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Fiberoptic biosensors in artificial organs.

A large variety of assay methods based on optical principles can be miniaturized and adapted for use as in vivo monitors with the currently available optical fiber technology. Especially exciting is the capability of adapting the selectivity of immunoassays to continuous on-line biosensors by the use of hollow dialysis fibers. Thus, one can envision biosensors that could have many different applications in artificial organ development, from passive systemic monitoring to active feedback control devices for drug delivery.

Artificial Organs↗

General planning of an artificial organ center.

There is an increasing need for research and development centers to deal with design and evaluation of organ replacement systems, the improvement of older devices, and the study of biocompatibility problems. Special attention, in this article, is focused on the determinant role of the background of the investigators involved in a given center and the selection of research programs to be pursued. Financial and architectural aspects are discussed in general terms. Appropriate planning of artificial organ centers should allow conceptualizing research and development that will exert a practical impact on patient care locally and worldwide.

Animals↗

The chronically stimulated muscle as an energy source for artificial organs. Preliminary results of a basic study in sheep.

In 5 adult sheep the psoas muscle of one side was electrically stimulated through the muscle nerves with an implantable stimulation unit for more than 5 weeks. In the final experiments the isometric tetanic tension of the stimulated muscles was reduced to 50-70% of the contralateral normal muscle. The use of only 15 Hz as a stimulation frequency led to a transformation of the originally fast muscle into a slow muscle with more resistance to fatigue. Future application of the chronically stimulated psoas muscle for driving artificial organs is discussed.

Animals↗

[Artificial organs and surgery. Present status and problems. The artificial heart].

Various means to assist the failing heart surgically will include, according to the order of simplicity and readiness of their application, intraaortic balloon pumping (IABP), veno-arterial bypass with oxygenator (VAB), and ventricular assist device (VAD). However, when the severity of the cardiac failure is beyond the capacity of these assist devices, the use of the total heart replacement device (total artificial heart-TAH) will be the final solution. Increase of the cardiac output by the use of IABP is limited being less than 1.0l/min. Results of VAB has been poor. The number of VAD cases reported to date is over 200 in the world. Thirty-six percent of them were successfully weaned, but only 15.8% of the patients were discharged. Among 14 cases experienced in Japan, 2 patients survived longer than one month following the VAD removal. The recent overall world result has been steadily improving. The TAH has been used in five patients in the world. In the first two patients TAH was used as a temporary relief assuming heart transplantation later, which was proposed by Cooley as two-staged heart replacement in 1969. In the recent three TAH was applied being expressly stated as a permanent device. Timely judgment and decision when to apply are most important.

Adult↗