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We present a miniaturized molecular beam epitaxy (miniMBE) system with an outer diameter of 206 mm, optimized for flexible and high-throughput operation. The three-chamber system, used here for oxide growth, consists of a sample loading chamber, a storage chamber, and a growth chamber. The growth chamber is equipped with eight identical effusion cell ports with linear shutters, one larger port for either a multi-pocket electron beam evaporator or an oxygen plasma source, an integrated cryoshroud, retractable beam-flux monitor or quartz-crystal microbalance, reflection high energy electron diffraction, substrate manipulator, main shutter, and quadrupole mass spectrometer. The system can be combined with ultrahigh vacuum (UHV) end stations on synchrotron and neutron beamlines, or equivalently with other complex surface analysis systems, including low-temperature scanning probe microscopy systems. Substrate handling is compatible with most UHV surface characterization systems, as the miniMBE can accommodate standard surface science sample holders. We introduce the design of the system, and its specific capabilities and operational parameters, and we demonstrate the epitaxial thin film growth of magnetoelectric Cr2O3 on c-plane sapphire and ferrimagnetic Fe3O4 on MgO (001).
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CONTEXT: Alternative hemodialysis schedules have been proposed to improve the quality of the dialysis. Nonetheless, their influence upon mineral and bone disorders is unknown. OBJECTIVE: To report the impact of a daily hemodialysis schedule upon the lesions of renal osteodystrophy. TYPE OF STUDY: Prospective non-controlled study. SETTING: Public University Hospital. PARTICIPANTS: Five patients treated by daily hemodialysis for at least 24 months. INTERVENTION: Daily dialysis sessions were accomplished with non-proportional dialysis machines without an ultrafiltration control device, with blood flow of 300 ml/min, bicarbonate dialysate ([Ca]=3.5 mEq/L) at 500 ml/min, and low-flux membrane dialyzers. Sessions were started at 6:00 p.m. (except Sundays) and lasted 2 hours. MAIN MEASUREMENTS: Serum levels of Ca and P from the last 6 months on conventional hemodialysis for the same patients were used for comparison with each semester of daily hemodialysis. Bone biopsies and PTH levels were obtained at the end of the conventional hemodialysis period and then again after 2 years of daily hemodialysis. RESULTS: Mean serum calcium was significantly higher during the second and third semesters of daily dialysis [10.0 mg% (SD 0.6), and 10.0 mg% (SD 0.8), respectively] compared to standard dialysis [9.4 mg% (SD 0.8)], p < 0.05. Mean values for phosphorus were significantly lower during every semester of daily hemodialysis [6.3 mg% (SD 1.8), 5.8 mg% (SD 1.7), 6.0 mg% (SD 1.7), and 6.0 mg% (SD 1.8)] compared to standard dialysis [7.2 mg% (SD 2.7)], P < 0.05. Variations in mean Ca x P product followed the same pattern as for phosphorus [59.5 (SD 16.0), 57.1 (SD 16.3), 59.8 (SD 17.7), and 58.31 (SD 20.9) vs. 68.6 (SD 27.3), P < 0.05]. After 2 years on daily hemodialysis, 2 patients who had aplastic lesion were found to have mild bone disorder. In addition, one patient with mixed bone lesion and moderate bone aluminum accumulation had osteitis fibrosa with no aluminum. Intact PTH values at the beginning of study and after 2 years on daily hemodialysis did not differ [134 pg/ml (SD 66) vs. 109 pg/ml (SD 26), P = 0.60, respectively]. CONCLUSIONS: Patients treated using daily hemodialysis had better control of serum phosphorus and perhaps a lower risk of metastatic calcifications. Daily hemodialysis also seemed to be beneficial to low turnover bone disease and bone aluminum deposition.
