Background: The number of dialysis patients has been increasing in Southeast Asia, but statistical data about these patients and on the quality of dialysates in Southeast Asian dialysis facilities are still imprecise. For this study, dialysis-related statistical data were collected in Southeast Asia. Methods: A survey of the quality of dialysates was carried out at 4 dialysis facilities in Vietnam and Cambodia. The dialysis patient survey included the numbers of dialysis facilities and patients receiving dialysis, a ranking of underlying diseases causing the initiation of dialysis, the number of patients receiving hemodialysis (HD)/on-line hemodiafiltration/continuous ambulatory peritoneal dialysis, the number of HD monitoring devices installed, the cost of each session of dialysis (in USD), the percentage of out-of-pocket payments, and the 1-year survival rates of the dialysis patients (in percent). The dialysate survey covered the endotoxin (ET) level and bacterial count in tap water, in water filtered through a reverse osmosis system and in dialysate. Results: In each of the countries, the most frequent reason for the initiation of dialysis is diabetes mellitus. HD is usually carried out according to the ‘reuse' principle. The 1-year survival rates are 70% in Myanmar and about 90% in the Philippines and Malaysia. The ET levels in standard dialysates were satisfactory at 2 facilities. The bacterial counts in dialysates were not acceptable at any of the facilities investigated. Conclusion: There is an urgent need to teach medical workers involved in dialysis how to prepare sterile and ET-free dialysates.
Little is knownof the structure of hollow-fiber dialysis membranesfor clinical use or of the effects of structure on solute and pure water permeability. Knowledgeof such aspects of membranestructure as pore radius, surface porosity, tortuosity and water content is required if the desired membranes are to be designed. The objective of the present study, therefore, is to obtain data on the pore radius, surface porosity and tortuosity of hollow-fiber dialysis membranesthrough an analysis of measured water content, and of solute and pure water permeability on the basis of a newly introduced tortuous pore model. In regenerated cellulose membranes, pore radius ranges from 21 to 34 x 10~10 m, and huge pores ranging in radius from 47 to 64 x 10"10 m are identified for EVAmembranes which are permeable to small amounts of serum protein. Values for surface porosity of the regenerated cellulose and EVAmembranes are approximately 33 and 22 %, and tortuosity is approximately 1.9 and 2.2, respectively. The tortuous pore model combined with the Lp and Pmmethod is well suited for elucidating the relationship between membranestructure and solute and pure water permeability.
Bacteria tests are conducted for quality control in many different industries. However, the cultivation method takes a long period of time to obtain results and there are more than a few bacteria that are difficult to cultivate. We have focused on the autofluorescence substance in the bacteria to detect them, and developed a sensor to measure the bacteria in real-time, without any pretreatments or addition of any reagents. This system uses a 405nm laser focused on the sample flowing through the flow-cell in order to detect the fluorescent light from the bacteria as well as scattered light. Fluorescent light and scattered light are separated by a dichroic mirror, and the number of viable particles (bacteria) and that of non-viable particles are obtained. We tested this system using fluorescent polystyrene latex particles and several bacterial strains, and confirmed that it had good detection capability. We believe that this system will become a next-generation bacteria detection system and help the introduction of PAT (process analytical technology) to all areas where real time and on-site detection is needed.
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