Histopathologic findings in routine biopsies of renal transplant allografts.
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Biomedical subjects
Publications and source records attributed to K Toki.
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We report a case of subclinical immunoglobulin A (IgA) nephropathy and cyclosporin associated arteriolopathy following renal transplantation. A 39-year-old male with chronic glomerulonephritis received kidney transplantation from a two- human leukocyte antigen (HLA) mismatched cadaveric donor. The initial immunosuppressive therapy was triple-drug therapy with cyclosporin, prednisolone and mizoribine. Four months after transplantation, he had an acute rejection episode, and the renal function was recovered by steroid pulse and 15-deoxyspergualin therapy. Eight years after transplantation, we conducted a non-episode biopsy of the renal allograft to examine subclinical lesions. The histopathological findings showed cyclosporin associate arteriolopathy (CAA) and IgA nephropathy. There was no sign of acute or chronic rejection. At the present time, the renal function of the allograft is good. In conclusion, the non-episode biopsy of renal allograft is useful for examination of subclinical lesions.
We conducted an analysis of biopsy specimens of non-episode renal allografts from patients treated with tacrolimus (FK506) or cyclosporine (CsA) to evaluate chronic drug-induced nephropathy in stable allografts. A total of 38 biopsy specimens from stable functioning renal allografts were examined. The patients had been treated with FK506 (n = 16) or CsA (n = 18) as main immunosuppressant for 0.3 to 7.4 years. Of the 38 biopsy specimens, 15 showed mild drug-induced arteriolopathy (hyalinosis or insudative change of arterioles and small arteries) with striped-form interstitial fibrosis, 10 showed minimum interstitial cellular infiltration (borderline rejection), 2 showed IgA nephropathy, 4 showed evidence of chronic rejection (transplant nephropathy) and 12 showed no abnormal findings. Of 34 renal allograft biopsy specimens with stable function, 22 (65%) showed pathological evidence of drug-induced nephropathy. There were no significant qualitative or quantitative differences between FK506- and CsA-associated nephropathy.
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Eight new anthocyanins 1-8 (ternatins C1, C2, C3, C4, C5, and D3 and preternatins A3 and C4) were isolated from Clitoria ternatea flowers. By the application of chemical, UV-vis, and FABMS methods, the structures of 1-6 were postulated as delphinidin 3-malonylglucoside having 3'-GCGC-5'-G, 3'-GCGCG-5'-G, 3'-GC-5'-G, 3'-GCG-5'-G, 3'-G-5'-G, and 3'-GC-5'-GC, and compounds 7 and 8 as delphinidin 3-glucoside having 3'-GCG-5'-GCG and 3'-GCG-5'-G as side chains, respectively, in which Dp is delphinidin, G is D-glucose, and C is p-coumaric acid. The structures of the compounds 1, 3-5, and 7 were established completely by additional NMR methods.
We reviewed 115 cases of acute rejection following renal transplantation. All cases were diagnosed after graft biopsy, and showed histopathological evidence of acute rejection. They were treated with administration of OKT3, 15-deoxyspergualin (DSG), anti-lymphocyte globulin (ALG) or methylprednisolone (MP). All rejections were histopathologically classified according to the Banff working classification. The clinical effects of each drug were evaluated both at 1 month and 1 year following the therapy for rejection, by measurement of serum creatinine level. The effective rate both at 1 month and 1 year was related with the Banff working classification ( p < 0.0001). At 1 month after treatment, there were no significant differences between the OKT3, DSG or ALG group and MP group in cases of borderline change and AR grade I. In cases of grade II and grade III, a significant difference was observed between the OKT3 or ALG group and MP group (p < 0.05). The DSG group showed a slightly better outcome than the MP group, although the difference was not significant. In conclusion, the Banff schema is shown to be valid for classification of acute renal allograft rejection, and it is necessary to determine the treatment for acute rejection according to histopathological classification.
Two series of structurally related anthocyanins, extracted from the blue flowers of Evolvulus pilosus cv. Blue Daze and from the blue-purple flowers of Eichhornia crassipes, exhibit remarkable colour stabilities in aqueous solution at mildly acidic pH values. All the pigments possess the same chromophore (delphinidin), but a different pattern of glycosylation and acylation. Moreover, one of the pigments has an apigenin 7-glucoside molecule (a flavone) attached to the glycosidic chain by two ester bonds with malonic acid, instead of an aromatic acid and is the only known anthocyanin with such a structure. All the molecules studied, except one which has only a 3-gentiobioside (a disaccharide) as substituent, denote an effect of reduction in the hydration constant when compared with the parent delphinidin 3-glucoside or 3,5-diglucoside molecules, which supports the existence of intramolecular hydrophobic interactions between the chromophoric skeleton and the acyl or flavonoid groups. The role played by the sugar units on the hydrophobicity/hydrophilicity of the pigments is also discussed.
