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[in Japanese]
1981 Volume 10 Issue 2 Pages
363-364
Published: April 15, 1981
Released on J-STAGE: October 07, 2011
JOURNAL
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[in Japanese]
1981 Volume 10 Issue 2 Pages
365
Published: April 15, 1981
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JOURNAL
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[in Japanese]
1981 Volume 10 Issue 2 Pages
366-367
Published: April 15, 1981
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N. WATANABE, N. KIMURA, S. SASAKI, M. UEDA, K. OHORI, S. KOMATSU
1981 Volume 10 Issue 2 Pages
368-371
Published: April 15, 1981
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It is very important to understand hemodynamics during extracorporeal circulation. So we intended to apply the ultrasonic flowmeter (MUV-2100) to measure venous and arterial flows accurately during extracorporeal circulation. This study was done to evaluate the reliability of the data measured by the ultrasonic flowmeter, changing various factors such as bore, thickness and material of the tube which was used for extracorporeal circuit, and hematocrit and temperature of blood. The results were satisfactory.
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[in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
1981 Volume 10 Issue 2 Pages
372-377
Published: April 15, 1981
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For the purpose of safer and more practical physiological extracorporeal circulation, authors have devised a new system of extracorporeal circulation.
In this system, the arterial and venous flow are automatically regulated by the preset arterial and central venous pressure with the use of simple pressure-trigger mechanism instead of micro computer
We named this syatem “automatic pressure limited extra-corporeal circulation”[APLEC]
This method promises less complications such as air embolism, myocardial damage due to cardiac overdistension, when compared with the conventional bypass technic.
Improvement in physiological aspects are that volume of the pliming solution decreased, pressure gradient between SVC and IVC was eliminated and intravascular volume became constant by the “pressure limited mechanism”
APLEC satisfys simplification of circuit, the shortning of it and automatic control except presetting of arterial and central venous pressure, which have. to be judged by pump doctor.
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[in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
1981 Volume 10 Issue 2 Pages
378-381
Published: April 15, 1981
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Fundamental experiment of hyperthermia with excorporeal circulation for cancer therapy was made by use of heal ty dogs. As the results, the hemolysis was not found when the blood temperature of excorpoeral circulation was 45°C. Hyperthermia condition was kept enough by 42°C of circuit water and the electric blanket. It will be able to minimize the damage to the body by high temperature. The survival rate was extremely up when the value, which means the area of rectal temperature over 42°C, was under 1.0 hr·deg.
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T. ISHIMOTO, H. IKEDA, K. SAKAI, A. YAMASHITA, T. SAKAI, T. UCHIMA, O. ...
1981 Volume 10 Issue 2 Pages
382-385
Published: April 15, 1981
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The in-vitro experiments reported here were designed to find some factors responsible for hemolysis in extracorporeal circuit including roller pump. Experimental condition studied (blood volume: 500ml, 30r. p. m.) were twenty times as severe as actual clinical conditions.
Occulusion pressure and temperature (especially over 300mmHg and 37°C) were found to be important for evalution of hemolysis.
Dust such as glass and adsorbent resin (Amberlite) is also responsible for hemolysis.
Hemolysis Model was devised for quantitative analysis of hemolysis phenomena in extracorporeal circuit, from which rate equation were obtained.
The change of Plasma Ha with time was explained well with these equations in bovine blood circulation.
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Hidetoshi TAMURA, Tadahiko MINOJI, Masaaki ATOBE, Manabu MATSUMOTO, No ...
1981 Volume 10 Issue 2 Pages
386-388
Published: April 15, 1981
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In cardiopulmonary bypass (CPB) and after bypass heparin concentration was estimated. The amount of heparin administered was 3.61mg/Kg and pr.otamine 3.48mg/Kg. During CPB heparinemia was maintained 0.88u/ml to 0.95u/ml. After bypass the concentration of heparin recovered with protamine within normal range. Owing to heparin concentration and ACT, no additional heparin was necessary at least for 2 hours in CPB. The activity of AT-III was descended about 50% of normal AT-III in CPB, but recovered to control level until 4 or 6 hours after CPB.
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Measurement during Open Heart Surgery
S. HASHIMOTO, N. AWATA, K. NAKAMOTO, K. IUCHI, K. NAKAMURA, T. MORI, U ...
1981 Volume 10 Issue 2 Pages
389-392
Published: April 15, 1981
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Transcutaneous oxygen tension (tcPo2) were continuously measured during open heart surgery for eighteen patients.
The Hagihara electrode were placed onthe three points of patient's skin, those were on the arm, abdomen and thigh. The tcPo2 showed no difference between arm, abdomen and thigh throughout the study. The tcPo2 was slightly lower than the arterial Po2 before E. C. C.
But during E. C. C. the tcPo2 were markedly dropped and the arterial Po2 was markedly elevated. The reason of this difference was thought to be the hypo-tissue-perfusion and hypothermia during E. C. C, and the use of bubble oxygenator.
This electrode is very useful for the detection of hypo-tissue-perfusion and for the continuous monitoring of Po2 in the intra- and post-operative severe patients.
