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赤池 敏宏
1982 年 11 巻 2 号 p.
359
発行日: 1982/04/15
公開日: 2011/10/07
ジャーナル
フリー
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William S. PIERCE, Grant V. S. PARR, John L. MYERS, James H. DONACHY, ...
1982 年 11 巻 2 号 p.
361-367
発行日: 1982/04/15
公開日: 2011/10/07
ジャーナル
フリー
A variety of compact ventricular assist pumps have been used to provide ventricular support since the first successful report of this technique by DeBakey and his associates. Our group has designed an air powered sac type ventricular assist pump (VAP) which has a smooth polyurethane surface and Björk-Shiley type inlet and outlet valves. This VAP has undergone extensive testing in calves and has been available for clinical use during the last five years. Of the 1, 500 adults undergoing open heart operations, 60 required intra-aortic balloon support and 19 required the VAP. When properly employed, the circulatory support provided permitted immediate separation of the patient from bypass. Definite hemodynamic evidence of improved ventricular function has been observed during the period of unloading of the deranged ventricle by the VAP. However, during the first three years of our experience, the VAP was used in 11 patients with one survivor. The initial low survival rate resulted from improper indications for use, excessive delay in applying the VAP, and problems attendant with learning a new technique. During the past two years, specific attention has been directed to use of right, left or biventricular assistance as indicated, to prompt application of the VAP when required, and use of atrial rather than ventricular cannulation for VAP inflow. Accordingly, the survival rate over this two year period has increased to 50% (four of eight patients). The short-term assist pump is an important adjuvant for the surgeon who operates on seriously ill cardiac patients. Furthermore, effective use of the short-term assist pump will provide the basis for the use of permanent forms of mechanical circulatory support.
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Tetsuzo AKUTSU
1982 年 11 巻 2 号 p.
368-369
発行日: 1982/04/15
公開日: 2011/10/07
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フリー
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能勢 之彦, 村林 俊, 古瀬 正康
1982 年 11 巻 2 号 p.
370-373
発行日: 1982/04/15
公開日: 2011/10/07
ジャーナル
フリー
During three decades of development of the hemodialyzer, only a few new membranes have been introduced in Europe and the United States. Various types of polymeric membranes being used in hemodialysis show enhancement of blood compatibility. Also, multiple use of cellulose base dialyzers improved blood compatibility and subsequently the patient's general condition and biochemical parameters. These two facts indicate the importance of biocompatibility of the hemodialyzer, particularly the membrane materials. Multiple use of dialyzers after protein deposition on the surface and cross-linking by aldehyde showed biologically compatible blood contacting surfaces. This concept is similar to the philosophy, which was proved in blood pumps utilizing the biolization hypotheses. It is important to study the biomaterial not only from the material point of view, but also its interaction with the physiological system. Utilizing more blood compatible materials for artificial organs is stressed for many years of clinical application.
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岩 喬
1982 年 11 巻 2 号 p.
374-377
発行日: 1982/04/15
公開日: 2011/10/07
ジャーナル
フリー
I have published 475 medical papers with my coworkers since I graduated medical school in 1949. Among them 178 papers or 37.4% were related with artificial organs directly or indirectly. As a lecture of the President, several of these 178 papers were presented in 5 categories; (1) pacemakers and related devices, (2) extracoreal circulation and related devices, (3) artificial tissues, (4) surgical instruments, (5) medical electronics devices.
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―急性期梗塞切除術における術式の改良と急性期補助循環―
島津 和彦, 遠藤 真弘, 小柳 仁, 和田 寿郎
1982 年 11 巻 2 号 p.
378-380
発行日: 1982/04/15
公開日: 2011/10/07
ジャーナル
フリー
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山里 有男, 村口 和彦, 白石 義定, 千葉 幸夫, 西脇 登, 松田 捷彦, 南 一明, 小西 裕, 龍田 憲和, 日笠 頼則, H. ...
1982 年 11 巻 2 号 p.
381-384
発行日: 1982/04/15
公開日: 2011/10/07
ジャーナル
フリー
During resecting of the descending thoracic aneurysms, transient bypass circuit using prosthetic vessel is very useful especially because of its no need of heparin. We made an axillo-femoral bypass tube with non-thrombogenic material to omit troublesome suturing technique. Under usinq this tube IABP balloon was inserted into the abdominal aorta to the point just beneath the diaphragma, for changing non-pulsatile flow to a more effective pulsatile one. Six patients were operated using this method with five survivors. The single death was that of a patient with postoperative respiratory failure. IABP balloon was able to insert easily without any complication in patients of thoracic aneurysm. Insertion of IABP balloon to them is not thought as contraindication.
We also made a pulsatile axillo-femoral bypass kit which includes of PBP apparatus with two ball valves at the inlet and outlet side of the apparatus. When this kit was driven by PBP, a regurgitant flow about 30% of the forward flow was found because of the property of the valves. In experiments on dogs, propagation of pulsatile flow was limited by the resistance at the site of cannulation tube.
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中村 良昭, 立神 高明
1982 年 11 巻 2 号 p.
385-388
発行日: 1982/04/15
公開日: 2011/10/07
ジャーナル
フリー
Experimental studies were performed using right heart assist device for these severe right heart failure right ventricular myocardial infarction. and right heart failure which follows left heart assisted circulation.
When the right heart was assisted, pulsatile flow was more effective than nonpulsatile one.
In case of right sided failing heart, the effect of right heart assist circulation was obviously noted.
