bluuebunny/crossref_metadata_2025_split huggingface dataset:
On-Line Monitoring of Solutes in Dialysate Using Absorption of Ultraviolet Radiation: Technique Description
Authors: Fridolin I. , Magnusson M. , Lindberg L.-G. 
Published: January 2018

Purpose The aim of this work was to describe a new optical method for monitoring solutes in a spent dialysate using absorption of UV radiation. Method The method utilises UV-absorbance determined in the spent dialysate using a spectrophotometrical set-up. Measurements were performed both on collected dialysate samples and on-line. During on-line monitoring, a spectrophotometer was connected to the fluid outlet of the dialysis machine, with all spent dialysate passing through a specially-designed cuvette for optical single-wavelength measurements. The concentrations of several substances of various molecular sizes, electrical charge, transport mechanism, etc. were determined in the dialysate and in the blood using standard laboratory techniques. The correlation coefficient between UV-absorbance of the spent dialysate and concentration of the substances in the spent dialysate and in the blood was calculated from data based on the collected samples. Results The obtained on-line UV-absorbance curve demonstrates the possibility to follow a single hemodialysis session continuously and to monitor deviations in the dialysator performance using UV-absorbance. The experimental results indicate a very good correlation between UV-absorbance and several small waste solutes removed such as urea, creatinine and uric acid in the spent dialysate and in the blood for every individual treatment at a fixed wavelength of 285 nm. Moreover, a good correlation between the UV-absorbance and substances like potassium, phosphate and β2-microglobulin was obtained. The lowest correlation was achieved for sodium, calcium, glucose, vitamin B12 and albumin. Conclusions A technique for on-line monitoring of solutes in the spent dialysate utilising the UV-absorbance was developed. On-line monitoring during a single hemodialysis session exploiting UV-absorbance represents a possibility to follow a single hemodialysis session continuously and monitor deviations in dialysis efficiency (e.g. changes in blood flow and clearance). The UV-absorbance correlates well to the concentration of several solutes known to accumulate in dialysis patients indicating that the technique can be used to estimate the removal of retained substances.
Biodegradable Polymer (D,L-Lactide-ε-Caprolactone) in Aortic Vascular Prosthesis: Morphological Evaluation in an Animal Model
Authors: Valente M. , Pettenazzo E. , Di Filippo L. , Laborde F. , Rinaldi S. , Thiene G. 
Published: January 2018

Biodegradable D,L-Lactide-ε-caprolactone copolymer was used in substitution to bovine collagen to seal porosity in nine Dacron vascular Sorin Carbografts®. One served as control and 8 were implanted in mini-pigs as vascular by-pass in the thoracic aorta. The grafts were explanted at 7 days (4 animals), 30 (2 animals) and at 90 days (2 animals), and submitted to gross examination, X-ray, histology and electron microscopy. Aim of the study was to assess the safety and the reliability of these polyester vascular prostheses impregnated with the copolymer in terms of containment of the bleeding in the perioperative period, host inflammatory response, copolymer biodegradation and prostheses “healing”. All the grafts were patent at angiographic and X-ray examination. At 7 days blood infiltration between Dacron and copolymer lining was detected. Inflammatory granulocyte infiltrates and granulomatous reaction with polymer degradation was observed at 30 days and fibrous tissue healing at 90 days. Luminal surface was covered by thin thrombi at 7 and by a neointima at 30 and 90 days. We conclude that D,L-Lactide-ε-caprolactone copolymer is effective in preventing perigraft bleeding, even though an early hematoma between Dacron and the copolymer coating occurs. Copolymer is degraded through a mild inflammatory reaction, with eventual evolution to fibrous healing.
Is Steam Sterilization Really Making Any Difference in Dialysis-Induced Cytokine Release?
Authors: Aucella F. , Tetta C. , Tessore V. , De Nitti C. , Vigilante M. , Gatta G. , Grandone E. , Margaglione M. , Colaizzo D. , Cappucci G. , Modoni S. , Stallone C. 
Published: January 2018

