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1. DIALYSIS VASCULAR ACCESS

Author

N. Fontsere, G. Mestres, M. Burrel, M. Barrufet, X. Montana, M. Arias, R. Ojeda, F. Maduell, J. M. Campistol, P. Nagaraja, D. Rees, T. Husein, J. Chess, C.-C. Lin, W.-C. Yang, M. Khosravi, H. Kandil, J. Cross, S. Hopkins, S. Collier, D. Lopes, S. Pereira, A. M. Gomes, A. Ventura, V. Martins, J. Seabra, T. C. Rothuizen, F. Damanik, M. J. T. Visser, T. Lavrijsen, M. A. J. Cox, L. Moroni, T. J. Rabelink, J. I. Rotmans, C. Cardozo, J. Donate, A. Soriano, M. Muros, M. Pons, J. Mensa, J. F. Navarro-Gonzalez, A. Wijewardane, A. Murley, S. Powers, C. Allen, J. Baharani, T. Wilmink, M. Esenturk, M. Zengin, M. Dal, N. Tahtal, K. Shibata, T. Shinzato, H. Satta, M. Nishihara, N. Koguchi, T. Kuji, S. Kawata, T. Kaneda, G. Yasuda, J. Scrivano, L. Pettorini, T. Rutigliano, G. M. Ciavarella, L. De Biase, G. Punzo, P. Mene, N. Pirozzi, W. El Haggan, K. Belazrague, S. Ehoussou, V. Foucher, M. El Salhy, G. Ouellet, J. Davis, P. Caron, M. Leblanc, F. Romitelli, L. Fazzari, G. Ortu, E. Di Stasio, G. Loizzo, S. M. Vigano, G. Bacchini, E. Rocchi, V. Sala, G. Pontoriero, K. Letachowicz, T. Go biowski, M. Kusztal, W. Letachowicz, W. Weyde, M. Klinger, L. Hollingsworth, R. Roca-Tey, R. Samon, O. Ibrik, A. Roda, J. C. Gonzalez-Oliva, R. Martinez-Cercos, J. Viladoms, C. J. Renaud, E. K. Lim, T. Y. Seow, H. S. Teh, J. Tosic, A. Jankovic, P. Djuric, V. Radovic Maslarevic, J. Popovic, N. Dimkovic, A. Kazantzi, K. Trigka, F. Buono, S. Laurino, G. Toriello, R. Di Luccio, A. Galise, Y. O. Kim, S. A. Yoon, Y. S. Kim, S. J. Choi, J. W. Min, M. A. Cheong, M. Asano, K. Oguchi, A. Saito, Y. Onishi, Y. Yamamoto, S. Fukuhara, T. Akiba, T. Akizawa, K. Kurokawa, M. Guedes Marques, J. Ibeas, P. Maia, P. Ponce, K. Y. Chang, H. S. Park, H. W. Kim, B. S. Choi, C. W. Park, C. W. Yang, D. C. Jin, E. Likaj, S. Seferi, G. Caco, E. Petrela, M. Barbullushi, A. Idrizi, N. Thereska, C. Lomonte, F. Casucci, P. Libutti, P. Lisi, C. Basile, P. Ancarani, G. Valsuani, L. Cavallo, D. Parodi, C. Lorusso, C. Renaud, B. C. Lai, S. Tho, L. Yeoh, C. Botelho, A. Yankovoy, S. Alexandr, A. Smoliacov, V. Stepanov, C. Parker, P. Davies, S. Taylor, A. Mikhail, J. Gubensek, V. Persic, B. Vajdic, R. Ponikvar, J. Buturovic-Ponikvar, U. Hadimeri, A. V. Warme, B. Stegmayr, S. Suvakov, T. Damjanovic, S. Bajcetic, V. Radovic-Maslarevic, T. Simic, M. Rroji, H. L. Chua, H. Kanda, S. L. See, N. C. Liew, K. Tsuchida, T. Tomo, M. Fukasawa, S. Kawashima, J. Minakuchi, V. Thanaraj, A. Dhaygude, K. Ikeda, G. Forneris, P. Cecere, M. Pozzato, M. Trogolo, A. Vallero, P. Mesiano, D. Roccatello, L. Keskin, J. R. Casey, C. S. Hanson, W. C. Winkelmayer, J. Craig, S. Palmer, G. Strippoli, A. Tong, D. Ferrara, S. Scamarda, L. Bernardino, L. Amico, M. C. Lorito, f. Incalcaterra, L. Visconti, G. Visconti, F. Valenza, F. D'Amato, A. Di Napoli, L. Tazza, S. Chicca, E. Lapucci, P. Silvestri, D. Di Lallo, P. Michelozzi, and M. Davoli

Subjects
Transplantation, medicine.medical_specialty, Nephrology, business.industry, Vascular access, medicine, Intensive care medicine, Dialysis (biochemistry), business
Published
2014

2. Vascular access

Author

L. Coentrao, C. Ribeiro, C. Santos-Araujo, R. Neto, M. Pestana, E. Rahman, H. Rahman, D. Ahmed, D. Mousa, M. El Bishlawi, H. Shibahara, N. Shibahara, S. Takahashi, E. Dupuis, X. Duval, Q. Dornic, C. Bonnal, J.-C. Lucet, O. Cerceau, C. Randoux, C. Balde, F. Besson, F. Mentre, F. Vrtovsnik, G. Koutroubas, P. Malindretos, G. Zagotsis, P. Makri, C. Syrganis, E. Mambelli, E. Mancini, C. Elia, V. Guadagno, M. G. Facchini, A. Zucchelli, M. Grazia, L. Patregnani, A. Santoro, G. Stefan, S. Stancu, C. Capusa, O. R. Ailioaiei, G. Mircescu, S. Anwar, C. Little, R. Kingston, P. Diwakar, R. Kaikini, E. Nikolaou, G. Loukas, A. Sabry, K. Alsaran, S. Al Sherbeiny, M. Abdulkader, I. Kwak, S. Song, E. Seong, S. Lee, D. Lee, I. Kim, H. Rhee, F. Silva, J. Queiros, J. Malheiro, A. Cabrita, A. Rocha, P. Bamidis, C. Liaskos, I. Chryssogonidis, C. Frantzidis, A. Papagiannis, D. Vrochides, A. Lasaridis, P. Nikolaidis, S. Kotwal, C. Muir, C. Hawley, P. Snelling, M. Gallagher, M. Jardine, K. Shibata, Y. Toya, S. Umemura, T. Iwamoto, S. Ono, E. Ikeda, A. Kitazawa, T. Kuji, N. Koguchi, H. Satta, M. Nishihara, S. Kawata, T. Kaneda, Y. Yamada, T. Murakami, M. Yanagi, G. Yasuda, S. Mathieu, D. Yves, T. Jean-Michel, Q. Nicolas, C. Jean-Francois, M. Ibrahim, M. Abdel Salam, A. Awadalla, W. Bichari, S. Zaki, R. Roca-Tey, R. Samon, O. Ibrik, A. Roda, J. C. Gonzalez-Oliva, R. Martinez-Cercos, J. Viladoms, C.-C. Lin, W.-C. Yang, Y.-O. Kim, S.-A. Yoon, Y.-S. Yun, H.-C. Song, B.-S. Kim, M.-A. Cheong, T. Ogawa, T. Kiba, S. Okazaki, M. Hatano, M. Iwanaga, C. Noiri, A. Matsuda, H. Hasegawa, T. Mitarai, A. DI Napoli, D. DI Lallo, L. Tazza, C. De Cicco, M. F. Salvatori, S. Chicca, G. Guasticchi, S. Gelev, L. Trajceska, E. Srbinovska, S. Pavleska, A. Oncevski, P. Dejanov, V. Gerasomovska, G. Selim, A. Sikole, S. Wilson, T. Mayne, M. Krishnan, J. Holland, A. Volz, L. Good, A. Nissenson, A. Stavroulopoulos, V. Aresti, G. Maragkakis, S. Kyriakides, C. Rikker, E. Juhasz, L. Tornoci, S. Tovarosi, J. Greguschik, O. Mag, L. Rosivall, T. Golebiowski, E. Watorek, M. Kusztal, K. Letachowicz, W. Letachowicz, K. Madziarska, H. Augustyniak Bartosik, M. Krajewska, W. Weyde, M. Klinger, A. Capitanini, S. Lange, A. Cupisti, T. Schier, G. Gobel, C. Bosmuller, I. Gruber, M. Tiefenthaler, T. Shipley, J. Adam, D. Sweeney, S. Fenwick, H. Mansy, S. Ahmed, I. Moore, P. Vigeral, S. Saksi, M. Flamant, H. Boulanger, W.-D. Park, M. A. Cheong, M. Nikam, A. Tavakoli, E. Chemla, J. Evans, H. Malete, L. Matyas, I. Mogan, M. Lazarides, A. Ebner, Y. Shi, J. Zhang, J. Cheng, L. R. Frank, H. Melanie, B. Dominique, G. Michel, K. Ikeda, T. Yasuda, H. Yotueda, L. Ebah, A. Jayanti, D. Kanigicherla, A. Summers, G. Manley, G. Dutton, N. Chalmers, S. Mitra, I.-A. Checherita, A. Niculae, D. Radulescu, C. David, F. L. Turcu, A. Ciocalteu, V. Persic, J. Buturovic-Ponikvar, R. Ponikvar, M. Touam, V. Menoyo, T. Drueke, M. Rifaat, C. Muresan, M. Abtahi, Z. Koochakipour, D. Joly, J. Baharani, S. Rizvi, K. P. Ng, L. Buzzi, C. Sarcina, E. Alberghini, F. Ferrario, I. Baragetti, G. Santagostino, S. Furiani, E. Corghi, V. Terraneo, F. Rastelli, G. Bacchini, C. Pozzi, M. Adorati Menegato, R. Mortellaro, A. Locicero, A. Romano, P. P. Manzini, D. Steckiph, S. Shintaku, H. Kawanishi, M. Moriishi, M. Bansyodani, S. Nakamura, M. Saito, S. Tsuchiya, F. Barros, R. Vaz, B. Carvalho, P. Martins, E. Likaj, S. Seferi, M. Rroji, A. Idrizi, A. Duraku, M. Barbullushi, and N. Thereska

