bluuebunny/crossref_metadata_2025_split huggingface dataset:
Hemoperfusion Over Small Liver Pieces for Liver Support
Authors: Kimura K. , Gundermann K. J. , Lie T. S. 
Published: July 2010

ABSTRACTIn order to develop a liver support system using a device with a simple technique, hemoperfusion was performed with pig livers obtained freshly or preserved by freezing in the form of 5‐mm cubic pieces. In the fresh liver pieces, the amount of ATP increased significantly from 0.080 to 0.266 μmol/gm wet weight (P<0.025) 120 min after the start of perfusion. The concentration of ammonia in the perfusate with fresh liver pieces was remarkably lower than controls (P<0.001) even immediately after the first ammonia load. It remained unchanged afterward despite two additional loads. The frozen liver pieces removed 83% of the bilirubin load (P<0.001) during the perfusion. It is suggested that not only the fresh liver pieces but also the frozen liver pieces are effective for hepatic assist.
Alteration of Human Leukocyte Chernotaxis, Chemiluminescence, and HMP Shunt Activity Caused By Mechanical Trauma
Authors: Dewitz T.S. , McIntire L.V. , Martin R.R. 
Published: July 2010

ABSTRACTThe effect of graded shear stress exposure (0 to 800 dynes/cm2 at 35°C) on human leukocyte function was examined in vitro, using a concentric cylinder viscometer. Boyden Chamber chemotaxis was significantly reduced at stress levels above 150 dynes/cm2, and was over a factor of three lower after exposure to trauma levels of 450 dynes/cm2 Hexose monophosphate (HMP) shunt activity following particle ingestion was also significantly lower after exposure to shear stresses of 150 dynes/cm2 or more for ten minutes. PMN chemiluminescence was reduced following stress trauma of 450 dynes/cm2 using whole blood, and after 150 dynes/cm2 using leukocyte suspensions. All the functional alterations reported appear to be bulk shear stress effects and not due to surface interaction, as changing the surface‐to‐volume ratio in the viscometer by over a factor of three did not change the damage caused at a given stress level. These functional alterations caused by mechanical trauma may be important in hemodialysis, cardiopulmonary bypass, venovenous perfu‐sion, and in any blood‐contacting artificial organ. The stress levels required for damage are of the same order as those required for platelet functional alteration, and much lower than those required for erythrocyte hemolysis for the same exposure times.
Sorbent Membranes: Determination of Sorption Capacity and True Membrane Permeability
Authors: Ozdural Ahmet R. , Pişkin Erhan 
Published: July 2010

ABSTRACTSorbent membranes are designed to meet the requirements for extracorporeal treatment of body fluids. These membranes offer the possibility of combining hemodialysis and hemoperfusion in a single device. Transport of solutes with both sorption and dialysis occurs simultaneously in a sorbent membrane dialyzer. In an effort to determine the sorption capacity and true membrane permeability (by dialysis only) of sorbent membranes, in vitro data were obtained for creatinine. The individual effects of dialysis and sorption on the rate of removal of solutes and their dependence upon flow rate in a sorbent membrane dialyzer were determined from the data of solute vessel concentration vs time. Experiments were carried out with a continuous flow, flat‐plate dialyzer and Enka AG sorbent membranes have been selected for evaluation. It was found that sorption plays an important role in the creatinine removal. However, as the time increases, sorption becomes relatively less important and the creatinine removal becomes dominated by dialysis.
A Reciprocating, Single‐Needle Hemodialyzer with Bidirectional Flow of Sorbent Suspension
Authors: Barile Ronald G. , Wang Nien‐Hwa L. , Blake Donald E. , Belcastro Patrick F. , Gupta Shri , Regnier Fred E. , Thornhill Jerry A. , Kessler David P. , Ash Stephen R. 
Published: July 2010

ABSTRACTPrevious theoretical analysis has indicated that adequate mass transfer is possible in a dialyzer with reciprocating membrane motion provided that the dialysate concentration of uremic substances is kept low. Earlier models have utilized a collection of sorbents (charcoal, urease, and a cation exchanger) constrained next to the dialyzer membranes. We have designed a new dialyzer with a sorbent suspension having free access from a reservoir to the spaces between membrane packages. At a treatment rate of 150 ml/min/m2, the in vitro creatinine clearance is 75 ml/min/m2, which agrees within experimental accuracy with the theoretical prediction. The creatinine clearance, flow resistance, and compliance of the dialyzer are constant during four to six hours of testing. In vivo tests have been performed during urea and creatinine infusion in a normal dog and in a dog with 3/4 nephrectomy. The in vivo creatinine clearance agrees within 10% with the in vitro clearance. Sodium, potassium, calcium, and bicarbonate fluxes are acceptable for patients in renal failure. The new design allows a higher capacity for urea and creatinine, since larger amounts of sorbent may be used.
Coating Membranes for a Sorbent‐Based Artificial Liver: Adsorption Characteristics
Authors: de Koning Henk W. M. , Chamuleau Rob A. F. M. , Bantjes Adriaan 
Published: July 2010

