Résumé
This is a report of 51 cases in renal allograft, which were treated at the Yeungnam University Hospital from February 1994 to July 1996 and compared the significance of changes of TNF-alpha in blood and urine as a diagnostic tool of acute rejection in renal allograft. The aim of this study was to investigate the value of plasma and urinary TNF-alpha in patients with renal allografts. Renal allografts divided them into four groups (control, acute rejection, acute tubular necrosis and systemic infection) that obtained plasma and urinary TNF-alpha. The sampling day of blood and urine in each group were as follows: in control group at the day of transplantation and postoperative 1, 5, 7 days respectively, in acute rejection group at before the day of initiation of therapy and the 1, 3 days after therapy, in acute tubular necrosis group at the day of low urine output and the 4 subsequent days, and in systemic infection group at the day of diagnosis and the 3 subsequent days. The results were as follows: Plasma TNF-alpha levels were significantly elevated in 68.4% (p0.05). In contrast, urinary TNF-alpha were detected in acute rejection group (42.1%, p<0.01) and acute tubular necrosis group (20.0%, p<0.05). Control and systemic infection groups were not detectable in urinary TNF-alpha. The results suggested that plasma and urinary TNF-alpha may be used as the complementary diagnostic tool of acute rejection in renal allograft patients.
Sujets)
Humains , Allogreffes , Diagnostic , Nécrose , Plasma sanguin , Facteur de nécrose tumorale alphaRésumé
Infantile hypertrophic pyloric stenosis(IHPS), which occurs three of 1,000 live births, is a major cause of 1 nonbilious vomiting of early infancy but its etiology and pathogenesis are still obscure. The operation of pyloromyotomy as described by Ramstedt in 1912 remains the standard of care for the treatment of IHPS. From January 1993 to October 1996, 35 infants with IHPS were surgically treated and the following results were obtained. 1. Thirty-five patients comprised 32 males and 3 females, and the ratio of male to female was 10.7:1. 2. The most prevalent age group was between 2 weeks and 8 weeks. 3. Of 35 infants, first born babies were 23 cases(65.7%). 4. Breast feeding was in 23 cases(65.7%). 5. The body weight percentile at admission was lower than 50 percentile in all 35 cases. 11. A total of seven associated anomalies were noted in six patients. 12. All 35 cases were treated with Fredet-Ramstedt pyloromyotomy. 13. There were postoperative complications of wound infection in 2 cases. Intermittent nonprojectile vomiting was presented in 8 cases(22.9%) after operation, but one of them was relieved in 13 days and the rest were relieved within one week by adjustment of oral intake.