Subjects
Transplantation, Nephrology
Published
2013

3. AKI - Clinical

Author

E. Gok Oguz, R. Olmaz, K. Turgutalp, N. Muslu, M. A. Sungur, A. Kiykim, W. Van Biesen, J. Vanmassenhove, G. Glorieux, R. Vanholder, S. Chew, K. Forster, T. Kaufeld, J. Kielstein, T. Schilling, A. Haverich, H. Haller, B. Schmidt, P. Hu, X. Liang, Y. Chen, R. LI, F. Jiang, Z. LI, W. Shi, C. C. W. Lim, C. M. L. Chia, A. K. Tan, C. S. Tan, R. Ng, S. Subramani, A. Perez de Jose, C. Bernis Carro, R. Madero Jarabo, J. Bustamante, J. A. Sanchez Tomero, W. Chung, H. Ro, J. H. Chang, H. H. Lee, J. Y. Jung, L. Fazzari, A. Giuliani, J. Scrivano, L. Pettorini, U. Benedetto, R. Luciani, A. Roscitano, A. Napoletano, D. Coclite, E. Cordova, G. Punzo, R. Sinatra, P. Mene, N. Pirozzi, L. Shavit, R. Manilov, N. Algur, Y. Wiener-Well, I. Slotki, C. Pipili, C. S. Vrettou, K. Avrami, F. Economidou, K. Glynos, S. Ioannidou, V. Markaki, E. Douka, S. Nanas, A. De Pascalis, P. Cofano, S. Proia, A. Valletta, O. Vitale, F. Russo, E. Buongiorno, V. Filiopoulos, D. Biblaki, D. Lazarou, D. Chrysis, M. Fatourou, S. Lafoyianni, D. Vlassopoulos, O. Zakiyanov, V. Kriha, J. Vachek, J. Svarcova, T. Zima, V. Tesar, M. Kalousova, M. Kaushik, C. Ronco, D. Cruz, L. Zhang, W. Zhang, N. Chen, A. A. Ejaz, G. Kambhampati, N. Ejaz, B. Dass, V. Lapsia, A. A. Arif, A. Asmar, M. Shimada, M. Alsabbagh, R. Aiyer, R. Johnson, T.-H. Chen, C.-H. Chang, M.-Y. Chang, Y.-C. Tian, C.-C. Hung, J.-T. Fang, C.-W. Yang, Y.-C. Chen, V. Cantaluppi, A. D. Quercia, F. Figliolini, S. Giacalone, A. Pacitti, M. Gai, C. Guarena, G. Leonardi, L. Biancone, G. Camussi, G. P. Segoloni, M. De Cal, P. Lentini, A. Clementi, G. M. Virzi, E. Scalzotto, A. Lacquaniti, V. Donato, M. R. Fazio, S. Lucisano, V. Cernaro, R. Lupica, M. Buemi, I. Helvaci, E. Anik, M. Wani, D. I. Wani, D. M. A. Bhat, D. K. Banday, D. M. S. Najar, D. A. R. Reshi, D. N. A. Palla, P. Iglesias, T. Olea, C. Vega-Cabrera, M. Heras, M. A. Bajo, G. Del Peso, M. J. Arias, R. Selgas, J. J. Diez, E. Daher, P. L. Costa, E. N. S. Pereira, R. D. P. Santos, K. L. Abreu, G. Silva Junior, E. D. B. Pereira, M. Raimundo, S. Crichton, Y. Syed, J. Martin, C. Whiteley, D. Bennett, M. Ostermann, A. Gjyzari, N. Thereska, A. Koroshi, M. Barbullushi, S. Kodra, A. Idrizi, A. Strakosha, E. Petrela, J. Lemmich Smith, A. Klimenko, E. Tuykhmenev, S. Villevalde, Z. Kobalava, S. Avdoshina, E. Tyukhmenev, M. Efremovtseva, H. Hayashi, S. Suzuki, K. Kataoka, Y. Kondoh, H. Taniguchi, D. Sugiyama, K. Nishimura, W. Sato, S. Maruyama, S. Matsuo, Y. Yuzawa, D. Geraldine, F. Muriel, H. Alexandre, R. Eric, P. Fu, M. Pozzato, F. Ferrari, P. Cecere, P. Mesiano, A. Vallero, S. Livigni, F. Quarello, L. Hudier, O. Decaux, A. Haddj-Elmrabet, L. Mandart, M. Lino-Daniel, F. Bridoux, E. Renaudineau, T. Sawadogo, P. Le Pogamp, C. Vigneau, D. Famee, H. M. Koo, H. J. Oh, S. H. Han, K. H. Choi, S.-W. Kang, M. Mehdi, M. Nicolas, C. Mariat, P. Shah, V. B. Kute, A. Vanikar, M. Gumber, H. Patel, H. Trivedi, C. Manetos, S. Poulaki, E.-S. Tripodaki, A. Papastylianou, C. Routsi, K. Uchida, U. Kensuke, K. Yamagata, C. Saitou, M. Okada, G. Chita, M. Davies, Y. Veriawa, S. Naicker, P. Mukhopadhyay, D. Mukherjee, R. Mishra, M. Kar, D. Zickler, H. Wesselmann, R. Schindler, E. Gutierrez, J. Egido, A. Rubio-Navarro, I. Buendia, L. M. Blanco-Colio, O. Toldos, F. Manzarbeitia, A. De Lorenzo, R. Sanchez, M. Praga, J. A. Moreno, M. Y. Kim, N. R. Kang, H. R. Jang, J. E. Lee, W. Huh, Y.-G. Kim, D. J. Kim, S.-C. Hong, J.-S. Kim, H. Y. Oh, T. Okamoto, K. Kamata, S. Naito, H. Tazaki, S. Kan, L.-G. Anne-Kathrin, K. Matthias, T. Speer, L. Andreas, G. Heinrich, V. Thomas, A. Poppleton, F. Danilo, C.-F. Lai, V.-C. Wu, C.-C. Shiao, T.-M. Huang, K.-D. Wu, M. Bedford, C. Farmer, J. Irving, P. Stevens, F. Patera, F. Mattozzi, S. Battistoni, R. M. Fagugli, M. Y. Park, S. J. Choi, J. G. Kim, S. D. Hwang, H. Xie, H. Chen, S. Xu, Q. He, J. Liu, W. Hu, Z. Liu, M. Dalboni, R. Blaya, B. M. Quinto, R. Narciso, M. Oliveira, J. Monte, M. Durao, M. Cendoroglo, M. Batista, A. L. Hanemann, A. Liborio, A. Martins, M. C. C. Pinheiro, G. Meneses, R. De Paula Pessoa, M. Sousa, F. S. M. Bezerra, P. L. M. M. Albuquerque, J. B. Lima, C. B. Lima, M. D. S. B. Veras, T. Nemoto Matsui, C. Totoli, M. C. Cruz Andreoli, M. P. Vilela Coelho, N. K. Guimaraes de Souza, A. L. Ammirati, F. De Carvalho Barreto, B.-H. Ferraz Neto, B. Fortunato Cardoso Dos Santos, A. Abraham, G. Abraham, M. Mathew, P. M. A. Duarte, F. B. Duarte, E. M. Barros, F. Q. S. Castro, H. Palomba, I. Castro, S. R. Sousa, A. N. Jesus, T. Romano, E. Burdmann, L. Yu, S. H. Kwon, J. Y. You, Y. K. Hyun, S. A. Woo, J. S. Jeon, H. J. Noh, D. C. Han, L. Tozija, Z. Petronievic, G. Selim, I. Nikolov, O. Stojceva-Taneva, K. Cakalaroski, A. Lukasz, J. Beneke, J. Menne, M. Schiffer, N. Polanco, E. Hernandez, V. Gutierrez Millet, E. Gonzalez Monte, E. Morales, L. Francisco Javier, G.-F. Nuria, M.-G. Jose Maria, M. Bes Rastrollo, A. Angioi, M. Conti, R. Cao, A. Atzeni, G. Pili, V. Matta, E. Murgia, P. Melis, V. Binda, A. Pani, F. Thome, F. Leusin, E. Barros, C. Morsch, A. Balbinotto, C. Pilla, V. Premru, J. Buturovic-Ponikvar, R. Ponikvar, A. Marn-Pernat, B. Knap, J. Kovac, J. Gubensek, B. Kersnic, L. Krnjak, M. Prezelj, J. Granatova, M. Havrda, Z. Hruskova, K. Kratka, O. Remes, M. Mokrejsova, M. Bolkova, V. Lanska, I. Rychlik, M. D. Uniacke, R. J. Lewis, S. Harris, P. Roderick, N. Martin, K. Ulrich, B. Jan, B. Jorn, B. Reinhard, K. Jan, H. Hermann, F. Meyer Tobias, R. Leyla, M. W. Schmidt Bernhard, S. Harald, S. Jurgen, K. Tanja, S. Mario, E. Sang Hi, M. Claus, V. Frank, S. Aleksej, S. Sengul, S. Robert, W. Karin, G. Feikah, F. Menne Tobias, N. Meyer Tobias, G. Beutel, S. Fleig, J. Steinhoff, T. Meyer, C. Hafer, J. Bramstedt, V. Busch, M. Vischedyk, U. Kuhlmann, W. Ries, S. Mitzner, S. Mees, S. Stracke, J. Nurnberger, P. Gerke, M. Wiesner, B. Sucke, M. Abu-Tair, A. Kribben, N. Klause, F. Merkel, S. Schnatter, E. Dorresteijn, O. Samuelsson, R. Brunkhorst, G. Stec-Hus Registry, A. Reising, F.-C. Bange, M. Hiss, F. Vetter, S. M. Bode-Boger, J. Martens-Lobenhoffer, B. M. W. Schmidt, J. T. Kielstein, H. S. Shin, Y. S. Jung, and H. Rim

