bluuebunny/crossref_metadata_2025_split huggingface dataset:
Preparation of Small Volume, Leuko and Erythrocyte Very Poor Platelet Concentrates
Authors: Valbonesi M. , Angelini G. , Malfanti L. , Lercari G. , Fella M. , Calderisi S. , Anselmo A. , Balistreri M. 
Published: March 2018

Recently developed automated discontinuous flow centrifuge (DFC) separators can produce leuko- and erythrocyte-poor platelet concentrates (PC). According to general experience with these machines it is difficult to obtain more than 4 × 1011 platelets, though a second program set up by Coffe et al. appears to produce PC containing approximately 5 × 1011 platelets suspended in a plasma volume of 390 ml. At our center we employed a new Dideco cell separator equipped with the surge pump and a technique developed for the production of small volume, RBC and WBC-very poor PC. In 60 routine procedures we obtained the following results: mean processing time 87 ±11 minutes; final volume of PC 136 ± 19 ml, with a mean platelet yield of 5.21 × 1011 platelets. WBC contamination was 1.8 × 108 (93% lymphocytes) and RBC were 3.1 × 108. Plasma volume as well as WBC and RBC contamination were reduced by recirculating PC after the 6th pass. The demand for single donor platelet concentrates (PC) is increasing progressively. Recently developed automated cell separators can produce leukocyte (WBC) and erythrocyte (RBC) poor PC. With these machines it may be difficult to obtain PC containing at least 4 × 1011 platelets and less than 1 × 109 leukocytes (1, 2, 3) since donor variables such as hematocrit, precounts, buffy coat formation and initial plasma light transmission are of paramount importance for the efficiency of the program (3). At our center a prototype discontinuous flow centrifuge (DFC) cell separator equipped with the surge pump was studied (4). It produced PC containing 3.58 ±1.5 × 1011 platelets suspended in a mean of 346.32 ± 51.7 ml of plasma and contaminated by 0.63 ± 0.51 × 109 WBC (95% lymphocytes). The quality of the PC was satisfactory, with good maintenance of platelet functions as measured by ristocetin-induced aggregation and malonaldehyde production, but our study brought to light the main limitations of the system, namely the variability of WBC and RBC contamination and the excessive loss of plasma. In this study we report on a technique developed with the Unicell prototype to produce small volume, WBC and RBC-very poor PC.
Mineral Metabolism during a Hemofiltration Session in Children
Authors: Bianchi M. L. , Bettinelli A. , Soldati L. , Saccaggi A. , Ortolani S. , Edefonti A. 
Published: March 2018

We studied the effects of one session of hemofiltration on the mineral metabolism in a group of uremic children. We observed an increase of calcemia, accompained by positive calcium balance, and a decrease of plasma phosphate and PTH-MM. No substantial loss of plasma 25-OH D was found. It is concluded that hemofiltration has a positive effect on calcemia and is very effective in removing phosphate, but it acts only temporarily on PTH removal. An adequate calcium concentration must be provided in the substitution fluid.
Hemoperfusion Based on Artificial Cells for Aluminium and Iron Removal, Immunosorption, Fulminant Hepatic Failure, Uremia, Poisoning and Metabolic Assists
Authors: Chang T.M.S. 
Published: March 2018

The author reviewed artificial cells and their applications in hemoperfusion for chronic renal failure, poisoning, fulminant hepatic failure, removal of aluminium and iron, and metabolic assists. Other areas reviewed included artificial cells containing enzymes, multienzymes, immunosorbents, cell cultures and other areas. Artificial cells can be formed as membrane coated adsorbent or microencapsulated adsorbent, enzymes and cells (1-3). The large surface to volume relationship and the ultrathin membrane of artificial cells allows the rapid equilibration of metabolites (1-3). Artificial cells containing enzymes, ion exchange resin and activated charcoal have been used for hemoperfusion (4). The microencapsulated or membrane coated absorbents, enzymes, cells, immunosorbents and other material are prevented from releasing unwanted material into the circulation and prevented from adverse effects on blood cells. Because of the problem of charcoal in releasing emboli and depleting platelets (5) we first developed coated activated charcoal hemoperfusion for clinical application (6, 7). This has been used extensively in clinical studies. The artificial cell approach has also been applied to a number of other hemoperfusion approaches. The lack of space only allows this paper to summarize some of the approaches originated from this research centre.
Adsorption of Lipoprotein Containing Apolipoprotein-B through Plasma Separation for Treatment of Familial Hypercholesterolemia
Authors: Odaka M. , Kobayashi H. , Soeda K. , Murotani N. , Saito Y. , Nishide T. , Yoshida S. , Tani N. , Takata S. 
Published: March 2018

