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It is well known that nanoparticles affect the interaction between lubricants and surfaces with various chemical compositions and different chemical and physical properties. In recent years, nanoparticles have started to play more important roles as lubricant additives for their potential in wear, friction and emission reduction and improving lubrication and fuel economy. Although nanolubricants are frequently used for friction tests, little is known about stability and degree of dispersion of these nanoparticles in viscous liquids. Most of them are unstable, agglomerate or aggregate which sediment over time. Boric acid (H3BO3) has always been a very important material due to its broad range of applications such as in medicine, cosmetics, automotive industry, metallurgy and also for miscellaneous purposes in other areas. Literature survey showed that friction between automobile engine parts could be greatly reduced using microscopic particles of boric acid.This study involves the new invention of successful suspension of nano boric acid (BA) additive added into 5W-40 fully synthetic commercial lubricating oil. This invention is confidential and realized by Murat ÖZAYMAN from Tribor ARGE Co. in Teknopark of YILDIZ Technical University in Istanbul-TURKEY. The particle size of BA is determined with (Transmission Electron Microscopy) (TEM). Backscattering and transmittance profiles proved that nano boric acid (BA) particles were in suspension in commercial engine oil. Suspended BA in engine oil is applied between piston ring and cylinder liner system in order to investigate their effect on friction and wear under boundary lubricated conditions. Simulation and measurement of friction and wear were conducted using a reciprocating tribometer. Surface analysis were performed using 3D digital optical microscope, Field Emission Scanning Electron Microscope (FESEM)/X-Ray, X-ray photoelectron spectroscopy (XPS) and Atomic Force Microscopy (AFM). Boron (B) from BA is well detected, mixed with other elements of additives and protected the surface under boundary lubrication conditions. The results indicate that BA can considerably improve the tribological performance of a piston ring and cylinder liner system under lubricated conditions. It has found that the friction coefficient is reduced with nano boric acid (BA) suspended engine oil and protected the surface mostly on cylinder liner mixing with other additives.

Lubricants play a vital role in machine life and performance, reducing friction and wear and preventing component failure. Performance-enhancing additives are a vital part of today’s modern lubricants. In response to this need, this experimental work presents the development of the new suspended nanoboric acid (nBA) additive added in engine oil that can drastically lowered friction and wear.This is a new invention of nBA additive hold in suspension and added into 5W-40 fully synthetic commercial lubricating oil. This invention is confidential and realized by Tribor ARGE Co. in Teknopark of YILDIZ Technical University in Istanbul-TURKEY.The particle size of nBA is determined with (Transmission Electron Microscopy) (TEM). Turbiscan Tower Stability Analyzer results proved that nBA particles were in suspension in commercial engine oil. Suspended nBA in engine oil is applied between ball and disk system in order to investigate their effect on friction and wear under lubricated conditions. Simulation and measurement of friction and wear were conducted using a ball on disk reciprocating tribometer UMT-3. Surface analysis was performed using 3D digital optical microscope and surface roughness, Field Emission Scanning Electron Microscope (FESEM)/X-Ray and Atomic Force Microscopy (AFM). Boron (B) from nBA is well detected, mixed with other elements of additives and protected the surface under boundary lubrication conditions. The results indicate that nBA can considerably improve the tribological performance of a ball and disk pairs under lubricated conditions. It has found that the friction coefficient is reduced with nBA suspended engine oil and protected the surface on both ball and disk mixing with other additives.

We investigated the tribological behavior of commercialized, fully synthetic engine oil upon the incorporation of reduced graphene oxide in seven different concentrations between 0.01 and 0.2 wt %. Stability of the prepared samples was assessed by turbidimetry and dynamic light scattering measurements, and their tribological properties through a reciprocating tribometer, using a steel ball on special cut steel blocks. The addition of 0.02 wt % of reduced graphene oxide led to an improvement of the tribological behavior compared to the pristine engine oil, by significantly lowering the friction coefficient by 5% in the boundary lubrication regime. Both the surfaces and the reduced graphene oxide additive were thoroughly characterized by microscopic and optical spectroscopy techniques. We also verified that a protective layer was formed between the worn surfaces, due to the presence of reduced graphene oxide. Carbon accumulation and various additive elements such as Ca, Zn, S and P were detected on the rubbing surfaces of both the ball and the block through energy-dispersive X-ray spectroscopy. Finally, it was shown that the wear scar diameter on the surface of the steel ball was lower by 3%, upon testing the engine oil sample containing reduced graphene oxide at concentration 0.02 wt %, compared to the control sample.

