Establishment of withdrawal time and analysis of tiamulin residue in tissues of orally dosed broiler chickens

This study was conducted to investigate tiamulin (TML) residues in the edible tissues of orally dosed broiler chickens and to re-establish the withdrawal time (WT). Thirty-six healthy Ross broiler chickens were administered 0.5 (TML-1) and 2.5 kg (TML-2) per ton feed, respectively, of the drug containing TML 78 g/kg for 10 days. Twenty-four tissue samples were collected from 6 chickens in each of the TML-1 and TML-2 groups on 0, 1, 3, and 5 days after drug administration, respectively. The residual concentrations of TML were measured using liquid chromatography-tandem mass spectrometry (LC-MS/MS). The correlation coefficient of the calibration curves was 0.9978 to 0.9998, and the limits of detection and the limits of quantification (LOQ) were in the range of 0.03 to 0.06, and 0.1 to 0.2 µg/kg, respectively. Recoveries ranged between 89.0% to 116.7%, and the coefficients of variation were less than 13.9%. After the drug administration, TML in the TML-1 and TML-2 groups was detected above the LOQ in 1 and 6 samples of liver, respectively, at day 0, and in 1 liver sample from both groups on day one. At 3 days after administration, TML was detected below the LOQ in all samples of TML-1 and TML-2. The calculated WT of TML in both TML-1 and TML-2 using the WT calculation program WT 1.4 was 0 days. In conclusion, the developed analytical method is suitable for detection, and the calculated WT of TML in poultry edible tissues is shorter than the current recommended WT of 7 days for TML in broiler chickens.

Expression of Chicken NK-Lysin and Its Role in Chicken Coccidiosis Induced by Eimeria necatrix

Coccidiosis in chickens is an intestinal parasitic disease caused by protozoan parasites named Eimeria spp. In some Eimeria infections, intestinal lymphocytes are known to highly express chicken NK-lysin (cNK-lysin), an antimicrobial peptide with anticoccidial activity. Therefore, this study aims to investigate the expression of cNK-lysin in E. necatrix-infected chickens and its role in E. necatrix infection. The expression of cNK-lysin transcript was significantly increased in E. necatrix sporozoites-treated lymphocytes. In E. necatrix infection, cNK-lysin transcript was induced in intestinal lymphocytes but not in the spleen. The recombinant cNK-lysin exhibited anticoccidial activity against E. necatrix sporozoites as well as immunomodulatory activity on macrophages by inducing proinflammatory cytokines. These results indicated that E. necatrix infection induces high local expression of cNK-lysin and the secreted cNK-lysin helps protect coccidiosis.

Acer tegmentosum Maxim Prevents Bone Loss by Inhibiting Osteoclastogenesis and Promoting Osteoblast Mineralization in Ovariectomized Mice

Osteoporosis is a worldwide disease leading to significant economic and societal burdens globally. Osteoporosis is caused by unbalanced bone remodeling between the rate of osteoclast bone resorption and osteoblast bone formation. Acer tegmentosum Maxim (AT) is a traditional herbal medicine containing multiple biological activities such as anti-oxidant and anti-inflammatory purposes. However, its role in osteoporosis has not been fully studied. Therefore, we investigated whether AT has a potent inhibitory effect on osteoporosis and its mechanism through a systemic evaluation in ovariectomized (OVX) mice. OVX mice were orally administrated with the AT at doses of 50, 100, and 200 mg/kg for 10 weeks. Histological images and histomorphometry analyses were performed by H&E and Toluidine blue satin, and the expression levels of receptor activator for nuclear factor-kB ligand (RANKL), nuclear factor of activated T cells cytoplasm 1 (NFATc1), c-Fos, and matrix metalloproteinase 9 (MMP9) related to the osteoclast differentiation were investigated using immunohistochemical analysis. Administration of AT prevented bone loss and the alternations of osteoporotic bone parameters at the distinct regions of the distal femur and spongiosa region in OVX mice. Further, administration of AT increased periosteal bone formation in a dose-dependent manner. Meanwhile, AT inhibited not only the expression of NFATc1 and c-Fos, which are two major regulators of osteoclastogenesis but also reduced bone resorbed encoding expression of MMP9 and RANKL. Our results indicated that administration of AT prevented bone loss and the alternations of osteoporotic bone parameters at the distinct regions of the distal femur and spongiosa region in OVX mice. Also AT has the bone protective effect through the suppression of osteoclast and promotion of osteoblast, suggesting that it could be a preventive and therapeutic candidate for anti-osteoporosis.

