The effect of supplementing the calcium phosphate cement containing poloxamer 407 on cellular activities.

Calcium phosphate cement (CPC) is generally used for bone repair and augmentation. Poloxamers are tri-block copolymers that are used as surfactants but have applications in drug and antibiotic delivery. However, their biological effects on bone regeneration systems remain unelucidated. Here, we aimed to understand how supplementing the prototype CPC with poloxamer would impact cellular activity and its function as a bone-grafting material. A novel CPC, modified beta-tricalcium phosphate (mß-TCP) powder, was developed through a planetary ball-milling process using a beta-tricalcium phosphate (ß-TCP). The mß-TCP dissolves rapidly and accelerates hydroxyapatite precipitation; successfully shortening the cement setting time and enhancing the strength. Furthermore, the addition of poloxamer 407 to mß-TCP could reduce the risk of leakage from bone defects and improve fracture toughness while maintaining mechanical properties. In this study, the poloxamer addition effects (0.05 and 0.1 g/mL) on the cellular activities of MC3T3-E1 cells cultured in vitro were investigated. The cell viability of mß-TCP containing poloxamer 407 was similar to that of mß-TCP. All specimens showed effective cell attachment and healthy polygonal extension of the cytoplasm firmly attached to hydroxyapatite (HA) crystals. Therefore, even with the addition of poloxamer to mß-TCP, it does not have a negative effect to osteoblast growth. These data demonstrated that the addition of poloxamer 407 to mß-TCP might be considered a potential therapeutic application for the repair and regeneration of bone defects.

Development and initial performance of a miniature axial flow blood pump using magnetic fluid shaft seal.

In this study, we developed a new catheter-mounted micro-axial flow blood pump (MFBP) using a new miniature magnetic fluid shaft seal (MFSS). The prototype of the catheter-mounted MFBP had a maximum diameter of 8 mm and a length of 50 mm. The new MFSS composed a neodymium magnet ring, an iron ring, and a magnetic fluid particularly designed for the MFSS. The new MFSS had outer and inner diameters of 4.0 mm and 2.6 mm, respectively, and a length of 3.0 mm. The sealing pressure of the MFSS was calculated to be 432 mmHg using FEM (Finite Element Method) result; therefore, the MFSS had sufficient sealing pressure for the catheter-mounted MFBP. The friction loss of the MFSS included the friction owing to the viscosity of the magnetic fluid and the magnetic force between the iron ring and ring magnet. The total friction loss of the MFSS was 0.08-0.09 W in the pump operational speed range from 22,000 to 35,000 rpm. From the in vitro experimental results, the catheter-mounted MFBP using the MFSS had a pump output of 3 L/min. against a differential pressure of 60 mmHg, and the pump characteristics of the MFBP were almost the same as those of Impella 5.0.

2-methacryloyloxyethyl phosphorylcholine polymer treatment prevents Candida albicans biofilm formation on acrylic resin.

PURPOSE: We aimed to evaluate the effectiveness of photoreactive 2-methacryloyloxyethyl phosphorylcholine (MPC) in inhibiting Candida albicans biofilm formation on polymethyl methacrylate (PMMA) and assess its mechanism and need for re-application by evaluating its interaction with salivary mucin and durability during temperature changes. METHODS: PMMA discs were used as specimens. The MPC coating was applied using the spray and cure technique for the treatment groups, whereas no coating was applied to the control. The MPC treatment (MT) groups were further differentiated based on the number of thermal cycles involved (0, 1000, 2500, and 5000). The optical density was measured to assess mucin adsorption (MA). Contact angle (CA) was calculated to evaluate surface hydrophilicity. The presence of MPC components on the PMMA surface was assessed using X-ray photoelectron spectroscopy (XPS). C. albicans biofilms were evaluated qualitatively (scanning electron microscope images) and quantitatively (colony-forming units (CFUs)). Statistical analysis was conducted using two-way analysis of variance and Tukey's multiple comparison test. RESULTS: MA rate and CA increased significantly in the MT groups, which exhibited significantly fewer CFUs and thinner biofilms than those of the control group. Based on the XPS, MA, and CFU evaluations, the durability and efficacy of the MPC coating were considered stable up to 2500 thermal cycles. Additionally, a significant interaction was observed between mucin concentration and MPC efficacy. CONCLUSIONS: The photoreactive MPC coating, which was resistant to temperature changes for approximately 3 months, effectively prevented C. albicans biofilm formation by modifying surface hydrophilicity and increasing mucin adsorption.

