Effect of Amino Acids and Albumin on Damage Induced by Cyanate in Osteoblast / 대한신장학회지

PURPOSE: Cyanate, known as one of the uremic toxins and derived spontaneously from urea, has several effects on the biologic substances including erythropoietin, antioxidant and ceruloplasmin. To find out the protective materials from the hazardous effect of cyanate in osteoblast, we added twenty amino acids, albumin globulin and hemoglobin in the culture media containing osteoblastic cells with cyanate. METHODS: Osteoblastic ROS 17/2.8 cells, exposed to various concentrations of sodium cyanate, were used to analyze for the cytotoxicity. The cyanate-induced cytotoxicity was assessed by the methylthiazolyldiphenyl-tetrazolium bromide (MTT) assay by measuring the absorbance of the reaction solution at 570 nm. Viability of the treated cells was expressed as A570 of sample/A570 of control. The degree of the carbamylation was measured using trinitrobenzenesulphonic acid. The degree of the carbamylation in amino acid was about 50% in average. RESULTS: The degree of the carbamylation in albumin was increased depending on the incubation time with cyanate and the concentration of the cyanate. The degree of the carbamylation in globulin and hemoglobin was nearly zero. Asp, Glu, Leu, Trp and Tyr among the twenty amino acids revealed the protective effect against the damage induced by cyanate. And only albumin among the three proteins revealed the protective effect. CONCLUSION: On the basis of these results, Asp, Glu, Leu, Trp, Tyr and albumin are useful tools for the protection against damages by cyanate carbamylation.

Infections Following Renal Transplantation: Long Term Follow-Up Study in Single Center / 대한신장학회잡지

The spectrum of infectious complications in 453 consecutive renal transplant recipients was examined retrospectively at Keimyung University Hospital from November, 1982 to March, 1999. Most patients(96.5%) received cyclosporine based immunosuppression therapy. The most common causative organisms were bacteria(45.6%), virus(40.9%), and fungus(12.4%), and the most common sites of infection were the mucocutaneous(40.9%), urinary tract(17.2%), and respiratory tract(14.5%) in decreasing order of frequency. Among the bacterial infections, the urinary tract (32.8%), respiratory tract(25.6%), skin and soft tissue (25.1%), bactremia(5.6%) were the most common sites of infection. In viral infections, cytomegalovirus (32.2%), herpes simplex(23.2%), varicellar zoster(23.2 %) were the most frequent organisms. 36 cases of CMV infection, ten(27.8%) were CMV diseases and two of 10 patients died of CMV disease. Forty one patients had episodes of urinary tract infections and the most common causative organisms were Gram negative bacilli(73.2%). Pneumonia occured in 17 patients and 12 of 17 patients had prior history of steroid pulse therapy for rejection. Six of 12 patients were expired and all of them had prior history of steroid pulse therapy. On the contrary, all five patients who did not receive prior steroid pulse therapy were recovered. Tuberculosis occured in seventeen patients and four(23.5%) of 17 patients died of tuberculosis. Nine of them had prior history of steroid pulse therapy for rejection. No opportunistic infections, for example cytomegalovirus, mycobacterium, pneumocystis carinii, fungus, occured within 1 month after transplantation. There was a temporal relationship between the timing of infection and causative organism after renal transplantation. However, opportunistic infections were frequently followed by the prior use of steroid pulse therapy. We conclude that infection still remains the leading cause of morbidity and mortality among the transplant recipients, and the prevention, early diagnosis and aggressive treatment are mandatory to reduce the infectious complications in these patients.

Varicella Pneumonia in Adult Following Renal Transplantation / 대한이식학회지

Varicella is usually a benign childhood disease, while in the adult is an infrequent but potentially serious infection. Varicella pneumonia is a potentially life-threatening complication that should be suspected in any adult with chickenpox and respiratory symptoms. In the adult it may be complicated by pneumonia with high morbidity and mortality rates. We present a case of varicella pneumonia complicated the course of chickenpox in the living-related donor renal transplant recipient. A 30-year-old male received an allograft kidney from his father following treatment with cyclosporine and low-dose steroids. Allograft function was stable over the next 27 months. He was admitted hospital with a week history of generalized varicelliform rash, malaise, fever, chills and a cough. Three weeks ago, his nephew (7-year-old) had chickenpox who was living together in the same house. On examination he looked severely ill, febrile and his skin was covered with typical chickenpox eruption. Auscultatory examination was unremarkable while chest X-rays revealed bilateral interstitial infiltration. HRCT findings showed multiple variable sized nodules, patchy ground-glass opacities, and some consolidation in both lower lung. Treament with i.v. acyclovir was started and continued for 10 days. The patient response to the treatment was excellent with complete resolution of pneumonia.