bluuebunny/crossref_metadata_2025_split huggingface dataset:
APPROACHES TO QUOTIDIAN DIALYSIS: The Gambro System for Home Daily Dialysis
Authors: Ledebo Ingrid , Fredin Richard 
Published: March 2004

ABSTRACTSafety and reliability have been the main emphasis when developing our system for home daily dialysis. The AK 95 is part of a comprehensive system of appropriate products consisting additionally of a silent water treatment module, an ultrafilter, and a range of dry disposables for dialysis fluid preparation and disinfection. The dialyzer can be selected from a family of synthetic, biocompatible filters, both low and high flux. To complete the system, a modern data management tool for online or off‐line surveillance and multilingual training manuals in both conventional format as well as animated software are available.
APPROACHES TO QUOTIDIAN DIALYSIS: The Allient Dialysis System
Authors: Ash Stephen R. 
Published: March 2004

ABSTRACTThe Allient is a dialysis system that combines various technologies to allow dialysis to be performed at sites outside of dialysis units (intensive care unit [ICU] or home) with ease and safety. A sorbent column regenerates dialysate, removing toxins and providing ultrapure dialysate from only 6 liters of tap water. The use of the sorbent column eliminates the need for costly and complex water purification systems. The Pulsar Blood Movement System provides blood flow at constant negative or positive pressure through single‐lumen or dual‐lumen accesses, maximizing blood flow rate while eliminating bothersome pressure alarms. Ultrasonic flow monitors control the operation of the pump and ensure adequate blood flow during each dialysis treatment. A completely disposable blood tubing and dialysate circuit eliminates the need for sterilization of the machine. The Allient should make dialysis in the ICU or home setting much more practical, reducing training requirements and increasing safety.
APPROACHES TO QUOTIDIAN DIALYSIS: The NxStage System One
Authors: Clark William R. , Turk Joseph E. 
Published: March 2004

ABSTRACTGiven the results of recent randomized controlled trials as well as staffing and budget challenges that today face many institutions across North America, a novel therapeutic approach is likely necessary to enable improvements in clinical outcomes for renal failure patients. The NxStage System One was developed to address these challenges. The system is an innovative, flexible device that delivers hemodialysis, hemofiltration, and/or ultrafiltration therapies to patients with renal failure or fluid overload. The unique characteristics of this system include a highly automated system design with a drop‐in cartridge to facilitate training and simple operation; portable size and independence from dedicated infrastructure to minimize practical barriers to where therapy may be administered; use of high‐quality premixed treatment fluids to enable capture of the potential clinical benefits of fluid purity without the hassles of local water treatment; and wide operating ranges to allow clinician flexibility in patient therapy prescriptions. In both the chronic and acute care environments, the System One presents clinicians with a new platform for delivering patient therapy improvements within real‐world constraints.
American Society of Diagnostic and Interventional Nephrology: Modification of the Peritoneoscopic Technique of Peritoneal Dialysis Catheter Insertion: Experience of an Interventional Nephrology Program
Authors: Asif Arif , Tawakol Jan , Khan Tasnim , Vieira Cristovao F. , Byers Patricia , Gadalean Florin , Hogan Rene , Merrill Donna , Roth David 
Published: March 2004

