• Korea-Australia Rheology Journal
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• v.17 no.3
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• pp.117-123
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• 2005

Background: Reduced deformability of red blood cells (RBCs) may play an important role on the pathogenesis of chronic vascular complications of diabetes mellitus. However, available techniques for measuring RBC deformability often require washing process after each measurement, which is not optimal for day­to-day clinical use at point of care. The objectives of the present study are to develop a device and to delineate the correlation of impaired RBC deformability with diabetic nephropathy. Methods: We developed a disposable ektacytometry to measure RBC deformability, which adopted a laser diffraction technique and slit rheometry. The essential features of this design are its simplicity (ease of operation and no moving parts) and a disposable element which is in contact with the blood sample. We studied adult diabetic patients divided into three groups according to diabetic complications. Group I comprised 57 diabetic patients with normal renal function. Group II comprised 26 diabetic patients with chronic renal failure (CRF). Group III consisted of 30 diabetic subjects with end-stage renal disease (ESRD) on hemo-dialysis. According to the renal function for the diabetic groups, matched non-diabetic groups were served as control. Results: We found substantially impaired red blood cell deformability in those with normal renal function (group I) compared to non-diabetic control (P = 0.0005). As renal function decreases, an increased impairment in RBC deformability was found. Diabetic patients with chronic renal failure (group II) when compared to non-diabetic controls (CRF) had an apparently greater impairment in RBC deformability (P = 0.07). The non-diabetic cohort (CRF), on the other hand, manifested significant impairment in red blood cell deformability compared to healthy: control (P = 0.0001). Conclusions: The newly developed slit ektacytometer can measure the RBC deformability with ease and accuracy. In addition, progressive impairment in cell deformability is associated with renal function loss in all patients regardless of the presence or absence of diabetes. In diabetic patients, early impairment in RBC deformability appears in patients with normal renal function.

• Journal of the Korean Society of Visualization
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• v.18 no.3
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• pp.103-108
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• 2020

RBC (red blood cell) deformability is one of factors inducing blood shear thinning effect. Reduction of RBC deformability increases blood viscosity in high shear region. In this study, 3D printed chip with proper distribution of wall shear rate (WSR) was proposed to measure RBC deformability of blood samples. To fabricate 3D printed chip, the design of 3D printed chip determined through numerical simulation was modified based on the resolution of the 3D printer. For the estimation of pressure drop in the 3D printed chip, two bypass outlets with low and high WSR are exposed to atmospheric pressure through the needles. By positioning the outlet of needles in the gravity direction, the formation of droplets at bypass outlets can be captured by smartphone. Through image processing and fast Fourier transform (FFT) analysis, the frequency of droplet formation was analyzed. Since the frequency of droplet formation is related with the pressure at bypass, high pressure drop caused by reduction of RBC deformability can be estimated by monitoring the formation of blood droplets using the smartphone.

• Korea-Australia Rheology Journal
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• v.16 no.2
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• pp.85-90
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• 2004

The present study investigated the deformability of red blood cells (RBC) and its effect on whole blood viscosity using a laser-diffraction slit-rheometer (LDSR). The LDSR has been recently developed with significant advances in laser-diffractometry design, operation and data analysis. While shear stress levels in a slit flow are continuously decreasing, both the deformation of red blood cells and the shear stress were simultaneously measured. Additionally, the viscosity of whole blood was measured using the LDSR. The present study found that the whole blood viscosity is strongly dependent on the RBC deformability. The less deformable the RBCs are, the higher the blood viscosity is.

• Proceedings of the KSME Conference
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• 2004.11a
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• pp.1505-1509
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• 2004

The suspension of hardened red blood cells (RBCs) differs from the suspension of normal RBCs with respect to their rheological behavior. The deformability of normal and hardened RBCs (obtained by heating blood at $49^{\circ}C$ or by incubating RBCs in a solution of hydrogen peroxide) was measured with a slit diffractometer and RBC suspension viscosity was measured with a rotational viscometer. The peroxide-treated RBCs showed a significant decrease of the deformability and their suspension viscosity increased over a range of shear rates. The suspension viscosity of the heated RBCs, however, where the deformability is even lower than that of the peroxide-treated RBCs, was slightly higher than that of the normal RBC suspension in the high shear rates. The present study found that not all rigid cells cause an increase of blood viscosity at high shear rate, and therefore that decreased membrane deformability is not predictive of high-shear blood viscosity.

