Clinical Hemorheology and Microcirculation - Volume 15, issue 6
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Clinical Hemorheology and Microcirculation, a peer-reviewed international scientific journal, serves as an aid to understanding the flow properties of blood and the relationship to normal and abnormal physiology. The rapidly expanding science of hemorheology concerns blood, its components and the blood vessels with which blood interacts. It includes perihemorheology, i.e., the rheology of fluid and structures in the perivascular and interstitial spaces as well as the lymphatic system. The clinical aspects include pathogenesis, symptomatology and diagnostic methods, and the fields of prophylaxis and therapy in all branches of medicine and surgery, pharmacology and drug research.
The endeavour of the Editors-in-Chief and publishers of
Clinical Hemorheology and Microcirculation is to bring together contributions from those working in various fields related to blood flow all over the world. The editors of
Clinical Hemorheology and Microcirculation are from those countries in Europe, Asia, Australia and America where appreciable work in clinical hemorheology and microcirculation is being carried out. Each editor takes responsibility to decide on the acceptance of a manuscript. He is required to have the manuscript appraised by two referees and may be one of them himself. The executive editorial office, to which the manuscripts have been submitted, is responsible for rapid handling of the reviewing process.
Clinical Hemorheology and Microcirculation accepts original papers, brief communications, mini-reports and letters to the Editors-in-Chief. Review articles, providing general views and new insights into related subjects, are regularly invited by the Editors-in-Chief. Proceedings of international and national conferences on clinical hemorheology (in original form or as abstracts) complete the range of editorial features.
The following professionals and institutions will benefit most from subscribing to
Clinical Hemorheology and Microcirculation: medical practitioners in all fields including hematology, cardiology, geriatrics, angiology, surgery, obstetrics and gynecology, ophthalmology, otology, and neurology. Pharmacologists, clinical laboratories, blood transfusion centres, manufacturing firms producing diagnostic instruments, and the pharmaceutical industry will also benefit.
Important new topics will increasingly claim more pages of
Clinical Hemorheology and Microcirculation: the role of hemorheological and microcirculatory disturbances for epidemiology and prognosis, in particular regarding cardiovascular disorders, as well as its significance in the field of geriatrics. Authors and readers are invited to contact the editors for specific information or to make suggestions.
Abstract: Jordan is a unique country where you have people living at 390 m below sea level at Dead sea area and others living at 1025 m above sea level at the capital Amman. The horizontal distance between these two areas is relatively short not exceeding 30 Km. High school students from each of Amman and Dead Sea areas were compared in respect to venous blood RBC, Hb, PCV, MCV, MCH, MCHC, WBC and washed erythrocyte deformability and intracellular electrolytes. Whole blood results of RBC, Hb, PCV and MCHC were significantly lower and erythrocyte MCV values were significantly higher at Dead…Sea level compared with Amman. Erythrocytes from students living at Dead Sea area also showed significantly lower filtration index values (i.e higher deformability) and higher intracellular K+ concentration compared with Amman. This study demonstrates the importance of environmental oxygen tension in determining the blood flow in vivo. The implication of this phenomenon is obvious when designing and interpreting clinical studies and also in advising patients with haemorheolgical problems.
Abstract: In ektacytometry (or laser-diffractometry), the deformation of red blood cells subjected to a series of shear stresses in Couette flow (high to low) is measured. The shear stress dependency of the measured deformation index DI is called a “deformation curve” and depends upon membrane and cell properties. We studied the relation between red cell rheology and the various stages of the deformation curve. We used this insight to introduce an empirical model to describe the deformation curve in parameters that represent characteristics of the curve. The Deformation Curve is an S-shaped curve when the shear stress is plotted…on a logarithmic scale, and found to be accurately described by: DI(τ)=DImin +(DImax −DImin )(τ/τi )m /(τ/τi )m +1]. The minimum deformation (DImin ) at low stress is determined by the orientation of undeformed cells. At intermediate stresses the DI is determined by both the orientation and the deformation. At these stresses the tank-treading is commonly believed to be important and is reflected in τi . This is confirmed by the sensitivity of τi to membrane deformability. At high stresses the orientation angle is small and DImax is mainly determined by the constant surface area-to-volume ratio of the cells. Parameter m determines the slope at intermediate stresses but the relation with cell rheology is yet unclear. Although the parameters cannot be independently linked to membrane or cell properties, the empirical model proved to be useful in describing deformation curves over a large range of red cell deformabilities. We think that such parametrization of the deformation curve will prove to be very useful in standardization of ektacytometric measurements for clinical purposes.