For the treatment of familial hypercholesterolemia, Liposorber LA-40 was clinically applied. The Liposorber is a commercially developed affinity adsorbent for plasma perfusion which selectivily adsorbs low density lipoproteins and very low density lipoproteins and is specially designed for plasmapheretic treatment of hypercholesterolemia. The Liposorber column, containing activated cellulose beads having an affinity for liporpotein containing apolipoprotein-B, has an excellent adsorption capacity, excellent selectivity, minimum albumin loss. This new apheresis system was applied to 2 clinical cases. After seven months of trial perfusion every 2 weeks, patient condition was good, with a level of total cholesterol under 300 mg/dl. No replacement fluids were given during or after treatment. In this paper, clinical results of these patients were shown and the mechanism of adsorption of this specific adsorbent was discussed.
Transmembrane pressures generated by filtrate line suction maneuvers and predilution fluid replacement during in vitro continuous arteriovenous hemofiltration
Authors: Golper T.A. , Kaplan A.A. , Narasimhan N. , Leone M. 
Published: March 2018

A recirculating in vitro CAVH system was designed which generated pulsatile blood and filtrate flows. Monitors recorded hydrostatic pressures simultaneously in the arterial, venous and filtrate lines during varying plasma or blood flow rates and predilution (vs postdilution) replacement fluid flow rates. Similar hydrostatic pressure monitoring was carried out during multiple maneuvers to generate suction on the filtrate side of the hemofilter (Amicon® D-20's and Renaflo®‘s). With a plasma flow (Qp) of 100 cc/min and predilution replacement fluid infusion rate of 500 cc/hr, the arterial pressure was 5% greater than during postdilution (p < 0.05). With a blood flow (Qb) of 50 cc/min, predilution fluid replacement rates of 500 and 1000 cc/hr, and vacuum suction applied to the filtrate compartment, the arterial pressure was 33% lower than during postdilution fluid replacement (p < 0.03). Nonetheless, the ultrafiltration rate (UFR) was 10 to 30% higher (p < 0.03). At many other combinations of Qp, Qb and replacement rates and modes, there were no significant changes in arterial pressure. Despite these arterial pressure changes, > 70% of the transmembrane hydrostatic pressure (TMP) was due to the negative pressure induced by filtrate suction (gravity, Gomco®, wall suction, IMED®). The actual pressure in the filtrate compartment measured during Gomco® or wall suction was 3/4 of that stated by their gauges, presumably due to leakage. Maximum wall suction never generated TMP's > 150 mmHg. Using an IMED® 960 as the suction device (bypassing the air alarm), for a Qp of 50, IMED® settings of 300, 600 and 900 cc/hr generated TMP's of 67 ± 3, 77 ± 3, and 97 ± 3 mmHg, respectively. When Qp was 20 cc/min, an IMED® setting of 999 cc/hr generated TMP's consistently < 136 mmHg but UFR was only 668 ± 246 cc/hr. With the IMED® set at 999 cc/hr and Qp of 30 cc/min, the TMP was < 132 mmHg and the UFR was 944 ± 10 cc/hr. No filters ruptured. These suction maneuvers do not generate enough pressure to rupture filters. When Qp is low the IMED® may not generate the UFR one expects. Predilution will probably alleviate this concern.
“Are the Differences between ‘High Performance’ Pacing Leads Clinically Significant? A Comparison of Sintered Platinum and Activated Carbon”
Authors: Bourke J.P. , Jameson S. , Howell L. , Gold R.G. 
Published: March 2018

