EPPD was developed to enhance peritoneal mass transport. Four dogs were anethetized and received PD which consisted of 2-hour control PD with 1L dialysate and EPPD as follows: 1L of dialysate was instilled intraperitoneally and a bag which contained 1000ml dialysate was connected to the retained Tenckhoff catheter. The bag was pulsated by an electric massager with vibration at either 150 or 1440 cycles/min. Dialysance of urea, creatinine and inulin were measured as well as ultrafiltration rate (UFR) and lymphatic absorption. UFR increased by 142% and dialysance by 23-95%. The latter increased more prominently as the molelular size increased and the frequency of vibration increased. An increase in peritoneal blood flow may partly contribute to an increase in dialysance and a decrease in peritoneal lymphatic flow to an increase in UFR.

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Peritoneal mass transfer rates were examined for canines both in vivo and ex vivo. First, the rates were measured for urea-nitrogen and creatinine before and after the total evisceration was performed. The results, however, showed the same mass transfer rates, although the peritoneal surface area was estimated to be less than half after the surgical operation. To explain this paradox, a new mathematical model that depends both on the overall mass transfer-area coefficient and on the effective peritoneal blood flow rate was introduced and was termed the comprehensive blood flow-diffusion model. Various parts of the peritoneum were separately put into a plastic bag that contained dialysate with urea and creatinine. All the tested portions, except for the mesentery, showed fairly good mass transfer capabilities. Peritoneal blood flow effective for mass transfer per unit surface area was estimated to be between 3.2x 10^-3 and 5.0x10^-3ml/min/cm², which would give an average of 71ml/min for a human equivalent.

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We newly developed a short circuit with several advantages, named CL-BS356, for hemodialysis use for aged and/or complicated patients with ESRD. The main tube has a small inner caliber of 3×6mm the reby decreasing the extracorporeal volume to 30-50%. Since the outer diameter has the same size as the regular ones, it can be attached to regular machines currently used. The material is ethylene vinyl with poly-merization degree of 2500, which can be autoclaved. Sampling and injection ports aredesigned so as to avoid accidents, and vascular access sites are made of isoprene in order to avoid leakage. In 13 out of 18 patients, mean blood pressure during theuse of this circuit was maintained about 20mmHg higher than before with less troubles. These results show the usefulness of CL-BS356 circuit.

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Heparin has been used as the anticoagulant for continuous blood purification (CBP: continuous hemofiltration and continuous hemodialysis) despite of its possible association with hemorrhage in the treatment of patients with multiple organ failure (MOF). Inhibitors of serine protease (ISP) were successfully developed and the incidences of bleeding complication with ISP were significantlly lower than that of heparin. To establish effective indices for optimal anticoagulation during CBP, we investigated plasma levels of thrombin/antithrombin III complex (TAT), fibrinopeptide A, fibrinopeptide B_β15-24. FDP-D-dimerin 15 patients with MOF. Nafamostat mesilate, one of serine protease inhibitors, was used as the anticoagulant. In the patients who did not improve the MOF score of ours, levels of TAT before CBP were high and in addition, there was a tedency to get worsened during treatment in the patients whose MOF score were improved, levels of TAT before CBP were low. TAT can be a rigorous index for optimal anticoagulation of the patients with MOF during COP.

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Hemodynamic and respiratory parameters were measured in patients treated with either continuous hemofiltration (CHF) or continuous hemodiafiltration (CHDF) for multiple organ failure, including acute renal failure, after gas troenterological surgery. The four survivors were compared with the six nonsurvivors (Group S vs Group N). In the two groups, the left and right ventricular stroke work index (LVSWI, RVSWI) were lower, and mean pulmonary arterial wedge pressure and right atrial pressure were higher than normal values, indicating left and right heart fail-ure, before CHF/CHDF. Cardiac index (CI), LVSWI and RVSWI were lower (p<0.05, p<0.05, p<0.01), heart rate was higher (p<0.05), and total peripheral vascular and pulmonary arteriolar resistance index were higher (p<0.05, p<0.05), indicating compensatory vasoconstriction, in Group N than in Group S, during CHF/CHDF. Therefore, the blood pressure was sustained during CHF/CHDF, in Group N. In Group S, CI was higher (p<0.05), after than before CHF/CHDF. In the two groups, respiratory index was reduced after CHF/CHDF as compared with before CHF/CHDF. Therefore, hemodynamic function was improved, and CHF/CHDF was effective in Group S.

