Development of an analytical method for multi-residue quantification of 18 anthelmintics in various animal-based food products using liquid chromatography-tandem mass spectrometry / 药物分析学报

In this study,we developed a simple screening procedure for the determination of 18 anthelmintics(including benzimidazoles,macrocyclic lactones,salicylanilides,substituted phenols,tetrahydropyr-imidines,and imidazothiazoles)in five animal-derived food matrices(chicken muscle,pork,beef,milk,and egg)using liquid chromatography-tandem mass spectrometry.Analytes were extracted using acetonitrile/1％acetic acid(milk and egg)and acetonitrile/1％acetic acid with 0.5 mL of distilled water(chicken muscle,pork,and beef),and purified using saturated n-hexane/acetonitrile.A reversed-phase analytical column and a mobile phase consisting of(A)10 mM ammonium formate in distilled water and(B)methanol were used to achieve optimal chromatographic separation.Matrix-matched standard calibration curves(R2≥0.9752)were obtained for concentration equivalent to ×1/2,×1,×2,×3,×4,and ×5 fold the maximum residue limit(MRL)stipulated by the Korean Ministry of Food and Drug Safety.Recoveries of 61.2-118.4％,with relative standard deviations(RSDs)of ≤19.9％(intraday and interday),were obtained for each sample at three spiking concentrations(×1/2,×1,and ×2 the MRL values).Limits of detection,limits of quantification,and matrix effects were 0.02-5.5 μg/kg,0.06-10 μg/kg,and-98.8 to 13.9％(at 20 μg/kg),respectively.In five samples of each food matrix(chicken muscle,pork,beef,milk,and egg)purchased from large retailers in Seoul that were tested,none of the target analytes were detected.It has therefore been shown that this protocol is adaptable,accurate,and precise for the quantification of anthelmintic residues in foods of animal origin.

Low-Dose Ionizing γ-Radiation Promotes Proliferation of Human Mesenchymal Stem Cells and Maintains Their Stem Cell Characteristics

Mesenchymal stem cells (MSCs), which are multipotent and have self-renewal ability, support the regeneration of damaged normal tissue. A number of external stimuli promote migration of MSCs into peripheral blood and support their participation inwound healing. In an attempt to harness the potential beneficial effects of such external stimuli, we exposed human MSCs (hMSCs) to one such stimulus-low-dose ionizing radiation (LDIR)-and examined their biological properties. To this end, we evaluated differences in proliferation, cell cycle, DNA damage, expression of surface markers (CD29, CD34, CD90, and CD105), and differentiation potential ofhMSCs before and after irradiation with γ-rays generated using a ¹³⁷ CSirradiator.At doses less than 50 mGy, LDIR had no significant effect on the viability or apoptosis of hMSCs. Interestingly, 10 mGyofLDIR increased hMSC viability by 8% (p<0.001) comparedwith non-irradiatedhMSCs.At doses less than 50 mGy, LDIR did not induceDNA damage, including DNA strand breaks, or cause cellular senescence or cell-cycle arrest. Surface marker expression and in vitro differentiation potential of hMSCs were maintained after two exposures to LDIR at 10 mGy per dose. In conclusion, a two-dose exposure to LDIR at 10 mGy per dose not only facilitates proliferation of hMSCs, it alsomaintains the stem cell characteristics of hMSCswithout affecting their viability.These results provide evidence for the potential ofLDIRas an external stimulus for in vitro expansion of hMSCs and application in tissue engineering and regenerative medicine.

A Case of Gastric Granular Cell Tumor: Review of Literature and Features of Endoscopic Ultrasonography

Granular cell tumor was originally described as granular cell myoblastoma by Abrikossoff. The incidence of GCT in the gastrointestinal tract is low, and most granular cell tumors occur in the esophagus and large bowel. Gastric granular cell tumors are rare and difficult to distinguish from carcinoid tumors by gross endoscopic findings and endoscopic ultrasonography findings. We report a case of gastric granular cell tumor, treated by endoscopic submucosal dissection, and review the endoscopic ultrasonography findings of recently reported gastric granular cell tumors.

