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Itsuro Saito

Publications and source records attributed to Itsuro Saito.

15 recordsLinked to original sources

Development of an electro-stethoscope system and design of an optimum filter based on tissue sound transmission for noninvasive early diagnosis of malfunction of an implanted mechanical total artificial heart.

Early diagnosis of the malfunction of a mechanical artificial heart implanted in a patient who has been discharged from hospital is very important. We have developed an electro-stethoscope system that enables the malfunction of an artificial heart to be detected from the analysis of sound signals from the artificial heart. The sound data can be transmitted to a hospital via a mobile telephone or the Internet, so that doctors can examine the condition of the artificial heart. The optimum frequency characteristics of a low-pass filter for the elimination of ambient sound through the electro-stethoscope casing were obtained by simulating sound transmission through tissue. We evaluated the usefulness of the electro-stethoscope system using a goat in which an undulation pump total artificial heart had been implanted. A frequency analysis of the sound signal provided information on the degree of degradation of each mechanical component of the artificial heart. The results of this study showed that the electro-stethoscope system is useful for the early detection of the malfunction of an artificial heart at home, and that the use of the system contributes to improvement in the quality of life of patients.

Animals↗

Preliminary study of a new type of energy transmission system for artificial hearts.

A transcutaneous energy transmission (TET) system is the most common way to power artificial hearts and ventricular assist devices. However, an external battery used with a TET system poses several problems, such as its heavy mass, small charge capacity, and long recharging time. The battery is indispensable when patients want to be ambulatory. This article proposes a new type of TET system that does not require an external battery because electrical energy is supplied remotely by using electromagnetic waves. For this system to operate, multiple transmitting antennas have to be mounted in a room or facility that has been shielded from electromagnetic waves, and a receiving antenna is attached to the patient. Electromagnetic waves transmit electrical power from the transmitting antennas to the receiving antenna. The received electrical power is sent to an implanted device through the TET system. The total power efficiency was plotted against the transmitter-receiver distance by measuring the power that was input to the transmitting antennas, and the final direct current (DC) power that was received by the receiving antenna. A 430-MHz frequency was applied in the experiments. The obtained efficiency was around 10% within a transmitter-receiver distance of 1 m when Yagi-Uda antennas were used for the transmitting antennas and two other types of antenna were used for the receiving antennas: a folded dipole with a reflector and a single loop with a reflector. The results suggested that the proposed system is worth considering. The proposed system would go a long way toward enhancing the patient's quality of life compared with the currently used conventional TET system.

Computer Simulation↗

Evaluation of pulsatile and nonpulsatile flow in microvessels of the bulbar conjunctiva in the goat with an undulation pump artificial heart.

This study has three purposes, as follows. The first is to develop a microscopic system to observe the microcirculation of animals implanted with an artificial heart. The second is to investigate the influence of flow pattern change from pulsatile to nonpulsatile on the microcirculation. The third is to study the effects of pulsatility in blood flow on endothelium-derived nitric oxide release in the microvasculature. When the flow pattern was changed from pulsatile to nonpulsatile, the velocity of erythrocytes in many capillaries dropped and remained at a low level, and the number of perfused capillaries decreased. After the flow pattern was returned to pulsatile, the velocity of erythrocytes recovered to the initial level. In many cases, the flow of nonperfused capillaries recovered to the initial level as well. Also, the pulsatile flow enhances the basal and flow-stimulated endothelium-derived nitric oxide release in microvessels.

Animals↗

Basic study to develop an electromagnetic drive method for the rotary undulation pump.

The rotary undulation pump, which is composed of a disk with a convex shape on both sides and a pump housing with one narrow side and one wide side, is a unique continuous flow pump with a new principle. The concept of the levitation drive method for this pump was proposed. The electromagnetic driver model and drive circuit were developed to examine the possibility and the difference among the delta wired, Y wired, and repulsion methods. In the repulsion method, the disk was driven by magnetic repulsion. The model could be driven with either method, and the repulsion method was demonstrated to also be possible. With either method, owing to the wide gap between the permanent magnets and coils, the output was not enough when the load was high. The efficiency was almost the same in the delta wired and Y wired methods. In the repulsion method, however, it was less than 50% of that in the other two methods. From the results, the delta wired and Y wired methods with an active control of the gap distance were considered to be better than the repulsion method, which required no active gap control.

Centrifugation↗

Progress in the control system of the undulation pump total artificial heart.