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IL-8 plays an important role in inflammation through its chemotactic and activating effects on neutrophils. To determine if IL-8 can be used as an index of biocompatibility of dialyzers, effects of hemodialysis (HD) using regenerated cellulose (RC) (TFα-1300H), PAN (PAN-13DX) or PMMA (BK-1.3P) on plasma IL-8 and peripheral blood mononuclear cell (PBMC) IL-8mRNA were studied. Plasma IL-8 levels significantly increased after HD using RC and PMMA, while they did not increase after HD using PAN. PBMC IL-8mRNA did not change after HD using PAN, but increased after HD using RC and PMMA. These results suggest that plasma. IL-8 level and PBMC IL-8 mRNA can be used as indices of biocompatibility of dialysis membranes.

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Accumulation of bradykinin (BK) has been supposed to be a pathogenetic factor of anaphylactoid reaction observed in hemodialysis (HD) patients receiving angiotensin converting enzyme inhibitor (ACEI). To elucidate the effects of ACEI and membrane material on BK production, three successive hemodialyses using AN-69 (AN), PAN-DX (DX) and polysulfone (PS) membrane dialyzer were administrated with the order of the three sequences randomized, for 6 patients taking ACEI and 6 other without taking ACEI. The plasma BK levels at the dialyzer outlet was significantly greater than at the dialyzer inlet at 5min after initiation of HD with AN, and not at 5min but at 10min after initiation of HD with DX, whereas no significant difference between inlet and outlet BK levels was observed with PS dialyzer. The changes in plasma BK level in patients taking ACEI did not differ from those without ACEI. These results indicate that membrane material is a determinating factor of BK production. Further study seems to be necessary to clarify the exact role of ACEI.

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A newly developed polysulfone hemofilter [FS-104, Toray Industries, Inc.] was clinically evaluated in 37 patients with chronic renal failure under renal replacement therapy. Totally 75 sessions of hemofiltration (HF) was performed under 210ml/min, 69ml/min and 15L (about 30% of dry weight) of blood flow rate (QB), ultrafiltration rate (QF) and substitution volume, respectively. TMP significantly increased in the course of HF and stabilized around 200mmHg after 3 hours of HF without any significant reduction of QF. Reduction rates of BUN, Cr, UA and β2M showed 42.5, 45.6, 57.3 and 73.5%, respectively. There were no significant differences in sieving coefficients for BUN, Cr, UA and β2M between 1 and 4 hours after the start of HF. About 180 mg of β2M was eliminated into ultrafiltrates, however, protein loss remained below 300mg per each treatment. Mild but significant leukopenia was observed at 15min after the start of HF (80% of pre-value, p<0.01). There was mild increase in plasma C3a at the outlet compared to the inlet blood of hemofilter without any significant changes in systemic plasma C3a concentration. From these results, it is concluded that FS-104 has not only effective removal capacity for uremic accumulates, in particular low molecular weight protein fractions, but also the excellent biocompatibility.

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Membrane charge was evaluated of thirteen dialysis membranes i.e., regenerated cellulose, cellulose di-actetate, cellulose triacetate, hemophan, polyethylene-glycol-graft-edcellulose, ethylene vinylalcohol, polymethylmetacrylate, polyacrylonitrile(Asahi, AN69), polysulfone, polyester polymer alloy, and polyamide using 6 dyes, i. e., methylene blue and crystal violet (cationic dye), orange II and acid yellow 23 (anionic dye), Congo red and direct yellow 8 (direct dye). The negatively or positively charged dialysis membranes are stained with positively or negatively charged dyes, but these dialysis membranes are stained by other mechanisms. Therefore, use of charged dyes is insufficient to evaluate membrane charge.

