Recent advances in the gyro centrifugal ventricular assist device

The gyro pump was developed as an intermediate-term assist pump (C1E3) as well as a long-term centrifugal ventricular assist device (VAD). The antithrombogenic design concept of this pump was confirmed throughout three 1 month ex vivo studies. The normalized index of hemolysis (NIH) of this gyro C1E3 model was lower than that of the BP-80. In the next step, a miniaturized centrifugal blood pump (The Gyro permanently implantable model PI-601) has been developed for use as a permanently implantable device after design optimization. A special motor design of the magnet circuit was utilized in this system in collaboration with the University of Vienna. The priming volume of this pump is 20 ml. The overall size of the pump actuator package is 53 mm in height, 65 mm in diameter, 145 ml of displacement volume, and 305 g in weight. This pump can provide 5 L/min against 120 mm Hg total pressure head at 2,000 rpm. The NIH value of this pump was comparable to that of the BP-80. The gyro PI-601 model is suitable for a VAD. The expected life from the endurance study is approximately 8 years. The evolution from C1E3 to the PI-601 converts this pump to a totally implantable centrifugal pump. Recent technologic advances in continuous flow devices are likely to realize a miniaturized and economical totally implantable VAD.

[Current treatment burn wounds: alternative wound coverage methods]

In patients with massive burn injuries and very limited skin donor sites, both acute-phase and long-term problems of skin loss must be solved by the use of alternative wound closure materials. Alternative materials can be used for either temporary wound coverage or for permanent wound closure. Recently, allogenic skin grafts have most commonly been used as alternative wound closure material. However, research is ongoing on many new materials to provide a readily available substitute for skin allografts for permanent wound closure. The best approach to the development of alternative permanent wound closure materials is to incorporate the host's own cellular and structural components. Four general strategies have been devised so far based on the type of matrix structure and cellular content: allografts; cultured epidermal grafts; dermal matrix grafts; and cultured-dermal matrix composite grafts. Several approaches using combined alternative wound closure materials have been used, including transplantation of artificial dermal matrix with thin epidermal autografts, and transplantation of artificial dermal matrix containing human fibroblasts. Ultimately, the best candidate materials for permanent wound closure after extensive burn injury must be determined in prospective, randomized, controlled clinical trials.

The simple in vitro thrombogenic test: modified methods for same priming pumps

The improvement of antithrombogenicity is one of the major objectives for the development of blood pumps. Previously we reported that an in vitro thrombogenic test was useful as a pilot study, especially to predict thrombogenic areas. In this study we modified the method for testing pumps with identical priming volumes by eliminating the blood reservoir. Identical compact mock loops (priming volume of 53 ml, without pump) were constructed and tested with the same priming volume of Nikkiso centrifugal pumps, noncoated verus heparin-coated. Two pumps were run simultaneously using the same source of fresh heparinized human blood (activated clotting time [ACT] 150-250 s) for 4 or 6 h. Results indicated that the heparin-coated pump had a longer thrombus free period than the noncoated one. The thrombi location and forms were consistently in the same places the in vivo study had identified. It is suggested that this modified in vitro thrombogenic test is a feasible pilot study, as well as the one previously reported. The minimal priming volume will allow evaluation of multiple pumps simultaneously with the same source blood.

Estimation of the minimum pump speed to prevent regurgitation in the continuous flow left ventricular assist device: left ventricular drainage versus left atrial drainage

Due to the fact that centrifugal and axial pumps do not require valves, there is a possibility of back flow when the pump speed is low. To estimate the minimum required pump speed to prevent this regurgitation, an in vitro simulation test was conducted. A pulsatile pump simulated the natural heart while a centrifugal pump simulated the continuous flow left ventricular assist device (LVAD). The LVAD flow was attained from the left atrial (LA) drainage or left ventricular (LV) drainage. The minimum or regurgitate flow was observed in the systolic phase with LA drainage and in the diastolic phase with LV drainage. LV drainage always provided higher flow than LA drainage at the same pump speed. These differences are due to the various total pressure heads of the LVAD. To prevent the regurgitation, the LVAD should maintain a certain pump speed which can create positive flow against the aortic systolic pressure with LA drainage and against the aortic diastolic pressure with LV drainage. These required pump speeds can be identified by the LVAD flow-pressure curve.

