Clinical Hemorheology and Microcirculation - Volume 5, issue 6

Article Type: Editorial

DOI: 10.3233/CH-1985-5615

Citation: Clinical Hemorheology and Microcirculation, vol. 5, no. 6, pp. I-III, 1985

Authors: Copley, Alfred L.

Article Type: Editorial

DOI: 10.3233/CH-1985-5601

Citation: Clinical Hemorheology and Microcirculation, vol. 5, no. 6, pp. 763-764, 1985

Authors: L. Copley, Alfred

Article Type: Research Article

Abstract: The author introduced in 1960 the concept that the blood vessel and the circulating blood constitute an entity, which in 1981 he named the “vessel-blood organ”. Hemorheology can thus also be defined as the rheology of the vessel-blood organ. Clinical hemorheology deals with the clinical manifestations in disturbances, pathological conditions and disease processes of the vessel-blood organ, their diagnosis, therapy and prevention. Although it is not generally appreciated, certain fields of clinical hemorheology go back to the recorded history of ancient peoples, when disease processes of the vessel-blood organ were first recognized. The author gives a historical survey of pathologic …manifestations pertaining to clinical hemorheology from antiquity to present day medicine. He found that Leonardo da Vinci in his text to his anatomical drawings was keenly aware of the continuous destruction and regeneration of blood. Hitherto unknown in the literature of the microcirculation, Copley discovered also that Leonardo was the first to recognize the existence of capillary blood vessels, named “vene chapillari”. Leonardo used the word “vene” to mean vein or vessel. Hemorheology was extended by the author to include the rheology of tissue fluids, the interstitial spaces, parenchymal cell membranes, lymph, lymph channels and its walls. For better identification of this field, it is named “parahemorheology”. Modern parahemorheology is discussed with regard to “structured flow”, electro-biorheology, piezoelectric effect, streaming potential caused by the flow of tissue fluid and the possibility of electromagnetic fields originating in the subject. Such small “auto-electro-magnetic fields”, if measurable, might contribute significantly to clinical parahemorheology. An outlook into the future development of medicine, in which clinical hemorheology plays a dominant role, is attempted. It is mainly derived from personal insights or reflections. They include some of the author’s experimental findings, his concepts or theories projected into the future of clinical hemorheology. The increasing significance of clinical hemorheology in the practice of medicine is stressed on the basis of contemporary findings. Show more

Keywords: auto-electro magnetic field, biorheology, blood-letting, “Cohnheim compaction phenomenon”, cupping, electric potential, electro-biorheology, Robin Fåhraeus, fibrin, fibrinogenin, hemorheology, history of medicine, Leonardo da Vinci, modern medicine, parahemorheology, phlebotomy, piezoelectric effect, Jean-Léonard-Marie Poiseuille, “Poiseuille velocity effect”, Renaissance medicine, streaming potential, structured flow, tissue fluid, transcapillary transport, vessel-blood organ, “Witte inner circulation”

DOI: 10.3233/CH-1985-5602

Citation: Clinical Hemorheology and Microcirculation, vol. 5, no. 6, pp. 765-812, 1985

Authors: Stoltz, J.F. | Donner, M.

Article Type: Research Article

Abstract: The red blood cell membrane is a complex medium with rheological characteristics that are dependent on a large number of parameters. These properties are connected with interaction phenomena between the red blood cell components (cytoskeleton, membrane lipids, etc.) which, when understood, make it easier to perceive certain biological phenomena. Several investigation techniques are available for studying membrane rheological properties at the molecular level (molecular emission spectroscopy, ESR, NMR, etc.). Among the most widely applied methods, spectroscopic techniques have been the subject of a large number of studies, because they are easy to apply and are highly sensitive. After a brief …reminder of theoretical and methodological aspects, the authors consider the clinical applications of these methods to the red blood cells. Show more

Keywords: Red blood cell, Molecular rheology, Membrane fluidity, Electron spin resonance, Fluorescence polarization

DOI: 10.3233/CH-1985-5603

Citation: Clinical Hemorheology and Microcirculation, vol. 5, no. 6, pp. 813-848, 1985

Authors: Caro, C.G. | Parker, K.H. | Fish, P.J. | Lever, M.J.

Article Type: Research Article

Abstract: The ability to obtain measurements of arterial velocity profiles non-invasively in man coupled with advances in the understanding of arterial haemodynamics and arterial wall transport has increased interest in the interaction of blood flow with the arterial wall and in the association of arterial haemodynamics and arterial disease.

Keywords: Arterial blood flow, blood:vessel wall interaction arteriosclerosis

DOI: 10.3233/CH-1985-5604

Citation: Clinical Hemorheology and Microcirculation, vol. 5, no. 6, pp. 849-871, 1985

Authors: Marcel, G.A.

Article Type: Introduction

DOI: 10.3233/CH-1985-5605

Citation: Clinical Hemorheology and Microcirculation, vol. 5, no. 6, pp. 873-874, 1985

Authors: Schmid-Schönbein, Holger

Article Type: Research Article

DOI: 10.3233/CH-1985-5606

Citation: Clinical Hemorheology and Microcirculation, vol. 5, no. 6, pp. 875-890, 1985

Authors: Born, G.V.R.