Differentially expressed proteins in the liver of Gulo-/- mice following treatments with Helicobacter pylori and diethylnitrosamine / 동물의과학연구지

Vitamin C (ascorbic acid) is an essential nutrient of most living tissues. We established a strain of Gulo-/- mice with known deficiency, in which vitamin C intake can be controlled by diet, like humans, and investigated the differentially expressed proteins following treatments with Helicobacter pylori and diethylnitrosamine (DENA) in the liver of Gulo-/- mice using a proteomic approach. Expression of p53, 14-3-3epsilon and 14-3-3delta in Gulo-/- mice liver tissue was analyzed by immunohistochemistry. 2-DE maps constructed from Gulo-/- mice liver and differentially expressed proteins in liver tissue were identified by matrix-assisted laser desorption/ionization time-of-flight (MALDI-TOF/MS). In Gulo-/- mice after H. Pylori infection, followed by treatment with DENA, no differences in p53, 14-3-3epsilon and 14-3-3delta were observed by immunohistochemistry. Proteome analyses using MALDI-TOF/MS resulted in successful identification of 12 proteins (nine proteins were up-regulated and three were down-regulated). Specifically, peroxiredoxin-6 and Alpha-1-antitrypsin 1-4 were up-regulated in liver after H. Pylori infection followed by treatment with DENA. These results indicated that oral supplementation with vitamin C led to rescue of Gulo-/- mice from vitamin deficiency, and protected the liver from H.pylori infection and/or DENA effect, and vitamin C also protected the liver against oxidative stress.

Comparison of the Anyplex II STI-7 and Seeplex STD6 ACE Detection Kits for the Detection of Sexually Transmitted Infections / 임상검사와정도관리

BACKGROUND: Sexually transmitted infections (STI) encompass a variety of clinical syndromes caused by many pathogens that are transmitted through sexual activity. Multiplex PCR is frequently used to detect STI. In this study, two multiplex real-time PCR-based assays were used to detect STI in clinical specimens, and the concordance of the results obtained by each method was evaluated. METHODS: A total of 626 specimens were tested using the Anyplex II STI-7 (Seegene, Korea) and Seeplex STD6 ACE Detection kits (Seegene). RESULTS: Among the 626 individuals tested, 227 (44.2%) tested positive for STI by using Anyplex II STI-7. The prevalence rates of the various infectious microorganisms detected were as follows: Chlamydia trachomatis (C. trachomatis), 19.2% (120/626); Neisseria gonorrhoeae (N. gonorrhoeae), 5.6% (35/626); Trichomonas vaginalis (T. vaginalis), 0.2% (1/626); Mycoplasma genitalium (M. genitalium), 8.1% (51/626); Mycoplasma hominis (M. hominis), 2.9% (18/626); Ureaplasma urealyticum (U. urealyticum), 17.6% (110/626); and Ureaplasma parvum, 3.7% (23/626). The concordance rates for the STI-7 and STD6 assays in detecting the various types of microorganism were as follows: C. trachomatis, (99.5%); N. gonorrhoeae, (99.7%); T. vaginalis, (100%); M. genitalium, (100%); M. hominis, (100%); and U. urealyticum (99.2%). CONCLUSIONS: A high degree of concordance was observed between the results obtained using the Anyplex II STI-7 kits and those obtained using the Seeplex STD6 ACE Detection kits.

Effect of Calcium and Vitamin D Supplementation on Bone Formation Around Titanium Implant

The purpose of this study was to observe the effect of calcium and vitamin D to the titanium implant osseointegration in animal model. 32 rats, 10 weeks of age, were divided into two group: additional calcium and vitamin D supplementation group and a control group. Titanium screw implant(diameter, 2.0mm; length, 3.5mm; pitch-height 0.4 mm) were placed into tibia of 32 rats, 16 in the control group and 16 in the experimental group. The rats were sacrificed at different time interval(1, 2, 4, and 8 weeks after implantation) for histopathologic observation, histomorphometric analysis and immunohistochemistry with osteocalcin and osteopontin antibody. Histopathologically findings, newly formed bone was seen at 1 weeks and became lamellar bone at 2 weeks, and mature trabecullar bone was seen at 4 weeks experimental group. In control group, thickness of regenerated bone increased till 4 weeks gradually and trabecullar bone was seen at 8 weeks. By histomorphometric analysis, bone marrow density was increased significantly at 1 and 2 weeks in experimental group compared to control group. Osteocalcin immunoreactivity was strong at 1 week experimental group and reduced after 4 weeks gradually. But it was continuously weakly from 1 to 4 weeks in control group. Osteopontin immunoreactivity was very strong in newly formed bone from 2 to 8 weeks experimental group. And the amount of osteopontin expression was more abundant in experimental group. The results of this study suggest that calcium and vitamin D supplementation promotes bone healing around dental implants.

