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[in Japanese]
1988 Volume 17 Issue 3 Pages
1182
Published: June 15, 1988
Released on J-STAGE: October 07, 2011
JOURNAL
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Y HARADA, N ISHIGAMI, T YAMAGUCHI, K YOSHIMURA, T SUGIURA, M KIMURA, S ...
1988 Volume 17 Issue 3 Pages
1183-1186
Published: June 15, 1988
Released on J-STAGE: October 07, 2011
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Two types of rate responsive pacemaker available in a fever were fabricated and tested in animal experiments. One type was a temperature-sensitive pacemaker (TSP) which detected right atrial blood temperature. And, another one was a respiratory rate-sensitive pacemaker (RSP) which counted the rate with a respiratory pick-up put around the chest wall. After the administration of pyrogenic drug, 2-4-Dinitrophenol, oxygen consumption promptly elevated, and the blood temperature slowly rose, and the respiratory rate initially also increased. TSP continued the elevation of pacing rate by the metabolic accelaration, and kept the cardiac output increasing, but, there was a considerable time lag between the oxygen consumption increasing and the pacing rate elevation. RSP promptly increased the packing rate with the metabolic elevation, but, it did not continued the rate increasing, and sometimes decreased the rate and the cardiac output in spite of the oxygen consumption increasing.
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S OSAKA, M IKESHITA, H MORIOKA, S YAMAUCHI, T SUZUKI, N SAEGUSA, M GOM ...
1988 Volume 17 Issue 3 Pages
1187-1191
Published: June 15, 1988
Released on J-STAGE: October 07, 2011
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We implanted a new rate-responsive pacemaker, KELVIN 500, in five patients with complete A-V block. KELVIN 500 senses changes in blood temperature in the right ventricle. Treadmill test was perforned in all patients one month after pacemaker implantation. We measured changes in right ventricular blood temperature during the treadmill test. There was excellent correspodence in pacing rate and changes in blood temperature. All patients showed a temperature dip immediately after the start of test and their pacing rate increased quickly. One patient had a hot bath test (42°C) in order to know the influence of external temperature. The blood temperature increased by 1.43°C for eight minutes and the pacing rate elevated from the lower rate to the upper.The clinical results of KELVIN 500 and its rate-responsive function proved to be very satisfactory.
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H. AIDA, T. SHIMIZU, S. SAKAMOTO, H. SHIRAKAWA, Y. KANETO, T. TOYODA, ...
1988 Volume 17 Issue 3 Pages
1192-1195
Published: June 15, 1988
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Three pacemaker (CPI Delta 925) patients of Sick Sinus Syndrome had the thermal rehabilitation. The device for rehabilitation was Microthermy ME 100, 50 made by OG Giken. The main ultra high frequency bands consisted of 2450 MHz. After rehabilitation no pacemaker output was detected in all three cases. No interrogation worked between the programmer and the pacemaker. After programming stat I mode VVI pacing began and DID pacing could be programmed. Inhibition of output is one of the most dangerous problems in EMI. This Microthermy should not be used for pacemaker patients. Both medical associates and patients should know the effect of EMI on pacemaker.
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S. TANAKA, F. SAITOH, S. SAKAKIBARA, J. NINOMIYA, Y. MATSUYAMA, S. OSA ...
1988 Volume 17 Issue 3 Pages
1196-1199
Published: June 15, 1988
Released on J-STAGE: October 07, 2011
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We measured respiratory metabolic function during exercise, in order to determine the application of each pacemaker according to its sensing system. As a control, we divided healthy subjects into three groups, males in their 20's, 40's and 60's. Respiratory response in patients in the VVI pacing mode averaged less than half that of the youngest control group and significantly less than the other two healthy groups. The rise to peak heartrate in exercise was fastest in the youngest control group and slowest in the oldest group. Therefore, the Kelvin-500 and Activitrax, which offer the fastest response to activity are the best choices for younger patients, while the slower BIO rate and Quintech-TX are for the older ones.
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K. KATSUMOTO, T. NIIBORI, T. TAKAMATSU
1988 Volume 17 Issue 3 Pages
1200-1204
Published: June 15, 1988
Released on J-STAGE: October 07, 2011
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We have developed a new type of glassy carbon electrode whose smooth surface with scattered craters reduces its polarization voltage. It has both exellent antithrombogenesity and slight tissue reaction. The energy threshold curve was the lowest when compared to the Siemens(411S, 412S) and the Solin (S-100) electrodes. We have prepared two kinds of surface areas, 6.5mm and 10mm
2. The 10mm
2 Dead Sea electrodes had a greater sensing capacity as compared to 6.5mm
2 and the other electrodes. It was very interestieg to find out no significant differences in stimulation threshold between 6.5mm
