Clinical Hemorheology and Microcirculation - Volume 5, 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: The effects of two beta-adrenoceptor antagonist drugs, propranolol and carteolol, on blood viscosity and its determinants were assessed in a double-blind, placebo-controlled study of 9 normal males, both at rest and following maximal exercise. Blood viscosity increased significantly at both high and low shear rates following exercise, and this was unaltered by effective beta-blockade. The increase in viscosity was associated with significant increases in haematocrit, plasma viscosity and fibrinogen level. Propranolol increased resting blood viscosity (corrected for haematocrit) at the high shear rate, a potential adverse effect not observed with carteolol. The increase in blood viscosity on exercise might reduce…blood flow in subjects with occlusive arterial disease, and hence may have clinical implications.
Abstract: Morphologic features of two cases of hyperviscosity syndrome are shown. They concern both the vessels and the surrounding tissue. The most distinctive features are the engorgement of small vessels by clumps of red cells, which appear often distorted and irregular in shape, and perivascular and pericellular edema. The vessel wall may be thin and normal in appearance at microscopic examination or thickened by a deposition of PAS-positive material. The connection between the impairment of microcirculation and the lesion of the surrounding tissue appears documented by the morphologic findings.
Keywords: Hyperviscosity Syndrome, Plasma cell dyscrasias, Cryoglobulinemia, Small vessel engorgement, Perivascular and pericellular edema
Abstract: Three vasoactive compounds (oxpentifylline, prazosin and indoramin) were given to beagle dogs in three separate studies. Oxpentifylline produced decreases in whole blood viscosity and in the viscosity of blood corrected to a standard haemoglobin concentration of 16.0g/dl. These effects, however, were not consistent. Prazosin produced a sustained decrease in whole blood viscosity related to a decreased red cell population and an improvement in blood rheology at the cellular level (red cell deformability and red cell aggregation). Indoramin produced a decrease in whole blood viscosity related to a decreased red cell population, this effect was not sustained in the beagle dog.
Abstract: A comparison of instruments for the measurement of erythrocyte deformability (Contraves LS30, Ektacytometer, Hemorheometre SP02 and Erythrometre) was made using in vitro manipulated erythrocytes and also ex vivo leucocyte-free blood samples from 110 patients. In vitro manipulation of either erythrocyte cytoplasmic viscosity, membrane elasticity, or cell shape was of limited value in predicting instrument performance in the subsequent clinical study which included patients with arterial disease (37), renal failure (30), liver failure (30) and excess alcohol (13). The study demonstrates that erythrocyte volume and shape are important determinants of rheological differences between patient groups and that a combination of instruments…is required to obtain maximum rheological information.
Abstract: In order to further the already existing knowledge of the relationship between cerebral aging and haemorheological parameters, we determined the haemorheological and neuro-psychological profiles in a group of normal, self-sufficient and active octogenarians. The haemorheological profile is an index of microcirculatory function, and the neuro-psychological profile is specific for the cortical functions. Thirty octogenarian subjects (average age 86 ± 1 SE), 12 males and 18 females, all with a negative clinical history for important diseases, were studied. Our results regarding the haemorheological status show that fibrinogen seems to act as a “marker for aging”, as there is…a clear correlation between this factor and age, while haematocrit seems to be the “longevity marker”, as it is substantially analogous to that of the young controls. The psycho-intellectual condition of the 30 healthy octogenarians shows that the superior cortical functions most suited to their life style are well conserved. This is in contrast with the findings of some authors that point out selective age-dependent compromission of the right hemisphere.
