COMMUNICATIONS 3 75

Abstracts from the Japanese Journal of Artificial Organs"

Published by the Japanese Society for Artificial Organs and Tissues

POSTOPERATIVE HEMATOLOGIC STUDY IN PATIENTS WITH AORTIC SILICON BALL VALVE AND PYROLITE CARBON TILTING DISC VALVE. Y. Asai, K. Sugiki, I. Ki- tano, T. Kazui, T. Abe, and S. Komatsu (Department of Tho- racic and Cardiovascular Surgery, Sapporo Medical College. Sapporo, Japan) Jinkozoki 12(3):817, 1983.

Hematologic investigation in patients who underwent aortic valve replacement with silicon ball valve (Starr-Edwards and Smeloff-Cutter, 16 cases) and pyrolite carbon tilting disc valve (Lillehei-Kaster, 18 cases) was undertaken. All patients were followed for 1 year after operation and were free from any medical or surgical problems. There was no statistical signifi- cance between silicon ball valve and tilting disc valve in whole blood examination, total bilirubin, serum iron, and serum LDH. Both groups showed higher levels of serum LDH activity, which means chronic hemolysis. Haptoglobin level of all cases was <I00 mg/dl, which also indicates chronic hemolysis. The mean values of tilting disc valve showed statistically significant higher levels than those for silicon ball valve (44.72 2 20.98 mgidl vs. 31.44 5 12.79 mgldl, p < 0.05). So silicon ball valve showed a greater tendency to produce hemolysis in the aortic position when compared to the pyrolite carbon tilting disc valve. Key Words: Silicon ball-Pyrolite carbon-Tilting disc valve- Serum LDH-Haptoglobin.

CLINICAL EXPERIENCE WITH THE TERUMO CAPIOX I1 HOLLOW-FIBER OXYGENATOR. H . Matsukura, M. Sakuma, K . Go, H. Horiguchi, Y. Matsui, M. Nenohi, K. Sakai, T. Kawakami, and T. Tanabe (Second Department of Surgery, Hokkaido University School of Medicine, Sapporo, Japan) Jin- kozoki 12(3):821, 1983.

The new hollow-fiber oxygenator Terumo Capiox I1 was used for open heart surgery in I5 patients and compared with the Shiley bubble oxygenator which was used in 16 patients. The following results were obtained: ( I ) the hollow-fiber oxygenator required less priming volume; (2) it showed less hemolysis and less metabolic changes; ( 3 ) i t maintained adequate perfusion pressure and flow in spite of one pump system; (4) it showed adequate oxygenation in spite of relative low oxygen-blood flow ratio (0.4). But, we now use a device for supplying mixed gas because inadequate elimination of carbon dioxide was observed. There were no problems with this unit during extracorporeal circulation. Key Words: Hollow-fiber oxygenator-Bubble oxygenator-Blood oxygen-flow ratio-Blood damage.

NECROSIS OF RAT HEPATOMA TISSUE AFTER EXTRA- CORPOREAL PLASMA PERFUSION OVER PROTEIN A COLUMNS. K. Kanai, T. Nakajima, H. Isoda, I. Shichi, K. Souda, N. Sakai, K. Komatsu, M. Toyama, *M. Kako, *M. Torii, tT. Kiyota, and tH. Hayashi (Second Department of Internal Medicine, University of Hamamatsu School of Medicine, Shi- zuoka; *Department of Internal Medicine, Teikyo University School of Medicine, Tokyo; and ?Institute for Technological Re- search, Asahi Chemical Industry, Shizuoka, Japan) Jinkozoki 12(3):828, rY83.

Extracorporeal plasma perfusions over columns containing Protein A of Staphylococcus aureus Cowan I (PA column) were

* Jinkozoki, Volume I ? , Numbers 3-5, 1983

performed in rats bearing the transplantable hepatoma AH 66. Extensive necrosis of the hepatoma tissues was observed 24 h after perfusion. Infiltration of mononuclear cells in tumor tissues was also remarkable. IgG was the only protein retained on the PA column. NO specific adsorption of plasma proteins was ob- served in control rats treated with a Sepharose column. Immu- nohistochemically, increased deposits of IgG in tumor tissues treated with PA column was observed. There were no side effects due to the extracorporeal plasma perfusion over the PA column. Key Words: Plasma perfusion-Protein A-Hep- atoma-Blocking factor-Necrosis.

PERITONEAL DIALYSIS WITH L-SODIUM LACTATE- LACTATE LEVEL OF BLOOD AND DIALYZATE AND ITS ALKALIZING EFFECT. T. Ogawa, Y. Koutou, F. Kurata, and Y. Hanyuda (Department of Internal Medicine, Second Hospital, Nippon Medical School, Kawasaki, Japan) Jinkozoki 12(4):878, 1983.