Quantitative approach to control spinning stability of the impeller in the pivot bearing-supported centrifugal pump

The Gyro C1E3 pump has been developed as a completely sealless centrifugal pump driven by a magnetic coupling system for long-term usage. The Gyro C1E3 pump is a pivot bearing-supported pump in which the impeller is supported with the top and bottom pivot bearings. In the Gyro C1E3 pump, the impeller spinning is affected by the force balance between the floating force (Ff[N]) of the hydrodynamic effect and the magnetic thrust force (Tf[N]). The authors quantitatively investigated the floating force of the impeller in vitro to determine the magnetic coupling distance (MCD[mm]) that would result in stable impeller spinning. In vitro tests were performed using a loop filled with 37% glycerin solution to obtain the relationship between the MCD and floating speed (Rf, rotational speed when the impeller starts floating [rpm]) and the relationship between the MCD and Tf. From the obtained relationships, we calculated Ff and determined the relationship between the Ff and the rotational speed (R). Furthermore, we determined the relationship between d (minimum required MCD [mm]) and R from the results of determining the relationship of the MCD and Tf and of the Ff and R. The following relationships were obtained: Rf = 6.24 x 10(4) x MCD-1.35; Tf = 5.27 x 10(3) x MCD-2.29; Ff = 4.71 x 10(-6) x RPM1.69; and d = 9.02 x RPM-0.85 where RPM is the rotational speed. It was demonstrated that the floating force of the impeller is a function only of the rotational speed in the pivot bearing-supported Gyro C1E3 pump. The floating force is estimated to be 10 N to 40 N at rotational speeds of 1,500 rpm to 3,000 rpm at which the Gyro pump may be used in most clinical situations. It would be possible to control the impeller position of the Gyro pump automatically at the stable spinning condition by controlling the adequate magnetic coupling distance based upon its relationship with the rotational speed which was obtained in this study.

Hemolysis test of a centrifugal pump in a pulsatile mode: the effect of pulse rate and RPM variance

Centrifugal pumps are generally employed as nonpulsatile blood flow pumps; however, these pumps can produce pulsatile flow by periodically alternating the impeller rotation speed. This study investigates blood trauma due to the effect of pulse frequency and various ranges of pump speed. The hemolysis tests were conducted using the Gyro C1E3 pump. The study was divided into the following categories: Group 1 in a nonpulsatile mode; Group 2 operated at 40 bpm with 30% of speed variance; Group 3, 60 bpm with 30% of speed variance; Group 4, 40 bpm with 70% of speed variance; and Group 5, 60 bpm with 70% of speed variance. A flow rate of 3 L/min and a total pressure head of 200 mm Hg were employed in all groups to simulate a percutaneous cardiopulmonary support condition. There were no significant differences in the hemolysis levels among Groups 1, 2, and 3. However, Groups 4 and 5 exhibited a significantly higher hemolysis rate compared to the other groups. These results indicate that a high rate of speed variance increases hemolysis; however, a range of less than 30% does not affect hemolysis. The pulse rate has no significant effect on hemolysis. In conclusion, the higher speed variance increases the hemolysis level when a pulsatile mode is applied with a centrifugal pump at the given test conditions. However, a speed variance of less than 30% or a pulse rate of less than 60 bpm does not affect hemolysis.

A single copy of linker H1 genes is enough for proliferation of the DT40 chicken B cell line, and linker H1 variants participate in regulation of gene expression

BACKGROUND

There is general agreement that large numbers of histone H1 are necessary for maintenance of the higher order structure of chromatin in higher eukaryotes. The chicken H1 gene family comprises six members per haploid genome, the total copy number being 12, and they encode six H1 variants which are considerably different from each other in amino acid sequence. We recently established that in two chicken DT40 mutants (1/2delta110kb and delta57kb), which lack, respectively, one allele of the gene cluster of 110 kb carrying six H1 genes, plus 33 core histone genes, and two copies each of four of the six H1 genes included in an approximately 57 kb segment of the cluster, expression of the remaining H1 genes is increased, resulting in constant steady-state levels of total H1 mRNAs. These results gave rise to the simple questions of how many H1 genes and how many H1 variants, at minimum, are necessary for the viability of DT40 cells.

