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[in Japanese]
1985 Volume 14 Issue 1 Pages
1
Published: February 15, 1985
Released on J-STAGE: October 07, 2011
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S. TAKESAWA, S. HIRANO, M. ASHIZAWA, K. SAKAI
1985 Volume 14 Issue 1 Pages
3-6
Published: February 15, 1985
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In an effort to assess the effect of dialysate flow rate on solute removal in a hemodialyzer and to analyze solute transfer using di sion s numbers, an overall imensionless equation -Sh=0.67(Gz)
1/3(Re)
0.73- has been developed for six commercially available dialyzers for urea and creatinine. Some of the dialyzers require design modification because the improved flow pattern in the dilaysate space results in an increased clearance. In other cases, the flow pattern was not particularly satisfactory despite the fact that clearance was high.
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R. OZAWA, R. SAKAI
1985 Volume 14 Issue 1 Pages
7-10
Published: February 15, 1985
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Transport analysis of large pore dialysis membranes (KF-101C, Kuraray Co. Ltd.) was performed by the velocity variation method, yielding solute permeability Pm and reflection coefficient o for PEG, Cytochrome-C, and bovine serum albumin. A solute transfer model combining mass balance and pore theory was introduced and its mathematical analysis revealed module efficiency. Further, the performance of membranes with high permeabilty was assessed in clinical use using Csmax as an important clinical parameter.
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A. YAMADA, E. MACHIYAMA, N. KABEI, T. OKANO, M. ISHIJIMA, Y. SAKURAI, ...
1985 Volume 14 Issue 1 Pages
11-14
Published: February 15, 1985
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In this paper we have descrived the equipment for continuous monitoring system of hemodialysis. The volume of bloodloss caused by this cell is very small and serum separation using a centrifuge is not necessary. This time the filtration membrane used in the U. F. cell was examined. Toyo UK-50 was the best ultrafiltrate membrane which was examined with the ultrafiltrate rate. Steady state values (the time to 100%) was seen in 5 min. and 30 sec. in the response time of Toyo UK-50.
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M. TANIGUCHI, K. UCHITA, Y. KAJIMOTO, Y. KITA, T. KOMURA, T. UJITA, T. ...
1985 Volume 14 Issue 1 Pages
15-20
Published: February 15, 1985
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High performance liquid chromatography (HPLC) combined with data processor (Personal computer: PC-8801) was utilized to characterize blood purification therapy, disease condition and organ function. The two types of HPLC colums supplied by A sahi Medical Co., Ltd. were tested to show us various peaks of high molecular weight compounds and low or middle molecular weight compounds in sera or plasma. Among them, albumin globulin peaks separations were so far found clinically effective; human nonmercaptalubumin (HNA) was observed in most cases of underdialysis and critical illness while the HNA was decreasing with uremic toxins decrease due to various blood purification therapies. Our method of HPLC was concluded useful to characterize disease condition and blood purification therapy.
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Y. SANKAI, M. OHTA, Y. KUMAGAI, J. IKEBE
1985 Volume 14 Issue 1 Pages
21-24
Published: February 15, 1985
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In the case of the dialysis patient, the depression of the arterial pressure mainly comes from the blood volume reduction. Though usual trend of blood pressure in hemodialysis is monotonic reduction, the continuous or occasional hypertension is also observable. The hypertension is thought to be the result of regulation efforts against the blood volume decrease which was detected as right atrial pressure (Pra), where the regulation performance was improved with enhanced cardio-contraction characteristics through HD. Based on this ideas, a circulation system model was rebuilt in this report introducing the Pra receptor as a volume receptor, which, along with the arterio-receptor, controls the circulation system consisting from 3-compartment model, cardiac model and blood vessel model. This model was found to simulate well the clinical data for both hypo-and hypertension.
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[in Japanese]
1985 Volume 14 Issue 1 Pages
25
Published: February 15, 1985
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K. SAKASHITA, T. TSUTSUI, H. KAGAMI, A. ITO, C. YAMAZAKI, K. MASUKO
1985 Volume 14 Issue 1 Pages
26-29
Published: February 15, 1985
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We compared each other two types (dry and wet) of AC dialyzer in basic experiment and clinical study. The dry type showed high value of ΔKMnO
4, residue on evaporation and UV spectrum as well. Hemolysis test was positive only in solution filled up in the wet type. LT of the dialyzer revealed different results when LT was done with three reagents for various samples. There is hardly possibility that LAL-RM arising from non-used dialyzer is endtoxin. Both dry and wet types showed same movements as to change in the leucocyte and complement during hemodialysis. Amoung patients of using AC dialyzer for long term, the dry type group exhibited significant high value in LT by Pyrosate and Toxicolor Test. All cases were negative by Pyrogen. There is also rare in possibility that LAL-RM detected by two reagents mentioned above is endtoxin. No significant difference between clinical data of dry type group and that of wet except IgE was found. We, however, think to require further examination about clinical study of AC dialyzer.
