bluuebunny/crossref_metadata_2025 huggingface dataset:
Pusher‐Plate Type TAH System Operated in the Left and Right Free‐Running Variable Rate Mode
Authors: Takatani Setsuo , Harasaki Hiroaki , Suwa Shuji , Murabayashi Shun , Sukalac Ronald , Jacobs Gordon , Kiraly Raymond , Nosé Yukihiko
Published: November 2008

A TAH system utilizing two pusher‐plate type pumps was developed and tested in two calves for 45 and 108 days with excellent results. A Hall effect sensor was utilized to operate each pump with a full stroke at variable rates (VR); each pump was then allowed to run independently at different rates depending on its own preload and afterload. With this system, the animals' atrial pressures were kept to near‐normal levels (less than 10 mmHg). However, significant differences in the left and right pump flows were observed (left higher than right) and they ranged from 5 to 30% of the left flow with a mean of 15%. These flow differences may be due to the bronchial circulation and related shunts. Right pump flows averaged 70 to 95 ml/min‐kg and circulating blood volume ranged from 67 to 95 ml/kg. When various control modes including fixed rate and master‐slave type simultaneously or alternately ejecting VR modes were applied in the same animals and both pump flows were forced to be equal, unphysiological atrial pressures resulted. This result indicates that perhaps left and right flow differences are necessary physiological conditions to regulate the atrial pressures within normal ranges. Metabolic data also indicated that under simultaneously and alternately ejecting modes, A‐V O2 content differences were increased due to decreased right pump flow as compared with those of the free‐running VR mode. The left and right free‐running VR mode of operation imposed minimal constraints on the animals' cardiovascular system and therefore yielded excellent hemodynamic and metabolic results.
Immunoabsorption in an Extracorporeal Plasma Perfusion System: In Vitro Studies
Authors: Burgstaler Edwin A. , Pineda Alvaro A.
Published: November 2008

A rechargeable plasma perfusion system developed to remove IgG immunoglobulins is described. Partially purified protein A was covalently bonded on two separate carriers, Sepharose 6MB and carboxyl acrylic beads. Plasma from a patient with IgG multiple myeloma was perfused through the Sepharose‐protein. A column, and this resulted in a maximum removal of 177% of the estimated removal capacity of the column. Plasma from the same source was perfused through the acrylic bead‐protein. A column and yielded an average of 220% of the estimated removal capacity of the column. In addition, plasma from a normal subject and from six patients with various autoimmune diseases was perfused through the Sepharose–protein A column, and varying percent removal was obtained. A detailed procedure for covalent coupling of purified protein A to carboxylated acrylic beads is also given.
Reticuloendothelial System Fc Receptor Function and Plasmapheresis in Systemic Lupus Erythematosus: A Preliminary Report
Authors: Hamburger Max I. , Gerardi Eugene N. , Fields Theodore R. , Bennett Ronald S.
Published: November 2008

Reticuloendothelial System (RES) Fc receptor‐mediated immune clearance and levels of immune complexes were measured in patients with systemic lupus erythematosus undergoing plasmapheresis. RES clearance defects improved and disease manifestations and levels of circulating immune complexes decreased after plasmapheresis. Patients with initially abnormal reticuloendothelial system function, elevated levels of circulating immune complexes, and active acute illness appeared to respond to plasmapheresis. One patient with normal immune clearance, lacking measureable immune complexes, and manifesting chronic disease remained unchanged.

Improvements seen following plasmapheresis were best maintained in patients receiving parenteral cyclophosphamide in the post‐pheresis period. The correlation of clinical response, improved RES function, and decreased levels of immune complexes suggests the interaction of the latter two parameters in disease pathogenesis. Plasmapheresis has an important role as a research tool, and may be of clinical usefulness in a small number of patients with serious complications of systemic lupus erythematosus.
How To Catch Urea? Considerations on Urea Removal from Hemofiltrate
Authors: Lehmann H. D. , Marten R. , Gullberg C. A.
Published: November 2008

Hemofiltration imitates the first step in the natural function of the kidney. After separation from corpuscular and high molecular weight blood components, a filtrate remains which contains urea together with electrolytes and other low molecular weight metabolites. To use a hemofilter in a recirculating closed‐loop system, a big quantity of urea must be eliminated.

A survey of published attempts to solve this problem is presented. Reasons are given for the difficulty to eliminate urea directly from dilute aqueous solutions. Explanations for ambiguous results of some reactions proposed for urea removal are discussed. The concept of hard and soft acids and bases is used to develop demands to the structure of a reagent which reacts preferrentially with urea in aqueous solution. On monomeric model substances—activated aldehydes—this hypothesis is proven in vitro.

In spite of the given technical possibility of urea removal, the authors doubt whether solving the problem of urea removal will enable a closed‐loop system for alternative simpler or more economic ways of treating renal failure.
Urea Elimination Using a Cold Activated‐Carbon Artificial TUbulus for Hemofiltration
Authors: Lehmann Hans‐D. , Marten Renate , Fahrner Irene , Gullberg Claes‐A.
Published: November 2008

Urea adsorption on active carbon is reversible and temperature‐dependent. Urea adsorption isotherms of different carbons were determined at 0°C and 65°C within the equilibrium concentration range of 1.0–3.4 gm/L. At low urea concentrations considerable differences (3.4–13.0 gm/kg carbon at concentrations of 1.0 gm/L) were found between different types of activated carbon. The overall internal surface area was of minor importance compared to the pore size distribution.