Article Type: Research Article

Abstract: This lecture is concerned mainly with questions about how haemodynamic conditions in atherosclerotic arteries affect arriving platelets that aggregate there and about the chemical agents responsible for making the platelets reactive. The effects of haemodynamic conditions and the agents are known mainly from in vitro experiments in which aggregation can be quantitatively correlated with blood flow and bioch6mical effects by simple and reproducible methods; the relevance to the more complicated situations in haemostasis and thrombosis is uncertain. It is difficult to devise quantitative in vivo methods, mainly because of the rapidity with which platelets adhere and aggregate in …diseased or damaged blood vessels. Hypotheses for explaining in vivo platelet aggregation in biochemical terms must take the haemodynamic situation into account. Show more

Keywords: platelets, haemorheology, cerebral thromboembolism

DOI: 10.3233/CH-1985-5607

Citation: Clinical Hemorheology and Microcirculation, vol. 5, no. 6, pp. 891-897, 1985

Authors: Schmid-Schönbein, Holger

Article Type: Research Article

Abstract: Blood rheology is “overtly abnormal” in various haematological diseases classically designated as “hyperviscosity states”; these disorders are rare and can be easily diagnosed. Much more common are diseases with “covertly abnormal” blood rheology, in which the rheological abnormality is present as an epiphenomenon to a vascular disorder. In diseases such as retinal arterial occlusion and secondary RAYNAUD phenomenon (early manifestations of systemic sclerosis) there is evidence of “abnormal blood thixotropy” i.e. a pathological tendency of the blood to loose its fluidity when subjected to low shear stresses. This tendency is assumed to perpetuate a low flow state caused by other …haemodynamic abnormalities. Isovolaemic haemodilution and plasmapheresis were employed with clinical success in retinal artery occlusion and secondary Raynaud phenomenon, respectively. The two forms of “antithixotropic” therapy were accompanied by clearly lowered blood thixotropy, clinical improvement and augmented blood flow. Show more

Keywords: Isovolaemic Haemodilution, Hyperviscosity syndromes, Plasma viscosity, Red Cell Aggregation, Haematocrit, Retinal Artery Occlusion, Secondary Raynaud Phenomenon, Plasmapheresis

DOI: 10.3233/CH-1985-5608

Citation: Clinical Hemorheology and Microcirculation, vol. 5, no. 6, pp. 899-916, 1985

Authors: Dintenfass, L. | Osman, P.D. | Jedrzejczyk, H.

Article Type: Research Article

Abstract: The ‘secret’ D.O.D. Mission on flight STS 51–C also carried nearly 100 kg of automated instrumentation of the Australian experiment on aggregation of red cells (“ARC”). The automated Slit-Capillary Photo Viscometer contained blood samples from subjects with history of coronary heart disease, cancer of the colon, insulin-dependent diabetes, etc., as well as normals. The experiment ran for nine hours, according to the program of its microcomputers. When shuttle landed and instrumentation recovered and opened in the presence of NASA quality control officers, it was obvious that experiment was a success. Tentative and preliminary results can be summarized as follows: red …cells did not change shape under zero gravity; red cells do aggregate under zero gravity, although the size of aggregates is smaller than on the ground; the morphology of aggregates of red cells appears to be of rouleaux type under zero gravity, notwithstanding the fact that pathological blood was used. These results will have to be confirmed in the future flights. The background and history of development of the project are described, and put into context of our general haemorheological studies. Show more

Keywords: aggregation of red cells, morphology of aggregation, slit-capillary photo-viscometer, NASA space shuttle, zero gravity experiments, rouleaux, clumps and sludges, “swarms” of red cells

DOI: 10.3233/CH-1985-5609

Citation: Clinical Hemorheology and Microcirculation, vol. 5, no. 6, pp. 917-936, 1985

Authors: McMillan, D.E. | Utterback, N.G. | Lee, M.M.

Article Type: Research Article

Abstract: Increased low shear rate blood viscosity in diabetes, linked in previous studies to elevated blood thixotropy, has been further examined by comparing erythrocytes from diabetic subjects with those from age- and sex-matched nondiabetic subjects. The red cells were resuspended at 0.60 hematocrit in phosphate-buffered saline containing sufficient 100–200,000 Dalton dextran to produce minimal erythrocyte aggregation. Diabetic erythrocytes were found to sediment at a rate not significantly higher than nondiabetic erythrocytes in this medium. Diabetic erythrocyte suspensions were 16% more viscous than those of nondiabetic erythrocytes at low shear rate, but their viscosity averaged only 3–4% higher at high shear rate. …The increased viscosity was found to be related to current fasting glucose level but not to erythrocyte glycosylated hemoglobin content. Flow onset and cessation shear stress patterns were examined to assess RBC suspension viscoelasticity and thixotropy at shear rates below 30 inverse seconds. The apparent elastic modulus of diabetic erythrocyte suspensions was found to be elevated at shear onset but did not differ at cessation. Flow onset thixotropy was found to parallel steady shear stress in diabetic and nondiabetic suspensions. Thixotropic (flow initiation) work increased more rapidly than shear rate for both diabetic and nondiabetic erythrocytes. When examined in relation to published studies of diabetic blood flow properties, these observations support the conclusion that diabetic erythrocyte deformation as flow begins consumes more energy than that of nondiabetic erythrocytes. Show more

Keywords: Diabetes mellitus, blood viscosity, blood thixotropy, erythrocyte deformability, erythrocyte aggregation, insulin

DOI: 10.3233/CH-1985-5610

Citation: Clinical Hemorheology and Microcirculation, vol. 5, no. 6, pp. 937-948, 1985

Authors: De Cree, J. | Geukens, H. | Leempoels, J. | Verhaegen, H.