Effects of poloxamer additives on strength, injectability, and shape stability of beta-tricalcium phosphate cement modified using ball-milling.

A new CPC was developed in this study using a ß-TCP powder mechano-chemically modified by ball-milling. The prototype CPC exhibits excellent fluidity for easy injection into bone defects; however, there is a risk of leakage from the defects immediately after implantation due to its high fluidity. The addition of poloxamer, an inverse thermoresponsive gelling agent, into CPC optimizes the fluidity. At lower temperatures, it forms a sol and maintains good injectability, whereas at the human body temperature, it transforms to a gel, reducing the fluidity and risk of leakage. In this study, the effects of poloxamer addition of 3, 5, and 10 mass% on the injectability, shape stability, and strength of the prototype CPC were evaluated. The calculated injectability of the prototype CPC pastes containing three different poloxamer contents was higher than that of the CPC paste without poloxamer for 15 min at 37 °C. Furthermore, the shape stability immediately after injection of the three CPC pastes with poloxamer was higher than that of the CPC paste without poloxamer. After 1 week of storage at 37 °C, the compressive strength and diametral tensile strength of the CPC compacts containing 10 mass% poloxamer were similar to those of the CPC compact without poloxamer. Additionally, the CPC compacts containing 10 mass% poloxamer exhibited clear plastic deformation after fracture. These results indicate that the addition of poloxamer to the prototype CPC could reduce the risk of leakage from bone defects and improve the fracture toughness with maintaining the injectability and strength.

Effect of immersion in NaCl solution on the electrical conductivity and the reduction of the shear bond strength of resin-modified glass-ionomer-cements after current application.

Advancements in dental cements have considerably improved their bond strengths. However, high bond strength often makes the removal of restorations difficult. Thus, smart dental cements that show controllable bond strength are required. A conventional resin-modified glass-ionomer-cement demonstrated a significant reduction in the bond strength after current application. However, for this system, the ions in the cement are released into the oral cavity, resulting in a reduction of the electrical conductivity and in losses of the expected on-demand debonding property. Herein, the effects of immersion in 0.9 and 15% NaCl solutions on the electrical conductivity and debonding properties were investigated. The cement immersed in 0.9% NaCl solution from 1 to 28 days maintained similar bond strength reductions after current application, whereas that in 15% NaCl solution initially showed no bond strength reduction after 1 day but exhibited an increase in the bond strength reduction after immersion for 28 days.

Dentin-Pulp Complex Tissue Regeneration via Three-Dimensional Cell Sheet Layering.

The dentin-pulp complex is a unique structure in teeth that contains both hard and soft tissues. Generally, deep caries and trauma cause damage to the dentin-pulp complex, and if left untreated, this damage will progress to irreversible pulpitis. The aim of this study was to fabricate a layered cell sheet composed of rat dental pulp (DP) cells and odontogenic differentiation of pulp (OD) cells and to investigate the ability to regenerate the dentin-pulp complex in a scaffold tooth. We fabricated two single cell sheets composed of DP cells (DP cell sheet) or OD cells (OD cell sheet) and a layered cell sheet made by layering both cells. The characteristics of the fabricated cell sheets were analyzed using light microscopy, scanning electron microscope (SEM), hematoxylin-eosin (HE) staining, and immunohistochemistry (IHC). Furthermore, the cell sheets were transplanted into the subrenal capsule of immunocompromised mice for 8 weeks. After this, the regenerative capacity to form dentin-like tissue was evaluated using micro-computed tomography (micro-CT), HE staining, and IHC. The findings of SEM and IHC confirmed that layered cell sheets fabricated by stacking OD cells and DP cells maintained their cytological characteristics. Micro-CT of layered cell sheet transplants revealed a mineralized capping of the access cavity in the crown area, similar to that of natural dentin. In contrast, the OD cell sheet group demonstrated the formation of irregular fragments of mineralized tissue in the pulp cavity, and the DP cell sheet did not develop any hard tissue. Moreover, bone volume/tissue volume (BV/TV) showed a significant increase in hard tissue formation in the layered cell sheet group compared with that in the single cell sheet group (p < 0.05). HE staining also showed a combination of soft and hard tissue formation in the layered cell sheet group. Furthermore, IHC confirmed that the dentin-like tissue generated from the layered cell sheet expressed characteristic markers of dentin but not bone equivalent to that of a natural tooth. In conclusion, this study demonstrates the feasibility of regenerating dentin-pulp complex using a bioengineered tissue designed to simulate the anatomical structure. Impact statement The dentin-pulp complex can be destroyed by deep caries and trauma, which may cause pulpitis and progress to irreversible pulpitis, apical periodontitis, and even tooth loss. Current treatments cannot maintain pulp health, and teeth can become brittle. We developed a three-dimensional (3D) layered cell sheet using dental pulp cells and odontogenic differentiation of pulp cells for dentin-pulp complex regeneration. Our layered cell sheet enables the regeneration of an organized 3D dentin-pulp-like structure comparable with that of natural teeth. This layered cell sheet technology may contribute to dentin-pulp complex regeneration and provide a novel method for complex tissue engineering.