Adsorbing at low temperature, desorbing at high temperature, and flushing the carbon adsorber with a limited volume of the liquid to be purified yielded an “artificial urine.“ Compared to the original urea concentration of the filtrate, this “artificial urine“ had an increased urea concentration.

From a 36‐liter volume containing 90 grams urea dissolved in saline. 18 liters were recirculated at a flow rate of 100 ml/min. The influence of adsorption and desorption time intervals was evaluated. After one to one and a half hours the carbon was saturated with urea. After saturation, about 1.4 grams urea were eliminated per cycle. In the “artificial urine“ urea concentrations of up to 4.5 gm/L were found when the original solution contained only 2.5 gm/L. In the “patient“ volume the urea concentration decreased from 2.5 gm/L to 1.9‐2.1 gm/L. Within three hours a total of 22 grams of urea was removed by 3 ± 120 grams activated carbon corresponding to removal of 50% of the urea passing the “artificial tubulus.“

The advantage of this system is that after priming, no additional physiological solution would be necessary. The necessity of excessive safety controls, additional electrolyte adjustment, energy demand in the form of direct current, and great amounts of waste in solid form lead to the conclusion that for intermittent hemofiltration treatment, commercially produced and controlled infusion solution is preferable.
Hemodialysis Therapy for Psoriasis
Authors: Chugh Kirpal S. , Kumar Bhushan , Pareek Surinder K. , Kher Vijay , Singhal Praveen C. , Lai Madan , Sharma Lakshmender
Published: November 2008

Twenty‐five patients with extensive plaque psoriasis resistant to conventional treatment were evaluated for study of the effects of dialytic therapy on the skin lesions. Twenty patients were dialyzed twice a week for six hours each time with a 1.0 m2Cuprophan membrane dialyzer. Eighteen patients responded to this therapy with regression of skin lesions. Twelve of them have not developed recurrence of lesions during a followup period extending from 6 to 27 months. A few new lesions were observed after two to six months in four patients, but the lesions were not severe enough to justify reinstitution of dialysis. Two patients developed relapse within two months after cessation of dialytic therapy. One of them was started on dialysis a second time and this was followed by remission of lesions. Five patients were taken as controls and were treated with other modes of therapy including sham dialysis, ultrafiltration without dialysis, or systemic heparinization before they were taken on the dialysis program. Whereas sham dialysis and systemic heparinization had no effect on the skin lesions which responded later to dialytic therapy, the ultrafiltration procedure was followed by partial regression of psoriasis. Dialysis appears to have a definite role in the treatment of psoriasis.
Portable Artificial Kidney with Advantages of Hemodialysis, Hemofiltration, and Hemoperfusion
Authors: Shettigar U. R. , Reul H.
Published: November 2008

The FDA (filtration, dialysis, adsorption) system developed in the present study operates on the principle of simultaneous filtration of blood and dialysis against its purified filtrate, the filtrate being purified by a multi‐adsorption system. The filtration of blood is done using a hemofilter which permits clearance of solutes up to 50,000 daltons and easy removal of excess fluid overload under minimal osmotic imbalance conditions. The clearance of small solutes in the above pure‐convective filtration process is enhanced by returning the purified filtrate to the hemofilter which introduces an additional diffusive mass transport to the otherwise pure‐convective process.

The purification of the filtrate is done by 3 kg charcoal and 450 gm of cation exchanger in the Ca++ and Na+ form. Sufficient urea binding is achieved by raising the post‐treatment urea level from 50 mg% to 150 mg% which may be justified as the blood urea level below 300 mg% was found to be nontoxic by others. By this procedure, about 40 gm urea is removed per treatment by 3 kg charcoal and 3 to 4 liters of excess fluid discarded. Three kg of charcoal is found to bind an adequate amount of phosphate, thus eliminating the use of phosphate binders, such as alumina, which is a toxic material. The ion exchangers in the Ca++ and Na+ form bind an adequate amount of K+ without altering Na+ and Ca++ levels. The filtrate purification cartridge can be easily regenerated and sterilized, if necessary, thus making it inexpensive. A comparison of the FDA system with other systems clearly shows that it has the advantages of HD, HF, and HP while the major disadvantages of HD, HF, and HP are eliminated in the FDA system.
A Computerized Model to Analyze Transcellular Fluid Shift During Hemofiltration
Authors: Kimura Genjiro , Satani Makoto , Kojima Schunichi , Kuroda Kazuaki , Itoh Keiichi , Ikeda Masao
Published: November 2008

Using urea and inulin as markers, we have developed a simple method to calculate intracellular and extracellular fluid volume in patients before and after hemofiltration therapy. During conventional hemofiltration using substitution fluid with a Na+ concentration of 140 mEq/L, a decrease in extracellular fluid volume was noted whereas the intracellular fluid volume was unaltered. Furthermore, we have developed a computerized mathematical model to analyze transcellular fluid shifts during hemofiltration. This model also indicates a decrease in extracellular fluid volume only, the intracellular fluid volume remaining unchanged. High‐Na+ hemofiltration using substitution fluid with an Na+ concentration of 160 mEq/L has enabled us to remove fluid from both intracellular and extracellular compartments. Thus, high‐Na+ hemofiltration is expected to normalize the intracellular hydration in uremic patients, and to reduce the decrease in extracellular fluid volume during hemofiltration therapy. Our data therefore suggest that high‐Na+ hemofiltration could prevent hypotension due to large decreases in extracellular fluid volume by inducing a transcellular fluid shift out of body cells. Our computerized model can be a useful tool in the prescription of the optimal Na+ concentration in substitution fluid for individualized hemofiltration therapy.
A Morphologic Study of Two Types of Porcine Valve Bioprostheses: Comparison of Aortic Wall Thickness
Authors: Culbertson M. R. , Spangler W. L.
Published: November 2008

