Jinko Zoki
Online ISSN : 1883-6097
Print ISSN : 0300-0818
ISSN-L : 0300-0818
Volume 16, Issue 2
Displaying 1-50 of 114 articles from this issue
  • [in Japanese]
    1987 Volume 16 Issue 2 Pages 701
    Published: April 15, 1987
    Released on J-STAGE: October 07, 2011
    JOURNAL FREE ACCESS
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  • A. NAITOU, M. OINUMA, K. OZAWA, A. YAMASHITA, S. TAKESAWA, K. SAKAI
    1987 Volume 16 Issue 2 Pages 703-706
    Published: April 15, 1987
    Released on J-STAGE: October 07, 2011
    JOURNAL FREE ACCESS
    Charged membranes have been recently developed in clinical use. Basic studies on electrolyte transport through charged dialysis membranes were rarely found. In the present study, we determined the effects of material and property of dialysis membranes on the transport of inorganic phosphate and sodium ion. The concentration dependence was found in ion transport because of charge density instead of the slight concentration dependence of ion radius and diffusion coefficient. This demonstrates that ion transport through charged membranes strongly depends on ion strength.
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  • H. OHASHI, S. TSUDA, K. OZAWA, S. TAKESAWA, K. SAKAI
    1987 Volume 16 Issue 2 Pages 707-710
    Published: April 15, 1987
    Released on J-STAGE: October 07, 2011
    JOURNAL FREE ACCESS
    The objective of this study is to elucidate the quantitative changes in membrane structure after blood contact by means of pore model studies utilizing radioisotope-labeled urea. Five kinds of tubular dialysis membranes were employed to determine both solute and pure water permeability before and after blood contact. The mean pore radius of EV A membranes (50Å) decreased after blood treatment. This demonstrates that serum albumin with a Stokes radius of 35.5Å tends to plug the pores of EV A membranes. The experimental results indicate that changes in membrane structure affecting the permeability of dialysis membranes are dependent on the adsorptive properties of membrane surface and pore size.
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  • H. CHIBA, S. TAKESAWA, K. SAKAI
    1987 Volume 16 Issue 2 Pages 711-714
    Published: April 15, 1987
    Released on J-STAGE: October 07, 2011
    JOURNAL FREE ACCESS
    A newly-improved method using dye (C. I. Direct Yellow 12 M. W. 680) was employed to determine pore radius of small tubular dialysis membranes made of regenerated cel lulose (RC). The diffusion coefficient of the dye in pores was measured by dyeing method. The diffusion coefficient allows determination of membrane pore radius using pore theory. The dye diffuses in membrane pores obeying Fick's 2nd law and pore radius data were almost identical with those obtained by RI method.
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  • -New Design and the Evaluation of Module-header Port
    S. YOSHIKAWA, H. FUKUMURA, K. HAYASHI, M. MIYA, I. KAWADA, A. SUEOKA
    1987 Volume 16 Issue 2 Pages 715-719
    Published: April 15, 1987
    Released on J-STAGE: October 07, 2011
    JOURNAL FREE ACCESS
    To get optimum result in hemofiltration for rather long period, design of the module without stagnation flow especially in the header port of the module is one of the most important points to be developed. Nine types of newly designed header were fabricated and evaluated both in vitro and ex vivo, They were classified into eddy, straight-in, and side-in type. The degree of stagnation (R) was defined for the evaluation of the header design in vitro. According to this indication, eddy type design was better than straight-in or side-in type module. Results of ex vivo experiments using dogs alse showed the superiority of this design from the view point of the thrombus formation.
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  • [in Japanese]
    1987 Volume 16 Issue 2 Pages 720
    Published: April 15, 1987
    Released on J-STAGE: October 07, 2011
    JOURNAL FREE ACCESS
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  • S. TAKESAWA, H. HIDAI, S. SATOH, K. SAKAI, M. SEKIGUCHI, T. TAKAHASHI
    1987 Volume 16 Issue 2 Pages 721-724
    Published: April 15, 1987
    Released on J-STAGE: October 07, 2011
    JOURNAL FREE ACCESS
    The clearance of middle molecular substances and pure water permeability decreased significantly with gamma-ray irradiation for dry regenerated cellulose membranes. On the other hand, no changes in the clearance of middle molecular substances and pure water permeability were found for wet membranes. Many peaks were observed on the chromatogram of fluids eluted from dry and wet membranes. Gamma-ray irradiation reduced the strength of wet membranes.
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  • T. SHONO, O. INAGAKI, T. HIRABAYASHI, H. MORI, S. INOUE, Y. FUJITA, T. ...
    1987 Volume 16 Issue 2 Pages 725-728
    Published: April 15, 1987
    Released on J-STAGE: October 07, 2011
    JOURNAL FREE ACCESS
    A new diethylaminoethyl-cellulose dialysis membrane (Hemophan; HP) was tested for biocompatibility compared with Cuprophan (CP) and Polymethylmethacrylate (PMMA). In WBC drop during the hemodialysis, HP showed a smaller change than CP and a greater change than PMMA. Changes of neutrophils, lymohocytes and platelets were similar to WBC. No significant changes were seen in PaO2 In C33a generation, HP displayed a smaller change than CP and a greater than PMMA. In platelet factor-4 generation, HP showed a smaller change than PMMA and a greater than CP. In conclusion, it is considered that the biocompatibility of HP is good.
