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[in Japanese]
1980 Volume 9 Issue 1 Pages
2
Published: February 15, 1980
Released on J-STAGE: October 07, 2011
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K. ASANO, M. SAGESHIMA, H. HARA, K. NAKAMURA
1980 Volume 9 Issue 1 Pages
3-6
Published: February 15, 1980
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Four patients paced with endocardial electrodes were diagnosed to have catheter perforation, and it was confirmed at surgery of myocardial electrode implantation. The diagnosis of perforation is sometimes difficult to establish. Electrograms recorded from the pacing catheter is simple and reliable method for the diagnosis of this complication.
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T. TAKAYAMA, [in Japanese], [in Japanese], [in Japanese], [in Japanese ...
1980 Volume 9 Issue 1 Pages
7-10
Published: February 15, 1980
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Since 1964, 83 epicardial leads were implanted in 39 patients. Sensing failures occured in 3 of them. The sensing failures were classified into 3 groupes in terms of their etiologies, listed as follows: 1, The low amplitude of R wave to be sensed. 2, Inappropriate electrical connection between the lead and myocardium. 3, Electromechanical failure of the pacer unit. Canine experiments were performed to elucidate the best portion of the heart to be implanted as well as the most appropriate method for implantation with regard to sensing the sinus beats. It was found that, improper implantation resulted in a marked decrease in the amplitude of R wave to.be senced although the amplitude showed little difference according to the sites of implantation.
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Toshiki SUZUKI, Shigeo TANAKA, Masatoshi IKESHITA, Shigehiro SAKAKIBAR ...
1980 Volume 9 Issue 1 Pages
11-14
Published: February 15, 1980
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A device of follow-up system for patients of pacemakers, the device has been developed which transmits not only the ECG but also the waveform of the pacemaker pulse.
It indicates voltage(1.0-500mv/cm)and pulse width(1.0-4.0sec/cm)on recording paper. The unique aspects are: 1) the recording of Lead of the ECG. 2) 3 ranges for pulse width recording (1.0, 2.0, 4.0msec/cm) 3) 9 ranges for amplitude recording. The device containing its own Micro-Computor, automatically calculates and prints out the amplitude, pulse width, sq. cm. area of the pulse and the interelectrode resistance.
Both bipolar and unipolar electrode stimulation of 210 pacemaker patients residing too far for conventional clinical follow-up were successfully transmitted by telephone.
This device will make the post-operative follow up of patients with pacemakers safer and lasier.
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[in Japanese]
1980 Volume 9 Issue 1 Pages
15
Published: February 15, 1980
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Yoshitsugu KITO, Tsuyoshi FUJITA, Yasuaki NAITO, Hitoshi KOYANAGI, Nob ...
1980 Volume 9 Issue 1 Pages
16-19
Published: February 15, 1980
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Two intrapleural and seven extraperiostealsubcostal pacemaker implantation in children were presented. There were 7 children with congenital A-V block, one with idiopathic SSS and one with surgical SSS. Placement of permanent cardiac pacemakers in children presents technical problems that are not encountered in the adult. Intrathoracic implantation is recommended for children because of the following advantages; (1) reduced risk of lead frueture, (2) protection from physical trauma, (3) reduced risk of infection and erosion, (4) improved cosmetic appearance, (5) minimized child/generator size dispropotion.
The bref surgical technique was presented.
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T. NISHIMOTO, [in Japanese], [in Japanese], [in Japanese]
1980 Volume 9 Issue 1 Pages
20-23
Published: February 15, 1980
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Since May 1975, we have followed one handred and eighty-two lithium powered pacemakers up.
Eleven generators were removed prematurely because of the pacemaker failure including the ealy exhaution of the battery or the circuit failure.
Signs of the pacemaker failure were the decrease in pacing rate (two cases), the irregularity of spike interval and width (five cases), the oversensing (two cases), and the loss of spike (two cases).
Nine of them were seen in the same model of generators in which the battery depleted during the period from 3 to 3.5 years after implantation.
