bluuebunny/crossref_metadata_2025_split huggingface dataset:
Present and Future Uses of Hemoperfusion with Sorbents
Authors: Winchester James F. , Gelfand Michael C. , Knepshield James H. , Schreiner George E. 
Published: July 2010

ABSTRACTInternational interest in the clinical uses of hemoperfusion has increasingly grown in the last ten years and, as a result, sorbent hemoperfusion has emerged as first‐line management in several areas. This center and many others have shown that there is a clear role for hemoperfusion in severe self‐poisoning. Plasma extraction ratios for most drugs are significantly higher for hemoperfusion over both resin (0.8) and activated charcoal (0.5; CHP) than for hemodialysis (0.27), under similar conditions of blood flow, plasma drug concentrations, etc. Using appropriate pharmacokinetic models in the analysis of plasma drug profiles, it has been shown that CHP can increase drug elimination rate constants and whole body clearance rates in experimentally intoxicated animals. Enhancement of drug elimination broadens the scope of sorbent hemoperfusion to other areas of application, such as the removal of anticancer drugs (e.g., methotrexate, adriamycin) after cancer chemotherapy.Evaluation of the role of hemoperfusion in hepatic encephalopathy or uremia is limited by the lack of knowledge regarding specific toxic molecules in these syndromes. Nevertheless, in the authors' series of ten patients with fulminant hepatic failure, four survived, in contradistinction to an 80–90% mortality for untreated patients, and virtually all awoke from deep coma. Accompanying reversal of coma, there were significant changes in plasma and cerebrospinal fluid amino acids and in cerebrospinal fluid cyclic AMP concentrations. This suggests that hemoperfusion over charcoal in hepatic encephalopathy may be a useful technique. In this series of uremic patients, although hemoperfusion with charcoal has been shown capable of adsorbing putative uremic toxins including middle molecules up to the present, hemoperfusion alone is only marginally superior to standard hemodialysis. Fouremia, it is likely that multiple specific sorbents will be required, and several compounds for urea and creatinine sorption are presently under investigation.
Renin, Growth Hormone and Insulin in Hemodialyzed Uremic Diabetics
Authors: Avram Morrell Michael 
Published: July 2010

ABSTRACTIn order to detect metabolic aberrations which could account for the poor therapeutic response of the diabetic to dialysis, a comparative study of nondiabetic and diabetic uremia patients treated with hemodialysis was undertaken. Plasma renin activity and levels of growth hormone, glucose and insulin were investigated.
Treatment of Metabolic Alkalosis with Peritoneal Dialysis in a Patient with Renal Failure
Authors: Vilbar R. M. , Ing T. S. , Shin K. D. , Gandhi V. C. , Viol G. W. , Chen W.‐T. , Geis W. P. , Hano J. E. 
Published: July 2010

AbstractPeritoneal dialysis using a chloride‐rich dialysate succeeded in correcting systemic metabolic alkalosis in a patient with renal failure. The present approach may have a place in the therapy of metabolic alkalosis.
Isolated Ultrafiltration in the Treatment of Dialysis Ascites
Authors: Shin Kee Dong , Ing Todd S. , Popli Subhash , Daugirdas John T. , Ghantous Wallid N. , Vilbar Remegio M. , Geis W. Peter , Hano Jessie E. 
Published: July 2010

ABSTRACTThree patients with dialysis ascites improved markedly after treatment with isolated ultrafiltrations. This simple, noninvasive technique should be applied first to patients with dialysis ascites before resorting to more drastic therapeutic measures.
Digoxin Removal from a Patient with Renal Failure by Hemoperfusion with Amberlite XAD‐4 Resin
Authors: Hoy Wendy , Gibson Thomas P. , Biddle Theodore 
Published: July 2010

ABSTRACTA digitoxic patient with severe renal failure underwent two hemoperfusion treatments with Amberlite XAD‐4 resin. Digoxin clearances calculated from plasma flow rates and plasma digoxin concentrations, as well as from the amount of digoxin eluted from the used columns, were superior to those previously described for peritoneal dialysis, hemodialy‐sis and charcoal hemoperfusion. There was a temporary improvement in the patient's life‐threatening digitoxic cardiac rhythm with the first hemoperfusion, and a permanent improvement after the second hemoperfusion. It is submitted that hemoperfusion with this resin may significantly lessen manifestations of digoxin poisoning and may hasten digoxin elimination in digitoxic patients with renal failure.
Long‐Term Clinical Assessment of Combined ACAC HemoperfusionUltrafiltration in Uremia
Authors: Chang Thomas Ming‐Swi , Chirito Edward , Barre Paul , Cole Craig , Lister Colin , Resurreccion Emma 
Published: July 2010

