We were studied in relation to viscosity and flow of blood. Blood was passed throgh in capillary (inside diameter 1.5mm, length 110mm) of laying down 35° angle from horizontal line and time passed from upper entry to under dientry was messured.
Result was as follows:
1. Flow time was rapidly slowed over Ht 60%.
2. Flow time was speedy in lower Ht, but in this cases, it was different from physical caracteristics of liquid suspected red cells.
3. Capillary resistance was functional increased under Ht 70%, but was parabolar increased over Ht 70%.

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Blood viscosity is a significant physical property to simulate the hemodialysis therapy. Fundamental experiment with the solution containing albumin and γ-grobulin showed that the intrinsic viscosity of proteins didn't change by temperature and the interaction between these proteins didn't exist. Then the viscosity of 14 normal sera, 23 HD patients sera and plasma water were measured to be found 0.7216 ± 0.0016 cp for normal plasma water and 0.7266 ± 0.0009 cp for HD patients plasma water. The statistical correlation could be demonstrated between the viscosity of normal sera and plasma proteins concentration, but no correlation was recognized between the viscosity of HD patients sera and plasma proteins concentration. HD patients results were devided into 5 groups by the results of AC electro-phoresis and correlation could be demonstrated in each group.

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Reduction in the free platelet count (FPC) and release from blood cells of platelet aggregation-causing substrate were investigated in sheared rabbit blood, using citrate an anticoagulant. Significant FPC decrease of whole blood in shear fields was observed in spite of little release of hemoglobin from blood cells. When platelet rich plasma was exposed to the same shear field, however, reduction in FPC was only slight. It was suggested that adenine nucleotides were released mainly from erythrocytes in the shear field. Released ATP was rapidly converted to ADP in plasma, and this and directly released ADP were capable of initiating the platelet aggregation.

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Blood clotting inside the ventricle is one of the biggest problem to be solved for the development of the artificail heart.
Scince the interaction of blood and material take place in the boundary layer, it is very important to eliminate a low blood flow area or a stagnation point close to a wall for the prevention of thrombus formation in the blood chamber.
Employing flow visualization technique, so called dye-washout method, we studied how in tegral picture of the boundary layer flow was affected by the parameters as follows; installed position and angle of inlet or outlet conduit, the orientation of the valve, and the shape of the blood chamber. Thirteen different pump housings were tested in this experiment. According to the results of this experiment, two pump designs which may have no clot formation inside the blood chamber were presented.

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This Controlled-release method newly established definitely reduces severe secondary effect of anticancer drug, since drug capsule is burried around or into inoperable tumor. Release rate of anticancer drug, capsule shape and size can be seluted freely to the patient's need. No leucocy topemia appeared. This capsule acted on local malignant cells effectively. This anticancer drug capsule is recommended in order to minimize the influence on blood cells and to achieve prolongation of life for inoperable patients.

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Magnetic control of drugs may facilitate a selective pharmacotherapy with minimum systemic side effects. We successfully prepared ferromagnetic mitomycin C microcapsules (FMMMC-m.c.) which consist of, on average, 50% (W/W) of active mitomycin C (MMC) as the core and 34% of ethylcellulose and 16% of zinc ferrite as the shell. The mean particle size was 309 μm so that FM-MMC-m.c. suspended in saline was readily infused through an 18-G needle. FM-MMC-m.c. provided a sustainedrelease property of the encased drug and were readily magnetized by external magnetic field over 200 Oe. Conventional magnetic control directed FM-MMC-m.c. into a target artery from the abdominal aorta, indicating the complete magnetic guide of FM-MMC-m. c. in the blood flow. V2 bladder tumor of rabbits was satisfactorily treated with magnetic control of intravesical FM-MMC-m. c., suggesting the intensive antineoplastic effect of magnetically controlled FM-MMC-m. c.. The results suggest that various drugs can be ferromagnetically microencapsulated, facilitating a magnetic control of the encased drugs in the blood stream or luminal spaces.

