bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical evaluation of plasma insulin and C-peptide levels with 3 different high-flux dialyzers in diabetic patients on hemodialysis
Authors: Abe M. , Okada K. , Maruyama T. , Inoshita A. , Ikeda K. , Uto E. , Kikuchi F. , Matsumoto K. 
Published: January 2018

Aim Changes in plasma immunoreactive insulin (IRI) and connecting-peptide immunoreactivity (CPR) concentrations during hemodialysis (HD) were evaluated in diabetic HD patients with 3 different high-flux membranes. The removal properties of the membranes were compared. Method In this prospective controlled study, 15 stable diabetic patients on HD were randomly selected for 6 HD sessions with 3 different membranes: polysulfone (PS), cellulose triacetate (CTA), and polymethylmethacrylate (PMMA). Blood samples were obtained from the blood tubing at the arterial (A) site at the beginning and end of the sixth HD session. At 60 minutes after dialysis initiation, blood samples were obtained from both the A and venous (V) sites of the dialyzer to investigate the clearance and removal properties of the membranes. Results The plasma IRI and CPR levels decreased significantly at each time point with all 3 membranes. IRI clearance with the PS membrane was significantly higher than that with the CTA and PMMA membranes. No difference was observed in the IRI reduction rate between the 3 membranes. CPR clearance and reduction rate with the PMMA membrane were lower than with the PS and CTA membranes. No significant difference was observed in serum creatinine clearance and reduction rates between the 3 membranes; however, serum urea nitrogen clearance was significantly lower with the PMMA membrane compared with the PS and CTA membranes. A significantly high β2-microglobulin clearance and reduction rate was achieved in the order PS > CTA > PMMA. Conclusion Plasma IRI and CPR are cleared by HD; their clearance rates differ with the dialyzer membranes. Plasma IRI clearance with the PS membrane is higher than that with the CTA and PMMA membranes. (Int J Artif Organs 2008; 31: 898–904)
Resistance of vascular access catheters for continuous renal replacement therapy: An ex vivo evaluation
Authors: Naka T. , Egi M. , Bellomo R. , Baldwin I. , Fealy N. , Wan L. 
Published: January 2018

Aim To assess the resistance posed by double-lumen vascular access dialysis catheters at low and high blood flow. Design Controlled ex vivo study Setting ICU Laboratory of tertiary hospital. Subjects Eleven proprietary vascular access catheters for continuous renal replacement therapy. Methods: Heparinized spent red cells diluted in polygeline solution were pumped using the Aquarius hemofiltration machine (Edwards Life Sciences, Sydney, NSW, Australia) and its standard circuit through several vascular access catheters. Blood flow was increased and then decreased in steps of 50 ml/min (50, 150, 200, 250 and 300 ml/min) while catheter outflow and inflow pressures were recorded. The pressure-flow relationship (hydraulic resistance) of each catheter was then calculated. Study catheters were divided into two groups according to their internal diameter (large gauge vs. smaller gauge) or length (long or short). Hydraulic resistances were compared between the groups. Results: Different double lumen catheters posed clearly different resistances to flow. For all groups of catheters, there was a linear relationship between pressure and flow. No statistically significant difference between short and long catheters could be demonstrated (p=0.715). On the other hand, larger gauge catheters (13 Fr or greater) had significantly lower resistances than smaller gauge (<13 Fr) catheters (p=0.0062). Furthermore, all larger gauge catheters had resistances lower than 0.430 mmHg/ml/min, while all smaller gauge catheters had resistances greater than 0.490 mmHg/ml/min. Conclusions: Commercial double-lumen dialysis catheters have variable resistance to blood flow under standard ex vivo conditions. Although both length and internal diameter varied, internal diameter had a dominant effect on resistance. This information might be useful to clinicians in guiding their choice of catheters for clinical use. (Int J Artif Organs 2008; 31: 905–9)
Optimized convective transport with automated pressure control in on-line postdilution hemodiafiltration
Authors: Joyeux V. , Sijpkens Y. , Haddj-Elmrabet A. , Bijvoet A. J. , Nilsson L.-G. 
Published: January 2018