• Korea-Australia Rheology Journal
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• v.21 no.2
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• pp.127-133
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• 2009

Hemorheological results may be influenced by the time between blood sampling and measurement, and storage conditions (e.g., temperature, time) during sample delivery between laboratories may further affect the resulting data. This study examined possible hemorheological alterations subsequent to storage of rat and dog blood at room temperature ($22^{\circ}C$) or with cooling ($4{\sim}10^{\circ}C$) for 2, 4, 6, 24, 48 and 72 hours. Measured hemorheological parameters included hematological indices, RBC aggregation and RBC deformability. Our results indicate that marked changes of RBC deformability and of RBC aggregation in whole blood can occur during storage, especially for samples stored at room temperature. The patterns of deformability and aggregation changes at room temperature are complex and species specific, whereas those for storage at the lower temperature range are much less complicated. For room temperature storage, it thus seems logical to suggest measuring rat and dog cell deformability within 6 hours; aggregation should be measured immediately for rat blood or within 6 hours for dog blood. Storage at lower temperatures allows measuring EI up to 72 hours after sampling, while aggregation must be measured immediately, or if willing to accept a constant decrease, over 24~72 hours.

• Proceedings of the KSME Conference
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• 2004.04a
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• pp.1682-1686
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• 2004

A slit-flow apparatus with laser diffraction method has been developed with significant advances in ektacytometry design, operation and data analysis. In the slit-flow ektacytometry (or laser-diffractometry), the deformation of red blood cells subjected to continuously decreasing shear stress in slit flow is measured. A laser beam traverses a diluted blood suspension flowing through a slit and is diffracted by RBCs in the volume. The diffraction patterns are captured by a CCD-video camera, linked to a frame grabber integrated with a computer, while the differential pressure variation is measured by a pressure transducer. Both measurements of laser-diffraction image and pressure with respect to time enable to determine deformation index and the shear stress. The range of shear stress of 0 ${\sim}$ 35 Pa and measuring time is less than 2 min. When deforming under decreasing shear stress, RBCs change gradually from the prolate ellipsoid towards a circular biconcave morphology. The Deformation Index (DI) as a measure of RBC deformability is determined from an isointensity curve in the diffraction pattern using an ellipse-fitting program. The advantages of this design are simplicity, i.e., ease of operation and no moving parts, low cost, short operating time, and the disposable kit which is contacted with blood sample.

• 순환기질환의공학회:학술대회논문집
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• 2002.11a
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• pp.3-18
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• 2002

Hemorheology plays an important role in atherosclerosis. Hemorheologic properties of blood include whole blood viscosity, plasma viscosity, hemaocrit, RBC deformability and aggregation, and fibrinogen concentration in plasma. Blood flow is determine by three parameters (pressure, lumen diameter, and whole blood viscosity), whole blood viscosity is one of the key physiological variables. However, the significance of whole blood viscosity has not yet not been fully appreciated. Whole blood viscosity has a unique property, non-Newtonian shear-thinning characteristics, which is primarily due to the presence of RBCs. Hence, RBC deformability and aggregation directly affect the magnitude of blood viscosity, and any factors or diseases affecting RBC characteristics influence blood viscosity. Therefore, on can see that whole blood viscosity is the causal mechanism by which traditional risk factors such as hypertension, hyperlipidemia, smoking, exercise, obesity, age, and gender are related to atherogenesis. In this regard, we included whole blood viscosity in the three key determinants of injurious pulsatile flow that results in mechanical injury and protective adaptation in the arterial system. Because whole blood viscosity is a potential predictor of cardiovascular diseases, it should be measured in routine cardiovascular profiles. Incorporating whole blood viscosity measurements into a standard clinical protocol could improve our ability to identify patients at risk for cardiovascular disease and its complications.

• Korea-Australia Rheology Journal
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• v.16 no.3
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• pp.141-146
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• 2004

Shear-induced damage of Red Blood Cell (RBC) is an imminent problem to be solved for the practical application of artificial organs in extra corporeal circulation, as it often happens and affects physiological homeostasis of a patient. To design and operate artificial organs in a safe mode, many investigations have been set up to correlate shear and shear-induced cell damage. Most studies were focused on hemolysis i.e. the extreme case, however, it is important as well to obtain a clear understanding of pre-hemolytic mechanical damage. In this study, the change in deformability of RBC was measured by ektacytometry to investigate the damage of RBC caused by shear. To a small magnitude of pre-shear, there is little difference, but to a large magnitude of pre-shear, cell damage occurs and the effect of shear becomes significant depending on both the magnitude and imposed time of shearing. The threshold stress for cell damage was found to be approximately 30 Pa, which is much less than the threshold of mechanical hemolysis but is large enough to occur in vitro as in the extra corporeal circulation during open-heart surgery or artificial heart. In conclusion, it was found and suggested that the decrease of deformability can be used as an early indication of cell damage, in contrast to measuring plasma hemoglobin. As cell damage always occurs during flow in artificial organs, the results as well as the approach adopted here will be helpful in the design and operation of artificial organs.

• 순환기질환의공학회:학술대회논문집
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• 2003.11a
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• pp.42-43
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• 2003

• 순환기질환의공학회:학술대회논문집
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• 2003.11a
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• pp.40-41
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• 2003