WO2004103439A1 - 血清調製用容器及びそれを用いた再生医療方法 - Google Patents
血清調製用容器及びそれを用いた再生医療方法 Download PDFInfo
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- WO2004103439A1 WO2004103439A1 PCT/JP2004/007299 JP2004007299W WO2004103439A1 WO 2004103439 A1 WO2004103439 A1 WO 2004103439A1 JP 2004007299 W JP2004007299 W JP 2004007299W WO 2004103439 A1 WO2004103439 A1 WO 2004103439A1
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- blood
- serum
- component
- separation device
- component separation
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M1/00—Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
- A61M1/02—Blood transfusion apparatus
- A61M1/0209—Multiple bag systems for separating or storing blood components
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M1/00—Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
- A61M1/02—Blood transfusion apparatus
- A61M1/0209—Multiple bag systems for separating or storing blood components
- A61M1/0218—Multiple bag systems for separating or storing blood components with filters
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M1/00—Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
- A61M1/02—Blood transfusion apparatus
- A61M1/0209—Multiple bag systems for separating or storing blood components
- A61M1/0231—Multiple bag systems for separating or storing blood components with gas separating means, e.g. air outlet through microporous membrane or gas bag
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M1/00—Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
- A61M1/02—Blood transfusion apparatus
- A61M1/029—Separating blood components present in distinct layers in a container, not otherwise provided for
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
- A61P41/00—Drugs used in surgical methods, e.g. surgery adjuvants for preventing adhesion or for vitreum substitution
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
- A61P43/00—Drugs for specific purposes, not provided for in groups A61P1/00-A61P41/00
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
- A61P7/00—Drugs for disorders of the blood or the extracellular fluid
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
- A61P7/00—Drugs for disorders of the blood or the extracellular fluid
- A61P7/08—Plasma substitutes; Perfusion solutions; Dialytics or haemodialytics; Drugs for electrolytic or acid-base disorders, e.g. hypovolemic shock
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M2202/00—Special media to be introduced, removed or treated
- A61M2202/0014—Special media to be introduced, removed or treated removed from the body
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M2202/00—Special media to be introduced, removed or treated
- A61M2202/04—Liquids
- A61M2202/0413—Blood
- A61M2202/0415—Plasma
Definitions
- the present invention relates to a blood container, a blood separation method using the same, and a regenerative medical method.
- Stem cells are attracting attention as cells that have the pluripotency to differentiate into various tissues and organs and are the key to regenerative medicine.
- the prepared serum is often temporarily frozen or refrigerated until use. For this reason, it is necessary to transfer the blood collection tube to a storage container. If this operation is repeated many times, there is a high possibility that the serum will be contaminated with microorganisms.
- a serum separating agent is often added to such a blood collection tube, and it cannot be denied that impurities may be mixed into the serum from this serum separating agent. Therefore, it is not appropriate to use the method disclosed in Japanese Patent Application Laid-Open No. 2 00 0-0 0 0 2 28 in the field of regenerative medicine intended for humans from the viewpoint of safety and hygiene. .
- the present invention has been made in view of the above problems, and a blood storage container suitable for producing a large amount of serum quickly and efficiently while ensuring high safety, and blood using the same
- the purpose is to provide separation methods and regenerative medicine methods.
- the present invention provides a serum generation function for generating a practically usable amount of serum in the presence of blood-derived liquid components and blood platelets by a coagulation activating action.
- a blood component separation device is provided.
- blood refers to whole blood consisting of blood cells (red blood cells, white blood cells, platelets) and plasma (serum), which is a liquid component, and a liquid containing at least one of these (for example, collected by component blood donation) Blood).
- plasma a liquid component
- serum refers to a pale yellow liquid that is separated from red clots (blood clots) after the collected blood is left undisturbed.
- serum is different from general serum in that it is not separated from clots, but the coagulation factors and growth factors contained therein are substantially the same as general serum.
- blood-derived liquid component refers to “a blood component other than blood cells” or “a mixed solution obtained by adding a drug such as an anticoagulant to a blood component other than blood cells”.
- Coagulation activating effect means activating a coagulation factor in blood in order to remove the coagulation factor from blood.
- the “serum-producing function that produces a practically usable amount of serum” refers to an amount that can be used for stem cell culture, for example.
- serum requires about 10% of the medium. Therefore, it is preferably 5 (m l) or more and 1 0 0 0 (m l) or less, more preferably 1 0 (m l) or more and 6 0 0 (m l) or less.
- the present invention is an apparatus for separating and storing collected blood into a plurality of blood components, and in the blood reservoir for storing the blood, an amount that can be practically used as serum is prepared. Therefore, a blood component separation device provided with a serum production function for removing a coagulation factor from the blood is provided. According to the blood component separation device, a large amount of collected blood can be stored in the blood storage unit by providing the blood storage unit. In addition, since the blood reservoir is provided with a serum generation function, platelets and coagulation factors in the blood can be rapidly activated. Furthermore, since these activators can be removed quickly, a large amount of serum can be prepared.
- the blood component separation device preferably includes a component storage unit that stores a plurality of blood components separated from blood. It is more preferable that the distilling part is aseptically and airtightly connected. As a result, a series of steps from blood collection to serum preparation can be performed without touching the outside air, so that the risk of contamination by microorganisms can be reduced.
- the blood component separation device can be used not only for human blood but also for blood of mammals such as rodents, livestock, and primates. It can also be used as a component separation device.
- the plurality of blood components may contain serum, and may contain white blood cells and red blood cells.
- the serum separated by the blood component separation device is a serum containing a large amount of cell growth factors, and is therefore suitable for use in the field of regenerative medicine. Furthermore, since the activator can be collected separately, the collected blood can be effectively used without being discarded.
- the blood storage part and the component storage part are flexible bags, and the serum generation function is performed by a blood coagulation promoting individual arranged inside the blood storage part. It may be given.