Subjects
Transplantation, Nephrology
Published
2012

4. High-grade renal transplant artery stenosis after suboptimal angioplasty: favourable long-term outcome

Author

R Ponikvar and J Buturović-Ponikvar

Subjects
Male, medicine.medical_specialty, Time Factors, medicine.medical_treatment, Urinary system, Angiotensin-Converting Enzyme Inhibitors, Revascularization, Renal Artery Obstruction, chemistry.chemical_compound, medicine.artery, Angioplasty, medicine, Humans, Renal artery, Aged, Transplantation, Creatinine, medicine.diagnostic_test, business.industry, Graft Survival, medicine.disease, Kidney Transplantation, Surgery, Stenosis, Treatment Outcome, chemistry, Angiography, Hypertension, Female, business
Abstract

The purpose of our report is to present the long-term outcomes of three renal transplant recipients with high-grade stenosis and suboptimal percutaneous angioplasty (PTA) because of technical difficulties. Two men and one woman of age 67, 53, and 54 years, who maintained functional cadaveric graft for 17, 9, and 13 years, and had diagnosed significant renal transplant artery stenosis at 2, 1, and 2 years after renal transplantation, respectively, were studied. Stenoses were diagnosed angiographically in the first patient and by Doppler in other two patients, then confirmed by angiography. All three patients had difficult-to-treat hypertension with deterioration of graft function in the presence of or after introducing ACE-inhibitor therapy. PTA was performed in all patients with suboptimal or unsuccessful results as assessed by angiography or control Doppler examination—the residual stenosis was significant and practically unchanged. Surgery was not performed because of high risk, so patients were further treated conservatively. Hypertension was treated avoiding ACE inhibitors. Twelve, 7, and 7 years after angioplasty the serum creatinine is stable in all patients, even decreased compared to pre-PTA and early post-PTA levels, namely, 134, 102, and 75 μmol/L, respectively. Control Doppler examinations revealed a residual stenotic jet in all patients, with slightly decreased peak systolic velocity over time, indicating a slightly decreased grade of stenosis. These observations suggest that renal transplant artery stenosis, even of high grade, can be stable, or even regress with time with excellent long-term graft survival. Randomized studies comparing conservative treatment versus revascularization are warranted.

Published
2003

5. Reply

Author

N. Skofic, M. Arnol, J. Buturovic-Ponikvar, and R. Ponikvar

Subjects
Transplantation, Nephrology
Published
2012

6. Absence of acute rejection using basiliximab with triple immunosuppression in cadaveric kidney recipients in first three months

Author

Damjan Kovač, R. Ponikvar, J. Buturović-Ponikvar, M. Koselj, Andrej Kmetec, Aljoša Kandus, A.F. Bren, and Jelka Lindič

Subjects
Adult, Graft Rejection, Male, medicine.medical_specialty, Time Factors, Basiliximab, medicine.medical_treatment, Urinary system, Recombinant Fusion Proteins, Text mining, Postoperative Complications, medicine, Humans, Transplantation, Kidney, Chemotherapy, Sex Characteristics, business.industry, Histocompatibility Testing, Antibodies, Monoclonal, Immunosuppression, Immunotherapy, Middle Aged, Kidney Transplantation, Surgery, medicine.anatomical_structure, Acute Disease, Cyclosporine, Drug Therapy, Combination, Female, Cadaveric spasm, business, Immunosuppressive Agents, medicine.drug
Published
2001

11. Chronic single needle predilutional haemofiltration in a pre-school child

Author

J B, Buturović, M, Calić, R R, Ponikvar, A M, Gucek, and R B, Kenda

Subjects
Male, Peritoneal Dialysis, Continuous Ambulatory, Waiting Lists, Needles, Patient Selection, Body Weight, Humans, Kidney Failure, Chronic, Hemofiltration, Child, Kidney Transplantation
Abstract

Peritoneal dialysis is the preferred dialysis mode for children with end stage renal disease (1). It avoids problems with vascular access and enables near normal life style. Haemodialysis is the only mode of treatment for a child waiting for renal transplantation when peritoneal dialysis is not possible. Haemofiltration, as a mode of renal replacement therapy, was introduced in 1967 by Lee Henderson (2).

Published
1996

12. Medical free-electron laser: fact or fiction?

Author

Donald R. Ponikvar and James P. Bell

Subjects
Engineering, business.industry, Free-electron laser, Electrical engineering, Tissue welding, Technology development, Laser, law.invention, Tissue optics, Laser tissue interaction, law, Systems engineering, Technology scaling, Hiv treatment, business
Abstract

The free electron laser (FEL) has long been proposed as a flexible tool for a variety of medical applications, and yet the FEL has not seen widespread acceptance in the medical community. The issues have been the laser's size, cost, and complexity. Unfortunately, research on applications of FELs has outpaced the device development efforts. This paper describes the characteristics of the FEL, as they have been demonstrated in the U.S. Army's FEL technology development program, and identifies specific medical applications where demonstrated performance levels would suffice. This includes new photodynamic therapies for cancer and HIV treatment, orthopedic applications, tissue welding applications, and multiwavelength surgical techniques. A new tunable kilowatt class FEL device is described, which utilizes existing hardware from the U.S. Army program. An assessment of the future potential, based on realistic technology scaling is provided.

Published
1994

13. THUNDERBALL: a power-beaming architecture for missile defense

Author

James P. Bell and Donald R. Ponikvar

Subjects
Engineering, business.industry, Missile defense, Laser, law.invention, Power (physics), law, Relay, Control system, Aerospace engineering, Architecture, business, Beam control, Simulation, Laser beams
Abstract

W.J. Schafer Associates has proposed an architecture for a laser system capable of not only beaming power from a ground site to space, but also capable of intercepting theater missiles during their boost phase for defense of ground troops in regional conflicts. The system comprises a ship-based multi-megawatt laser and beam control system, a relay mirror package mounted on a high altitude, long endurance, unmanned lighter-than-air vehicle, and a sensor package, mounted on the balloon, which directs the laser beam to the target and can also provide an early commitment of ground based kinetic energy interceptors. A system concept is presented, as well as an assessment of system effectiveness.

