Shin-ichi Nitta

Ultrasonic tissue characterization of infarcted myocardium by scanning acoustic microscopy

The purpose of this study was to ultrasonically characterize infarcted human myocardial tissue at the microscopic level by scanning acoustic microscopy. Infarcted myocardial specimens from ten cases with acute myocardial infarction were studied. Specimens were formalin fixed, paraffin embedded and sectioned to 10-micron thickness. A specially developed scanning acoustic microscope system, operating in the 100- to 200-MHz ultrasound frequency range, was used for the measurements. The values of the attenuation constant were 0.94 +/- 0.04 dB/mm/MHz in normal myocardium, 0.71 +/- 0.12 dB/mm/MHz in degenerated myocardium, 0.88 +/- 0.47 dB/mm/MHz in granulation tissue and 1.75 +/- 0.11 dB/mm/MHz in fibrosis. The values of sound speed were 1620.2 +/- 8.2 m/s in normal myocardium, 1572.4 +/- 10.6 m/s in degenerated myocardium, 1590.2 +/- 32.5 m/s in granulation tissue and 1690.3 +/- 9.1 m/s in fibrosis. The ultrasonic properties of the diseased myocardium at the microscopic level will provide important information for ultrasonic tissue characterization at the macroscopic level.

ACOUSTIC PROPERTIES OF ATHEROSCLEROSIS OF HUMAN AORTA OBTAINED WITH HIGH-FREQUENCY ULTRASOUND

The ultrasonic properties of the tissue elements in the aorta were measured using a scanning acoustic microscope (SAM). Twelve autopsied aortas were formalin-fixed, frozen and sectioned at 10 microm thickness and mounted on glass slides for SAM investigation. A specially developed SAM system operating in the frequency range of 100-200 MHz was employed, and color-coded images of the two-dimensional (2-D) distributions of attenuation and sound speed were displayed. The region-of-interest (ROI) for attenuation and sound speed measurements was determined by comparison of optical and acoustic images. The average value of the slope of attenuation was 0.61 dB/mm/MHz and the sound speed was 1568 m/s in the normal intima; 2.5 dB/mm/MHz, 1760 m/s in the calcificated lesion; 1.7 dB/mm/MHz and 1677 m/s in the fibrosis; and 0.34 dB/mm/MHz, 1526 m/s in the fatty material, respectively. Acoustic microscopy provides the basic data for understanding the IVUS imaging of atherosclerosis, as well as on the pathological features of atherosclerosis.

Cardio-ankle vascular index (CAVI) for the monitoring of the atherosclerosis after heart transplantation

Atherosclerosis has been reported to progress rapidly after heart transplantation. A quantitative diagnosis is required for the diagnosis of atherosclerosis after heart transplantation. In this study, we compared brachial-ankle pulse wave velocity (baPWV) and cardio-ankle vascular index (CAVI) for the diagnosis. The average values of both baPWV and CAVI in the seven cases after heart transplantation were found to be signif-icantly large in comparison to the average values of the normal healthy people of the same age group. When comparisons were made before and after the heart transplantation in a particular case, CAVI was stable and baPWV changed sharply. A lot of parameters such as blood pressure, blood volume, etc. have been reported to influence baPWV. The results of this study suggested that CAVI was a stable parameter in comparison to baPWV even after heart transplantation. Thus, CAVI may be useful in the diagnosis of arteriosclerosis after heart transplantation.

Application of scanning acoustic microscopy for assessing stress distribution in atherosclerotic plaque.

AbstractScanning acoustic microscopy (SAM) was equipped to assess the acoustic properties of normal and atherosclerotic coronary arteries. The SAM image in the atherosclerotic lesion clearly demonstrated that the sound speed was higher than that in the normal intima, and that the variation of elasticity was found within the fibrous cap of the plaque. Youngs elastic modulus of each region was calculated and the finite element analysis was applied to derive the stress distribution in these arterial walls. In a case of normal coronary artery, the stress was dominant in the intima and the distribution was rather homogeneous and in a case of atherosclerosis, high stress was concentrated to the relatively soft lesion in the fibrous cap overlying lipid pool. SAM provides information on the physical properties, which cannot be obtained by the optical microscope. The results would help in understanding the pathological features of atherosclerosis.

Electrical Stimulation of Skeletal Muscles

The aim of this study was to investigate whether electrical stimulation of skeletal muscles could represent a rehabilitation alternative for patients with chronic heart failure (CHF). Thirty patients with CHF and NYHA class II-III were randomly assigned to a rehabilitation program using either electrical stimulation of skeletal muscles or bicycle training. Patients in the first group (n = 15) had 8 weeks of home-based low-frequency electrical stimulation (LFES) applied simultaneously to the quadriceps and calf muscles of both legs (1 h/day for 7 days/week); patients in the second group (n = 15) underwent 8 weeks of 40 minute aerobic exercise (3 times a week). After the 8-week period significant increases in several functional parameters were observed in both groups: maximal VO2 uptake (LFES group: from 17.5 +/- 4.4 mL/kg/min to 18.3 +/- 4.2 mL/kg/min, P < 0.05; bicycle group: from 18.1 +/- 3.9 mL/kg/min to 19.3 +/- 4.1 mL/kg/min, P < 0.01), maximal workload (LFES group: from 84.3 +/- 15.2 W to 95.9 +/- 9.8 W, P < 0.05; bicycle group: from 91.2 +/- 13.4 W to 112.9 +/- 10.8 W, P < 0.01), distance walked in 6 minutes (LFES group: from 398 +/- 105 m to 435 +/- 112 m, P < 0.05; bicycle group: from 425 +/- 118 m to 483 +/- 120 m, P < 0.03), and exercise duration (LFES group: from 488 +/- 45 seconds to 568 +/- 120 seconds, P < 0.05; bicycle group: from 510 +/- 90 seconds to 611 +/- 112 seconds, P < 0.03). These results demonstrate that an improvement of exercise capacities can be achieved either by classical exercise training or by home-based electrical stimulation. LFES should be considered as a valuable alternative to classical exercise training in patients with CHF.