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Calcio/sangre , Trastorno Mineral y Óseo Asociado a la Enfermedad Renal Crónica/etiología , Fallo Renal Crónico/terapia , Fósforo/sangre , Diálisis Renal/efectos adversos , Adulto , Biopsia , Distribución de Chi-Cuadrado , Trastorno Mineral y Óseo Asociado a la Enfermedad Renal Crónica/sangre , Creatina/sangre , Estudios de Seguimiento , Humanos , Fallo Renal Crónico/sangre , Masculino , Estudios Prospectivos , Albúmina Sérica , Urea/sangreRESUMEN
Little attention has been given to the effects of reuse on the permeability of low-flux membranes, especially regarding middle molecules. We studied two different types of low-flux membranes at reuses 0, 6, and 12 in five patients undergoing hemodialysis with the following combinations of membrane and sterilant: cellulose diacetate membrane and formaldehyde, polysulfone membrane and formaldehyde, cellulose diacetate membrane and peracetic acid, and polysulfone and peracetic acid. The permeability of the membranes was assessed through the hydraulic ultrafiltration coefficient (K(UF)), sieving coefficient for beta(2)-microglobulin (B2M), and vitamin B(12) and albumin concentrations in ultrafiltrate. After 12 reuses, total cell volume (TCV) tended to be reduced in both cellulose diacetate and polysulfone dialyzers irrespective of the sterilant used, but significance was only found for the first set of dialyzers. Cellulose diacetate dialyzers reprocessed with either formaldehyde or peracetic acid showed an important reduction in K(UF) (31% [P < 0.05] and 23% [P < 0.05], respectively). A significant elevation in K(UF) was found in polysulfone membranes reprocessed with peracetic acid (41%; P < 0.05), but no alterations in K(UF) were found in polysulfone membranes reprocessed with formaldehyde. Cellulose diacetate membranes were intrinsically more permeable to B2M than polysulfone membranes (sieving coefficient, 6. 85 +/- 2.53 versus 0.04 +/- 0.02 x 10(-2); P < 0.001), which was not modified by any of the sterilants. Vitamin B(12) levels in ultrafiltrate decreased to an undetectable level in four of five samples collected after 12 reuses in polysulfone membranes reprocessed with peracetic acid (90 +/- 71 to 3 +/- 8 pg/mL; P < 0. 05 versus reuse 0). Albumin leakage occurred in two of five samples after the 12th reuse, but only in polysulfone membranes reprocessed with peracetic acid. Our findings suggest that reuse of low-flux polysulfone dialyzers reprocessed with peracetic acid is associated with structural damage of the membrane and a reduced permeability to middle molecules.
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Soluciones para Diálisis/química , Membranas Artificiales , Diálisis Renal , Estudios Cruzados , Equipo Reutilizado , Humanos , Permeabilidad , Estudios ProspectivosRESUMEN
In the present study, levels of free oxygen radicals, generated in the very early period of reperfusion during human kidney transplantation, were assessed by determination of malondialdehyde (MDA) levels using a high-pressure liquid chromatography (HPLC) method. Renal blood samples were obtained during reperfusion by intraoperative cannulation of the renal vein. Simultaneously, systemic MDA levels were determined. Furthermore, local and systemic levels of interleukin 6 (IL-6), tumor necrosis factor (TNF) receptors, p55 and p75, and vitamin E were measured. In a second group of patients, 500 mg of ascorbic acid were given prior to reperfusion. Renal MDA levels in the control group were always higher compared to systemic levels. IL-6 showed a marked increase shortly after reperfusion in the renal blood. In the scavenger group there was a diminution of these effects. TNF receptor levels and vitamin E remained largely unchanged. The results of this pilot study demonstrated clinically the moderate production of reactive oxygen species and the liberation of IL-6 shortly after reperfusion of human transplanted kidneys. Furthermore, the modulating effect of a radical scavenger on these effects was shown.
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Depuradores de Radicales Libres/farmacología , Trasplante de Riñón , Oxígeno/metabolismo , Adulto , Ácido Ascórbico/farmacología , Femenino , Radicales Libres , Humanos , Interleucina-6/análisis , Peroxidación de Lípido , Masculino , Malondialdehído/análisis , Persona de Mediana EdadRESUMEN
Three new aspects of the operative treatment of renal cell carcinoma can be made out: 1. for the removal of tumor thrombus extending to the right atrium, the surgical technique of choice involves whole-body hypothermia and extra-corporeal circulation. Only in this way can these tumors be removed completely under good vision. 2. Provided the patient's contralateral kidney is healthy, even small peripheral renal tumors should be submitted to radical nephrectomy. The rate of concomitant small tumors is reported to be as high as 20, while the recurrent rate associated with local incision is just on 7%, and the risk of carcinomas developing in the contralateral kidney is only 1.8-3.8%. 3. Radical nephrectomy for tumor should continue to include the ipsilateral adrenal gland. Although in our own patients the incidence of simultaneous adrenal metastasis was only 1.4%, if the adrenal gland is left in situ, part of the renal capsule also has to be left behind, and the upper pole of the kidney dissected free, with the associated risk of disseminating tumor cells.