Published
1994

14. End-to-end power beaming model

Author

Matthew J. Schor, James P. Bell, and Donald R. Ponikvar

Subjects
Engineering, Electrically powered spacecraft propulsion, business.industry, Photovoltaic system, Electrical engineering, Communications satellite, Geostationary orbit, Satellite, Electric power, Laser power scaling, Orbital mechanics, business
Abstract

wj. Schafer Associates, Inc. has produced an interactive endto-end model of a laser power beamingsystem designed to deliver electrical power from a ground based free electron laser (FEL) to a satellite. The model includes a description of pertinent FEL physics, realistic atmospheric propagation effects, photovoltaic interactions for various semiconductor materials, and satellite onboard power conditioning. Adetailed orbital model with graphical output is available, which visualizes the effect of electric propulsion for orbital reboost or orbit transfer. This flexible tool has been applied to specific examples of satellite battery charging for geostationary communication satellites, as well as parametric studies of photovoltaic cell performance. Preliminary results of system wavelength/power/aperture diameter trades will be presented. 1. BACKGROUND A number of groups, including NASA and the Department of Defense, have investigated the utility of lasers to beam power to satellite platforms, using photovoltaic conversion to produce usable electricalpower1. This concept involves the simultaneous application of a number of different concepts, from

Published
1994

15. Outcome and prognosis of cyclosporine-related hemolytic-uremic syndrome in kidney graft recipients: clinical and histopathologic study of 13 cases

Author

R. Ponikvar, A. Vizjak, M Koselj, Jelka Lindič, D. Ferluga, A.F. Bren, Jadranka Buturović, A Kandus, and Damjan Kovač

Subjects
Adult, Male, Hemolytic anemia, medicine.medical_specialty, Pathology, Time Factors, Postoperative Complications, Humans, Medicine, Platelet, Retrospective Studies, Transplantation, Kidney, business.industry, Middle Aged, Prognosis, medicine.disease, Ciclosporin, Kidney Transplantation, Treatment Outcome, medicine.anatomical_structure, Hemolytic-Uremic Syndrome, Toxicity, Cyclosporine, Female, Surgery, Histopathology, business, Immunosuppressive Agents, Follow-Up Studies, medicine.drug, Kidney disease
Published
2002

16. Transplantation: clinical studies (2)

Author

R. Walker, I. Ruderman, R. Masterson, S. Cohney, M. Salvadori, P. Conti, E. Bertoni, A. Durrbach, F. Citterio, L. Mulloy, E. David-Neto, G. Russ, S. Vitko, R. Zhang, J. Xing, M. B. Harler, J. Grinyo, C. Rugiu, A. Trubian, P. Bernich, A. Lupo, A. Asbe-Vollkopf, A. Pannu, H. Hoefeld, S. Gauer, J. Gossmann, H. G. Kachel, S. Froese, S. Korom, H. Geiger, I. A. Hauser, L. Liefeldt, C. Kluener, P. Glander, M. Giessing, O. Gralla, H.-H. Neumayer, K. Budde, T. Kroencke, A. B. Liborio, R. M. Barros, R. M. Esmeraldo, M. L. M. B. Oliveira, F. J. V. Nogueira Paes, T. R. Mendoza, G. B. Silva Junior, E. F. Daher, M. Siekierka-Harreis, C. Bantis, N.-M. Kouri, C. Schwandt, L.-C. Rump, K. Ivens, J. Slatinska, E. Honsova, M. Burgelova, E. Slimackova, O. Viklicky, G. Tabernero, K. Rivero, G. Fernandez, J. Canueto, P. Garcia, P. Fraile, C. Lucas, J. M. Tabernero, A.-S. Bargnoux, N. Simon, V. Garrigue, A.-M. Dupuy, G. Mourad, J.-P. Cristol, U. Yapici, J. Kers, F. Bemelman, J. Roelofs, J. Groothoff, C. van der Loos, K. van Donselaar-van der Pant, M. Idu, N. Claessen, I. ten Berge, S. Florquin, B. Knap, Z. Dragonja, S. Dobnik, J. Buturovic Ponikvar, R. Ponikvar, A. Kandus, A. Bren, J. Kleemann, J. Engel, S. Winter, M. Brzoska, N. Obermueller, E. Schaeffeler, M. Oldak, J. Pazik, Z. Lewandowski, E. Sitarek, M. Dabrowski, R. Ploski, J. Malejczyk, M. Durlik, K. Slubowska, A. Urbanowicz, A. Sadowska, B. Lichodziejewska, K. Kurnicka, Z. Galazka, A. Chmura, J. Masin-Spasovska, G. Spasovski, G. Petrusevska, Z. Popov, N. Ivanovski, A. Di Napoli, M. F. Salvatori, F. Franco, D. Di Lallo, G. Guasticchi, A. Sancho, E. Gavela, S. Beltran, J. Kanter, B. Alemany, J. F. Crespo, L. M. Pallardo, A. Lionet, J.-B. Beuscart, D. Buob, A. BenHenda, F. Provot, M. Hazzan, C. Noel, F. Galan-Sanchez, P. Marin-Casanova, A. Mazuecos, T. Garcia-Alvarez, E. Aznar, M. Rodriguez-Iglesias, S. Ossareh, M. Salami, E. Mohammad, M. Hosseini, A. Pawlik, J. Chudek, A. Kolonko, J. Wilk, P. Jalowiecki, A. Wiecek, E. Zyablitskaya, E. Galkina, E. Yushina, C. Botelho, P. Aires, L. Santos, C. Romaozinho, F. Macario, R. Alves, P. Veiga, A. Mota, M. Yashi, T. Yagisawa, T. Kimura, A. Nukui, T. Fujiwara, Y. Sakuma, N. Ishikawa, T. Iwabuchi, O. Muraishi, P. Hambach, S. Esmen, K. Keven, S. Sengul, M. Ozcan, A. Ensari, A. Tuzuner, R. Calayoglu, G. Nergizoglu, T. Gullu Koca, N. Koca, A. Ersoy, B. Faria, M. Bustorff, F. Barros, I. Tavares, J. Santos, I. Ferreira, S. Sampaio, M. Pestana, B. Suvak, I. Kurultak, H. Tutkak, H. M. Choi, H. N. Yang, S.-K. Jo, W. Y. Cho, H.-K. Kim, A. Aybal Kutlugun, B. Altun, U. Akman, T. Aki, E. Turkmen, T. Yildirim, M. Altindal, R. Yilmaz, U. Yasavul, U. Thiem, G. Heinze, U. Gossler, T. Perkmann, F. Kainberger, F. Muhlbacher, W. Horl, K. Borchhardt, A. Sanchez-Escuredo, S. Holgado, C. Biosca, M. L. Granada, E. Barluenga, R. Lauzurica, R. Romero, A. Espinal, V. Torregrossa, B. Bayes, K. Tomida, T. Hamano, N. Fujii, N. Ichimaru, I. Matsui, Y. Isaka, H. Rakugi, S. Takahara, A. Avila, F. Dor, E. Massey, M. Frunza, R. Johnson, A. Lennerling, C. Loven, N. Mamode, A. Pascalev, S. Sterckx, K. Van Assche, W. Zuidema, W. Weimar, R. Allwin, null Roessel, S. Buettner, V. Belwe, J. Apaza, E. Gonzalez, N. Polanco, I. Bengoa, C. Cadenillas, A. Andres, J. M. Morales, S. Rocha, I. Fonseca, L. S. Martins, J. Vidinha, L. Dias, M. Almeida, S. Pedroso, A. Henriques, A. Cabrita, I. Neretljak, K. Mihovilovic, Z. Vidas, F. Jurenec, M. Knotek, S. Justa, R. Minz, M. Minz, S. Anand, A. Sharma, A. Lacquaniti, V. Donato, V. Chirico, G. Pettinato, M. Buemi, J. Galle, J. Addison, P. Perry, K. Claes, M. Farouk, A. Guerin, I. Kiss, C. Winearls, S. Di Giulio, N. Basic-Jukic, J. Slavicek, L. Bubic-Filipi, P. Kes, T. Scholbach, H.-K. Wang, A. H. Yang, C. C. Loong, T. H. Wu, I. Abboud, C. Antoine, T. Serrato, C. Lefaucheur, E. Pillebout, F. Gaudez, F. Fieux, M. Flamant, J. Verine, D. Viglietti, M.-N. Peraldi, and D. Glotz

Subjects
Transplantation, Nephrology
Published
2011

17. Urolithiasis/calcinations in renal graft—a link with renal transplant bone disease treatment?

Author

J.B. Ponikvar, A. Kmetec, and R. Ponikvar

Subjects
Adult, Male, medicine.medical_specialty, Adolescent, Bone disease, medicine.medical_treatment, Nephropathy, Kidney Calculi, Postoperative Complications, Lithotripsy, Humans, Medicine, Retrospective Studies, Transplantation, Kidney, Chemotherapy, business.industry, Graft Survival, Calcinosis, Middle Aged, medicine.disease, Kidney Transplantation, Surgery, Osteopenia, medicine.anatomical_structure, Urinary Calculi, Complication, business, Kidney disease
Published
2001

19. Independent assessment of laser power beaming options

Author

Donald R. Ponikvar

Subjects
Physics, High power lasers, business.industry, Laser, law.invention, Optics, Atmospheric propagation, law, Control system, Health physics, Laser power scaling, Aerospace engineering, business, Adaptive optics, Beam control
Abstract

Technical and architectural issues facing a laser power beaming system are discussed. Issues regarding the laser device, optics, beam control, propagation, and lunar site are examined. Environmental and health physics aspects are considered.