Purpose In a stable patient population we evaluated on-line postdilution hemodiafiltration (HDF) on the incremental improvement in blood purification versus high-flux HD, using the same dialyzer and blood flow rate. For HDF we used a new way of controlling HDF treatments based on the concept of constant pressure control where the trans-membrane pressure is automatically set by the machine using a feedback loop on the achieved filtration (HDF UC). Methods We enrolled 20 patients on on-line HDF treatment and during a 4-week study period recorded key treatment parameters in HDF UC. For one mid-week study treatment performed in HD and one midweek HDF UC treatment we sampled blood and spent dialysate to evaluate the removal of small- and middle-sized solutes. Results We achieved 18±3 liters of ultrafiltration in four-hour HDF UC treatments, corresponding to 27±3% of the treated blood volume. That percentage varied by patient hematocrit level. The ultrafiltration amounted to 49±4% of the estimated plasma water volume treated. We noted few machine alarms. For β2m and factor D the effective reduction in plasma level by HDF (76±6% and 43±9%, respectively) was significantly greater than in HD, and a similar relation was seen in mass recovered in spent dialysate. Small solute removal was similar in HDF and HD. Albumin loss was low. Conclusion The additional convective transport provided by on-line HDF significantly improved the removal of middle molecules when all other treatment settings were equal. Using the automated pressure control mode in HDF, the convective volume depended on the blood volume processed and the patient hematocrit level.
Continuous veno-venous hemofiltration with regional citrate anticoagulation: A four-year single-center experience
Authors: Cassina T. , Mauri R. , Engeler A. , Giannini O. 
Published: January 2018

Background Hemofiltration protocols using a citrate-buffered replacement solution offer the advantage of regional anticoagulation and a buffer effect. The role played by such fluids in clinical practice is not yet well established. The risk of electrolytic disorders, acid-base imbalance, or citrate accumulation should be clarified. We report on a renal therapy protocol based on a citrate isonatremic replacement solution. Method We considered all patients needing renal replacement therapy admitted to our cardiovascular intensive care unit between January 2003 and June 2007. A citrate-buffered fluid was delivered in pre-dilution mode to a post-filter ionized calcium target ≤0.25 mmol/L. Extracorporeal blood flow was set at a constant of 140±10 ml/min. Blood calcemia was maintained by a 5% calcium-chloride solution infused into the patient. We recorded the patients' acid-base variables, ionized calcium, daily electrolytes, albumin, urea and filter life-span. Results We observed 101 consecutive patients out of 2,523; incidence 4%, overall mortality was 57% at ICU discharge. Mean replacement rate was 2,554±475 ml/h corresponding to 34±5 ml/kg/h. Mean patient ionized calcium level was 1.07±0.04 mmo/L, maintained by 13±2 ml/h of infused calcium-chloride. All other electrolytes remained in the normal range. The Stewart biophysical approach confirmed a strong anion gap of 3.1± 3 meq/L. Acid-base balance showed a buffer effect. Mean filter life-span was 52±11 h. Conclusion Renal replacement therapy based on citrate-buffered fluid may be useful in clinical practice. This methodology presented an adequate metabolic control and allowed regional anticoagulation. A sufficient calcium supply was mandatory to avoid hypocalcemia. The small strong ion gap suggested a modest citrate accumulation.
Effect of fiber structure on dialysate flow profile and hollow-fiber hemodialyzer reliability: CT perfusion study
Authors: Kim J. C. , Kim J. H. , Kim H.-C. , Kang E. , Kim K. G. , Kim H. C. , Min B. G. , Ronco C. 
Published: January 2018

Background Uniform dialysate distributions in hollow-fiber hemodialyzers facilitate effective solute removal, and the fiber structure inside hemodialyzers plays a significant role in determining dialysate flow distribution and dialysis efficiency. The authors analyzed the effects of undulated fibers on dialysate flow profiles and hemodialyzer reliability using a perfusion CT technique. Method Using a multi-detector row CT unit, perfusion studies were performed on two different types of hemodialyzers: (A) straight fiber configuration; (B) undulated fiber configuration (wavy-shaped fibers). Deconvolution theory was used for image processing to derive dialysate flows, dialysate volumes, and mean transit time distributions. Three-dimensional perfusion maps for the two types of hemodialyzers were reconstructed using high resolution images and these parameters were compared at hemodialyzer midsections. Results Dialysate maldistributions were observed in both types of hemodialyzer. However, dialysate flow distributions were more uniform in the undulated-fiber hemodialyzer, whereas more complex flow distributions developed in straight-fiber hemodialyzer. Reliability as determined using intraclass correlation coefficients was markedly higher for the hemodialyzer containing undulated fiber (0.968 vs. 0.496 for type A and type B, respectively). Conclusions The undulated-fiber type was found to have more uniform, consistent dialysate flow profiles. It is believed that this type of hemodialyzer will be found helpful for measurement and prescription of the delivered hemodialysis dose due to its better consistency.
TGFβ-1 and epithelial-mesenchymal interactions promote smooth muscle gene expression in bone marrow stromal cells: Possible application in therapies for urological defects
Authors: Becker C. , Laeufer T. , Arikkat J. , Jakse G. 
Published: January 2018

