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Biomedical subjects

T Akamatsu

Publications and source records attributed to T Akamatsu.

227 records · Page 13Linked to original sources
PubMedDate not supplied

Hemodynamics on abrupt stoppage of centrifugal pumps during left ventricular assist.

A magnetically suspended centrifugal pump (MSCP), developed for long-term ventricular assist, is reliable and durable because it has no shaft or seal. However, with nonvalve pumps such as a MSCP, regurgitation occurs when they accidentally stop without cannula clamping. We investigated the hemodynamics during temporary stoppage of a MSCP being used as a left ventricular assist system (LVAS), comparing two inflow cannulation sites. In four sheep (weight, 35-45 kg), microspheres were injected into the left main coronary artery to induce heart failure. An outflow cannula was sutured onto the descending aorta, and two inflow cannulae were inserted into the left atrium and the left ventricle. The MSCP was stopped with both the left ventricular cannula and left atrial cannula clamped, and the hemodynamics and P-V loops were recorded. Each cannula was then unclamped in order, and similar parameters were recorded. LVEDP increased at unclamping of the left ventricular cannula (ULVC), and rose further at unclamping of the left atrial cannula (ULAC). Aortic pressure did not change at ULVC, but decreased at ULAC. The effective systemic flow that subtracted the regurgitant flow through the MSCP from left ventricular output was half at ULVC and almost 0 at ULAC. When stopping centrifugal pumps without circuit clamping, hemodynamic deterioration is less at ULVC than at ULAC. This finding suggests that left ventricular inflow cannulation is recommended to allow more time in emergency situations.

Animals↗
PubMedDate not supplied

Cytologic features of a primary myxoid malignant fibrous histiocytoma arising in the uterus: a case report.

BACKGROUND: Primary malignant fibrous histiocytoma (MFH) of the uterus is extremely rare. The 10 cases reported in the literature all involved the pleomorphic variant, and to the best of our knowledge, the myxoid variant has not been reported before. We describe the cytologic findings of primary uterine myxoid MFH in relation to the myxoid component, potentially leading to an incorrect diagnosis. CASE: A 68-year-old woman presented with a primary uterine tumor. Endometrial cytology showed numerous loosely arranged, spindle-shaped fibroblastlike cells; atypical histiocytelike cells; and giant cells with a necrotic background. The overall cytologic picture was of a degenerated pleomorphic leiomyosarcoma with an inconclusive diagnosis. A diagnosis of myxoid MFH was established after electron microscopic and immunohistochemical studies of the primary tumor and tumor transplanted, as primary cultured cells, in nude mice. The patient underwent an exploratory laparotomy and died of tumor progression 38 days after the initial consultation, without treatment. CONCLUSION: Because of overlapping cytologic features among uterine sarcomas with myxoid stroma, it is important to recognize the histiocytic lineage of tumor cells by immunohistochemistry and electron microscopy in various presentations of fresh samples.

Aged↗
PubMedDate not supplied

Optimal prefixation of cells to demonstrate apoptosis by the TUNEL method.

OBJECTIVE: To determine the optimal fixation method for cultured human ovarian cancer cell line SHIN-3 to document cisplatin-induced apoptosis by the terminal deoxynucleotidyl transferase-mediated biotinylated dUTP nick end-labeling (TUNEL) assay. STUDY DESIGN: Cisplatin-treated cancer cell suspensions were (1) fixed in 4% buffered formalin for 10 minutes (BF group); (2) treated with 2% Carbowax in 50% ethanol (CW) for 10 minutes and then fixed in 100% ethanol for one hour (CW + ET); or (3) treated with CW for 10 minutes and then fixed in 4% buffered formalin for one hour (CW + BF). Cell morphology, adhesion to the glass slides and TUNEL reactivity were compared among the three groups. The effects of prolonged prefixation of cell suspensions in CW and of the postfixation of cell smears in BF for one, three and seven days were also examined. RESULTS: CW + BF treatment yielded satisfactory cell morphology, minimum cell loss and an excellent TUNEL reaction. However, prolonged prefixation in CW resulted in cell shrinkage. CONCLUSION: CW + BF treatment can be widely recommended for use with cytologic preparations for the TUNEL assay.

