Clinical Hemorheology and Microcirculation - Volume 2, issue 4
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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: Rheological study was initiated in 1971 on blood samples obtained from patients treated by Melanoma Clinic (Head: Professor Gerald Milton) of Sydney Hospital. These studies, covering 120 patients, included investigations of blood viscosity, plasma viscosity, rigidity of red cells, aggregation of red cells, protein levels and ratios, and formation of artificial thrombi in vitro. Patients were followed in order to observe effect of metastases and in order to correlate time intervals between tests and death with blood viscosity factors. Only half of the patients survived till end of 1980. Both the survivors and the deceased showed significant abnormalities of blood…viscosity factors when compared to normal values. Presence of high degree of aggregation of red cells and of high plasma viscosity appears to be linked with the onset of metastases, and appears to be a diagnostic and predictive test even when the usual clinical tests for metastases are negative. Plasma viscosity in patients with metastases was elevated 2.7 to 4.5 standard deviations above the normal mean value; aggregation of red cells was elevated by 2.8 to 3.4 standard deviations above the normal mean value. Abnormalities increase as the death from metastases nears by. For instance, correlation between plasma viscosity and survival time shows correlation coefficient r = −0.437 and significance P < 0.02. The predictive value of rheological assessment of survival time improves when two main parameters, plasma viscosity and aggregation of red cells, are used simultaneously as a sum of standard deviations from the normal values: y (surv time)= = −3.99x + 36.1 ± 8.7; r = −0.803, P<0.001. Hypothesis has been proposed that metastases are enhanced by increased aggregation of red cells and hyperviscosity (which also inhibits immunological defence).
Keywords: Malignant Melanoma, metastases, blood viscosity, aggregation and rigidity of: red cells, survival time in cancer
Abstract: A new technique of epi-fluorescent video microscopy has been used to continuously monitor platelet and leukocyte interactions with the lumenal surface of collagen and endothelial cell coated glass tubes. The platelets were rendered fluorescent by addition of quinacrine (10 µm) to heparinized (10 units/ml) human blood. Blood was perfused through the tubes at wall shear rates from 80 to 4000 per second. Platelets arrived as individual cells which adhered to the collagen-coated surface on contact. Subsequent platelets preferentially adhered distally and laterally to already-adherent platelets, forming wedge-shaped mural aggregates that were axially aligned. Aggregate growth downstream is consistent with a…platelet-derived material, such as ADP or thromboxane A2 , emitted from adherent platelets promoting platelet accumulation. Endothelial cell surfaces were essentially non-adherent even when aspirin pre-treated.
Abstract: Blood behaves like a suspension of deformable particles in a macromolecular medium and blood viscosity is conditioned by a number of factors. The determining factors include in particular: macroscopic factors (hematocrit, plasma proteins...), physical factors (temperature, shear rate...) and microrheological factors (internal viscosity, mechanical properties of the erythrocyte membrane...). Considered from this general viewpoint, the rheological modifications which are liable to be encountered during diseases may be related to: – an increase in the number of blood elements, – an increase in plasma protein levels, the appearance of an abnormal protein and a change in erythrocyte aggregation,…– an increase in internal erythrocyte viscosity, – reduced elasticity or change in the shape of the erythrocyte. On the basis of this data, the author has examined a classification of the main hemorheological disturbances encountered during hematological diseases. an increase in the number of blood elements, an increase in plasma protein levels, the appearance of an abnormal protein and a change in erythrocyte aggregation, an increase in internal erythrocyte viscosity, reduced elasticity or change in the shape of the erythrocyte.
Abstract: This brief overview discusses the theoretical reasons why drugs acting on vascular smooth muscle cells may be beneficial in the treatment of peripheral vascular disease, taking the calcium entry blockers as examples. A logical explanation for their potential beneficial effect must consider their ability not only to alleviate vasospasm but also to affect the function of the blood constituents, the endothelial cells, and the tissue cells themselves.
Abstract: The interactions of platelets between themselves or with a damaged endothelium can be diagrammatically divided into three more or less simultaneous phases : contact, stimulation by aggregating substances, formation of microthrombis. On this basis it is possible to examine how an antiplatelet agent may interfere with the rheological factors of blood and alter one or more stages of this theoretical diagram. Two main groups of drugs can be then considered: – drugs which cause physiological changes (release, synthesis, adhesion...) which differ according to blood flow conditions. – drugs which act directly on the membrane and cause modifications…on macrorheological parameters (rouleaux formation, viscosity, viscoelasticity) or on microrheological parameters (R.B.C. deformability, membrane fluidity, surface charge...). On the basis of these two main types of interference, it is possible to study some drugs acting on platelets which are liable to act according to the above patterns. drugs which cause physiological changes (release, synthesis, adhesion...) which differ according to blood flow conditions. drugs which act directly on the membrane and cause modifications on macrorheological parameters (rouleaux formation, viscosity, viscoelasticity) or on microrheological parameters (R.B.C. deformability, membrane fluidity, surface charge...).
Abstract: The findings of 398 consecutive measurements of blood viscosity, plasma viscosity and hematocrit were submitted to a statistical analysis. Hematocrit appeared to be the major determinant of blood viscosity, even though its influence was not as strong as had been claimed previously. The correlation between blood viscosity and hematocrit appeared strictly related to the red cell mass of blood sample, being stronger when the latter exceeded physiologic range. The correlation disappeared when red cell mass was severely reduced. The correlation of plasma viscosity and blood viscosity behaved in an opposite manner. The data allow one to draw some corollaries which…may be helpful in clinical practice.
Keywords: Blood Viscosity, Plasma Viscosity, Hematocrit, Red Cell, Plasma Proteins
Abstract: The red cell shear induced elongation in some hemolytic diseases was determined using the diffractometric method (ektacytometry). Significantly decreased cellular elongation was found in hereditary spherocytosis, autoimmune idiopathic hemolytic anemia and some hemoglobinopathies. On the other hand in other hemolytic disorders including paroxysmal nocturnal hemoglobinuria, glucose-6-phosphate dehydrogenase and pyruvate kinase deficiencies, non-spherocytic hemolytic anemia and even autoimmune hemolytic anemia in remission we failed to observe the altered elongation in shear compared to normal donors. These results confirm our previous findings obtained by the simple filtration method and they show that there is good negative correlation between elongation index and red…blood cell.s retention on filter.
Keywords: red cell shear induced elongation, ektacytometry, hemolytic anemias