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[in Japanese]
1988 Volume 17 Issue 1 Pages
1
Published: February 15, 1988
Released on J-STAGE: October 07, 2011
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N. MAEDA, H. OKUYAMA, T. KOBAYASHI, T. AKIZAWA, S. KOSHIKAWA, R. NAKAZ ...
1988 Volume 17 Issue 1 Pages
3-9
Published: February 15, 1988
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The removal performance and mechanism of β
2M were studied with a new PAN dialyzer (ASAHI PAN 12CX2) both in vitro and in vivo. Sieving coefficients (SC) for β
2M and for albumin were found to be 0.6 and 0.002, respectively. Adsorption of β
2M was observed only in early stage of dialysis. The diffusive part of β
2M clearance was evaluated as 27.3ml/min at QB=200ml/min and estimated to be as much as two-third of total β
2M clearance even in 9 liter substituted HDF. The backfiltrating effect in β
2M clearance was calculated to be less than 10% of total clearance for HD without filtration. In vivo removal ratio of β
2M were 48.8% for hemodialysis and 55.6% for 6 liter substituted HDF and these results were in good accordance with the in vitro estimation. These results indicate that new PAN dialyzer possesses high removal capacity for β
2M, and the elimination by diffusion is a major contributing factor for the removal.
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A SUEOKA, I KAWATA, R MIMURA, H AKASU
1988 Volume 17 Issue 1 Pages
10-13
Published: February 15, 1988
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In case of high performance membrane (HPM), there are some difficulties in evaluating the characteristics by conventional method of hemodi alysi s membrane because of the peculiarity of HPM. The difference between UFR taken by water and bovine blood varies depending on each HPM. Therefore, blood should be used for the evaluation of HPM. Because of higher UFR of HPM, the filtration at the inlet of module and the backfiltration at the outlet will occure even if the UFR is adjusted to be 0. In evaluating the clearance of low molecules, filtration should be taken into consideration as well as the diffusion. We developed a new method using the mixture of concentrated SCUM solution from the patient and bovine blood for the evaluation of β
2-MG sieving in vitro. The data by this method shows a good correlation with the clinical data. This method is usable and applicable to the evaluation of HPM.
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S. SATO, K. OHASHI, T. KASHIMURA, R. YOSHIDA, K. OZAWA, K. SAKAI
1988 Volume 17 Issue 1 Pages
14-17
Published: February 15, 1988
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We studied to elucidate adsorption characteristic for beta-2-microglobulin (beta-2-mg) on several adsorbents. Beta-2-mg is much adsorbed by collagen beads, DHP-1 active carbon, XAD-7 and 8. The amount of adsorbed beta-2-mg is fully equilibrayted 5 to 10 hrs for collagen beads, XAD-7 and XAD-8, over 60 hrs for DHP-1 and over 24 hrs for microporous glass beads. XAD-7 with mild hydrophobic property was the most amount of adsorption beta-2-mg. Adsorbent with mild hydrophobic properties and pore diameter of over 40 angstrom is required for adsorption of beta-2-mg.
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Y. SAKAI, Y. TANIGUCHI, T. KOBAYASHI, T. ONO
1988 Volume 17 Issue 1 Pages
18-21
Published: February 15, 1988
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To optimize PMMA membranes for β
2-MG removal and to estimate the clinical removal of β
2-MG, in vitro 4hr perfusion studies were carried out, using pooled plasma from dialysis patients, on PMMA hollow fiber mini-modules of various ultrafiltration coefficient (UFR). Contrary to that the amount of dialyzed β
2-MG increased according to the increase of UFR, there was a maximum range of ca. 100mg/m
2 at UFR through 30 to 50ml/hr·mmHg·m
2 for that of adsorbed β
2-MG. From these results, estimated removal of β
2-MG for modules of 1.0, 1.6, 2.1m
2 were 120, 190, 250mg, respectively. From considerations on the conditions of the experiment and the preliminary data on the amount of washed-out β
2-MG from clinically used modulues, the results obtained by in vitro studies roughly simulate the clinical β
2-MG removal.
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[in Japanese]
1988 Volume 17 Issue 1 Pages
22
Published: February 15, 1988
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H. KOBAYAKAWA, T. SHINZATO, Y. FUJITA, I. TAKAI, Y. OZAWA, K. MAEDA
1988 Volume 17 Issue 1 Pages
23-26
Published: February 15, 1988
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We used a Kuraray PS filter and a Hospal AN69HF for HF and push/pull HDF in order to investigate the variation of the plasma beta-2-MG level and the reduction of shoulder joint pain. Forty long-term dialysis patients were divided into 4 groups, and the following treatments were given. First group; HF with PS filter, second group; push/pull HDF with PS filter, third group; HF with AN69HF, fourth group; push/pull HDF with AN69HF. The beta-2-MG removal rate in every group was markedly higher than that of conventional HID with a high-performance membrane. The pre-treatment plasma concentration of beta-2-MG in every group fell significantly at one week after the initiation of the new treatment series. As indicators of shoulder joint pain, we used backward extension, adduction and abduction ranges of the upper arms. The results indicated a marked alleviation of shoulder joint pain in a week after the initiation of the treatment series, and there was a significant increase in the movement ranges of shoulder joint.
