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Biomedical subjects

Y Taenaka

Publications and source records attributed to Y Taenaka.

At least 19 recordsLinked to original sources

A metastatic haemangiopericytoma of the floor of the mouth.

A case of metastatic haemangiopericytoma in the floor of the mouth is described. Haemangiopericytoma is a relatively rare slow-growing vascular tumour with variable malignant potential. This tumour has been identified in almost every region of the body, but its occurrence in the oral cavity has been rarely reported. The rate of regional and distant metastasis of the tumour is low. This case, presented 12 years after initial surgery suggested the need for careful long-term follow-ups of patients with haemangiopericytoma.

Antigens, CD34↗

Observation and quantification of cavitation on a mechanical heart valve with an electro-hydraulic total artificial heart.

In previous studies, we investigated the cavitation phenomenon in a mechanical heart valve using an electro-hydraulic total artificial heart. With this system, a 50% glycerin solution kept at 37 degrees C was used as the working fluid. We reported that most of the cavitation bubbles were observed near the valve stop and were caused by the squeeze flow. However, in these studies, the effect of the partial pressure of CO(2) on the mechanical heart valve cavitation was neglected. In this study, in order to investigate the effect of the partial pressure of CO(2) on mechanical heart valve cavitation using an electro-hydraulic total artificial heart, we controlled the partial pressure of the CO(2) in vitro. A 25-mm Medtronic Hall valve was installed in the mitral position of an electro-hydraulic total artificial heart. In order to quantify the mechanical heart valve cavitation, we used a high-speed camera. Even though cavitation intensity slightly increased with increases in the PCO(2) at heart rates of 60, 70 and 100 bpm, throughout the experiment, there was no significant difference between the PCO(2) and cavitation intensity.

Electricity↗

Cavitation phenomenon in monoleaflet mechanical heart valves with electrohydraulic total artificial heart.

Recently, cavitation on the surface of mechanical heart valves has been studied as a cause of fractures occurring in implanted mechanical heart valves. In this study, to investigate the mechanism of cavitation bubbles associated with monoleaflet mitral valves in an electrohydraulic total artificial heart (EHTAH), and to select the best valves for our EHTAH system, we measured three parameters. First, an image was created of the cavitation bubbles using a high-speed camera. Second, pressure drop in the vicinity of the valve surface was measured using mini pressure sensor. Then, the closing of the valve was observed using a Laser displacement sensor. Most of the cavitation bubbles in the Medtronic Hall valve were observed at the edge of the valve stop. With the Omnicarbon valve, the cavitation bubbles were observed at the edge of the valve and on the inner side of the leaflet. On the other hand, cavitation bubbles were observed only on the inner side of the leaflet in Björk-Shiley valve. Cavitation bubbles concentrated on the edge of the valve stop; the major cause of these cavitation bubbles was determined to be the squeeze flow. The formation of cavitation bubbles depended on the valve closing velocity and the valve leaflet geometry. From a viewpoint of squeeze flow, a low closing velocity and a small size of the valve stop could minimize cavitation.

Blood Pressure↗

Change in vasoconstrictive function during prolonged nonpulsatile left heart bypass.

We investigated changes in vasoconstrictive function accompanying prolonged nonpulsatile left heart bypass (NLHB). After 2-week pulsatile left heart bypass (PLHB) in 11 goats, NLHB was conducted for another 4 weeks (Group N) in 6 goats. In the other 5 goats, PLHB was continued for another 4 weeks (Group P). Systemic vascular resistance at rest (rSVR) was measured on the last days of the second and sixth postoperative week (W2 and W6, respectively). Subsequently, phenylephrine was injected, and the maximum values (SVRmax) and the maximum increasing change in SVR (DeltaSVR) were measured. No significant difference was observed in rSVR between groups at W2 or W6. The SVRmax and the DeltaSVR at W2 were consistent in both groups. However, at W6, the SVRmax and the DeltaSVR of Group N were significantly lower than those of Group P. In conclusion, prolonged NLHB caused a significant decrease in the SVR response to phenylephrine, indicating a dimunition of vasoconstrictive function.

