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[in Japanese]
1987 Volume 16 Issue 3 Pages
1127
Published: June 15, 1987
Released on J-STAGE: October 07, 2011
JOURNAL
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[in Japanese]
1987 Volume 16 Issue 3 Pages
1129-1134
Published: June 15, 1987
Released on J-STAGE: October 07, 2011
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H TAKANO, T NAKATANI, M UMEZU, [in Japanese], [in Japanese], [in Japan ...
1987 Volume 16 Issue 3 Pages
1135-1140
Published: June 15, 1987
Released on J-STAGE: October 07, 2011
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Profound heart failure was induced by complete interception of blood supply (AMI group) to the extent of 50, 70-80, and 80-90% of the LV free wall and by anoxic arrest (AA group) by aortic cross-clamp for 30-60 min under normothermia. The air-driven, diaphragm type blood pump was implanted between left atrium and aorta. The 50-80% AMI group recovered between 6-16 days and the AA group between 13-18 days after the onset of LVAD pumping. However, above 80% AMI group and severely damaged AA group could not recover. The decompression of LV at the beginning will prevent overextension of the impaired myocardium and simultaneously accelerate the scar formation. And gradual increase of LV work will promote the compensation ability of the residual myocardium.
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K. IMACHI
1987 Volume 16 Issue 3 Pages
1141-1144
Published: June 15, 1987
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The assist heart is diffusing into clinical stage as a new therapeutic method of cardiac surgery. At the present time, 4 kinds of blood pump and 3 kinds of driving systems are using in the clinical cases in our country. However, their functions are not necessarily satisfactory, and involve many problems to be improved. In this paper, the author would like to mention about the basic design requirement of assist heart hard wares to compre with the present systems for clinical use. Antithrombogenicity aound the valves, at the junction between blood pump and cannulae is one of the most important problems. As for the driving system, compactmizing of present system is required.
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Hiroyuki FUKUMASU, Aria YAMAZATO, Kazunobu NISHIMURA, Yasunori FUJIWAR ...
1987 Volume 16 Issue 3 Pages
1145-1149
Published: June 15, 1987
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The Tomasu ventricular assist device (VAD) has been applied to three patients and the Thoratec type of Pierce-Donachy VAD developed in the United State has been applied to two patients in our institutes. Out of the five three patients could be successfully weaned from the VAD, and one of them achieved long-term survival. Non synchronizing pumping of the VADs was significantly effective as well as the synchronizing pumping might be. There were no significant evidences of thromboembolism.
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INDICATION, CONTROL OF DRIVING, STEP OF WEANING AND COMPLICATIONS
Y. KAGAWA, N. SATO, T. WATANABE, M. MIURA, M. SADAHIRO, N. AKINO, T. H ...
1987 Volume 16 Issue 3 Pages
1150-1154
Published: June 15, 1987
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Since December 1984, 6 cases underwent application of VAD for relief of postcardiotomy acute profound ventricular failure. Etiology was AMI, severe valvular disease and congenital heart disease in each 2 cases. Reasons for application of VAD were difficulty in weaning from extracorporeal circulation and postoperative LOS in each 3 cases. Criteria for weaning from VAD was decided mainly by on-off study. Four cases weaned from VAD and one case became long-term survivor. Of the complications with many divergences, infection was most serious and strongly influenced on the results of VAD.
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T FUJITA, H TAKANO, T NAKATANI, [in Japanese], [in Japanese], [in Japa ...
1987 Volume 16 Issue 3 Pages
1155-1159
Published: June 15, 1987
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At the beginning of VAS assistance, the bypass flow stayed high to keep LAP at 0-5mmHg and to maintain systemic flow at 3.0-3.5L/min/m
2. During the recovering stage, the preset level of LAP was gradually raised. The 7 patients' entire circulation was well maintained at normal level during the period of 3-15 days and VAS was successfully removed. Appropriate, safe and automatic circulation control during profound heart failure and subsequent recovery from it were achieved by our automatic VAS. Although the natural hearts could recover, the most patients died of multiple organ failure which developed during prolonged ischemia prior to VAS assistance. In clinical situation, timely use of VAS by right judgment is important.
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M. ENDO, H. NISHIDA, H. KOYANAGI, K. ATUMI
1987 Volume 16 Issue 3 Pages
1160-1163
Published: June 15, 1987
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LVAD was effective for severe LV failure with limitation of IABP. Combination method with IABP and LVAD could markedly improve hemodynamics. In this combination method, urine output was not reduced in this case. Combination method was more safety than individual LVAD by back up system.