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Effect of an orally administered adsorbent has been investigated in an animal model of hepatic failure.
A spherical carbonaceous adsorbent (AST-120), newly developed for oral administration, was used in this study.
A drop in the elevated levels of amino acids and normalization of serum protein composition have been observed after the oral adsorbent was given to the dogs with portacaval shunt. The dogs gained weight following this treatment.
Hepatitis, induced in the rats by D—galactosamine, was markedly improved by the oral adsorbent treatment from the view of histological finding of the liver and biochemical parameters, such as GOT, GPT, LDH and BIL. The abnormal peaks of serum high—speed liquid chromatograms observed in the animals of hepatic failure, also diminished. Nevertheless in our experiment the adsorbent was shown not to remove D—galactosamine.
It is concluded from these results that the adsorbent improved hepatic damage by removing hepatotoxic substances in intestinal tract.

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Effect of a spherical carbonaceous adsorbent (AST-120), newly developed for oral administration, on uremic animals has been investigated.
Uremic rats, following the ligation of bilateral renal hilum, were classified into two groups as follows: (1) 11 uremic rats untreated and (2) 10 uremic rats treated with the adsorbent, one gram/day. The mean survival periods of the group (1) and (2) were 2.0±0.7 and 4.1±0.9 days, respectively.
The adsorbent was also given to the uremic dogs, following unilateral vein constriction accompanied by the ligation of the ureter or the hilum in the other side. The elevated levels of BUN and serum creatinine in the uremic dogs dropped during the adsorbent administration, however, tended to rise again after the adsorbent treatment was discontinued.
In serum HLC analysis, abnormal peaks observed in the control animals, clearly diminished in the adsorbent administered groups.
These results indicated that the oral adsorbent has the capability of improving uremic conditions by removing uremic toxins in the intestinal tract. The mechanism is under further investigation.

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We transplanted 4-5cm artificial esophagus of canine neck esophagus by Expanded Polytetra-fluoroethylene (EPTFE).
Five dogs were treated, only two dogs were long survived with slightly stenosis, but they had not silver disphagy.
We treated stenosis area by endoscopic cutting without traditional extension method, this new extension method of cutting was every easy and recurrence was slightly.
After one month postoperation, its inner surface of artificial esophagus was covered with reproduce mucosa, and it looked like normal mucosa.
In the future, we will transplant this artificial esophagus from neck to stomach as by-pass with unresectiable esophagial carcinoma patients.

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This is the second report on artificial esophagus made of collagen -sil icon copolymer. The most difficult problems in the study on artificial esophagus are leakage of the anastomosis and stenosis of the new esophagus.
We found that there were many superior properties on our material against these troublesome problems, so our artificial esophagus might be used on clinical cases by developing of the method of anastomosis and making an ideal type of the prosthesis in near future.

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Twelve patients, ages 7-77yr., who required long-term maintenance of nutrition parenterally, were placed on a program of an artificial gut system consisting of infusion bag, iv-line, and continuous infusion pump combined within the special jaketfor periods ranging from 1 to 119 days. This artificial gut system was safe and effective for maintaning an optimal nutritional status, and allowed all patients greater mobility and resumption of a more normal daily lifestyle.

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Continuous hypothermic perfusion is today an accepted method of renal preservation in the world. Some preservation machine such as Belzer, Waters (Mox 100), Travenol and Gambro are clinically used in U. S. A. and Europe. However, perfusion method of kidney preservation is not yet clinically used in this country. We have been developing a new preserving machine that would be easier to handle and cheaper to purchase. This machine is consisted of an organ chamber, two roller pumps, a membrane oxygenator, a heart exchanger, a refrigerator, two in-line thermistor probes and two automatic pressure controllers. An organ chamber has double walls which is consisted of inside and outside walls. Cold water flows between two walls to cool an organ chamber. A pressure controller maintains arterial systolic pressure to the indicated one, which is usually 60mmHg, and when the pressure rises, the controller decreases the rotation of the roller pump, making the renal flow rate lower. Belzer's cryoprecipitated plasma was used as the perfusate and we succeeded in preserving canine kidneys using this machine for 72-96 hrs.

