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Volume 21 (1992)
- Issue 6 Pages 1397-
- Issue 5 Pages 1367-
- Issue 4 Pages 1287-
- Issue 3 Pages 823-
- Issue 2 Pages 345-
- Issue 1 Pages 1-
Volume 21, Issue 4
Displaying 1-16 of 16 articles from this issue
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[in Japanese]1992 Volume 21 Issue 4 Pages 1287
Published: August 15, 1992
Released on J-STAGE: October 07, 2011
JOURNAL FREE ACCESSDownload PDF (132K) -
[in Japanese]1992 Volume 21 Issue 4 Pages 1289-1294
Published: August 15, 1992
Released on J-STAGE: October 07, 2011
JOURNAL FREE ACCESSDownload PDF (807K) -
S MAKI, A HASHIMOTO, T HIRAYAMA, S AOMI, K EISHI, M HACHIDA, H KOYANAG ...1992 Volume 21 Issue 4 Pages 1295-1298
Published: August 15, 1992
Released on J-STAGE: October 07, 2011
JOURNAL FREE ACCESSA knitted dacron graft impregnated with collagen (HemashieldTM) was implanted in 31 patients. From October 1990 to September 1991, a clinical study was carried out in 28 males and 3 females with average age of 61 yr. In the 31 patients, 12 tube grafts and 19 bifurcation grafts were used. There was no death in these patients, and all grafts were patent. The mean intraoperative blood loss was 1, 100±1, 290 mls (±S. D.). Postoperative evaluation for inflammatory index and immunological responce revealed no significant changes. In conclusion, the HemashieldTM double velour MicrovelTM prosthesis is a safe and reliable vascular graft. By using HemashieldTM graft, intraoperative blood loss can be
decreasedView full abstractDownload PDF (560K) -
N AKABA, H UJIIE, T OHKI, K SKURAI, K SASAKI, A KITAMURA1992 Volume 21 Issue 4 Pages 1299-1301
Published: August 15, 1992
Released on J-STAGE: October 07, 2011
JOURNAL FREE ACCESSA 4mm diameter tube made of a woven fabric was produced using ultrafine polyester fibers. The tube was then treated with alkali peeling used to thin the synthetic fiber. After the crimp of wall was processed, the tube assumed a 3.2mm vascular prosthesis. The graft was very soft to the touch, and pliant with a wall thickness as thin as 0.08mm. The physical characteristics of the graft includes a strength factor enough to use for arterial recon-struction. The scanning electron microscope revealed that the inner surface of the graft was a microfine structure consisting of 3.0μm ultrafine fibers. Examination of a graft implantation in mongrel dogs, indicate a patency rate of two to six weeks at 60% without anticoagulant therapy after the operation. The result indicate the small caliber vascular prosthesis we developed has high anti-throm-bogenicityView full abstractDownload PDF (3558K) -
T MASAI, T SAKAKIBARA, K TAMURA, S WATANABE, Y NAKA, Y FURUTANI, K KOD ...1992 Volume 21 Issue 4 Pages 1302-1306
Published: August 15, 1992
Released on J-STAGE: October 07, 2011
JOURNAL FREE ACCESSProstaglandin E1 (PGE1) has known to improve renal and peripheral circulation in shock state. We estimated the perioperative renal function and peripheral blood flow in 30 cardiac surgical patients (pts) with or without PGE1 during cardiopulmonary bypass (CPB). 15 pts were administered 0.05-0.2μg/kg/min of PGE1 during CPB (group PG) and other 15 pts served as control (group C). Age, CPB time and aortic clamping time showed no statistical difference between two groups. In both groups no one seemed to have advanced to renal failure considering from Cr and Ccr value. But perioperative sodium excretion ratio (FENa), free water clearance (CH2O), urine β2-microglobulin (UBMG) and urine NAG showed significant increase indicating perioperative renal tubular dysfunction. In group PG, significantly lower FENa and CH2O at CPB than group C, lower UBMG at 1 postoperative day (1POD) and lower NAG at both 5 POD and 7 POD were observed. Peripheral blood flow during CPB decreased significantly compared to pre CPB in group C but not in group PG. Administration of PGE1 during CPB wad suggested to improve subclinical renal tubular dysfunction and impaired peripheral circulation caused by CPBView full abstractDownload PDF (692K) -