2 and 10mm
2 Dead Sea electrodes.
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M. KIMURA, Y. HARADA, T. SUGIURA, K. YOSHIMURA
1988 Volume 17 Issue 3 Pages
1205-1208
Published: June 15, 1988
Released on J-STAGE: October 07, 2011
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A diaphragm pacemaker which can be controlled by both heart rate and body temperature was developed. It was applied to 19 mongrel dogs. The pacing rate was controlled (1) by the heart rate, (2) by the body temperature and (3) by both heart rate and body temperature. The metabolism was elevated by the administration of the 2, 4-dinitrophenol. Analyses of the blood gases indicated that this pacemaker maintained sufficient pulmonary ventilation for supporting the highly elevated metabolism. It was confirmed that controlling by both the heart rate and the body temperature was the best method for diaphragm pacing.
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[in Japanese]
1988 Volume 17 Issue 3 Pages
1209
Published: June 15, 1988
Released on J-STAGE: October 07, 2011
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H. KOHNO, K. MATSUI, M. SAKAMOTO
1988 Volume 17 Issue 3 Pages
1210-1213
Published: June 15, 1988
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In 18 patients, atrial pacing and sensing were evaluated for 12.1±8.7 months. At implantation, the atrial stimulation threshold (T) was 0.87±0.38ms×mA, and the intracardiac P wave amplitude (P) was 2.26±0.75mV. During 2 weeks after implantation, T increased and P decreased significantly (p<0.05 and p<0.01). At long-term follow-up, the increased T significantly decreased (p<0.01) by the level at implantation, whereas the decreased P did not show a significant improvement. Based on these results, careful observation especially for atrial sensing is recommended after physiological pacemaker implantation.
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M. MURASE, T. ABE, M. TANAKA, E. TAKEUCHI, T. WATANABE, T. MASEKI, T. ...
1988 Volume 17 Issue 3 Pages
1214-1217
Published: June 15, 1988
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Rate responsive pacing was performed in 62 patients. Pacing modes were AAI in 18 cases and VVI in all the rest. By rate responsive VVI, clinical symptoms were improved in about 70% of patients. In young patients with good cardiac function, rate responsive VVI can be adopted. In older patients with impaired cardiac function, DDD pacing is preferable. Hemodynamic state can deteriorate by rate responsive VVI in patients with retrograde conduction. Sick sinus syndrome with no atrio-ventricular conduction disturbance is the best candidate for rate responsive AAI.
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T. ISHIKAWA, M. KASHIWAGI, T. USUI, H. OCHIAI, Y. OHYAMA
1988 Volume 17 Issue 3 Pages
1218-1221
Published: June 15, 1988
Released on J-STAGE: October 07, 2011
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We studied the occurence of atrial fibrillation, atrial flutter and atrial tachycardia (atrial arrhythmias) after VVI-pacemaker (PM) and DDD-PM implantation in sick sinus syndrome. Retrograde P was present in 12 of 20 patients with VVI-PM and 9 Of them (75%) had atrial arrhythmias. In Rubenstein III (R-III), 6 Of 8 patients had atrial arrhythmias after VVI-PM implantation. 5 of 23 patients had atrial arrhythmias after DDD-PM implantation, and all of them were R-III. 4 of 9 of R-III did not have atrial arrhythmias after DDD-PM implantation. In 6 patients whose generators were changed to DDD-PM from VVI-PM, left atrial diameter reduced significantly. In R-III, we can not expect VVI-PM to protect from atrial arrhythmias, but we can expect DDD-PM.
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M. KAJI, N. SAEGUSA, Y. MATSUYAMA, T. ASANO, S. SAKAKIBARA, M. IKESITA ...
1988 Volume 17 Issue 3 Pages
1222-1223
Published: June 15, 1988
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Using a device that automatically measures O
2 SDR. Results shawed O
2 SDR of DVI to be greater than that of VVI (p<0.05). SDR, DVI, VVI
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Y. HATTORI, S. SUGIMURA, K. OZAWA, T. IRIYAMA, K. NEGI, H. NAKAMURA, M ...
1988 Volume 17 Issue 3 Pages
1224-1226
Published: June 15, 1988
Released on J-STAGE: October 07, 2011
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Patients who required permanent pacemaker implantation following open heart surgery were studied. There were 11 such patients among our cardiac surgery patients during the period from April 1975 to August 1987. Seven of the eleven patients were valvular heart disease patients, mostly of the mitral valve, and two were older ASD patients. Six patients required PM within one month of the operation and a causal relationship could not be denied between surgery and the need for PM implantation, the rest of the cases required PM beyond four months of the operation. Although many patients were on anticoagulation therapy and had had tricuspid annuloplasty, the pervenous PM implantation could be safely performed in all patients. Especially in valve replacement patients (except in trisuspid valve replacement) early PM implantation avoids prolonged period of external pacing and will be safer from the standpoint of infection, and in many cases earlier PM implantation will be beneficial for smoother restoration of functional status of the patients.
