{"@context":{"@vocab":"https://cir.nii.ac.jp/schema/1.0/","rdfs":"http://www.w3.org/2000/01/rdf-schema#","dc":"http://purl.org/dc/elements/1.1/","dcterms":"http://purl.org/dc/terms/","foaf":"http://xmlns.com/foaf/0.1/","prism":"http://prismstandard.org/namespaces/basic/2.0/","cinii":"http://ci.nii.ac.jp/ns/1.0/","datacite":"https://schema.datacite.org/meta/kernel-4/","ndl":"http://ndl.go.jp/dcndl/terms/","jpcoar":"https://github.com/JPCOAR/schema/blob/master/2.0/"},"@id":"https://cir.nii.ac.jp/crid/1390282679654433664.json","@type":"Article","productIdentifier":[{"identifier":{"@type":"DOI","@value":"10.4009/jsdt.44.543"}},{"identifier":{"@type":"NDL_BIB_ID","@value":"11168069"}},{"identifier":{"@type":"URI","@value":"http://id.ndl.go.jp/bib/11168069"}},{"identifier":{"@type":"URI","@value":"https://ndlsearch.ndl.go.jp/books/R000000004-I11168069"}},{"identifier":{"@type":"NAID","@value":"10029407142"}},{"identifier":{"@type":"URI","@value":"https://search.jamas.or.jp/link/ui/2011324351"}}],"dc:title":[{"@language":"en","@value":"The efficacy and safety of double-filtration plasmapheresis (DFPP) with mass transfer simulation"},{"@language":"ja","@value":"溶質移動シミュレーションを用いた二重濾過膜血漿交換（ＤＦＰＰ）の安全な施行"},{"@language":"ja-Kana","@value":"ヨウシツ イドウ シミュレーション オ モチイタ ニジュウ ロカ マク ケッショウ コウカン DFPP ノ アンゼン ナ シコウ"}],"dc:language":"ja","description":[{"type":"abstract","notation":[{"@language":"en","@value":"[Introduction] DFPP is useful therapy to remove pathological IgG in patients who have undergone transplantation and in those with autoimmune disease. However, excess DFPP may reduce essential proteins such as albumin and fibrinogen (Fbg) since the removal rate of Fbg is greater than that of IgG. Especially in patients scheduled for transplantation, lack of Fbg may lead to serious complications including massive bleeding. It is important to predict the levels of IgG and Fbg after DFPP prior to treatment in order to decide appropriate treatment. To investigate the efficacy and safety of DFPP, a formula to predict changes in these proteins was established. [Methods] A patient with acute myeloblastic leukemia who had undergone plasma exchange gave written informed consent to the examination of effluent during plasma exchange. The plasma effluent was processed using plasma fractionators with a closed circuit <I>in vitro</I>, and plasma parameters were serially determined at 10-minute intervals during the processing. A prediction formula for these parameters was established based on a 1-compartment model. The prediction formula was prepared using the parameters before DFPP, circulating plasma volume (VP), flow rate of plasma (QF) and drainage (QS), sieving coefficient of plasma separation and fractionator (Sc<SUB>I</SUB>,<SUB>II</SUB>). Using this formula, estimated data were compared with measured data <I>in vitro</I>. Likewise <I>in vitro</I>, estimated data of clinical DFPP (18 treatments) <I>ex vivo</I> were compared with measured data <I>ex vivo</I>. [Results] The prediction formula ; Concentration at t time=concentration at 0 time*exp (-Sc<SUB>I</SUB>*(QF-Sc<SUB>II</SUB>*(QF-QS))*t/VP). The estimated data from the formula were consistent with measured data both <I>in vitro</I> and <I>ex vivo</I> (R<SUP>2</SUP>>0.950). [Discussion] The formula for DFPP is available to predict the levels of albumin, IgG, and Fbg after DFPP prior to treatment, and to remove IgG without causing a deficiency of Fbg. Using the prediction formula, suitable DFPP for individual patients could be performed effectively and safely."