Abstract: Filtrability of erythrocytes through polycarbonate sieves with a mean pore diameter of 5 m was studied in fresh blood and stored donor blood before and after rejuvenation with PIGPA and the result was related to simultaneous variations in red cell 2,3-diphosphoglycerate content (2,3-DPG). Following incubation with PIGPA for 2 hours there occurred a significant increase in the content of red cell 2,3-DPG reaching the highest values in fresh blood (14.85 ± 1.05 vs. 4.80 ± 0.65 mmol/l eryth., p < 0.001). The oxygen affinity of hemoglobin simultaneously decreased, and the P50 , 7.40 closely correlated with red cell 2,3-DPG content…(r = 0.86, p < 0.001). Erythrocyte filtrability of all samples with excess 2,3-DPG content significantly decreased and a negative correlation was present between the concentration of red cell 2,3-DPG and the flow rate (r = −0.67, P < 0.001).
Abstract: By using a new, accurate and sensitive filtration method, we report that at atmospheric pO2 and at 25°C the red blood cell rigidity is highly increased in sickle cell syndromes (SS and AS) and in β thalassemia (minor and intermedia). A rigidity index IR, related to red cell deformabillty was 10 times higher for SS RBCs than that for control AA cells. The heterozygotes states of β thalassemia and of sickle cell disease exhibited an increase in the rigidity index of 90% and 330% of the normal value, respectively.
Abstract: The viscosity of cord blood from 47 normal infants, 23 small for dates (SFD) infants and 14 infants from mothers with amnionitis was measured at low shear rates to elucidate the fluidity of blood at low flow states. The blood viscosity of the SFD infants was 29.1 ± 12.2 cp (mean ± S.D.) at 0.5 sec-1 and 13.6 ± 3.8 cp at 3.4 sec-1 , being significantly higher than that of the normal infants (18.6 ± 6.5 cp at 0.5 sec-1 ; 10.3 ± 2.8 cp at…3.4 sec-1 ) (p < 0.01). The levels of viscosity of the infants with maternal amnionitis were 30.2 ± 9.6 cp at 0.5 sec-1 and 14.1 ± 3.5 cp at 3.4 sec-1 , being also significantly higher than the normal ones (p < 0.01). The measurements of hematocrit and fibrinogen levels of the infants of the three groups revealed that the increased blood viscosity in the SFD infants was due to increased hematocrit and in the infants with maternal amnionitis due to increased fibrinogen. It was suggested that in such abnormal fetuses, increased clumping and sludging of red blood cells would occur in fetal and feto-placental microcirculation and impair the tissue oxygenation of the fetuses during parturition.
Keywords: amnionitis, blood viscosity, fetal distress, fetal membranes premature rupture, infection, small for dates infant
Abstract: Forty elderly patients suffering from primary mental deterioration were assessed for haemorheological factors and intellectual capacity. They were then divided into four randomized groups and treated with one of the following 1) PLACEBO 2) “TRENTAL” 400 (pentoxifylline) 3) “MENTIUM” (2-dimethylaminoethanol) 4) “NORZETAM” (2-oxo-1 pyrrolidone acetamide). After three months of treatment the two parameters were re-evaluated and the results compared with the pre-therapy data to establish whether there is any correlation between haemorheological values and psychological test scores. The differences found would seem to warrant further investigations on the role of haemorheological factors in mental deterioration, as well as on the…three drugs tested.
Keywords: Mental deterioration, haemorheological factors in elderly, psychometric tests in elderly
Abstract: Azotaemia in patients with myeloma at the time of presentation is regarded as indicating a poor prognosis. Hypercalcaemia, hyperuricaemia, sepsis, nephrotoxic drugs, amyloid and plasma cell infiltration may be important in some cases, but intrarenal haemodynamics, glomerular filtration dynamics, tubular dysfunction and paraprotein nephrotoxicity may be more important. Immunoglobulin light chains which are freely filtered by the glomerulus have been shown to have a high correlation with the presence of renal insufficiency and there is evidence for these proteins being toxic to the renal tubular cells. With forced alkaline diuresis, with plasma exchange in some patients, it has been possible…to improve renal function. Experience with 14 patients with multiple myeloma in whom this has been achieved has given new insights into the pathophysiology and guidelines to the various modes of therapy.