A Case of Fungating Type Natural Killer Like T Cell Lymphoma of the Ascending Colon / 대한소화기학회지

Primary colorectal lymphoma is a very rare disease entity that accounts for less than 0.2-0.65% of all colon cancers. It is as an extranodal lymphoma of the colon that mainly arises from B cells and primary colorectal lymphoma that arises from T cells is very rare both in Western countries and in Korea. Colonic lymphoma can be classified endoscopically into 5 categories as follows: fungating, ulcerative, infiltrative, ulcerofungating, and ulceroinfiltrative type. The endoscopic features of primary colorectal lymphoma differ according to their cellular origin; about half of B cell lymphomas are fungating type whereas most of T cell lymphomas are of ulcerative or ulceroinfiltrative type. Mass forming primary T cell lymphoma of the colon is extremely rare. Herein, we present a case of primary natural killer like T cell lymphoma of the colon presenting as fungating type with review of literature.

Neuroprotective effects of INM-176 against lipopolysaccharide-induced neuronal injury.

Neuroinflammation plays a critical role in the etiology of chronic neurodegenerative diseases such as Alzheimer's disease. INM-176 is a standardized ethanolic extract of Angelica gigas, which has been traditionally used as a tonic to treat anemia. In the present study, we investigated whether INM-176 exhibits neuroprotective activities against lipopolysaccharide (LPS)-induced neuronal damage in vitro and in vivo. In primary microglial cells, INM-176 significantly inhibited LPS-induced nitric oxide release and expression of tumor necrosis factor-α and interleukin-1ß. The expression levels of inducible nitric oxide synthase and cylcooxygenase-2 in BV2 microglial cells were markedly upregulated by LPS, but this increased expression was counteracted by INM-176. LPS-mediated neuronal damage in an organotypic hippocampal slice culture was also attenuated by the administration of INM-176. In addition, LPS (1 µg/2 µl, i.c.v.)-induced cognitive dysfunction in mice, as determined by passive avoidance and Y-maze tasks, was significantly attenuated by the administration of INM-176. Furthermore, the activation of microglia or astrocytes by LPS in the hippocampal regions of mice was suppressed by INM-176. These results suggest that the neuroprotective and cognition ameliorating effects of INM-176 against LPS-induced damage are mediated, in part, by its anti-inflammatory activities.

Indirubin-3'-oxime inhibits inflammatory activation of rat brain microglia.

Microglial cells play critical roles in the immune and inflammatory responses of the brain. Under pathological conditions, the activation of microglia helps to restore brain homeostasis. However, chronic microglial activation endangers neuronal survival through the release of various proinflammatory and neurotoxic factors. As such, regulators of microglial activation have been considered as potential therapeutic candidates to reduce the risk of neurodegeneration associated with neurodegenerative diseases, including Alzheimer's and, Parkinson's diseases. Indirubin-3'-oxime, a potent inhibitor of cyclin-dependent kinases and glycogen synthase kinase-3ß, has been shown to have neuroprotective potential. The specific aim of this study was to examine the efficacy of indirubin-3'-oxime in the repression of microglial activation. Indirubin-3'-oxime was shown to effectively inhibit lipopolysaccharide (LPS)-induced nitric oxide release from cultured rat brain microglia. This compound reduced the LPS-stimulated productions of tumor necrosis factor-α, interleukin-1ß, prostaglandin E(2), and intracellular reactive oxygen species and also effectively reduced LPS-elicited NF-κB activation. In organotypic hippocampal slice cultures, indirubin-3'-oxime blocked LPS-related hippocampal cell death. These results suggest that indirubin-3'-oxime provides neuroprotection by reducing the productions of various neurotoxic molecules in activated microglia.

