bluuebunny/crossref_metadata_2025_split huggingface dataset:
Did Circulating Tumor Cells Tell us all they Could? The Missed Circulating Tumor Cell Message in Breast Cancer
Authors: Fina Emanuela , Reduzzi Carolina , Motta Rosita , Di Cosimo Serena , Bianchi Giulia , Martinetti Antonia , Wechsler Janine , Cappelletti Vera , Daidone Maria G. 
Published: September 2015

Purpose To compare circulating tumor cell (CTC) detection rates in patients with early (M0) and metastatic (M+) breast cancer using 2 positive-selection methods or size-based unbiased enrichment. Methods Blood collected at baseline and at different times during treatment from M0 patients undergoing neoadjuvant therapy and from M+ women starting a new line of treatment was processed in parallel using AdnaTest EMT-1/ and EMT-2/Stem CellSelect/Detect kits or ScreenCell Cyto devices. CTC positivity was defined according to the suggested cutoffs and cytological parameters, respectively. Results Higher CTC detection rates were obtained with the AdnaTest approach when using for CTC-enrichment antibodies against ERBB2 and EGFR in addition to MUC1 and the classical epithelial surface marker EPCAM (13% vs. 48%). In M0 patients mainly, CTC positivity rates further increased when EMT- and stemness-related marker expression (PIK3CA, AKT2 and ALDH1) was evaluated in addition to EPCAM, MUC1 and ERBB2. When the physical properties of tumor cells were exploited, CTCs were detected at higher percentages than with positive-selection-based methods, without any difference between clinical stages (78% in M0 vs. 72% in M+ cases at baseline). Circulating tumor microemboli (CTMs) were detected in addition to single CTCs with significantly higher frequency in M0 than M+ samples (78% vs. 27%, p = 0.0002). Conclusions Different approaches for CTC detection probably identify distinct tumor cell subpopulations, but need technical standardization before their clinical validity and biological specificity may be adequately investigated. The distinct role of CTMs compared with CTCs as prognostic and predictive biomarkers represents a further challenge.
Simple Surgical Method for a Native Arteriovenous Fistula of Chronic Hemodialysis Patients and the Patency Rate
Authors: Tsuchida Kenji , Nagai Kojiro , Yokota Narushi , Okada Daigo , Muromiya Yasuhito , Suenaga Takehiro , Ueda Yuka , Kawahara Kana , Kanayama Hiro-omi , Minakuchi Jun 
Published: September 2015

Background/Aim The maintenance and control of vascular access in chronic hemodialysis patients are causing serious problems not only in the quality of life of patients but also in the medical economy. In this regard, we investigated the cumulative patency rate of native arteriovenous fistula (AVF) as a vascular access. Methods Simple surgical method for a native AVF is selected. The cumulative patency rate of AVF was compared for each parameter. More particularly, the patency rate in the AVF was investigated by primary disease, age at the time of operation, gender, condition, and site. Furthermore, the influence of factors, including primary disease, gender, age at the time of operation (1 year old), and dialysis period (1 year) on the patency rate, was investigated using Cox's proportional hazard model. Results The patency rate of AVF was 85.6, 75.0, 67.5, 52.2% for 12, 36, 60, 120 months, respectively. When the patency rate was investigated by factor, the rate was significantly higher in the males than females. When the influence of risk factors on the patency rate was investigated, the significant and independent risk factors in all the cases were ‘female’ sex. Conclusions The AVF is considered as the vascular access with the highest patency rate in the chronic hemodialysis patients. However, the factor influencing this rate is gender. In conclusion, female has a higher risk than male.
How to Monitor Vascular Access in Our Hospital
Authors: Ogawa Tomonari , Matsuda Akihiko , Kanayama Yuki , Sasaki Yusuke , Harada Etsuko , Tanabe Atsuko , Yasuda Kunihiko , Okada Yoshimi , Sano Tatsuro , Kiba Tota , Shimizu Taisuke , Tayama Yosuke , Hasegawa Hajime 
Published: September 2015