- the blood storage part and the component storage part are plastic bags and are lightweight and convenient to carry. At least one of these is provided, but a plurality of these may be provided, and it is preferable that one blood storage part and two or more component storage parts are provided.
- Each volume is not particularly limited as long as each blood component can be substantially separated from blood, but it is preferably 5 (ml) to 100 (ml). In particular, it is particularly preferably from 1 0 (m 1) to 6 0 0 (m 1).
- a blood coagulation promoting individual in the inclusion of this blood reservoir, blood It is possible to provide a cleansing function. Blood coagulation-promoting individuals are contained to such an extent that blood clotting factors such as fibrin and platelets can be removed from the blood, and are insoluble in blood, so that the resulting serum contains impurities. The situation of doing can be avoided.
- the blood coagulation promoting individual is insoluble in the blood and has a massive appearance. Further, it is more preferable that the movement is set in the blood stored in the blood storage part.
- the blood coagulation promoting individual is in the form of particles, granules, or lumps, so that handling at the time of production can be improved.
- the blood coagulation promoting individual is set to be movable, the contact with blood can be made smoother and the blood activation efficiency can be improved.
- the specific gravity of the blood coagulation promoting individual may be larger than each blood component separated from the blood. Thereby, the prepared serum can be easily taken out from the blood reservoir.
- the appearance shape of the blood coagulation promoting individual is substantially spherical from the viewpoint of suppressing breakage of the blood reservoir and blood.
- silicon dioxide compound at least one selected from glass, silica, diatomaceous earth, kaolin and the like can be used. It is not limited to.
- blood can be stirred by applying a magnetic field to the blood reservoir, and the activator can be activated quickly.
- a blood coagulation promoting individual is preferable for activation because it has a porous structure and can set a large surface area per unit volume. In this case, however, it is necessary to allow blood to enter the hole.
- the surface area is set with a relationship of 0.1 (mm 2 / ml) to 25 (mm 2 / m 1) for the amount of blood that can be stored in the blood reservoir. It is preferable from the viewpoint of both promotion of activation and suppression of hemolysis. It should be noted that this value is the best condition value at the present time, and values other than this range also have the same effect are included in the present invention.
- the blood reservoir may be one in which a serum separating agent is not injected.
- connection ports are formed in the blood reservoir, and one of the two connection ports is used for introducing the blood into the blood reservoir.
- the introduction path may be hermetically connected, and on the other side, a lead-out path for deriving each blood component separated from the blood in the blood reservoir may be hermetically connected.
- the component storage portion includes two or more bags
- the lead-out path includes a plurality of lead-out rods connected to the bags. The at least some of the plurality of lead-out rods may be used in combination.
- the component accommodating portion is composed of two or more bags, and by using at least a part of the plurality of lead-out rods, the respective bags are connected together, and handling is facilitated.
- microorganisms can be prevented from being mixed by keeping the respective parts airtightly connected.
- the blood reservoir may contain air.
- the air contained in the blood reservoir is preferably 0.03 (cc / ml) and 1 (cc / ml) relative to the amount of blood that can be stored.
- the blood separation method of the present invention is a blood component to which a blood generation function for generating serum in a quantity that can be practically used by coagulation activation in the presence of blood-derived liquid component and platelets is provided. It is characterized by separating blood into a liquid component and a non-liquid component using a separation device.
- a blood component separation apparatus having a function, a storage step of storing the collected blood in the blood storage unit, and the blood generation unit storing the blood generation unit by activating the serum generation function
- An activation promoting step that promotes activation of an activator including platelets and a coagulation factor, and a separation step that separates the activator that has been activated and aggregated in the activation promoting step from blood.
- the activation promoting step may be a step of shaking the blood component separation device.
- the serum generation function may be provided by a blood coagulation promoting individual arranged inward of the blood reservoir.
- each blood component derived in the deriving step may include serum.
- the derivation step is a step of accommodating the blood component in the component accommodating portion by flowing the liquid component in each blood in a state where the blood coagulation promoting individual is fixed.
- the blood coagulation promoting individual in the derivation step may be fixed by a fixing means attached to at least one of the inside and the outside of the blood reservoir. Good.
- the fixing means is selected from the group consisting of a magnet, a clamp, a holding body that holds the blood storage part, and a plurality of protrusions provided in the blood storage part. It may be more than that. '
- a derivation step of deriving each blood component excluding the activated factor separated from blood in the separation step to the component storage unit may be provided.
- the activator can be activated by shaking the whole blood component separation device or the blood reservoir. How to shake The method is not particularly limited as long as it does not cause hemolysis, but it is preferable that the velocity is such that blood coagulation promoting individuals can move evenly in the blood. In addition, when a blood coagulation promoting individual using a magnet for the core is used, the blood can be stirred by applying a magnetic field to the blood reservoir.
- the separation step fibrin is produced in a state where the activated factor is attached to the blood coagulation promoting individual. This facilitates serum recovery.
- red blood cells can be collected more easily by fixing the blood coagulation promoting individual with fipurin attached thereto by a fixing means. Furthermore, the present invention provides the following method for recovering fiber in blood and regenerative medical method.
- Liquid components and non-liquids are obtained using a blood component separation device that has been provided with a serum-generating function that produces serum that can be used practically by coagulation activation in the presence of blood-derived liquid components and platelets.
- a method for recovering the fibrous material from the non-liquid component is obtained using a blood component separation device that has been provided with a serum-generating function that produces serum that can be used practically by coagulation activation in the presence of blood-derived liquid components and platelets.
- blood is separated into liquid components using a blood component separation device that is provided with a serum-generating function that generates a practically usable amount of serum by clotting activation.
- the liquid component is separated into non-liquid components, the liquid components are added to the medium, cells collected from the subject are seeded and cultured on the medium, and the resulting cells or tissues are transferred to the subject. Regenerative medicine method for transplantation.
- the liquid component may contain serum.
- Serum generating function for generating a practically usable amount of serum in the presence of blood-derived liquid component and platelets by clotting activation.
