Peripheral vascular resistances during total left heart bypass with an oscillated blood flow

For development aimed at a totally implantable type ventricular assist device (VAD), the vibrating flow pump (VFP) has been developed at Tohoku University. A transcutaneous energy transmission system (TETS) using amorphous fibers was developed to power the totally implantable VAD system. The VFP works at a high frequency compared to that of a natural heart of a biological system. It is a frequency of 10-50 Hz. In this research, animal experiments with left heart bypass were carried out with healthy adult goats. For comparison between nonpulsatile flow and oscillated flow, a rotary pump (RP) and the VFP were used in the experiments. For the achievement of total left heart bypass, left ventricular approaches were carried out, and blood was pumped from the left ventricle to the descending aorta. Adequate support of the left heart was provided by both pumps. In terms of the results, the vascular resistances tended to decrease during the use of both pumps during 100% bypass driving. When we compared these pumps at the same flow rate, the resistances during RP driving were significantly smaller than those during VFP driving. These results may suggest that the influences of the VFP upon the peripheral vessels may be relatively small compared to those of the RP. This may be an important result when a stable hemodynamic condition is required during artificial circulation. The VFP was considered as a candidate for a totally implantable VAD as a result.

Vagal nerve activity recording in the awake condition for the control of an artificial heart system

To detect useful information for an artificial heart control system, we paid attention to the autonomic nervous system. For stable recording, we used vagal nerve activity in chronic animal experiments using healthy adult goats in an awake condition because this nerve was sufficiently bold and large enough. Vagal nerve discharges were successfully recorded from awake goats. They were synchronized with respiration and responded to the hemodynamic changes induced by drug administration, suggesting that they may provide useful information for an artificial heart control algorithm. For automatic control, some time delay plays a vitally important role. Thus, predictive control for an artificial heart system may be desirable. It may be embodied by the use of autonomic nerve information.

Vagal nerve activity and the high frequency peak of the heart rate variability

For the Quality of life (QOL) of patients with an artificial heart system, monitoring an information of the cardiovascular control system may be important. We have been evaluating the autonomic nervous system for that purpose. Recently, fluctuations in hemodynamic parameters including heart rate variability (HRV) were evaluated by means of spectral analysis and nonlinear mathematical analysis. Respiratory wavers in HRV were thought to reflect ongoing information of the parasympathetic nerve activity. Is it true? In order to confirm this hypothesis, we recorded vagal nerve activity directly in the chronic animal experiments. Six healthy adult goats were anesthetized with Halothene inhalation and thoracotomy were performed by the fourth lib resection during mechanical ventilation. Arterial blood pressure, right and left atrial pressures were continuously monitored with the catheter insertion. Cardiac output was measured by the electromagnetic flowmeter attached to the ascending aorta. After the chest was closed, incision was made to the left neck and left vagal nerve was separated. Stainless steel electrodes were inserted into the vagal nerve and fixed by the plasticizer. After the incision was closed, the goats were transferred to the cage and extubated after waking. Hemodynamic parameters and vagal nerve activity were measured in the awake condition. The results showed that clear observation of the autonomic nerve discharges were embodied by this experimental system. The vagal nerve discharges were synchronized with heart beat and respiration. The vagal nerve tonus was significantly influenced by the hemodynamic alteration. However in some condition, the respiratory wave was not always consistent with tonus of the vagal nerve activity, thus suggesting that we should check another information to evaluate the parasympathetic tone. We must continue this study to evaluate an autonomic nerve during artificial heart circulation.

A future prediction type artificial heart system

The demand of the biological system needs to be predicted to consider the quality of life (QOL) of a patient with an artificial heart system. The purpose of this study was the prediction of the imminent cardiac output and the predictive control for an artificial heart. For that purpose, autonomic nerve information was applied in this study. Nervous sympathicus action potentials were measured, and a prediction function of cardiac output was made using the sympathetic tone and preload and after-load measurement with multiple regression analysis. The predicted value showed significant correlation with the measured value after 2.9 s. Currently, however, long-term instrumentation of the nervous sympathicus potential is difficult. Thus, hemodynamic fluctuations, which recently have attracted attention, were used in this study. A prediction function using the Mayer wave, which represented nervous sympathicus, was determined. As a result, mid-term prediction became possible. Furthermore, a measurement of the vagal nerve was used as a possible long-term prediction parameter. For long-term prediction, Hurst exponent analysis was used in this study. Vagal nerve discharges in the changing position showed alteration of long-term determination. In conclusion, the future prediction control of an artificial heart takes shape using these prediction functions.

