Thoracic endoscopic sympathectomy for treatment of upper-limb hyperhidrosis.
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Biomedical subjects
Publications and source records attributed to M Kux.
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Hyperacute renal allograft rejection is described in a patient suffering from mesangio-proliferative glomerulonephritis. The transplanted kidney was HL-A identical and the direct cytotoxic cross-match between the recipient's serum and donor lymphocytes was negative. Intrarenal consumption of C 3, but not of C 1 q, C 4, total haemolytic complement, IgG or Igm was demonstrated. Immunofluorescence studies exhibited dense granular deposits of C 3, but not of IgG, IgM C 1q or C 4. These findings together with the observation of beta 1 C-beta 1A converting activity in the patient's serum, raised the possibility that the alternative pathway of complement activation induced by nephritic factor could have operated in this case. Further studies will be necessary to clarify the question whether hyperacute rejection of renal allografts is only antibody mediated or not.
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Eighteen months after cadaver kidney transplantation a 22-year-old woman was successfully delivered of a healthy female child. Onset of allograft rejection in the third trimenon was followed three weeks after delivery by progressive renal failure and resumption of regular dialysis treatment. Pregnancy risk factors after successful renal transplantation and immunosuppressive therapy are discussed.
Hyperacute rejection was studied in presensitized recipients of renal homografts and pig-to-dog heterografts. In these experiments antidonor antibodies can be observed but their participation in the rejection process cannot be assessed quantitatively. The importance of antibodies lies in their capacity to activate the complement system, which in turn destroys the graft. Intrarenal complement activation was also demonstrated in two clinical cases of hyperacute rejection, in one of which activation was by the alternate pathway.
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