Background The number of dialysis patients in Japan has amounted to approximately 310,000. Most of the patients undergo hemodialysis. The reason why they can undergo hemodialysis is because maintaining and managing vascular access (VA) has improved. Recently, thanks to the progress of medical equipment, a variety of monitoring systems have been developed. It is important to make good use of these monitoring systems. Results In our hospital, we have been monitoring with an ultrasonic device and HD02. We measure blood flow of brachial artery with an ultrasonic device during nondialysis treatment. We examine real blood flow and blood recirculation with HD02 and evaluate the function of VA during dialysis. Conclusions In order to provide good dialysis care, good use of monitoring devices of VA is significant.
Practice of Peritoneal Dialysis Access Education using the New Hybrid Simulator in Japan
Authors: Fukasawa Mizuya 
Published: September 2015

Introduction To promote the increase in patients undergoing peritoneal dialysis (PD) in Japan, the Japanese Society for Dialysis Access started offering workshops on peritoneal access (PA) preparation procedures for doctors with less experience. Since the transfer of technology used in surgical procedures is difficult in small communities such as individual hospitals, a specialist group such as a society should take the initiative and fulfill this responsibility. Methods Here we used a hybrid simulator developed by Terumo Medical Pranex that uses the abdominal wall of an edible pig (a lump from the peritoneum to skin) and a mannequin. Since the structure of the porcine abdominal wall is similar to that of humans, the PA procedure can be simulated in this actual procedure. With three-dimensional reproduction of the Douglas pouch and other features of the pelvis using human computed tomography images, we created a system in which even drainage is possible if the catheter is well placed. Results Using this simulator, students were able to experience the PA access preparation procedure 2-4 times and easily observed the catheter position after insertion by peeling the abdominal wall from the mannequin. Conclusions In the future, by leveraging the advantages of the hybrid simulator, we aim to promote the training of medical staff interested in PD health care and increase the number of patients able to benefit from the many advantages of PD.
Practice and Education of the Vascular Access
Authors: Kukita Kazutaka 
Published: September 2015

Introduction The Japanese Society for Dialysis Access (JSDA) has held the practical skills trainings for the doctors working for the vascular access (VA) access since 2014 in order to improve both quality and quantity of the VA construction. Terumo Medical Pranex (Kanagawa, Japan) is the institution of the general medical training established for the creation and the spread of medical technique, and it also has the hybrid simulator of VA. Methods and results In the training institute in 2014, not only the practical skills but also the training on the simulator from the basic lecture of VA construction were conducted. The dummy of a radical artery and a cephalic vein is faked in the forearm on the simulator. Two carotid arteries of a pig are made as the position of a pair of artery and vein. The pig's skin taken from the neck to the chest is covered on the proceed part, then the dummy forearm was completed. We can make recognize the beats in the artery. We also can make a fake avf in the dummy forearm instead. The instructor is directly able to give the trainees the lectures while watching the scenes. jsda will continue to make such efforts from now. Conclusions We are concerned that the more the VA access would be demanded, the more the VA construction would be needed. So, the matter of the urgency is the training of the doctors working for VA construction.
Vascular Access Infection: Survival or Mortality
Authors: Hirotani Sachiko , Kai Kotaro , Iwatoh Kazuhiro , Sannomiya Akihito , Nakajima Ichiro , Fuchinoue Shohei 
Published: September 2015

Methods We conducted an analysis on 11 cases of death after AVG infection that occurred between 1996 and 2013, and compared their information with those of 23 cases of generalized infection due to arteriovenous graft (AVG) infection during the same period who survived. Results The cause of death was sepsis in all 11 patients. The initial C-reactive protein (CRP) was 10.2-39.8 (28 in average) and the duration from onset of fever to vascular access (VA) hemostasis/removal procedure was 6-9 days (6.4 days in average) in the 11 cases of death. Blood culture revealed a high frequency of methicillin-resistant staphylococcus aureus (MRSA) in 7 of the 11 cases of death. In contrast, in 23 survivors with VA infection and generalized infection, the CRP at the initial visit was 3.2-15.8 (5.6 in average) and the duration from onset of the fever to VA hemostasis/removal procedure was 0-5 days (2.6 days in average), and blood culture revealed a high frequency of methicillin-sensitive staphylococcus aureus (MSSA). Among the cases of death, although VA infection in the upper extremity itself resolved after removing the artificial vessel, they died without an improvement of sepsis. The reason why the sepsis did not resolve is that infectious foci were secondarily formed in other areas than the upper extremity because the start of treatment for VA infection was delayed. Conclusions Treatment for VA infection should be started as early as possible after onset to avoid the formation of secondary infectious foci in other areas.
Superficialization of Segmentally Matured Brachial Vein Complex as the Last Possible Native, Upper arm Vascular Access for Hemodialysis
Authors: Przywara Stanisław , Iłżecki Marek , Terlecki Piotr , Zubilewicz Tomasz 
Published: September 2015