A retrospective assessment was performed of the acute implantation characteristics of two pacing leads, one with a sintered platinum (S 80-T) electrode and the other with an activated vitreous carbon (412-S) electrode in 124 patients. The S80-T lead had a significantly lower implantation threshold. The differences between the two leads in sensing properties, in current flow at threshold voltage and at the output of the generator were not significant at implantation. The 412-S lead had a higher impedance measurement than the S-80-T at implantation but this was mainly due to the resistance differences of the conductors rather than to electrode-patient interactions. A subgroup of 20 patients had chronic threshold measurements. The S 80-T lead had a significantly lower chronic voltage threshold. However because the acute and chronic differences are small we conclude that, although these differences are statistically significant, they are not clinically significant. Both can justifiably be termed ‘high-performance’ leads.
Hypertension Profiling by Total Body Water (Tbw) Determinations in Patients on Chronic Hemodialysis
Authors: Thylén P. , Ericsson F. , Odar-Cederlöf I. , Kjellstrand C.M. 
Published: March 2018

Hypertension is an important risk factor in hemodialysis patients. Fluid overload and increased peripheral resistance are considered the two main causes. We studied the relation between volume state and blood pressure in 18 hemodialysis patients. Actual total body water (aTBW) was measured as tritium space and “ideal” total body water (iTBW) by an anthropometric method. The difference between aTBW and iTBW was considered a measure of fluid excess or deficit. Twelve patients were overhydrated, 5%-23%. Their predialysis blood pressure was significantly correlated to their degree of fluid excess; systolic BP:r=0.71, p=0.03, diastolic BP:r=0.73, p=0.02, mean arterial BP:r=0.76, p=0.03. Five of these patients had multiple antihypertensive drugs instead of adequate ultrafiltration. Five patients had a fluid deficit of -3 to -13% and hypertension due to vasoconstriction. Four of these were adequately treated with antihypertensive drugs but had exaggerated ultrafiltration. TBW determination with tritium is simple to perform and gives information on the volume state and thereby on the cause of hypertension in hemodialysis patients. Based on this, appropriate treatment can be chosen.
Studies on Contact Lens Materials
Authors: Alyanak H. , Aksoy S. , Hasirci N. 
Published: March 2018

The development of plastics with the optical properties of glass led promptly to their use as contact lenses and intra-ocular lenses to rectify certain visual defects. Research to improve these polymeric materials is continuous but there is not much in the literature since most of the findings are patented. In this work, polymethyl methacrylate, the most commonly used lens material was chosen as the base material and its co and terpolymers were prepared using 2-hydroxyethyl methacrylate, N-vinyl-2-pyrrolidinone, hexamethyl disiloxane, and polypropylene glycol. The transparency, refractive index, contact angle, density, equilibrium water content, and percent hydration properties were examined. Theoretical values were calculated for linear expansion and oxygen permeation from the density and hydration values.
Cinematics and Sticking of Heart Valves in Pulsatile flow Test
Authors: Köhler J. , Wirtz R. 
Published: March 2018

The aim of the project was to develop laboratory test devices for studies of the cinematics and sticking behaviour of technical valve protheses. The second step includes testing technical valves of different types and sizes under static and dynamic conditions. A force-deflection balance was developed in order to load valve rims by static radial forces until sticking or loss of a disc (sticking- and clamping-mould point) with computer-controlled force deflection curves. A second deflection device was developed and used for prosthetic valves in the aortic position of a pulsatile mock circulation loop with simultaneous video-cinematography. The stiffness of technical valve rims varied between 0.20 (St. Jude) and about 1.0 N/μm (metal rim valves). The stiffness decreased significantly with increasing valve size. Sticking under pulsatile flow conditions was in good agreement with the static deflection measurements. Hence, valve sticking with increasing danger of thrombus formation is more likely with a less stiff valve rim. In the case of forces acting perpendicularly to the pendulum axis, the clamping mould-point of the valve can be reached, followed by disc dislodgement.
Apheresis-Elutriation Program for Adoptive Immunotherapy with Autologous Activated Monocytes in Cancer Patients
Authors: Faradji A. , Bohbot A. , Schmitt-Goguel M. , Dumont S. , Eischen A. , Wiesel M.L. , Stierle A. , Follea G. , Eber M. , Bergerat J.P. , Bartholeyns J. , Poindron P. , Witz J.P. , Frost H. , Oberling F. 
Published: March 2018