Abstract: In the frame work of a cross sectional study n=40 patients with mostly minor to moderate degree type I von Willebrand JUrgens syndrome (vWJ syndrome) were examined. Besides examining the concentration and activity (reduced by 20 to 40%) of the von Willebrand factor including the multimere analysis, the factor VIII activity and factor VIII antigen in these patients we also determined the PTT, the coagulation time and microscopically examined the nail fold capillaries. This showed morphological and dynamic changes of the microcirculation in comparison to a collective of n=100 apparently healthy subjects. Where as the capillary density was within the…physiological limits 38 of the 40 patients showed a markedly increased torquation. 30 of the 40 patients presented dilated arteriole and venous branches of the capillary in part very marked. It was of particular interest that we observed extravascular blood cells and blood bands surrounding the capillary in 16 of the 40 patients.33 patients had a discontinuous and discordant capillary perfusion at rest and in 10 patients a stagnation of flow was observed. 30 patients presented a lower mean capillary erytlrrocyte velocity than according to norm and 24 patients had a decreased vasomotor reserve. All patients examined showed changes in the capillary morphology. The correlation between the clinical data and the laboratory and capillary microscopic findings shown here stress the high sensitivity of the capillary microscopy.
Keywords: von Willebrand Jürgens syndrome, video capillary microscopy, cutaneous microangiopathy
Abstract: The action of prostaglandins on the vascular smooth muscle but not on the blood itself is well established. The present study evaluates possible effects of the prostaglandins (PGs) D2 , E1 , E2 , F1α , F2α and of the I2 analogue Iloprost®on blood flow properties. To get insight mto the mode of action of the compounds their effects on different hemorheological parameters were measured under physiological conditions. In no case an effect on plasma viscosity could be seen; in the presence of PG D2 , F1α and F2α no effect at all was observerd. With…PG E2 , however, the erythrocyte filtrability and the elastic component of the visco-elasticity decreased, while the erythrocyte aggregation increased. The opposite was seen as well in whole blood, run with PG E1 , as in platelet- and leucocyte-depleted blood, run with Iloprost®. A similar or identic side of action is assumed for the effective compounds. Noteworthly these agents did not show typical sigmoid shaped dose-efficacy dependencies. They rather exerted their hemorheological actions with the extraordinary low doses of 10−11 resp. 10−9 mol/l and were effective over a concentration range of 2 - 3 decimal places only. The over all subtle effects utmostly were deviations of the controls about 5 - 10 %. These features are suggestive of semaphores without any therepeutic actions on the erythrocyte fluidity.
Abstract: The aim of the study was to assess the separate influences of plasma lipoproteins and fibrinogen on plasma viscosity (PV), minimizing/controlling for the effect of confounders by patient selection and by data analysis. In 30 normal male volunteers, nonsmokers, and 90 male, nonobese nonsmokers with various types of primary hyper lipoproteinemias, but otherwise healthy, the plasma levels of total cholesterol (Chol), the low density cholesterol (LDL) , the high density cholesterol (HDL) , triglyceride. (Tg) and fibrinogen (Fib) were measured in conjunction with determinations of plasma viscosity (PV). By the stepwise regression variable selection 60% of variation in PV was…explained by equating PV as: PV(mPa·s) = 1.352 + 0.0167·Chol(mmol/L) + 0.0285·Fib(g/L) + 0.0054·Tg(mmoljL) + 0.00318·Hematocrit(%) - 0.030·HDL(mmol/L), R=0.774. Expressed in standardized residuals the effect of Chol was about 3 times greater compared to Fib and Tg. Thus, in the studied sample the leading influence of cholesterol on plasma viscosity was observed, whereas hematocrit and HDL exerted independent positive and negative associations with plasma viscosity, respectively.
