Acute effects of calcineurin inhibitors on kidney allograft microperfusion visualized by contrast-enhanced sonography.

BACKGROUND: Calcineurin inhibitors induce detrimental vascular remodeling, which may be one cause of chronic allograft failure. Real-time contrast-enhanced sonography (CES) is a relatively new technique in providing quantitative information on microvascular tissue perfusion in kidney allografts in more detail. The purpose of the study was to explore whether acute changes of kidney allograft microperfusion due to the administration of cyclosporine A (CsA) and tacrolimus (Tac) can be evidenced using real-time CES. METHODS: In an explorative single-center clinical trial, renal parenchymal tissue perfusion of 32 stable kidney allograft recipients was evaluated with CES before and 2 hr after the intake of CsA or Tac. In addition to laboratory and clinical parameters, Doppler indices and estimated glomerular filtration rate were measured. RESULTS: Although systolic and diastolic blood pressure and color Doppler indices did not significantly differ, there was a significant decrease of renal blood flow 2 hr after the intake of CsA compared with baseline (4.78±2.31 dB/s, 49%, respectively). In contrast, kidney allograft microperfusion was neither significantly reduced in patients receiving CsA paralleled by calcium channel blockers nor significantly reduced in patients receiving Tac. Furthermore, there was a significant correlation between renal blood flow obtained before drug administration and kidney function. CONCLUSIONS: CES revealed a 49% reduction of kidney allograft microperfusion 2 hr after the intake of CsA, which might be abrogated by calcium channel blockers. In comparison to CsA, Tac did not result in a significant decrease of kidney blood flow.

STM-induced surface aggregates on metals and oxidized silicon.

We have observed an aggregation of carbon or carbon derivatives on platinum and natively oxidized silicon surfaces during STM measurements in ultra-high vacuum on solvent-cleaned samples previously structured by e-beam lithography. We imaged the aggregated layer with scanning tunneling microscopy (STM) as well as scanning electron microscopy (SEM). The amount of the aggregated material increases with the number of STM scans and with the tunneling voltage. Film thicknesses of up to 10 nm with five successive STM measurements of the same area have been obtained.