Journal of Artificial Organs最新文献_第9页

Feasibility of an animal model for long-term mechanical circulatory support with Impella 5.5 implanted through carotid artery access in sheep 绵羊颈动脉通路植入 Impella 5.5 长期机械循环支持动物模型的可行性

IF 1.3 4区医学

Journal of Artificial Organs Pub Date : 2024-04-20 DOI: 10.1007/s10047-024-01444-0

Shusuke Imaoka, Tomohiro Nishinaka, Toshihide Mizuno, Akihide Umeki, Takashi Murakami, Tomonori Tsukiya, Masashi Kawamura, Shigeru Miyagawa

{"title":"Feasibility of an animal model for long-term mechanical circulatory support with Impella 5.5 implanted through carotid artery access in sheep","authors":"Shusuke Imaoka, Tomohiro Nishinaka, Toshihide Mizuno, Akihide Umeki, Takashi Murakami, Tomonori Tsukiya, Masashi Kawamura, Shigeru Miyagawa","doi":"10.1007/s10047-024-01444-0","DOIUrl":"https://doi.org/10.1007/s10047-024-01444-0","url":null,"abstract":"Impella is a mechanical circulatory support device of a catheter-based intravascular microaxial pump for left ventricular support and unloading. However, nonclinical studies assessing the effects of the extended duration of left ventricular unloading on cardiac recovery are lacking. An animal model using Impella implanted with a less invasive procedure to enable long-term support is required. This study aimed to evaluate the feasibility of an animal model for long-term support with Impella 5.5 implanted through carotid artery access in sheep.Impella 5.5 was implanted in four sheep through the proximal region of the left carotid artery without a thoracotomy, and myocardial injuries were induced by coronary microembolization. Support by Impella 5.5 was maintained for 4 weeks, and the animals were observed. The position of Impella 5.5 and cardiac function was evaluated using cardiac computer tomography at 2 and 4 weeks after implantation.All four animals completed the 4-week study without major complications. The discrepancy in the Impella 5.5 flow rate between the conscious and anesthetized states was observed depending on the device’s position. Animals in whom the inflow was above the left ventricular papillary muscle had a relatively high flow rate under the maximum performance level without a suction alarm during the conscious state. Pathological changes in the aortic valve were observed. Cardiac function under the minimum performance level was observed with no remarkable deterioration.The animal model with myocardial injuries supported for 4 weeks by Impella 5.5 implanted through carotid artery access in sheep was feasible.","PeriodicalId":15177,"journal":{"name":"Journal of Artificial Organs","volume":"60 1","pages":""},"PeriodicalIF":1.3,"publicationDate":"2024-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140623648","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Advance care planning in the treatment of implantable left ventricular assist device: a republication of the review published in Japanese Journal of Artificial Organs 植入式左心室辅助装置治疗中的预先护理计划：重新发表在《日本人工器官杂志》上的评论文章

IF 1.3 4区医学

Journal of Artificial Organs Pub Date : 2024-04-13 DOI: 10.1007/s10047-024-01443-1

Yoko Sakamoto, Ryohei Matsuura, Daisuke Yoshioka, Ai Kawamura, Sumiharu Nakamae, Shigeru Miyagawa

{"title":"Advance care planning in the treatment of implantable left ventricular assist device: a republication of the review published in Japanese Journal of Artificial Organs","authors":"Yoko Sakamoto, Ryohei Matsuura, Daisuke Yoshioka, Ai Kawamura, Sumiharu Nakamae, Shigeru Miyagawa","doi":"10.1007/s10047-024-01443-1","DOIUrl":"https://doi.org/10.1007/s10047-024-01443-1","url":null,"abstract":"Advance care planning (ACP) is essential in managing serious and chronic illnesses to ensure that patients receive care aligned with their personal values, goals, and preferences. This review focuses on integrating ACP in the treatment of patients receiving implantable left ventricular assist devices (VADs). The heart failure palliative care team developed a unique advance directive form and pamphlet to facilitate ACP discussions, emphasizing not only medical treatment preferences but also patients’ values and life goals.The study highlights the distinction between bridge to transplantation (BTT) and destination therapy (DT) in VAD patients, with different goals and considerations for ACP. The use of decision aids developed especially for DT candidates as a communication tool helps in sharing patients’ wishes and facilitates shared decision-making, particularly in the complex decisions surrounding DT therapy.Challenges in implementing ACP, such as time constraints due to urgent medical conditions, difficulties in patient communication, and the recent COVID-19 pandemic, are addressed. The need for a comprehensive healthcare system capable of supporting patients’ ACP wishes, especially in the community setting, is also pointed out.Future directions include not only developing materials to ease ACP discussions and ensuring that ACP content is shared among healthcare providers to foster collaborative and detailed planning, but also a call for widespread adoption of ACP in Japan.This is a translation of a paper written in Japanese Journal of Artificial Organs (Vol. 52, No. 1, pp. 89–92) with additions and corrections.","PeriodicalId":15177,"journal":{"name":"Journal of Artificial Organs","volume":"2016 1","pages":""},"PeriodicalIF":1.3,"publicationDate":"2024-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140583601","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Management of aortic valve insufficiency in patients with continuous-flow left ventricular assist device: a republication of the review published in Japanese Journal of Artificial Organs 使用持续流左心室辅助装置的主动脉瓣功能不全患者的管理：重新发表在《日本人工器官杂志》上的评论文章