Animals↗

Application of indirect flow rate measurement using motor driving signals to a centrifugal blood pump with an integrated motor.

The method of measuring the flow rate of a centrifugal blood pump from the input electric power, which will be indispensable for the long-term use of such devices, was developed and was applied to the direct-driven centrifugal blood pump that has been developed by our research group. The accuracy was evaluated in a chronic animal experiment using an adult goat. The results demonstrated that this method carries the sufficient potential of the instantaneous monitoring method, but errors due to electromagnetic and mechanical losses were not determined always precisely. The detection of adverse phenomena such as the obstruction of the inlet cannula was also possible from the estimated value of the flow rate and its waveform pattern.

Animals↗

Oxygen metabolism under various bypass flow conditions during cardiopulmonary support in awake goats.

Despite its wide clinical application, patient recovery from cardiopulmonary support (CPS) is not necessarily satisfactory. To clarify what influence CPS has on organ perfusion, we investigated the oxygen metabolism under various bypass flow (BF) conditions in a series of chronic animal CPS experiments. The CPS system, which consists of a pulsatile ventricular assist device and a compact artificial lung was installed without anesthesia in 6 adult goats weighing 49-51 kg. BF was adjusted stepwise from 0% to 50%, 75%, 90%, and 100% of total systemic blood flow (TSF) by balancing the pulmonary arterial flow. The animals' TSF and oxygen delivery (DO2) were sufficiently maintained throughout the experiments. The oxygen consumption (VO2) and the oxygen extraction rate (ExO2) increased from 178+/-14 to 342+/-19 ml/min, and from 28+/-2% to 64+/-1%, respectively, in proportion to the increase of CPBF dependency from 0% to 100%. The blood lactate level did not change appreciably even at 90% BF from 5.7+/-0.3 to 11.2+/-1.2 mg/dl, but drastically elevated to 23.5+/-4.6 mg/dl at the total bypass. This indicates that CPS leads to a relative lack of oxygen and can induce organ dysfunction due to increasing VO2 and ExO2 in proportion to the increase of BF dependence even if TSF and DO2 are sufficiently maintained.

Analysis of Variance↗

Preprimed artificial lung for emergency use.

We investigated the possibility of preprimed storage of an artificial lung (AL), aiming at facilitating its emergency use. Test ALs, consisting of a special microporous hollow fiber membrane made of polyolefin in which direct blood-gas contact was completely eliminated, were preprimed with saline solution, sterilized by gamma-ray irradiation, and evaluated after 1-3 months of storage at room temperature. A small amount of bubble was noted in the priming solution after storage in some ALs, which most likely originated from the air dissolved in the priming solution or persisted in the liquid compartment at priming. Although the preprimed solution contained several polyolefin-breakdown products due to irradiation, including ethyl alcohol, n- and t-butyl alcohol, acetone, and carbon dioxide, the levels of these substances were at concentrations known to be not toxic. Endotoxin concentration was negligible. In SEM observation, no perceptible microstructural change was observed in the hollow fibers after preprimed storage. Maximum tensile stress and ultimate elongation of the hollow fiber in the test ALs were reduced by approximately 20% and 3%, respectively, from those of the control AL. The influence of preprimed storage on gas-exchange function was examined in a venoarterial bypass animal study using a goat. Oxygen transfer function was well preserved whereas carbon dioxide removal function was slightly lowered according to the storage term in the stored ALs compared with those of a nonpreprimed control AL. On the basis of these results, we conclude that preprimed storage of the AL with gamma-ray sterilization is basically feasible and realistic.

1-Butanol↗

Effects of reduced pulse pressure to the cerebral metabolism during prolonged nonpulsatile left heart bypass.

