• Journal of Chest Surgery
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• v.37 no.3
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• pp.201-209
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• 2004

Extracorporeal life support (ECLS) system is a device for respiratory and/or heart failure treatment, and there have been many trials for development and clinical application in the world. Currently, a non-pulsatile blood pump is a standard for ECLS system. Although a pulsatile blood pump is advantageous in physiologic aspects, high pressure generated in the circuits and resultant blood cell trauma remain major concerns which make one reluctant to use a pulsatile blood pump in artificial lung circuits containing a membrane oxygenator. The study was designed to evaluate the hypothesis that placement of a pressure-relieving compliance chamber between a pulsatile pump and a membrane oxygenator might reduce the above mentioned side effects while providing physiologic pulsatile blood flow. The study was performed in a canine model of oleic acid induced acute lung injury (N=16). The animals were divided into three groups according to the type of pump used and the presence of the compliance chamber, In group 1, a non-pulsatile centrifugal pump was used as a control (n=6). In group 2 (n=4), a single-pulsatile pump was used. In group 3 (n=6), a single-pulsatile pump equipped with a compliance chamber was used. The experimental model was a partial bypass between the right atrium and the aorta at a pump flow of 1.8∼2 L/min for 2 hours. The observed parameters were focused on hemodynamic changes, intra-circuit pressure, laboratory studies for blood profile, and the effect on blood cell trauma. In hemodynamics, the pulsatile group II & III generated higher arterial pulse pressure (47$\pm$ 10 and 41 $\pm$ 9 mmHg) than the nonpulsatile group 1 (17 $\pm$ 7 mmHg, p<0.001). The intra-circuit pressure at membrane oxygenator were 222 $\pm$ 8 mmHg in group 1, 739 $\pm$ 35 mmHg in group 2, and 470 $\pm$ 17 mmHg in group 3 (p<0.001). At 2 hour bypass, arterial oxygen partial pressures were significantly higher in the pulsatile group 2 & 3 than in the non-pulsatile group 1 (77 $\pm$ 41 mmHg in group 1, 96 $\pm$ 48 mmHg in group 2, and 97 $\pm$ 25 mmHg in group 3: p<0.05). The levels of plasma free hemoglobin which was an indicator of blood cell trauma were lowest in group 1, highest in group 2, and significantly decreased in group 3 (55.7 $\pm$ 43.3, 162.8 $\pm$ 113.6, 82.5 $\pm$ 25.1 mg%, respectively; p<0.05). Other laboratory findings for blood profile were not different. The above results imply that the pulsatile blood pump is beneficial in oxygenation while deleterious in the aspects to high pressure generation in the circuits and blood cell trauma. However, when a pressure-relieving compliance chamber is applied between the pulsatile pump and a membrane oxygenator, it can significantly reduce the high circuit pressure and result in low blood cell trauma.

• Proceedings of the KOSOMBE Conference
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• v.1996 no.05
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• pp.199-202
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• 1996

Artificial hearts are intended for use in patients with severe forms of heart disease for which no surgical repair is possible. The moving-actuator pump was developed to decrease the overall volume size of the electromechanical total artificial heart (TAH) by eliminating the occupied space of the fixed-actuator in the conventional pusher-plate type pump. In our pump, the actuator moves back and forth for alternative ejections of left and right ventricles. The problem of fitting the TAH to atrial remnants and arterial vessels could also be improved by circular or penduluous mot ion of the actuator instead of linear mot ion of the pusher-plate in the conventional pumps. We have evaluated two types of moving- actuator pump; one is a rolling cylinder type, and the other a pendulum type pump. In the rolling cylinder pump, frictional energy loss exists between the pump housing's guide bars and the actuator's end caps, while the bottom rack under the cylindrical actuator increases the height of the pump, the pump is therefor not implantable inside the small chest of human-sized animals with a body weight of less than 70kg. The new human type pump has a penduluous mot ion actuator to correct the above problems while maintaining the advantage of the moving- actuator's small total volume. The totally implantable TAH is composed of a blood pump, a control system and pheriperal equipments. The blood pump, which is constructed by a moving actuator, a right and left blood sac, and four artificial valves, is implanted in the thoracic. In 1988, the first implantation of the rolling cylinder TAH was performed into a female calf weighing 100kg, and the cal f recovered to the degree of voluntary standing and eat ing and survived to 100 hrs. We then survived two female sheep weighing about 63kg with the new human type TAH for three days.

