Ibuprofen-Immobilized Thin Films: A Novel Approach to Improve the Clearance of Protein-Bound Uremic Toxins.

Chronic kidney disease (CKD), a pressing global health issue, affects millions and leads to end-stage renal disease (ESRD). Hemodialysis (HD) is a crucial treatment for ESRD, yet its limited efficiency in removing protein-bound uremic toxins (PBUTs) results in high morbidity and mortality rates. A high affinity of pharmaceutical drugs for human serum albumin (HSA) can be leveraged to compete effectively with PBUTs for the same HSA binding sites, thereby enabling them to be capable of displacing these toxins. One such drug is ibuprofen (IBF), known for its very high affinity for HSA and sharing the same binding site as indoxyl sulfate (IS). This study explores the development of IBF-immobilized cellulose acetate-based (CA-based) thin films. The films were created by reacting CA with IBF-modified silica precursors at varying concentrations. The presence of IBF in CA/TEOS/APTES-IBF-3 and CA/TEOS-IBF-25 films, containing 3 and 25 wt % IBF, respectively, was confirmed through 1H NMR spectra. Competitive displacement binding assays indicated that while the incorporation of 3 wt % IBF showed no significant enhancement in IS displacement, the 25 wt % IBF film increased the dialyzed IS by 1.3 when normalized to non-IBF films. Furthermore, there was a 1.2-fold decrease in the total percentage of IS, and the free percentage of IS increased 1.3 to 3.0 times. Although direct systemic infusion of IBF in HD patients achieves a 2.4 times higher removal of IS, it is impractical due to the risks it poses to ESRD patients. The IBF-immobilized films offer the advantage of localized binding, thus eliminating the need for systemic exposure. This innovative approach lays a foundation for developing more efficient HD membranes, aiming to address the challenging issue of PBUT elimination and potentially enhance the quality of life and treatment outcomes for ESRD patients.

Bipolar Membranes for Direct Borohydride Fuel Cells-A Review.

Direct liquid fuel cells (DLFCs) operate directly on liquid fuel instead of hydrogen, as in proton-exchange membrane fuel cells. DLFCs have the advantages of higher energy densities and fewer issues with the transportation and storage of their fuels compared with compressed hydrogen and are adapted to mobile applications. Among DLFCs, the direct borohydride-hydrogen peroxide fuel cell (DBPFC) is one of the most promising liquid fuel cell technologies. DBPFCs are fed sodium borohydride (NaBH4) as the fuel and hydrogen peroxide (H2O2) as the oxidant. Introducing H2O2 as the oxidant brings further advantages to DBPFC regarding higher theoretical cell voltage (3.01 V) than typical direct borohydride fuel cells operating on oxygen (1.64 V). The present review examines different membrane types for use in borohydride fuel cells, particularly emphasizing the importance of using bipolar membranes (BPMs). The combination of a cation-exchange membrane (CEM) and anion-exchange membrane (AEM) in the structure of BPMs makes them ideal for DBPFCs. BPMs maintain the required pH gradient between the alkaline NaBH4 anolyte and the acidic H2O2 catholyte, efficiently preventing the crossover of the involved species. This review highlights the vast potential application of BPMs and the need for ongoing research and development in DBPFCs. This will allow for fully realizing the significance of BPMs and their potential application, as there is still not enough published research in the field.

Improving Structural Homogeneity, Hydraulic Permeability, and Mechanical Performance of Asymmetric Monophasic Cellulose Acetate/Silica Membranes: Spinodal Decomposition Mix.