The undulation pump total artificial heart (UPTAH) is a small implantable total artificial heart. As the UPTAH generates outflow and inflow at the same time, control of the UPTAH is very difficult. Therefore suitable control methods specifically for the UPTAH should be established. Various motor control, left-right flow balance control, and physiological control methods were examined and tried for the UPTAH control in this study. The control system is divided into seven categories. It has a hierarchical structure and all control modes work at the same time. The UPTAH with the newly developed control method has been implanted into the chest cavities of 48 goats. Until now, six goats survived for more than one month, including 63 days in the longest case. The good condition of the UPTAH implanted animal could be maintained with the newly developed control scheme, consisting of the 1/R control and several other additional controls.

Animals↗

A study on an energy supply method for a transcutaneous energy transmission system.

This study proposes a new type of a transcutaneous energy transmission system (TETS) that can supply electrical power for an implanted device without an external battery. In this system, the power is supplied from the floor to the shoes of the patients through coils that are set beneath the floor and the bottom of the shoes. If the patients wear the special shoes, they will be able to move freely on the specially designed floor without an external battery. Direct current (DC)-DC power efficiency was measured in the experiments, and the results showed that it varies with relative positions between the shoe and the floor coils. The results suggested that three-layered floor coils would enable the system to meet the demand for providing the required power anywhere on the floor without intermission. DC-DC power efficiency could be kept over 60% under the practical condition. It can then be concluded that the proposed system has a potential to provide better quality of life for the patients using a TETS.

Electromagnetic Fields↗

Ripple reduction control of the undulation pump total artificial heart.

An undulation pump total artificial heart (UPTAH) in which the revolutions of the motor are converted to undulation motion of a disk has been developed. In an experiment, a goat using the UPTAH survived for 54 days. However, a large ripple was observed in the device's output pressure and flow waveform. In calculating the spectrum of the ripple, we found that the ripple mainly comprised 2 frequency sine waves: 1 having the same frequency as and 1 having double the frequency of the motor revolutions. To reduce the ripple, 2 sine waves, 1 having the same frequency as and 1 having double the frequency of the motor revolutions, were provided to the motor current to modulate the pulse width of the pulse width modulation controlling the motor revolutions. This ripple control method reduced the pressure ripple by 90% in a mock circulation and by 70% in animal experiments. These results revealed that the ripple generated in the UPTAH could be controlled through the use of motor control software.

Animals↗

The improved Jellyfish Valve: durability enhancement with sufficient blood compatibility.

The Jellyfish Valve is one of the most promising polymer valves for artificial hearts. The present problems to be solved are 1) how to prevent a membrane fracture and 2) how to eliminate a calcification, because both of these problems were observed in experiments with goats after 312 days and 414 days of pumping. Finite element analysis demonstrated that mechanical tensile strain induced in the membrane at valve closure was clearly consistent with the fracture location as well as calcification area in in vivo experiments. Based on this finding, a new valve seat with an additional concentric ring 14 mm in diameter and 0.5 mm in width was finally developed. The maximum strain was dramatically reduced to 52% by the design improvement. Moreover, accelerated fatigue tests demonstrated that the improved valve was 10 times more durable as compared with the original valve, which was equivalent to an in vivo duration of 8.3 years. In animal experiments, including 31 days and 46 days use in a total artificial heart (TAH), no thrombus was found despite the lack of anticoagulant or antiplatelet therapies. These results indicate that the improved Jellyfish Valve might be one of the most durable polymer valves, able to perform in artificial hearts for a long period of time.

Animals↗

Third model of the undulation pump total artificial heart.

The undulation pump is a small, continuous flow displacement type blood pump, and the undulation pump total artificial heart (UPTAH) is a unique, implantable total artificial heart based on this pump. To improve the durability of the UPTAH for investigating long-term pathophysiology with UPTAH, a third model (UPTAH3) has been developed. UPTAH3 was designed to separate the left and right undulation shafts and to be more durable. The undulation pumps were also redesigned. UPTAH3 was implemented with a diameter of 76 mm, width of 78 or 79 mm, total volume of 292 ml, and weight of 620 g. The priming volumes of the left and right pumps are 26 and 21 ml, respectively. The atrial cuffs and outflow cannulae were also redesigned for UPTAH3. The maximum output against an arterial pressure load of 100 mm Hg is about 11 L/min. The maximum pump efficiency is about 15% in the left pump and 18% in the right pump, giving a maximum total efficiency for both of about 11%. To date, UPTAH3 has been tested in 17 goats, and the longest survival period was 46 days. This third model will be useful for investigating pathophysiology with UPTAH.

