High-flux dialysis treatment removes various toxins via diffusion as well as convection, which is induced by ultrafiltration and backfiltration. In this study, in vitro (Using the distilled water and the bovine's blood) comparison test was performed to determine whether utilization of a high flux dialyzer paired with different pumps would increase the efficiency of convection. At the same blood flow rates, a pulsatile pump and a roller pump were employed to propel the distilled water and bovine whole blood to a high flux dialyzer. Pressures at the dialyzer inlet and outlet in the blood circuit and in the dialysate circuit were measured, respectively. From these data, we calculated the transmembrane pressure and predicted the ultrafiltration and backfiltration rates developed by both pumps. Using the bovine's blood experiment, ultrafiltration and backfiltration rates were 1.6 times higher with the pulsatile pump than with the roller pump. We conclude that utilization of a pulsatile pump in high flux hemodialysis treatments increases ultrafiltration volume, compared with a roller pump under conditions of the same blood flow rate.
A theoretical study for the flux enhancement by pulsation of transmembrane pressure is presented for osmotic pressure controlled ultrafiltration under laminar flow regime. The transient velocity profile is solved analytically using Green's function method. Time dependent convective diffusive equation is solved to quantify the membrane surface concentration and the permeate flux, numerically. The effects of the amplitude and frequency of pulsation on flux, surface concentration and observed retention are studied.
The arteries are very important in cardiovascular system and easily adapt to varying flow and pressure conditions by enlarging or shrinking to meet the given hemodynamic demands. The blood flow in arteries is dominated by unsteady flow phenomena due to heart beating. In certain circumstances, however, unusual hemodynamic conditions cause an abnormal biological response and often induce circulatory diseases such as atherosclerosis, thrombosis and inflammation. Therefore quantitative analysis of the unsteady pulsatile flow characteristics in the arterial blood vessels plays important roles in diagnosing these circulatory diseases. In order to verify the hemodynamic characteristics, in-vivo measurements of blood flow inside the extraembryonic arterial bifurcation cascade of chicken embryo were carried out using a micro-PIV technique. To analyze the unsteady pulsatile flow temporally, the (low images of RBCs were obtained using a high-speed CMOS camera at 250fps with a spatial resolution of $30{\mu}m\times30{\mu}m$ in the whole blood vessels. In this study, the unusual flow conditions such as flow separation or secondary flow were not observed in the arterial bifurcations. However, the vorticity has large values in the inner side of curvature of vessels. In addition, the mean velocity in the arterial blood vessel was decreased and pulsating frequency obtained by FFT analysis of velocity data extracted in front of the each bifurcation was also decreased as the bifurcation cascaded.
Objective: There exist gender differences in pulsatile contour waveform. Women have a greater age-related increase in left ventricular mass than do men and more likely to experience symptomatic heart failure after infarction. SDPTG (the second derivative of photoplethysmogram waveform) is a noninvasive method for evaluating the pulse wave and is correlated with age and other risk factors for atherosclerosis. We studied the effect of gender on SDPTG and made clear why the gender differences appear. Methods: To study the effects of effect factors, including height and blood pressure, on SDPTG in the fourth decade, data on height, weight, PTD (pulse transit distance), blood pressure, serum lipid levels, and SDPTG were collected in 115 laboratory healthy men and women. SDPTG is derived from double-differential processing of fingertip photoplethysmography and consists of a, b, c, and d waves in systole and an e wave in diastole; SDPTG aging index (AI) was calculated as (b-c-d-e)/a. Results: There were significant gender-related differences of SDPTG AI, height, and blood pressure. Age, height, and mean blood pressure were respectively and significantly correlated with SDPTG AI. SDPTG is dependent upon age, height, and blood pressure. Restricting analysis to SDPTG AI, age, height, and mean blood pressure, yielded that there were gender-related differences in SDPTG AI (P<0.05) which were derived from those of height (F<0.001, df=l, P=0.994). Conclusions: These new data may help to explain previous findings about age-related differences in pulsatile contour waveforms and why gender differences of SDPTG appear. The results of this study suggest that SDPTG AI, used for evaluation of biological vascular aging, should be calibrated by height as well as age and blood pressure.
