bluuebunny/crossref_metadata_2025_split huggingface dataset:
20 Early Arteriovenous Fistula Construction–Late Beginning of Hemodialysis Treatment?
Authors: Malovrh M 
Published: February 2005

Introduction  It was noticed that the decline of renal function was slower in patients (pts) with end stage renal disease (ESRD) after early arteriovenous fistula (AVF) construction. The aim of this prospective study was to find out the influence of AVF on the progression of renal failure.Patients and methods  Sixty ESRD pts with serum creatinine level (SCL) between 400 and 500 µmol/L were included and randomized in two groups. One group of pts received AVF and the other did not. Serum creatinine level, creatinine clearance (CC), and mean arterial pressure (MAP) were followed every two months for one year. All pts were clinically evaluated for signs of cardiac insufficiency. Hemodialysis (HD) was started when SCL was 850 µmol/L or CC 10 mL/min or when signs of uremia were presented.Results   In Group A, 30 ESRD pts, 17 males and 13 females, age 61 ± 7.3 years, mean SCL 446.4 ± 30.5 µmol/L, mean CC 29.3 ± 4.1 mL/min, native forearm AVFs were constructed. No AVFs were constructed in Group B, 30 pts, 12 males and 18 females, mean age 62.8 ± 8.2 years, mean SCL 447.6 ± 37.6 µmol/L, mean CC 29.1 ± 4.7 mL/min. Mean SCL during a 12 month period in both groups is shown in Table A20.

Serum creatinine in a 12 month period (µmol/L)

Group A
Group B

Start
446.4 ± 30
447.6 ± 37

2 months
451.9 ± 39
472.8 ± 39*

4 months
466.4 ± 43
508.0 ± 60*

6 months
482.8 ± 77
579.6 ± 123**

8 months
493.1 ± 73
612.7 ± 127**

10 months
494.3 ± 74
653.0 ± 141**

12 months
509.2 ± 50
660.3 ± 123**

P < 0.05,

P < 0.01.

After 12 months in Group A, 4/30 pts (13%) (1 after 6 months, 2 after 8 months, 1 after 10 months) started hemodialysis (HD), 26 pts had mean CC 23.1 ± 4.5 mL/min, MAP was 118 mmHg, no sign of cardiac insufficiency was found. In Group B, 11/30 (37%)(P < 0.01) (1 after 4 months, 5 after 6 months, 4 after 8 months, 1 after 10 months) started HD, central vein catheter was used as a vascular access. In the remaining 19 pts mean CC 15.6 ± 4.5 mL/min (P < 0.01), MAP was 123 mmHg (NS).Conclusions  This prospective study confirmed our previous observations of renal function after AVF construction. Besides matured AVF, the before‐HD benefit of early AVF on progression of renal insufficiency can be important. The reasons for this are not well known. There are two possibilities: increased cardiac output and decreased resistance of intrarenal vessels. Measurement of renal perfusion and calculation of resistance index by duplex sonography is planned.
30 Increased Mercury Load in Protein A Immunoadsorption
Authors: Pernat A Marn , Horvat M , Logar M , Ponikvar R 
Published: February 2005

