• 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.

• 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.

• 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.

• 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.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.30 no.3
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• pp.181-185
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• 2004

Malignant tumor have hypoxic cell fraction, which makes radio-resistant and hypoxia in tumor is a result from the blood flow decrease caused by increase in blood flow resistance. Blood viscosity increase is major factor of increased blood flow resistance and it could be attributed to the decrease in blood deformability index. For the evaluation of the change of blood viscosity and blood deformability in oral squamous cell carcinoma, we perform the test of the change of those factors between the normal control group and oral squamous cell carcinoma cell patient group. Relative viscosity measured against distilled water was $5.25{\pm}0.14$ for normal control group, and $5.78{\pm}0.26$ for the SCC patient group and there was statistical significance between the groups. However, there was no significant difference between the groups in blood viscosity between the groups by tumor size (T1+T2 vs T3+T4). Also, there was no significant difference between the normal control group and SCC patient group in blood deformability index and between the groups by tumor size (T1+T2 vs T3+T4). Increase in blood viscosity was confirmed with this study and it can be postulated that modification blood viscosity might contribute to decrease of hypoxia fraction in oral squamous cell carcinoma, thus improve the effect of radiotherapy and it can be assumed that the main factor of blood viscosity increase is not decrease of blood deformability in oral squamous cell carcinoma.

• 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.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.

• International Journal of Vascular Biomedical Engineering
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• v.4 no.1
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• pp.17-26
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• 2006

Diabetes mellitus (DM) is a metabolic disorder, characterized by varying or persistent hyperglycemia, which induces several changes in the erythrocyte membrane and its cytoplasm, leading to alteration in the deformability. Techniques applied to measure this are based on filtration of erythrocyte suspension through a membrane and to obtain diffraction pattern under sheared conditions. Ektacytometry requiring less quantity of blood with disposable flow chamber used to measure the deformability of erythrocytes obtained from patients with diabetes and also associated with nephropathy and retinopathy. A decreasing trend of deformability in these patients is observed. The shape parameter form factor, as determined by image processing procedure, increases with the increased of blood glucose levels and shows a pattern similar to filtration time of erythrocyte suspensions through cellulose membranes. Further work is suggested to detect micro-level changes in cell membrane in diabetic patients

• 순환기질환의공학회:학술대회논문집
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• 2005.12a
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• pp.29-30
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• 2005

• 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.