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[in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
1981 Volume 10 Issue 2 Pages
393-396
Published: April 15, 1981
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For reducing ischemic injury, it is effective to lower ionized calcium (Ca
++) level to protect myocardial cells from calcium influx during early phase of reperfusion. From this point of view, changes of Ca
++ were studied in 20 cases of infants and children and 26 adult cases during cardiopulmonary bypass (CPB). To keep low Ca
++ level during CPB, Ca
++ concentration of the pump prime was minimized to 0.03mM and no calcium salt was added when ACD blood was used. Blood sample was obtained immediately before CPB, at 5min, 30min, 60min, 90min on CPB, at aortic declamping, and at the end of CPB.
In cases of infants and children, prebypass Ca
++ concentration was 1.15±0.04mM, and at 5min on CPB, it was reduced markedly to 0.43±0.01mM by hemodilution and by the effect of ACD blood. This low Ca
++ level was persisted until aortic declamping when Ca
++ concentration was 0.74±0.05mM. After 14ml of calcium gluconate administration, Ca
++ recovered to normal range. While, in adult cases, Ca
++ decreased from control level of 1.15±0.02mM, to 0.74±0.01mM at 5min on CPB. Although it increased little by little to 0.95±0.02mM at 90min on CPB and 0.88±0.02mM at aortic declamping, these values were still lower than control level significantly.
We concluded that it is useful method for decreasing Ca
++ level during CPB to minimize Ca
++ level in the pump prime and not to add Ca salt when ACD blood was used. And this decrease of Ca
++ level during CPB, especially at early phase of reperfusion, may play an important role in reducing reperfusion injury.
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[in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
1981 Volume 10 Issue 2 Pages
397-400
Published: April 15, 1981
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Coenzyme Q
10 (Co Q
10) is a critical component of the electron transport chain and also has regulatory influences on the NADH dehydrogenesis of complex one in the chain. As the Co Q
10 is labile exzyme, in the mitochondria, Co Q
10 is lost from the membrane during ischemia which causes depletion of high energy phosphates. In the valvular heart diseases, level of Co Q
10 remain low which causes biochemical and structurial changes of mitochondria.
The purpose of the present study is to establish whether Co Q
10 is lost from mitichondria resulting decrease in blood Co Q
10 by extracorporeal circulation, and then to establish whether Co Q
10 can be used prophylactically to protect depletion of Co Q
10.
The study was carried out on 52 adults patients who underwent open heart surgery, and devided in two groups; pretreated (n=20) and non-treated (n=32) with Co Q
10 group.
In conclusion, pretreatment with Co Q
10 resulted in high level of Co Q
10 in blood, and less diminished the level of blood Co Q
10 to some extent by extracorporeal circulation. However, the level of Co Q
10 of pretreated group reached to same level as that of nontreatedgroup on two days after operation, and no significant diference was observed between two groups when the time of extracorporeal circulation exceeded more than 3 hours. Pretreatment with Co Q
10 produce high level of Co Q
10 in blood which may protect the heart from irreversible cardiac failure.
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[in Japanese]
1981 Volume 10 Issue 2 Pages
401
Published: April 15, 1981
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-SURFACE TEXTURE AND PERMEABILITY-
N. AKABA, Y. YAMAMOTO, M. ISHIKAWA, T. YOHDA, Y. AOYAMA, H. UJIIE, T. ...
1981 Volume 10 Issue 2 Pages
402-405
Published: April 15, 1981
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The porosity of vascular prosthesis is concerned with blood leak, the formation of initial fibrin matrix layer and their ultimate organization. In initial stages after implantation a high porous, fine-texture surface structure of the prosthesis has a effect of producing a thin, uniform coat of coagula. Blood leak tends to be less with those prostheses in which interstices between staple fiber are narrow and winding, even high porous. The pseudointima which has been formed to be thinly and smoothly is held in place by an anchoring effect and obtains sufficient nutrients directly from circulating blood, even if impermeable and thus shows favorable processes of organization. When large amounts of coagula filled up the pore of prosthesis in step of preclotting this is followed by a release of coagulative substances from the coagula secondarily, which in turn gives rise to an increase in thrombus formation with a resultant occlusion of the prosthesis. Moreover, it is also likely that the coagula is eventually replaced with collagen fibers which leads to increased rigidity of the prosthesis.
From the above it seems inappropriate to idea that vascular prostheses of large permeability are excellent. Now the suggestion that the porosity of vascular prosthesis to increase to a maximum allowable for the prevention of blood leak should be reconsidered.
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K. IMACHI, M. NAKAJIMA, I. FUJIMASA, H. MIYAKE, N. TAKIDO, A. KOUNO, T ...
1981 Volume 10 Issue 2 Pages
406-409
Published: April 15, 1981
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Thrombus and pannus formation, carcification and infection are often generated from pseudoneointima on vascular prosthesis connected between artificial heart (AH) pump and blood vessel. Though smooth surface vascular prosthesis is ideal to protect these phenomena, it has been difficult to get material with appropriate properties, such as softness for easy suturing, flexibility for fitness to blood vessel, enough strength and antithrombogenecity. Smooth surface vascular prosthesis was developed by surface coating of Avcothane on expanded polytetrafluoroethylene (EPTFE) vascular graft inner surface. About 20 micron thick Avcothane layer was formed on EPTFE by one coating and the Avcothane layer was strongly fixed with EPTFE.