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STATUS AND PROBLEM FOR VENTRICULAR ASSIST DEVICE
Yukiyasu SEZAI
1987 Volume 16 Issue 3 Pages
1164-1167
Published: June 15, 1987
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Ventricular Assist Device (VAD) is an effective means of saving patients with severe cardiac failure. I expressed my opinion about status of the VAD and problems of the pump-driven system in Japan.
At present, staged or bridged cardiac transplantation utilising apartial artificial heart is available and should be used more often in further to provide effective life for suffering from end-staged cardiac failure.
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[in Japanese], [in Japanese]
1987 Volume 16 Issue 3 Pages
1168
Published: June 15, 1987
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K. SAKAI
1987 Volume 16 Issue 3 Pages
1169-1172
Published: June 15, 1987
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A vast quantity of tubular dialysis membranes is presently used in hemodialysis treatment, yearly amounting approximately 30 million m
2 of membrane area. Approximately two billion liters of blood are then purified for patients with chronic renal failure. The membranes have been prepared through trial and error since the relationship between structure and permeability is almost unknown. The permeability of membranes is affected by their structure depending on preparing conditions. Determination of membrane structure facilitates preparing membranes. Some models are essential for determining the structure of dialysis and ultrafiltrati on membranes. Based on the tortuous pore model improved from the simplified pore model, the structure of commercially available tubular dialysis membranes is clarified.
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A. SAITO
1987 Volume 16 Issue 3 Pages
1173-1176
Published: June 15, 1987
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There are 3 conditions needed for desirable membrane: 1) the pore size compatible for the molecular weight of target molecules to be removed; 2) the uniform pore size; 3) excellent biocompatibility. The filter that the sieving coefficient of albumin approximates to 0 and that of β
2-microglobulin is 0.4-0.6 is recently developed for hemodialysis and hemofiltration. The current membrane is very effective for the removal of low molecular proteins. Albumin binding intoxication, such as hyperbilirubinemia and drug intoxication was treated by plasmapheresis, however, the exchange of whole blood including the globulin fraction is not economical. Therefore, hemofiltration is conducted by using a filter with the albumin rejection rate of 50-40%.
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S. NAKAGAWA, T. AKIBA, [in Japanese], T. SHINODA, M. OGURA, K. KISHI
1987 Volume 16 Issue 3 Pages
1177-1179
Published: June 15, 1987
Released on J-STAGE: October 07, 2011
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Peritoneum as a dialysis membrane differs from artificial membrane in its complex structure. From capillary lumen into peritoneal cavity, uremic solutes travels across several barriers; stagnant film of blood, capillary basement membrane, pinocytes (vesicules) or intercellular junctions, interstitium, mesothelium basement membrane, mesothelial pinocytes or intercellular junctions, and stagnant film of dialysate. The most remarkable characteristic is pinocytec (vesicular) transport. The efficacy and reporducibility is variable. The performance of transport is easily influenced by extrinsic factors; hemodynamics, vasoactive substances, diseased state. The contribution of convective transport in comparison with artificial membrane is noteworthy.
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M. SUZUKI
1987 Volume 16 Issue 3 Pages
1180-1184
Published: June 15, 1987
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Developement of dialysis equipments and associated technical proplembs, as well as the biocompatibility of the meterials were reviewed. Much reamains to be resolved in the pathogenesis and treatments against hypotension, arteriosclerosis, low turn-over bone, xerostomia, itching skin lesion, hyperphosphatemia, and amyloid osteoarthropathy. After β
2-microglobulin was recognized as the amyloid protein, the attention is focussed on the removal of it. Cuprohpane dialyzer could not clear it at all. 650mg of β
2-microglobulin was eliminated weekly by hemofiltration using polysulfone hemofilter in our clinical trials.
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K. MAEDA, T. SHINZATO, H. KOBAYAKAWA
1987 Volume 16 Issue 3 Pages
1185-1188
Published: June 15, 1987
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Theoretically, HDF is the most effictive blood purification method. However, HDF is more expensive than hemodialysis (HD) because the substitution fluid is always necessary for HDF. In order to solve this problem, Push and Pull HDF has been developed. Inulin clearance was 11.1±4.3ml/min by hemodialysis (HD), against a significantly higher 43.3±7.0ml/ml in Push and Pull HDF therapy. The sieving coefficient of the new hemofilter membrane for inulin was 0.86±0.06, against 0.30±0.16 with the hemofiltration membrane used for conventional hemofiltration, against 0.53±0.18 with the membrane used for Push and Pull HDF.
The pretreatment serum phosphate level was 5.9±1.6mg/dl at the start of Push and Pull HDF treatment against a significantly lower at 4, 8, 12, 24 weeks into Push and Pull HDF treatment.