In case of heavy right heart overloading (abnormal pressure or volume loading), changes of right atrial wave was specific findings and one of determinants of indication of right heart assist circulation.
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壁井 信之, 桂島 康, 土屋 喜一, 桜井 靖久
1982 年 11 巻 2 号 p.
389-392
発行日: 1982/04/15
公開日: 2011/10/07
ジャーナル
フリー
The left ventricular assist (LVA) becomes the treatment of choice for the management of left heart failure in the post operative period. During this period, if right ventricular failure should occur, another assist pump is required. But the application of an ordinary blood pump is more or less invasive. To minimize the damage, the RVBP i. e. a balloon inserted into the right ventricular cavity via the jugular vein was pumped to expel the blood into the pulmonary artery, was developed.
The balloon, unstreched volume is approximately 15mL, was madee of segmented polyether urethane urea (PEUU) and tied onto a catheter, 30cm long and 3mm ID, with multiple side holes. Twenty mongrel dogs weighing around 10Kg were used. In this experiment, the balloon was inserted via the right auricle or apical area of the right ventricle.
It was found that even when the natural heart was not beating, the right ventricular systolic pressure of more than 30mmHg was generated, and the pulmonary arterial blood flow was able to maintaine above 80mL/min/Kg body weight and central venous pressure was kept normal, less than 10mmHg, by the combination of RVBP and LVA. When the natural heart was beating, increase of the pulmonary arterial blood flow by applying RVBP depended on the degree of the right heart failure, but it was enough to compensate the power failure of the right ventricle. Regurgitation through the tricuspid valve was seldom found during the RVBP. These results indicate that RVBP may be a promissing method for right ventcular failure which occurs during LVA.
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田村 栄稔, 田原 士朗, 中田 誠介, 美濃地 忠彦, 跡部 正明, 北村 信夫
1982 年 11 巻 2 号 p.
393-396
発行日: 1982/04/15
公開日: 2011/10/07
ジャーナル
フリー
Is Intrapulmonary Balloon Pumping (IPBP) effective in acute right heart failure? This study was planned to evaluate the efficacy of IPBP for the acute right heart failure. At first the functional reservoir graft was placed on the pulmonary trunk owing to Miller's report. The balloon (pumping volume 5ml) in its graft was instituted at 1:1 ratio with triggering on R wave of Ecg. Acute right heart failure was prepared after Tricuspidal regurgitation (TR) was produced.
The results were as follows.
In normal heart (TR not present) IPBP did not demonstrate the significant results, for example, blood pressure, cardiac output, and right ventriculer pressure except systolic unloading and diastolic augmentation of pulmonary artery pressure. In acute right heart failure IPBP made the failing heart improved. When IPBP was employed, BP increased 76±6mmHg to 97±4mmHg in systole, 39±8mmHg to 54±1.0mmHg in diastole. PA pressure decreased 31±1.4mmHg to 27±1.9mmHg in systole, and increased 13±2.4mmHg to 41±1.4mmHg in diastole. Controlled mean aortic flow was 0.83±0.11l/min, but it increased 0.63±0.14l/min with IPBP comparing with 0.48±0.12l/min when TR was present. Either RA pressure and RVEDP decreased gradually.
The pulmonary vascular resistance was calculated 28μ in control, 40μ in failing state but decreased 27μ with IPBP. Stroke work of LV was calculated equal of control, otherwise stroke work of RV was 44% of control if failing heart was supported with IPBP. These hemodynamical changes were reproducible.
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妙中 義之, 高野 久輝, 梅津 光生, 松田 武久, 林紘 三郎, 中村 孝夫, 阿久津 哲造
1982 年 11 巻 2 号 p.
397-400
発行日: 1982/04/15
公開日: 2011/10/07
ジャーナル
フリー
We have experimentally evaluated hemodynamic effects of left side partial artificial heart (L-PAH) on low output syndrome following right heart bypass operation in dogs.
The experimental model of right heart bypass operation was made by ligation of the tricuspid valve from outside of the heart and construction of atrio-pulmonary bypass using a conduit. The conduit had no valve and its internal diameter was 14mm. The results are as follows:
1. L-PAH can increase the total output in experimental model of right heart bypass operation. When PA mean pressure is higher than 14mmHg, almost normal total output can be maintained.
2. In case of bilateral ventricular failure, it is possible under certain condition to improve the systemic circulation.
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須磨 幸蔵
1982 年 11 巻 2 号 p.
401
発行日: 1982/04/15
公開日: 2011/10/07
ジャーナル
フリー
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南谷 晴之, 市川 篤実, 横山 和弘, 原 泰造, 井上 正, 今村 洋二
1982 年 11 巻 2 号 p.
402-405
発行日: 1982/04/15
公開日: 2011/10/07
ジャーナル
フリー
In this study, three type of Xenograft valves have been hydraulically evaluated under the steady flow condition as well as pulsatile condition in a pulse duplicator. Image analysis of valve-leaflet motion has been also undertaken to obtain the actual orifice area and the opening characteristics by using high speed cinecamera and ITV system. Regarding hydraulic energy loss and the observed actual orifice area, Ionescu-Shiley Xenograft showed the best hydraulic function among them, however it should be noted that the dynamic function, particularly transient characteristics of the Xenografts are greatly dependent on the structure and mechanical properties of the valve leaflets.
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庄村 赤裸, 山崎 順彦, 矢田 公, 草川 実
1982 年 11 巻 2 号 p.