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[in Japanese]
1988 Volume 17 Issue 3 Pages
1227
Published: June 15, 1988
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K. HOSHINO, K. TANISHITA
1988 Volume 17 Issue 3 Pages
1228-1231
Published: June 15, 1988
Released on J-STAGE: October 07, 2011
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Based on the evaluation of oxygen transfer performance of oxygenation in terms of nondimensional valiables, the conditions achieving the performance of physiological artificial lung (high performance oxygenator) is discassed. The non-dimensional length at the rated condition, in which the oxygen saturation at the outlet becomes 95%, was determined in the diagram exhibiting the relation between the fractional saturation and non-dimensinal length. Simultaneously the oxygen transfer performance expressed by oxygen Sherwood number has been evaluated in relation to the variation of non-dimensional length. Finally the design parameter such as internal radius and length of tubing, priming volume and residence time are determined based on the rated condition.
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comparison with HF-4000 Mera Silox, Capiox II.
Y. ISHII, K. OHMRI, Y. SHINOHARA, H. NATORI, O. NISHIMURA, M. HORIKOSH ...
1988 Volume 17 Issue 3 Pages
1232-1235
Published: June 15, 1988
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We have developed a new extracapillary blood flow type oxygenator. It consisted of a Single polypropylene hollow fiber bundle. It was compact, and prime volume was approximately 280ml, and was
easy for use. And, it was low
transmembrane blood phase pressure gradient. We compared PHO to HF-4000, Sit ox, Capiox II on hematologic con cequence and efficicancy of gas
transfer in
clinical use and compared on
transmembrane blood phase pressure gradient in previous data. Then electron microscopic examination was performed in
four types of hollow fiber membrane oxygenator.
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H. MIZUNO, J. ISOBE, S. MATSUNOBE, T. NAKAMURA, K. TIHARA, [in Japanes ...
1988 Volume 17 Issue 3 Pages
1236-1239
Published: June 15, 1988
Released on J-STAGE: October 07, 2011
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We have used a method of hemodialysis to clear CO
2 because it was CO
2 excretion could be achieved effectvely by dialyzing out bicarbonate ion. In our system, dialysate was recirculated, carbonic anhydrase was added to transform bicarbonate ion to carbon dioxide, and an FC-43 emulsion was used for delivering oxygen. The evaluation of this system in faulty gas exchange in vivo is described in the present paper.
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T. TSUJI, T. TOGAWA, K. TANISHITA, Y. FUKUI, K. MUNEOKA, M. OKAMOTO, A ...
1988 Volume 17 Issue 3 Pages
1240-1243
Published: June 15, 1988
Released on J-STAGE: October 07, 2011
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When the pressure of venous blood (Pb) in EVA hollow fibers was kept lower than the pressure (Pf) of O2 saturated dialysate out of the fibers (Pf-Pb=35mmHg), the venous blood at the flow rate of 50ml/min was oxygenated at O2 transter of 2.45ml/min. Dialysate infused into the blood circuit was ultrafiltrated with a dialyser from blood and recirculated into the reservoir. This ECMO system worked not only as an oxygenator but also as an dialyser.
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J. ISOBE, H. MIZUNO, S. MATUNOBE, T. TERADA, S. KAWARAZAKI, K. CHIHARA ...
1988 Volume 17 Issue 3 Pages
1244-1247
Published: June 15, 1988
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Mongrel dogs were connected to a respirator after muscular relaxation induced by pancronium. Extracorporeal circulation (ECC) was initiated under hypomechanical ventilation, i. e. 50% O
2, 10ml/kg tidal volume, 5 ventilations/min. Flow rate of ECC was 10ml/kg/min. Dialysis was carried out by recycle method using a commercially available dialyzer and 1.5 L of an acetate dialysate containing carbonic anhydrase. Bicarbonate that was transferred from the blood to the dialysate was allowed to react with H
+ for elimination as CO
2 with the air blowed into the dialysate. The volume of CO
2 removed from the blood was about 16ml/dl during ECC. ECCO
2R using this system could remove CO
2 efficiently.