Outer aortic wall morphology and thickness were compared in the Hancock porcine aortic bioprosthesis and the Carpentier‐Edwards porcine aortic bioprosthesis. The overall average aortic wall thickness, the average maximum thickness, the average minimum thickness, and the average variation in aortic wall thickness were greater in the Hancock valve. Differences in preparation technique accounted for the disparities. The tunica adventitia and variable amounts of the outer tunica media were generally removed during processing of the Carpentier‐Edwards valve prior to mounting in the stent. The removal of this tissue at times exposed the deeper collagenous cusp anchor at the commissures. Possible implications of these differences are briefly considered.
Acute Functional Changes of Platelets in Left Ventricular Assist in a Dog Model
Authors: Mori Y. , Kawase S. , Nagaoka S. , Kikuchi T. , Yokoyama Y. , Kusakabe M. , Okawa Y. , Ito K.
Published: November 2008

Left ventricular assist bypass was performed in nine dogs using pneumatically actuated blood pumps fabricated of segmented polyurethane and heparinized hydrophilic polyurethane (H‐USD) newly developed so as to render excellent antithrombogenicity. The survival of the dogs ranged from 1 to 82 days. In all cases, significant reductions in platelet count and in platelet aggregability were observed. Simultaneously, severe hemorrhage from the anastomosed descending aorta occurred four to six hours after the pump implantation. This hemorrhage, leading to death, was not related to systemic heparinization, but was closely related to the mechanical impairment of platelets by the pumping operation. Five days after the pump implantation, complete recovery of the platelet aggregability was observed and no further hemorrhage occurred in the dog that survived for 82 days.
Hematologic Features of Chronic Renal Failure Associated with Spinal Cord Injury
Authors: Vaziri N.D. , Byrne C. , Mirahmadi M. K. , Golji H. , Nikakhtar B. , Alday B. , Gordon S.
Published: November 2008

We examined the available hematologic data on 43 spinal cord injury (SCI) patients with end‐stage renal disease (ESRD) treated with hemodialysis since 1972. A control group consisting of 45 ESRD patients without SCI was included for comparison. Moderate to severe anemia was found in all patients. The observed anemia was generally normocytic, normochromic, and associated with a low reticulocyte response. Transfusion requirement in the SCI group was considerably more than in the control group. There was a high incidence of splenomegaly, splenic amyloidosis, and lymph node enlargement in the SCI group. Lymph node and bone marrow amyloid deposits were found in some SCI patients but not in the control subjects.
In Vitro Evaluation of U. S. and U. S. S. R. Artificial Hearts
Authors: Guskov Igor A. , Itkin Georgii P. , Lokshin Moiseii A. , Shumakov Valeriy I. , Chimoskey John E. , O'Bannon William , Walker William F. , Lloyd John M. , Noon George P. , DeBakey Michael E.
Published: November 2008

This report summarizes the results of the in vitro evaluation of Soviet and American artificial hearts. The devices were tested at the All‐Union Institute of Transplantation and Artificial Organs, Moscow, U.S.S.R., and Baylor College of Medicine, Houston, Texas, U. S. A. These studies were designed to standardize procedures to allow comparison of artificial ventricles of different designs. Also, these studies might provide a means for evaluation of other characteristics such as hemolysis, durability, and reliability. Static and dynamic tests were performed, varying preload, afterload, rate, and systolic and diastolic time intervals. All designs demonstrated comparable function curves with capability of taking over the pressure and volume work of the natural heart.
Preparation and In Vitro Evaluation of a New Extracorporeal Dialyzer with Immobilized Insulin
Authors: Singh Pratap , Goldman José , Jackson Charles E.
Published: November 2008

A specific extracorporeal immunoadsorbent system has been developed that has potential application for the treatment of complications related to the presence of plasma insulin antibodies, namely severe insulin resistance and autoimmune hypoglycemia. The immunoadsorbent system described here makes use of a commercially available cellulose‐based, hollow‐fiber hemodialyzer. Optimal conditions for the coupling of insulin to cellulose matrices were found to involve activation with 1,4‐butanediol diglycidyl ether and reaction with insulin at pH 7.4. The insulin‐dialyzer prepared under these conditions contained 35.5 mg to 37.9 mg of insulin which correspond to a theoretical binding capacity of 887.5 to 947.5 units of insulin. Recirculation of human plasma with high insulin antibody titers through the insulin‐dialyzer resulted in the clearance of 82–99% and 50–83% of high affinity and total insulin antibodies, respectively. The clearance of insulin antibodies approached a steady state after 15 minutes of recirculation at a flow rate of 50 ml/min. Regeneration of used insulin‐dialyzers was accomplished by treatment with 0.02Mcitrate buffer pH 3.2, which restored their ability to clear 90% and 40% of high affinity and total insulin antibodies, respectively. The principle of the insulin‐dialyzer may find application in other disease states where removal of specific antibodies or other high molecular weight species may be of therapeutic value.
Hemoperfusion and DNA Synthesis in the Rat Liver Part II: The Effect of Hemoperfusion on DNA Synthesis in the Rat Liver Undergoing Compensatory Hyperplasia after Partial Hepatectomy
Authors: Ryan Calvin J. , Courtney James M. , Blumgart Leslie H.
Published: November 2008