RESULTS

We generated two DT40 mutants, delta10/12H1 and delta11/12H1, which are devoid, respectively, of two copies each of five H1 genes, and those plus a single copy of the last H1 gene, in addition to 17 core histone genes. Analyses involving a RNase protection assay, SDS-PAGE and acid-urea-PAGE revealed, not only that in the delta10/12H1 mutant the steady-state levels of total H1 mRNAs and the amounts of histone H1 were not changed, but also that in the delta11/12H1 mutant both were approximately one-half the normal levels, and the amounts of HMG proteins were increased about twofold. No alteration in the growth rate or global chromatin structure was observed in either mutant. On the other hand, the protein patterns on 2D-PAGE of the delta11/12H1 mutant were definitely distinct from those of the wild-type cell line.

CONCLUSION

These results indicate not only that a lack of five of the six H1 variants causes changes in the protein patterns, but also that only a single copy of the H1 genes is enough for cell proliferation.

One allele of the major histone gene cluster is enough for cell proliferation of the DT40 chicken B cell line

Thirty-nine of the 44 chicken histone genes are located in a major histone gene cluster of 110 kb, the others residing in four separate regions. We generated a heterozygous chicken DT40 mutant, 1/2 delta110 kb, devoid of one allele of the cluster, using gene targeting techniques. Analyses of the mutant revealed that the growth rate of DT40 cells was unchanged even in the absence of one allele of the cluster. Moreover, analyses involving a RNase protection assay, SDS-PAGE or Triton-acid-urea-PAGE revealed not only that in the 1/2 delta110 kb mutant the steady-state levels of total mRNAs of gene families H1, H2A, H2B, H3 and H4 remained constant, but also that the amounts of histones H1, H2A, H2B, H3 and H4 were not changed. A comparison by 2D-PAGE revealed no changes in total cellular protein patterns of the mutant. These observations demonstrate that all the histone gene families have the inherent ability to compensate for the disruption of one allele of the gene cluster, with no influence on cell functions.

Effects of pulsatile flow on gas transfer of membrane oxygenator: MENOX EL-4000 and Gyro C1-E3 pulsatile mode

It is acknowledged that pulsatile flow enhances the gas exchange performance of membrane oxygenators. However, the data for currently developed oxygenators are limited. In this study, the effect of pulsatile flow was assessed utilizing the MENOX EL-4000 oxygenator. The in vitro test was performed following the Association for the Advancement of Medical Instrumentation (AAMI) standards. Pulsatile flow was produced by the Gyro C1-E3 centrifugal pump with periodical changing of the impeller speed. In Study 1, the following 3 groups were created and examined: nonpulsatile flow, pulsatile flow of 40 bpm, and pulsatile flow of 60 bpm. The blood flow rate was maintained at 3 L/min, and the V/Q ratio was 1. In Study 2, four groups were examined, nonpulsatile flow with V/Q = 1, nonpulsatile with V/Q = 2, pulsatile with V/Q = 1, and pulsatile with V/Q = 2. The blood flow rate was maintained at 4 L/min, and the pulse frequency was set at 40 bpm. In study 1, although O2 transfer was not enhanced, CO2 transfer was significantly improved (40-50%) by pulsatile flow, regardless of pulse frequency. Study 2 demonstrated that pulsatile flow resulted in improved CO2 transfer as did higher ventilation (V/Q = 2). Furthermore, even after applying higher ventilation, the pulsatile mode enhanced CO2 transfer more than the nonpulsatile mode. It was considered that the pulsatile mode induced an active secondary flow and enhanced mixing effects, and consequently CO2 transfer was improved. In conclusion, the pulsatile flow significantly enhanced the CO2 transfer of the MENOX oxygenator. It is indicated that applying the pulsatile mode is a unique and effective method to improve the gas exchange performance for a current membrane oxygenator.