Successful closure of coronary-bronchial artery fistula with vein graft-coated stent

A coronary-bronchial fistula and aneurysmal dilatation of the proximal part of the fistula was successfully closed using an autologous vein graft-coated stent (Palmaz-Schatz stent). This is the first report that demonstrates the feasibility of the vein-coated stent for the treatment of congenital disease.

Chaotic dynamics in circulation with Tohoku University vibrating flow pump

For the development of a totally implantable ventricular assist system (VAS), we have been developing the vibrating flow pump (VFP), which can generate oscillated blood flow with a relative high frequency (10-50 Hz) for a totally implantable system. In this study, the effects of left ventricular assistance with this unique oscillated blood flow were analyzed by the use of nonlinear mathematics for evaluation as the whole circulatory regulatory system, not as the decomposed parts of the system. Left heart bypasses using the VFP from the left atrium to the descending aorta were performed in chronic animal experiments using healthy adult goats. The ECG, arterial blood pressure, VFP pump flow, and the flow of the descending aorta were recorded in the data recorder during awake conditions and analyzed in a personal computer system through an A-D convertor. By the use of nonlinear mathematics, time series data were embedded into the phase space, the Lyapunov numerical method, fractal dimension analysis, and power spectrum analysis were performed to evaluate nonlinear dynamics. During left ventricular assistance with the VFP, Mayer wave fluctuations were decreased in the power spectrum, the fractal dimension of the hemodynamics was significantly decreased, and peripheral vascular resistance was significantly decreased. These results suggest that nonlinear dynamics, which mediate the cardiovascular dynamics, may be affected during left ventricular (LV) bypass with oscillated flow. The decreased power of the Mayer wave in the spectrum caused the limit cycle attractor of the hemodynamics and decreased peripheral resistance. Decreased sympathetic discharges may be the origin of the decreased Mayer wave and fractal dimension. These nonlinear dynamic analyses may be useful to design optimal VAS control.

Mutual information discloses relationship between hemodynamic variables in artificial heart-implanted dogs

A mutual information (MI) method for assessment of the relationship between hemodynamic variables was proposed and applied to the analysis of heart rate (HR), arterial blood pressure (BP), and renal sympathetic nerve activity (RSNA) in artificial heart-implanted dogs to quantify correlation between these parameters. MI measures the nonlinear as well as linear dependence of two variables. Simulation studies revealed that this MI technique furnishes mathematical features well suited to the investigation of nonlinear dynamics such as the cardiovascular system and can quantify a relationship between two parameters. To constitute a model free of the natural heart, two pneumatically actuated ventricular assist devices were implanted as biventricular bypasses in acute canine experiments. RSNA was detected with the use of bipolar electrodes attached to the renal sympathetic nerve. Analysis of data during control revealed that correlation between HR and RSNA was higher than that between HR and BP and that between RSNA and BP (P < 0.05). Although RSNA seemed to fluctuate noncorrelatedly with BP in higher pacing rates, the MI values between them disclosed their strong correlation. Surprisingly, correlation between RSNA and BP was stronger during a pacing rate of 60 beats/min than during higher pacing rates and control (P < 0. 05). It is suggested that the baroreflex system may be susceptible to pacing rates during the total artificial heart state. We calculated the time delay between HR and RSNA, between RSNA and BP, and between HR and BP by regarding a time delay at which the maximum MI value between each pair of parameters was given as a physiological delay. Our results indicate that RSNA leads BP, BP leads HR, and RSNA leads HR during control (P < 0.05). We conclude that this method could provide a powerful means for measuring correlation of physiological variables.

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.

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.

Virtual percutaneous transluminal coronary angioplasty system for an educational support system

With the increase of ischemic diseases of the circulatory system in Japan, the necessity for cardiovascular intervention continues to increase. However, because intervention operations have been developed only recently, the education system for the corresponding specialists in our country has not been established yet. In this study, an intervention educational support system using a virtual reality (VR) technique was developed. Of course, intervention includes percutaneous transluminal coronary angioplasty (PTCA). PTCA is an operation enlarging the stenosis of the coronary artery with a balloon through a guide catheter. The technique that lets the guide wire for the PTCA balloon cross the stenosis is one of the most difficult. A simulation system for the manipulation of a torque device for the PTCA guide wire was developed with this technology for VR. In virtual space, reconstitution of the 3-dimensional coronary artery with atherosclerosis was performed, and the virtual PTCA system was produced experimentally. An interesting system was produced experimentally as a system for the training of doctors studying to become interventional specialists. After the system was combined with an Expert system for treating ischemic heart diseases, its usefulness was steadily increased. With the development of more sophisticated VR methodology in the future, a PTCA training system without using a patient will be embodied.