An investigation has been made into whether hemoperfusion over activated charcoal effects the rate of DNA synthesis in the rat liver undergoing compensatory hyperplasia. Hemoperfusion was performed in the unrestrained and conscious rat, thus minimizing any possible effects of stress and eliminating exposure to anesthetic agents. The results demonstrate that hemoperfusion over Norit RBX1 charcoal does not influence the liver to undergo compensatory hyperplasia following partial hepatectomy when hemoperfusion is performed immediately after hepatic injury, and that liver mass, function, and fat content consequent upon partial hepatectomy are also not influenced.
Intraoperative and Immediate Postoperative Management of Calves Undergoing Valve or Total Artificial Heart Implantation
Authors: van der Wey Leo‐Peter , Hastings Wm. Lawrence , Olsen DonB. , Kolff W. J.
Published: November 2008

The intraoperative and immediate postoperative management data were recorded in a series of twelve artificial device implantation operations in calves. Nine of these were valved conduit experiments not requiring cardiopulmonary bypass, and three were total artificial heart implantations in which bypass was needed. The intraoperative and immediate postoperative management procedures of this laboratory are described including anesthesia, respiratory and drug therapy, and cardiopulmonary bypass management. This paper shows how these procedures may aid in reducing the recovery times of research animals.
Status of Implantable Energy Systems to Actuate and Control Ventricular Assist Devices
Authors: Altieri Frank D.
Published: November 2008

Summary: A major goal of the Devices and Technology Branch of the National Heart, Lung, and Blood Institute (NHLBI) is the development of a family of devices that can be effectively used in the rehabilitation of patients with advanced heart disease. The development of implantable circulatory assist and total heart replacement devices forms a major portion of this goal. A miniature, implantable energy converter is a key to the development of a tether‐free, implantable ventricular assist system. This paper defines the energy system design requirements, identifies key subsystems, briefly reviews NHLBI‐sponsored research activities, defines the current research status, and identifies current problem areas and research issues.
Clinical Effectiveness of Mechanical Ventricular Bypass in Treating Postoperative Heart Failure
Authors: Pierce William S. , Parr Grant V. S. , Myers John L. , Donachy James H. , Rosenberg Gerson , Landis Donald L. , Bull Anthony P.
Published: November 2008

Summary: Our group has designed an air‐powered, sac‐type ventricular assist pump (VAP) that has a smooth polyurethane surface and Bjork‐Shiley‐type valves. This VAP has undergone extensive testing in calves and has been available for clinical use during the last 5 years. When properly employed, the circulatory support permitted immediate separation of the patient from bypass. Definite hemodynamic evidence of improved ventricular function has been observed during the period of unloading of the deranged ventricle by the VAP. However, during the first 3 years of our experience, the VAP was used in 11 patients with 1 survivor. During the last 2 years, specific attention has been directed to use of right, left, or biventricular assistance as indicated, to prompt application of the VAP when required, and to use of atrial rather than ventricular cannulation for VAP inflow. Accordingly, the survival rate over this 2‐year period has increased to 50% (four of eight patients). The short‐term assist pump is an important adjuvant for the surgeon who operates on seriously ill cardiac patients.
Physical Testing of Elastomers for Cardiovascular Applications
Authors: McMillin Carl R.
Published: November 2008

Summary: There are presently no short‐term in vitro fatigue tests available that can predict long‐term in vivo performance of elastomers in physiological environments. Thus, the introduction of new and better elastomers for cardiovascular applications is hampered in the development stage by lack of data about which materials should be commercialized. After development, new materials are also slow to be used because of the lack of comparative data on current elastomers. Thus, short‐term fatigue tests are being developed in three U.S. laboratories. In our laboratory, a wide variety of fatigue tests has been conducted using a constant strain fatigue test machine. In most of these fatigue tests, the strain is increased daily until failure occurs. Although blood is generally considered to be a very corrosive environment, our tests indicate that it actually extends the fatigue life of elastomers, compared with air or water environments. A combination of fatigue tests using both cut‐initiated and uncut test specimens appears to provide the most predictive information.
Modeling and Prospects for Study of Cardiovascular Pathology with the Artificial Heart
Authors: Petrovsky Boris V. , Gigauri Vladimir S. , Melemuka Ivan V. , Melusov Konstatin L.
Published: November 2008

Summary: A series of models of the artificial heart has been developed for simulating different heart defects including stenosis of the atrioventricular ostium and mitral and tricuspid incompetence. Simulation of ventricular fibrillation is also possible. Repeated perturbation and restoration of artificial heart function are possible in the same animal. These processes are controlled externally. The surgical technique of implanting the artificial heart does not differ from the usual technique. Models of the artificial heart permit the study of fundamental problems in the physiology and pathology of the cardiovascular system.
Electrodialysis and Reverse Osmosis as a Regeneration System for Hemofiltrate
Authors: Hintzen K. , Stiller S. , Brunner H. , Rautenbach R. , Mann H.
Published: November 2008

Abstract: The separation of urea from the hemofiltrate (or from spent dialysis fluid) must be considered the critical step in all regeneration systems. A promising solution for this problem is the combination of electrodialysis and reverse osmosis. A mathematical simulation of the process and in vitro experiments have been carried out in order to determine operating conditions and design specifications. The experiments confirmed the predicted performance of the regeneration system with respect to the separation of urea and the recovery of electrolytes. As expected, some ionic toxins, such as uric acid, and some middle molecules are recovered also. These substances, however, can be easily removed by a small adsorption cartridge.