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Tadaomi MIYAMOTO, Koho MIYAMOTO, Hikaru NAKANISHI, Masaaki INOUYE
1988 Volume 17 Issue 3 Pages
1248-1254
Published: June 15, 1988
Released on J-STAGE: October 07, 2011
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A new pulsatile roller pump based on the concept of intermittent flow produced by one roller instead of two in conjunction with a compliant pump head tube and a pinch valve on the outlet side of the pump head has been developed. The pressure and flow characteristics mimick those of the natural heart, having even the equivalent to the isometric phase and the fast initial ejection of the natural heart. The pump delivers one stroke per each revolution. The stroke volume is a function of the tube size, but for a given size there is an optimal rpm rate at which the stroke volume is largest. Smaller tubes (6 and 9mmID) for use in infants or children have a high optimal rate (100-130/min), while tubes larger than 12.5mmID have an optimal rate of 60-90/min and are suited for use in adults. In vitro mean flows of 10l/min with peak flow velocities reaching 25-27l/min are consistently obtained. The in-vitro hemolysis is similar to that induced by conventional roller pump or the pneumatically driven valved ventricular assist device (Nihon Zeon LVAD) but significantly less (p<0.01) than that induced by the arterial line pulsator (Kontron PBP). Preliminary clinical application in 60 patients has proven its efficacy as a pulsatile pump (pulse pressure of 45 to 65mmHg being consistently obtained), as well as its simplicity and low operational cost.
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[in Japanese]
1988 Volume 17 Issue 3 Pages
1255
Published: June 15, 1988
Released on J-STAGE: October 07, 2011
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T. SEO, T. ITO, K. IIO, H. TAKAGI
1988 Volume 17 Issue 3 Pages
1256-1259
Published: June 15, 1988
Released on J-STAGE: October 07, 2011
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To develope a safer and simpler ECMO for pediaic respiratory failure, the new ECMO circuit with an automatically controlled blood pump (Takagi's pump) was studied in eleven small dogs. The ECMO circuit without a reservoir did not require, negative pressure during expansion of a blood chamber, and consisted of a small sized pump and a membrane oxygenator (Merasilox). Its whole priming volume was 120ml. The results were (1) 80 to 90% of the cardiac output was bypassed, and PaO
2 increased and PaCo
2 decreased significantly during ECMO. (2) the bypass flow was controlled automatically in response to changes in venous return and arterial pressre. (3) blood pressure remained stable for a long period at 50% bypass flow, but fell gradually to circulatory failure at higher bypass flow.
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Y. FUKUI, A. FUNAKUBO, I. SAKUMA, N. TAKAI, T. KAWAMURA
1988 Volume 17 Issue 3 Pages
1260-1263
Published: June 15, 1988
Released on J-STAGE: October 07, 2011
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We developed a prototype of a compact ECMO system for the neonates with respiratory failure. The system has the following features. 1) A single lumen catheter is used for both blood withdrawal and infusion. 2) Low priming volume 3) Compact size. This system is less invasive and more easy to operate than an usually used standard system. Animal experiments were conducted on seven mongrel dogs. The animals were anesthetized and mechanically ventilated to induce respiratory failure. The oxygenation and CO2 removal by the developed system were satisfactory, where PaO2 increased from 79+8 to 111+7mmHg, PaCo2 decreased from 64+11 to 47+5mmHg during the first 5 to 10 minutes. The ECMO system offers favorable gas transfer and easier operation with less invasion for application to respiratory aid for neonates.
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T. SEO, T. ITO, K. IIO, H. TAKAGI
1988 Volume 17 Issue 3 Pages
1264-1267
Published: June 15, 1988
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A small sized blood pump was developed for safer and simpler venoarterial ECMO. The pump driven in a double chambered alternate pumping system (Takagi's pump) consisted of a pair of blood chambers of 10ml, housings, and modified duct ball valves. The pump performance was measured in a mock circulatory system. The results were as follows: (1) the sufficient byass flow was obtained by moderate driving air pressure without a membrane oxygenator, but decreased to 1/2 to 1/3 in the presence of an oxygenator. (2) the bypass flow increased automatically when pumping rate and driving air pressure increased in response to elevated venous pressure, but remained almost same in spite of changes in arterial pressure.
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-A study of fetal A-V ECMO-
N UNNO, K NAGAYA, N SHINOZUKA, Y KUWABARA, T OKAI, S KOUZUMA, T MAEDA, ...
1988 Volume 17 Issue 3 Pages
1268-1274
Published: June 15, 1988
Released on J-STAGE: October 07, 2011
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A study was undertaken to investigate the applicability of the arte riovenous ECMO via umbilical vessels for “Artificial Uterus”, which would be designed to incubate the fetus in the environment simulating in-utero conditions. 42 goat fetuses were incubated in the artificial amniotic fluid container. The oxygenation was totally sustained by A—V ECMO using the silicone hollow fiber membrane oxygenator. In the improved system, the average of incubation period was 146 hours, and the longest was 236 hours. Active fetal movements were demonstrated during incubation. The results suggest that fetal A—V ECMO will be useful for the study of fetal physiology and the management of ill fetuses in near future.
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H. ADACHI, K. UEDA, I. KOYAMA, S. KYO, S. TAKAMOTO, U. YOKOTE, R. OMOT ...