Successful Treatment of Vancomycin-Resistant Enterococci Peritonitis with Quinupristin/Dalfopristin in a Patient on Continuous Ambulatory Peritoneal Dialysis / 대한내과학회지

Peritonitis is one of the major complications of continuous ambulatory peritoneal dialysis (CAPD). Multidrug-resistant organisms, including vancomycin-resistant enterococci (VRE), have been reported as pathogens of CAPD-associated peritonitis. The incidence of hospital-associated infections caused by VRE has recently increased. Some drugs, such as linezolid and quinupristin/dalfopristin, have been introduced as treatments of VRE infection. However, there is limited information about the effects of VRE-associated CAPD peritonitis. We present a case of successful treatment of CAPD peritonitis caused by VRE with quinupristin/dalfopristin and include a review of the literature.

A Case of Duodenal Wall Abscess Caused by a Foreign Body / 대한소화기내시경학회지

Duodenal abscess is a form of phlegmonous enterocolitis and is a rarely reported disease throughout the entire world. Duodenal abscess mostly develops from complications of duodenal ulcer perforation, and may result in a clinically fatal course because it is difficult to differentiate from some diseases such as gastric ulcer, gastric cancer, hepatobiliary disorders etc.. The therapeutic gold standard is surgical intervention including abscess removal and drainage. We experienced a case of duodenal abscess that expressed non-specific symptoms, weight loss and epigastric pain, and diagnosed by gastrointestinal endoscopy, abdominal computed tomography. We successfully treated it through surgical intervention with intravenous antibiotics.

Estimation of Internal Motion for Quantitative Improvement of Lung Tumor in Small Animal / 의학물리

The purpose of this study was to estimate internal motion using molecular sieve for quantitative improvement of lung tumor and to localize lung tumor in the small animal PET image by evaluated data. Internal motion has been demonstrated in small animal lung region by molecular sieve contained radioactive substance. Molecular sieve for internal lung motion target was contained approximately 37 kBq Cu-64. The small animal PET images were obtained from Siemens Inveon scanner using external trigger system (BioVet). SD-Rat PET images were obtained at 60 min post injection of FDG 37 MBq/0.2 mL via tail vein for 20 min. Each line of response in the list-mode data was converted to sinogram gated frames (2~16 bin) by trigger signal obtained from BioVet. The sinogram data was reconstructed using OSEM 2D with 4 iterations. PET images were evaluated with count, SNR, FWHM from ROI drawn in the target region for quantitative tumor analysis. The size of molecular sieve motion target was 1.59x2.50 mm. The reference motion target FWHM of vertical and horizontal was 2.91 mm and 1.43 mm, respectively. The vertical FWHM of static, 4 bin and 8 bin was 3.90 mm, 3.74 mm, and 3.16 mm, respectively. The horizontal FWHM of static, 4 bin and 8 bin was 2.21 mm, 2.06 mm, and 1.60 mm, respectively. Count of static, 4 bin, 8 bin, 12 bin and 16 bin was 4.10, 4.83, 5.59, 5.38, and 5.31, respectively. The SNR of static, 4 bin, 8 bin, 12 bin and 16 bin was 4.18, 4.05, 4.22, 3.89, and 3.58, respectively. The FWHM were improved in accordance with gate number increase. The count and SNR were not proportionately improve with gate number, but shown the highest value in specific bin number. We measured the optimal gate number what minimize the SNR loss and gain improved count when imaging lung tumor in small animal. The internal motion estimation provide localized tumor image and will be a useful method for organ motion prediction modeling without external motion monitoring system.

Evaluation of Dose Distribution Using a Radiophotoluminescence Glass Dosimeter in Biobeam8000 Gamma Irradiation Device / 의학물리

Gamma irradiator is widely used for cell, animal experiment, irradiation for blood, dose measurement, and education. Biobeam8000 gamma irradiator (STS Steuerungstechnik &. Strahlenschutz GmbH, Braunschweig, Germany, Cs137, 81.4 TBq) that KIRAMS (Korea Institute of Radiological and Medical Science) has is a irradiation device that enables to be used in large-capacity of 7.5 L and extensive area. Cs-137 source moves range of 24 cm back-and-forth in a regular cycle in beaker for uniform irradiation and a beaker that puts a specimen like existing radiation irradiator such as Gammacell3000 rotates 360degrees during irradiation. Precise dose information according to the location of radiation source would be needed because of the movement of radiation source, whereas radiation could be uniformly irradiated in comparison with existing gamma irradiator. In this study, dose distribution of the inside beaker located in Biomeam8000 gamma irradiator was measured using glass dosimeter, and dose evaluation and distribution regarding dose linearity and dose reproducibility were implemented based on measurement results. This aims to show guideline for efficient use of irradiator based on measurement result when doing experiment or radiation exposure.