Effects of water immersion on shear bond strength reduction after current application of resin-modified glass-ionomer-cements with and without an ionic liquid.

The enhancement in the bonding strength of advanced dental cements has enabled long-lasting dental restorations. However, the high bonding strength can cause difficulty in removing these restorations. Therefore, "smart" dental cements with simultaneous strong bonding and easy on-demand debonding ability are required. A resin-modified glass-ionomer-cement (RMGIC) with an ionic liquid (IL) has demonstrated significant reduction in the bonding strength with current application (CA). This research investigates the effect of immersion in distilled water on the electric conductivity and bonding strength of RMGIC with and without an IL and CA. The RMGIC without the IL exhibited significant electric conductivity after immersion, and a significant decrease in bonding strength with CA. In comparison, the electric conductivity after immersion and the decrease in bonding strength with CA were greater for RMGIC with the IL. Thus, the feasibility of smart dental cements capable of electrically debonding-on-demand is indicated.

Electrical shear bonding strength reduction of resin-modified glass-ionomercement containing ionic-liquid: Concept and validation of a smart dental cement debonding-on-demand.

With improvement of bonding strength of recent dental cement, it is difficult nowadays to remove restorations without excessive force or vibration to tooth, occasionally resulting in damage of dentin, enamel, and dental root. Therefore, "smart" dental cement indicating strong bonding and easy debonding-on-demand simultaneously is required. In this research, resin-modified glass-ionomer-cement containing an ionic-liquid, tris(2-hydroxyethyl)methylammonium methylsulfate was produced, and the shear bonding strength before and after direct current application were evaluated. The prototype cement containing 15 to 20 mass% ionic-liquid indicated simultaneously no significant reduction of shear bonding strength from that of the original cement not containing ionic-liquid, and significant reduction of bonding strength to approximately 20% of that of the original cement after direct current application of more than 2 mmC/mm2. The prototype cement in this research demonstrated that the concept of smart dental cement electrically debonding-on-demand is feasible.

Effects of powder-to-liquid ratio on properties of ß-tricalcium-phosphate cements modified using high-energy ball-milling.

The authors have developed a ß-tricalcium-phosphate (ß-TCP) powder modified mechano-chemically through the application of a ball-milling process (mß-TCP). The resulting powder can be used in a calcium-phosphate-cement (CPC). In this study, the effects of the powder-to-liquid ratio (P/L ratio) on the properties of the CPCs were investigated, and an appropriate P/L ratio that would simultaneously improve injectability and strength was clarified. The mß-TCP cement mixed at a P/L ratio of 2.5 and set in air exhibited sufficient injectability until 20 min after mixing, and strength similar to or higher than that mixed at a P/L ratio of 2.0 and 2.78. Although the mß-TCP cements set in vivo and in SBF were found to exhibit a lower strength than those set in air, it did have an appropriate setting time and strength for clinical applications. In conclusion, P/L ratio optimization successfully improved the strength of injectable mß-TCP cement.

Application of porous titanium in prosthesis production using a moldless process: Evaluation of physical and mechanical properties with various particle sizes, shapes, and mixing ratios.