ABSTRACTBowel perforation is a well‐recognized complication of peritoneal dialysis catheter insertion and is associated with increased morbidity and cost of medical care. In this article we describe our 2‐year experience (August 2001–October 2003) with a modified peritoneoscopic technique of peritoneal dialysis catheter insertion to minimize the incidence of bowel perforation. Seventy patients underwent 82 consecutive peritoneal dialysis catheter insertions using the innovative technique. The modified technique is very similar to the traditional peritoneoscopic procedure except for the following differences. To gain access to the peritoneal cavity, a Veress insufflation needle (Ethicon Endo‐Surgery Inc., Cincinnati, OH) is utilized instead of the trocar. In contrast to the sharp tip of the trocar, the Veress needle has a blunt, self‐retracting end. In addition, the Veress needle is only 14 gauge as opposed to the 2.2 mm diameter of the trocar. Upon introduction of the Veress needle into the abdominal cavity, two “pops” are discerned similar to the trocar. After introduction, 400–500 cc of air are infused and the needle is removed. The infusion of air creates a space between the peritoneal surface of the anterior abdominal wall and the bowel loops. At this point, the cannula with trocar is inserted into the space created. The rest of the steps of the procedure are the same as the traditional peritoneoscopic technique. Utilizing the innovative technique, all 82 catheter insertions were performed successfully without a single bowel perforation. No other complications except for catheter migration (n = 2) were noted. The extra cost of the needle ($35) should be viewed in the context of the costs associated with management of a bowel perforation. Large‐scale studies are needed to confirm the superiority of this innovative technique over the traditional peritoneoscopic insertion found in our case series. In the interim, however, the increased morbidity and cost associated with bowel perforation calls for logical measures to be taken to avoid this dreaded complication.
Induction of apoptosis in monocytes and lymphocytes by serum from patients with systemic lupus erythematosus − an additional mechanism to increased autoantigen load?
Authors: BENGTSSON A A , STURFELT G , GULLSTRAND B , TRUEDSSON L 
Published: March 2004

SUMMARYThe most likely source of autoantigens in systemic lupus erythematosus (SLE) is apoptotic material. Because increased levels of circulating apoptotic cells are found in SLE we wanted to investigate the capacity of serum from patients with SLE or other autoimmune or infectious diseases and normal healthy donors (NHD) to induce apoptosis in normal monocytes, lymphocytes and corresponding cell lines, in relation to clinical and immunological data. Monocytes and lymphocytes from healthy donors were incubated with sera from 37 SLE patients, 37 sex- and age-matched NHD and sera from patients with rheumatoid arthritis, vasculitis, sepsis and mononucleosis. Sera from SLE patients were sampled at both active and inactive disease. The apoptosis-inducing effect (AIE) of these sera was monitored with flow cytometry using annexin V and propidium iodide (PI) binding. The AIE in monocytes and lymphocytes was significantly higher in sera from SLE patients than in other patient groups and NHD (P &lt; 0·001) and was also higher when cell lines were used. Level of C5a in cell culture supernatant correlated with AIE in monocytes (r = 0·451, P = 0·005), suggesting involvement of complement. Heat-inactivation of sera did not affect the AIE, nor did depletion of IgG by protein G absorption of serum. Kinetic analyses showed a peak in apoptosis induction at 12–16 h, with a delayed PI positivity. AIE was equally high using sera from active and inactive SLE cases, and did not correlate with the SLE Disease Activity Index (SLEDAI). Thus, SLE serum has a strong and apparently disease-specific apoptosis-inducing capacity, which could contribute to a high load of potential autoantigen.
Longitudinal Changes of Solute Transport in Peritonitis‐free Peritoneal Dialysis Patients
Authors: Hung Shih‐Yuan , Hung Yao‐Min , Chiou Yee‐Hsuan , Chou Kang‐Ju , Chung Hsiao‐Min 
Published: March 2004

Abstract:  Background:  The aim of this study was to evaluate the longitudinal changes in peritoneal transport in patients on long‐term, peritonitis‐free, continuous ambulatory peritoneal dialysis (CAPD) therapy.Methods:  Results were longitudinally recorded for the standard peritoneal equilibration test (PET) in 76 consecutive, nondiabetic, adult patients from the beginning of CAPD therapy until their first episodes of peritonitis, abdominal surgery, or any cause of drop out. The PET results were evaluated once annually using the dialysate‐to‐plasma  ratio  of  creati‐nine (D/PCr) and the dialysate‐to‐instilled dextrose ratio (D4/D0) at 4 hours after beginning dialysis.Results:  A total of 168 PET results were obtained. A statistically significant tendency toward decreased D/PCr and increased D4/D0 values over time for up to 3 years was found.Conclusions:  This  study  shows  a  tendency  toward  progressive  decline in small molecular transport over time in nondiabetic patients with uneventful CAPD therapy. Sequential PET follow‐up cannot be overlooked in peritonitis‐free CAPD patients.
Optimal Continuous Retrograde Coronary Perfusion Flow Rate with Beating Heart in Normal Temperature
Authors: Tsukioka Toshihide , Tomita Sigeyuki , Watanabe Go , Takemura Hirohumi 
Published: March 2004