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To clarify ion transport, it is important to evaluate changes in membrane charge and structure after protein adsorption. Dialysis experiments at 310K were carried out in a parallel flow operation to determine the permeabilityfor hydrogenphosphate ion and urea of polyacrylonitrile membrane (PAN-DX) at varying dialysate flow rates using a test dialyzer of original design composed of 10cm long, 200 hollow fibers before and after cytochrome C and α-lactalbumin adsorption at concentrations of 0.1g/l.
Hydrogenphosphate ion permeability of the membrane increased and urea permeability decreased after cytochrome C adsorption that caused an increase in membrane charge. Hydrogenphosphate ion and urea permeabilities decreased after α-lactalbumin adsorption that caused a decrease in membrane charge, and the hydrogenphosphate ion permeability highly decreased compared with the permeability, In conclusion, ion permeability changes after protein adsorption because of altered membrane charge and structure and the protein adsorption is one of the important factor to evaluate the performance of dialysis membrane for medical applications.

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The aim of our study was to clarify the effect of high flux dialysis membranes on the adsorption and permeability of low molecular weight heparin (LMWH). The dialyzers investigated were AM-GP (ASAHI), CL-SS (TERUMO), KF-C (KAWASUMI), BK-P (TORAY), PS (KAWASUMI), FLX (NIKKISO) and BLX (NIKKISO). In vitro study using such as CL-SS/KF-C/AM-GP/BK-P/PS/FLX/BLX (QB=100ml/min, QF=10ml/min) revealed that the average values of SC of LMWH were 0.39/0.53/0.56/0.79/0.87/1.03/0.00, respectively. Similary, the adsorption of LMWH was recognized only in BLX. Using BLX/AM-GP/BK-P/KF-C/FLX in clinical study (QB=200ml/min, QF=30ml/min) the reduction rate of LMWH on 15 min filtration were 71.9%/21.4%/19.9%/13.7%/3.3%, respectively, and statisti-cal significant decleases were found in all dialyzers except FLX. LMWH in filtrate was detected in only two types of dialyzers such as BK-P and FLX, respectively, and the mean SC of BK-P and FLX were 0.064 and 0.017.
In conclusion, the time and the site of LMWH injection is the critical points to be determined when hemodialysis is conducted using high flux membrane dialyzers. In addition, the dose of LMWH should be increased when BLX is used.

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Individualized therapy is capable of the quality control of dialysis treatments. In clinical situations, blood chemistries are taken only twice a month. Predicting blood concentrations from dialysate concentrations using mass balance equations is possible with real time evaluation of dialysis treatments at each hemodialysis. We measured the concentrations of urea, creatinine, phosphoric acid and uric acid in dialysate as well as in blood to confirm accuracy of the estimation during hemodialysis with high performance dialyzers for 8 patients. Estimation results for uric acid and phosphoric acid were not very accurate in treatments with high performance dialyzers compared with in those with conventional ones. Then an apparent distribution volume for each solute was determined for better estimation. The apparent distribution volume of uric acid was lower than that of urea, and that of phosphoric acid varied for each patient. These results demonstrate that the individualized therapy using a high performance dialyzer is feasible by collecting dialysate concentration data of the patients on hemodialysis.

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An optimum designed dialyzer requires an advanced explication of a mechanism of solute transfer through a hollow fiber membrane. As a measurement of dialysate flow condition in the dialyzer is usually difficult to carry out, an explanation of the transfer mechanism has many problems. The overall mass transfer resistance is calculated as a sum of membrane, blood and dialysate side mass transfer resistances. The dialysate side mass transfer resistance influences on the solute clearance. Therefore, this paper describes effect of fins on a dialysis membrane. These fins could decrease the degree of contact of membranes each other in a dialyzer, for increase of the effective surface area, and for improvement on the dialysate flow conditions. Hand made modules of single hollow fiber with and without fins showed no difference in dialysate side mass transfer coefficient. It suggested that the fns have no effects on increasing the dialysate side resistance. A dimensionless calculation with solute clearances showed an increase of effective surface area in a dialyzer having fin type hollow fiber membrane. An observation of dialysate flow pattern with X-ray CT suggested that the fins decrease the channeling in a dialyzer.