This vascular prosthesis was used as AH cannula and sutured to 11 goat's pulmonary artery and descending aorta with side-to-end anastomosis. Except one acute experiment, all the specimen were implanted for more than 2 months including 288 days as the longest one. No thrombus and fibrin layer was observed on Avcothane surface and boundary area between blood vessel and Avcothane. From these results, it can be concluded that Avcothan coated EPTFE is an ideal material for smooth surface vascular prosthesis.
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M. MATSUSHITA, Y. KUBO, T. ATSUTA, Y. NISHIOKA, T. SASAJIMA, H. IKEDA, ...
1981 Volume 10 Issue 2 Pages
410-413
Published: April 15, 1981
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We had found that a compound graft made of a non-woven polypropylene sheet enforced by a tetron mesh layer had given rise to better tissure healing comparing with usual synthetic vascular grafts.
In this report the results of canine carotid artery replacement using the new type of compound graft supported with monofilament polypropylene suture rings on both ends were presented.
The graft patency rates of 80% at 3 weeks and 42.9% at 12 to 15 weeks after implantation were satisfactory, so it became clear that the supporting ring at suture line was effective.
In order to get better patency of small caliber vascular graft, we should not only study about the graft materials, but also clarify the cause for the trouble of suture lines and consider how to cope with the situation.
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Y. HARADA, Y. KANDA, R. AOSHIMA, D. FUJIMOTO
1981 Volume 10 Issue 2 Pages
414-417
Published: April 15, 1981
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Urokinase was immobilized on the vascular graft of knitted Dacron and woven Tetron.
The inner surface of the prostheses was investigated by the SEM at the early period after the implantation in the canine arteries.
There was no significant difference about the amount of thrombosis between the crimped graft with and without the antithromogenic enzyme.
On the surface of the non-crimped woven Tetron with UK, the fibrin fiber formation was much little at one hour, and the only small amount of fibrin and blood cell deposit was observed at 7 days.
After the preclotting in the UK graft, the deformation of the aggregated blood cell and the making of the thin layer were found at 20min.
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H. UJIIE, Y. YAMAMOTO, M. ISHIKAWA, N. AKABA, T. YOHDA, T. WATANUKI, M ...
1981 Volume 10 Issue 2 Pages
418-421
Published: April 15, 1981
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Auto-vein and exiting graft vascular prosthesis have been used for patch graft angioplasty. We devised nonwoven cloth as patch graft. The non woven cloth for medical use have been produced which is made of polyester fibers (Tetoron) bound with latex rubber. The non-woven cloth is able to cut any size without fraying, has elaticity and no blood porosity. The clinical use is mainly patch graft to location of incision for endarterectomy and defect after taking out catheter for balloon pumping and resection of malignant tumor which make an invasion upon a blood vessel. These operation have produced good results.
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H. SASAKI, M. KASAI, H. NAKAYA, A. UTSUO
1981 Volume 10 Issue 2 Pages
422-423
Published: April 15, 1981
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A compound prosthetic graft, which was woven with alternated yarns of non-absorbable (Tetron) and absorbable (Collagen) fibers, was made (We called it as C-T graft.). The study was done in order to know about the effect of heating for C-T graft.
Method:
(1) C-T graft was made of tetron yarn and 0.95 gluteradehyde solution tanned collagen yarn. The rate of collagen yarn was 30% in that graft. The diameter of graft to were 8mm (7 cases) and 4mm (4 cases).
(2) Heating of graft; three type of heated graft was made. (a) non-heated graft (control) (b) 140°C, 15-30 minute, heated graft (c) 180°C, 15-30 minute, heated graft was done in heated C-T grafts by modified Salzmann method.
(4) C-T grafts was implanted at the abdominal aorta and iliac artery of 7 mongrel dogs.
Result:
(1) Heated C-T graft was not different in the platlet adhesiveness from non-heated C-T graft.
(2) But, patency of heated C-T graft was better than non-heated C-T graft.
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[in Japanese]
1981 Volume 10 Issue 2 Pages
424
Published: April 15, 1981
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R. YOZU, T. MAEHARA, I. KISO, T. INOUE, K. KAWADA, S. TAKEUCHI, Y. SOH ...
1981 Volume 10 Issue 2 Pages
425-430
Published: April 15, 1981
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The purpose of this paper is to present the intraoperative G. A tanning method which would prevent anastomotic aneurysm. Prosthetic grafts have greatly improved, so the fragility of host aortic wall and infections have been pointed out as the principal etiological factors about the anastomotic aneurysm. Glutaraldehyde has been used popularly in certain fields such as preparation for porcine heterografts, but its intraoperative tanning method has not yet been reported. We have developed Glutaraldehyde Tanned Anastomosis (GATA method); the host aortic walls were tanned with G. A during operation before anastomotis. This method was employed in 15 cases of aortic aneurysm (3 in thoracic, 12 in abdominal). The longest follow-up period is 18 months. All 15 postoperative courses were uneventful. No complications hate been found in nervous systems, gastrointestinal tracts and other organs. This method has many advantages; first of all, it's very simple, the aortic tissues are firmly reinforced by aldehyde crosslinking (which was demonstrated by histological and tensilstrength study) and strong bactericidal action of G. A is expected to prevent infections.
The present study leads us to conclude that GATA method is very useful as the reinforcement procedure of suture line in the vascular surgery. This work was supported in part by Grant in aid for scientific reserch of Japanese Ministry of Education, No. 457335.
