were measured, radii (r) were calculated, and vessel wall thickness was determined (outer r - inner r). These findings were compared with the findings from 78 placentas from normal pregnancies (between 28-40 weeks) and 27 placentas from pregnancies with medical complications without IUGR (non-IUGR) and with normal Doppler velocimetry (between 33 and 38 weeks).RESULTS:Weight of placentas were significantly (P < 0.005) lower in IUGR than the normal and non-IUGR groups. The vessel wall thickness was significantly (P < 0.0001) increased in IUGR group (mean 21.17 +/- 3.16 micron [SD]) compared to normal and non-IUGR groups (mean 13.19 +/- 1.66 micron). With advancing gestational age, the thicknesses of vessel walls in all groups were significantly (P < 0.001) decreased. There was significant (P < 0.001) decrease in lumen circumference in the IUGR group (mean 173 +/- 31 micron) compared to normal and non-IUGR groups (mean 69 +/- 23 micron). Significant (P < 0.001) correlation was observed between the thickness of a vessel wall and the increase in Doppler RI.CONCLUSIONS:Pregnancies with growth retardation are associated with smaller placentas, increase in the thickness of tertiary-stem villi vessel wall, and decrease in lumen circumference. These changes are associated with an increase in the resistance index of the umbilical artery Doppler flow velocimetry.
Autoimmune phenomena are common in human immunodeficiency virus (HIV) infection, yet systemic lupus erythematosus (SLE) and HIV infection rarely are seen concurrently in the same patient. Many of the cases of combined HIV infection and SLE reported in the literature are patients with SLE before HIV infection and who did not undergo renal biopsy at a time when both processes were present. We report the clinical manifestations and renal biopsy findings in four subjects with concurrent HIV infection and SLE and compare them with the seven previously reported cases in the literature. Taken together, most patients were black (91%) and male (73%), and approximately half (55%) were children with perinatal HIV infection. These demographics differ markedly from those of idiopathic SLE, a disease that predominantly affects female adults. Renal presentations included proteinuria and hypocomplementemia, frequently with hematuria and renal insufficiency. Renal biopsy findings in 10 cases included all classes of lupus nephritis (class IIb in two cases, class III in one case, class IV in three cases, class V in three cases, class III and V in one case), two of which also displayed overlapping features of HIV-associated nephropathy (HIVAN). One case had isolated findings of HIVAN. This cohort provides a unique population in which to study interacting pathomechanisms between HIV infection and SLE.
We encountered 4 individuals with Marfan syndrome who presented with microhematuria and proteinuria. In 2 of them, a renal biopsy was performed. The predominant glomerular change by light microscopy was a focal segmental increase in mesangial matrix with early sclerotic lesions. Ultrastructurally, there was variable subendothelial widening containing haphazardly arranged microfibrils, 10-13 nm in diameter. Changes in small arteries present in the biopsies were mild in case 1 and more striking in case 2 which consisted of elastolysis and fragmentation and focal disruption of internal elastic lamina, and focal degenerative changes in the media. In light of observations on the abnormalities of microfibrillar protein (fibrillin) in the microfibrillar-fiber system and the presence of abnormal type IV collagen in the connective tissues in Marfan syndrome, the glomerular basement membrane alterations may be related to these defects and lead to microhematuria and proteinuria.
Adrenal cysts are uncommon lesions. The authors discuss two cases of adrenal pseudocyst, and its classification and possible pathogenesis and complications. The role of radiologic findings in preoperative evaluation of renal/suprarenal masses also is detailed.
A case of Bowen's disease of the nipple clinically resembling Paget's disease is reported. This lesion was differentiated from other pagetoid lesions by negative histochemical stains for mucin and melanin, positive immunohistochemical preparation for high-molecular weight cytokeratin 66 kd (904) using adequate controls, and electron microscopic findings of squamous cell features. The therapeutic implications of such a pagetoid nipple lesion in the absence of an underlying breast carcinoma are discussed.