1988 Volume 17 Issue 3 Pages
1275-1278
Published: June 15, 1988
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Donor core cooling method for transplantation by cardiopulmonary bypass (CPB) was examined using a experimental calf model and clinical cases. In the experimental model, the donor calf was cooled down below 15°C by CPB. After cooling, the heartlung block was transplanted immediately to the recipient (Group I), or transplanted after 4 hour cold preservation (Group II). Cardiopulmonary function after transplantation was examined. There are no significant differences between these two groups. Organ function was well preserved in clinical cases of circulatory arrest.
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[in Japanese]
1988 Volume 17 Issue 3 Pages
1279
Published: June 15, 1988
Released on J-STAGE: October 07, 2011
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H. FURUKAWA, Y. NAKAGAWA, M. MASUDA, T. YAMAGUCHI, H. KASEGAWA, Y. OON ...
1988 Volume 17 Issue 3 Pages
1280-1283
Published: June 15, 1988
Released on J-STAGE: October 07, 2011
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Peripheral circulatory insufficiency was studied pre-post extracorporeal circulation in 68 patients, divided into 4 groups, classified by their cardiac disease. Patients with mitral valve disease, especially complicated with tricuspid valve, were needed to be treated carefully concerning with hypotension and overhydration. Otherwise, patients with aortic valve disease or IHD were done so concerning with hypertension perioperatively.
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J. NINOMIYA, T. MOROTA, S. HARAGUCHI, M. KAJI, N. SAEGUSA, H. MORIOKA, ...
1988 Volume 17 Issue 3 Pages
1284-1287
Published: June 15, 1988
Released on J-STAGE: October 07, 2011
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Clinical study was undertaken to investigate effect on cardiac function and metabolism by pulsatile flow and counterpulsation with PBP 20 system during and after cardiopulmonary bypass in 16 infants under 6 years of age.
The results were as follows. Pulsatile bypass group was less required electrical defibrillation after aortic declamp and more than moderate dose of catecholamine after cardiopulmonary bypass. CK-MB was significantly lower in pulsatile bypass group compared to control group on operative day and 1st postoperative day. Endocardial viability ratio was significantly decreased in control group after cardiopulmonary bypass. But there was no difference of myocadial oxygen intake between two groups. Therefore, pulsatile bypass with this method could improve cardiac function during and after open heart surgery in infants.
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-ITS EXPERIMENTAL STUDY-
H. KANEYASU, H. KAIZUKA, Y. SONE, T. ITAOKA, M. YOKOYAMA, S. NITTA
1988 Volume 17 Issue 3 Pages
1288-1292
Published: June 15, 1988
Released on J-STAGE: October 07, 2011
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As the clinical use of ventricular assist device (VAD) increases, its safety and efficiency have been almost established. Otherwise, this device has not been used in heart-lung machine.
This experimental study reports its usefulness for cardiopulmonary bypass and pressure limited automatic control system.
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H. TAKANO, H. MATSUDA, Y. SASAKO, S. NAKATA, M. OHTANI, A. KAWAGUCHI, ...
1988 Volume 17 Issue 3 Pages
1293-1296
Published: June 15, 1988
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A new automated and computerized monitoring system for cardiopulmonary bypass (CPB) is developed. The system consists of intelligent terminal units in each operating room and a versatile host computer. The host computer is also connected to the main computer system of the hospital and the subcomputer system of central laboratory to access various information of the patients. During CPB, nineteen biological and CPB information such as blood pressure, temperature, perfusion index and myocardial temperature are accumulated every 30 seconds from the monitoring devices and the CPB machine, displayed on the color monitor in a trend format and stored in the host computer. All the works related to CPB can be also performed easily with this system. The main purpose of the system is to monitor and record various biological information during CPB automatically so as to improve the recordkeeping and to allow perfusionist more time for importantt observations and urgent maneuvers. Furthermore it is expected that these stored data might clarify the pathophysiology of CPB.
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H. OKAMOTO, [in Japanese], [in Japanese], [in Japanese], [in Japanese] ...
1988 Volume 17 Issue 3 Pages
1297-1300
Published: June 15, 1988
Released on J-STAGE: October 07, 2011
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We have developed cavoatrial venous cannula, being each size of 24, 26, and 28F, 60cm in length, and having 12 side holes in its distal portion, that permits adequate drainage from both the right atrium and the inferior vena cava. We have used these cannulae for femoro-femoral bypass in 26 cases of cardiovascular surgery. These cavoatrial cannulae could provide sufficient venous drainage enough to stabilize hemodynamic change during femorofem oral bypass.