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The feasibility and safety of liver irrigation using a three-lumen, two-balloon catheter were studied. The catheter was originally developed for selective venography (renal venography, hepatic venography), blood sampling and organ irrigation. The shaft part of the catheterr is made of silicon rubberr and the balloon part is mane of latex rubber. In 15 mongrel dogs with their BW ranging from 10 to 15Kg, the catheter was introduced through the femoral vein and advanced into the inferior vena cava near the orifice of the hepatic vein so that the proximal and distal balloons were located distally and proximally to the orifice, respectively. The location of the catheter was confirmed rentogenographically by injecting 15 to 20ml of 76% Urografin. Another two-lumen catheter was inserted through the opposite femoral vein and advanced to the inferior vena cava. One of the two lumens of the second cathcter was used as a bypass circuit for the occluded inferior vena cava, and the other for monitoring the inferior vena caval pressure. A third catheter introduced through basilic vein to monitor the CVP. HCG and direct arterial pressure were also monitored. After the inflation of the two balloons, liver irrigation was started. Each of the venous return from the hepatic vein and the inferior vena cava distal to the occlusion was returned to the external jugular vein through a separate extracorporeal circuit. Flow rate of each circuit was adjusted so that the pressure in the hepatic vein o the inferior vena cava mimic the CVP. The rate averaged between 20 to 30ml/Kg/min for the hepatic circuit and 10 to 18ml/Kg/min for the vena oval circuit. The present results the potential applicability of the double balloon catheter to the selective irrigation of the liver in vivo in the clinical situations.

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The feasibility and safety of selective kidney cooling using a three-lumen, two-balloon catheter were studied. The catheter was originally developed for selective venography (renal venography, hepatic venography), blood sampling and organ irrigation. The shaft part of catheter was made of silicon rubber and the balloon part was made of latex rubber. The diameters of the catheters used in the present experiment are 10F, 12F and 16F. The intervals between the two balloons are 7cm and 10cm. In 15nongrel dogs with their BW ranging from 7 to 15Kg, the catheter was introduced through the femoral or iliac artery and advanced into the abdominal aorta near the orifices of the renal arteries so that the proximal and distal balloons were located distally and proximally to the orifices, respectively. The location of the catheter in relation to the renal arteries was confirmed rentogenographically by injecting 10 to 15ml of 76% Urografin. After respiratory arrest by administration of succinylcholine the irrigation was started. The greater the irrigation speed per minute was, and with the shorter distance between the balloons, the higher was the cooling rate of the kidney surface. The pressure elevation between the balloons monitored by another catheter was in proportion to the irrigation speed.

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The experimental studies on left ventricular assist circulation (LVAC) using a pulsatile roller pump were carried out to relieve the strain on the failing left ventricle. This pump was attached between the left atrium and descending thoracic aorta in mongrel dogs weighing 14 to 20 kg. Left ventricular bypass pumping was instituted synchronously or asynchronously and hemodynamic changes were detected. The left atrial pressure decreased but was kept not to be in negative pressure. The left ventricular pressure decreased to zero and the systemic pressure was well maintained. But the pulmonary artery pressure increased slightly. Po₂ decreased, Pco₂ increased gradually and pH of blood decreased during LV bypass pumping.

