Clinical Hemorheology and Microcirculation - Volume 34, issue 3

Authors: Futrakul, Narisa | Butthep, Punnee | Vongthavarawat, Varaphon | Futrakul, Prasit | Sirisalipoch, Sasitorn | Chaivatanarat, Tawatchai | Suwanwalaikorn, Sompongse

Article Type: Research Article

Abstract: This paper was aimed to investigate (1) the early marker of endothelial injury in type 2 diabetes, (2) the intrarenal hemodynamics and renal function, and (3) the therapeutic strategy aiming to restore renal function. Fifty patients (35 normoalbuminuric and 15 albuminuric type 2 diabetes) were examined. Blood was collected for determination of circulating vascular endothelial cells (CEC) and the serum was prepared for determination of transforming growth factor beta (TGFβ), ratio of CEC/TGFβ, and soluble vascular cell adhesion molecule. Intrarenal hemodynamics and renal function were also assessed. The results showed that increased number of circulating EC, elevated TGFβ and depleted …ratio of CEC/TGFβ were significantly observed. Intrarenal hemodynamic study revealed a hemodynamic maladjustment characterized by preferential constriction of the efferent arteriole, intraglomerular hypertension and reduction in peritubular capillary flow. It was concluded that early marker of endothelial injury is reflected by increasing number of CEC. Such markers correlate with the glomerular endothelial dysfunction associated with hemodynamic maladjustment. Early detection of endothelial injury and appropriate correction of hemodynamic maladjustment by multidrug vasodilators can effectively restore renal function in type 2 diabetic nephropathy. Show more

Keywords: Endothelial injury, glomerular endothelial dysfunction, circulating endothelial cells, transforming growth factor beta, vascular endothelial growth factor, FE Mg

Citation: Clinical Hemorheology and Microcirculation, vol. 34, no. 3, pp. 373-381, 2006

Authors: Biesiada, Grażyna | Krzemień, Joanna | Czepiel, Jacek | Teległów, Aneta | Dąbrowski, Zbigniew | Spodaryk, Krzysztof | Mach, Tomasz

Article Type: Research Article

Abstract: The rheological properties of erythrocytes: elongation and the aggregation, as well as basic peripheral blood parameters: RBC number, hematocrit, MCV, MCH, MCHC reticulocytes, fibrinogen level, ESR, and glucose level were studied in a group of erysipelas patients. The concentration of malonyl dialdehyde (MDA) in erythrocytes was also measured, as an indicator of oxidative stress exerted. The study involved 18 erysipelas patients and 18 healthy subjects. The rheological properties and the aggregation of erythrocytes were studied with the use of a LORCA instrument (Laser-assisted Optical Rotational Cell Analyser). Differences were found in elongation index (EI) between the blood control (C) and …patients (P), with an increase of this value only at 0.58 Pa shear stress and at 1.13 Pa shear stress. Upstroke were used as the indexes of RBC deformability, and the following aggregation parameters: intensity of light scattering in the prior disaggregation (Isc dis) – C – 43.0 au (arbitrary units), P – 44.8 au, time when cells are round and not aggregated (Isc top) – C – 51.6 au, P – 49.3 au, the amplitude of aggregation, the difference between Isc max and Isc min (AMP) – C – 39.9 au, P – 28.7 au, aggregation index (AI) – C – 64.6%, P – 70.0%, time for reach one half of the maximum aggregation (t½) – C – 2.0 s, P – 1.5 s, threshold shear stress, the lowest force that breaks the aggregation formed (Ythr ) in P exceed 170% control group were measured. A decrease in the elasticity of erythrocytes in erysipelas patients was associated with the simultaneous increase of MDA – C – 0.08 nM/mgHb, P – 0.11 nM/mgHb content in the membranes of red blood cells. Basic peripheral blood parameters studied in patients with erysipelas did not differ significantly from the control group except for WBC, fibrinogen (C – 3.8 g/l, P – 7.8 g/l), and ESR (C – 6.1 mm/h, P – 45.4 mm/h) which were significantly higher. Show more

