Effect of micro/nano-particles in cavitation erosion

The tests in de-ionized water with micro/nano CeO2 particles are carried out to study the effect of the micro/nano particles in inception of cavitation erosion. The existence of micro/nano particles is found to be the requisite factor and the degree of cavitation erosion is related to the sizes of the particles. Particles in the micro/nano scale may act as the transporters of micro bubbles to keep or get close to the solid surface together and the pressure fluctuation induced by the surface roughness causes the collapse of bubbles and erosion of the surface. Discrete phase models are employed to simulation the moving tracks of the particles. The sizes of the particles affect their capabilities of keeping and getting close to the surface. The effect of the particles of a certain size in cavitation erosion is determined by the combinational action of the two.

[Surgical exploration of the sentinel lymph nodes in the papillary thyroid carcinoma]

OBJECTIVE

To study the technique of sentinel lymph node mapping in the papillary thyroid carcinoma and its evaluation in the search for cervical metastases.

METHOD

Exploration of the sentinel lymph nodes of the papillary thyroid carcinoma by injection of methylene blue around the tumour among 25 patients during surgery. The nodes which stained blue and the other nodes removed by functional neck dissection were examined histologically after staining with hematoxylin-eosin-saffron (HES). We have evaluated the predictive value of the technique in mapping the cervical metastases in the sentinel lymph node.

RESULTS

Among the 25 patients, 22 patients presented sentinel lymph nodes (blue-stained), that is to say a rate of identification of 88%. At histological examination, 19 of the 22 patients had positive sentinel lymph nodes, of which 13 had also positive nodes not coloured with blue. The histological examination of patients without sentinel lymph node was negative.

CONCLUSION

The technique of the sentinel lymph node has a strong positive predictive value in the search for cervical node metastases in the papillary thyroid carcinoma.

Menstrual-like changes in mice are provoked through the pharmacologic withdrawal of progesterone using mifepristone following induction of decidualization

BACKGROUND

Cyclic shedding of the endometrium is unique to menstruating species, and mouse menstruation models by physiologic progesterone withdrawal have been previously reported. Since progesterone action ablated pharmacologically may provide more insight into the mechanism of action, a mouse menstruation model using mifepristone was established.

METHODS

Mifepristone was administered following oil-induced decidualization in ovarectomized mice primed with hormones. Morphology, hormone levels, leukocytes and apoptosis were evaluated over a period of 48 h after treatment. Vaginal smears were used to monitor bleedings.

RESULTS

Mifepristone induced menstrual-like changes. Tissue breakdown was drastic by 16 h, and the decidual zone was shed by 24 h while the mice bled. The endometrium regenerated from 24 h onwards and became completely restored by 48 h. These results are consistent with previous reports. However, although progesterone levels remained constant, estradiol levels increased after the treatment. The CD45(+) cells showed two peaks of increase at 16 h (breakdown phase) and 32 h (regeneration phase) (Leukocyte levels also increased in the unstimulated horns, but no breakdown changes occurred there). Moreover, apoptosis drastically increased by 16 h concurrent with tissue destruction. These results differed from those of the physiologic withdrawal models.

CONCLUSIONS

The pharmacologic withdrawal of progesterone by mifepristone successfully provoked a menstrual-like process in mice after artificial decidualization.

Bacillus circulans WZ-12—a newly discovered aerobic dichloromethane-degrading methylotrophic bacterium

A novel dichloromethane (DCM)-degrading bacterial strain named WZ-12 (GenBank accession no. EF100968) was isolated and identified as Bacillus circulans based on standard morphological and physiological properties and nucleotide sequence analysis of enzymatically amplified 16S ribosomal deoxyribonucleic acid. DCM dehalogenase from B. circulans WZ-12 was purified to 8.27-fold with a yield of 34.83%. The electrophoretically homogeneous-purified enzyme exhibited a specific activity of 118.82 U/mg. Sodium dodecyl sulfate-polyacrylamide gel electrophoresis of purified DCM dehalogenase gave a distinct band with an estimated molecular mass of 20,000 +/- 1,000.

Life expectancy of patients with newly-diagnosed HIV infection in the era of highly active antiretroviral therapy

BACKGROUND

Limited data are available on the life expectancy of patients with newly-diagnosed HIV infection in the era of highly active antiretroviral therapy (HAART).

AIM

To provide such an estimate using a semi-parametric projection.

DESIGN

Statistical analysis.