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  • T. MUROI, T. KOYANO, K. OZAWA, M. TAMURA, K. SAKAI
    1987 Volume 16 Issue 2 Pages 729-732
    Published: April 15, 1987
    Released on J-STAGE: October 07, 2011
    JOURNAL FREE ACCESS
    Techniques of membrane distillation have been developed in the fieled of desalination and alcohol concentration. In this work, solute-free water was removed from bovine plasma, bovine blood and discarded dialysate with the use of polytetrafluoroethylene (PTFE) and polyvinylidene-fluoride (PVDF) membranes. Both membrane structure and temperature polarization layer affect permeate flux in membrane distillation.
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  • [in Japanese]
    1987 Volume 16 Issue 2 Pages 733
    Published: April 15, 1987
    Released on J-STAGE: October 07, 2011
    JOURNAL FREE ACCESS
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  • E. KUSHIMA, M. SATOH, M. OKI, M. TONITA, M. AKIMOTO
    1987 Volume 16 Issue 2 Pages 734-737
    Published: April 15, 1987
    Released on J-STAGE: October 07, 2011
    JOURNAL FREE ACCESS
    Recently, it is useful Double Lumen Catheter (DLC) for temporary Blood Access. We have been measured removal rate by experience model of External shunt·A-V Fistula·DLC, and examined clinical experience and clinical laboratory data. The results of an experience were in External shunt·A-V Fistula·DLC order. However, they couldn't admit for statistical significance. In clinical evaluation, the catheter wasn't admit bacteria infections, and catheter insertion method was very easy. Therefore, DLC was effective temporary Blood Access as hemopurification in experimentally and clinically.
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  • Y. INAGAKI, S. AOKI, I. AMANO
    1987 Volume 16 Issue 2 Pages 738-742
    Published: April 15, 1987
    Released on J-STAGE: October 07, 2011
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    Flexible double-lumen (FDL) catheter was designed as a temporary blond access (TBA). Silicone rubber is used for the material to enable the patients to walk around freely even if the FDL catheter is inserted through the femoral vein. An inner tube was placed inside of the lumen to insert the catheter using Seldinger's method. The maximum blood flow is more than 300ml/min and V pressure is below 100mmHg under the condition of 200ml/min. A new micropump using two syringes was designed to prevent clotting of the lumens by continuous in-jection of heparin. Clinical application was undertaken in 219 patients and the catheters were used for 1-4 weeks without serious complications FDL catheter is thought superior to external shunt because it can be used as a CVP or infusion line in addition to TBA.
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  • T. SATOU, K. GOTOU, S. NAKAGAWA
    1987 Volume 16 Issue 2 Pages 743-748
    Published: April 15, 1987
    Released on J-STAGE: October 07, 2011
    JOURNAL FREE ACCESS
    Soft HDF is HDF to use hypertonic bicarbonate substitution fluid in a smaller amount as European “biofiltration” utilized 3l with composition of Na 145 Cl 45 and HCO-3 100m Eq/l.
    Soft HDF were done in a similar manner as biofiltration in reduced times than control HD by 1 hour; 4hr biofiltration was compared with 5hr HD and 3hr biofiltration with 4hr HD.
    Reduction rate of urea, creatinine and uric acid were significant worse in biofiltration. But pretreatment level of urea was not significant between biofiltration and HD, Suggesting increased tissue clearance. Correction of uremic acidosis was sufficient in biofiltration without excessive alkalosis despite hypertonic bicarbonate infusion. Serum level of electrolytes were not significant but increased Cl concentration in HD. Ht level was increased and trigly ceride concentration was decreased in biofiltration. All patients were well torelated in biofiltration. In conclusion, biofiltration can be applied for short time dialysis in the sense of elimination of uremic solute and correction of uremic acidosis.
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  • K. GOTOU, T. SATOU, S. NAKAGAWA
    1987 Volume 16 Issue 2 Pages 749-753
    Published: April 15, 1987
    Released on J-STAGE: October 07, 2011
    JOURNAL FREE ACCESS
    In various blood depurative therapy available today, High flux HDF (hard HDF) with more than 10l substitution fluid is one of the best method for the great removal of uremic toxin (small, middle and large molecular weight solute) with vascular stability in the shortest possible time. The present problem of hard HDF was the cost of large volume of sterile bicarbonate substitution fluid and the need of special equipment for balancing infusate and ultrafiltrate. For the production of large volume of bicarbonate substitution fluid, bicarbonate dialysate passing through reverse osmosis and two PMMA ultrafiltrater was supplied for substitution fluid, which include less than 1pg/ml of endotoxin (chromogenic substrate method). Using double pump as an equolizer, the volume of infusate and ultrafiltrate was volume-balanced. For the purpose of reducing treatment period and removing low molecular weight protein, convective flow was increased up to 5l/hr. With this system, satisfactory reduction of urea, creatinine and β2-microglobulin was achieved in the short time. On line Hight flux HDF may be one of the best blood purification method for short time dialysis and elimination of low molecular weight protein.
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  • K. HIRANO, J. KONDO, R. ADACHI, K. IMOTO, H. KAJIWARA, A. MATUMOTO, N. ...