Sodium D,L-lactate is commonly used a s an acidosis-cor- recting agent in parenteral solutions for fluid therapy. As its D- configuration is nonphysiological, disadvantages such a s a slower rate of metabolism and a different metabolic pathway from that of its L-configuration have been reported. Therefore, the D-configuration makes its usefulness as well as its safety questionable, especially in infants, as they can metabolize D- configuration only a little. In this study, a comparison was made between a peritoneal dialysate containing the L-configuration only (L-solution) and the conventional one containing L- and D- configurations (50:50; D,L-solution). The lactate levels in blood and dialysate, alkalizating effect, etc., were examined in 2 cases of chronic renal failure on intermittent peritoneal dialysis. With s solution, the D- and L-lactate levels in blood remained un- changed, while an increase of D-lactate level in blood was ob- served after dialysis with D,L-solution. The former solution had a tendency to have more improvement in BE, although statisti- cally significant differences were not observed. Sodium L-lactate seems preferable as an acidosis-correcting agent since endoge- nous lactic acid has an L-configuration. Other favorable effects are expected in abnormal carbohydrate metabolism or hepatic failures. Key Words: L-Lactate- Peritoneal dialysate-Aci- dosis-correcting agent.

PHARMACOKINETIC ANALYSIS OF DIRECT HEMO- PERFUSION WITH SPECIAL CONCERN FOR ACUTE RE- MOVAL OF ANTICANCER AGENTS. J. Yamagata (Kidney Center, Tokyo Women's Medical College, Tokyo, Japan) Jinko- zoki 12(5):934, 1983.

Sixteen mongrel dogs weighing 10-17 kg were divided into three experimental groups: DHP, control, and intraarterial in- fusion. Hemoperfusion over charcoal was performed for 180 rnin with blood flow of 100 ml/min immediately after administration of an anticancer agent using Hydron-coated activated charcoal, DHP-1 (Kuraray, Japan). A large dose of anticancer agent (mi- tomycin C, l mg/kg) was administered into the femoral vein as a bolus (infusion time was (2 rnin). In control group, the same dose of mitomycin C was administered into the antecubital vein without hemoperfusion. All animals died within 8 days after bolus administration of mitomycin C (1 mg/kg) in the control group due to acute intoxication; in contrast, all dogs were com-

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3 76 COMM UNICA TIONS

pletely rescued from this toxicity by direct hemoperfusion. Dis- tribution volume in the central compartment ( V , ) was 0.17833 2 0.03587 L/kg in the control group and 0.45251 2 0.06843 L/kg in the DHP group ( p < 0.01). Distribution volume in the periph- eral compartment (Vdss) was larger in the DHP group than in the control group, also (p < 0.001). Estimated mitomycin C removed during hemoperfusion was 13% of the administered doses. Key Words: Mitomycin C-Pharmacokinetics-He- moperfusion- Activated charcoal.

SUBSTANCE RESPONSIBLE FOR SCLERITIS INDUCED BY NAC DIALYZER. S. Koshikawa, *M. Kogure, tM. Mae- kawa, SN. Mimura, IN. Nakabayashi, and *K. Ota (Showa Uni- versity Fujigaoka Hospital, Yokohama; *Tokyo Women’s Med- ical College, Tokyo; ?Osaka City University; SToranomon Hos- pital; and §Tokyo Medical and Dental University, Tokyo, Japan) Jinkozoki 12(5):943, 1983.

Scleritis was induced in about 170 patients, whose hemodi-

alysis were performed with an NAC dialyzer composed of cel- lulose acetate hollow fibers. Though pain and redness of eyes persisted for about 2 weeks, visual disturbances improved com- pletely except in one case. Searches for an etiologic agent were carried out. Extracts of the dialyzer injected intravenously into animals caused conjunctivitis in rabbits and scleritis in dogs. Fractionations of extracts were performed by Sephadex LH-20. When each fraction was injected into animals, fractions 5 and 6 produced redness of eyes. Analyses of these fractions by IR, UV, and NMR demonstrated that they contained cellulose ac- etate oligomers and urethane oligomers. These substances were produced experimentally by the reaction of cellulose acetate oli- gomer and urethane. Extracts of these substances showed in Sephadex fractionation the same fractions 5 and 6, and injections in dogs produced scleritis. These results indicate that the causal factors are composed of cellulose acetate oligomer and urethane oligomer and are produced by reaction of the two at the assembly of dialyzer. Key Words: Dialyzer-Scleritis-Cellulose ac- etate oligomer- Urethane oligomer.

ArtifOrgans, Vol. 8, No. 3 , 1984