ABSTRACTACAC hemoperfusion was used in series with a small fluid removal system for a clinical trial in the treatment of uremia. A 22‐month trial included a pretest control period, test period and a post‐test control period. The most significant observations from this trial are: 1) the predialysis body weight of the patient could be maintained closer to the patient's dry weight; 2) there was a significant increase in hematocrit; and 3) there was insufficient removal of urea. With the development of an effective urea removal system, a more compact artificial kidney than any presently available will become feasible.
A Model Enzymic Extracorporeal Detoxification System
Authors: Sofer Samir S. , Wills Robert A. , Van Wie Bernard J. 
Published: July 2010

ABSTRACTPreliminary studies at the University of Oklahoma have incorporated the use of a continuous, seal‐less blood centrifuge as an extracorporeal detoxification unit to aid in the removal of foreign chemicals from the blood. Detoxification is performed by immobilized enzymes in conjunction with a cofactor (NADPH) bound to a water‐soluble macromolecule.A drug enters the device with the plasma and then passes across a semipermeable membrane which serves to retain the cofactor. At this point, a combination of the drug, the cofactor and the enzyme react to form the drug‐oxide. The oxide then passes back through the membrane into the blood and back into the body. Concurrently, the macroNADP+ is reduced by G‐6‐P and G‐6‐PD in the cofactor regeneration portion of the device.To facilitate detoxification, the centrifuge is employed to provide plasma rich in toxins, but void of potentially interfering blood components such as platelets and whole blood cells. These components tend to dilute the toxins or adhere to the interfacing membrane, decreasing the permeability of these toxins into the detoxification unit. It is felt that the centrifugedetoxification combination will provide a potentially efficient hepatic assist device.
A Detoxification Scheme for Liver Assist Utilizing Plasmapheresis, Bioincompatible Sorbents and Dialysis
Authors: Maini Roshan 
Published: July 2010

ABSTRACTThe rationale behind the design of a sorbent‐based detoxification system for use as a liver assist is presented. A membrane‐based plasmapheresis' system giving high plasma flows (>40 ml/min) with maximum transmission of albumin makes this concept feasible.
The Current Status of Home Total Parenteral Nutrition
Authors: Grundfest Sharon , Steiger Ezra , Sattler Laura , Washko Susan , Wateska Leon 
Published: July 2010

ABSTRACTThe history and current status of home total parenteral nutrition are reviewed. Patients without a functional intestinal tract are able to lead a relatively normal life, infusing their essential nutrients through a Silastic® central venous catheter while they sleep at night. The average catheter life is nine months. Suspected sepsis and obstruction of the catheter were the leading causes for catheter removal.
Performance of Baffled Bubble Blood Oxygenators
Authors: Ohshima Norio , Yoshido Fumitake 
Published: July 2010

ABSTRACTBubble blood oxygenators equipped with baffles of various types in the oxygenating column were studied. The rate of hemolysis, the volumetric coefficient for oxygen absorption into blood, and the fractional gas holdup were found to be affected mainly by the superficial gas velocity. When compared with the conventional bubble blood oxygenator without baffles, the bubble oxygenators equipped with various types of baffles (i.e., horizontal perforated baffles, radial vertical baffles, and a concentric hollow cylinder with and without horizontal perforated baffles) showed less hemolysis, larger gas holdup and higher values of the coefficient for oxygen absorption. Values of the heat transfer coefficient on the surface of the cylindrical baffle, which is useful as a built‐in heat exchanger, were several times greater than those for single‐phase heat transfer in conventional blood heat exchangers.
Artificial Organs: Thoughts & Progress:Orally Diluting Hemofiltration
Authors: Agishi Tetsuzo , Yamashita Norimase , Ozaku Yasuo , Era Kazuo , Ota Kazuo 
Published: July 2010

AbstractOrally diluting hemofiltration (ODHF), herein reported, is a new technique where the body fluid is purified by cooperative procedures of dilution‐supplementation with oral electrolyte solution and filtration using the RP‐6 dialyzer. One uremic patient was maintained for two months on a five‐hour, three‐times‐per‐week ODHF schedule, and another patient was maintained for four months on the same regimen with no supportive hemodialysis.
Semibiological Left Heart Assist: In Vitro Evaluation
Authors: Bodnar Endre , Ross Donald N. 
Published: July 2010