K IHA, K KOJA, Y KUNIYOSHI, M AKASAKI, K MIYAGI, M SHIMABUKURO, M KINA ...1992 Volume 21 Issue 4 Pages 1307-1310
Published: August 15, 1992
Released on J-STAGE: October 07, 2011
JOURNAL FREE ACCESSWe clinically evaluated the Univox-IC membrane oxygenator comparing with Cobe Membrane Lung (CML). The Univox-IC membrane oxygenator was used for open heart surgery in 60 patients and the CML was used for 25 patients. The priming volume of the Univox-IC was 220ml, smaller than the CML. In addition to small priming volume, the Univox-IC has excellent O2 transfer rate and CO2 transfer rate and good heat exchange efficacy. The Univox-IC has low pressure drop than previously reported extracapillary blood flow type hollow fiber membrane oxygenator. Increasing rate of free plasma hemoglobin in the Univox-IC was lower than the CML. Preservation rate of the platelet was good in two groupsView full abstractDownload PDF (542K) -
(Acute experiments on the ischemic heart model)T KUSAKA, T NAKAMURA, T MATSUMOTO, K HAYASHI, M ASADA, K YASUDA, T TAN ...1992 Volume 21 Issue 4 Pages 1311-1317
Published: August 15, 1992
Released on J-STAGE: October 07, 2011
JOURNAL FREE ACCESSBulk and regional mechanics of the left ventricle during pumping of a left ventricular assist device (LVAD) implanted between the left ventricular apex and descending thoracic aorta (apical bypass) were studied by in vivo acute experiments on mongrel dogs having ischemic hearts using implantable miniature sonomicremeters. Hemodynamic and mechanical effects of the apical bypass method were compared with those of the atrial bypass method in which LVAD was implanted between the left atrium and descending thoracic aorta. Hemodynamic parameters, mechanical works and endocardial viability ratio observed under pump-off condition were lowest or highest at 1 to 2h after ligating the left anterior descending coronary artery, although they showed a tendency of recovery 3h later. These results indicate that the apical bypass method is more effective than the atrial bypass method in the abilities not only of the circulatory assist and ventricular unloading but also of the recovery of cardiac function.View full abstractDownload PDF (1070K) -
from hemoadsorption and plasma exchange to plasma adsorptionK SOEDA, M ODAKA, K ISONO1992 Volume 21 Issue 4 Pages 1318-1323
Published: August 15, 1992
Released on J-STAGE: October 07, 2011
JOURNAL FREE ACCESSHemopurification were performed 928 times in 168 cases of hepatic failure patients from Sep. 1975 to Sep. 1991. This study was undertaken to investigate the variety of hemopurification in chronological order, and survival rates following hepatic diseases and hemopurifications. Hemoadsorption (HA) started from 1975, plasma exchange (PE) did from 1979 and plasma adsorption (PA) did from 1988. Times of performed PE were most in 1985 and then decreased. Survival rates following hepatic diseases were 19% in all cases, 28% in fulminant hepatitis, 40% in acute hepatic failure, 38% in multiple organ failure and 11% in post-operative hepatic failure. There was not any survival case in subacute hepatitis, acute on chronic and primary biliary cirrhosis. Survival rates following hemopurification were 13% by HA, 16% by PE and 19% by PA in all cases, and then 16% by HA, 31% by PE and 57% by PA in fulminant hepatitis. Survival rates in post-operative hepatic failure were 0% by HA, 7% by PE and 100% by PA. According to these evidences hemopurification for hepatic failure would be diversified from HA and PE to PA and hemodiafiltration from now on.View full abstractDownload PDF (845K) -
