Clinical Significance of an Early Protocol Biopsy in Living-Donor Renal Transplantation: Ten-Year Experience at a Single Center

We report here our 10-year experience of a biopsy performed at day 14 after transplantation in 304 patients with stable graft function. The factors that may have influenced subclinical rejection were analyzed according to histology. The incidence of subclinical rejection was 13.2%. Addition of mycophenolate mofetile (MMF) as a primary immunosuppressant significantly decreased the incidence of subclinical rejection compared with patients without such treatment (odds ratio, 0.23; p < 0.05). On the other hand, HLA-DR antigen mismatch (odds ratio, 2.39) and unrelated donor (odds ratio, 2.10) were also significantly associated with decreased subclinical rejection (p < 0.05). The incidence of acute rejection in patients with normal findings was lower than in those with borderline changes or subclinical rejection (0.23 +/- 0.05 vs. 0.48 +/- 0.07 and 0.60 +/- 0.11, respectively; p < 0.05). The graft survival rates in patients with subclinical rejection were lower than in patients with normal or borderline changes at 1 (88.4% vs. 97.9% and 99.1%; p < 0.05), 5 (77.8% vs. 96.2% and 95.9%; p < 0.05) and 10 (62.3% vs. 96.2% and 93.7%; p < 0.05) years. Thus, a protocol biopsy performed on day 14 after transplantation is useful for predicting graft survival. Triple therapy including MMF, related donor and HLA-DR antigen match are important factors for reducing subclinical rejection in living-donor renal transplantation.     

Issues of obesity in kidney transplantation.

The purpose of this literature review is to evaluate the scientific evidence regarding the relationship between obesity and outcome of renal transplant recipients. The impact of obesity on kidney transplant outcomes continues to be controversial. Obesity seems to influence delayed graft failure, graft survival, and patient survival. A body mass index of 35 kg/m(2) or more is significant for greater posttransplant complications, especially new-onset transplant diabetes mellitus, wound complications, and posttransplant weight gain. Several important advances in the general medical management of the patient, both before and after transplantation, have occurred over the last decade. The decrease in mortality may be related to better patient management, whereas the improvement in graft survival is most likely the result of more effective immunotherapy and better management of hypertension and hyperlipidemia, which overall lessens the risk of obesity among kidney transplant recipients.     

Schizotypal disorder and schizophrenia: a profile analysis of neuropsychological functioning in Japanese patients.

This study compares neuropsychological functioning in a Japanese schizophrenia spectrum disorder group and a group of healthy Japanese volunteers. Participants were 37 patients diagnosed with schizophrenia, 28 schizotypal patients, and 99 psychiatrically-normal volunteers. A wide range of cognitive measures were examined. All participants completed a Japanese version of a neuropsychological battery assessing executive function, working memory, processing speed, language, verbal memory, and spatial organization. Comparisons of neuropsychological function demonstrated similarities and differences between patients diagnosed with schizotypal disorder and those diagnosed with schizophrenia. Impairments in verbal memory, language, and processing speed were common to both patient groups and may represent a vulnerability to schizophrenia. Impairments in aspects of working memory, spatial organization and executive function were preferentially observed in schizophrenia and may be features of the overt manifestation of psychosis. Possible differences in the contributions of prefrontal and temporo-limbic structures provide direction for further studies.     

Effect of Postnatal Ethanol Exposure on Expression of Differentiation Antigens of Murine Splenic Lymphocytes