• Journal of Sensor Science and Technology
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• v.9 no.1
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• pp.51-60
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• 2000

This paper outlines the development of a non-pulsatile axial flow type blood pump control system. By utilizing blood pressure and heart rate, this system can assist the left ventricle in controlling blood pressure and blood volume. The system is comprised of a blood pump, signal sensor, signal interface, and signal-processing component. A control algorithm is also proposed which can control non-pulsatile, continuous blood flow in the human circulatory system. To facilitate the control required for non-pulsatile blood pump in a physiological system, an experimental control rule was developed utilizing ECG and blood pressure data, both of which are easily detectable variables in the body. The system was then tested using a mock-up circulation system and we found that it is possible that this systems could be temporarily used in clinic.

• BMB Reports
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• v.39 no.4
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• pp.377-382
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• 2006

Oxidative stress occurs in patients undergoing coronary artery bypass operation. The aim of this study was to investigate the difference in oxidative stress in off-pump versus on-pump coronary artery bypass surgery. In the present study, in serial blood samples, plasma malondialdehyde (MDA) as index of lipid peroxidation, red blood cells glutathione peroxidase (GPx) and superoxide dismutase (SOD) were measured to compare the extent of oxidative stress in 30 patients undergoing OPCAB (off-pump coronary artery bypass grafting), 12 patients undergoing CABG (on-pump coronary artery bypass grafting) and 18 healthy controls. In CABG group, MDA levels increased significantly from $2.87{\pm}0.62\;nmol/mL$ before anesthesia and $2.87{\pm}0.65\;nmol/mL$ after anesthesia to $3.05{\pm}0.66\;nmol/mL$ after ischemia (p < 0.05). Similarly, SOD levels also elevated significantly from $661.58{\pm}78.70\;U/g$ Hb before anesthesia and $659.42{\pm}81.21\;U/g$ Hb anesthesia induction to $678.08{\pm}75.80\;U/g$ Hb after ischemia (p < 0.01, p < 0.01, respectively). In OPCAB group, only SOD levels increased from $581.73{\pm}86.24\;U/g$ Hb anesthesia induction to $590.90{\pm}88.90\;U/g$ Hb after reperfusion (p < 0.05). Glutathione peroxidase levels were not changed according to blood collection times in both of CABG group or OPCAB group (p > 0.05). Our results show that only mild signs of oxidative stress is found after reperfusion in OPCAB operation compared with CABG operation. Further studies are needed in order to confirm this hypothesis.

• Journal of Chest Surgery
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• v.28 no.12
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• pp.1079-1095
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• 1995

Recently endogenous digitalis-like substances were found in the blood of various cardiovascular diseases and they have been considered one of the causes of evoking hypertension. However, the mechanism of endogenous digitalis-like substances-induced hypertension is not clarified yet. Therefore, the effects of Na-K pump inhibition on the contractility of vascular smooth muscle[conduit and resistant artery were investigated, using organ bath and bioassay experiment. Aortic and carotid arterial rings[conduit artery and the branches of brachial and superior mesenteric artery[resistant artery were used to find the effect of Na-K pump inhibition. The results obtained were as followes;The magnitudes of contractions induced by norepinephrine, serotonin, or acetylcholine in all these arteries were significantly increased by the inhibition of Na-K pump. The increased contractile responses to these agonists, especially to serotonin, were much more prominant in resistant arteries. Nitroprusside-induced relaxations were attenuated by Na-K pump inhibition and there were no significant differences in the effects of Na-K pump inhibition on nitroprusside-induced relaxations of these blood vessels. Endothelium-dependent relaxation was suppressed by the inhibition of Na-K pump, especially by the administration of ouabain, and this inhibitory effect was much more prominent in the branches of superior mesenteric artery, compared with other arteries. In the branches of superior mesenteric arteries, endothelium-dependent relaxation was completely blocked by ouabain. The release of EDRF was partially suppressed by Na-K pump inhibition.From the above results, it is suggested that the hypertension due to the increase in vascular resistance can be evoked by the inhibition of Na-K pump and endogenous digitalis-like substances induce hypertension through this mechanism.

• Parasites, Hosts and Diseases
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• v.22 no.2
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• pp.203-208
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• 1984

This experiment shows cellular and humoral immune responses induced by soluble egg antigen of Schistosoma manscni, that is, change of the number of peripheral blood eosinophil, delayed hypersensitivity measured by the degree of ear swelling, granulomatous change of liver tissue and elevation of serum antibody titer by ELISA. SEA was given continuously by the insertion of a minipump into peritoneal cavity of mouse. In control group, same pump with HGG was inserted. New pump was eachansed once In two weeks and followed the result until 9 weeks after mini-pump insertion. 1. Highest peripheral blood eosinophil level was recorded at 2∼3 weeks after SEA punp insertion, 2. MaRirnum ear swelling was observed at 2 weeks arid then decreased gradually. 3. In liver tissue, several granulomas without egg were formed at 4 weeks. 4. Serum antibody titer was eleyated from 4 weeks after SEA pump insertion.