    1987 Volume 16 Issue 2 Pages 754-757
    Published: April 15, 1987
    Released on J-STAGE: October 07, 2011
    JOURNAL FREE ACCESS
    Continuous arteriovenous hemofiltration (CAVH) was performed in seven patients with acute renal failure following aortic reconstruction. Hemofilter was PAN-5OP. Blood access was obtained with 14G catheter from femoral artery. Ultrafiltration was obtained by the arterial blood pressure. Heparin was administered as anticoagulation therapy. Hemofilter was exchanged when ultrafiltration rate was getting less than 200 mililiter per hour. The average period of hemofilter exchange was 41.6 hours and the average rate of ultrafiltration was 791 mililiter per hour. Systolic arterial blood pressure and ultrafiltraion rate had a positive correlative tendency. Three cases were weaned from CAVH, two cases died within two days after the begining of CAVH and another two cases were well controlled for long period concerning acid-base, electrolyte and body fluid valance. In three of four unsuccessful cases retroperitoneal hematoma which had existed before operation increased. We need further examination about the anticoagulation therapy but CAVH was effective for acute renal failure following aortic reconstruction.
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  • S. MIKI, S. YUASA, Y. TAKAMITSU
    1987 Volume 16 Issue 2 Pages 758-761
    Published: April 15, 1987
    Released on J-STAGE: October 07, 2011
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    The purpose of this study was to evaluate the clinical effectiveness of CAVNMD as treatment for patients with renal failure who can not be treated with the standard dialysis therapies. Twelve patients with renal failure were treated with this new CAVNMD method. We used a dialyzer with a low surface area (<0.6m2) without the use of pumps for extracorporeal blood circulation. The dialyzing solution was Subrad A solution or Kindaly No. 2 solution diluted 35 times. We perfused a warmed (40°C) dialysate at a rate of 1L per hour. The values of both urea-N and creatinine in the dialysate post dialyzer were the same as those found in blood. The level of blood urea-N was reduced by 25.8% and 42.3%, and tha of serum creatinine by 21.4% and 39.8%, measured at 24 and 48 hours intervals, respectively. After 24 hours, the values of serum potassium decreased to normal in all cases. From 0 to 400ml per hour of fluid could be removed by varying the adjustment. This CAVNMD method proved beneficial for patients with progressive renal failure who cannot undergo standard dialysis therapies.
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  • [in Japanese]
    1987 Volume 16 Issue 2 Pages 762
    Published: April 15, 1987
    Released on J-STAGE: October 07, 2011
    JOURNAL FREE ACCESS
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  • H. NAITO, T. MIYAZAKI, [in Japanese], [in Japanese], [in Japanese], [i ...
    1987 Volume 16 Issue 2 Pages 763-766
    Published: April 15, 1987
    Released on J-STAGE: October 07, 2011
    JOURNAL FREE ACCESS
    The blood was withdrawn from the antebrachial vein of healthy persons and passed through the minimodules of EVAL, PS and PAN membranes and a minimodule containing no membrane, at the same time. Examination of the blood which had passed through the minimodules revealed that the Cuprophan membrane activates the intrinsic and extrinsic coagulation factors, the PS and PAN membranes activate the blood coagulation due to activated platelet factors, and EVAL membranes provoke less activation of coagulation factors than the other membranes.
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  • Y. KITAMOTO, H. SUGAI, H. MONMA, M. ISHIZAKI, H. TAKAHASHI, H. SEKINO, ...
    1987 Volume 16 Issue 2 Pages 767-769
    Published: April 15, 1987
    Released on J-STAGE: October 07, 2011
    JOURNAL FREE ACCESS
    Sixty-one urokinase immobilized femoral vein catheters (UKFC) were applied to 56 patients as a transient blood occess. The catheters were indwelled 2 to 113 days (14 days in average) and were patent in all patients except one. Only 4 patients were suffered from catheter fever. The residual activity of UK after use was 0.1 to 6.1%, (2.1% in average). The plasma concentration of neither plasminogen nor α2-plasmin inhibitor changed very much at hemodialysis and hemorrhagic diathesis were not observed at all. Three different catheters-polyurethane femoral catheter (FC), UKFC and UKFC inactivated with (p-amidinophenyl) methanesulfonyl fluoride hydrochloride (APMSF-UKFC)-were indwelled in the jugular vein of the 4 goats 2 days and were observed with scanning electromicroscopy after pulling out. Platelets adhesion was observed on the surface of PC but not observed on the surface of both UKFC and APMSF-UKFC. We concluded that the antithrombogenicity of UKFC is owing to the inhibition of platelets adhesion to the material as well as the enhancement of fibrinolysis.
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  • H. OHGIYA, T. MAKINO, Y. ZANMA, H. MONMA, H. TAKAHASHI, Y. KITAMOTO
    1987 Volume 16 Issue 2 Pages 770-773
    Published: April 15, 1987
    Released on J-STAGE: October 07, 2011
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    Gabexate mesilate (GM) and heparin showed synergism as anticoagulants in vitro. This synergism was observed between 20 to 50μg/ml of GM and 0.05μ/ml of heparin in the blood of hemodialysis (HD) patients. According to the result of in vitro experiment, 425 low dose GM dialyses were performed in 105 patients using 150μ of heparin at the priming of dialysis circuits and 500-600mg/H of GM during HD. There were neither clotting troubles during HD nor enhancement of bleeding tendencies during and after HD. Platelet adhesion to glass beads were more suppressed in dialyses using heparin for priming compared with dialyses using GM for priming. The synergism in vitro and in vivo between heparin and GM was interpreted as the result of the suppression of clotting system and platelet function. Probably this synergism were amplified in HD patients because their platelet count is decreased and their platelet function is deteriorated.