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S. YAMAGAMI, H. YOSHIHARA, S. IRITANI, M. UMEDA, M. SENJU, T. KISIMOTO ...
1985 Volume 14 Issue 1 Pages
30-33
Published: February 15, 1985
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We have found a Limulus lysatepositive substance in the washing solutions of dialyzers with cuprophane membranes, but a pyrogen test revealed no pyrogeneticity. Therefore, we analyzed the substance using Factor C and G systems, and found that it did not show a positive reaction both in vitro and vivo pyrogen tests and activated an alternative pathway for the cascade reaction in the endotoxin assay. This suggests that the substance contained in the washing solution may be β-glucan. Hey Words Endotoxin, Cuprophane membrane, β-glucan, No pyrogeneticity, LAL
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I. NAKAGAWA, [in Japanese], [in Japanese], [in Japanese], [in Japanese ...
1985 Volume 14 Issue 1 Pages
34-36
Published: February 15, 1985
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For the attempt at preventation from the plasticizers leak, inner surfaces of the blood tubings were coated by thin layer of gelatin or urethane. Plasma levels of di-ethylhexyl phthalate (DEHP) were measured during the hemodialysis treatment using the 2 types of coated blood tubings. Increments of DEHP levels were significantly suppressed by both gelatin and urethane coating. Gelatin decreased especially the plasma DEHP levels by 60%. Our results indicated that both gelatin and urethane coating of the blood tubings were effective to prevent from the release of plasticizers.
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T. ONO, N. IWAMOTO, N. YAMAMOTO, M. KONDO, T. FUKUDA, S. YAMAZAKI, Y. ...
1985 Volume 14 Issue 1 Pages
37-40
Published: February 15, 1985
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Pharmacokinetic study on removal of aluminum (Al) from dialysis (HD) patients by desferrioxamine (DFO) and HD. To optimize protocol for Al removal, the increase in plasma Al caused by DFO administration (AD) and Al permeability through cellulosic (C) and protein-leaking PMMA (TK-401) membranes were investigated. Shorter duration of HD, absence of bone pain and repeated AD of DFO reduced the peak value of plasma Al after DFO AD. The concentration-dependent clearance and reduction rate of Al were significantly higher with TK-401 than with C. Membrane-permeable Al generated by DFO infusion seems to be effectively removed by the leaky membrane.
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[in Japanese]
1985 Volume 14 Issue 1 Pages
41
Published: February 15, 1985
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H. NAITO, T. MIYAZAKI, [in Japanese], [in Japanese], [in Japanese], [i ...
1985 Volume 14 Issue 1 Pages
42-44
Published: February 15, 1985
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In an attempt to elucidate the hollow fiber radius effect on the mechanism of non anti-coagulant hemodialysis (NAHD) by EVAL HFAK, SEM observation, GPC observation and chemical analysis have been carried out for three different radius (175, 200, 260pm) HFAK after NAHD. It was observed that the protein content in the hollow fiber is less at the smaller radius hollow fiber. It was suggested that the blood share rate in HF and the component of protein deposit may be important factors during HD.
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H. NAITO, T. MIYASAKI, [in Japanese], [in Japanese], [in Japanese], [i ...
1985 Volume 14 Issue 1 Pages
45-48
Published: February 15, 1985
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In an attempt to elucidate the mechanism of non-anticoagulant hemodialysis (NAHD) by EVAL HFAK, SEM, TEM and GPC observation have been carried out by the γ-ray sterilized HFAK (wet type: W) compared with the EOG HFAK after NAHD. It was found by electron microscopic observation that there is difference on the profile of blood protein deposit on the inner surface of HF in the W- and D HFAK.
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T. SHIBAMOTO, H. SAITO, J. TAKEUCHI
1985 Volume 14 Issue 1 Pages
49-52
Published: February 15, 1985
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In order to know the mechanism of copolymer of ethylene and vinyla cohol (EVA) membrane anti-thrombogenic characteristics, the extract from the dialyzer membrane was injected into rabbits and the changes of platelet aggregability before and after the administration were studied. Ethylene alcohol 500ml circulated through the dialyzer was collected. The solution was condensed to 2ml by evaporator. This condensed solution was injected into New Zealand white rabbits by 0.5ml/days. The control group was same amount of ethylene alcohol solution was treated for ten days. ADP 10μM, collagen 10μg, arachidonic acid (AA) 1.0mM and 2.0mM were used for determination of platelet aggregability. No particular changes of platelet aggregability were observed in the control group. The extract administered group a significant decrease in platelet aggregability induce by ADP 10μM after the administration than before (p<0.05, n=5). Although not significant, platelet aggregability induced by AA 1.0 and 2.0mM shows a tendency of decrease after administration than before. The extract from the circulated solution through the dialyzer made of EVA had a decrease in the platelet aggregability in New Zealand white rabbits, thus suggesting that EVA membrane has an inhibitory effect on platelet aggregability.
