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Biomedical subjects

K Imachi

Publications and source records attributed to K Imachi.

At least 37 records · Page 2Linked to original sources

Strange hemodynamic attractor parameter with 1/R total artificial heart automatic control algorithm.

To evaluate the automatic control algorithm of the total artificial heart (TAH) as an entity, and not just as parts, a non-linear mathematical analyzing technique including chaos theory was utilized. Chronic experiments on the biventricular bypass type artificial heart implantation were performed in healthy adult goats after the natural ventricles were removed. Hemodynamic time series data were recorded under the awake standing condition with TAH 1/R and fixed driving. Time series data were recorded on a magnetic tape and analyzed on a personal computer system with an A-D converter. Using the nonlinear mathematical technique, the time series data were embedded into the phase space and the Lyapunov numerical method was carried out for the quantitative evaluation of the sensitive dependence on the initial condition of the reconstructed attractor. Calculation of the largest Lyapunov exponents suggested that the reconstructed attractor of the left pump output during TAH 1/R control was a larger dimensional strange attractor, a characteristic pattern of deterministic chaos. A total system indicating chaotic dynamics was thought to be a flexible and intelligent control system. Thus, our results suggest that 1/R TAH control may be suitable for the biventricular assist type total artificial heart.

Algorithms↗

Basic study to develop the undulation pump for practical use: antithrombogenicity, hemolysis, and flow patterns inside the pump.

The undulation pump (formerly called the precessional displacement pump) is a continuous flow displacement-type blood pump that is being developed as an implantable total artificial heart. A new undulation pump was developed for chronic use and was examined with animal experiment and flow visualization studies. In the animal experiment using a left ventricular bypass in goats, severe hemolysis occurred. After driving for 12 h, thrombus formation inside the pump was found. In the flow visualization studies, the flow pattern showed that the flow inside the pump was a very complicated turbulent flow. Improvement of hemolysis and thrombus formation is important to realize implantable total artificial hearts using undulation pumps.

Animals↗

New version of flow-transformed pulsatile total artificial heart with no electrical switching valve.

The flow-transformed pulsatile total artificial heart (FTPTAH) is a new pulsatile total artificial heart that consists of a single continuous flow rotary blood pump and blood flow switching valves. It can perfuse the pulmonary and the systemic circulation alternately with pulsatile flow. A new version of the FTPTAH, which consists of one undulation pump (UP), 4 jellyfish valves, and a compensatory chamber, has been proposed. The UP is a reversible continuous flow blood pump, and flow transformation is caused by switching the direction of the motor rotation so that no electrical flow switching valve is needed. A prototype model could perfuse alternately pulmonary and systemic circulation with 3.0 L/min in a mock circulation. Unoxygenated blood in the UP at the end of pulmonary circulation will be stored in the compensatory chamber by shifting a flexible membrane to the direction of the left atrium (LA); therefore, the blood is not sent to the systemic circulation.

Atrial Function↗

Development of a new apparatus to observe microcirculation chronically in continuous flow blood pump research.

To observe microcirculation chronically is an important key to the successful evaluation of the continuous flow blood pump. In this study, we succeeded in developing a new apparatus by which microcirculation could be observed chronically without a microscope in a conscious animal. The apparatus utilizes a charge coupled device (CCD). A thin living tissue, such as mesentery, is put directly on a highly integrated CCD and is lit up through the tissue with a light-emitting diode (LED). The vascular nets in the tissue are projected onto the CCD like a contact photograph, which is then sent to a television screen and which can be used to analyze their motion and function. A 0.5-inch CCD having 250,000 pixels was used in this study. The cover glass of the CCD was removed, and a fiber optic plate was fixed onto the surface of the CCD for the tissue to be able to contact with the apparatus surface without clearance. The CCD as well as the LED were molded with epoxy resin for electrical insulation. The apparatus was 35 mm wide and 12 mm high with a micro stand for an LED, which can be easily implanted into an animal. The apparatus was implanted into a rabbit for 12 h. The configuration of arterioles and venules, tens of micrometers in diameter, and their motions in subcutaneous tissue could be observed.

Animals↗

Multivariate analysis of risk factors for thrombus formation in University of Tokyo ventricular assist device.