Published
1992

21. Beta 2-microglobulin elimination characteristics during hemofiltration with acrylonitrile and polysulfone membrane hemofilters

Author

A, Kandus, R, Ponikvar, J, Drinovec, K, Pavlin, and P, Ivanovich

Subjects
Male, Acrylonitrile, Polymers, Materials Testing, Nitriles, Humans, Female, Sulfones, Hemofiltration, Middle Aged, beta 2-Microglobulin, Aged
Abstract

Elimination characteristics of beta 2-microglobulin (BMG) during hemofiltration (HF) with acrylonitrile (AN69) and polysulfone (PS) hemofilters were investigated in a prospective clinical investigation. Seven chronic uremics on regular HF were treated for 4 weeks, three times a week, with AN69 hemofilters. The study was then repeated with PS hemofilters. There were no significant differences in the patients' body weight, the ultrafiltrate volume per session, and the duration of each HF session between both treatments. At the start of HF, arterial plasma concentration of BMG was (for AN69) 33.5 +/- 4.0 mg/L (mean +/- SD) and (for PS) 35.8 +/- 6.5 mg/L (NS); at the end of HF it was (for AN69) 11.0 +/- 1.8 mg/L and (for PS) 17.5 +/- 4.2 mg/L (p less than 0.001). The amount of BMG in total ultrafiltrate was (for AN69) 179.3 +/- 22.6 mg and (for PS) 140.6 +/- 26.8 mg (p less than 0.02). With AN69 hemofilter, maximum BMG plasma clearance and sieving coefficient were 51.0 +/- 9.5 mL/min and 0.42 +/- 0.04 at 60 minutes. With PS hemofilter, maximum BMG plasma clearance and sieving coefficient were 37.4 +/- 5.7 mL/min and 0.27 +/- 0.03 at 15 minutes. Twenty-two percents of BMG entering the AN69 hemofilter at 15 minutes were adsorbed on the membrane (p less than 0.001). BMG elimination with the AN69 hemofilter was more efficient than with the PS hemofilter. Long-term studies will be necessary to demonstrate whether this difference is of any clinical significance.

Published
1990

22. Anaphylatoxins C3a and C5a adsorption on acrylonitrile membrane of hollow-fiber and plate dialyzer--an in vivo study

Author

A, Kandus, R, Ponikvar, J, Drinovec, S, Kladnik, and P, Ivanovich

Subjects
Adult, Male, Time Factors, Acrylonitrile, Complement C5a, Membranes, Artificial, Middle Aged, Renal Dialysis, Complement C3a, Humans, Kidney Failure, Chronic, Female, Adsorption, Complement Activation, Kidneys, Artificial, Aged
Abstract

We studied the adsorption of anaphylatoxins C3a and C5a on acrylonitrile (AN69) hollow-fiber (AN69HF) and plate (AN69P) dialyzers in 8 patients during 4-hour hemodialyses (HD). Blood passed first through a cuprophan dialyzer and then through AN69 dialyzers that were not in contact with dialysis fluid. Plasma C3a and C5a were measured in samples taken from the afferent and efferent blood lines of the acrylonitrile dialyzers at 15, 60 and 240 min. Plasma C3a concentrations decreased significantly in blood that had passed through AN69 dialyzers. This decrease, indicating membrane adsorption, was maximal (by 65% in AN69HF and by 59% in AN69P) at 15 min and minimal (by 53% in AN69HF and by 18% in AN69P) at 240 min. The decrease in plasma C5a concentrations was smaller and significant throughout HD only with AN69HF. The amount of C3a adsorbed was at least 45,000 micrograms in AN69HF and 18,000 micrograms in AN69P. These findings demonstrate that acrylonitrile dialyzers adsorb more C3a and C5a than they produce. This membrane adsorption may explain why the increase of plasma C3a and C5a is inhibited during HD.

Published
1990

24. Plasma exchange in myeloma renal failure

Author

M, Kajtna-Koselj, J, Drinovec, S, Kaplan, P, Cernelc, R, Ponikvar, and A, Licina

Subjects
Adult, Male, Plasma Exchange, Humans, Female, Acute Kidney Injury, Middle Aged, Multiple Myeloma, Aged
Published
1990

26. Seven years experience with vascular access for plasma exchange therapy

Author

A, Gucek, J, Drinovec, J, Varl, R, Ponikvar, M, Benedik, and A, Bren

Subjects
Adult, Male, Catheterization, Central Venous, Adolescent, Plasma Exchange, Infant, Middle Aged, Catheterization, Catheters, Indwelling, Child, Preschool, Catheterization, Peripheral, Humans, Female, Child, Aged, Follow-Up Studies
Published
1990

27. 28 The Influence of Aerobic Training During Hemodialysis Procedure on Blood Pressure, Heart Rate and Aerobic Capacity of Chronic Hemodialysis Patients

Author

R Ponikvar, J Buturović‐Ponikvar, and S Fazlić

Subjects
medicine.medical_specialty, Hemodialysis procedure, business.industry, Physical exercise, Hematology, Target heart rate, Blood pressure, Nephrology, Internal medicine, Heart rate, medicine, Cardiology, Physical therapy, Aerobic exercise, Chronic hemodialysis, business, Aerobic capacity
Abstract

Background Several studies have shown beneficial effect of aerobic exercise performed during hemodialysis procedure. The aim of our prospective clinical study was to evaluate the effect of 2 months aerobic exercise during hemodialysis procedure on blood pressure, heart rate and aerobic capacity of chronic hemodialysis patients. Methods Eleven adult chronic hemodialysis patients participated the prospective clinical study. Nine of them completed a 2 month aerobic exercise program. Exercise training was carried out during hemodialysis procedure, three times a week, in lying position, on the “bed” cycle ergometer Thera-Joy (Medica, Germany). The exercise was prescribed based on aerobic capacity and Borg's scale of subjective effort perceiving and corresponded to moderate physical exercise (50–70% of the maximum target heart rate). Heart rate and blood pressure were monitored continuously during the procedure. Aerobic capacity was tested before and after the 2 month exercise program. Results Mean values of systolic, diastolic blood pressure and heart rate before exercise were 146 ± 9 mmHg, 87 ± 5 mmHg, and 77 ± 7 beats/min, respectively. After the exercise systolic and diastolic blood pressure were significantly lower and heart rate significantly higher than before (142 ± 9 mmHg, 84 ± 6 mmHg, 82 ± 8, P

Published
2005

31. Blood purification in the intensive care unit.

Author

R. Ponikvar

Subjects
DIALYSIS (Chemistry), CRITICAL care medicine, HOSPITAL wards, INTENSIVE care units
Abstract

The cornerstone of renal replacement therapy in critically ill patients with acute renal failure (ARF) in our hospital, was intermittent bicarbonate dialysis with synthetic membranes, prescribed daily for anuric patients. Filling of the extracorporeal circuit with 5% human albumin or saline solution before the start of dialysis, as well as hypernatraemic dialysis with profiling, lower dialysate temperature and higher ionized calcium concentration have been used to prevent harmful hypotensive episodes either at the start or during dialysis. Continuous renal replacement therapy (CRRT) in adults was used primarily for anuric, hypotensive patients who might not tolerate standard haemodialysis. All newborns and infants in whom peritoneal dialysis was not possible were treated by continuous procedures. Sustained low efficiency dialysis (SLED) or extended daily dialysis (EDD) were an acceptable compromise between intermitent haemodialysis and CRRT. However, in our opinion, the most promising approach to intensive care unit (ICU) patients with ARF would be the combination of CRRT in the anuric patient followed by intermittent daily dialysis thereafter. Although the mortality rate of ARF patients was as high as 88% in adults and 73% in small children due to the lack of reliable criteria for the selection of patients with poor or good prognosis, aggressive treatment for all patients who needed dialysis was recommended recently. Apheresis has dramatically improved the prognosis and outcome in patients with myasthenia gravis, Guillain-Barré syndrome, Goodpasture syndrome and thrombotic thrombocytopenic purpura. The mortality rate of patients with septic shock and fulminant hepatic failure was still very high, and the role of apheresis and dialysis, in spite of some encouraging results, remains controversial. [ABSTRACT FROM AUTHOR]

Published
2003
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32. Follow-up of donors in living related renal transplantation

