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The aim of this study was to evaluate the influence of short-term dietary intake of bread obtained by a selected variety of old grain grown in Tuscany, Italy on some parameters related to the atherosclerotic process. Twenty healthy subjects (median age, 39.5 years) followed for 10 weeks a diet containing bread (150 g/day) made from the test grain (test period) and for the same period a diet containing commercially available bread of the same quantity (control period). Lipid, inflammatory, and hemorheological profiles before and after dietary intervention were evaluated. The test period showed a significant (P < .05) improvement of total cholesterol (pre-intervention, 211.2 +/- 10.8 mg/dL; post-intervention, 196.5 +/- 9.8 mg/dL) and low-density lipoprotein-cholesterol levels (pre-intervention, 137.5 +/- 8.1 mg/dL; post-intervention, 119.5 +/- 7.5 mg/dL), whereas no significant changes during the control period were observed. With regard to inflammatory and hemorheological parameters, the test period showed a significant decrease in some of the parameters investigated (interleukin-8 [pre-intervention vs. post-intervention, 67.4 +/- 10.7 vs. 43.9 +/- 4.1 pg/mL], whole blood viscosity at high [4.36 +/- 0.03 vs. 4.32 +/- 0.03 mPa x s, respectively] and low [26.1 +/- 0.4 vs. 24.8 +/- 0.5 mPa x s, respectively] shear rates, and erythrocyte filtration [8.4 +/- 0.7% vs. 9.1 +/- 0.6%, respectively]) relative to the control period, which showed no significant changes. Short-term dietary intake of whole grain bread obtained from an old grain variety seems to impose a favorable status with regard to lower circulating levels of markers of atherosclerosis.

To date, all major clinical trials for anemia correction using erythrocyte stimulating agents (ESAs) failed to show improved outcomes for cardiovascular disease (CVD), stroke, and vascular thrombosis. Even moderate elevations in hemoglobin (e.g., to 13 g/dL) using erythropoietin have been associated with significantly increased risk of thrombotic cardiovascular events and heart failure. This review presents a biophysical rationale for increased risk of CVD among certain patients treated with ESAs and suggests a risk management approach based on blood viscosity. Whole blood viscosity is a key determinant of the work of the heart, and elevated blood viscosity appears to be both a strong predictor of cardiovascular disease and an important pathophysiological factor in the development of atherothrombosis. Blood donation has been shown to reduce viscosity. Reflecting these findings, studies in male blood donors and in women of premenopausal age with regular menstruation have shown reduced incidence of cardiovascular events such as myocardial infarction, angina, stroke, and the requirement for procedures such as percutaneous transluminal coronary angioplasty and coronary artery bypass graft compared with non-donors and postmenopausal women, respectively. We propose that blood viscosity monitoring should be considered as part of a cardiovascular risk assessment, whenever an increased cardiovascular risk is detected and particularly in the context of anemia correction.

Objective: To study the effect of Shenfu injection (SF) treating cancer-related fatigue (CRF) of the patients with advanced carcinoma., Method: From September 2005 to June 2009, 113 patients with advanced carcinoma who was treated in our department were selected, and were divided into test group and control group. The test group was treated with SF and common method, while the control group only was treated with common method. Three weeks later, CRF, hemoglobin (Hb), immune function, cardiac function and blood viscosity were compared between the two groups. Meanwhile, the correlations between CRF and the other indicators were analyzed., Result: The test group was treated more effectively than the control group in some ways, such as relieving CRF, improving hemoglobin, some immune indicators, and cardiac function, and reducing blood viscosity. Moreover, CRF had negative correlation with Hb and cell-mediated immune, and had positive correlation with cardiac disfunction degree., Conclusion: SF could relieve CRF of the patients with advanced carcinoma effectively by treating anemia and improving cell-mediated immune and cardiac function.

Background and Aim: Some studies recently reported a favourable effect for cis-9, trans-11 conjugated linoleic acid (CLA) on plasma lipoprotein profile of healthy subjects. Aim of this crossover intervention study was to evaluate the influence of a short-term dietary intake of a cheese derived from sheep's milk naturally rich in CLA on several atherosclerotic biomarkers, in comparison with a commercially available cheese., Methods and Results: Ten subjects (6 F; 4 M) with a median age of 51.5 followed for 10 weeks a diet containing 200 g/week of cheese naturally rich in CLA (intervention period) and for the same period a diet containing a commercially available cheese of the same quantity (placebo period). Consumption of the dairy product naturally rich in cis-9, trans-11 CLA determined a significant (p<0.05) reduction in inflammatory parameters such as interleukin-6 (pre: 8.08+/-1.57 vs. post: 4.58+/-0.94 pg/mL), interleukin-8 (pre: 45.02+/-5.82 vs. post: 28.59+/-2.64 pg/mL), and tumour necrosis factor-alpha (pre: 53.58+/-25.67 vs. post: 32.09+/-17.42 pg/mL) whereas no significant differences in the placebo period were observed. With regard to haemorheological parameters, the test period significantly ameliorated erythrocytes' filtration rate (pre: 7.61+/-0.71% vs. post: 9.12+/-0.97%; p=0.03) with respect to the placebo period. Moreover, a reduction in the extent of platelet aggregation, induced by arachidonic acid [pre: 87.8+/-1.76% vs. post: 77.7+/-3.56%; p=0.04] was observed during the test period in comparison with the placebo period., Conclusions: Dietary short-term intake of the tested dairy product naturally rich in cis-9, trans-11 CLA appeared to cause favourable biochemical changes of atherosclerotic markers., (Copyright 2009 Elsevier B.V. All rights reserved.)