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In the left heart bypass in which blood is withdrawn from the left atrium and pushed into a artery by a roller pump, the pulse pressure of arteries decreases in proportion to increase of bypassed blood flow. And peripheral circulatory failure occurs if the bypass is prolonged. Although blood is usually ejected in diastole of the heart in the left heart bypass using a pulsatile pump, it is better to eject it in systole when we think much of augmentation of pulse pressure and improvement of peripheral circulation. We examined how much the after-load to the heart increased in case blood is ejected in systole by measuring hemodynamic change and myocardial oxygen consumption.
Method) In mongrel dogs left heart bypass was instituted by inserting the cannulae to the left atrium and the left femoral artery. The coronary sinus was also canulated through the right atrial wall to sample out coronary sinus blood and measure the blood flow. Result) (1) The pulse pressure of arteries in steady-flow bypass group was 43% of that in control group, 82% in diastolic ejection group, 105% in systolic ejection group. (2) The end-diastolic pressure of the left ventricle was lower than that of control group even in systolic ejection group. It was in diastolic ejection group that the lowest pressure was recorded. (3) Myocardial oxygen consumption was about two thirds of that of control group in both steady-flow bypass group and diastolic ejection group. On the other hand it slightly increased (72%) in systolic ejection group, but was significantly lower as compared to that in control group.

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Effectiveness of both pulsatile and nonpulsatile LVADs in terms of systolic and diastolic LVP decompression, and diastolic augmentation was studied; both in vitro and in vivo data supports the validity o synchronous pulsatile LVAD concept during the recovery process of the myocardium.

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A permanently implantable intrathoracic left ventricular assist device (LVAD) for human use has been developed and evaluated in vitro and in vivo. A seamless layer of glutaraldehyde-treated gelatin as the blood contacting surface and the use of valves made of human dura mater eliminates the need for anticoagulation. The pump was designed to fit the chest wall interposed between the cardiac apex and the thoracic aorta. In vitro performance and flow visualization studies have shown satisfactory pump performance. Left ventricular unloading was well demonstrated in 11 in vivo experiments. Laboratory data for chronic experiments were within normal limits. Four long-term animals are continuing for periods of 1-3 months.

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In spite of improvement in membrance oxygenerator and assist circulatory device, the survival rate of severe patients such as ARDS, severe post myocardial infarction patients was still low range.
Recently many anthors reported that there is close relationships between interstitial odema and ARDS.
To clarify the transient osmotic fluid movement to/from interstitial tissue space and the role of colloid osmotic pressure in ARDS patients, basic animal experiments and clinical investigations were made with use of a new needle type oncometer.
By these study, the damage of capillary endothelial cell membranes and low colloid osmotic pressure were major reasons for ARDS.

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We designed originally the new neonatal apparatus for long respiratory assists (ECMO). Itscharacterics were closed circuit and single roller pump (8ml/RPM maximum, 240ml/30RPM) with automatic Sensors of intracircuit pressure, drainage pressure and air bubble detector. Using the 3kg dogs in hypoxic condition, the ECMO for 12 hours was perfumed with small plate membrane oxygenators (04M²). The satisfied gas transfer rates was showed under two membrane oxygenators V/Q=3.

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The present experiment was designed to study whether isolated hepatocytes maintained their metabolic activity after cryopreservation. Isolated hepatocytes were obtained from rabbit and prepared by the collagenase digestive methods. The hepatocytes were preserved in a liquid nitrogen freezer at -196°C. The metabolic activity was examined by the incubation technique utilizing a shaker flask. After thawing, the recovery rate of hepatocytes was 50% and their viability was 35%. Some metabolic activities were observed even after storage at -196°C for two weeks. This supports the possibility of developing a hybrid artificial liver utilizing cryopreserved hepatocytes.

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We mad is chemic liver failure model in, dogs with two step method, first postcaval shunt and second ligation of hepatic artery and common bile duct.
Hepatic assist was performed by separation rabbit liver cells (Hepatocyte). Both hepatic failure groups were by infusion of 10% glucose solution meintained and Linger's solution in the proportion one to two, and then this prognosis of hepatic assist group (three dogs) were compared to control group (seven dogs).
Chamber priming volume was 85ml and the blood was contacted with hepatocyte through N. M. F. There was no significant difference between bouth group in survival time but there was significant decrease of serum NH₃-N, GPT and LDH in hepatic assist group.

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1. Silicone oil hemodialysis is an effective method to eliminate glutethimide from the individuals and recovery of consciousness in dogs intoxicated with glutethimide can be attained. The longterm silicone oil hemodialysis is recommended especially in eliminating lipid-soluble substance which is bound with protein.
2. Thrombocytopenia is one of the inevitable side-effects in hemodialysis and development of more blood-compatible materials is essential. We devised new screening tst in vitro in order to evaluate blood-compatibility of newly-synthetic materials.