Ryohei Yozu, M. D. Saiseikai Utsunomiya Hospital 4-17 chuo-honcho Utsunomiya Tochigi, 320 JAPAN.
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S. UEMURA, Y. MIYAUCHI, Y. NAKAGAWA, H. SAITO, K. NAGAOKA, K. OKUI
1981 Volume 10 Issue 2 Pages
431-434
Published: April 15, 1981
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Twelve glutaraldehyde- tanned human saphenous veins (GHSV), fourteen ficin-treated glutaraldety-de-tanned human saphenous veins (FGHSV), and ten gore-tex were implanted in the abdominal aorta of dogs. The patency rate was 83% (GHSV), 85% (FGHSV), and 80% (Gore-tex).
Two GHSV and Two FGHSV had so high ant igenicity that we found no thrombus on their surface and microscopically their structure were as same as they were implanted more thane 1 year ago. We conclud that modified human saphenous vein homografts are reliable to use as a small calibar arterial substitutes.
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for the small caliber artery
Yoshiaki KOMOTO, Masayuki MANO
1981 Volume 10 Issue 2 Pages
435-438
Published: April 15, 1981
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Encouraged at the preliminary data on the application of bias-cut artificial blood vessel to the small caliber arterial reconstruction, the implantation experiment on dog has been continuing to verify the original assumption of maintaining biological porosity close to the original porosity which resists scar contraction.
70% of patency rate was found both on the bias-cut grafts and on the control side of 4mm I. D. Microknit grafts by angiography and/or autopsy in a period of nearly 2 years.
It was found on a review of recovered specimens up to one year of implantation histologically that the inner capsule of bias-cut grafts showed better vascularity in basal layer than the inner capsule of control grafts did.
Good biological porosity found in the bias-cut grafts is quite unique and advantageous to the development of a small caliber arterial prosthesis.
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T. SASAJIMA, Y. KUBO, Y. IZUMI, E. YAMAZAKI, M. INABE, [in Japanese], ...
1981 Volume 10 Issue 2 Pages
439-443
Published: April 15, 1981
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Late failure of PHUV often results from anastomotic pannus hyperplasia. Varying factors have been implicated in the process. In this paper, we studied the influence of compliance mismatch (C. M.) at anastomotic sites and use-fulness of the phonoangiography (PAG) and frequency analysis to evaluate the ideal anastomotic geometry. Compliance, C is defined by V/V0·Δp×100, (Δp=100; pressure from 50 to 150mmHg), therefore C=V/V0. It is noted that umbilical vessels and knitted Dacron are about 8 times less compliant than that of the thoracic aorta of dog whereas woven Dacron and EPTFE are about 50 times less compliant. In order to evaluate the influence of C. M. on the anastomotic site, we studied the diameter change in the area under pressure range of 50mmHg to 150mmHg. That is, the diameter of the anastomotic area was measured from X-ray film taken in the pressure range using mercury as a contrast medium. We have concluded that, 1) the compliance of the suture line depends on graft compliance, 2) the region affected on the C. M. is host artery within 5mm from suture line, and 3) stenosis at the anastomotic site and disproportion of graft diameter amplify the influence of the C. M. In order to alleviate the C. M., we are studing the fixation of the host vessel wall near the suture line using Teflon ring. We also studied PAG and its frequency analysis of anastomotic bruits under controlled graft flow. The data showed that abnormality of the anastomotic geometry is proportional to the bruits and inversely proportional to flow, therefore its quantitative evaluation is possible by means of determining the maximal graft flow at the level, at which the anastomotic bruits disappear from the bruits frequency spectrum.
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K. NAGAOKA, Y. MIYAUCHI, Y. NAKAGAWA, H. SAITOH, S. UEMURA, Y. MINEMUR ...
1981 Volume 10 Issue 2 Pages
444-447
Published: April 15, 1981
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The pig ureters treated with ether and glutaraldehyde were implanted in the canine ileofeworal or thovaco-abdominal positions to asses the value as a long arterial bypass graft.
Of ten these, bypass, nine remained patent for a 90 percent overall patency rate, maximum follow-up one year. Anti-platelet agents were not used.
Histologically, the structure of mucosal propria and muscle layer was found of be steadily preserved and no cell infiltrations were observed one year after implantation. These data support the possible clinical use of this graft, however, continued evaluation is necessary as regards the further histological changes in the longer period.
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Masato TOUYAMA, [in Japanese], [in Japanese], [in Japanese], [in Japan ...
1981 Volume 10 Issue 2 Pages
448-451
Published: April 15, 1981
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Replacement of superior vena cava with EPTFE graft (30-50mm length) associated with creation of temporary bridge type distal arterio-venous shunt was investgated in dogs. Shunt ratio was 13-48%.
Eight of nine (88.9%) showed good graft patency in the dogs with A-V shunt examined by venography performed six months after the operation. On the other hand only tow of seven (28.6%) was patented in the dogs without distal A-V shunt.
Temporary bridge type distal A-V shunt was effective in the patency of the replaced EPTFE Graft.
Arterio-venous shunt with shunt ratio less than 48% made no cardiac failure in dogs.
Proper time to close temporary A=V shunt is more than six months after the operation.