The prosthetic applications of titanium have been challenging because titanium does not possess suitable properties for the conventional casting method using the lost wax technique. We have developed a production method for biomedical application of porous titanium using a moldless process. This study aimed to evaluate the physical and mechanical properties of porous titanium using various particle sizes, shapes, and mixing ratio of titanium powder to wax binder for use in prosthesis production. CP Ti powders with different particle sizes, shapes, and mixing ratios were divided into five groups. A 90:10wt% mixture of titanium powder and wax binder was prepared manually at 70°C. After debinding at 380°C, the specimen was sintered in Ar at 1100°C without a mold for 1h. The linear shrinkage ratio of sintered specimens ranged from 2.5% to 14.2%. The linear shrinkage ratio increased with decreasing particle size. While the linear shrinkage ratio of Groups 3, 4, and 5 were approximately 2%, Group 1 showed the highest shrinkage of all. The bending strength ranged from 106 to 428MPa under the influence of porosity. Groups 1 and 2 presented low porosity followed by higher strength. The shear bond strength ranged from 32 to 100MPa. The shear bond strength was also particle-size dependent. The decrease in the porosity increased the linear shrinkage ratio and bending strength. Shrinkage and mechanical strength required for prostheses were dependent on the particle size and shape of titanium powders. These findings suggested that this production method can be applied to the prosthetic framework by selecting the material design.

Bone ingrowth of various porous titanium scaffolds produced by a moldless and space holder technique: an in vivo study in rabbits.

Porous titanium has long been desired as a bone substitute material because of its ability to reduce the stress shielding in supporting bone. In order to achieve the various pore structures, we have evolved a moldless process combined with a space holder technique to fabricate porous titanium. This study aims to evaluate which pore size is most suitable for bone regeneration using our process. The mixture comprising Ti powder, wax binder and PMMA spacer was prepared manually at 70 °C which depended on the mixing ratio of each group. Group 1 had an average pore size of 60 µm, group 2 had a maximum pore size of 100 µm, group 3 had a maximum pore size of 200 µm and group 4 had a maximum pore size of 600 µm. These specimens were implanted into rabbit calvaria for three and 20 weeks. Thereafter, histomorphometrical evaluation was performed. In the histomorphometrical evaluation after three weeks, the group with a 600 µm pore size showed a tendency to greater bone ingrowth. However, after 20 weeks the group with a pore size of 100 µm showed significantly greater bone ingrowth than the other groups. This study suggested that bone regeneration into porous titanium scaffolds is pore size-dependent, while bone ingrowth was most prominent for the group with 100 µm-sized pores after 20 weeks in vivo.

Bone Ingrowth to Ti Fibre Knit Block with High Deformability.

OBJECTIVES: The objective of this study is to develop a Ti fibre knit block without sintering, and to evaluate its deformability and new bone formation in vivo. MATERIAL AND METHODS: A Ti fibre with a diameter of 150 µm was knitted to fabricate a Ti mesh tube. The mesh tube was compressed in a metal mould to fabricate porous Ti fibre knit blocks with three different porosities of 88%, 69%, and 50%. The elastic modulus and deformability were evaluated using a compression test. The knit block was implanted into bone defects of a rabbit's hind limb, and new bone formation was evaluated using micro computed tomography (micro-CT) analysis and histological analysis. RESULTS: The knit blocks with 88% porosity showed excellent deformability, indicating potential appropriateness for bone defect filling. Although the porosities of the knit block were different, they indicated similar elastic modulus smaller than 1 GPa. The elastic modulus after deformation increased linearly as the applied compression stress increased. The micro-CT analysis indicated that in the block with 50% porosity new bone filled nearly all of the pore volume four weeks after implantation. In contrast, in the block with 88% porosity, new bone filled less than half of the pore volume even 12 weeks after implantation. The histological analysis also indicated new bone formation in the block. CONCLUSIONS: The titanium fibre knit block with high porosity is potentially appropriate for bone defect filling, indicating good bone ingrowth after porosity reduction with applied compression.

Effects of high-energy ball-milling on injectability and strength of ß-tricalcium-phosphate cement.

Calcium phosphate cement (CPC) offers many advantages as a bone-substitution material. The objective of this study is to develop a new CPC that simultaneously exhibits fine injectability, a short setting time, and high strength. ß-tricalcium phosphate (ß-TCP, control) powder was ball-milled for 24h to produce a new cement powder. The modified ß-TCP after 24h milling (mß-TCP-24h) exhibited excellent injectability even 1h after mixing. The mechanical properties of the set cement (compact) were evaluated using compressive strength (CS) and diametral tensile strength (DTS) testing. The CS and DTS values of the mß-TCP-24h compacts were 8.02MPa and 2.62MPa, respectively, at 5h after mixing, and were 49.6MPa and 7.9MPa, respectively, at 2 weeks after mixing. All the CS and DTS values of the mß-TCP-24h compacts were significantly higher than those of the control for the same duration after mixing. These results suggest that the mechano-chemically modified ß-TCP powder dissolves rapidly and accelerates hydroxyapatite precipitation, which successfully shortens the cement setting time and enhances the strength. This study supports that mß-TCP-24h is a promising candidate for use in injectable CPCs with improved strength.

