[Ambulatory continuous recording of pH and pressure in the esophagus]. / Ambulant kontinuerlig registrering af pH og trykaktivitet i esophagus.

Ambulatory simultaneous recording of oesophageal pressures and pH is a recently developed technique for evaluation of oesophageal function. The paper describes the experience gained with this technique at the Oesophagus Laboratory, department of Thoracic and Cardiovascular Surgery T, Odense University Hospital. A combined pH and pressure probe is positioned in the oesophagus and connected to a portable recorder. Data are digitised on-line and stored for later transfer to a computer. Analysis of pH-variations and contractile activity is performed automatically. Sections with normal and abnormal acid clearing are shown. A normal pressure response to reflux consists of frequent contractions of normal amplitude and propagation resulting in a stepwise clearing of acid from the oesophagus. Repetitive simultaneous contractions and periods of failed peristalsis are illustrated in sections from a patient with oesophagitis. Contractions of high amplitude and prolonged duration, as well as frequent non-propagating contractions in the distal oesophagus, are elements of a normal peristaltic pattern. The conventional manometric investigation performed under laboratory conditions still has first priority when esophageal dysmotility is suspected. In several instances, however, ambulatory recording of motility and pH may add valuable additional information.

[Free jejunal autograft for reconstruction of the pharynx and cervical esophagus]. / Frit jejunum-autotransplantat ved rekonstruktion af pharynx/cervikale esophagus.

Reconstruction of the pharynx and cervical oesophagus by transplantation and revascularisation of a free jejunal graft is reported in a 47-year old male with cancer of the pharynx. The time interval from operation to oral intake was 12 days.

The predictive value of specific protein clearances in detecting acute rejection episodes after renal transplantation.

The relative clearances of albumin, transferrin, haptoglobin, IgG, IgA, and IgM and the relative excretion of immunoglobin free lambda- and kappa light chains, lysozyme, and beta2-microglobulin were measured in 24 patients who had recently received renal transplants. Eleven out of 13 acute rejection episodes were predicted 1 to 5 days before the clinical diagnosis was made, and in 2 patients the clinical diagnosis of rejection and the prediction were made simultaneously. Successful antirejection therapy was followed by a decrease in protein excretion; in irreversible rejection episodes protein excretion continued to increase in spite of antirejection therapy. It is recommended that the relative clearances of IgG and haptoglobin be measured daily in patients recently treated by renal transplantation.