METHODS

Follow-up data for patients newly diagnosed with HIV infection in Taiwan (HIV/AIDS Cohort) from 1 May 1997 to 30 April 2003 (n = 3351, only 1% are injecting drug users) were analysed using the Kaplan-Meier method. The survival function for an age- and gender-matched reference population was generated by the Monte Carlo method from the life-table of the general population. A constant excess hazard model was used to project long-term survival of HIV-infected patients, with linear extrapolation of a logit-transformed curve of survival ratio between HIV-infected patients and the reference population.

RESULTS

The 5-year survival rate was 58% in patients who had already developed AIDS at diagnosis (AIDS group), and 89% in those who had not (non-AIDS group). Extrapolation yielded an expected mean survival time of 10.6 years after diagnosis for the AIDS group, and 21.5 years after diagnosis for the non-AIDS group.

DISCUSSION

Our results support the expansion of HIV screening programs to minimize delay in diagnosis. With continuing advances in HAART, this estimate of survival in initially asymptomatic patients may be conservative. Their long life expectancy raises questions about what kind of preventive heath services should be offered. These should be addressed through further analysis of overall benefit and cost-effectiveness.

Assessment of soil lead exposure in children in Shenyang, China

Soil lead pollution is serious in Shenyang, China. The paper brings together the soil work, the bioaccessibility, and the blood lead data to assess the soil lead exposure in children in Shenyang, China. Approximately 15.25% of the samples were above China Environment Protection Agency guideline concentration for soil Pb to protect human from health risk (350 mgkg(-1)). Pb concentrations varied among use scenarios. The main lead contamination sources are industry emission and automobile exhaust. Bioaccessibility also varied among use scenarios. Children, who ingested soil from industrial area, public parks, kindergarten playground, and commercial area, are more susceptible to soil lead toxicity. The industrial area soil samples presented higher bioaccessibility compared to the other use scenario soil samples contaminated by automobile exhaust. The result also suggested a most significant linear relationship between the level of Pb contamination and the amount of Pb mobilized from soil into ingestion juice. Soil pH seemed to have insignificant influence on bioaccessibility in the present study. Bioaccessibility was mainly controlled by other factors that are not investigated in this study. A linear relationship between children blood lead and soil intestinal bioaccessibility was present in the study. Children who are 4-5 years old are more likely to demonstrate the significant relationship between soil lead bioaccessibility and blood lead as their behaviors place them at greatest risk of soil lead toxicity, and their blood lead levels are more likely to represent recent exposure.

Update on clarithromycin resistance in Helicobacter pylori in Hong Kong and its effect on clarithromycin-based triple therapy

AIM

To determine the antibiotic susceptibility of Helicobacter pylori and evaluate the efficacy of a clarithromycin-based triple therapy in relation to antibiotic resistance.

METHODS

Consecutive patients referred for upper endoscopy due to dyspeptic symptoms were recruited. Gastric biopsies were obtained for the CLO test, histology and culture. Antibiotic susceptibility was assessed by the E-test. Patients with H. pylori infection received rabeprazole 20 mg, clarithromycin 500 mg, and amoxicillin 1,000 mg, all twice daily for 7 days.

RESULTS

Of 234 patients recruited, 124 were H. pylori-positive and culture was successful in 102 patients. The updated prevalences of resistance to clarithromycin, amoxicillin and metronidazole were 7.8, 0 and 39.2%, respectively. A total of 86 patients received 1-week triple therapy with rabeprazole 20 mg, clarithromycin 500 mg, and amoxicillin 1,000 mg, all twice daily, and 81 patients attended the follow-up test. Eradication rates by per-protocol and intention-to-treat analysis were 92.6 and 87.2%, respectively. The eradication rate by per protocol was significantly higher in patients with clarithromycin-susceptible strains than in those with clarithromycin-resistant strains (98.6 vs. 28.6%, p < 0.001).

CONCLUSION

Clarithromycin resistance reduces the clinical efficacy of clarithromycin-based triple therapy. However, due to the low prevalence of clarithromycin resistance, clarithromycin-based therapy is still the first choice for clinical use.

Effect of cyclo-oxygenase inhibitors on Helicobacter pylori susceptibility to metronidazole and clarithromycin

BACKGROUND

We previously reported that aspirin inhibited Helicobacter pylori growth and suppressed the mutagenic effect of metronidazole.

AIM

To determine the effects of a cyclo-oxygenase (COX)-2-specific inhibitor, SC-236, and a non-selective COX inhibitor, indometacin, on the growth, urease activity and antimicrobial susceptibility of H. pylori.