In this paper, we propose an optimized protocol to synthesize reproducible, accurate, sustainable integrally skinned monophasic hybrid cellulose acetate/silica membranes for ultrafiltration. Eight different membrane compositions were studied, divided into two series, one and two, each composed of four membranes. The amount of silica increased from 0 wt.% up to 30 wt.% (with increments of 10 wt.%) in each series, while the solvent composition was kept constant within each series (formamide/acetone ratio equals 0.57 wt.% in series one and 0.73 wt.% in series two). The morphology of the membranes was analyzed by scanning electron microscopy and the chemical composition by Fourier transform infrared spectroscopy, in attenuated total reflection mode (FTIR-ATR). Mechanical tensile properties were determined using tensile tests, and a retest trial was performed to assess mechanical properties variability over different membrane batches. The hydraulic permeability of the membranes was evaluated by measuring pure water fluxes following membrane compaction. The membranes in series two produced with a higher formamide/acetone solvent ratio led to thicker membranes with higher hydraulic permeability values (47.2-26.39 kg·h-1·m-2·bar-1) than for the membranes in series one (40.01-19.4 kg·h-1·m-2·bar-1). Results obtained from the FTIR-ATR spectra suggest the presence of micro/nano-silica clusters in the hybrid membranes of series one, also exhibiting higher Young's modulus values than the hybrid membranes in series two.

A Novel Strategy for Enhanced Sequestration of Protein-Bound Uremic Toxins Using Smart Hybrid Membranes.

Currently available hemodialysis (HD) membranes are unable to safely remove protein-bound uremic toxins (PBUTs), especially those bonded to human serum albumin (HSA). To overcome this issue, the prior administration of high doses of HSA competitive binders, such as ibuprofen (IBF), has been proposed as a complementary clinical protocol to increase HD efficiency. In this work, we designed and prepared novel hybrid membranes conjugated with IBF, thus avoiding its administration to end-stage renal disease (ESRD) patients. Two novel silicon precursors containing IBF were synthesized and, by the combination of a sol-gel reaction and the phase inversion technique, four monophasic hybrid integral asymmetric cellulose acetate/silica/IBF membranes in which silicon precursors are covalently bonded to the cellulose acetate polymer were produced. To prove IBF incorporation, methyl red dye was used as a model, thus allowing simple visual color control of the membrane fabrication and stability. These smart membranes may display a competitive behavior towards HSA, allowing the local displacement of PBUTs in future hemodialyzers.

Adsorption- and Displacement-Based Approaches for the Removal of Protein-Bound Uremic Toxins.

End-stage renal disease (ESRD) patients rely on renal replacement therapies to survive. Hemodialysis (HD), the most widely applied treatment, is responsible for the removal of excess fluid and uremic toxins (UTs) from blood, particularly those with low molecular weight (MW < 500 Da). The development of high-flux membranes and more efficient treatment modes, such as hemodiafiltration, have resulted in improved removal rates of UTs in the middle molecular weight range. However, the concentrations of protein-bound uremic toxins (PBUTs) remain essentially untouched. Due to the high binding affinity to large proteins, such as albumin, PBUTs form large complexes (MW > 66 kDa) which are not removed during HD and their accumulation has been strongly associated with the increased morbidity and mortality of patients with ESRD. In this review, we describe adsorption- and displacement-based approaches currently being studied to enhance the removal of PBUTs. The development of mixed matrix membranes (MMMs) with selective adsorption properties, infusion of compounds capable of displacing UTs from their binding site on albumin, and competitive binding membranes show promising results, but the road to clinical application is still long, and further investigation is required.

Gas Permeability and Mechanical Properties of Polyurethane-Based Membranes for Blood Oxygenators.

The production of medical devices follows strict guidelines where bio- and hemocompatibility, mechanical strength, and tear resistance are important features. Segmented polyurethanes (PUs) are an important class of polymers that fulfill many of these requirements, thus justifying the investigation of novel derivatives with enhanced properties, such as modulated carbon dioxide and oxygen permeability. In this work, three segmented polyurethane-based membranes, containing blocks of hard segments (HSs) dispersed in a matrix of soft segment (SS) blocks, were prepared by reacting a PU prepolymer (PUR) with tris(hydroxymethyl)aminomethane (TRIS), Congo red (CR) and methyl-ß-cyclodextrin (MBCD), rendering PU/TRIS, PU/CR and PU/MBCD membranes. The pure (control) PU membrane exhibited the highest degree of phase segregation between HSs and SSs followed by PU/TRIS and PU/MBCD membranes, and the PU/CR membrane displayed the highest degree of mixing. Pure PU and PU/CR membranes exhibited the highest and lowest values of Young's modulus, tangent moduli and ultimate tensile strength, respectively, suggesting that the introduction of CR increases molecular mobility, thus reducing stiffness. The CO2 permeability was highest for the PU/CR membrane, 347 Barrer, and lowest for the pure PU membrane, 278 Barrer, suggesting that a higher degree of mixing between HSs and SSs leads to higher CO2 permeation rates. The permeability of O2 was similar for all membranes, but ca. 10-fold lower than the CO2 permeability.

