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S Ohtsubo

Publications and source records attributed to S Ohtsubo.

At least 37 records · Page 2Linked to original sources
PubMed1997

The hemolysis test of the Gyro C1E3 pump in pulsatile mode.

While a centrifugal pump is generally used for nonpulsatile blood flow, it can also produce a pulsatile flow by alternating the impeller rotational speed (rpm) periodically. However, there is a concern that this centrifugal pump pulsatile mode may induce added hemolysis as a result of the repeated acceleration and deceleration of rpm. Thus, a hemolysis study of the pulsatile modes of the Gyro C1E3 centrifugal pump (Gyro-P) was conducted. The results were then compared with the nonpulsatile mode of the same pump (Gyro-N) and the nonpulsatile BioMedicus BP-80 (Bio-N) pump. Three different conditions were simulated: left ventricular assist device (LVAD), cardiopulmonary bypass (CPB), and percutaneous cardiopulmonary support (PCPS). The beating rate of the Gyro-P was set at 40 bpm, with repetition of two different impeller speed (the lower being 70% of the higher speed). The 2 impeller speeds were set to obtain the same average flow as that of the nonpulsatile mode. The hemolysis results of the Gyro-P were comparable to or better than those of Bio-N, and no excessive hemolysis was observed, compared to the Gyro-N. In conclusion, The Gyro-P had an excellent hemolytic characteristic and generated no excessive hemolysis in most clinical usage conditions. With the concern of hemolysis eliminated, this pulsatile mode may have various possible mode advantages.

Analysis of Variance↗
PubMed1997

Reconsideration of total erythrocyte destruction phenomenon.

During a particular long-term in vitro hemolysis test, the plasma free hemoglobin suddenly increased even though the hemolysis level had risen linearly for the previous several hours. This phenomenon was dubbed the total destruction of erythrocytes (TDE) phenomenon, and it was hypothesized that this was the result of the accumulation of sublethal damage to erythrocytes. It was suggested that the TDE might demonstrate the hemolytic characteristics of a pump more sensitively than a conventional hemolysis test. However, the previous report did not consider the effects of temperature or contamination. To study these effects, 3 long-term hemolysis tests were concluded under the following conditions. For Study 1 blood temperature was maintained at 27 degrees C (n = 2); for Study 2, at 37 degrees C (n = 4); and for Study 3, at 37 degrees C with gentamicin (n = 4). The BioMedicus and Nikkiso pumps were used as they were in our previous report. Gas sterilization of all circuits and pumps preceded experimentation. In Studies 1 and 3, hemolysis increased linearly for 29 h. However, in Study 2 a sudden increase of hemolysis occurred for both pumps. Possible causes of this were the dramatic changes in environmental factors such as severe acidosis, high O2 and glucose consumption, and CO2 accumulation. In contrast, neither Study 1 nor Study 3 showed a sudden increase in hemolysis. The plasma free hemoglobin increased linearly in both groups until 29 h of pumping. The environmental changes resulting from contamination were considered to be the cause of the sudden increase in hemolysis. In conclusion, the TDE did not reflect mechanical blood cell damage, but rather different environment situations. Hemolysis increased linearly up to 29 h in either 27 degrees C or germ-free conditions.

Animals↗
PubMed1997

In vitro thrombogenic evaluation of centrifugal pumps.

One of the major considerations in the development of a circulatory assist device is its antithrombogenecity. Although the precise evaluation should be accomplished by in vivo tests, these tests are costly and require a relatively long period. In this study, we established a simple in vitro test and assessed feasibility using 2 clinically available centrifugal pumps, the BioMedicus and Nikkiso pumps. Two identical mock loops were fabricated, and fresh heparinized human blood (activated clotting time of 150-250 s) was circulated at 5 L/min against a total pressure head of 100 mm Hg. After 3 h of pumping, only the BioMedicus pumps had thrombi while the Nikkiso pumps were thrombus free. Following 6 h of pumping, thrombi were observed in both pumps. Clotting patterns and locations were reproducible in each pump and similar to the results of clinical or ex vivo studies. This simple in vitro test was considered to be feasible as a pilot study, particularly to predict thrombogenic sites.

Centrifugation↗
PubMed1997

A pivot bearing-supported centrifugal pump for a long-term assist heart.