Abstract:  Purpose:  We were led to the premise that with retrograde oxygenated blood perfusion, it would be possible to perform operations on the beating heart.Methods:  The experiment consisted of two stages: procedure 1 and 2. In procedure 1, six pigs were used. Retrograde perfusion flow was controlled to be in the range of 5.0–10.0 mL/kg/min and was gradually increased. In procedure 2, six pigs were used. Retrograde perfusion was continued for 120 min at the optimal flow rate obtained from procedure 1.Results:  The optimal flow rate was 7.0 mL/kg/min in procedure 1. In procedure 2, retrograde perfusions for 120 min were performed with perfusion flows set at optimal flow rate.Conclusions:  The procedure used in this study made it possible to maintain empty beating heart with normal sinus rhythm for 120 min, and the results suggest the possibility of clinical application to open heart surgery.
Lentivirus‐based Gene Delivery in Mouse Embryonic Stem Cells
Authors: Kosaka Yoshikazu , Kobayashi Naoya , Fukazawa Takuya , Totsugawa Toshinori , Maruyama Masanobu , Yong Chen , Arata Takashi , Ikeda Hideaki , Kobayashi Kazuya , Ueda Tadayoshi , Kurabayashi Yuzuru , Tanaka Noriaki 
Published: March 2004

Abstract:  Background:  Embryonic stem (ES) cells are widely used in therapeutic research as an unlimited source of cell therapy. Therefore, it is of great value to find a way to efficiently manipulate ES cells. HIV‐1‐derived lentiviral vectors are now considered to be an efficient vehicle for delivering genes into a variety of cells. In this study, we examined the efficacy of lentivirus‐based gene delivery into mouse ES (mES) cells.Materials and methods:  Recombinant HIV‐I‐based lentiviral vectors Lt‐GFP, expressing green fluorescent protein (GFP), and Lt‐LacZ, expressing E. coli LacZ gene in conjunction with neomycin resistance gene, were generated using a FuGENE 6 transduction method and used for transducing ES cells derived from 129Sv mice. Lentiviral transduction efficacy was evaluated by GFP expression assay using flow cytometry and by X‐gal staining. The in vivo potential of developing teratoma of such transduced mES cells was examined in severe combined immunodeficiency (SCID) mice.Results:  FuGENE 6 showed no considerable transduction‐associated cytotoxicity. The expression rate of GFP and LacZ of mES cells increased on a multiplicity of infection (MOI)‐dependent manner with the amount of Lt‐GFP and Lt‐LacZ used. Approximately 42% of mES cells were positive for GFP after infection of Lt‐GFP at an MOI of 30. Notably, after G418 selection, nearly 100% of Lt‐LacZ‐transduced mES cells were positive for LacZ and formed teratomas in SCID mice.Conclusions:  This work demonstrates that HIV‐I‐based lentiviral vectors are capable of transducing mES cells. Lentiviral vectors may facilitate an advance in the field of gene transfer and expression in various types of ES cells, including human  ES  cells.
Hla-Dq Typing in The Diagnosis of Celiac Disease
Authors: Kaukinen Katri , Partanen Jukka , Mäki Markku , Collin Pekka 
Published: March 2004

ABSTRACT

OBJECTIVE:
More than 95% of celiac patients share the major histocompatibility complex II class human leukocyte antigen (HLA) DQ2 or DQ8 haplotype; patients negative for both types are unlikely to suffer from celiac disease. Our aim was to investigate whether HLA-DQ2 and -DQ8 typing is helpful when diagnosis is uncertain because of the absence of unequivocal small bowel villous atrophy.