- Blood is separated into a liquid component and a non-liquid component using a blood component separation device to which A regenerative medical method for transfusion to the subject after preparing the concentration of the liquid component.
- the non-liquid component may include serum, white blood cells, and red blood cells.
- fibrin can be collected after serum collection. Therefore, the concentration can be adjusted for self-transfusion, or fibrin can be used as a scaffold for stem cells (scafo 1d). Or it can be used as a barrier for wounds.
- the blood component separation device of the present invention is used to separate collected blood for each component, and includes a blood reservoir that stores blood, and the blood reservoir has a serum generation function. Therefore, it is possible to quickly prepare a large amount of serum in which the growth of microorganisms is suppressed, and it is suitable for preparing a large amount of serum used for stem cell culture in regenerative medicine.
- erythrocytes and other components after serum collection are suitable for use as autotransfusion blood and wound barriers.
- the blood component separation device Accordingly, by using the blood component separation device according to the present invention, a large amount of blood components including serum can be prepared (produced) quickly and efficiently while ensuring high safety from the collected blood. Can do.
- the blood component separation device In the blood separation method of the present invention, the blood component separation device according to the present invention is used, and the storage step of storing the collected blood in the blood storage unit and the serum generation function are activated.
- An activation promoting step for promoting activation of an activator including platelets and coagulation factors in blood stored in the blood reservoir, and the activated and aggregated in the activation promoting step A separation step of separating the activator from the blood, and if necessary, The blood components remaining after serum collection were collected and used for autologous blood transfusion and stem cell scaffolds or wound barriers.
- serum prepared by using the blood separation method described above is added to a medium, stem cells collected from a subject are seeded on the medium, cultured, and cultured. The resulting cells or tissues were to be transplanted into the subject.
- the collected red blood cells should be transfused. It was.
- FIG. 1 is a view showing a blood component separation device according to a first embodiment of the present invention.
- FIG. 2 is a diagram showing a procedure from blood collection to serum storage by the blood component separation device according to the first embodiment of the present invention.
- FIG. 3 is a diagram in which the blood reservoir 10 of the blood component separation device according to the first embodiment of the present invention is shaken.
- FIG. 4 is a view in which the tube 41 of the blood reservoir 10 of the blood component separation device according to the first embodiment of the present invention is fused.
- FIG. 5 shows a centrifugal separation of the blood component separation device according to the first embodiment of the present invention.
- FIG. 6 is a cross-sectional view showing the blood reservoir 10 after separation.
- FIG. 6 is a cross-sectional view showing a method for deriving the serum 71 prepared in the blood reservoir 10 of the blood component separation device according to the first embodiment of the present invention into the bag 21 for storing the serum.
- FIG. 6 is a cross-sectional view showing a method for deriving the serum 71 prepared in the blood reservoir 10 of the blood component separation device according to the first embodiment of the present invention into the bag 21 for storing the serum.
- FIG. 7 is a view in which the blood reservoir 10 and the tube 42 of the bag body of the blood component separation device according to the first embodiment of the present invention are fused.
- FIG. 8 is a view showing the bag body 21 that has undergone the fusing process in the blood component separation device according to the first embodiment of the present invention.
- FIG. 9 is a perspective view showing the blood reservoir 10 in the derivation step after the blood component separation device according to the first embodiment of the present invention has been centrifuged.
- FIG. 10 is a perspective view (partially sectional view) showing a coagulated body-attached glass processed body 14 according to the blood component separation apparatus according to the second embodiment of the present invention.
- FIG. 11 is a view showing a blood component separation device 1 according to the fourth embodiment of the present invention.
- FIG. 12 is a diagram showing a blood component separation device 1 according to the fifth embodiment of the present invention.
- FIG. 13 is a view showing a blood component separation device 1 according to the sixth embodiment of the present invention.
- FIG. 14 is a view showing a blood component separation device 1 according to the seventh embodiment of the present invention.
- FIG. 15 is a diagram showing a process of introducing physiological saline into the blood fluid storage unit 10 of the blood component separation device 1 according to the fifth embodiment of the present invention.
- FIG. 16 is a characteristic diagram showing the relationship between the elapsed time from blood collection and the residual rate of platelets according to Example 1.
- FIG. 17 is a characteristic diagram showing the relationship between the area of the processed glass body in contact with blood and the amount of cell growth factor (TGF-GF) released into serum according to Example 2.
- TGF-GF cell growth factor
- FIG. 18 is a characteristic diagram showing the relationship between the area of the processed glass body in contact with blood and the amount of cell growth factor (PDGF—BB) released into serum according to Example 2.
- PDGF—BB cell growth factor
- FIG. 19 is a characteristic diagram showing the relationship between the area of the processed glass body in contact with blood according to Example 3 and the amount of hemoglobin released from the supernatant.
- FIG. 20 shows the relationship between each sample and the number of cells according to Example 4.
- FIG. 21 is a graph showing changes with time in the red blood cell recovery rate of each sample according to Example 5.
- FIG. 22 is a graph showing the growth factor release rate and blood platelet plasma clotting time for each specimen according to Example 6.
- FIG. 23 is a graph showing the platelet residual rate of each specimen according to Example 7. BEST MODE FOR CARRYING OUT THE INVENTION
- a blood component separation device is a device capable of generating blood coagulation promoting functions in a space for storing blood components that produce serum and generating a practically usable amount of serum. .
- a typical example of the device configuration is one in which at least one flexible bag body is connected in a sterile, liquid-tight, and air-tight manner and has a blood coagulation promoting function. Conceivable.
- Such a blood component distribution and storage device is similar in appearance to a so-called blood bag or separation bag.
- the same configuration as these is used to aseptically and liquid-tighten the various components collected by these devices. This is because it has a long history of being suitable for airtight distribution.
- the point which provided the blood coagulation promotion function is related to the essence of this invention.
- a simple flexible bag contains liquid components including blood coagulation factors
- coagulation factors are activated over time, and serum can be produced.
- the growth factor contained in the serum is inactivated, resulting in insufficient activity. Therefore, blood coagulation promoting function was added.