Ex Vivo Generation of RBCs from CD34+ Cells in Human Umbilical Cord Blood and Expression Profile Analysis Using Microarray / 대한진단검사의학회지

BACKGROUND: In this study, we attempted to generate RBCs from CD34+ cells in cord blood using a 3-step culture protocol and also evaluated a change in immunophenotypic characteristics and expression profile according to erythropoietin (EPO) concentrations and culture duration. METHODS: Using mini-MACS columns, CD34+ cells were isolated from cord blood. The culture procedure comprised three steps. For each step, cells were cultured sequentially for 7 days in a serum free liquid medium with a specific combination of growth factors for 21 days. [1st step: Flt3-ligand (Flt3-L), thrombopoietin and stem cell factor (SCF); 2nd step: IGF-1, SCF and EPO; and 3rd step: IGF-1 and EPO] To evaluate the effect of EPO on proliferation and differentiation, cells were cultured with different EPO concentrations (0, 3, 10 & 20 U/mL). Cell count and morphology were monitored during the culture. For phenotyping, antibodies to CD34, CD38, CD45 and glycophorin A (GPA) were used. The expression profile of cultured cells was analyzed by 17, 000-gene microarray analysis. RESULTS: As EPO concentration increased, cell expansion was also increased, showing a maximum expansion at 20 U/mL. The cell population showed a gradual decrease in expression of CD34 and CD45, whereas the expression of GPA was not prominent in any conditions. However, we observed increased expression in some genes associated with erythropoiesis (e.g. glycophorin A, rhesus blood group CcEe antigens). CONCLUSIONS: This study shows that erythropoietin enhances the proliferation of hematopoietic progenitor cells. Our culture system did not achieve pure production of RBCs, but induced expression changes that indicated erythroid differentiation.

Analysis of Present Status as Blood Donation Center of Hospital Blood Banks and Satisfaction Level with the Korean Red Cross / 대한수혈학회지

BACKGROUND: Blood supply in Korea has been unstable in more than a year because transfusion-related infection was repeated in patients receiving blood that the Korean Red Cross Blood Center (KRCBC) had supplied. The purpose of this study is to contribute to stable and efficient blood supply in our country by analysis of present status of hospital blood banks as blood donation center and their satisfaction levels with the KRCBC. METHODS: From July to August 2004, we performed questionnaire survey in 129 hospital blood banks that the KRCBC issued donor card in 2003. Among them, 73 hospitals replied and we analyzed them. RESULTS: Fifty-one (69.8%) among 73 hospital blood banks collected less than 100 cases of blood donation in 2003 and 16 of them collected no blood component. Satisfaction level with KRCBC was only 1.8 in hospitals less than 300 beds. Improvement in the delivery of blood components and blood testing of donated blood were in highest need among all areas of services supplied by KRCBC. Hospitals more than 1,000 beds answered that they would not transfer the collection service to KRCBC no matter how NAT be performed in all donated blood because of the directed and autologous donation of their hospitals. CONCLUSION: Satisfaction level of Hospital blood banks in Korea with blood services of KRCBC was rated below average, especially in hospitals less than 300 beds. It is important that the government should be the subject of national blood services and suggest appropriate schemes such as national audit program through close cooperation with the KRCBC and hospitals.

Experimental culture condition for endothelial and their progenitor cells from CD34+ hematopoietic stem cells / 대한수혈학회지

