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Biomedical subjects

T Yambe

Publications and source records attributed to T Yambe.

At least 91 records · Page 5Linked to original sources

Development and clinical evaluation of the long time digital Holter ECG system using non-tracking technology.

Newly developed long time digital Holter ECG system utilizing a stamp-size non-tracking (NT) tape which can be used for 192 hours as 2ch recording, was evaluated in the clinical cases. The system has employed newly developed VLSIs and NT technology which enables to obtain reliable long time recording with smaller and lighter Holter system of ECG and variety of biological signals. The results indicated that good data reproduction was shown in this system.

Adult↗

Systemic circulation with high frequency blood flow--analysis from neurophysiological point of view.

The vibrating electromagnetically driven univalved artificial heart, which provided more than 10 1/min at 10 Hz/sec. vibration, was developed in our team. This vibrating electromagnetic pump (VEMP) produced the original flow pattern compared with the flow pattern of the natural heart, so that circulatory regulatory system during maintain the circulation with VEMP must be investigated before the clinical application. In order to assess the effect of high frequency blood flow produced by the VEMP from the neurophysiological point of view, power spectral analysis of the hemodynamics was performed. VEMP was implanted as the total left heart bypass in adult goats and right heart circulation was maintained by natural hearts. In arterial blood pressure during maintain circulation by the high frequency blood flow, Mayer waves (0.01-0.15 Hz) were significantly decreased, though respiratory waves (0.25-0.40 Hz) were not significantly changed. These results suggest that circulatory regulatory system was influenced by the high frequency blood flow produced by the VEMP.

Animals↗

Long-time inflation of the PTCA balloon.

For patients for whom the conventional percutaneous transluminal coronary angioplasty (PTCA) did not adequately improve stenosis, or sufficient angioplasty was impossible because of occurrence of dissection, we attempted using a long-time balloon inflation for more than 10 minutes. In order to allow the use of this balloon, we instituted an active rehabilitation program using a bicycle ergometer to promote the development of the collateral circulation up to the time of performing diagnostic angiography and PTCA, while attempting to use a perfusion balloon catheter for those patients not developing sufficient collateral circulation. Of the 134 patients undergoing PTCA, unsatisfactory angiographic results were obtained in 13 patients. Of these patients, long-time balloon inflation was performed in seven and primary success was achieved in six. From this study, we believe that the long-time balloon inflation in PTCA can improve the primary success rate and reduce postoperative complications.

Angina Pectoris↗

[A case of giant cell myocarditis associated with a progressive disturbance in the conduction system].

A 73 year old male patient with a history of pulmonary tuberculosis was admitted to our department because of dyspnea and abdominal pain. The chest X-ray film on admission showed bilateral lung congestion. The ECG showed atrial fibrillation, left axis deviation and incomplete right bundle branch block. Five days after admission, the ECG changed into sinus rhythm and complete right bundle branch block. Eight days after admission, the patient complained of chest pain and the ECG showed ST elevation in II, III, aVF, reciprocal ST depression in V, and complete A-V block with junctional rhythm. Emergency coronary angiography revealed no significant stenosis. Echocardiography showed reduced contraction of the inferior wall and diffuse granular echoes in the myocardium. Light microscopic study revealed fibrosis, infiltration of eosinophils and histiocytes, degenerated myocardium and multinucleated giant cells. Some of the giant cells were morphologically similar to myocardium, so the myocardium might be a place of immunological reaction.

Aged↗

Experimental study of renal sympathetic nerve activity during left ventricular assist device pumping.

To determine the effect of left ventricular assist device (LVAD) pumping on sympathetic tone, renal sympathetic nerve activity (RSNA) was recorded in acute animal experiments. Our TH-7B pneumatically driven sac type ventricular assist device (VAD) was used in 7 adult mongrel dogs. RSNA was detected by use of bipolar electrodes attached to the left renal sympathetic nerve under conditions of various LVAD pumping modes. All hemodynamic data and the RSNA were calculated with a personal computer system. In general, LVAD assistance produced increased systolic aortic pressure, increased pulmonary artery flow and decreased left atrial pressure, which caused decreased RSNA, especially in the counterpulsation mode. These results suggest that renal vascular resistance might be reduced in parallel with the decrease of RSNA. Thus, counterpulsation mode LVAD assistance has the more evident effect in preventing acute prerenal renal failure.

