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Biomedical subjects

J Bommer

Publications and source records attributed to J Bommer.

At least 91 records · Page 5Linked to original sources
PubMed1985

Reduction of silicone particle release during haemodialysis.

Spallation of silicone was evaluated in an in vitro system, using a commercial blood pump and dialysis tubing. Silicone particle release was assessed at various occlusion forces (5.5-22 kp). When the occlusion force was reduced from 22 to 5.5 kp, the number of released silicone particles decreased by approximately 80 per cent; in parallel, the amount of silicone retrieved from the recirculation fluid decreased from 1.6mg to less than 0.23mg. It is concluded that reduction of occlusion pressure within the blood pump effectively reduces spallation of silicone tubing.

In Vitro Techniques↗
PubMed1985

Vaccination against hepatitis B in patients with renal insufficiency.

To define the degree of renal insufficiency at which the immune response to vaccination against hepatitis B is impaired, anti-HB concentrations after vaccination with 20 micrograms HB-Vax at 0, 1 and 6 months were examined in 76 dialysis patients, 24 patients with incipient renal failure (S-creatinine 1.4-3.5mg/dl) and in 43 controls. Compared with controls, seroconversion rate and anti-HB concentrations were significantly (p less than 0.02) lower in patients with incipient renal failure. The time course of anti-HBs in dialysis patients with successful vaccination, either with three doses (0, 1, 6 months) or with five doses (0, 1, 2, 4, 6 months) of HB-Vax was compared with healthy controls. The proportion of patients losing anti-HBs and the decrease of antibody concentration was significantly greater in dialysis patients immunised with three doses of the vaccine. In dialysis patients vaccinated with five doses, the percentage losing HB antibodies was slightly higher than in controls, but final titres after 24 months were comparable.

Adult↗
PubMed1984

Plastic filing from dialysis tubing induces prostanoid release from macrophages.

Multiorgan, abnormalities in dialysis patients (for example, hepatosplenomegaly, granulomatous hepatitis, cytopenia from hypersplenism) have recently been ascribed to the loading of macrophages (MO) with silicone particles released from the pump segment of dialysis tubing. In the present study, the effect of chronic intravenous or intraperitoneal loading of rats with silicone, polyvinylchloride (PVC) and polyurethane (PU) particles on arachidonic acid metabolism of peritoneal MO and splenic cells was examined in vitro. Intravenous injections of silicone, PVC, or PU particles caused accumulation of the material within the lysosomes of MO of spleen, liver, and lung. Spontaneous release of prostaglandin E2 (PGE2) and thromboxane B2 (TXB2) was significantly increased in peritoneal MO of rats injected with silicone, PVC, or PU (Control: 4.27 +/- 0.85 ng PGE2/ml/24 hr; silicone 51.9 +/- 13.2; PVC 57.5 +/- 10.6; PU 28.8 +/- 2.3). Zymosan or LPS stimulated PGE2 release from control MO, but caused no consistent further elevation of high basal PGE2 release from MO after particle loading. Furthermore, increased spontaneous and stimulated TXB2 release was also observed in spleen cells of rats given intravenous injection of silicone particles. It is concluded that storage of plastic particles (silicone, PVC, and PU) by macrophages stimulates arachidonic acid metabolism.

Animals↗
PubMed1984

Multicystic transformation of kidneys in chronic renal failure.

With real-time sonography, 120 nondialyzed uremic patients prior to hemodialysis, 108 patients on maintenance hemodialysis and 9 patients postdialysis after successful homotransplantation were examined for the presence of renal cysts. Even in incipient renal failure, multiple cysts were demonstrable in some patients (at a serum creatinine of 3 mg/dl in 22% of patients), particularly in patients with analgesic nephropathy. When hemodialysis was started (serum creatinine approximately 10 mg/dl), 35% of the patients had multiple cysts. On hemodialysis, the prevalence, number and size of cysts rose progressively with time. After 8 years of hemodialysis, 92% of the patients had multiple cysts. However, enlargement of the kidneys was observed in only 2/108 patients. No major clinical complications were noted with the possible exception of 1 case of renal cell carcinoma. No correlation was noted between hematocrit and presence or extent of cystic transformation, but the 2 patients with cystic enlargement of the kidneys were polyglobulic. In 8/9 patients after transplantation, cysts were demonstrable in the patient's own kidneys after a median follow-up of 16 months. On light microscopy, cysts were lined by cuboidal or columnar epithelial cells with frequent papillary or adenomatous proliferations. The cyst lumen was filled with amorphous or lamellated organic material, which exhibited microfibrillar structure on electron microscopy. One kidney examined after ex vivo perfusion fixation showed multiple interconnected cavities on scanning electron microscopy. Ultrastructural studies showed epithelia with either the characteristics of proximal tubular cells (i.e. numerous microvilli, interdigitations and abundant lysosomes or mitochondria) or distal tubular cells (i.e. highly interdigitating processes) or finally collecting duct cells (i.e. no interdigitations and few microvilli).

