ABSTRACT
Background Biocompatibility of haemodialysis membranes is the most important quality criteria to enable long‐term dialysis without major harmful effects. This study sought to evaluate the ...differences of genomic signatures derived from peripheral blood mononuclear cells (PBMC) in patients undergoing haemodialysis treatment using two different dialyser membranes: one semi‐synthetic and one full‐synthetic membrane.
Design Microarray experiments were conducted in PBMCs of four stable haemodialysis patients before and after dialysis comparing semi‐synthetic (Hemophan® GFS Plus 16) and full‐synthetic (Hemoflow® FX80) dialysis membranes, respectively. Genes differentially expressed when comparing the two different membranes used were analysed in order to elucidate the underlying molecular mechanisms affecting PBMCs in the course of dialysis treatment.
Results One hundred and seventy‐two genes were identified as up‐regulated after treatment with semi‐synthetic membranes when compared to full‐synthetic membranes. These genes could be assigned to processes including immunity and defence, signal transduction, and apoptosis. Dialysis with a full‐synthetic membrane, on the other hand, led to an activation of 72 genes that were mainly involved in cell cycle and cell cycle control.
Conclusion The over‐representation of genes belonging to immunity/defence, signal transduction, and apoptosis as found with semi‐synthetic membranes suggests that full‐synthetic membranes are more biocompatible than semi‐synthetic membranes.
Cochlear implantation in patients with functional residual low-frequency hearing is performed according to an established hearing-preserving surgical technique in order to cause minimal trauma of ...inner ear structures. Due to the increasing number of cochlear implants in children, the preservation of residual hearing is becoming increasingly important in this patient collective.
Short- and mid-term hearing preservation outcome in pediatric patients is investigated.
A group of 9 children (12 ears) between 5 and 12 years of age were examined after hearing-assisted cochlear implantation with respect to the pure tone audiometric thresholds. Retrospectively, short-term hearing preservation (up to 3 months after surgery) was examined. In a subgroup of 5 children, mid-term hearing preservation (7.5 to 16 months after surgery) was also analyzed. The mean values of hearing preserved (HL%) and hearing loss (HL) due to electrode insertion were calculated as measured values.
In the whole group, the mean values of the preoperative PTA
were 29.8 dB and the short-term postoperative PTA
42.6 dB. The mean value of the HL% was 73.6%, corresponding to an HL of 9.4 dB. In the subgroup, the mean PTA
postoperatively was 46.0 dB in the mid-term and the HL% at 80.7% with a HL of 6.6 dB.
The results in children are consistent with the results in adults. Electric-acoustic stimulation (EAS) should be used in the treatment of children with existing low-frequency residual hearing, as good residual hearing preservation can also be achieved in children after implantation.
Magneto-rheological (MR) fluids are suspensions of micron-sized ferromagnetic particles in a non-magnetic carrier fluid. The essential characteristic of MR fluid is the rapid and reversible ...transition from the state of a Newtonian-like fluid to the behaviour of a stiff semi-solid by applying a magnetic field of ∼0.1–0.4 T. This feature can be understood from the fact that the particles form chain-like structures aligned in the field direction. The MR fluid offers three modes of operation, namely the direct shear mode, the valve mode, and the squeeze mode. The latter is of particular interest due to its highly non-linear behaviour, which is still not fully understood and therefore expected to give rise to new industrial applications. A test rig for the exploration of the MR-fluid behaviour was designed for experimental purposes. The present article describes the results of measurements under sinusoidal loading modes. Special emphasis was posed on the dependence of the MR-fluid response with respect to parameter variations of the applied static magnetic field, the cyclic loading amplitude, and frequency values. Cavitation effects have been investigated and partially suppressed by pre-pressurizing the MR fluid, which enables a more thorough insight into particle chain disruption and segregation effects. Well-pronounced hysteresis loops are observed and exhibit characteristic kinks, which cannot be understood within the frame of elementary constitutive laws such as for Bingham fluids. To describe the squeeze mode phenomenon numerically, adequate constitutive laws were applied, checked numerically by utilizing finite-element simulations, and validated against experimental data. New perceptions attained so far provided reason to design an adaptive MR-fluid bearing in squeeze mode behaviour for industrial applications.
