Clinical Hemorheology and Microcirculation - Volume 53, issue 3
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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: Investigation of regional hemorheological properties are important in ischemia-reperfusion experimental surgical and microsurgical research models, however, the physiological arterio-venous as well as porto-caval differences in erythrocyte deformability and aggregation are still controversial. In this study, besides measuring blood pH, blood gases, lactate concentration and hematological parameters we determined erythrocyte deformability (rotational ektacytometer) together with osmoscan data as well as erythrocyte aggregation (light transmittance aggregometer) in blood samples taken from the portal vein, caudal caval vein and abdominal aorta of rats. Blood pH, partial blood gas pressures showed the anticipated physiological differences. Leukocyte count was lower in arterial blood; hematocrit, erythrocyte…and platelet count was higher in systemic and portal venous blood. The lowest elongation index values were measured in arterial blood, the highest in venous and portal venous blood showed values in between. The osmoscan data did not show important differences. Erythrocyte aggregation M index 5 s showed the lowest values in arterial, higher in systemic venous and portal venous blood samples. M index 10 s showed significantly low values in systemic venous blood. M1 values were slightly higher in arterial blood compared to venous blood but the highest were in portal venous blood. Erythrocyte deformability and aggregation may show aorto-porto-caval differences in the rat. The appropriate control examinations thus are important in experimental surgical and microsurgical research models.
Keywords: Hemorheology, porto-caval difference, arterio-venous difference, red blood cell deformability, osmoscan, rat
Abstract: The present study evaluated the relationship between acute chest syndrome (ACS) and autonomic nervous system (ANS) activity in patients with hemoglobin SS disease (Hb SS). Nine patients had suffered ACS were matched by age and gender to patients who had not suffered ACS and ANS activity, pulmonary function and history of painful crisis were compared. Correlations between number of episodes of ACS suffered and these variables were determined. The results demonstrated that 1) patients with a history of ACS ever had lower parasympathetic nervous system (PNS) activity and lower global ANS activity than patients with no ACS ever (p <…0.05), 2) the number of ACS episodes ever negatively correlated (p < 0.05) with PNS activity and global ANS activity and 3) There were no significant associations between lung function or a history of painful crisis in these patients. In conclusion, a history of ACS was associated with ANS dysfunction in adults with Hb SS disease.
Abstract: Type 2 diabetes mellitus can increase osmotic fragility of red blood cells. Osmotic fragility test is an index of the function of cytoskeletal proteins and of the calcium pump activity in RBC membrane. The aim of this study is to determine the effect of physiological calcium supplement on red blood cell osmotic fragility of patients with type 2 diabetes mellitus. Osmotic fragility of red cells was determined for 30 healthy subjects and 30 patients in a NaCl gradient medium. 5 mg/dl of calcium was added to media and the osmotic fragility were evaluated for RBCs of patients and healthy subjects.…Comparison of patients and control group showed higher sensitivity of red cells of patients to osmotic fragility upon exposure to higher sodium chloride concentrations. Comparison of initial, fifty percent and total hemolysis showed significant difference on initial and fifty percent hemolysis between two groups (P < 0.001). In healthy subjects, Fifty percent hemolysis index showed a smaller change after addition of calcium, from 4.1 ± 0.22 to 3.9 ± 0.2 (P < 0.05). Fifty percent hemolysis index for patients significantly decreased from 4.45 ± 0.17 to 4 ± 0.17 after addition of calcium (P < 0.001). Osmotic fragility increases in patients with diabetes. The role of calcium in cell membrane integrity was more prominent in the patients with diabetes than the healthy subjects, emphasizing the role of calcium on the membrane stability. We showed for the first time that controlling calcium ion concentration in patients with diabetes could exert a protective and beneficial role against membrane-affecting conditions.
Keywords: Osmotic fragility, calcium level, type 2 diabetes mellitus
Abstract: We measured the time of initiation of blood coagulation (Ti) from pregnancy 10-months (36~40 weeks) till 1-month after delivery, paying particular attention to the very early postpartum period, using a damped oscillation rheometer that is approximately 160 times more sensitive than the Thromboelastogram® to evaluate the risk of thrombus formation. Blood samples were obtained from healthy volunteers at pregnancy 10-month, 1-hour, 3-hours, 4-days, 7-days, 3-weeks and 1-month after delivery. Ti values at pregnancy 10-month, 1-hour, 3-hours, 4-days, 7-days, 3-weeks, 1-month after delivery and in non-pregnant females were 20.4 ± 2.2, 11.7 ± 1.6, 13.2 ± 3.1, 17.2 ± 2.0,…20.2 ± 1.6, 21.4 ± 4.0, 24.6 ± 3.6, and (25.0 ± 3.4) minutes, respectively. Ti was significantly shorter at pregnancy 10-month, 1-hour, 3-ours, 4-days, 7-days and 3-weeks after delivery than in non-pregnant females. These data show that the blood of pregnant females is more hypercoagulable than non-pregnant females from pregnancy 10-month until 3-weeks post delivery, suggesting that they are at high risk of VTE after discharge from hospital.
