bluuebunny/crossref_metadata_2025_split huggingface dataset:
Surface Modification of Polyurethane Heart Valves: Effects on Fatigue Life and Calcification
Authors: Bernacca G.M. , Wheatley D.J. 
Published: March 2018

Polyurethane heart valves can be functionally durable with minimal calcification, in vitro. In vivo, these characteristics will depend on the resistance of the polyurethane to thrombogenesis and biodegradation. Surface modification may improve the polyurethane in these respects, but may adversely affect calcification and durability. This study investigates the effects of surface modifications of two polyurethane heart valves (PEU and PEUE) on their in vitro fatigue and calcification behaviour. Modifications included heparin, taurine, 3-aminopropyltriethoxysilane and polyethylene oxide (PEO). Neither hydrodynamic function nor leaflet thickness distribution was significantly altered by surface modification. PEO-modification was detrimental to valve fatigue durability and calcification. Heparin, taurine or aminosilane modifications of PEU valves increased durability. Aminosilane modification of PEUE valves increased durability compared with PEO modification. Appropriate surface modification may be useful to improve blood compatibility of implantable polyurethanes, and may also be advantageous as regards fatigue durability of flexing materials in long-term applications.
Symptoms in Hemodialysis Patients and Their Relationship with Biochemical and Demographic Parameters
Authors: Virga G. , Mastrosimone S. , Amici G. , Munaretto G. , Gastaldon F. , Bonadonna A. 
Published: March 2018

Symptoms can markedly influence the hemodialysis patients well-being and quality of life. The aim of this paper is to study the frequency of symptoms at home and how these relate to biochemical and treatment variables. Seventy-three hemodialysis patients were questioned on the absence, occasional presence or daily recurrence (score = 0, 1, 2) of 14 symptoms and a record was made of their biochemical parameters, age, time on treatment and KtIV as a function of each symptom. The following relationships were detected: thirst with high Osm and BUN; asthenia with old age and hypoalbuminemia; insomnia with hypercalcemia; hypersomnia with hypoxemia and hypernatremia; anorexia with hypokalemia; dyspnea with old age, hypernatremia and hypokalemia; dysgeusia with hypoxemia; nausea with alkalemia, hypoxemia and low BUN; vomiting with alkalemia. Pruritus, arthralgia, restless legs syndrome, cramp and tremor showed no relationships. Monitoring acid-base balance and plasma electrolytes could help to alleviate symptoms and ameliorate quality of life of hemodialysis patients.
Changing Acute Renal Failure Treatment from Intermittent Hemodialysis to Continuous Hemofiltration: Impact on Azotemic Control
Authors: Bellomo R. , Farmer M. , Bhonagiri S. , Porceddu S. , Ariens M. , M'Pisi D. , Ronco C. 
Published: March 2018

Background Continuous renal replacement therapy is increasingly used in the management of acute renal failure in critically ill patients. The advantages of continuous renal replacement therapy (CRRT) over intermittent hemodialysis (IHD), however, are not yet fully documented. In particular, it is unknown whether continuous veno-venuous hemodiafiltration (CVVHDF) provides better control of azotemia than IHD. Objectives To study the effect on azotemic control of changing acute renal failure treatment from IHD to CVVHDF. Settings Tertiary intensive care unit. Patients Forty seven consecutive critically ill patients with multiorgan failure and acute renal failure treated with IHD and 47 similar patients treated with CVVHDF. Methods Analysis of daily morning urea and creatinine concentrations over the period of renal replacement therapy in the ICU. Statistical comparison of data. Results The two groups of patients were comparable for mean age (55 years for IHD vs. 60 years for CVVHDF; NS) and number of failing organs prior to therapy (mean of 4.2 for IHD vs. 3.7 for CVVHDF; NS). Severity of illness at admission as assessed by APACHE II score, however, was greater for patients receiving CVVHDF (29.4 vs 25.7; p<0.003). CVVHDF was associated with a significantly lower plasma urea (p< 0.0001) and serum creatinine (p<0.01) level at 24 hours of treatment despite similar levels at the start of therapy. Throughout the duration of therapy, mean urea levels (35.0 mmol/L for IHD vs 23.4 mmol/L for CVVHDF) and mean serum creatinine levels (513 micromoles/L for IHD and 263 micromoles/L for CVVHDF) showed significantly (p <0.0001) better control of uremia with CRRT. Conclusions Changing the form of renal replacement therapy from intermittent hemodialysis to continuous hemofiltration is associated with improved control of azotemia. The superior adequacy of small solute clearance achieved during CVVHDF provides additional support for its preferential use in the management of acute renal failure in the ICU.
Functionally Adapted Surfaces on a Silicone Keratoprosthesis
Authors: Langefeld S. , Völcker N. , Kompa S. , von Fischern T. , Bienert H. , Klee D. , Höcker H. , Reim M. , Schrage N. F. 
Published: March 2018