Y HARAGUCHI, M HOSHINO, M KIRITA, M SAKAI, T ISHIHARA1992 Volume 21 Issue 4 Pages 1324-1327
Published: August 15, 1992
Released on J-STAGE: October 07, 2011
JOURNAL FREE ACCESSArtificial pancreas was used as a device of nutritional support as well as blood glucose control in more than 100 patients for more than 800 cumulative days since October 1985. The usefulness of artificial pancreas was evaluated. Thirty-two patients were studied. Artificial pancreas of bedside type (STG-11A, manufactured by Nikkiso corporation) was used for more than one consecutive week for them. The daily mean blood glucose and the ratio of administered insulin per energy intake, or I/E ratio were analyzed. The former parameter was used to determine the appropriateness of blood glucose control. The latter was used to evaluate the degree of glucose intolerance. These parameters were calculated daily and devided into four groups (group I: 1 to 3 days, group II: 4 to 6 days, group III: 7 to 9 days, group IV: 10 to 12 days). The mean values of the daily mean blood glucose was 181±33mg/dl and thought to be good. This value lowered gradually as the days progressed. There were statistically significant differences between group I and III and group I and IV. The I/E ratio tended to decrease as the days progressed, and the glucose intolerance appeared to have lessened, though statistically not significant. The blood glucose control with the artificial pancreas was appropriate. Improvement in the glucose metabolism was suspected.View full abstractDownload PDF (550K) -
S KITANO, K KATAOKA, Y KOYAMA, M YOKOYAMA, T OKANO, Y SAKURAI1992 Volume 21 Issue 4 Pages 1328-1333
Published: August 15, 1992
Released on J-STAGE: October 07, 2011
JOURNAL FREE ACCESSIn the case of diabetes, a self-regulated insulin releasing system responding to variations in glucose concentration has been strongly desired. To produce such a system, we have developed a novel polymer complex system sensitive to glucose. In this system, a phenylboronic acid moiety was incorporated into poly (N-vinyl-2-pyrrolidone) (poly (NVP-co-PBA)) as a sensor molecule for glucose. The complex formation of poly (NVP-co-PBA) with poly (vinyl alcohol) (PVA) as well as its dissociation responding to glucose was estimated by viscosity change in the complex solution. The maximum point in viscosity was observed at a certain molar ratio of PVA to poly (NVP-co-PBA). The rate of dissociation of polymer complex is able to controlled by changing the molar ratio of both constituent polymers. Further, amino groups were newly introduced into poly (NVP-co-PBA), to increase water solubility as well as to facilitate complex formation with PVA under physiological conditions (pH=7.4). The release of FITC-insulin from the complex gel was increased immediately after the addition of glucose, due to the transition of gel into sol state, indicating the feasibility of this complex gel as candidate materials for glucose-responsive delivery system for insulin.View full abstractDownload PDF (839K) -
A GOMI, Y TAKEUCHI, Y OKAMURA, S TORII, H MORI, S YOKOYAMA, T OKADA, T ...1992 Volume 21 Issue 4 Pages 1334-1338
Published: August 15, 1992
Released on J-STAGE: October 07, 2011