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Y. SAKURAI, E. AOKI, Y. MARUYAMA
1980 Volume 9 Issue 1 Pages
24-26
Published: February 15, 1980
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This paper give the results of multi-programmable pacemaker therapy in 7 patients who received implantation and replacement during the period of May 1979 to December in Niigata Shimin Hospital.
Type of the multi-programmable pacemaker used Medtronic Spectrax SX(5985) and Intermedics Cyberlith(235-05).
The study was made on 7 patients to investigate multi programmability and stimulation threshold.
The stimulation threshold measurements can be utilized Pacing System Analizer (PSA Medtronic 5300) and auto threshold measurement by programmer 9701 (Medtronic).
Pulse generator function and programmable function were stabled in all cases.
The auto threshlod feature of the 9701 programmer allows determination of the exact threshold capture.
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[in Japanese]
1980 Volume 9 Issue 1 Pages
27
Published: February 15, 1980
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Michimaro OZEKI, Keiichiro KONDO, Hisao KISHIDA, Kunio ASADA, Katsuhik ...
1980 Volume 9 Issue 1 Pages
28-31
Published: February 15, 1980
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To preserve the physiological advantages of atrial contraction, we have implanted atrial and A-V sequential pacemakers in 8 patients with Sick Sinus Syndrome. The latter pacing was performed in 3 patients with A-V conduction disturbance. All patients were analysed in relation to hemodynamic and antiarrhythmic effects. It was concluded that these pacing method were superior to ventricular pacing not only in hemodynamic aspect, but also from antiarrhythmic point of view.
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Yoshio KOSAKAI, T. NISHIMURA, T. FUJITA, Y. NAITO, H. KOYANAGI, Y. KIT ...
1980 Volume 9 Issue 1 Pages
32-35
Published: February 15, 1980
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We invented new method using radioisotope by which we could obtain the relative changes of left ventricular volume at each measurement in same patient as well as same time.
We studied the effects of the left ventricular volume of increasing heart rate by atrial pacing in 5 patients of sick sinus syndrome and ventricular pacing in 6 patients of complete A-V block.
As the heart rate was increased, the left ventricular end-diastoric volume indices and the stroke volume indices were decreased by ventricular pacing exceeded than by atrial pacing and the cardiac indices increased gradually by atrial pacing but they showed flat and peaked type by ventricular pacing.
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A. NAKAMURA, K. OGA, Y. SASAKI, S. SHIRAKATA, K. TAMARI, Y. WADA, H. S ...
1980 Volume 9 Issue 1 Pages
36-39
Published: February 15, 1980
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Hemodynamic observation prior to pacemaker implantation and generator replacement were performed to obtain the details of cardiac function and to adjust the pacing rate in response to the function.
The pacing rate was determined with reference to maximal cardiac output and lowest intracardiac pressure.
To observe the rate-output curve, cardiac output was measured by the thermodilution method and the intracardiac pressure was measured with a catheter to 40 paced patients.
The rate-output curves tended toward a flat tracing and the right atrial pressure and pulmonary arterial end-diastolic pressure did not elavate. During long-term pacing, no congestive heart failure or pulmonary hypertension occured.
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[in Japanese]
1980 Volume 9 Issue 1 Pages
40
Published: February 15, 1980
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N. INOUE, K. KOIDE, S. UWADOKO, J. TOYAMA, Z. YAMAZAKI, T. SAKAI, T. W ...
1980 Volume 9 Issue 1 Pages
41-44
Published: February 15, 1980
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New analytical method for uremi c plasma by high-speed liquid chromatography has been developed and applied to analyze plasma of patients with chronic renal failure. The column was packed with methylolated styrenedivinyl benzene resin and pretreated by albumin before use.
Ten u1 of plasma from patients with chronic renal failure could be analyzed within 30 min. The results were satisfactory. Chromatograms showed several characteristic peaks of chronic renal failure. Each peak was characterized by physicochemical methods. Two of them were shown to be uric acid and creatinine, respectively, and others to be unknown Uremic metabolites including Uremic toxins. Strong inhibition of glucose utilization by the two unknown peak fractions was observed.