Influence of tissue preparation on the high-frequency acoustic properties of normal kidney tissue

The influence of various tissue preparations on the acoustic properties of normal kidney tissue at high frequencies was investigated. Eight surgically excised normal kidney tissue specimens were classified into three groups: (i) fresh, frozen section, (ii) formalin-fixed, frozen section and (iii) formalin-fixed, paraffin section. Scanning acoustic microscopy operating in the frequency range of 100-200 MHz was used to display the two-dimensional distribution of attenuation constant and sound speed. Our results indicate that (i) there is no significant variation in both acoustic parameters between the three tissue groups, (ii) fixation by 10% formalin produces no significant change in the acoustic parameters, (iii) in fat-free tissue regions, the acoustic parameters are independent of preparation method and (iv) frozen sections must be used to assess the acoustic parameters in fat-rich tissues.

Visualization of human umbilical vein endothelial cells by acoustic microscopy

The morphology and acoustic properties of the human umbilical vein endothelial cells (HUVECs) were evaluated using a scanning acoustic microscope system. HUVECs were cultured for 4 days and exposed to the endotoxin for 4 h. The frequency of the scanning acoustic microscope was variable between 100 and 210 MHz. By changing the measuring frequency, ultrasonic amplitude and phase were measured and the quantitative value of attenuation was calculated. Before and after endotoxin stimuli, HUVECs were observed by scanning acoustic microscopy and the attenuation was measured. The acoustic images were successfully obtained to identify the outer shape of the HUVEC and the location of the nucleus in the cell. The attenuation of the nucleus is higher than that of the cytoplasm. The attenuation of the cytoplasm was increased and became inhomogeneous after endotoxin exposure. This finding would be related to the change of F-actin filaments, which is the main component of the cytoskeleton. Scanning acoustic microscopy is useful for assessing the cellular viscoelastic properties since it can detect both the morphological and acoustic changes without contacting the cellular surface.

Transcutaneous DC-DC converter for totally implantable artificial heart using synchronous rectifier

To drive a totally implantable artificial heart for a long period with transcutaneous energy transmission, it is necessary that the temperature rise of devices implanted inside the human body is minimized. In this paper we study the properties of a transcutaneous DC-DC converter which transfers energy from an external source to a vibrating flow pump within the body, The temperature rise of the internal rectifying circuit has been rectified by as much as 30% to 50% by employing synchronous rectifiers rather than Schottky diodes, In addition, we have investigated a method for controlling the vibrating flow pump (VFP). This pump would be a constituent part of a totally implantable artificial heart. Also, the use and current limitation of an implanted rechargeable battery for emergency use is discussed.

Ultrasonic Tissue Characterization of Renal Cell Carcinoma Tissue

The purpose of this study was to characterize renal cell carcinoma tissue by the measurement of microacoustic properties. A scanning acoustic microscope system operating in the frequency range of 100-200 MHz was employed and the attenuation constant and sound speed were measured on the two-dimensional distribution. The values of attenuation constant and sound speed were lower in both kinds of cancer cells than those in normal kidney, although a significant difference was not found between the clear cell and granular cell. Also, both acoustic parameters of cancer cells were significantly lower than those in hemorrhage and fibrosis. These data suggest that the elasticity of renal cell carcinoma tissue may be lower than that of normal kidney. Moreover, the high intensity echo in clinical echography may be related to the heterogeneity of the microacoustic field in the carcinoma tissue.

Changes of Blood Flow Volume in the Superior Mesenteric Artery and Brachial Artery with Abdominal Thermal Stimulation

In traditional Chinese medicine, moxibustion is a local thermal therapy that is used for several conditions. Quantifying the effects of moxibustion therapy has been difficult because the treatment temperature depends on the physicians experience, and the temperature distribution in the target area is not uniform. This prospective observational study aims to quantify the effect of local thermal stimulation to the abdomen. We developed a heat transfer control device (HTCD) for local thermal stimulation. Twenty-four healthy subjects were enrolled and they underwent abdominal thermal stimulation to the para-umbilical region with the device for 20 min. Blood flow volume in the superior mesenteric artery (SMA) and brachial artery (BA), the heart rate and the blood pressure were measured at rest, 15 min after starting thermal stimulation and 10, 20, 30 and 40 min after completing thermal stimulation. Blood flow parameters were measured by high-resolution ultrasound. In the SMA, blood flow volume was significantly increased during thermal stimulation (P < .01), as well as at 10 min (P < .01) and 20 min (P < .05) after stimulation. In the BA, blood flow volume decreased at 40 min after stimulation (P < .01). In conclusion we could quantify the effect of local thermal stimulation with an HTCD and high-resolution ultrasound. Thermal stimulation of the para-umbilical region increased blood flow in the SMA 20 min after stimulation in healthy subjects.