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Biomedical subjects

G Bergonzi

Publications and source records attributed to G Bergonzi.

6 recordsLinked to original sources

Aging of silastic peritoneal catheters.

Increasing the survival of patients on CAPD is related to the long-term reliability of the peritoneal access. Six silicone Tenckhoff catheters (with strip or diffuse barium sulphate inclusion) removed after 39-69 months because of the appearance of external segment fissures, were analysed by scanning electron microscopy (SEM) and infra-red spectroscopy with attenuated total refractance (ATR). The extracorporeal portion of the catheters showed (by ATR) a more prominent oxidation peak on the external than the internal surface; SEM showed marks and cracks on the external surface and exfoliation and flattening of the silastic reticle on the intraluminal surface. No evidence of oxidation was found in the intra-abdominal portion of the catheters but biofilm was found. We suggest that barium sulphate may render the silastic brittle and physiological and environmental long-term factors (such as uv-rays, temperature, sweat and disinfectants) could cause oxidation and loss of physico-chemical properties, with critical aging of the silastic and loss of catheter resistance to mechanical injury.

Adult↗

Dextran deposits in tissues of patients undergoing haemodialysis.

Recently the possible storage of dextran-related material in patients undergoing regular haemodialysis has been suggested. We examined biopsy and autopsy specimens of 32 patients treated with regular haemodialysis for 61 +/- 34 months. All patients received dextran-40 as a plasma expander because of hypotension during haemodialysis. The same study was carried out in a control group of 11 haemodialysed patients who were given other plasma expanders. In the 11 patients who received larger doses of dextran-40 (0.38 g/kg body weight per week) we found particles in the cytoplasm of macrophages in various organs, which proved PAS positive and diastase resistant on light microscopy, and birefringent on polarisation. Electron microscopy revealed a fibrillar structure, but ionic analysis by electronic sampler on scanning electron microscopy excluded the presence of silicon. No intracellular inclusions were observed in the control group, nor in the patients given dextran-40 in doses lower than 0.08 g/kg body weight per week. As we also found a linear relationship between the number of particles and the dextran-40 doses given, we hypothesise that the material demonstrated in the macrophages is a structurally modified dextran.

Cytoplasm↗