Search PubMed⌕ Search

Biomedical subjects

G J Jan

Publications and source records attributed to G J Jan.

8 recordsLinked to original sources

Development of a totally implantable pulsatile centrifugal pump as a ventricular assist device.

The Taita No. 1 ventricular assist device (T-VAD) is a totally implantable pulsatile impeller centrifugal pump driven by a magnetically suspended motor. The flow can achieve 2.01 +/- 0.17 L/min against a pressure of 100 mm Hg under 0.266 +/- 0.017 amp and 13.55 +/- 0.41 voltage. The speed was around 3,500 rpm. It consumed less than 6 W of power, resulting in less heat production and mechanical bearing complications. The impeller vane was designed to have both radial and axial curves according to the stream surface and stream lines to reduce thrombosis and hemolysis. Eight calves weighing 80 to 100 kg (mean 87 +/- 12 kg) were used for experiments. With the calves under general anesthesia, left posterolateral thoracotomy was performed to connect the inflow tube with the atrial appendage and to anastomose the outflow tube with the descending aorta. The calves usually awoke and stood up within hours after discontinuation of anesthetics. The mean survival of the calves was 75 +/- 42 days (range 33-148 days). The terminations of experiments were mainly due to infection. During the course of pumping, no significant deterioration of liver or renal function was noted. The evaluation of serum samples from the implanted calves indicated that hemolysis was not associated with use of the T-VAD. The average daily free hemoglobin level was 8.08 +/- 3.05 mg/dl, which was less than the set limit of 20 mg/dl. The red blood cell and platelet count and hemoglobin of implanted animals were within the normal range. In our results, the T-VAD provided competent pulsatile function without severe blood damage or organ dysfunction.

Animals↗

Physiologic analysis of cardiac cycle in an implantable impeller centrifugal left ventricular assist device.

The purpose of this study was to determine the physiologic relationship between the cardiac cycle and the nonpulsatile impeller centrifugal Taita No.1 left ventricular assist device (T-LVAD) in a chronic animal study. The relationship of the cardiac cycle, pump flow, aortic pressure, left ventricle pressure, and pump power were analyzed by 5 phases in 4 stages. The isovolumetric ventricular phase is from mitral valve closure (MVC) to aortic valve opening (AVO) and is called Stage 1. The ejection phase is from AVO to aortic valve closure (AVC) and is called Stage 2. The isovolumetric relaxation phase is from AVC to MVC and is called Stage 3. The passive filling and atrial contraction phase is from MVC to mitral valve opening (MVO) and called Stage 4. Based on evidence from the physiologic volume change of the left ventricle, the change of pump flow of the T-LVAD in a cardiac cycle by variable voltages of pump control was evaluated using animal models. After left posteriolateral thoracotomy via the fifth intercostal space under general anesthesia, the nonpulsatile centrifugal T-LVAD was implanted into 2 healthy calves. The inflow of the T-LVAD was inserted into the left ventricle through the mitral valve via the left atrial appendage. The arterial blood pressure waveform was measured and recorded on the outflow of the T-LVAD. The 4 phases of a cardiac cycle were defined as MVC-AVO (Stage 1), AVO-AVC (Stage 2), AVC-MVO (Stage 3) and MVC-MVO (Stage 4) according to the outflow pressure of the outflow of the T-LVAD and differential pressure between the outflow and inflow of the T-LVAD. We carried out the real-time waveform measurement for electrocardiogram, the outflow pressure, the T-LVAD flow and the speed, as well as open loop and constant voltage (V). In a cardiac cycle, the sensing current of the T-LVAD was inverse to the speed. The flow of the T-LVAD at the 4 stages was measured individually and analyzed with different control voltages from 10 to 18 V. The highest flow ratio of MVC-AVC/AVC-MVC was noted when the T-LVAD worked on 14 V. By using analysis methodology of the flow ratio of a cardiac cycle, the optimal physiologically effective control of the T-LVAD might be achieved.

Animals↗

Application of extracorporeal membrane oxygenation in adult burn patients.

Adult respiratory distress syndrome (ARDS) has been the major cause of mortality in burn injury. The authors reported the experience of using extracorporeal membrane oxygenation (ECMO) to treat adult burn patient with ARDS. Three patients with burn or electric injury, around 48.9% of body surface area over second-degree burns, developed ARDS after resuscitation. All had positive blood culture and depended on a ventilator more than 5 days before ECMO. Venovenous (VV) ECMO was started at the beginning of severe respiratory failure with an oxygen index of 61.6 +/- 15.5 cm H2O/mm Hg (> or =40 cm H2O/mm Hg), partial arterial oxygen tension to inspired oxygen fraction (Pa(O2)/Fi(O2)) of 46.1 +/- 7.0 mm Hg (< or =200 mm Hg), positive end expiratory pressure (PEEP) of 15.7 +/- 1.6 cm H2O (> or =10 cm H2O), alveolar-arterial difference in oxygen concentration (A-a D(O2)) of 618.9 +/- 19.3 mm Hg (> or =300 mm Hg), and lung compliance of 17.3 +/- 4.6 ml/cm H2O (< or =30 ml/cm H2O). The VV type had to be converted to the newly designed veno-venoarterial (V-VA) ECMO due to the myocardial dysfunction. Two of three patients survived. The duration of ECMO was 160.2 +/- 51.1 h. Two patients received debridement of escar during ECMO support and desmopressin infusion, and no increased bleeding or coagulopathy was found. The respiratory parameters were significantly improved after ECMO, especially in the survivors. ECMO is also suitable for ARDS in adult burn injury.