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K. NIHEI, S. OHTA, Y. MAEDA, H. AOKI, N. KANNO, M. SAKUMA, T. TANABE
1981 Volume 10 Issue 2 Pages
452-455
Published: April 15, 1981
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Hemodynamic and pathologic changes of 11 jump grafts which were grafted between canine's right ventricle and pulmonary artery with woven dacron conduit containing 1.3% Diaddehyde starch treated porcine aortic xenograft valve were examined. Soon after replacement, no valve failure were noted. Eight of 11 canines survived for 18 months on the average, but three were died of bacterial endcarditis. Hemodynamic values before sacrifice showed two slight pressure gradients and three pulmonary regurgitations. On gross findings of conduit grafts, intraluminal surface of woven dacron were completely smooth.
Thickening or sclerosing of valve were noted in 9 leaflets and thrombus in one leaflet.
No atrophy and tear were seen. On light microscopic findings, collagen and elastic fibers of valve were well preserved, and inflammatory cell infiltration was minute and focally at leaflets, Therefore, DAS treated porcine aortic xenograft valve and woven dacron conduit were considered satisfactory for the conduit graft.
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Yasushi NISHIYA, Eisaburo IMAMURA, Takafumi OKOSHI, Kazuo SAWATARI, Hi ...
1981 Volume 10 Issue 2 Pages
456-459
Published: April 15, 1981
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The patch graft with sinus was implanted in 15 dogs, and compared with pericardial cusp patch. without sinus implanted in 5 dogs. Right ventriculography in the cases of the monocusp patch with sinus showed an enough size at the part of the reconstructed outflow tract, while in the cases of the monocusp patch without sinus showed the shape of the slow curve at the part of the reconstructed outflow tract. Both cusps with sinus and without revealed a good mobility, but the former already exhibited semiclosure of the cusp in the end systolic phase of the right ventricle, while the latter began the closure of the cusp in the mid diastolic phase. Then, pulmonary arteriography showed that there was little pulmonary insufficiency in the casesof the monocusp patchwith sinus, but there was moderate pulmonary insufficiency in the cases of the monocusp without sinus.
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[in Japanese]
1981 Volume 10 Issue 2 Pages
460
Published: April 15, 1981
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I. FUJIMASA, K. IMACHI, H. MIYAKE, N. TAKIDO, M. NAKAJIMA, A. KOUNO, T ...
1981 Volume 10 Issue 2 Pages
461-464
Published: April 15, 1981
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In our long survival cases of total artificial heart (TAH) experiment, three cases survived more than 7 months lately, and the longest survivor lived 288 days. The artificial heart system was total both heart bypass, and the ascending aorta and pulmonary artery were ligated and occluded completely. The natural heart was kept beating to perfuse coronary arteries. Pulmonary and systemic circulation was maintained by the artificial heart.
In post operative cource, the goats have lived well, and the value of hematocrit and total protein has been maintained normal, and anemia and ascites which usually accompanied in the long survivals did not occure. The beating of the remained natural heart was continued until death or the timeof forcedly fibrillating. No specific change was observed on ECG follow up.
This method of TAH cannot only be a resolution to a problem of bypass type TAH, but also with some modifications be applicable to temporally assisted circulation for failing heart.
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H. MIYAKE, I. FUJIMASA, K. IMACHI, T. TAKIDO, M. NAKAJIMA, A. KOUNO, T ...
1981 Volume 10 Issue 2 Pages
465-468
Published: April 15, 1981
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In order to clarify the effect of beating natural heart, Wintrobe constants and 10 items of blood chemical data were statistically investigated on 24 goats replaced with TAH and electrically fibrillated natural heart (F-TAH) and 6 goats replaced with TAH and beating natural heart--hybrid type (H-TAH).
The results show H-TAH is better than F-TAH in the improvement of hematocrit, total protein and LDH elevation. But hematocrit improvement is due to the increase of MCV and there is still anemia.
From these facts, it can be said that fibrillated heart had some negative effect and that even H-TAH has problems to solve.
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-ventricular pressure in the piston-bellows pump-
S. HASHIMOTO, T. SASADA, K. MABUCHI, M. MORITA, K. NISHIYAMA, T. ITO, ...
1981 Volume 10 Issue 2 Pages
469-472
Published: April 15, 1981
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The relation between the stroke volume and the ventricular pressure has been studied in a mock circulation changing the compliance of bellows. Firstly, compliance of four kinds of bellows (buthylrubber molded, siliconrubber sheet, siliconrubber molded and welded bellows of stainless steel) was measured under static conditions. Secondly, the ventricular pressure was measured during the pulsatile flow with various pulse rate in a mock circulation. Thirdly, the actual stroke volume (volumetric change of a ventricle during one stroke) estimated from the compliance of bellows and from the ventricular pressure was compared with the effective stroke volume (flow rate per pulse rate) determined from the measured flow rate and from the measured pulse rate in a mock circulation.
Consequently, it is found that the flow rate of the piston-bellows pump hardly increases with the pulse rate because the stroke volume is governed by the elastic compliance of the bellows. Using a steel bellows of low compliance, the flow rate is able to be controled mechanically. This last type of the pump with steel bellows was connected to the dog which survived for 13h 30.
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M. NAKAJIMA, I. FUJIMASA, K. IMACHI, H. MIYAKE, N. TAKIDO, A. KOUNO, T ...