A pivot bearing-supported centrifugal blood pump has been developed. It is a compact, cost effective, and anti-thrombogenic pump with anatomical compatibility. A preliminary evaluation of five paracorporeal left ventricular assist studies were performed on pre-conditioned bovine (70-100 kg), without cardiopulmonary bypass and aortic cross-clamping. The inflow cannula was inserted into the left ventricle (LV) through the apex and the outflow cannula affixed with a Dacron vascular graft was anastomosed to the descending aorta. All pumps demonstrated trouble free performance over a two-week screening period. Among these five studies, three implantations were subjected for one month system validation studies. All the devices were trouble free for longer than 1 month. (35, 34, and 31 days). After achieving one month studies, all experiments were terminated. There was no evidence of device induced thrombus formation inside the pump. The plasma free hemoglobin levels were within normal ranges throughout all experiments. As a consequence of these studies, a mass production model C1E3 of this pump was fabricated as a short-term assist pump. This pump has a Normalized Index of Hemolysis of 0.0007 mg/100L and the estimated wear life of the impeller bearings is longer than 8 years. The C1E3 will meet the clinical requirements as a cardiopulmonary bypass pump. For the next step, a miniaturized pivot bearing centrifugal blood pump P1-601 has been developed for use as a permanently implantable device after design optimization. The evolution from C1E3 to the PI-601 converts this pivot bearing centrifugal pump as a totally implantable centrifugal pump. A pivot bearing centrifugal pump will become an ideal assist pump for the patients with failing heart.

Animals↗
PubMed1996

Development of a pivot bearing supported sealless centrifugal pump for ventricular assist.

Since 1991, in our laboratory, a pivot bearing-supported, sealless, centrifugal pump has been developed as an implantable ventricular assist device (VAD). For this application, the configuration of the total pump system should be relatively small. The C1E3 pump developed for this purpose was anatomically compatible with the small-sized patient population. To evaluate antithrombogenicity, ex vivo 2-week screening studies were conducted instead of studies involving an intracorporeally implanted VADs using calves. Five paracorporeal LVAD studies were performed using calves for longer than 2 weeks. The activated clotting time (ACT) was maintained at approximately 250 s using heparin. All of the devices demonstrated trouble-free performances over 2 weeks. Among these 5 studies, 3 implantations were subjected to 1-month system validation studies. There were no device-induced thrombus formations inside the pump housing, and plasma-free hemoglobin levels in calves were within the normal range throughout the experiment (35, 34, and 31 days). There were no incidents of system malfunction. Subsequently, the mass production model was fabricated and yielded a normalized index of hemolysis of 0.0014, which was comparable to that of clinically available pumps. The wear life of the impeller bearings was estimated at longer than 8 years. In the next series of in vivo studies, an implantable model of the C1E3 pump will be fabricated for longer term implantation. The pump-actuator will be implanted inside the body; thus the design calls for substituting plastic for metallic parts.

Blood Cell Count↗
PubMed1996

Comparison of centrifugal and roller pump hemolysis rates at low flow.

We compared in vitro rates of hemolysis for a recently developed centrifugal pump with a conventional roller pump (10-10-00; Stöckert, Munich, Germany). Flow rates of 0.3 L/min and 1 L/min and a pressure of 200 mm Hg were chosen to simulate conditions during neonatal extracorporeal membrane oxygenation (ECMO). There was no significant difference in hemolysis rates between centrifugal and roller pumps (p = 0.57) nor between high and low flow (p = 0.86). The centrifugal pump caused no more blood trauma than the roller pump at the low-flow/high-pressure conditions required for neonatal ECMO. The Nikkiso pump is superior to roller pumps in size and priming volume (25 ml) and may permit development of a smaller and simpler ECMO system.

Animals↗
PubMed1996

Clinical comparative study of cardiopulmonary bypass with Nikkiso and BioMedicus centrifugal pumps.

The Nikkiso centrifugal pump was evaluated in elective adult open heart surgery in comparison with the BioMedicus pump. Ten patients using the Nikkiso pump (Group N), and 10 patients using the BioMedicus pump (Group B) were examined for (or to determine) hematobiologic parameters and patient outcome data as well as pump controllability. During cardiopulmonary bypass (CPB), both pumps maintained systemic perfusion satisfactorily without any mechanical adverse event. Rotation speed of the Nikkiso centrifugal pump (3,580 +/- 100 rpm) was significantly higher than that of the BioMedicus pump (3,170 +/- 100 rpm; p < 0.05) whereas changes in free plasma hemoglobin, platelet count, blood urea nitrogen, and creatinine levels showed no significant differences between the two groups. Urine output in Group N for 20 min after the initiation of CPB (7.10 +/- 1.50 ml/kg/h) was significantly higher than that in Group B (3.23 +/- 0.46 ml/kg/h; p < 0.05). Patient outcome data were similar in both groups, such as duration of intensive care unit stay, hospital stay, postoperative intubation time, amount of postoperative bleeding, and amount of blood transfused. These equivalent results with the BioMedicus pump suggested that the Nikkiso pump can be used in open heart surgery as a reliable and atraumatic CPB pump.

