Clinical Hemorheology and Microcirculation - Volume 16, issue 5

Article Type: Other

DOI: 10.3233/CH-1996-16501

Citation: Clinical Hemorheology and Microcirculation, vol. 16, no. 5, pp. 575-575, 1996

Authors: Castenholz, A.

Article Type: Review Article

Abstract: Lymph formation and lymph flow involved in the “inner circulation” (Eppinger) as vital events are influenced by histomechanics and physico-chemical factors. The flow dynamics of lymph flow resulting from microcirculation have recently been attributed to an own discipline, the “perihemorheology” (Copley, Witte). Visualization of flow phenomena just at the origin of the lymph vascular system needs some technical requirements encompassing appropriate tissue models and optimum equipment for microscopy, recording, and flow analysis. A review on the history of observations on lymph flow phenomena is given. New approaches are described referring to the rat tongue as appropriate organ for studies of …peripheral lymph flow. New techniques based on the use of fluorescent flow markers are applied. Flow registration is made by “maximum trace image” technique. Characteristic now patterns such as partial and parallel streams, fountain-like and jet-like currents are found in initial lymphatics. Rhythmic lymph now caused by breathing and suction activity of the lymph collectors. Transport of labelled cells in peripheral lymph could be registered as well. The interaction of peripheral lymph now with the highly specialized endothelium provides an effective filter function for the elimination of particulate matter by absorption and phagocytosis assigning to the prenodal sector of the lymphatic system an important defence task. Moreover, endothelial interaction with different cells (leucocytes, macrophages, mast cells) suggests additional functions for immunobiological mechanisms and control of vascular permeability of fine lymphatics. Show more

Keywords: Lymph flow, rheology, initial lymphatics, histomechanics, vitalmicroscopy, fluorescent flow markers

DOI: 10.3233/CH-1996-16502

Citation: Clinical Hemorheology and Microcirculation, vol. 16, no. 5, pp. 577-601, 1996

Authors: Yan, Wenhai | Wang, Lijuan | Tang, Ning | Li, Haiyan | Huang, Youtian | Lu, Jiesheng | Song, Wei | Wang, Baisheng

Article Type: Research Article

Abstract: The effect of isovolumetric hemodilution with dextran 40 and glucose-insuline-KCI (GIK) were evaluated on the left ventricular function (± dp/dt-max, left ventricular systolic pressure: LVSP) in dogs with acute myocardial infarction (AMI) during 6 hours. All animals were anesthetized, chest opened and ventilated with pure oxygen, The results were as follows. In the group of isovolumetric hemodilution or GIK infusion, +dp/dt-max increased as compared with that in the control group (no treatment was given after occlusion) (P<0.05), and the GIK infusion, came into effect later than the former. In the group of the combination of the ho therapies, LVSP and …−dp/dt-max elevated as compared with those in either of the two groups, in each of which the animals were affected by only one therapy (P<0.05). The results indicated that both isovolumetric hemodilution with dextran 40 and GIK infusion significantly improve the left ventricular contractility in the early phase of AMI, that the GIK infusion took effect slowly, and that the combination of the two therapies could not only further improve the left ventricular contractility, but also enhance the relaxation significantly. It is demonstrated that the combination gives obvious coordinated effects. Show more

Keywords: acute myocardial infarction, hemorheology, heart function, hemodilution, glucose, insuline, potassium

DOI: 10.3233/CH-1996-16503

Citation: Clinical Hemorheology and Microcirculation, vol. 16, no. 5, pp. 603-610, 1996

Authors: Hummel, B. | Schwerdt, H. | Link, A. | Jung, F. | Maurer, U. | Neher, G. | Schieffer, H.