1981 Volume 10 Issue 2 Pages
473-476
Published: April 15, 1981
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Cardiac function was evaluated in a goat with hybrid type total artificial heart. The measured parameters were right and left ventricular pressure, aortic and pulmonary arterial pressure, CVP, pulmonary arterial flow and ECG. Ventricular dP/dt and TTI were calculated from these datas.
The natural heart showed no signs of functional disturbance for more than three months and responded well to treadmill exercise. Left ventricular pressure and TTI were elevated postoperatively and dP/dt did not decrease. Histological examination revealed slight hypertrophy of the left ventricle.
From these datas, it was expected that coronary blood flow was maintained well throughout the course and cardiac external work was diminished but pressure work was increased in this system. It seemed necessary to evaluate this method in failing heart animals.
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I. MATSUSHITA, H. TAKEDA, T. MATSUDA, T. SUZUKI, R. ITOH, Y. YAMADA, S ...
1981 Volume 10 Issue 2 Pages
477-480
Published: April 15, 1981
Released on J-STAGE: October 07, 2011
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This experimental studies were done with 17 dogs, and the possibility of using animal heart as a substitute instead of artificial heart by polymer.
Anstadt cup was drived by pneumotic driving system which using in polymer artificial heart.
First, we injected Young's and GA solution of mixed Gentiana violet into the heart via both coronary arteries.
Next, in the mock circulatory setup the removed heart were soaked with GA solution in each concentration.
Test of each heart muscular elasticity was measured with UTM-4-I00 made of Tokyo Boldwinn Co. (Japan).
I. The heart treated with 0.2% and I% GA solution can be used as a cardiac substitute for a short time.
2. A heart treated with 0.1% GA solution for two days can be hemodinamically and pathologically used in mockcirculation.
3. In pathological findings, a heart treated 0.2% GA solution were showed degeneration in a part of heart muscles after one week.
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N. TAKIDO, I. FUJIMASA, K. IMACHI, H. MIYAKE, M. NAKAJIMA, A. KOHNO, T ...
1981 Volume 10 Issue 2 Pages
481-484
Published: April 15, 1981
Released on J-STAGE: October 07, 2011
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In the hybrid type Total Artificial Heart (HTAH) experiments, in which, pulmonary and systemic circulations were maintained by artificial heart and only coronary circulation was maintained by beating natural heart, experimental animals survived long-term successfully.
In a case of HTAH experiment, measurement and analysis of hemodynamic parameters were achieved for over 14 weeks.
Long-term transitions and short-term transient responses against change of posture or treadmill loading of hemodynamic parameters were measured and analysed.
Results by analysis showed the probable tendency of adaptation process between natural circulatory system and artificial heart.
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[in Japanese]
1981 Volume 10 Issue 2 Pages
485
Published: April 15, 1981
Released on J-STAGE: October 07, 2011
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Yutaka INAGAKI, Takashi KAWAMURA, Izumi AMANO
1981 Volume 10 Issue 2 Pages
486-489
Published: April 15, 1981
Released on J-STAGE: October 07, 2011
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Seven patients with renal failure manifested metabolic alkalosis due to the drainage of gastric juice and vomiting. Hemodialysis was less effective for severe metabolic alkalosis and/or contraindicated for the patients with gastro-intestinal bleeding and postoperative wound. So peritoneal dialysis with CaCl
2- and KCl- added to physiological saline solution (PD-PSS) was used for the treatment. In result all the patients responded well to PD-PSS and there were no serious major complication. The basic idea to correct metabolic alkalosis by PD-PSS is to diffuse certain ions based on the chemical gradient at the peritoneal membrane as a semipermeable membrane. One out of the seven patients manifested hypernatremia and and hyperosmolemia caused by an excess amount of NaHCO
3 administration during cardio-pulmonary resuscitation. Peritoneal dialysis with hyposaline solution was used for the treatment and in result, the concentration of serum Na
+ was decreased to normal range. These results suggest that peritoneal dialysis is an effective treatment for the diseases, especially metabolic alkalosis and hypernatremia.
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Toshiaki SUZUKI, Hidemasa MUTOH, Kazuo KUBO, Norimasa YAMASHITA, Tadao ...
1981 Volume 10 Issue 2 Pages
490-493
Published: April 15, 1981
Released on J-STAGE: October 07, 2011
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Fifty intractable ascitic patients were treated with peritoneocaval shunt pump. The effectiveness of this procedure was reported at the previous meeting. We experienced some complications of this method (fever 14, gastrointestinal bleeding 5, disseminated intravascular coagulopathy 3, leakage of asciteil, pulmonary embolism 1), of which the disseminated intravascular coagulopathy (DIC) and the rupture of esophageal varicoses should be especially paid attention to. DIC is said to result from intravenous infusion of the ascitic fluid with the procoagulant factors (FDP, cell debris, bilirubin and endotoxin etc.). If the procoagulant factors are demonstrated in the fluid by Limulus test and the ascites-reinfusion test, we are used to perform the ascites-reinfusion method with plasma separator (polyvinylalcohol membrane) and activated charcoal column in stead of the operation.
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Yasuharu NOISHIKI, Yuichi MORI, Shoji NAGAOKA, Tetsuya KIKUCHI, Hirosh ...
1981 Volume 10 Issue 2 Pages
494-497
Published: April 15, 1981
Released on J-STAGE: October 07, 2011
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The silicone tubes have been used as the ascites shunt devices. In the case of ascites caused by malignant deseases, however, the tube was tended to be obstructed due to deposition of fibrin on it.