The patients treated with Push and Pull HDF had significantly higher hematocrit value, hemoglobin level and erythrocyte count than when on hemodialysis.
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H. HIRASAWA, M. ODAKA, Y. TABATA, H. KOBAYASHI, K. SOEDA, T. SUGAI, H. ...
1987 Volume 16 Issue 3 Pages
1189-1192
Published: June 15, 1987
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For the past five and a half years the HA was applied on 1632 patients with various diseases. The fundamental and clinical studies reveal that the mechanism of the efficacy of the HA can be through the improvements in hepatic cellular metabolism and RES phagocytic function. The changes in the serum osmolality gap, which is a good parameter of the middle molecular weight substances, decreased with the HA and the plasma exchange, but not with the hemodialysis. The HA should be chosen for the removal of causative substances from the patients.
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K. KOIDE, J. TOYAMA, N. INOUE, S. KOSHIKAWA, T. AKIZAWA, K. TAKAHASHI, ...
1987 Volume 16 Issue 3 Pages
1193-1198
Published: June 15, 1987
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Oral sorbent therapy is a distinctive blood purification method as it is applicable in conservative period. In order to suppress the progress of chronic renal failure (CRF), we have applied an oral sorbent (AST-120) composed of spherical porous carbon particles, to patients with CRF upto 56 months. Its effect was observed in improvement of linear regression of reciprocal of serum creatinine vs, time plots and delayed initiation of hemodialysis compared to control patients, together with improved symptoms and reduced uremic peak in liquid chromatography of serum. The result leads us to consider that the oral sorbent therapy is an useful blood purification method in CRF.
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S. SAKAI, K. TOJO
1987 Volume 16 Issue 3 Pages
1199-1202
Published: June 15, 1987
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First, we refered to the effectiveness of plasmapheresis in various immunological disorders from the point of cellular immunity and reticuloendotherial system function. It may be thought that plasmapheresis causes therapeutic effects not by a simple mechanism, but by various factors which interact alternatively. In this study, we investigated the effect of plasmapheresis on blood coagulation abnormalities and lipid abnormalities in the patients with drug-resistant nephrotic syndrome due to primary and secondary renal diseases. An increase in plasma FPA, FPB
β15-42 and TxB
2 levels was noted in all the patients, and marked reduction of these parameters was obtained by plasmapheresis. We performed plasmapheresis and LDL adsorption in two nephrotic patients due to focal glomerular sclerosis associated with hyperlipidemia, and the remission of renal dysfunction and massive proteinuria was found in parallel with the removal of lipids. Based on these findings, there is a possibility that blood coagulation abnormalities and lipid abnormalities may provide an index of disease activity in the drug resistant nephrotic syndrome, and it may be suggested that these abnormalities are involved in the effective mechanism of plasmapheresis in addition to the abnormalities of cellular and humoral immunity.
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Z. YAMAZAKI, F. KANAI, Y. IDEZUKI, N. YAMAWAKI, K. INAGAKI, N. TSUDA
1987 Volume 16 Issue 3 Pages
1203-1206
Published: June 15, 1987
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Immunoadsorption is interpreted as an adsorptionutilizing the immunological reaction, in a narrow sense. While taking the word in a wide sense, specific or selective adsorption of pathogenic immune reactants by affinity adsorbent isincluded in immunoadsorption. There are several immunoadsorbents currently available for clinical application and testing, which have given us fairly good results. These procedures, replacing plasma exchange, have a promising future in the treatment of immune diseases.
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[in Japanese], [in Japanese]
1987 Volume 16 Issue 3 Pages
1207
Published: June 15, 1987
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H. NAITO
1987 Volume 16 Issue 3 Pages
1208-1211
Published: June 15, 1987
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We investigated the antithrombotic properties of the EVAL membrane for use in the artificial kidney and obtained the following finding. (1) The proteins deposited on the EVAL membrane surface at the initial stage of dialysis was mainly albumin and globulin. The composition of the deposited proteins remained unchanged 4 to hours after the start of reqular dialysis. The other membranes, however, allowed more deposition of fibrinogen than albumin and globulin. (2) In the blood passing test using healthy blood, the EVAL membrane provoked less activation of platelet factors such as β-TG and PF-4 as well as of blood coagulation factors than the other membranes.
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T. AKAIKE
1987 Volume 16 Issue 3 Pages
1212-1215
Published: June 15, 1987
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Research and development of artificial organs have been made energetically, whereas the elemental material for artificial organs have not yet acquired complete antithrombogenicity. In most cases the material for organs and tissues must combine several functions with antithrombogenicity. For example the ideal membrane for artificial kidney is expected to have various bloodcompatible characters as well as dialytic function and mechanical strength. In this study we put an emphasis on the biomimetic material design for the element of artificial organs. Especially it is very important to evaluate the biocompatibility of various bioelements and their derivatives. The possibility of such biomoleculs as lipids, collagens and the modified for mutifunctional medical materials was discussed.
