: Recently, B‐cell infiltrates in acute rejection grafts have attracted interest as an indicator of refractory rejection. Here, we report a case of deceased donor renal transplantation in a Japanese ...recipient operated overseas in which the recipient suffered from persistent tubulointerstitial rejection episodes associated with B‐cell infiltrates. A 59‐yr‐old man with end‐stage renal disease caused by immunoglobulin A nephropathy underwent deceased donor renal transplantation overseas in December 2005. The initial post‐operative course was uneventful. The patient was referred to our hospital one month after transplantation. He maintained stable renal function throughout the follow‐up period. The maintenance immunosuppressive regimen consisted of tacrolimus, mycophenolate mofetil and methylprednisolone. His serum creatinine concentration remained around 1.0 mg/dL, with no evidence of proteinuria. However, a discrepancy was detected between the renal function and the pathological findings. The pathology showed subclinical tubulointerstitial rejection with nodular B‐cell infiltrates refractory to aggressive antirejection therapy. A steroid pulse and 15‐deoxyspergualin were ineffective and the patient developed interstitial fibrosis and tubular atrophy by one yr after the transplantation, with persistent tubulitis and B‐cell infiltrates. We treated the refractory rejection with B‐cell infiltrates with a single 200 mg/body dose of rituximab and obtained an improvement. The pathological findings after administering rituximab consisted of mild tubulitis classified as Banff borderline, and elimination of the nodular B‐cell infiltrates. At present, 20 months after renal transplantation, the patient continues to maintain stable renal function, with a good serum creatinine concentration (0.87 mg/dL).
: A 54‐yr‐old Japanese male received overseas deceased kidney transplantation in January 2006. His allograft functioned immediately and he received immunosuppression with cyclosporine A (CyA), ...mycophenolate mofetil (MMF), and prednisone (PR). On day 24 after transplantation, he came back to Japan. His serum creatinine level (s‐Cr) was 1.39 mg/dL at two months after transplantation when he was admitted into Toda Central General Hospital on March 2006, for follow‐up his renal allograft. He had taken only two immunosuppressive drugs, MMF and PR, and had not taken CyA at that time. His serum creatinine gradually rose after hospitalization. Allograft biopsy performed on April 6, 2006, showed acute vascular rejection (Banff 97 acute/active cellular rejection Grade III), together with suspicious for acute humoral rejection (Banff 97 antibody‐mediated rejection Grade II). After treatment of two courses of steroid pulses and five d of gusperimus, acute vascular rejection and acute humoral rejection were relieved, which had been proven by the third allograft biopsy. In conclusion, this was a case of acute vascular rejection after overseas deceased kidney transplantation, resulted from non‐compliance with immunosuppressive therapy.
Seventeen derivatives of imidazo2,1-bthiazol-5-ylsulfonylurea were synthesized and their herbicidal activities were examined. Among them, 1-(6-chloroimidazo2,1-bthiazol-5-ylsulfonyl)-3-(4,6-dimeth ...oxypyrimidin-2-yl)urea 13 was most effective in controlling paddy weeds without any phytotoxicity to rice plants and with the activity comparable to that of TH-913
Seventeen derivatives of imidazo2, 1-bthiazol-5-ylsulfonylurea were synthesized and their herbicidal activities were examined. Among them, 1-(6-chloroimidazo2, 1-bthiazol-5-ylsulfonyl)-3-(4, ...6-dimethoxypyrimidin-2-yl)urea 13 was most effective in controlling paddy weeds without any phytotoxicity to rice plants and with the activity comparable to that of TH-913.
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