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[in Japanese]
1991 Volume 20 Issue 5 Pages
1377
Published: October 15, 1991
Released on J-STAGE: October 07, 2011
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S.borovetz HARVEY, L.kormos ROBERT, M.pristas JOHN, P.griffith BARTLEY
1991 Volume 20 Issue 5 Pages
1379-1381
Published: October 15, 1991
Released on J-STAGE: October 07, 2011
JOURNAL
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[in Japanese]
1991 Volume 20 Issue 5 Pages
1382-1385
Published: October 15, 1991
Released on J-STAGE: October 07, 2011
JOURNAL
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M SHIBATA
1991 Volume 20 Issue 5 Pages
1386-1389
Published: October 15, 1991
Released on J-STAGE: October 07, 2011
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T TANI
1991 Volume 20 Issue 5 Pages
1390-1394
Published: October 15, 1991
Released on J-STAGE: October 07, 2011
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M WAKASHIN, Y MORI
1991 Volume 20 Issue 5 Pages
1395-1402
Published: October 15, 1991
Released on J-STAGE: October 07, 2011
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K NAKAHARA
1991 Volume 20 Issue 5 Pages
1403-1410
Published: October 15, 1991
Released on J-STAGE: October 07, 2011
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T KANAMORI, K SAKAI
1991 Volume 20 Issue 5 Pages
1411-1420
Published: October 15, 1991
Released on J-STAGE: October 07, 2011
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H SHIMAOKA, K ATAGI, T SHIGEMOTO, O KAWASAKI, M SATANI, K NISHIMURA
1991 Volume 20 Issue 5 Pages
1421-1424
Published: October 15, 1991
Released on J-STAGE: October 07, 2011
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Continuous hemofiltration (CHF) is accepted as an alternative method to conventional hemodialysis for treating acute renal failure in critically ill patients with unstable hemodynamics. However, solute removal of CHF depends on convection alone, higher ultrafiltration volume up to 20l or more is required to attain adequate control of uremia for severe catabolic patients. For there patients, we attempted to apply 6hr continuous venovenous hemodialysis (CVVHD) combined with CHF. A dialysis flow rate of 26.4 ml/min made it possible to increase the creatinine clearence to 19.1ml/min. Daily Cr increase was also significantly supressed. These results indicate that CVVHD with CHF possesses superior capacity for solute removal to CHF alone.
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Newly-developed percutaneous cannula and portable cardiopulmonary bypass equipment
N KOGA, H OHTEKI, H SUDA, S OHTSUBO, T BABA, T NISHIMURA, H SASAKI, T ...
1991 Volume 20 Issue 5 Pages
1425-1433
Published: October 15, 1991
Released on J-STAGE: October 07, 2011
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We have newly-developed percutaneous cannula for use in combination with portable cardiopulmonary bypass support to enable quick and easy application during percutaneous transluminal coronary angioplasty (PTCA) and for patients with severe coronary heart disease. A venous cannula (22-16 Fr in diameter, 48 cm in length) was inserted from the femoral vein into the right atrium. The upper length of the tip of the cannula had 25 radial side holes (each 3 mm in diameter). We obtained an adequate blood flow of 3.2-3.5 l/min using an 18 Fr cannula in our clinical cases. An arterial cannula (18-14 Fr in diameter, 11 cm in length) with similar end radial holes was also used. We performed PTCA using cardiopulmonary bypass support for 11 patients, involving 5 patients with unstable angina (UA) and 6 patients with acute myocardial infarction (AMI). We obtained successful dilatation for the obstructive lesions in all 11 patients. The results for the 5 patients with UA were beneficial and 4 of them were discharged from hospital. However, none survived of the 6 patients with AMI all of whom had received urgent PTCA due to shock or cardiac arrest. However, in the cases of AMI, we obtained some improvements in the clinical symptoms during the cardiopulmonary bypass (CBP) procedeure and succeeded to wean three cases from CPB. Percutaneous cardiopulmonary bypass is effective support for PTCA in severe cases and we recommend this method for those at high risk or with severe cardio-respiratory failure.
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T YAMBE, S NITTA, Y KATAHIRA, T SONOBE, S NAGANUMA, H AKIHO, Y KAKINUM ...
1991 Volume 20 Issue 5 Pages
1434-1439
Published: October 15, 1991
Released on J-STAGE: October 07, 2011
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In order to determine the effect of total artificial heart on autonomic nervous system, renal sympathetic nerve activity (RSNA) were analysed by the use of power spectrum and coherence function. Two pneumatically actuated sac type ventricular assist devices were implanted as biventricular bypass (BVB) in animal experiments. After the BVB pumping, natural heart was electrically fibrillated to constitute a BVB type of TAH model. After the left frank was opened bipolar electrode was attached to the left renal sympathetic nerve via retroperitoneal approach to detect the RSNA. Values of the squared coherence between the arterial pressure waveform and RSNA were measured at the same frequency level of cardiac rhythm and VAD pumping rhythm. With the TAH pumping, coherence spectra at the cardiac rhythm frequency was decreased, and the coherence at the pumping rhythm frequency was increased. These results indicate that arterial pulse wave which was made by TAR contributed to the postganglionic sympathetic activity.
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Y MIYATA, H SAKAI, A MASUMOTO, E UCHIDA, M SATOH, F YAMAMOTO, M TOKUMA ...