Anatomical consideration for an implantable centrifugal biventricular assist system

A miniaturized pivot bearing-supported centrifugal blood pump (Gyro PI) has been developed as a long-term biventricular assist system (BiVAS). In this study we determined the anatomical configuration of this system using a bovine model. Under general anesthesia, a left lateral thoracotomy was performed to open the chest. Two Gyro PI-601 pumps for left and right assists were placed in the preperitoneal pocket by a subcostal abdominal incision. The left pump could be placed along the dome of the diaphragm just beneath the apex of the left ventricle. The right pump could be placed next to the left pump. The inlet and outlet ports of both pumps penetrated the diaphragm. The inlet port of the left pump, with a length of 55 mm, was inserted directly into the apex of the left ventricle. A woven Dacron graft (150 mm long, 11 mm inner diameter) was placed between the outlet port of the left pump and the descending aorta. As for the right pump, a 100 mm long and 120 degree angled inflow conduit was placed between the inlet port and the right ventricular infundibulum. The outlet port of the right pump was connected to the main trunk of the pulmonary artery using a 90 mm long, 11 mm inner diameter Dacron graft. We could perform biventricular assistance to confirm the anatomical feasibility of the Gyro implantable centrifugal BiVAS.

Biocompatibility of alumina ceramic and polyethylene as materials for pivot bearings of a centrifugal blood pump

The double pivot bearings in the Gyro C1E3 centrifugal blood pump incorporate a high-purity alumina (Al2O3) ceramic and an ultra-high-molecular-weight polyethylene (UHMWPE). This centrifugal pump has been developed as a completely sealless pump for long-term usage. The combination of Al2O3 and UHMWPE are the materials of choice for the acetabular bearing in artificial joints, which have proven to be clinically reliable for over 10 years. Previous studies have examined the biocompatibility of Al2O3 and UHMWPE as bulky implant materials. The present study investigated this material as a blood-contacting material using a standard assessment in vitro and in vivo analysis. The examined items were systemic toxicity, sensitization (guinea pig maximization test), cytotoxicity (elution test), mutagenicity (Ames test), direct contact hemolysis, and thrombogenicity. The studies were performed according to the United States Pharmacopoeia and published previous studies. The samples of both Al2O3 and UHMWPE demonstrated no differences from the negative controls in all tests. These findings indicate that both Al2O3 and UHMWPE are biocompatible materials for double-pivot bearings in the centrifugal blood pump.

Preclinical evaluation of the Kyocera Gyro centrifugal blood pump for cardiopulmonary bypass

The Kyocera Gyro pump has been developed as a completely seal-less centrifugal pump to overcome the problems of the conventional centrifugal pumps. The Gyro pump is a double pivot bearing-supported centrifugal pump with several specific design features, including its eccentric inlet port. We investigated the feasibility of the Gyro pump for cardiopulmonary bypass (CPB) in a bovine model, comparing it with the BioMedicus pump (BP-80). Ten healthy calves (5: Gyro pump, 5: BP-80) underwent 6 h of mildly hypothermic CPB at approximately 33 degrees C. Both pumps provided more than 50 ml/kg/min without any incidents. The haemodynamics of both groups remained stable within the normal range. All haematology and biochemistry data demonstrated no significant differences between the two groups. However, values of plasma-free haemoglobin and lactate dehydrogenase were less throughout the experiments of the Gyro pump than those of the BP-80. To obtain flow equivalent to that of the BP-80, the Gyro pump needed less rotational speeds than the BP-80 (2749.7 +/- 233.3 versus 3170.6 +/- 300.8 rpm. p < 0.05). Less rotational speed in addition to the difference in operating principle may contribute to less blood damage during the CPB OF the Gyro pump. After pumping for CPB, no leakage or thrombus formation was observed in either pump. The present study indicated that the Kyocera Gyro pump can be applied as a centrifugal pump for CPB with the same performance as the BP-80 and with relatively less haemolysis than the BP-80.

