In this study, 53 children suffering from recurrent urinary tract infections were investigated both by ultrasound and direct radionuclide voiding cystography (RNVC). The findings were: Most high-grade vesicopelvic refluxes were detected by both methods consistently. Discrepant results of high-grade vesicopelvic refluxes were seen in 6 kidneys from 4 children. Main advantages of RNVC are the quick results and the ease of interpretation of these results. In RNVC the whole urinary tract can be observed during the filling phase as well as during the voiding and postvoiding phase. In sonography, the different parts of the urinary tract must be explored one after another during the filling, voiding, and postvoiding phase. The investigation by sonography is time consuming and a strongly investigator-dependent procedure.

To test the effect of acute cellular rejection on liver function as represented by cytochrome-P-450 enzyme activity, the 14C-aminopyrine breath test (ABT) was performed prospectively in 46 patients (31 men, 15 women; mean age 48 [15-66] years) who had undergone a total of 50 orthotopic liver transplantations. Routine biochemical tests were performed daily until the 30th postoperative day, while the ABT was done daily on days 1-10 and three times weekly on days 11-30, and liver puncture biopsies were obtained once weekly or more often if there was clinical suspicion of rejection. Histologically confirmed cellular rejection occurred within the stated period of observation in eight patients (five women, three men; median age 45 [18-59] years). Results of routine laboratory tests (transaminases, bilirubin, thromboplastin time), as well as bile-flow and body temperature, did not vary uniformly. On the other hand, results of ABT at the time of rejection showed a decrease in all patients by an average of 65% (P < 0.01). Changes in the ABT preceded those in other tests by 1-2 days in four patients, being the only measurable functional abnormality in one. All rejection episodes responded to glucocorticoid pulse-treatment (three times 1 g methyl-prednisolone). Using ABT results as criterion, liver function became normal after the glucocorticoid injection within 4-11 days. These data indicate that the ABT is suitable in the routine monitoring of transplant function, thus facilitating early diagnosis and controlled treatment of acute cellular rejection.

No abstract