Of 77 University of Tokyo ventricular assist devices used in a total of 70 patients at 21 institutions, 13 pumps were found to have macroscopic thrombus formations. Because 19 devices that were used for less than 24 hours showed no thrombus deposition, they were considered not to have been sufficiently exposed to the thrombogenic environment for macroscopic thrombus deposition and were removed from the subsequent multivariate study. A total of eight potential risk factors were assessed in relation to thrombosis. Prevalences of thrombus formation were compared between two groups with or without each of the risk factors. In a univariate analysis, the following categoric variables were demonstrated to be significantly associated with complications, in descending order of significance: use of gabexate mesilate (protease inhibitor) as an anticoagulant (p = 0.005), normal platelet count (p = 0.010), duration of support (p = 0.038), leukocytosis (p = 0.042), and minimum pumping flow (p = 0.042). Use of heparin and the consequent increase in activated clotting time showed no relationship. Multivariate discriminant analysis, which was done to identify risk factors rejecting cross correlation between each variable, demonstrated platelet count (p = 0.006), use of gabexate mesilate (p = 0.007), and minimum flow (p = 0.008) to have significant and independent risks. These results indicate the importance of maintaining pumping flow above a certain minimum level, addition of antiplatelet drugs to the antithrombogenic regimen, and nonuse of gabexate mesitate.

Adolescent↗

Development of a flow-transformed pulsatile total artificial heart for total implantation.

To realize a totally implantable total artificial heart (TAH), a new pulsatile TAH, the flow-transformed pulsatile TAH (FTPTAH), was developed. The system was composed of a single centrifugal pump (CFP) and two three-way valves. One port of each three-way valve was connected to the inlet and outlet of a CFP. The other two ports of each valve were connected to the right and left atrium, and the pulmonary artery and aorta. The CFP can perfuse the pulmonary and systemic circulation alternately with pulsatile flow by switching the two three-way valves. A prototype and the secondary model in which the solenoid valves and a spool valve were included, respectively, were connected to a mock circulatory unit with the results that a pulsatile TAH with physiological flow wave form could be obtained from a single CFP, about 5 L/min of pulsatile output could be obtained alternately on the right and left side by switching the solenoid valves or a spool valve, and flow balance between the right and left could be easily controlled by the switching duration. The system is feasible for a totally implantable TAH because it does not need a compliance chamber and can be miniaturized.

Heart, Artificial↗

[Artificial hearts--toward future technologies].

What are the most essential technologies for developing the implantable artificial heart in future? The first is the development of autonomic and dispersed micro actuators for acting as sarcomeres of the heart muscle. An electric motor driven artificial heart transmitted the power with belts had been developed as a preliminary mechanism. A micro actuation using noise energy has been developed for simulating the structure and the function of striate-muscle sarcomeres. The chemical energy conversion mechanism must be applied instead of the conventional electro-mechanical mechanisms, when we implant the total artificial heart permanently. As a implantable assisted artificial heart using tentatively, we have developed an axial flow pump system. The pump system acts as a systemic and a pulmonary pump produced pulsatile flow switching an axial pump output. The second is the search of biocompatible materials, which do not only mean blood compatibility but also tissue compatibility. The great masses in chest cavity have inevitably occurred infection. The autonomic and dispersed control system is the third item. We have developed a jellyfish valve with low fluid dynamical resistances for improving the pump dynamic characteristics.

Heart, Artificial↗

Percutaneous fiberoptic spinal laser endoscopy.

For percutaneous observation of lesions near the spinal cord and percutaneous spinal laser surgery under the visual field, we studied a method and approach to the spinal cord and intraspinal surgical procedures with laser using a newly developed, small-diameter laser endoscope. The subarachnoid and epidural spaces of a goat were punctured using a 17-gauge epidural needle, and the endoscope (diameter 0.7 mm) was inserted through the needle. The spinal cord and surrounding tissue were observed. Next, an endoscope (diameter 1.5 mm) was inserted into the subarachnoid space, and the quality of the picture and manageability of the endoscope were examined. The Xe:Cl excimer laser was irradiated to a nerve root through a 0.4 mm optical fiber for laser transmission through this endoscope. The spinal cord, nerve roots, and arachnoid were clearly observed through this endoscope. The pulsation of the artery accompanying a root was seen clearly, and the quality of the picture of the endoscope was thought to be sufficient for diagnosis. The nerve root was cut within 30 seconds by excimer laser, and the possibility of laser surgery was demonstrated. Although it was shown that this endoscope could be a useful diagnostic and therapeutic tool, improvement in the manageability of the tip of the endoscope was considered to be important for a clinically usable endoscope.

Animals↗

The system and procedures of percutaneous intradiscal laser nucleotomy.

Since 1986, percutaneous intradiscal laser nucleotomy (PILN) has been studied in the authors' laser laboratory. The purpose of this report is to develop PILN as an alternative to chemonucleolysis and percutaneous discectomy, which are currently applied, and to establish a safe, easy, accurate and short-time therapy method for lumbar disc herniation. After laser irradiation, intradiscal pressures (IDP) decreased and the nucleus pulposus was gradually replaced with cartilaginous fibrous tissue. The evaluation of heat distribution with thermocouples and thermography was done to determine safe optimum irradiating conditions and to develop a new double-lumen needle and a bare quartz fiber. Neodymium-yttrium-aluminum-garnet (Nd-YAG) laser devices have been improved for easy and safe use, and a new tip type pressure transducer has been made for improved therapeutic results using this new method.