Keywords: Erysipelas, rheology of RBC, elongation, aggregation, MDA

Citation: Clinical Hemorheology and Microcirculation, vol. 34, no. 3, pp. 383-390, 2006

Authors: Yusuksawad, Mariem S. | Chaiyabutr, Narongsak

Article Type: Research Article

Abstract: The present study was designed to investigate whether L-ascorbic acid (AA) supplementation could prevent changes in renal hemodynamics in diabetic rats or not. The experiments were carried out in 48 male Sprague-Dawley rats. Diabetes mellitus was induced in rats by intravenous injection with streptozotocin (STZ) (55 mg/kg.bw), while the control rats were received citrate buffer alone. The renal hemodynamics was examined after the supplementation of AA (1 mg/l) for 8 and 16 weeks. The results demonstrated that AA could retard the increase (p<0.05) in renal vascular resistance (RVR) significantly compared with diabetic rats (STZ). Besides, at week 16, the effective …renal plasma flow (ERPF) and the glomerular filtration rate (GFR) of STZ-AA were significantly higher than those of STZ (p<0.05). In conclusion, supplementation of AA was able to ameliorate the renal dysfunction in STZ-induced diabetic rats by decrease in RVR concomitant with an increase in both ERPF and GFR. Show more

Keywords: L-ascorbic acid, renal hemodynamics, streptozotocin-induced diabetic rats

Citation: Clinical Hemorheology and Microcirculation, vol. 34, no. 3, pp. 391-399, 2006

Authors: Seki, Koji | Sumino, Hiroyuki | Nara, Misa | Ishiyama, Nobuyoshi | Nishino, Michio | Murakami, Masami

Article Type: Research Article

Abstract: We investigated the relationships between blood rheology assessed by microchannel method and the various hemorheologic factors in healthy subjects. One hundred seventy-six healthy volunteers (90 men and 86 women, mean age; 32.9±11.3 years) were participated in this study. Body weight, body mass index, red blood cell count, hematocrit, hemoglobin, white blood cell count, and platelet count, plasma fibrinogen, and fasting serum lipid and lipoprotein concentrations were measured. In order to assess blood rheology, blood passage time was determined by a microchannel method (Micro Channel Array Flow Analyzer). Age, body mass index, red blood cell count, hematocrit, hemoglobin, white blood cell …count, total cholesterol, low-density lipoprotein cholesterol, and triglyceride were positively correlated with blood passage time in all subjects, respectively (p<0.01) and high-density lipoprotein cholesterol was inversely correlated with blood passage time (p<0.01). However, platelet count, and fibrinogen were not correlated with blood passage time. The present study showed that increased age, body mass index, red blood cell count, white blood cell count, total cholesterol, low-density lipoprotein cholesterol, and triglyceride and decreased high-density lipoprotein cholesterol were associated with impaired blood rheology measured by microchannel method in healthy subjects, suggesting that aging, obesity, erythrocytosis, leukocytosis, and dyslipidemia may be related to hemorheological disorders. This microchannel method may be useful to study blood rheology which may be associated with various risk factors of cardiovascular disorders. Show more

Keywords: Blood rheology, MC-FAN

Citation: Clinical Hemorheology and Microcirculation, vol. 34, no. 3, pp. 401-410, 2006

Authors: Brimble, K. Scott | McFarlane, Andrew | Winegard, Nancy | Crowther, Mark | Churchill, David N.

