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Indifferent streptococci in sticky eyes of neonates.

Treatment with cyclosporin for immunosuppression in renal allograft recipients was started in this hospital at the beginning of the year. Cyclosporin is nephrotoxic, but the exact mechanism by which the nephrotoxic effect is excited is unknown. In this preliminary study three cases were examined in an attempt to recognise the effect of cyclosporin on a cytological basis. Fresh preparations of urinary sediment were stained in the usual way by Giesma, methylgreen pyronin, and Papanicolaou. One preparation was also subjected to study under blue light fluorescence. During the first two to three days after the allograft when the patients were receiving a high dose of cyclosporin most of the cells in the urinary deposits showed faint yellow fluorescence. By the third day cells had appeared that displayed a variable degree of blue-green fluorescence extending from just the nucleus or periphery of the cell to the entire cell. The number of cells exhibiting blue-green fluorescence and the intensity of fluorescence continued to increase as the dosage of cyclosporin was maintained. The types of cells that displayed the blue-green fluorescence were initially tubular cells, renal tissue fragments, lymphocytes, and red cells, if these were present. The cells were identified by phase contrast microscopy. The blue-green fluorescence appeared only when high doses of cyclosporin were given, and on three occasions whole blood monitoring of cyclosporin by radioimmunoassay showed cyclosporin concentrations above 1000 ng/ml. When the dosage of cyclosporin was reduced fewer cells exhibited blue-green fluorescence, and the intensity of the fluorescence was reduced. The urinary deposits from recipients of renal allografts on low maintenance doses of cyclosporin were also examined and no blue-green fluorescence was observed. The urinary sediments from patients other than recipients of renal allografts, and who were not receiving cyclosporin treatment but were receiving various other drugs were also examined, and no blue-green fluorescence was seen. Cell deposits from other body sites such as pleural effusions and breast cyst fluids, were also examined and blue-green fluorescence was not observed. In all of these samples many cells did show varying degrees of yellow fluorescence that were considered to be non-specific. Letters