Adult↗

ECG data compression using truncated singular value decomposition.

The method of truncated singular value decomposition (SVD) is proposed for electrocardiogram (ECG) data compression. The signal decomposition capability of SVD is exploited to extract the significant feature components of the ECG by decomposing the ECG into a set of basic patterns with associated scaling factors. The signal informations are mostly concentrated within a certain number of singular values with related singular vectors due to the strong interbeat correlation among ECG cycles. Therefore, only the relevant parts of the singular triplets need to be retained as the compressed data for retrieving the original signals. The insignificant overhead can be truncated to eliminate the redundancy of ECG data compression. The Massachusetts Institute of Technology-Beth Israel Hospital arrhythmia database was applied to evaluate the compression performance and recoverability in the retrieved ECG signals. The approximate achievement was presented with an average data rate of 143.2 b/s with a relatively low reconstructed error. These results showed that truncated SVD method can provide an efficient coding with high-compression ratios. The computational efficiency of the SVD method in comparing with other techniques demonstrated the method as an effective technique for ECG data storage or signals transmission. Index Terms-Data compression, electrocardiogram, feature extraction, quasi-periodic signal, singular value decomposition.

Algorithms↗

Removal of cardiac beat artifact in esophageal pressure measurement via a modified adaptive noise cancellation scheme.

Information on volume-pressure relationships of human lungs is usually based on indirect determination of intrapleural pressure (P(ip)) obtained from the esophagus. Unfortunately, cardiac beat artifact frequently corrupts measurement of esophageal pressure (P(es)). In this study, we presented a modified adaptive noise cancellation (MANC) scheme for removing the cardiac beat artifact in the P(es) signal. The proposed methodology used an airflow signal as the reference signal with least-mean-square method as the adaptive algorithm. The results of six experiments on two Brown-Norway rats showed a significant reduction of the apparent cardiac pulsation with minimal distortion of the P(es) signal. The MANC filter also showed evidence of peak suppression at integer multiples of heart rate in the fast Fourier transform of the P(es) signal while leaving the remaining spectrum largely unperturbed. A t-test method and the ratio of standard deviation to mean (std/mean) statistics of airway resistance (R(aw)) values were used to evaluate the performance of the MANC filter. In all six experiments, a reduction of std/mean of R(aw) by 12.5%-68% was obtained, indicating the effectiveness of the proposed scheme.

Airway Resistance↗

Removal of cardiac beat artifact in oesophageal pressure measurement by frequency analysis.

Oesophageal pressure (Pes) measurements are important in medical research and useful in clinical diagnosis. Measurements, however, are contaminated heavily by cardiac artifacts. The spectrum and waveform of the Pes signal is obtained from the oesophageal balloon. Adaptive finite impulse response (AFIR) filter and modified adaptive noise cancellation (MANC) methods are adopted to filter out cardiac beat interference. These results are compared. In the frequency domain, frequency variations and spectral overlap between the Pes components and cardiac beat signal components impact on the performance of the filter. From our experimental results on power strength, the fourth or higher harmonics did not have any significant effect on the filter performance. However, the second harmonics of these signals had a significant effect on the filtering result. Thus, in the design of AFIR filters, attention is needed to minimise these effects. In frequency analysis, these harmonics or overlapping frequencies do not affect MANC. MANC was the better method for eliminating cardiac beat artifact in Pes measurement. The dynamic compliance (Cdyn) was also used to evaluate the performance of MANC and AFIR. The standard deviation of Cdyn was less than 0.15 using MANC, compared with standard deviations as high as 0.57 for AFIR. We conclude that MANC performs better than AFIR.

Animals↗

A new automated method for detection and recording of animal moving path.

A new electronic system has been developed to trace the location and movement of small animals in an open-field environment. The system, incorporated with a conventional touch panel position sensor (TPPS) and an IBM AT compatible computer, automtically digitizes and records the moving path of the animal. The detection principle of the TPPS is based on the pressure effect. Whenever an animal is put on the TPPS, the location of the animal can be detected. The personal computer system is in corporate to record the locomotion data of the animal. The system described here is shown to be a reliable and accurate tool to record the moving path of an animal. This measurement did not require extra light or other stimuli, and the apparatus is low priced, and simple to build up and user friendly.

Animals↗