• 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

• Proceedings of the KSME Conference
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• 2004.04a
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• pp.1682-1686
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• 2004

A slit-flow apparatus with laser diffraction method has been developed with significant advances in ektacytometry design, operation and data analysis. In the slit-flow ektacytometry (or laser-diffractometry), the deformation of red blood cells subjected to continuously decreasing shear stress in slit flow is measured. A laser beam traverses a diluted blood suspension flowing through a slit and is diffracted by RBCs in the volume. The diffraction patterns are captured by a CCD-video camera, linked to a frame grabber integrated with a computer, while the differential pressure variation is measured by a pressure transducer. Both measurements of laser-diffraction image and pressure with respect to time enable to determine deformation index and the shear stress. The range of shear stress of 0 ${\sim}$ 35 Pa and measuring time is less than 2 min. When deforming under decreasing shear stress, RBCs change gradually from the prolate ellipsoid towards a circular biconcave morphology. The Deformation Index (DI) as a measure of RBC deformability is determined from an isointensity curve in the diffraction pattern using an ellipse-fitting program. The advantages of this design are simplicity, i.e., ease of operation and no moving parts, low cost, short operating time, and the disposable kit which is contacted with blood sample.

• 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.

• 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.