IF 1.3 4区医学

Journal of Artificial Organs Pub Date : 2024-04-10 DOI: 10.1007/s10047-024-01439-x

Naoki Tadokoro, Kohei Tonai, Satoshi Kainuma, Naonori Kawamoto, Kota Suzuki, Masaya Hirayama, Satsuki Fukushima

{"title":"Management of aortic valve insufficiency in patients with continuous-flow left ventricular assist device: a republication of the review published in Japanese Journal of Artificial Organs","authors":"Naoki Tadokoro, Kohei Tonai, Satoshi Kainuma, Naonori Kawamoto, Kota Suzuki, Masaya Hirayama, Satsuki Fukushima","doi":"10.1007/s10047-024-01439-x","DOIUrl":"https://doi.org/10.1007/s10047-024-01439-x","url":null,"abstract":"Since 2011, implantable ventricular assist devices have been a standard treatment for severe heart failure alongside heart transplantation in Japan. However, the limited availability of donors has led to a prolonged wait for transplants, now averaging 1719 days, intensifying the issue of aortic insufficiency in patients with continuous flow ventricular assist devices. These devices limit the opening of the aortic valve, leading to sustained closure and increased shear stress, which accelerates valve degradation. Risk factors for aortic insufficiency include having a smaller body surface area, being of advanced age, and the presence of mild aortic insufficiency prior to device implantation. In patients presenting with mild or moderate aortic regurgitation at the time of ventricular assist device implantation, interventions such as aortic valve repair or bioprosthetic valve replacement are performed with the aim of halting its progression. The choice of surgical procedure should be tailored to each patient’s individual condition. The management of de novo aortic insufficiency in patients with continuous flow ventricular assist devices remains challenging, with no clear consensus on when to intervene. Interventions for significant aortic insufficiency typically consider the patient’s symptoms and aortic insufficiency severity. De novo aortic insufficiency progression in continuous flow ventricular assist devices patients necessitates careful monitoring and intervention based on individual patient assessments and valve condition. This review was created based on a translation of the Japanese review written in the Japanese Journal of Artificial Organs in 2023 (Vol. 52, No. 1, pp. 77–80), with some modifications.","PeriodicalId":15177,"journal":{"name":"Journal of Artificial Organs","volume":"25 1","pages":""},"PeriodicalIF":1.3,"publicationDate":"2024-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140583609","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Impact of inflammation and steroids on anti-coagulation in children supported on a ventricular assist device 炎症和类固醇对使用心室辅助装置的儿童抗凝血功能的影响

IF 1.3 4区医学

Journal of Artificial Organs Pub Date : 2024-04-06 DOI: 10.1007/s10047-024-01442-2

