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  • 1.
    Aljadi, Zenib
    et al.
    KTH, Skolan för bioteknologi (BIO), Proteomik och nanobioteknologi. Karolinska Institute, Sweden.
    Mansouri, Ladan
    Nopp, Anna
    Paulsson, Josefin M.
    Winqvist, Ola
    Russom, Aman
    KTH, Skolan för bioteknologi (BIO), Proteomik och nanobioteknologi.
    Stahl, Marten
    Hylander, Britta
    Jacobson, Stefan H.
    Lundahl, Joachim
    Activation of Basophils Is a New and Sensitive Marker of Biocompatibility in Hemodialysis2014Ingår i: Artificial Organs, ISSN 0160-564X, E-ISSN 1525-1594, Vol. 38, nr 11, s. 945-953Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The hemodialysis procedure involves contact between peripheral blood and the surface of dialyzer membranes, which may lead to alterations in the pathways of innate and adaptive immunity. We aimed to study the effect of blood-membrane interaction on human peripheral basophils and neutrophils in hemodialysis with high- and low-permeability polysulfone dialyzers. The surface expression of CD203c (basophil selection marker) and CD63 (activation marker) after activation by the bacterial peptide formyl-methionyl-leucyl-phenylalanine (fMLP) or anti-Fc epsilon receptor I (Fc epsilon RI) antibody and the absolute number of basophils was investigated before and after hemodialysis with each of the dialyzers. Moreover, the expression on neutrophils of CD11b, the CD11b active epitope, and CD88 was analyzed in the same groups of individuals. The expression of CD63 in basophils following activation by fMLP was significantly higher in the patient group compared with that in healthy controls, but no differences were observed after activation by anti-Fc epsilon RI. During the hemodialysis procedure, the low-flux membrane induced up-regulation of CD63 expression on basophils, while passage through the high-flux membrane did not significantly alter the responsiveness. In addition, the absolute number of basophils was unchanged after hemodialysis with either of the dialyzers and compared with healthy controls. We found no significant differences in the expression of the neutrophil activation markers (CD11b, the active epitope of CD11b, and CD88) comparing the two different dialyzers before and after dialysis and healthy controls. Together, these findings suggest that alterations in basophil activity may be a useful marker of membrane bioincompatibility in hemodialysis.

  • 2. Fuchs, Gabriel
    et al.
    Berg, Niclas
    KTH, Skolan för teknikvetenskap (SCI), Mekanik. KTH, Skolan för teknikvetenskap (SCI), Centra, Linné Flow Center, FLOW.
    Eriksson, Anders
    Prahl Wittberg, Lisa
    KTH, Skolan för teknikvetenskap (SCI), Mekanik. KTH, Skolan för teknikvetenskap (SCI), Centra, Linné Flow Center, FLOW.
    Detection of Thrombosis in the Extracorporeal Membrane Oxygenation Circuit by Infrasound: Proof of Concept2017Ingår i: Artificial Organs, ISSN 0160-564X, E-ISSN 1525-1594, Vol. 41, nr 6, s. 573-579Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    As of today, there exist no reliable, objective methods for early detection of thrombi in the extracorporeal membrane oxygenators (ECMO) system. Within the ECMO system, thrombi are not always fixed to a certain component or location in the circuit. Thus, clot fragments of different shapes and consistencies may circulate and give rise to vibrations and sound generation. By bedside sound measurements and additional laboratory experiments (although not detailed herein), we found that the presence of particles (clots or aggregates and fragments of clots) can be detected by analyzing the strength of infra-sound (< 20 Hz) modes of the spectrum near the inlet and outlet of the centrifugal pump in the ECMO circuit. For the few patients that were considered in this study, no clear false positive or negative examples were found when comparing the spectral approach with clinical observations. A laboratory setup provided insight to the flow in and out of the pump, confirming that in the presence of particles a low-amplitude low-frequency signal is strongly amplified, enabling the identification of a clot.

  • 3. Lindfors, M.
    et al.
    Frenckner, B.
    Sartipy, U.
    Bjällmark, A.
    Broomé, Michael
    KTH, Skolan för teknik och hälsa (STH), Medicinsk teknik.
    Venous Cannula Positioning in Arterial Deoxygenation During Veno-Arterial Extracorporeal Membrane Oxygenation-A Simulation Study and Case Report2016Ingår i: Artificial Organs, ISSN 0160-564X, E-ISSN 1525-1594Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Venoarterial extracorporeal membrane oxygenation (VA-ECMO) is indicated in reversible life-threatening circulatory failure with or without respiratory failure. Arterial desaturation in the upper body is frequently seen in patients with peripheral arterial cannulation and severe respiratory failure. The importance of venous cannula positioning was explored in a computer simulation model and a clinical case was described. A closed-loop real-time simulation model has been developed including vascular segments, the heart with valves and pericardium. ECMO was simulated with a fixed flow pump and a selection of clinically relevant venous cannulation sites. A clinical case with no tidal volumes due to pneumonia and an arterial saturation of below 60% in the right hand despite VA-ECMO flow of 4 L/min was described. The case was compared with simulation data. Changing the venous cannulation site from the inferior to the superior caval vein increased arterial saturation in the right arm from below 60% to above 80% in the patient and from 64 to 81% in the simulation model without changing ECMO flow. The patient survived, was extubated and showed no signs of hypoxic damage. We conclude that venous drainage from the superior caval vein improves upper body arterial saturation during veno-arterial ECMO as compared with drainage solely from the inferior caval vein in patients with respiratory failure. The results from the simulation model are in agreement with the clinical scenario.

  • 4. Popovic, Dejan B.
    et al.
    Bijelic, Goran
    KTH, Skolan för kemivetenskap (CHE), Kemi, Ytkemi.
    Miler, Vera
    Dosen, Strahinja
    Popovic, Mirjana B.
    Schwirtlich, Laszlo
    Lumbar Stimulation Belt for Therapy of Low-Back Pain2009Ingår i: Artificial Organs, ISSN 0160-564X, E-ISSN 1525-1594, Vol. 33, nr 1, s. 54-60Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    We developed the STIMBELT, an electrical stimulation system that comprises a lumbar belt with up to eight pairs of embedded electrodes and an eight-channel electronic stimulator. The STIMBELT is an assistive system for the treatment of low-back pain (LBP). We describe here technical details of the system and summarize the results of its application in individuals with subacute and chronic LBP. The direct goals of the treatment were to relieve pain, reduce muscle spasms, increase strength and range of motion, and educate individuals with LBP in reducing the chances of its reoccurrence. The outcome measures include: a Visual Analogue Scale (VAS), the Oswestry LBP Disability Questionnaire, the Short Form (SF)-12 health survey, and the Manual Muscle Test. The results indicate significant benefits for individuals who use the STIMBELT in addition to the conventional therapy as opposed to only the conventional therapy.

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