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-Analysis of ultrafiltrate by HIGH PERFORMANCE LIQUID CHROMATOGRAPHY-
T. HORIUCHI, Y. YAMADA, I. TAKAHASHI, O. OTSUBO, [in Japanese], T. INO ...
1980 Volume 9 Issue 1 Pages
45-48
Published: February 15, 1980
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It is necessary to evaluate hemofiltration membrane clinically. However, due to the interaction between blood and membrane, this criteria is complicated.
So we have studied the ultrafiltrate to analyze the permeability of solutes through membrane by High Performance Liquid Chromatography, which is capable of analyzing various materials within a very short period of time without endangering the ability of separation.
This analysis data suggests that this information is available for selection of membrane together withother physical properties.
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K. SAKAI, S. TAKESAWA, M. MINESHIMA, M. SUZUKI, M. SUZIKI, M. INOUE
1980 Volume 9 Issue 1 Pages
49-52
Published: February 15, 1980
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High speed gel chromatography (HSGC) was used to observe the removal efficiency of uremic toxins from renal failure patients. It is convenient to define a hemodialysis number (F
HD) to compare HSGC results in hemodialysis. Amino acid analysis was further introduced to subdivide the peaks of M. M. in HSGC, and its removal ratio was calculated for the explanation of M. M. removal efficiency.
F
HD of peak “a” was influenced by the H. D. conditions in HSGC. However, F
HD of clinical data such as BUN, Creat., UA, were not changed with H. D. conditions. It means that F
HD of peak “a” represents the change of its conditions clearly and is available for the determination of the suitable H. D, . The peaks corresponding to M. M. were appeared on amino acid chromatogram (Fig. 2). The removal ratio of these peaks were higher by hemofiltration than by hemodialysis or hemodiafiltration.
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[in Japanese]
1980 Volume 9 Issue 1 Pages
53
Published: February 15, 1980
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K. SAKAI, H. IKEDA, A. YAMASHITA, M. MINESHIMA, Y. NISHIMOTO, K. KOBAY ...
1980 Volume 9 Issue 1 Pages
54-57
Published: February 15, 1980
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The object of this study is to account for the effect of dialysate recirculation on the transport of uremic toxins through analysis of 3-pool model, which is made up of intracellular fluid, extracellular fluid and dialysate tank.
The good agreement between
in vitro data,
in vivo data and theoretical value gives the optimum operating conditions determining the appropriate dialysate recirculating therapy. It has become apparent that the dialysate recirculating therapy is more effective for protection of disequilibrium syndrome, stable dialysis, mild dialysis, and stability of blood pressure and osmotic pressure compared with dialysate single pass therapy.
This fact was well confirmed by theoretical analysis based on 3-pool model.
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K. SAKAI, M. HIBI, K. MATSUDA, M. MINESHIMA, M. SUZUKI, N. AZUMA, M. I ...
1980 Volume 9 Issue 1 Pages
58-61
Published: February 15, 1980
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It is convenient and useful to be able to obtain the blood concentration from the dialysate concentration alone. We have already reported the usefulness of this concept.
In this paper, the useful formulas were derived by applying the single pool model to SP system (plate type dialyzer and hollowfiber dialyzer) and RSP system (coil dialyzer) with ultrafiltration.
Satisfactory results could be obtained by this method. However, the dialysate concentration was so low that this method led to some errors in clinical therapy. If the accuracy of assay is improved, the results will become more favorable.
The formulas for hemodialysis along this concept were also derived on the basis of 2-pool model, and those for hemofiltration and hemodiafiltration were further derived on the basis of single pool model.
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T. ISHITOBI, T. KUNITOMO, Y. SAKAI, H. KATAOKA, M. ONOHARA, Y. TANIGUC ...