Animals↗

[Automatic control of total artificial heart to simulate the hemodynamics under natural heart circulation].

We developed control system of total artificial heart (TAH) during exercise simulating the circulatory response of natural heart. The following procedures were taken to develop this system. 1) Measurement of hemodynamics and physical activity rate (PAR) of natural heart goats during treadmill exercise. 2) Estimation of cardiac output from PAR using a non-linear model. 3) Development of a pneumatic artificial heart (AH) driver with high speed controllability and a control unit to deliver CO calculated from PAR beat by beat. 4) Evaluation of the physiological condition of the TAH goat during exercise controlled by this system. Using this control method, CO of TAH goats was similar to that of natural heart goats during treadmill exercise. Hypertension was observed during exercise. This hypertension was considered to be derived from two causes. One was high inflow and outflow resistance of cannulae between AH pump and living body. The other was the disorder of peripheral circulatory control mechanism in TAH animal. Such as increased sympathetic activity, insufficient secretion of atrial natriuretic polypeptide (ANP) and decreased sensitivity of peripheral circulatory system with ANP.

Animals↗

[Clinical experience for ventricular assist device].

We began applying of our VAD system clinically in 1982 and have subsequently obtained good results. The first case treated with the VAD returned to normal life. In a total of 70 cases of clinical applications this system there has been instance of apparatus dysfunction. Confirming the reliability and safety promised by the results of biological experiments. Here, we report the results of clinical application of the system in a total of 61 cases between August, 1985 and March, 1989. The following conclusions were reached: 1) Satisfactory weaning and survival rates were obtained i.e. 18 cases out of 61 cases (30%) survived over one month and 13 cases (21%) are currently surviving, even in elderly patients of 60 years of age or older. 2) The weaning rate and survival rates were good after approximately 1 week of support. Detailed evaluation of the recovery of the heart and functions of other major organs has led to the conclusion that the results can be improved further when the weaning period is carefully determined. 3) With regard to surgical factors, good findings were obtained when the artificial heart-lung bypass time was less than 6 hours. The VAD can be used in the early stages without vainly attempting weaning from the artificial heart-lung bypass. 4) There were no mechanical problems with the hardware of the blood pump drive assembly, etc., or noteworthy side effects.

Aged↗

Research and development on total artificial heart in University of Tokyo.

The research and development on the total artificial heart (TAH) in the University of Tokyo can be divided chronologically into the three stages, i.e., the first stage (1959-1970); trial and error stage to find appropriate hardwares, the second stage (1970-1985); software stage to find how to control pneumatic TAH and to manage the animals, and the third stage (1985- ); final goal to develop implantable TAH for animal and human. This paper reviews the process of research and development in each stage.

Animals↗

Quantitative surface analysis of Cardiothane 51 by FT-IR-ATR spectroscopy.

Surface analysis has been carried out for Cardiothane 51 samples as commercially available balloon pumps and cast films prepared from the solution. Silicone contents on surfaces have been quantitatively determined by FT-IR-ATR spectroscopy coupled with a subtraction technique. The contents on the air-facing surface vary from 0.7 to 5.3% among six balloon pumps examined; three of them contain less silicone on the air-facing surface than on the substrate-facing surface, whereas just the opposite is true for one, and the other two have nearly and quite an equal content of it between the two surfaces. Silicone contents on surfaces of cast films vary also from a sample to another even when sample films were prepared from the same Cardiothane solution, indicating difficulty in quality control of Cardiothane surfaces. An appreciable fraction of silicone was found not to be covalently bonded to polyurethane in Cardiothane 51 for the cast film samples.

Biocompatible Materials↗

Quantitative approach to determine the application time of the left ventricular assist device.

This study was designed to establish a method for determining the optimal time of the application of the left ventricular assist device from the viewpoint of the metabolism of the vital organs. Quantitative systemic low flow states were made utilizing goats with total artificial hearts. During these experiments, arterial lactate and pyruvate values were sequentially measured. The behavior of anaerobic metabolism during low cardiac output states and in the recovery process following normalization of the cardiac output was quantitatively described and evaluated. The experimental results are summarized as follows: If a time when the decay of arterial lactate ceases at a level above the normal level by greater than 30 mg/dl is observed despite the use of intraaortic balloon pumping, that time is the exact optimal time for application of the left ventricular assist device. There is a great possibility that circulatory failure will be irreversible if left ventricular assist pumping is not initiated before the arterial lactate value increases to greater than or equal to 140 mg/dl. The method of evaluating the alteration of anaerobic metabolism described in this study is useful for determining the application time of the left ventricular assist device.

Animals↗