Acute Kidney Injury↗
PubMed1983

[Vaccination of uremic patients against hepatitis B].

Hepatitis B vaccine (Merck, Sharp & Dohm) was administered according to various vaccination schedules to 12 patients in preterminal renal failure without haemodialysis treatment, 81 patients on a chronic haemodialysis programme and 43 staff of a nephrological centre. After three-times vaccination (at 0, 1, 6 months) with 20 micrograms HBs antigen, seroconversion occurred in 91% of persons without kidney disease. A double dose (40 micrograms) was given, at the same time intervals, to 29 dialysis patients, with a seroconversion rate of 55% and titre levels less than in those without renal disease. Of 26 dialysis patients given the same dose (40 micrograms) five times (at 0, 1, 2, 4, 6 months), 63% achieved seroconversion with a definitely higher anti-HBs titre than those dialysis patients vaccinated only three times. Passive-active vaccination with 40 micrograms HBs antigen (at 0, 1, 2, 4, 6 months) as well as 3 ml hepatitis B immunoglobulin (at 0, 2 months) was given to 26 dialysis patients. There was a comparable frequency of seroconversion (58%) and a comparable titre rise to those obtained with active vaccination alone. Twelve pre-uraemic patients not requiring dialysis (serum creatinine 753 +/- 184 mumol/l) also were actively vaccinated three times, the results not differing from those in dialysis patients. The findings indicate that patients with renal disease potentially needing dialysis should, in the early stages of renal failure (serum creatinine less than 500 mumol/l) be vaccinated with hepatitis B vaccine.

Antibody Formation↗
PubMed1983

Non-A, non-B hepatitis in hemodialysis.

Episodes of presumable non-A, non-B hepatitis were determined among hemodialysis patients during a two year period as well as possible secondary infections in household contacts. We determined hepatitis A and B markers by commercial RIA kits, and IgM-anti-CMV and IgM-anti-EBV by ELISA techniques. 154 dialysis patients, 118 relatives of patients, and 42 members of the staff were included in the study. 71% of the center dialysis patients, 63% of the home dialysis patients, 50% of the staff, and 19% of the relatives were HBV marker positive. Spouses of patients more often had HBV markers than other relatives. Anti-HAV was highly prevalent both in center patients (98.8%) and in home dialysis patients (83.3%). The incidence of IgM-anti-CMV was marked in home dialysis patients (15.5%). During a two year period, 9% of all dialysis patients had an episode of presumable non-A, non-B hepatitis. As compared to previous data in the same dialysis centers, there is a change in the epidemiology of hepatitis.

Adult↗
PubMed1983

Effect of vaccination schedule and dialysis on hepatitis B vaccination response in uraemic patients.

Antibody response to vaccination with hepatitis B vaccine (HB-Vax) was evaluated in 43 staff, 81 dialysis patients and 12 non-dialysed uraemic patients. We confirmed less frequent seroconversion and lower concentration of antibody to hepatitis B surface antigen (anti-HBs) in dialysis patients despite a higher dose (40 micrograms vaccine). However, more frequent vaccination (5 times vs 3) increased anti-HBs concentration to almost normal. Concomitant administration of hepatitis B immunoglobulin (HBIG) and hepatitis B vaccine (passive/active) did not interfere with vaccination success. Antibody response was equally poor in dialysed non-dialysed uraemic patients.

Adult↗
PubMed1982

Presumable non-A, non-B hepatitis in hemodialysis.

Hepatitis A and B markers, IgM-anti-CMV and -EBV were determined in 154 dialysis patients, 118 relatives of patients and 42 members of the staff. Episodes of elevated transaminases were investigated for presumable non-A, non-B hepatitis as well as secondary infections among relatives. --The cumulative frequency of HBV markers was 71% in center dialysis patients, 63% in home dialysis patients, 50% in staff and 19% in relatives. The frequency of HBV markers increased with duration of dialysis treatment and with the number of blood units transfused. Spouses of dialysis patients had more often HBV markers than other relatives (22% vs. 8.8%). 96.8% of the center dialysis patients, 83.3% of home-dialysis patients, 41% of the staff, and 42% of the relatives were anti-HAV-positive. The incidence of IgM-anti-CMV was highest in home-dialysis patients (15.5%). The frequency of IgM-anti-EBV was 4.3% in center-dialysis patients and 12.7% in home-dialysis patients. --9% of all dialysis patients had an episode of elevated transaminases compatible with non-A, non-B hepatitis. The possible secondary attack rate among relatives was 31%.

Antibodies, Viral↗