Purpose For regenerative and cellular therapies of the urinary tract system, autologous bladder smooth muscle cells (SMCs) have several limitations, including constricted in vitro proliferation capacity and, more importantly, inability to be used in malignant conditions. The use of in vitro (pre-)differentiated multipotential adult progenitor cells may help to overcome the shortcomings associated with primary cells. Methods By mimicking environmental conditions of the bladder wall, we investigated in vitro effects of growth factor applications and epithelial-mesenchymal interactions on smooth muscle gene expression and on the morphological appearance of adherent bone marrow stromal cells (BMSCs). Results Transcription growth factor beta-1 (TGFβ-1) upregulated the transcription of myogenic gene desmin and smooth muscle actin-γ2 in cultured BMSCs. Stimulatory effects were significantly increased by coculture with urothelial cells. Prolonged stimulation times and epigenetic modifications further enhanced transcription levels, indicating a dose-response relationship. Immunocytochemical staining of in vitro-differentiated BMSCs revealed expression of myogenic protein α-smooth muscle actin and desmin, and changes in morphological appearance from a fusiform convex shape to a laminar flattened shape with filamentous inclusions similar to the appearance of bladder SMCs. In contrast to the TGFβ-1 action, application of vascular endothelial growth factor (VEGF) did not affect the cells. Conclusions The combined application of TGFβ-1 and epithelial-mesenchymal interactions promoted in vitro outgrowth of cells with a smooth muscle-like phenotype from a selected adherent murine bone marrow-derived cell population.
Recombinant human type II collagen as a material for cartilage tissue engineering
Authors: Pulkkinen H.J. , Tiitu V. , Valonen P. , Hämäläinen E.-R. , Lammi M.J. , Kiviranta I. 
Published: January 2018

Purpose Collagen type II is the major component of cartilage and would be an optimal scaffold material for reconstruction of injured cartilage tissue. In this study, the feasibility of recombinant human type II collagen gel as a 3-dimensional culture system for bovine chondrocytes was evaluated in vitro. Methods Bovine chondrocytes (4x106 cells) were seeded within collagen gels and cultivated for up to 4 weeks. The gels were investigated with confocal microscopy, histology, and biochemical assays. Results Confocal microscopy revealed that the cells maintained their viability during the entire cultivation period. The chondrocytes were evenly distributed inside the gels, and the number of cells and the amount of the extracellular matrix increased during cultivation. The chondrocytes maintained their round phenotype during the 4-week cultivation period. The glycosaminoglycan levels of the tissue increased during the experiment. The relative levels of aggrecan and type II collagen mRNA measured with realtime polymerase chain reaction (PCR) showed an increase at 1 week. Conclusion Our results imply that recombinant human type II collagen is a promising biomaterial for cartilage tissue engineering, allowing homogeneous distribution in the gel and biosynthesis of extracellular matrix components.
Design and performance testing of an axial-flow ventricular assist device developed at the Fu Wai Hospital in Beijing
Authors: Zhang Y. , Hu S.S. , Zhou J.-Y. , Sun H.-S. , Zhang H. , Zheng Z. , Zhu X.-D. , Li G.-R. , Gui X.-M. , Zhan Z. , Jin D.-H. 
Published: January 2018

Purpose Various ventricular assist devices (VADs) have been developed for clinical use in recent years. The aim of a multidisciplinary research team at the Fuwai Hospital of the Peking Union Medical College is to design and develop an axial flow left ventricular assist device (LVAD) for adults. Methods Using Computational Fluid Dynamics (CFD), the inflow characteristics of the axial flow pump were analyzed. After CFD analysis, the axial pump was fabricated using a 5-axis, computer numerical control (CNC) milling machine. Performances of the pump both in vitro and in vivo were tested. Results This VAD, which was developed after numerous CFD analyses for the flow characteristics of the pump, is 58.5 mm long, 30 mm wide and weighs 120 g. The pump can deliver 5 lpm for pressures of 100 mmHg over 8500 rpm. The NIH value was 0.01 g/100 L. The hemolysis, which was evaluated in an in vivo test, was a bit higher than the normal value, but remained within an acceptable range. Conclusions Performance of the pump in vitro and in vivo was considered sufficient for an LVAD. Further design improvements are being undertaken in terms of hemolysis and thrombosis to improve the biocompatibility of the pump.
Ertapenem clearance during modeled continuous renal replacement therapy
Authors: Stevenson J.M. , Patel J.H. , Churchwell M.D. , Vilay A.M. , Depestel D.D. , Sörgel F. , Kinzig M. , Jakob V. , Mueller B.A. 
Published: January 2018