There is a subgroup of patients with Wilms' tumour (WT) having favourable clinicopathological features but adverse outcome. We aimed to investigate the prognostic significance of angiogenesis and whether it can be used for predicting which patients will fall into this category, and the possible role of vascular endothelial growth factor (VEGF) on angiogenesis in WT.Tumours in nephrectomy specimens from 63 WT patients were investigated for neovascularisation and VEGF expression by immunohistochemistry. The endothelial cells were highlighted by anti-CD34 and anti-CD31, and the microvessels in the hot-spots were counted. Correlations between the microvessel density (MVD), VEGF expression, clinicopathological features and prognosis were studied.Among 21 patients with follow-up data, favourable histology was detected in 17, seven of which died of disease. Patients with highly vascular tumours showed significantly poorer prognosis than those with low vascular tumours. There was no significant relationship between angiogenesis and VEGF expression. VEGF immunostaining revealed various patterns in different components of WT.We suggest that high MVD can be used as an indicator of poor prognosis with WT patients displaying favourable histology and there might be some additional growth factors other than VEGF which may also be responsible for angiogenesis in WTs.

Paragangliomas of the urinary bladder is one of the rare tumors and accounts for 0.06% of all bladder tumors. Malignancy is uncommon, occuring in 10–15% of the bladder paragangliomas with less than 20 cases previously reported and determined by its clinical behaviour rather than the histological features. Herein, we describe a case of urinary bladder paraganglioma in a 33-year-old male patient who exhibited with macroscopic painless hematuria. On ultrasonographic examination, a 6 cm × 4 cm mass along the left lateral wall of the urinary bladder was detected. The patient underwent CT examination, which revealed a hyperdense mass with some calcification in it. Also bilateral obturator and iliac lymph nodes measuring up to 2 cm were detected. MR imaging was also performed and again an intense enhancing mass in the left lateral wall of the bladder with bilateral lymph nodes and possible invasion to the seminal vesicles and sigmoid colon was shown. In the laboratory analysis, the 24 h urine vanillylmandelic acid (VMA) level was significantly elevated. During transurethral cystoscopy (TUR) and biopsy a hypertension crisis occured which was controlled by medical therapy. Following histopathologic analysis the diagnosis was established as paraganglioma. The patient has undergone radiation therapy for 2 months and only minimal regression of the tumoral size was observed. Due to the fact that long term follow-up is mandatory for these tumors, the patient is closely being monitored by the urology clinic.

Among the epithelial renal tumours with eosinophilic cytoplasm, the main differential diagnostic problem arises between renal oncocytomas (ROs) and eosinophilic variants of chromophobe renal cell carcinomas (RCCs). We investigated the possible role of anti-mitochondrial (AMA), anti-caveolin 1 (CAV1), anti-CD63 (CD63) and anti-cytokeratin 14 (CK14) antibodies in the differential diagnosis of eosinophilic epithelial tumours and applied the Muller and Mowry modification of Hale's colloidal iron stain (HCI). Thirty-five ROs and 77 eosinophilic RCCs (27 chromophobe, 28 clear cell and 22 papillary RCCs) were included in this study. Apical and/or polar CD63 immunostaining (94%) and diffuse AMA (91%) and CAV1 (88%) immunostainings were the characteristics of ROs, whereas diffuse CD63 immunostaining (96%) and diffuse-peripheral AMA (96%) and CAV1 (92%) immunostainings were characteristic immunohistochemical features of eosinophilic chromophobe RCCs. We showed CK14 antibody not to be useful in the differential diagnosis of the eosinophilic epithelial renal tumours. The staining localisations with AMA, CAV1 and CD63 antibodies were significantly different between tumour groups. AMA had 96% sensitivity and 94% specificity, whereas CAV1 had 92% sensitivity and 97% specificity in diagnosing chromophobe RCCs. With HCI staining, ROs, showing apical and/or polar staining, could be differentiated from chromophobe RCCs, showing diffuse cytoplasmic staining. HCI had fairly low (69%) sensitivity and 100% specificity, whereas CD63 had 95% sensitivity and 100% specificity to diagnose ROs. We recommend using CD63 as the best marker of choice for distinguishing ROs from eosinophilic chromophobe RCCs when standard diagnostic criteria are not helpful.