ABSTRACTTechniques are described for the coating of sorbents to be used in an artificial liver support system based on mixed sor‐bent bed hemoperfusion. Activated charcoal has been coated with cellulose acetate (CA) by solvent evaporation. With Amberlite XAD‐4, the Wurster technique was used for coating with CA. XAD‐4 has also been coated with a synthetic poly‐electrolyte with anticoagulant activity by adsorption and fixation by gamma radiation‐induced crosslinking. Activated charcoal, XAD‐4, and a cation exchange resin, all in powdered form, were encapsulated in agarose gel beads. Adsorption characteristics onto the sorbents are described. The results are in agreement with a theoretical model presented. In general, adsorption onto XAD‐4 is limited by film diffusion. With activated charcoal, pore diffusion limitation is generally observed. Blood compatibility is improved by coating.
Arterial Pressure: Its Role in Perfusion and as a Criterion of Extracorporeal Circulation Adequacy
Authors: Osipov Valentin P. , Khodas M. J. , Dementjeva I. I. , Pjatnitskaja G. Kh. 
Published: July 2010

ABSTRACTThirty‐five patients undergoing open‐heart surgery are reported. Cardiac index, mean arterial pressure, oxygen consumption, lactate, pyruvate, and lactate excess in the blood were measured. An inverse correlation of arterial pressure with oxygen consumption and lactate excess was found during perfusion. Comparison of those parameters with hemodynamic and metabolic data before perfusion demonstrated that, even prior to extracorporeal circulation, lactate and lactate/pyruvate ratio affect cardiac index. These parameters determined the level of “hypoxic” lactate concentration as well as arterial pressure during perfusion.These data appear to suggest that during perfusion the severity of metabolic disturbances determines the level of arterial pressure rather than vice versa. Arterial pressure and oxygen consumption, thus, cannot be applied as general criteria of the adequacy of extracorporeal circulation.
A Method for Temporary Complete Substitution of Gas Exchange Function of the Lung
Authors: Osipov Valentin P. , Efuny Sergei , Lurie Gennady , Knjazeva Galina , Saveljev Sergei , Jushkov Mark , Mosolova Larisa 
Published: July 2010

ABSTRACTTotal substitution of lung gas exchange function can be achieved by oxygenating all blood in a heart‐lung machine and requires thoracotomy. In accordance with calculations based on physical principles, if extracorporeal oxygenation is combined with barometric pressure raised to 3 atm, half of the cardiac output will suffice to maintain normal blood oxygenation. Excessive amounts of oxygen dissolved in blood passed through an oxygenator will suffice for the total oxygenation of the rest of the blood.This assumption was investigated in 15 experiments on dogs and one human patient in a hyperbaric chamber. The bubble oxygenator and pneumatic membrane pumps were used. The results suggest that this method of total substitution of lung gas exchange function is feasible. This technique does not require thoracotomy and can be carried out on a patient in any position on the operating table. This method can be used during bronchoscopy treatment, lung lavage, and trachea surgery.
Severe Reactions to Cuprophan Capillary Dialyzers
Authors: Popli Subhash , Ing Todd S. , Daugirdas John T. , Kheirbek Ali O. , Viol Geoffrey W. , Vilbar Remegio M. , Gandhi Vasant C. 
Published: July 2010

ABSTRACTFive severe reactions occurred in four maintenance hemodialysis patients 1 to 5 minutes after initiating dialysis with Cuprophan capillary dialyzers. All reactions were life‐threatening and one resulted in death. Inadequate rinsing of the dialyzers was probably the cause of the reactions. The severe reactions were managed by immediate discontinuation of dialysis and the institution of supportive treatment. Antianaphylactic measures were also attempted, but their therapeutic effectiveness remains to be determined.
Storage of Silicone Particles in Macrophages: An Iatrogenic Complication in Dialysis Patients
Authors: Bommer J. , Ritz E. , Waldherr R. , Gastner M. , von Sonntag C. 
Published: July 2010