In this study, to prevent the deposition of fibrin, heparinized tubes, which was developed as nonthrombogenic materials was applied to ascites fluid tube. A soft vinyl-chloride tube 35cm long and 2.8mm. in outer diameter, (2.0mm. in internal diameter) was coated with a hydrohilic polymer (Toray Ind. Inc.) and was heparinized. The tubes were used in four patients with ascites due to peritonitis of stomach cancer. The tubes functioned well and were patent at the time of removal. By means of light and electron microscopy, the surface of the tube was observed to be covered with a layer of about 1000Å thickness without specific structure. Any fibrin nor cells were observed on it.
These results indicated that the heparinized tubes was useful as ascites tube even in the case of malignant deseases.
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[in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
1981 Volume 10 Issue 2 Pages
498-500
Published: April 15, 1981
Released on J-STAGE: October 07, 2011
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Twentyfive patients aged 52±13 years old carried on CAPD program in Japan. Better and steady state biochemical, hematologcal and electrolytes values were obtained two months after the inciation (BUN 52.2±32.1mg%, S-Cr 8.7±3.4mg%). Five patients were inter rupted this program because of recurrent peritonitis (1), malnutrition (1), catheter failure (1) and psychological discomfort (2). The incidence of peritonitis were one episode/10 patient month and also rehabilitation status was favorable (65%). This technique is acceptable form of dialysis, especially in patients who are not suitable to extracorporial dialysis and kidney transplantation.
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[in Japanese]
1981 Volume 10 Issue 2 Pages
501
Published: April 15, 1981
Released on J-STAGE: October 07, 2011
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I. TAKAHASHI, O. OTSUBO, T. INOU, T. WATANABE, M. MUTO, T. IIZUKA
1981 Volume 10 Issue 2 Pages
502-505
Published: April 15, 1981
Released on J-STAGE: October 07, 2011
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An expanded polytetrafluorethylene (EPTFE) tube which was recently developed for use as a vascular prosthesis was applied as an artificial esophagus in dogs.
A tube of relatively short length, 5cm, was implanted in five dogs at neck region for the initial trial. The trial was successful in two animals, of which survived for more than 12 months. In both of these animals, stenosis occurred in the caudal region of the prosthesis and was removed by surgical expansion of the lumen endoscopically.
The inner surface of the implanted tube was progressively lined by regenerating mucosa which presented essentially the same appearance as normal esophageal mucous membrane when observed with a fiberscope. The regeneration of the mucosal epithelium was probably consequent to the fibrobrastic proliferation through the fine pores of the EPTFE fabric. The remaining two dogs died within a week due to dehiscence of the sutured anastomosis because they had been allowed to eat after an insufficient period of time after operation in the initial trial. It is of profound interest that dehiscence occured on the caudal side of the implanted tube in both cases while sutures on the rostral side remained intact.
Experimental studies of esophageal prosthesis from the cervical esophagus to the stomach using various types of EPTFE tubes are in progress at our laboratory, with the gratifying results using a long tube more than 30cm. But we could not succeed on the long artificial esophagus.
However we succeeded, a dog which was done artificial esophagus (about 10cm) in the thoracic esophagus did not have only stenosis but also leakage.
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Isao KAWAMURA, Shohei OGOSHI, Sadahito USUI, Ujiyasu IRIE, Kazuma YAMA ...
1981 Volume 10 Issue 2 Pages
506-509
Published: April 15, 1981
Released on J-STAGE: October 07, 2011
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We have reported about our experimental study on artificial esophagus made of collagen-silicone copolymer.
We could make sure that the artificial esophagus was exellent for preventing the leakage of the anastoimsis.
But it is difficult to prevent the narrowness at the new esophagus, that would occur in the cases of long survivals.
In this report, we showed two cases of the narrowness, that prosthesis had removed at one month and seven months after operation.
It might be difficult to make out the perfect artificial esophagus enough to use in clinical case without changing the model of the prosthesis.
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Y. MIYAMOTO, Y. SHIMIZU, S. MATSUNOBE, H. KATO, T. TERAMATSU, S. OKAMU ...
1981 Volume 10 Issue 2 Pages
510-513
Published: April 15, 1981
Released on J-STAGE: October 07, 2011
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We tried to reconstruct the cervical trachea of dogs with two physically different types of meshes, Marlex knitted polypropylene mesh (PP mesh) and Marlex high density polyethylene mesh (PE mesh). Each mesh was treated by collagen coating. Both in the patchgrafts and tubegrafts, reconstructive cases with PP mesh were much more excellent than the cases with PE mesh. Which might be due to the high porosity or elasticity of PP mesh. Collagen coating was effective to prevent air leakage, but might not influence the long term survival.
These results revealed the potentiality of PP mesh as a material for tracheal reconstruction
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H. KATO, H. MIZUNO, K. TAMURA, S. WATANABE, Y. SHIMIZU, T. TERAMATSU, ...
1981 Volume 10 Issue 2 Pages
514-517
Published: April 15, 1981
Released on J-STAGE: October 07, 2011
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In order to make sure of the availability of alumina ceramic in thoracic surgery, we have newly designed test-pieces of alumina ceramics and implanted them into the defect of dog sternum where the initial fixation was impossible. We examined roentgenologically the relation between ceramic bone and sternum.