Interaction of Human Serum Albumin with Uremic Toxins: The Need of New Strategies Aiming at Uremic Toxins Removal.

Chronic kidney disease (CKD) is acknowledged worldwide to be a grave threat to public health, with the number of US end-stage kidney disease (ESKD) patients increasing steeply from 10,000 in 1973 to 703,243 in 2015. Protein-bound uremic toxins (PBUTs) are excreted by renal tubular secretion in healthy humans, but hardly removed by traditional haemodialysis (HD) in ESKD patients. The accumulation of these toxins is a major contributor to these sufferers' morbidity and mortality. As a result, some improvements to dialytic removal have been proposed, each with their own upsides and drawbacks. Longer dialysis sessions and hemodiafiltration, though, have not performed especially well, while larger dialyzers, coupled with a higher dialysate flow, proved to have some efficiency in indoxyl sulfate (IS) clearance, but with reduced impact on patients' quality of life. More efficient in removing PBUTs was fractionated plasma separation and adsorption, but the risk of occlusive thrombosis was worryingly high. A promising technique for the removal of PBUTs is binding competition, which holds great hopes for future HD. This short review starts by presenting the PBUTs chemistry with emphasis on the chemical interactions with the transport protein, human serum albumin (HSA). Recent membrane-based strategies targeting PBUTs removal are also presented, and their efficiency is discussed.

Paullinieae (Sapindaceae) of the restingas of Rio de Janeiro, Brazil: taxonomy and distribution / Paullinieae (Sapindaceae) das restingas do estado do Rio de Janeiro, Brasil: taxonomia e distribuição

Abstract Paullinieae is a predominantly neotropical tribe comprising six genera (Cardiospermum, Lophostigma, Paullinia, Serjania, Thinouia and Urvillea), of which Lophostigma is the only one not found in Brazil. This study was conducted in the sandy coastal plains (restingas) of Rio de Janeiro state, which from the mouth of the Itabapoana river in the north, bordering Espírito Santo state, to Ponta da Trindade (including Ilha Grande) in the south, bordering São Paulo state. This ecosystem has great biodiversity, but has been constantly threatened by deforestation, human occupation and degradation resulting from tourism. In this area we found 30 species in five genera: Cardiospermum (1 sp.), Paullinia (9 spp.), Serjania (15), Thinouia (2) and Urvillea (3). The taxonomic treatment includes a key to identify the taxa, and for each species a morphological description, illustrations, a map of its geographical distribution, ecological information, phenological data, and conservation status. Most species occurred in ridge forests, followed by dune thicket and non-flooded scrub formations. Among of the 30 species, four (Paullinia coriacea, P. ternata, Serjania fluminensis and S. littoralis) were recorded only in the sandy coastal plains, and four are endemic to Rio de Janeiro state (Serjania eucardia, S. fluminensis, S. littoralis and S. tenuis). In addition, four species are already included in the Red List of Brazilian Flora and another three are indicated in this study as threatened. This research is important not only to improve knowledge of Paullinieae species found in Rio de Janeiro's sandy coastal plains, but also to provide information to be used for conservation measures in the State, as well as in other coastal plains of Brazil.