Objectives: To investigate whether coexistence of high-grade prostatic intraepithelial neoplasia (HPIN) should change our therapeutic approach to infravesical obstruction. Material and Methods: Of 505 patients who underwent sextant transrectal ultrasonography (TRUS)-guided prostate biopsy, 65 (12.8%) had HPIN and 29 of them underwent prostatectomy (23 transurethral resection of prostate (TURP), 6 open) due to obstructive urinary symptoms. Patients without carcinoma were followed up with semiannual prostate-specific antigen (PSA) and digital rectal examination. After a follow-up of 24.8 ± 11.0 months, 19 of 29 patients who accepted our call had another sextant biopsy. Results: Mean age and initial mean PSA values of 29 patients were 67.6 ± 6.7 years and 9.26 ± 5.91 ng/ml, respectively. The final pathological evaluation of the surgical specimens revealed 2 prostatic adenocarcinomas both in the TURP group. The remaining 27 (93.2%) patients were found to have benign prostatic hyperplasia (BPH) and their serum PSA levels declined from 9.26 ± 5.91 to 4.59 ± 2.0 ng/ml 3 months after prostatectomy. Of the 19 patients who had another biopsy with a mean PSA value of 4.06 ± 4.61 ng/ml, 15 and 4 of them had BPH and HPIN respectively. Conclusions: Our preliminary data indicate that the presence of HPIN on TRUS-guided biopsies is not a factor to delay an indicated surgical intervention for infravesical obstruction.

The objective of this study was to evaluate the possible role of transforming growth factor beta 1 (TGF-beta1) antibodies (ab) for the prevention of fibrotic effects of priapism in a rat model. In total, 30 adult Sprague-Dawley rats were divided into five groups. Priapism with 6 h (group 1), priapism with 6 h+ab (group 2), priapism with 24 h (group 3), priapism with 24 h+ab (group 4) and control (group 5). Priapism was induced with a vacuum erection device and a rubber band was placed at the base of the erect penis. At 1 h after the initiation of priapism, TGF-beta1 antibodies were given intracavernosaly. All rats underwent electrical stimulation of the cavernous nerve after 8 weeks. Intracavernous and systemic blood pressures were measured during the procedure. Rats in group 1 showed significantly higher (intracavernosal pressure (ICP) pressures to cavernous nerve stimulation and had higher ICP/BP ratios when compared to other groups. Similarly, histopathologic examination revealed less fibrosis in group 2, compared with the other groups. Consequently, TGF-beta1 antibodies antagonise the fibrotic effects of TGF-beta1, especially in cases with duration of priapism less than 6 h.