Background  Immunoadsorption is an adsorption technique for extracorporeal removal of circulating autoantibodies in autoimmune diseases such as myasthenia gravis and Guillain‐Barré syndrome. To prevent microbial growth during storage, the protein A columns are primed with thiomersal containing toxic ethylmercury which could be released during the immunoadsorption treatment and potentially result in its accumulation and toxicity. To reduce a thiomersal‐related mercury release during immunoadsorption treatment we introduced a modified rinsing solution containing N‐acetylcysteine which is an avid mercury scavenger.Methods  Thirteen patients were treated by 17 protein A immunoadsorption treatments and venous blood samples were collected immediately before and after each session. Whole blood mercury levels were measured by atomic absorption spectroscopy and ethylmercury levels by atomic fluorescent spectroscopy. According to the manufacturer's recommendations we used 600 mg of N‐acetylcysteine to rinse the mercury from protein‐loaded columns before each immunoadsorption treatment.Results  Following protein A immunoadsorption ethylmercury levels increased from 0.148 ± 0.402 ng/g to 2.026 ± 1.944 ng/g (P < 0.001) and whole blood mercury increased from 2.447 ± 3.065 ng/g to 20.437 ± 28.603 ng/g (P = 0.02). Post‐treatment values of whole blood mercury exceeded upper safety level of 5 ng/g in all 17 immunoadsorption treatments but no patient developed clinical signs of mercury toxicity.In one patient immunoadsorption treatment was repeated within 7 days and the results of serial determinations of blood mercury levels are shown in Table A30.

Ethylmercury
Whole blood mercury

(ng/g)
(ng/g)

Before IA
After IA
Before IA
After IA

Day 0
0.13 ± 0.03
1.35 ± 0.12
0.49 ± 0.06
76.8 ± 5.6

Day 1
0.17 ± 0.00
0.10 ± 0.02
8.14 ± 1.24
19.4 ± 0.6

Day 2
0.05 ± 0.00
0.09 ± 0.00
9.57 ± 0.80
11.8 ± 0.9

Day 3
0.03 ± 0.00
0.08 ± 0.01
6.96 ± 0.09
8.52 ± 0.39

Day 7
1.69 ± 0.00
4.23 ± 0.12
5.54 ± 0.32
9.04 ± 0.48

Data are presented as means ± standard deviation. IA, immunoadsorption.

Conclusions  The results of our study showed that whole blood mercury and ethylmercury levels were increased during the immunoadsorption treatments, suggesting mercury release from thiomersal‐primed columns even with addition of N‐acetylcysteine to the rinsing solution. Mercury release was more pronounced at the beginning of serial immunoadsorption treatments which indicates that mercury exposure might depend on the storage time of protein A columns containing thiomersal priming solution.
31 Plasma Exchange Therapy for Severe Hypertriglyceridemia with Acute Pancreatitis
Authors: Ponikvar R , Marn‐Pernat A. , Žugić R. , Varl J , Benedik M , Buturović‐Ponikvar J 
Published: February 2005