Animals↗

Advance in animal experiments with the undulation pump total artificial heart: 50 and 54 day survival periods with 1/R control.

The undulation pump total artificial heart (UPTAH) is a unique, implantable, total artificial heart (TAH) that uses undulation pumps. To achieve long-term survival in animals with physiologic hemodynamic conditions, a control method based on conductance and arterial pressure was applied to UPTAH. With this control method, called 1/R control, survival periods of 50 days (No. 0016, 49.6 kg) and 54 days (No. 0030, 42.5 kg) were obtained in adult female goats. In No. 0016, 1/R control was applied to the left pump, whereas in No. 0030, it was applied to the right pump. Another pump was used for left-right balance control. The control stability was better in No. 0030 than in No. 0016. The sucking effect of the left atrium was remarkable in No. 0016, possibly because of a time delay when left-right balance control was performed with the right pump. In No. 0016, the cause of death was probably a thrombus flown from a panus in the left atrium. It is possible that the left atrial suction effect influenced the thrombus and panus formation in the left atrium. In No. 0030, the cause of death was a small rupture of the membrane in the right pump. The rupture may have been caused by excessive negative pressure inside the pump. This pressure resulted from suction of the right atrium because of an unexpected control excursion, which was probably caused by a software bug. It will be necessary to redesign the undulation pump and improve the software to achieve longer survival periods for animals with physiologic hemodynamic conditions.

Animals↗

A new approach to detection of the cavitation on mechanical heart valves.

The cavitation on the mechanical heart valves (MHVs) is thought to be a cause of the mechanical failure of the occluder; also, the free radicals that would be generated when the cavitation bubbles implode might affect the patients chemically. These cavitation effects are attributed to the bubble collapse. Therefore, it is important to detect the bubble implosion behavior to analyze the cavitation on MHVs. The cavitation bubbles induce the generation of free radicals at their implosion, and the excited hydroxyl radicals emit the faint light. Based on this fact, we have tried to observe the faint light emission from a MHV to specifically capture the implosion of the cavitation bubbles. A highly sensitive CCD (charge coupled device) camera (C2400-35 VIM camera, Hamamatsu Photonics, Hamamatsu, Japan) was adopted in this study. This camera can observe low light down to the single photon counting range, and it gives two-dimensional mapping of the light. A 20 mm Björk-Shiley valve was submerged in the water tank of 10 L deionized water with luminol as a light enhancer, and then the pressure difference of 150 mm Hg was exerted on the valve at a rate of 60 bpm with a pulse duplicator. The camera and the water tank were settled in the lightproof configuration. After 2 hours of exposure, faint light images have been obtained successfully. The light emits mostly from the edge of the occluder on the inflow side in the major orifice of the valve. Therefore the results suggest that the bubbles would implode around this region and that free radicals caused by cavitation might be produced on MHV, which has coincided with our preliminary result by an electron spin resonance spectrometry.

Biophysical Phenomena↗

A temporal and spatial analysis of cavitation on mechanical heart valves by observing faint light emission.

Cavitation on mechanical heart valves (MHVs) could cause the mechanical failure of the occluder. A simple and reliable in vitro test method to evaluate cavitation potential must be developed. The bubble implosion damages the MHV material; thus, observing the behavior of the bubble implosion is essential. According to sonoluminescence, the collapsing cavity emits faint light. Therefore, in this study, the bubble collapse was analyzed both temporally and spatially by observing faint light emission. A photon counting system has been developed using a photomultiplier tube (H7360-01, Hamamatsu Photonics, Japan). The highest time resolution of this system is 5 microsec. A quartz optical fiber bundle of 2 mm diameter can be connected to this photomultiplier tube and traversed two-dimensionally over the MHV. The closure of the MHV triggers the photon counter, and the photons through 500 beats are recorded and integrated. A 20 mm Björk-Shiley valve was submerged in a water tank containing 10 L deionized water, and the pressure difference of 120 mm Hg was exerted on the valve at a rate of 60 bpm with a pulse duplicator. Approximately 700 microsec after the valve closure, light emission was detected along the edge of the occluder on the inflow side in the major orifice. Then, approximately 1,000 microsec after the closure, light along the occluder's edge in the minor orifice was recorded as well. Compared with the analysis, using a stroboscope and a high-speed camera, faint light was emitted from the collapsing cavities. In conclusion, sonoluminescnece was successfully observed around the MHV, and the photon counting technique and the traversing mechanism of the optical fiber bundle revealed the temporal and spatial distribution of the cavity collapse on the MHV.