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  • J. KUROKAWA, M. HIDA, S. HIRAGA, T. IIDA, T. SATO
    1987 Volume 16 Issue 2 Pages 774-777
    Published: April 15, 1987
    Released on J-STAGE: October 07, 2011
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    Post operative adjuvant chemotherapy of CDDP were performed in three dialysis patients with malignancy, and elimination of plasma CDDP with various blood purification methods were studied. There are two diffent components of plasma CDDP, that one is protein binding CDDP and anotheris free CDDP. Plasma platinum concentration was measured by atomic absorption spectrophotometry. Free CDDP was eliminated with HD, HDF, HE and DHP. but totalplasma platinum concentration rate reduced only 10.4-37.5%, which were not satisfactry value. However, the reduction rate of plasma total platinum consentration with PE was 68.6%, which was satisfactory effect. Steep a phase was found in the profile of plasma platinum concentration after administration of CDDP in the patient after bilateral nephrectomy. It was suggested, that the uptake of CDDP to tissue occurred rapidly. The conclusion of this study is that the most effective methods ofblood purification for reducing plasma CDDP in the dialysis patients is PE.
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  • [in Japanese]
    1987 Volume 16 Issue 2 Pages 778
    Published: April 15, 1987
    Released on J-STAGE: October 07, 2011
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  • K. SAKASHITA, T. TSUTSUI, H. KAGAMI, A. ITO, C. YAMAZAKI, K. MASUKO
    1987 Volume 16 Issue 2 Pages 779-782
    Published: April 15, 1987
    Released on J-STAGE: October 07, 2011
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    This study was undertaken to determine whether LAL-RM had to do with hemodialysis leukopenia and thrombocytepenia. Using the conventional CHF dialyzers and the non-LAL-RM CHF dialyzers, the leukocyte and thrombocyte inll hemodialysis patients were counted at prehemodialysis, 15 minutes, 30 minutes, 60 minutes and 240 minutes after beginning, respectively. The non-LAL-RM CHF dialyzer was made by washing with 13 liters of lactated Ringer's injection. The changes of leukocyte and thrombocyte during hemodialysis were no different between conventional CHF dialyzer and non-LAL-RM CHF one. As the control experment, two hundreds, mililiters of washing solution of AM-Neo-2000H were Injected into the nomal human (male-5, femal-3). Their leukocyte, thrombocyte and complement (CH 50) were measured at preinjection, 15 minutes, 30 minutes. 60 minutes and 120 minutes, later. There were no significant changes found in the leukocyte and complement (CH 50). It showed that the thrombocyte dicreased signifucantly at 30 minutes and 60 minutes as compared that of preinjection.
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  • T. KOBAYASHI, H. AMEMIYA, M OOTOMO, H. OKUYAMA, T. AKIZAWA, S. KOSHIKA ...
    1987 Volume 16 Issue 2 Pages 783-786
    Published: April 15, 1987
    Released on J-STAGE: October 07, 2011
    JOURNAL FREE ACCESS
    We developed 6μ thickness hollow fiber (HF) with fin for hcmodialyzer (D) which could not be applied to D by its fragility without the attachment of fin. D composed of 6μ HF showed about 20% higher dialysis efficiencies than those of ordinary 8μ thickness HF D. Neither coagulation nor leakage was observed in the 6μ HF D. The attachment of fin to HF with high molecular cut off point also increased dialysis efficiencies of low molecular substances, which were not removed so effectively by the HF without fin. These results indicate that the attachment of fin to HF increases the dialysis efficiency not only by reducing the dialysate side mass transfer resistance but also by applying the very thin HF effectively. HF with fin can be applicable for widespread high performance D.
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  • Y. ONO, M. OGURA
    1987 Volume 16 Issue 2 Pages 787-790
    Published: April 15, 1987
    Released on J-STAGE: October 07, 2011
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    It is well known that some severe complications on regular dialysis patients-retractory anemia, bone disease, and dialysis amyloidosis etc- are so difficult to cure by conventional dialysis. Recently effective results of the complications are reported by using protein permeable filter. We tested five different membrane filter about UFR, low molecule clearance, large molecule clearance and adhesive protein to membrane surface. Reduction rate of UFR were much larger than that by conventional dialyzer. Large molecule clearance was so larger than that by conventional one. In all filter adhesion of protein were seen on the surface. We examined to remove adhesive protein by using Triton X-100. The results showed that in PMMA adhesive protein, especially β2-MG was the largest among all membrane. The reason why a large amount of β2-MG adherented to PMMA membrane is not clear but further study is needed to clarify this membrane charateristic.
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  • T. TAKAGI, K. SAKURAI, H. OGAWA, A. SAITO
    1987 Volume 16 Issue 2 Pages 791-794
    Published: April 15, 1987
    Released on J-STAGE: October 07, 2011
    JOURNAL FREE ACCESS
    The removal of plasma proteins (β2-microglobulin, retinol binding protein and albumin) was studied with sane high-performance filter at proteinpermeating hemodiafiltration. The sieving coefficients (SC) of β2-microglobulin were: KF101-15C, 0.55; TAF102S, 0.40; Duo-Flux, 0.32; H12-2400S, 0.29; AM-2400UP, 0.42; TF-E15P, 0.33. The SC of albumin were: KF101-15C, 0.08; TAF 120S, 0.02; Duo-Flux HP, H12-2400S, AM-2000UP and TF-E15P, below 0.01. The removing ratio of β2-microglobulin to albumin were: KF101-15C, 1.3%; TAFI20S, 4.7%; Duo-Flux HP, 9.1%; AM-2000UP, 7.1%; TF-E15P, 7.2%; H12-2400S, 312%. A high removing ratio of β2-microglobulin to albumin was observed in use of H12-2400S (PAN) membrane, eapared with EVAL and cellulose membrane. It will be possible to select a high-performance filter suitable for each patient.