Article Type: Research Article

Abstract: Blood cell (BC) filtration in platelet rich plasma (PRP) or platelet poor plasma (PPP) was equally decreased in patients with acute myocardial infarction. Cross-exchange experiments showed plasma of patients with acute myocardial infarction to be responsible for the impairment of Be filtration. In a double-blind placebo-controlled study 2 groups of 30 patients with acute myocardial infarction received an acute oral dose of 60 mg of ketanserin, a 5-hydroxytryptamine (5-HT, serotonin) receptor antagonist, at 5-HT2 receptors, or placebo. Ketanserin treatment significantly improved BC filtration in PRP, whereas placebo had no effect. In a subsequent study ketanserin also significantly improved …BC filtration in PPP in patients with acute myocardial infarction. Filtration of plasma improved after ketanserin treatment in PRP, but not in PPP. Cross-exchange experiments showed the ketanserin-induced improvement of Be filtration in PRP and PPP to be also plasmadependent. The possible role of serotonin on red blood cell (RBC) deformability and the interaction with platelet activation is discussed. Show more

Keywords: Ketanserin, 5-HT2 Receptor Antagonist, RBC Filtration, Acute Myocardial Infarction, RBC Deformability, Platelet Activation

DOI: 10.3233/CH-1985-5611

Citation: Clinical Hemorheology and Microcirculation, vol. 5, no. 6, pp. 949-957, 1985

Authors: Irwin, S.T. | McGuigan, J.A. | Rocks, M.J. | Morris, T.C.M. | Merret, J.D. | O’Reilly, J.G.

Article Type: Research Article

Abstract: Impaired red cell filterability has been demonstrated in peripheral vascular disease. We have analysed the causes of impaired red cell filterability (using a simple filtration technique). The number of residual white cells in the filtered sample is critical. There was no evidence of white cell retention in the filter. The residual white cell count in the filtered samples was related to the plasma viscosity. The presence of a plasma factor, probably an acute phase reactant, makes the white cells more difficult to remove from whole blood by a standard technique. The white cells are more difficult to remove in patients …with severe ischaemia and this therefore delays filtration of blood in these patients. Show more

Keywords: Red cell filterability, leucocytes, ischaemia

DOI: 10.3233/CH-1985-5612

Citation: Clinical Hemorheology and Microcirculation, vol. 5, no. 6, pp. 959-963, 1985

Authors: Stoltz, J.F. | Penin, F. | Voisin, Ph. | Gaillard, S. | Donner, M. | Streiff, F.

Article Type: Research Article

Abstract: Blood viscosity, and a certain number of platelet parameters have been studied on 36 patients, aged between 56 and 90 (average age 79 years), who had suffered a cerebral vascular accident. Measurements were carried out less than 24 hours after the stroke. The results of this study show significant plasma hyperviscosity as well as an increase in fibrinogen level. Platelet hyperaggregability is demonstrated at low ADP levels in all the patients, but at the highest ADP level (2.64 µM) only hypertensive patients reveal an increase in this parameter. The β thromboglobulin level, which is a platelet …activation indicator, is higher in patients than in controls, but the effect of age on this parameter is well known. The MDA platelet level, which is related to prostaglandin biosynthesis, remains within normal values. Show more

Keywords: Stroke, hyperviscosity, βTG, platelet MDA, Platelet aggregability

DOI: 10.3233/CH-1985-5613

Citation: Clinical Hemorheology and Microcirculation, vol. 5, no. 6, pp. 965-973, 1985

Authors: Dormandy, J. | Flute, P. | Matrai, A. | Bogar, L. | Mikita, J. | Lowe, G.D.O. | Anderson, J. | Chien, S. | Schmalzer, E. | Herschenfeld, A.

Article Type: Research Article

Abstract: A new commercially available blood filtration apparatus is described, which can be used with whole blood, red cell or white cell suspensions. The apparatus is interfaced to a computer which automatically analyses sequential flow rates and thus distinguishes between cell transit time and pore clogging rate. A series of validation experiments carried out in three different laboratories by the authors show that results are comparable and reproducible. The apparatus is sensitive to detecting small subpopulations of hardened cells or small changes in the filterability of all the cells.

Keywords: Erythrocyte deformability, Blood cell filtration

DOI: 10.3233/CH-1985-5614

Citation: Clinical Hemorheology and Microcirculation, vol. 5, no. 6, pp. 975-983, 1985