Ethylene oxide (ETO) is presently the most commonly used sterilization method for medical devices. Although alternative sterilization modes such as steam sterilization have been suggested, the effect of steam on dialysis-induced cytokine release is unknown. We enrolled 9 patients on chronic hemodialysis and evaluated at different intervals IL- 1βproduction while treated with ETO (NC1785–Bellco) and steam sterilized NC 1785S-Bellco) Synthetically Modified Cellulose (SMC). A basal test during treatment with NC 1785 was performed (A); the same test was set up 4 weeks after treatment with NC 1785S (B) and, lastly, 4 weeks after returning to NC 1785 (C). Peripheral blood mononuclear cells (PBMC) were purified before and after the dialysis session, were isolated on a Ficoll/Hypaque gradient and incubated for 24 h. Spontaneous IL-1β release was evaluated in the supernatant and in the lysate. In A, IL-1βlevels were (in pg/ml/106 cells, in supernatant and lysate, respectively): 5.8 ± 4.8 and 7.6 ± 5.2 in pre-HD and 4.68 ± 3.6 and 9.7 ± 6.65 in post-HD. These levels showed a clear reduction in B: 2.5 ± 2.2 and 4.4 ± 3.1 in pre-HD, and 4.35 ± 6.6 and 7.52 ± 7.22 in post-HD. In the C test, 4 weeks after the return to the ETO membrane, IL-1βlevels remained unchanged: 2.9 ± 1.8 and 4.5 ± 3.1 in pre-HD; and 2.6 ± 3 and 5.7 ± 6.6 in post-HD. Statistical analysis showed significant changes in the pre-HD levels both in supernatant (p < 0.04) and in lysate (p < 0.04). Steam sterilization of SMC induced a lower spontaneous IL-1β release, but this effect was not statistically significant due to the large inter-individual variation. Hence, contrary to claims of better biocompatibility, steam sterilization does not result in a reduced production of pro-inflammatory IL-1β.
Hemodialysis (HD) versus Peritoneal Dialysis (PD): Latent Overhydration in PD Patients?
Authors: Oe B. , De Fijter C.W.H. , Geers T.B.M. , Vos P.F. , De Vries P.M.J.M. 
Published: January 2018

Data on the difference in fluid status between hemodialysis (HD) and peritoneal dialysis (PD) patients are scarce. Bio-electrical impedance analysis (BIA) is able to detect total body water (TBW) and its distribution in intracellular (ICW) and extracellular water (ECW). Echographic determination of the diameter of the inferior caval vein (VCD) provides information about the intravascular space (IVS). Nineteen PD-patients and 20 HD-patients in stable clinical condition were studied. In HD-patients a significant decrease in VCD, mean arterial pressure (MAP), TBW and ECW was noted due to ultrafiltration. Both ratios of VCD to ICW/ECW and of VCD to ECW/TBW decreased. No significant differences were found in these variables between PD-patients and HD-patients before HD. In both patient groups the measured variables pointed towards overhydration and the increased ratios both of VCD to ICW/ECW and VCD to ECW/TBW towards the storage of surplus of fluid in the intravascular space. It can be concluded that both PD-patients and HD-patients before HD have a surplus of fluid in the extracellular compartment, predominantly stored in the intravascular space.
Epidemiology of End-Stage Renal Disease and Current Status of Hemodialysis in Yugoslavia
Authors: Djukanović L. , Radović M. , Baković J. , Budošan I. , Bukvić D. , Cvetičanin A. , Davinić S. , Dragoljić B. , Djordjević V. , Djurić S. , Haviža-Lilić B. , Ilić M. , Janoš B. , Jelačić R. , Jelić S. , Kostić N. , Mandić M. , Oštrić V. , Plješa S. , Radišić M. , Radojević M. , Rakić N. , Rangelov V. , Ratković M. , Stojanović M. , Stojanović R. , Tintor D. , Vasić V. 
Published: January 2018

