The untoward symptoms characterized by nausea, vomiting, yawning, abdominal discomfort, muscle cramps, general weakness and shock are encountered during hemodialysis and even extracorporeal ultrafiltration method (ECUM) without remarkable changes in blood chemistry.
Until today, a number of hypotheses have been proposed about the cause of the so-called disequilibrium syndrome: However, thoroughly established theory have not been postulated at present. It may be debatable, but we considered those symptoms written above as clinical evidences originated from the disequilibrium syndrome occurred during hemodialysis and ECUM. Hence, hemodynamic changes were investigated to elucidate possible causes of the symptoms which occurred during both procedures, especially by using C.O. and PA as parameters.
The following conclusions were obtained.
1) C.O. change during ECUM as well as hemodialysis was chiefly classified into two different types; Type A (Type A: Y=aX²+BX+c, a<0, b>0) and Type B (Type B: Y=aX+b, a<0).
No untoward symptoms were noticed in Type A, but present in Type B.
2) The untoward symptoms occurred when hourly C.O. reductions were more than approximately 400ml/min/hr in both procedures.
3) Rapid infusion of 100 to 200ml of isotonic solution caused instantaneous elevation in both C. O. and PA, and simultaneously the immediate recovery from the symptoms without any significant change in chemicals.
4) Change of PA during hemodialysis and ECUM decreased linearly in spite of different C. O. patterns under the influence of changes in blood pH, central blood volume and total pulmonary resistance.
5) Hemodynamic change might play a major role in the occurence of the untoward symptoms related with both procedures.

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Direct hemoperfusion was performed in the six patients with paraquat poisoning and the five with hepatic coma utilizing heparin-adsorbed uncoated carbon (Terumo-DHP). Adsorption of paraquat was demonstrated in in vitro experiments and in all the cases with survival of two patients. Both clinical and laboratory impovement of hepatic coma was also observed by use of the grade of coma, the finding of electroencephalogram, and amino acids analysis in all the patients, of whom, two survived.
With excellent adsorbing capacity and less priming volume, heparin-adsorbed uncoated carbon is considered as better comparing with the other coated carbon material.
Although every case can not be successfully treated becuse of the nature of the problem, it appears to further improve the survival rate of the patients suffering from paraquat intoxication and hepatic coma by early discovery and prompt application of direct hemoperf usion along with the other appropriate medical therapy.

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It was found that expanded polytetrafluoroethylene tubes easily absorbed water, saline, ringer and heparin solutions when they were immersed in these solutions and the pressure of the container was decreased and increased repeatedly.
The degree of absorption increased with the increase of fibril length of the sample and with the number of cyclic change of pressure. The saturated value of absorption was smaller in the order of heparin, ringer, saline and water.
Considerable amount of absorbed heparin remained even after the sample was exposed in the running water for a few days.

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