Antineoplastic Agents↗
PubMedDate not supplied

Evaluation of the antimicrobial activity and materials compatibility of orthophthalaldehyde as a high-level disinfectant.

We tested the antimicrobial activity of orthophthalaldehyde (OPA) against 21 strains (16 species) of pathogenic microorganisms that cause hospital-associated infections. Changes in hepatitis B surface antigen (HBs-Ag) resulting from the addition of OPA to HBs-Ag-positive serum were measured using a radioimmunoassay. We also examined the effect of immersing medical instruments in OPA (0.55%) for 168 h at room temperature. OPA (0.5%, 0.37% and 0.25%) killed 11 strains of vegetative bacteria within 15 s, and it killed the test micro-organisms faster than 3.0% glutaraldehyde (GTA). Incubation with OPA or GTA caused levels of HBs-Ag to fall below a cut-off value within 30 s. OPA did not adversely affect instruments made from various materials. OPA demonstrated more effective antimicrobial activity than GTA against a range of microorganisms. We conclude that OPA should replace GTA as the first-choice high-level disinfectant for endoscopes, considering its antimicrobial efficacy and low inhalation toxicity.

Anti-Infective Agents↗
PubMedDate not supplied

A magnetically suspended centrifugal pump. In vitro and in vivo assessment.

To overcome problems derived from the shaft within conventional centrifugal pumps, we have developed a new centrifugal pump, the magnetically suspended centrifugal pump (MSCP), which has no shaft and operates as a bearingless centrifugal pump. The impeller is suspended freely and centrally by magnetic force within the pump. Hemolysis tests were performed in comparison with the Biopump. Index of hemolysis and destruction of platelets were significantly lower in the MSCP than in the Biopump. Animal studies were designed to evaluate the durability and antithrombogenicity of the MSCP. Short-term animal studies were performed using two mongrel dogs. Left heart bypass was established with the MSCP. After 3 hr, the layer of thrombus adherent to the surface of the polycarbonate impeller impaired pumping efficiency. However, using the impeller coated with silicone, no thrombus was observed on the impeller after continuous pumping for 24 hr. In addition, long-term animal studies were performed using two sheep. Left heart bypass was established with the MSCP containing an impeller coated with silicone. In one sheep, the MSCP ran for 14 days without problems in pumping performance and showed no thrombus within the pump. In the other sheep, the MSCP ran for 15 days, and showed no thrombus on the impeller. During each experiment, plasma free hemoglobin levels were less than 15 mg/dl. The MSCP induced less hemolysis than did the Biopump, and the MSCP containing an impeller coated with silicone demonstrated the potential to run for 14 days without thrombus formation within the pump.

Animals↗
PubMedDate not supplied

Development of a magnetically suspended centrifugal pump as a cardiac assist device for long-term application.

To overcome problems with the shaft seal in conventional centrifugal pumps, the authors have been developing a magnetically suspended centrifugal pump (MSCP) that operates as a valveless, sealless, and bearingless pump. The prototype of the MSCP was modified with respect to size of the volute diffuser and impeller blade profiles. A hemolysis test in vitro using a new version of the MSCP was performed in comparison with a commercially available centrifugal pump. The test circuit for the hemolysis test comprised a blood reservoir, a pump, and polyvinyl tubes, and was filled with fresh heparinized bovine blood. The pumping conditions were a flow rate of 5 L/min and a pump head afterload of 100 mmHg. The index of hemolysis in the MSCP was significantly lower than that in the Biomedicus pump (0.0035 +/- 0.0025 versus 0.0097 +/- 0.0056 g/100 L, p < 0.05). Reduction in the platelet count during pumping also was lower in the MSCP compared with the Biomedicus pump at both 6 hrs and 12 hrs of pumping (p < 0.01). This MSCP may be advantageous for extended use of assist devices, not only from the theoretical point of view, but in a practical sense after the results of the current hemolysis test.

Centrifugation↗
PubMedDate not supplied

More than 1 year continuous operation of a centrifugal pump with a magnetically suspended impeller.