A combination of ED and RO is a promising solution for the regeneration of hemofiltrate. The separation of neutral uremic toxins, such as urea and creatinine, and the recovery of water and electrolytes are satisfactory. Ionic toxins such as uric acid and some middle molecules will be recovered, i.e., not separated to a certain degree. These substances, however, can be easily separated by adsorption. Trivalent ions like phosphate will be partly separated by the regeneration system, because in ED their rate of transport is lower than that of mono and bivalent ions.

The experiments indicate that the ED unit has to be optimized. It would need ˜ 5.7 m2 of membrane area in order to achieve the desired removal. It could be demonstrated, however, that with improved flow conditions in the ED unit, a membrane area of ˜ 1 m2 may be sufficient.

A detailed flow diagram of the complete regeneration system is shown in Fig. 9. The ED‐RO system in principle can also be used for regeneration of dialysate.
Novel Composite Sorbent Beads for Paraquat Removal by Hemoperfusion
Authors: Tabak A. , Lotan N. , Sideman S. , Taitelman U.
Published: November 2008

Abstract: The present Report describes the development and performance of a column that is to be used for removal of paraquat from circulating blood in a hemoperfusion‐type set‐up. The key element of the system is a newly developed sorbent material containing fuller's earth entrapped in cross‐linked agarose beads (Talosit). The technique produces a sorbent material exhibiting a very large active surface area while allowing for high mobility of paraquat molecules within the beads and favorable flow characteristics of packed column. Cross‐linking of the agarose (by epichlorohydrin) also has a most beneficial effect on the mechanical strength of the beads as well as on their stability to sterilization in an autoclave. The composite beads exhibit good blood compatibility. A scanning electron microscope analysis of the beads showed no adherence of cellular blood components after contact with blood. Moreover, no significant changes in plasma composition had taken place when the beads were properly conditioned prior to contact with fresh human blood. A comparative study of paraquat removal from saline solution by the new beads and by cellulose‐coated activated charcoal (Adsorba‐300C) indicates a higher removal rate with the former. The results obtained so far with this new sorbent are very promising and extension of these studies to in vivo hemoperfusion is under way.
Comparison of a Charcoal Sorbent Fiber with Commercial Charcoals for Hemoperfusion
Authors: Gundermann Karl‐Josef , Uhlhaas Siegfried , Grünn Ursula , Olek Klaus , Ukigusa Minoru , Lie Tschong‐Su
Published: November 2008

Abstract: A charcoal sorbent fiber (Enka, F.R.G.), was assessed for impurities, surface area, and adsorptive properties of its native charcoal, and compared with other uncoated activated charcoals. In vivo and in vitro hemo‐compatibility of the fiber were assessed as well as the adsorptive properties for endogenous toxins. The charcoal of the fiber had few impurities and a high surface area of 1,200 m2/g charcoal. For measuring the adsorptive speeds, 2 g of the uncoated charcoals were milled and screened to a particle size of 150–250 μrn (Enka; 30–40 μ.m) and then mixed with the solutions of the individual solutes. The charcoal types of Enka, used in the charcoal sorbent fiber, and of Sutcliffe Speakman, used in the acrylic hydrogel coated charcoal, exhibited the highest adsorptive rates for bromthalein (middle molecular weight marker) and inulin (high molecular weight marker). No hematological differences among the various charcoals were found during the in vivo hemoper‐fusions. In the in vitro hemoperfusions with heparinized fresh blood, the fibers showed the lowest loss of leucocytes and thrombocytes. In the in vitro evaluation of the absorbents for hepatic support, the charcoal fiber and the petroleum pitch charcoal of Asahi had the best adsorptive properties for substances in the low molecular weight range.
Experimental Urinary Bladder Reconstruction Using a Synthetic Poly (α‐amino acids) Membrane
Authors: Koiso K. , Komai T. , Niijima T.
Published: November 2008

Abstract: Biodegradability of the poly (ε‐benzyloxycarbonyl‐L‐lysine) membrane was tested for use as a biodegradable graft for the reconstruction of rabbit urinary bladder. Rabbit urinary bladder was exposed through a midline incision under general anesthesia and segmental resection with full thickness was done, with replacement by this synthetic membrane. The membrane was gradually reabsorbed, serving as a framework of support for regeneration of normal bladder tissues. Follow‐up study at 1 year revealed no urinary tract complications, such as bladder stones or urinary tract infection. Also, no disturbance of renal function was demonstrated. Bladder capacity remained within normal limits and bladder functions were almost normal. These results indicate that biodegradable membrane may be well suited to this clinical use.
Effectiveness of Hemodialysis in Chronic Schizophrenic Patients: A Double‐Blind Study
Authors: Wagemaker Herbert , Rogers James L. , Cade Robert
Published: November 2008

