• 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.

• YAKHAK HOEJI
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• v.31 no.5
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• pp.308-314
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• 1987

In cardiovascular disease the flow adaptation of erythrocytes can be affected by reduced shear stresses and metabolic influences on red cell fluidity as a consequence of tissue hypoxia. In addition there are indications that risk factors of cardiovascular diseases are able to decrease the intrinsic red cell deformability. Erythrocyte deformability was studied by the filtration technique of Reid et al. to investigate the relationship between blood pressure chances and erythrocyte deformability. In this experiment normotensive rats, spontaneously and DOCA-salt treated hypertensive rats were used. Erythrocyte deformability was significantly reduced by blood pressure elevation in hypertensive rats but was not fully recovered by normalization of blood pressure after antihypertensive drug treatment. Therefore other factors than blood pressure may be involved in erythrocyte deformability reduction during blood pressure elevation.

• 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.

• 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.

• International Journal of Vascular Biomedical Engineering
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• v.4 no.2
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• pp.7-12
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• 2006

The present study investigated the effects of the osmotic environment on the rheological properties of erythrocytes and their suspensions. In an iso-osmotic medium, erythrocytes forming a biconcave discocyte under resting conditions, exhibited high deformability. In a low-osmotic medium, the deformability of erythrocytes, which swelled and exhibited a spherical shape, significantly decreased at a high shear stress and the high-shear viscosity of the cell suspension was slightly higher than that of normal blood. Hyper-osmotic stress, however, which caused to form echinocytes, decreased cell deformability but exhibited smaller viscosity in low shear rates than iso-osmotic blood viscosity. These results showed a close relation with the aggregability measurements, in that hypertonic blood showed lower aggregability than the hypotonic and isotonic RBC suspensions. These findings indicate that the physicochemical environment has a strong influence on the rheological properties of the erythrocyte and its suspensions.

• 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.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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• 2005.12a
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• pp.29-30
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• 2005

• Transactions of the Korean Society of Mechanical Engineers A
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• v.32 no.10
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• pp.844-849
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• 2008

We present a novel cell deformability monitoring chip based on the digitally measured cell lysis rate which is dependent on the areal strain of the cell membrane. This method offers simple cell deformability monitoring by automated high-throughput testing system. We suggest the filter design considering the areal strain imposed on the cell membrane passing through the filter array having gradually increased orifice length. In the experiment using erythrocytes, we characterized the cell deformability in terms of average fracture areal strain which was $0.24{\pm}0.014\;and\;0.21{\pm}0.002$ for normal and chemically treated erythrocytes, respectively. We also verified that the areal strain of 0.15 effectively discriminates the deformability difference of normal and chemically treated erythrocytes, which can be applied to the clinical situation. We compared the lysis rates and their difference for the samples from different donors and found that the present chips can be commonly used without any calibration process. The experimental results demonstrate the simple structure and high performance of the present cell deformability monitoring chips, applicable to simple and cost-effective cell aging process monitoring.

• 순환기질환의공학회:학술대회논문집
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• 2004.11a
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• pp.52-53
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• 2004