{"title":"Impact of inflammation and steroids on anti-coagulation in children supported on a ventricular assist device","authors":"","doi":"10.1007/s10047-024-01442-2","DOIUrl":"https://doi.org/10.1007/s10047-024-01442-2","url":null,"abstract":"<h3>Abstract</h3> Critically ill pediatric patients supported on ventricular assist devices (VADs) are increasingly being anticoagulated on bivalirudin, but with difficulty monitoring anticoagulation. Activated partial thromboplastin time (aPTT) has recently been shown to poorly correlate with bivalirudin plasma concentrations, while dTT had excellent correlation. However, aPTT is the more common monitoring test and dTT testing is rarely used. In addition, effects of frequent clinical VAD scenarios (such as inflammation) on the accuracy of aPTT and dTT testing remains uncertain. We reviewed the effects of clinical scenarios (infection/inflammation, chylothorax, and steroids administration) on anticoagulation monitoring in 10 pediatric VAD patients less than 3 years at Cincinnati Children's Hospital Medical Center from 10/27/2020 to 5/6/2022 using bivalirudin for anticoagulation. There were 16 inflammation/infection, 3 chylothorax, and 6 steroids events. Correlation between dTT and aPTT was significantly lower after infection/inflammation, with dTT increasing prior to inflammation/infection while aPTT remained unchanged. In addition, steroids are administered to VAD patients to reduce inflammation and thus additionally stabilize anticoagulation. However, this anticoagulation stabilization effect was reflected more accurately by dTT compared to aPTT. In children requiring VAD support utilizing bivalirudin anticoagulation, inflammation/infection is a common occurrence resulting in anticoagulation changes that may be more accurately reflected by dTT as opposed to aPTT.","PeriodicalId":15177,"journal":{"name":"Journal of Artificial Organs","volume":"57 1","pages":""},"PeriodicalIF":1.3,"publicationDate":"2024-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140583610","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Predictive role of regional thigh tissue oxygen saturation monitoring during cardiopulmonary bypass in lung injury after cardiac surgery 心肺旁路过程中大腿区域组织氧饱和度监测对心脏手术后肺损伤的预测作用

IF 1.3 4区医学

Journal of Artificial Organs Pub Date : 2024-03-18 DOI: 10.1007/s10047-024-01438-y

Tomoki Tamura, Fumiaki Shikata, Tadashi Kitamura, Masaomi Fukuzumi, Yuki Tanaka, Tomoyo Ebine, Kiyotaka Fujii, Satoshi Kohira, Kagami Miyaji

{"title":"Predictive role of regional thigh tissue oxygen saturation monitoring during cardiopulmonary bypass in lung injury after cardiac surgery","authors":"Tomoki Tamura, Fumiaki Shikata, Tadashi Kitamura, Masaomi Fukuzumi, Yuki Tanaka, Tomoyo Ebine, Kiyotaka Fujii, Satoshi Kohira, Kagami Miyaji","doi":"10.1007/s10047-024-01438-y","DOIUrl":"https://doi.org/10.1007/s10047-024-01438-y","url":null,"abstract":"Acute respiratory distress syndrome (ARDS) is a serious complication following cardiac surgery mainly associated with the use of cardiopulmonary bypass (CPB), which could increase the risk of mortality and morbidity. This study investigated the association of regional oxygen saturation (rSO2) during CPB with postoperative outcomes, including respiratory function. Patients who underwent cardiac surgery with CPB from 2015 to 2019 were included. Near-infrared spectroscopy was used to monitor rSO2 at the forehead, abdomen, and thighs throughout the surgery. Postoperative markers associated with CPB were assessed for correlations with PaO2/FiO2 (P/F) ratios at intensive care unit (ICU) admission. Postoperative lung injury (LI) was defined as moderate or severe ARDS based on the Berlin criteria, and its incidence was 29.9% (20/67). On multiple regression analysis, the following were associated with P/F ratios at ICU admission: vasoactive-inotropic scores at CPB induction (P = 0.03), thigh rSO2 values during CPB (P = 0.04), and body surface area (P < 0.001). A thigh rSO2 of 71% during CPB was significantly predictive of postoperative LI with an area under the curve of 0.71 (P = 0.03), sensitivity of 0.70, and specificity of 0.68. Patients with postoperative LI had longer ventilation time and ICU stays. Thigh rSO2 values during CPB were a potential predictor of postoperative pulmonary outcomes.","PeriodicalId":15177,"journal":{"name":"Journal of Artificial Organs","volume":"48 1","pages":""},"PeriodicalIF":1.3,"publicationDate":"2024-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140149965","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Comparison of the pre-dilution and post-dilution methods for online hemodiafiltration. 在线血液渗滤的预稀释法和后稀释法的比较。

IF 1.3 4区医学

Journal of Artificial Organs Pub Date : 2024-03-01 Epub Date: 2023-04-03 DOI: 10.1007/s10047-023-01391-2