Background Silicone intraocular lenses as well as silicone sponges and encircling bands on the bulbar surface are widely used and are well tolerated. The aim of this project is a new one-piece silicone keratoprosthesis with enhanced cell adhesion in the haptic region to optimize the keratoprosthesis stability. These investigations show how enhanced profileration of conjunctival fibroblasts and, therefore, improved tissue compatibility can be achieved by hydrophilizing and by protein immobilisation on a hydrophobic silicone surface. This allows a combination of desired chemical and mechanical properties of the silicone bulk material with surfaces of improved tissue compatibility. Methods Silicone foils with surface modifications of different kinds were tested. Experiments were done using cell cultures with murine fibroblasts L-929 and human conjuctival fibroblasts. Cytotoxicity assays were carried out with cells grown on the material in direct contact, as well as in indirect contact, with extracts (EN 30993-5). Viability stains by means of fluoresceindiacetate and ethidiumbromide together with morphology analyses by hemalaun-staining were performed. Results For the unmodified and modified foils themselves and their extracts any negative influence on cell cultures of murine and human cells could be excluded. There was a gradual improvement of cell morphology, spreading and proliferation dependent on the degree of surface modification. Covalently immobilised fibronectin showed the best results in contrast to adsorptive binding. Conclusions Silicone surfaces can be modified chemically with bioactive proteins. These modifications are cell compatible and do not result in toxic reactions. The degree and type of silicone hydrophilization results in improved development of cell morphology, spreading and proliferation. Even better results are obtained after covalent binding of bioactive proteins like fibronectin. Improved biocompatibility with enhanced cellular overgrowth has been demonstrated in vitro for the modified silicone of the haptic region. We believe that this type of modification will help in reducing extrusion problems observed with former keratoprostheses.
Significantly Improved Survival Time in Pigs with Complete Liver Ischemia Treated with a Novel Bioartificial Liver
Authors: Flendrig L.M. , Calise F. , Di Florio E. , Mancini A. , Ceriello A. , Santaniello W. , Mezza E. , Sicoli F. , Belleza G. , Bracco A. , Cozzolino S. , Scala D. , Mazzone M. , Fattore M. , Gonzales E. , Chamuleau R.A.F.M. 
Published: March 2018

Aim of the study was to evaluate treatment efficacy and safety of a scaled-up version of our porcine hepatocytes based BAL system in pigs with complete liver ischemia (LIS). Thirty-one pigs underwent total devascularization of the liver (LIS) by termino-lateral porta-caval shunts and sutures around the bile duct, the common hepatic and gastroduodenal arteries and their accessory branches. The hepato-duodenal ligament was completely transected. Four experimental groups were studied: the first control group (LIS Control, n = 10) received glucose infusion only, the second control group (LIS Plasmapheresis, n = 8) was connected to a centrifugal plasma-separator with a bottle representing the bioreactor volume, the third control group (LIS Empty-BAL, n = 5) received BAL treatment without cells, and the treated group (LIS Cell-BAL, n = 8) was connected for a maximum period of 24 hours to our scaled-up BAL seeded with around 14 billion viable primary porcine hepatocytes. BAL treatment significantly prolonged life in large animals (-35 kg) with complete LIS (Controls, mean ± SEM: 33.1 ± 3 h, Cell-BAL: 51.1 ± 3.4 h; p = 0.001; longest survivor 63 h). In addition, blood ammonia and total bilirubin levels decreased significantly, indicating metabolic activity of porcine hepatocytes in the bioreactor. No significant differences were noticed among the three control groups, indicating that there was no device effect and that the plasmapheresis procedure was well tolerated. No important adverse effectes were observed.
Development of a New Biodegradable Intravascular Polymer Stent with Simultaneous Incorporation of Bioactive Substances
Authors: Blindt R. , Hoffmeister K.M. , Bienert H. , Pfannschmitt O. , Bartsch G. , Thissen H. , Klee D. , Dahl J. Vom 
Published: March 2018

