Infection, thrombosis, and stenosis are among the most frequent complications associated with blood contacting catheters. Because these problems are usually related to surface properties of the base catheter material, surface treatment processes, such as ion implantation and ion beam assisted deposition (silver based coatings), can be used to mitigate such complications. Because these ion beam based processes affect only the near-surface region (approximately the outer 1 microm), there is little effect on bulk material properties. This study evaluated silver coated large bore catheters used for extracorporeal detoxification. In a 122 patient prospective study, 156 large bore catheters were inserted into the internal jugular or subclavian veins. Seventy-eight surface treated catheters (SPI-ARGENT, Spire Corporation, Bedford, MA; n = 32 acute catheters, n = 45 long-term catheters) were Bambauer inserted in 55 patients. Seventy-eight untreated catheters placed in 67 patients served as controls (n = 35 acute catheters, n = 43 long-term catheters). After removal, the catheters were cultured for bacterial colonization using standard microbiologic assays. They were also examined using a scanning electron microscope (SEM). Bacterial colonization was observed in 15.4% of the treated catheters compared with 44.9% of untreated catheters. The SEM investigations showed all treated catheters to possess low thrombogenicity. Results of the study indicate that ion beam based processes can be used to improve thrombus and infection resistance of blood contacting catheters.

Adult↗

PubMedDate not supplied

Cerebroretinal vasculopathy and leukoencephalopathy mimicking a brain tumor. Report of two early-onset cases with Fanconi's anemia-like phenotypes suggesting an autosomal-recessive inheritance pattern.

We report two sisters affected with a unique disorder characterized by recurrent space-occupying brain lesions and retinal vasculopathy since their early twenties. Affection status was associated with abnormalities characteristic of Fanconi's anemia, i.e. aplastic anemia, microcephaly, short stature, an unusual face and pigmentation abnormalities of skin. In cytogenetic analyses performed in childhood signs of chromosome fragility or any chromosomal aberration were lacking. Histopathological examination of brain biopsy samples in both cases demonstrated identical histomorphological features of an unusual occlusive vasculopathy with multilayered basement membranes and coagulation necroses which were confined to the white matter. A veno-occlusive retinopathy with neovascularization attributed to progressive visual loss. One of the sisters died at an age of just 24 years, the other is now 27 years old. Unlike any other published cases of hereditary cerebroretinal vasculopathy, the sisters' complex early-onset vaso-occlusive CNS-/eye-disease seems to be genetically associated with their Fanconi's anemia-like phenotypes and is suggested to constitute an autosomal-recessive variant. Patchy white matter calcifications, an incidental finding in either of the affected sisters, may represent preclinical manifestation of disease onset in childhood.

Adult↗

PubMedDate not supplied

Frequency, therapy, and prevention of infections associated with large bore catheters.

Since the introduction of large bore catheters for acute hemodialysis 30 years ago, many problems with handling, material, and contamination of these catheters existed. Nevertheless, the catheterization of the inferior and superior vena cavae with a large bore catheter has proved to be suitable as a rapid connection process for hemodialysis, hemofiltration, hemoperfusion, plasmapheresis, plasmaperfusion, etc. In a retrospective study with 2,626 large bore catheters in 1,627 patients, the frequency of infections, thrombosis, bleeding, and other side effects was investigated. All complications and side effects are presented dependent upon vascular access route. In total, the complication rate was 44.2% higher in subclavian puncture than in internal jugular puncture at 23.9%. The highest complication rates in both vascular access routes were infections or septicemia; infections were observed in 22.8% of subclavian catheters versus 9.5% of internal jugular catheters. Three different catheter materials (Teflon, polyurethane, and polypropylene) were investigated with scanning electron microscopy after removal. The advantages and disadvantages of the different materials are presented.

Anti-Bacterial Agents↗

PubMedDate not supplied

Cholinesterase activity in the perineuronal net.

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Animals↗