We investigated changes in the cerebral metabolism with long-term reduced pulse pressure. Nine goats underwent pulsatile left heart bypass (LHB) for 2 weeks while awake, and nonpulsatile LHB was subsequently conducted for 4 weeks. The average pulse pressure during nonpulsatile LHB (13, 10, 11, and 11 mm Hg at the 1st, 2nd, 3rd, and 4th nonpulsatile LHB week, respectively) was significantly lower than that during pulsatile LHB (36 mm Hg). There were no significant differences in either arterio-jugular venous oxygen differences (AJDO2) and cerebral oxygen extraction ratio between the 2nd pulsatile LHB week and the 1st, 2nd, 3rd, and 4th nonpulsatile LHB weeks. The arterio-jugular venous glucose differences, jugular venous-arterial lactate differences (JAD Lactate), and lactate oxygen indexes (JAD Lactate/AJDO2) also remained unchanged during the entire course of the experiments. In conclusion, the cerebral metabolism during nonpulsatile LHB did not change compared to that during pulsatile LHB.

Analysis of Variance↗

Computational fluid dynamics analysis of a centrifugal blood pump with washout holes.

The authors studied avoidance of coagulation occurrence using computational fluid dynamics (CFD) analysis from the fluid dynamical point of view. Concerning centrifugal pumps, blood coagulation sometimes occurs at the region behind the impeller where the flow is generally stagnant. Therefore, we conducted a thorough study with the specimen pump with and without washout holes, mocking up the Nikkiso HPM-15. As the result, the model with washout holes indicated that the fluid rotates rapidly at the vicinity of the shaft and generates washout effects near the stationary rear casing. On the other hand, the model without washout holes showed that fluid cannot be quickly shipped out of the area behind the impeller and rotates mildly around the shaft. To clarify the moving relations between the impeller and the fluid, validation studies by comparing the results of CFD analysis and flow visualization experiments are ongoing; thus far, the studies show that CFD results are similar to the results from flow visualization experiments.

Centrifugation↗

Three-dimensional thoracic modeling for an anatomical compatibility study of the implantable total artificial heart.

Anatomical compatibility with the thoracic cavity is important in developing a completely implantable total artificial heart (TAH). The purpose of this study was to examine the optimal morphology of our TAH and to develop a computer implantation simulation environment for preoperational discussion. As the first stage, we constructed a prototype simulation system by creating a 3-D surface model of a thoracic cavity and one of a TAH. In this system, the thoracic surface model, composed of the aorta, pulmonary artery, ventricle resected heart, diaphragm, and thoracic wall, was created based on the organ contours extracted from electrocardiogram (ECG)-synchronized ultrafast computer tomographic images. The accuracy of the thoracic model was discussed using a phantom. The fitting study can be performed on the computer with the model of the thorax and that of the TAH. In the future, construction of a database for the thoracic cavities of heart failure patients is planned to improve the morphology of the TAH.

Computer Simulation↗

The development of a control method for a total artificial heart using mixed venous oxygen saturation.

For physiological control of a total artificial heart (TAH), applying mixed venous oxygen saturation (SVO2) as a parameter for TAH control is a promising approach regarding sensitivity to the recipient's oxygen demand and the practical possibility of continuous monitoring using near infrared rays through transparent blood pump housings. To develop a control method for the TAH using SVO2, the relationship between SVO2 and cardiac output (CO) was investigated in a normal calf, and a control algorithm was developed based on this correlation. Then the feasibility of this method (SVO2 mode) was evaluated in a calf implanted with a pneumatic TAH and compared with the fixed drive control mode (fixed mode) in which the drive parameters were unchanged. The calf performed a graded exercise test in both modes. The CO was effectively increased from 7.3 to 13.0 L/min in the SVO2 mode, and the capacity for exercise was augmented compared to the fixed mode. We conclude that this SVO2 mode is feasible and may be effectively applied in TAH control.

Animals↗

In vivo evaluation of the national cardiovascular center electrohydraulic total artificial heart.

