2018年8月20日月曜日

【offer information】Okayama University Medical Research Updates (OU-MRU) Vol.56

Source: Okayama University (JAPAN), Public Relations and Information Strategy
For immediate release: 10 August 2018
Okayama University research: New device for assisting accurate hemodialysis catheter placement

(Okayama, 10 August) Researchers at Okayama University report in The Journal of Vascular Access a supporting device for accurately placing hemodialysis catheters on kidney patients. The device was successfully used on a group of 10 patients and is expected to become an essential tool in situations where other, catheter-free hemodialysis approaches are not possible.

Patients with improperly functioning kidneys often need to undergo hemodialysis — the procedure of purifying blood in an artificial kidney outside the body — on a regular basis. Hemodialysis requires access to blood vessels, for the collection of blood and its re-introduction after purification. In this context, vascular access is commonly achieved with a so-called tunneled cuffed catheter (TCC). Accurate TCC placement is important; incorrect positioning can lead to blood clots and induce central vein thrombosis. Assistant Professor Toshiaki Ohara from Okayama University and colleagues have now developed a device enabling accurate TCC placement. The researchers’ insertion support device accommodates for individual body shape differences and is expected to decrease the rate of TCC replacements — typically ranging between 8.9% and 56%.

The device was made from a material called expanded polytetrafluoroethylene (ePTFE), having the property of maintained plasticity. It can be described as a bendable ribbon with holes (eyelets) spaced 1 cm apart; the holes allow making markings on the patient’s body with a felt-tip pen.

The insertion support device was tested on 10 Japanese adult hemodialysis patients (6 men and 4 women with a mean age of 71.3 years) treated at Shigei Medical Research Hospital. Placement of the device on the body took place with the help of X-ray imaging: the tip of the device, for marking the TCC entry site, was laid so that it overlaps with the right heart border. With the help of the markings made on the patient’s body, the physician could insert the TCC within an error of about 1 cm. The patients were observed for 2 months, during which there was no catheter replacement needed.

The device of Dr.Ohara and colleagues helps to reduce catheter waste and the overall cost of hemodialysis. In addition, as the attachment of a catheter requires exposure to X-rays, it reduces accumulated radiation doses for both patients and physicians. Although the study was only carried out for 10 patients in a short observation period, the scientists “anticipate that this new device … can be used for catheter intervention in many fields”.
Background
Hemodialysis

Hemodialysis, also known as kidney dialysis or just dialysis, refers to the purification of the blood of a person with malfunctioning kidneys. In hemodialysis, blood is extracted from the body, purified from waste substances such as creatinine and urea, and re-introduced into the blood circulation system.

For blood extraction and re-introduction, access to blood vessels is required. Vascular access is typically realized by an arteriovenous fistula (AVF), an arteriovenous graft (AVG) or a tunneled cuffed catheter (TCC). Access through AVF or AVG — both involve surgically created passageways between an artery and a vein — are generally preferred, because of better prevention of infection. Some patients cannot undergo AVF or AVG, however, because of heart failure or low cardiac reserve (the difference between the heart’s pumping rate and its maximum pumping capacity). For these patients, a TCC is the appropriate solution.

Accurate placement of a TCC, crucial for its successful functioning, is difficult because of differences in body shapes. A team of researchers led by Dr.Ohara from Okayama University have now developed a bendable support device that helps placing a TCC on a patient’s body — the tool enables making temporary markings on the body, based on which the TCC can be accurately inserted.


Reference
Toshiaki Ohara, Kazufumi Sakurama, Satoshi Hiramatsu,Toshimasa Karai, Toshiaki Sato, Yuta Nishina. New insertion support device assisted the accurate placement of tunneled cuffed catheter: first experience of 10 cases. The journal of vascular access, 2018 May 1:1129729818771884.
DOI: 10.1177/1129729818771884.

New insertion support device assisted the accurate placement of tunneled cuffed catheter: First experience of 10 cases


Reference (Okayama University e-Bulletin & OU-MRU) : Assistant Professor Ohara’s team
OU-MRU Vol.22:
Medical supportive device for hemodialysis catheter puncture
OU-MRU Vol.50:Iron removal as a potential cancer therapy


Correspondence to
Assistant Professor Toshiaki Ohara, M.D., Ph.D.
Department of Pathology & Experimental Medicine,
Graduate School of Medicine, Dentistry and Pharmaceutical
Sciences, Okayama University, Shikata-cho 2-5-1, Okayama
city, Okayama 700-8558, Japan
E-mail: t_ohara(a)cc.okayama-u.ac.jp
For inquiries, please contact us by replacing (a) with the @ mark.

Department of Pathology & Experimental Medicine, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University


Further information
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Okayama University Medical Research Updates (OU-MRU)
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Vol.2:Ensuring a cool recovery from cardiac arrest
Vol.3:Organ regeneration research leaps forward
Vol.4:Cardiac mechanosensitive integrator
Vol.5:Cell injections get to the heart of congenital defects
Vol.6:Fourth key molecule identified in bone development
Vol.7:Anticancer virus solution provides an alternative to surgery
Vol.8:Light-responsive dye stimulates sight in genetically blind patients
Vol.9:Diabetes drug helps towards immunity against cancer
Vol.10:Enzyme-inhibitors treat drug-resistant epilepsy
Vol.11:Compound-protein combination shows promise for arthritis treatment
Vol.12:Molecular features of the circadian clock system in fruit flies
Vol.13:Peptide directs artificial tissue growth
Vol.14:Simplified boron compound may treat brain tumours
Vol.15:Metamaterial absorbers for infrared inspection technologies
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Vol.18:Therapeutic protein targets liver disease
Vol.19:Study links signalling protein to osteoarthritis
Vol.20:Lack of enzyme promotes fatty liver disease in thin patients
Vol.21:Combined gene transduction and light therapy targets gastric cancer
Vol.22:Medical supportive device for hemodialysis catheter puncture
Vol.23:Development of low cost oral inactivated vaccines for dysentery
Vol.24:Sticky molecules to tackle obesity and diabetes
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Vol.26:Protein for preventing heart failure
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Vol.30:Cancer stem cells’ role in tumor growth revealed
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Vol.33:Attacking tumors from the inside
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Vol.43:Potential origin of cancer-associated cells revealed
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Vol.45:Link between biological-clock disturbance and brain dysfunction uncovered
Vol.46:New method for suppressing lung cancer oncogene
Vol.47:Candidate genes for eye misalignment identified
Vol.48:Nanotechnology-based approach to cancer virotherapy
Vol.49:Cell membrane as material for bone formation
Vol.50:Iron removal as a potential cancer therapy
Vol.51:Potential of 3D nanoenvironments for experimental cancer
Vol.52:A protein found on the surface of cells plays an integral role in tumor growth and sustenance
Vol.53:Successful implantation and testing of retinal prosthesis in monkey eyes with retinal degeneration
Vol.54:Measuring ion concentration in solutions for clinical and environmental research
Vol.55:Diabetic kidney disease: new biomarkers improve the prediction of the renal prognosis
  
http://www.okayama-u.ac.jp/eng/research_highlights/index_id73.html



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