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T. MAEKAWA, K. NISHIMOTO, H. TANAKA, K. UMIMOTO, N. IZUMI, T. KISHIMOT ...
1985 Volume 14 Issue 1 Pages
53-56
Published: February 15, 1985
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Platelet cyclo-oxygenase (PCO) activity was estimated by measuring the platelet malondialdehyde (MDA) production rate. After PCO was blocked by acetylsalicylic acid (ASA) intake, the PCO activity was measured serially until it restored its pre-ASA value. The time required for its complete ecovery indirectly indicates platelet life span. P CO activity was 12.9±1.9nmol/10
9 platelets and 8.1±1.9nmol/10
9 platlets and platelet life span was 10.3±0.9 days and 6.7±1.0 days in healthy volunteers and hemodialysis patients respectively. No significant difference in PCO activity was observed before and after hemodialysis. These results suggest that the platelet of hemodialysis patients were still unpaired and was not improved by dialysis therapy.
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K. KAWASUGI, M. MORIOKA, A. HIGASHIONNA, K. NAKAMURA, M. KAZAMA, T. KI ...
1985 Volume 14 Issue 1 Pages
57-60
Published: February 15, 1985
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Six stable patients on maintenance hemodialysis were examined using three membranes by crossover method. PF
4 levels were elevated at 30min. and B-TG levels were elevated continously during hemodialysis using all membranes. F.XII, F.VIII, Fbg, SFMC did not show remarkable changes. However, FPA levels were transiently decreased at 30min. during dialysis. PLg, α
2-PI or FDP were not significantly changed, but B
β15-42 levels were elevated continously in all cases and plasminogen activator was increased in some cases.
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[in Japanese]
1985 Volume 14 Issue 1 Pages
61
Published: February 15, 1985
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M. NAMBU, S. KUSAKARI, Y. ITOH, S. MATUHASHI, K. KUMANO, T. SAKAI
1985 Volume 14 Issue 1 Pages
62-65
Published: February 15, 1985
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Non anticoagulant hemodialysis (NAHD) is now possible in some patients with the recent advances in dialyzer technology. This study was designed to determine the important factors which may affect outcome in NAHD. Cuprophane and EVAL dialyzers (high shear rate types) were used in this study. Total doses on heparin, blood clotting time during a in after dialysis and the degree of clotting in dialyzers were analyzed prospectively in 53 patients, who underwent dialysis using either low dose heparinization or NAHD. Low dose heparin dialysis (LDHD) required 1742 units of heparin on the average during the treatment for 5 hours. There was no prolongation in blood clotting time after dialysis, although 50 to 85% of dialyzer fibers were clotted in 22.7% of 352 LDHD in 43 patients. Moderate to complete clotting of dialyzers was observed in 15% of 60 NAHD in 10 patients, who did not show any change in clotting time during and after treatment. No significant difference was seen in blood clotting time and the degree of clotting in dialyzers (cuphrophane and EVAL dialyzers). Judging from our experiences, we conclude that it is necessary for NAHD to use dialyzers with high shear rate and employ a specially designed blood tubing to obtain sufficient blood flow through dialyzer.
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M. TATEYAMA, I. ISHIZAWA, H. NISHIMAKI, M. OMURA, Y. KOSAKA, T. ONODER ...
1985 Volume 14 Issue 1 Pages
66-71
Published: February 15, 1985
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At present, a number of reports says hemodialysis without anticoagulant is appropriate as a treatment to hemorrhagic complications in hemodialyzed patients, the use of EVAL membrane which is composed of high molecule is particularly effective as a method. We aimed at the process of coagulation in the blood circuit (especialy, in the drip chamber) of extracorporal circuit and examined it at the aspect of hydrodynamics. By improving the chamber with equalized watercourse in each chamber and decreased blood stagnation, easy and stabilized hemodialysis without anticoagulant could be performed with various dialyzers without limiting membrane material and so on when it was used 80 times clinically. Furthermore, though the changes in blood properties affected the usage of hemodialysis without anticoagulant, the time blood coagulated during it could be grasped and it was performed smoothly by using thromboelastgram. From the above mentioned, it becomes clear that maintaining blood quantity equally in the circuit inhibits an effect of membrane material or structure of port's part.