We have been developing an electrohydraulic total artificial heart system. The system comprises an intrathoracic pumping unit composed of diaphragm type ellipsoidal blood pumps and an energy converter in addition to an electronics unit. The in vivo performance of the pumping unit was evaluated in a series of animal implantations with 3 calves weighing 62-85 kg. An interatrial shunt 4.5 mm in diameter was made in the atrial septum to compensate left-right imbalance. Two calves died early postoperatively, one of external controller power failure and the other of interatrial shunt stenosis due to thrombus formation. One calf, however, survived over 10 days under stable circulatory conditions. No abnormality was found in the oxygen metabolic condition or in major organ functions. The generation and dissipation of heat from the device was acceptable. This animal died of device malfunction caused by energy converter bearing breakdown. The device demonstrated a good anatomic fit without compromising the great vessels and adjacent tissues. It is concluded that the pumping unit has a sufficient in vivo basic performance although appropriate countermeasures are to be implemented against the detected problems concerning mechanical durability and interatrial shunt patency.

Animals↗

Cardiac autonomic nervous function during long-term nonpulsatile left heart bypass.

We investigated the changes in cardiac autonomic nervous activities during long-term nonpulsatile left heart bypass (NLHB) by analyzing heart rate variability. A pulsatile ventricular assist device was installed in 3 goats, and pulsatile left heart bypass (PLHB) was conducted for 2 weeks. Then, NLHB was maintained for the following 4 weeks. The segmental data of the R-R intervals (R-Rs) was analyzed by maximum entropy spectral analysis. Changes in evaluated parameters from the last week of PLHB to the 4th week of NLHB were as follows: the mean R-Rs increased from 511 ms to 692 ms; the coefficient of variation of R-R increased from 10.2 to 14.1%; the power of the low frequency band (LF) increased from 747 ms2 to 2,855 ms2; the power of the high frequency band (HF) increased from 512 ms2 to 1,270 ms2; and the ratio of LF to HF increased from 2.6 to 6.5. These results indicated that the cardiac autonomic nervous activity, both sympathetic and parasympathetic, increased during long-term NLHB.

Analysis of Variance↗

Development of an ultracompact integrated heart-lung assist device.

A novel integrated heart-lung assist device has been developed as a simple to use portable cardiopulmonary support system. The device comprises a centrifugal pump and an artificial lung, which is located around the pump, in an all in one system. The special membrane employed precludes plasma breakthrough in protracted use and enables preprimed setup. Test lungs consisting of the same membrane preserved gas exchange function well after 3 months of preprimed storage. The entire blood contacting surface is treated with covalent heparin bonding to impart good antithrombogenicity. Heparin bonded test lungs could be continuously perfused without systemic anticoagulation as long as 36 days in a venoarterial bypass chronic animal study using goats. The prototype device (diameter, 126 mm; height, 59 mm; membrane area, 0.85 m2; priming volume, 180 ml) demonstrated 9 L/min pump output at a 400 mm Hg pressure head and 180 ml/min oxygen and 110 ml/min carbon dioxide transfer rates at 5 L/min blood flow. We conclude that this device has potential to be the next generation cardiopulmonary support system.

Animals↗

Flow visualization study to improve hemocompatibility of a centrifugal blood pump.

A correlation study was conducted among quantitative flow visualization analysis, computational fluid dynamic analysis, and hemolysis tests regarding the flow in a centrifugal blood pump to prevent hemolysis. Particular attention was paid to the effect of the impeller/casing gap widths on the flow in the volute and in the outlet. Flow vector maps were obtained for 250% scaled-up models with various geometries, using an argon ion laser light sheet, a high speed video camera, and particle tracking velocimetry. In terms of the results, in the small radial gap model, high shear occurred near the inside wall of the outlet and stagnation near the outside wall of the outlet whereas the standard model maintained smooth flow and low shear. The small radial gap model showed a lower head and greater hemolysis than the standard model. This head decrease could be partly restored by relocating the outlet position; however, the hemolysis level hardly decreased. From these results, it was found that the small radial gap itself is important. It was also confirmed by detailed flow visualization and simple laminar shear analysis near the wall that the small radial gap caused a wider high shear layer (110-120 microm) than the standard model (approximately 80 microm). In the small radial gap model, the high shear layer in the outlet (approximately 50 microm) is much narrower than that in the volute. Flow visualization together with the aid of computational fluid dynamic analysis would be useful to eliminate the causes of hemolysis.