Author

J, Drinovec, M, Malovrh, A, Kandus, B, Cizman, S, Luzar, M, Kosak, L, Ravnik, R, Kveder, R, Ponikvar, and M, Mocivnik

Subjects
Postoperative Complications, Hypertension, Urinary Tract Infections, Humans, Kidney Transplantation, Tissue Donors, Follow-Up Studies, Retrospective Studies
Published
1987

33. Is Age Over 55 Years Risk Factor for Kidney Donor and for Graft Function in Living Related Renal Transplantation?

Author

A. Kandus, J. Drinovec, M. Malovrh, R. Kveder, and R. Ponikvar

Subjects
medicine.medical_specialty, Kidney, Proteinuria, business.industry, Renal function, Retrospective cohort study, Disease, urologic and male genital diseases, medicine.disease, Surgery, Transplantation, surgical procedures, operative, medicine.anatomical_structure, medicine, Risk factor, medicine.symptom, business, Acute tubular necrosis
Abstract

The role of the renal transplantation program in the management of end-stage renal disease is well established. Living related donor (LRD) renal transplantation is a common and safe procedure (1, 2). In some centers, up to 75% of grafts come from LRDs. The main reasons are the inadequate supply of cadaveric kidneys and the higher success rate (1–6). In situations of extreme recipient needs kidneys from LRDs older than 55 years can be used (5). The renal transplantation from elderly LRD may represent a possible risk for the donor and also for the renal allograft function immediately after transplantation. A retrospective study was performed to evaluate changes in renal function, proteinuria, and hypertension in LRD older than 55 years and to examine function of renal allograft from elderly LRD in first few days.

Published
1989

34. Treatment of Rapidly Progressive Lupus Glomerulonephritis

Author

J. Drinovec, R. Ponikvar, S. Kaplan, A. Ličina, and M. Koselj

Subjects
medicine.medical_specialty, Cyclophosphamide, business.industry, Renal function, Azathioprine, Gastroenterology, Lupus glomerulonephritis, immune system diseases, Prednisone, Internal medicine, medicine, skin and connective tissue diseases, Complication, business, medicine.drug
Abstract

Rapidly progressive lupus glomerulonephritis (RPLGN) is a severe and unfavorable complication of systemic lupus erythematosus. (SLE). Progress in supportive and aggressive therapy in recent years has considerably improved the prognosis. Since there is no agreement about the most efficient therapy, the treatment of RPLGN remains a highly controversial topic in clinical medicine (1,2). In this paper, we report a follow-up of 11 patients with RPLGN, monitored for 2–64 months. All patients were treated with prednisone cyclophosphamide or azathioprine and plasma exchange.

Published
1989

36. The clinical evaluation of biofiltration

Author

J, Drinovec, M, Mocivnik, A, Bren, A, Kandus, R, Ponikvar, R, Kveder, M, Benedik, and M, Malovrh

Subjects
Adult, Male, Blood, Time Factors, Adolescent, Evaluation Studies as Topic, Renal Dialysis, Humans, Kidney Failure, Chronic, Ultrafiltration, Female, Hypotension, Middle Aged
Abstract

The clinical evaluation of biofiltration. The authors have studied the effectiveness of biofiltration (BF) in patients with terminal renal failure. They did not find any reduction in the number of hypotensive episodes during BF. The reduced length of the dialysis procedure made possible by BF is suitable for some patients. Subjective feeling during the interdialysis period was better under treatment with BF than under conventional hemodialysis.

Published
1986

37. The treatment of staphylococcus peritonitis in patients on continuous ambulatory peritoneal dialysis

Author

J, Drinovec, A, Bren, A, Gucek, J, Lindic, A, Kandus, and R, Ponikvar

Subjects
Adult, Male, Clindamycin, Middle Aged, Peritonitis, Staphylococcal Infections, Anti-Bacterial Agents, Methicillin, Random Allocation, Peritoneal Dialysis, Continuous Ambulatory, Mezlocillin, Humans, Female, Prospective Studies, Gentamicins, Cloxacillin, Aged
Abstract

The aim of this prospective, randomized, open study was to survey the frequency course and to evaluate the therapy of peritonitis induced by staphylococci in patients on continuous ambulatory peritoneal dialysis (CAPD). From June 1983 to November 1986, 20 patients (9 men, 11 women) aged from 25 to 73 were treated. During 258 months of the CAPD treatment they had 54 episodes of peritonitis. Staphylococcus saprophyticus was the most frequent offender of peritonitis, isolated from peritoneal effluent in 44% of the cases, Staphylococcus epidermidis was isolated in 7% of the cases. Staphylococcus aureus was isolated in 5% of the cases and caused a more severe form of peritonitis. The combination of gentamicin and methicillin was used in 14 cases, in 2 cases this treatment was unsuccessful. A combination of gentamicin and cloxacillin was used in 5 cases and a combination of clindamycin and mezlocillin in 12 cases of peritonitis, giving good results in all cases. The last combination seemed to be the most effective in the treatment of staphylococcus induced peritonitis.

Published
1988

38. Adequacy of Biofiltration: A Comparative Study with Standard Acetate Hemodialysis

Author

B. Knap, A. Kandus, J. Drinovec, R. Ponikvar, R. Kveder, and M. Malovrh

Subjects
chemistry.chemical_compound, Chromatography, Chemistry, medicine.medical_treatment, Bicarbonate, Biofilter, medicine, Blood purification, Polyacrylonitrile, Renal replacement therapy, Hemodialysis
Abstract

Biofiltration (BF) represents a new way of renal replacement therapy. The method is simplified hemodiafiltration using highly permeable polyacrylonitrile (PAN) membrane and postdilutional infusion of a bicarbonate containing solution. It possibly favours better control of acid-base status, vascular stability as well as well being of patients (1).

Published
1989

39. Stabilized single-frequency stimulated Brillouin fiber ring laser

Author

Shaoul Ezekiel and Donald R. Ponikvar

Subjects
Double-clad fiber, Materials science, Optics, Brillouin scattering, business.industry, Fiber laser, Dispersion-shifted fiber, Polarization-maintaining optical fiber, Laser power scaling, business, Lasing threshold, Graded-index fiber, Atomic and Molecular Physics, and Optics
Abstract

The detailed behavior of the cw stimulated Brillouin fiber laser has been studied by using a narrow-linewidth cw pump argon laser at 5145 A and an 83-m fiber ring cavity. By stabilizing the fiber cavity, we achieved stable single-frequency Brillouin-laser output with a linewidth determined primarily by the 100-kHz modulation used in the feedback system. Lasing threshold for the 4.5-microm-core fiber used was observed at a pump power of 77 mW, and the maximum Brillouin output was 13 mW for a pump of 320 mW. The Brillouin gain medium was shown to exhibit homogeneouslike behavior.

Published
1981

40. Nephrology Partnership for Advancing Technology in Healthcare (N-PATH) Erasmus+ project: The Renal Expert in Vascular Access (REVAC) module.

Author

Lomonte C, Ibeas J, Kitrou P, Giusto A, Baratto M, Bocchibianchi V, Brunori G, Pirozzi N, Ponikvar R, Forneris G, Malik J, Katsanos K, Snoeijs M, Tozzi M, Gallieni M, and Gesualdo L

Abstract

The Renal Expert in Vascular Access (REVAC) is one of the four modules of the Nephrology Partnership for Advancing Technology in Healthcare (N-PATH) project, the first European-wide advanced training course in diagnostics and interventional nephrology, funded by Erasmus+ Knowledge Alliance, a European Commission program. The N-PATH primary goal was to train 40 young European nephrologists in both theoretical knowledge and practical skills related to interventional nephrology. The REVAC module focused on the crucial aspects of vascular access (VA) care in nephrology practice, as a complementary training path to the actual residency program. The aim was to provide nephrology fellows with comprehensive knowledge and skills related to VA management. The methodology was based on face-to-face meetings and online learning, modern facilities, experienced tutors, cutting edge simulators, augmented reality tools by means of a multidisciplinary international faculty and hands-on-courses. A feedback survey reported the experience of fellows who attended the REVAC module, confirming the positive impact on their ongoing nephrology training. We are confident that this project will revitalize their nephrology careers and will help training the next generation of nephrologists; they will be able to manage VA needs with the help of multi-disciplinary teams to safely optimize the care of hemodialysis patients., Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Published
2024
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41. A national cohort study on hemodialysis arteriovenous fistulas after kidney transplantation - long-term patency, use and complications.