Background  Serum triglyceride concentrations above 11 mmol/L can precipitate attacks of acute pancreatitis, although the pathogenesis of inflammation in this setting is unclear. In children with inherited disorders of lipoprotein metabolism that are associated with severe hypertriglyceridemia, attacks of acute pancreatitis can be prevented by lowering their serum triglycerides to less than 2.2 mmol/L. Some reports revealed favorable effects of membrane plasma exchange in severe hypertriglyceridemia and severe acute pancreatitis. The aim of our retrospective clinical study was to evaluate the efficacy of membrane plasma exchange (MPE) therapy in adult patients with severe hypertriglyceridemia and acute pancreatitis in terms of reduction of serum lipids, clinical improvement and reliability of the procedure itself.Methods  25 patients (pts; 24 men, 1 woman), aged 31–59 years (mean 44.6 ± 8.0) have been treated with MPE and LDL apheresis (one procedure) for severe hypertriglyceridemia and acute pancreatitis. Fresenius‐Excorim PE monitor and PF 2000 plasmafilter were used for MPE and Kaneka LDL monitor with dextran sulphate columns for LDL apheresis. Vascular access was via femoral catheter and peripheral vein in 16/25 pts (64%), 2 femoral catheters in 8/25 pts (32%), and 2 peripheral veins in 1/25 pt (4%). The anticoagulant used was heparin in 24/25 pts (96%) and citrate in 1/25 (4%). The replacement solution was a mixture of human albumin and hemofiltration solution. One to two volumes of plasma were exchanged per procedure.Results   In total 42 procedures, 41 MPE and 1 LDL apheresis were carried out, mean 1.68 ± 1.0 per patient, one procedure in 14/25 pts (56%), 2 procedures in 7/25 pts (28%), 3 procedures in 3/25 pts (12%) and 5 procedures in 1/25 pt (4%). One volume of plasma was exchanged in 9/25 pts (36%), 1.5 volumes in 7/25 pts (28%) and 2 volumes in 9/25 pts (36%). From 3000–7200 mL of plasma was exchanged per procedure, mean 4724 ± 1806 mL. Mean running time was 185 ± 64 min., range 95–440 min. Triglyceride concentration before and after MPE was 53 ± 29 mmol/L (range 15.3‐109 mmol/L) and 12.9±10 mmol/L (range 1.5‐33.1 mmol/L), respectively. Total cholesterol before and after MPE was 18.9±8.2 mmol/L (range 8‐35) and 7.5 ± 5.4 mmol/L (range 0.6–22.6 mmol/L), respectively.Technical side effects were hemolysis in 1/42 MPE and plugging of the plasma filter with lipids, with substantial drop of plasma filtration rate in 3/42 MPEs. Hematoma after cannulation of the peripheral vein occurred in 2/42 MPE. Three patients had signs of hypocalcemia and were given Ca gluconate or calcium chloride.Conclusions  In 25 patients with severe hypertriglyceridemia and acute pancreatitis substantial reduction of triglyceride and cholesterol serum concentration was achieved during plasma exchange therapy, along with clinical improvement of the patients.
35 The Survey of Kidney Transplantation in Slovenia: The First Four Years Since Joining The Eurotransplant
Authors: Arnol M , Kovaš D , Bren A F , Kandus A 
Published: February 2005

Objectives  The aim of this retrospective study is a 4‐year survey of kidney transplantation since January 2000 when Slovenia became an active member of the Eurotransplant.Methods We reviewed all kidney transplants between January 2000 and December 2003. All patients received equal immunosuppression with basiliximab or daclizumab, cyclosporine, mycophenolate mofetil and steroids. Beside donor and recipient demographic characteristics the incidence of delayed graft function (DGF), acute rejection, and graft and patient survival were analyzed.Results  During the observed period 189 patients (109 men, 80 women), aged from 13 to 66 years (mean 46 ± 11 years) were transplanted. Fifteen patients (7.9%) received second allograft. All kidney grafts came from cadaveric donors, aged from 6 to 60 years (mean 37 ± 14 years). Eighty‐seven grafts (46%) were from Slovenia. Mean HLA (A, B and DR) mismatches were 2.7 ± 1.1 (range 0 to 5). Mean cold ischemia time was significantly longer for grafts shipped from abroad compared with those procured in Slovenia (25 ± 6.5 h vs. 18.5 ± 7.5 h, P < 0.01). The incidence of DGF was 31.2%. From January 2000 through May 2004 (observation period 5 to 53 months) 9 recipients (4.7%) experienced acute rejection, successfully treated in 8 patients. Actuarial graft survival at 1 and 3 years was 95.5%. Two patients (1.1%) died; both deaths were due to septic infection during the first 6 months after transplantation.Conclusions  In the last 4 years since joining the Eurotransplant use of efficient and safe immunosuppression strategy resulted in very low incidence of acute rejection and high graft and patient survival rate. Slovenian membership in the Eurotransplant offers good HLA matching and with this, probably long term benefit. Joining the Eurotransplant is also related to longer cold ischemia time which can explain high incidence of DGF.
41 Serum C‐Reactive Protein in Kidney Transplant Patients – A Useful Marker of Immune Activation
Authors: Bubić‐Filipi L , Barišić I , Hršak Puljić I , Bašić‐Jukić N , Puretić Z , Kes P 
Published: February 2005