Resumo Paullinieae é uma tribo predominantemente neotropical e compreende seis gêneros (Cardiospermum, Lophostigma, Paullinia, Serjania, Thinouia e Urvillea), dos quais Lophostigma é o único gênero não encontrado no Brasil. Este estudo foi conduzido nas restingas do estado do Rio de Janeiro, que começam na foz do rio Itabapoana, na fronteira com o estado do Espírito Santo e se estende até a Ponta da Trindade (incluindo a Ilha Grande), próximo à fronteira com o estado de São Paulo. Este ecossistema possui grande biodiversidade, mas tem sido constantemente ameaçado pelo desmatamento, ocupação humana e ações de degradação decorrentes do turismo. Nesta área foram encontradas 30 espécies pertencentes a cinco gêneros: Cardiospermum (1 spp), Paullinia (9 spp), Serjania (15), Thinouia (2) e Urvillea (3). O tratamento taxonômico incluiu descrição e chave para identificação das espécies, informações sobre as formações vegetacionais das restingas onde cada táxon ocorre, além de ilustrações e mapas de distribuição geográfica das espécies. A maioria das espécies ocorre em floresta de cordão arenoso, seguidas das espécies de vegetação arbustiva fechada de cordão arenoso e arbustiva aberta não inundável. Entre as 30 espécies, quatro delas (P. coriacea, P. ternata, S. fluminensis e S. littoralis) são encontradas apenas nas formações de restinga e quatro espécies são endêmicas do Rio de Janeiro (S. eucardia, S. fluminensis, S. littoralis e S. tenuis). Além disso, quatro espécies já estão incluídas na Lista Vermelha da Flora do Brasil e outras três estão indicadas neste estudo. Este trabalho é importante não apenas para melhorar o conhecimento das espécies de Paullinieae encontradas nas restingas do Rio de Janeiro, mas também para fornecer informações a serem utilizadas em medidas de conservação no Estado e nas demais regiões de restinga do Brasil.

Novel Cellulose Acetate-Based Monophasic Hybrid Membranes for Improved Blood Purification Devices: Characterization under Dynamic Conditions.

A novel cellulose acetate-based monophasic hybrid skinned amine-functionalized CA-SiO2-(CH2)3NH2 membrane was synthesized using an innovative method which combines the phase inversion and sol-gel techniques. Morphological characterization was performed by scanning electron microscopy (SEM), and the chemical composition was analyzed by Fourier transform infrared spectroscopy in attenuated total reflection mode (ATR-FTIR). The characterization of the monophasic hybrid CA-SiO2-(CH2)3NH2 membrane in terms of permeation properties was carried out in an in-house-built single hemodialysis membrane module (SHDMM) under dynamic conditions. Permeation experiments were performed to determine the hydraulic permeability (Lp), molecular weight cut-off (MWCO) and the rejection coefficients to urea, creatinine, uric acid, and albumin. SEM confirmed the existence of a very thin (<1 µm) top dense layer and a much thicker bottom porous surface, and ATR-FTIR showed the main bands belonging to the CA-based membranes. Permeation studies revealed that the Lp and MWCO of the CA-SiO2-(CH2)3NH2 membrane were 66.61 kg·h-1·m-2·bar-1 and 24.5 kDa, respectively, and that the Lp was 1.8 times higher compared to a pure CA membrane. Furthermore, the CA-SiO2-(CH2)3NH2 membrane fully permeated urea, creatinine, and uric acid while completely retaining albumin. Long-term filtration studies of albumin solutions indicated that fouling does not occur at the surface of the CA-SiO2-(CH2)3NH2 membrane.

Improving hydraulic permeability, mechanical properties, and chemical functionality of cellulose acetate-based membranes by co-polymerization with tetraethyl orthosilicate and 3-(aminopropyl)triethoxysilane.