Author

Vajdič Trampuž B, Arnol M, Gubenšek J, Ponikvar R, and Buturović Ponikvar J

Subjects
Adolescent, Adult, Aged, Arteriovenous Shunt, Surgical statistics & numerical data, Cohort Studies, Female, Humans, Incidence, Male, Middle Aged, Postoperative Complications epidemiology, Procedures and Techniques Utilization statistics & numerical data, Retrospective Studies, Slovenia, Time Factors, Young Adult, Arteriovenous Shunt, Surgical adverse effects, Kidney Transplantation, Postoperative Complications etiology, Renal Dialysis
Abstract

Objective: To describe the long-term hemodialysis arteriovenous fistula (AVF) patency, incidence of AVF use, incidence and nature of AVF complications and surgery in patients after kidney transplantation., Patients and Methods: We retrospectively analysed the AVF outcome and complications in all adult kidney allograft recipients transplanted between January 1st, 2000 and December 31, 2015 with a functional AVF at the time of transplantation. Follow-up was until December 31, 2019., Results: We included 626 patients. Median AVF follow-up was 4.9 years. One month after kidney transplantation estimated AVF patency rate was 90%, at 1 year it was 82%, at 3 years it was 70% and at 5 years it was 61%; median estimated AVF patency was 7.9 years. The main cause of AVF failure was spontaneous thrombosis occurring in 76% of AVF failure cases, whereas 24% of AVFs were ligated or extirpated. In a Cox multivariate model female sex and grafts were independently associated with more frequent AVF thrombosis. AVF was used in about one third of our patients. AVF-related complications occurred in 29% of patients and included: growing aneurysms, complicated thrombosis, high-flow AVF, signs of distal hypoperfusion, venous hypertension, trauma of the AVF arm, or pain in the AVF/arm., Conclusions: AVFs remain functional after kidney transplantation in the majority of patients and are often re-used after graft failure. AVF-related complications are common and require proper care., (© 2021. The Author(s).)

Published
2021
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42. Therapeutic plasma exchange and dextran-sulfate plasma adsorption as extracorporeal treatments of extremely preterm preeclampsia with fetal growth restriction.

Author

Gubensek J, Ponikvar R, Premru Srsen T, Fabjan Vodusek V, Moertl MG, and Lucovnik M

Subjects
Adsorption, Biomarkers blood, Blood Coagulation, Blood Component Removal, Cesarean Section, Female, Gestational Age, Hospitalization, Humans, Infant, Extremely Low Birth Weight, Infant, Extremely Premature, Infant, Newborn, Linear Models, Plasmapheresis, Pregnancy, Retrospective Studies, Dextran Sulfate chemistry, Fetal Growth Retardation blood, Plasma Exchange methods, Pre-Eclampsia blood, Vascular Endothelial Growth Factor Receptor-1 blood
Abstract

Aim: To evaluate effectiveness and safety of therapeutic plasma exchange (TPE) and dextran-sulfate plasma adsorption (DSA) for extracorporeal removal of soluble Fms-like tyrosine kinase-1 (sFlt-1) as part of expectant management of preeclampsia at extremely preterm gestational age., Methods: Retrospective case series of six patients with preeclampsia at <28 weeks of gestation, treated with DSA or TPE. Laboratory results, clinical characteristics and neonatal outcomes were collected from charts and National Perinatal Information System., Results: Fetal growth restriction (FGR) was diagnosed in all cases. Pregnancy was prolonged for a median of 14 (range 5-74) days from admission and 10 (3-73) days from first apheresis. A mixed effects model showed a decrease in sFlt-1 and sFlt-1/PlGF ratio during DSA/TPE (significant effect of time [before/after]), which was comparable between DSA and TPE (no effect of procedure type). Median absolute reduction in sFlt-1 was 42% (inter-quartile range [IQR] 13%-57%) during DSA and 34% (16%-40%) during TPE; for sFlt-1/PlGF ratio it was 29% (22%-36%) and 38% (29%-42%), respectively. All procedures were well tolerated by fetuses. Anaphylactoid reaction, often with angioedema, occurred in 4/6 patients undergoing DSA and was attributed to bradykinin activation. One patient developed wound hematoma after cesarean section, possibly attributed to depletion coagulopathy., Conclusions: As potential novel treatment of early preeclampsia, a non-selective and widely available TPE was comparable to DSA regarding sFlt-1 reduction but was associated with fewer side-effects. Both seem to allow maternal stabilization and pregnancy prolongation even when early preeclampsia is complicated by FGR., (© 2021 Wiley Periodicals LLC.)

Published
2021
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43. Clinical and dialysis-related characteristics of extremely long-term hemodialysis survivors: Three case reports.

Author

Malgaj Vrečko M, Ponikvar R, Gubenšek J, and Buturović Ponikvar J

Abstract

More than 40-year hemodialysis survivors are living evidence of the achievements of hemodialysis therapy. We present the case reports of three patients treated by chronic hemodialysis for 47 (Patient 1), 43 (Patient 2), and 42 years (Patient 3) from a single center. These patients possess characteristics that were already shown to be associated with improved long-term survival: initiation of hemodialysis at a young age, absence of diabetes, and a relatively low and stable body weight with good nutritional status. Although all of them underwent complications of long-term hemodialysis treatment, they lived (Patient 3), or are still living (Patients 1 and 2), an independent and full life. Their hemodialysis prescriptions included long sessions with a moderate blood flow rate, state-of-the-art hemodialysis technology, vascular access surgeries and care provided by nephrologists, good overall management of chronic kidney disease, and preventive measures and/or immediate action in case of cardiovascular disease., (© 2021 The Authors. Hemodialysis International published by Wiley Periodicals LLC on behalf of International Society for Hemodialysis.)

Published
2021
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44. Treatment of preeclampsia at extremely preterm gestation with therapeutic plasma exchange.

Author

Gubenšek J, Ponikvar R, Premru Sršen T, Fabjan Vodušek V, Moertl MG, and Lučovnik M

Subjects
Biomarkers, Female, Follow-Up Studies, Humans, Infant, Extremely Premature, Infant, Newborn, Placenta Growth Factor, Plasma Exchange, Pregnancy, Vascular Endothelial Growth Factor Receptor-1, Pre-Eclampsia diagnosis, Pre-Eclampsia therapy
Abstract

Aims: Different forms of apheresis have been proposed as potential therapeutic approaches to remove soluble Fms-like tyrosine kinase-1 (sFlt-1) and allow safe pregnancy prolongation in cases of extremely preterm preeclampsia. This is a follow-up study presenting our experiences with therapeutic plasma exchange (TPE) in 5 women with preeclampsia at < 28 weeks of gestational age., Materials and Methods: All women received standard treatment for preeclampsia and 2 - 3 TPE treatments per week. Blood samples for sFlt-1 and placental growth factor (PlGF) measurements were collected before and after each TPE., Results: Seventeen TPE procedures were performed, 2 - 5 per patient. TPE significantly reduced sFlt-1 (by 35 ± 6%), sFlt-1/PlGF ratio (by 24 ± 13%), and to a lesser degree also PlGF (by 12 ± 16%), with a rebound observed on day 1 post procedure. TPE procedures were well tolerated by pregnant women and fetuses. Stabilization of sFlt-1 allowed pregnancy prolongation for a median of 8 (range 2 - 14) days from first TPE and for a median of 10 (range 4 - 17) days from hospital admission. There were no signs of increased risks of adverse neonatal outcome associated with TPE. One neonate died due to extreme prematurity 3 days after delivery, 2 had bronchopulmonary dysplasia, and 1 had retinopathy of prematurity., Conclusion: This study provides new evidence of effective reduction in sFlt-1 and sFlt-1/PlGF ratio with TPE treatment, which seems to allow a clinically meaningful prolongation of pregnancy. Controlled studies are necessary to convincingly show the potential benefit of apheresis treatment in preeclampsia at extremely preterm gestation.

Published
2021
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45. Regional citrate anticoagulation for continuous renal replacement therapy in newborns and infants: Focus on citrate accumulation.

Author

Persic V, Vajdic Trampuz B, Medved B, Pavcnik M, Ponikvar R, and Gubensek J

Subjects
Acidosis, Citric Acid blood, Female, Humans, Infant, Infant, Newborn, Male, Retrospective Studies, Water-Electrolyte Balance, Anticoagulants therapeutic use, Citric Acid therapeutic use, Renal Replacement Therapy
Abstract

Continuous renal replacement therapy (CRRT) with regional citrate anticoagulation (RCA) in newborns and infants is challenging and accumulation of citrate can occur. There are only a few studies reporting the detailed data on RCA. We aimed to analyze RCA-CRRT at our institution with focus on citrate accumulation. Critically ill newborns and infants up to 11 kg of body weight (BW), treated with RCA-CRRT in the 2011-2016 period were included in this retrospective observational study. Prismaflex(R) and Multifiltrate-CiCa(R) dialysis monitors were used with either automated or manual RCA. Data was collected regarding the circuit lifetime, parameters of RCA, markers of citrate accumulation (total/ionized calcium ratio > 2.5), and metabolic complications. We included 10 children with mean age of 2.6 ± 3.8 months and BW of 4.6 ± 2.7 kg. In-hospital mortality was 60%. RCA-CRRT parameters were: blood flow 46 ± 9 mL/min (12 ± 5 mL/min/kg BW), citrate dose 2.8 ± 0.6 mmol/L of blood resulting in estimated citrate load to the patient of 1.7 ± 0.8 mmol/h/kg BW. In total, 57 dialysis circuits were used with mean filter lifetime of 39 ± 29 h. Citrate accumulation (total/ionized calcium ratio > 2.5) was observed in 7/10 patients and in 14/57 (25%) of circuits; those circuits were performed in children with lower age and BW, had higher relative blood flow and citrate load, while citrate dose was similar. When citrate load to the patient was used to predict citrate accumulation, AUC under the ROC curve was 0.78 and 1.7 mmol/h/kg BW was considered the optimal cutoff value (sensitivity 71% and specificity 72%). CRRT with RCA using equipment, developed for adult population, is feasible in newborns and infants. Signs of citrate accumulation developed relatively often. To prevent it, we suggest avoiding citrate loads above 1.7 mmol/h/kg BW, which can best be achieved by keeping the blood flow below 9 mL/min/kg BW., (© 2019 International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.)