Yusuke Kawai, Kazuya Maeda, Misaki Moriishi, Hideki Kawanishi, Takao Masaki

{"title":"Comparison of the pre-dilution and post-dilution methods for online hemodiafiltration.","authors":"Yusuke Kawai, Kazuya Maeda, Misaki Moriishi, Hideki Kawanishi, Takao Masaki","doi":"10.1007/s10047-023-01391-2","DOIUrl":"10.1007/s10047-023-01391-2","url":null,"abstract":"Online hemodiafiltration (OL-HDF) is a treatment modality using diffusion and ultrafiltration. There are two types of dilution methods in OL-HDF: pre-dilution, which is commonly provided in Japan, and post-dilution, which is commonly provided in Europe. The optimal OL-HDF method for individual patients is not well studied. In this study, we compared the clinical symptoms, laboratory data, spent dialysate, and adverse events of pre- and post-dilution OL-HDF. We conducted a prospective study of 20 patients who underwent OL-HDF between January 1, 2019 and October 30, 2019. Their clinical symptoms and dialysis efficacy were evaluated. All patients underwent OL-HDF every 3 months in the following sequence: first pre-dilution, post-dilution, and second pre-dilution. We evaluated 18 patients for the clinical study and 6 for the spent dialysate study. No significant differences in spent dialysates regarding small and large solutes, blood pressure, recovery time, and clinical symptoms were observed between the pre- and post-dilution methods. However, the serum α1-microglobulin level in post-dilution OL-HDF was lower than that in pre-dilution OL-HDF (first pre-dilution: 124.8 ± 14.3 mg/L; post-dilution: 116.6 ± 13.9 mg/L; second pre-dilution: 125.8 ± 13.0 mg/L; first pre-dilution vs. post-dilution, post-dilution vs. second pre-dilution, and first pre-dilution vs. second pre-dilution: p = 0.001, p < 0.001, and p = 1.000, respectively). The most common adverse event was an increase in transmembrane pressure in the post-dilution period. Compared to pre-dilution, the post-dilution method decreased the α1-microglobulin level; however, there were no significant differences in clinical symptoms or laboratory data.","PeriodicalId":15177,"journal":{"name":"Journal of Artificial Organs","volume":" ","pages":"48-56"},"PeriodicalIF":1.3,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9235668","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Successful treatment of diabetic ketoacidosis secondary to fulminant type 1 diabetes mellitus using a closed-loop artificial pancreas in a pediatric patient. 使用闭环人工胰腺成功治疗一名儿童患者因暴发性 1 型糖尿病而引发的糖尿病酮症酸中毒。

IF 1.3 4区医学

Journal of Artificial Organs Pub Date : 2024-03-01 Epub Date: 2022-12-13 DOI: 10.1007/s10047-022-01378-5

Takahiko Tamura, Tsukasa Tadokoro, Hideki Iwata, Tsutomu Namikawa, Kazuhiro Hanazaki, Takashi Kawano

{"title":"Successful treatment of diabetic ketoacidosis secondary to fulminant type 1 diabetes mellitus using a closed-loop artificial pancreas in a pediatric patient.","authors":"Takahiko Tamura, Tsukasa Tadokoro, Hideki Iwata, Tsutomu Namikawa, Kazuhiro Hanazaki, Takashi Kawano","doi":"10.1007/s10047-022-01378-5","DOIUrl":"10.1007/s10047-022-01378-5","url":null,"abstract":"Diabetic ketoacidosis (DKA) is a life-threatening complication of pediatric diabetes mellitus (DM). A bedside closed-loop artificial pancreas (AP) (STG-55; NIKKISO, Tokyo, Japan) maintains the blood glucose (BG) levels within the target range via automatic infusion of insulin and glucose. We report the application of the closed-loop AP to safely control the BG levels of a pediatric patient with DKA. A 12-year-old child with an unremarkable medical history presented with fever and restlessness. The patient was diagnosed with DKA secondary to fulminant type 1 DM and was treated with insulin infusion. He presented with Glasgow Coma Scale of E2V3M4. Arterial blood gas analysis revealed metabolic acidosis and BG levels of 489 mg/dL. His urine test was positive for ketones. Along with infusion therapy, automatic BG control using a closed-loop AP was initiated after ICU admission. This was adjusted to maintain BG levels within 100 mg/dL/6 h or less. After 24 h in the ICU, the patient regained consciousness and recovered from the metabolic acidosis. His general condition improved, and he was prescribed a diet treatment. The treatment was shifted to continuous insulin infusion, and he was transferred to the general ward, and was discharged on the 33rd day of hospitalization. The closed-loop AP prevented repetitive blood extractions, achieved prompt glycemic control, and prevented cerebral edema in a pediatric patient with DKA. This is the first report of successful treatment of DKA using a bedside closed-loop AP.","PeriodicalId":15177,"journal":{"name":"Journal of Artificial Organs","volume":" ","pages":"73-76"},"PeriodicalIF":1.3,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10700241","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Left ventricular remodeling and long-term outcomes of aortic stenosis patients receiving 19 mm Mosaic. 接受 19 毫米 Mosaic 治疗的主动脉瓣狭窄患者的左心室重塑和长期预后。