Human blood monocytes (Mo) and monocyte-derived macrophages (MØ) are known to be potent antitumor cytotoxic effector cells through activation with recombinant human interferon gamma (rIFN-y), bacterial muramyldipeptide or the synthetic derivative muramyltripeptide phosphatidylethanolamine entrapped in liposomes (L-MTP-PE). Large-scale generation of ex vivo activated Mo from the blood of cancer patients proved feasible. We report our experience with a fixed rotor speed counterflow centrifugation elutration (CEE) procedure using the newly available Beckman high capacity JE-5.0 rotor system that reproducibly isolates up to 1.0-1.5×109 Mo with > 90% purity, in suspension and functionally intact derived from peripheral blood mononuclear cell-enriched suspensions obtained by leukapheresis (LP) from healthy volunteers and cancer patients. The semiclosed, easy to handle CCE system, was adapted to a sterile technique that permitted clinical trials in adoptive monocyte immunotherapy. Freshly isolated Mo did not lose morphological or functional integrity and had no spontaneous activation. Their abilities to become activated to the cytotoxic state after 18-h stimulation with 500 U/ml rIFN-γ or 1 μg/ml L-MTP-PE and to differentiate into matured MØ in vitro were not altered. The system was therefore used to isolate large numbers of Mo for a phase I clinical trial of intraperitoneal immunotherapy with L-MTP-PE activated autologous Mo in nine patients with peritoneal carcinomatosis. Each patient received weekly Mo infusions (n=5) with an intrapatient dose escalation schedule (from 107 to 109 Mo). Toxicities were mild including fever, chills and abdominal pain. There was no treatment-induced thromboembolic event or capillary leak syndrome. The degree of Mo activation in vitro was shown by the release of procoagulant activity and monokines (IL-1, TN Fa and IL-6) in the culture supernatants and the antitumor activity against U937 cells and human ovarian carcinoma cells in vitro and in tumor-bearing nude mice in vivo. The in vivo immunomodulatory activity of i.p. infused Mo was demonstrated by an elevation of WBC and granulocyte counts, fibrinogen, C-reactive protein and neopterin in peripheral blood and generation of IL-1, TFNa and IL-6 in peritoneal fluid. Phase II clinical trials, now in progress, should further define the therapeutic potential of human adoptive cellular immunotherapy using Mo or MØ.
Prosthetic Heart Valve Evaluation in Vitro: Critical Aspects of Data Comparability
Authors: Barbaro V. , Bartolini P. , Daniele C. , Grigioni M. , Palombo A. 
Published: March 2018

The technology of heart valve substitution has considerably improved in the last few years, but its reliability after implantation is still not good enough, hence the need to study new valve design and improve quality testing. Different pulse duplicators are used for heart valve testing, but the results depend very much on the system adopted and the measurement protocol. Tests on two pulse duplicators currently used at the Biomedical Engineering Laboratory at the Istituto Superiore di Sanità, Rome, are reported here. The most significant parameters for valve evaluation were measured following each system's own protocol. Attention was focused on vascular load tuning when setting up the system and on the relationship between drive unit flow waveform and valve regurgitation and energy loss measurements. Standardization criteria must be defined in order to ensure the reliable comparability of in vitro testing results.
Inhibition of Complement Activation with EDTA in Vivo during Sham Hemodialysis
Authors: Kandus A. , Benedik M. , Bren A.F. , Drinovec J. , Fliser D. , Knap B. , Kladnik S. , Ivanovich P. 
Published: March 2018

To check whether in vivo EDTA prevents complement activation resulting from blood contact with the dialyzer membrane, sham hemodialysis (HD) was performed in seven healthy volunteers using Cuprophan hollow-fiber dialyzers. Blood samples were drawn from the arterial and venous blood lines of the dialyzer before and after EDTA was infused into the arterial line. Venous line plasma C3a concentrations before EDTA infusion were significantly higher than after EDTA. Also, venous line plasma C3a concentrations before and after EDTA infusion were significantly higher than in the arterial line. These results indicate that complement activation can be attenuated by EDTA during sham HD. Technical improvements in the procedure may permit complete inhibition of complement activation.
Plasma Exchange (Pe) Treatment in Drug-Induced Toxic Epidermal Necrolysis (Ten)
Authors: Sakellariou G. , Koukoudis P. , Karpouzas J. , Alexopoulos E. , Papadopoulou D. , Chrisomalis F. , Skenteris N. , Tsakaris D. , Papadimitriou M. 
Published: March 2018