ABSTRACTForeign body substances consisting of silicone particles released from tubing during exposure to roller pumps were demonstrated in the viscera of several dialysis patients at autopsy and in vivo. The material was identified by light microscopy, transmission electron microscopy, and scanning electron microscopy with electron beam microanalysis. Potential clinical consequences include hepatosplenomegaly, non‐A, non‐B hepatitis, and hypersplenism. Potential immunological and cardiogenic hazards cannot be currently assessed.
Mechanical White Blood Cell Damage in Rotary Blood Pumps
Authors: Takami Yoshiyuki , Yamane Shingo , Makinouchi Kenzo , Glueck Julie , Nosé Yukihiko 
Published: July 2010

Abstract: Mechanical trauma of white blood cells (WBC) due to the operation of a rotary blood pump was examined, using a simple method of trypan blue dye exclusion test for a cell viability measurement. The degree of WBC trauma was investigated using a roller pump (RP) and 3 commercially available centrifugal pumps (Bio‐Medicus [BP], Capiox [CP], Nikkiso [NK]), and compared with the red blood cell (RBC) trauma. Each pump was operated 3 times at a flow rate of 5 L/min against the total pressure head of 350 mm Hg for 6 h in a mock circuit with 400 ml of fresh bovine blood. Blood was sampled at 2 h intervals measuring plasma free hemoglobin concentration and the percentage of damaged WBC in the trypan blue dye exclusion test. Each pump demonstrated a linear increase in the degree of WBC trauma, and there were differences among the tested pumps (RP > BP > CP > NK). These findings were similar to those of the free hemoglobin measurements. To compare the degree of RBC and WBC trauma, the probability (γ,ω) of RBC and WBC to be damaged was calculated, respectively.γ = δ DRBC
δAN, ω=δDWBCδANwhere DRBC and DWBC are the ratios of the damaged RBC and WBC, respectively, and N is the passing number defined as Qt/V (Q, flow rate; t, time; V, circulating volume). The data of this study demonstrated that the ω value was approximately 20 times or more greater than the γ equally in all the tested pumps. This suggests that a WBC is more vulnerable to mechanical damage by a rotary blood pump than a RBC.
Local Glycoprotein IIb/IIIa Receptor Inhibitor Delivery From the Pump Surface Attenuates Platelet Adhesion in Continuous Flow Ventricular Assist Devices
Authors: Linneweber Joerg , Dohmen Pascal M. , Kertzscher Ullrich , Affeld Klaus , Konertz Wolfgang 
Published: July 2010

AbstractShear‐induced platelet activation (SIPA) has been identified to induce platelet adhesion and thrombus formation in continuous flow left ventricular assist devices (LVAD). Platelet glycoprotein (GP) IIb/IIIa receptor inhibitors are effective to prevent SIPA. However, systemic GP IIb/IIIa receptor inhibitor application is associated with severe bleeding complications. The aim of the study was to evaluate (i) the feasibility of absorption and elution of the GP IIb/IIIa receptor blocker TAK‐029 from the Ti6Al4V surface of the pump; and (ii) the effect of local GP IIb/IIIa receptor blocker delivery regarding platelet adhesion on the surface of a continuous flow VAD model.Saturating concentrations of TAK‐029 were adsorbed on the surface of a centrifugal pump. Whole human blood was perfused in circulatory mock loops using untreated (control), albumin‐coated, or TAK‐029‐coated pumps. Peripheral resistance of the circulatory systems were adjusted accordingly to generate 5 L flow per min with impeller rotational speeds of 3500 (high‐shear group) and 1500 rpm (low‐shear group), respectively. Platelet adhesions on the respective impellers were quantified by ELISA and scanning electron microscopy (SEM). TAK‐029 elution and half‐life time were determined by ELISA.Compared with control, albumin‐coated pumps showed 64 and 20% less platelet adhesions in the high‐ and low‐shear group, respectively. TAK‐029 coated pumps reduced platelet adhesion by additional 33 and 65%, respectively, compared with the albumin group. Elution of TAK 029 was initially very rapid and continued slowly.The results show that it is possible to adsorb and elute a small molecular weight GP IIb/IIIa receptor blocker from the pump surface. This drug elution reduced platelet adhesion on the pump significantly. Further studies are necessary to find a suitable drug bonding that will prolong the antiplatelet effect and preclude any bleeding complication caused by this procedure.
Applied Neuromonitoring and Improving Central Nervous System Outcomes
Authors: Murkin John M. 
Published: July 2010