Purpose To determine ertapenem transmembrane clearance (CLtm) during continuous renal replacement therapy (CRRT) using a validated in vitro model. Methods Ertapenem clearance during continuous hemofiltration and hemodialysis was assessed with AN69 and polysulfone hemodiafilters at 4 dialysate (Qd) and ultrafiltration rates (Quf): 1, 2, 3, and 6 l/hour. Blood and dialysate samples were collected at each flow rate and assayed for urea (control solute) and ertapenem concentrations. The experiment was repeated 5 times for each hemodiafilter type. Ertapenem and urea sieving coefficient (SC) and saturation coefficient (SA) were assessed, and CLtm calculated Results: In continuous hemofiltration mode, urea and ertapenem SC ranged from 1.00 to 1.19 at all Quf and did not differ between hemodiafilter types. Consequently, convective CLtm also did not differ between hemodiafilters. In continuous dialysis mode, urea Cltm did not differ between hemodiafilter types at any Qd. However, ertapenem SA and CLtm were significantly different between hemodiafilter types at Qd 6l/hour (p<0.001). As Qd increased, mean ± SD AN69 SA declined significantly from 0.87 ± 0.12 at Qd 1 l/hour to 0.45 ± 0.02 at Qd 6 l/hour (p<0.001). Ertapenem SA did not differ at any Qd with the polysulfone hemodiafilter (range 0.71–0.80). Conclusion Ertapenem was cleared substantially in these in vitro CRRT models. However, our findings illustrate discordance between our observed SC and SA and the published unbound fraction of ertapenem. This finding has been reported with many other drugs, including carbapenem antibiotics. If in vivo studies corroborate our SA and SC findings, dosage adjustment for patients receiving CRRT will be required.
A novel model for external biliary drainage in rat orthotopic liver transplantation
Authors: Hang H.-L. , Qiu Y.-D. , Zhu X.-H. , Mao L. , Ding Y.-T. 
Published: January 2018

Objective The objective of this study was to establish a stable model of orthotopic liver transplantation with external biliary drainage in rats, to provide the possibility for dynamic detection of bile characteristics after transplantation. Methods Ninety-eight Sprague Dawley rats were divided randomly into a control group (n = 30) and an external drainage group (n = 68). Biliary extra-drainage group rats were established as follows: an epidural catheter was implanted into the common bile duct and an appropriate hose was connected from the outside. A stoma was made into the high jejunum, and a hose was implanted. Then the 2 hoses were induced to connect with each other in the subcutis of the right lateral abdominal wall. Results The operative success rate and 1-week and 2-week survival rates of the extra-drainage group were 94.1% (64/68), 88.2% (60/68), and 79.4% (54/68), respectively. Meanwhile, in the control group, the operative success rate and 1-week and 2-week survival rates were 93.3% (28/30), 90% (27/30), and 83.3% (25/30), respectively. There were no significant differences at any time between the 2 groups (p > 0.05). Conclusions The biliary extra-drainage model in rat orthotopic liver transplantation provides a novel, simple, and reliable method for dynamic collection of bile. The operation success rate was satisfactory. This model was successful and could be applied in various experimental studies.
Ophthalmic Complications after Surgery for Nasal and Sinus Polyposis
Authors: Vassallo P. , Tranfa F. , Forte R. , D'Aponte A. , Strianese D. , Bonavolontà G. 
Published: January 2018

Purpose To describe ophthalmic complications after nasal and sinus surgery. Methods Four cases with orbital complications were retrospectively selected from among more than 2000 cases of orbital pathologies. Results Motility disturbances due to extraocular muscle injury occurred in two patients after intranasal ethmoidectomy and in one patient after a Caldwell-Luc procedure. In the fourth case an orbital apex syndrome was noted after intranasal ethmoidectomies. Conclusions Ophthalmic complications may occur after nasal and sinus surgery, even using an endoscopic procedure. Successful handling of these complications could be reached by on their early recognition and treatment.
Color Doppler Imaging Study in Patients with Primary Open-Angle Glaucoma Treated with Timolol 0.5% and Carteolol 2%
Authors: Montanari P. , Marangoni P. , Oldani A. , Ratiglia R. , Raiteri M. , Berardinelli L. 
Published: January 2018