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M. NAMBU, K. KUMANO, S. KUSAKARI, K. SAKURAI, T. SAKAI
1988 Volume 17 Issue 1 Pages
27-32
Published: February 15, 1988
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Kinetic analysis of β2-microglobulin (β2-MG) was made in vivo and in vitro studies among three dialyzers with different potency on complement activation. Plasma β2-MG was significantly increased at the end of dialysis using cuprophan or PMMA (β2) membrane dialyzer, but significant reduction was noticed in EVAL membrane dialysis. Complement activation dose not seem to be involved, because less activation was observed in PMMA membrane dialyzer than others. β2-MG synthesis on cultured peripheral mononuclear cells revealed that extracorporeai recirculation itself increased β2-MG synthesis with no relation to dialyzer membrane and sterilyzation method. Kinetic study showed that mean distribution volume of β2-MG was 27.6% of body weight which was larger than intravascular volume and that prodaction rate was 0.129mg/hr/Kg.
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M. MINESHIMA, T. HOSHINO, K. ERA, Y. SASAKI, T. SANAKA, T. AGISHI, K. ...
1988 Volume 17 Issue 1 Pages
33-36
Published: February 15, 1988
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Four types of modules with high performance membrane were examined during in vitro study. β
2-microglobulin (BMG) concentrations of a feed tank were constant in cellulosic membranes, regenerated cellulose (RC) and cellulose triacetate (CTA), whereas synthetic polymer membranes, polysulfone (PS) and polymethylmethacrylate (PMMA), showed membrane adsorption and/or plugging in constant-rate filtration experiments with a closed circuit. Time-averaged sieving coefficients for BMG were 0.444, 0.924 and 0.516 for RC, CTA and PS, respectively. Overall mass transfer coefficients for BMG were obtained as 3.70μm/min for RC and 17.83 for CTA by dialysis experiments.
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K. GOTOU, T. SATOU, S. MAEJIMA, E. SUGITA, T. IWAMOTO, S. NAKAGAWA
1988 Volume 17 Issue 1 Pages
37-41
Published: February 15, 1988
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With long survival of patients on hemodialysis, accumuration of non-or poorly dialyzable solutes has resulted in severe complications. On-line HDF (hard HDF) was performed to remove as large amount of B2-MG as possible. With use of High performance membrane (HPM) as hemodiafilter and bicarbonate dialysate ultrafiltrated by PMMA filter as substitution fluid, hard HDF was applied for 6 patients. In condition of QB: 200-300, QD: 500ml/min, QF: 4000-5000ml/hour, Total exchage volume: 15-20L/session and HPM: F60 (polysulfone) or H12-3000s (PAN, AN 69), following results were obtained. Total elimination of B2-MG per sessin and reduction rate of B2-MG ranged 150-300mg, 50-70%, respectively. Maintenance level of B2-MG could be lowered by 10-20mg/L (about 30%).
In conlusion, maximum removal of B2-MG up to 1g/week may be possible with HPM and on-line system.
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S. TAKESAWA, H. HIDAI, H. OGAWA, T. TAKAGI, A. SAITO, K. SAKAI
1988 Volume 17 Issue 1 Pages
42-45
Published: February 15, 1988
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The objective of the present study is to clarify beta-2-microglobulin (B2-m) behavior at intra- and interdialysis periods by kinetic modelling. Pools of B2-m are composed of intracellular, interstitial and plasma spaces. Values for generation rate of B2-m for patients on long-term hemodialysis are less than 100mg/day, which are lower than those of healthy subjects. Cell membrane clearance data indicate that B2-m is released easily from cell membrane surface.
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[in Japanese]
1988 Volume 17 Issue 1 Pages
46
Published: February 15, 1988
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A. KISHIDA, Y. IKADA
1988 Volume 17 Issue 1 Pages
47-50
Published: February 15, 1988
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Complement activation induced by regenerated cellulose membranes was successfully reduced by grafting of poly (ethylene glycol) (PEG) with terminal carboxylic acid on the surface without affecting the bulk characteristics. Binding was effected via as ester linkage between the terminal carboxyl groupes of PEG's chains and the hydroxyl groupes on the membrane surface. PEG with different molecular weights (400, 1000, 4000 and 8000) were used. The best result was obtained with the 400 and 1000 molecular weight PEG samples. The mechanism of reducing complement activation was different from the case of palmitoyl chain grafting.
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H. NAITO, T. MIYAZAKI, A. SUEOKA, [in Japanese], [in Japanese], [in Ja ...