Monitoring system for the totally implantable ventricular assist system by use of sensors for virtual reality

For the development of the totally implantable artificial organs, it is an important problem to monitor the conditions of the implantable devices, especially when used in clinical cases. In this study we used position sensors for the 3-dimensional (3-D) virtual reality (VR) system monitor an implantable artificial heart. The sensors used in the experiments were 3-space Fastrak (Polhemus, USA). The position sensors using electro-magnetic forces were attached to the inner actuating zone. Sensitivity of the position sensors was in the order of around 0.8 mm. By use of these VR position sensors, we could easily detect the six degrees of freedom as x,y,z, and pitch, yaw, roll of these sensors. Experimental evaluation using a model circulation loop and healthy adult goats was performed. Experimental results suggest that our newly developed implantable sensors for monitoring the implantable artificial heart system were useful for sensing driving condition, thus possibly useful for the implantable devices for clinical usage.

Control of the pulmonary arterial resistance by the use of the oscillated assist flow

In the clinical application of supporting circulation, the treatment of a patient with pulmonary hypertension is very important. We developed the electromagnetically driven vibrating flow pump (VFP) as a totally implantable type ventricular assist system. The artificial heart driven by electromagnetic forces creates high speed oscillation flow around 10-50 Hz. Assistance by high-speed oscillation flow has an interesting influence on the cardiovascular system. In this study, we carried out research on the influence such oscillation flow had on the pulmonary arterial vessels, and the supporting flow wave-form that controlled pulmonary vascular resistance was considered. Six healthy adult goats of both sexes were used in the experiments. We carried out inhalation anesthesia and performed intubation. The thorax was opened through left fourth rib resection. Right heart bypass was performed from the right atrium to the pulmonary artery. The flow of right heart assistance was maintained within 20-25% of total flow. Our purpose was to add flow of a specific high frequency to the right heart circulation. The hemodynamic parameters were recorded on a magnetic tape data recorder and input into a computer through an A-D converter. A result identified was that the pulmonary vascular resistance changed according to the alteration of the driving frequency of the VFP even during the same flow assistance. The resistance of the pulmonary arterial vessels became smaller when the driving of the VFP of 30 Hz was added to the right heart circulation. This was significant even when compared with continuous flow right heart assist. The characteristics of impedance appeared to have interesting alterations as well. Control of pulmonary vascular resistance by right heart assistance becomes possible if these results are applied. Accordingly, it may become one of the choices for treatment of a patient with pulmonary hypertension.

Development of total artificial heart with economical and durability advantages

To develop a total artificial heart (TAH) pump system, we created a design paying particular attention to durability and cost. We adopted a pneumatically driven sac type artificial heart, where the configuration of the sac was decided according to the methodology of flow visualization. Its configuration is almost round to achieve as little stagnation as possible and a low turbulent flow. The main body of the sac was made using polyvinyl chloride (PVC) paste. The paste was poured into an external mold, and heated in a hot air drying oven. Coating was performed using polyurethane. The basic performance of this pump system was tested using a model circulation circuit, and a fitting study through acute animal experiment, using a healthy adult goat, was carried out. As for the TAH produced experimentally, a pump output exceeding 5.0 l/min in the model circulation circuit was provided. Implantation in the internal pleural cavity of a healthy adult goat, 55 kg in weight, proved possible and quite easy in comparison. It is thought that a more refined design in the connector part is desirable. Furthermore, a chronic experiment with the TAH will be carried out, and examination will need to be repeated in the future.