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N UENO, T YATABE, H NAGAI, T BIRUMACHI, T ISHIYAMA, T MIKAMI, H MISAWA ...
1985 Volume 14 Issue 1 Pages
72-75
Published: February 15, 1985
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Regional anticogulation was successfully performed as use of Ca-free dialysate and sodium citrate infusion. Ca-free hemodialysis system is as follows; firstly, 44% sodium citrate solution containing additional 1.6% citric acid is infused at a rate of 120ml/hr from arterial drip chamber in order to reduce ionized Ca concentration; secondly, residual ionized Ca is dialyzed by Ca-free dialysate containing 10mEq/l of sodium citrate as a binder of a trace amount of ionized Ca; finally, decreased ionized Ca is corrected by infusion of 2% CaCl2 solution from venous line at a rate of 1.4 to 1.6ml/min. Although in this system, ionized Ca was not detected and Kaolin actioated whole blood clotting time (KCT) was prolonged to more than 10 minutes at the outlet of dialyzer, ionized Ca concentration and KCT of systemic blood were kept within normal limits throughout the hemodialysis procedure. Clinically, no adverse effects were observed. It is concluded that regional anticoagulation by eliaination of ionzed Ca, one of the essential factors for both blood coagulation and platelet fanction, from extracorporeal is very useful for hemodialysis patients in high risk bleeding tendency.
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Y. INAGAKI, I. AMANO, H. ISHIGURE, H. KANO
1985 Volume 14 Issue 1 Pages
76-81
Published: February 15, 1985
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It is well known that the cerebro-vascular disease and gastro-intestinal (GI) bleeding of the regular hemodialysis (HD) patients are very serious and heparin is the worst factor to induce bleeding. We used Gabexate Mesilate (GM) as an anticoagulant for 223 patients with bleeding complications. As GM is resolved by blood esterase and eliminated by dialysis due to its small molecular weight (417), it is possible to prolong the coagulation time in only the circuit. But the venous circuit has tendancy to be more coagulated. And it was difficult to continue HD in some cases due to the increased pressure. We designed a new circuit with double bubble traps which enaled all the patients to be treated using GM. 1500-2000mg/Hr of GM itself is necessary and the addition of 1000/Hr of heparin can decrease its dose to 600mg/Hr. The argumentation of the bleeding were not seen during HD and the post-operative management has been easier than before. HD with GM can increase lifesaving rate from 40% to 76% in massive GI bleeding.
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Y. KITAMOTO, H. OHGIYA, Y. ZANMA, K. MIYAGI, H. MONMA, H. TAKAHASHI, M ...
1985 Volume 14 Issue 1 Pages
82-85
Published: February 15, 1985
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In 28 hemodialysis (HD) patients with bleeding complications, minimal dose of gabexate mesilate (GM) for regional anticoagulation was determined in 3 kinds of circuits. Regular circuits were used in 13 patients (group I). Circuits with double chamber arranged in parallel in the venous line were used in another 4 patients (group II). For remaining 11 patients (group III), circuits with exchangeable chamber were used. Infusion dose of GM during HD was 1600mg/H for group I, 800mg/H for group II and III-A and 600mg/H for group III. In all patients studied, HD were performed without any trouble. It was concluded that the dose of GM for regional anticoagulation in HD can be decreased to 800mg/H without any complications.
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[in Japanese]
1985 Volume 14 Issue 1 Pages
86
Published: February 15, 1985
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T. UEDA, K. SHIROSHITA, T. SAKURAI, Y. KATAOKA, S. TAMURA, T. FUJISAWA
1985 Volume 14 Issue 1 Pages
87-90
Published: February 15, 1985
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A CAM system has a CPU connected with the scale beds and dialysis machines. By this computerized system, TMP in dialysis is controled automatically to get expected body weight. Also it can be monitoring constantly the detector systems by alarm. A definite correlation was obtained between the average expected body weight change and the average real body weight change showing a coefficient of 0.924. During dialysis body fluid is removing constantly and automatically until to obtaining expected body weight, and so the incidence of the symptomes associated with transient hypovolemia, nausea and headache in dialysis was eliminated.
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R. AWATA, T. KISHIMOTO, S. YAMAGAMI, Y. IZUMI, Y. NOGUCHI, M. MAEKAWA
1985 Volume 14 Issue 1 Pages
91-94
Published: February 15, 1985
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We have developed a new hemofilter driven by blood pressure. The new hemofilter is a hollow fiber type made of polysulfone membrane. We estimated its performance in the animal experiment using Beagle dog.
The following results was obtained.
(1) The module could be used continuously for over 50 100 hours.
(2) UFR was over 600 ml/hr as mean value.