1991 Volume 20 Issue 5 Pages
1440-1446
Published: October 15, 1991
Released on J-STAGE: October 07, 2011
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Four patients with different kinds of icteric hepato-biliary diseases (primary biliary cirrhosis, obstructive jaundice, fulminant hepatitis, acute aggravation of lupoid hepatitis) were treated with therapeutic plasma perfusion through an ion-exchange resin column (BR column). The relief of jaundice and itching, and increase of bile output through the biliary drainage were noted. One case with fulminant hepatitis survived her episode. Adsorption rates of plasma bilirubin to a BR column were 40-55% and 116-598 mg of bilirubin was removed from plasma during 2-5 liters of plasma perfusion through a BR column (BR-PP). Adsorption rates of glycocholic acid were higher than 91-99% and 19-100 mg of glycocholic acid was removed during a BR-PP. The adsoption rates of folic acid were about 90% but B
12 was not adsorbed. The adsorption rates of T
3 were about 80% and those of T
4 were about 40%. The blood cortisol and insulin were also adsorped. But there were no clinical symptoms for deficiency of these hormones and vita-mins during a BR-PP. In conclusion, BR-PP is a useful method in the treatment patients with intra-and extrahepatic cholestasis without any side effects. However, therapeutic effect of BR-PP for patients with fulminant hepatic failure requires further investigation.
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M SUENAGA, T AKIBA, T SIBAMOTO, N SAKAMOTO, K TOMITA, F MARUMO
1991 Volume 20 Issue 5 Pages
1447-1451
Published: October 15, 1991
Released on J-STAGE: December 02, 2011
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Although plasmaexchange was reported to be partly effective for systemic neurological disease, its clinical usefulness was limited because of consuming a large amount of fresh frozen plasma and losing important plasma substances. To solve above prob-lems, immunoabsorption plasmapheresis, which does not require frozen plasma and reduced unnecessary removal of plasma substances, was tried. After applying immunoabsorption plasmapheresis to five myasthenia gravis and four Guillain-Barré syndrome patients, all patients were improved in the clinical symptomes within 2 weeks and amount of steroid and immunosuppressive agents could be reduced. Although, these therapy removed specific substances of the disease, there are no consistent pattern between symptomes and blood concentration of this substances. These results indicate that immunoabsorption plasmapheresis is clinicaly effective in neurological disease therapy and this method should be applied for severe myasthenia gravis patients and Guillain-Barré syndrome patients in acute phase after careful considerations of patients conditions.
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Comparison with glutaraldehyde-treated porcine valve
O SAWATANI
1991 Volume 20 Issue 5 Pages
1452-1459
Published: October 15, 1991
Released on J-STAGE: October 07, 2011
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The epoxy group of the epoxy compounds has an oxygen arm which can work as a flexible joint in a cross-linking bridge, and can block not only amino group but also carboxy group of collagen peptide. The purpose of this study is to evaluate the anticalcification efficacy of the epoxy compounds as a cross-linking agent for xenograft bioprostheses. Porcine aortic leaflets were treated with 2% epoxy compounds (glycerol polyglycidyl ether; EX-314) and implanted in subctuaneous layer of 4-week rats. Measurement of calcium content showed that epoxy-treated implants received a minimal calcification: mean 0.64 μg/mg dry weight leaflet tissue (range 0.5-0.8; N=7) at 1 month; mean 0.94 μg/mg (range 0.3-1.3; N=9) at 2 months; and mean 1.2μg/mg (range 0.5-2.1; N=10) at 3 moths. Natural leaflets contained calcium of mean 0.43μg/mg. By contrast, 0.625% glutaraldehyde-preserved implants were severely calcified: mean 102μg/mg (range 41-130; N=14) at 1 month; mean 139μg/mg (reange 73-205; N=20) at 2 months; and mean 170μg/mg (range 90-214; N=20) at 3 months. It is concluded that the epoxy compounds provide the more pronounced anticalcification effects than does the glutaraldehyde under the pressure and volume loadfree subcutaneous circumstances.
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T SHIMIZU, H AKUTSU, H SUESADA, K OSADA, H YAMAGUCHI, S ISHIMARU, K FU ...
1991 Volume 20 Issue 5 Pages
1460-1464
Published: October 15, 1991
Released on J-STAGE: October 07, 2011
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Salvage of plasma in the waste blood from the surgical field after centrifugation and washing with a Haemonetics Cell Saver was investigated in 5 cases of surgically treated thoracic aneurysm. Haptoglobin administration and double filtration were performed in order to save available components and to remove toxic substances of plasma in the waste. Free-hemoglobin in the waste combined with haptoglobin given before filtration. After that larger molecular substances, such as haptoglobin-hemoglobin complex or microfibrin, were removed with a plasma-filter, and large amounts of saline were removed with an ultrafilter. This method had the advantage that 66% of albumin, 62% of immunoglobulin G and 55% of Immunoglobulin A in the waste could be saved, but its disadvantage was that a large amount of haptoglobin administration was required to remove free-hemoglobin in the waste, and protamin administration was required because of the large amount of heparin in the collected plasma.
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S NOMOTO, Y OKAMOTO, T BAN, Y ISHIHARA, F YOSHIMOTO, T TSUCHIYA
1991 Volume 20 Issue 5 Pages
1465-1469
Published: October 15, 1991
Released on J-STAGE: December 02, 2011
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A new hemoconcentrator (LH-420 P) was employed to control plasma volume in 30 patients during cardiopulmonary bypass operation. LH-420 P was made of polyethersulfone membrane, and had a smaller priming volume than the current model (Hemocon®). At 350-400 torr and a flow rate of 250-300 ml/min, the ultrafiltration rate was 82.4±27.3 ml/min, which was 1.8 times higher than Hemocon®. The permeable properties of the blood components were equal to those of the previous device, and blood cells and plasma proteins were concentrated with ease. Thus, LH-420 P was useful for plasma water removal by ultrafiltration in association with cardiopulmonary bypass.
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[in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
1991 Volume 20 Issue 5 Pages
1472-1476
Published: October 15, 1991
Released on J-STAGE: October 07, 2011
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