Animals↗

[A case of aortitis syndrome].

A 57 years old woman was admitted for the investigation of anginal chest pain. Her coronary angiography didn't show any typical finding seen in the aortitis syndrome, but coronary sclerosis and stenosis seen in the usual atherosclerotic patients. The cerebral angiography was performed, too. The right vertebral artery, which was tortuous and dilated, was seen, but the other three cerebral vessels were not seen. These rare findings were reported in this report. We added the discussion about the relation between the aortitis syndrome and angina pectoris.

Angina Pectoris↗

Effect of left ventricular assistance on sympathetic tone.

To determine the effect of left ventricular assist device (LVAD) pumping on sympathetic tone, renal sympathetic nerve activity (RSNA) was detected in acute animal experiments. Our TH-7B pneumatically driven, sac-type ventricular assist device was used in 7 adult mongrel dogs. RSNA was detected by the use of bipolar electrodes attached to the left renal sympathetic nerve. RSNA was amplified and integrated by use of an R-C integrator circuit. The area of the integrated nerve discharge per unit time was calculated in the computer system and expressed as RSNA per unit time. During LVAD pumping, RSNA decreased with increase in blood pressure, with an increase in pulmonary artery flow, and with a decrease in left atrial pressure. These data suggest that LVAD has an effect on the sympathetic nervous system which is mediated by the aortic and cardiopulmonary baroreflex system.

Animals↗

Micro-pressure sensor for continuous monitoring of a ventricular assist device.

We have been involved in the development of a clinical ventricular assist device (VAD) system. Here, we report our investigation of in vitro and in vivo stability and sensibility of pressure microsensors. The sensors were mounted in the in-flow and out-flow cannulae wall to measure the left atrial and aortic pressures during VAD pumping. The pressure sensitive surface of the piezoresistive effect absolute pressure sensor was coated with a thrombo-resistant polymer, as was the inner surface of the cannulae of the VAD. In the in vitro and chronic animal experiments which were of more than a month duration, reliable stability and sensitivity, without any thrombus formation on the blood contacting surface of the sensors, and high sensitivity were observed. After chronic experiments, the sensitivity of sensors was reevaluated in the mock circulatory system as compared to reference values. The relationship between the output of the micro-sensors and the reference value was linear and correlated well.

Animals↗

[Expanded indication of percutaneous transluminal coronary angioplasty to the infarcted zone--using thallium-201 exercise scintigram after rehabilitation].

In some cases of old myocardial infarction (OMI), left ventricular wall motion was improved after revascularization, though viability of the infarcted myocardium was not detected by left ventriculography (LVG) and exercise thallium-201 myocardial scintigraphy (EX-Tl). So to obtain more correct information of the viability, EX-Tl was performed again after ergometer rehabilitation for an OMI patient whose myocardial viability of the infarcted zone could not detected by LVG and EX-Tl. Incomplete fill in was showed in the EX-Tl after rehabilitation. So percutaneous transluminal coronary angioplasty (PTCA) was performed. Left ventricular wall motion was improved after three months. EX-Tl after rehabilitation is useful to evaluate the viability that could not detected by LVG and EX-Tl.

Angioplasty, Balloon, Coronary↗

Continuous monitoring of autonomic nerve information for the control of an artificial heart.

To drive an artificial heart system optimally, information from the autonomic nervous system may be needed; however, it is very difficult to monitor autonomic nerve discharges continuously. In this study, we propose a new automatic control algorithm for a total artificial heart (TAH) using fluctuations in the circulatory system. It was reported that fluctuations in hemodynamics reflect ongoing information from the autonomic nervous system. A Mayer wave at 0.1 Hz was reported to reflect sympathetic information. We observed fluctuations in vascular resistance, which can be measured during use of an artificial heart. Four adult goats were used for the experiments. Through a left thoracotomy, hemodynamic parameters were measured during chronic animal experiments. All time series data were recorded on magnetic tape. Quantitative analysis, statistics, and spectral analysis were carried out on a computer through an analog-digital (AD) converter. A Mayer wave peak was clearly recognized in all goats in the spectrum of vascular resistance. A band pass filter was used to convert this information to automatic control. Time series curves of the Mayer wave of vascular resistance were provided, and compared with the time series curve of the cardiac output. After a change in the Mayer wave, increase in cardiac output was observed. This phenomenon may be interpreted as sympathetic nervous control of changes in cardiac output. These results suggest that an artificial heart may be controlled by the measurement of the Mayer wave of vascular resistance, making it possible to control an artificial heart with neural information.