1988 Volume 17 Issue 1 Pages
51-55
Published: February 15, 1988
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Some blood purification membranes of the same material were examined as to whether their biocompatibility was influenced or not by the difference in the membrane's inner surface structure. The membrane material used was EVAL supplied by Kuraray, Japan, and the blood purification membranes examined were the Non-porous membrane (Non-P), dialyzing membrane (D-membrane), plasma fractionation secondary membrane (4A), and plasma separation membrane (PS). The result showed that Factors V, VIII, XIII, and fibrinogen were activated stronger by the Non-P and PS than by the D-membrane and 4A.
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Y. SASAKI, S. TERAOKA, M. SUGAWARA, T. HOSHINO, K. ERA, Y. HAYASAKA, M ...
1988 Volume 17 Issue 1 Pages
56-59
Published: February 15, 1988
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It is well known that the number of peripheral leucocytes decrease during hemodialysis especially when cellulose membranes are used. This time, we observed microscopic leucocytes change during extracorporeal circulation using rabbit ear chamber technique. Leucocytes are observed rolling along the vascular wall slowly. After starting extracorporeal circulation, the leucocyte disappear in the visual field. Two or tree hours later, many leucocytes appear again at once. The change of peripheral leucocytes count correlates this phenomenon. At least, in this experience, the Craddock's theory, which explains the hemodialysis leucopenia resulting from the leucocyte's aggregation in the capillary, could not be proved.
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Y. HAYASAKA, K. OTA, K. SHOJI, Y. UCHIKOSHI, [in Japanese], K. ERA, Y. ...
1988 Volume 17 Issue 1 Pages
60-63
Published: February 15, 1988
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Adsorbavility of leukocytes from normal and uremic patients to cation exchange or anion exchange were tested. As consequently, Leukocytes from uremic patients were shown rate of high adsorbavility to cation exchange, but not normal leukocytes.
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[in Japanese]
1988 Volume 17 Issue 1 Pages
64
Published: February 15, 1988
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A. NAITO, M. OINUMA, K. SAKAI, T. WATANABE, K. IMAMURA, T. TSURUMI, Y. ...
1988 Volume 17 Issue 1 Pages
65-68
Published: February 15, 1988
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Permeability for inorganic phosphate and sodium ion using regenerated cellulose (RC) membrane and pol ymethyi methacryl ate (PMMA) membrane was studied by zeta potential measurement. Zeta potential was determined by the streaming potential method. A newly-improved method using radioisotope labeled disodium hydrogenphosphate has been employed to determined the solute permeability of RC membranes and PMMA membranes. Zeta potential of RC membrane is not contributed to over-all mass transfer coefficient and solute permeability for inorganic phosphate. That of PMMA membrane, however, affects these for it and over-all mass transfer coefficient for sodium ion.
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K. TOTSUNE
1988 Volume 17 Issue 1 Pages
69-72
Published: February 15, 1988
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In order to obtain the formula to calculate the Donnan ratio (R) from protein concentration in plasma (C
tp) and sodium concentration in dialysate (D[Na]), the experimental equilibrium dialyses were performed in vitro. The formula was represented as follows:
R=1.0-αR×C
tp/D[Na] where αR is a constant.
The values of αR varied with the measurement methods for Na and Cl. The results indicated that when the Donnan equilibrium phenomenon was discussed, Na concentrations measured by flamephotometry and Cl by potentiometric titration should be used after the correction as to the complex-binding to albumin, and also suggested that Na and Cl concentrations by Ion-Selective Electrode should be carefully dealt with.
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T. MIYAZAKI, N. TERAMACHI, Y. INAGAKI, I. AMANO
1988 Volume 17 Issue 1 Pages
73-76
Published: February 15, 1988
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Development of a wearable artificial kidney is not an easy work, since dialysate or substitution fluid used must be minimized for such a kidney. Recently, slow water removal type of wearable artificial kidney has much attention. Hence, the authors developed a wearable artificial kidney with veno-venous type access (flexible double lumen catheter with dacron cuff) and studied its advantages and drawbacks.
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M. ABE, H. URANO, M. SUZUKI, Y. HIRASAWAY
1988 Volume 17 Issue 1 Pages
77-80
Published: February 15, 1988
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We had already revealed that same kinds of polypeptides and low molecular weight proteins were significantly removed fran the uremic plasma by the absorption mechanism on same dialysis membranes in vitro. In the present study, commercially available absorbent resins XAD-7, XAD-8, IRA-45, and IRC-50 showed the venous absorption properties for β
2-MG, lysozyme, ribonuclease, myoglobin, retinol-binding protein, α
1-microglobulin, glucagon, C and N-terminal PTH respectively. XD-4 had no absorption effects. Especially, XAD-7 and XAD-8 had the strong affinity to β
2-MG. One gram of XAD-7 or XAD-8 were estimated to absorbe 0.90mg or 0.36mg of β
2-MG respectively.
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[in Japanese]
1988 Volume 17 Issue 1 Pages
81
Published: February 15, 1988
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M. YOSHIDA, Y. TABATA, H. KOBAYASHI, K. SOEDA, H. HAYASHI, [in Japanes ...