Adult↗
PubMed1996

Morphological changes of autoclaved autogenic bone implantation and autoclaved autogenic bone supplemented with allogenic demineralized bone matrix in rat parietal bone.

The healing process of resected, autoclaved (121 degrees C, 20 minutes) and re-implanted bone in the rat parietal bone was compared with that of autoclaved bone that was supplemented with allogenic bone matrix (AAA-bone), using a scanning electron microscope and a light microscope. In the implant without AAA-bone, bone union and replacement of the autoclaved bone was seen at 2 weeks after implantation. There was no evidence of any inflammatory reaction around the autoclaved bone. The implant was gradually replaced by the new bone. In the implant with AAA-bone, the new bone formation around the implanted bone was more abundant than that of the implant without AAA-bone. An inflammatory reaction was also observed after 1 week. The replacement of the implant with AAA-bone was inferior to the nonsupplemented group. The reason for the poor replacement was the disturbance of the blood supply in the implant by abundant new bone formation. In these results, the autoclaved bone re-implantation was an excellent bone substitute with osteoconductive ability and biocompatibility. The implantation with AAA-bone was good for the new bone formation, but the position and the technique of supplement with AAA-bone have to be more deeply investigated.

Animals↗
PubMed1995

Initial clinical experience with the Baylor-Nikkiso centrifugal pump.

Recently, a newly developed centrifugal pump, the Baylor-Nikkiso pump, was approved for clinical use in the United States. This pump is the most compact centrifugal pump with a priming volume of only 25 ml. Although it is small, this pump can provide a flow of 4 L/min against a total pressure head of 300 mm Hg at 3,000 rpm. In vitro and in vivo validation of the Baylor-Nikkiso pump has proved that this pump could effectively reduce blood trauma even under high total head pressure. In addition, 48-h durability tests with biventricular bypass using calves verified the reliability of shaft sealing and antithrombogenicity. Clinical trials of the Baylor-Nikkiso pumps have been initiated in our department. This pump provides flows of 60-70 ml/kg/min with stable hemodynamic conditions. No leakage of thrombus formation was observed. The results of the initial clinical experience of the Baylor-Nikkiso pump suggest that it is suitable for cardiopulmonary bypass surgery.

Animals↗
PubMed1995

Scanning electron and light microscopic observations on the healing process after sintered bone implantation in rats.

The healing process after implantation of sintered bone in the rat parietal bone was compared with that of synthetic hydroxyapatite using both scanning electron and light microscopy. The results showed that the differences between the sintered natural bone and the synthetic hydroxyapatite implantations were in the states of bone union and the bioresorbability of the implanted materials, even though both materials consist of the same hydroxyapatite. In the sintered bone implantation, the newly formed bone invaded into the material at 1 to 2 weeks after implantation. The sintered bone surface on the dura mater side was completely covered by the new bone at 5 weeks. It is noteworthy that bone resorbing areas characterized by Howship's lacunae were observed on the sintered bone surface at 2 weeks and the material was replaced by new bone. Light microscopy, which revealed the invasion and the development of the new bone into the sintered bone, supported the scanning electron microscopic observations. In the synthetic hydroxyapatite, the new bone adhered closely to the material just like the sintered bone implantation. The new bone did not invade into the synthetic hydroxyapatite. There was no evidence of the resorption of the hydroxyapatite. This shows that the natural and the biological structures of the sintered bone offer an advantageous environment to fluid circulation and ingrowth after implantation.

Animals↗
PubMed1994

[Congenital isolated tricuspid insufficiency in an elderly woman].

Isolated congenital tricuspid insufficiency due to primary malformation of the tricuspid valve is rare. The patient was a 70-years-old woman complaining of exertional dyspnea. Cardiac echo-sonography and catheterization showed severe TR with no other cardiac abnormality. At surgery, the anterior leaflet of the tricuspid valve was hypoplastic and attached to the right ventricle with shortened chorda. Tricuspid valve replacement was successfully performed with a 31 mm Carpentier-Edwards pericardial valve. The postoperative clinical course was smooth. This is the oldest known reported case of a successful operation for congenital tricuspid insufficiency.