406-409
発行日: 1982/04/15
公開日: 2011/10/07
ジャーナル
フリー
Clinical results of prosthetic valve replacement with the Björk-Shiley valve were reported. Between November 1970 and July 1981, 124 patients had been operated 128 times with 143 Björk-Shiley valves in Mie University Hospital. 44 aortic, 58 mitral, 18 aortic and mitral, 2 tricuspid and 2 pulmonic valve replacement were done. In 3 cases reoperation was done four times, because of one thrombosed valve and three infected valves. Overall mortality rate was 14.5%.
Postoperative anticoagulant therapy was performed routinly in all cases, though thromboembolism occured five times in 4 cases (1.3% per 100 patient years). In 2 cases thromboembolic episodes occured when the anticoagulant therapy was interrupted. Anticoagulations-related retroperitoneal bleeding was in one cases.
Prosthetic valve endocarditis were in 3 cases. After surgery, the N. Y. H. A. functional classification of the 106 survivers were I (88%) and II (11%), except one case with aortic perivalvular leakage after prosthetic valve endocarditis.
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―その弁機能について―
永瀬 裕三, 石原 茂樹, 黒沢 博身, 鈴木 紳, 夏秋 正文, 清野 隆吉, 石井 潔, 今村 栄三郎, 重田 帝子, 橋本 明政, 小 ...
1982 年 11 巻 2 号 p.
410-413
発行日: 1982/04/15
公開日: 2011/10/07
ジャーナル
フリー
The hemodynamic performance of Omniscience valve has been assessed. From Feb. 1981 to Oct. 1981, 62 valves have been implanted in 50 patients. Operative mortality 8.0%.
Cardiac performance has been improved remarkably, mean pressure gradient has been 6.19 mmHg and effective orifice area has been 1.79cm
2 in mitral position with the TAD of 29mm. Opening angle has been 50° to 80° at atrial fibrillation.
There have been no thrombolic episodes, no dysfunctional valves and no infected valves.
The hemodynamic performance of Omniscience valve is satisfactory and this valve will be continued to use clinically.
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石原 茂樹, 今村 栄三郎, 青見 茂之, 永瀬 裕三, 星野 修一, 筒井 達夫, 今井 康晴, 橋本 明政, 小柳 仁, 和田 寿郎
1982 年 11 巻 2 号 p.
414-417
発行日: 1982/04/15
公開日: 2011/10/07
ジャーナル
フリー
From July 26, 1978, through June 30, 1981, 240 patients were performed for replacement of tripple valves, double valves, aortic, and mitral valve, utilizing 266 S. J. M. Valves.
Of the 240 patients in the study, 16 died in the first 30 days after operation (6.7%).
The most cases of thromboembolic events ocurred within three weeks after operation.
Thromboemblic events at the 36 month interval for Aortic & Mitral valve replacement was 9.39%/patient years, for AVR 2.17%/patient years, for MVR 4.28%/patient years, and total cases 3.38%/patient years.
Valve malfunction occurred in one valve implanted in the tricuspid position. The cause of thrombosed valve was considered because of the poor anticoagulation therapy.
We emphasize importance of anticoagulation therapy in the early post operative period.
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―摘出生体弁の病理組織学的検討―
林 研二, 川副 浩平, 呉 聡栄, 公文 啓二, 小坂井 嘉夫, 小原 邦義, 鬼頭 義次, 藤田 毅, 曲直部 寿夫
1982 年 11 巻 2 号 p.
418-421
発行日: 1982/04/15
公開日: 2011/10/07
ジャーナル
フリー
Twenty xenografts (Hancock; 5, Ionescu-Shiley; 15) from 17 patients were investigated histopathologically.
Bacterial colonies were found out deep within cusp tissue on 5 out of 6 PVE xenografts.
Inflammatory cell infiltrations were found out only within fibrinclots of the cusp surface on 3 out of 7 xenografts exposed in bacteremias early after operations. And, the bacterial colony was found out only within fibrinclots on 1 out of those 3 xenografts.
In Ionescu-Shiley pericardial xenografts, the structures of the cusp tissue were less disrupted than Hancock xenografts even in PVE.
We think that xenografts are not biological inert in human bodies and the infection begins with the inflammatory cell infiltration and the bacterial colony within fibrinclots on the cusp surface initialy.
It is impossible to make diagnosis of PVE at the stage that the inflammatory cell infiltration and the bacterial colony are found out only within fibrinclots on the cusp surface.
But, the enough dose of antibiotics to penetrate into fibrinclots will be effectice even at this stage.
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―心肺標本による検討―
西谷 泰, 今村 栄三郎, 石原 茂樹, 八田 光弘, 手塚 光洋, 瀬尾 和宏, 小柳 仁, 菅原 基晃
1982 年 11 巻 2 号 p.
422-425
発行日: 1982/04/15
公開日: 2011/10/07
ジャーナル
フリー
A new type of the patch graft for reconstruction of the right ventricular outflow tract in repair of Tetralogy of Fallot is developed and examined in vivo. The design principle is based on the well-known role of the Valsalva sinus on the semilunar valve performance. A semilunar cusp is created with a glutaraldehyde preserved bovine pericardium, and anchored to the dacron velour patch. A concaved structure is formed in the patch graft so as to mimic the natural architecture of the right ventricular outflow tract. The graft is inserted in the outflow portion of the right ventricle in isolated heart-lung preparations, and hemodynamic parameters were assessed. This form of patch graft proved quite effective in relieving the obstruction and in minimizing the regurgitation.