Article Type: Research Article

Abstract: In atherogenesis and myocardial reperfusion injury attention has been focused on polymorphonuclear neutrophils (PMN). Hence it is important to develop simple and reliable tests to distinguish normal PMN function from pathological conditions. In the following investigation three PMN function assays are tested for effects of age and gender in healthy volunteers, in particular a new method of PMN adhesion. Samples have been taken from 80 healthy volunteers (40 male, 40 female; 20 younger, 20 older than 40 years respectively). PMN were separated from whole blood using density gradients. For PMN adhesion, PMN were run through the capillary tube of …a plasma viscosimeter where they can adhere to the capillary surface. The adhesion index (NAD) was defined as the fraction of adhering PMN resuspended in saline solution (N-NAD) or plasma (P-NAD) compared to baseline values. PMN aggregation (NAG) was measured by differences in optical transmittance of a PMN suspension before and after addition of aggregating inductors such as adenosinediphosphate (ADP), collagen (COL) and formyl-methionyl-leucyl-phenylalanine (FMLP). PMN activation (NBT) was measured by the ingestion of nitroblue tetrazolium after PMN stimulation as phagocyting value (ph-NBT) and compared to the resting value (r-NBT). The following parameters of PMN function proved to be independent of age and gender (U-Test; Mann-Whitney): P-NAD (p(gender) = 0,3531, p(age) = 0,7254), NAG-ADP (p(gender) = 0,4884, p(age) = 0,1544), NAG-COL (p(gender) = 0,6546, p(age) = 0,5444), NAG-FMLP (p(gender) = 0,8436, p(age) = 0,0675) and r-NBT (p(gender) = 0,1516, p(age) = 0,3708). With the described assays for PMN adhesion, aggregation and activation simple and reliable tests of PMN function being independent of age and gender are available. Show more

Keywords: neutrophil adhesion, neutrophil aggregation, neutrophil activation

DOI: 10.3233/CH-1996-16504

Citation: Clinical Hemorheology and Microcirculation, vol. 16, no. 5, pp. 611-622, 1996

Authors: Mellinghoff, Achim C. | Reininger, Armin J. | Landgraf, Rüdiger | Wurzinger, Laurenz J. | Dietrich Hepp, K.

Article Type: Research Article

Abstract: The rheological properties of blood play an important role in determining blood flow. Blood inertia, as characterized by blood density, controls blood flow in the large arteries, whereas blood viscosity becomes increasingly important with decreasing vessel diameter. We investigated potential determinants of plasma and whole blood density in 26 Type 1 diabetic patients and in 24 healthy controls matched for age and sex. Plasma density correlated significantly with total protein (p<0.001) and albumin concentrations (p<0.004), whole blood density was significantly associated with hematocrit (p<0.001) and mean corpuscular hemoglobin concentration (p<0.04). Plasma and whole blood density correlated significantly with plasma (p<0.001) …and whole blood viscosity (p<0.005), respectively. Diabetic patients did not differ from healthy controls in plasma or whole blood density. When no densitometer is available, it will be sufficient to measure total protein concentration and hematocrit, respectively, to address inertial forces of plasma and whole blood qualitatively. Show more

Keywords: Density, viscosity, plasma, whole blood, diabetes

DOI: 10.3233/CH-1996-16505

Citation: Clinical Hemorheology and Microcirculation, vol. 16, no. 5, pp. 623-630, 1996

Authors: Jung, F. | Meier, C. | Koscielny, J. | Pindur, G. | Moll, A. | Schimetta, W. | Kiesewetter, H.

Article Type: Research Article

Abstract: In an open Phase-II study on 10 patients with POAD II the plasmatic elimination, rheological and hemostasiological parameters of a new hydroxyethyl starch with a mean molecular weight of 100,0000 Dalton, a molar substitution of 0.5 and a C2/C6 substitution ratio of 6.2 (HES 100/0.5) were determined. Measurements were carried out before and 1, 3, 6, and 24 h after infusion. The mean molecular weight of 100,000 Dalton decreased only slightly up to 24 hours. The plasmatic molecular distribution width of the HES 100/0.5 was unchanged during the whole period of time - in contrary to other HES-types. …The decrease in the hematocrit of 5.5% is comparable to other HES-types, and is still significant up to 24 h after infusion. Similar effects can be seen for the plasma viscosity. The decrease is about 3% which is still significant 24 h after infusion (from 1.33 mPas to 1.28 mPas after 24 h). The maximal decrease of erythrocyte aggregation is about 26% (from 23 to 18 one hour after infusion), and this effect is still significant 24 h after infusion. Plasmatic haemostasis is not influenced by hemodilution treatment with HES 100/0.5; prothrombin time and partial thromboplastin time remained unchanged. The amount of rheological changes is comparable to HES 200/0.5 whilst the improvement of blood fluidity is lasting longer. The lack of influence on plasmatic hemostasis could offer advantages from a hemostasiological point of view. HES 100/0.5 seems to be an interesting variant of a known and proven colloid which however has to be evaluated in further clinical biometrically stringent studies. Show more