Aged↗
PubMed1993

[A case of acute postinfarction mitral regurgitation and cardiogenic shock caused by a total rupture of the papillary muscle].

We report a case of mitral regurgitation caused by a total rupture of the posterior papillary muscle that had occurred after acute myocardial infarction. A 72-year-old woman was transferred to our hospital for cardiogenic shock. Echocardiogram revealed massive mitral regurgitation and prolapse of posterior mitral leaflet presumably due to a rupture of a papillary muscle. Cardiac catheterization demonstrated a total occlusion in the segment 2 of the right coronary artery. She had developed progressively increasing heart failure even though the patient had received a successful PTCA for a total occlusion of the right coronary artery. She underwent an emergency mitral valve replacement with preservation of the posterior leaflet using a SJM prosthetic valve. Intraoperative findings were confirmative of total rupture of the posterior papillary muscle. A postoperative course was uneventful. This case is the seventh case which has been reported as the successful operation of a total rupture of the papillary muscle in Japan.

Aged↗
PubMed1992

Comparison of acetate utilization among strains of an aceticlastic methanogen, Methanothrix soehngenii.

The kinetics of acetate utilization by concentrated suspensions of cells was examined in five strains of Methanothrix soehngenii. The rate of acetate utilization by all strains was dependent on the initial acetate concentration and followed simple Michaelis-Menten kinetics. The ability to utilize acetate differed among the various strains of M. soehngenii and was highest in the strain designated MTAS.

Acetates↗
PubMed1992

[Syphilitic coronary ostial obstruction and aortic regurgitation associated with advanced gastric cancer: successful 2-stage surgery].

We report a case of syphilitic coronary ostial obstruction and aortic regurgitation associated with advanced gastric cancer for which subtotal curative gastrectomy and AVR with CABG was successfully performed in a two-stage operation. A 65-year-old male was admitted complaining of tarry stool and angina. A serological test for syphilis was strongly positive and angiography demonstrated a left coronary ostial obstruction accompanied by moderate aortic regurgitation. An endoscopic examination of the stomach revealed a Borrmann type II advanced gastric cancer with active bleeding. In the first stage, a subtotal gastrectomy with wide margin was performed, under hemodynamic monitoring because of the active tumoral bleeding. After the second-stage AVR, the postoperative course was uneventful.

Adenocarcinoma, Mucinous↗
PubMed1991

[Marfan's syndrome with annulo-aortic ectasia and ruptured mitral chorda--a case report of combined composite valve graft replacement of the aortic root and mitral valve replacement].

We report a case of Marfan's syndrome with acute heart failure caused by a ruptured mitral chorda that was successfully treated by one operation of combined composite valve graft replacement of aortic root and mitral valve replacement (MVR). A 23-year-old man was admitted to our hospital presenting severe dyspnea and chest pain. Echocardiography and cardiac catheterization studies demonstrated marked annulo-aortic ectasia, aortic regurgitation and significant mitral regurgitation due to a ruptured chorda. In operation, it was found that a chorda of the mitral posterior leaflet had been torn, with the leaflet completely prolapsed to the left atrium, and that the aortic root was dilated to 90 mm in diameter. The ascending aorta was extensively resected leaving those areas of aortic tissue involving the coronary ostia. Then the mobilized coronary arteries were reattached to the composite graft. MVR was performed with preservation of the whole anterior and posterior mitral valve apparatus except for that small part with the torn chorda. Histopathological findings of the aortic wall and mitral valve were compatible with those of Marfan's syndrome.

Adult↗
PubMed1989

Germanium myopathy: clinical and experimental pathological studies.

Pathological examinations were carried out on the skeletal muscle of a patient with germanium intoxication. The prominent histochemical finding was vacuolar myopathy with lipid excess, increased acid phosphatase activity and decreased cytochrome c oxidase activity. Ultrastructural lesions revealed a mitochondrial abnormality, autophagic vacuoles and accumulation of high electron-dense materials in deformed mitochondria and at the periphery of lipid droplets. Furthermore, the toxic effect of germanium on skeletal muscle was confirmed by the experimentally induced germanium myopathy, which showed autophagic degeneration, decreased cytochrome c oxidase activity and a mitochondrial abnormality with high electron-dense materials.

Child, Preschool↗