A Pilot Research for Real-Time Specific Patient Quality Assurance Using the Hybrid Optimized Vmat Phantom (Hovp) in Volume Modulated Arc Therapy / 의학물리

The purpose of this was to investigate the measurement of fluence dose map for the specific patient quality assurance. The measurement of fluence map was performed using 2D matrixx detector. The absorbed dose was measured by a glass detector, Gafchromic film and ion chamber in Hybrid Optimized VMAT Phantom (HOVP). For 2D Matrixx, the results of comparison were average passing rate 85.22%+/-1.7 (RT_Target), 89.96%+/-2.15 (LT_Target) and 95.14%+/-1.18 (G4). The dose difference was 11.72%+/-0.531, -11.47%+/-0.991, 7.81%+/-0.857, -4.14%+/-0.761 at the G1, G2, G3, G4. In HOVP, the results of comparison for film were average passing rate (3%, 3 mm) 93.64%+/-3.87, 90.82%+/-0.99. We were measured an absolute dose in steep gradient area G1, G2, G3, G4 using the glass detector. The difference between the measurement and calculation are 8.3% (G1), -5.4% (G2), 6.1% (G3), 7.2% (G4). The using an Ion-chamber were an average relative dose error -1.02%+/-0.222 (Rt_target), 0.96%+/-0.294 (Lt_target). Though we need a more study using a transmission detector. However, a measurement of real-time fluence map will be predicting a dose for real-time specific patient quality assurance in volume modulated arc therapy.

A Study of Characteristics of MicroLion Liquid Ionization Chamber for 6 MV Photon Beam / 의학물리

Recently PTW developed a MicroLion liquid ionization chamber which is water_equivalent and has a small sensitive volume of 0.002 cm3. The aim of this work is to investigate such dosimetric characteristics as dose linearity, dose rate dependency, spatial resolution, and output factors of the chamber for the external radiotherapy photon beam. The results were compared to those of Semiflex chamber, Pinpoint chamber and Diode chamber with the sensitive volumes of 0.125 cm3, 0.03 cm3 and 0.0025 cm3, respectively and evaluated to be suitable for small fields. This study was performed in the 6MV photon energy from a Varian 2300 C/D linac accelerator and the MP3 water phantom (PTW, Freiburg) was used. Penumbras in the varios field sizes ranged from 0.5x0.5 cm2 to 10x10 cm2 were used to evaluate the spatial resolution. Output factors were measured in the field sizes of 0.5x0.5 to 40x40 cm2. Readings of the chamber was linearly proportional to dose. Dose rate dependency was measured from 100 MU/min to 600 MU/min, showed a maximum difference of 5.0%, and outputs decreased with dose rates. The spatial resolutions determined with comparing profiles for the field sizes of 0.5x0.5 cm2 to 10x10 cm2 agreed between every detector except the Semiflex chamber to within 2%. Outputs of detectors were compared to that of Semiflex chamber and showed good agreements within 2% for every chamber. This study shows that MicroLion chamber characterized by a high signal-to-noise ratio and water equivalence could be suitable for the small field dosimetry.