Mapping of pump efficiency on the pressure-flow curve of a centrifugal blood pump

Because pump efficiency is closely related to heat generation and blood trauma in a centrifugal blood pump, it is quite important to study pump efficiencies in a variety of conditions. In the present study, pump efficiencies were mapped on the pressure head-flow rate curves of 4 different pumps; BioMedicus BioPump (BP-80), Nikkiso (NK), Gyro C1E3, and Gyro PI601 (diameter of the impeller, NK: 50 mm, C1Ee3: 65 mm, and PI601: 50 mm). The mapping of pump efficiency revealed the following findings. First, the cone type (BP-80) has less pump efficiency than the impeller type (NK and C1E3); second, the miniaturization of the C1E3 to the PI601 has resulted in an increase in pump efficiency; and third, the diameter of the impeller may contribute to the pump efficiency of an im peller type pump. The mapping of the pump efficiency, as demonstrated in this study, is useful for the analysis of hydraulic pump performance in a wide range of clinically applied conditions.

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.

In vitro thrombogenesis study in the Gyro C1E3 for vibration assessment

To clarify the correlation between vibration and thrombus formation in a centrifugal blood pump, a preliminary simulated thrombus study was conducted for possible detection of thrombus formation inside a pump. Additional in vitro thrombogenesis studies were performed to confirm the results of the preliminary study. The primary data acquisition equipment included an accelerometer (Isotron PE accelerometer, Endevco, San Juan Capistrano, CA, U.S.A.), digitizing oscilloscope (TDS 420, Tektronic, Inc., MA, U.S.A.), and pivot bearing centrifugal pumps. The accelerometer was mounted to the top of the pump casing to sense radial and axial accelerations. For the preliminary study, a piece of Silastic was adhered to each of the 3 common areas of thrombus formation inside the pump. The results provided baseline information to speculate on the possibility of detecting thrombus formation by vibration signal changes. For the next studies, fresh bovine blood was harvested under sterile conditions and with strict avoidance of air contact, adding 1.0 U/ml of heparin. The sterilized test circuit consisted of 3/8 inch tubing (Tygon) and a soft reservoir. During the operating time, the activated clotting time (ACT) was maintained between 150 to 300 s using protamin. A restrictor on the outflow tube maintained the flow rates at about 4.5 L/min. The pumps ran continuously for 6 h. Possible blood clot formation inside the pump was monitored by observing the vibration signal from the device for 6 h. These studies revealed that it was possible to distinguish between an impeller that did not form thrombus and ones that formed fibrogenous thrombus using vibration signal assessment. Vibration assessment is worthwhile as a thrombus monitoring tool for a centrifugal blood pump.

Development and initial testing of a permanently implantable centrifugal pump

To be able to salvage heart failure patients, the need for an economical permanent ventricular assist device is increasing. To meet this increasing demand, a miniaturized centrifugal blood pump has been developed as a permanently implantable device. The Gyro permanently implantable model (PI-601) incorporates a sealless design with a blood stagnation free structure. The pump impeller is magnetically coupled to the driver magnet in a sealless manner. This pump is atraumatic and antithrombogenic and incorporates a double pivot bearing system. A miniaturized actuator was utilized in this system in collaboration with the University of Vienna. The priming volume of this pump is 20 ml. The overall size of the pump actuator package is 53 mm in height and 65 mm in diameter, 145 ml of displacement volume, and 305 g in weight. Testing to date has included in vitro hydraulic performance and hemolysis. This pump can provide 5 L/min against a 110 mm Hg total pressure head at 2,000 rpm and 8 L/min against 150 mm Hg at 2,500 rpm. The normalized index of hemolysis (NIH) value of this pump was 0.0028 g/100 L at 5 L/min against 100 mm Hg. A preliminary anatomical study revealed the possibility of the implantability of 2 such systems in biventricular bypass at a preperitoneal location. This system is feasible for use as a permanently implantable biventricular assist device.