1988 Volume 17 Issue 1 Pages
82-85
Published: February 15, 1988
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The patient who is 49 years old, female, and the LDL apheresis has been performed 55 times once/two weeks since begi ni ng of this treatment till April 1987. Serum total cholesterol level was well controlled below about 250mg/dl. Evaluation of biocopatibility revealed that it seems to be no problems on this system. Clinical status and findings have been significantly improved about 1 year later since this treatment was started. Till now, we had not any kinds of side effect. We concluded that the LDL apheresis system had the effectiveness for the treatment of FH.
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-IN VITRO AND ANIMAL STUDY-
N. KANAMORI, Y. NAKASHIMA, E. KINUGASA, F. NAKAYAMA, T. SEKIGUCHI, T. ...
1988 Volume 17 Issue 1 Pages
86-89
Published: February 15, 1988
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In order to clarify the characteristics of low molecular weight heparin (LH) as an anti-coagulant for hemodialysis (HD), the pharmacological effects of LH were evaluated comparing to those of ordinary heparin (OH) in vitro and beagle dogs. The half-life of LH and OH was calculated to be 159 and 100mm, respectively. A single dose of LH provided sufficient anticoagulation for HD for over than 8 hours, while OH did for only about 290min. Under the same concentration of LH or OH, APTT, CCT and TT showed longer prolongation in OH than in LH. Thrombocytopenia was more profound in OH, and there was no difference in the change in NEFA. These results indicate that LH has several preferable characteristics to OH, and LH may be useful for high bleeding risk HD.
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A. YAMADA, N. KABEI, T. TAKASE, Y. SAKURAI, K. KIHARA, K. ISHIKAWA
1988 Volume 17 Issue 1 Pages
90-93
Published: February 15, 1988
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Protein flux which carry protein on the surface of filtrate membrane balances that of the diffusion of protein to blood, and make gel-layer after that. This gel-layer influences the filtrate efficiency. In the case of low T. P. the theory of Juf*=K log (Tpw/Tp) was proved, T. P. is as low as in the experiment, the necessary time which ultrafiltrate flux become stable takes long time. T. P, is as low as in the experiment, the stable Juf*showed the stable high value. In the test about T. M. P. stable Juf*showed to escape from pressure and there is the situation controlled from the concentrate polarized phenomenon. T. P, was as high as it was saturated by low pressure and Juf'showed lower value. Each T. P, necessarily has the range which didn't receive the control of pressure and was controled by the concentrate polarized phenomenon. Therefore that didn't adjust the T. M. P. to level up Juf*, but should elevate the shear velocity.
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T. MURASAWA, Y. HANYUDA, O. SUZUKI, Y. UEDA, F. HARA
1988 Volume 17 Issue 1 Pages
94-97
Published: February 15, 1988
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Cardiac function measured by a Swan-Ganz catheter during hemodialysis (HD) of 12 diabetic patients (ON group) was compared with that of 18 non-diabetic patients (non-DN group). Double product (DP, oxygen consumption index), left ventricular stroke work index (SWI) and systemic vascular resistance index (SVRI) were evaluated prior to and each hour after HD began. Results showed; 1) The mean DP, SWI and SVRI before HD did not differ significantly between the groups. 2) The relationship between %DP (the rate of variation expressed as a % of the pre-HD value) and %SWI (expressed identically) revealed a high positive correlation coefficient in both groups, and the regression coefficient of %SWI to %DP was lower (p<0.05) in the DN group (0.40 vs. 0.97). 3) The regression coefficient of %SVRI (expressed identically) to %SWI was positive in the N group, and different (p<0.005) from that of the non-ON group which expressed negative (+0.44 vs. -0.27). The lower increasing %SWI rate associated with %DP increase, and the decreasing tendency of %SVRI (which was expected to increase in order to compensate for the decreasing %SWI) contribute to hypotension in the diabetic patient with CRP during HD.
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M. UMEDA, K. UMIMOTO, N. IZUMI, M. KAMIZURU, S. NISHIO, M. MAEKAWA
1988 Volume 17 Issue 1 Pages
98-101
Published: February 15, 1988
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To investigate aluminum (Al) accumulation in dialysis and nondialysis patients, we measured serum aluminum concentration (s-Al) and red blood cell Al concentration (RBC-Al) using flameless atomic absorption spectrometry. In healthy volunteers, Al could not be detected in the serum or RBC, but RBC-Al was high in non-dialysis patients. In HD patients, there was a positive correlation between s-Al and dose of Al-hydroxide-gel, but no correlation between RBC-Al level and the dose. HD patients who had not been given Al-containing medication showed high level of RBC-Al. We found that Al accmulates in RBC in chronic nephritis and CAPD patients. These results suggest that RBC is one of the target cells in hyperaluminemia.