1980 Volume 9 Issue 1 Pages
62-65
Published: February 15, 1980
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Although creatinine (CR) has been long used as an indicator for the measurement of renal function and dialyzer performance, its dynamic behavior in blood has not been thoroughly clarified. For establishing a method to accurately determine CR dialysance (D), distribution of CR as well as urea (U) between red blood cell (RBC) and plasma (P) has been studied in vitro and clinically. In contrast to U which diffuses almost instantaneously through RBC membrane, CR is proven to traverse so slowly that an equilibrium can not be reached within 9 hours. Prompt P separation and D calculation based on P concentration are necessary for the accurate detericination of CR related parameters.
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M. MINESHIMA, T. HOSHI, M. TORII, K. SAKAI
1980 Volume 9 Issue 1 Pages
66-69
Published: February 15, 1980
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It is important to know how the binding of a solute in blood to serum albumin influences the performance of solute removal by artificial kidney.
It has been said that the binding of a solute to serum protein is a reversible adsorption phenomena due to van der Waals force, hydrogen bond or hydrohobic bond.
Amount of equilibrium adsorption r and equilibrium constant K may be determined by the method of ulutrafiltration or equilibrium dialysis. The adsorption-desorption model has revealed the influence of dissociation rate constant k' on the hemodialysis performance
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[in Japanese]
1980 Volume 9 Issue 1 Pages
70
Published: February 15, 1980
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J. IN, M. MATSUO, S. SHINKO, FUJITA, S. INOUE, R. SAKAI, NISHIOKA, H ...
1980 Volume 9 Issue 1 Pages
71-74
Published: February 15, 1980
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emodialysis leukopenia was studied ing various dialyzers and membranes. found that dialyzers with convenonal cellulosic membranes caused rked leukopenia, but in recently veloped non cellulosic membranes cellulose acetate membrane, its currence was significantly less. ditionally, the extent of white cod cell decrease correlated inverse-with an increase in the ultrafiltra- on rate per membrane area of dialyzer. uring pure ultrafiltration procedure th a conventional cellulosic dialyzer, 2 was significantly decreased at fteen and thirty minutes after the itiation of hemodialysis. This diasis hypoxemia may suggest pulmonary sfunction resulted from pulmonary questration of leukocytes.
owever further research is necessary elucidate the mechanism of hemodiasis leukopenia.
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Tetsuzo AGISHI, Kazuo ERA, Yasuo OZAKU, Norimasa YAMASHITA, Tsutomu SA ...
1980 Volume 9 Issue 1 Pages
75-78
Published: February 15, 1980
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In order to release uremic patients from restriction of social activities due to regular hemodialysis, mobile artificial kidney systems with which the patients are allowed to keep social activities during blood purification have been devised.
Those are 1) a suitcase type, portable artificial kidney, 2) an automotive artificial kidney, 3) a wearable artificial kidney based upon homodialysis and dialysate regeneration and 4) a wearable artificial kidney based upon orally diluting hemofiltration. It is concluded that a wearable kidney utilizing orally diluting hemofiltration is most promising with simpleness and compactness of the apparatus and continuance of blood purifying function.
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Kenji MAEDA, Shunsuke KAWAGUCHI, Akira SAITO, Sentaro KOBAYASHI, Toshi ...
1980 Volume 9 Issue 1 Pages
79-82
Published: February 15, 1980
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Fourteen patients with severe, refractory, long-standing psoriasis were treated with haemodiafiItration (HDF) and direct haemoperfusion (DH).
Five patients had complete remissions, although two of them had relapses after discontinuation of HDF and DH.
Five patients had moderate improvement. Four patients had no objective improvement Heparin and Placebo effects of HDF were evaluated, too, Psoriasis is not improved by heparin and sham dialysis.
It is apparent that HDF and DH are effective to psoriasis..
Tetradecanoic acid octadecyl ester (M. W480), hexadecanoic acid octadecyl ester (M. W508), octadecanoic acid octadecyl ester (M. W536) were detected in the nails of psoriasis patients by GC-MS.