Fabrications of zinc-releasing biocement combining zinc calcium phosphate to calcium phosphate cement.

Recently, zinc-releasing bioceramics have been the focus of much attention owing to their bone-forming ability. Thus, some types of zinc-containing calcium phosphate (e.g., zinc-doped tricalcium phosphate and zinc-substituted hydroxyapatite) are examined and their osteoblastic cell responses determined. In this investigation, we studied the effects of zinc calcium phosphate (ZCP) derived from zinc phosphate incorporated into calcium phosphate cement (CPC) in terms of its setting reaction and MC3T3-E1 osteoblast-like cell responses. Compositional analysis by powder X-ray diffraction analysis revealed that HAP crystals were precipitated in the CPC containing 10 or 30wt% ZCP after successfully hardening. However, the crystal growth observed by scanning electron microscopy was delayed in the presence of additional ZCP. These findings indicate that the additional zinc inhibits crystal growth and the conversion of CPC to the HAP crystals. The proliferation of the cells and alkaline phosphatase (ALP) activity were enhanced when 10wt% ZCP was added to CPC. Taken together, ZCP added CPC at an appropriate fraction has a potent promotional effect on bone substitute biomaterials.

Evaluation of strontium introduced apatite cement as the injectable bone substitute developments.

We have developed bone cement introducing Strontium (Sr) to promote early bone regeneration. To prolong the release duration of Sr, we applied inorganic Sr filler for containing into the cement powder. The purpose of this study is to evaluate the mechanical properties, crystallinic properties, and ion release activities, especially Sr anion, of this cement. Alpha-TCP powder was mixed with Sr filler, with 0.1wt%, 0.5wt%, 1.0wt%, and 5.0wt%. These were mixed with mixing liquid and formed for each test. They were incubated and crystalized in 95% moisture for 1 week. The mechanical properties were studied by the compression, the diametral tensile strength and 4-point vending. Tested specimens were evaluated by X-ray diffraction(XRD) and scanning electron microscopic(SEM) imaging. The ion release behaviors were measured by inductively coupled plasma mass spectrometry(ICP-MS). The mechanical properties were increased in consistency of filler, but decreased in some samples because of declining the apatite matrix. And the Sr release showed interesting results as the sequential resource of Sr. By adjusting the mixing ratio or considering the application of these Sr releasable cements, this material would show good performance by its strength and longer Sr release for bone regeneration.

Biochemical evaluation of an artificial anal sphincter made from shape memory alloys.

Severe anal incontinence is a socially incapacitating disorder and a major unresolved clinical problem that has a considerable negative impact on quality of life. In this study, we developed a new artificial anal sphincter using shape memory alloys (SMAs) in order to improve the quality of life of such patients and evaluated the influence of this sphincter on blood serum chemistry in animal experiments. The artificial anal sphincter was driven by two Ti-Ni SMA actuators sandwiching the intestine and was implanted in three female goats. Blood was collected from the jugular vein on days 1 and 4; at weeks 1 and 2; and at months 1, 2, and 3, postoperatively. Biochemical parameters including total protein, albumin, total bilirubin, aspartate amino-transferase, blood urea nitrogen, creatinine, and C-reactive protein were examined. The time courses of total bilirubin and aspartate amino transferase of the three goats were within the baseline levels after 1 week of implantation and remained normal, demonstrating no liver function complications. The blood urea nitrogen and creatinine levels remained within the normal range, indicating no renal function complications. The total protein and albumin fluctuated within the normal range throughout the duration of this study. In these goats, it was also found that the level of C-reactive protein did not increase and that there was no stricture of the intestine where the artificial sphincter was attached. Our findings indicate that the artificial sphincter SMA demonstrated no adverse influence on blood serum chemistry and exhibited an effective system performance.