JOURNAL FREE ACCESSWe studied to determine the frequency band for the analysis to detect a thrombosed valve more precisely and at an earlier stage. We analysed the following valve sounds by using 315Hz and 2kHz lowcut filters, and signal processor. The valve sounds were analyzed (1) in clinical cases, (2) in the air by tilting mannually, (3) in the hydromechanical apparatus, using thrombosed valve models. (1) All prosthetic valve sounds except a silicon ball valve sound have 2 or 3 peaks between 0-8kHz. Besides B-S and OS valves have peaks over 8kHz. Peaks over 3.5kHz seemed to be made by the sounds of occluder and housing of valves. The peak around 2kHz are mainly made by blood streem. (3) It is useful to diagnose parts and thickness of thrombosed valve models, by the frequency analysis between 0-10kHz. (4) Frequency of prosthetic valve sounds over 10kHz is too decreased to use for diagnosis.View full abstractDownload PDF (596K) -
S NAGANUMA, T AGISHI, A MIURA, K OTA1992 Volume 21 Issue 4 Pages 1339-1343
Published: August 15, 1992
Released on J-STAGE: October 07, 2011
JOURNAL FREE ACCESSAlthough LDL apheresis is proved to be effective on regression of arteriosclerosis in a larger vessel, the mechanism of improvement of peripheral microcirculation by LDL apheresis isn't clarified yet. The objective of study is to evaluate the hemorheological effect of LDL apheresis on atherosclerosis disease with hyperlipidemia. LDL apheresis has been done utilizing a Liposorber column. Usually, 4, 000ml of plasma processed by a membrane plasma separator is led into the adsorption system. LDL apheresis by adsorption was effective and safe in removing LDL specifically from arteriosclerotic and hyperlipidemic patients. The average reduction rate was 66.4% for LDL. Blood and plasma viscosity was shown to be abnormally high in hyperlipidemia and LDL apheresis reduced blood viscosity effectively. The positive correlation of plasma viscosity and LDL level was suggested. The deformability of red cells was improved significantly by LDL apheresis. The correlation of red blood cell deformability and LDL level was negative tendency. In this study, LDL apheresis reduced plasma viscosity and probably reflected changes in the rheologic properties of red cells. We concluded the improvement of peripheral microcirculation by LDL apheresis was contributed to the hemorheological improvement such as blood viscosity and deformability of red cells.View full abstractDownload PDF (643K) -
experimental study of hemodynamic controlS Aomi1992 Volume 21 Issue 4 Pages 1344-1348
Published: August 15, 1992
Released on J-STAGE: October 07, 2011
JOURNAL FREE ACCESSLeft heart bypass is beneficial procedure for the operation of the thoracic aneurysm, but its hemodynamic control has not been studied. We conducted an experiment of the left heart bypass in dogs, using a newly designed compact centrifugal pump, instituted from the left atrium to the left femoral artery. After the start of bypass, total descending aorta was clamped and, there-after, cardiac output, left renal flow, systolic pressure of the left carotid artery and mean pressure of the right femoral artery were measured. The pressure of the right femoral artery was well controlled by the pump flow (r=0.91). The renal blood flow was well correlated with the pressure of the left femoral artery (r=0.86) and pump flow (r=0.89). Because of renal and spinal cord protection, the pump flow should be kept more than 30 ml/min/kg. However, cardiac output and the pressure of the left carotid artery were decreased when pump flow was increased. When that increased to 100 mmHg in the right femoral artery, the pressure of the left carotid artery well correlated with that before left heart bypass had been started (r=0.76). And phentolamine mesilate (alpha-blocker) was very effective when the pressure of the left carotid artery was over 140 mmHg and was not influenced by the pump flow.