IF 1.3 4区医学

Journal of Artificial Organs Pub Date : 2024-03-01 Epub Date: 2023-03-29 DOI: 10.1007/s10047-023-01390-3

Daijiro Hori, Takahiro Yamamoto, Naoyuki Kimura, Atsushi Yamaguchi

{"title":"Left ventricular remodeling and long-term outcomes of aortic stenosis patients receiving 19 mm Mosaic.","authors":"Daijiro Hori, Takahiro Yamamoto, Naoyuki Kimura, Atsushi Yamaguchi","doi":"10.1007/s10047-023-01390-3","DOIUrl":"10.1007/s10047-023-01390-3","url":null,"abstract":"Mosaic valve shows higher pressure gradient after aortic valve replacement compared to other same size labeled prostheses in postoperative echocardiogram. The purpose of this study was to evaluate the mid-term echocardiogram findings and long-term clinical outcomes of patients receiving a 19 mm Mosaic. Forty-six aortic stenosis patients receiving 19 mm Mosaic and 112 patients receiving either 19 mm Magna or Inspiris, who underwent mid-term follow-up echocardiogram were included in the study. Mid-term hemodynamic measurements evaluated by trans-thoracic echocardiogram and long-term outcomes were compared. Patients receiving Mosaic were significantly older (Mosaic: 76 ± 5.1 years vs. Magna/Inspiris: 74 ± 5.5 years, p = 0.046) and had smaller body surface area (Mosaic: 1.40 ± 0.114m2 vs. Magna/Inspiris: 1.48 ± 0.143m2, p < 0.001). There were no significant differences in comorbidities and medications. Post-operative echocardiogram performed at 1 week after the surgery showed higher maximum pressure gradient in patients receiving Mosaic (Mosaic: 38 ± 13.5 mmHg vs. Magna/Inspiris: 31 ± 10.7 mmHg, p = 0.002). Furthermore, mid-term echocardiogram follow-up performed at median duration of 53 ± 14.9 months after the surgery continuously showed higher maximum pressure gradient in patients receiving Mosaic (Mosaic: 45 ± 15.6 mmHg vs. Magna/Inspiris: 32 ± 13.0 mmHg, p < 0.001). However, there were no significant difference in changes in left ventricular mass from baseline in both groups. Kaplan-Meyer curve also showed no difference in long-term mortality and major adverse cardiac and cerebrovascular event between the two groups. Although the pressure gradient across the valve evaluated by echocardiogram was higher in 19 mm Mosaic compared to 19 mm Magna/Inspiris, there were no significant differences in left ventricular remodeling and long-term outcomes between the two groups.","PeriodicalId":15177,"journal":{"name":"Journal of Artificial Organs","volume":" ","pages":"32-40"},"PeriodicalIF":1.3,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9203855","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Investigation of the inhibition of bacteria and endotoxin influx by back filtration through dialyzer membranes. 通过透析膜反向过滤抑制细菌和内毒素流入的研究。

IF 1.3 4区医学

Journal of Artificial Organs Pub Date : 2024-03-01 Epub Date: 2023-02-10 DOI: 10.1007/s10047-023-01385-0