Keywords: Hydroxyethyl starch, hemodilution, elimination kinetics, rheology

DOI: 10.3233/CH-1996-16506

Citation: Clinical Hemorheology and Microcirculation, vol. 16, no. 5, pp. 631-643, 1996

Authors: Miao, H. | Hu, Q.H. | Xue, Q.F. | NiiMi, H. | Zhuang, F.Y.

Article Type: Research Article

Abstract: Inflammation of the airway is thought to be one of the main factors contributing to the bronchial hyperresponsiveness which is characteristic for allergic asthma. Leukocyte adhered to vascular endothelium, which is caused by the interaction of adhesion molecules, is necessary for inflammatory cells infiltration. To elucidate the mechanism of leukocyte infiltration in asthma, we developed an animal model of asthma by using Wistar rats. In this model the leukocyte adhered to tracheal venular endothelium was assessed by in vivo microscopic observation. The results showed that the number of leukocytes adhered to tracheal venular endothelium increased significantly in asthmatic rats, as …compared with those of controls, and it was accompanied by a significant inflammatory cell infiltration in lung tissue. It is concluded that the increase of leukocyte adhered to venular endothelium is pivotal in inflammatory cell infiltration in asthmatic rats. Show more

Keywords: leukocyte adhesion, in vivo, asthma, rat

DOI: 10.3233/CH-1996-16507

Citation: Clinical Hemorheology and Microcirculation, vol. 16, no. 5, pp. 645-651, 1996

Authors: Battistelli, S. | Manasse, G. | Gaudio, R. | Borgogni, T. | Forconi, S.

Article Type: Research Article

Abstract: To investigate plasma endothelin behaviour in aging we measured circulating endothelin immunoreactivity in fifteen normal young adults (mean age 25.3±2.2) and nineteen elderly, apparently healthy people (mean age 85.4±3.7). The mean (±SD) plasma endothelin concentrations was 2.04±0.53 pg/ml in the young subjects and 2.6±0.56 pg/ml in the elderly subjects. The difference was statistically significant (p<0.01). The mechanism of the increased plasma endothelin concentrations in the elderly might be multifactorial. In particular the increase of circulating endothelin may reflect a rise in its vascular production in response to endothelial cell injury, due to a clinically silent atherosclerotic process. It therefore has …to be established if the increase of circulating endothelin in elderly, apparently healthy people is due only to a physiological aging or also other factors, such as un atherosclerotic process already underway but clinically silent, are involved. Show more

Keywords: endothelin, vasoactive substances, aging, atherosclerosis

DOI: 10.3233/CH-1996-16508

Citation: Clinical Hemorheology and Microcirculation, vol. 16, no. 5, pp. 653-660, 1996

Authors: Wautier, J-L. | Wautier, M-P. | Chappey, O. | Zoukourian, C. | Guillausseau, P-J. | Capron, L.

Article Type: Research Article

Abstract: Vascular dysfunction is one of the major complications in diabetes mellitus. The extended interaction of proteins with aldoses results in non enzymatic glycation, ultimately leading to formation of Advanced Glycation End Products (AGEs). We previously showed that increased adhesion of diabetic red blood cells (RBCs) was statistically correlated with the vascular severity and the glycated hemoglobin level. We demonstrated that diabetic erythrocytes bear cell surface AGE which enhance their binding to endothelium, resulting in oxidative stress through generation of thiobarbituric acid reactive substances (TBARS) and activation of the transcription factor NFKB, both of which were prevented by preincubating of endothelial …cells with anti-RAGE IgG or the antioxidant probucol. Incubation of diabetic erythrocytes with endothelial cells increased the diffusional transit of 125 I albumin, an effect prevented by preincubation of endothelial cells with anti-RAGE antibodies or an antioxidant compound. These data indicate that the interaction of diabetic erythrocytes with endothelium results in oxidative stress one consequence of which is increased vascular permeability. Show more

Keywords: Diabetes, erythrocytes, advanced glycation end products, vascular permeability, endothelium

DOI: 10.3233/CH-1996-16509

Citation: Clinical Hemorheology and Microcirculation, vol. 16, no. 5, pp. 661-667, 1996

Authors: McMillan, Donald E.