• 한국전산유체공학회:학술대회논문집
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• 2008.03b
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• pp.105-106
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• 2008

As a carrier of malaria and sneak of blood, mosquitoes are an unpleasant insect. However, there are several unknown natural secretes related with mosquitoes. Among them, we focused on the blood sucking process of a female mosquito. The main objective of this study is to understand the mosquito's blood sucking mechanism that can be used to resolve the problem encountered in the injection or transport of infinitesimal biological fluids in a micro-chip. At first, the velocity fields of blood-sucking flow in a proboscis were measured using a micro-particle image velocimetry (PIV) technique. The velocity signals of flow in the proboscis show periodic variation. This seems to be resulted from the beating of the pharyngeal pump which works as driving power. To analyze the pumping mechanism, the temporal variation of the pharyngeal pump was visualized using the synchrotron X-ray micro-imaging technique. The volume variation was estimated by the help of digital image processing techniques. Once the main mechanism of blood sucking process was found, a effective micro-pumping system with high efficiency would be developed in near future.

• International Journal of Fluid Machinery and Systems
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• v.7 no.1
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• pp.34-41
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• 2014

Computational fluid dynamics (CFD) and particle image velocimetry (PIV) are commonly used techniques to evaluate the flow characteristics in the development stage of blood pumps. CFD technique allows rapid change to pump parameters to optimize the pump performance without having to construct a costly prototype model. These techniques are used in the construction of a bi-ventricular assist device (BVAD) which combines the functions of LVAD and RVAD in a compact unit. The BVAD construction consists of two separate chambers with similar impellers, volutes, inlet and output sections. To achieve the required flow characteristics of an average flow rate of 5 l/min and different pressure heads (left - 100mmHg and right - 20mmHg), the impellers were set at different rotating speeds. From the CFD results, a six-blade impeller design was adopted for the development of the BVAD. It was also observed that the fluid can flow smoothly through the pump with minimum shear stress and area of stagnation which are related to haemolysis and thrombosis. Based on the compatible Reynolds number the flow through the model was calculated for the left and the right pumps. As it was not possible to have both the left and right chambers in the experimental model, the left and right pumps were tested separately.

• Advances in biomechanics and applications
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• v.1 no.2
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• pp.127-141
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• 2014

A preliminary study of a new pulsatile pump that will work to a frequency greater than 1 Hz, is presented. The fluid-structure interaction between a Newtonian blood flow and a piston drive that moves with periodic speed is simulated. The mechanism is of double effect and has four valves, two at the input flow and two at the output flow; the valves are simulated with specified velocity of closing and reopening. The simulation is made with finite elements software named COMSOL Multiphysics 3.3 to resolve the flow in a preliminary planar configuration. The geometry is 2D to determine areas of high speeds and high shear stresses that can cause hemolysis and platelet aggregation. The opening and closing valves are modelled by solid structure interacting with flow, the rhythmic opening and closing are synchronized with the piston harmonic movement. The boundary conditions at the input and output areas are only normal traction with reference pressure. On the other hand, the fluid structure interactions are manifested due to the non-slip boundary conditions over the piston moving surfaces, moving valve contours and fix pump walls. The non-physiologic frequency pulsatile pump, from the viewpoint of fluid flow analysis, is predicted feasible and with characteristic of low hemolysis and low thrombogenesis, because the stress tension and resident time are smaller than the limit and the vortices are destroyed for the periodic flow.

• Journal of Chest Surgery
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• v.47 no.4
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• pp.350-357
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• 2014

Background: Conservation of blood during cardiac surgery is important because of the shortage of donor blood, risks associated with transfusion, and the costs of allogeneic blood products. This retrospective study explored the feasibility of off-pump coronary artery bypass (OPCAB) without transfusion. Methods: One hundred and two consecutive patients underwent OPCAB from January 2007 to June 2012 at Hallym University Sacred Heart Hospital. Excluding 10 chronic renal failures patients, 102 patients were enrolled. Their characteristics, clinical data, and laboratory data were analyzed. We investigated the success rate of OPCAB without transfusion according to preoperative hemoglobin (Hb), and the cutoff point of the Hb level and the risk factors for transfusion. We implemented multidisciplinary blood-saving protocols. Results: The overall operative mortality and the success rate of OPCAB without transfusion were 2.9% (3/102) and 73.5% (75/102). The success rates in patients with Hb<11, 11 70 years, diagnosis of acute myocardial infarction, preoperative Hb and creatinine levels, and operation time. The events precipitating the need for transfusion were low Hb level in 9 patients and hypotension or excessive bleeding in 18 patients. Conclusion: The preoperative Hb level of >11 facilitates OPCAB without transfusion. These results suggest that transfusion-free OPCAB can be performed by modifying the risk factors and correctable causes of transfusion and improving various blood salvage methods.