These substances were not detected in the nails of psoriasis patients who had complete remissions and controls
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S. NAKAJIMA, I. NAKAYAMA, K. IKEDA, Y. KUBO, N. SAMEJIMA, K. HUKUI
1980 Volume 9 Issue 1 Pages
83-86
Published: February 15, 1980
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Recently we have examined the immunoresponse of cancer patients by use of recall antigen (PPD, PHA, Mumps, Candida, SKSD) and lymphoblastogenesis stimulated by PHA, Con A. By these study, extensive immunosuppressive effect was found especially in lung squamos cancer patients.
A new device which eliminate the immunosuppressive substance was made in our laboratory and basic clinical, experimental study have been tried.
Immunosuppressive substance of serum which contains only in a molecular weight of more than 7×10
4 was found in squamos lung cancer, but not found in normal control group.
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[in Japanese]
1980 Volume 9 Issue 1 Pages
87
Published: February 15, 1980
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J. KUMADA, K. ASHIZAWA, E. KURATA, Y. KUMAMOTO, O. KOBAYASHI, A. MATSU ...
1980 Volume 9 Issue 1 Pages
88-90
Published: February 15, 1980
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Experimental study was performed to determine the most preferable graft for the small arterial substitute.
External or internal velour Dacron grafts and Gore-Tex graft were implanted in adult mongrel dogs and were removed for assessment. The patency rate and histologic evaluation revealed the superiority of velo ur Dacron graft. The results suggest that further experimental study of E-PTFE graft, as a small vessel substitute, is necessary prior to its clinical use.
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M. MANO, H. UCHIDA, S. TERAMOTO
1980 Volume 9 Issue 1 Pages
91-94
Published: February 15, 1980
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Three kinds of expanded polyietrafluoroethylene (EPTFE) grafts (10, 20 and 30μ fibril length) 5cm in length with 7 to 10mm diameters were implanted in the infrarenal venae cava in 43 dogs with and without administration of a 20mg/kg of dipyridamole daily for one month after implantation. In the non-dipyridamole group, the over all potency rate in the early (less two weeks) was 65.0%, but, in the late (two weeks to 10month) was reduced to 40.0%. In the dipyridamole group, the over all patency rate in the early was 78.3%, but, in the late was reduced to 52.2%. The 10μ fibril length group with and without dipyridamole had the high patency rate of 85.7% in the early campared with the 20μ & 30μ groups, but, the over all late patency in the these three groups was all poor.
It appears that a 10μ fibril length EPTFE groft may be superior to other materials for inferior versa cave, replacement with the administration of dipyridamole. However, additional studies shoud be necessary to obtain tree better long term patency.
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Y. JINBO, K. WATANABE, K. MAKINO, H. SASA, T. HACHIYA
1980 Volume 9 Issue 1 Pages
95-97
Published: February 15, 1980
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Expanded polytetrafluoroethylene grafts (fibril length: 7.5μ, internal diameter: 1.5mm, length:20mm) were inserted between the dissected femoral veins in 16 rabbits, using microvascular technique. The result of these grafts were as follows.
The patency rare of 7 days after replacement were 6 of 6 grafts (100% patency) and 1 month after replacement were 4 of 9 grafts (44% patency ). In histological study, light and scanning electoron microscopic findings showed a thin neointima on the inner surface of the EPTFE grafts.
At the present time, the artificial prosthesis of the small veins is not perfect, but, in view of this experience, the following notes may be of interest to other microsurgeons.
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K. ASHIZAWA, J. KUMADA, E. KURATA, Y. KUMAMOTO, O. KOBAYASHI, A. MATSU ...
1980 Volume 9 Issue 1 Pages
98-100
Published: February 15, 1980
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Two expanded polytetrafluoroethylene grafts were placed in the abdominal aorta and the external iliac arteries of dogs or the femoral arteries of does. The animals were sacrificed at varying intervals from one day to seven months. The patency rates of the Gore-Tex grafts were 57% in the case of 4mm. diameter, 69%, 5mm. diameter and 75%, 6mm. diameter. The thickness of the neointima of the grafts were variable in early stage. Organization of the grafts were poor. There remain some problems at the site of anastomosis.