Objective Due to the thrombogenicity and permanent implant nature of metallic stents, bioresorable synthetic polymers have been proposed for stents and local drug delivery systems. Bioresorbable polyesters like poly(D,L-lactide) demonstrated excellent biocompatibility in various tissues. This paper describes a novel method for the molding of these polymers. The specific CESP-process (Controlled Expansion of Saturated Polymers) is characterised by the use of the plasticizer carbon dioxide and allows the incorporation of bioactive substances at physiologic temperatures into the polymer bulk and the production of complex designed implants. Methods The CESP-process is characterised by the exposure of an amorphous polymer to an inert gas at high pressure with a significant lower glass transition point. The plasticizing effect makes it possible to process polylactides at a temperature close to room temperature. The low process temperature constitutes a key advantage for thermally sensitive polymers and allows the incorporation of thermally sensitive pharmaceutical additives. To obtain some preliminary information on the biocompatibility, in vitro cell toxicity testing as well as drug release assessment was performed. Results Different polymer sheets were produced using the CESP-process. Cytotoxicity was not observed in any molded polymer material. According to the mechanical and biocompatibility results Poly(D,L-lactide) (P-DL-LA) was investigated in the CESP-process. Finite element analysis was used to test the possible geometry of an adequate stent. A helical design was chosen and a stent-prototype was produced using the CESP-process. Peroxidase activity as an incorporated marker enzyme could be measured over 6 weeks. DIfferent drug release profiles were obtained due to various pore sizes of the polymer. Conclusions The new CESP-process can be used to process biodegradable polymers and to mold different stent geometries without inducing cytotoxic effects to the material. Furthermore, this procedure permits the simultaneous incorporation of bioactive substances during the molding process. Drug release kinetics can be regulated by different pore sizes of the material.
Weight-Bearing Cone-Beam CT Scan Assessment of Stability of Supination External Rotation Ankle Fractures in a Cadaver Model
Authors: Lawlor Mark C. , Kluczynski Melissa A. , Marzo John M. 
Published: March 2018

Background: The utility of computed tomography (CT) for measuring medial clear space (MCS) for determination of the stability of supination external rotation (SER) ankle fractures and in comparison to standard radiographs is unknown. We compared MCS on gravity stress (GS) radiographs to GS and weight bearing (WB) cone-beam CT (CBCT). Methods: An AO SER 44B3.1 ankle fracture was simulated in 10 human cadavers, also serving as controls. MCS was measured on GS radiographs, GS CBCT, and a simulated WB CBCT scan. Specimens were stable if MCS was <5 mm and unstable if MCS was ≥5 mm. Paired t tests were used to compare MCS from each imaging modality for controls versus SER injuries and stable versus unstable specimens. Results: Compared with controls assessed by GS radiographs, MCS was greater for an SER injury when assessed by GS radiograph and GS CBCT scan within the stable group. Compared with controls assessed by GS radiographs, MCS was greater for SER injuries when assessed by GS radiograph, GS CBCT scan, and WB CBCT within the unstable group. MCS was reduced for stable versus unstable SER injuries assessed by WB CBCT. Conclusion: In a cadaveric model of SER ankle fracture, the medial clear space was statistically significantly greater for the experimental condition when assessed by gravity stress radiograph and gravity stress CBCT scan. Under weight-bearing conditions, the cone-beam CT scanner distinguished between stable and unstable ankles in the experimental condition. Clinical Relevance: This study suggests that a WB cone-beam CT scan may be able to distinguish between stable and unstable SER ankle fractures and influence operative decision making.
A survey of vaccine history in German cats and owners’ attitudes to vaccination
Authors: Gehrig Anne-Claire , Hartmann Katrin , Günther Felix , Klima André , Habacher Gabriele , Bergmann Michèle 
Published: March 2018