(3) Low-molecular weight solutes such as urea and creatinine permeated freely and albumin hardly permeated.
(4) This. hemofilter was superior in antithrombogenicity.
In conclusion, this new hemofilter will be able to use clinically in the many kinds of deseases.
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G. TAKAHASHI, T. YOSHIDA, M. HIROSE, H. MITACHI, T. UTUMIYA, A. OGAWA, ...
1985 Volume 14 Issue 1 Pages
95-97
Published: February 15, 1985
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Single needle method (S. N.) which is being used frequently for the trouble of blood access and emergency dialysis, presents bad dialytic efficiency compared with double needle method (W. N.). In na in vitro test it was ccnfirmed that S. N. presented a lack of blood flow averaging 6.8% compared with W. N. at QB: 150ml/min 19G catheter and a decrease in rate of solute elimination of 6 to 10% for Urea-N (19G single lumen catheter). A lads of blood flow caused by the beats involving the clamp of the arteriovenous circuit and an intermixture at flow in and out are thought to be responsible for these phenomena, in view of which we made an examination to obtain stable blood flow and dialytic efficiency. In S. N. method, total blood flow required for a single dialysis is calculated and the total blood flow thus colculated is pre-set into the electronic counter incorporated in the blood pump. Dialysis is terminated at a point when target counts are attained. With this method, dialytic time required averaged 5.5h and rate of elimination averaged 58.3 for S-U. N. and 55.6 for S-creatinine, respectively (QB: 150mi/min 19G catheter).
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-Development of volume reservoir-
V. INAGAKI, I. AMANO, T. YOSHIDA, N. TERAMACHI
1985 Volume 14 Issue 1 Pages
98-103
Published: February 15, 1985
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Single needle dialysis (SND) is inferior to double needle dialysis in efficiency because it is always accompanied by ineffective flow (IF) and recirculation that become greater when switchings of the A and V phases (S of A-V) are increased. IF is caused by the skidding of the blood pump and dead space. In the experiment with city water, IF became increased with rise of the intended flow. This tendancy was more clearly represented in the condition that maximal V pressure was stipulated lower. We designed a new circuit with volume reservoir (VR) which is composed of two parts: inner part is a balloon to store fluid and outer part is a pipe to prevent the rupture of the balloon. The balloon part of VR is made of raw rubber or latex rubber. Three types of VR length are follows: 10cm, 15cm and 20cm. The circuit with VR was able to decrease S of A-V and IF in SND.
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H. OHWADA, T. NAOI, Y. NAKAMURA, K. SAKAGAWA, M. TAKAHASHI, M. Ogasawa ...
1985 Volume 14 Issue 1 Pages
104-106
Published: February 15, 1985
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We made an improved system of Centry-2, which enable easily to exchange acetate dialysate for bicarbonate one. The new system is briefly indicated below. Basic dialysate without bicarbonate (Solution A) is diluted by the ordinary system of Centry-2. (Solution A). Solution B (5% HCO
-3) is infused into Solution A' between the control conductivity cell and the stabilyzer by the additional supply pump. (Solution A'+B). The control converter, which monitors the concentration of both Solution A and Solution A'+B, was newly constructed. Results of running test showed good stability of this system. The nature of Solution A'+B was of pH 7.194±0.009, PCO
265.9±1.7mmHg, HCO
-3 25.4±0.6mEq/L, Na 139.6±0.7mEq/L and K 2.4±0.0mEq/L. These improvements of Centry-2 are very simple and not so expensive as other bicarbonate infusers. Therefore this system is very useful for the dialysis with bicarbonate.
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Izumi AMANO
1985 Volume 14 Issue 1 Pages
107-109
Published: February 15, 1985
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We have experienced with the treatments of fore types of double lumen catheters as tenporary blood access. Of four, three catheters have a septun running through the center, dividing the lumen into two separate, non-communicating D-shaped channels. We have sured of ease of placement in a short period of time with a low risk of complications.
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[in Japanese]
1985 Volume 14 Issue 1 Pages
110
Published: February 15, 1985
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A. YAMASHITA, H. NAGUMO, H. HIDAI, K. KUMANO, K. IITAKA, T. SAKAI
1985 Volume 14 Issue 1 Pages
111-114
Published: February 15, 1985
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It is diffusive transport to play a large part of solute removal not only for small solutes but albumin. According to our analog simulation for 3Q dialysate CAPO system, amount of removed Urea-N will increase in per exchange and in per day, however, protein losses will be unchanged. It suggests that the transport oflarge solute across the peritoneum depends upon the product of membrane permeability and membrane area.
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K. ISONO, H. MORITA, H. HOSHINO, T. KATAKURA, N. WATANABE, T. SUZUKI, ...