- the liquid component containing the blood coagulation factor comes into contact with the blood coagulation factor in the space, and blood coagulation is promptly promoted.
- serum can be prepared in an extremely short time, and serum can be prepared in a state where the decrease in activity is suppressed.
- the present invention does not exclude such a form. That is, generally, a form in which a storage space wall surface is formed of a material having a blood coagulation promoting function higher than that of a medical material used for a blood bag or a separation bag is also included in the category of the present invention.
- a glass processed body As a substance having a blood coagulation promoting function, a glass processed body can be mentioned as one that has been confirmed to be most effective at present. Glass has long been known to have a blood clotting effect. There are no examples of active use for the production of relatively large amounts of serum.
- the inventors of the present invention used a processed glass as a substance having a function of promoting blood coagulation, made it exist in blood components that produce serum, and repeated contact with each other. As a result, a large amount of serum was activated in a short time. We succeeded in generating without lowering.
- Substances that have a function of promoting blood clotting become more active as they come into contact with blood. I know that In other words, it has been found that it is effective to increase the specific surface area in the case of a glass processed body, and it is effective to increase the content in the case of air. However, when a solid is used as a substance having a blood coagulation promoting function, such as a glass processed body, the concern of hemolysis must be considered.
- a liquid component containing a blood coagulation factor and a substance having a blood coagulation promoting function hereinafter referred to as a blood coagulation promoting individual
- blood collected from the human body is stored in a blood reservoir that contains a blood coagulation promoting individual, and blood coagulation is promoted to separate serum.
- the separated serum is aseptically transferred to a bag other than the blood reservoir and can be stored in this bag.
- the separated serum can be aseptically derived outside and added to the cell culture system as a growth factor for use.
- other blood components red blood cells, fibrin, etc.
- blood collected from the human body is stored in the blood reservoir, and after adding blood coagulants to the reservoir, the blood components are separated, and the components that produce serum among the separated components
- the liquid component containing blood coagulation factor and platelets are aseptically transferred to a separate bag and serum is produced in this bag.
- a neutralizing agent for neutralizing the mixed anticoagulant is added.
- the separated serum is stored as it is in the blood reservoir or aseptically transferred to another bag and stored.
- the separated serum is aseptically extracted outside and added to the cell culture system as a growth factor. If you add, you can also use it at any time.
- Other blood components red blood cells, fibrin, etc.
- separated before and after serum separation can be used for blood transfusion and regenerative treatment.
- the third is a form related to the second form.
- the serum-producing component is collected from the blood and serum is produced in the same manner as in the second form.
- component blood is collected from the beginning, unnecessary blood components are immediately returned to the test subject when the purpose is to collect serum fibrin. Such physical burden is reduced.
- the configuration of the blood component separation device 1 according to the embodiment of the present invention will be described with reference to FIG. In FIG. 1, only the main part of the configuration of the blood component separation device 1 is extracted and shown.
- a blood component separation device 1 is mainly composed of a blood storage unit 10 and a component storage unit 20.
- the blood reservoir 10 is a main body formed in a bag shape by fusing two sheets of flexible resin material, for example, soft polyvinyl chloride, at the outer edge 11a. It is composed of a part 11 and a glass processed body 12 inserted into the main part 11. That is, the blood reservoir 10 has a configuration in which a glass processed body 12 as a blood coagulation promoting individual is accommodated inside a main body 11 as an exterior body.
- the blood reservoir 10 is similar to a so-called blood bag or separation bag in the internal volume and appearance of the main body 11, but is different from the blood bag in that the anticoagulant is not filled therein. It is different in that it contains a coagulation promoter. Different from G. In addition, the inside of the blood reservoir 10 has been sterilized in advance.
- the processed glass body 12 in the main body 11 has, for example, a substantially spherical shape made of soda glass. Further, in FIG. 1, the blood storage section 10 is provided with three glass processed bodies 1 2. However, in order to obtain a blood coagulation promoting function, the surface area of the glass processed body 12 relative to the amount of blood that can be stored is determined. , 0.1 (m mVm 1) or more is preferable. Note that the glass processed body 12 is not joined to the inner wall of the main body 11 and is free to move inside the main body 11 when a shaking action or a vibration action is applied to the main body 11. It is set to a possible state.
- the glass processed body 12 is set with a surface area having a relationship of 25.0 (mm / m 1) or less with respect to the amount of blood that can be stored in the main body portion 11 of the blood storage portion 10. It is preferable to keep. The reason why these numerical ranges are preferable will be described later.
- the component container 20 is composed of six bags 21 to 26, each of which is made of soft polyvinyl chloride. These will be sterilized in advance.
- two tubes 4 1 and 4 2 are hermetically connected to the connection edge of the upper edge of the main body 11 of the blood reservoir 10.
- the tube 41 plays a role of an introduction path for introducing blood, so the blood collection needle 30 or a connection portion connectable to the blood collection needle is connected to the other end.
- the other tube 4 2 hermetically connected to the blood reservoir 10 is connected to each bag 2 1-26 via tubes 4 3-4 6, 5 1-5 6 and branch bodies 6 1-6 5 It is connected.
- These tubes 4 1 to 4 6 and 5 1 to 5 6 are made of a resin material having flexibility, for example, a material such as soft polyvinyl chloride.
- the bag body 2 1 to 2 6 and the tubes 5 1 to 5 6 of the component container 20 are also airtightly connected.
- the sizes of the tubes 4 1 and 4 2 are set so that the inner diameter is smaller than the outer diameter of the glass processed body 12. This is to prevent the processed glass body 12 from entering the tubes 4 1 and 4 2 when the serum is prepared and derived.
- the blood reservoir 10 and the bags 2 1 to 2 6 and the tubes 4 1, 4 2 and 5 1 to 5 6 are connected in a state where the internal space is isolated from the external environment.