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[in Japanese]
1988 Volume 17 Issue 1 Pages
102
Published: February 15, 1988
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K. SHISHIDO, H. AMEMIYA, M. OTOMO, Y. HASHIMOTO, E. KINUGASA, T. AKIZA ...
1988 Volume 17 Issue 1 Pages
103-106
Published: February 15, 1988
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This study was performed to make clear the performance and safety of newly developed dialyzer FB-190U GA, composed of cellulose triacetate membrane, which could efficiently permeate low molecular weight protein including 82-MG. Thirteen regular hemodialysis (HD) patients were treated with FB-190U GA for 5 hours with 200ml/min of blood flow. UFR and sieving coefficient (SC) of β
2-MG at the start of HD were 30.3ml/mmHg·hr and 0.52, respectively. Significant decrease in UFR, but not in SC was noted at the end of HD. The clearance and reduction rate of small molecular weight substances were even or more than those of conventional dialyzers. The clearance and reduction rate of β
2-MG reached to 58.3ml/min and 63%, respectively, which were the most excellent values among those obtained by various blood purification methods up to now. Only slight changes in peripheral leucocytes, platelets and activated complements were observed during HD. The side effects induced by endotoxin contamination were not noted during treatment and the loss of albumin was minimum. The maintenance level of serum β
2-MG fell down rapidly by about 30% of prevalue within two weeks. These results indicate that this dialyzer may become very useful therapeutic tool for the correction of β
2-MG accumulation.
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T. NAGANO, M. NAKAGIMA, H. SUGIZAKI
1988 Volume 17 Issue 1 Pages
107-111
Published: February 15, 1988
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The effect of plasma from the arterial side blood (pre-dialysis, 15-minutes after the start of dialysis and post-dialysis) on PHA-or Con A-induced proliferation respones of healthy controls was investigated. The plasma prostaglandin E
2 (PGE
2) concentrations of healthy controls and dialysis patients were determined, predialysis plasma were demonstrated to be strong inhibitory to PHA- and Con Ainduced blastogenic responses of healthy lymphocyte cells, pre-dialysis plasma did not depress the reactivity of lymphocytes from dialysis patients to mitogens. The lowest levels of PGE
2 were seen pre-dialysis plasma. The results suggested that the factor inducing suppression on mitogen-stimulated responses was exhibited in pre-dialysis plasma and disappeared during 15 minutes after the start of dialysis. The response of lymphocytes to cell-mediated immunity in healthy indivisuals and hemodialysis patients was different in the qualitative capacity. The concentrations of. PGE
2 seemed no correlation to lymphoblastogenesis stimulated with mitogens.
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J. MINAKUCHI, S. KAWASHIMA, A. SAITO
1988 Volume 17 Issue 1 Pages
112-114
Published: February 15, 1988
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In order to discuss the difference of total amount of β
2 MG to be produced due to the characteristic of membrane materials, the change of β
2MG value after the dialysis using 4 types of dialyzers (cuprophan, cellulose acetate, EVAL. PMMA-B2) was examined. 28 patient of end-stage renal failure maintained on regular hemodialysis therapy were picked up for the object of this study. Both β
2 MG and TP in blood were measured prior to and after the dialysis. Avoiding the influence of homoconcentration, the β
2 MG/TP ratio was taken up as a standard, and periodical change of the ratio above was examined in each group. Consequently, no significant change was observed in each group at any stage of measurement, therefore it could be concluded that no prominent difference was found concerning the production of β
2 MG during hemodialysis and the selection of membrane materials.
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S. TSUDA, S. TAKESAWA, K. SAKAI
1988 Volume 17 Issue 1 Pages
115-118
Published: February 15, 1988
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The objective of the present study elucidates changes in pure water permeability after plasma contact and adsorption capacity of serum albumin on dialysis membranes. Both reduction percentage (RP) of pure water permeability and adsorbed amount of bovine serum albumin (BSA) were determined for nine dialysis membranes including high flux membrane. The amount of BSA adsorbed on high flux membrane (BK-1.0) is three order of magnitude higher than that on the other membranes. Pore plugging causes a lowering of pure water permeability of treated membranes. Values for BSA adsorption capacity of PMMA, EVAL, CA and RC membranes decrease in that order.
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Y. INAGAKI, T. MIYAZAKI, I. AMANO
1988 Volume 17 Issue 1 Pages
119-122
Published: February 15, 1988
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Peritoneal dialysis (PD) is also found to be effective for the therapy of electrolyte and acid base disorders besides renal failure. Physiological saline solution was used as a main composition of a PD fluid in nine patients with metabolic alkalosis. PH and base excess of these patients were improved to the normal level. The fluid of lower Na concentration (Na=70mEq/L) was used for one patient with hypernatremia and the one of higher Na concentration (Na=190mEq/L) for two patients with hyponatremia. Serum Na in these three patients were corrected to the normal range. The fluid mixed with distilled water, 10%NaCl and 7%NaHCO
3 (HCO
3-=34-68mEq/L) was effective for the treatment of lactic acidosis caused by shock in two patients.