Purpose We present a case report on superficialization of the segmentally matured brachial vein complex as the last possible native vascular access for hemodialysis in the upper arm. Methods A 57-year-old, female patient was hemodialysed for 14 years. Due to multiple failures of her previous forearm and upper arm vascular access for hemodialysis, the last attempt at the creation of upper arm native vascular access was planned in terms of the formation of a two-stage autogenous brachial-brachial arterio-venous fistula (ABBA). The second stage exposure of the brachial vein – 4 weeks after anastomosis with the brachial artery showed an unusual intraoperative situation. Segmental maturation of both brachial veins, connected by a bridging vein was encountered. Both the mature segments of the brachial veins, connected by the bridging vein were elevated/superficialized into a subcutaneous bed. Immature parts of brachial veins were left near their anatomical position. Results Superficialized venous conduit was easily accessible and provided adequate parameters of uncomplicated hemodialysis for 6 months. In month 7, thrombosis of the fistula caused by an embolus due to an atrial fibrillation episode required thrombo-embolectomy. The fistula is still in use 13 months after its creation. Conclusions Our technique is feasible in cases of unusual, segmental maturation of both brachial veins during two-stage ABBA formation. Selective superficialization of matured segments only may provide suitable access for hemodialysis. Vascular access surgeons should be aware of possible anatomical variations and be prepared to perform unusual access configurations as dictated by the local anatomy.
Evaluation of Percutaneous Transluminal Angioplasty Screening using Color Doppler Ultrasonography
Authors: Tabuchi Keiji , Kobayashi Toshio , Kumagai Junko , Takahashi Naoko 
Published: September 2015

Purpose Well-functioning vascular access is important in hemodialysis patients. The aim of this study was to assess stenosis using color Doppler ultrasonography as well as to investigate a possible association between the need for percutaneous transluminal angioplasty and hemodynamic parameters. Methods A prospective study of the medical records of color Doppler ultrasonography routine examinations of 372 patients was conducted at a dialysis satellite clinic in Japan. Data were analyzed using logistic regression analysis and the receiver operating characteristic curve. The cutoff point for hemodynamic parameters was determined to explore the predictors of percutaneous transluminal angioplasty. Results Logistic regression analysis showed that brachial artery flow volume, brachial artery resistance index and puncture point flow volume divided by the quantity of dialysis blood flow rate were independently associated with percutaneous transluminal angioplasty. Brachial artery resistance index over 0.61, brachial artery blood flow volume under 665 mL/min and puncture point flow volume divided by dialysis blood flow rates under 1.25 were predictive values of the need for percutaneous transluminal angioplasty. Conclusions These parameters could be used as markers for assessing percutaneous transluminal angioplasty risk in hemodialysis patients.
A Comparative Study on the Mechanical Behavior of Polyurethane PICCs
Authors: Poli Paolo , Scocca Antonella , Di Puccio Francesca , Gallone Giuseppe , Angelini Lorenza , Calabrò Emanuele Maria 
Published: September 2015

Purpose This study describes a comparative analysis of eight commercial polyurethane, single-lumen peripherally inserted central venous catheters (PICCs) from different vendors. The aim was to investigate the mechanical response of the catheters providing objective and quantitative data to support a comparison among them. Such data could help nurses and physicians to select a central venous catheter (CVC) not only on the basis of the expected dwell duration or of the assessment of the vessels at the desired insertion site but also of the chemical and mechanical properties of the CVC and of the projected response of the body to these properties. Methods An experimental procedure was defined and tests were performed to assess some main characteristics of the PICC lines, including macro and microgeometric features, chemical and physical properties, and mechanical response. Preliminary measurements were performed to accurately define all geometric characteristics, including length, inner and outer diameters, and any inherent initial curvature of the catheter. Micro-geometric features were investigated using surface roughness analysis, optical microscopy, and scanning electron microscopy. Mechanical properties were studied by means of dynamic mechanical thermal analysis, simple uniaxial tensile tests, and kinking tests. Results Results are discussed in order to compare the different PICC lines. In particular, they show that polyurethane catheters can have a different mechanical behavior, which might play a role in the onset of pathologic processes and result in an increased risk and incidence of catheter-related complications. Conclusions This study provides useful information that can help identifying and facilitate the choice of a PICC.
The Impact of Access Blood Flow Surveillance on Reduction of Thrombosis in Native Arteriovenous Fistula: A Randomized Clinical Trial
Authors: Aragoncillo Inés , Amézquita Yésika , Caldés Silvia , Abad Soraya , Vega Almudena , Cirugeda Antonio , Moratilla Cristina , Ibeas José , Roca-Tey Ramón , Fernández Cristina , Quiroga Borja , Blanco Ana , Villaverde Maite , Ruiz Caridad , Martín Belén , Ruiz Asunción M. , Ampuero Jara , López-Gómez Juan M. , de Alvaro Fernando 
Published: September 2015