Toxic epidermal necrolysis (TEN) or Lyell's syndrome is a rare fulminating skin disease notorious for its rapidly progressive course and high mortality rate. TEN is characterized by the sudden onset of epithelial necrosis of skin with frequently associated involvement of the gastrointestinal, genitourinary tract and bronchopulmonary linings. We describe the clinical course of five patients with severe drug-induced TEN, treated with PE. The suspected drugs were carbamazepine in one patient, paracetamol in one, a combination of paracetamol and mefenamic acid in one, allopurinol in one and ciprofloxacin in one. Three had a skin involvement affecting almost the entire surface of the body. In addition to the skin lesions, mouth, esophagus and lungs were also involved. Steroids proved ineffective. PE was carried out because of the rapid deterioration of the clinical picture. The mean number of PE sessions was 3.22 (range 1-5). Complete remission of the syndrome was achieved in four patients. One patient died due to septic shock. As so far there is no treatment of proven value for this condition, controlled trials should be set up in order to assess the value of PE in TEN.
A Randomized Trial of Plasmapheresis and Subsequent Pulse Cyclophosphamide in Severe Lupus: Design of the Lpsg Trial
Authors: Euler H.H. , Schroeder J.O. , Zeuner R.A. , Teske E. 
Published: March 2018

A group of clinics cooperating as the Lupus Plasmapheresis Study Group (LPSG) is starting an international multicenter study of the treatment of severe systemic lupus erythematosus. The primary goal of this randomized and prospective trial is to establish whether treatment with plasmapheresis and subsequent pulse cyclophosphamide improves the outcome compared to treatment with pulse cyclophosphamide alone. The underlying rationale assumes that plasmapheresis: a) eliminates pathogenic autoantibodies and immune complexes and b) induces a compensatory activation of pathogenic lymphocyte clones through a feedback between circulating antibodies and their respective antibody-producing clones. Synchronization of plasmapheresis with subsequent pulse cyclophosphamide should enhance the deletion of pathogenic clones during the period of greatest vulnerability. This overview reviews the first results of treatment approaches based on this concept and summarizes the design of the LPSG trial
New J-3 Flexible-Leaflet Polyurethane Heart Valve Prosthesis with Improved Hydrodynamic Performance
Authors: Jansen J. , Willeke S. , Reiners B. , Harbott P. , Reul H. , Rau G. 
Published: March 2018

The aim of this new three-leaflet valve development was to design a leaflet with minimum membrane stresses during performance. This is achieved by manufacturing the valve leaflets shaped almost flat in a medium opening position. Thus, the leaflets have two stable positions, one with maximum opening area and the other with favorable stress distribution in the closed position. The transition between the two end positions is achieved through a two-dimensional rolling motion without buckling and with minimum membrane stresses (bulge forces). The manufacturing technique is dip-coating in polyurethane. Hydrodynamic evaluation of the J-3 valve in steady and pulsatile flow showed minimum pressure drop compared to other commercially available valves. Laser-Doppler-anemometry studies indicated very low shear stresses in the flow field downstream of the valve. In durability tests prototypes have reached lifetimes of up to 17 years. In conclusion, the J-3 valve shows superior hydrodynamic performance thereby reducing potential thrombus formation. Minimization of stresses within the valve leaflets through design could reduce calcification.
Tfe-Plasma Polymerized Dermal Sheep Collagen for the Repair of Abdominal Wall Defects
Authors: Van Der Laan J.S. , Lopez G.P. , Van Wachem P.B. , Nieuwenhuis P. , Ratner B.D. , Bleichrodt R.P. , Schakenraad J.M. 
Published: March 2018

The aim of this study was to design and evaluate a degradable biomaterial for the repair of abdominal wall defects. Hexamethylenediisocyanate-tanned dermal sheep collagen (HDSC) was plasma-polymerized with tetrafluoroethylene (TFE) which resulted in a hydrophobic surface on the visceral side (TFE-HDSC). Full-thickness abdominal wall defects were made in rats and repaired with HDSC or TFE-HDSC implants. Unmodified HDSC implants showed excellent fixation to the adjacent muscle tissue but intestinal adhesions were observed. These implants showed insufficient strength after four weeks, illustrated by bulging of the peritoneal contents (herniation). Plasma-polymerized implants after four weeks of implantation showed firm incorporation into the surrounding muscle tissue. With one exception there were no bowel adhesions. Fewer herniations were observed, indicating a prolonged degradation period. Further studies on the optimalization of degradation time are in progress.