AbstractA semibiological left heart assist device has been designed and built at the Cardiothoracic Institute and National Heart Hospital, London, England. This device is a Dacron/polyurethane conduit between the left ventricle and aorta in which part of the conduit assumes the function of a pumping chamber. This segment is enclosed by two biological valves and has a side arm. A polyurethne balloon is inserted through this side arm, and is pumped in a synchronously counter‐pulsating manner. Upon completion, the balloon can be removed without tho‐racotomy and with the conduit left in situ. Under simulated physiologic pressure and rate conditions, the pumping device gives reasonably good performance.
Hemodynamic Studies in Long‐Term Peritoneal Dialysis Patients
Authors: Schurig Randolf , Gahl Gerhard M. , Becker Helmut , Schiller Renate , Kesel Michael , Paeprer Horst 
Published: July 2010

ABSTRACTA study was undertaken to evaluate the acute hemodynamic effects in ten patients from this clinic's long‐term peritoneal dialysis program. With a Swan‐Ganz catheter, the following parameters were measured in each patient during peritoneal dialysis: cardiac index, pulmonary artery pressure, right atrial pressure, inferior vena cava pressure, heart rate and arterial pressure.Mean predialysis cardiac index, stroke volume index and heart rate were normal. Predialysis pulmonary artery pressure and arterial pressure were slightly elevated. Mean weight loss during peritoneal dialysis was 1.6 kg. The most striking post‐dialysis changes were a significant 20% decrease of the cardiac index and a 17% decrease of the pulmonary artery pressure. Heart rate and arterial pressure remained constant due to a 25% increase of total peripheral resistance. After filling the abdomen with one, two and three liters of dialysate, intra‐abdomi‐nal pressure and inferior vena cava pressure increased up to 150 and loo%, respectively, whereas central hemodynamic parameters (pulmonary artery pressure, cardiac index, stroke volume index, heart rate and arterial pressure) were unchanged.
Preparation of Parietal Peritoneum for Measurements of In Vitro Permeability
Authors: Knapowsk Jan B. , Simon M. P. , Feder E. M. 
Published: July 2010

ABSTRACTAn experimental method for in vitro studies of permeability of parietal peritoneal membrane was developed in rats. Sodium and potassium fluxes across the peritoneum lining two different regions (the diaphragm and the anterior abdominal wall) were estimated and electrical resistance of the isolated membranes were determined. A significant reciprocal correlation was observed between the two indices. Quantitative differences between the two types of membranes were found, the diaphragmatic region being more permeable than the other. It is suggested that a monolayer of mesothelial cells covering the membranes is partially responsible for these differences. The parietal peritoneum was found to be less permeable than visceral peritoneum (mesentery) studied under identical conditions.
Acceleration of Peritoneal Mass Transport by Drugs and Hormones
Authors: Maher John F. 
Published: July 2010

ABSTRACTThe major restrictions to the transport of solute and solvent across the peritoneum are the limited peritoneal blood flow, area and permeability. Recent investigations have demonstrated that several vasoactive drugs influence transport parameters. Isoproterenol, nitroprusside, dipyridamole and dopamine exemplify drugs that dilate the splanchnic vasculature, thereby augmenting transport, whereas vasoconstriction induced by Q‐norepine‐phrine decreases clearances. The tissue prostaglandins affect peritoneal mass transport in accord with their known vasoactive effects, suggesting a role in modulating peritoneal blood flow. The gastrointestinal hormones vasodilate the splanchnic circulation. Exposure of the endothelial surface to glucagon markedly increases peritoneal mass transport, while secretin increases the ultrafiltration rate significantly. These preliminary studies suggest the possible future clinical use of drugs and hormones to augment the efficiency of peritoneal dialysis.
The Use of Hemoperfusion as an Adjunct to Hemodialysis
Authors: Trafford Anthony , Ireland Robin , Evans Rhianydd 
Published: July 2010