The clinical manifestations of different complications after kidney transplantation are often vague and simple laboratory tests for early diagnosis would be valuable. This study investigated whether serial measurements of serum C‐reactive protein could help differentiate episodes of transplant dysfunction due to rejection, infection, acute tubular necrosis, or cyclosporine A nephrotoxicity in renal allograft recipients. We retrospectively analyzed our data on the daily measurements of serum C‐reactive protein (sCRP) in 117 renal allograft recipients (a total of 543 measurements were performed and 391 episodes of elevated sCRP were recorded) in the diagnosis of acute rejections and other complications in the immediate post‐transplant period. Nineteen patients were treated with cyclosporine A, azathioprine, and prednisolone and 98 patients with cyclosporine A, mycophenolate mophetil, and prednisolone. In patients with stable graft function the sCRP concentrations were in the normal range.Serum C‐reactive protein concentration was initially significantly increased in 23 episodes of rejection responsive to methylprednisolone (median of 54 mg/L) but fell very rapidly in response to treatment (median 15 mg/L). In episodes of rejection unresponsive to methylprednisolone, median initial sCRP levels were significantly higher, with a median of the 69 mg/L at the end of the treatment. Twenty‐nine patients with graft dysfunction caused by CsA nephrotoxicity showed no incraese in sCRP concentration. A similar pattern was seen in patients with acute tubular necrosis. Bacterial infections other than asymptomatic bacteriuria were accompained by the significant increase in sCRP (median of 77 mg/L). The most significant elevations were associated with bacterial infections. Serum C‐reactive protein seemed to be a more sensitive marker than fever or white blood cell count in diagnosis of all complications. Serial sCRP measurements provide economical and reproducible evidence of immune activation, help discriminate renal dysfunction due to CsA nephrotoxicity or rejection, and may be helpful in modification of immunosuppressive therapy.
45 Renal Transplant Artery Stenosis: The Possible Association With Acute Rejection Episodes and Immunosuppressive Treatment
Authors: Župunski A , Kandus A , Bren AF , Buturović‐Ponikvar J 
Published: February 2005

Background  Renal transplant artery stenosis is a relatively frequent complication after transplantation and is a potentially correctable cause of hypertension and/or deterioration of renal function and graft loss. There were reports of the immunological mechanism playing a role in the pathogenesis of stenosis.Purpose  The aim of our retrospective clinical study was to assess the association of renal transplant artery stenosis with the acute rejection episodes and immunosuppressive treatment.Methods  Thirty‐four renal transplant recipients, 14 females and 20 males, aged 42.7 ± 13 years, were found to have significant (>50%) stenosis. In the control group there were 34 patients without stenosis, matching the patients from stenosis group for age, sex, year of transplantation, type of graft and number of previous grafts. Patients were followed for 3 years post‐transplant. Acute rejection episodes were diagnosed histologically.Results   In the stenosis group 8/34 (23%) patients had 10 acute rejection episodes compared to 5/34 (15%) patients having 6 episodes in control group (P = 0.353). In stenosis group 20/34 (59%) patients have received double (cyclosporine A and methylprednisolone), and 14/34 (41%) patients triple immunosuppressive treatment (cyclosporine A, methylprednisolone and azathioprine or mycophenolate mofetil), respectively. In the control group 28/34 (82%) patients have received double, and 6/34 (18%) patients triple immunosuppressive treatment, respectively (P = 0.033). There were no significant differences in serum creatinine and blood pressure at 1, 2 and 3 years after transplantation between the groups.Conclusions  There was a tendency towards higher number of acute rejection episodes in the stenosis group, however not statistically significant. Patients with stenosis have received more intensive immunosuppressive treatment.
The Influence of Water Storage on Durometer Hardness of 5 Soft Denture Liners Over Time
Authors: Kiat‐Amnuay Sudarat , Gettleman Lawrence , Mekayarajjananonth Trakol , Khan Zafrulla , Goldsmith L. Jane 
Published: February 2005