Composite cellulose acetate (CA) membranes are widely used but their multiphase nature results in additive losses, poor mechanical strength, low chemical resistance and thermal stability, limiting their separation/purification yields. To overcome this, we fabricated monophasic hybrid membranes using a modified phase inversion technique, where tetraethylorthosilicate and 3-(aminopropyl)triethoxysilane were added to the CA casting solution. The resulting co-polymerization between CA, silanols and amine-functionalized silica groups, through sol-gel chemistry, was proved by ATR-FTIR (1118 cm-1, ν(SiOC)). The presence of propyl-amine groups increases the hydraulic permeability (3×), the rupture elongation (×1.5), and decreases the Young modulus (×1/2), due to the disruption of the CA-silica 3D network. For high propyl-amine contents this behaviour is reversed due to intensive cross-linking between CA-silica chains (decrease in 903 cm-1, ν(CH3COOC-)). The addition of silica- and amine-based structures to the CA framework increases the system degrees of freedom, opening the door to the design of new CA membranes.

Challenges of reducing protein-bound uremic toxin levels in chronic kidney disease and end stage renal disease.

The prevalence of chronic kidney disease (CKD) in the worldwide population is currently estimated between 11% and 13%. Adequate renal clearance is compromised in these patients and the accumulation of a large number of uremic retention solutes results in an irreversible worsening of renal function which can lead to end stage renal disease (ESRD). Approximately three million ESRD patients currently receive renal replacement therapies (RRTs), such as hemodialysis, which only partially restore kidney function, as they are only efficient in removing mainly small, unbound solutes from the circulation while leaving larger and protein-bound uremic toxins (PBUTs) untouched. The accumulation of PBUTs in patients highly increases the risk of cardiovascular events and is associated with higher mortality and morbidity in CKD and ESRD. In this review, we address several strategies currently being explored toward reducing PBUT concentrations, including clinical and medical approaches, therapeutic techniques, and recent developments in RRT technology. These include preservation of renal function, limitation of colon derived PBUTs, oral sorbents, adsorbent RRT technology, and use of albumin displacers. Despite the promising results of the different approaches to promote enhanced removal of a small percentage of the more than 30 identified PBUTs, on their own, none of them provide a treatment with the required efficiency, safety and cost-effectiveness to prevent CKD-related complications and decrease mortality and morbidity in ESRD.

Synthesis and Characterization of Novel Integral Asymmetric Monophasic Cellulose-Acetate/Silica/Titania and Cellulose-Acetate/Titania Membranes.

Two series of novel integral asymmetric monophasic hybrid membranes, cellulose acetate/silica/titania (CA/SiO2/TiO2-series 1) and cellulose acetate/titania (CA/TiO2-series 2), were developed by the coupling of sol-gel technology and a modified version of the phase inversion technique. SEM micrographs confirmed the integral asymmetric structure of all membranes. ATR-FTIR and ICP-OES results showed that, for the membranes in series 1, TiO2 is covalently bound to SiO2, which, in turn, is covalently bound to CA, while for the membranes in series 2, TiO2 is directly and covalently bound to the CA matrix. Permeation experiments revealed that the permeation performance of the membranes in series 1 is unaffected by the introduction of TiO2. In contrast, the introduction of TiO2 in the series 2 membranes increased the hydraulic permeability by a factor of at least 2 when compared to the pristine CA membrane and that incremental additions of TiO2 further increased the Lp.

Sorption/Diffusion Contributions to the Gas Permeation Properties of Bi-Soft Segment Polyurethane/Polycaprolactone Membranes for Membrane Blood Oxygenators.

Due to their high hemocompatibility and gas permeation capacity, bi-soft segment polyurethane/polycaprolactone (PU/PCL) polymers are promising materials for use in membrane blood oxygenators. In this work, both nonporous symmetric and integral asymmetric PU/PCL membranes were synthesized, and the permeation properties of the atmospheric gases N2, O2, and CO2 through these membranes were experimentally determined using a new custom-built gas permeation apparatus. Permeate pressure vs. time curves were obtained at 37.0 °C and gas feed pressures up to 5 bar. Fluxes, permeances, and permeability coefficients were determined from the steady-state part of the curves, and the diffusion and sorption coefficients were estimated from the analysis of the transient state using the time-lag method. Independent measurements of the sorption coefficients of the three gases were performed, under equilibrium conditions, in order to validate the new setup and procedure. This work shows that the gas sorption in the PU/PCL polymers is the dominant factor for the permeation properties of the atmospheric gases in these membranes.