Left heart bypass using the oscillated blood flow with totally implantable vibrating flow pump

Aiming at a totally implantable ventricular assist device (VAD), a vibrating flow pump (VFP) was developed in Tohoku University. A transcutaneous energy transmission system (TETS) using an amorphous fiber was developed for the totally implantable VAD system. The VFP works with a higher frequency than the natural heart of a biological system, a frequency of 10-50 Hz. In this research, animal experiments on left heart bypass were performed with healthy goats. Blood from the apex of the left ventricle was received and was sent to the aorta so that an adequate supporting effect of the left heart was provided. In particular, the depression effect of the left ventricle was obvious. As a result, sufficient artificial heart flow was provided. For a totally implantable type VAD, left heart bypass of almost 100% may become necessary in some situations. Therefore, apex approaches of left heart bypass may be desirable. From an anatomical consideration, an apex of the heart is suitable for the VFP of this totally implantable type. In the left heart bypass for which the apex of the heart was used, an almost 100% bypass was possible. This is a requirement that is important when waiting for recovery of sufficient cardiac function. It is also important that left heart circulation is maintained fully by an artificial heart of the complete implantation type. The VFP was considered to be useful as a totally implantable type artificial heart from the results.

Development of Vibrating flow Pump for Left Ventricular Assist Circulation

Vibrating flow pump (VFP) can generate high frequency oscillated blood flow within 1040 Hz. In this study, new type VFP was developed as a ventricular assist device. Left Ventricular assist circulation using VFP were performed as aseptic animal experiments using goats, hemodynamic parameters were recorded continuously at awaked state. Driving frequency of VFP was 25 Hz and pump flow rate was controlled to approximately 2 l/min. Frequency of VFP was 25 hz and pump flow rate was controlled to approximately 2 L/min. Frequency analysis method was used for analyzing hemodynamics. The peak of power was observed at 25 Hz from the Fourier transformation of blood flow waveform. Systemic vascular resistance was decreased by the start of left ventricular assistance using oscillated blood flow. No fatal arrhythmia was osberved during this study. As the conclusion, new type VFP has a sufficient performance for left ventricular assistance. Small size blood pump may be enabled by the oscillated blood flow because VFP is driven at high frequency moving with short stroke volume.

Development of vibrating flow pump for left ventricular assist circulation

Vibrating flow pump (VFP) can generate high frequency oscillated blood flow within 10-40 Hz. In this study, new type VFP was developed as a ventricular assist device. Left Ventricular assist circulation using VFP were performed as aseptic animal experiments using goats. hemodynamic parameters were recorded continuously at awake state. Driving frequency of VFP was 25 Hz and pump flow rate was controlled to approximately 2 l/min. Frequency of VFP was 25 hz and pump flow rate was controlled to approximately 2 L/min. Frequency analysis method was used for analyzing hemodynamics. The peak of power was observed at 25 Hz from the Fourier transformation of blood flow waveform. Systemic vascular resistance was decreased by the start of left ventricular assistance using oscillated blood flow. No fatal arrhythmia was observed during this study. As the conclusion, new type VFP has a sufficient performance for left ventricular assistance. Small size blood pump may be enabled by the oscillated blood flow because VFP is driven at high frequency moving with short stroke volume.

Development and evaluation of totally implantable ventricular assist system using a vibrating flow pump and transcutaneous energy transmission system with amorphous fibers

We have developed a vibrating flow pump (VFP) that can generate oscillated blood flow with a relatively high frequency (10-50 Hz) for a totally implantable ventricular assist system (VAS). To evaluate the newly developed VAS, left heart bypasses, using the VFP, were performed in chronic animal experiments. Hemodynamic parameters were recorded in a data recorder in healthy adult goats during an awake condition and analyzed in a personal computer system through an alternating-direct current converter. Basic performance of the total system with a transcutaneous energy transmission system were satisfactory. During left ventricular assistance with the VFP, Mayer wave fluctuations of hemodynamics were decreased in the power spectrum, the fractal dimensions of the hemodynamics were significantly decreased, and peripheral vascular resistance was significantly decreased. These results suggest that cardiovascular regulatory nonlinear dynamics, which mediate the hemodynamics, may be affected by left ventricular bypass with oscillated flow. The decreased power of the Mayer wave in the spectrum caused the limit cycle attractor of the hemodynamics and decreased peripheral resistance. These results suggest that this newly developed VAS is useful for the totally implantable system with unique characteristics that can control hemodynamic properties.

Acoustic properties of dialysed kidney by scanning acoustic microscopy

BACKGROUND

A correlation between acquired renal cysts in the dialysed kidney and renal cancer has long been debated, but no changes in the physical properties of kidneys at the microscopic level have been reported. The purpose of the present study was to classify the physical properties of the kidneys of patients undergoing haemodialysis at several stages of pathology by use of the scanning acoustic microscope.