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In this study, we measured the platelet concentration of calcium ions (Ca²⁺) and thrombin-stimulated platelet Ca²⁺ increases during hemodialysis in 33 patients (19 male, 14 female, mean age 55.2±2.3 years) with chronic ronal failire. The following results were obtained:1)Just after hemodialysis with a semi-synthetic membrane dialyzer, platelet Ca²⁺ increased significantly. However, this did not occur during hemodialysis with a synthetic menbrane dializer or during extra-corporeal ultrafiltration with both menbrane dialyzers. 2)The increase in platelet Ca²⁺ by thrombin stimulation at a dose of 0.1U/ml was significantly larger after than before use of the semi-synthetic dialyzer. This phenomenon was not seen during hemodialysis with the synthetic menbralne dialyzer. 3)Platelet Ca²⁺ decreased significantly just after the injection of anti-coagulants (heparine or nafamostat mesilate). 4)The anti-coagulants significantly suppressed the thrombin-induced increase in platelet Ca²⁺. The mobilization of Ca²⁺ in platelets and the influx of Ca2+ into platelets both decreased significantly after anti-coagulants adnministration. These results suggest that platelet Ca²⁺ concentration tends to increase after blood passed through a semi-synthetic membrane dializer, and suppress increases in platelet Ca²⁺, induced by thrombin stimulation.

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Removal ability of Cisplatinum (CDDP) by hemodialysis (HD) and cryofiltration was examined of HD patients complicated advanced lung cancer. Serum concentration of CDDP decreased rapidly after 10 mg and 20 mg intraveneous administration by 4 hours. It decreased more rapidly by 1 hour when HD started just after CDDP administration. The concentration did not decrease after 24 hours of CDDP administration by HD, but decreased to 73.9% by 4L cryofiltration. The difference would come from that serum CDDP is almost all protein bound type 4 hours after administration. Removal of CDDP by HD was possible just after administration, but cryofiltration should be needed for the removal of CDDP after it combined to serum protein.

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Adsorptive capacities of newly, developed β₂-microglobulin (β2M) adsorbent column for direct hemoperfusion (BM-01) were examined in vitro and clinically. The adsorbent adsorbed more than 1 mg of β2M per ml adsorbent, and other low molecular weight proteins including lysozyme and retinol-binding protein were also adsorbed in vitro. Clinical study, in which BM-01 was connected with dialyzer in series, showed approximately 70% mean reduction rate of β2M. The β2M plasma level at the end of each treatment was less than 1mg/ml. The mean adsorbed amount of β2M was evaluated to be 218.3±56.7mg/column in cases of 30-50mg/l plasma β2M before the treatment, and the maximum amount was estimated to be 371.9mg/column when pretreatment β2M level was 47.6mg/l. The adsorptive selectivity in clinical study was similar to those observed in vitro. These results suggest that BM-01 is useful device to eliminate β2M from dialysis patients.

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Some reports have been issued indicating the effectiveness of plasmapheresis(PP) applied to rheumatoid arthrities(RA). This time we hereby report the comparison of the changes in the blood and plasma viscosites according to the treated quantity of plasma by PP to find an effectively treated quantity of plasma. The blood viscosity was hardly thought to index the effectiveness of PP. As the plasmatreatment progressed, a significant drop in the plasma viscosity was observed. A drop in the plasma viscosity was apt to be weakned gradually. From the plasma viscosity point of view, it was desirable that at least 30ml of plasma per kirogram for each person's body weight be treated. In the future, we believe that the viscosity of plasma needs to be compared with clinical symptoms and clinical examination data.

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Observed data of endotoxin, in dialysate, usually decrease with passage of time, especially after freezing. Therefore, a 50μl of human serum albumin with 0.02% aqueous solution for 2ml of dialysate was used to obtain the stable data. The endotoxin activity in dialysate during dialysis treatment is decreased within the first 60 min. and reaches minimum level. The results obtained front a few dialysis centers, show that the main contaminated position of dialysate, at a well-maintained dialysis center, is the RO tank.

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Human hepatocyte procurement from thirteen surgical liver specimens and functions in primary culture were evaluated for the future appication on a hybrid artificial liver. The warm ischemia time of the surgical liver specimens (mean weight of 27.3g) ranged 0-180 minutes. The viability and yield of isolated hepatocytes were the mean values of 88.6% and 10.9×10⁶ cells/g liver, respectively. The gluconeogenesis and ureogenesis of the cultured hepatocytes were maintained for ten days with values of 26.2-45.5 and 2.7-3.8 ng/μg DNA/min, resppctively. Those hepatic functions did not show statistic correlation against the warm ischemia time of the liver specimens. It was concluded that high yield of viable human hepatocytes was effectively isolated from warm ischemia liver up to 180 minutes and isolated human hepatocytes in the primary culture revealed high level of hepatic metabolic functions. Use of cultured hepatocyte obtained from warm ischemia liver was considered to be promising as a metabolic component of a hybrid artificial liver.KEYWORD: human hepatocytes, liver warm ischemia, primary culture, hybrid artificial liver