Abstract: Twenty‐four chronic schizophrenic patients were treated with active or sham hemodialysis in a double‐blind, randomized‐group design. Treatment outcomes, as measured by the Schedule for Affective Disorders and Schizophrenia (version PD), are presented. Patients in both active and sham conditions responded to the dialysis process. The research design may have prevented the separation of these groups of responders. Further research is needed to evaluate the effectiveness of hemodialysis on a selected group of schizophrenic patients.
Detoxification Treatment for Chronic Schizophrenic Patients: Experimental Results and Data from a Survey
Authors: Nedopil Norbert , Dieterle Doris , Gurland Hans Jürgen , Hillebrand Günther , Köpcke Wolfgang , Selwood Neville A. , Wing Anthony J.
Published: November 2008

Abstract: Blood detoxification as a treatment of schizophrenia has been studied intensively since 1977 by a number of research centers. Results of an open study on 10 chronic schizophrenic patients‐two showing improvement‐were less favorable than those Reported in the initial publications. In order to possibly identify a subgroup of responders to this treatment, a survey was undertaken in which 95 centers were invited to participate. Of the 95 centers which originally treated schizophrenic patients with detoxification and which were asked to send data on these patients to the Registry of the European Dialysis and Transplant Association, 39 centers replied (35 from Europe and four from the United States). From the 100 patients Reported on in Europe, 17 were Reported to be very much improved and 22 to be improved. Of the patients from the United States, 86% were Reported as improved. No subgroup of responders could be identified, and differences between centers concerning nosological subgroups, treatment methods, and results were so great that no real comparison was possible. Although data from this survey are not totally conclusive, in connection with the updated literature they do not encourage further research in this treatment of schizophrenia.
Hemodialysis in the Treatment of Chronic Schizophrenic Patients: A Double‐Blind Crossover Study
Authors: Schulman A. , Salum I. , Wahlund L. O. , Wetterberg L. , Asaba H. , Bergström J. , Örsten P.‐A.
Published: November 2008

Abstract: In order to examine the Reported beneficial effects of hemodialysis in chronic schizophrenic patients, a double‐blind crossover study was carried out. Of the 47 patients considered for treatment, 10 diagnosed as chronic schizophrenics according to the Feighner and DSM‐III criteria were accepted to the study. Seven of these patients completed the full program, four of whom belonged to a large family with a high incidence of schizophrenia. All patients were on antipsychotic medication throughout the study. Psychopathological evaluations were performed regularly in a blind fashion using the Comprehensive Psychopathological Rating Scale (CPRS) and the Nurse Observation Scale for Inpatient Evaluation (NOSIE‐30). Samples of blood, urine, cerebrospinal fluid, and dialysate were obtained for examination. Three patients improved during active dialysis and two patients improved during sham treatment. Improvement in the five patients took place during the first treatment period. This study failed to demonstrate a therapeutic effect of hemodialysis superior to the sham procedures.
Concentrations of 5‐Hydroxyindoleacetic Acid and Homovanillic Acid in the Cerebrospinal Fluid of Chronic Therapy‐Resistant Schizophrenics Before and After Hemodialysis Therapy
Authors: Magnusson Olle , Fowler Christopher J. , Ross Svante B. , Schulman Abraham , Wetterberg Lennart
Published: November 2008

Abstract: The concentrations of the monoamine metabolites 5‐hydroxyindoleacetic acid (5‐HIAA) and homovanillic acid (HVA) have been determined by high‐performance liquid chromatography in samples of lumbar cerebrospinal fluid from chronic therapy‐resistant schizophrenics, both before and after either inactive or active hemodialysis for 10 weeks. A reasonable test‐re‐test reliability was found for 5‐HIAA during the inactive dialysis, but this was not found during active dialysis.
Serum Lipids and Lipoproteins in Schizophrenic Patients with Normal Renal Function Treated with Hemodialysis
Authors: Norbeck Hans‐Erik , Asaba Hiroyuki , Schulman Abraham , Wetterberg Lennart
Published: November 2008

Abstract: To study the effect of hemodialysis on serum lipids and lipoproteins, five patients with normal renal function who had undergone hemodialysis for schizophrenic symptoms for 10 weeks in a crossover study were investigated. Active or sham (no dialysate flow through the filter) dialysis was instituted randomly. Serum lipids were isolated by ultracentrifugation and precipitation before and after each period. High density lipoprotein (HDL) cholesterol levels were constantly low and correlated negatively with serum alkaline phosphatase concentrations (p < 0.05). Serum and very low density lipoprotein (VLDL) triglycerides and VLDL cholesterol increased during active, and to a lesser extent during sham, dialysis. Dialysis of this intensity does not affect HDL. The low levels may be secondary to subclinical cholestasis from neuroleptic drug treatment. Some individuals may develop hypertriglyceridemia of unknown pathogenesis during hemodialysis. Both these lipoprotein abnormalities are risk factors for the development of atherosclerosis.
Schizophrenia and Dialysis
Authors: Carpenter William T. , Sadler John H. , Light Paul D. , Hanlon Thomas E. , Kurland Albert A.
Published: November 2008

Abstract: Open‐trial Reports of substantial clinical improvement in most schizophrenic patients on hemodialysis for their psychiatric condition prompted the present study to determine the efficacy of hemodialysis under double‐blind, controlled conditions. Fifteen schizophrenic outpatients were randomly assigned to either a real‐sham or sham‐real dialysis treatment sequence. Presented in detailed, graphic form, results of repeated measurement and other analyses of symptom and behavioral data collected initially, at crossover, and at the end of treatment revealed no differential effects between real and sham dialysis. These results provide important experimental evidence of the lack of therapeutic efficacy of hemodialysis in schizophrenia.
Hemodialysis Treatment of Methanol Intoxication
Authors: Hoy Wendy E. , Scandling John D. , Carbonneau Robert J.
Published: November 2008