Published
2020
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47. Does Guidewire Exchange Influence Infection Rate Related to Catheters Used for Vascular Access in Children on Chronic Hemodialysis?

Author

Rus RR, Battelino N, Ponikvar R, Premru V, and Novljan G

Subjects
Adolescent, Adult, Child, Child, Preschool, Chronic Disease, Female, Humans, Incidence, Male, Retrospective Studies, Young Adult, Bacteremia epidemiology, Catheter-Related Infections epidemiology, Catheterization, Central Venous instrumentation, Catheters, Indwelling microbiology, Central Venous Catheters microbiology, Renal Dialysis
Abstract

A central venous catheter (CVC) can either be inserted "de novo" or placed by guidewire exchange (GWE). From September 1998 to September 2015, 32 children (19 boys, 13 girls) were hemodialyzed in our unit by using a CVC. The mean age at CVC insertion was 12.6 ± 0.5 years. A total of 121 uncuffed catheters were placed, either "de novo" or by GWE in 64 (52.9%) and 57 (47.1%) cases, respectively. The most frequent cause for line revision was catheter dysfunction in 40/121 (33.1%) patients. The overall incidence of bacteremia was 1.5/1000 catheter-days. The incidence in newly inserted and GWE catheters was 1.4 and 1.7/1000 catheter-days, respectively. The difference did not reach statistical significance (P = 0.939). The infection rate correlated with patient age, and was higher in younger children (P = 0.006). GWE is an effective option of line revision, and did not influence the infection rate in our study., (© 2016 International Society for Apheresis, Japanese Society for Apheresis, and Japanese Society for Dialysis Therapy.)

Published
2017
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48. Anticoagulation assessment methods in plasma exchange with regional citrate anticoagulation: evaluation of post-filter and filtered plasma ionized calcium.

Author

Antonič M, Gubenšek J, Buturović-Ponikvar J, and Ponikvar R

Subjects
Filtration, Humans, Prospective Studies, Renal Dialysis methods, Anticoagulants pharmacology, Calcium blood, Citric Acid pharmacology, Plasma Exchange
Abstract

Aim: To assess the possibility of using filtered plasma instead of postfilter ionized calcium (iCa) for the assessment of anticoagulation in plasma exchange (PE) with citrate anticoagulation., Methods: 140 PE treatments were performed using either 4% or 15% citrate at a comparable dose. Paired samples of postfilter blood and filtered plasma were taken for iCa measurements with a point-of-care analyzer. Anticoagulation was also assessed with a bedside clotting time and visual assessment of the circuit after procedures., Results: In 490 paired samples, mean postfilter iCa was 0.39 ± 0.14 mmol/L, and filtered plasma iCa was 0.33 ± 0.11 mmol/L. Mean bedside clotting time was 18 ± 7 minutes. Neither the postfilter (r = 0.03, p = 0.73) nor the filtered plasma iCa (r = 0.09, p = 0.25) correlated significantly with bedside clotting time. Bland-Altman analysis showed a modest agreement between filtered plasma and postfilter iCa values (mean difference -0.07 mmol/L, upper and lower 95% limits of agreement 0.10 and -0.23 mmol/L). Median visual assessment score was excellent at all three checkpoints., Conclusions: A modest agreement between filtered plasma and postfilter iCa values could be acceptable if only a confirmation of anticoagulant effect is required. Measuring filtered plasma instead of postfilter iCa would reduce blood loss with sampling, which could be important in some settings.
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Published
2017
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49. Acute kidney injury in critically-ill adult patients with seasonal influenza infection.

Author

Dovč A, Premru V, Pečavar B, and Ponikvar R

Subjects
Acute Kidney Injury epidemiology, Acute Kidney Injury therapy, Adult, Aged, Critical Illness, Female, Humans, Incidence, Male, Middle Aged, Renal Replacement Therapy, Retrospective Studies, Seasons, Acute Kidney Injury etiology, Influenza, Human complications
Abstract

Background: Acute kidney injury (AKI) occurs in 22.4 - 100% of critically-ill hospitalized patients with influenza infection. In up to 2/3, it is severe enough to necessitate renal replacement therapy. We aimed to document the incidence of AKI among patients with influenza-related critical illness and its relation to clinical outcomes., Methods: We conducted a retrospective observational study of all adult patients with acute respiratory illness and laboratory-confirmed influenza infection admitted to non-surgical intensive care units at the University Medical Centre Ljubljana between January 1, 2016, and March 31, 2016., Result: Our sample consisted of 28 adult patients with mean age in years of 57.5 ± 20.2. Incidence of AKI was 71.4%. Mortality was 28.6% (35% in patients with AKI and 41.6% in patients who required renal replacement therapy)., Conclusions: Influenza-related critical illness is rare but can cause AKI in a large proportion of affected patients. In this setting, requirement for renal replacement therapy could be associated with increased mortality risk.
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Published
2017
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50. Treatment of antibody-mediated rejection of kidney grafts with bortezomib and/or rituximab compared to standard regimen: experience of Slovene National Center.

Author

Oblak T, Lindič J, Gubenšek J, Kveder R, Aleš Rigler A, Škoberne A, Večerić Haler Ž, Borštnar Š, Avguštin N, Ponikvar R, Mlinšek G, Ferluga D, Kojc N, Godnov U, and Kovač D

Subjects
Adult, Aged, Bortezomib administration & dosage, Female, Graft Survival, Humans, Male, Middle Aged, Retrospective Studies, Rituximab administration & dosage, Antibodies immunology, Bortezomib therapeutic use, Graft Rejection drug therapy, Kidney Transplantation adverse effects, Rituximab therapeutic use
Abstract

Background: The aim of our study was to determine outcomes of standard treatment of antibody-mediated rejection (ABMR) of kidney grafts as compared to the addition of bortezomib or rituximab., Methods: The cohort of this retrospective study included patients treated for ABMR of kidney grafts at our national center in the period of 2005 - 2017, divided into two groups: standard (ST) group treated standardly with plasmapheresis or immunoadsorption, intravenous immunoglobulins, and corticosteroids, and BR group treated with the addition of bortezomib and/or rituximab. Patient and graft survival at 2 years was analyzed by Kaplan-Meier method, and predictors of graft survival were analyzed by Cox regression., Results: There were 78 patients with ABMR (48 in the ST group, 30 in the BR group), 41 (53%) were men, mean age 49.5 ± 13.8 years. In ST and BR, respectively, mean serum creatinine was 267 ± 164 and 208 ± 112 µmol/L (p = 0.088), donor-specific antibodies (DSA) were positive in 75% and 97% (p = 0.022), and ABMR was acute in 50% and 33% (p = 0.149). Patient survival at 2 years was 89% in the ST and 100% in the BR group (p = 0.125). Cumulative proportion of kidney graft survival at 1 and 2 years was 67% and 53% in the ST group and 73% and 48% in the BR group, respectively, (p = 0.641). Chronic ABMR (HR 5.22, p = 0.004) was significant, while dialysis dependency at biopsy (HR 3.28, p = 0.072), serum creatinine at kidney biopsy (HR 1.003, p = 0.082), and presence of DQ-DSA (HR 3.37, p = 0.062) were borderline significant predictors of worse graft outcome. Infections were relatively common in both groups, with a trend towards more rehospitalizations due to infections in the first 6 months after treatment in the BR group (p = 0.066). In 5 patients (17%), treatment with bortezomib was discontinued prematurely due to cytopenia., Conclusions: Bortezomib or rituximab, added to standard treatment, did not significantly improve kidney graft survival and was also not associated with significant side effects, except cytopenia in some cases. Treatment of acute ABMR resulted in better graft survival than chronic ABMR.
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Published
2017
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