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Preservation of hepatocytes is a key technical factor towards a successful clinical application of hybrid artificial liver. Preserved hepatocytes were cultured in collagen gel to study the effect of preservation on artificial liver device. Rat hepatocytes were cultured in collagen gel for two weeks after 8-day-preservation in 4°C UW solution. Round-shape morphology of each hepatocytes was maintained. Ureogenesis of preservation group showed 33.5±3.0μg/ml (2nd day in culture) and 29.6±6.4μg/ml (6th day in culture). These are 95.2% and 72.5% of ureogenesis of compatible control group. It means that preserved hepatocytes have maintained a good function of ureogenesis. It was suggested that rat hepatocytes can be well preserved for 8 days in 4°C UW solution.

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Adult rat hepatocytes formed spheroids in the pores of polyurethane foam (PUF) for 5 days, when they were cultured in serum-free medium. After that, when the spheroids were cultured in 100% rat blood plasma, the internal structure of the spheroid was broken down on 16th day. In the rat plasma supplemented with epidermal growth factor, insulin, glucagon, dexamethasone, aprotinin (100KIU/ml), the structure of the spheroid was maintained for at least 20 days in PUF stationary culture. Urea synthesis activity of the spheroid in rat plasma with hormones was also maintained at higher level than that in rat plasma without hormones. Furthermore, in Multi-Capillary PUF packed-bed culture, the activity of the spheroid was maintained at higher level in rat plasma with hormones than that in serum-free medium.

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Hepatocyte spheroids rapidly formed by 1-day suspension culture in a spinner flask were immobilized at 1.0×10⁷ cells/cm³ with collagen (CN) gel into the extracapillary space of a hollow fiber (HF) module. Various liver-specific functions were investigated for 10 days of perfusion culture. The spheroid/CN-HF module showed these functions at about the same levels as compared to other modules reported previously. When the module was perfused with 100%-bovine serum (BS), a slight deterioration was observed in the module performance except albumin secretion. Thus, the spheroid/CN-HF module type is expected to show stable functional expressions in clinical application.,

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To prepare a long-life and stable glucose sensor, a newly designed biocompatible mem-brane, consisting of 2-methacryloyloxyethyl phosphorylcholine (MPG), has been developed and applied to the surace of a ferrocene-mediated needle-type glucose sensor. In vitro experiments, the amounts of adsorbed protein on PVA or MPG membrane were 35.6, 14.0μg/cm² on 14th day, respectively. In vivo experiments, the amounts of adsorbed protean on PVA or MPG membrane were 31.2, 16.9μg/cm² on 14th day, respectively. Therefore, we conclude that MPG membrane exhibited exceller biocompatibility in vitro and in vivo. We are now applying wearable artificial endocrine pancreas with this sensor to long-term clinical treatment of ambulatory diabetic patients.

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We have developed a miniaturized extracorporeal glucose monitoring system which combines a needle-type glucose sensor and a microdialysis hollow-fiber probe. This paper dealt with the in vitro and in vivo characteristics of this glucose monitoring system. 1) In in vitro experiments, by recording rapid changes of the glucose concentrations by switching the medium from 100 to 200 mg/100ml glucose and vise versa, the times to reach 90% of the maximum and minimum values were 5.6±0.4 min and 7.4±0.5 min, respectively (mean±SEM). 2) In in vivo experiments, subcutaneous tissue glucose concentrations were measured with a time delay of 6.9±1.2 min associated with a rise in glucose and 8.8±1.6 min with a fall in glucose level. During continuous tissue glucose monitoring, a highly significant correlation between subcutaneous tissue glucose concentrations (Y) and blood glucose concentration (X) was observed (Y=1.08X+3.42, r=0.99). Regression lines obtained during 5 to 7 days monitoring were significantly different from those obtained during I to 4 days monitoring, However, by introducing the in vivo calibration technique every morning afler 4 days continuous monitoring, subcutaneous tissue glucose concentrations measured by this system correlated again with the glycemic excursions for 7 days. By exchanging the probes every 5th day, this system can be used for continuous glucose monitoring and for glyceric control with the wearable artificial endocrine pancreas in diabetic patients for longer periods.