Purpose: This laboratory study investigated the influence of water storage on the durometer hardness of 2 RTV and 3 HTV soft denture liners over a 1‐year period.
Materials and Methods: Five soft denture liners were used: 2 HTV silicone rubber (Luci‐Sof™ and Molloplast‐B®), 1 RTV silicone rubber (Tokuyama), 1 HTV polyphosphazene (Novus™), and an RTV plasticized acrylic (PermaSoft®) that uses a surface sealer. They were processed following manufacturers' instructions, cured, and stored in tap water at 37°C. The water was changed every 2 weeks. Five durometer A hardness measurements were made at logarithmically spaced intervals of 16.7 minutes, 27.8 hours, 11.6 days, 34.7 days, 115 days, and 347 days. Repeated measures analysis of variance (MANOVA), one‐way analysis of variance (ANOVA), Pillai trace statistic, the difference scores (last–first) among the groups, and the Tamhane T2 multiple comparison test were used to compare the groups over time, all on SPSS V. 7.5 and 9.0.
Results: The order of highest initial indentation hardness was Luci‐Sof™, Molloplast‐B®, Novus™ (HD= 38 to 33). Tokuyama and PermaSoft® as a group were softer (HD= 18 to 22). Tokuyama Soft Relining changed the least over 347 days, followed by Luci‐Sof™, Novus™, Molloplast‐B®, and PermaSoft® in that order (p≤ 0.05). Within the PermaSoft® group, sealer applied only once changed the least over 347 days, followed by no sealer, and then sealer applied every month (p < 0.0005).
Conclusions: After 347 days of water storage, Tokuyama had the lowest indentation hardness changes, followed by Luci‐Sof™, Novus™, PermaSoft® with sealer applied once; Molloplast‐B®, PermaSoft® without sealer; and PermaSoft® with sealer applied every month. All HTV soft denture liners had higher indentation hardness than RTV liners initially. After 347 days, PermaSoft® without sealer and with sealer every month became the hardest.
The prevalence and pathogenic differences of Porphyromonas gingivalis fimA genotypes in patients with aggressive periodontitis
Authors: Miura Mayumi , Hamachi Takafumi , Fujise Osamu , Maeda Katsumasa 
Published: February 2005

Background:  The fimA gene, which encodes fimbrillin (FimA), is found in Porphyromonas gingivalis and has been classified into six genotypes based on nucleotide sequence. P. gingivalis that possesses the type II fimA gene is prevalent in adult periodontitis.Objectives:  The aim of this study was to investigate the prevalence of P. gingivalis fimA genotypes in Japanese aggressive periodontitis patients, and to examine their virulence.Methods:  Subgingival plaque samples were obtained from 223 sites in 18 aggressive periodontitis patients and 95 sites in 22 periodontally healthy young adults. Actinobacillus actinomycetemcomitans, P. gingivalis and Tannerella forsythensis detection, determination of the fimA genotype in P. gingivalis, and the quantification of P. gingivalis were analyzed by polymerase chain reaction (PCR) methods. The proteolytic activities of the P. gingivalis fimA type I and fimA type II were also examined.Results:  In aggressive periodontitis patients, the most prevalent fimA genotype was the type II (46.7%), followed by the type Ib and type I, whereas in healthy subjects, the type I fimA was the only genotype detected. The number of P. gingivalis pathogens was the greatest in the type I fimA positive sites, and the frequency of coexisting A. actinomycetemcomitans and T. forsythensis was highest in the type II fimA positive sites in the aggressive periodontitis patients. Both the arginine‐specific cysteine proteinase (Arg‐gingipain) and lysine‐specific cysteine proteinase (Lys‐gingipain) activity of the P. gingivalis fimA type I strain were significantly higher than those of the fimA type II strains.Conclusions:  These results suggest that differences in virulence exist among different fimA genotypes. Coadherence with other pathogens in P. gingivalis fimA type II‐associated aggressive periodontitis and quantitative increases in P. gingivalis in fimA type I‐associated aggressive periodontitis are related to this virulence.
Effects of enamel matrix proteins on tissue formation along the roots of human teeth
Authors: Bosshardt Dieter D. , Sculean Anton , Windisch Péter , Pjetursson Bjarni E. , Lang Niklaus P. 
Published: February 2005