- each of the tubes 4 2 to 4 6, 5 1 to 5 6 and each branch body 6 1 to 6 5 are connected to a state in which the region where the serum circulates is isolated from the external environment. . Specifically, they are connected by solvent adhesion, heat welding, ultrasonic welding or the like. .
- blood is obtained by sandwiching the required portions of the tubes 4 2 to 4 6 and 5 1 to 5 6 with clamps.
- the flow path can be switched when the extracted serum is derived.
- FIGS. Fig. 2 A serum preparation operation using the blood component separation apparatus 1 having the above-described configuration will be described with reference to FIGS. Fig. 2 is used together for explanation of the operation.
- the blood separation operation using the blood component separation apparatus 1 is roughly composed of seven steps (S 1 to S 7).
- the blood collection needle 30 in FIG. A person (patient) is stabbed and blood is collected.
- the blood collected from the blood collection needle 30 is stored in the blood storage section 10 located below via the tube 41 (storage process S 1).
- a breakable partition wall is provided between the tube 42 and the blood storage unit 10 so that the blood collected in the blood storage unit 10 does not flow into the component storage unit 20.
- the tube 4 2 is closed on the root side of the blood reservoir 10 using a clamp or the like.
- the storage step S 1 is completed after collecting the required amount in consideration of the patient's physical condition at the time of blood collection.
- the required amount here is about 200 to 600 (ml) when there is no problem in the patient's physique or physical condition.
- the blood storage unit 10 is shaken so as to be parallel thereto (activation promotion step S 2).
- activation promotion step S 2 the blood storage unit 10 storing the collected blood is gently stirred by the shaking device 100 and comes into contact with the glass processed body 12 housed therein.
- the platelets and coagulation factors contained in the blood coagulate on the surface of the glass body 12, and the growth factors derived from these are released from the platelets activated during the coagulation.
- this activation promotion step is performed at low temperature, it is effective for promoting platelet aggregation.
- blood reservoir 10 is formed to have the same outer dimensions as a normal blood pug, a known shaking device can be used for shaking of blood reservoir 10. Further, although not shown in FIG. 3, the blood reservoir 10 is connected to each bag 21 1-26 via each tube 41-4 46, 51-6. It is also possible to fold and shake.
- the blood collection needle 30 is removed from the blood collection target, a part of the tube 41 connecting the blood collection needle 30 and the blood storage unit 10 is melted, and the same Sometimes the fusing end is welded (fusing step S3).
- a fusing machine 110 for fusing the tube 41, a fusing machine 110 (so-called sealer) as shown in FIG. 4 can be used.
- the blood reservoir 10 separated from the patient is composed of the component container 20 and the tubes 42 to 46, 51 to 56, and the branch bodies 61 to 65, etc.
- the activation promotion step S 2 they are combined into a compact and subjected to a centrifuge (centrifugation step S 4).
- the tube 42 is maintained in a state where the path is closed by a breakable partition wall or a clamp as in the storage step S 1.
- the fusing step S 3 and the centrifugation step S 4 may be performed before the activation promoting step S 2 when blood is collected by adding an anticoagulant in advance. In this case, centrifuge under the following conditions.
- Centrifugation conditions for the blood reservoir 10 are set according to the amount of blood stored and the types of components to be separated. For example, 2 250 (g) XI 0 (min.), 4 ( Set to ° C). The blood reservoir 10 after centrifugation will be described with reference to FIG.
- the glass processed body 12 is attached to the bottom of the main body portion 11a in the blood storage section 10a with a blood plate and a coagulation body 74 of a coagulation factor (hereinafter referred to as "coagulation body adhesion glass"). It ’s called “Processed body 1 4”.)
- coagulation body adhesion glass As shown in the enlarged portion of the figure, the body 14 is formed by adhering a coagulated body 74 having a blood platelet and a coagulation factor coagulated on the surface of the glass processed body 12.
- the reference numeral 14 is attached to the glass body after the solidified body 74 is adhered.
- the serum 71 which is a supernatant component in the state of FIG. 5, contains growth factors derived from these sufficiently released from platelets and coagulation factors in the activation promoting step S2. Also in the centrifugation step S 4, the two tubes 4 1 and 4 2 that are hermetically connected to the upper edge of the main body portion 11 of the blood reservoir 10 are both closed. Therefore, it is isolated from the external environment and microorganisms do not enter.
- the activator activated in the activation promotion step S 2 to the centrifugation step S 4 is agglomerated and separated from the blood (separation step S 5 and separation step S 5 Then, the serum 71 separated and extracted in the blood reservoir 10 is subdivided sequentially for all or a part of the bag bodies 21 to 26 in the component container 20 (derivation step S 6).
- the derivation method will be explained using Fig. 6.
- the path of the tube 43 is closed using the clamp 90.
- the blood reservoir 10 is pressurized (F 1) with the pressurizer 80 installed outside the blood reservoir 10.
- the tube 41 that is airtightly connected to the blood reservoir 10 is fused at the time when the reservoir process S 1 is completed, and the end and the vicinity 41 1 are in the middle. b is welded.
- a part of serum 71 which is a supernatant extracted by separation by receiving pressurized F1 is divided into tube 42, branch 61, and tube. It is led out to the bag body 21 for serum preservation through the bu 51.
- the passage closing of the tube 4 3 is performed by sandwiching the flexible tube 43 between the disc 91 of the clamp 90 and the base 92.
- the tube 51 is melted and welded (melting step S7).
- the fusing and welding are performed using a method similar to that for fusing and fusing the tube 42 before the centrifugation step S4.
- a preservation treatment such as cryopreservation is performed for the bag body 21 in which the serum 71 is filled.
- This derivation process S6 and fusing process S7 are sequentially performed on each of the bags 21 to 26, and all or part of the bags 21 to 26 are filled with serum 71. At that time, the serum preparation operation is completed. Furthermore, if necessary, the red blood cells 73 can be washed and diluted with an anticoagulant such as physiological saline, CPD, ACD_A solution, or a blood storage solution such as MAP, and stored as blood for transfusion. This method will be described later.