Abstract: Higher erythrocyte deformability may reduce the risk of circulatory diseases by enhancing oxygen delivery and reducing the load on the cardiovascular system. The effect of endurance training on erythrocyte deformability is not clear. This study explored the impact of endurance training on erythrocyte deformation and shape and investigated the underlying mechanisms of hemorheological alterations. Forty male Wistar rats were randomly divided into two groups: sedentary (S; n = 21) and exercised (E; n = 19). Hematological indices and erythrocyte shape were measured at the end of the 11th week. The gene expression of erythropoietin (Epo) and the Epo receptor (EpoR)…was quantified using reverse transcription-PCR (RT-PCR), and Epo protein expression was analyzed using Western blotting. Endurance training significantly decreased the abnormality ratio of erythrocyte shape (P < 0.01). The deformability indicator (DI) of red blood cells was lower in the E group than in the S group (P < 0.01). Eleven weeks of endurance training increased Epo mRNA and protein expression in the kidney (P < 0.01), EpoR mRNA expression in the bone marrow (P < 0.05), and relative circulating Epo (P < 0.01) compared to the sedentary group. The decrease in the erythrocyte morphological index and the maximum of deformability indicator were associated with an increase in relative circulating Epo. In conclusion, 11 weeks of endurance training increased erythrocyte deformability. Epo and EpoR may contribute to the decreased morphological index and deformability indicator in erythrocytes during endurance training in rats.
Keywords: Erythropoietin, erythrocyte shape, deformability indicator, treadmill, kidney, bone marrow
Abstract: Hypertension is asymptomatic until late stages of pathogenesis, rendering an effective means of detection for early diagnosis essential. The current method of diagnosing hypertension requires two or more sphygmomanometric readings over two or more office visits, which potentially hinders early detection. Though retinopathy is an indicator of vascular damage, it generally presents in later stages of hypertension. Previous and related studies have suggested that the microvasculature in the bulbar conjunctiva may be a sensitive site to assess vasculopathy. Conjunctival microangiopathy was assessed using CAIM and reported on a severity index (SI). Images of the retinal fundus were taken via non-mydriatic…fundus photography and graded using the Scheie scale in the same subjects to compare with CAIM. Conjunctival microangiopathy was significantly elevated in hypertensive subjects (SI = 5.35 ± 1.04, n = 20) compared to control subjects (SI = 1.75 ± 1.39, n = 8; p ≤ 0.05), and correlated with time since disease diagnosis (R2 = 0.33). Hypertensive subjects with Grade 1 retinopathy displayed increased conjunctival microangiopathy (SI = 5.85 ± 0.90, n = 13) compared to those without retinopathy (SI = 4.43 ± 0.53, n = 7; p ≤ 0.05). These data indicate a possible pre-retinopathy time window during which conjunctival microangiopathy may indicate the risk of organ damage, supporting the hypothesis that the conjunctival microcirculation may serve as a platform for early detection and monitoring disease progression.
Abstract: Objective: To investigate macro- and microperfusion during 14 days of treatment with a new 2-layer compression system (3M™ Coban™ 2 Lite), designed for patients with leg ulcer and concomitant peripheral arterial occlusive disease. Methods: A single-centre, open-label, prospective pilot study was performed with 15 subjects suffering from peripheral arterial occlusive disease with an ankle brachial pressure index (ABPI) of 0.5–0.8, who volunteered to have their ‘study leg’ bandaged with the new system. Coincident leg ulcer or chronic venous disease was not mandatory. All subjects received the new compression system, which stayed in place from 1 up to 4 days according…to scheduled study visits. The system was reapplied by study personnel at each clinical visit (days 1, 2, 3, 4, 7, 10 and 14). The study participation stopped after 14 days. At each clinical visit safety assessments were performed: measurement of acral pulsation to capture macroperfusion; laser Doppler fluxmetry to capture microperfusion; clinical signs of pressure related skin damage, hypoxia-related pain and sub-bandage pressure measurement. In addition, the leg volume was measured and a comfort questionnaire was completed. Results: An average sub-bandage pressure in standing position of approximately 30 mmHg was measured at the B1 location immediately after bandage application. Laser Doppler fluxmetry demonstrated positive effects on microcirculation regarding vasomotion and respiratory reflux. No change of the cardiac signal appeared. For acrale pulsations a high intraindividual variability was found with no clear interference to the bandage application. No pressure-related skin damage or hypoxia-related pain was detected. Conclusion: After application of the new compression system in subjects with moderate PAOD, laser Doppler fluxmetry indicated significant improvements of the microcirculation. High variability and lack of correlation to clinical symptoms was found for the acral pulsation. The new compression system revealed a high grade of tolerability and a good safety profile.
Keywords: Leg ulcer , pressure-related skin damage