ABSTRACTStudies are reported on the use of short dialysis, sequential ultrafiltration/short dialysis and hemoperfusion in chronic renal failure. Short dialysis (<12 hourdweek) is a satisfactory regime with good patient acceptance, adequate small and middle molecule clearance and control of fluid and blood pressure. Sequential ultrafiltration in the first hour improves fluid removal and reduces the side effects of dialysis. The addition of hemoperfusion increases clearance of small and middle molecules and has little effect on the osmolality of the serum. Thus, it does not increase the side effects of dialysis. Preliminary results suggest that hemoperfusion may be useful in the treatment of chronic renal failure in combination with ultrafiltration and dialysis.
Experimental and Clinical Studies on the Effect of Intra‐Aortic Balloon Pumping for Cardiogenic Shock Following Acute Myocardial Infarction
Authors: Okada Masayoshi , Shiozawa Takuo , Iizuka Masashi , Okuno Kunio , Chen Chuan Chung , Matsuda Shozo , Yoneda Kozo , Yano Atsushi , Kawai Masaru , Asada Sakae 
Published: July 2010

ABSTRACTThe effect of intra‐aortic balloon pumping (IABP) on cardiogenic shock following acute myocardial infarction was studied experimentally and clinically. Effects of IABP on hemodynamic and electro‐cardiographic changes were studied with cardiogenic shock which was produced by multiple ligation of the coronary artery in dogs. Consequently, the hemodynamics as well as the ECG could be improved by diastolic augmentation and systolic unloading during IABP. But, these favorable effects of IABP were not seen in dogs whose infarcted area involved more than 50% of the free wall of the left ventricle. These facts were seen clinically in three autopsied cases.IABP was also attempted in dogs with complications such as ventricular septal defect (VSD) and mitral regurgitation (MR) following acute myocardial infarction, and significant improvement was obtained by IABP. No effects of IABP were seen in these series, however, when the value of the pulmonary‐to‐systemic flow ratio was over 4.5 in the VSD group and the mean left atrial pressure was more than 30 mmHg in the MR group.Clinically, IABP was employed in 16 patients with cardiogenic shock secondary to acute myocardial infarction. Six (37.5%) were weaned from IABP. It can be concluded that IABP is effective in improving hernodynamics as well as the ECG.
Artificial Organs: Thoughts & Progress:Determination of Cardiac Output of the Artificial Heart from the Drive Air Flow
Authors: Hanzelka P. , VaŠkå J. , Urbdáek P. , VaŠkå J. , Urbánek E. 
Published: July 2010

AbstractAn indication chamber, inserted between the right heart drive and the pump proper, was designed to provide continual measurement of the quantity of blood pumped by the pneumatic artificial heart. The flow is evaluated from the motion of a piston provided with a photoelectric transducer. The effect of compressibility of the drive gas on measurement accuracy is eliminated. The indication chamber provides for automatic replenishment of gas that escapes by diffusion and through minor leakage. During testing in an artificial circulation within the range of physiological conditions, measurement inaccuracies did not exceed 5%.
Bloodless Cardiac Surgery Utilizing a New Low‐Prime Oxygenator
Authors: Urzua Jorge , Irarrazaval Manuel , Moran Sergio , Maturana Gustavo , Valdks Francisco , Quiroga Martita , Allende Mario , Dubernet Juan 
Published: July 2010

ABSTRACTOne undred consecutive patients undergoing openheart surgery were subjected to a prospective protocol designed for reduction of homologous blood utilization. The main points of this protocol were careful surgical hemostasis, normovolemic hemodilution, and retransfusion of blood lost to the operating field. It included use of the new Bentley BOS‐10 Spiraflom oxygenator (Bentley Laboratories, Inc., Irvine, California, U.S.A.).The patients' ages ranged from 6 to 68 years and their weights from 18 to 84 kg. Fifty‐four patients were subjected to valvular surgery, 30 to coronary revascularization, 13 to congenital defects repair, and 3 to resection of atrial myxomas.All patients could be weaned from bypass without receiving any blood. Eighty patients completed their surgery, and 60 were discharged from the intensive care unit without receiving any homologous blood or its derivatives. Total blood usage for the series throughout the entire stay in hospital was 1.32 units/patient, which included six reoperations for excessive bleeding.This reduction in blood utilization was achieved without excessive hemodilution and did not produce significant complications.
Enzyme Reactors Consisting of Matrix‐Bound or Entrapped Red Cell Ghosts
Authors: Schmer G. 
Published: July 2010