Purpose To evaluate with color Doppler imaging (CDI), in patients with primary open-angle glaucoma (PDAG), the possible influence on ocular hemodynamics of a beta-blocking agent with intrinsic sympathomimetic acitivity (carteolol 2%) compared to a beta-blocker agent without this activity. Methods A study was carried out on 20 patients, with bilateral POaG, intraocular pressure (IOP) ≤ 20 mmHg, all treated twice a day with timolol maleate 0.5% ophthalmic solution. The visual field was evaluated (Octopus 2000 perimeter, G1 program) examining the mean sensitivity (MS) and the mean defect (MD). CDI was carried out to evaluate the resistance index of the internal carotid artery (ICA), the ophthalmic artery (OA), the central retinal artery (CRA), and the short posterior ciliary arteries (SPCA). After these examinations, the therapy was changed to carteolol 2% twice a day. After six months of treatment the examinations were repeated. The data were analysed statistically using Student's t test. Results The mean intraocular pressure during treatment with timolol 0.5% was 16.7 ± 1.67 mmHg and 16.33 ± 1.72 mmHg after treatment with carteolol 2%, the difference not being significant (p=0.494). After six months of treatment with carteolol 2% the MS increased significantly from 22.4 ± 2.5 dB to 24.1 ± 1.8 dB (p=0.018), and the mean defect (MD) fell from 5.3 ± 0.8 dB to 4.7 ± 0.6 dB (p=0.011). There was no significant difference in the resistance index of the CA, the OA and the CRA with the two treatments, whereas the resistance index of the SPCA dropped significantly, from 0.80 ± 0.05 to 0.77 ± 0.02 (p = 0.017). Conclusions CDI did not show significant differences in the resistance indexes of the internal CA, the OA, and the CRA after treatment with carteolol 2% but the resistance index of the SPCA was significantly reduced. Carteolol 2% induced significant changes in the perimetric indexes examined, with an increase in MS and a decrease in MD. These findings suggest that the intrinsic sympathomimetic activity of carteolol may reduce peripheral vascular resistance of the SCA, thus improving perfusion of the optic nerve head, with a protective effect on visual function.
Allopurinol has Immunomodulating Activity following Topical and Systemic Application in Experimental Autoimmune Uveitis
Authors: Grus F.H. , Augustin A.J. , Loeffler K. , Dick B. , Lutz J. , Pfeiffer N. 
Published: January 2018

Purpose Allopurinol has beneficial effects in the systemic treatment of lens-induced uveitis and experimental autoimmune uveitis (EAU). This is believed to be due to a reduction of oxidative tissue damage through its dose-dependent free radical scavenging ability, and to an immunomodulating effect. The purpose of this study was to demonstrate the immunological effects on the IgG-antibody repertoire in EAU after topical and systemic allopurinol and steroids. Methods We assigned 43 male Lewis rats to 6 different groups: healthy rats (BASE, n=3), EAU without therapy (CTRL, n=9); systemic treatment with allopurinol (ALSYS, n=9, 50 mg/kg body wt.i.v., given every three days for two weeks), topical allopurinol (ALLOC, n=6, 8 times/day), systemic methylprednisolone (STSYS, n=10, 7.5 mg/kg body wt. i.v. (Hoechst, Frankfurt, Germany)), and topical treatment with prednisolone acetate 1% (Inflanefran Forte®) (STLOC, n=6). Sera were tested against Western blots (WB) of SDS-PAGE (sodium-dodecyl-sulfate polyacrylamide-gelelectorphoresis) of retinal proteins. Based on digital image analysis, discriminance was analysed. Results The analysis of discriminance indicated that all therapy groups were significantly different from untreated controls (Wilks' lambda = 0.174; p<0.01). Comparing only the number of peaks and the intensities, the WB of allopurinol treated animals showed a much stronger, significant, immunomodulating effect than those treated with steroids (p>0.05), even after topical application (p<0.01). Conlcusions Allopurinol had an immunomodulating effect in EAU. Surprisingly, the topical application had more effect than systemically applied allopurinol. Allopurinol had stronger effects than systemic or topical steroids. Allopurinol appears to offer promise in the treatment of uveitis. Topical application of the drug helps to reduce possible complications such as the allopurinol hypersensitivity syndrome.