It is necessary to develop a pulsatile Extracorporeal Membrane Oxygenator (p-ECMO) with counter-pulsation control(CPC), which ejects blood during the diastolic phase of the heart rather than the systolic phase, due to the known issues with conventional ECMO causing fatal complications such as ventricular dilation and pulmonary edema. A promising method to simultaneously detect the pulsations of the heart and p-ECMO is to analyze blood pressure waveforms using deep neural network technology(DNN). However, the accurate detection of cardiac rhythms by DNNs is challenging due to various noises such as pulsations from p-ECMO, reflected waves in the vessels, and other dynamic noises. This study aims to evaluate the accuracy of DNNs developed for CPC in p-ECMO, using human-like blood pressure waveforms reproduced in an in-vitro experiment. Especially, an experimental setup that reproduces reflected waves commonly observed in actual patients was developed, and the impact of these waves on DNN judgments was assessed using a multiple DNN (m-DNN) that provides accurate determinations along with a separate index for heartbeat recognition ability. In the experimental setup inducing reflected waves, it was observed that the shape of the blood pressure waveform became increasingly complex, which coincided with an increase in harmonic components, as evident from the Fast Fourier Transform results of the blood pressure wave. It was observed that the recognition score (RS) of DNNs decreased in blood pressure waveforms with significant harmonic components, separate from the frequency components caused by the heart and p-ECMO. This study demonstrated that each DNN trained on blood pressure waveforms without reflected waves showed low RS when faced with waveforms containing reflected waves. However, the accuracy of the final results from the m-DNN remained high even in the presence of reflected waves.
Pulsation is an inherent phenomenon in reciprocating compressors. It interacts with piping to cause vibrations and performance problems. Indiscriminately connecting to a compressor can be dangerous and cost money in the form of broken equipment and piping, poor performance, inaccurate metering, unwanted vibration, and sometimes noise. Piping connected to a compressor can materially affect the performance and response. To minimize these detrimental effects, reciprocating compressor system should be equipped by pulsation suppression system. This study discusses pressure pulsation phenomena occurred in a reciprocating compressor system. An experiment applied air compressor unit, as pulsating pressure generator, has been done. The compressor was connected sequentially to a snubber model and pressure tank. Sensor probes were placed on the inlet and outlet pipes of snubber. Compressor was driven by a motor controlled by a frequency regulator. The experiment was conducted by adjusting the regulator at 40Hz. General information about an internal gas flow can be achieved by numerical analysis approach. Information of the velocity, pressure and turbulence kinetic energy distribution are presented in this paper. Based on this result, the design improvement might be done.
Kim Hyun Koo;Son Ho Sung;Fang Yang Hu;Park Sung Young;Kim Kwang Taik;Kim Hark Jei;Sun Kyung
Journal of Chest Surgery
/
v.38
no.1
s.246
/
pp.13-22
/
2005
It has been known that pulsatile flow is physiologic and more favorable to tissue perfusion than nonpulsatile flow. The purpose of this study is to directly compare the effect of pulsatile versus nonpulsatile blood flow to renal tissue perfusion in extracorporeal circulation by using a tissue perfusion measurement system. Material and Method: Total cardiopulmonary bypass circuit was constructed to twelve Yorkshire swines, weighing 20$\~ $30 kg. Animals were randomly assigned to group 1 (n=6, non pulsatile centrifugal pump) or group 2 (n=6, pulsatile T-PLS pump). A probe of the tissue perfusion measurement system $(QFlow^{TM}-500)$ was inserted into the renal parenchymal tissue. Extracorporeal circulation was maintained for an hour at a pump flow of 2 L/min after aortic cross-clamping. Tissue perfusion flow of the kidney was measured at baseline (before bypass) and every 10 minutes after bypass. Serologic parameters were collected at baseline and 60 minutes after bypass. Result: Baseline parameters were not different between the groups. Renal tissue perfusion flow was substantially higher in the pulsatile group throughout the bypass (ranged 48.5$\~$ 64 in group 1 vs. 65.8$\~$88.3 mL/min/100 g in group 2, p=0.026$\~$ 0.45) The difference was significant at 30 minutes bypass $(47.5{\pm}18.3\;in\;group\;1\;vs.\;83.4{\pm}28.5$ mL/min/100 g in group 2, p=0.026). Serologic parameters including plasma free hemoglobin, blood urea nitrogen, and creatinine showed no differences between the groups at 60 minutes after bypass (p=NS). Conclusion: Pulsatile flow is more beneficial to tissue perfusion of the kidney in short-term extracorporeal circulation. Further study is suggested to observe the effects to other vital organs or long-term significance.
Between April 1976 and March 1978, six cases of tricuspid valve replacement were done in the Department of Thoracic Surgery, Seoul National University Hospital. There were 4 men and 2 women and the age of the patients ranged from 17 years of the youngest to 48 years of the oldest. Most of them had characteristic symptoms of tricuspid valve disease, such as a systolic murmur audible over the lower sternum and varying with respiration, pulsatile and distended neck vein, and an enlarged and pulsatile liver. Preoperative functional levels according to NYHA Calcification were class III in 4 cases, and class IV in 2 eases. Most of the cases showed moderate to severe cardiomegaly in chest films and elevated right atrial pressure on preoperative right heart catheterization. Five of them underwent concomittent mitral valve replacement and one pulmonary valvotomy. All of them showed tricuspid insufficiency resulted from massive dilatation of annulus, destructive lesions of valve structure, or both anomalies. One postoperative hospital death was encountered and the cause of death was low out-put syndrome. All survivors showed clinical improvement and cardiomegaly regressed and left hospital in a good condition . *Attendum; Recently 2 more cases of tricuspid valve replacement with mitral valve replacement were done after this review.