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[in Japanese]
1988 Volume 17 Issue 3 Pages
1301
Published: June 15, 1988
Released on J-STAGE: October 07, 2011
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Passibility of renal damage exists in the use of extra-corporeal ultrafiltration method (ECUM)
S. TANABE, N. OHSIMA, H. NAKAHARA, T. YAMADA
1988 Volume 17 Issue 3 Pages
1302-1305
Published: June 15, 1988
Released on J-STAGE: October 07, 2011
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The effect of ECUM on the kidney function was investigated in 57 consecutive cardiac patients with normal renal function preoperatively. Patients were divided into group A (n=44): conventional CPB without ECUM and group B (n=13):CPB with ECUM by HEMOCON (Cordis Dow). Renal function tests, free Hb and platelets count were examined at pre-CPB, immediately after CPB, 3, 6 hours postoperatively and 1 postoperative day. The renal functions tested were as follows; urine output, C, Cosm, Ccr and curea, FENa, s-Cr and BUN, s-Cr after CPB in group B was significantly lower than those in group A. No significant differences were observed in other indices. It is concluded that the use of intra-operative ECUM has no deleterious effect on the kidney function.
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Y. MATSUI, K. GOH, J. OKUDE, T. GOHDA, M. SAKUMA, K. YASUDA, K. SAKAI, ...
1988 Volume 17 Issue 3 Pages
1306-1309
Published: June 15, 1988
Released on J-STAGE: October 07, 2011
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Changes of renal function during cardiopulmonary bypass (CPB) were estimated by BUN, S-Cr, S-BMG, u-BMG, u-NAG, and u/s Osm. on 36 cases of open-heart surgery. BUN were beyond normal range after 2nd post-operative day. u-BMG, MAGI, u/s Osm were beyond/below normal range during CPB. u-BMG were still beyond normal range after 7th post-operative day. Renal damage on CPB was mainly tubular. Tubular organic damage seemed to occur, and functional damage follow it. Although tubular damage did not necessarily cause renal failure after CPB, recovery seemed to depend on cardiac function after CPB rather than factors of CPB.
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H. MORO, K. TOGASHI, Y. YAMAZAKI, S. EGUCHI, Y. SATO
1988 Volume 17 Issue 3 Pages
1310-1313
Published: June 15, 1988
Released on J-STAGE: October 07, 2011
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In thjs paper, we studied effect of pulsatile cardiopulmonary bypass on renal hemodynainics in cacnparison with no pulsatle bypass. Pulsatile flow induced by IABP and nonpulsatile delivered by a roller pimp. Renal hewodynamics study included renal blood flow (RBF), renal vascular resistance (RVR), perfusion pressure and urine volume. We studied effect by assist rate of IABP, too. RBF was determined by the local thermodilutian method. There were no significant difference in the values of RBF and RVR before bypass. But significant difference in those was found between groups, during and after bypass. RBF of the pulsatile group had significantly higher than that of non pul satile group, and RVR of the one had significantly lower than the other. RBF and RVR were affected by assist rate of IABP. Increased assist rate of IABP produced increase of RBF and decrease RVR Therefore, we concluded that pulsatile cardiopulmonary bypass induced by IABP is useful from the point of minimizing damage from renal ischemia during bypass, and benefical on the renal performance during and after bypass.
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K. OHNISHI, Y. NONAMI, K. MATSUSAKI, M. YAMASAKI, T. TAMIYA
1988 Volume 17 Issue 3 Pages
1314-1317
Published: June 15, 1988
Released on J-STAGE: October 07, 2011
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Activation of renin-angiotensin-aldosterone (R-A-A) system in brain, lung, kidney, portal system organs and liver were investigated in adult mongrel dogs. Plasma renin activity, Angiotensin I, Angiotensin II, Aldosterone, Angiotensin-converting enzyme of the blood were compared between pulsatile and non-pulsatile groups. The sample sources of the blood were artery, cervical vein, pulmonary vein, renal vein, portal vein, hepatic vein. Results thus far obtained were as follows; 1) R-A-A system was presumably activated in lung, kidney, and brain during extracorporeal circulation, 2) Pulsatile perfusion suppressed the abnormal activation of R-A-A system which occurred in non-pulsatile perfusion.
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[in Japanese]
1988 Volume 17 Issue 3 Pages
1318
Published: June 15, 1988
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M. UEDA, K. FUSE, H. MAKUUCHI, T. KONISHI, M. KUKITA
1988 Volume 17 Issue 3 Pages
1319-1322
Published: June 15, 1988
Released on J-STAGE: October 07, 2011
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We investigated the number and size of the particles (diameter:>2μm) in the extracorporeal circuit by means of particle counter. We also evaluated the efficacy of pre-bypass filters in the extracorporeal circuit. In vitro tests, the removal efficiency of PP3802 and H-600 were 99.3% and 63.8% respectively after rinsing for 5 minutes. In thee clinical cases, mean number of the particle in the cardiopulmonary products after 5 minutes rinsing was 4287±836 pcs/ml. After using PP3802, it dropped to 52±11 pcs/ml. It is describle to use the PP3802 pre-bypass filter for rinsing all cardiopulmonary products before operation.