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A. IZUMI
1987 Volume 16 Issue 3 Pages
1216-1219
Published: June 15, 1987
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Now, cellurose acetate or synthetic polymer were mainly used as plasma separator which have maximum pore size of 0.5μm. The formation of thrombus in the plasma separators were rarely found on condition that blood flow rate, TMP and plasma flux were exactly controlled.
Plasma separators (CDA, PMMA, DVA) activated complement levels of C3a and C4a at not only membrane surface but also intra-membranously.
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M. OKADA, K. SHIO, K. NAKAMURA, S. MATSUDA
1987 Volume 16 Issue 3 Pages
1220-1226
Published: June 15, 1987
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Open heart surgery has been widely performed with aids of heart and lung machine. At this time, heparin has been routinely used as an anticoagulant drug during extracorporeal circulation (ECC), But, there are some problems concerning to the control of platelet aggregation and vasodilation. This study is to evaluate and improve antithrombogenicity during and after ECC. From these standpoints of view, changes of platelet counts and the value of β-Thromboglobulin with or without administration of Gabexate mesilate (FOY) were precisely observed during and after ECC. And the values of TXB
2 and 6 Keto PGF
1α which are stable substances produced from TXA
2 and PGI
2 were also evaluated to get the changes of antithrombogenicity during ECC. Subsequently, a marked changes of antithrombogenicity could be obtained. That is, remarkable decrease of platelet counts and increase of β-TG were disclosed. Besides, an increase of TXB
2 and a decrease of 6 keto PGF
1α were clearly recognized during ECC. For the purpose to correct these abnormal changes, FOY or PGE
1 were given in 55 cases with cardiac disease, and satisfactory results could be obtained. In conclusion, on the basis of these findings these drugs as well as PGI
2 analogue (OP-41483) should be adequetly given for control of platelet aggregation or vasodilation in addition to administration of heparin.
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-SMALL CALIBER VASCULAR GRAFT-
R. SEINO, C. NOJIRI, M. OKANO, S. W. KIM, Y. NOISHIKI, A. HASHIMOTO, H ...
1987 Volume 16 Issue 3 Pages
1227-1231
Published: June 15, 1987
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The excellent antithrombogenicity of small caliber vascular graft can be obtained by the prompt and complete neoendothelialization of the luminal graft, determined by the graft fabrication, the inner structure of a graft wall, the speed and amount of perigraft tissue ingrowth. In addition, the graft should have elastic properties to prevent a mismatch between the mechanical properties of a vascular graft and its host artery, which can cause eventual thrombosis and graft failure. Since our heparin slow release collagen graft has such properties as mentioned above, its clinical application can be possible if the problem of antigen-antibody reaction is solved.
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N. AKABA, Y. YAMAMOTO, K. SAKURAI
1987 Volume 16 Issue 3 Pages
1232-1235
Published: June 15, 1987
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Various factors of the the luminal surface of the vascular prosthesis including the surface texture, surface charge and surface free energy are related to thrombus formation and subsequent occlusion of the lumen. The authors have particularly investigated the problem of surface charge. The influence of the electrical charge on thrombus formation was examined using electroconductive materials. And the process of neointima formation in the implanted prosthesis was observed under SEM from the viewpoint of bioelectric physiology. The results proved that adhesion and deformation of the platelets are influenced by an electric charge and indicate that electric conductivity is essential for antithrombogenecity of the synthetic blood conduit.
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T. KOZUKUE, S. HORIKOSHI, S. SUZUKI, S. MIYAZAWA, K. MASHIKO, T. ARAI
1987 Volume 16 Issue 3 Pages
1236-1239
Published: June 15, 1987
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The incidence of thromboembolisms (TE) after valve replacement were 1.0%/patient-year in AVR with BS valve group, 1.6%/patient-year in MVR with mechanical valves group, 0.6%/patient-year in MVR with tissue valve group, and O in double valve replacement groups. In MVR group, the incidence of TE were O with BS valve, 3.1%/patient-year with SJM valve, 8.9%/patient-year with Duromedics valve, and 0.6%/patient-year with IS valve. The TE episodes occurred within 1 year after AVR, but 1 year later after MVR. The valve thrombosis occurred in 3 patients after AVR with BS valve. The severe embolic episodes occurred in 4 patients after MVR group. The 10-year % free from TE were 97.9% after MVR with tissue valve group, 94% after MVR with mechanical valves group, and 90.4% after AVR with mechanical valve group. In conclusion, the anti-coagulant therapy was needed after valve replacement with both mechanical and tissue valve
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T. KUDO, K. FURUKAWA
1987 Volume 16 Issue 3 Pages
1240-1243
Published: June 15, 1987
Released on J-STAGE: October 07, 2011
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The effectiveness of antiplatelet therapy with the drugs changing platelet aggregability for the valve replaced patients was investigated. The platelet aggregability by ADP and collagen reduced significantly in group of ticlopidine 300mg daily, by arachidonic acid reduced in group of ASA 80mg daily. Then, in group of ticlopidine, the platelet aggregability were examined for the difference of surgical procedure. It was demonstrated form this study that the platelet aggregability decreased in the order of AVR, MVR and AVR+MVR.