A hydrodynamically suspended, magnetically sealed mechanically noncontact axial flow blood pump: design of a hydrodynamic bearing.

To overcome the drive shaft seal and bearing problem in rotary blood pumps, a hydrodynamic bearing, a magnetic fluid seal, and a brushless direct current (DC) motor were employed in an axial flow pump. This enabled contact-free rotation of the impeller without material wear. The axial flow pump consisted of a brushless DC motor, an impeller, and a guide vane. The motor rotor was directly connected to the impeller by a motor shaft. A hydrodynamic bearing was installed on the motor shaft. The motor and the hydrodynamic bearing were housed in a cylindrical casing and were waterproofed by a magnetic fluid seal, a mechanically noncontact seal. Impeller shaft displacement was measured using a laser sensor. Axial and radial displacements of the shaft were only a few micrometers for motor speed up to 8500 rpm. The shaft did not make contact with the bearing housing. A flow of 5 L/min was obtained at 8000 rpm at a pressure difference of 100 mm Hg. In conclusion, the axial flow blood pump consisting of a hydrodynamic bearing, a magnetic fluid seal, and a brushless DC motor provided contact-free rotation of the impeller without material wear.

Impact of type A behavior on brachial-ankle pulse wave velocity in Japanese.

Pulse wave velocity (PWV) is the velocity of a pulse wave traveling a given distance between 2 sites in the arterial system, and is a well-known indicator of arteriosclerosis. Brachial-ankle PWV (baPWV) is a parameter more simple to obtain, compared with the conventional PWV, and is an easy and effective means of evaluating arteriosclerosis. BaPWV can be obtained by only wrapping the four extremities with blood pressure cuffs, and it can be easily used to screen a large number of subjects. Type A behavior has been confirmed as an independent risk factor for the development of coronary heart disease. To examine the relationship between Type A behavior and arteriosclerosis, 307 normal Japanese subjects were classified into either a Type A group (n = 90) or a non-Type A group (n = 217) by using Maeda's Type A Scale. BaPWV was evaluated using a PWV diagnosis device. The baPWV in the Type A group was significantly higher than that obtained in the non-Type A group. The baPWV showed a positive correlation with age both in the Type A group and in the non-Type A group; however, the straight-line regression slope of baPWV versus age in the Type A group was significantly larger than that in the non-Type A group. Therefore, our results suggest that arteriosclerosis might be promoted earlier in subjects expressing the Type A behavior pattern. Type A behavior pattern is confirmed as a risk factor for arteriosclerosis, and may increase the risk of the cardiovascular disease related to arteriosclerosis.

Evaluation of cardiac function based on ventricular pressure-volume relationships during assistance with a rotary blood pump.

Nowadays, a rotary blood pump can be used as not only for a bridge to transplantation (BTT) but also for a bridge to recovery (BTR) and a destination therapy (DT). In such cases, evaluation of the recovery level of the native heart provides useful information to improve the clinical strategy and decide adequate timing for removing of the RBP. In contrast, the indices for cardiac function have been studied. However, most of them do not consider the assistance with the RBP. In this study, we aimed at evaluating whether Emax, which is an index for cardiac function based on the pressure-volume relationships, is still valid during assistance with the RBP from an animal experiment. In the acute animal experiment with an adult goat, we measured pressure-volume (P-V) loops while cardiac function was normal, augmented or diminished. The experimental results revealed that there were typical differences in the shapes of P-V loops when the cardiac function was altered, and Emax can still be used as an index for the cardiac function even if the assistance with the RBP is ongoing.

Development of the pulsation device for rotary blood pumps.

A rotary blood pump (RP) is desirable as a small ventricular assist device (VAD). However, an RP is nonpulsatile. We tried to develop a device that attaches a pulse to the RP. We also tried to develop a pulse-generating equipment that was not air-pressure driven. The ball screw motor was considered a candidate. The application of a small-sized shape memory alloy was also attempted. An electrohydraulic system was adopted, and actuator power was connected to the diaphragm. The diaphragm was placed on the outer side of the ventricle. Most RPs that have been developed all over the world drain blood from the ventricle. The wave of a pulse should be generated if a pulse is added by the drawn part. The output assistance from the outer side of the ventricle was attempted in animal experiments, and the device operated effectively. This device can be used during implantable operation of RP. This may serve as an effective device in patients experiencing problems in peripheral circulation and in the function of internal organs.