Algorithms↗

Origin of chaos in the circulation: open loop analysis with an artificial heart.

To develop the optimal automatic control algorithm for an in vivo artificial heart system, investigation of the basic characteristics of the cardiovascular system may be important. The clinical significance of chaotic dynamics in the cardiovascular system has attracted attention. The circulation is a so-called complex system with many feedback circuits, making it very difficult to investigate the origin of chaos within the system. In this study, we investigated the origin of chaos by open loop analysis with an artificial heart (which has no fluctuation in pumping rate or contraction power) in chronic animal experiments with healthy adult goats. As a result, in the artificial heart circulatory time series data, low dimensional deterministic chaos was discovered by nonlinear mathematical analysis, suggesting the importance of blood vessels in the chaotic dynamics of the cardiovascular system. To investigate the origin of chaos further, sympathetic activity was directly measured in animals with artificial hearts. Chaotic dynamics was also recognized in sympathetic action potentials, even during artificial heart circulation. Coupling of the nonlinear information between blood vessels and sympathetic activity was suggested by analysis of mutual information. In chaotic dynamics, the central nervous system (CNS) played an important role through sympathetic activity. These findings may be useful for the development of an automatic control algorithm for an artificial heart.

Algorithms↗

Development of an implantable artificial anal sphincter by the use of the shape memory alloy.

In this study, we developed and assessed an artificial anal sphincter driven by an shape memory alloy actuator (AS-SMA). The performance characteristics of the device were analyzed with a measurement system. Assessment showed that the AS-SMA could generate a pressure of 55 mm Hg at an atmospheric temperature of 36 degrees C, and displacement of the SMA actuator was 7.5 mm when the temperature of the SMA plate was 55 degrees C. To evaluate opening and closing, we studied a piglet colostomy model, in which the AS-SMA was implanted around the colostomy in the extraperitoneal space. Flow control tests using living porcine intestine revealed that the AS-SMA could maintain fecal continence against an intestinal pressure of 75 mm Hg. The high pressure zone corresponding to the location of the device was demonstrated in a manometric examination. For 6 days after surgery, we activated the AS-SMA twice a day and observed the bowel movements. The animal experiment indicated that the AS-SMA is able to control the bowel movements of patients with fecal incontinence if several problems, such as burning of tissue around the device and compression injury of the intestine, are resolved.

Alloys↗

Automatic monitoring system for artificial hearts using self organizing map.

This study presents an automatic monitoring system for artificial hearts. The self organizing map (SOM) was applied to monitoring and analysis of an aortic pressure (AoP) signal measured from an adult goat equipped with a total artificial heart. In the proposed system, two different SOMs were used to detect and classify abnormalities in the measured AoP signal. In the first stage, an ordinary SOM, taught with only normal AoP data, was used for detection of abnormalities on the basis of the quantization error in the real-time monitoring task. In the second stage, a supervised SOM was used for classification of abnormalities. The supervised SOM can be regarded as an ordinary SOM with an extra class vector for solving the classification problem. The class vector is assigned to every node in the second SOM as an output weight learned according to Kohonen's learning rule. The effectiveness of detection and classification of abnormalities using these two SOMs was confirmed.

Animals↗

Fundamental rhythm of sympathetic nerve discharges in animals with total artificial hearts.

To evaluate the effect of total artificial heart replacement on the autonomic nervous system, sympathetic neurograms were analyzed by power spectrum and coherence function. Two pneumatically driven, sac type ventricular assist devices were implanted as biventricular bypasses (BVB) in adult, mongrel dogs. After initiation of BVB pumping, the natural heart was electrically fibrillated to form a BVB TAH model. Renal sympathetic nerve activity (RSNA) was recorded using a bipolar electrode attached to the left renal sympathetic nerve. RSNA was amplified and integrated by use of an R-C integrator. Power spectra of the RSNA and values of squared coherence between the arterial pressure wave form and the RSNA were calculated by computer. In animals with total artificial hearts (TAHs), coherence at the cardiac rhythm frequency was decreased, and coherence at the TAH pumping rhythm frequency was increased. These results indicate that the arterial pulse wave observed in TAH animals contributed to the sympathetic neurogram.

Animals↗