Objectives Vaccination is the most important measure for prevention of feline infectious diseases. Cat owner compliance with vaccination recommendations has been investigated in the UK but not in other European countries. The aim of the present study was to determine cat owners’ attitudes towards vaccination in cats in Germany, to identify factors that are associated with the vaccination status of their cats and to compare the results with those of the UK survey. Methods The survey was conducted using an online questionnaire and was aimed at respondents throughout Germany. Respondents under 16 years of age, cats that were less than 9 weeks old and veterinarians were excluded. A total of 920 questionnaires were evaluated, and information about cats and respondents was assessed with respect to the current vaccination status of the cats using a linear logistic regression model. Results The majority of cats (77.9%; n = 717) were vaccinated according to current guidelines; only 5.4% (n = 50; 95% confidence interval [CI] 5.00–9.00) of cats had never received a vaccine. Having visited a cattery, a cat show or travelled abroad in the past 12 months (n = 96/773; odds ratio [OR] 6.95; 95% CI 1.65–52.19) had the highest positive impact on the vaccination status of cats. In addition, detailed veterinary advice about vaccination had a positive impact (n = 275/773; OR 2.09; 95% CI 0.67–6.25) on the attitude of owners towards vaccinating their cats. Conclusions and relevance A history of travelling abroad or visiting cat shows or a cattery, and thus regulatory requirements, had the greatest positive impact on the current vaccination status of the cats. Veterinary consultation on preventive measures, including vaccination, is crucial for protecting the cat population against infectious diseases.
The effect of clinical severity and eyelid rash on ocular involvement in primary varicella infection
Authors: Sungur Gulten , Hazirolan Dicle , Duran Serkan , Şatana Banu , Arikan Inci , Duman Sunay 
Published: March 2018

Purpose To describe ocular manifestations in primary varicella infection and their relationship to systemic severity and the associated eyelid rash. Methods One hundred consecutive children with primary varicella were examined prospectively. The cases were classified as mild, moderate, and severe according to the severity of clinical presentation. Excluding the presence of eyelid rash, children with ocular findings were assigned to group 1 (G1), and those without ocular findings were assigned to group 2 (G2). Patients in G1 were also evaluated according to the nature of ocular manifestations and the course of uveitis. Results Twenty-one percent of patients had ocular involvement (G1) and 79% had no ocular involvement (G2). While chickenpox had a mild course in 85.7% of patients in G1 and 88.6% of patients in G2, all others had a moderate course. None of the children had a severe course. A varicella eyelid rash was present in 28.6% of patients in G1 and 13.9% in G2. Among ocular findings, 38.1% of patients had conjunctivitis, 57.1% had anterior uveitis, and 4.8% had disciform keratouveitis. There was no significant association between severity of chickenpox and severity of ocular involvement (p=0.712). There was also no relationship between eyelid rash and ocular involvement (p=0.787). Conclusions There is neither an association between the severity of chickenpox and the severity of ocular involvement nor an association between the presence of a varicella eyelid rash and the development of uveitis. As the prognosis regarding sequelae of ocular involvement in varicella infection is good, only those patients with ocular signs and symptoms need be referred by pediatricians for an ophthalmologic examination.
Subconjunctival application of regenerative factor-rich plasma for the treatment of ocular alkali burns
Authors: De Aracena Del Cid Rafael Márquez , De Espinosa Escoriaza Ignacio Montero 
Published: March 2018

Purpose To study the efficiency of the subconjunctival application of autologous regenerative factor-rich plasma (RFRP) in patients with different degrees of ocular alkali burns. Methods Thirty-five eyes of 35 patients with ocular alkali burns were analyzed. They were classified into moderate and relevance groups according to the severity of the burn. A control group was established for each with conventional topical medical treatment; subconjunctival regenerative factor rich plasma (RFRP) was applied to the other groups. A further group was added to the severe chemical burn group, which received autohemotherapy. The clinical evolution of the lesions and the period in which the pathology prevented the patient from working were studied; monitoring was carried out until the patient had healed. Results In the moderate chemical burns, there was a significant reduction in corneal and conjunctival epithelization times, sick leave duration, and healing time when the patients were treated with RFRP in comparison to the control group. With regard to the severe burns, significant reduction in time to corneal scarring in those treated with RFRP in comparison to traditional treatment was reported. RFRP showed, at least as effective and less side effects than the autohemotherapy. Conclusions Subconjunctival infiltration with autologous RFRP can be considered an effective, straightforward, and economical form of treatment for burns of the ocular surface.
Primary low-risk trabeculectomy augmented with low-dose mitomycin-C
Authors: Alwitry Amar , Abedin Asyia , Patel Vick , Moodie Jonathan , Rotchford Alan , King Anthony J. 
Published: March 2018