Article Type: Research Article

Abstract: Blood manifests a rapidly recovered form of thixotropy called transient resistance. Thixotropy and transient resistance are closely related to each other. Both are elevated in diabetes. Transient resistance has been shown to be mediated by the need to restore the orientation of individual red blood cells as flow becomes reestablished. In resting blood, the red cells start as rouleaux that must be disrupted to start flow. The red cells are able to form enough structure between heartbeats to generate a sharp resistance peak as blood flows in arteries during the next systole. Transient resistance measures this peak load in arteries …due to the predilection of red blood cells to aggregate. Transient resistance and plasma fibrinogen are both elevated in diabetes. A recent analysis of Diabetes Control & Complications Trial (DCCT) patients has shown a strong relation between fibrinogen and total globulin levels and the development of diabetic eye and kidney complications. The complications were measured as major end points in that study. DCCT blood viscosity and thixotropy results have already been reported in this journal. They were developed in a study of 45 DCCT patients in Tampa. Both fibrinogen and hemoglobin A1c levels were shown to influence low shear rate blood viscosity. Total globulin is not elevated in diabetes. Its linkage to the development of diabetic complications therefore has particular interest. Some details of the already reported study have greater interest now than when the report was prepared. They are reported now because of their relation to the recently discovered roles of fibrinogen and total globulin levels. The new findings of interest are a close relation between low shear rate blood viscosity and transient resistance. Fibrinogen influences both. Total globulin influences transient resistance but not low shear rate viscosity. Transient resistance is made higher by fibrinogen and total globulin levels linked to diabetic complications and generates a peak systolic flow resistance. Show more

Keywords: diabetes mellitus, blood viscosity, thixotropy, viscoelasticity, transient resistance

DOI: 10.3233/CH-1996-16510

Citation: Clinical Hemorheology and Microcirculation, vol. 16, no. 5, pp. 669-676, 1996

Authors: Le Dévéhat, C. | Khodabandehlou, T. | Vimeux, M. | Aouane, F.

Article Type: Research Article

Abstract: The hemorheological properties and transcutaneous oxygen pressure “TcPO2” are studied in both 20 healthy subjects and 36 insulin-dependent diabetic “IDD” patients without micro and macroangiopathy. Patients are classified on the basis of having HbA1C values either persistently below 7.5% (D1 : 23 with good metabolic control) or persistently above 7.5% (D2 : 13 with poor metabolic control). RBC aggregation is shown to be more important in patients while TcPO2 values are decreased. Impairements are more marked in diabetics of group D2 than either those of group D1 or the healthy subjects. These results suggest that a poor metabolic control is …associated with abnormalities in both RBC aggregation and TcPO2. Furthermore, the effects of a 3-year intensive insulin therapy is studied. In this study, 34 IDD patients are selected on the basis of having a poor metabolic control. The therapy is found to improve the HbA1C level in 68% of patients (D3 n=23) while 32% (D4 n=11) remained with a persistent poor metabolic control. In group D3, RBC aggregation and TcPO2 are shown to be improved consistently with HbA1C decrease. In contrast, in group D4, both hemorheologic and microcirculatory disturbances persist despite of the intensive insulin therapy. These results confirm that disturbances in RBC aggregation and TcPO2 can be resulted from a poor and chronic metabolic control. Besides, they underline that beneficial effects on these parameters, can be obtained from an intensive insulin therapy. Show more

Keywords: insulin-dependent diabetes, glycemic control, RBC aggregation, TcPO2

DOI: 10.3233/CH-1996-16511

Citation: Clinical Hemorheology and Microcirculation, vol. 16, no. 5, pp. 677-683, 1996

Authors: Caimi, G.