Purpose The usefulness of access blood flow (QA) measurement is an ongoing controversy. Although all vascular access (VA) clinical guidelines recommend monitoring and surveillance protocols to prevent VA thrombosis, randomized clinical trials (RCTs) have failed to consistently show the benefits of QA-based surveillance protocols. We present a 3-year follow-up multicenter, prospective, open-label, controlled RCT, to evaluate the usefulness of QA measurement using Doppler ultrasound (DU) and ultrasound dilution method (UDM), in a prevalent hemodialysis population with native arteriovenous fistula (AVF). Methods Classical monitoring and surveillance methods are applied in all patients, the control group (n = 98) and the QA group (n = 98). Besides this, DU and UDM are performed in the QA group every three months. When QA is under 500 ml/min or there is a >25% decrease in QA the patient goes for fistulography, surgery or close clinical/surveillance observation. Thrombosis rate, assisted primary patency rate, primary patency rate and secondary patency rate are measured. Results After one-year follow-up we found a significant reduction in thrombosis rate (0.022 thrombosis/patient/year at risk in the QA group compared to 0.099 thrombosis/patient/year at risk in the control group [p = 0.030]). Assisted primary patency rate was significantly higher in the QA group than in control AVF (hazard ratio [HR] 0.23, 95% confidence interval [CI] 0.05-0.99; p = 0.030). In the QA group, the numbers unddergoing angioplasty and surgery were higher but with no significant difference in non-assisted primary patency rate (HR 1.41, 95% CI 0.72-2.84; p = 0.293). There was a non-significant improvement in secondary patency rate in the QA group (HR 0.510, 95% CI 0.17-1.50; p = 0.207). Conclusions The measurement of QA combining DU and UDM shows a reduction in thrombosis rate and an increased assisted primary patency rate in AVF after one-year follow-up. Trial registration ClinicalTrials.gov Identifier: NCT02111655.
Use of Biosynthetic Grafts (Omniflow II) for High Infection Risk Haemodialysis Vascular Access
Authors: Shakarchi Julien AI , McGrogan Damian , Yates Philip J. , Inston Nicholas 
Published: September 2015

Purpose Infective complications of patients requiring insertion of arteriovenous grafts for hemodialysis remain a challenge. In particular, patients who have exhausted autologous options and have had recent infective complications relating to alternative dialysis modalities such as peritonitis or central venous catheter-associated bacteremia can pose a significant dilemma. We present a series of challenging cases that represent examples of the use of biosynthetic grafts in patients with on-going infective risks. A review of available literature for the use of the Omniflow II graft in dialysis access is included. Methods Electronic databases were searched for studies assessing the use of the Omniflow II graft for dialysis in accordance with PRISMA published up to 31st March 2014. The primary outcomes for this study were 1-year primary and secondary patency rates. Secondary outcomes were rates of infection and aneurysmal degeneration. Results Three cases are described that were considered at high risk of infection and all successfully managed with the Omniflow II arteriovenous graft (AVG). None showed signs of infection and all grafts were patent at three months' follow-up. On review of the literature and following strict criteria, four studies were included with a total of 236 procedures. We found that the one-year primary patency rate for Omniflow II AVGs was 60.1% (53.6-66.5) with a secondary patency rate of 82.1% (76.7-86.9). Infection rates are reported at 0% to 5.7%, with aneurysmal rates ranging between 0% and 6.8%. Conclusions This small series reports on the successful use of the Omniflow II graft in patients with high risk of infection and, whilst limited in its size and scientific design, it does support the limited existing literature for the potential benefits of the biosynthetic approach where concerns regarding infective complications of synthetic material exist.
Surgical Techniques for Haemodialysis Access-Induced Distal Ischaemia
Authors: Al Shakarchi Julien , Stolba Jan , Houston J. Graeme , Inston Nicholas 
Published: September 2015