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[in Japanese]
1980 Volume 9 Issue 1 Pages
101
Published: February 15, 1980
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Y. HARADA, Y. KANDA, R. AOSHIMA, D. FUJIMOTO, A. TAKADA
1980 Volume 9 Issue 1 Pages
102-105
Published: February 15, 1980
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Antithrombogenic enzymes Urokinase and Streptkinase were immobilized to the graft copolymer of atelo collagen and silicone. The vascular grafts with 5-7mm diameter were inserted in the aorta of 11 dogs. All grafts checked until 31 days were still open. The obstruction by the organized thrombus was found at 5 of 7 grafts investigated after 65 days. The patency of a graft was observed by the angiography at 118th day. By the SEM studies, the adhesion of amorphous cells on the inner surface and a little of fibrin network at the proximal end were found after 30min. After 1 hour, the thin membrane covered the inner surface. The enzyme coated vascular graft can make the thrombus thinner in the canal at the early period of the implantation.
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Yasuharu NOISHIKI
1980 Volume 9 Issue 1 Pages
106-109
Published: February 15, 1980
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A newly arterial graft, a fibrocollagenous tissue tube supported by polyester mesh, was evaluated as a substitute for a small caliber artery.
The graft itself had no antithrombogenecity, which was usually required for small vessel substitute. The newly formed vascular wall was soft and stable. The graft showed good endothelization of the neointima and good affinity to the arterial wall. Once the patency was established at an early period of implantation, the patency extended over a long period, and the rate of the graft was 73% from 0 to 7 months following the operation
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[in Japanese]
1980 Volume 9 Issue 1 Pages
110
Published: February 15, 1980
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Yoshiaki KOMOTO, Toshihide NAKASHIMA, Akira KUBOTSU
1980 Volume 9 Issue 1 Pages
111-114
Published: February 15, 1980
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The previous study of the BIAS-CUT arti ial blood vessels clarified the capability keeping the inner capsule thin and mainning the biological porosity.
In oraer to extend the application of is type of graft to the small caliber ery, 4mm I. D. and 5.7cm long BIAS-CUT ificial blood vessels, hand made of Millit patch cloth, were implanted in the place the external iliac arteries of dogs.
Patency was confirmed by angiography /or autopsy. The specimen obtained 8 ths after implantation, for example, showsy thin and clear inner capsule. Over all ency was 70% on the bias-cut grafts and on the control side of 4mm I. D. Microt respectively in a period of one year.
Though the present experiments are still continuation and the data based mainly on findings within one year after implantan, the preliminary data presented heree advantages for the application of artiial blood vessels with small diameter.
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-effects of steroid and immunosuppression-
C. YOSHIDA, T. SHINTANI, A. NAGAI, T. BANDO, M. MATSUMOTO, Y. WATANABE ...
1980 Volume 9 Issue 1 Pages
115-118
Published: February 15, 1980
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The effects of steroid and immunosuppression on bilateral femoral arterial Goretex and Double velour dacron(inner 6mm) bypass graft were studied in 18 adult mongrel dogs. These dogs were devided three groups (control, steroid and immunosuppression) and observed for 8 weeks. On graft patency and anastomotic intimal thickness, the result in steroid group were not different from the control group. But immunosuppression group were effective, specially anastomotic intimal thickness of Double velour were half the size of control group. The histological finding of immunosuppression group had rich and an orderly elastic fiber and were dominated mucopolysacchride ground substance.
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[in Japanese]
1980 Volume 9 Issue 1 Pages
119
Published: February 15, 1980
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Y. YOKOYAMA, M. KUSAKABE, Y. OHKAWA, K. ITO
1980 Volume 9 Issue 1 Pages
120-123
Published: February 15, 1980
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To drive the assist heart, when synchronizing with natural heart, it needs highly controlled driver of assist heart pump.
We applied the Electro-Hydraulic Stepping Cylinder (EHSC) to the assist heart driver.
The driving air of blood pump in the metal bellows is compressed by the motion of piston rod of the EHSC. And the stepping motor of the EHSC iscontrolled by the pulse from the control unit. Moving speed of the piston rod is controlledby the pulse rate and the numbers of pulse decides the stroke.