Article Type: Research Article

Abstract: In 31 VAD subjects (mean age 66.9 ± 7.0 years) and in 20 VAD subjects with NIDDM (mean age 67.6 ± 7.2 years), we evaluated whole-blood filtration (VBC - according to the Reid method), mean erythrocyte aggregation (MEA - employing the aggregometer MA1 of Myrenne), erythrocyte membrane fluidity (marking intact red blood cells with 10-[1-pyrene] decanoic acid), red cell membrane protein lateral mobility (marking intact red blood cells with pyrene-3-maleimide), total red cell calcium content (using an atomic absorption spectrophotometer) and cytosolic red cell Ca2+ content (employing Fura 2-AM), and the relationships between them. In both groups, compared to …controls, we observed a decrease of VBC, an increase of MEA, a decrease of the erythrocyte membrane fluidity and of the red cell membrane protein lateral mobility. As regards the red cell calcium content, we observed that, in VAD subjects with and without NIDDM, the total red cell calcium content is not different from controls, while only in VAD subjects with NIDDM, in comparison with normal controls, an increase in cytosolic red cell Ca2+ content is present. In normals and in VAD subjects with and without NIDDM, VBC and MEA are not related to the parameters reflecting the membrane dynamic properties nor to the red cell calcium content. Show more

Keywords: Vascular atherosclerotic disease, Non-insulin-dependent diabetes mellitus, Whole-blood filtration, Erythrocyte aggregation, Erythrocyte membrane, Erythrocyte calcium

DOI: 10.3233/CH-1996-16512

Citation: Clinical Hemorheology and Microcirculation, vol. 16, no. 5, pp. 685-699, 1996

Authors: Modesti, Pietro Amedeo

Article Type: Research Article

Abstract: Endothelin-1 (ET-1) is a 21 amino acid peptide endowed with a powerful vasoconstrictor activity. The molecular structure and biological activities of endothelin were explored in several studies starting soon after its discovery in 1988, but only recently has the availability of specific ET-1 antagonists allowed its physiological activities to be explored. It is now becoming evident that circulating ET-1 plays a key role in the continuous adaptation of vessel wall tone, of both resistence and capacitance vessels. On the other hand, in addition to the ability to control blood flow, ET-1 synthesis is in turn controlled by blood flow itself, …thus making the connection between ET-1 and peripheral circulation particularly close. This review will focus on recent knowledge about the physiological role of circulating endothelin-1. Show more

Keywords: Endothelin physiology, Haemodynamics, Vasoactive substances, Dynamic forces, Gene regulation

DOI: 10.3233/CH-1996-16513

Citation: Clinical Hemorheology and Microcirculation, vol. 16, no. 5, pp. 701-711, 1996

Authors: Isogai, Y. | Ikemoto, S. | Tanaka, H.

Article Type: Research Article

Abstract: The pathogenesis of diabetic microangiopathy has been considered to be closely related with abnormal viscous blood flow and hypercoagulability in microcirculation. This study aims to find good indices for forecasting the incidence of aggravation of microangiopathy in diabetes. Two kinds of devices have been applied to investigate the rheologic property in diabetics, especially the viscoelasticity in anticoagulation and clotting state of blood. OP-Rheometer system for non-clotting blood and a viscoelastorecorder (VER) for clotting process were used to observe each significance of viscoelasticity for contribution to microangiopathy respectively. The abnormality in viscoelasticity of the blood was well correlated with plasma fibrinogen …and the severity of microangiopathy. In VER maximum value of dynamic rigidity modulus (G'm) was a good index for hypercoagulable state which includes high plasma viscosity, the increased plasma fibrinogen, high red cell aggregation and the severity of retinopathy. To correlate in vivo study with in vitro examination tests, we observe the intravascular erythrocyte aggregation (IEA) in bulbar conjunctiva by a biomicroscopy. There was a good correlation of IEA to G'm and other hemorheological factors. In conclusion, elevation of both viscoelasticity of blood and clotting process (G'm) and high grade IEA suggest the increase of the incidence of aggravation on diabetic microangiopathy. Show more

Keywords: viscoelasticity, diabetes mellitus, microangiopathy, coagulation, intravascular erythrocyte aggregation

DOI: 10.3233/CH-1996-16514

Citation: Clinical Hemorheology and Microcirculation, vol. 16, no. 5, pp. 713-735, 1996