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In 22 acute liver failure patients, we have experienced that 64% of the patients with coma grade and 82% of the patients with coma grade were basic above 7.45 of arterial blood pH.
The patients in the basic condition were recovered from the illness in rase cases and were oftenly complicated with cerebral edema.
As temporary case system for compensation of basic condition, bicarbonate dialysis was useful, but buffer-free dialysis was more effctive for the pH control of the patients.
During bicarbonate or buffer-free dialysis, Their mental levels were not impaired, and therefore I think we must try the long-term dialysis for continuous control of their arterial blood pH levels.

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Recently we performed exchange transfusion (E. T.) and charcoal hemoperfusion (H. P.) on four cases of hepatic coma encountered by us and made a clinical study on E. T. ana H. P. They consisted of fulminant hepatitis three cases and one case of rapture of esophageal varix due to liver cirrhosis, there being one case on E. T., and two cases on H. P. and one case on the combination of E. T. and H. P. A comparative study was made on the clinicalbiochemical effect before and after E. T. and H. P. performed on these four cases to reach a conclusion as follows:
(1) It is unlikely that NH₃ could be eliminated to such an extent as is concerned with the recovery of consciousness following E. T. and H. P.
(2) As for methionine, phenylalanine, tyrosine and tryptophane of which values had hitherto been considered high it hepatic coma, they showed no relation with level of consciousness.
(3) It is presumed that not single substance but two or more substance other than the one hitherto mentioned will be concerned with the disturbance of consciousness.

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Rearoval of toxic substances from the circulating blood of patients with severe hapatic failures may be life-saving. Hemoperfusion with activated charcoal has been reported to be sometimes effective in recovering patients from hepatic coma, although the exact mechanism and removed substances from the blood responsible for these improvements has yet to be clarified. In the previous study, we have revealed that IONEX (Toray Industries) adsorbs both direct and indirect bilirubin from the blood in vitro. This removal of bilirubin from the blood has also been confirmed in direct hemoperfusion of the jaundiced dogs. It has been found that the removal of bilirubin is disturbed by thrombus formation on the IONEX fibers.
Prostagrandins (PG E₁ or PG I₂) was administered continuously into the arterial line of the extracorporeal circulation using IONEX column during the two-hour direct hemoperfusion. Thrombus formation in the IONEX column was not observed and the average removal rate of bilirubin from the blood of the jaundiced dogs was as much as 40%. It has also been found that bile acid in the blood is removed by direct hemoperfusion with IONEX. Average removal rate of bile acid after two-hour perfusion with 70gm of IONEX was 60%.

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In the sixth report, we had reported the new adsorber “Orelite”, which can adsorb the ammonia from the ultrafiltrate in our newly developed assisted artificial liver, direct ultrafiltrate perfusion (DUP) system, and also showed the high adsorption rate of ammonia.
In this study, we have studied about the two factors which influence the adsorption capacity in the orelite adsorber column. One is flow velocity and another is priming volume of the orelite in the column.
Furthermore, we investigated the new adsorbers which can adsorb the billirubin and non estelified fatty acid from the plasma, and have confirmed the high adsorption ratio.

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The use of activated charcoal for direct hemoperfusion (DHP) was attempted by Yatzidis in 1964 and by Chang in 1970. Since then, this method has come into wide use as a symptomatic therapy for drug intoxication, renal failure and hepatic failure.
In DHP therapy, however, the release of microparticles of charcoal causing thrombogenesis is the main problem.
Charcoal derived from thermosetting resin (CTSR) is more rigid than many kinds of activated charcoal used in the medical field. Furthermore, in vitro and in vivo experiments, it is suggested that this charcoal has superior adsorbability for many toxins and it will be available for DHP.