Article Type: Research Article

Abstract: Background: Anemia of renal failure is primarily a problem of decreased RBC production due to erythropoietin deficiency. RBC survival is also reduced, perhaps due to decreased RBC deformability. This study measured blood viscosity over a range of shear rates in erythropoietin-treated patients on hemodialysis (HD), and compared the findings to matched patients with chronic renal insufficiency (CRI) and healthy controls. Methods: Four groups (control, CRI, non-diabetic HD, and diabetic HD) of 9 matched subjects were recruited. Blood viscosity was measured using a cone-plate viscometer over a variety of shear rates (11 to 225 s−1 ). Results: Control subjects had lower …viscosity values throughout all shear rates when compared to the 3 renal disease groups (P value=0.039). A trend was observed to higher levels of renal function being associated with decreased blood viscosity in patients with CRI. Conclusions: Patients with kidney disease have increased blood viscosity at all shear rates. This may be related to changes in RBC shape and decreased deformability in patients with kidney disease, independent of HD- or DM-status. This may have implications for strategies to treat anemia in these patients. Show more

Keywords: Erythrocyte, deformability, hemodialysis, viscosity

Citation: Clinical Hemorheology and Microcirculation, vol. 34, no. 3, pp. 411-420, 2006

Authors: Ferrara, Filippo | Novo, Salvatore | Grimaudo, Stefania | Raimondi, Francesco | Meli, Francesco | Amato, Corrado | Amodeo, Gabriella | Lo Presti, Rosalia | Caimi, Gregorio

Article Type: Research Article

Abstract: The aim of the study was to verify the association between abdominal aortic aneurysms (AAA) and methylenetetrahydrofolate reductase (MTHFR) mutation, in relation to age. We studied the frequency of the MTHFR 677T allele in two groups of AAA patients, over and under 60 years. The first AAA group included 42 patients (30 men and 12 women) aged between 65 and 75 years; the second AAA group included 46 patients (32 men and 14 women) aged between 49 and 59 years; the control group included 44 healthy controls (29 men and 15 women) aged between 49 and 75 years. We examined …MTHFR allele frequency and MTHFR genotype using Nuclear Laser Medicine. MTHFR allele frequency was significantly increased in AAA patients >60 compared to healthy controls and in AAA patients <60 compared to those >60. The genotype study showed a difference between controls and AAA patients and between AAA patients >60 and those <60. The frequency of MTHFR mutation was more elevated in both AAA groups vs controls, but it was more elevated in younger patients than in the older ones. This mutation might induce an early elastin degradation in the aortic wall. Show more

Keywords: Abdominal aortic aneurysms, methylenetetrahydrofolate reductase, hyperhomocysteinemia

Citation: Clinical Hemorheology and Microcirculation, vol. 34, no. 3, pp. 421-426, 2006

Authors: Lehmann, Ch. | Bac, V.H. | Pavlovic, D. | Lustig, M. | Maier, S. | Feyerherd, F. | Usichenko, T.-I. | Meissner, K. | Haase, H. | Jünger, M. | Wendt, M. | Heidecke, C.-D. | Gründling, M.

Article Type: Research Article

Abstract: To explore the effects of metronidazole (Me) on intestinal microcirculation in septic rats, intravital microscopy (IVM) following 16 hours of colon ascendens stent peritonitis (CASP model) was used. Four groups of animals were studied: control group (sham operation) and CASP group, each with and without Me treatment (10 mg/kg i.v.). In order to investigate the substance-specific effects of Me independently of the antibacterial effects within a pathologically altered microcirculation, a second experimental series with lipopolysaccharide challenge (LPS model) was carried out. The LPS model consisted of the four groups (control animals and LPS animals (15 mg/kg i.v. LPS from E. …coli) with and without Me). IVM in the LPS experiments was performed following a two hour observation period. Me treated CASP or LPS animals, as compared with untreated, demonstrated significant improvement of functional capillary density (FCD) of the intestinal wall. The increase in the number of leukocytes firmly adhered to the endothelium (leukocyte sticking) in the untreated CASP or LPS animals within the V1 venules of the intestinal submucosal layer, was significantly reduced in the Me treated animals. In conclusion, Me exerts beneficial anti-bacterial and anti-inflammatory effects within the septic microcirculation. Show more

Keywords: Metronidazole, peritonitis, sepsis, endotoxemia, microcirculation

Citation: Clinical Hemorheology and Microcirculation, vol. 34, no. 3, pp. 427-438, 2006

Authors: Bogar, L.L. | Tarsoly, P.P.