Abstract: Erythrocyte deformability, erythrocyte membrane fluidity, mean corpuscular volume (MCV) and mean corpuscular hemoglobin concentration (MCHC) were determined in 36 healthy subjects and 38 cases of acute exacerbation patients with chronic cor pulmonale, and the shape of RBCs was observed with a scanning electron microscope (SEM) in 6 healthy subjects and 8 cases of patients. The results showed that erythrocyte deform ability, erythrocyte membrane fluidity and MCHC of patients decreased significantly compared with those of healthy subjects. MCV and percentage of abnormally shaped RBCs (most of them were stomatocytes, codocytes and spherocytes) of patients increased significantly compared with those of healthy…subjects. It is concluded that the decrease of erythrocyte deform ability in acute exacerbation patients with chronic cor pulmonale may be caused by reduction of erythrocyte membrane fluidity and increase of abnormally shaped RBCs.
Keywords: chronic COI pulmonale, erythrocyte deformability, erythrocyte membrane fluidity, morphology of RBCs
Abstract: The maximum deformation indexes (DI)max and integration defromation index (IDI) of RBC in patients with noninsulin-dependent diabetes mellitus (NIDDM) were measured with Ektacytometry. Comparing with controls, (DI)max and 101 for NIDDM patients change with duration of NIDDM. No difference of (DI)max between less than 3 year-term NIDDM patients without complications and the controls was found but significant difference of IDI in this subgroup of patients was present. (DI)max , IDI in greater than 3 year-term NIDDM patients decreased with the duration of NlDDM when compared with the controls. Moreover, (DI)max and IDI were related with complications.…These facts suggest that the duration or patient's condition in NIDDM patients might be judged by means of deformation indexes.
Abstract: Omega-3-fatty acids (n-3-FA) have various positive hemorheological effects in different clinical conditions. Ten male patients (mean age: 50 years) with ischemic heart disease and hyperlipoproteinemia were studied. They were treated by 10 capsules of Ameu (Omega Pharma, Berlin, Germany; 0.5 g salmon oil with 33% of n-3-FA) daily for two months. Besides routine laboratory parameters, hemorheological measurements (whole blood, plasma and serum viscosity) and exercise stress test with noninvasive hemodynamic control at baseline and after two months of treatment were carried out. Significant decrease (p < 0.01) of triglycerides (58%) was found. Cholesterol and plasma viscosity showed only a moderate…decrease. Whole blood viscosity, exercise capacity and the measured hemodynamic parameters improved significantly (p < 0.05 or better). Our results show that this preparation can be useful in clinical practice because it has a beneficial effect on plasma lipids and on hemorheological and hemodynamic parameters.
Abstract: We demonstrate that in vitro incubation of erythrocytes from normal human adults in a series of aspirin analogues of increasing lipophilicity leads to a correspondingly decreased resistance (apparent viscosity) to their flow in narrow capillaries. No particular trend was observed in mean cell volume and morphologic characteristics of the cells. These observations demonstrate that erythrocyte flow characteristics are affected even before any observable changes occur in morphologic and geometric characteristics. We suggest that other changes occur in the membrane constitution which lead to a decreased membrane elastic stiffness and shear viscosity. These changes are greater with more lipophilic salicylates, perhaps,…because they are adsorbed to a greater degree in the lipid bilayer and they disrupt the constitution of the membrane to a greater extent.