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  • T. SHIBAMOTO, Y. IINO, H. OHSHIMA
    1987 Volume 16 Issue 2 Pages 795-798
    Published: April 15, 1987
    Released on J-STAGE: October 07, 2011
    JOURNAL FREE ACCESS
    Since release of soluble components from dialyzer could be inocorporated into blood circulation, an extracts of rinsing fluid were analysed.After rinsing various module with 500ml distilled water, other 300ml of distilled water was circulated for 4hrs andanalysed. During the extracttion of soluble components, silicon was used at connecting portion of the module and also rolling part of blood pump, while teflon was used in the all other portions of the tubing. Transparency of the rinsing fluid was 98.7-100%. ΔpH between extract and blank was 0.48-1.47. Consumption of KMnO4 was 1.1-19.3ml. Infrared absorption of the extract revealed the same pattern as membrane materials in the modules sterilized with r-ray. Glycerin peak was noticed in the dry typemodules. Without adequate rinsing of the dialyzer, there is a possibility of incorpiration of soluble components into the blood. It is recommended to rinse the dialyzer modules well enough to wash out those components before use.
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  • [in Japanese]
    1987 Volume 16 Issue 2 Pages 799
    Published: April 15, 1987
    Released on J-STAGE: October 07, 2011
    JOURNAL FREE ACCESS
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  • H. YOSHIHARA, T. SUGIMURA, M. SENJU, S. YAMAGAMI, T. KISHIMOTO, M. MAE ...
    1987 Volume 16 Issue 2 Pages 800-803
    Published: April 15, 1987
    Released on J-STAGE: October 07, 2011
    JOURNAL FREE ACCESS
    A Limulus test-positive substance is eluted from the cellulose membrane dialyzer, and the serum of hemodialysis (HD) patients on this dialyzer is Limulus test positive. When the dialyzer wash solution (DWS) from the cuprophan membrane was added to peripheral blood roonocytes, interleukin-1 (IL-1) productivity significantly increased. However, DWS from the polymethylmetacrylate (PMMA) membrane was Limulus test negative and did not increase IL-1 productivity. Furthermore, IL-1 productivity of peripheral blood roonocytes from HD patients on the cuprophan membrane dialyzer was significantly higher than that for healthy controls and HD patients on the PMMA membrane dialyzer.
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  • T. MIYAZAKI, H. NAITO, [in Japanese], [in Japanese], [in Japanese], [i ...
    1987 Volume 16 Issue 2 Pages 804-807
    Published: April 15, 1987
    Released on J-STAGE: October 07, 2011
    JOURNAL FREE ACCESS
    To study the bio compatibility of blood purification membrane, the blood passing test was conducted by using several minimodules of different membranes at the same time on a single subject. The subjects were three healthy male and the membranes used were PE, PVA, EVAL (D) and EVAL (4A). The membrane area of each module was 0.01m2. Blood was withdrawn from the median cubital vein through PVC tubings and let to five modules (one module was blank) where the blood flowed at a rate of 10ml/min. Ten minutes later, the blood was sampled to investigate the influence of each membrane material on the complement system by measuring the activation of complements (C3a, C4a). The complements were most strongly activated by PVA, followed by EVALs (D and 4A), PE, and “blank”. There was no significant difference in the effect between EVAL (D) and EVAL (4A).
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  • S. HOSHINA, M. ABE, Y. IKEDA, F. NAKAMURA, M. FURUKAWA, N. ENDO, I. NA ...
    1987 Volume 16 Issue 2 Pages 808-811
    Published: April 15, 1987
    Released on J-STAGE: October 07, 2011
    JOURNAL FREE ACCESS
    globulin (β2-MG), one of the small molecular proteins accumulated in the plasma of chronic dialysis patients, was recognized as the new type amyloid protein. We already had reported the effectively adsorptive removal of β2-MG by PMMA membrane after the incubation experiments four years ago. In the present study, we tried to re-evaluate the adsorptive effects of the newly-developed synthetic membranes as well as PMMA (B-1 and B-2 series) and PAN (Asahi and Hospal). β2-MG was markedly reduced by PMMA (not B-2 but B-1 only), PAN, and Polysulfone. Some other solutes of glucagon, PTH, lysozyme, ribonuclease, myoglobin, and retinol binding protein were also checked the membrane-specific affinities.
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  • Y. SUZUKI, H. KANIYU, S. NASUNO, T. SHIBATA, H. NIHEI, N. MIMURA
    1987 Volume 16 Issue 2 Pages 812-816
    Published: April 15, 1987
    Released on J-STAGE: October 07, 2011
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    The biocompatibility of a new modified cellulose (MC) dialysis membrane in which 5% of cellulosic OH group are substituted by DEAE group was tested as compared to Cuprophan (Cu) and PMMA membrane. MC showed less transient leukopenia than Cu and PMMA did not. C3a generation through dialyser occured most in Cu. MC generated less C3a than Cu and PMMA was the least generator of C3a. C5a generation was only observed in Cu. β-TG slightly increased in the blood through dialyser in Cu and MC but much increased in PMMA. This was the same thing concerning PF4 too. PMN elastase, measured as PMN elastase·α1-Pi complex, increasd at same extent in these three membrane in the blood according to dialysis times, suggesting there was no relationship between PMN elastase release in the blood and the peripheral leukocyte count or serum complment considering their changes in Cu and PMMA.
