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Biomedical subjects

H Göhl

Publications and source records attributed to H Göhl.

13 recordsLinked to original sources
PubMed1994

Bacteria- and endotoxin-free dialysis fluid for use in chronic hemodialysis.

As the quality of water in the dialysis fluid varies considerably, dialysis fluid is contaminated with a high percentage of bacteria and endotoxins. The bacterial populations contained in the dialysis fluid are as heterogeneous as the chemical structure of the endotoxins that result. The latter can pass through the dialysis membrane whereby high-flux membranes permit a larger number of retransportable molecules than low-flux membranes. A central aim toward a future, safe dialysis process should, therefore, be the production of a dialysate that is free of bacteria and endotoxins. As we were able to demonstrate in various examinations, this goal is most likely to be achieved with the aid of sterile filtration using hollow fiber modules of polyamid. To avoid disinfection of the polyamid membrane, as this would only reach bacteria but not endotoxins, the filter was changed after at most 10 h. The achieved dialysis fluid was free of bacteria and endotoxins. We were also able to show that the release of interleukin-1 was reduced. In addition, side-effects, such as a drop in blood pressure, headaches, muscular cramps, and nausea, were reduced.

Bacteria↗
PubMed1994

Role of proteinase/antiproteinase inhibitor disequilibrium in the bioincompatibility induced by artificial surfaces.

As one aspect of bioincompatibility, the importance of activation of proteolytic systems as a result of an imbalance between protease and antiprotease activity has been increasingly recognized. This principle is illustrated by selected studies in our laboratory. These concern (i) generation of kinins on membranes with negative surface charge, (ii) activation of the complement system as a function of binding to the membrane of the regulatory protein H, (iii) generation of thrombin-antithrombin complexes (TAT), and (iv) generation of plasmin/antiplasmin complexes with an interesting discrepancy between in vivo and in vitro.

Animals↗
PubMed1994

Studies of biocompatibility of different dialyzer membranes: role of complement system, intracellular calcium and inositol-triphosphate.

PMNLs are activated during extracorporeal circulation. The aim of this cross-over biocompatibility study was to investigate the role of complement system, intracellular calcium [Ca2+]i and inositol-triphosphate (IP3) on PMNL degranulation during hemodialysis (HD) with following membranes: polyamide, hemophane and cuprophane. In a second study the effect of complement system, intracellular calcium and IP3 on lactoferrin release during HD with polysulfone and polymethylmethacrylate (PMMA) was also investigated. HD with cuprophane leads to the highest formation of terminal complement component (TCC) followed by PMMA and hemophane. There was a strong correlation between maximal arterial TCC formation and procentual increase of plasma lactoferrin during hemodialysis treatment with all membranes. Both HD with PMMA and hemophane leads to a significant increase of resting [Ca2+]i after 30 minutes of HD. Lowest TCC formation and lowest rise in [Ca2+]i were observed with polysulfone and polyamide. Procentual and absolute increase of [Ca2+]i did also correlate with maximal TCC formation during HD using PMMA, hemophane, polyamide and polysulfone. Since cuprophane induces an initial drop of PMNLs, these cells could not be isolated during HD with cuprophane membranes. Resting PMNL IP3 values were similar before and 30 minutes after begin of hemodialysis and comparable with all membranes used. These data indicate that TCC and intracellular calcium are important signals for PMNL degranulation during HD with cuprophane, PMMA and hemophane. However, mild degranulation of specific PMNL granules can also occur in the absence of significant change in TCC, [Ca2+]i or IP3 levels during HD with polyamide or polysulfone.

Biocompatible Materials↗
PubMed1992

Basic features of the polyamide membranes.

Progress in membrane and membrane process development have contributed to the continuous improvement of the extracorporeal treatment of renal failure during the last 40 years. Today membranes can be adapted to the specific needs required by their clinical application. Synthetic structures like the polyamide membranes offer a wide range of possibilities in performance and hemocompatibility, due to: (1) the use of block polymers or polymer blends and mixtures, and (2) modification of membrane structure, pore size and porosity, due to changes of the preparation process. However, further improvements are still required to achieve the ultimate goal of matching the performance of biological membranes.

Diffusion↗
PubMed1986

PC-PE hollow-fiber membrane. Structure, performance characteristics and manufacturing.

Polyether-polycarbonate hollow fibers, spun by the phase inversion method, yield a dialysis membrane with a limited ultrafiltration coefficient but high diffusive permeability. Dialysers are made out of this membrane and are sterilized by gamma radiation. The dialysers show controlled ultrafiltration and clearance values for smaller molecular weight substances in the range of cellulosic membranes, but for larger molecular weight substances the clearances are higher. Correlation for ultrafiltration and clearance values, measured in saline and whole blood, indicate low interactions between blood and membrane.

Creatinine↗
PubMed1983

Hyperthermic perfusion in malignant melanoma: 5-year results.

Between December 1975 and December 1980 a total of 154 patients with potentially curable malignant melanoma were treated by adjuvant hyperthermic perfusion. The basic therapy consisted in local excision of the primary tumor with elective dissection of the regional lymph nodes. The 4- and 5-year survival rates for our 103 patients with stage-I disease who were perfused are 90% +/- 9% and 80% +/- 17%. The 4- and 5-year survival rates for 51 patients with stage-II disease are 50% +/- 16% and 37% +/- 28%. Compared with historic control groups of patients who were treated at our hospital with the same surgical methods but without perfusion, essentially better results were achieved with adjuvant hyperthermic perfusion. It is concluded from our results that hyperthermic perfusion can further improve the prognosis for patients with malignant melanomas of the limbs.

Chemotherapy, Cancer, Regional Perfusion↗
PubMedDate not supplied

Significant reduction of factor D and immunosuppressive complement fragment Ba by hemofiltration.

Because of their effect on the immune response, especially in patients with chronic or acute renal failure, factor D (FD) and the immunosuppressive complement fragment Ba are substances which may be important for the immunological status. Since they cannot be eliminated by conventional Cuprophan hemodialysis because of their high molecular weight (24,000 and 33,000 D, respectively), the effect of hemofiltration (HF) on the plasma concentration of both components was tested. It was shown that plasma levels of FD can be lowered by 43.5% during an HF treatment and the plasma concentration of Ba by 30.6%. Moreover, the two substances could be detected in the hemofiltrate. Up to 75 mg FD and up to 37 mg Ba could be eliminated per treatment, depending on the plasma concentrations and the filtration volume. A convective method such as chronic HF is therefore clearly superior to diffusive methods of blood purification when substances with such a high molecular weight have to be eliminated. It has still to be established whether the elimination of FD and Ba by chronic intermittent HF results in a sustained improvement in the immunological status of patients treated in this way.

Adult↗