Park Young-Woo;Her Keun;Lim Jae-Ung;Shin Hwa-Kyun;Won Yong-Soon
Journal of Chest Surgery
/
v.39
no.5
s.262
/
pp.354-358
/
2006
Background: Pulsatile pumps for extracorporeal circulation have been known to be better for tissue perfusion than non-pulsatile pumps but be detrimental to blood corpuscles. This study is intended to examine the risks and benefits of $T-PLS^{TM}$ through the comparison of clinical effects of $T-PLS^{TM}$ (pulsatile pump) and $Bio-pump^{TM}$ (non-pulsatile pump) used for coronary bypass surgery. Material and Method: The comparison was made on 40 patients who had coronary bypass using $T-PLS^{TM}\;and\;Bio-pump^{TM}$ (20 patients for each) from April 2003 to June 2005. All of the surgeries were operated on pump beating coronary artery bypass graft using cardiopulmonary extra-corporeal circulation. Risk factors before surgery and the condition during surgery and the results were compared. Result: There was no significant difference in age, gender ratio, and risk factors before surgery such as history of diabetes, hypertension, smoking, obstructive pulmonary disease, coronary infarction, and renal failure between the two groups. Surgery duration, hours of heart-lung machine operation, used shunt and grafted coronary branch were little different between the two groups. The two groups had a similar level of systolic arterial pressure, diastolic arterial pressure and mean arterial pressure, but pulse pressure was measured higher in the group with $T-PLS^{TM}\;(46{\pm}15\;mmHg\;in\;T-PLS^{TM}\;vs\;35{\pm}13\;mmHg\;in\;Bio-pump^{TM},\;p<0.05)$. The $T-PLS^{TM}$-operated patients tended to produce more urine volume during surgery, but the difference was not statistically significant $(9.7{\pm}3.9\;cc/min\;in\;T-PLS^{TM}\;vs\;8.9{\pm}3.6\;cc/min\;in\;Bio-pump^{TM},\;p=0.20)$. There was no significant difference in mean duration of respirator usage and 24-hour blood loss after surgery between the two groups. Plasma free Hb was measured lower in the group with $T-PLS^{TM}\;(24.5{\pm}21.7\;mg/dL\;in\;T-PLS^{TM}\;versus\;46.8{\pm}23.0mg/dL\;in\;Bio-pump^{TM},\;p<0.05)$. There was no significant difference in coronary infarction, arrhythmia, renal failure and morbidity rate of cerebrovascular disease. There was a case of death after surgery (death rate of 5%) in the group tested with $T-PLS^{TM}$, but the death rate was not statistically significant. Conclusion: Coronary bypass was operated with $T-PLS^{TM}$ (Pulsatile flow pump) using a heart-lung machine. There was no unexpected event caused by mechanical error during surgery, and the clinical process of the surgery was the same as the surgery for which $Bio-pump^{TM}$ was used. In addition, $T-PLS^{TM}$ used surgery was found to be less detrimental to blood corpuscles than the pulsatile flow has been known to be. Authors of this study could confirm the safety of $T-PLS^{TM}$.
Bileaflet mechanical valves have the complications such as hemolysis and thromboembolism, leaflet damage, and leaflet break. These complications are related with the fluid velocity and shear stress characteristics of mechanical heart valves. The first aim of the current study is to introduce fluid-structure interaction method for calculation of unsteady and three-dimensional blood flow through bileaflet valve and leaflet behavior interacted with its flow, and to overcome the shortness of the previous studies, where the leaflet motion has been ignored or simplified, by using FSI method. A finite volume computational fluid dynamics code and a finite element structure dynamics code have been used concurrently to solve the flow and structure equations, respectively, to investigate the interaction between the blood flow and leaflet. As a result, it is observed that the leaflet is closing very slowly at the first stage of processing but it goes too fast at the last stage. And the results noted that the low pressure is formed behind leaflet to make the cavitation because of closing velocity three times faster than opening velocity. Also it is observed some fluttering phenomenon when the leaflet is completely opened. And the rebounce phenomenon due to the sudden pressure change of before and after the leaflet just before closing completely. The some of time-delay is presented between the inversion point of ventricle and aorta pressure and closing point of leaflet. The shear stress is bigger and the time of exposure is longer when the flow rate is maximum. So it is concluded that the distribution of shear stress at complete opening stage has big effect on the blood damage, and that the low-pressure region appeared behind leaflet at complete closing stage has also effect on the blood damage.
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