A 12-month-old boy presented to a local hospital with periorbital oedema and microscopic haematuria. He was pale and hypertensive and had low serum complement C3. He was treated for and followed with the diagnosis of acute post-streptococcal glomerulonephritis. The patient’s parents were second-degree relatives of each other, but his family history was entirely negative for renal disease, hypertension and anaemia. When he was 17 months, he was referred to our unit for persisting haematuria and periorbital oedema. Physical examination revealed a pale, oedematous boy with a blood pressure of 180/90mmHg. His laboratory values included: urea 35mg/dl, creatinine 0.54mg/dl, albumin 4.3 g/dl, cholesterol 175mg/dl, haemoglobin 6.3 g/dl, MCV 77.7 fl, reticulosit count 0.52%. His platelet count was normal, and a peripheral blood smear showed no evidence of microangiopathy. The direct Coombs’ test was positive; the test for cold agglutinins was negative. Urinalysis revealed haematuria and proteinuria. Creatinine clearence (Ccr) was 122ml/min/1.73m 2 and the urine protein/ creatinine ratio was 3.76 (mg/mg). Tests for anti-nuclear and anti-glomerular basement membrane antibodies and anti-streptolysin O were negative. Serum C3 was 180mg/l (range 825–1140mg/l) and C4 was normal. C3 nephritic factor was negative. A renal biopsy and complement profiling were performed, and with the diagnosis of membranoproliferative glomerulonephritis (MPGN), the patient was treated with 0.5mg/kg/day oral enalapril and 2mg/kg/day oral prednisolone. His urine was protein free at the end of the first week, but he relapsed at the end of 1 month, when he was 18 months old. He now had: hypertension, proteinuria of 56.9mg/ m/h (protein/creatinine1⁄4 3mg/mg), Ccr of 120ml/min/ 1.73m, serum cholesterol of 242mg/dl, urea 53mg/dl, creatinine 0.3mg/dl, haemoglobin 9.2 g/dl and albumin 3.8 g/dl. He was treated with 30mg/kg doses of i.v. methyl prednisolone for 3 days, and afterwards with i.v. 500mg/m cyclophosphamide—monthly six times— and prednisolone 1.5mg/kg/day on alternate days. Enalapril was prescribed for hypertension. Microscopic haematuria and nephrotic-range proteinuria persisted over the 6 months of this therapy. He required hospitalization to control a sudden severe hypertensive crisis at the end of 6 months; and his blood pressure was regulated with 2mg/kg/day nifedipine, 25mg/day atenolol and 0.5mg/kg/day enalapril. Microhaematuria and nephrotic-range proteinuria persisted with high serum cholesterol, but he still had a normal Ccr. A second renal biopsy was performed at the age of 2.5 years. Cyclosporine A (CyA) at a dose of 5mg/kg was started, and alternate-day prednisone, nifedipine, enalapril and atenolol were continued. Serum cyclosporine levels were controlled against C0 and C2 levels. Cyclosporine doses were adjusted to maintain C0< 50ng/ml and C2 around 400 ng/ml. At the end of the second week, when C0 was 15 ng/ml and C2 was 434 ng/ml, urine protein began to decrease from the nephrotic-range, and microscopic haematuria disappeared. After 3 months of cyclosporine therapy, urine was protein-free and serum albumin and cholesterol normal; therefore, prednisolone and anti-hypertensive drugs were decreased gradually. CyA therapy was terminated at the end of 15 months of follow-up when he was 3.5 years old. He is still being followed-up, and has been on no medications for 6 months. His blood pressure, Ccr, serum cholesterol and serum albumin are at normal levels and his urine is protein-free; but he still has low complement—C3 (160mg/l). Correspondence and offprint requests to: Zelal Bircan, MD, Kocaeli Universitesi Tip Fakultesi Hastanesi, Cocuk Sagligi ve Hastaliklari Anabilim Dali, Derince/Kocaeli, Turkey. Email: zbircan@kou.edu.tr

In this case report a 5-year-old girl is presented who had Celiac disease and presented with nephrotic syndrome due to focal segmental glomerulosclerosis. Her intestinal biopsy which had been performed 2 years previously had revealed chronic duodenitis characterized by total villous atrophy and crypt hyperplasia. She presented with abdominal cramps, diarrhea, nausea, vomiting, failure to thrive and generalized edema while she was on gluten-free diet and in clinical remission for the disease. Kidney biopsy was performed considering the probable diagnoses of nephrotic syndrome and renal failure. The histopathological diagnosis was a cellular type focal segmentary glomerulosclerosis. A progressive deterioration could not be prevented in renal functions despite all therapeutic approaches including pulse methylprednisolone and cyclophosphamide administration. An end-stage renal disease (ESRD) developed within eight months, and the patient died due to the cardiovascular complications of ESRD 18 months after the initial presentation of renal findings. Very rare association of progressive glomerular disease and Celiac disease should be kept in mind during the follow-up of any child with Celiac disease

Background: We aimed to review our experience with childhood lupus nephritis (LN) in respect to the analysis of the clinical and histopathological presentation of LN and prognostic factors affecting the kidney and patient outcomes. Method: Forty-three children (39 girls, 4 boys) with biopsy-proven LN were included in the study. The mean age of the children was 12.0 ± 2.8 years. Based on the renal histopathology and clinical presentation, patients were treated with oral prednisone, intravenous pulses of methylprednisolone or intravenous cyclophosphamide. The final clinical status was classified as follows: (1) renal and extrarenal remission; (2) clinically active renal disease, or (3) adverse outcome, i.e., end-stage renal failure (ESRF) or death. Results: The mean duration of follow-up was 7.2 ± 2.8 years (1 month to 14.2 years). All 43 children had hematuria and 53.5% had proteinuria at admission. Fourteen children were in nephrotic status at the onset of disease. Class IV (diffuse proliferative) nephritis was observed in 29 patients as the most frequent histopathology (67.4%). The patients with class IV nephritis had a tendency to develop nephrotic syndrome, heavy proteinuria, increased Cr levels and persistent hypertension at initial evaluation. Thirty-two of 43 children (74.4%) were in renal remission at the last visit. Five-year kidney and patient survival rates from the time of diagnosis to the endpoints of ESRF or death were 83.7 and 90.7% respectively in the whole group while it was 75.9 and 86.2% respectively in the class IV group. Adverse outcome was significantly associated with the persistent hypertension, anemia, high serum Cr level, heavy proteinuria, nephrotic syndrome and class IV nephritis at presentation. Conclusion: We can conclude that the prognosis of LN in children is primarily dependent on the histopathological lesions. Severity of the clinical renal disease at admission and presence of persistent hypertension are the main poor prognostic factors rather than age, gender, low C3 and C4 levels, ANA positivity and the treatment modalities in Turkish children.