Four new acylated delphinidin 3,7-glycosides were isolated from the blue-violet flowers of Consolida armeniaca as major anthocyanin pigments. The first pigment was based on delphinidin 3,7-diglucoside and was identified as delphinidin 3-O-[6-O-(malonyl)-beta-D-glucopyranoside]-7-O- [6-O-(4-O-(6-O-(p-hydroxybenzoyl)-beta-D-glucopyranosyl)-p-hydroxybenzoy l)- beta-D-glucopyranoside] by spectral methods. The other three acylated anthocyanins were based on delphinidin 3-glucoside-7-sophoroside. The second pigment was determined to be delphinidin 3-O-[6-O-(malonyl)-beta-D-glucopyranoside]-7-O-[2-O-(beta-D- glucopyranosyl)-6-O-(4-O-(6-O-(p-hydroxybenzoyl)-beta-D-glucopyranosyl)- p- hydroxybenzoyl)-beta-D-glucopyranoside]. The third pigment was elucidated to be delphinidin 3-O-[6-O-(malonyl)-beta-D-glucopyranoside]-7-O-[2-O-(6-O-(p- hydroxybenzoyl)-beta-D-glucopyranosyl)-6-O-(4-O-(6-O-(p-hydroxybenzoyl)- beta-D- glucopyranosyl)-p-hydroxybenzoyl)-beta-D-glucopyranoside], and the fourth as delphinidin 3-O-[6-O-(malonyl)-beta-D-glucopyranoside]-7- O-glucopyranosyl[(2-O-(6-O-(p-hydroxybenzoyl)-beta-D-glucopyranosyl)-6-O - (4-O-(6-O-(p-hydroxybenzoyl)-beta-D-glucopyranosyl)-p-hydroxybenzoyl)-be ta-D- glucopyranoside].
Five new ternatins 1-5 have been isolated from Clitoria ternatea flowers, and the structures have been determined by chemical and spectroscopic methods as delphinidin 3-malonylG having 3'-GCG-5'-GCG, 3'-GCG-5'-GC, 3'-GCGCG-5'-GC, 3'-GCGC-5'-GCG, and 3'-GCGC-5'-GC side chains, respectively, in which G is D-glucose and C is p-coumaric acid. Pigment 1 had symmetric 3',5'-side chains. Compounds 3 and 4 are structural isomers. These ternatins were shown to form an intramolecular stacking between the aglycon ring and the 3',5'-side chains in solution.
A new acylated anthocyanin was isolated from the red-purple flowers of Dendrobium 'Pramot' (phalaenopsis type cv) as a major anthocyanin. The structure of this pigment was determined to be cyanidin-3-O-malonyl)-beta-D-glucopyranoside) 7,3'-di-O-(6-O-(4-O-(beta-D- glucopyranosyl)oxybenzoyl)-beta-D-glucopyranoside) mainly based on the spectroscopic evidence.
A novel acylated delphinidin glycoside was isolated from the blue-purple flowers of Eichhornia crassipes as a major pigment, and was identified as (6'''-O-(delphinidin 3-O-(6''-O-(beta-D-glucopyranosyl)-beta-D-glucopyranosyl))) (6''-O-(apigenin 7-O-(beta-D-glucopyranosyl)))malonate by spectral methods. The three dimensional structure of this pigment was suggested from the observation of the negative Cotton effect at lambda max 535 nm that delphinidin (chromophore) and apigenin (co-pigment) occupy a folding conformation as a binary complex.
Infected urachal remnants in early childhood are occasionally seen. However, intraperitoneal penetration of an infected urachal remnant, resulting in acute peritonitis, is rare. We report a case of infantile granulomatous urachal abscess extending into the peritoneum and appendix. The diagnosis and treatment of urachal abscess in childhood are discussed.
This paper presents a case of perineal epidermal cyst. Diagnostic imagings by ultrasonography, CT scanning and MR imaging described the mass as a cystic tumor on the perineal median raphe. It was excised for the histological diagnosis. The removed mass was shown microscopically to be filled with laminated keratin and to be lined with differentiated cornified squamous epithelium. The pathological diagnosis was benign perineal epidermal cyst.
The effect of (-)N-[alpha-phenyl-beta-(p-tolyl)ethyl] linoleamide (PTLA) on intestinal absorption of cholesterol was studied in rats. Oral administration of 15 mg PTLA to rats resulted in a significant (P less than 0.05) decrease in the radioactivity in serum and liver 4 hr after administration of labeled cholesterol. The effect of PTLA was greater on the absorption of cholesteryl oleate as compared with free cholesterol. The rate of hydrolysis of cholesteryl oleate in mucosal homogenates of rat intestine was decreased with PTLA, suggesting that the inhibition of cholesterol absorption by PTLA is related to its effect on cholesteryl ester hydrolysis in the intestine.
1. In urine of rats dosed with N-(alpha-methylbenzyl)linoleamide (MBLA), three dicarboxylic acid monoamides, N-(alpha-methylbenzyl)succinic acid monoamide, N-(alpha-methylbenzyl)glutaric acid monoamide and N-(alpha-methylbenzyl)adipic acid monoamide, were identified. Conjugated alpha-methylbenzylamine, hippuric acid and conjugates of the dicarboxylic acid monoamides were also found in the urine. N-(alpha-Methylbenzyl)succinic acid monoamide was the main metabolite in rats. 2. Biliary excretion of radioactivity was studied in rats, cannulated for collection of bile and duodenal infusion, after oral administration of N-(alpha-methylbenzyl)[1-14C]linoleamide. With constant duodenal infusion of bile, about 7% of the dose was excreted in the bile, while excretion of radioactivity was negligible without bile infusion. 3. The g.l.c. analysis of human urine after oral administration of MBLA revealed that two dicarboxylic acid monoamides were present and N-(alpha-methylbenzyl)succinic acid monoamide was the main metabolite. 4. MBLA was excreted unchanged in the faeces of men who received MBLA to the extent of about 53% dose in 3 days. 5. MBLA was not detected (less than 1 mug/ml) in the serum of a volunteer who had been taking an oral daily dose of 1500 mg of MBLA for 3 months.
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