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  • [in Japanese]
    1987 Volume 16 Issue 2 Pages 817
    Published: April 15, 1987
    Released on J-STAGE: October 07, 2011
    JOURNAL FREE ACCESS
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  • Y. SASAKI, M. TAKAHASHI, S. TERAOKA, M. MINESHIMA, K. ERA, K. KUBO, K. ...
    1987 Volume 16 Issue 2 Pages 818-821
    Published: April 15, 1987
    Released on J-STAGE: October 07, 2011
    JOURNAL FREE ACCESS
    We use many kinds of membranes when we do hemodialysis and each membrane has it's specificity. It is said that newly developped modified cellulose ( we call it Hemophan) is more excellent than ordinary membranes from the point of baiocompatibility. We used this Hemophan during hemodialysis and compared (C3a, C5a, WBC, PLT, β-TG, PF4, TXB2 and LTB4 with PMMA and regenerated cellulose. It was obvious that Hemophan is than PMMA from the point of platelet activation and than Regenerated cellulose from the point of leukocyte activation.
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  • T. AKIZAWA, T. KITAOKA, S. KOSHIKAWA, T. WATANABE, K. IMAMURA, T. TSUR ...
    1987 Volume 16 Issue 2 Pages 822-825
    Published: April 15, 1987
    Released on J-STAGE: October 07, 2011
    JOURNAL FREE ACCESS
    A new cellulose membrane in which the active hydroxyl and carboxyl groups of the original cellulose fibers are masked with cationic synthetic polymers has been developed. The membrane was shown by in vitro and clinical tests to effect very little activation of the complement system, and retains the high dialysis efficiency, good tolerance to steam autoclave sterilization of the original cellulose membrane. The new cellulose provides the optimum combination of qualities necessary in a membrane for hemodialysis.
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  • S. NAGANUMA, K. TERAOKA, K. OTA, K. NAKURA
    1987 Volume 16 Issue 2 Pages 826-829
    Published: April 15, 1987
    Released on J-STAGE: October 07, 2011
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    Serum LTB4 levels, the activation of LTB4 during hemodialysis, and the corelation between activated LTB4 and leukocyte counts were examined for hemodialysis patients.
    Serum LTB4 levels did not differ from those of the normal control. No corelation was observed between LTB4 activation and dialysis membrane employed.
    However, relatively stronger activation was found in PMMA membrane than in regenerated cellurose membrane. In each membrane, transient leukopenia was severer in patients with higher activation of LTB4.
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  • Y. NAKASHIMA, Y. HASHIMOTO, M. WAKASA, N. KANAMORI, K. SHISHIDO, H. KO ...
    1987 Volume 16 Issue 2 Pages 830-833
    Published: April 15, 1987
    Released on J-STAGE: October 07, 2011
    JOURNAL FREE ACCESS
    Plasma leucotrien (LT) B4 and C4/D4 levels were evaluated during various blood purification methods. Although fasting LT concentrations of regular hemodialysis (HD) patients were not different from those of normal controls, LTs increased gradually during HD, in which LTs at the outlet of dialyzers were higher than those at the inlet. The elevation of LTs was more remarkable in HD with regenerated cellulose than that with PMMA or new cellulose membrane which had little effects on complement system. More significant increase in LTs was noted in direct hemoperfusion with activated charcoal. In hemofiltration, only venous LTs increased at the end of therapy concomitantly with the concentration polarization of the membrane. LTs showed little changes during plasmapheresis, however same concentration of LTs as systemic blood was noted in the separated plasma. These results indicate that the alteration of plasma LTs might be determined by membrane materials and/or modes of treatment. LTs appear to be useful indices to evaluate the blood compatibility of blood purification methods.
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  • O. MATSUMURA, T. SANAKA, Y. TANAKA, K. ERA, H. AMEMIYA, N. SUGINO
    1987 Volume 16 Issue 2 Pages 834-837
    Published: April 15, 1987
    Released on J-STAGE: October 07, 2011
    JOURNAL FREE ACCESS
    We studied a removal capacity of Al, Fe and clinical efficiency by PPHD using protein leaking membrane dialyzer and DFO therapy (10-30mg/kg, weekly) for AABD 10 cases and hemosiderosis 5 cases. The removal capacity of Al-DFO complex by PPHD was significantly higher than by usual HD. Al and Fe were together removed by DFO and PPHD. All AABD cases reduced bone pain by administrated DFO to one from three times, and one case with multiple pathological fructures had healed after 3 months. Hemosiderosis cases did not clearly take effect, but serum ferritin decreased significantly after 3 months, so DFO therapy may be stopped the development of hemosiderosis. The method of weekly administrated DFO was rare to find side effects and took sufficient effects clinically. In conclusion, PPHD can carry out easily and is useful the removal of Al-DFO or Fe-DFO complex.