A unique case of bilateral multiple intrarenal angiomyolipomas in a 21-year-old woman with tuberous sclerosis is reported. The microscopic examination showed peculiar intraglomerular microlesions, epithelioid areas, microscopic foci of renal cell carcinoma and renal cysts, and the classical features of angiomyolipoma lesion. HMB-45 positivity was detected within some nodules and epithelioid areas. Intraglomerular microlesions were composed of adipose and smooth-muscle cells within the glomerular capillary tuft. These lesions, which were continuous with the capillary tuft, did not show any attachment to the Bowman's capsule. These findings suggest that these are not a consequence of an infiltration from the outside but were originated from inside the glomerulus. The simultaneous presence of multiple angiomyolipoma nodules either inside or outside the glomeruli, multifocality and bilaterality of these lesions, together with the HMB-45 positivity and the finding of scattered epithelioid areas supports the theory that there is a progenitor cell giving origin to all these lesions, the cell which has been named as perivascular epithelioid cell by most authors.

PubMed ID: 17551409 Systemic juvenile xanthogranuloma is a rare disease in children. A 10-year-old boy who showed renal, pulmonary, and liver involvement is reported. He had pulmonary invasion, renal mass, and nodular liver lesions but no bone involvement. The diagnosis was confirmed by renal biopsy, which revealed foamy, lipid-laden macrophages with positive CD68, but negative CD1a and S-100. The patient was treated with pulse high-dose methylprednisolone (10 mg/kg/d for 3 d for 6 courses). On 1-year follow-up period after 6 courses therapy was resulted in remarkable regression in renal and liver lesions. © 2007 Lippincott Williams & Wilkins, Inc.

The signet ring cell carcinoma of the urinary bladder is a rare neoplasm; the 70 cases found in the literature pursued a fulminant and mostly fatal course; the neoplasms diffusely invaded the bladder wall without forming intraluminal growths and could not be controlled by segmental resection, radiotherapy and chemotherapy alone or in combination. We herewith present 2 cases of primary signet ring cell carcinoma of the urinary bladder--one associated with high-grade transitional cell carcinoma and in situ carcinoma--and review the literature.

(1995). Renal Cell Carcinoma in Childhood: A Case Report. Pediatric Hematology and Oncology: Vol. 12, No. 3, pp. 313-316.

Ewing’s sarcoma/primitive neuroectodermal tumor (ES/PNET) of the penis has been very rarely defined. We report a case of a 19-year-old patient with a tumor, localized in the dorsal side of penis, composed of small round cells with diffuse membranous mic-2 (CD99) immunopositivity. The patient was treated with multiagent chemotherapy and radiotherapy.

In predicting the aggressive behavior of bladder tumors, the histopathological characteristics of grade and invasive stage are of principal importance. However, for predicting tumor recurrence and progression, these are sufficient only to a limited extent, particularly in the case of superficial (pTa and pT1) urothelial cell carcinomas. New prognostic factors are therefore needed to avoid either insufficient or excessive treatment. In this retrospective study, we investigated the prognostic value of the p53 and Ki-67 immunoreactivity indices. The present study included 118 superficial urinary bladder tumors consisting of 58 recurrent and 60 non-recurrent cases. Twenty of the recurrent tumors progressed into a higher grade and/or invasive stage. Paraffin immunohistochemical analysis was carried out using anti-p53 and anti-Ki-67 antibodies on the initial tumor tissues. We concluded that there is a highly significant relationship between the p53 and Ki-67 immunoreactivities and the histological grade and pathological stage of the tumors (P < 0.0001). We observed a significant relationship between the presence of recurrence and progression and the p53 immunoreactivity index (P < 0.01 and P = 0.017, respectively) and Ki-67 immunoreactivity index (P < 0.0001 and P = 0.046, respectively). Positivity for p53 and Ki-67 can demonstrate the risk of recurrence (p53: sensitivity = 76%, specificity = 58%; Ki-67: sensitivity = 86%, specificity = 48%) and progression (p53: sensitivity = 80%, specificity = 46%; Ki-67: sensitivity = 85%, specificity = 36%; ). We believe that both of these immunohistochemical markers can be considered valuable in addition to classical histopathological prognostic parameters for predicting recurrence and progression risks.