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K. MORITA, S. HORIKOSHI, T. KOZUKUE, Y. SUGITA, T. MASHIKO, J. FURUKAW ...
1988 Volume 17 Issue 3 Pages
1323-1327
Published: June 15, 1988
Released on J-STAGE: October 07, 2011
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In order to evaluate the effects of Neutrophil Depletion (N. D.) utilizing the leukocyte removal filter (Sepacell R-500), 9 dogs underwent 90min of coronary occlusion and 60min reflow. Regional function (% Segmental Shortening: %SS) during reflow was compared between two groups: G-I (control) and G-II (N. D). The recovery of %SS at the end of protocol in G-I and G-II were -5.6±42% and 48.5±17.7% (P<0.05), respectively. Furthermore the incidence of new Q wave after reperfusion was smaller in G-II compared to that in G-I. So we concluded N. D. reperfusion reduced the myocardial damage during reperfusion.
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K. AKEMOTO, T. UEYAMA, K. KOTOH
1988 Volume 17 Issue 3 Pages
1328-1331
Published: June 15, 1988
Released on J-STAGE: October 07, 2011
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The detrimental alterations occurring in the erythrocyte during cardiopulmonary bypass (CPB) were studied from the viewpoint of erythrocyte deformability. And the relation between the incidence of postoperative complications and the values of erythrocyte deformability after CPB was comparatively examined. 27 cases which were underwent ardiovascular surgery with CPB during May, 1985 to October, 1986 were examined. Erythrocyte deformability was determined by modifying Reid's microfilter method, and red cell filtration rate (ERR) was calculated. Before CPB, ERR was 78.5±12.6ul/sec. During CPB, if CPB was done over than 60minutes, the values dropped significantly from that of before CPB. And postoperative complication of the liver, kidney and heart was observed more frequently in the cases which those values of after CPB dropped more than 20% from the values of before CPB. In contrast, in the cases which CPB was done over than 120minutes if ERR was not disturbed so much, postoperative complications occurred very rare. Therefore, the monitoring of ERR is a useful mean for the judging of microcirculatory disturbance in tissues and for the expecting the occurrence of postoperative complications.
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T. SASAKI, S. HORIKOSHI, S. SUZUKI, M. NAKANO, H. FURUKAWA, K. MORITA, ...
1988 Volume 17 Issue 3 Pages
1332-1335
Published: June 15, 1988
Released on J-STAGE: October 07, 2011
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We intended to remove the free hemoglobin (Hb) directly and selective from the blood after cardiopulmonary bypass using double filtration plasma pheresis (DFPP) method. The first to separate plasma from blood and add haptoglobin (Hp) to make Hb-Hp complex. And the second-of smaller pore size-to separate the plasma into fractions according to molecular weight. AC-1730 (I), AC-1740 (II) and AC-1270 (III) were used as second filter. These results were as follows; 1) Removal rate of free-Hb from blood were 61.5% (I), 60.8% (II) and 39.3% (III). 2) Removal rate of Total Plotein were 44.4% (I), 28.3% (II) and 16.8% (III).
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[in Japanese]
1988 Volume 17 Issue 3 Pages
1336
Published: June 15, 1988
Released on J-STAGE: October 07, 2011
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K. TANAKA, M. OKABE, T. MIZUTANI, I. YADA, H. YUASA, M. KUSAGAWA
1988 Volume 17 Issue 3 Pages
1337-1340
Published: June 15, 1988
Released on J-STAGE: October 07, 2011
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This study was performed to investigate the activity of fibrinolytic system and its inhibitors in open heart surgery. Twenty patients undergoing cardiac surgery with cardiopulmonary bypass (CPB) were included in this study. ATIII was decreased and FPA was increased during CPB, suggesting that coagulation pathway is activated during CPB despite the use of heparin. On the other hand, FDP and FPBβ15-42 were increased during CPB. These data and fibrin plate tests indicats that during CPB the extrinsic fibrinolytic system was predominantly activated following the transient activation of the intrinsic fibrinolytic pathway. Alpha 2-PI and plasmin complex (α
2PI.Pm complex) was increased gradually during CPB, At the same time these fibrinolytic activities were decreased gradually, indicating that generated plasmin is rapidly inactivated by inhibitors such as α
2-PI in the circulating blood.
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J UTOH, H GOTO, Y MIYAUCHI
1988 Volume 17 Issue 3 Pages
1341-1344
Published: June 15, 1988
Released on J-STAGE: October 07, 2011
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Periaperative alteration of palymarphanuclear leukocyte (PMN) functions was investigated with focusing on the superoxide and leukatriene producing capacity in twelve patients with open heart surgery and thirteen patients with other major surgery. Superaxide production of PMN was significantly depressed in both groups pastaperatively. LTB4 production of PMN significantly increased postoperatively, in contrast, LTC4 production decreased. However, there was no statistical difference between the open heart surgery and other major surgery groups. Accordingly, it can be concluded that cardiopulmonary bypass had less effect on the pastaperative PMN functions.