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F. IWAYA, S. HOSHINO, T. IGARI, K. TAKANO, M. ANDO, T. ABE, K. HAGIWAR ...
1987 Volume 16 Issue 3 Pages
1244-1247
Published: June 15, 1987
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We have been performed 45 total artificial heart experiments using calves and sheep and 2 LVADs for clinical cases. Sites of thrombosis were at the junction of valve housing and quick connector, quick connector and the artificial graft in animal cases and there was small thrombus at the de-airing needle puncture of LVAD.
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Y. NOISHIKI
1987 Volume 16 Issue 3 Pages
1248-1251
Published: June 15, 1987
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Foreign body reaction works continuously during the foreign body is in the host. To observe the biological reaction against antithrombogenic materials, the polymer coated suture method (Jap. J. Artificial Organs, 11, 794, 1982) was used. Three kinds of polymers were used, i. e., heparinized hydrophilic polymer (H-RSD), hydrophilic polymer with long polyethyleneoxide side chains (PEO), and heparinized denatured keratine (HK). Macroscopically, these polymers showed excellent antithrombogenicity. No thrombus was noticed on each polymer surface, however, the mechanism and process to get antithrombogenicity were completely different from each other. In case of H-RSD, a protein layer of 1, 000A in thickness covered the polymer surface. In case of PEO, a special double membrane like cell membrane was observed in every specimen after more than 1 day. In case of HK, it could prevent from the thrombus formation during the dissolving of HK. After no more dissolving, the surface was covered with thin layer of fibrin, then was endothelialized. These three polymers can get stable antithrombogenicity in the blood stream. These results revealed that the biological reactions to antithrombogenic materials do not always work same way. The investigation of such as variant phenomena is quite improtant for the development of new antithrombogenic materials.
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T. MATSUDA
1987 Volume 16 Issue 3 Pages
1252-1256
Published: June 15, 1987
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various body's defense mechanisms are triggered at blood/material interfaces when foreign surfaces are implanted. These include coagulation, complement, fibrinolysis and cellular systems. In this paper, much emphasis was placed how muitiinteracting biological systems mutually amplify for each other to generate local adverse reactions (thrombus, pannus, calcification) and systemic reactions (supersensitive syndrome). The general relationship between biological responses and surface properties of polymers are established here. Based on classification of four physiological and biochemical functions of vessel's endothelium cells (microphase, hydrated layer, secretion and metabolism), the conceptual approaches to molecular design of blood-compatible polymers are presented. Recent efforts toward upgrading blood compatibility are summarized.
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[in Japanese], [in Japanese]
1987 Volume 16 Issue 3 Pages
1257
Published: June 15, 1987
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K. OKABE, K. OUCHI, S. MATSUBARA, T. SATO
1987 Volume 16 Issue 3 Pages
1258-1262
Published: June 15, 1987
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Whole blood cross circulation and plasma cross circulation were carried out in GalN induced hepatic failure and normal rats. Both methods were beneficial for improvement of mitochondrial function, especially ATP synthesis, in Ga1N injured liver. Fourty two patients with hepatic failure were treated with blood purification and the overall survival rate was 31.0%. Multiple systems organ failure was developed in 29 out of 42 patients and caused poor prognosis, a survival rate of 17.2%. Plasma exchange could be helpful for the deteriorated host defense mechanism in hepatic failure because it improves the impaired immunity of lymphocyte beside the favarable effect on reticuloendothelial system.
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H. IWATA, T. MATUDA, H. AMEMIYA, R. HAYASHI, H. TAKANO, T. AKUTU
1987 Volume 16 Issue 3 Pages
1263-1266
Published: June 15, 1987
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Islets of Langerhans were encapsulated in microbeads made from agarose gel or several kinds of polyion-complex membranes. Microbeads act as mechanical barriers between islets and the host's immune cells and antibodies. Islets maintained the ability to secret insulin and further could respond to the step increase in glucose concentration, even when they were cultured in vitro for long period. 1000 hamster islets in agarose microbead were implanted into the peritoneal cavity of diabetic mice. They reversed diabetes in mice for up to 52 days.