Co-current crossflow microfiltration in a microchannel.

Steady state crossflow microfiltration (CMF) is an important and often necessary means of particle separation and concentration for both industrial and biomedical processes. The factors controlling the performance of CMF have been extensively reviewed. A major factor is transmembrane pressure (TMP). Because microchannels have small height, they tend to have high pressure gradients in the feed-flow direction. In the extreme, these gradients may even reverse the pressure across the membrane (inciting backflow). It is therefore desirable to compensate for the effect of feed-flow on the TMP, aiming at constant transmembrane pressure (cTMP) at a value which maximizes filtrate flux. This is especially critical during filtration of deformable particles (e.g. erythrocytes) through low intrinsic resistance membranes. Filtration flux is generally taken to be directly proportional to TMP, with pressure drop along the channel decreasing in the flow direction. A co-current flow of filtrate in a suitably designed filtrate collecting channel is shown to allow the TMP to remain constant and permit the sieving surface to perform optimally, permitting up to twice as much filtration over that of a naïve configuration. Manipulation of the filtrate channel may be even more beneficial if it prevents backflow that might otherwise occur at the end of a sufficiently long channel. Experiments with erythrocyte suspensions, reported here, validate these concepts.

Bacterial DNA patterns identified using paired-end Illumina sequencing of 16S rRNA genes from whole blood samples of septic patients in the emergency room and intensive care unit.

BACKGROUND: Sepsis refers to clinical presentations ranging from mild body dysfunction to multiple organ failure. These clinical symptoms result from a systemic inflammatory response to pathogenic or potentially pathogenic microorganisms present systemically in the bloodstream. Current clinical diagnostics rely on culture enrichment techniques to identify bloodstream infections. However, a positive result is obtained in a minority of cases thereby limiting our knowledge of sepsis microbiology. Previously, a method of saponin treatment of human whole blood combined with a comprehensive bacterial DNA extraction protocol was developed. The results indicated that viable bacteria could be recovered down to 10 CFU/ml using this method. Paired-end Illumina sequencing of the 16S rRNA gene also indicated that the bacterial DNA extraction method enabled recovery of bacterial DNA from spiked blood. This manuscript outlines the application of this method to whole blood samples collected from patients with the clinical presentation of sepsis. RESULTS: Blood samples from clinically septic patients were obtained with informed consent. Application of the paired-end Illumina 16S rRNA sequencing to saponin treated blood from intensive care unit (ICU) and emergency department (ED) patients indicated that bacterial DNA was present in whole blood. There were three clusters of bacterial DNA profiles which were distinguished based on the distribution of Streptococcus, Staphylococcus, and Gram-negative DNA. The profiles were examined alongside the patient's clinical data and indicated molecular profiling patterns from blood samples had good concordance with the primary source of infection. CONCLUSIONS: Overall this study identified common bacterial DNA profiles in the blood of septic patients which were often associated with the patients' primary source of infection. These results indicated molecular bacterial DNA profiling could be further developed as a tool for clinical diagnostics for bloodstream infections.

Erythrocyte fouling on micro-engineered membranes.

Crossflow microfiltration of plasma from blood through microsieves in a microchannel is potentially useful in many biomedical applications, including clinically as a wearable water removal device under development by the authors. We report experiments that correlate filtration rates, transmembrane pressures (TMP) and shear rates during filtration through a microscopically high channel bounded by a low intrinsic resistance photolithographically-produced porous semiconductor membrane. These experiments allowed observation of erythrocyte behavior at the filtering surface and showed how their unique deformability properties dominated filtration resistance. At low filtration rates (corresponding to low TMP), they rolled along the filter surface, but at higher filtration rates (corresponding to higher TMP), they anchored themselves to the filter membrane, forming a self-assembled, incomplete monolayer. The incompleteness of the layer was an essential feature of the monolayer's ability to support sustainable filtration. Maximum steady-state filtration flux was a function of wall shear rate, as predicted by conventional crossflow filtration theory, but, contrary to theories based on convective diffusion, showed weak dependence of filtration on erythrocyte concentration. Post-filtration scanning electron micrographs revealed significant capture and deformation of erythrocytes in all filter pores in the range 0.25 to 2 µm diameter. We report filtration rates through these filters and describe a largely unrecognized mechanism that allows stable filtration in the presence of substantial cell layers.