BACKGROUND: The concept of "neovascularization", which was first applied to describe the pathogenesis of diseases such as diabetic retinopathy or rheumatoid arthritis, has been extended to other fields of study such as myocardial ischemia and tumorigenesis. Endothelial progenitor cells (EPCs), play a critical role in neovascularization and have been reported to also be capable of colonizing vascular grafts. In this study, EPCs were isolated from cord blood, peripheral blood and bone marrow, and then cultured. Various cytokines, such as vascular endothelial growth factor(VEGF), Insulin growth factor(IGF), endothelial growth factor(EGF) fibroblast growth factor-basic(FGF-b), stem cell factor(SCF), flt3-ligand(FL), and thrombopoietin(TPO) were added to the cultures and observed for their effects on endothelial cells for their potential use in antineoplastic therapy or treatment of regional ischemia. METHODS: The mononuclear cells (MNCs) were isolated from cord blood, peripheral blood buffy coat, and bone marrow. They were collected from healthy donors using Ficoll-Hypaque. CD34+ cells were isolated by MACS system. To evaluate the effect of various cytokines, purified CD34+ cells were cultured under conditions of various cytokine combinations including SCF, Fl, TPO, VEGF, EGF, IGF, and FGF-b. After four weeks of culture, umbilical cord blood and bone-marrow derived adherent cells were analyzed for endothelial markers by immunohistochemical stain. RESULTS: Cultured adherent cells expressed the endothelial specific markers, such as KDR, CD34, CD31, CD62E, and CD cadherin but did not express vWF antigen. Typical morphology of endothelial cells was observed, such as the cord-like structure and cobblestone appearance during the culture period, which suggested that the adherent cells were consistent with endothelial cells. CONCLUSION: We described the experimental conditions in which endothelial progenitors were differentiated from CD34+ cells isolated from three hematopoietic stem cell sources: bone marrow, peripheral blood and cord blood.

Evaluation of a simultaneous HIV antigen and antibody detection test in Korean population

Current diagnosis of human immunodeficiency virus (HIV) infection relies on the detection of anti-HIV antibodies by enzyme-linked immunosorbent assay (ELISA). Recently, kits detecting both p24 antigenemia and anti-HIV/anti-HIV2 antibodies have been developed. Thus, it is necessary to compare those kits developed as such. The aim of this study was to evaluate the diagnostic efficiency of a simultaneous detection test of p24 antigen and anti-HIV1/2 antibodies in a low prevalence area. Eight hundred and four randomly selected sera proven negative for HIV infection and 110 sera from 54 patients diagnosed as HIV infected, obtained between 1999 and 2000, were used for this study. One commercial lot of panels composed of consecutive sera obtained from known HIV-infected patient was included. Anti-HIV1/2 antibodies were detected by two different commercial ELISA kits, one from Korean and the other from German manufacturer. P24 antigen test was performed by ELISA. The simultaneous HIV antigen and antibody detection test was carried out. In the meantime, HIV RNA PCR and anti-HIV and anti-HIV2 western blot assays were also performed to confirm the test results in cases the test results didn't agree. The simultaneous detection kit showed 100% sensitivity and 99.6% specificity. Furthermore, the test displayed the possibility of earlier diagnosis than conventional anti-HIV1/2 ELISA with the results obtained from a group of consecutive panel sera infected with HIV. From these results, we concluded that the simultaneous HIV antigen and antibody detection test can be applied as a substitute clinical screening test in the place of conventional anti-HIV1/2 ELISA, and there is the probable benefit of early diagnosis.

Troponin T and CK-MB by Electrochemiluminescense Assay in Acute Coronary Syndrome / 대한임상병리학회지

BACKGROUND: Early diagnosis and treatment of acute coronary syndrome(ACS) encompassing acute myocardial infarction(AMI) and unstable angina(UA) is very important. Cardiac troponin T(cTnT) is known to be more specific to myocardium, and the level increases early and persistently during the period of 7 to 14 days after the onset of symptoms. The aim of this study was to evaluate the usefulness of cTnT for the diagnosis of ACS comparing with other biochemical markers. METHODS: The precision, linearity, lower limit of detection and interferences for cTnT by electrochemiluminescence were evaluated. cTnT and other conventional cardiac markers were determined for 128 AMI, 96 UA and 72 stable angina(SA) patients. The medical records of these patients were reviewed. RESULTS: cTnT-positive rates in AMI patients were 87.5-100% in all periods. cTnT positive rate was maintained as 100% from 3 hours to 96 hours after heart attack. Although CK-MB positive rate was as high as 85.7% at 6 hours, it decreased after 61 hours. The positive rate of LD and LD isoenzyme were very low(33.8-75%). In UA patients, mean positive rates of cTnT and CK-MB were 22.6% and 22.9% respectively. For the diagnosis of ACS comparing with SA, the sensitivity and specificity of cTnT were 63% and 94%(cut-off, 0.1 microgram/ml), meanwhile these of CK-MB were 53% and 90%, respectively(cut-off, 5 microgram/ml). CONCLUSIONS: cTnT was more useful and sensitive than CK-MB, LD, or LD isoenzyme. ACS also could be diagnosed with cTnT and CK-MB with sufficiently high specificity. cTnT seemed to be slightly more specific than CK-MB for the diagnosis of ACS.