1985 Volume 14 Issue 1 Pages
115-118
Published: February 15, 1985
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The most serious complication in CAPD today, is peritonitis. In order to decrease the frequency of peritonitis caused by accidents during the exchange of dialysis solutions, we have developed a new connecting device (FLAMELOK®) which makes use of flame sterilization. Clinical tests were performed on this device, and we have been able to achieve a decrease in the occurrence of peritonitis. However, fracture, crack and choke of the ceramic joints took place. Accordingly, the ceramic joints were improved. On confirmation of the durabiliby and safety of the new joints, we have observed an improvement in the heat resistance and intensity without a loss in the sterile effect.
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T. SANAKA, S. TERAOKA, H. SATOH, C. HIGUCHI, M. OMATA, J. ARAI, T. TAK ...
1985 Volume 14 Issue 1 Pages
119-122
Published: February 15, 1985
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Peritoneal dialysis were performed to 3 patients with severe acute pancreatitis which were clsified into severe group by Ranson's positive score. They were treated with excellent success. One of them was found that pseudo-pancreatic cyst disappeared after continuous peritoneal dialysis by abdominal Ct. Amylase clearances of peritoneum in the active period of acute pancreatitis were 3.9+1.0ml/min(M+SE) as much as 14 times of the peritoneal clearance in CRF patients without peritonitis. These results are seemingly suggestive that amylase removed not only by concentration gradient but also by directly spilling effect into dialysate from retroperitoneal cavity. Pertoneal dialysis might be an extremely effective adjunct to management of acute severe pancreatitis with Ranson's high score.
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Shin EGAWA, Katsuto SHINOHARA, Kazuo KUMANO, Tadasu SAKAI
1985 Volume 14 Issue 1 Pages
123-125
Published: February 15, 1985
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We have recently experienced CEPD (continuous equilibration peritoneal dialysis) in 8 poor risk patients, which was introduced by Posen et al. in 1978. We found CEPD is more suitable in some patients with poor risk than the conventional dialysis techniques. The biggest advantage of CEPD is easy to maintain water balance for the patients being required the large amount of intravenous infusion in treatment such as hyperelimentation; The risk of peritonitis is less frequent in CEPD than in conventional peritoneal dialysis, which may cause a lethal complications in the immunosuppressed patients of ARF. Once the nurses are well trained, the management of those patient is less complicated in terms of nursing care. In addition, the patient after intracranial operation is the good indication of CEPD especially in the early postoperative period to prevent from increasing the intracranial pressure, which could sometimes happen during hemodialysis or acute peritoneal dialysis. CEPD seems much easier to avoid hypovolemic component especially in the early stage of ARF because rapid removal of extracellular fluid in HD or APD does not occur. It might be possible that this can benefit to improve impaired function of renal tubules. In conclusion, CEPD can well be applied to the treatment for some patients with poor risk.
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K. KUMANO, K. SHINOHARA, S. EGAWA, S. YOKOTA, M. NANABU, S. KUSAKARI, ...
1985 Volume 14 Issue 1 Pages
126-129
Published: February 15, 1985
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Continuous cyclic peritoneal dialysis (CCPD) provides a new dimension in the field of peritoneal dialysis. This new form of home peritoneal dialysis has becom an acceptable modality of treatment, and offers a low incidence of peritonitis and complete daytime freedom. This paper reports our recent experiences in CCPD among three patients using automated peritoneal dialysis machine, which was recently developed in Japan. One patient dropped out early during the training program of CCPD due to psychological rejection of the machine. The other two patients enjoyed daytime freedom with alleviation of uremic symptoms. Our present experiences also confirmed that CCPD could leesen the potential patient or family burnout related to the repetitive performance of exchange procedures during the day as well as decrease the incidence of peritonitis. CCPD provides an excellent alternative for the patients with end-stage renal disease requiring chronic dialytic therapy.
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[in Japanese]
1985 Volume 14 Issue 1 Pages
130
Published: February 15, 1985
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K. ERA, M. MINESHIMA, T. AGISHI, K. YAMAGATA, T. SUZUKI, K. KUBO, N. S ...
1985 Volume 14 Issue 1 Pages
131-134
Published: February 15, 1985
Released on J-STAGE: October 07, 2011
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Continuous arteriovenous hemofiltration (CAVH) has been reported to be useful for removal of excessive body fluid in patients with congestive heart failure or generalized edema. Clinical effectiveness CAVH has been ascertained by our own experiences in 6 patients, especially in terms of safe and reliable fluid removal without marked influence on the cardiovascular system. However, CAVH is insufficient in removal of solutes and correction of electrolytes imbalance in severe renal failure patients. Therefore, a new technique of Continuous HF automated is developed and supplementation is added to CAVH using a simple balance system.