METHODS:
HLA-DQ2 and -DQ8 typing was carried out in 59 patients evincing nondiagnostic small bowel mucosal lesion or positive celiac serology, and in 17 patients maintaining a gluten-free diet without biopsy-proven celiac disease. HLA findings were compared to small bowel mucosal morphology; intraepithelial lymphocytes; and serum endomysial (EmA), reticulin, tissue transglutaminase (anti-tTG) and gliadin antibodies.

RESULTS:
Of the 59 patients evincing only minor small bowel mucosal changes or positive celiac disease serology, 22 (37%) were negative for DQ2 and DQ8. All EmA-positive patients had celiac-type HLA, but antireticulin antibody, anti-tTg, and antigliadin antibody were also present in HLA-DQ2– and -DQ8–negative individuals. Eleven of 17 patients (65%) observing a gluten-free diet before small bowel biopsy did not share celiac-type HLA. None of the 17 had apparent villous atrophy. Serum EmA and anti-tTG were negative in all. HLA-DQ typing is less expensive than follow-up biopsy in the exclusion of celiac disease.

CONCLUSIONS:
HLA-DQ2 and -DQ8 determination is useful in exclusion, probably lifelong, of celiac disease in individuals with an equivocal small bowel histological finding. The low specificity of this test must, however, be borne in mind.
Clinical, Endoscopic, and Functional Studies in 408 Patients With Barrett's Esophagus, Compared To 174 Cases of Intestinal Metaplasia of The Cardia
Authors: Csendes Attila , Smok Gladys , Quiroz Juan , Burdiles Patricio , Rojas Jorge , Castro César , Henríquez Ana 
Published: March 2004

ABSTRACT

OBJECTIVE:
The pathophysiology of gastroesophageal reflux disease (GERD) has been studied extensively in patients with long-segment Barrett's esophagus (LSBE), but few reports have explored GERD pathophysiology in patients who have short-segment Barrett's esophagus (SSBE) or intestinal metaplasia at the cardia (IMC). We aimed to compare clinical, endoscopic, histological, and functional features in patients with LSBE, SSBE, and IMC.

METHODS:
We identified 582 patients who had intestinal metaplasia at the squamocolumnar junction in the distal esophagus and divided them into three groups based on the extent of columnar-lined esophagus observed endoscopically: 1) patients with IMC who had no columnar-lined esophagus (i.e., the squamocolumnar and gastroesophageal junctions coincided), 2) patients with LSBE who had >3 cm of columnar-lined esophagus, and 3) patients with SSBE who had <3 cm of columnar-lined esophagus. All patients had esophageal manometric evaluation, and 24-h esophageal pH monitoring was performed to determine the extent of acid and bile (bilirubin) reflux.

RESULTS:
There were 174 patients with IMC, 155 with LSBE, and 25 with SSBE. Compared to patients with LSBE and SSBE, patients with IMC had significantly lower frequencies of GERD symptoms, hiatal hernia, and erosive esophagitis; significantly higher lower esophageal sphincter pressures; and significantly shorter durations of acid and bile reflux. Between patients with SSBE and LSBE, significant differences were found in the frequency of hiatal hernia and duration of acid reflux (both greater in the patients with LSBE). Also, dysplasia was significantly more frequent in patients with LSBE than in those with SSBE or IMC.