METHODS

Sixteen surgically excised kidneys of dialysis patients were investigated. Tissues were fixed in 10% formalin, frozen in acetone, and cut 10 microns thick on a cryostat. We used a scanning acoustic microscope operated in the frequency range of 100-200 MHz. Attenuation constant and sound speed were measured on a two-dimensional distribution.

RESULTS

The attenuation constant for inflammatory granulation tissue was significantly higher than that for hyaline degeneration tissue (P < 0.001). Sound speed was high for granulation tissue, but tended to diminish gradually for hyaline degeneration. Sound speed increased again with progression to cystic degeneration (P < 0.001), but the attenuation constant remained low. When a cystic kidney contained a malignant lesion, the previously low attenuation constant rose at that site (P < 0.001), and the previously high sound speed was diminished (P < 0.001).

CONCLUSION

Our data suggest that the physical properties of dialysed kidneys at different stages of pathology can be classified by their acoustic properties. Simultaneous evaluation of attenuation constant and sound speed is considered applicable to determining whether tissues contain malignant elements.

Pulmonary arterial impedance analysis by the use of the oscillated assist flow

Pulmonary arterial impedance is an important and interesting characteristic that can be used to evaluate the physiological properties of the pulmonary vessel. However, power spectrum analysis of the pulmonary artery pressure and flow pattern have suggested that peak power in the relatively high frequency range (> 10 Hz) is significantly low; thus, we cannot analyze the vessel properties in the high frequency range. In this study, we used the newly developed vibrating flow pump (VFP), which can generate oscillated blood flow with a relatively high frequency (10-50 Hz) for right heart bypass, to evaluate the pulmonary arterial impedance pattern in the high frequency range. Acute animal experiments of the right heart bypass from the right atrium to the pulmonary artery using 6 healthy adult goats were performed. The flow pattern and pressure of the pulmonary artery, electrocardiograms (ECGs), and arterial and right atrial pressures were continuously monitored during the experiments. Spectral analysis of the hemodynamic parameters using the fast Fourier transform (FFT) method was performed to evaluate the spectral properties. The coherence function, transfer function, and phase patterns were calculated to analyze the impedance pattern in the relatively high frequency area. Previously, various investigators had tried to analyze the impedance patterns of the pulmonary artery; however, they could not analyze the impedance patterns over 10 Hz because the spectral patterns of the pulmonary flow do not have high power at high frequencies. These physiological analyses may be useful in designing the optimal pulmonary circulation.

Hemolysis test of disposable type vibrating flow pump

The vibrating flow pump (VFP) can generate high frequency oscillated blood flow. Because of the high frequency driving with short stroke volume, the pump system can be small. The disposable type VFP (D-VFP) was developed for use for extracorporeal circulation. The electromagnetic actuator was detached from the vibrating tube, which was newly designed to be a disposable tube with a jellyfish valve. Hemolysis tests of the D-VFP, VFP, centrifugal pump, and roller pump were performed in a mock circulation study using goat blood. Plasma free hemoglobin was measured every 15 min under the same conditions. The plasma free hemoglobin of the D-VFP was 16 mg/dl although that of the VFP was 160 mg/dl at 30 min. The plasma free hemoglobin of the centrifugal pump and roller pump at 30 min were 3 mg/dl and 9 mg/dl, respectively. The hemolysis performance of the D-VFP may be studied further as a result of this study. Two important factors affecting hemolysis development may be the materials of which the vibrating tube is made and heat transmission from the actuator. The D-VFP has a smooth acrylic surface for blood contact compared with the metal surface of old type VFP. The electromagnetic actuator of the VFP surrounded the vibrating tube, so heat from the actuator could be easily transmitted to the blood. Because the D-VFP has a disposable vibrating tube that is detached from the actuator, heat is not readily transmitted to the blood. A mock circulation study of heat transmission was performed using the D-VFP and VFP. Results of the heat transmission study showed that the fluid temperature of the D-VFP was not increased and stayed at room temperature although that of the VFP increased approximately 1 degree C above room temperature. The D-VFP may be a good style for the development of the VFP for use for extracorporeal circulation.