Purpose To present outcome data on low risk primary trabeculectomy augmented with low dose peroperative (0.1 mg/mL for 1 minute) mitomycin-C (MMC). Methods Retrospective case note review. All cases of trabeculectomy utilizing MMC augmentation at a concentration of 0.1 mg/mL with an application time of 1 minute and at least 1 year follow-up during the study period were included. Only first eyes were included. Patient demographics and postoperative course including complications, interventions, and outcomes were documented and analyzed. Results Fifty-nine trabeculectomies that met the inclusion criteria were identified. Mean age of cases was 70.8 years. Mean follow-up time was 19.3 months. Bleb leaks occurred in 16 (27.1%) cases. Only one case required surgical intervention in the form of resuturing after 14 days. At 1 year, there was a reduction in mean number of topical medications from 2.70 to a mean of 0.07. Unqualified success (intraocular pressure [IOP] at 1 year of less than 16 mmHg without medication) was achieved in 49 cases (83.1%). Mean IOP was reduced from the preoperative value of 23.1 mmHg (SD 5.8) to 13.5 mmHg (SD 5.0) (p<0.001). Conclusions Our data suggest that a primary trabeculectomy augmented with a low dose of MMC is a safe and effective procedure for IOP reduction in patients with a low risk of trabeculectomy failure.
Scleral buckle removal associated with pars plana vitrectomy for recurrent retinal detachment
Authors: Rossi Tommaso , Boccassini Barbara , Iossa Mario , Lesnoni Guido , Mutolo P. Alessandro 
Published: March 2018

Purpose Scleral buckle (SB) removal is rarely performed due to extrusion, infection, or diplopia. We report a series of patients with recurrent retinal detachment (RRD) after primary SB due to new breaks occurring at sites where the presence of a pre-existing SB was judged counterproductive. All patients were treated by means of pars plana vitrectomy (PPV) and SB removal with the sole purpose of achieving a more favorable retinal profile. Methods We retrospectively reviewed all patients undergoing PPV and SB removal for RRD due to new breaks occurring at sites hidden by pre-existing exoplants. Results Mean age was 52 years and VA on presentation was 20/620 and 20/216 at latest visit (p<0.01), 23 months of follow-up. On presentation, 3/11 (27%) had a VA better than 20/400 and 1/11 (9%) better than 20/40. At the end of follow-up, 9/11 (81%) and 3/11 (27%) saw better than 20/400 and 20/40 (p<0.05). At the end of follow-up, 8/11 (72%) had an attached retina, 2/11 (18%) had a partially attached retina, and 1/11 (9%) had a total RD. Explanted buckles included 5 silicone sponges and 6 solid silicone rubber elements. Conclusions Although occasionally cumbersome and time-consuming, SB removal may provide a more favorable retinal profile and improve retina–tamponade contact. Larger series are needed to assess if this translates into a significant benefit in the treatment of selected RRD.
Goldenhar syndrome with unusual association of pre-axial polydactyly
Authors: Mishra Deepak , Sinha Bibhuti P. , Kumar Rakesh 
Published: March 2018

Purpose Goldenhar syndrome is a multiorgan involvement affecting mainly the eyes, auricle, and oral cavity. Methods Case report. Results A 7-month-old boy presenting with features of Goldenhar syndrome had ocular and auricular manifestations. There were no vertebral anomalies, but he had the unusual association of pre-axial polydactyly, which is not reported in the literature. Conclusions Pre-axial polydactyly should also be considered as an association of Goldenhar syndrome.
Spontaneous resolution of Descemet membrane detachment following big-bubble deep anterior lamellar keratoplasty
Authors: Goldich Yakov , Zadok David , Avni Isaac 
Published: March 2018

Purpose To report 2 cases of delayed spontaneous Descemet membrane (DM) reattachment following big-bubble deep anterior lamellar keratoplasty (DALK). Methods A 21-year-old man with keratoconus and a 36-year-old woman with corneal macular dystrophy underwent big-bubble DALK. No injury to DM was noted intraoperatively or postoperatively. Postoperatively, the patients developed central DM detachment with double anterior chamber formation. A nonsurgical conservative approach (waiting technique) was adopted. Results Three weeks postoperatively, the double anterior chamber resolved spontaneously with complete DM reattachment and a clear donor cornea. Conclusions DM detachment and double anterior chamber following big-bubble DALK may resolve spontaneously.