The effects of pulse methylprednisolone (PM) therapy were studied in 15 patients (aged 3-14 years) with biopsy proven membranoproliferative glomerulonephritis (MPGN). Patients were treated with intravenous PM 30 mg/kg (max 1 g) given over 30 min every other day for a mean of 9.8 days (3-15 days). Oral prednisolone therapy was continued at a dose of 1 mg/kg/24 h for 1 month and subsequently tapered off the following month. Eight patients had hematuria and six had medically controlled hypertension. Serum C3 levels were low in 11 patients and all of the patients had proteinuria. Following PM therapy proteinuria was significantly reduced from 2602.9 +/- 1852.5 mg/24 h to 1871.2 +/- 2090.8 mg/24 h (P < 0.05) and at final evaluation, proteinuria was 774.33 +/- 1225.67 mg/24 h which was significantly lower than pre- and post-PM therapy values (P < 0.05). Serum creatinine levels were high in five patients before PM therapy and remained high in one of the patients who progressed to end-stage renal failure. After PM therapy, high serum creatinine levels normalized in three patients and was reduced, but still above normal, in one. One patient, with initially normal serum creatinine, had elevated levels afterwards. Nine of the patients were considered responsive and six non-responsive according to our tentatively defined criteria. Mean follow-up period was 27.4 +/- 24.1 months (6-84 months). Three patients were lost for follow-up, and 12 were re-evaluated.(ABSTRACT TRUNCATED AT 250 WORDS)

We studied the efficacy of captopril, an angiotensin-converting enzyme inhibitor in treating persistent moderate or severe proteinuria in children with various glomerular diseases other than minimal-change nephrotic syndrome. Captopril was administered for 3 months to 15 normotensive and nonazotemic or mildly azotemic patients (12 boys, 3 girls) in whom corticosteroid and cytotoxic treatment had failed to induce remission. Urinary protein excretion decreased from 2873.14 +/- 1937.50 (mean +/- s.e.m.) to 1684.71 +/- 1463.13 mg/day (P < 0.05). The reduction in proteinuria was not related to a significant fall in systemic blood pressure or a change in renal function. Serum albumin did not rise and side effects due to captopril were not observed. We concluded that, in the short term, captopril can be used safely and effectively for decreasing the proteinuria of nephrotic children unresponsive to conventional therapy.

Due to inadequate cadaveric and living related organ supply, many end-stage renal disease patients go to third-world countries for living unrelated (paid) kidney transplantation. Thirty-four patients who have had transplantations in two centres in India before coming to our centre for post-transplant care and follow-up are reported in this study. In the post-transplant phase at our centre, the mean follow-up period of the patients was 209.7 +/- 137.3 (range 6-450) days. Fourteen of them, having an uneventful course, were followed on an outpatient clinic basis. The rest of the patients were hospitalized because of the following surgical and/or medical complications, during admission: urinary fistula in two patients; lymphocele in three patients; urinary tract obstruction in two patients; decubitus ulcer in one patient; severe wound infection in one patient; subacute myocardial infarction in one patient; acute irreversible vascular rejection in two patients; urinary tract infection in two patients; pneumonia in two patients; congestive heart failure and severe electrolyte disturbance in two patients; post-transplant diabetes mellitus and ketoacidosis in one patient; cyclosporin nephrotoxicity in two patients; cyclosporin nephro-, hepato-, and neurotoxicity in one patient. Plasmodium falciparum malaria in three patients, generalized mucormycosis infection in one patient, and genitourinary aspergillosis in one patient were seen during the first month. Hepatitis B virus infection followed by chronic active hepatitis was diagnosed in two patients, 2 and 4 months after the operation; and Kaposi's sarcoma was noted in another two patients, 1 and 5 months after the operation.(ABSTRACT TRUNCATED AT 250 WORDS)