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K. OHKURA, H. ICHIHASHI, H. TAKAGI, T. KONDO, S. IKEDA, K. ITO
1987 Volume 16 Issue 3 Pages
1267-1269
Published: June 15, 1987
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It is very important to make a long-life and stable glucose sensor on development of artificial pancreas. We observed a dog and a rabbit which were implanted oxygen electrodes in subcutaneous tissue or intraabdomen for about 200 days. The output of sensor was going down within 2-3days and then the sensor recovered the output in about 50 days after implantation. After implantation oxygen electrodes were covered with thin membrane or thick granulation.
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K. KATAOKA, Y. SAKURAI, A. MARUYAMA, T. TAURUTA
1987 Volume 16 Issue 3 Pages
1270-1273
Published: June 15, 1987
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New polymeric adsorbent for cell adsorption chromatography was prepared and its advantageous characteristics was examined, This new adsorbent is graft copolymer of poly(2-hydroxyethyl methacrylate) (PHEMA) and polyamine (HA copolymer), and was applied to separation between two major subpopulations of lymphocytes (B cell and T cell), By using column containing HA copolymer as adsorbent, T cells with more than 90% purity was obtained in 60% yield within a short time-period of 3, 5 min, Further, B cells were obtained in a good yield by recovering adsorbing cell fraction from the column with gentle pipetting of the adsorbent.
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Y. YAMASAKI
1987 Volume 16 Issue 3 Pages
1274-1277
Published: June 15, 1987
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For the completion of artificial endocrine pancreas, development of monitoring device, such as glucose sensor and insulin sensor, is the most crucial breakthrough. For extending the long-life of a needle-type glucose sensor, alginatepolylysine-alginate membrane was coated. The sensor with this membrane was implanted in sc tissue and monitored tissue glucose concentration for 3 weeks. A insulin-immune sensor in which titanium electrode was coated with insulin antibody membrane was developed. The sensor responded immediately after insulin application. The sensor output linearly related to the insulin concentration. These data indicate that these sensors are importance as the prototype of sensors for a variety of artificial organs.
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M. MINESHIMA, K. YAMAGATA, K. ERA, T. SANAKA, T. AGISHI, K. OTA, H. HA ...
1987 Volume 16 Issue 3 Pages
1278-1281
Published: June 15, 1987
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Although the mass transport in CAVH is induced by ultrafiltration same as in conventional HF, time decay of hemofilter performance is a serious problem in CAVH. In this paper, performances of several CAVH filters were examined during in vitro experiments. There are little differences of filter performance in steady state between four types of membrane under the constant shear rate per fiber length and inlet concentration of total protein in a module. Filtration flux in CAVH filters could be estimated by gel polarization model. More than 50% reduction of filtration flux was shown at the maximum during 24 hours.
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S. TAKESAWA, K. SAKAI
1987 Volume 16 Issue 3 Pages
1282-1285
Published: June 15, 1987
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This paper presents a newly-developed approach to dialysis treatment-monitoring system based on kinetic modelling. The blood concentration of urea and creatinine can be monitored during dialysis treatment. Removed amounts of fluid from HD patients can be estimated from transmembrane pressure data. It is preferred to have additional monitors of removed fluid, blood pressure, blood volume and dialysate sodium concentration in the monitoring system. New functional membranes are required to develop an implantable artificial kidney necessary for patients with chronic renal failure
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A. TAKAGI, M. SHIRAKAWA, Y. TADA, Y. IDEZUKI, S. SHINDO, A. D. WHITTEM ...
1987 Volume 16 Issue 3 Pages
1286-1289
Published: June 15, 1987
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The hybrid vascular prosthesis was made by seeding the cultured endothelial cells to a small caliber synthetic vascular prosthesis in expectation for its antithombogenicity. Vascular endothelial cells were derived enzymatically by the modified Maruyama's method from canine external jugular veins. Delayed seeding of the cultured cells was applied to the collagen-coated Dacron prosthesis sized 6mm in diameter. Seeding procedure was performed by the rotation method. The graft including cells suspension was put to clockwise rotation (180°, 90°, 90°, 90°, 90°) after every five minutes interval of stationary incubation. One week after endothelial seeding in vitro, the hybrid vascular prosthesis was implanted to the canine femoral artery. Good endothelial covering was confirmed microscopically at the midpoint of the experimental graft 4 weeks after implantation. In consideration, constant culturing of pure endothelial cells and development of biocompatible synthetic material will be necessary for ideal hybrid prosthesis. Skillful technique of suturing the graft without damaging the seeded endothelium will be required for vascular surgeons. And immunological aspects should be examined for clinical use in the future.