METHODS

Three H. pylori reference strains, and 18 clinical isolates were treated with SC-236 or indometacin for 24 and 48 h. Growth, urease activity and susceptibility to clarithromycin and metronidazole of the bacteria were assessed by viable colony counting, spectrophotometry and E-test respectively.

RESULTS

SC-236 and indometacin inhibited H. pylori growth in a dose-dependent manner with the lowest inhibitory concentrations of 0.03 and 0.1 mm, and the lethal concentrations of 0.09 and 0.3 mm, respectively. The numbers of CFU/mL in Brucella broth containing 0.09 mm SC-236 were 2 log lower at 24 h, and even 3 log lower at 48 h than that at 0 h (P = 0.035, compared with the vehicle control). Treatment of 0.3 mm indometacin reduced the number of CFU/mL by 1 log at 24 h compared with that at 0 h (P = 0.037 compared with the vehicle control). Helicobacter pylori urease activity began to decrease with 0.06 mm SC-236 at 24 h (P = 0.016), and 0.3 mm indometacin at 48 h (P = 0.025). MICs of metronidazole and clarithromycin against H. pylori were decreased significantly in the presence of 0.03 mm SC-236 or 0.1 mm indometacin (all P < 0.001).

CONCLUSION

Both SC-236 and indometacin suppressed the growth and urease activity of H. pylori in a dose-dependent manner, and increased its susceptibility to the antibiotics.

Pharmacokinetics and Lipid-Lowering Effect of Fluvastatin in Hypercholesterolaemic Patients on Maintenance Haemodialysis

Patients undergoing haemodialysis are predisposed to serum lipid abnormalities that can accelerate the development of atherosclerosis. Serum lipid levels must therefore be controlled over a long period. For patients with reduced renal function (including dialysis patients), special attention must be paid to hyperlipidaemia therapy, particularly drug selection. In this study, 30 mg/day fluvastatin was administered orally to five patients receiving maintenance haemodialysis. Their serum lipid levels and blood biochemistry were monitored during the 6 months of fluvastatin administration, and the pharmacokinetic parameters calculated. The therapeutic efficacy and safety of fluvastatin were demonstrated in this patient group. Furthermore, fluvastatin is not influenced by the dialysis membrane and does not accumulate in haemodialysis patients with hyperlipidaemia.

Epithelial maturation and extracellular matrix in reduced enamel epithelium

OBJECTIVE

To evaluate epithelial-mesenchymal interactions in morphological homeostasis through histologically orientated observations on the reduced enamel in epithelium.

STUDY DESIGN

Specimens were taken from impacted molar sites in 20 patients using the surgery. These were processed using standard histological, pathological and biochemical techniques. Slides were observed with a Nikon Eclipse E-600, Plan Apo piece, Microscopy, and photography was done using a Nikon Coolpix 990 digital camera.

RESULTS

Radiolucent lesions displayed the supporting fibrous connective tissue wall with stratified squamous epithelium lining mostly. None of the specimens displayed prominent CAM 5.2, and anti-human K7 reacuvity, and PAS positive staining.

CONCLUSION

While the results of this study suggest that the reduced enamel epithelium showed a lower tendency in cell cycle, it does indicate that a histologically oriented study of reduced enamel epithelium is needed for the understanding of epithelial-mesenchymal interactions in morphogenesis.

Comparative evaluation of the BACTEC MGIT 960 system with solid medium for isolation of mycobacteria

SETTING

The utilisation of new, rapid methods of diagnosis of tuberculosis is currently of great interest for tuberculosis control. This study was carried out in a teaching hospital in the eastern region of Taiwan.

OBJECTIVE

The BACTEC MGIT 960 system was evaluated and compared with Lowenstein-Jensen (LJ) medium and Middlebrook 7H11 plate for recovery rate and time to detection of mycobacteria.

DESIGN

A total of 1396 sputum samples were tested for the presence of mycobacteria. Specimens were processed and inoculated separately in the BACTEC MGIT 960 system, on LJ medium and 7H11 for comparative study.

RESULTS

The BACTEC MGIT 960 detected 235 isolates (100%), followed by LJ with 205 isolates (87.2%) and 7H11 with 178 isolates (75.7%). The mean time to detection of Mycobacterium tuberculosis complex was 11.6 days with MGIT 960, 20.1 days with LJ, and 18.7 days with 7H11. The contamination rates were 15.1% with MGIT 960, 10.1% with LJ and 9.7% with 7H11.