Feasibility Study of Vertical Multileaf Collimator for Determination of Irradiation Size / 의학물리

The purpose of this study was to evaluate feasibility of Vertical Multileaf Collimator for determination of irradiation size using Vertical Multileaf Collimator and lead block to determine 4 different irradiation shape in case of Co-60 gamma-ray and 6 MV X-ray. We chose ion chamber, glass dosimeter and EBT chromic film to compare with Vertical Multileaf Collimator results and lead block results. In case of Co-60 gamma-ray and 6 MV X-ray, the central axis point dose normalized at reference field of lead block with ion chamber results for Vertical Multileaf Collimator were estimated higher than lead block about 5.1%, 4.2%. In case of Co-60 gamma-ray, the central axis point dose normalized at reference field of lead block with glass dosimeter results for Vertical Multileaf Collimator were estimated higher than lead block about 2.2%, 7.8%, 7.2%, 4.0% for reference, circle, triangle, cross field, respectively. In case of 6 MV X-ray, the central axis point dose normalized at reference field of lead block with glass dosimeter results for Vertical Multileaf Collimator were estimated higher than lead block about 6.7%, 6.2%, 3.8%, 6.2% for reference, circle, triangle, cross field, respectively. The results of EBT chromic film, Vertical Multileaf Collimator of penumbra size for all irradiation shape was smaller than lead block of those size that 2.0~3.5 mm for Co-60 gamma-ray, 0.5~1.0 mm for 6 MV X-ray. The results from this study, radiation treatment volume that results in shielding block can be minimized. In addition, during radiation treatment for 2, 3-dimensional radiation therapy using a Vertical Multileaf Collimator of this survey can be used to determine variety of irradiation fields.

Quantitative Assessment Technology of Small Animal Myocardial Infarction PET Image Using Gaussian Mixture Model / 의학물리

Nuclear medicine images (SPECT, PET) were widely used tool for assessment of myocardial viability and perfusion. However it had difficult to define accurate myocardial infarct region. The purpose of this study was to investigate methodological approach for automatic measurement of rat myocardial infarct size using polar map with adaptive threshold. Rat myocardial infarction model was induced by ligation of the left circumflex artery. PET images were obtained after intravenous injection of 37 MBq 18F-FDG. After 60 min uptake, each animal was scanned for 20 min with ECG gating. PET data were reconstructed using ordered subset expectation maximization (OSEM) 2D. To automatically make the myocardial contour and generate polar map, we used QGS software (Cedars-Sinai Medical Center). The reference infarct size was defined by infarction area percentage of the total left myocardium using TTC staining. We used three threshold methods (predefined threshold, Otsu and Multi Gaussian mixture model; MGMM). Predefined threshold method was commonly used in other studies. We applied threshold value form 10% to 90% in step of 10%. Otsu algorithm calculated threshold with the maximum between class variance. MGMM method estimated the distribution of image intensity using multiple Gaussian mixture models (MGMM2, em leader MGMM5) and calculated adaptive threshold. The infarct size in polar map was calculated as the percentage of lower threshold area in polar map from the total polar map area. The measured infarct size using different threshold methods was evaluated by comparison with reference infarct size. The mean difference between with polar map defect size by predefined thresholds (20%, 30%, and 40%) and reference infarct size were 7.04+/-3.44%, 3.87+/-2.09% and 2.15+/-2.07%, respectively. Otsu verse reference infarct size was 3.56+/-4.16%. MGMM methods verse reference infarct size was 2.29+/-1.94%. The predefined threshold (30%) showed the smallest mean difference with reference infarct size. However, MGMM was more accurate than predefined threshold in under 10% reference infarct size case (MGMM: 0.006%, predefined threshold: 0.59%). In this study, we was to evaluate myocardial infarct size in polar map using multiple Gaussian mixture model. MGMM method was provide adaptive threshold in each subject and will be a useful for automatic measurement of infarct size.

Feasibility Study of the Radiophotoluminescent Glass Dosimeter for High-energy Electron Beams / 의학물리