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M. SAKUMA, K. YASUDA, T. TANABE
1987 Volume 16 Issue 3 Pages
1290-1293
Published: June 15, 1987
Released on J-STAGE: October 07, 2011
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To improve the performance of vascular prostheses, seeding experiments and measurement of elastic properties of grafts have been carried out. (1) The scanning electron micrograph 6 weeks after implantation showed that the luminal lining of seeded grafts had more cellular ingrowth than control grafts and the efficacy of endotherial cell seeding was demonstrated. (2) Compliance of grafts currently in use was measured using a new type ultrasonic system. In comparison of compliance of human arteries to that of grafts, the difference of compliance between grafts and human arteries was obviously recognized.
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-EFFECTS OF LONG AORTIC GRAFTING WITH SYNTHETIC PROSTHESES ON THE CIRCULATORY SYSTEM
H. MAETA, M. HORI, Y. MORI
1987 Volume 16 Issue 3 Pages
1294-1297
Published: June 15, 1987
Released on J-STAGE: October 07, 2011
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After a long aortic bypass grafting combined with an exclusion of the proximal aorta, marked circulatory changes were observed in all the aortic and arterial system. These circulatory factors in combination may lead concentric hypertrophy of the left ventricle and ischemia of the hypertrophied ventricle. Hypertention and pulse widening may also increase the degeneration of aortic wall. Contrarily, it will decrease arterial resistance through a baroreflex mechanism. A new compliant vascular graft will minimize these circulatory disorders. These clinical and experimental observations will propose a new sophisticated horizon in artificial organs research as seen from a system approach.
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Yoichi SUGITA, Yukihiko NOSE
1987 Volume 16 Issue 3 Pages
1298-1302
Published: June 15, 1987
Released on J-STAGE: October 07, 2011
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The first concept of Single Pump Artificial Heart is that both failed right and left natural ventricles are combined either in series or parallel, to maintain the low pressure pulmonary circulation, while single artificial pump carries the systemic circulation. In the “series” approach, a ventricular septal defect of ca. 3 cm size is created and the mitral valve orifice is closed with a felt patch. A pusher-plate type pump is connected between the LA and the aorta. In the second “parallel” configuration, the atrial septum is removed totally and a pericardial baffle relocates both tricuspid and mitral valves in the new PA. A valved conduit is placed between the LV apex and the main PA so that the LV receives venous blood from the new RA and eject into the pulmonary circulation. A pusher-plate type pump is connected between the new LA and the aorta. The second concept of Single Pump Artificial Heart is that both failed right and left natural ventricles are removed and the atrial septum is also removed totally. Both right and left atrium are anastomosed to create common atrium to maintain low pressure pulmonary circulation, while single artificial pump which is connected between the PA and the aorta carries the systemic circulation. In this method, pulmonary circulation is totally reversed. Preliminary studies indicate that the approach is feasible, and that some number of biventricular failure cases can be treated in this manner using only single artificial heart.
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N. NEGISHI, Y. TOMITA, Y. NIKAWA, M. KIKUCHI
1987 Volume 16 Issue 3 Pages
1303-1306
Published: June 15, 1987
Released on J-STAGE: October 07, 2011
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To elucidate the action of microwave(MW) for drug delivery system, the complex dielectric constants of polymers was measured in the region of 430 MHz. The results indicate that polyelectrolytes are easy to be heated by MW irradiation. Macromolecular prodrug(PHPG-MTX) was synthesized by condensation of biodegradable poly(hydroxypropyl)-L-glutamine(PHPG) with methotrexate(MTX) of anticancer drug. When irradiated with M W to this PHPG-MTX, the temperature rise of this conjugate was higher than that of base polymer, PHPG. These results suggests that this new system using MW offers a powerful method to carry out the release of anticancer toward target area only.
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Y. HAMADA
1987 Volume 16 Issue 3 Pages
1307-1311
Published: June 15, 1987
Released on J-STAGE: October 07, 2011
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Cement less total hip system is required non-weight bearing for longer time based on rigid fixation with new bone formation fhe development of new material and design improvement concerning the surgical technique are necessary to make it shorter. The evaluation of anchoring force between bone and prostheses is study, ed regarding new materials in experimental study using beagles which are operated on with THR made of 316L coated with Al
2O
3 and Ti-6A 1-4V coated with hydroxyapatite, TiO
3 and TiN. The fixation between sockets coated with Al
2O
3 or hydroxyapatite and bone showed mechanically more than 100Kg without proliferation of fibrous tissue around the socket histopathologically. The ideal inserting angle of the socket for osteoarthritis of the hip with acetabulum hypoplasia is studyed in computer simulation. The socket with 35 degrees to the horizontal line should be inserted with bone graft into the space between a socket and acetabulum in the case of osteoarthritis of the hip. The position of 3 spikes were slightly moved laterlly and 2 spikes shortened 2 mm in length to avoid the penetration of spikes into the pelvis to obtain better fixation in comparison with original type.