CONCLUSION

The BACTEC MGIT 960 system is a sensitive, rapid mycobacterial culturing system. However, the high contamination rate is a concern that should be carefully evaluated in the clinical setting.

Validation of the World Health Organization quality of life instrument in patients with HIV infection

We studied the reliability and validity of the World Health Organization quality of life (WHOQOL) assessment instrument in patients with human immunodeficiency virus (HIV) infection. WHOQOL-BREF was used to assess 136 HIV-infected outpatients. The results were analyzed and compared with data from 213 healthy persons. The Cronbach's alpha for internal consistency ranged from 0.74 to 0.85 across domains in HIV-infected patients. The test-retest reliability ranged from 0.64 to 0.79 across domains at average 4-week retest interval. Factor analysis identified four major factors: social, psychological, environment, and physical, consistent with the four domains of the instrument. The scores of all four domains correlated positively with self-evaluated health status and happiness (r range: 0.52-0.60 and 0.55-0.73 across domains, respectively), and correlated negatively with the number and severity of symptoms (r range: -0.40 to -0.47 and -0.41 to -0.52, respectively). The scores of physical, psychological and social domains, but not the environment domain, discriminated between healthy persons and HIV-infected patients (all p < 0.01). We conclude that the WHOQOL-BREF can be a useful quality-of-life instrument in patients with HIV infection.

An alternative method to enhance vagal activities and suppress sympathetic activities in humans

Vagal withdrawal and/or sympathetic overactivity is always accompanied by various kinds of stress and is dangerous to the body. We proposed that mild acupuncture on the Sishencong points may effectively enhance vagal activities but suppress sympathetic regulations of the heart in humans. Experiments were carried out on nine healthy male volunteers, while they were lying in a quiet room during 2-4 P.M. Acupuncture was applied 2 mm deep into the skin using standard stainless acupuncture needles at the Sishencong points, which are located on the vertex of the head, each 1 cm away from Baihui (GV 20) in four directions. Four points around the temporal area were selected as control points. Forty minutes of precordial ECG signals before, during, and after acupuncture were recorded continuously. Frequency-domain analysis of the stationary RR intervals was performed to evaluate the total variance, high-frequency power (HF, 0.15-0.40 Hz) and low-frequency power (LF, 0.04-0.15 Hz) in normalized units (LF%). Acupuncture on the Sishencong points resulted in an increased HF but a decreased LF% compared with the before acupuncture stage. Such effects did not occur when manual acupuncture was applied to the control points. The differences in the heart rate dynamics between Sishencong and the control groups took place 10 min after initiation of acupuncture and persisted even after the removal of the needles. Based on these results, we concluded that manual acupuncture on the Sishencong points enhanced cardiac vagal and suppressed sympathetic activities in humans. The underlying mechanisms and potential applications warrant further investigations.

The differences between late graft loss group and long-term graft survival group in renal transplantation

In renal transplantation, the long-term graft survival rate has not been improved. Until now, the differences between late graft loss and long-term graft survival have still not been estimated thoroughly. We have attempted to define clinical risk factors and parameters for late graft loss by comparing the differences in these two groups. Data from the Osaka University Database were assessed on 156 renal allografts during a 7-yr period. Thirty-six patients comprised the late graft loss group (patients in this group had graft function without need for dialysis for more than 3 yr post-transplantation, afterwards lost the allograft: 'loss group'). One hundred and twenty patients comprised the long-term graft survival group (patients in this group had graft function without need for dialysis until 31 December 1999: 'survival group'). Various immunological and non-immunological parameters were included in an univariate regression analysis. This analysis showed that donor age (P < 0.01), HLA mismatch number (P < 0.01) and a repeat of acute rejection (P < 0.01) were significant factors. Serum creatinine levels at 3 months (P = 0.01), proteinuria at 1 yr (P < 0.01) and antihypertensive treatment at 2 yr (P = 0.03) after transplantation were predictive of the risk of late graft loss. CsA trough concentration at 3-6 months (P < 0.05) and body mass index increase at 1 yr (P = 0.046) were elevated in the loss group. These results from a single centre suggest that immunological as well as non-immunological factors are associated with the pathogenesis of late graft loss.