Detection of Vancomycin Heteroresistant Staphylococcus aureus Using Mu-3 Agar / 감염

BACKGROUND: The aim of the study was to determine prevalence of potential heterogeneous vancomycin-resistant Staphylococcus aureus (h-VRSA) among methicillin-resistant S. aureus (MRSA) isolated in Korea by using Mu-3 agar and to determine the effect of in vitro vancomycin exposure on the resistance. METHODS: MRSAs isolated in 1980-1999 were screened for the presence of VISA or h-VRSA using Mu-3 agar. MIC of vancomycin was tested by NCCLS agar dilution and broth microdilution tests. Suspected h-VRSA were selected by vancomycin-containing media and change of resistance was determined by population analysis. A strain with Mu50 type growth was serially exposed to 8 pg/ml of vancomycin containing media and change of the vancomycin resistance was determined. RESULTS: Among the 455 MRSA isolates, 18 (3.9 %) grew on selective brain heart infusion agar (BHIA), and 354 (77,8%) on Mu-3 agar, 66 (14.5%) with Mu3 type growth and 78 (17.1%) with Mu50 type growth. MIC of vancomycin was 11 pg/ml for some of the isolates when inocula were approximately 10' CFU, but VISA was not present when tested by NCCLS broth microdilution test. Exposure of the isolates to van-cornycin raised the MIC. Serial exposure once to 8 pg/ml of vancomycin resulted in significant decrease of cells susceptible to 8-12 pg/ml of vancomycin. CONCLUSION: VISA was not present among the test isolates, but 34.2% were suspected to be potential h-VRSAs, suggesting possible emergence of VISA if vancomycin was administered prolonged period. It is considered that suitable screening media are vancomycin containing BHIA for VISA and Mu-3 agar for h-VRSA. The isolates showing Mu50 type growth on Mu-3 agar are not always VISA, but rather h-VRSA.

Evaluation of a Screening Test kit of Simultaneous p24 Antigen and Anti-HIV1/2 Detection in Diagnostic Aspect / 대한임상병리학회지

BACKGROUND: Human immunodeficiency virus(HIV) is the causative agent of acquired immune deficiency syndrome(AIDS). Current diagnosis of HIV infection relies on the detection of anti-HIV antibodies by ELISA. Recently, simultaneous detection kit of p24 antigenemia and anti-HIV1/anti-HIV2 antibodies were developed. The aim of this study was to evaluate the diagnostic kit of simultaneous detection with p24 antigen and anti-HIV1/2 in diagnostic aspect. METHODS: Eight hundred and four sera which were obtained between July 1999 and August 1999 and 110 sera from 54 patients diagnosed as HIV infection were included. One lot of panels composed of consecutive sera obtained from known HIV-infected patients was included. The detection of anti-HIV1/2 antibodies was done by Genedia HIV1/2 ELISA 3.0 kit(Greencross, Seoul, Korea) and Enzygnost anti-HIV1/2 Plus(Behringwerke, Marburg, Germany). The simultaneous detection of p24 antigenemia and anti-HIV1/2 antibodies was done with VIDAS DUO kit(bioMerieux, Lyon, France). The Vironostika HIV-1 antigen kit was used for detection of p24 antigen. The HIV RNA PCR and anti-HIV western blot assay were also performed to confirm the test results in discrepant cases. RESULTS: The simultaneous detection kit showed 100% sensitivity and 99.6% specificity. The possibility of earlier diagnosis than conventional anti-HIV1/2 EIA was also suggested by the results obtained with a group of consecutive panel sera infected with HIV. CONCLUSION: The simultaneous p24 antigen and anti-HIV1/2 detectin kit can be applied as a clinical screening test as a substitution of conventional anti-HIV1/2 EIA, and there is a probable gain especially in early diagnosis.