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COMPLIANCE MATCHING AND IN VIVO PERFORMANCE
T. YAMAGUCHI, T. MATSUDA, T. ITOH, H. IWATA, K. HAYASHI, K. TAKAMIZAWA ...
1987 Volume 16 Issue 3 Pages
1312-1315
Published: June 15, 1987
Released on J-STAGE: October 07, 2011
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Novel surgical adhesive based on the chemistry of hydrophilic urethane prepolymer was developed for cardiovascular applications. The adhesives completely cure in physiological environments within several to ten minutes to form rubbery polyurethanes. In this paper, mechanical properties of cured films and adhesive-coated vessels were measured under longitudinal and transverse stresses applied, respectively. The more flexible the adhesive is, the more the compliance is like a vessel, while excessive flexibility is responsible for the early-phase cohesive failure. The designed adhesive formulated with “Compliance Matching” concept performs very well under pulsati1e stresses.
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T. KITAOKA, E. KINUGASA, T. AKIZAWA, S. KOSHIKAWA, N. NAKABAYASHI
1987 Volume 16 Issue 3 Pages
1316-1319
Published: June 15, 1987
Released on J-STAGE: October 07, 2011
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The effects for subcutaneous soft tissue of implants of braid colloidal carbon (CC) and hydroxylapatite (HA) are reported. In order to examine the biocompatibility and adhesion to soft tissue with artificial materials, we evaluated CC and HA implanted in rats by macroscopic and microscopic observations. These results were compared with Dacron material, which is used in the present peritoneal catheter cuff. These experiments showed Dacron and CC materials are evaluated to have excellent ability of adhesion, but exhibited slight inflamation reactions in a part of the soft tissues. On the other hand, adhesion of HA are evaluated to be inferior to Dacron and CC, especially in early phase of experiments. However, in long term experiments, adhesions of HA are gradually increased without significant inflamation reactions. Also in trans-cutaneous implant experiments of HA, no down growth phenomenon of skin are observed. These results of HA are proved to be superior materials in both biocompatibility and adhesion to soft tissues. In summary, HA are expected to be applied, for example, as peritoneal catheter cuff to prevent from peritonitis and tunnel infections of continuous peritoneal dialysis.
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H. OHMAE, M. OKAZAKI, T. HINO
1987 Volume 16 Issue 3 Pages
1320-1323
Published: June 15, 1987
Released on J-STAGE: October 07, 2011
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Apatite composites were made by mixing synthetic apatite powder with 2·2'-bis (4-methacryloxydiethoxyphenyl) propane. The mechanical strength and biocompatibility of the composites increased with the increasing apatite content, and then approached plateau above Ap/R=1. Collagen-coated apatite composites were implanted into hypodermic part of rat body for 1-9 wks and examined histological properties. The compatibility increased still more, and newly created cross-linking collagen fibers were observed between the two collagen-coated implants.
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K. ONISHI, T. TAKAHAMA, M. HIRAISHI, F. KANAI, Y. IDEZUKI, T. YOSHITAK ...
1987 Volume 16 Issue 3 Pages
1324-1327
Published: June 15, 1987
Released on J-STAGE: October 07, 2011
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The purpose of this experimental study is to evaluate the histocompatibility of HA for cartilage tissue in vitro (in a further strict condition without inflammation). HA plates were prepared for organ culture. Cartilaginous femura were taken from 9 day chicken embryos and were placed on the HA plates, and in BGJb F-T Mod. medium supplemented with 10% chicken embryonal extract, PTH, and Vit. D
3, incubated at 37°C in a humidified air with 5% CO
2, and organ culture was maintained from 6 days to 8 days. By light microscopic examination, ingrowth of tissue of cartilage tissue of the embryo into HA pores was observed. And with the differentiation of the embryonal cartilage, ossification was observed at the site of embryonal femura adjacent to the HA plates. This in vivo study indicates a good histocompatibility of porous HA for cartilage tissue. And this organculture system model can be applied to evaluate the histocompatibility of ceramics materials for bone or cartilage.
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[in Japanese]
1987 Volume 16 Issue 3 Pages
1328
Published: June 15, 1987
Released on J-STAGE: October 07, 2011
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