Both blood viscosity and carbon monoxide (CO) has been associated with cardiovascular diseases (CVDs). In order to investigate the effects of chronic low-level CO exposure on the determinants of blood viscosity (hematocrit, plasma viscosity, erythrocyte deformability, and erythrocyte aggregation), 10 men exposed to CO at work for at least 6 months and 10 healthy controls were included in the study. Plasma viscosity was determined by a cone-plate viscometer, erythrocyte deformability and erythrocyte aggregation by laser-assisted optical rotational cell analyzer. Mean plasma viscosity of the group exposed to CO (1.4 +/- 0.1 mPa.sn) was significantly higher than that of the controls (1.2 +/- 0.06 mPa.sn) (p < .05). Plasma fibrinogen level of the CO group (275 +/- 11 mg/dL) was slightly higher than that of the controls (263 +/- 14 mg/dL). The rise in plasma viscosity by chronic low-level CO exposure may be the mechanism of CO-induced increase in the risk for CVDs.

Dichlorvos is an important insecticide used largely. Some studies have demonstrated that organophosphate pesticide has effects on erythrocyte membrane structures, which is critical to erythrocyte function and hemorheology. The aim of the present study was to explore the effect of oxidative stress on hemorheological changes during dichlorvos poisoning in rabbits. Data indicated that after dichlorvos exposure the hematocrit adjusted viscosity at high shear rate increased and erythrocyte membrane fluidity decreased. Data obtained from plasma showed that lipid peroxidative substance-malonaldehyde was elevated and superoxide dismutase was reduced. In summary, oxidative stress does occur in dichlorvos poisoning and may lead to hemorheological alterations. The changes of hemorheology may be responsible for the pathophysiology of the dichlorvos poisoning.

Arsenic (As) is a toxic semi-metal of wide distribution in nature. People living in regions where drinking water contains large quantities of arsenic, have an unusually high likelihood of developing blood-vessel diseases, but little is known about the mechanisms involved, i.e. the blood rheologic alterations that would contribute to the circulatory obstruction. Erythrocytes are the main target cells for arsenic compounds systemically absorbed and their cell membrane is the first place against the toxic. In this paper we have examined the in vitro effect of arsenic (As(V)) on the rheologic properties of human erythrocytes in relation with membrane fluidity and internal microviscosity. According to our present results, As(V) treatment produces oxidative degradation of membrane lipids and alteration of internal microviscosity. These red blood cells (RBCs) membrane and cytoplasmic structural damage consequently alters RBCs rheologic properties: an alteration of the RBCs discoid shape to stomatocytes, a diminution of erythrocyte deformability and an enhancement of osmotic fragility and cell aggregability. These effects impaired blood fluid behaviour that contribute to obstruct peripheral circulation and provides anemia, both clinic evidences typical of arsenic cronic intoxication.

Cadmium (Cd) is a heavy metal which affects many systems in humans and animals as a consequence of environmental and industrial pollution. The aim of this study was to investigate the effect of chronic Cd toxicity on blood pressure and plasma viscosity. Experimental group rats were given doses that contained 15 ppm CdCl(2) in drinking water for 8 weeks. The systolic blood pressure and heart rate were measured from rats' tails and recorded by plethysmography every two weeks. Blood samples were drawn, Cd levels were determined by atomic absorption spectrophotometer and plasma viscosity values by viscometer. Blood Cd levels were found to be significantly higher in the experimental group compared to the control group (p < 0.001). The whole blood analysis was made by an analyzer. Polymorphonuclear leukocytes and monocytes increased (p < 0.01) and lymphocyte number (p < 0.05) decreased in the experimental group. Viscosity values were 2.21 ± 0.54 and 1.62 ± 0.31 centipoises in the experimental and control groups, respectively (p < 0.001). In the experimental group, changes in systolic blood pressure between weeks were significant (p < 0.001) and were found to be correlated with plasma viscosity (p < 0.001). In the experimental group, changes in heart rate between weeks were significant (p < 0.001). According to our findings, Cd toxicity may lead to an increase in blood pressure by increasing plasma viscosity., (Copyright © 2011 S. Karger AG, Basel.)