},{"@language":"ja","@value":"二重濾過膜血漿交換（double-filtration plasmapheresis：DFPP）においては患者個々の体格，血漿分離比，血漿成分分離比，置換液量および置換アルブミン濃度によって体内の溶質の収支は変化し，治療後の血漿中溶質濃度の予測は困難であった．特に自己免疫性神経疾患や血液型不適合腎移植に対するDFPPは，短期間に連続的に施行される場合が多く，生体に必要な物質の収支においても十分な注意が必要である．今回われわれは，DFPPによる生体の溶質移動をシミュレートする計算式（DFPP理論式）を作成するとともに，実験および臨床における測定値と，シミュレーション値との比較検討を行い，DFPP理論式を用いた溶質移動シミュレーションの臨床における有用性について検討した．DFPP理論式には治療前の溶質濃度，患者の体重とヘマトクリット（Ht）から算出した循環血漿量，血漿分離流量，ドレーン流量，血漿分離器ふるい係数，血漿成分分離器ふるい係数，アルブミン補充量を用いた．IgG，フィブリノゲン，アルブミンを対象とし，各ふるい係数には臨床データを使用した．実験においては血漿交換施行後のヒト廃棄血漿を用い，10分ごとの測定値と，シミュレーション値との適合性を検討した．臨床においては6患者18例の治療前後の測定値をHt補正した値と，シミュレーション値との適合性を検討した．シミュレーション値は，実験値と臨床値とのいずれの間にも有意な相関関係がみられ，DFPP施行における溶質濃度変化をシミュレートできることから，臨床においてDFPP施行時の溶質収支指標として十分活用できると考えられた．本研究で作成したDFPP理論式は個々の患者に合わせて，さらにさまざまな設定条件下で，溶質濃度変化をシミュレートすることができる．また，ほかの製品を用いる場合でも，各ふるい係数がわかっていればDFPP理論式の応用が可能であり，製品の選択，治療条件の決定，DFPP施行時の安全性の確保などにおいて有用である．"}],"abstractLicenseFlag":"disallow"}],"creator":[{"@id":"https://cir.nii.ac.jp/crid/1410282679654433668","@type":"Researcher","personIdentifier":[{"@type":"NRID","@value":"9000363357659"}],"foaf:name":[{"@language":"ja","@value":"鈴木 尚紀"},{"@language":"en","@value":"Suzuki Naoki"}],"jpcoar:affiliationName":[{"@language":"en","@value":"Division of Kidney and Dialysis, Department of Internal Medicine, Hyogo College of Medicine"},{"@language":"ja","@value":"兵庫医科大学内科学腎・透析科"},{"@language":"ja","@value":"兵庫医科大学病院臨床工学室"},{"@language":"en","@value":"Hospital of Hyogo College of Medicine, Division of Clinical Engineering"}]},{"@id":"https://cir.nii.ac.jp/crid/1410282679654433671","@type":"Researcher","foaf:name":[{"@language":"ja","@value":"蓮池 由起子"},{"@language":"en","@value":"Hasuike Yukiko"}],"jpcoar:affiliationName":[{"@language":"ja","@value":"兵庫医科大学内科学腎・透析科"},{"@language":"en","@value":"Division of Kidney and Dialysis, Department of Internal Medicine, Hyogo College of Medicine"}]},{"@id":"https://cir.nii.ac.jp/crid/1410290697331318657","@type":"Researcher","personIdentifier":[{"@type":"NRID","@value":"9000363355816"},{"@type":"NRID","@value":"9000254099651"}],"foaf:name":[{"@language":"en","@value":"Tokuyama Masanori"},{"@language":"ja","@value":"徳山 正徳"}],"jpcoar:affiliationName":[{"@language":"en","@value":"Division of Kidney and Dialysis, Department of Internal Medicine, Hyogo College of Medicine"},{"@language":"ja","@value":"兵庫医科大学内科学腎・透析科"}]},{"@id":"https://cir.nii.ac.jp/crid/1410290697331318659","@type":"Researcher","foaf:name":[{"@language":"en","@value":"Kawasaki Yuki"},{"@language":"ja","@value":"川崎 由記"}],"jpcoar:affiliationName":[{"@language":"ja","@value":"兵庫医科大学病院臨床工学室"},{"@language":"en","@value":"Hospital of Hyogo College of Medicine, Division of Clinical Engineering"}]},{"@id":"https://cir.nii.ac.jp/crid/1410290697331318662","@type":"Researcher","personIdentifier":[{"@type":"NRID","@value":"9000363357662"}],"foaf:name":[{"@language":"en","@value":"Nakano Tomohiko"},{"@language":"ja","@value":"中野 智彦"}],"jpcoar:affiliationName":[{"@language":"en","@value":"Hospital of Hyogo College of Medicine, Division of Clinical Engineering"},{"@language":"ja","@value":"兵庫医科大学病院臨床工学室"}]},{"@id":"https://cir.nii.ac.jp/crid/1410290697331318660","@type":"Researcher","personIdentifier":[{"@type":"NRID","@value":"9000363357663"}],"foaf:name":[{"@language":"en","@value":"Tachibana Ginpei"},{"@language":"ja","@value":"橘 銀平"}],"jpcoar:affiliationName":[{"@language":"ja","@value":"兵庫医科大学病院臨床工学室"},{"@language":"en","@value":"Hospital of Hyogo College of Medicine, Division of Clinical Engineering"}]},{"@id":"https://cir.nii.ac.jp/crid/1410001204655935876","@type":"Researcher","personIdentifier":[{"@type":"NRID","@value":"9000003843556"},{"@type":"NRID","@value":"9000252881422"}],"foaf:name":[{"@language":"en","@value":"Kimura