[Preparation and evaluation of alkyl ether-bonded phase for reversed-phase high performance liquid chromatography]

A new silane coupling agent, beta-(3,4-epoxycyclohexyl)ethyltrimethoxy silane, was for the firsty time used to react with octanol, then the intermediate product was coupled onto porous silica to obtain a novel bonded phase for reversed-phase high performance liquid chromatography (RP-HPLC). Characterization of prepared packing was carried out with elemental analysis, solid-state 13C nuclear magnetic resonance spectrometry (NMR), Fourier transform infrared(FT-IR) spectroscopy. Chromatographic evaluations were carried out by using a mixture of organic compounds and methanol-water as the binary mobile phase. The results showed that the stationary phase has excellent chromatographic properties and resist to hydrolysis at a pH value between 2.5 and 7.5. The silanophilic activity of the OEBP was weakened because of the existence of the cyclohexyl group in the packing. It can be efficiently used for the separation of basic compounds.

Changes in lipid metabolism and effect of simvastatin in renal transplant recipients induced by cyclosporine or tacrolimus

Hyperlipidemia is frequently developed following renal transplantation and results in worsening of the patient's prognosis. In study 1, the effects of immunosuppressants, cyclosporine (CsA) and tacrolimus on serum lipids were compared in-patients undergoing renal transplantation. The study included 32 cases of renal transplantation recipients who randomized to the CsA treatment group (15 patients) and the tacrolimus group (17 patients). Before and 1 month after the transplantation, we assessed the serum lipid levels, apolipoprotein levels, the concentrations of cholesterol in the respective lipoprotein fractions and the enzyme activities related to lipid-metabolism. The serum lipid levels in both groups were significantly increased at 1 month after renal transplantation. In the CsA group, there were significant increases in cholesterol contents in very-low-density lipoprotein (VLDL), LDL2 and HDL2 fractions, whereas, in the tacrolimus group, cholesterol content was increased in VLDL and HDL2 fractions. In study 2, 1 month after renal transplantation, 19 patients with hypercholesterolemia (total cholesterol (TC) >200 mg/dl) and hypertriglyceridemia (triglyceride (TG) >150 mg/dl) were treated with simvastatin 5-10 mg/day for 6 months. Simvastatin treatment significantly decreased serum TC (240+/-29-200+/-22 mg/dl, P<0.001), low-density lipoprotein cholesterol (LDL-C; 114+/-20-99+/-17 mg/dl, P<0.05) and TG levels (217+/-103-130+/-38 mg/dl, P<0.01). In addition, there were significant decreases in very-low-density lipoprotein cholesterol (VLDL-C; 53+/-20-34+/-15 mg/dl, P<0.001). The Cmax and AUC of simvastatin were increased about eight-fold, when simvastatin was given in combination with CsA. In contrast, no significant changes in simvastatin levels were observed when combination with tacrolimus. Although simvastatin levels were increased with CsA, there were no abnormal changes in renal and liver functions, creatinine phosphokinase (CPK) levels or in incidence of adverse effects.

[Using genetic algorithm for quantitative analysis of overlapped spectra in FTIR]

Technique for the quantitative analysis of FTIR spectra, which are serious overlapped in the spectral bands, is studied by genetic algorithm. The multicomponent in the mixture, which contains ten air toxic organic components, such as benzene, phenixin, chlorobenzene, nitrobenzene, phenol, toluene, methanol, o-cresol, m-cresol and p-cresol, is simultaneously determined. The effect of the probability of crossover and the establishment of objective function are discussed. The method of adaptive mutation is used. The results indicate that genetic algorithm has excellent non-linear ability of solution. Mean relative error of each results is really small, generally not bigger than 1%, when the conditions are properly controlled.

[Preparation and evaluation of amide-octyl-bonded phase for the separation of basic substances in reversed-phase liquid chromatography]

A new bonded-phase, amide-octyl-bonded phase (AOBP), with an internal polar functional group-amide was firstly prepared in domestic by two-step reaction process. The amino phase was formed in the first step and further modified in the second step by attaching an alkyl chain via reaction of an acid chloride with the amino ligand. Characterization of prepared packing was carried out with elemental analysis and Fourier transform infrared (FTIR) spectrometry. Hydrophobicity, selectivity and silanophilic activity of AOBP were evaluated by using organic components including acidic, bascic and neutral analytes and methanol-water as binary mobile phase. The applicable ranges of pH and stability of AOBP were also evaluated. The results showed that AOBP has excellent chromatographic properties and resistance to hydrolysis between pH = 2.5-7.5, It can be used for the separation of basic solutes efficiently.

Impact of age on the injury pattern and survival of people with cervical cord injuries

STUDY DESIGN

A retrospective, follow-up study.

OBJECTIVES

To differentiate the injury pattern and survival of people with cervical cord injuries with onset at different ages.