Comparison of the Gyro C1E3 and BioMedicus centrifugal pump performances during cardiopulmonary bypass

The compact eccentric inlet port (C1E3) centrifugal blood pump was developed as a cardiopulmonary bypass (CPB) pump. The C1E3 pump incorporated a sealless design with a blood stagnation free structure. The pump impeller was magnetically coupled to the driver magnet in a sealless manner. To develop an atraumatic and antithrombogenic centrifugal pump without a shaft seal junction, a double pivot bearing system was introduced. Recently, a mass production model of the C1E3 was fabricated and evaluated. The ratio of the normalized index of hemolysis (NIH) of the C1E3 was 0.007 g/ 100 L, in comparison to the NIH of the BP-80, 0.018 g/ 100 L, each in a CPB condition of 5 L/min against 325 mm Hg. Both pumps were compared in identical in vitro circuits. To further evaluate the pumps during cardiopulmonary bypass for reliability and function, 6 h of CPB was performed on each of 8 bovines using either the C1E3 or BP-80 centrifugal pump. The BP-80 and C1E3 provided pump flows of 50-60 ml/kg/min without incident. The hemodynamics were stable, and the hematology and biochemistry data were within normal ranges. There were no statistically significant differences between the 2 groups. Concerning the plasma free hemoglobin values, a mass production model of the C1E3 pump had the same hemolysis levels as the BP-80. Our preliminary studies reveal that the C1E3 pump is reliable. Also, the C1E3 will satisfy clinical requirements as a cardiopulmonary bypass pump.

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.

Hemolytic effect of surface roughness of an impeller in a centrifugal blood pump

The present study investigates how the surface roughness of an impeller affects hemolysis in the pivot bearing supported Gyro C1E3 pump. This study focuses on particular areas of the impeller surface in the impeller type centrifugal pump. Seven Gyro C1E3 pumps were prepared with smooth surface housings and different impeller parts with different surface roughnesses. The vanes, top side, and backside of the impeller were independently subjected to vapor polishing, fine sand blasting, or coarse sand blasting to produce three different grades of surface roughness. These surfaces were then examined by a surface profile instrument. Using these pumps with different impellers, in vitro hemolysis tests were performed simulating cardiopulmonary bypass (5 L/min, 350 mm Hg). The findings of this study conclusively proved that surface roughness of the back side of the impeller has the greatest effect on hemolysis, followed by the top side and then the vanes. The following are reasons for these findings. First, the shear rate may be greater on the back side than on the top side because of the smaller gap between the back and the housing and the greater relative speed against the impeller. Second, the fluid beneath the impeller may have a longer exposure time because there is little chance for the fluid to mix beneath the impeller. Third, the shear rate may be greater on the top side of the impeller than on the vanes because a vortex formation occurs behind the vanes.

A method for determining the distribution of fluoride, calcium and phosphorus in human dental plaque and the effect of a single in vivo fluoride rinse

A new sampling method, capable of sampling plaque from its surface to its interior for quantitative studies, was modified to meet some of the requirements for the determination of the fluoride and mineral (Ca and P) profiles within dental plaque formed in vivo. Plaque samples were repeatedly collected from the same individual, using special devices, before a single fluoride rinse (900 parts/10(6) fluoride) and 10 min and 24 hr after rinse. The method allowed examination of fluoride, calcium and phosphorus distribution along the entire thickness of plaque. Fluoride content significantly increased throughout the sample 10 min after rinsing, indicating the fluoride had rapidly penetrated into the plaque. Although the elevated fluoride concentrations diminished almost to baseline with 24 hr, a high correlation was found between fluoride and minerals in each plaque fraction. It is concluded that this technique will be useful for evaluating the fluoride and mineral behaviour in the saliva/plaque and plaque/enamel interfaces, and the anti caries efficacy of fluoride applications.

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.

Hemolytic effects of surface roughness of a pump housing in a centrifugal blood pump