Development of a novel centrifugal pump: magnetic rotary pump

The rotational axis of the centrifugal pump has some associated problems such as blood destruction and sealing between the axis and pump housing. To improve upon these deficits we have developed a new type of blood pump, the magnetic rotary pump (MRP). The MRP has an original design with no rotational axis and no impellers. We made a prototype MRP and examined its hemodynamics in mock circulation. The prototype MRP flow rate is only 1.0 L/min with an afterload of 30 mm Hg, and we have made some modifications in the size and drive mechanisms from these results. The modified MRP can achieve high flow rates and rotational speeds (6.0 L/min with an afterload of 100 mm Hg, 2,000 rpm) in a mock circuit, and the modified MRP was used for left heart assistance in an acute animal experiment. The MRP could maintain the hemodynamics of an anesthetized adult goat. These results suggest that the MRP needs to be improved in several areas, but the MRP may be useful as a blood pump.

Nonlinear mathematical analysis of the hemodynamic parameters during left ventricular assistance with oscillated blood flow

For the development of a totally implantable ventricular assist system (VAS), we have been developing the vibrating flow pump (VFP), which can generate oscillated blood flow with a relatively high frequency (10-50 Hz) for a totally implantable system. In this study, effects of left ventricular assistance with this unique oscillated blood flow were analyzed by nonlinear mathematics for evaluation as the entire circulatory regulatory system, not as a separate part of the system. Left heart bypasses using VFPs from the left atriums to the descending aortas were performed in chronic animal experiments using healthy adult goats. Electrocardiogram (ECG), arterial blood pressure, VFP pump flow, and flow of the descending aorta data taken while the goats were awake were recorded in the data recorder and analyzed in the personal computer system through the AD convertor. Using nonlinear mathematics, time series data were embedded into the phase space, and the Lyapunov numerical method, fractal dimension analysis, and power spectrum analysis were performed to evaluate the nonlinear dynamics. During left ventricular assistance with the VFP, Mayer wave fluctuations were decreased in the power spectrum, the fractal dimension of the hemodynamics was significantly decreased, and peripheral vascular resistance was significantly decreased. These results suggest that nonlinear dynamics, which mediate the cardiovascular dynamics, may be affected during LV bypass with oscillated flow. Decreased power of the Mayer wave in the spectrum caused the limit cycle attractor of the hemodynamics and decreased the peripheral resistance. Decreased sympathetic discharges may be the origin of the decreased Mayer wave and fractal dimension. These nonlinear dynamical analyses may be useful to design the optimal VAS control.

Development of intracoronary local adhesive delivery technique

Acute coronary occlusion may occur in weak coronary atherosclerotic lesions, including dissection, ulceration or thrombus. In some cases of occlusion "bail-out" is performed by using recently developed New Devices. However, these have not yet completely solved the problem to this end, we designed a new method of coronary revascularization, the Intracoronary Local Adhesive Delivery Technique, utilizing antithrombotic and absorbable adhesive injected locally into the fragile and morbid arterial wall using a drug delivery PTCA catheter more flexible than the existing New Devices. This adhesive strengthened and hardened the lesions. In this study, we examined the efficacy of making an adhesive cylinder in arteries of similar size to the coronary, through acute animal experiments using the existing clinical adhesives and drug delivery PTCA catheters and 12 femoral arteries of adult goats. We were successful in forming firm tunnels along the inside of six arteries, infused with approximately 0.04 ml Cyanoacrylate. These tunnels were observed with intravascular ultrasound (IVUS) imaging and evaluated microscopically. These results suggest the feasibility of this method as a new approach for making synthetic resinous stents.

Characterization of renal angiomyolipoma by scanning acoustic microscopy

A scanning acoustic microscope system was used to differentiate renal angiomyolipoma from renal cell carcinoma. The ultrasonic frequency used ranged from 100 to 200 MHz, and the attenuation constant and sound speed were measured on a two-dimensional distribution. The sound speed was significantly lower for lipoma cells than for vessels, smooth muscle fibres, clear cell renal cancer or granular cell renal cancer. The attenuation constant was significantly lower for lipoma cells than for vessels or clear cells. Both acoustic parameters for smooth muscle fibres were significantly lower than for vessels. The heterogeneity of the microacoustic field in renal angiomyolipoma is closely related to the high intensity echo observed on clinical echography. Renal angiomyolipoma and renal cell carcinoma can thus be distinguished by acoustic examination.