Masayoshi"},{"@language":"ja","@value":"木村 政義"}],"jpcoar:affiliationName":[{"@language":"en","@value":"Hospital of Hyogo College of Medicine, Division of Clinical 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Medicine"},{"@language":"ja","@value":"兵庫医科大学内科学腎・透析科"}]}],"publication":{"publicationIdentifier":[{"@type":"PISSN","@value":"13403451"},{"@type":"EISSN","@value":"1883082X"},{"@type":"NDL_BIB_ID","@value":"000000091485"},{"@type":"ISSN","@value":"13403451"},{"@type":"LISSN","@value":"13403451"},{"@type":"NCID","@value":"AN10432053"}],"prism:publicationName":[{"@language":"en","@value":"Nihon Toseki Igakkai Zasshi"},{"@language":"ja","@value":"日本透析医学会雑誌"},{"@language":"en","@value":"Nihon Toseki Igakkai Zasshi"},{"@language":"en","@value":"Journal of Japanese Society for Dialysis Therapy"},{"@language":"en","@value":"J. Jpn. Soc. Dial. Ther."},{"@language":"ja","@value":"透析会誌"}],"dc:publisher":[{"@language":"en","@value":"The Japanese Society for Dialysis Therapy"},{"@language":"ja","@value":"一般社団法人 日本透析医学会"}],"prism:publicationDate":"2011","prism:volume":"44","prism:number":"6","prism:startingPage":"543","prism:endingPage":"550"},"reviewed":"false","url":[{"@id":"http://id.ndl.go.jp/bib/11168069"},{"@id":"https://ndlsearch.ndl.go.jp/books/R000000004-I11168069"},{"@id":"https://search.jamas.or.jp/link/ui/2011324351"}],"availableAt":"2011","foaf:topic":[{"@id":"https://cir.nii.ac.jp/all?q=double-filtration%20plasmapheresis","dc:title":"double-filtration plasmapheresis"},{"@id":"https://cir.nii.ac.jp/all?q=mass%20transfer%20simulation","dc:title":"mass transfer simulation"},{"@id":"https://cir.nii.ac.jp/all?q=prediction%20fomula","dc:title":"prediction fomula"},{"@id":"https://cir.nii.ac.jp/all?q=fibrinogen","dc:title":"fibrinogen"},{"@id":"https://cir.nii.ac.jp/all?q=immunoglobulin%20G","dc:title":"immunoglobulin G"},{"@id":"https://cir.nii.ac.jp/all?q=%E4%BA%8C%E9%87%8D%E6%BF%BE%E9%81%8E%E8%86%9C%E8%A1%80%E6%BC%BF%E4%BA%A4%E6%8F%9B","dc:title":"二重濾過膜血漿交換"},{"@id":"https://cir.nii.ac.jp/all?q=%E6%BA%B6%E8%B3%AA%E7%A7%BB%E5%8B%95%E3%82%B7%E3%83%9F%E3%83%A5%E3%83%AC%E3%83%BC%E3%82%B7%E3%83%A7%E3%83%B3","dc:title":"溶質移動シミュレーション"},{"@id":"https://cir.nii.ac.jp/all?q=%E4%BA%88%E6%B8%AC%E5%BC%8F","dc:title":"予測式"},{"@id":"https://cir.nii.ac.jp/all?q=%E3%83%95%E3%82%A3%E3%83%96%E3%83%AA%E3%83%8E%E3%82%B2%E3%83%B3","dc:title":"フィブリノゲン"},{"@id":"https://cir.nii.ac.jp/all?q=IgG","dc:title":"IgG"}],"relatedProduct":[{"@id":"https://cir.nii.ac.jp/crid/1572261549892041728","@type":"Article","relationType":["cites"],"jpcoar:relatedTitle":[{"@value":"腎移植"}]},{"@id":"https://cir.nii.ac.jp/crid/1572543024868750080","@type":"Article","relationType":["cites"],"jpcoar:relatedTitle":[{"@value":"アフェレーシス療法における kinetic modeling の利用"}]},{"@id":"https://cir.nii.ac.jp/crid/1572824499845457408","@type":"Article","relationType":["cites"]},{"@id":"https://cir.nii.ac.jp/crid/2050025942039898624","@type":"Article","relationType":["cites"],"jpcoar:relatedTitle":[{"@value":"置換液の使用方法と至適濃度設定法"}]},{"@id":"https://cir.nii.ac.jp/crid/2050588891993324672","@type":"Article","relationType":["cites"],"jpcoar:relatedTitle":[{"@value":"アフェレシス関連モニタリング技術の最近の動向 : 循環血液量(BV)モニタのアフェレシスへの応用"}]}],"dataSourceIdentifier":[{"@type":"JALC","@value":"oai:japanlinkcenter.org:0037366591"},{"@type":"NDL_SEARCH","@value":"oai:ndlsearch.ndl.go.jp:R000000004-I11168069"},{"@type":"CROSSREF","@value":"10.4009/jsdt.44.543"},{"@type":"CIA","@value":"10029407142"}]}