AbstractThis article will review the pathogenesis of perioperative neurological injury in patients undergoing coronary revascularization. The high percentage of such patients with diabetes or concomitant cerebrovascular disease renders this population particularly susceptible to injury as a consequence of both hypoperfusion and atheroemboli. The role of transesophageal echocardiography for assessment of ascending aortic atherosclerosis and the use of noninvasive cerebral oximetry to detect cerebral hypoperfusion are discussed with respect to their impact on patient outcomes.
Reducing Emboli in Cardiac Surgery: Does It Make a Difference?
Authors: Slaughter Mark S. , Sobieski Michael A. , Tatooles Antone J. , Pappas Patrokolos S. 
Published: July 2010

AbstractParticulate embolization remains a serious complication of cardiac surgery. Adverse events associated with particulate embolization affect patient morbidity and long‐term survival, and increase the length of hospital stay and the cost of health care. Today, atherosclerosis plays a role in at least two‐thirds of all adverse events after coronary artery revascularization, and postoperative stroke is the second most common cause of operative mortality. Because many lower‐risk patients now undergo interventional revascularization, higher‐risk patients are now typically referred for surgical revascularization. These patients are older and sicker, and have multiple comorbidities, making them more susceptible to adverse events. For these high‐risk patients, surgeons should be proactive in attempting to reduce the possibility of emboli. Patients must be carefully assessed before surgery to determine their risk, and if the risk is high, surgeons should consider using newer, innovative devices, and techniques in their operative strategy that have proven to be effective in mitigating some of the potential embolic adverse events. A multifaceted, preventive strategy can make a difference, not only in reducing particulate emboli, but also in reducing morbidity and in lowering the economic burden on the health‐care system. This brief review will address three areas of focus that are important for the prevention of particulate embolization: (i) prevalence and morbidity of atherosclerotic disease; (ii) risk factors for adverse neurologic events; and (iii) prevention/mitigation of adverse events for patients undergoing cardiac surgery.
Role of Microglia in Ethanol’s Apoptotic Action on Hypothalamic Neuronal Cells in Primary Cultures
Authors: Boyadjieva Nadka I. , Sarkar Dipak K. 
Published: July 2010

Background:  Microglia are the major inflammatory cells in the central nervous system and play a role in brain injuries as well as brain diseases. In this study, we determined the role of microglia in ethanol’s apoptotic action on neuronal cells obtained from the mediobasal hypothalamus and maintained in primary cultures. We also tested the effect of cAMP, a signaling molecule critically involved in hypothalamic neuronal survival, on microglia‐mediated ethanol’s neurotoxic action.Methods:  Ethanol’s neurotoxic action was determined on enriched fetal mediobasal hypothalamic neuronal cells with or without microglia cells or ethanol‐activated microglia‐conditioned media. Ethanol’s apoptotic action was determined using nucleosome assay. Microglia activation was determined using OX6 histochemistry and by measuring inflammatory cytokines secretion from microglia in cultures using enzyme‐linked immunosorbent assay (ELISA). An immunoneutralization study was conducted to identify the role of a cytokine involved in ethanol’s apoptotic action.Results:  We show here that ethanol at a dose range of 50 and 100 mM induces neuronal death by an apoptotic process. Ethanol’s ability to induce an apoptotic death of neurons is increased by the presence of ethanol‐activated microglia‐conditioned media. In the presence of ethanol, microglia showed elevated secretion of various inflammatory cytokines, of which TNF‐α shows significant apoptotic action on mediobasal hypothalamic neuronal cells. Ethanol’s neurotoxic action was completely prevented by cAMP. The cell‐signaling molecule also prevented ethanol‐activated microglial production of TNF‐α. Immunoneutralization of TNF‐α prevented the microglia‐derived media’s ability to induce neuronal death.Conclusions:  These results suggest that ethanol’s apoptotic action on hypothalamic neuronal cells might be mediated via microglia, possibly via increased production of TNF‐α. Furthermore, cAMP reduces TNF‐α production from microglia to prevent ethanol’s neurotoxic action.
Efficacy and Safety of Baclofen for Alcohol Dependence: A Randomized, Double‐Blind, Placebo‐Controlled Trial
Authors: Garbutt James C. , Kampov‐Polevoy Alexei B. , Gallop Robert , Kalka‐Juhl Linda , Flannery Barbara A. 
Published: July 2010