Unlabelled: We tested the in vivo and the in vitro effects of both Ligaria cuneifolia catechin- and quercetin-enriched fractions on erythrocyte shape and deformability, and on plasma cholesterol level. For in vivo studies, adult male Wistar rats were randomized in three experimental groups which received intraperitoneally, once a day, 3 days:, Control: saline solution (C; n = 6); catechin from L. cuneifolia, 0.60 mg/100 g body weight (CLc; n = 6), or quercetin from L. cuneifolia, 2.3 mg/100 g body weight (QLc; n = 6). For in vitro studies, blood samples obtained from male Wistar rats were divided into three fractions, which were incubated with saline solution (C), catechin (CLc; n = 5) and quercetin (QLc; n = 5), in a concentration equivalent to 0.60 mg/100 g body weight, and 2.3 mg/100 g body weight, respectively. CLc significantly reduced the rigidity index due to a diminished mean concentration volume. QLc induced erythrocyte rigidization (less deformability), thus increasing blood viscosity. Neither of the two treatments produced any changes in plasmatic or biliary excretion of cholesterol. Opposite results were observed in rigidity index with CLc and QLc. In vitro studies showed an interaction of both CLc and QLc with the erythrocyte membrane, which induced changes in the erythrocyte shape from discocyte to stomatocyte.

Reperfusion injury and no-reflow phenomenon are known entities that contribute to persistent impairment in myocardial perfusion and regional myocardial dysfunction following restoration of epicardial coronary blood flow after a myocardial infarction. Following prolonged ischemia, oxidative stress and inflammation-mediated alterations in erythrocyte mechanics and microvascular architecture play a major role in ischemia/reperfusion injury and no-reflow phenomenon. An increase in red cell rigidity is an important rheological aspect of RBCs, which facilitates platelet aggregation with the subendothelium. Dipyridamole inhibits the reuptake of adenosine which causes platelet inhibition and vasodilatation. Dipyridamole improves microvascular function by increasing RBC deformability and reducing blood viscosity. In addition, it has anti-oxidant and anti-inflammatory properties that provide protection to the microvasculature. This review discusses the potential role for dipyridamole therapy in the treatment of microvascular dysfunction.

Decreasing blood viscosity has been proposed since the advent of hemodilution as a means for increasing perfusion in many pathological conditions, and increased plasma viscosity is associated with the presence of pathological conditions. However, experimental studies show that microvascular functions as represented by functional capillary density in conditions of significantly decreased viscosity is impaired, a problem corrected by increasing plasma and blood viscosity. Blood viscosity, primarily dependent on hematocrit (Hct) is a determinant of peripheral vascular resistance, and therefore blood pressure. In the healthy population Hct presents a variability, which is not reflected by the variability of blood pressure. This is due to a regulatory process at the level of the endothelium, whereby the increase of Hct (and therefore blood viscosity) leads to increased shear stress and the production of the vasodilator nitric oxide (NO), a finding supported by experimental studies showing that the acute increase of Hct lowers blood pressure. Studies that in the healthy population show that blood pressure and Hct have a weak positive correlation. However, when the effect of blood viscosity is factored out, blood pressure and Hct are negatively and significantly correlated, indicating that as blood viscosity increases, the circulation dilates. Conversely, lower Hct and blood viscosity conditions lead to a constricted circulation, associated with a condition of decreased NO bioavailability, and therefore a pro-inflammatory condition.

The shiitake polysaccharides were obtained from shiitake mushroom. Four fractions were isolated from the polysaccharides using a Sephadex G-100 gel column. Chemical components of the two main fractions were determined by thin layer chromatography (TLC), and high performance liquid chromatography (HPLC). F1 was composed of rhamnose, glucose, and mannose. F3 was composed of xylose, mannose, arabinose and galactose. The obtained results still showed that administration of shiitake polysaccharides could improve muscle's comfortability of animals under a long period of vibration. The above findings might be applicable to studies of vibration ergonomics.

The hemorheological activity of a series of hypoglycemic drugs and the new antidiabetic agent RU-254 (9-diethylaminoethyl-2,3-dihydroimidazo[1, 2-a]benzimidazole dihydrochloride) was studied by comparative tests on rats with model diabetes. All the tested drugs reduce the number of ADP-activated platelet forms, inhibit platelet aggregation, and decrease the blood viscosity in both intact rats and the animals with streptosotocin-induced diabetes. RU-254 exhibited maximum activity with respect to a complex of hemorheological parameters. Glyclazide was less effective in this respect than RU-254, but exceeded the activity of both glybenclamide and glydifen.