Keywords left heart bypass, thoracic aortic aneurysm, centrifugal pump, renal blood flow, hemodynamic controlView full abstractDownload PDF (2601K) -
H Miyazaki, S Murabayashi, A Mitoh, T Yuhta1992 Volume 21 Issue 4 Pages 1349-1353
Published: August 15, 1992
Released on J-STAGE: October 07, 2011
JOURNAL FREE ACCESSIt is well known that the adsorption behavior of lymphocytes on fiber materials is related to the fiber size. In our previous study, murine lymphocytes cultured on various sizes of polypropylene fibers showed different IL-2 activity. The ultra-fine fiber of 1.5μm in diameter showed the highest value. Based upon these facts, to study whether ultra-fine fiber is applicable for modulating the lymphocyte functions, Con A was immobilized on the surface of polypropylene fibers having five different diameter ranging from 1.5μm to 7.9 μm, and cultured with murine lymphocytes. Fiber size effect on lymphocytes were evaluated in terms of IL-2 production and adhesion morphology. The Con A immobilized fibers could stimulate lymphocytes as high levels as 70-80% of maximal value induced by Con A solution. Statistical differ-ences in IL-2 production were not observed among the fiber sizes, although as fibers decreased in size, the contact area of the lymphocytes with fibers became smaller. The results suggested fiber size effect on the lymphocyte functions. In addition, it could be expected that damage of lymphocytes isolated from ultra-fine fibers were less than from larger size ones. Therefore, ultra-fine fibers might be useful substrates for immobilizing immunocyte activators.
Keywords lymphocyte function, IL-2 activity, Con A immobilized ultra-fine fibers, fiber size effectView full abstractDownload PDF (3688K) -
H Shiga, H Ueno, N Kitamura, K Matsuda, K Nakanishi, S Oda, Y Ohtake, ...1992 Volume 21 Issue 4 Pages 1354-1359
Published: August 15, 1992
Released on J-STAGE: October 07, 2011
JOURNAL FREE ACCESSThe present study was undertaken to investigate the efficacy of various blood purifications in emergency and critical care medicine. During past 6 years, we applied hemodialysis (HD), continuous hemofiltration (CHF), continuous hemodiafiltration (CHDF), peritoneal dialysis (PD), plasma exchange (PE), double filtration plasmapheresis (DFPP), hemoadsorption (HA), plasma adsorption (PA) and endotoxin adsorption with polymyxin B immobilized fiber (PMX) on 160 patients in our institution resulting in the survival rate of 60%. Among these various blood purifications, CHF and CHDF could be applied safely even on patients with unstable hemodynamic condition. For anuric critically ill patients, CHF and CHDF were particularly effective to maintain water, electrolytes and acid-base balance, to remove metabolic products and to make nutritional management easier. Another possible effect of CHF and CHDF was the removal of humoral media-tors or causative substances of multiple organ failure (MOF). We applied PE, PA and CHDF on patients with hepatic failure, and DFPP on patients with autoimmune disease. Under the proper use of anticoagulant such as low molecular weight heparin or nafamostat mesilate, CHF and CHDF could be performed safely without remarkable bleeding complication. From these results, we conclude that blood purification is effective and safe modality in the emergency and critical care medicine, and that it becomes an inevitable therapeutic tool in this field.
Keywords emergency and critical care medicine, blood purification, continuous hemofiltration (CHF), continuous hemodiafiltration (CHDF)View full abstractDownload PDF (940K) -
H Kaneyasu, T Hino, T Ikeda, T Itaoka, T Onuki, M Yokoyama, S Nitta1992 Volume 21 Issue 4 Pages 1360-1363
Published: August 15, 1992
Released on J-STAGE: October 07, 2011
JOURNAL FREE ACCESSWe investigated the clinical characteristics of the Monolyth membrane oxygenator (Sorin Biomedica) and compared this oxygenator with another membrane oxygenator, D 703 Compactflo (Dideco) during CABG operation. The gas exchange efficiency, both oxygen transfer and carbon dioxide removal, was sufficient for clinical use. We introduced the PaO2/FIO2, named PaO2 index, into the assessment of oxygenation, especially for evaluating the PaO2 contnol of the membrane oxygenator. In these aspects, there was no significant difference between both artificial lungs. The influence of this membrane oxygenator on blood trauma and complements was within permitted limits. This membrane oxygenator needs only small amount of priming fluid in the whole system of the cardiopulmonary bypass (900-1, 100 ml). We concluded that it will be one of the most useful parts of CPB with the aim of carrying out the cardiac operation without blood transfusion.View full abstractDownload PDF (2146K)
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