SETTING

Rehabilitation wards of a university hospital that is a tertiary referral center in Taipei, Taiwan.

METHODS

The records of acute and traumatic cervical cord injury patients hospitalized from 1989 to 1997 were reviewed. All subjects received comprehensive rehabilitation programs during hospitalization. Their survival status at the end of follow-up was studied.

RESULTS

Forty-seven of 109 (43.1%) people with cervical cord injuries were 50 years or older at onset. Older patients were more frequently injured by minor falls, resulting in more incomplete quadriplegia. They also showed fewer spinal fractures, and more demonstrated associated spondylosis and ossification of the posterior longitudinal ligament. Eleven (10.2%) subjects were deceased, found by a linkage to a death registration database at the end of follow-up. The significant predictor of survival status at follow-up was older age at injury using Cox proportional hazards model.

CONCLUSION

Spinal cord injured patients had different injury patterns, demanding different preventative strategies. Those injured at older ages were at higher risk of mortality according to our study.

SPONSORSHIP

This study was supported in part by grants from the National Taiwan University Hospital (89S2005), Taipei, Taiwan.

Clinicopathological evaluation in non-episode biopsies of renal transplant allograft

Histopathological findings in renal allograft with stable function remain unclear. We therefore performed non-episode biopsy in the long-surviving renal allograft to investigate the histopathological changes. Our data show that, although arteriolopathy is characteristic of drug-induced nephropathy, it is unrelated to dosage and concentration of cyclosporine or tacrolimus in non-episode biopsy. We evaluated therefore the clinicopathological findings of arteriolopathy in this study. Non-episode biopsy was defined as follows: as serum creatinine level lower than, 2.0 mg/dl and a urinary protein level lower than 500 mg/day. A total of 65 biopsy specimens were enrolled in this study as non-episode biopsy. Twenty-nine specimens revealed arteriolopathy. There were no statistically significant differences between arteriolopathy and dosage or concentration of cyclosporine or tacrolimus. Arteriolopathy in non-episode biopsy was related to time of biopsy, kidney age, hypertension, and hyperlipidemia, suggesting that it is important for graft survival to strictly control blood pressure and blood lipid level.

Factors influencing vertebral bone density after renal transplantation

To improve our understanding of the mechanisms underlying osteoporosis following renal transplantation, we compared bone mineral density (BMD) in 158 transplant recipients and in 293 patients undergoing maintenance hemodialysis with age- and sex-matched normal controls. Observations in graft recipients were made up to several years following transplantation. Dual-energy X-ray absorptiometry was used to measure BMD. Correlations with clinical variables including serum concentration of parathyroid hormone (PTH) and steroid therapy were evaluated. Lumbar BMD was lower in transplant patients than in dialysis patients at all ages, and continued to decrease with increasing interval posttransplant until the second year after transplantation. Persistent hyperparathyroidism and daily prednisolone dosage were both associated with decreased BMD. Age and creatinine clearance were independent long-term predictors of BMD by multiple regression analysis. Treatment of renal graft recipients with calcium and vitamin D supplements or calcitonin may be indicated in the early months after transplantation.

Arteriolopathy in non-episode biopsies of renal transplant allograft

PURPOSE

We have been performing protocol biopsies since 1995 to predict the outcome of renal allograft. However, histopathological findings in renal allograft with stable function remain unclear. For this reason, we performed non-episode biopsy on long-surviving renal allograft and investigated the histopathological changes. Among the several diseases seen in non-episode biopsies, arteriolopathy, such as drug-induced nephropathy, is one of the most frequent diseases. However, it is unrelated to the dosage and the concentration of cyclosporine or tacrolimus. Consequently, we evaluated the clinicopathological findings of arteriolopathy in this study in order to clarify whether cyclosporine (CsA) or tacrolimus (FK506) is responsible for these findings.

MATERIALS AND METHODS

We defined non-episode biopsy as a case with a serum creatinine level less than 2.0 mg/dL and containing less than 500 mg/dL of urinary protein. Final results showed that 71 cases were identified as non-episode biopsy. We then evaluated the histopathological findings and the clinical characteristics of these cases.

RESULTS

Thirty-two of the 71 non-episode biopsy specimens showed findings of arteriolopathy. The frequency and the severity of arteriolopathy are not concerned with dosage and concentration of CsA or FK506. The arteriolopathy seen in non-episode biopsy was related to the time of the biopsy and the kidney age. Arteriolopathy in nonepisode biopsy also had a relationship with hypertension, suggesting that it is important to strictly control blood pressure for graft survival.