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T. SHIMONO, H. TANABE, K. MAKINO, Y. KANAMORI, M. OKABE, T. MIZUTANI, ...
1988 Volume 17 Issue 3 Pages
1345-1348
Published: June 15, 1988
Released on J-STAGE: October 07, 2011
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Before and after total cardiopulmonary bypass (CPB) in dogs, reticuloendothelial system (RES) phagocytic function was studied by its ability to clear the circulating blood of an administered load of lipid emulsion. And at the end of the CPB, the liver was examined to ascertain the ultrastructural changes of the hepatic kupffer cells by electron microscopy. Futher, a suspension of iron chondroitin sulfate was injected intravenously into the dogs after the CPB, following which the liver was examined histologically to ascertain the extent and distribution of iron phagocytosis by the kupffer cells. The results of these studies have shown that there is a significant depression of the phagocytic function of the kupffer cells following CPB and this impairment is due to the fact that the mandatory RES phagocytosis during the bypass brings about a state of partial RES saturation.
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A. YAMAGUCHI, N. KITAMURA, H. IIDA, M. OTAKI, H. TAMURA
1988 Volume 17 Issue 3 Pages
1349-1352
Published: June 15, 1988
Released on J-STAGE: October 07, 2011
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Acute phase reactants (APR) were measured in 14 patients undergoing cardiopulmonary bypass. The levels of alpha 1 anti-trypsin(α
1-AT) and sialic acid (SA) began to increase from 1st day after operation, and reached a peak within 3rd day after operation. Both levels were continuing highly until 14th day after operation. Immunosuppressive acidic protein (IAP) level showed a rapid increase just after operation and maintained the high level postoperatively. Alpha2-macroglobulin (α
2-M) showed a change within normal range. C-reactive protein (CRP) showed a rapid increase as same as IAP, but it decreased rapidly from 7th day after operation. The measurements of APR can be a marker of the inflammatory stage and as a postoperative management.
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[in Japanese]
1988 Volume 17 Issue 3 Pages
1353
Published: June 15, 1988
Released on J-STAGE: October 07, 2011
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E. TATSUMI, T. MATSUDA, H. IWATA, Y. TAENAKA, H. NODA, H. KINOSHITA, H ...
1988 Volume 17 Issue 3 Pages
1354-1359
Published: June 15, 1988
Released on J-STAGE: October 07, 2011
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We investigated the possibility of the synthetic tetrapeptide Arg-Gly-Asp-Ser (RGDS), identified as the common cell attachment site of adhesive plasma proteins, to be used as a novel platelet-preserving agent during cardiopulmonary bypass. RGDS inhibited platelet aggregation and adhesion in both platelet rich plasma and whole blood in a dose-dependent manner. The tetrapeptide also inhibited the platelet secretion of TXA
2 and MTG. Platelet consumption during simulated cardiopulmonary bypass circulation was remarkably reduced by addition of RGDS. Electron microscopic observation revealed that this platelet-preserving effect of the tetrapeptide resulted from the inhibition of adhesion and aggregation onto the material surfaces. Intravenous injection of RGDS to mongrel dogs showed no significant side effect and fairly rapid recovery of the platelet function. These suggest that the synthetic IDS is a novel platelet-preserving agent especially used for extracorporeal circulation with high blood-material contact area such as cardiopulmonary bypass.
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Masayasu YAMASHITA, Kohichi HISATOMI, Kenichi KOSUGA, Kiroku OHISHI
1988 Volume 17 Issue 3 Pages
1360-1363
Published: June 15, 1988
Released on J-STAGE: October 07, 2011
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Its effect on neutrophil function. Extracorporeal circulation is known to stimulate the body's SDM (self defense mechanism), causing damage to the organism. Increased neutrophil function is one cause of this damage. We performed in vitro experiments with urinastatin to determine whether or not urinastatin would suppress neutrophil activity, and thus reduce neutrophil caused damage to the body. Neutrophil adhesion, phagocyte function, and oxidative burst activit were measured. Neutrophils were incubated for thirty minutes at 37°C in 20, 200, or 2, 000u/ml urinastatin, n solution. Controls without urinastatm were also prepared. The results showed no change in phagocyte function. Oxidative burst activity was not suppressed rather it increased at the urinastatin level of 2, 000u/ml. Adhesion was suppressed in a dose dependent manner. Although oxidative burst function rose at this highest urinastatin, level, adhesion, which is the first step in the mechanism of neutrophil induced damage, was inhibited. This indicates that urinastatin, may function not only as a multiple enzyme inhibitor, but may also function to inhibit neutrophil function.
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