Abstract: Hemodialysis was undertaken to treat methanol intoxication in a patient with intravascular hemolysis, myoglobinuria, systemic acidosis, renal insufficiency, retinal abnormalities, and a blood methanol level of 400 mg/dl, 29 h after methanol ingestion. Sixteen hours of treatment were required to achieve safe blood levels. Calculated methanol removal was 218 g, or 73% of the ingested dose, and extraordinarily large volumes of ethanol were required to maintain blood levels >100 mg/dl. All the manifestations of methanol poisoning were reversed and there were no permanent sequelae. It is concluded that, if methanol levels remain high, even significantly delayed institution of hemodialysis can be beneficial. The treatment may need to be quite prolonged, and the amount of ethanol administered should be individualized according to the patient's blood levels.
Recovery from Pentobarbital‐Induced Sleep After Administration of Perfluorinated Blood Substitutes
Authors: Lutz Joachim , Wagner Manfred
Published: November 2008

Abstract:The sleeping time after administration of pentobarbital at 30 mg/kg body weight (BW) was used in rats as a simple, noninvasive screening test of liver function. In controls, repeated tests showed no shortening of the time and thus no signs of enzyme induction. After the injection of perfluorochemicals in the form of Fluosol‐DA at doses of 4.4 and 10 g/kg BW, significant prolongations occurred that, in case of the higher dose, lasted only until the fourth day. The formerly observed liver cell proliferation thus seems to have a compensating effect, since the detoxifying function was restored when the maximum of increased liver mass was reached.
Reassessment of Criteria for the Selection of Perfluorochemicals for Second‐Generation Blood Substitutes: Analysis of Structure/Property Relationships
Authors: Riess Jean G.
Published: November 2008

Abstract: The criteria for the selection of perfluorochemicals destined to serve as oxygen carriers in second‐generation blood substitutes are critically discussed in light of the presently available body of data. The need for pure, well‐defined, reproducible, industrially feasible perfluorochemicals, in order to attain the degree of reliability desirable for their use in medicine, is stressed. Particular attention is given to the inverse excretion rate versus emulsion stability relationship and to its sharp dependence on molecular weight. The range of acceptable molecular weights is established as 460–520. Oxygen‐dissolving capacity, rheologic characteristics, and intravascular persistence are also discussed. The need for standard methodology and experimental protocols is reaffirmed. Perspectives are evaluated, in particular, with the aim of easing certain of the present limitations.
Fluid Volume Monitoring with Electrical Impedance Technique During Hemodialysis
Authors: Tedner Bo , Lins Lars Eric
Published: November 2008

Abstract: A tetrapolar whole‐body impedance technique has been developed for bedside monitoring of fluid volume changes during hemodialysis. A microprocessor is utilized for control and calculations. Recorded values of fluid volume changes for 10 patients were compared to concomitant changes in weight. A linear relationship with a correlation coefficient of r = 0.89 was obtained. Fluid volume changes as small as 0.1 L could be detected.
Fibroblastic Activities Post Implantation of Cobalt Chromium Alloy and Pure Germanium in Rabbits
Authors: Carter J. Malcolm , Natiella Joseph R. , Baier Robeet E. , Natiella Roberta R.
Published: November 2008

Abstract: Different preimplantation surface finishes were applied to surgical vitallium discs and germanium prisms implanted for 20 days within the back muscles of adult rabbits. Histopathologic analysis of the numbers of nuclei of active fibroblasts immediately adjacent to the implants was carried out. The mean apparent volume fractions (MAVF) for the subdermal implant sites were found to depend on the surface cleanliness of the implant, the cleanest or highest‐surface‐energy surfaces giving the highest MAVF values for active fibroblasts.
Effects of Homologous Plasma Cross‐Circulation on Liver Function in Galactosamine‐Induced Hepatic Necrosis in Rats
Authors: Ouchi Kiyoaki , Okabe Kenji , Asanuma Yoshihiro , Koyama Kenji , Sato Toshio
Published: November 2008

Abstract: Plasma cross‐circulation that resembles clinical plasma exchange was carried out in rats with galactosamine (GalN)‐treated hepatic failure to investigate its effect on the damaged liver function. Twenty‐four hours after the injection of GalN, plasma cross‐circulation was performed at a plasma flow rate of 0.1 ml/min for 6 h. At 48 h after the injection of GalN, survival was obtained in 6 of 8 GalN‐injected rats treated with plasma cross‐circulation as compared with 4 of 10 GalN‐injected rats treated with sham circulation. State 3 oxygen consumption and ATP synthesis (mitochondrial respiratory function) and ATP, ADP, and total adenine nucleotide contents in the liver were significantly higher in the former group than in the latter group at that period, as determined by sacrificing the surviving animals. Although the survival rate was not significantly improved, evidence suggests that plasma cross‐circulation enhanced mitochondrial phosphorylative activity and produced an augmented high‐energy state of the liver, which had been markedly reduced by GalN administration. An efficient removal of toxic metabolites as well as an influx of a large amount of fresh plasma by plasma cross‐circulation would be beneficial for the regenerative process of the necrosing liver tissues.
Effect of Extracorporeal Enzymatic Deheparinization on Formed Blood Components
Authors: Larsen Annette K. , Linhardt Robert J. , Tapper David , Klein Michael , Langer Robert
Published: November 2008