Objective:  Enamel matrix‐derived proteins (EMD) are thought to trigger the formation of acellular extrinsic fibre cementum (AEFC), while other reports indicate that EMD may have osteogenic potential. The aim of the present study was to characterize the tissues developing on the root surface following application of EMD.Methods:  Twelve human periodontitis‐affected teeth, scheduled for extraction, were treated with EMD. Two to 6 weeks later, the teeth were extracted, demineralized and processed for embedding in acrylic and epoxy resins. New tissue formation was analysed by light and transmission electron microscopy.Results:  New tissue formation on the root was observed in the notch and on both scaled and unscaled root surfaces distant of the notch area in six defects. The newly formed tissues on the root were thick, collagenous, devoid of extrinsic fibres, and had an irregular surface contour. The presence of electron‐dense, organic material in the collagenous matrix indicated at least partial mineralization. Embedded cells were numerous and the cells on the matrix surface were very large in size. Abundant rough endoplasmic reticulum and a prominent Golgi complex were evident. The presence of a split between the treated root surfaces and the newly formed tissue was a common observation, as was the presence of bacteria and host cells in the interfacial gap.Conclusion:  Following treatment with EMD, a bone‐like tissue resembling cellular intrinsic fibre cementum may develop on the root surfaces, instead of AEFC. Furthermore, EMD may both induce de novo formation of a mineralized connective tissue on scaled root surfaces and stimulate matrix deposition on old native cementum. Interfacial bonding appeared to be weak after 6 weeks of healing.
Regulation of extracellular signal‐regulated protein kinase signaling in human osteosarcoma cells stimulated with nicotine
Authors: Huang Chih‐Yang , Chen Juen‐Hau , Tsai Chung‐Hung , Kuo Wei‐Wen , Liu Jer‐Yuh , Chang Yu‐Chao 
Published: February 2005

Background:  Cigarette smoking is a major risk factor in the development and further progression of periodontal diseases. Currently, there is limited information on the regulation of mitogen‐activated protein kinases (MAPK) expression in smoking‐associated periodontal disease.Objectives:  The aim of the present study was to investigate the effects of nicotine on the expression of MAPKs in human osteosarcoma cell line U2OS cells. Furthermore, various pharmacological agents were added to search the possible regulation mechanisms on nicotine‐induced MAPKs expression.Methods:  Cytotoxicity and western blot assays were used to investigate the effects of U2OS cells exposed to nicotine. In addition, various pharmacological agents [NS‐398, dexamethasome, 2‐oxothiazolidine‐4‐carboxylic acid (OTZ), herbimycin A, and curcumin] were added to test how they modulated the effects of nicotine‐induced MAPKs expression.Results:  Concentrations of nicotine higher than 5 mm demonstrated cytotoxicity to U2OS cells (p < 0.05). A nicotine concentration of 5 mm was found to induce extracellular signal‐regulated kinase (ERK) phosphorylation in a time‐dependent manner (p < 0.05). In addition, amounts of ERK protein were unaffected by nicotine during the same time interval. By contrast, nicotine has no effect on either c‐Jun N‐terminal kinase (JNK) or p38, respectively. In addition, NS‐398, dexamethasone, OTZ, herbimycin A, and curcumin were found to inhibit the nicotine‐induced ERK expression (p < 0.05).Conclusions:  The activation of ERK expression by nicotine suggests a potential role for nicotine in the pathogenesis of cigarette smoking‐associated periodontal disease. In addition, nicotine‐induced ERK expression was down‐regulated by NS‐398, dexamethasone, OTZ, herbimycin A, and curcumin.