ABSTRACTPotent enzyme reactor systems could be synthesized using red cell ghost membranes containing urease and coval‐ently binding these “semi‐artificial” cells to polydextran gels (Sephadex) or entrapping them in agarose gel. In vitro studies as well as in vivo studies in sheep indicate excellent physicochemical stability of the system. Limitations of the method include insufficient diffusion of certain substrates through the cell membrane, or a tight binding of the substrate to carrier proteins.
An Artificial Endocrine Pancreas Containing Cultured Islets of Langerhans
Authors: Sun Anthony , Parisius Wolf , Macmorine Hilda , Sefton Michael , Stone Robert 
Published: July 2010

ABSTRACTThis study was directed toward the development of an artificial endocrine pancreas. The device contains functioning Islets of Langerhans sequestered in a chamber equipped with an internal, looped semipermeable fiber which may be attached to a blood vessel. Our experiments showed that when the device was attached to diabetic monkeys by an arteriovenous shunt, the islets responded to increased levels of blood glucose by increased flow of insulin across the semipermeable barrier and that a normoglycemic state was attained. These findings are in agreement with those of others, and with our published data, but a major drawback to practical application of previously described devices is the necessity of preventing thrombi in the lumen of the fiber by a high dosage of circulating anticoagulants. We have addressed this problem and have developed a fiber which contains heparin covalently bonded to the lumen. The coating has been found to be irreversibly bound to the surface of the fiber. After attachment of the device, containing the modified fiber, to monkey blood vessels, function was maintained for as long as six days after which the anastomosis between the blood vessel and the fiber was found to have been occluded by a thrombus. The lumen remained patent. Further work is needed to resolve this problem but it would appear that the device has practical application in the treatment of the diabetic.
Cells Cultured on Artificial Capillaries and Their Use as a Liver Assist Device
Authors: Wolf Carl F.W. 
Published: July 2010

ABSTRACTMammalian cells in culture can be maintained and, in some cases, will proliferate to form tissue‐like masses on the exterior surfaces of artificial capillaries made of semi‐permeable membrane when nutrient medium is circulated within the capillaries. Published experience with the system in a variety of applications is reviewed with particular attention to the use of cells of liver origin to provide hepatic metabolic functions when the blood of a host animal replaces the nutrient medium and a symbiotic relationship is established between host and device through the semipermeable capillary walls. The rationale for liver assist in acute fulminant hepatic failure (FHF) and animal models for FHF are reviewed. Exploratory studies of bil‐irubin metabolism with congenitally jaundiced host rats are described which provide a quantitative measure of the capillary culture liver assist device's functional capacity and suggest that substantial increases in the metabolic capacity of the device are needed. Potential means to increase capacity are considered, especially the use of con vective mass transfer to supplement diffusion by inducing ultrafiltration through the capillary walls, and the application of relevant theoretical methods for the analysis of convective transfer in the capillary culture chamber is proposed.
Hybrid Artificial Organs: Are They Really Necessary?
Authors: Nosd Yukihiko , Malchesky Paul S. , Smith James W. 
Published: July 2010

ABSTRACTIn order to reproduce completely the function of an organ, past research has considered hybrid artificial organs as the only method to achieve this goal. Various attempts have been made to use cell components, whole cells, tissue, and organ sections in conjunction with artificial organ systems. However, utilization of biological preparations or tissues is not clinically practical today. In this paper disadvantages of using natural tissue preparations are outlined. Recent progress in membrane technology such as membrane plasmapheresis, particularly on‐line plasma treatment by multiple reactors, on‐line plasma treatment by cryogelation, or the use of a cascade membrane scheme for the selective removal of macromolecules, will provide the tools to treat and remove macromolecules which were once considered extremely difficult to treat. The historical development of membrane plasmapheresis is described, including potential applications of this type of artificial organ for practical clinical treatment of metabolic, toxic and immunologic disease states.
Extracorporeal Liver Perfusion in the Treatment of Acute Hepatic Failure
Authors: Tung L.C. 
Published: July 2010

ABSTRACTTwenty‐three extracorporeal liver perfusions have been performed for the treatment of hepatic coma in 13 patients. No improvement was found in four patients, improvement in nine. Six of these nine patients recovered full conciousness. All seven patients with pre‐existent liver disease died. Of six patients without pre‐existent liver disease, three were discharged and are still alive. At present, extracorporeal liver perfusion seems to be a promising treatment for hepatic coma. It should be undertaken at stage IV and at stage 111 with increasing prothrombin time. Pre‐existent liver disease should be excluded beforehand by laparoscopy.