Our goal is to assess the suitability of a glass dosimeter on detection of high-energy electron beams for clinical use, especially for radiation therapy. We examined the dosimetric characteristics of glass dosimeters including dose linearity, reproducibility, angular dependence, dose rate dependence, and energy dependence of 5 different electron energy qualities. The GD was irradiated with high-energy electron beams from the medical linear accelerator andgamma rays from a cobalt-60 teletherapy unit. All irradiations were performed in a water phantom. The result of the dose linearity for high-energy electron beams showed well fitted regression line with the coefficient of determination; R2 of 0.999 between 6 and 20 MeV. The reproducibility of GDs exposed to the nominal electron energies 6, 9, 12, 16, and 20 MeV was +/-1.2%. In terms of the angular dependence to electron beams,GD response differences to the electron beam were within 1.5% for angles ranging from 0degrees to 90degrees and GD's maximum response differencewas 14% lower at 180degrees. In the dose rate dependence, measured dose values were normalized to the value obtained from 500 MU/min. The uncertainties of dose rate were measured within +/-1.5% except for the value from 100 MU/min. In the evaluation of the energy dependence of the GD at nominal electron energies between 6 and 20 MeV, we obtained lower responses between 1.1% and 4.5% based on cobalt-60 beam. Our results show that GDs have a considerable potentiality for measuring doses delivered by high-energy electron beams.

Anti-inflammatory effects of crocin and crocetin in rat brain microglial cells.

Microglial cells play critical roles in the immune and inflammatory responses of the central nervous system (CNS). Under pathological conditions, the activation of microglia helps in restoring CNS homeostasis. However, chronic microglial activation endangers neuronal survival through the release of various proinflammatory and neurotoxic factors. Thus, negative regulators of microglial activation have been considered as potential therapeutic candidates to target neurodegeneration, such as that observed in Alzheimer's and Parkinson's diseases. Crocin and crocetin, found in the fruits of gardenia and in the stigmas of saffron, have been considered for the treatment of various disorders in traditional oriental medicine. Crocin and crocetin have been reported to have diverse pharmacological functions, such as anti-hyperlipidemic, anti-atherosclerotic, and anti-cancer effects. Specifically, the neuroprotective potential of crocetin derivatives has previously been demonstrated. The specific aim of this study was to examine whether crocin or crocetin represses microglial activation. Crocin and crocetin were shown to be effective in the inhibition of LPS-induced nitric oxide (NO) release from cultured rat brain microglial cells. These compounds reduced the LPS-stimulated productions of tumor necrosis factor-α, interleukin-1ß, and intracellular reactive oxygen species. The compounds also effectively reduced LPS-elicited NF-κB activation. In addition, crocin reduced NO release from microglia stimulated with interferon-γ and amyloid-ß. In organotypic hippocampal slice cultures, both crocin and crocetin blocked the effect of LPS on hippocampal cell death. These results suggest that crocin and crocetin provide neuroprotection by reducing the production of various neurotoxic molecules from activated microglia.

Genipin inhibits the inflammatory response of rat brain microglial cells.

Microglia are the prime effectors in immune and inflammatory responses of the central nervous system (CNS). Under pathological conditions, the activation of these cells helps restore CNS homeostasis. However, chronic microglial activation endangers neuronal survival through the release of various proinflammatory and neurotoxic factors. Thus, negative regulators of microglial activation have been considered as potential therapeutic candidates to target neurodegeneration, such as that in Alzheimer's and Parkinson's diseases. Genipin, the aglycon of geniposide found in gardenia fruit has long been considered for treatment of various disorders in traditional oriental medicine. Genipin has recently been reported to have diverse pharmacological functions, such as antimicrobial, antitumor, and anti-inflammatory effects. The specific aim of this study was to examine whether genipin represses brain microglial activation. Genipin was effective at inhibiting LPS-induced nitric oxide (NO) release from cultured rat brain microglial cells. Genipin reduced the LPS-stimulated production of tumor necrosis factor-alpha, interleukin-1beta, prostaglandin E(2), intracellular reactive oxygen species, and NF-kappaB activation. In addition, genipin reduced NO release from microglia stimulated with interferon-gamma and amyloid-beta. Both pretreatment and post-treatment of genipin to LPS-stimulated microglia were effective at decreasing NO release. Furthermore, genipin effectively inhibited microglial activation in a mouse model of brain inflammation. These results suggest that genipin provide neuroprotection by reducing the production of various neurotoxic molecules from activated microglia.