Biomedical Engineering↗

Microcirculation of the bulbar conjunctiva in the goat implanted with a total artificial heart: effects of pulsatile and nonpulsatile flow.

A new system to observe the microcirculation on the bulbar conjunctiva was developed using a digital high definition microscope to investigate the influence of the flow patterns on the microcirculation in a goat with a total artificial heart (TAH). The undulation pump TAH was implanted into the goat. When the whole body condition became stable, the flow pattern was modulated between the pulsatile and the nonpulsatile mode, and the changes in the microcirculation were observed. When the flow pattern was changed from pulsatile to nonpulsatile mode, the erythrocyte velocity in capillaries dropped from 526+/-83 to 132+/-41 microm/s and remained at a low level. The number of perfused capillaries decreased as well. Then the nonpulsatile flow mode was maintained for 20 minutes. After the flow pattern was returned to the pulsatile mode again, the erythrocyte velocity recovered to the initial level (433+/-71 microm/s). In many cases, the flow of the nonperfused capillaries in the nonpulsatile mode recovered to the initial level after the flow pattern was changed to the pulsatile mode again. The perfused capillary density in the nonpulsatile mode (19.7+/-4.1 number of capillaries/mm) was significantly lower than that in the pulsatile mode (34.7+/-6.3 number of capillaries/mm). It is thought that the basal and flow stimulated endothelium derived nitric oxide release in the microvessels decreased because of the disappearance of pulsatility and that the nitric oxide induced the constriction of arterioles after the flow pattern was changed to the nonpulsatile mode. At the same time, the baroceptors might sense the decrease in the arterial peak pressure or dp/dt, and the sympathetic nerve increases activities and induce the constriction of arterioles. Then, the erythrocyte velocity in capillaries would decrease. Because of the flow pattern further in the chronic phase, it is important to follow the change in the microcirculation.

Animals↗

Pathophysiologic study of goats with undulation pump total artificial heart: those that survived for more than 1 month.

The undulation pump total artificial heart is an implantable total artificial heart that is being developed at the University of Tokyo. Many advances in our system have been made by the adoption of hardware and software solutions that enabled the animals with the undulation pump total artificial hearts to survive more than 1 month. Pathophysiologic observations were performed for these goats that survived. In this article, the pathophysiologic findings are described in detail for three goats that survived for 46 (goat 9916), 54 (0030), and 63 (0107) days. The microscopic findings indicated that in goat 0107 the histologic changes in key organs occurred at the termination of the experiments. Therefore, the pathophysiologic changes in goats 9916 and 0030 were mainly investigated in this study to evaluate the chronic effect caused by our total artificial heart system. The signs of chronic ischemia and cell dystrophy were observed in both the liver and kidney. Until now, 13 goats had survived more than 1 week and 6 goats survived more than 1 month, including one that survived for 63 days, which is the longest in our experimental series. The pathophysiologic results of goats 9916 and 0030 showed that the undulation pump total artificial heart might still cause some damage to the liver and the kidney. To accomplish long-term survival with the undulation pump total artificial heart, further pathophysiologic studies are required, and the necessary modifications to the total artificial heart system will need to be made.

Animals↗

Functions for detecting malposition of transcutaneous energy transmission coils.

A transcutaneous energy transmission system (TETS) for artificial hearts and ventricular assist devices uses electrical coupling of power between external and implanted coils. If the position of coils changes relative to each other, the TETS cannot feed the required power of the implanted device. During activity or sleep, the coils may move accidentally. TETS users and the people around them have to pay attention to this because the range of the position where the required power can be fed efficiently is not wide. Therefore, we added functions for the position changes of the coils to the TETS. Regular, cautious, and irregular positions were introduced, and the ranges of them were decided upon in our experiments. The cautious position was determined by the area where the change of the relative position of the coils was relatively small. When the coils were in the cautious position, the circuit was tuned by way of changing the resonant point. This modulation could give good power efficiency in the cautious position. When the coils were in the irregular position, an alarm switch was turned on. These functions ease the restriction of the coil position and give better quality of life (QOL) than do the conventional TETS.

Biomedical Engineering↗