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  • SHINICHI HOSOKAWA, HIROSHI NISHITANI, TADAO TOMOYOSHI, OSAMU YOSHIDA
    1987 Volume 16 Issue 2 Pages 838-841
    Published: April 15, 1987
    Released on J-STAGE: October 07, 2011
    JOURNAL FREE ACCESS
    Manganese (Mn) transport and dialysance during hemodialysis were examined in fifteen chronic hemodialysis patients. Serum Mn levels in fifteen volunteer outpatients tended to increase after 5-hour dialysis; (0.20±0.06μg/dl before HD; 0.25±0.06 after HD). Serum Mn levels were 0.64±0.12μg/dl in normal subjects. The increase was mainly due to hemoconcentration evidenced by a significant increase in the hematocrit during HD. To study the changes resulting from diffusion, we measured Mn in the arterial blood and in the dialysate at the inflow and outflow sites of the dialyzer. Mn diffused across the dialyzer from the blood to the dialysate in fifteen cases. Mn dialysance of 15 patients was-48.6±71.7ml/min. The relationship between ultrafiltrable Mn levels and serum Mn levels before HD was a significant correlation (r=0.69, p<0.005).
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  • [in Japanese]
    1987 Volume 16 Issue 2 Pages 842
    Published: April 15, 1987
    Released on J-STAGE: October 07, 2011
    JOURNAL FREE ACCESS
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  • T. SHINZATO, K. MAEDA, F. YOSHIDA, H. KOBAYAKAWA
    1987 Volume 16 Issue 2 Pages 843-846
    Published: April 15, 1987
    Released on J-STAGE: October 07, 2011
    JOURNAL FREE ACCESS
    In the present study, it has been confirmed that some symptoms which fail to disappear with hemodialysis are, in fact, reduced or disappear by push/pull HDF: restless legs syndrome, irritability, sleeplessness and pruritus. Using 41 patients with more than one of the above complications, we changed the form of treatment from hemodialysis to push/pull HDF, and within 2 months there was an obvious reduction in the complications in most of the patients. Seven of 10 patients with restless legs syndrome, for example, and 14 of 16 patients with feelings irritation, showed distinct improvement. Also, all 10 patients complaining of insomnia completely recovered from the problem after switching to push/pull HDF, and 7 of 24 patients suffering from pruritus also showed improvement. However, there were no significant differences in the pre-dialysis values of BUN, plasma creatinine and plasma electrolyte with either method of therapy.
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  • Y. TSURUTA, K. MAEDA, F. YOSHIDA, T. SHINZATO, T. ISHIHARA, F. INAGAKI ...
    1987 Volume 16 Issue 2 Pages 847-850
    Published: April 15, 1987
    Released on J-STAGE: October 07, 2011
    JOURNAL FREE ACCESS
    Using a hematocrit continuously measuring system we developed earlier, we monitored changes in the circulating blood volume during HD in order to determine a possible relationship between symptomatic hypotension and blood volume. The blood volume when symptomatic hypotension developed did not always coincide with the lowest level during HD. In some patients, it was 10 percent or more over the lowest level. The minimum level of circulating blood volume was reached approximately I hour after symptomatic hypotension occurred. This suggests that there is variation of compensatory mechanisms during HD in order to maintain blood pressure in relation to decreases in the blood volume. We noted no abrupt decrease in the blood volume prior to the symptomatic hypotension, and it was abvious that the plasma refilling rate did not vary either. This indicates that, in the mechanisms of the symptomatic hypotension, there is no water transfer from the intravascular space to the interstitial space.
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  • -DIALYSIS DISEQUILIBRIUM SYNDOROME AND BRAIN DEATH-
    S. AOKI, Y. INAGAKI, I. AMANO
    1987 Volume 16 Issue 2 Pages 851-855
    Published: April 15, 1987
    Released on J-STAGE: October 07, 2011
    JOURNAL FREE ACCESS
    Arterial blood (B) and CSF (C) of hemodialysis (HD) patients were obtained and analysed to investigate dialysis disegailibrium syndrome (DDS). B-BUN was decreased more significantly compared to C-BUN during HD. As a result, this caused the folowing condition: B-Osm<C-Osm. B-pH was increased but C-pH was almost constant. These two differences in pH and Osm between B and C were thought to be related to DDS. Although B-K, B-Ca and B-P were changed greatly, the changes of C-K, C-Ca and C-P were very small. This stability of CSF were recognized in a case with cerebral bleeding and continued for two days after brain death. The low concentration and smaller change of C-Cr, compared to B-Cr, probably indicate that Cr has more toxicity than BUN.
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  • Y. NAKAGAWA, S. TERAOKA, F. ITOH, S. FUJITA, H. HONDA, T. KAWAI, S. FU ...
    1987 Volume 16 Issue 2 Pages 856-859
    Published: April 15, 1987
    Released on J-STAGE: October 07, 2011
    JOURNAL FREE ACCESS
    Extravascular lung water (EVLW) was examined in seven hemodialysis (HD) patients by means of double indicator dilution method, using Lung Water Computer (American Edwards Comp.). Concurrently, hemodynamics were measured by Swan-Ganz catheter, and arterial blood gases were analyzed, too. EVLW was the value 10.5±2.9ml/kg just before HD, it just increased up to 11.5ml/kg after the initiation of HD. Then, it decreased gradually with the times and finally took the value 10.3ml/kg at the end of HD. Both arterial oxygen tension and cardiac output decreased, on the other hand, pulmonary vascular resistance increased during HD. Judging from the increase in EVLW in spite of the removal of the body fluid during HD, the increase in EVLW attribute the elevation of pulmonary capillary permiability from unknown mechanism. So-called HD-induced hypoxemia may be related to the increase in EVLW. It is interesting that the increase in EVLW during HD may be related to hypersensitivity syndrome.
