Characteristics of alloreactive T cells measured before renal transplantation.

Several assays to measure pre-existing allospecific T cell immunity in renal transplant candidates have been developed in the past years. In 46 patients, we used flow cytometry-based mixed lymphocyte culture to measure the precursor frequency and phenotype of alloreactive T cells before renal transplantation, using donor-specific or third-party cells for allostimulation. Allostimulation induced up-regulation of co-stimulatory molecules, chemokine receptors relevant for migration of T cells into the graft and effector proteins. Recipients prone for acute rejection had a higher precursor frequency of alloreactive CD8(+) T cells and a lower percentage of interleukin (IL)-7Rα expressing alloreactive CD8(+) T cells than non-rejectors. These data point to quantitative and qualitative differences between T cells of patients who will experience acute cellular rejection episodes from those who will not.

[Dientamoeba fragilis: possibly an important cause of persistent abdominal pain in children]. / Dientamoeba fragilis: een mogelijk belangrijke oorzaak van persisterende buikpijn bij kinderen.

OBJECTIVE: To determine the effect of an antiprotozoic treatment on children with persistent abdominal pain and infection with Dientamoeba fragilis. DESIGN: Retrospective. METHOD: A total of 43 children with D. fragilis infection and persistent gastrointestinal complaints were included in the study. Of these 27 were treated with clioquinol and 16 with a nitroimidazole drug: metronidazole or tinidazole. The parasitological and clinical effects of the treatment were assessed. RESULTS: In 33 of the 43 (77%) children, no parasites were detected during follow-up with a triple faeces test: 22/27 following treatment with clioquinol and 11/16 following treatment with a nitroimidazole drug. In 27 of the 33 (82%) children with a negative follow-up result, gastrointestinal complaints were considerably less or had completely disappeared. In 2 of the 10 (20%) children in which D. fragilis had not disappeared in the follow-up period, the complaints were less or had disappeared. CONCLUSION: Effective treatment of D. fragilis infection in children with longstanding gastrointestinal complaints often resulted in a reduction or disappearance of the complaints.

First clinical experience with polysol solution: pilot study in living kidney transplantation.

In this study, we assessed the safety of the new organ preservation solution polysol solution in the clinical setting of living kidney transplantation. We conducted a prospective pilot study in nine adult donor-recipient couples using polysol solution for washout and cold storage of kidney grafts. Adverse reactions possibly related to the use of polysol solution as well as renal function at 1, 6, and 12 months after transplantation were monitored. All living kidney transplantation performed in adults in our center within 2002 to 2008 using the University of Winconsin solution served as controls (n = 190). The use of polysol solution was associated with a higher acute rejection rate compared to University of Wisconsin solution at all time points. Also, antibody-mediated rejection occurred more frequently in the polysol group. Renal function at all time points was also comparable between the groups. This pilot study in living kidney transplantation is the first clinical study on the use of polysol solution. Although the study was not powered on the endpoint rejection, we observed a high number of acute rejection and antibody-mediated rejection episodes in recipients of polysol solution preserved grafts as compared to University of Wisconsin solution controls. As a consequence the study was terminated prematurely.

[The venous drainage of the long bone after reaming and intra medullary nailing. An experimental study of the dog tibia (author's transl)]. / Die venöse Drainage des langen Röhrenknochens nach Aufbohrung und Marknagelung. Eine experimentelle Untersuchung an der Hundetibia.

Following the destruction of the medullary vascular system the venous drainage takes place exclusively in a centrifugal direction through vessels leading transcortically to the periost. This is in accordance with the described observations made on the arterial vascular system under the respective conditions of destruction.

[The vessel behavior of the bone following plate osteosynthesis and subsequent osteomyelitis. An experimental study at the dog tibia (author's transl)]. / Das Gefässverhalten des Knochens bei Plattenosteosynthese und nachfolgender Osteomyelitis. Eine experimentelle Untersuchung an der Hundetibia

In this paper the revascularisation pattern of the dog tibia diaphyse following osteotomy and plate osteosynthesis with subsequent osteomyelitis is described at various stages. As compared to undisturbed plate osteosynthesis the differences and conformities in revascularisation are shown. It is attempted to interpret the vessel behaviour under clinical aspects.