- an anticoagulant such as physiological saline, CPD, ACD_A solution, or a blood storage solution such as MAP
- a blood reservoir 10 is formed from a main body 11 having an internal volume equivalent to that of a blood bag, and a glass processed body 12 disposed in the body. Since serum is prepared from blood inside this blood reservoir 10, a larger amount of serum can be prepared at a time than in the case of using a conventional blood collection tube. Effective in terms of process. This also reduces the risk of the prepared serum being contaminated by microorganisms and is suitable for preparing highly safe serum.
- glass processing is performed as a blood coagulation promoting individual. Since the body 12 is accommodated, blood clots adhere to the surface of the glass processed body 12 at the time of serum preparation, so that fipurin and blood clots are prevented from being mixed into the serum when the serum is separated.
- the blood component separation device 1 has a blood reservoir 10 and a bag body 2 1 to 2 6 and tubes 4 1, 4 2, 5 1 to 5 6 and an internal space outside. Because it is airtightly connected to the environment, blood or serum is not exposed to the external environment. Therefore, further safety is ensured.
- the tubes 41, 42, 51-5 are made of a material that is flexible and can be cut and welded. The inside is not exposed to the external environment. Therefore, also from this aspect, it can be said that the blood component separation device 1 has high safety.
- the glass processed body 1 as a blood coagulation promoting individual having a blood coagulation promoting function is provided inside the blood reservoir 10 for storing blood. 2 so that most platelets (for example, 95% or more of platelets) and coagulation factors coagulate within 10 (min.), So that the serum preparation operation can be performed quickly. it can. Therefore, serum can be rapidly prepared by using the blood component separation device 1 according to the embodiment of the present invention.
- red blood cells remaining in the blood component separation apparatus 1 are removed. Most of them do not become blood clots, so red blood cells may be reused as a component for transfusion.
- serum 71 is prepared and stored using the blood component separation apparatus 1, In addition, serum can be prepared and stored quickly. Therefore, by using the blood component separation device 1 according to the present embodiment, it is possible to perform regenerative treatment of a tissue or function with high efficiency while ensuring high safety for a patient.
- the glass workpiece 12 is formed with a surface area having a relationship of 0.1 (mm 2 / ml) or more with respect to the amount of blood that can be stored in the blood reservoir 10.
- 0.1 (mm 2 / ml) or more with respect to the amount of blood that can be stored in the blood reservoir 10.
- the surface area of the glass body 12 with respect to the storable blood volume is set to be within the range of 0.1 (mm / m 1) to 25.0 (mm / m 1). It is possible to achieve both suppression of hemolysis in the activation promotion step S2 and centrifugation step S4 and promotion of activation of platelets and coagulation factors.
- the number of glass processed bodies 12 in the blood reservoir 10 is three in this embodiment, but is not limited to this. Regarding the number of glass workpieces 12 that can be accommodated, it is practically appropriate to set the number to 1 or more and 50 or less.
- the glass processed body 12 is used as the blood coagulation promoting individual, but the blood coagulation promoting individual is not limited to this.
- the contact region with blood may be composed of an inorganic substance composed of at least one selected from silicon dioxide compounds such as silica, diatomaceous earth, and kaolin.
- the substance disposed in the contact area is not limited to inorganic substances.
- the blood coagulation promoting function may be achieved as long as the blood coagulation promoting individual is not accommodated in the blood reservoir 10.
- a part of the inner wall of the main body part 11 of the blood storage part 10 may be covered with the inorganic substance.
- the glass processed body 12 in the blood component separation apparatus 1 has a substantially spherical appearance, but the appearance of the blood coagulation promoting individual according to the present invention is not limited thereto.
- glass processing is performed by blocking the glass processing body to which fibrin has adhered from the outside of the blood storage unit 10, for example, with a clamping unit 16 such as a clamp.
- Red blood cells can be derived by separating platelets and coagulation factors attached to the surface of the body.
- the clamping portion 16 has a corrugated shape or an uneven shape on the contact surface with the blood reservoir 10 so that erythrocytes or fibrin washing liquid can flow even after the blood reservoir 10 is sandwiched. It is preferable.
- the solid glass processed body 12 is used.
- a substance having a blood coagulation promoting function is formed on the outer surface, it is not necessarily required to be solid.
- a porous structure may be used, and the entire region in contact with blood including the wall surface in the pore may be coated with a silicon dioxide compound such as glass.
- the blood component separation device is a form of the blood component separation device 1 according to the first embodiment and a glass processed body accommodated in the blood reservoir 10. There are differences. Therefore, in the following, the form of the glass processed body will be described with reference to FIG. 10, and description of other parts will be omitted.
- the coagulated body-attached glass processed body 14 according to the present embodiment is similar to the glass processed body 12 in that it has a substantially spherical appearance, but the core body portion 14 It is characterized by having a two-layer structure consisting of 1 and a surface layer portion 14 2.
- the core body section 14 1 is composed of a magnet.
- the surface layer portion 14 2 is made of, for example, soda glass as the same inorganic material as the material constituting the glass filler body 12.
- the blood reservoir 10 containing the coagulated body-adhered glass processed body 14 having such a structure therein, the blood reservoir 10 is not subjected to the activation promoting step S2 in FIG.
- the effect of promoting the stirring of blood can be obtained by applying a magnetic field together with shaking. That is, by applying a magnetic field to the blood reservoir 10 from the outside with, for example, a stirrer such as a magnetic stirrer, the coagulant-adhered glass processed body 14 rotates in the container. Wake up and come into contact with blood more efficiently.