Article Type: Research Article

Abstract: Leukocyte function tests are suitable for monitoring the severity of chronic inflammatory and acute infectious diseases. The tests usually require time consuming leukocyte separation techniques while the original character of leukocytes can substantially alter. In contrast, we noted that gravity sedimentation properties of leukocytes is simple to measure and it also reflects non-specific inflammatory reactions of leukocytes. Our novel test is named leukocyte antisedimentation rate (LAR) which is measured by leukocyte counting in the upper (U) and lower (L) half of the sedimentation blood column after one-hour gravity sedimentation of the whole blood. The formula LAR=100·(U−L)/(U+L) is used to calculate …the percentage of leukocytes crosses the middle line of sedimentation blood column upward during one-hour sedimentation (normal range<15%, inter-assay coefficient of variation<5%). In this study we found that in vitro pre-treatment of septic patients' blood samples with protamine, lidocaine and prednisolone decreased leukocyte antisedimentation rate in a concentration dependent manner without effecting erythrocyte sedimentation rate. Leukocyte adherence was measured by the retention rate of leukocytes in a nylon fibre column. There was a significant positive correlation between leukocyte antisedimentation rate and leukocyte adherence (p<0.01), hematocrit (p<0.05), erythrocyte sedimentation rate (p<0.05) when blood samples of 35 healthy individuals were analysed. We concluded that leukocyte antisedimentation rate in septic patients is significantly elevated comparing to healthy controls and as a bedside test it can reflect leukocyte involvement in infections. In vitro protamine, lidocaine and prednisolone pre-treatment of septic patients' blood samples indicates that leukocyte antisedimentation process is partially independent from the ongoing erythrocyte sedimentation. Show more

Keywords: Erythrocyte sedimentation rate, leukocyte adherence, lidocaine hydrochloride, prednisolone sodium succinate, protamine chloride

Citation: Clinical Hemorheology and Microcirculation, vol. 34, no. 3, pp. 439-445, 2006

Authors: Kessler, Ulf | Guenther, Patrick | Zachariou, Zacharias

Article Type: Research Article

Abstract: Aim: First to assess coagulation changes after surgery in children below 6 months of age. Second to detect differences attributable to the extent of surgery and postoperative infection. Materials and methods: Blood counts, haemoglobin concentration (Hb), haematocrit (Ht), prothrombine time (PT), activated partial thromboplastine time (aPTT) and thrombelastography (TEG) were studied pre- and 2±1/2 d postoperatively. Patients were divided in 3 groups. I: minor surgery without access to the abdomen or thorax (n=51); II: abdominal or thoracic interventions (n=24); III: abdominal surgery with postoperative sepsis (n=11). Results: Preoperative values of Hb, Ht and INR were related to the age of …the infant. Postoperatively clot strength and formation rate increased in gr. I (p<0.05). In gr. II, clot formation was initiated earlier (p<0.05) even though PT decreased (p<0.05). In group III, patients postoperatively developed a tendency for hypocoagulability in all TEG-parameters, but not in plasmatic coagulation. Postoperative TEG measurements were significantly inferior in gr. III when compared to gr. I and II. Conclusion: Our findings suggest activation of whole blood coagulation in the uncomplicated postoperative period despite of a decrease in plasmatic coagulation. In sepsis, only thrombelastography, but not plasmatic coagulation was affected. Show more

Keywords: Pediatric surgery, coagulation, postoperative infection, thrombelastography

Citation: Clinical Hemorheology and Microcirculation, vol. 34, no. 3, pp. 447-452, 2006