Abstract: A stirred blood filter containing an immobilized enzyme, heparinase, has been used to neutralize heparin's anticoagulant activity at the outflow of an extracorporeal circuit in dogs. The hematocrit and red blood cell count remained unchanged throughout the 90‐min perfusion period. Platelet and white blood cell counts de‐creased early in the procedure to ˜20% of the initial levels, but then returned to 30 and 70%, respectively, of their initial values by the end of the procedure. After 24 h normal levels were reestablished. In vitro experiments with human blood were conducted to determine the principal cause of the observed decrease of formed blood components. An unstirred heparinase filter preserved platelets and white blood cells better than stirred filters possessing higher, the same, or no heparin‐degrading capacity, suggesting that most of the loss of formed blood components is due to stirring and not to the heparinase or the Sepharose support on which the enzyme is immobilized.
Design of Pusher‐Plate‐Type Left Ventricular Assist Device Based on Mechanical Analyses
Authors: Hayashi Kozaburo , Nakamura Takao , Takano Hisateru , Umezu Mitsuo , Taenaka Yoshiyuki , Matsuda Takehisa
Published: November 2008

Abstract: A permanently implantable left ventricular assist device (LVAD) pump of the pusher‐plate type was designed based on mechanical analyses. A series of three different segmented polyether polyurethanes was utilized for the diaphragm, cannulae, and their blood‐contacting surfaces, considering each material's characteristics. The span and thickness of the pump diaphragm were determined so as to minimize the stress developed by the bending and blood pressure forces. The inflow and outflow cannulae were designed using fundamental equations that describe the operation of a piston‐type reciprocating pump. The pump diameter was determined considering the required flow for the average Japanese person. In vitro and in vivo experiments showed good pump performance, which satisfied the design specifications. No failure was observed in the designed diaphragm. The Hall effect sensor incorporated in the pump was very useful in monitoring the cardiac output of the pump.
Massive Mediastinal Hematoma Caused by a Double‐Lumen Subclavian Catheter
Authors: Vaziri N. D. , Maksy M. , Lewis M. , Martin D. , Edwards K.
Published: November 2008

Abstract: Double‐lumen subclavian catheters have recently been released for use as a temporary blood access for extracorporeal circulation. Initial reports indicate that once properly inserted, these catheters are safe. However, massive mediastinal hematoma that occurred 3 days after insertion and uneventful initial dialysis with a double‐lumen subclavian catheter has been documented. The patient experienced excruciating pain immediately after the onset of the subsequent dialysis and was found to have developed a massive mediastinal hematoma. It appears that at some point after the completion of the initial dialysis, the catheter tip eroded the vein and entered the mediastinum. As a result, the proximal (arterial) perforations were inside the vein, allowing blood to freely enter the circuit and be forcefully pumped into the mediastinum through the distal (venous) perforations near the tip. Prompt recognition of the problem and immediate discontinuation of dialysis prevented a potential fatal outcome in this case.
Lidocaine Removal During Resin Hemoperfusion for Phenobarbital Intoxication
Authors: Barber Kevin , Chen Shwu‐Mün , Ferguson Roger , Kramer Mark S. , Raja Rasib M.
Published: November 2008

Abstract: A deeply comatose patient with severe phenobarbital intoxication was hemoperfused with an Amerlite XAD‐4 column. She was receiving lidocaine for ventricular ectopy. The rate of lidocaine infusion had to be increased to control ventricular arrhythmias during hemoperfusion. Plasma clearance for lidocaine by the column was 122 ml/min at initiation and 75 ml/min at 2 h. These findings suggest that an increment in lidocaine infusion may be needed during resin hemoperfusion in patients receiving this drug because of its removal by the column.
Introduction: Incidence of Hypersensitivity in Hemodialysis
Authors: Villarroel Fernando
Published: November 2008

Abstract: Hypersensitivity reactions in hemodialysis are rare. They have been identified only recently, since the U.S. dialysis patient population became sufficiently large for pattern recognition. These reactions might be the result of a variety of factors, including the manufacturing process and patient characteristics. Some reactions may be due to components of the dialysis system other than the dialyzer, such as the tubing sets. Data collected by the Food and Drug Administration showed that in 1982 there were 3.5 severe hypersensitivity reactions per 100,000 hollow‐fiber dialyzers sold. This rate of reaction occurrence does not appear to be appreciably different from that in previous years for which information, though scant, was available. Recently, a significant reduction in the rate of the reactions seems to have occurred after some U.S. manufacturers changed their manufacturing procedures.
Complement Activation During Hemodialysis: Clinical Observations, Proposed Mechanisms, and Theoretical Implications
Authors: Chenoweth Dennis E.
Published: November 2008

Abstract: Human C3a radioimmunoassay techniques were employed to define both the temporal profile and the amount of complement activation taking place in the extracorporeal circuit during maintenance hemodialysis. Prospective studies demonstrated that C3a formation, like hemodialysis‐associated leukopenia, was a transient phenomenon that occurred predominantly during the first 30 min of dialysis. Quantitative comparisons revealed that new Cuprophan hemodialyzers displayed somewhat greater complement‐activating potential than cellulose acetate dialyzers. By contrast to new Cuprophan membranes, both reused Cuprophan and polyacrylonitrile dialyzers exhibited only a modest ability to activate human complement. These findings are compatible with the known mechanisms of complement activation and suggest that certain chemical and biochemical methods might be exploited to enhance the biocompatibility of cellulose dialysis membranes.