Background:  Recent clinical trials and case‐reports indicate that baclofen, a GABAB agonist, may have efficacy for alcohol dependence. Baclofen has been shown to enhance abstinence, to reduce drinking quantity, to reduce craving, and to reduce anxiety in alcohol‐dependent individuals in 2 placebo‐controlled trials in Italy. However, the clinical trial data with baclofen is limited. The purpose of the present study was to test the efficacy and tolerability of baclofen in alcohol dependence in the United States.Methods:  The study was a double‐blind, placebo‐controlled, randomized study comparing 30 mg/d of baclofen to placebo over 12 weeks of treatment and utilizing 8 sessions of BRENDA, a low‐intensity psychosocial intervention. One hundred and twenty‐one subjects were screened to yield 80 randomized subjects (44 men) with randomization balanced for gender. Percent heavy drinking days was the primary outcome measure with other drinking outcomes, anxiety levels, and craving as secondary outcomes. Tolerability was examined.Results:  Seventy‐six percent of subjects completed the study. No difference by drug condition was seen in percentage of heavy drinking days where on‐average rates were 25.5% (±23.6%) for placebo and 25.9% (±23.2%) for baclofen during treatment (t73 = 0.59, p = 0.56). Similarly, no differences were seen by drug condition in percentage of days abstinent, time to first drink, or time to relapse to heavy drinking. Baclofen was associated with a significant reduction in state anxiety (F1,73 = 5.39, p = 0.02). Baclofen was well tolerated with only 2 individuals stopping baclofen because of adverse events. There were no serious adverse events.Conclusions:  Baclofen, a GABAB agonist, represents a possible new pharmacotherapeutic approach to alcohol dependence. Despite encouraging preclinical data and prior positive clinical trials with baclofen in Italy, the current trial did not find evidence that baclofen is superior to placebo in the treatment of alcohol dependence. Additional clinical trial work is necessary to establish whether baclofen does or does not have therapeutic efficacy in alcohol dependence and, if it does, what factors are predictive of response.
Disability Associated With Alcohol Abuse and Dependence
Authors: Samokhvalov Andriy V. , Popova Svetlana , Room Robin , Ramonas Milita , Rehm Jürgen 
Published: July 2010

Background:  Alcohol use disorders (AUD), i.e., alcohol dependence and abuse, are major contributors to burden of disease. A large part of this burden is because of disability. However, there is still controversy about the best disability weighting for AUD. The objective of this study was to provide an overview of alcohol‐related disabilities.Methods:  Systematic literature review and expert interviews.Results:  There is heterogeneity in experts’ descriptions of disabilities related to AUD. The major core attributes of disability related to AUD are changes of emotional state, social relationships, memory and thinking. The most important supplementary attributes are anxiety, impairments of speech and hearing.Conclusions:  This review identified the main patterns of disability associated with AUD. However, there was considerable variability, and data on less prominent patterns were fragmented. Further and systematic research is required for increasing the knowledge on disability related to AUD and for application of interventions for reducing the associated burden.
Fetal Alcohol Exposure Increases Mammary Tumor Susceptibility and Alters Tumor Phenotype in Rats
Authors: Polanco Tiffany A. , Crismale‐Gann Catina , Reuhl Kenneth R. , Sarkar Dipak K. , Cohick Wendie S. 
Published: July 2010

Background:  Altered fetal programming because of a suboptimal in utero environment has been shown to increase susceptibility to many diseases later in life. This study examined the effect of alcohol exposure in utero on N‐nitroso‐N‐methylurea (NMU)‐induced mammary cancer risk during adulthood.Methods:  Study 1: Pregnant Sprague Dawley rats were fed a liquid diet containing 6.7% ethanol (alcohol‐fed), an isocaloric liquid diet (pair‐fed), or rat chow ad libitum (ad lib‐fed) from day 11 to 21 of gestation. At birth, female pups were cross‐fostered to ad lib‐fed control dams. Adult offspring were given an I.P. injection of NMU at a dose of 50 mg/kg body weight. Mammary glands were palpated for tumors twice a week, and rats were euthanized at 23 weeks postinjection. Study 2: To investigate the role of estradiol (E2), animals were exposed to the same in utero treatments but were not given NMU. Serum was collected during the preovulatory phase of the estrous cycle.Results:  At 16 weeks postinjection, overall tumor multiplicity was greater in the offspring from the alcohol‐fed group compared to the control groups, indicating a decrease in tumor latency. At study termination, 70% of all animals possessed tumors. Alcohol‐exposed animals developed more malignant tumors and more estrogen receptor‐α–negative tumors relative to the control groups. In addition, IGF‐binding protein‐5 (IGFBP‐5) mRNA and protein were decreased in tumors of alcohol‐exposed animals. Study 2 showed that alcohol‐fed animals had significantly increased circulating E2 when compared to either control group.Conclusions:  These data indicate that alcohol exposure in utero increases susceptibility to mammary tumorigenesis in adulthood and suggest that alterations in the IGF and E2 systems may play a role in the underlying mechanism.