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藤田 毅
1982 年 11 巻 2 号 p.
426
発行日: 1982/04/15
公開日: 2011/10/07
ジャーナル
フリー
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山下 達博, 永井 賢一, 川崎 正晴, 三上 千秋, 本山 光博, 中光 晴彦, 土谷 太郎
1982 年 11 巻 2 号 p.
427-429
発行日: 1982/04/15
公開日: 2011/10/07
ジャーナル
フリー
In recent years, so many research works of Bicarbonate Dialysate have been published.
On the production method of Bicarbonate Dialysate, we have been known that Sodium carbonate concentrated solution shall be able to be used instead of Sodium bicarbonate concentrated solution as ever. We, therefore, fabricated a tentative Mixing Apparatus for Sodium carbonate concentrated solution, and provided a Bicarbonate Dialysate as follows;
1. Composition
A (designated) Concentrated solution: Sodium carbonate
B (desig.) Concentrated solution: NaCl, CaCl
2·2H
2O, MgCl
2·6H
2O, KCl, CH
3COOH, C
6H
12O
6, HCl,
2. Procedure
(1) Mixing step 1: concentrated solution A+warm water (35°C) Designated solution M.
(2) Mixing step 2: concentrated solution B+solution M.
(3) Equipment: Mixing pump.
(4) Ratio: 34:1 in each step.
This unit system shall make possible to smooth current dialysate supply and much facilitate to control and maintenace in releasing from the present inconveniences, i. e. production of immediate before use and use in haste within same day.
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古川 守, 阿部 町子, 遠藤 信之, 中川 一郎, 中村 藤夫, 保科 繁, 池田 裕, 浦野 壽夫, 鈴木 正司, 平沢 由平, 野田 ...
1982 年 11 巻 2 号 p.
430-432
発行日: 1982/04/15
公開日: 2011/10/07
ジャーナル
フリー
The stepping-infuser of sodium cloride solation and the Ultrafiltrotion rate (UFR) controlling device were combined to th bicarbonate dialysis fluid sapply system. The stepping infuser could offer the vorieties of sodium concentration into the bicarbonate (or acetate) dialysate, amonge the any consective 10 steps. A single infusion interval was able to set up within one to 99 minutes. The UFR controlling device had the copacity up to 1.99 litter every hour. This new combination dialysis system could produce the bicarbonate dialysis fluid deliuery with any patterns of high-sodium gradient. The clinical trial of this new system prooued the remorkable benefitial effects rather than bicarbonate dialysis system alone, in the patients with refractorilly persistent hypotension.
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宮崎 哲夫, 内藤 秀宗, 清水 政美, 尾畑 昭二, 春名 邦昭, 川橋 勝, 山根 忠之, 窪津 彰, 高島 征助, 高倉 孝一, 砂原 ...
1982 年 11 巻 2 号 p.
433-435
発行日: 1982/04/15
公開日: 2011/10/07
ジャーナル
フリー
Blood line designed for non- anticoagulant dialysis was prepared, and in its clinical trials with use of KF101 dialyzer, satisfactory result was obtained.
1) By using the double tubing system pressure monitor chamber, it is possible to measure P
BO without contacting blood with air, and to control ultrafiltration.
2) A stream-line shaped air trap--chamber was designed to prevent turbulent blood flow, and a polyester filter-mesh of the air-trap chamber was spray-coated with uniformly hydrophilic HEMA copolymer solution in ethanol so as to inhibit bubble formation on the surface of filter mesh. In this way, the thrombus formation in the system was prevented.
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稲垣 豊, 川村 孝, 露木 幹人, 天野 泉
1982 年 11 巻 2 号 p.
436-442
発行日: 1982/04/15
公開日: 2011/10/07
ジャーナル
フリー
A superior vena cava catheter was designed as a temporary blood access and its effect was studied. Percutaneous catheterization of the subclavian vein, the internal jugular vein and the external jugular vein was done 114 times in 82 cases. The catheters were inserted into the superior vena cava by Seldinger's method and left there. The new type of the catheter consists of two parts, one is the inner tube made of teflon and another is the outer tube made of one of these materials: heparinized-polyurethane (H-PU), silicon rubber or polyvinyl chloride(PVC). The H-PU catheter was superior to others in anticoagulability but we could not obtain enough blood flow for hemodialysis by this catheter. In our stady, the subclarian vein was punctured sixty-two times, the internal jugular vein five times, and the external jugular vein fourty seven times as an approach vein. The catheterization of the subclarian veins resulted in pneumothrax in one case and hematoma with severe pain in five cases. The hematoma with severe pain was indused by the catheterization of the internal jugular veins in two cases. Major complications were not observed in the catheterization of the external jugular veins. Based on the above results, the insertion of the superior vena cava catheter via the external jugular vein seems to be the most safe method. It was also found that these catheters are flexible and wearable so that the patients are alowed to do daily activities. The frequency of infection was less than one-third in that of femoral catheters.
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井上 喬之
1982 年 11 巻 2 号 p.
443
発行日: 1982/04/15
公開日: 2011/10/07
ジャーナル
フリー
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山下 明泰, 吉本 達雄, 善本 勝男, 酒井 糾, 新井 信之, 峰島 三千男, 酒井 清孝
1982 年 11 巻 2 号 p.