Purpose Haemodialysis access-induced distal ischaemia (HAIDI) is a significant complication of vascular access creation, and has traditionally been difficult to manage without loss of access. Current treatment options include ligation, banding, distal revascularisation with interval ligation (DRIL), proximalisation of the arterial inflow (PAI) and revision using distal flow (RUDI). The purpose of this review was to evaluate the effectiveness of the different surgical techniques in the treatment of HAIDI. Methods Electronic databases were searched for studies assessing surgical techniques in the treatment of HAIDI in accordance with PRISMA. The primary outcome for the study was symptomatic relief for each technique, defined within each study. Secondary outcomes included comparison of early thrombosis rates following each different procedure. Results Following strict inclusion/exclusion criteria by two reviewers, twenty-seven studies of surgical interventions were included and divided into subgroups for banding, DRIL, PAI and RUDI procedures. Both DRIL and banding procedures were found to have high rates of symptomatic relief. In addition, the DRIL has a significantly lower rate of early thrombosis than banding although the more recent papers seem to suggest that early thrombosis is less of a problem in banding. PAI and RUDI showed some promise but there were too few studies to be able to make any clear conclusions. Conclusions All four procedures have high success rate in relieving ischaemic symptoms with the DRIL procedure having a significantly better vascular access patency rate than other techniques, although further well designed studies are required to compare all four surgical techniques.
Assemblées de Smyrne et de Philadelphie et congrégation de Satan
Authors: Painchaud Louis 
Published: September 2015

Pendant près de deux millénaires, « faux-Judéens » et « synagogue de Satan » de Smyrne et de Philadelphie (Ap 2,9 ; 3,9) ont été considérés comme des « Juifs », membres des « synagogues » de ces villes, hostiles aux « chrétiens » qu’ils auraient même dénoncés auprès des autorités. Dans la deuxième moitié du xxe siècle, dans un contexte qui a suscité tout un courant de réflexion critique sur l’antisémitisme chrétien, plusieurs ont proposé de voir dans ces « Juifs » des factions hostiles à Jean au sein des assemblées auxquelles il s’adresse. L’hypothèse qui est proposée ici est de voir, dans ces Judéens accusés de blasphème et taxés d’être de faux Judéens ou des Judéens menteurs, des membres de l’ethnos Judéens souillés, aux yeux de Jean, un prophète judéen sectaire, par leur intégration dans le tissu associatif de la cité. Quant à la « congrégation de Satan » qu’ils formeraient, elle ne doit pas être entendue comme la désignation d’une communauté judéenne ayant une existence réelle dans la cité, mais comme une pure construction de Jean, prophète de Jésus le Vivant qui ne se savait pas encore chrétien, visant à démoniser non pas tous les Judéens de ces deux cités, mais certains Judéens infidèles aux commandements et, donc, à leur identité judéenne.
Les lecteurs impliqués d’Éphésiens 2,11-22 : ni citoyens d’Israël, ni citoyens de l’Empire romain, mais concitoyens des saints et membres de la maisonnée de Dieu
Authors: Hurley Robert 
Published: September 2015

Éphésiens 2 décrit l’offre de salut aux nations (les païens) comme ayant été rendue possible « par le sang de Christ » (2,13) et « par la croix du Christ » (2,16). La recherche actuelle tient pour acquis que le salut des nations dépend d’une troisième condition, à savoir leur incorporation dans la cité d’Israël. Une étude des lecteurs implicites et de l’auteur implicite de la lettre mène à une conclusion différente. Ce que Dieu accomplit dans le Christ a été ordonné avant la fondation du monde et a préséance sur toute revendication juive au privilège découlant des « alliances de la promesse ». Dans le Christ, Dieu abolit la Loi et fonde une nouvelle communauté de justice et de vérité. Les saints d’Éphèse y rejoignent les saints d’ailleurs dans le monde pour s’opposer à l’esprit à l’oeuvre dans l’Empire romain et aux fils de la désobéissance qui sont ses fidèles soutiens et alliés.