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[in Japanese]
1988 Volume 17 Issue 1 Pages
123
Published: February 15, 1988
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BIOCOMPATIBILITY AND CLINICAL PERFORMANCE
T. SHONO, O. INAGAKI, H. NAGASAKA, Y. FUJITA, S. INOUE, H. MORI, T. HI ...
1988 Volume 17 Issue 1 Pages
124-127
Published: February 15, 1988
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The three protein permeable membranes, regenerated cellulose (RC), cellulose acetate (CA) and polyacrylonitrile (PAN) were tested for biocompatibility and clinical performance. Seven patients on maintenance hemodialysis took part in this study. In the drop of white blood cells during the hemodialysis, PAN showed the smallest change in the three membranes. No significant difference was seen in pletelets, PaO
2 and granulocyte elastase during the hemodialysis between the membranes. In C
3a generation, PAN dispalyed the smallest change in the three membranes. No difference was seen in the mean clearances of small molecules. In the removal of β
2-microglobulin during the hemodiafiltration, PAN was the most effective membrane in this study. The results indicate differences in biocompatibility and clinical performance between the different protein-permeable membranes.
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T. NAGAI, T. KOBAYASHI, H. OKUYAMA, K. TAKAHASHI, T. AKIZAWA, T. KITAO ...
1988 Volume 17 Issue 1 Pages
128-131
Published: February 15, 1988
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The performance and blood compatibility of a newly developed dialyzer, BLX-I2GW (BLX), composed of porous modified cellulose membrane, were evaluated clinically. A porous modified cellulose membrane possessed decreased activating capacity for complement system, and could permeate the substances of low molecular weight protein fractions. 18 stable hemodialysis (HD) patients were dialyzed with BLX maximumly for 3 months. UFR of BLX decreased from 12.8 at the start to 9.8ml/mmHg.hr at the end of HD significantly, however the sieving coefficient of β
2M remained to be arround 0.3 throuout HD. The reduction rate of β
2M by each dialysis was 18±10.4%, and about 15% of decrease in maintenance β
2M level was noted after the 3 months of treatment. Elimination of albumin to dialysate or ultrafiltrate was scarcely observed. Transient reduction of WBC and platelet disappeared during HD, and the increases inactivated complements were lesser than those with cuprophane dialyzer. BLX showed the high clearance for small molecular substances as well. These results indicate that BLX, preserving the benefits of original and modified cellulose membranes, has effective eliminating capacity for low molecular weight proteins. Thus BLX can be applicable widely, alternatively to conventional cellulose membrane dialyzer.
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Y. FUJITA, T. SHINZATO, I. TAKAI, H. KOBAYAKAWA, Y. OZAWA, K. MAEDA
1988 Volume 17 Issue 1 Pages
132-135
Published: February 15, 1988
Released on J-STAGE: October 07, 2011
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L-carnitine was given to long-term dialysis patients with continuous hypotension, and its efficacy was investigated. Two groups were used, one consisting of 14 long-term dialysis patients who were administered L-carnitine 1, 200mg/day for 12 weeks, the other 14 serving as the control. Four weeks after beginning the L-carnitine treatment, the plasma L-carnitine concentration in the drug group was significantly higher than in the controls. There was no significant difference, however, in either weight or pulse rate throughout the course of treatment between the two groups. Neither was there any significant difference in plasma levels of triglycerides or fatty acids between them, but at 8 weeks following the initiation of L-carnitine treatment, the ketone bodies in the treated group were significantly higher than in the control group. From these results it was considered that the L-carnitine administration served to improve the energy metabolism and proved effective in the elevation of blood pressure in dialysis patients presenting with hypotension.
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I. TAKAI, H. OGAWA, A. SAITO, H. KATAOKA, T. KUNITOMO
1988 Volume 17 Issue 1 Pages
136-139
Published: February 15, 1988
Released on J-STAGE: October 07, 2011
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In long-term dialysis patients, Al accumulation poses a problem, and deferoxamine (DFO) administration is proposed to be an effective therapy. However, DFO has numerous side effects. Therefore, an optimal dose should be administered in hemodialysis patients. In the present investigation, we administered 0.5g of DFO per week to one group and 0.5g twice a week to the other group, attempting to remove the Al during HD using BK-1, OH (PMMA membrane). In the first group the DFO level one week after administration was 186±37.8μg/L, and 151.7± 73.1μg/L at 8 weeks, reflecting minimum accumulation. In the second group, the level rose to 400-500μg/L after 8 weeks of treatment, revealing a definite accumulation. The Al concentration tended to decline with DFO treatment in either group, but no significant difference was noted between two groups. From the foregoing, given the side effects as well as the efficacy, a weekly DFO dose of 0.5g was considered to be suitable for long-term treatment.