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N. MURTANI, H. HIRASAWA, H. KOBAYASHI, K. SOEDA, S. KOBAYASHI, Y. ITO, ...
1985 Volume 14 Issue 1 Pages
135-138
Published: February 15, 1985
Released on J-STAGE: December 02, 2011
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The efficacy of CAVH in removing the excess water was investigated using mongrel dogs. Following the ligation of ureters, the dog received saline intravenously. Then pumpless CAVH was performed. The changes in serum protein level, CVP and muscle water content indicated the improvement of pathological overhydration with CAVH. The sieving coefficient (SC) of Na, K and Cl was almost 1,
and that of BUN and creatinine was 0.9. SC of total protein, however, was 0. These results indicate that CAVH is effective to remove the excess water improving the symptoms caused by it.
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K. TAKAHASHI, M. OOTOMO, K. NISHIYAMA, T. KOBAYASHI, K. TAKAYAMA, T. T ...
1985 Volume 14 Issue 1 Pages
139-143
Published: February 15, 1985
Released on J-STAGE: October 07, 2011
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To treat the ureinic patients with multi-organ failure, we performed continuous hemofiltration(CHF) with minimum sized hemofilter (PAN-30, Asahi) and newly developed bicarbonate substitution fluid. CHF had sufficient capacity to remove uremic substrates and fluid, and to correct the electrolyte and acid-base disturbances. CHF showed dramatic effects on severe lung edema, hepatic failure, lactic acidosis and so on. These results indicate that CHF is preferable therapeutic procedure to treat the severe patients with multi-organ failure.
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H. KOJIMA, K. SHISHIDO, F. NAKAYAMA, K. TAKAHASHI, T. AKIZAWA, S. KOSH ...
1985 Volume 14 Issue 1 Pages
144-148
Published: February 15, 1985
Released on J-STAGE: October 07, 2011
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Newly developed substitution fluid for bicarbonate hemofiltration(BCHF) is consist of solution A and B. A contains NaCl, KCl and NaHCO
3, and B contains CaCl
2, MgCl
2, glucose and Na-acetate. For the usage, they should a mixed at the ratio of A;B=100:1 manually. Final composition of the mixed fluid is as follows: Na 140.0, K 2.0, Ca 3.5, Mg 1.0, Cl 111.0, HCO
3 35.0, CH
3COO 0.5mEq/l, glucose 100mg/dl and PH 7.35. The concentration of solutes nd pH in the mixed fluid did not change at least for 24 hours. In the clinical studies, BCHF prevented many disequilibrium symptoms, corrected electrolyte disturbances and removed uremic substrates sufficiently during therapy. It was calculated that about 150mEq of HCO
3 and 10mEq of Ca flew into the body during each BCHF. No side effects were observed in the course of 5 months BCHF. These results indicate that this solution is very simple for preparation and has many beneficial effects on the treatment of renal failure.
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T. USHIDA, H. FUNAKUBO, T. DOHI, T. TAGORI, N. TAKAI, A. TAKEUCHI, H. ...
1985 Volume 14 Issue 1 Pages
149-152
Published: February 15, 1985
Released on J-STAGE: October 07, 2011
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We have continued to develope a wearable artificial kidney by filtration-adsorption methode and to make ex vivo experiments of its prototype. In consideration of these results, we set up a micro-computer controlled wearable artificial kidney system and made ex vivo experiment. The filtrate is purified with the Column(1) where urea, uric acid, creatinine, P are adsorbed, and with the Column(2) where the concentration of ions is regulated. A part of volume of the filtrate is eliminated to a reservoir. The system monitors P. L. and T. M. P., controls the volume of eliminated filtrate and infused anticoagulant, and detects the leakage of blood. The total weight of the system, including the priming volume is 3.5Kg.
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J. KOHJINA, S. TAKESAWA, K. SAKAI, A. YAMASHITA, J. SIMAMURA, T. HONMA ...
1985 Volume 14 Issue 1 Pages
153-156
Published: February 15, 1985
Released on J-STAGE: October 07, 2011
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Using the WADIC(Waseda Automatic Dialysis Controller) beside monitoring system for toxic substances and water removal from HD patients, short time dialysis is safely performed with a high clearance dialyzer. Performance estimation of short time dialysis using the WADIC system shows almost the same results as by. chemical methods using creatinine as a marker. A newly developed system for monitoring water removal is in use for clinical treatment, which is composed of a pressure transducer and a microprocessor and could be attached, to any positive pressure type console.