CONCLUSION:
GERD symptoms, signs, and physiological abnormalities are found more often in patients with Barrett's esophagus than in those with IMC, and the duration of acid reflux in patients with LSBE is greater than that in patients with SSBE. These findings suggest that the extent of intestinal metaplasia in the esophagus is related directly to the severity of underlying GERD.
Esomeprazole (40 Mg) Compared With Lansoprazole (30 Mg) in The Treatment of Erosive Esophagitis
Authors: Castell Donald O , Kahrilas Peter J , Richter Joel E , Vakil Nimish B , Johnson David A , Zuckerman Seth , Skammer Wendy , Levine Jeffrey G 
Published: March 2004

ABSTRACT

OBJECTIVES:
Esomeprazole, the S isomer of omeprazole, has been shown to have higher healing rates of erosive esophagitis than omeprazole. This study compared esomeprazole with lansoprazole for the healing of erosive esophagitis and resolution of heartburn.

METHODS:
This United States multicenter, randomized, double blind, parallel group trial was performed in 5241 adult patients (intent-to-treat population) with endoscopically documented erosive esophagitis, which was graded by severity at baseline (Los Angeles classification). Patients received 40 mg of esomeprazole (n = 2624) or 30 mg of lansoprazole (n = 2617) once daily before breakfast for up to 8 wk. The primary efficacy endpoint was healing of erosive esophagitis at week 8. Secondary assessments included proportion of patients healed at week 4, resolution of investigator-recorded heartburn, time to first and time to sustained resolution of patient diary-recorded heartburn, and proportion of heartburn-free days and nights.

RESULTS:
Esomeprazole (40 mg) demonstrated significantly higher healing rates (92.6%, 95% CI = 91.5–93.6%) than lansoprazole (30 mg) (88.8%, 95% CI = 87.5–90.0%) at week 8 (p = 0.0001, life-table estimates, intent-to-treat analysis). A significant difference in healing rates favoring esomeprazole was also observed at week 4. The difference in healing rates between esomeprazole and lansoprazole increased as baseline severity of erosive esophagitis increased. Sustained resolution of heartburn occurred faster and in more patients treated with esomeprazole. Sustained resolution of nocturnal heartburn also occurred faster with esomeprazole. Both treatments were well tolerated.

CONCLUSIONS:
Esomeprazole (40 mg) is more effective than lansoprazole (30 mg) in healing erosive esophagitis and resolving heartburn. Healing rates are consistently high with esomeprazole, irrespective of baseline disease severity.
Predictive Factors of Gi Lesions in 241 Women With Iron Deficiency Anemia
Authors: Nahon Stéphane , Lahmek Pierre , Lesgourgues Bruno , Nahon-Uzan Karine , Tuszynski Thierry , Traissac Laurent , Delas Nicolas 
Published: March 2004

ABSTRACT

OBJECTIVES:
GI blood loss is the most common cause of iron deficiency anemia (IDA) in postmenopausal women and menstrual blood loss in premenopausal women. We aimed to evaluate the diagnostic yield of endoscopy in women with IDA and to define predictive factors of a GI lesion.

METHOD:
Clinical, biological, endoscopic, and histological data from patients with IDA were systematically collected on a computer. Multivariate analysis (logistic regression) was performed to determine whether these data were associated with a GI lesion.

RESULTS:
Between January, 1989 and June, 1999, 241 consecutive women had endoscopies for IDA (mean age = 52.3 ± 21.8 yr). A substantial GI lesion was detected in 119 patients (49.4%). Ten patients (4%) had both upper and lower GI lesions. A source of IDA was revealed by upper endoscopy in 86 cases (35.6%) and by colonoscopy in 33 (13.7%). The most common upper lesions were peptic ulceration (42/241 [17.4%]), esophagitis (15/241 [6.2%]), and cancer (9/241 [3.7%]). Colonic cancer (15/241 [6.2%]) and polyps (10/241 [4.1%]) were the most frequent lesions detected by colonoscopy. Predictive factors (odds ratio, 95% CI) of GI lesions diagnosed by endoscopy were abdominal symptoms (8.3, 3.9–17.2), age > 50 yr (4.4, 2.1–9.2), and Hb < 9 g/dl (3, 1.5–6.1). Thirty-one women (13%) had none of these predictive factors; in this group only two lesions were identified (one esophagitis and one duodenal ulcer). The positive predictive value of these three independent predictors was 87%, and the negative predictive value was 93.5%.