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-controle of volume reservoir by gaseous pressure-
N. TERAMACHI, Y. INAGAKI, T. MIYAZAKI, I. AMANO
1988 Volume 17 Issue 1 Pages
140-143
Published: February 15, 1988
Released on J-STAGE: October 07, 2011
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Single needle dialysis (SND) is inferior to double needle dialysis (DND) in its efficiency because it is always accompanied by ineffective flow recirculation. We previously reported that volume reservoir (VR) positioned in venous (V) circuit can increase the efficiency of SND. A special device was developed to return blood patients immedietly as passible by gasseous pressure when a ‘V’ circuit pressure is reached to its upper limit. This device consists of four parts: gas container, volume reservoir, programmable controller with solenoid valves and connecting tube. It previously took longer time to return blood to the body because the balloon of VR is deflated by restitution. But, it allowed shorter time to deflate the balloon in our new device. As a result, time in ‘A’ phase become longer, and the efficiency of SND is increased. There was no rupture of balloon within five or more hours in endulance test in mongrel dogs.
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K. GOTOU, T. IWAMOTO, T. SATOU, S. MAEJIMA, E. SUGITA, S. NAKAGAWA
1988 Volume 17 Issue 1 Pages
144-147
Published: February 15, 1988
Released on J-STAGE: October 07, 2011
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Completely acetate free biofiltration (Biofiltration with buffer free dialysate) was tried as followings to remove deleterious effects of acetate (acetate intolerance, bioincompatibility)
Compositions of dialysate: Na 125, K 2.0, Ca 3.5, Mg 1.0, Cl 140mEq/L, Glu 100mg/dl; Substitution fluid: Na 250, HCO
3-250mEq/L; Substitution volume: 3L/session=1000ml/hour; QD:500ml/min, QB:300ml/min; Treatment time:3hours; Hemodiafilter:H12-3000S.
Laboratory dates and clinical tolerance were compared to those of bicarbonate HD and biofiltration.
No problems in removal of solutes and fluid overload and correction of acid-base balance appeared in acetate free biofiltration despite 3h treatment. All patients were well tolerated.
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[in Japanese]
1988 Volume 17 Issue 1 Pages
148
Published: February 15, 1988
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M. TANIGUCHI, [in Japanese], Y. ABE, K. UCHITA, T. ABE, Y. SANO, M. UE ...
1988 Volume 17 Issue 1 Pages
149-152
Published: February 15, 1988
Released on J-STAGE: October 07, 2011
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New dialysate delivery machines equipped with computer was developed to allow safe operation and compact sized design based on our long experience in prior batch type designs.
Continuous diluent water heating mechanism under evacuation is used as hardware in the compact design. Dialysate preparation is performed through doubled concentration monitorings to assure safe and failsafe operation, CPU is used in control section to operate various safety monitors including self check mechanism never found in prior machines, Furthermore. color CRT is used to monitor operation, display changes of dialysate conductivity and temperature with time, and operate by interactive information system for troubleshooting.
According to our experience on the new machines. pH. HCO
3-. Ca
2+and Na
+ concentrations as measures of bicarbonate dialysate stability were stable and similar to those found in prio rmachines.
The foregoing means that the new machines is safe and clinically effective.
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K. TSUJI, S. MIZUMACHI, A. NAKAMURA
1988 Volume 17 Issue 1 Pages
153-156
Published: February 15, 1988
Released on J-STAGE: October 07, 2011
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Two types of polysulfone capillary plasma-separator, which were filled with (wet type) and without (dry type) reverse osmosis water, were irradiated with gamma-ray of 1.5, 2.5, 5.0, and 10 Mrad, and various chemical and physical characteristics were examined. In the water extracts (extracting condition:121 C, 60min) of the capiilaries, UV absorption and potassium permanganate reducing substances increased up to 2.5 Mrad then decreased at 5.0 Mrad, and increased again at 10 Mrad. The amount of permanganate reducing substances and UV absorption in the wet type were significantly larger than those in the dry type at every radiation strength. Tensile strength and elongation percentage of capillaries decreased with increasing radiation strength, while the magnitude of decrease in the wet type was significantly larger than that in the dry type. No changes on NMR and IR spectra of polysulf one membrane due to irradiation were observed.
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I. AMANO, T. MIYAZAKI, U. INAGAKI
1988 Volume 17 Issue 1 Pages
157-160
Published: February 15, 1988
Released on J-STAGE: October 07, 2011
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We have developped a new replacable peritoneal catheter. In the treatment of catheter, it was easy for us to insert a new catheter into abdanial cavity. We had clinical datas and X ray findings during 2 years about 10 patients with a new catheter, 28 patients with straight typed catheter and 20 patients with curled type catheter. 39 percent in straight typed, 10 percent in curled typed, and 0 percent in a new catheter, were significantly out of adequte position in abdminal cavity. It was evidenced that no defect was not found in X ray photograph of a new catheter using urographin.