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[in Japanese]
1985 Volume 14 Issue 1 Pages
157
Published: February 15, 1985
Released on J-STAGE: October 07, 2011
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K. OZAWA, M. OINUMA, I. KAWATA, K. SAKAI
1985 Volume 14 Issue 1 Pages
158-161
Published: February 15, 1985
Released on J-STAGE: October 07, 2011
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The transport characteristics of serum electrolytes (Nat, Cl
-, K
+) were clarified using four commercial dialyzers and a newly developed dialyzer using negatively chrged membranes.
The following resluts were obtained: (1) The permeability of potassium is slightly greater than that of sodium, which may be explained on the basis of diffusion coefficients and hydrated radii. (2) The transport mechanism of electrolytes in a dialyzer differs from that of non-electrolytes. (3) Transport of small uclecular electrolytes is little affected by a negatively charged membrane, but the membrane is completely impermeable to low nalecular weight protein, which is negatively charged in blood.
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K. MAEDA, T. SHINZATO, Y. TSURUTA, M. USUDA, F. YOSHIDA, T. ISHIHARA, ...
1985 Volume 14 Issue 1 Pages
162-165
Published: February 15, 1985
Released on J-STAGE: October 07, 2011
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Electrical resistivities in blood and ultrafiltrate were continuously measured with disposable electrodes placed in extracorporeal blood circuit. Geddes's formula which indicated the relation between hematocrit and blood electrical resistivity was modified by the authors. Clinical findings obtained with monitoring the blood volume change during hemofiltraticn treatment for chronic renal failure are as follows: 1. When the body position was changed f ram reclining to sitting posture, the blood volume decreased to 4.2±0.3% (mean±S. D.). 2. Keeping the body water removal rate ccnstant, the blood volume change has been greatly affected by food intake.
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K. TOTSUNE, M. NOZUKI, T. FURUYAMA, K. YOSHINAGA
1985 Volume 14 Issue 1 Pages
166-169
Published: February 15, 1985
Released on J-STAGE: October 07, 2011
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This paper aims to evaluate the simple calculation method based on the new mass transfer model of dialyzer. Using logarithmic mean concentration difference [L] for diffusive transport and mathematical mean concentration [M] for convective transport ([L+M] method), our equation was well fitted to the experimental data. By use of the [L+M] method, the linear relation of Cbo=S1*Cbi+S2*Cdi was found among the variables of Cbi, Cdi and Cbo, where S1 and S2 are constant.
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J. SHIN, S. SHINKO, Y. FUJITA, S. INOUE, R. SAKAI, M NISHIOKA, K KOMAB ...
1985 Volume 14 Issue 1 Pages
170-173
Published: February 15, 1985
Released on J-STAGE: October 07, 2011
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We performed clinical comparative study of dialysis using protein permeable EVAL membrane and conventional cellulosic membrane, such as cuprophan and cellulose acetate. Removal ratio and clearance of small molecular solutes were low in EVAL membrane and high in cuprophan membrane. Whereas sieving coefficient of large molecular solutes was high in EVAL membrane and cuprophan membrane was not permeable to protein. Sieving coefficient of prolactin, albumin, transferrin, IgO and total protein was significantly higher inEVAL-C membrane than EVAL-D memrane. As eommon characteristic findings obserbed in EVAL-C and EVAL-Dmembrane dialysis, increase of platelet, WBC, phosphate, cholesterol and fibrinogen were obserbed. While decrease of serum creatinine and increase of serum calcium were obserbed in cuprophan membrane dialysis. Thus, from clinical course of 9 dialysis patients using various membranes, distinct and interesting differences were obserbed.
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T. TAKAGI, T. G. CGUNG, H. OGAWA, A. SAITO
1985 Volume 14 Issue 1 Pages
174-177
Published: February 15, 1985
Released on J-STAGE: October 07, 2011
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HDF and ECUM filtrates for the hemofilters, TAF 120S (regenerated cellulose) and Duo-Flux HP (cellulose acetate), were analyzed by gel permeation chromatography, SDS polyacrylamide gel electrophoresis and two dimensional electrophoresis. The elimination of plasma proteins from the HDF ultrafiltrates by use of cellulose and other synthetic membranes was determined, and the cellulose membranes sharply cut the removal of the proteins compared with the synthetic membranes.
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M. HIROHATA, A. SAITO, H. NAITO
1985 Volume 14 Issue 1 Pages
178-181
Published: February 15, 1985
Released on J-STAGE: October 07, 2011
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We have now examined an EVAL-CD membrane with UFR and cut-off point lower than those of the C membrane, for protein permeability and clinical effect. The protein permeability of the CD membrane stands between those of the C membrane and standard EVAL membrane, slightly near to the former side. In regard to the clinical effect of the CD membrane, improvement in itching, irritation and bone pain similar to the C membrane was observed but i t was slightly moderate.
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