444-447
発行日: 1982/04/15
公開日: 2011/10/07
ジャーナル
フリー
Because each patient has his own body fluid volume, it is not reasonable to examine a patient only by solute concentration In this paper, we calculated total body fluid using urea as a marker, called urea space (US), by four different kinetic models. Each result, calculated by those four equations, is puite agreed. So we concluded that the urea behavior in a body was explained by single-pool model. Hypertension patients were high in UBR (US-Body weight Ratio), and hypotension were low. UBR may be one step to evaluate the symptom of blood pressure depended upon salt and water.
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(循環血漿量と除水)
小林 峰徳, 西堀 文男, 鈴木 利昌, 江良 和雄, 久保 和雄, 鈴木 利昭, 阿岸 鉄三, 太田 和夫, 杉野 信博, 加藤木 和徳, ...
1982 年 11 巻 2 号 p.
448-451
発行日: 1982/04/15
公開日: 2011/10/07
ジャーナル
フリー
High sodium dialysis method (HINAM) is applied to prevent disequibrium syndrom and to remove the excess water from the patient without any untoward symptoms. We tried to clarify the mechanism of this method by means of the ratio of the removal of water (ΔBW/DW) and the ratio of plasma protein level (Pri/Prf).
The results of this study are as follows; 1) It is suggested that the effect of the removal of water on the changes of plasma volume in HINAM is less than that in conventional dialysate method. 2) The frequency of untoward symptoms is more significantly decreased with high sodium dialysate. 3) Dry weight of the patient in HINAM is reduced by approximately 2.5kg compared with that in conventional sodium dialysate method.
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-酸・塩基バランスからの設計-
小野 利彦, 岩元 則幸, 山本 則之, 近藤 守寛, 田端 義久, 福田 豊史, 片岡 浩, 谷口 泰雄, 鬼沢 美知子, 国友 哲之輔
1982 年 11 巻 2 号 p.
452-455
発行日: 1982/04/15
公開日: 2011/10/07
ジャーナル
フリー
As acid-base balance should be taken into consideration for realizing a rapid and comfortable therapy, we have measured permeability of HCO
3- and CH
3COO
- across membranes of dialyzers and found that PMMA membrane dialyzer, “B2-300” has significantly lower permeability for these two solutes than a cellulosic dialyzer with same surface area despite of its comparable permeability for urea and creatinine. It seems that such reduced permeability of “B2-300” prevents rapid loss of HCO
3- into and inflow of CH
3COO
- from dialysate containing CH
3COO
- and that it thus contributes to a decrease in dialysis-related symptoms observed in the comparative clinical evaluations.
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～特にアセテートの心血管反応について～
垣内 孟, 馬渕 非砂夫, 丸山 圭史, 杉原 みどり, 西沢 弘道, 村尾 之義, 中橋 弥光
1982 年 11 巻 2 号 p.
456-459
発行日: 1982/04/15
公開日: 2011/10/07
ジャーナル
フリー
It has been reported that sodium acetate has a depressant action on the cardiovascualr system. In this study hemodynamic change during five hours hemodialysis was invasively evaluated by a method of left and right heart catheterization in four patients, especially on ventricular contractility, total peripheral resistance index (TPRI) and their interactions with blood acetate. We adopted max dp/dt and max dp/dt/p as indices of the contractility.
At the onset of hypotension the contractility was depressed with concomittant falls in cardiac index (C. I.), mean blood pressure (BP) and TPRI. After rapid infusion the depressed contractility was improved with marked rises in C. I. and BP. Even during asymptomatic periods the contractility might be depressed or enhauncedo Blood sample for the determination of acetate level was obtained from four sites such as shunt, left ventricle, pulmonary artery and right atrium. The level in shunt was closely identical with those in left ventricle as well as in pulmonary artery, however, in right atrium, about a half of the level.
Each contractility parameter and TPRI were statistically compared with acetate levels in all sites, respectively. However, no better corelations were found in all.
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太田 道男, 江住 明泰, 熊谷 頼明, 久保 和雄, 池辺 潤
1982 年 11 巻 2 号 p.
460-463
発行日: 1982/04/15
公開日: 2011/10/07
ジャーナル
フリー
An auto-regulation factor (ARF) of the circulation system is proposed for predicting the cardiac shock during the hemodialysis. ARF summarises the controllability of maintaining the cardiac output and mean arterial pressure. ARF reflects the increment of HR and TPR against the decrement of blood volume and cardiac output. ARF can be counted only from the systolic and diastolic pressure and HR. ARF changes more widely from the early stage of dialysis than mean arteril pressure itself.
We could find the possibility of using the ARF as the index for predicting the occurance of the dialysis-induced bypotention.
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小高 通夫
1982 年 11 巻 2 号 p.
464
発行日: 1982/04/15
公開日: 2011/10/07
ジャーナル
フリー
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古田 忠昭, 山脇 直邦, 稲垣 健二, 加藤 正明, 丹羽 利充, 前田 憲志
1982 年 11 巻 2 号 p.
465-467
発行日: 1982/04/15
公開日: 2011/10/07
ジャーナル
フリー
The specific adsorbents have been sought in an attempt to utilize them for removal of autoantigens, autoantibodies and immune complexes in SLE.
The anion exchangers were broadly investigated for treatment in patients plasma in vitro.
The following results were obtained;
(1) The hydrophiric anion exchangers had large capacities of adsorption of DNA.
(2) The immobilized DNA binded large quantities of anti-DNA antibodies, anti-nuclear antibodies, futhermore, immune complexes.
(3) The anion exchangers, pretreated with heparin, adsorped only partial immune complexes.