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The alarm of artificial pancreas was studied Three types of artificial pancreas, STG-11A, STG-22 and modification of STG-22 (mod STG-22) made by Nikkiso corporation in Japan, were used, and they had different alarm systems. One hundred and seventeen patients were devided in 3 groups, according to the artificial pancreas used: group A (102 pateints) with STG-11A, group B(7 patients) with STG-22, and grout C (7 patients) with mod STG-22. Most of the alarm encountered were that of blood glucose abnormality, that is, blood glucose exceeding upper limit, lower limit, and/or change ratio, and they were almost completely caused by artifacts. Increased frequengy of the alarm were found when (1)short blood sampling catheter for peripheral vein was used, (2)long catheter were inserted into the femoral vein, (3)patients were not under mechanical ventilation, and (4)STG-22 were used. Sufficient blood sampling was frequently difficult because of low blood flow, catheter bending or clotting in condition written in the above (1), (2), (3). Sudden increase of venous pressure by coughing or body movement caused false positive high blood glucose. In STG-22 and mod STG-22, the frequencyof catheter flushing was relatively few in comparison with STG-11A. The alarm system for blood glucose minute change was extremely sensitive in STG-22. Increased tendency of blood coagulation, dehydration, and inappropriate configuration of glucose sensor were also considered to be important factors as causes of the alar operation.

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Various kind of adoptive immunotherapies for cancer with LAK cells had been tried. Nevertheless, these trials had some problems related to long-term cell culture and by high doses of IL-2. In order to solve these problems, we designed the extracorporeal circulation system, furnished with the inducer column. An anti-CD3 antibody, known possessing mltogenlc activity in a solution, was selected as a ligand of the killer activity inducer. The killer activity inducer, polysaccharide beads immobilized with anti-CD3 antibody or its Fab fragment, increased the lymphocyte cytotoxicity towards a carcinoma cell line (HeLa-S3), and didn't increase for the autologous lymphocyte. In a brief contact time between blood and killer activity inducer column, the activity was induced with only little lymphocytes adsorbed.

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Recently, lymphocytapheresis (LCP) has been applied in the treatment of autoimmune disease. LCP has been used for patients with rheumatoid arthritis (RA) unresponsive to the conventional therapy. We performed LCP using a leukocyte removal filter and a continuous flow cell centrifugation system on the same five RA patients to evaluate the effectivity of LCP using the filter. First, we performed LCP with the leukocyte removal filter (Cellsorba®, Asahi Medical Co. Ltd.) once per week for two weeks. Thereafter, LCP using centrifuge system was performed on the same RA patients, utilizing the continuous flow centrifugal blood cell separator (Spectra®, LOBE Co. Ltd.). The clinical findings (morning stiffness, grip strength and joint score) were improved significantly after LCP' using the leukocyte removal filter. The T-cell subsets and CD4/CD8 ratio were improved after four consective LCP sessions. Using the filter, HLA-DP⁺CD4⁺ cells were efficiently reduced. As a results of one procedure, the number of removed WBCs was 1.0×10¹⁰, and that of lymphocytes was 3.5×10⁹ on average. There was no significant difference in the number of removed cells between two methods. It was surmised that LCP using the leukocyte removal filter may be promising in the treatment of patients with RA unresponsive to the conventional therapy.

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Cryogel produced duringcryofiltration consists mainly of a complex of fibrinogen (Fbg) and fibronectin (FN) (Cryofibrinogen: c-Fbg), which precipitates under cooling condition with heparin. EDA(+)FN (Cellular FN) is involved in the complex more specifically than plasma FN (pFN). To clarify the mechanisms of this specificity, we compared the binding rate (BR) of both fxbronectins onto immobilized Fbg as well as onto immobilized heparin at a temperature range of 4°C to 37°C. pFN showed a high BR onto both immobilized molecules at low temperatures. The BR of EDA(+)FN onto immobilized Fbg was modestly higher than that of pEN at each temperatures. The binding between EDA(+)FN and immobilized heparin showed a high BR even at high temperatures. In the cryoprecipitation study in vitro, EDA(+)FN showed a more rapid and higher cryoprecipitable character than that of pFN. In plasma removed of EDA(+)FN, Fbg didn't gel with heparin, but did with heparin upon the addition of EDA(+)FN. Therefore, EDA(+)FN appears to be essential in constructing c-Fbg during cryofiltration. Formation of the Fbg-FN-Heparin complex was caused more rapidly by the high cryoprecipitable potency of EDA(+)FN and the high affinity between EDA(+)FN and heparin at all temperature ranges in this study.