Tension levelling is employed in strip processing lines to minimise residual stresses resp. to improve the strip flatness by inducing small elasto-plastic deformations. To improve the design of such ...machines, precise calculation models are essential to reliably predict tension losses due to plastic dissipation, power requirements of the driven bridle rolls (located upstream and downstream), reaction forces on levelling rolls as well as strains and stresses in the strip. FEM (Finite Element Method) simulations of the tension levelling process (based on Updated Lagrangian concepts) yield high computational costs due to the necessity of very fine meshes as well as due to the severely non-linear characteristics of contact, material and geometry. In an evaluation process of hierarchical models (models with different modeling levels), the reliability of both 3D and 2D modelling concepts (based on continuum and structural elements) was proved by extensive analyses as well as consistency checks against measurement data from an industrial tension leveller. To exploit the potential of computational cost savings, a customised modelling approach based on the principle of virtual work has been elaborated, which yields a drastic reduction of degrees of freedom compared to simulations by utilising commercial FEM-packages.
Abstract
Background
Despite a higher prevalence of chronic kidney disease among women, more men than women start renal replacement therapy (RRT). We hypothesized that gender differences in health ...care access exist and therefore aimed at determining whether characteristics and outcomes of haemodialysis patients over time differ by sex.
Methods
We studied all 28 323 adults who began haemodialysis during 1965–2014 in the Austrian Dialysis Registry, analysing trends in patient characteristics by sex and decade with mortality (via Cox regression), which was compared with the mortality of the Austrian general population.
Results
More men than women started haemodialysis (60.1% men versus 39.9% women overall), with minor differences among decades and age groups. The male:female mortality rate ratio in the general population ranged from 1.2 to 2.4 for age groups >18 years and in haemodialysis patients ranged from 0.80 to 1.3 (closer to 1 than in the general population, but consistently >1 in Decades 3–5). In recent decades, diabetes and hypertension replaced glomerulonephritis as the primary cause of end-stage renal disease in both men and women. Interaction analyses showed the mortality risk associated with haemodialysis access (only recorded in Decade 5) was significantly lower for men than for women.
Conclusions
The male:female mortality rate ratio and the proportion of women starting haemodialysis were remarkably stable, which does not support the hypothesis of gender differences in health care/haemodialysis access or could imply that such differences might have persisted over decades. Future research should expand to other countries and other forms of RRT.
The discovery of novel classes of non-coding RNAs (ncRNAs) has revolutionized medicine. Long thought to be a mere cellular housekeeper, surprising functions have recently been uncovered. MicroRNAs ...(miRNAs), are a representative of the class of short ncRNAs, play a fundamental role in the control of DNA and protein biosynthesis and activity as well as pathology. Currently, miRNAs are being investigated as diagnostic and prognostic markers and potential therapeutic targets in kidney transplantation for such indolent processes as ischaemia-reperfusion injury, humoral rejection or viral infections. It is realistic to believe that monitoring of renal allograft recipients in the future will include genome-wide miRNA profiling of biological fluids. Based on these individual profiles, an informed decision on therapeutic consequences will be possible. A first success with a specific suppression of miRNAs by antisense oligonucleotides was achieved in experimental studies of reperfusion injury and humoral rejection. Proof of this concept in men comes from studies in such indolent viral infections as Ebola and hepatitis C, where anti-miR therapy led to sustained viral clearance. In this review, we summarize the basis of the recent ncRNA revolution and its implication for kidney transplantation.
Several studies investigated the association of histologic scores of donor kidney biopsies obtained before engraftment with posttransplant outcomes. Discrimination and goodness of fit of these ...scores, however, is low.
Thus, we sought to identify and elucidate the performance of molecular rather than histologic markers for this purpose using whole genome gene expression microarray experiments.
We identified 80 unique differentially regulated genes in 82 samples, showing no histologic damage versus those with histologic damage, based on the Chronic Allograft Damage Index (CADI) and acute tubular injury. Main biological categories enriched with up-regulated genes in damaged tissue were "immunity and defense," "cell communication," or "apoptosis." Interestingly, genes involved in cell structure, cell adhesion, and protein trafficking were specific for tubular atrophy. Histology (CADI score) explained only 14% of the variability of 1 year creatinine (adjusted R2 for panel-reactive antibodies, biopsy confirmed acute rejection, and sum of human leukocyte antigen mismatches) whereas a combination of three biomarkers without clinical covariables explained 28%. The three molecular markers are the NLR family, pyrin domain containing 2 (NLRP2), immunoglobulin J polypeptide, and the regulator of G-protein signaling 5.
In summary, we identified biomarkers in transplant kidney biopsies, which are predictive for medium-term allograft function.
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