The surface roughness of artificial blood contacting devices is an important surface property that is closely related to blood cell trauma. The present study investigated the effect of the surface roughness of a pump housing on hemolysis in an impeller-type centrifugal blood pump, a pivot bearing supported Gyro C1E3 pump. The purpose of the study was to determine which part of a housing has the greatest surface roughness effect on hemolysis in a centrifugal pump. Seven Gyro C1E3 pumps were prepared, each with a smooth surface impeller and a housing with differing areas of altered surface roughness. Both top and bottom housings were divided into half subregions, each with the same area. Seven test pumps were produced by subjecting various subregions of the housings to vapor polishing and sandblasting. The treated surfaces were then examined by a surface profile instrument. Using these 7 pumps with different areas of altered housing roughness, in vitro hemolysis tests were performed simulating cardiopulmonary bypass (5 L/min, 350 mm Hg). The results of this study are as follows. First, the surface roughness of the top housing had a greater effect on hemolysis than that of the bottom housing. Second, on the surface of the top housing, the surface roughness of the outer half area had a greater effect on hemolysis than that of the inner half area. Third, on the surface of the bottom housing, the surface roughness of the inner half area had a greater effect on hemolysis than that of the outer half area. These findings concur with previous studies of flow patterns in pumps. Thus, it is expected that the method in this study, comparative in vitro hemolysis tests of the pumps with surfaces of the same roughness but different locations, can be used to detect the high shear area inside a pump.

Vibration assessment for thrombus formation in the centrifugal pump

To clarify the correlation of vibration and thrombus formation inside a rotary blood pump, 40 preliminary vibration studies were performed on pivot bearing centrifugal pumps. No such studies were found in the literature. The primary data acquisition equipment included an accelerometer (Isotron PE accelerometer, ENDEVCO, San Juan Capistrano, CA, U.S.A.), digitizing oscilloscope (TDS 420, Tektronix Inc., Pittsfield, MA, U.S.A.), and pivot bearing centrifugal pumps. The pump impeller was coupled magnetically to the driver magnet. The accelerometer was mounted on the top of the pump casing to sense radial and axial accelerations. To simulate the 3 common areas of thrombus formation, a piece of silicone rubber was attached to each of the following 3 locations as described: a circular shape on the center bottom of the impeller (CI), an eccentric shape on the bottom of the impeller (EI), and a circular shape on the center bottom casing (CC). A fast Fourier transform (FFT) method at 5 L/min against 100 mm Hg, with a pump rotating speed of 1,600 rpm was used. The frequency response of the vibration sensors used spans of 40 Hz to 2 kHz. The frequency domain was already integrated into the oscilloscope, allowing for comparison of the vibration results. The area of frequency domain at a radial direction was 206 +/- 12.7 mVHz in CI, 239.5 +/- 12.1 mVHz in EI, 365 +/- 12.9 mVHz in CC, and 163 +/- 7.9 mVHz in the control (control vs. CI p = 0.07, control vs. EI p < 0.001, control vs. CC p < 0.001, EI vs. CC p < 0.001, CI vs. CC p < 0.001). Three types of imitation thrombus formations were roughly distinguishable. These results suggested the possibility of detecting thrombus formation using vibration signals, and these studies revealed the usefulness of vibration monitoring to detect thrombus formation in a centrifugal pump.

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.

Eccentric inlet port of the pivot bearing supported Gyro centrifugal pump

An eccentric inlet port is a unique feature of the pivot bearing supported Gyro Compact-1 Eccentric Inlet Port Model 3 (C1E3) centrifugal pump, a completely sealless centrifugal pump. The latest C1E3 has an eccentric inlet port with a 30 degree vertical angle. To investigate the adequacy of this 30 degree angle, flow visualization studies and in vitro hemolysis tests were performed, comparing 4 pumps, each with a different angle of the eccentric inlet port (0, 30, 60, and 90 degrees). The flow visualization study utilizing a tracer method focused on the flow pattern just distal to the inlet port of each pump, and each pump was operated at 5 L/min against 100 mm Hg and 5 L/min against 350 mm Hg. In the pumps with angles of 90 and 60 degrees, the flow direction changed horizontally, causing a vortex formation. In the pump with the 30 degree angle, the inflow did not change its course, resulting in minimal space for vortex formation. In the pump with the 0 degree angle, the inflow collided with the pump housing, resulting in a small vortex formation along the housing surface. The in vitro hemolysis tests at 5 L/min against 350 mm Hg revealed that the pump with the 30 degree angle was the least hemolytic and the pump with the 90 degree angle was the most hemolytic among the 4 pumps. These results suggest that the angle of the eccentric inlet port of the Gyro C1E3 pump should be 30 degrees to have less vortex formation and less red blood cell trauma.