CONCLUSION:
Endoscopy revealed a source of IDA in 49.4% of cases. Three predictive factors of GI lesion were identified. Endoscopic investigation should be avoided in women without these three predictive factors. Conversely, these factors are strongly associated with a GI lesion.
Evaluation of The Helicobacter Pylori Stool Antigen Test for Monitoring Eradication Therapy
Authors: Odaka Takeo , Yamaguchi Taketo , Koyama Hidehiko , Saisho Hiromitsu , Nomura Fumio 
Published: March 2004

ABSTRACT

OBJECTIVE:
We aimed to clarify the time course of the Helicobacter pylori stool antigen (HpSA) level during and after eradication therapy and to determine the appropriate time of measurement of HpSA to evaluate eradication.

METHODS:
The subjects were 47 patients who were positive for H. pylori. The patients underwent a 1-wk regimen of triple therapy. The outcome of the eradication therapy was judged by urea breath test, culture, and histology 6 wk after the end of treatment. The HpSA level was serially measured nine times from before therapy until 12 wk after the end of therapy.

RESULTS:
In the group with successful eradication, HpSA became negative immediately after the end of therapy and the negativity persisted. In contrast, in the noneradication group HpSA became negative immediately after therapy, but became positive again within 2 wk after the end of therapy. The mean absorbance value of the HpSA test on the 4th day after the initiation of eradication therapy was significantly higher in the noneradication group than in the group with successful eradication. The diagnostic accuracy of the HpSA test increased to ≧90% 2 wk after therapy and thereafter. Comparison of the diagnostic accuracy at 4 wk after the end of therapy showed no significant differences with that at 2, 6, 8, and 12 wk after the end of therapy.

CONCLUSIONS:
The course of the HpSA levels during and after eradication therapy in patients with successful eradication was quite different from that in noneradication patients. Measurement of HpSA was useful to evaluate eradication, and the appropriate evaluation of the outcome of treatment could be made as early as 2 wk after the end of therapy.
Gi Symptoms in Diabetes Mellitus Are Associated With Both Poor Glycemic Control and Diabetic Complications
Authors: Bytzer Peter , Talley Nicholas J , Hammer Johann , Young Lisa J , Jones Michael P , Horowitz Michael 
Published: March 2004

ABSTRACT

OBJECTIVE:
Diabetes mellitus is associated with an increased prevalence of GI symptoms, but the mechanisms underlying symptoms are poorly defined and controversial. We aimed to determine whether there is a relationship between GI symptoms and both diabetic complications and glycemic control.

METHODS:
We performed a cross-sectional questionnaire study of 1101 subjects with diabetes mellitus recruited from outpatient clinics (n = 209) and the community (n = 892). Data on eight GI symptom groups, complications of diabetes (retinopathy, neuropathy, nephropathy), and self-reported glycemic control were obtained from a validated questionnaire. Glycated hemoglobin was measured in 463 of the subjects. The association between diabetic complications, glycemic control, and GI symptoms was assessed using logistic regression analysis, adjusted for demographic and clinical factors.

RESULTS:
Of the 1101 subjects, 57% reported at least one complication. Diabetic complications were independently associated with both symptom complexity (number of symptom groups reported) (adjusted odds ratio = 1.92 per symptom group [95% CI = 1.51–2.45]) and seven of the eight GI symptom groups. For all symptom groups, the association was explained by self-reported symptoms of peripheral neuropathy. Poor glycemic control measured by both self-report and Hb A1c was an independent risk factor for upper GI symptoms, whereas other potential risk indicators, including duration and type of diabetes, were not significant.

CONCLUSIONS:
GI symptoms in diabetes mellitus may be linked to diabetic complications, particularly peripheral neuropathy, and to poor glycemic control.