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Shinichi HOSOKAWA
1988 Volume 17 Issue 1 Pages
161-164
Published: February 15, 1988
Released on J-STAGE: October 07, 2011
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Silicon intoxication causes nephropathy, neuropathy, liver diseases and other diseases in chronic hemodialysis patients, however silicon (Si) is an essential trace elements for human growth. Changes of serum silicon levels in sixty chronic hemodialysis patients by dialysis were studied. Kinetics of Si transport during hemodialysis were examined in 60 patients who were received three times a week, a 5-hour dialysis using hollow fiber dialyzer with cuprophan and cellulose acetate membrane. Si levels of city water were 64.5±22.6μg/dl and final dialysate Si levels were 6.6±3.1μg/dl. Ultrafiltrate Si is free diffusible Si in serum during hemodialysis. Ultrafiltrable Si levels (6.5±1.8μg/dl) approximately equal to dialysate Si levels (6.5±2.4μg/dl). Therefore, diffusion of Si was little from dialysate to blood or blood to dialysate as free diffusible Si levels were approximately same as utrafiltrate Si levels in 60 patients. Eighty to two hundred and forty μg Si were liberated from silicon tube during a 5-hour hemodialysis. However, liberation of Si from dialyzer membrane was not found when dialyzers were washed out with about 2, 000ml normal saline before dialysis. Serum Si levels significantly (p<0.01) increased from 67.1±25.4μg/dl before HD to 77.4±22.8μg/dl after dialysis. Total protein values significantly (p<0.01) increased 6.2±0.6g/dl to 6.8±0.6g/dl. These results indicate that serum Si levels increased due to hemoconcentration and liberation of silicon tube dusing dialysis.
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K. SATO, T. CHIKU, T. TAKEDA, T. HORIO, N. TAKAI
1988 Volume 17 Issue 1 Pages
165-168
Published: February 15, 1988
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Regarding the peritonitis: a serious reverse disease of CAPD therapy, HPLC was applied to find any distinction of peritonitis effluent. The infected effluent group showed one increased peak (Peak B) and one decreased peak (Peak C) against normal effluent group. Isolation of Peak B resulted in two types of component and either type belonged to each patient. And the Peak C was identified to be one of furan derivatives: furoyiglycine. This systematic HPLC analysis of CAPD effluent with unknown and nonspecific substances would be expected to be an useful diagnostic tool for a disease sympton.
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[in Japanese]
1988 Volume 17 Issue 1 Pages
169
Published: February 15, 1988
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A. FUNATSU, E. HASHIMURA, F. KUMAGAI, T. TSUBURAYA, T. KOMAI, T. KON, ...
1988 Volume 17 Issue 1 Pages
170-174
Published: February 15, 1988
Released on J-STAGE: October 07, 2011
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Viable hepatocytes were isolated from adult dog liver by
in situ collagenase perfusion, and then cultured on the collagen coated glass plates (w;10cm, 1;20cm) at confluent cell density. Long-stroke type artificial liver module was constructed by piling up 200 glass plates with hepatocytes, containing 6 billion primary cultured cells in total, i. e. almost equivalent to 1/3 of intact dog liver. All hepatocytes in the module have been quite viable during 2 weeks in perfusion culture, and maintained various liver functions at high level. Moreover, those functions have been maintained for at least 2 weeks in dog plasm as well as in culture medium supplemented with hormones. This hybrid type artificial liver could exert various liver functions like
in vivo liver.
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F. KUMAGAI, Y. TSUBRAYA, Y. NAKAJIMA, T. HASE, A. KAKITA, J. UCHINO, A ...
1988 Volume 17 Issue 1 Pages
175-178
Published: February 15, 1988
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A new hybrid artificial liver using primary cultured beagle hepatocytes attached to glass plates was deviced. Cultured cells attached to the plates were placed in a transparent acrylic module. Total number of cells were approximately 6×109 (70-80g). The functions of the module were evaluated on unhepatic dogs. Mean survival time of treated group (53.3hrs) was extremely prolonged than that of nontreated control (21.5hrs). APTT activity, serum albumin and NH
3 levels revealed satisfactory condition in the treated group. This new hybrid artificial liver may pilot for the complete artificial liver.
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-BASIC STUDY FOR ARTIFICIAL LIVER-
T. SHINJI, N. KOIDE, A. OGAWA, T. TANABE, K. ASANO, Y. ARAKI, T. TSUJI
1988 Volume 17 Issue 1 Pages
179-182
Published: February 15, 1988
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Intralobular liver biomatrix was fractionated into tree components (collagens, glycoproteins, proteoglycans). Rat hepatocytes were cultured on each component as substrate in serum free medium, and the effect of each substrate on albumin secreton, cell growth was examined. Cultured hepatocytes became monolayer on collagen or glycoprotein dish. While, hepatocytes on proteoglycan dish formed floating spheroidal aggregates (Spheroid). Albumin secretion of Spheroid was better than Monolayer culture during 2 weeks of culture. On the contrary, cell growth of Spheroid was lower than Monolayer. Spheroidal culture might be another choice culture system for making an artificial liver
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