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XAD-4 resin is an uncoated and uncharged acrorenticular, styrene-diviriylbenzene coolymer with particular adsorbability for ipid-soluble and protein-bound substances, eing one of the most promising among various adsorbents for hepatic support. Depletion of the platelet and WBC is, however, one of the ritical problems for its clinical application.
To improve the blood compatibility, the coating of the resin by various materials, such. as Diacetylchitin, Poly-γ-benzyl-L-glutamic acid (PBLG), Cellulose acetate (CA) and Lysine ave been adopted and evaluated.
In vitro adsorption studies for ICG and entobarbital, followed by ex vivo blood comatibility study indicated Diacetylchitin, PB G and CA were promising in this order. In _vitro studies revealed Diacetylchitin effective o improve the blood compatibility, both for BC and platelet, PBLG was effective only for BC, while CA was for neither of them.
Based on these studies, Diacetylchitin coating of the XAD-4 resin is believed to be eady for clinical use.
In addition, the systematic evaluation or coating materials descrived here is recomended, because of its simplicity, reproducibility and requirement for small quantity of iven material for the study.

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XAD-4 Resin, one of the most promising among various adsorbents for hepatic failure, has been evaluated for its biocompatibility and performance. And, because of significant white blood cell and platelet depletion, plasma filtration system utilizing polyacrylonitrile membrane was employed for direct perfusion of the ultrafiltrate through the resin in hepatic ischemia model in this study.
The result so far is acceptable in that survival time was prolonged, release enzyme levels were controlled. Total amono acid level was suppressed remarkably by the treatment. Further, molar ratio valine + leucine + isoleucine vs. tyrosine + phenylalanine or essential amino acids were improved during the treatment. Neither white blood cell nor platelet counts showed significant depletion.
Efficacy and improved blood compatibility of this system learned by this study is interpreted to imply that this is ready for clinical application in which the liver is still supplied with blood and has capability to regenerate.

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A new type of artificial liver support system which was composed of two different sized hollow fibers was made in our clinical department.
Large pore sized hollow fiber consisted of the plasma separating apparatus can pass through the moderate molecular substances and small molecular substances such as electrolytes were reabsorbed by smaller pore sized hollow fiber.
This system was utilized for animal experiments successfully.
Bilirubin and transaminase in serum were reduced and there were no remarkable changes in the electrolytes.
Molar ratio was raised significantly.
Three patients suffered from hepatic coma were treated by this system and reduction of bilirubin was satisfactory even if we lost three of them.

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Many kinds of polymer, as cellulose acetate, polycarbonate and polyvinylalcohol, have not been satisfied on clinical use complitely.
We developed a new plasma sepalator using polysulfon hollow fiber and evaluted in vitro and in vivo experiment.
The structure of this membrane have three layer (inside and outside layer: skin layer, midle layer: pound layer).
In vitro examination evidenced that UFR was 1.1-1.6 1/mmHg.hr.m².
In vivo examination, we carried plasma exchange for hepatic failure in dogs.
As the result of plasma exchange at polysulfone, serum LDH, GOT and levels were decreased in clearly.
Polysulfon membrane will be hoped as a plasma separator and other application of a line from the view point of its flexible structure.

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The Simple and effective method of plasma exchange utilijing continuous flow membrane plasma pheresis has been developed and applied to a patient with acute renal failure well as those with hepatic failure.
The platelet free plasma was filtered through cellulose acetate hollow fibre during extracor poreal circulation.
Transmembrane pressure was kept within an desired range by pressure controller to avoid hemolysis. The same amount of fresh frozen plasma was substituted for the filtered plasma by double channed—roller—pump. The all procedure of plasma exchange was designed to be carried out automatically.
The patients has responded well to treatment. Plasma exchange is shown to be useful in managing a patient with acute renal failure who has not responded to the conventional dialysis and direct hemoperfusion to coated charcoal.
For hepatic failure, plasma exchange appears to be useful for removal of protein—boand toxins and correction of metabolic deficiencies by hepatic synthetic defects.