Structure of water in hybrid cellulose acetate-silica ultrafiltration membranes and permeation properties.

Hybrid cellulose acetate (CA) silica (SiO2) (CA/SiO2) membranes were synthesized by promoting the in situ condensation between silanols from the SiO2 precursor and the COH or acetate groups from the CA polymer. For all the CA/SiO2 membranes, the ATR-FTIR peak assigned to (SiOC) proves the hybrid condensation reaction and confirms the synthesis of monophasic hybrid membranes. ATR-FTIR shows the presence of uncondensed highly reactive SiOH species, in membranes with silica contents higher than 20 mol%. Together with RMN studies, results show molecular water strongly hydrogen-bonded with SiOH groups, yielding a drastic decrease in the membrane hydraulic permeability, from 57 to 10 kg/h/m2/bar. The incorporation of 5 and 10 mol% of silica increased the hydraulic permeability from 32 to 82 kg/h/m2/bar when compared to the CA membrane.

Particle spallation in a microfluidic blood processing device: the problem of using peristaltic pumps and silicon-based microfilters.

Peristaltic pumps rely on constant compression of elastomeric tubing from which particles may be shed, a phenomenon known as spallation. We studied spallated particles on microfluidic filtration devices with photolithographically prepared micron-level pore fields. Filtration of ultra-pure water through these pores was analyzed using either the usual peristaltic pump or a reciprocating pair of syringe pumps. Using syringe pumps, transmembrane pressure (TMP) values during filtration at 2.5 cm3/min revealed steady filtration for over 80 minutes at 2.3 mmHg. Using the peristaltic pump, TMP was never stable, increasing to approximately 11 mmHg during the first 10 minutes. Pore plugging was the culprit, evidenced by post-perfusion microphotography.

Spallation of Small Particles From Peristaltic Pump Tube Segments.

In most extracorporeal filtration devices such as hemodialysis a peristaltic pump is used to circulate blood. Pump function requires the repeated compression of an elastomeric tube from which particles may be shed into the circulatory system, a process called spallation. Earlier studies are likely to have missed the large number of small particles (<2 µm in diameter) that appear. The present study uses more modern equipment that detects and sizes particles down to 0.6 µm. As polyvinyl chloride (PVC) tubing is commonly used for this process, a series of studies was conducted on three different types to study its spallation characteristics, along with a co-extruded PVC/polyurethane tubing known for its enhanced biocompatibility properties. For all types of PVC tubes, the average size of the spallated particles was 0.83 ± 0.03 µm; for the PVC/polyurethane tubing the average size of the spallated particles was approximately twice that reported for PVC tubing. For PVC tubes with equal inner diameter, those with less plasticizer released fewer particles; for tubes with the same Shore hardness, tubes with larger internal diameters released fewer particles. It was also shown that PVC tubes operating at a slower flow rate does not reduce the total number of particles released per volume pumped. The total number of particles spallated from the PVC/polyurethane tubing was 10 times lower than from the lowest spallating PVC tubing.

Single cutaneous metastasis of colon adenocarcinoma - Case report.

Skin metastases are relatively rare and occur most often when the cancer is already advanced, invading other organs. As to location, they often seem to elect areas located close to the primary tumor, although distant sites, such as the scalp, may be affected with some frequency. We present a case of a 76-year-old woman with colon adenocarcinoma that had a single metastatic lesion on the scalp.