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  • M. KONISHI, N. TSUSHIMA, M. SAKAKURA, M. KABA, H. TOIKAWA, T. HAYASHI
    1987 Volume 16 Issue 2 Pages 860-863
    Published: April 15, 1987
    Released on J-STAGE: October 07, 2011
    JOURNAL FREE ACCESS
    In this experiment, hemorheological changes were examined and microcirculatory changes on the human bulbar conjunctiva and nail bed also were observed. Body weight showed significant negative correlations with TP, Alb, Glb, Ht and Fib, and also showed sigificant negative correlations with whole blood viscosities at high shear rate, plasma viscosities at high shear rate and whole blood viscosities at low shear rate. The passage time of plasma were prolonged markedly after hemodialyses and also showed significant negative correlations. But the passage time of 40% RBC suspension were shortened significantly after hemodialyses. On the bulbar conjunctiva, the blood flow velocities were decreased and I. E. A. and sludges were increased after hemodialyses. Rapid hemoconcentration by hemodialysis made hemorheological and microcirculatry changes of patient worse. Numbers of capillary loops on nail bed were decreased in chronic renal failure under hemodialysis compared with those in healting subjects and those were increased after hemodialysis.
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  • [in Japanese]
    1987 Volume 16 Issue 2 Pages 864
    Published: April 15, 1987
    Released on J-STAGE: October 07, 2011
    JOURNAL FREE ACCESS
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  • Kazuhito TOTSUNE
    1987 Volume 16 Issue 2 Pages 865-868
    Published: April 15, 1987
    Released on J-STAGE: October 07, 2011
    JOURNAL FREE ACCESS
    In order to study the relationship among the concentrations in inlet blood (CBi), inlet dialysate (CDi), and outlet blood (CBo), the experimental hemodialyses with and without ultrafiltration were performed in vitro using creatinine, vitamin B12, and albumin as test solutes. The data obtained gave the following equation: CBo=C1·CBi+C2·CDi where C1 and C2 were constants. This equation fits well in all cases regardless of molecular weight of the solute, difference in dialyzer membrane, or the existence of ultrafiltration. On inspection of dialyzer clearance and dialysance by this equation, it was proved that they were not constants but functions of CDi/CBi and dialysance could not be used in pool models except for the case without ultrafiltration. These results suggest that this equation is a law representing the solute transport in dialyzer, and C1 and C2 are the characteristic constants representing dialyzer performance.
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  • T. KUNITMOTO, H. KATAOKA, M. KIMURA, F. GEJYO, M. ARAKAWA, T. ONO
    1987 Volume 16 Issue 2 Pages 869-876
    Published: April 15, 1987
    Released on J-STAGE: October 07, 2011
    JOURNAL FREE ACCESS
    To identify pathogenic substances accumulated in chronic HD patients, ultrafiltrates obtained from them using BK were analyzed and bioassayed. Cytotoxic fractions (K1, K2) and β2m were isolated. On the other hand, β2m was identified as a major component of amyloid from HD patients with CTS. Further studies revealed; 1) Plasma β2m in patients is extraordinarily high (25-75 times that of normal) irrespective of HD duration. 2) β2m suppresses calcification of osteoblastic cell cultured just as aluminum. 3) Continuous use of BK decreases plasma β2m without any change in plasma total protein.
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  • K. KUMANO, M. NANBU, S. KUSAKARI, T. SAKAI, K. SAKURAI
    1987 Volume 16 Issue 2 Pages 877-880
    Published: April 15, 1987
    Released on J-STAGE: October 07, 2011
    JOURNAL FREE ACCESS
    Removal capacities and serum concentration of beta-2 microglobulin (B-2M) were evaluated among various modes of treatments. Serum levels of B-2M could be reduced to some extent with hemodialysis (HD), hemofiltration (HF) or hemodiafiltration (HDF) using synthetic membrane filters. Reduction rate of was 60% on HF with RP-6 or HF 200 and 30% on HD with AN-69 or BK1. 0. Not only filtration and diffusion but also membrane absorption of B-2M seem to play an important role in the mechanism for B-2M removal in these synthetic membrane filter. Cuprophane dialyzer did not produce a significant change in serum B-2M. Patients on HD or CAPD had significant correlations between serum B-2M and duration of dialysis, even if patients with residual renal function were excluded for this analysis. Serum B-2M level did not change between patients with HD and CAPD, although latter removed a significant amount of B-2M and former did not. There seems to be complicated mechanisms to regulate serum levels of B-2M in various modes of treatments. Generation rate might be different between HD and CAPD, which remains to be clarified.
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  • M. SENJU, T. SUGIMURA, S. YAMAGAMI, H. YOSHIHARA, T. KISHIMOTO, M. MAE ...
    1987 Volume 16 Issue 2 Pages 881-884
    Published: April 15, 1987
    Released on J-STAGE: October 07, 2011
    JOURNAL FREE ACCESS
    Dynamics of β2-microglobulin (β2-MG) was studied in patients on blood purification comparing various dialyzers. Serum β2-MG was significantly lower in CAPD patients than in hemodialysis (HD) and hemofiltration (HF) patients, maybe due to the short period of treatment on CAPD. The accumulation of serum β2-MG did not correlate with period of treatment, serum creatinine and type of dialyzer. Serum β2-MG was removed during treatment with HD on EVAL membrane and HF, but its concentration before treatment was comparable. Long-term use of EVAL membrane seemed to suppress or reduce serum β2-MG accumulation. β-glucan eluted from cuprophan membrane was not related to β2-MG production.
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