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A new technique named double filtration plasmapheresis in which larger molecular substances of plasma conponents are selectively removed has been developed utilizing filtration separation. With a technique of extracorporeal circuration. Blood is devidid into the formed blood elements and the plasma by a first plasma separator made from polyvinylalcohol hollow fibers. Then, the plasma is separated into larger molecular substances such as globulin fraction and smaller molecules substances such as albumin and electrolytes by a second plasma filtrator made from Ethylenevinylalcohol hollow fibers. The latter is mixed with the formed blood elements to be returnd to the body. Larger molcular substanced are selectivery removed from the line. Double filtration plasma pheresis is proved to be technically feasible both in vitro and in clinical practice.

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Autoascit® had been developed to treat intractable ascites and succesfully used for the last several years. Cells and bacteria from the ascitic fluid are removed by this device and the sterilized, cell-free and concentrated ascitic fluid is reinfused into the blood stream. The device had been applied to more than 300 cases of intractable ascites with satisfactory result.
Recently a new completly automated model of Autoascit has been developed. This device is superior to the old one because of the following three point:
(I) the intermittent air driven, volumelimited pump is replaced by a roller pump with the regulator to operate the pump within safe pressure limits. The continuous flow of the fluid is helpful to prevent filter microhole to be blocked with corpuscular elements of the fluid. (2) The new device is equipped with a newly developed protein sensor to regulate the protein level of the concentrated asciric fluid at the desired level. (3) The efficiency of the filter and a concentrator has been improved.
The new device has been satisfactorily applied to 23 cases of intractable ascites. Its efficiency is almost twice that of the old one. It is expected to find wider use in the near future.

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Thirty eight intractable ascitic patients were treated with peritoneocaval shunt pump. Thier original diseases were various. (liver cirrhosis 24, carcinomatous peritonitis 6, uremia 6, obstructive jaundice 1, Budd-Chiari syndrome 1, unknown origin 1) All patients had a significant reduction in body weight and abdominal girth concomitant with an increase in urine output after implantation. Improvement in renal and liver function was obtained in eight patients. One third of the patients (11 patients) died within the first month after pump implantation. The causes of the death at this period were original disease (5 patients), disseminated intravascular coagulopathy (4 patients), gastro-intestinal bleeding (1 patient) and unrelated disease (1 patient).
Further studies are nessesary to make the mortality rate diminish within the first month after operation.

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The urea cycle and related enzymes were immobilized on CNBr-activated Sepharose 4B. Ammonia was succesively converted to urea by the immobilized urea cycle enzymes with ATP-regenerating systems.
The optimum conditions for the cycle reaction in a packed column reactor were obtained theoretically and experimentally for performing continuous urea synthesis under various feed concentrations of ammonia, ornithine and ATP. The optimum packed system for urea synthesis was obtained by separating carbamoylphosphate synthetase (EC 2. 7. 2. 5) from ornithine-cycled enzymes, i. e. ornithine carbamoyltransferase (EC 2. 1. 3. 3), argininosuccinate synthetase (EC 6. 3. 4. 5), argininosuccinate lyase (EC 4. 3. 2. 1) and arginase (EC 6. 5. 3. 1), mixing the ornithine-cycled enzymes in one phase. The optimal total enzyme activties required and ATP-efficiency for urea conversion from ammonia in the packed system were also obtained.

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The infectious agent in serum hepatitis is not clearly defined, but the presence of hepatitis B antigen (hepatitis B virus) is an indicator of potential infectivity.
This report represented the study on immunoadsorption of HBs-antigen from HBs-antigen positive serum by means of sepharose immobilized HBs-antibody. The removal of HBs-antigen from serum was performed in batch process and column affinity process.
The results were as follows:
1. Immobilized HBs-antibody is able to adsorb specifically HBs-antigen.
2. High adsorbent rate is gained by immobilizing HBs-antibody which has more pure and more active immunological potency.
3. Immunoadsorbent method is exceedingly superior to non-specific adsorbent method such as activated charcoal.

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