Maintenance hemodialysis (HD) in Yugoslavia started in the sixties and followed the dialysis trends in the Western Europe. However, in the last decade the development of renal replacement therapy (RRT) slowed down. In this report the epidemiology of ESRD from 1997–1999 and the survey of the status of HD treatment in Yugoslavia in 1999 are presented. Epidemiological data are obtained by the annual center questionnaires (response rate: 92.6 −94.2%). The survey of HD status is based on a specific questionnaire and covered 2108 patients (65%). At the end of 1999 there were 56 RRT centers in Yugoslavia treating 3939 patients: 3232 (82%) patients by HD, 248 (6.3%) by peritoneal dialysis, and 459 (11.7%) living with transplanted kidney. In a three year period, incidence of ESRD ranged from 108–128 pmp, point prevalence from 435–463 pmp and mortality rate from 20.7–17.9. Numerous refugee patients were treated over the last 10 years. Main causes of ESRD were glomerulonephritis (30%); Balkan nephropathy represented 11% and diabetic nephropathy 7% of all primary renal diseases. Cardiovascular and cerebrovascular diseases were the most common causes of death of RRT patients. Most centers are overcrowded and HD machines are worn out. Mean Kt/V was 1.19±0.08, mean URR% 58.8±7.4. The shortage of drugs prevented adequate management: 83% of HD patients had hemoglobin level less than 100 g/L but only 10.3 −17.8% were treated with rHuEpo; 64.5% of patients had phosphate levels higher than 1.7 mmol/L but only 33.5% used phosphate binders; 47% of patients had hypertension despite the antihypertensive therapy. The prevalence of hepatitis B remained unchanged (about 14%) in HD population during the last three years, but the prevalence of anti-HCV positive patients decreased (31–23%). In conclusion, there is a well developed dialysis service in Yugoslavia but insufficient conditions for adequate treatment.
Fabricated HyalS Micropatterns and Surface Guidance of NCTC 2544 Continuous Cell Line: An in Vitro Study
Authors: Mattioli-Belmonte M. , Gabbanelli F. , Casoli T. , Delfino A. , Giantomassi F. , Biagini G. , Giavaresi G. , Torricelli P. , Fini M. 
Published: January 2018

Surface topography is important in establishing tissue organisation adjacent to implants, smooth surfaces generally being associated with fibrous encapsulation. By virtue of its large hydrated molecular volume and its capacity to form molecular matrix, hyaluronic acid can expand the interfibrillar collagen spaces to allow the movement of cells, although it can also hamper their locomotion. Low molecular-weight hyaluronan can also stimulate cell proliferation, especially at low concentrations. The aim of the present work was to evaluate in vitro the growth and migratory behaviour of NCTC 2544 keratinocytes cultured on different materials microstructured with hyaluronic acid or sulfated hyaluronic acid to assess the possibility of using these devices in the repair process of soft tissues. Ultrastructural morphological analyses, morphometric evaluations and detection of cytoskeletal elements were performed. Our observations provide evidence that micrometer-size parallel grooves of hyaluronic acid can influence cell growth behaviour since cells seeded onto the microstructured substrate arranged themselves according to a shape and an orientation that clearly reflected the chemotropism exerted on them by the two forms of acid. These data also highlight the importance of accurate microtexture fabrication. We intend to follow up these in vitro studies with in vivo experimental applications using PET and gelatin substrates structured with HyalS to evaluate wound healing responses, and to extend our investigations of the cytoskeletal modifications induced by different microstructures.
Advanced Technology for Extracorporeal Liver Support System Devices
Authors: Borra M. , Galavotti D. , Bellini C. , Fumi L. , Morsiani E. , Bellini G. 
Published: January 2018

Acute Liver Failure (ALF) still presents high mortality rates, and liver transplant is the only treatment with proven efficacy. However transplant is not always possible and systems for Extracorporeal Liver Support (ELS) are being developed which can treat patients with ALF, for whom a transplant is not available, or is delayed. They can also treat patients with chronic liver disease who develop ALF. There are two types of ELS: artificial systems (hemoperfusion, plasmaperfusion, therapeutic plasma exchange, continuous hemodialysis and high volume continuous hemofiltration) and bioartificial systems. These are based on a biological component (animal or human hepatocytes) inserted into a bioreactor, whose main function is to perform the metabolic activity and synthesis that the liver can no longer perform. The results obtained in clinical trials have so far shown that the best results in terms of compensating for lost metabolic function and detoxification are obtained inserting artificial components in the bioartificial circuit.
Analysis of Allogeneic versus Xenogeneic Auxiliary Organ Perfusion in Liver Failure Reveals Superior Efficacy of Human Livers
Authors: Pascher A. , Sauer I.M. , Neuhaus P. 
Published: January 2018