12 mongrel dogs were used for the experiment (10 dogs for ceramic, 2 dogs for steel). 2 of 10 pieces were dislocated from the sternum in the early time, and the other 8 successfully kept the implanted place and fixed both sides of sternum for 6 months, but steel bone migrated from the center of sternum. 2 months after implantation, periosteum started to grow over the free surface of ceramic bone and periosteal ossification of about 6mm length was brought about within 6 months. As to the contact surface, no connective tissue layer was observed at the top and a thin fibrous tissue layer was observed at the lateral side in a few cases. Screw-side of ceramic bone had mechanically a little bit tighter connection than flat-side.
In conclusion, ceramic bone has high tissue affinity and is much effective to keep the fixation of sternum. If the structure of inserted part of ceramic bone, such as screw type, prevents the dislocation in the early time, ceramic bone is much available for the artificial bone in the field of thoracic surgery.
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Yoji TAKAGI, Akira OKADA, Muneyuki FUJITA, Masao KIM, Yasunaru KAWASHI ...
1981 Volume 10 Issue 2 Pages
518-519
Published: April 15, 1981
Released on J-STAGE: October 07, 2011
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Since 1978, 28 patients have participated in our artificial gut program for periods rainging from 1 to 173 days. There have been no significant complications related the use of this artificial gut system. This system has been valuable not only in allowing more freedom and ambulaton in hospitalized patients who require long-term maintenance of nutrition parenterally, but also in permitting them to resume a nearly normal life at home.
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Hiroshi ONO, Shigeji SAITO, Jin KANZAKI, Hiroyuki FUKUDA, Kazutoshi MI ...
1981 Volume 10 Issue 2 Pages
520-523
Published: April 15, 1981
Released on J-STAGE: October 07, 2011
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One of the major complaints of hearing aid users is their inability to understand speech in noisy environments. We have developed a new hearing aid that uses selective aplification in the speech frequency band utilizing a compression amplifier which automatically compresses the lower frequency range as a function of the level and spectrum of the environmental noise. The output of the LPF is passed through a compression amplifier and then mixed with the signal passing through the HPF. Use of this hearing aid on five hearing impaired patients showed that the environmental noise was decreased and the voice sounds became clearer and more audible.
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Kazuoki KODERA, Hitoshi YAMANE, Katsumi SUZUKI, Hiromasa ARAKI
1981 Volume 10 Issue 2 Pages
524-527
Published: April 15, 1981
Released on J-STAGE: October 07, 2011
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The efficacy of a piezoelectric ceramic vibrator was evaluated by measurement with the auditory-evoked brain stem response and capacitive probe. The tip of the vibrator was attached to the head of the stapes and the base was fixed to the bony wall of the middle ear. The auditory brain stem responses were recorded in 5 cats by applying electrical signals to the vibrator. Input-output functions of the responses were the same as those evoked by auditory stimuli. Applying 1 Vp-p electrical signals, outputs of the vibrator were about 90 dB SPL at 4000 Hz, 83 dB SPL at 2000 Hz and 75 dB SPL at 1000 and 500 Hz.
The vibrator had good linearity from 35 to 90 dB SPL at 4000 Hz. These results obtained from the auditory brain stem response agreed well with those from capacitive probe.
The characteristics of the piezoelectric ceramic vibrator were sufficient for the implantable hearing aid.
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Tsuguo IGARI, Ikuo HAYASHI, Paul S. FREED, Adrian KANTROWITZ
1981 Volume 10 Issue 2 Pages
528-531
Published: April 15, 1981
Released on J-STAGE: October 07, 2011
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A prosthetic myocardium (PM) is being developed as the treatment of akinetic or dyskinetic regions in the left ventricle. The PM was implanted to replace an excised experimentally induced infarct. Under external control the PM actively contracts and dilates approximating the action of myocardium. When inactive it can be stopped in it systole or diastole.
Sixteen implantations in mongrel dogs weighing 29-35kg were carried out. Afterload and heart rate were maintained constant, while the preload was varied in steps by means of a right heart bypass. Left ventricular function curves (LVFC) were measured. Then 25.0±1.7% of left ventricular mass was resected, a patch of Electrolour was sutured over the defect and the PM was implanted. LVFC measurements were repeated with the PM active and inactive. LVFC with the PM active was above and to the left of curves obtained with the PM inactive in every experiments.
The results showed the combination of the remaining left ventricle and implanted PM shifts LVFC toward normal.
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[in Japanese]
1981 Volume 10 Issue 2 Pages
532
Published: April 15, 1981
Released on J-STAGE: October 07, 2011
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M. SHIOTA, N. OHSHIMA
1981 Volume 10 Issue 2 Pages
533-536
Published: April 15, 1981
Released on J-STAGE: October 07, 2011
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In order to elucidate the optimum conditions of hepatocyte culture for use as a hybrid-type artificial liver, kinematic studies were performed in a suspension culture of isolated hepatocytes of rats, concerning the effects of partial pressures of dissolved oxygen in medium and the ambient temperature on the hepatocyte viability as well as the ammonia removal rate.
Results revealed that both viability and metabolic functions of hepatocytes were greatly affected by the partial pressure of dissolved oxygen and the temperature of medium. Based on a simplified mass-transfer model, theoretical considerations about the optimum culture condition were also made.
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