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The objective of this study is to compare the efficiency of two plateletpheresis machines in terms of white blood cell (WBC) contamination. Plateletpheresis was performed in normal donors using COBS Spectra and HAEMONETICS V-50. Biochemical and hematological assays, serum hemoglobin and C3a, C5a were measured before and after the procedure. WBC contamination in the platelet concentrate product was studied using a Coulter counter (conventional) and a Cytron Absolute (flow cytometric analysis; FCM). Procedure time was shorter in Spectra (73.5min) than in V-50 (105.7 min), but platelet yield was comparable. C3a and C5a were not increased after procedure both in Spectra and V-50. WBC contamination assayed by Coulter counter was significantly higher in V-50 (683.3/μl) than in Spectra (not detected). FCM could detect extremely low concentration of WBC (<50/μl) compared with the conventional assay. WBC in the platelet concentrate product was 1.04×10⁵/product in Spectra measured by FCM. The data suggested that Spectra was more effective in collecting platelet with less WBC contamination and that FCM was useful method to evaluate WBC contamination in the platelet concentrate by apheresis.

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To monitor the changes in the concentration of antibody produced in body fluids due to infection, we developed a new method for continuous measuring of the antibody concentration. Conventional immunoassay is applicable to heterogeneous reaction between antigen and antibody, and is unavailable for continuous measurement. We used the technique of electrochemiluminescence(ECL) to measure antibody concentration continuouslyin a homogeneous reaction system. We used human serum albumin(HSA) as antigen and luminol as luminous substance, ECL reaction occurred on electrically conductive glass electrode the electric potential of which was kept constant at -0.70V vs saturated calomel electrode(SCE), In conclusion, antibody concentration can be measured continuously by the ECL reaction which is a promising technique of measurement of antibody specifically reacting with antigen.

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Plasmapheresis(PP) was performed in 7 cases of PV and in 4 cases of BP without any improvement by steroid and other drugs. This study was undertaken to investigate their complications, the effects of the PP treatment and reduction rates of serum IgG and antibodies of PV and BP. They had steroid-induced complications such as diabetes mellitus, osteoporosis and infections. We noted disappearance of their skin lesions and antibodies, and reduced ammount of steroid administration in all cases after DFPP and in one case after LAPP. After the PP treatment, serum levels of IgG were lowerd 38% in DFPP and 30% in IAPP. A half reduction of titers was shown in PV antibody by DFPP and BP antibody by IAPP. These results indicate that the PP treatment is beneficial and useful for these drug resistant disorders except for some cases. We recommend that it is also available for these diseases following high titers of PV and BP antibodies.

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clinical features and effect of anticoagulants
LDL apheresis has been reported to induce anaphylactic shuck. (AS) in some patients. Although it is recognized that elevated plasma bradyki to (BK) levels participate in the pathogenesis of AS, which can be successfully prevented by an inhibitor of serene protease such as nafamostat mesilate (NM), the optimal therapeutic starategy remaines unresolved. We encountered 46 patients undergoing LDL apheresis. Three of the patients were included in a comparison study on the effect ofnm or heparin.nm was intravenously infused at a speed of 0.5mg/kg/hr, and heparin at 800 units/hr.nm suppressed BK elevation, which remained under 50pg/ml, while heparin did not suppress BK elevation. In patients recieving heparin-infusion, plasma BK increase from 64.2pg/ml to 1558.5pg/ml on average when the patient received 300ml of plasma. One patent who recieved angiotensin converting enzyme inhibitor (ACEI) developed anaphylactic shock.nm suppressed plasma BK elevation even in patients receiving ACEI. The required dose of N was successfully decreased from 0.5 to 0.2 mg/kg/hr without any life-threatening symptoms. From these results LDL apheresis might be uneventfully performed using 0.2mg/kg/hr ofnm as an anticoagulant.

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