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山縣 淳, 阿岸 鉄三, 星野 敏久, 大池 健司, 久保 和雄, 鈴木 利昭, 寺岡 慧, 太田 和夫
1982 年 11 巻 2 号 p.
468-471
発行日: 1982/04/15
公開日: 2011/10/07
ジャーナル
フリー
Removability of mitomycin C (MMC) by charcoal was studied pharmacokinetically. Mongrel dogs weighing 10-17kg were anesthetized by pentobarbital and femoral vessels were canulated with usual dialysis needles. Immediately after 1mg/kg of MMC was systemically administered, direct hemoperfusion over charcoal (DHP) was initiated with blood flow 100ml/min for 180min.
Two-compartment open model was applied to this pharmacokinetical analysis. First component, distribution phase, were estimated to be C(T)=1.675e
-0.064t in DHP group and C(T)=5.22e
-0.056t in control, distribution volume V
1 were 0.660l/kg in DHP group and 0.230l/kg in control. Second component, elimination phase, had almost same excretion rate in two groups.
A rapid excretion rate and a large distribution volume of MMC in early phase were observed in DHP group associated with reduction in its untoward effects.
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川西 秀樹, 土谷 太良, 西亀 正之, 江崎 治夫, 椙山 雅文, 中光 晴彦
1982 年 11 巻 2 号 p.
472-475
発行日: 1982/04/15
公開日: 2011/10/07
ジャーナル
フリー
Ammonia is a very soluble gas in water. And the stage of NH
3 and NH+
4 is affected by pH and temperature.
This studies reports an ammonia removement by air stripping tower in which filled up packing bed (Intalox Saddles). This tower is an apparatus that remove only isolated NH
3 by air stripping.
In vitro removement studies have revealed that ammonia removal rates are 97.3, 95.0, 91.5% when each test solution's flow rates are 100, 200, 300ml/min at condition that pH 11.0. It also revealed that ammonia removal rates are more than 90% without regard to test solutions initial conc. at the pH 11.0, flow rate 100ml/min. But when pH is 9.0, it revealed only 18% removal rate. Each result agree with theoretical values of ammonia in water.
Thease studies suggest that our ammonia removement system is effective in liver support and artificial kidney with dialysate regeneration.
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浜辺 茂樹, 出月 康夫, 浜口 実, 守屋 仁布, 渡辺 弘, 与那覇 朝英, 苑田 毅, 寺本 和雄, 菊地 哲也, 丹沢 宏
1982 年 11 巻 2 号 p.
476-479
発行日: 1982/04/15
公開日: 2011/10/07
ジャーナル
フリー
A new tertiary amine type anion exchange resin (IONEX) which is capable of combining both bilirubin and bile acids has been developed for used in the artificial hepatic assist system. Direct hemoperfusion with IONEX fiber effectively reduced bilirubin and bile acids in the blood of the jaundiced dogs, however rather a large amount of heparin or Prostaglandin I
2 was necessary to prevent platelet adhesion to the IONEX fiber and to continue the extracorporeal circulation.
In order to avoid the hazards with the direct hemoperfusion, membrane plasmaphresis was performed using a new plasma separator (Toray PLASMAX), and on-line adsorption of bilirubin and bile acids in the membrane separated plasma, was performed experimentally in the jaundiced dog.
Mean reduction rate of bilirubin in the four dogs after 90-minute membrane plasmapheresis with on-line adsorption by IONEX fiber was 38.7% and that of bile acids was 56.5%.
The extracorporeal circulation with this system was performed without difficulty and no detectable derangement of plasma protein fractions.
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前田 憲志
1982 年 11 巻 2 号 p.
480
発行日: 1982/04/15
公開日: 2011/10/07
ジャーナル
フリー
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―代謝補助システムの基礎的検討―
葛西 真一, 及川 巌, 林 宏一, 浅川 全一, 山本 哲, 関口 定美, 水戸 廸郎
1982 年 11 巻 2 号 p.
481-484
発行日: 1982/04/15
公開日: 2011/10/07
ジャーナル
フリー
The present experiment was performed to establish the basic design of metabolic support system for a hybrid artificial liver utilizing hepatocytes. As the concept, an extracorporeal hemoperfus ion will be employed for the support system. The following points were examined that which is effective PAN and PMMA as the semipermeable membrane, which is better for hepatocytes perfusate Hank's salt solution and Waymouth's medium in point of the maintenance of hepatocyte function, what kind of perfusion system is suitable for the support system and whether an intermittent ultrafiltration system is useful for the metabolic effects, in in-vitro perfusion experiments. The results were obtained that the same range of metabolic rates were observed in both membranes, Hank's solution was not suitable for hepatocyte perfusate and that the intermittent ultrafiltration were useful for the perfusion system.
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-in vitroの検討-
田畑 陽一郎, 小高 通夫, 平沢 博之, 小林 弘忠, 林 春幸, 菅井 桂雄, 大竹 喜雄, 織田 成人, 佐藤 博, Thomas M ...
1982 年 11 巻 2 号 p.
485-488
発行日: 1982/04/15
公開日: 2011/10/07
ジャーナル
フリー
The in-vitro removal of p-nitrophenol by means of perfusion over the immobilized UDP-glucuronyl transferase within artificial cells was studied. The assayed activities of the immobilized UDP-glucuronyl transferase were about a half of the value of the same amount of free enzyme.
The storage stabilities of immobilized enzyme and free enzyme werstudied under the temperature of 4°C, 22°C and 37°C, respectively. The results showed that immobilized enzyme was more stable than the free enzyme.