Purpose: To compare the efficacy of allogeneic and xenogeneic extracorporeal liver perfusion (ECLP). Methods: An Internet-based keyword search was performed in the established online databases. Univariate and multivariate analysis of variance (general linear method) were performed. Results: Data from 198 patients were included in the statistical analysis, 142 of whom were treated by ECLP using porcine livers. Baboon livers were used in 29 patients, human livers in 14, and other or mixed species in 13 patients. Pig liver perfusions resulted in a 20% long-term-survival whereas the use of human livers was significantly more successful (survival rate (SVR) 43%, p<0.05). Baboon livers also revealed superior success (41%; p<0.05). Twenty-three patients were treated after 1991, 12 surviving long-term (52%). The latter all belonged to a group of 14 patients who received combined treatment consisting of ECLP and LTx (SVR-86% in this subgroup). Conclusion: Allogeneic ECLP was accompanied by significantly improved outcome compared with discordant xenogeneic ECLP. The role of hyperacute rejection in acute liver failure with reduced complement levels remains controversial. Physiologic disparity between pig and man may be the even more decisive determinant of outcome.
Xenotransplantation for Liver Therapy Or: Can Porcine Hepatocytes Generate Physiological Functions Sufficient for a Human Patient in ALF?
Authors: Hammer C. 
Published: January 2018

Detailed knowledge about physiology, biochemistry and function is required before artificial liver devices using porcine hepatocytes may be used successfully. Improvement of cell culture conditions and tissue engineering may permit the generation of human hepatocytes as substitutes for grafts in a transplantation setting. The physiological functions of xenografts have to be compatible with those of the recipient. However, first observations indicate that most physiological interaction in widely divergent species combinations such as pig and man are considerably different. This may be crucial for the selection of a suitable organ, tissue or cell for a clinical set-up. These differences vary from organ to organ and cell to cell. Only very conservative molecules, like for example insulin or calcitonin function properly in both species, while others such as complement, albumin and erythropoietin do not fulfill their task properly or not at all.
Results from EuCliD® (European Clinical Dialysis Database): Impact of shifting treatment modality
Authors: Godino J.I. Merello , Rentero R. , Orlandini G. , Marcelli D. , Ronco C. 
Published: January 2018

Background: The use of biocompatible high-flux membranes is more efficient than low-flux membranes in controlling a number of hemodialysis-related diseases. The aim of this cooperative study was to evaluate the 6-month effect of a switch from low- to high-flux dialysers on patients treated in 39 Spanish dialysis centres. Methods: The clinical data used in this analysis were prospectively collected by the EuCliD® database, developed to monitor the quality of treatment delivered in a large network of European Dialysis Centres. Inclusion criteria for the study were the condition of end-stage renal disease (ESRD) on chronic hemodialysis and low-flux dialysis for at least six months before the switch to high-flux dialysis. Of 1,543 patients enrolled in the study between 2000 and 2001, 1,046 patients were considered for the analysis. 497 patients were excluded because they did not complete the follow-up. Outcome measures were the reduction of pre-dialysis beta-2 microglobulin, the improvement of anemia or reduction in rHu-EPO dose required to maintain best correction of anemia, reduction of inflammatory parameters (CRP), improvement in lipid profile (Total and HDL cholesterol, tryglycerides), maintenance of nutritional status. Albumin and “dry” (post-hemodialysis) body weight were both evaluated as nutritional indexes. Results: During the six months of high-flux hemodialysis, there was a significant increase in hemoglobin (from 11.55±1.41 to 11.88±1.43 g/L; p<0.001). Considering the temporarily untreated patients on a 0 U/week dose, erythropoietin remained stable (from 5,670±4,199 to 5,657±4,411 U/week). During the second part of the follow-up, the lipid profile significantly improved (Fig. 3). Total cholesterol and triglycerides decreased significantly (p<0.001), while HDL cholesterol increased (p=0.006). Calculated levels of LDL cholesterol also significantly decreased (p=0.001). Dry body weight remained stable (64.7±11.9 vs. 64.7±12.0 kg) as well as in albumin levels (3.93±0.43 vs. 3.94±0.43 g/dL) between the two modalities of treatment. The level of ß2-microglobulin significantly decreased during high-flux dialysis (33.5±14.4 vs. 26.3±8.6 mg/dL, p<0.001). Conclusion: All above mentioned results may have as a common denominator an improved blood purification from uremic toxins and a reduced level of chronic sub-clinical inflammation. All together, these results seem to confirm the superiority of high-flux dialysis in terms of clinical and physiological outcomes.
Protease Removal by Means of Antiproteases Immobilized on Supports as a Potential Tool for Hemodialysis or Extracorporeal Blood Circulation
Authors: Grano V. , Diano N. , Portaccio M. , De Santo N. , Di Martino S. , Rossi S. , De Santo L.S. , Salamino F. , Mattei A. , Mita D.G. 
Published: January 2018