- the glass processed body 14 when the glass processed body 14 is composed of a magnet, it can be fixed with a magnet from the outside of the blood reservoir 10 in the derivation step S 6. ⁇ Third embodiment>
- the blood component separation device is the blood according to the first embodiment. There is a difference between the component separator 1 and one of the bag bodies 21 to 26 constituting the component container 20 for air venting (see FIG. 1). When blood is collected, only the volume of the tube 41 is inevitably mixed into the blood reservoir 10, but it is preferable that each blood component is not present during the separation step S5. Therefore, if the air vent bag according to the present embodiment is installed between the blood storage unit 10 and the component storage unit 20, it is possible to remove only air from each blood component before the separation step S5. is there. Note that other configurations in the present embodiment are the same as those in the first embodiment, and thus description of other portions is omitted. ⁇ Fourth embodiment>
- the blood component separation device uses air 15 5 instead of the blood coagulation promoting individual added to the blood reservoir 10 of the blood component separation device 1 according to the first embodiment.
- air 15 is preferably 0-0 3 (cc Z ml) to 1 (cc / m 1) with respect to the amount of blood that can be stored.
- the tube 41 has a mechanism for preventing leakage of the tube until use.
- Air and blood coagulation promoting individuals may be used in combination.
- the blood component separation device is provided in at least one of the bag bodies 21 to 26 that constitute the component storage portion of the blood component separation device 1 according to the first embodiment.
- the difference is the addition of glass processed body 12 (blood coagulation promoting individual).
- a citrate neutralizing agent containing calcium ions may be further added to the container to which the glass processed body 12 is added.
- the blood reservoir 10 can be a so-called “blood donation blood bag” to which an anticoagulant such as a CPD solution is added.
- the blood in the blood reservoir 10 is supplemented with a force S that is separated to some extent by centrifugation or the like, and an anticoagulant, so that serum cannot be produced as it is.
- the blood in the blood reservoir 10 is neutralized with a neutralizing agent added in the bag 21, the growth factor in the blood is activated, and the generated serum is stored in the bag 2 2.
- the blood component separation device uses air 1 instead of the blood coagulation promoting individual added to the bag body 21 of the blood component separation device 1 according to the fifth embodiment.
- air 1 instead of the blood coagulation promoting individual added to the bag body 21 of the blood component separation device 1 according to the fifth embodiment.
- the content of air 15 is preferably 0.0 3 (cc / ml) to 1 (cc / m 1) with respect to the storable blood volume, and is sealed in advance so as to be the content described above.
- the tube 51 has a mechanism for preventing air leakage until it is used.
- Air and blood coagulation promoting individuals may be used in combination.
- the component storage portion is configured by the six bag bodies 21 to 26.
- the number of bags constituting the component storage portion is not limited. Is not limited to this.
- the force in which a glass processed body is used as a blood coagulation promoting individual may be the same even if it contains air instead of the glass processed body. The effect of. In this case, 0 ⁇ 03 (c cZm l) to 1 (c cZm l) is preferable for the storable blood volume.
- the present invention can effectively utilize erythrocytes or fibrin remaining in the blood reservoir 10 after separating blood. About that This will be described in detail.
- a blood component separation device 1 that separates blood is used.
- blood is separated and blood is introduced into the bag body 21 (component storage section), and then blood storage section 10 has a coagulated body adhered glass processed body 1 with fibrin attached thereto. Residues such as 4 and red blood cells remain.
- One of the component storage units 21 to 26 that is airtightly connected to the blood storage unit 10 does not store serum.
- Saline-containing bag body 1 20 containing physiological saline is connected to tube 41 and mixed with red blood cells in blood reservoir 10 and used as blood for transfusion (Fig. 1 5).
- the coagulated body-attached glass processed body 14 with fibrin adhered should be further washed after all blood components are derived, and the fibrin obtained after washing should be used as a scaffold for stem cells or a barrier for wounds. Can do.
- the blood component separation device a configuration in which the blood storage unit and the component storage unit are communicated with each other by a tube or the like is employed, but the blood storage part and the serum are stored. It is not always necessary to configure the parts to be separated as separate containers. For example, it is possible to prepare a container that can be partially separated by fusing, welding, etc., store blood in this container, and then use it as the component container 20. . In the derivation step S 6, a clamp with the blood reservoir 10 sandwiched so as not to derive the glass additive 12 with fibrin attached or the coagulated substance-attached glass processed article 14 was mentioned. It is not limited to.
- Figure 16 shows the relationship between the number of platelets and the incubation time. From this, it can be seen that the larger the surface area ratio of the processed glass per 1 m1 of blood, the more the platelets are activated and aggregate. In addition, it was shown that the sample without the glass processing body took quite a long time, about 90 minutes, until blood aggregation. Furthermore, even if it is allowed to stand for a long time without adding the glass processed body and promotes the release of growth factors from the platelets, the activation of other coagulation is insufficient, so that the serum coagulates in the subsequent process, or A large amount of bouillin often precipitates. Therefore, samples B to I related to the experimental example It can be seen that the container contains the processed glass, so that platelets can be rapidly aggregated, and the platelet-derived growth factor required for serum preparation can be released with high efficiency.
- the growth factor release effect was examined. Select 5 samples from the 9 samples used in Example 1, add fresh blood from 5 subjects to each sample, and measure growth factors after 20 minutes. Specifically, after incubation in the same manner as in Example 1 under the conditions shown in Table 2 below, the amount of growth factor (TGF-j31, PDGF-BB) was measured using a commercially available test kit (R & D SYSTEMS). It was measured using a mouth plate reader (Mu 1 tiskan BI CHROMAT ICL absystem) and expressed as a ratio to the amount in the specimen having a contact area of 0 with the glass processed body. The results are shown in Figs. 17 and 18.
- the horizontal axis represents the glass surface area
- the vertical axis represents the amount of each growth factor. From Fig. 17, it can be seen that the amount of growth factor released significantly increased when glass processing bodies were added as little as 0.6 mm 2 per 1 ml of blood. However, when the surface area ratio was extremely increased, the amount of TGF-3 1 was found to be almost in equilibrium. In addition, in FIG. 18, a significant increase in growth factors was confirmed by adding a small amount of glass processed body. Furthermore, it was found that when the surface area ratio is extremely increased, as in Fig. 17, the PDGF-BB amount is almost balanced. ⁇ Table 2>
- the contact area of the glass processed body per 1 ml of blood was set to 0 (mm 2 ) or 1.5 (mm), and the blood sampled from the human contained one of the glass processed bodies. Shake for 20 minutes in the blood reservoir. After shaking, the blood was centrifuged (centrifugation conditions: 2 25 50 (g) X 10 (min)), 4 (° 0), and the supernatant was separated. After heat treatment for 30 minutes, it was filtered through a 0.22 ( ⁇ ) filter and stored frozen at 80 ° C. The supernatant was thawed during cell culture and added to the cell culture medium.