Ethanol is a recognized immunosuppressive agent in the chronic alcoholic. However, the effects of ethanol exposure on the developing immune system have not been extensively investigated. This study evaluated the effects of early postnatal ethanol exposure, via breast milk, on splenic lymphocyte differentiation antigen expression in offspring reared by ethanol-fed mice. Maternal mice were fed a liquid diet containing 20% ethanol-derived calories during pregnancy (E-P), pregnancy and lactation (E-PL), or lactation (E-L). Ad libitumfed (C) and pair-fed (PF) control groups, fed a control liquid diet, were included. Expression of differentiation antigens on splenic lymphocytes from 21-day-old offspring reared by females in 1 of the 3 ethanol exposure conditions was evaluated by flow cytometry. Offspring reared by E-P females had similar numbers of splenic lymphocytes as offspring reared by C and pair-fed during pregnancy (PF-P) females. In contrast, offspring reared by E-PL and E-L females had fewer splenic lymphocytes than both PF-PL and PF-L (respectively), and C offspring. The number of Thy 1.2⁺, CD4⁺, CD8⁺, and IgG⁺ (B-cell) splenic lymphocytes was reduced in E-PL and E-L offspring compared with PF and C offspring. E-P offspring had fewer CD4⁺ and IgG⁺ splenic lymphocytes than C, but not PF-P, offspring. The percentage of Thy 1.2⁺ splenic lymphocytes was significantly reduced among E-PL and E-L offspring compared with PF-PL and PF-L (respectively), and C offspring. These results suggest that ethanol exposure of female mice during pregnancy, pregnancy and lactation, or lactation alone, alters the phenotypic development of splenic lymphocytes of offspring reared by these females. The greatest effect on differentiation antigen expression occurred when females consumed ethanol during the period of lactation. We speculate that direct exposure of the nursing offspring to ethanol via the breast milk was responsible for the reductions in specific splenic lymphocyte populations. These data demonstrate that mice reared by females fed ethanol during the early postnatal period have a marked depletion of each of the major subpopulations of splenic lymphocytes, and that Thy 1.2⁺ lymphocytes are differentially sensitive to ethanol.     

增殖细胞核抗原在口腔鳞状细胞癌中的表达

采用鼠抗ＰＣＮＡ单克隆抗体，ＡＢＣ法，对１１例正常口腔粘膜及２９例口腔鳞癌进行了染色。结果表明：正常粘膜仅在基底层中有少量的ＰＣＮＡ阳性细胞，其阳性分级为１级。而鳞癌阳性分级主要是３～４级，随着组织学分级的升高，ＰＣＮＡ阳性表达率也相应增高。经统计学分析，正常组织与鳞癌之间及鳞癌各级均有非常显著差异（Ｐ＜００１）。提示：ＰＣＮＡ的表达与口腔鳞癌组织学分级有关。     

实验性视网膜光化学损伤中的蛋白激酶C

目的：研究实验性视网膜光化学损伤中蛋白激酶C(protein kinase C，PKC)活性的改变；探索地塞米松(dexamethasone，DXM)对视网膜中PKC活性的影响。 方法；48只SD大鼠分为对照组和DXM组，后者于光照前3天开始，连续5天腹膜腔注射DXM 1mg/(kg·d)。经(1 900±106.9)Ix的绿色荧光灯(λ＝510nm～560nm)连续照射24小时后的6小时和1、3、7、14天，进行视网膜PKC活性检测。 结果：光化学损伤后视网膜中的PKC活性在短暂的上升后即出现持续性的下降；DXM对PKC的活性改变无明显作用。 结论：光化学损伤中的视网膜功能障碍可能与PKC活性的持续降低有关。 （中华眼底病杂志，1997，13：78-80）     

复合维生素对抗体形成细胞的影响

单独一种维生素缺乏对免疫功能的影响已有较多研究报道,但维生素缺乏一般不会单独发生,为此本实验研究了维生素A、E、B_2、B_6及叶酸供给不足(1/3生理需要量)、加倍补充(2倍和3倍生理需要量)后对小鼠抗体形成细胞的复合效应。动物喂养6周(不足纠正组喂8周),结果显示,不足组抗体形成细胞显著低于对照组,而2倍、3倍组则显著升高,不足组补充正常量维生素后,抗体形成细胞升高超过对照组,与2倍量组无显著差异;另外,该几种维生素对肝脏RNA、脾脏DNA、RNA及肝脏蛋白质均有明显影响,且抗体形成细胞的变化与核酸、蛋白质含量改变相平行,提示后者可能是维生素作用于体液免疫系统的生化机制。     

磺胺噻二嗪硫酮衍生物的合成及其抑菌活性

利用药物化学骈合原理设计并合成了一系列新的３，５－二取代１，３，５－噻二嗪－２－硫酮类化合物，其结构经红外光谱，紫外光谱及元素分析证实，抑菌活性试验显示了良好的抑菌活性。