Tadashi Tomo, Kazuhiro Matsuyama, Junichi Michikoshi, Katsuhiro Hanada

{"title":"Investigation of the inhibition of bacteria and endotoxin influx by back filtration through dialyzer membranes.","authors":"Tadashi Tomo, Kazuhiro Matsuyama, Junichi Michikoshi, Katsuhiro Hanada","doi":"10.1007/s10047-023-01385-0","DOIUrl":"10.1007/s10047-023-01385-0","url":null,"abstract":"We investigated the usefulness of assays using human neutrophils for radical production as well as endotoxin (ET) measurement and bacterial culture for endotoxin and bacterial influx by back filtration using dialyzers with different membrane pore diameters. Three types of dialyzers made of cellulose triacetate membrane material with different pore size FB-110EG eco, FB-110U eco, and FB-150UHβ eco were used. A circuit to generate back filtration was created. Back filtrate generated by hydraulic head pressure operation was collected. ET and bacteria were examined. Human neutrophils were exposed to back filtrate (experiments using three different membranes) and contaminated solution, and free radical production was measured using LBP-953 (Berthold) to see if there were differences in production. No bacteria were detected and the concentration of endotoxin was below the detection limit in the back filtrate from the three types of membranes and purified water. Free radical production from neutrophils in the contaminated water was highest at 4,405,750 ± 61,244 cpm (counts per minute) (mean ± SD) (P < 0.01 vs FB-150UHβ eco, FB-110U-eco, and FB-110EG eco) followed by that in back filtrate via FB-150UHβ eco, FB-110U-eco, FB-110EG eco. Radical production from neutrophils was thereby higher in the back filtrate of dialyzers with larger pore-size membranes. No bacteria were observed and the concentration of ET was below the detection limit in back filtrate from any of the membranes. However, when the reverse filtrate was exposed to neutrophils, radical production increased along with pore size, suggesting the influx of small pyrogens and other pyrogenic substances.","PeriodicalId":15177,"journal":{"name":"Journal of Artificial Organs","volume":" ","pages":"41-47"},"PeriodicalIF":1.3,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9238324","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The effect of balloon-expandable stent and self-expanding stent on changes in mitral annular motion after aortic valve replacement in patients with aortic stenosis. 主动脉瓣狭窄患者主动脉瓣置换术后球囊扩张支架和自扩张支架对二尖瓣环运动变化的影响。

IF 1.3 4区医学

Journal of Artificial Organs Pub Date : 2024-03-01 Epub Date: 2023-02-04 DOI: 10.1007/s10047-023-01384-1

Daijiro Hori, Yohei Nomura, Yosuke Taniguchi, Koichi Yuri, Makiko Mieno, Naoyuki Kimura, Atsushi Yamaguchi

{"title":"The effect of balloon-expandable stent and self-expanding stent on changes in mitral annular motion after aortic valve replacement in patients with aortic stenosis.","authors":"Daijiro Hori, Yohei Nomura, Yosuke Taniguchi, Koichi Yuri, Makiko Mieno, Naoyuki Kimura, Atsushi Yamaguchi","doi":"10.1007/s10047-023-01384-1","DOIUrl":"10.1007/s10047-023-01384-1","url":null,"abstract":"Objectives: The purpose of this study was to evaluate the effect of decalcification and existence of stent at the aortic annulus on mitral annular motion after surgery.Methods: Patients receiving Inspiris (Edwards, CA, USA, n = 117), Intuity (Edwards, n = 36), Perceval (Corcym, London, UK, n = 36), Evolut (Medtronics, MN, USA, n = 81) and Sapien 3 (Edwards, n = 250) were included in the study. Mitral annular motion was evaluated by E', using tissue doppler imaging.Results: After surgery, a significant increase in E' was observed in patients receiving Inspiris (Before: 4.2 ± 1.21 cm/s vs. Discharge: 5.0 ± 1.23 cm/s, p < 0.001). Mid-term echocardiogram performed at 11.8 ± 2.2 months after the surgery, showed a significant increase in E' in patients receiving Inspiris (Before: 4.2 ± 1.21 cm/s vs. Mid-term: 5.2 ± 1.20 cm/s, p < 0.001) and Perceval (Before: 3.9 ± 1.34 cm/s vs. Mid-term: 4.5 ± 1.24 cm/s, p = 0.008). Univariable analysis showed a higher increase in E' in patients with decalcified annulus compared to those without decalcified annulus (Decalcification: 0.15 ± 1.321 cm/s vs. No Decalcification: 0.66 ± 1.420 cm/s, p < 0.001). Multivariable analysis showed that balloon-expandable stent (β = - 0.6960, p < 0.001) and self-expanding stent (r = - 0.3592, p = 0.042) were independent limiting factors for an increase in E' at discharge. However, balloon-expandable stent (β = - 0.8382, p < 0.001), and not self-expanding stent (β = - 0.3682, p = 0.089), was a remaining independent factor associated with E' at mid-term follow-up.Conclusions: Decalcification was associated with improvement in E' after surgery. Balloon-expandable stent was an independent limiting factor for improvement in E' up to 1 year after the surgery, while self-expanding stent was not a significant factor after 1 year.","PeriodicalId":15177,"journal":{"name":"Journal of Artificial Organs","volume":" ","pages":"23-31"},"PeriodicalIF":1.3,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10645777","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

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