The Influence of Food Ingestion and Sample Storage on Direct LDL-Cholesterol Measurement by Immunoseparation Method / 대한임상병리학회지

BACKGROUND: Elevated level of low density lipoprotein-cholesterol (LDL-C) is one of the major risk factors for the development of coronary heart disease. Direct LDL-C determination method by immunoseparation (DLDL-C) recently developed is claimed not to be influenced by food ingestion. We re-evaluated the effects of diet and storage conditions for this method. METHODS: Samples were collected from thirty-two medical college students before and after meal to study the effects of diet on this method. We compared the difference of LDL-C of filtered samples between refrigerated and frozen state. We also compared direct and indirect calculated measurements of LDL-C with ultracentrifugal beta-quantification (BQLDL-C) method. RESULTS: Morning 2-hour-postprandial specimen can be acceptable with no minimal significant bias, but afternoon 2-hour or 4-hour-postprandial specimen cannot be recommended due to significant negative bias (8.6-9.6%). Storage of filtered samples showed no significant difference between frozen and refrigerated state. Calculated LDL-C when triglyceride level is more than 400 mg/dL was not reliable due to large proportional and constant bias. In contrast, DLDL-C showed good accuracy comparing with BQLDL-C (y=0.909x+3.3, r=0.869, n=9, x=BQLDL-C, y=DLDL-C). CONCLUSION: In conclusion, morning two-hour postprandial specimens can be acceptable for DLDL-C, but afternoon postprandial specimens may not be recommended due to significant negative bias. DLDL-C seems to be reliable and useful especially for hypertriglyceridemic patients or follow-up cases of hypercholesterolemia with normal triglyceride or HDL-C levels.

Detection of Toxin B Gene of Clostridium difficile by Polymerase Chain Reaction from Clinical Isolates / 대한임상미생물학회지

BACKGROUND: Clostridium difficile causes antibiotic-associated diarrhea or pseudomembranous colitis by producing of toxins in patients treated with antimicrobial agents. Stool cultures for C. difficile and tests for the presence of its toxin are the most widely used methods for the diagnosis of infection. The aim of this study was to determine the usefulness of polymerase chain reaction for the detection of toxin B gene from C. difficile isolates. METHODS: In this study, 85 strains of C. difficile were used, which were isolated from stool specimens of patients with suspected antibiotic-associated diarrhea or pseudomembranous colitis from 1987 to 1994 using cefoxitin-cycloserine-fructose agar. DNA of the C. difficile isolates was extracted by boiling and by conventional methods. The primers used for toxin B gene amplification were YT-17, 5'-GGTGGAGCTTCAATTGGAGAG-3' and YT-18, 5'- GTGTAACCTACTTTCATAACACCAG-3'. Amplification products were electrophoresed in a 1% agarose gel containing ethidium bromide and the presence of the 399 bp band was examined under ultraviolet light. The results were compared with those of toxin A detection by PCR and with the results of quantitative cultures. RESULTS: Toxin B gene was detected in 74% (63/85) of the C. difficile isolates. Toxin B gene was detected in all strains with toxin A gene, but not in the strains without toxin A gene. DNA extraction by boiling and by conventional methods gave the same detection rate. The positive rate of toxin B gene was slightly higher in the strains which were isolated with a higher colony count from stool than nontoxigenic ones. CONCLUSIONS: The PCR detection of toxin B gene is a useful method for identifying the toxigenic C. difficile strain in the clinical laboratory, and the boiling method is simple for DNA extraction. The use of a toxin test can reduce false positive diagnosis due to the presence of nontoxigenic strains among the isolates.

A Severe Thrombocytopenia Associated with Cyclosporine-Dependent Antiplatelet Antibody Against Platelet Glycoproteins Ib/IX and IIb/IIIa Complexes / 대한임상병리학회지

A 51 year-old woman underwent living related renal transplantation under cyclosporine A immunosuppression. After surgery, she did well initially, but the serum creatinine level subsequently rose to 3.6 mg/dL on postoperative day 95, she was admitted at Severance Hospital for further evaluation. On admission day 4, a renal biopsy was performed, and the microscopic findings revealed an interstitial mononuclear cell infiltrate, suggestive of severe allograft rejection. Because of persistently impaired renal function, the patient was began on twice weekly hemodialysis, and the progression of renal deterioration paralleled the onset of a thrombocytopenia. The platelet count dropped to 13x109/L despite daily platelet transfusion. On admission day 19, antiplatelet antibody against the glycoprotein Ib/IX (GP Ib/IX) and glycoprotein IIb/IIIa (GP IIb/IIIa) complex was detected in the presence of cyclosporine A (CsA) with modified antigen capture ELISA (MACE) assay, thereby implicating the drug. CsA was stopped immediately and immunosuppression drug was changed to FK506. After CsA was discontinued 7 day later, her platelet count returned to normal, up to 170x109/L without requirement of any platelet concentrates. This paper presents the first case of CsA induced thrombocytopenia in Korea which was confirmed by in vitro CsA dependent antiplatelet antibody detection test.