The authors have been developing a centrifugal pump with a magnetically suspended impeller (MSCP) designed for total artificial heart and long-term ventricular support. The MSCP consists of a magnetic bearing, an impeller and housing, and a driving motor. The impeller is suspended by a magnetic bearing, therefore providing contact free rotation of the impeller inside the pump. This study was designed to evaluate long-term durability and nonthrombogenicity of the MSCP in a chronic sheep model. The blood contacting surfaces of the pump and conduits were completely modified by a heparin immobilization technique (Hepaface). The MSCP was placed paracorporeally as a left heart bypass between left ventricle and descending aorta in three adult sheep. Coumadin was given orally to maintain prothrombin time at 15-20 sec. The coagulation and hematologic parameters, including plasma free hemoglobin, were periodically monitored throughout the experiment. Under daily movement in the cage, the pump could produce average flow rates of 3-6 L/min (50-100 ml/kg) at 1,700-2,000 rpm. Although the arterial pulse contour decreased, there was no physiologic deterioration. The axial impeller excursion monitored by a position sensor was < 25 microns. Plasma free hemoglobin level remained at < 5 mg/dl throughout the experiment. There was no increase in the motor current, which indicates no massive thrombus formation around the impeller. One experiment was terminated at 70 days due to Hall sensor dysfunction of the motor. The retrieved pump was entirely free from thrombus formation. There was no detectable thrombus formation inside the pump or the inflow and outflow conduits. Hematologic, renal, and hepatic parameters remained within the normal range throughout the experiment. The other two sheep have survived for more than 395 and 41 days without major complication. These studies demonstrated that the MSCP has significant potential for long-term use.

Animals↗
PubMedDate not supplied

Control of the pressure flow relationship with a magnetically suspended centrifugal pump in a chronic animal experiment.

A magnetically suspended centrifugal pump (MSCP) has been developed for long-term ventricular support. Effective torque to blood of the MSCP is exactly proportional to a motor current because of no friction inside the MSCP. The authors have devised new driving modes using these characteristics and applied it to a chronic animal experiment. Three driving modes were compared: 1) a constant rotational speed (N), 2) a constant motor current (I), and 3) a controlled motor current (CI). In two of nine sheep, the MSCPs were operated by the N and in seven by the I mode. The motor current and the rotational speed were always monitored. The CI mode was studied by altering the resistance of the vessels. In the I mode, the rotational speed varied depending upon the pressure head, and the slope of the pressure-flow (P-Q) relationship was steeper than that of the N mode, so that the pump flow was stabilized. In the CI mode, in which the motor current increased to compensate for the decrease in pump flow as the rotational speed increased, the P-Q slope was effectively controlled when the resistance was changed. The MSCP was able to control the P-Q slope without monitor of the pump flow. Various driving modes could be selected according to changes in resistance.

Animals↗
PubMedDate not supplied

In vivo and in vitro evaluation of the pulsatile mode of a magnetically suspended centrifugal pump.

The authors have been developing a magnetically suspended centrifugal pump (MSCP). They have devised a pulsatile mode for the MSCP, which was generated by altering rotational speed. This article describes in vitro and in vivo studies with the pulsatile mode of the MSCP. Hemolysis tests were performed in two identical circuits to compare the nonpulsatile (NP) mode and the pulsatile (P) mode. In vivo studies were performed in sheep. First, biventricular assisted circulation was instituted in the left heart with the MSCP and in the right heart with the Biopump. The native heart was induced to ventricular fibrillation. Second, a left ventricular assisted circulation was instituted as the native heart was beating. An inflow cannula was inserted into the left atrium in one sheep and into the left ventricle in the other. The normalized indices of hemolysis of the NP and P groups were 0.0025 +/- 0.0018 g/100 L, and 0.0032 +/- 0.0024 g/100 L (N = 4, not significant). During ventricular fibrillation in the P mode, the pulse pressure was 14 mmHg (the rotational speed: 1,500 to 2,600 rpm). In a beating heart, at atrial withdrawal, the pulse pressure increased from 10 to 24 mmHg (2,100 +/- 500 rpm), while at ventricular withdrawal, it decreased from 17 to 40 mmHg (2,000 +/- 500 rpm) on P mode. The MSCP in pulsatile mode did not increase hemolysis. At ventricular withdrawal, it was easier to produce a pulsation than at atrial withdrawal. The pulsatile mode of the MSCP is applicable to a left ventricular assist system.

Animals↗