We analyzed the driving motion by using the mock circulation and the assist heart blood pump.
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[in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
1980 Volume 9 Issue 1 Pages
124-127
Published: February 15, 1980
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In 34 infants who underwent open heart surgery in our hospital, more effective pulsatile flow was obtained with a pump of NIKKISO Model pp-11, which is a newly designed pulsatile pump with hydraulic drive system by lchinose, NIKKISO Co.. But this pump was sometimes against the patient's own pulse in partial cardiopulmonary bypass, for this pump was only manually controlld. To aboid this fighting in partial bypass, a ECG triggered rate control system (syncronizer) was newly introduced. This system made it possible to effectively assist the patient's circulation with the pulsatile pump in partial cardiopulmonary bypass.
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Yutaka OGAWA, Jun AKUNE, Shigeru HIROSE, Kenzo YASUURA, Akira SEKI
1980 Volume 9 Issue 1 Pages
128-131
Published: February 15, 1980
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[in Japanese]
1980 Volume 9 Issue 1 Pages
132
Published: February 15, 1980
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Takashi KOIDE, Yoshio SAITO, Nagao YASUTOMI, Tadaaki IWASAKI, Susumu Y ...
1980 Volume 9 Issue 1 Pages
133-136
Published: February 15, 1980
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Members of the first Department of Internal Medicine, Hyogo College of Medicine elaborated the noninvasive circulatory assistant apparatus for the treatment with myocardial infarction.
The device is consisted of three large rubber bags fitted.around lower part of the abdomen and bilateral lower extremities.
Positive Pressure is added with the compressed air flowing into the bags to the lower half of the body during diastole and loosened during systole with negative pressured air.
Cardiac output increased from 3.6 (±0.9) to 4.1 (±0.9) liter per minute and mean pulmonary capillary wedge pressure decreased from 23 (±9) to 17 (±7) mmHg.
These results may indicate that external counterpulsation is effective in improving the hemodynamics of severe acute myocardial infarction.
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Keiichiro KATSUMOTO, Shigetoh ODAGIRI, Mikihiko OHKURA, Masaaki MAEHAR ...
1980 Volume 9 Issue 1 Pages
137-140
Published: February 15, 1980
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Veno-arterial bypass with PAD (pulsatile assist device) was studied using 15 adult mongrel dogs and bypass was actuated on the diastolic phase with FCG trigger and driving machin.. Two valves were attached to the outlet and the inlet of the PAD. A reservoir was needed for the stable production of veno arterial bypass. Strong diastolic augmentation was admitted and the systolic unloading of the left ventricle was successfully obtained. On the experiment of coronary artery ligation, this system significantly increased the regional myocardial blood flow to the jeopardized area, using the hydrogen gas clearance technique. Veno-arterial bypass pumping revealed a new type of the assisted circulation for the salvage of the patient with acute myocardial infarction with shock.
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K. UEDA, Y. YOKOTE, T. HATANO, R. OMOTO
1980 Volume 9 Issue 1 Pages
141-144
Published: February 15, 1980
Released on J-STAGE: October 07, 2011
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Concomitant use of IABP with NP (NP with IABP) was studied around the effect in hemodynamics and myocardial ischemic injury. Myocardial injury was estimated with ST segment change in epicardial EKG record. Myocardial ischemia was produced by ligation of left anterior descending artery (LAD). NP with IABP was introduced 30 min and 120 min after ligation of LAD for 10 min. Hemodynamically, this method increased mAoP 10% conpared with NP alone and reduced SW 14% conpared with control data. ST seg. elevation at the center of the ischemic area was reduced 35% by introduction of this method. But there was no ST seg. change 120 min after ligation. Early initiation of NP with IABP on coronary ischemic have benefit to reduce ischemic injury.
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[in Japanese]
1980 Volume 9 Issue 1 Pages
145
Published: February 15, 1980
Released on J-STAGE: October 07, 2011
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H. TAKIYA, R. TOMIDA, M. HIROSE, K. MURASE, M. TARAO, R. MIYAMOTO, A. ...