- Cells obtained from rat femur bone marrow were cultured in advance for 7 days, and the obtained adherent cells were used as bone marrow-derived cells in this Example. Cells are seeded and the supernatant obtained by adding glass processed body to the medium to a concentration of 10%, supernatant obtained without adding glass processed body, or commercially available urchin fetal serum for cell culture The number of cells was counted 1, 3, and 7 days after the start of culture Figure 20 shows the results of confirming the effect on cell proliferation.
- the collected red blood cells were confirmed.
- the contact area of the glass processed body is 12.5 (mm 2 ) per 1 ml of blood, and 20 (ml) after blood collection, 60 minutes after shaking with Multi-shaker MMS-300 (manufactured by Tokyo Science Instruments Co., Ltd.) I let you.
- the change in the number of red blood cells over time was examined. The result is shown in FIG. As a result, when the number of red blood cells immediately after blood collection was 100%, about 80% of red blood cells remained after shaking for 60 minutes with the glass processed body.
- serum was collected by the conventional method most of the blood in the container became blood clot, and only 10% of red blood cells were collected 60 minutes after blood collection.
- serum rich in growth factors could be prepared from blood collected using anticoagulants such as CPD solution or platelet rich plasma (PRP) prepared by blood donation.
- CPD solution or platelet rich plasma (PRP) prepared by blood donation.
- Fresh human blood to which CPD was added was prepared so that the final concentration was 12.2%.
- This CPD-added blood was centrifuged at 760 g for 10 minutes (22 ° C) to prepare platelet-rich plasma.
- 0.8 ml of the obtained platelet-rich plasma was incubated at 37 ° C in a container to which calcium chloride and a glass processed body had been added in advance, and shaken appropriately. The time until fibrin precipitated from platelet-rich plasma after addition of platelet-rich plasma and fluidity decreased in appearance was measured.
- each sample with reduced fluidity is immediately 2,250 g, 10 minutes Centrifugation was performed at (4 ° C), and the resulting supernatant was separated. Thereafter, the amount of PDGF-BB and the amount of TGF_i31 contained in the supernatant were measured. The amount of each growth factor measured is shown in FIG. 22 as a ratio (%) to the amount of each growth factor contained in serum prepared from the same blood.
- Example 1 it was found that it is effective to house a glass processed body as a blood coagulation promoting individual in a blood reservoir in order to rapidly aggregate platelets. That is, if a blood reservoir containing a glass processed body is used, platelet-derived growth factors necessary for preparing serum from collected blood can be rapidly and efficiently generated. Therefore, if such a glass processed body is stored in the blood component separation apparatus, a large amount of serum can be rapidly prepared (produced).
- serum prepared from blood collected in a container containing a glass processed body has a useful increase in cell growth during the preparation process. Growth factors were sufficiently released, and as a result, it was confirmed that adding the serum to the medium contributed to the growth of bone marrow-derived cells. Therefore, storing the processed glass in the blood component separation apparatus is useful for preparing serum effective for promoting cell growth.
- Example 3 from the viewpoint of the amount of hemoglobin in the supernatant freed from the serum separated by the centrifugation step, it is necessary to store the excessive glass processed body in the blood reservoir in the case of erythrocytes during shaking and centrifugation. It will lead to smashing (hemolysis), which is not desirable.
- the glass processed body in the blood reservoir can be stored in a container from the viewpoint of promoting the activation of platelets and coagulation factors and collecting the growth factors. It is desirable to set the surface area of the glass workpiece to 0.1 (mm 2 / ni l) or more with respect to the amount, and 25.0 (m mVm 1) It is understood that it is preferable to set so as to have the following relationship.
- the blood component separation device of the present invention can quickly and in large quantities prepare serum in which the growth of microorganisms is suppressed. Therefore, it is suitable for preparing a large amount of serum used for stem cell culture in regenerative medicine. doing.
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Abstract
Description
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JPWO2004103439A1 (ja) | 2006-07-20 |
JP2010222376A (ja) | 2010-10-07 |
US8796017B2 (en) | 2014-08-05 |
EP2769745B1 (en) | 2016-05-04 |
CN100551452C (zh) | 2009-10-21 |
US20060251622A1 (en) | 2006-11-09 |
US20140305876A1 (en) | 2014-10-16 |
CN101496917A (zh) | 2009-08-05 |
JP5229277B2 (ja) | 2013-07-03 |
JPWO2004103440A1 (ja) | 2006-07-20 |
WO2004103440A1 (ja) | 2004-12-02 |
JP2010227582A (ja) | 2010-10-14 |
US8993321B2 (en) | 2015-03-31 |
EP1625861A4 (en) | 2012-04-11 |
JP5229342B2 (ja) | 2013-07-03 |
JP2011162547A (ja) | 2011-08-25 |
JP4752504B2 (ja) | 2011-08-17 |
HK1089706A1 (en) | 2006-12-08 |
CN1791438A (zh) | 2006-06-21 |
HK1134046A1 (en) | 2010-04-16 |
JP5195809B2 (ja) | 2013-05-15 |
US20140301914A1 (en) | 2014-10-09 |
JP2010189415A (ja) | 2010-09-02 |
JP3788479B2 (ja) | 2006-06-21 |
EP1625861A1 (en) | 2006-02-15 |
EP2769745A1 (en) | 2014-08-27 |
JP5088394B2 (ja) | 2012-12-05 |
CN101496917B (zh) | 2013-07-31 |
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