Further studies were conducted to determine the stability, kinetics of this system. The results obtained suggest that immobilized UDP-glucuronyl transferase is efficient in conjugating p-nitrophenol in vitro.
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天野 泉, 稲垣 豊, 溝上 雅史, 加納 英行
1982 年 11 巻 2 号 p.
489-492
発行日: 1982/04/15
公開日: 2011/10/07
ジャーナル
フリー
45 patients with acute liver failure were treated with hepatic assists, such as charcoal tnemoperfusion, PAN membrane hemodialysis, and membrane plasma pheresis. Of the 45 patients, 8 were survived.
Complications in the 45 patients were; renal failure 11, G. I. bleeding 16, and cerebral edema 16.
We think the efficacy of the present hepatic assists are constant below 20 percent in the survival rate.
In order to increase the survival rate by hepatic assists in the treatment of acute liver failure, the cares of complications, especially cerebral edema, were important problems.
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―特に劇症肝炎と妊娠性急性脂肪肝の救命例について―
山本 実, 佐藤 浩一
1982 年 11 巻 2 号 p.
493-495
発行日: 1982/04/15
公開日: 2011/10/07
ジャーナル
フリー
The artificial liver support system using charcoal hemoperfusion, cuprophan membrane hemodialysis has been developed and applied to patients with acute hepatic failure. We used this system with plasma exchange and in result 3 out of 30 patients with fulminant hepatitis and all 5 patients with acute fatty liver of pregnancy were survived.
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―抗体固定化の様式
大城 孟, 神前 五郎, 田中 富美子, 船越 哲, 大村 孝男, 高木 邦彦
1982 年 11 巻 2 号 p.
496-499
発行日: 1982/04/15
公開日: 2011/10/07
ジャーナル
フリー
One of the causes of infection with hepatitis B (HB) virus in blood or plasma transfusion. The most effective method to prevent such infection is to transfuse Dane particle negative blood or plasma.
Now, we have been looking into the possibility of eliminating Dane particle through HBs-antibody treated filter.
This paper presents the findings of the basic experiments on binding form of HBs-antibody. Immobilized HBs-antibody was prepared by coupling antihuman HBs-antibody with activated Sepharose 4B and digested by pepsin in 37°C×16 hours incubation. The fragments such as Fab' and Fc' were qualified by Ouchterlony method and measured by Gelfiltration method. The binding form was guessed from releasing pattern of fragments into experimental solution.
We obtained the some hypothesis that the ratio of formal binding and reversed Y binding was approximately 2:1, but the horizontal Y binding could not be calculated.
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―脳波の偏差値解析法―
山崎 善弥, 藤森 義蔵, 高浜 龍彦, 和田 達雄, 織田 敏次, 井上 昇, 戸川 達男, 赤川 雅健, 増田 武, 片岡 金吉, 藤崎 ...
1982 年 11 巻 2 号 p.
500-503
発行日: 1982/04/15
公開日: 2011/10/07
ジャーナル
フリー
A computerized coma monitor (CCM), analyzing standard deviations of EEG parameters, such as probability function, peak point histogram, integrated histogram and frequency distribution histogram, and zero cross counts, has been developed for evaluating level of hepatic or metabolic encephalopathy.
The analyzed values are displayed on the monitor scope in graphic or digital mode at regular intervals. The dispaly on the scope is automatically printed out at regular interval if desired. hepatectomized pigs and the patients suffering from acute hepatic failure with satisfactory results. The standard deviation of frequency distribution increased and number of zero cross counts decreased gradually, with the passage of time, in tottaly hepatectom mized pig. Theses trends reversed by charcoal plasma perfusion. This improvement of brain wave was confirmed by molar ratio of plasma aminoacids. Similar relationship between the trends of theses parameters and the clinical coma grade of the patients with acute hepatic failure, treated by plasma exchange, was observed.
CCM has a great advantage to evaluate brain wave mathematically and it is useful for monitoring hepatic and metabolic encephalopathy.
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神前 五郎
1982 年 11 巻 2 号 p.
504
発行日: 1982/04/15
公開日: 2011/10/07
ジャーナル
フリー
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大島 宣雄, X.-X. ZHENG, 佐藤 正明, 安田 晃, 小田 直人
1982 年 11 巻 2 号 p.
505-508
発行日: 1982/04/15
公開日: 2011/10/07
ジャーナル
フリー
For the use as an artificial blood substitute, a number of pharmacological data on perfluorochemical emulsion have recently been reported, however, very little are known about the microcirculatory behavior of this substance. Thus, microhemodynamic effects of the intravenous injection of the emulsified perfluorotributylamine (Fluosol-43) were studied in the rat mesentery by the intravital microscope method.
Intravenous injection (7.5ml/kg) of Fluosol-43 emulsion resulted in a remarkable decrease in the whole blood viscosity. Capillary blood flow velocity measured within 30 minutes after the injection of the emulsion was found to increase by a factor of about 2.9 in maximum, which was attributable to a emulsifying agent rather than the hemodilution due to the replacement of the circulating blood. It was also noted that leucocytes showed increased tendency to adhere onto the vessel wall particularly in venules.
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俣野 順, 本間 杖价, 川上 敏晃, 黒島 振重郎, 田辺 達三
1982 年 11 巻 2 号 p.
509-511
発行日: 1982/04/15
公開日: 2011/10/07
ジャーナル
フリー
Electrophrenic respiration (EPR) is one of the negative pressure artificial respiration, and is effective method for ventilatory support.