1980 Volume 9 Issue 1 Pages
146-149
Published: February 15, 1980
Released on J-STAGE: October 07, 2011
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Ten dogs were treated with pulsatile flow cardiopulmonary bypass and counterpulsation with Pulsatile Assist Device (PAD) during and after 45min. aortic cross clamping, while nine dogs were treated with non pulsatile flow with roller pump.
In PAD group, all dogs were successfully weaned from bypass while two dogs died after weaning from bypass in non pulsatile group. Aortic flow was significantly greater in PAD group compared to non pulsatile group, 1.67± 0.44 1/min/100gLV versus 1.13±0.60 at weaning and 1.80±0.50 versus 1.20±0.87 at 60min. after weaning.
Coronary flow (1-circumflex branch) was also significantly greater in PAD group, 56±13ml/min/100gLV versus 34±8.5 at weaning and 57±20 versus 34±9.7 at 60min. after weaning.
Changes in excess lactate and redox potential were more significant showing aerobic metabolic state in PAD group at weaning from bypass.
Benificial effects of pulsatile flow and, counterpulsation with PAD on cardiac function and metabolism were revealed in this study.
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R. TOMIDA, H. TAKIYA, M. HIROSE, K. MURASE, A. SANO, M. TARAO, R. MIYA ...
1980 Volume 9 Issue 1 Pages
150-153
Published: February 15, 1980
Released on J-STAGE: October 07, 2011
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This experimental work has been carried out with the aim of studying the effects of pulsatile flow with PAD upon the ultrastructural myocardial changes, which caused by prolonged anoxic cardiac arrest for 45 min.
Eight dogs were treated with pulsatile flow, and five dogs with Roller pump. All animals were resuscitated well.But only 2 dogs of control group came down to LOS after weaning, while PAD group maintained good hemodynamic state.
After 45 min, cardiac anoxia, the ultrastructural changes of myocardial cell showed partly severe myocardial damage, with marked mitochondrial changes, intracellular edema and contractor band. “Mito chondrial score” was adopted for semiquantitat ive evaluation.
The values changed significantly, and after weaniug PAD group had a better score than control.
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Masayoshi OKADA, Chuan CHEN, Kunio OKUNO, Takuo SHIOZAWA, Masashi IIZU ...
1980 Volume 9 Issue 1 Pages
154-157
Published: February 15, 1980
Released on J-STAGE: October 07, 2011
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This study is aimed to evaluate the effect of intraaortic balloon pumping on microcirculation in the ischemic myocardium. Acute myocardial infarction (AMl) was produced by ligation of the left anterior descending artery, or circumflexus artery of the left coronary artery, Epicardial ECG, myocardial surface pH and microcirculation measurement were employed to determine the extent of ischemic myocardium.
First of all, myocardial surface pH was compared with epicardial ECG, which revealed a close correlation (r=0.86) in two techniques. Epicardial ECG and myocardial surface pH at five points in the ischemic and infarcted myocardium were recorded at immediately, 15 minutes, 30 minutes and 1 to 4 hours after coronary ligation, and after initiation of IABP. The size of the ischemic and infarcted area of the myocardium was measured by the value of myocardial surface pH.
Subsequently, a decrease of ST on epicardial EGG and recovery of myocardial surface pH were remarkably observed after initiation of IABP.
On the other hand, improvements of hemodynamics and microcirculation in the ischemic myocardium were also obtained after beginning of IABP.
Pathohistological changes of the myocardium were less, when improvement of epicardial ECG and myocardial surface pH were remarkably revealed after initiation of IABP.
But, myocardial necrosis was observed in the area of the myocardium, in which ST elevation on epicardial ECG disclosed over 3mV, and the value of myocardial surface pH indicated under 7.60.
In conclusion, it was considered that IABP was effective method to improve firstly microcirculation, secondly hemodynamics in the ischemic myocardium.
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[in Japanese]
1980 Volume 9 Issue 1 Pages
158
Published: February 15, 1980
Released on J-STAGE: October 07, 2011
JOURNAL
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