Water permeability of high-flux dialyzer membranes after Renalin reprocessing.

Dialysis with high-flux membranes is widely used, in part, because they are thought to increase the removal of middle molecules when compared with low-flux membranes. Dialyzer reprocessing; however, is thought to alter middle molecule clearance. Renalin, a mixture of germicidal agents, has widespread use in dialyzer reprocessing. We determined the effect of Renalin reprocessing on the water permeability of three different dialyzers of Fresenius (F80A and 200A) and Gambro (17R) manufacture using the dead-end filtration method. Two hundred and seventeen, predominantly used but some new, dialyzers were evaluated. Water permeability of the used, but not the new, dialyzers fell abruptly and dramatically with reprocessing. The permeability fell almost 70% in the F80A dialyzer after three reprocessing procedures with similar, but somewhat slower declines, seen in the other two dialyzers. We conclude that there is a decline in water permeability seen in Renalin reprocessed dialyzers. This factor and the associated change in solute clearance and ultrafiltration characteristics should be considered in assessing the effectiveness of dialyzer reprocessing.

Effect of interface/offset (I/O) adjustment on collection efficiency using the Fenwal CS3000 Plus Blood Cell Separator for peripheral blood progenitor cell collection.

Peripheral blood progenitor cells (PBPC) reside within the mononuclear cell (MNC) component of the blood and can be collected using a number of apheresis devices, including the Fenwal CS3000 Plus Blood Cell Separator. Increased MNC collection efficiency, therefore, may reduce the number of apheresis required to achieve collection goals. In this study, patients were divided into groups by absolute MNC count to determine the effect of interface detector offset (I/O) adjustment on MNC collection efficiency. Apheresis products from 104 procedures collected using a standard I/O setting of 100 were compared with 121 collections for which the I/O setting was adjusted according to the preapheresis MNC count. Adjustment of the I/O setting in this manner had no statistically significant impact on the per kilogram dose of MNC collected. The data did show that MNC collection efficiency was reduced as both the MNC count and I/O setting increased, as the collection efficiency was greatest for patients with the lowest peripheral MNC counts and was inversely correlated with the preapheresis MNC count. Although contamination of the product with platelets was drastically reduced at higher I/O settings, there was a concomitant rise in RBC contamination. We conclude that a standard setting of 100 is preferable to adjustment of the I/O setting as a function of the preapheresis MNC count.

[Arthroscopic anatomy and diagnosis of posterior cruciate ligament injuries]. / Artroskopowa anatomia i diagnostyka uszkodzen wiezadla krzyzowego tylnego.

Basic problems of arthroscopically assisted diagnostics of posterior cruciate ligament injuries are presented. Anatomic "three-part" concept and arthroscopic postero-medial approach are recommended in visual judging of ligament competence. "Sloppy ACL" is considered as most valuable sign in diagnosis of posterior cruciate ligament injuries.

[Cyclops type changes--a specific complication after anterior cruciate reconstruction--a clinical and histopathologic study]. / Zmiana typu cyklopa--specyficzne powiklanie po rekonstrukcji wiezadlla krzyzowego przedniego--obraz kliniczny i histopatologiczny.

Four cases of specific complication following 15 anterior cruciate ligament reconstructions using isometric vascularized patellar tendon tendon graft are presented. During "second-look" arthroscopy in all 4 cases a nodule in anterior knee compartment was found. The consistent microscopic finding within the nodule was the presence of disorganized dense fibroconnective tissue. Small bone debris were found in all cases. Arthroscopic debridement was performed resulting in proper joint function.

Bilateral knee gunshot wounds successfully treated with arthroscopic bullet retrieval: a case report.

One unusual case of bilateral knee joint gunshot wounds caused by a low-velocity low-energy missile is presented. Arthroscopic retrieval of the bullets was performed resulting in recovery within 5 days.

Arthroscopic knee joint synovectomy in the treatment of early stages of rheumatoid arthritis.

Clinical results of 14 arthroscopic knee joint synovectomies are presented. They were done in grade II and III rheumatoid arthritis. Good and moderate results (according to Ogilvie-Harris) were obtained in 79% cases. Operative technique and postoperative management is presented. It was stated that arthroscopic synovectomy is most useful in II degree RA.

Vascularised patellar tendon graft in anterior cruciate ligament reconstruction.

Clinical results of 13 anterior cruciate ligament reconstructions by use of vascularised patellar tendon graft are presented. In all patients improvement was achieved resulting in good results in 62% cases (according to Lysholm score). Technical merits, fate of the graft and rehabilitation program are discussed. Described operation is recommended as the procedure of choice for the symptomatic anterior cruciate-deficient knee.

Intrathecal interferon in multiple sclerosis.

Human fibroblast interferon (IFN-beta) was administered by serial lumbar puncture to ten patients with multiple sclerosis (MS). Their clinical courses were compared with those of ten MS control patients who did not receive IFN-beta. As of this writing, the recipients have been followed up for 1.8 to 2.0 years (mean, 1.9 years), and the controls for 1.5 to 1.7 years (mean, 1.6 years). During the study, two recipients suffered four exacerbations, and six controls suffered 11 exacerbations. The recipients' rates of exacerbation during the study were significantly less than their rates both for the entire prestudy duration of the disease and for the 1.8 to 2.0 years immediately preceding entry into the study. The controls' rates of exacerbation before the study and during the study period did not differ significantly. Clinically, the conditions of five recipients and two controls improved, those of three recipients and four controls were unchanged, and those of two recipients and four controls worsened. Headaches, sometimes accompanied by fever and rarely by nausea and vomiting, occurred after injections of IFN-beta. Toxic symptoms usually disappeared within 24, hours; rarely, they persisted for seven to ten days. Each recipient had transient CSF pleocytosis and elevated levels to total protein (the latter remaining elevated in seven). These findings show that intrathecal administration of IFN-beta is feasible in patients with MS, warrant cautious optimism that intrathecal IFN-beta may be effective in altering the course of the disease, and support concepts of a viral or dysimmune cause of MS.