We have newly devised a proto-type generator for transvenous EPR with radiofrequency coupling.
The function of the generator is evaluated.
1) Stimulation impulses and pulse trains were transmitted by radio frequency coupletly.
2) Out puts and ventilatory volumes were measured in various situation of the transmitter and the receiver by changing the position of the transmitter. Out puts were strong enough for stimulation of the phrenic nerves in various situations. Thus, EPR by this device is applicable to the clinical cases safely. Ventilatory volumes were adequate.
3) Relation of ventilatory volume and out put was almost equal in this method and the previously devised generator.
4) EPR by radiofrequency coupling is more practical for long term clinical application. But, more exquisite apparatus should be developed.
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小寺 一興, 山根 仁, 山田 修, 鈴木 克已, 荒木 宏昌
1982 年 11 巻 2 号 p.
512-515
発行日: 1982/04/15
公開日: 2011/10/07
ジャーナル
フリー
The efficacy of a input transducer for a implantable hearing aid was evaluated during six months after implantation to the middle ear. Auditory brain stem responses were recorded just after surgery, two weeks after surgery, two months after surjery and six months after surgery. The input transducer worked properly during six months. The inputoutput function of the transducer improved antill two weeks after surgery, then showed almost constant value antill six months after surgery. The transducer had good linearity from 35 to 80 dB SPL at 4000Hz. The characteristics of the input transducer were sufficient to use for implantable hearing aid.
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庄野 久男, 滝西 清俊, 鈴木 克巳, 福山 邦彦, 鈴木 淳一, 池田 宏之助
1982 年 11 巻 2 号 p.
516-519
発行日: 1982/04/15
公開日: 2011/10/07
ジャーナル
フリー
Over a period of 3 years, the design policy and basic components of the implantable hearing aid for the artificial middle ear (AME) have been examined.
In vitro testing, most components were immersed and autoclaving in saline at 40°C. More than 200 days of development testing have been accumulated to date on the Fuloro-Carbon resin coated tiny vibrators, hermetically sealed Li/MnO
2 cells, Ni/Cd rechageable cells, electlet condenser microphones and amplifiers.
In vivo testing, during the period of April 1979 to October 1981, 17 vibrators, 9 microphones and 6 prototype AMEs were chronically implanted on the skull of cats. The vibrators and AMEs were evaluated with the auditory-evoked brain stem response, and the microphones were monitored with the percutaneous input signals.
The longest succesful implants of the present vibrators, microphones and AMEs are 510 days, 200 days and 130 days each.
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藤本 淳
1982 年 11 巻 2 号 p.
520
発行日: 1982/04/15
公開日: 2011/10/07
ジャーナル
フリー
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泉 暢英, 木村 勲, 太田 崇喜, 吉本 忍, 岸本 武利, 柏原 昇, 山上 征二, 前川 正信
1982 年 11 巻 2 号 p.
521-524
発行日: 1982/04/15
公開日: 2011/10/07
ジャーナル
フリー
The changes of thrombocytes and their aggregation activity were investigated during the dialysis with two different membrane dialyzers. Cuprophane hollow fiber (TE-10) and polymethylmethacrylate hollow fiber (B2-150) were compared. The platelet aggregation was accelerated during the hemodialysis. B2-150 produced significantly more thrombocytopenia and higher plasma level of β-thromboglobulin than TE-10. However, no significant difference was seen in the fall of arterial oxygen tension during the dialysis with the two different dialyzers. Oral administration of trapidil (300mg/day) reduced the extent of thrombocytopenia during the hemodialysis with B2-150, but not with TE-10.
The results suggest differences in biocompatibility between TE-10 and B2-150.
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松井 則明, 中西 太一, 馬場 操, 篠田 俊雄, 中川 成之輔, 武内 重五郎
1982 年 11 巻 2 号 p.
525-528
発行日: 1982/04/15
公開日: 2011/10/07
ジャーナル
フリー
A highly selective thrombin inhibitor, MD 805 was evaluated as an anticoagulant for hemobialysis.
In in vitro study, MD 805 inhibited coagulation system without any effect on platelet function. MD 805 prologed clotting time enough to prevent blood coagulation in extracorporeal circulation with no adverse effects during hemodialysis. Transiently decreased platelet counts in early phase of hemodialysis returned to initial levels within one hour from the start of hemodialysis.
Fibringen was not changed significantly by hemodialysis.
Half life of MD 805 was about 30 minutes.
In conclusion, MD 805 is considered to be a usefull anticoagulant for hemodialysis.
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馬場 操, 中西 太一, 篠田 俊雄, 松井 則明, 中川 成之輔, 武内 重五郎
1982 年 11 巻 2 号 p.
529-532
発行日: 1982/04/15
公開日: 2011/10/07
ジャーナル
フリー
Prostaglandin (PG) D
2 was evaluated as an antiplatelet agent for hemodialysis by dialyzer clearances.
Simultaneous administration of 100μg/hr PGD
2 and 1, 000U/hr heparin was compared with 1, 000U/hr heparin as regards platelet counts, plasma β-thromboglobulin (β-TG) levels and dialyzer clearances.
In both groups, transiently decreased platelet counts returned to initial levels within one hour after the start of hemodialysis. Plasma β-TG levels were significantly increased by hemodialysis in heparin group, but not in PGD
2 group. In PGD
2 group, declines of dialyzer clearances observed in heparin group were significantly prevented.
These data indicate that PGD
2 is a usefull antiplatelet agent for hemodialysis.
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