The Effect of Autonomic Nerve System on Neurotensin Induced Motility in Isolated, Vascularly Perfused Rat Colon

BACKGROUND/AIMS: Although neurotensin (NT) stimulates colon motility and the passage of intestinal contents, the associated mechanism of action remains unclear. The objective of this study was to investigate the effects of NT on colon motility using isolated rat colon. METHODS: Intraluminal pressure was measured at both the proximal and distal portions of the isolated colon. An isolated rat colon was perfused with Krebs solution via the superior mesenteric artery. After stabilization, NT was administered in concentrations of 14, 28, 138 and 276 pM. After pretreatment with phentolamine, propranolol, hexamethonium, atropine or tetrodotoxin, NT was administered at a concentration of 276 pM, and then the intraluminal pressure was monitored. RESULTS: NT significantly increased colon motility at concentrations of 14, 28, 138, and 276 in the proximal colon (25.1+/-6.5%, 175.4+/-117.0%, 240.8+/-115.1% and 252.3+/-110.6%, respectively) and in the distal colon (35.6+/-11.8%, 97.5+/-35.1%, 132.7+/-36.7% and 212.1+/-75.2%, respectively). The stimulant effect of NT was more potent in the proximal colon, in a concentration-dependent manner (P<0.05). The stimulant effect of NT was significantly inhibited by atropine at both the proximal and distal colon and by tetrodotoxin at the proximal colon, but not by tetrodotoxin at the distal colon and not by propranolol, phentolamine, or hexamethonium at both the proximal and distal colon. CONCLUSIONS: NT increased colon motility at both the proximal and distal portions of the rat colon. The effects were more prominent at the proximal portion. The results of this study suggest that the stimulant action of NT may be mediated by local cholinergic muscarinic receptors.

Rituximab and Plasmapheresis for Post-transplant Recurrence of FSGS / 대한신장학회지

Focal segmental glomerular sclerosis (FSGS) is known to recur in 20-40% of the renal allografts with graft loss in about half of these cases. We report a successful treatment of a recurrent FSGS after kidney transplantation with rituximab and plasmapheresis. An 16-year-old patient whose primary kidney disease was FSGS developed recurrence of proteinuria after living donor kidney transplantation despite preemptive plasmapheresis and one dose of rituximab (375 mg/m2). After kidney transplantation, nephrotic range proteinuria was detected. Kidney biopsy was done and showed recurrent FSGS. She undergone 11 times of plasmapheresis in the first 4 week post transplantation. In addition, she received additional one dose of rituximab (375 mg/m2) on day 14. Proteinuria was decreased below nephrotic range at 37 day. Ten months later, proteinuria was at 30 mg/day with excellent graft function. No significant adverse events related to rituximab or plasmapheresis were observed. Rituximab with plasmapheresis may be another option for recurrent FSGS after kidney transplantation.

A Case of Reversible Posterior Leukoencephalopathy Syndrome in a Patient with ABO Incompatible Kidney Transplantation / 대한신장학회지

Reversible posterior leukoencepalopathy syndrome (RPLS) was noted by a reversible syndrome of headache, altered mental status, seizure, and visual loss associated with findings indicating predominantly posterior leukoencephalopathy on imaging studies. We report a successful treatment of RPLS after secondary ABO incompatibility kidney transplantation with blood pressure control. A 41-year-old female whose primary kidney disease was chronic glomerulonephritis had graft failure developed after living donor kidney transplantation (1st kidney transplantation). She was admitted to our hospital for 2nd ABO incompatibility kidney transplantation. She had undergone 6 times of plasmapheresis and received additional two doses of rituximab (375 mg/m2) and intravenous immunoglobulin (0.5 g/kg) before kidney transplantation. She received basiliximab induction therapy, tacrolimus, steroid and mycophenolate mofetile after transplantation. The ABO antibody titer had been low (below 1:1) and evidences of rejection were not detected. Generalized tonic clonic type seizure, eyeball deviation, facial cyanotic change and loss of consciousness occurred at post operation 7th day. Several minutes later, she recovered her consciousness without disability and neurologic deficit. She did not represent attacks any more after we controlled blood pressure without withdrawal of immunosuppressants or dose reduction.