人工腎臓に関する研究
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The author devised the modified Alwall type artificial kidney which could be applied simply and safely to clinical use and investigated on the fundamental problems experimentally and clinically focusing to the influences on the blood hemo-dynamics. A. The ability of this apparatus 1) It is small and portable, weighing 15Kg and is easily constructed and operated. 2) The elevation of internal pressure of this apparatus is almost negligible against the increase of circulatory blood. The Variation of pressure from 0 to 300mmHg in circuit brought the blood volume changes in apparatus within 100ml and so this convienient for ultra-filtration. 3) Extra-corporal circulation and balance maintenance of circulatory blood volume were easily performed by applying the blood pool bag and the small pump. Thus, this is convienient for adoptation of V-V induction system. 4) The dializing ability demonstrated by circulating the 5L urea solution with the concentration of 200mg/dl through this apparatus, 35% of urea after 1hr., 65% of urea after 2hr. and 78% of urea after 3hr. were removed respectively with the flow rate of 200 ml/min., 5) The decrease of non-nitrogen protein in clinical cases were 10-40mg (average 20mg) /dl/hr.. B. Experimental results. 1) The leucocytes decreasing rate was 25-51% after 2 hours dialysis and the platelets decreasing rate was 47.1% on the average. The leucocytes which attached to the cellophane tube were below 3000/mm^2. 2) The 44 mongrel dogs weighing 10-20Kg were used, dividing into three groups, 8 as a control, 22 as a A-V group and 14 as a V-V group. Half of which were undergone bilateral nephrectomy 24-48 hours before and N.P.N. were being elevated up to 96-182 mg/dl. The changes of hemo-dynamics were investigated inconformity with Saito's method from Wezler-Boger's analysis of physical circulatory dynamics. The author confirmed that A-V induction system is not always dangerous, V-V induction system is more safer. C. Clinical results. Dialyses were performed 22 times in all on 12 patients of acute renal insufficiencies and 8 patients of chronic deseases. For acute disease, remarkable effects were noted in 7 cases (58.4%), moderates effects were also noted in 5 cases (41.6%) were dead. All cases died after dialyses were due to serious original disease. Moderate effects were demonstrated in 50% for clinically suffered cases but all cases were dead. For these cases necessity of intermittent dialysis and transplantation of kidney should be emphasized.
- 千葉大学の論文
- 1963-11-28
著者
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