This work studies protease concentration decrease in aqueous solutions in contact with a modified polyethersulphone graft membrane onto which antiproteases were immobilized. As a model of protease/antiprotease interaction, elastase and α1-antitrypsin were used. Experiments were carried out either under fixed amounts of immobilized antiproteases and variable protease concentration or under fixed protease concentration and variable amounts of immobilized antiproteases. In both cases, active protease concentrations decreased with increase in contact time with the membrane. Experimental conditions under which active elastase concentration becomes zero were also found. Occurrence of the same phenomenology has also been ascertained with protease solutions obtained from human blood neutrophils. The membrane activated with α1-antitrypsin showed differential inhibitory power on elastase and cathepsin G. This technology could open new perspectives in manufacturing new membranes to be used in hemodialysis and extracorporeal circulation when elastase is released.
A Hybrid Mock Circulatory System: Development and Testing of an Electro-hydraulic Impedance Simulator
Authors: Kozarski M. , Ferrari G. , Clemente F. , Górczyńska K. , De Lazzari C. , Darowski M. , Mimmo R. , Tosti G. , Guaragno M. 
Published: January 2018

Mock circulatory systems are used to test mechanical assist devices and for training and research purposes; when compared to numerical models, however, they are not flexible enough and rather expensive. The concept of merging numerical and physical models, resulting in a hybrid one, is applied here to represent the input impedance of the systemic arterial tree, by a conventional windkessel model built out of an electro-hydraulic (E-H) impedance simulator added to a hydraulic section. This model is inserted into an open loop circuit, completed by another hybrid model representing the ventricular function. The E-H impedance simulator is essentially an electrically controlled flow source (a gear pump). Referring to the windkessel model, it is used to simulate the peripheral resistance and the hydraulic compliance, creating the desired input impedance. The data reported describe the characterisation of the E-H impedance simulator and demonstrate its behaviour when it is connected to a hybrid ventricular model. Experiments were performed under different hemodynamic conditions, including the presence of a left ventricular assist device (LVAD).
Radial Bone Mineral Density in Hemodialysis Patients with Adynamic Bone Disease
Authors: Nakashima A. , Yorioka N. , Doi S. , Ueda C. , Usui K. , Shigemoto K. , Harada S. 
Published: January 2018

Adynamic bone disease (ABD) has attracted attention as the most frequent type of renal osteodystrophy, but there are few reports about the bone mineral density (BMD) in ABD patients. This study investigated the BMD in hemodialysis patients with ABD and with relatively normal bone turnover. We measured the BMD of the distal one-third of the radius by dual-energy X-ray adsorptiometry. In the ABD group (intact PTH<65pg/ml, intact osteocalcin<30ng/ml), there were 19 men and 17 women with a mean age of 56.4±12.0 years. In the relatively normal bone turnover group (intact PTH: 120-250pg/ml), there were 24 men and 16 women with a mean age of 57.1±14.7 years. Although there were no significant differences between the two groups with respect to age, gender, and duration of hemodialysis, a significant increase of the BMD and the calcium x phosphate product was observed in the ABD group (radial BMD: 0.648±0.137 g/cm2 versus 0.572±0.132 g/cm2, calcium x phosphate product: 57.53±14.92 mg2/dl2 versus 49.76±12.13 mg2/dl2). These findings suggest that an increase in radial BMD may not be a useful marker of the improvement in bone lesions in ABD patients.
Carboxyfluorescein Diacetate Succinimidyl Ester Facilitates Cell Tracing and Colocalization Studies in Bioartificial Organ Engineering
Authors: Mueller-Stahl K. , Kofidis T. , Akhyari P. , Wachsmann B. , Lenz A. , Boublik J. , Heine M. , Muehlfait V. , Haverich A. , Mertsching H. 
Published: January 2018

Background We demonstrate a method that includes colocalization studies to analyze cell suspensions after isolation and to characterize 3-dimensional grafts consisting of cells and matrix in vitro and in vivo. Materials and methods Neonatal rat cardiomyocytes were labelled by CFDA-SE after harvest. Cells in the isolated cell suspension, the embodied cells in the seeded scaffolds were characterized measuring features such as viability and distribution of the cell types. Results Selective cell count revealed high yields of viable cardiomyocytes. After seeding cells in collagen matrix, viability of the cells decreased gradually in the time process in vitro. Histology of implanted bioartificial myocardial tissue detected viable cardiomyocytes within the graft. Conclusion Using colocalization histology we could label and track cells within the bioartificial myocardial tissue graft in vitro and post implant and assess viability and distribution.