Blood Flow Velocity↗

Diminished vasoconstrictive function caused by long-term nonpulsatile left heart bypass.

We investigated the functional changes of the systemic vascular system due to prolonged nonpulsatile left heart bypass (NPLHB). Three adult goats underwent pulsatile left heart bypass (PLHB). Two weeks later the PLHB was changed to the NPLHB, which was conducted for 4 weeks. The aortic pulse pressure was 39 and 16 mm Hg during the PLHB and NPLHB, respectively. Systemic vascular resistance (SVR) and the plasma norepinephrine level were measured at the end of PLHB (PUL), and in the 1st, 2nd, 3rd, and 4th weeks of NPLHB (NP1w, NP2w, NP3w, and NP4w). At each point, 1 microg/kg norepinephrine was injected, and the elevation of the SVR (deltaSVR) was calculated. The SVR and the plasma norepinephrine level did not change significantly during the entire course. However, deltaSVR decreased during NPLHB and became significantly lower at NP3w and NP4w than that at PUL (NP3w: 839 +/- 164, NP4w: 746 +/- 268, and PUL: 1,239 +/- 324 dyne x s x cm(-5)). These results strongly indicated that prolonged NPLHB significantly diminished the constrictive function of the vascular system.

Animals↗

Augmentative effect of pulsatility on the wall shear stress in tube flow.

Wall shear stress (WSS) has been considered to play an important role in the physiological and metabolic functions of the vascular endothelial cells. We investigated the effects of the pulse rate and the maximum flow rate on the WSS to clarify the influence of pulsatility. Water was perfused in a 1/2 inch transparent straight cylinder with a nonpulsatile centrifugal pump and a pulsatile pneumatic ventricular assist device (VAD). In nonpulsatile flow (NF), the flow rate was changed 1 to 6 L/min by 1 L/min increments to obtain standard values of WSS at each flow rate. In pulsatile flow (PF), the pulse rate was controlled at 40, 60, and 80 bpm, and the maximum flow rate was varied from 3.3 to 12.0 L/min while the mean flow rate was kept at 3 L/min. The WSS was estimated from the velocity profile at measuring points using the laser illuminated fluorescence method. In NF, the WSS was 12.0 dyne/cm2 at 3 L/min and 33.0 dyne/cm2 at 6 L/min. In PF, the pulse rate change with the same mean, and the maximum flow rate did not affect WSS. On the other hand, the increase in the maximum flow rate at the constant mean flow rate of 3 L/min augmented the mean WSS from 13.1 to 32.9 dyne/cm2. We concluded that the maximum flow rate exerted a substantial augmentative effect on WSS, and the maximum flow rate was a dominant factor of pulsatility in this effect.

Blood Flow Velocity↗

Development of design methods for a centrifugal blood pump with a fluid dynamic approach: results in hemolysis tests.

The purpose of this study was to examine the relationship between local flow conditions and the hemolysis level by integrating hemolysis tests, flow visualization, and computational fluid dynamics to establish practical design criteria for centrifugal blood pumps with lower levels of hemolysis. The Nikkiso centrifugal blood pump was used as a standard model, and pumps with different values of 3 geometrical parameters were tested. The studied parameters were the radial gap between the outer edge of the impeller vane and the casing wall, the position of the outlet port, and the discharge angle of the impeller vane. The effect of a narrow radial gap on hemolysis was consistent with no evidence that the outlet port position or the vane discharge angle affected blood trauma in so far as the Nikkiso centrifugal blood pump was concerned. The radial gap should be considered as a design parameter of a centrifugal blood pump to reduce blood trauma.

Animals↗