Purpose: We examined the activity of bortezomib, dexamethasone, and rituximab (BDR) in patients with symptomatic, untreated Waldenström macroglobulinemia (WM)., Patients and Methods: A cycle of therapy consisted of bortezomib 1.3 mg/m(2) intravenously; dexamethasone 40 mg on days 1, 4, 8, and 11; and rituximab 375 mg/m(2) on day 11. Patients received four consecutive cycles for induction therapy and then four more cycles, each given 3 months apart, for maintenance therapy. Twenty-three patients received a median of seven cycles of treatment., Results: Median bone marrow disease involvement declined from 55% to 10% (P = .0004), serum immunoglobulin M levels declined from 4,830 to 1,115 mg/dL (P < .0001), and hematocrit increased from 29.8% to 38.2% (P = .0002) at best response. The overall response rates and major response rates were 96% and 83% with three complete responses, two near complete responses, three very good partial responses, 11 partial responses, and three minor responses. Responses occurred at a median of 1.4 months. With a median follow-up of 22.8 months, 18 of 23 patients remained free of disease progression. Peripheral neuropathy was the most common toxicity, and it resolved to grade < or = 1 in 13 of 16 patients at a median of 6.0 months. Four of the first seven treated patients developed herpes zoster, resulting in the institution of prophylactic antiviral therapy., Conclusion: The results demonstrate that BDR produces rapid and durable responses, along with high rates of response and complete remissions in WM. Herpes zoster prophylaxis is necessary with BDR, and reversible peripheral neuropathy was the most common toxicity leading to premature discontinuation of bortezomib in 61% of patients. Exploration of alternative schedules for bortezomib administration that includes weekly dosing should be pursued.

Danhong Injection (DHI), a Chinese Materia Medica standardized product extracted from Radix Salviae Miltiorrhizae and Flos Carthami tinctorii, has the actions of promoting blood circulation and resolving stasis to promote regeneration. The clinical therapeutic effects of DHI on traumatic intracranial hematoma (TICH) were observed. Eighty patients with TICH were randomly assigned to trial group and a control group (40 patients per group), and all were administered with routine medication. Additionally, DIH was administered intravenously to patients in the trial group. Pre and post-treatment GCS was observed in the two groups, along with GOS after therapy. The intracranial hematoma absorption, hemorheological changes, and changes in coagulation indexes pre- and post-treatment were evaluated. The results indicated that GCS and GOS after therapy for the trial group were superior to those for the control group (p<0.05). There was a significant post-treatment difference in the intracranial hematoma absorption between the two groups (p<0.01). Each hemorheological index in the trial group improved significantly as compared with that of the control group (p<0.05 or p<0.01). The plasma levels of fibrinogen and D-dimer in the trial group were significantly decreased after therapy (p<0.01). These results suggest that DHI is conducive to the recovery of patients with TICH.

Hemorheological disorders may play an important role in the pathogenesis and development of many diseases. Blood stasis, i.e. the decrease of blood flow velocity, indicates hemorheological abnormalities. The carthamins yellow (CY), isolated from Carthamus tinctorius L., has been extensively used as a natural food colorant. We investigated the effects of CY on a blood stasis model, which was obtained by placing rats in ice-cold water during the time interval between two injections of epinephrine. The results demonstrated that the CY significantly decreased the whole blood viscosity, plasma viscosity, and erythrocyte aggregation index, which were increased in the blood stasis model. Hematocrit and platelet aggregation were reduced, while prothrombin time was delayed with increasing doses of CY. Therefore, CY administration might provide the additional benefit of increasing blood fluidity by lowering blood viscosity, which can be of great value in the prevention of hemorheological disorder-associated diseases in at risk patients. Meanwhile, the mild activities of antiplatelet aggregation and anticoagulation induced by CY should be considered, if these relatively untoward symptoms occurred when the hemorrhagic patients ate food colored by CY. However the small amounts used in food are highly unlikely to cause adverse effects.

Although magnesium and vitamin E (VE) have differing effects on diabetes, both are beneficial. We hypothesized that preventive supplementation of magnesium combined with VE could improve the metabolism of lipids and blood viscosity more effectively than the use of magnesium or VE alone. Our objective was to detect the effects of preventive supplementation of magnesium combined with VE on lipid peroxidation, lipid metabolic parameters, and blood viscosity in diabetic rats. Six dietary groups, all fed with high-energy diets, were formed and studied for 8 weeks: control group (C); VE group (E); middle-dose magnesium group (MM); high-dose magnesium group (HM); VE plus middle-dose magnesium group (EMM); and VE plus high-dose magnesium group (EHM). Compared with C group, malondialdehyde was inhibited in the E, EMM, and EHM groups (all P < .05); total cholesterol decreased in all 5 treated groups, and significant differences were found in groups E (P = .004), MM (P = .017), EMM (P = .016), and EHM (P = .020). Compared with the C group, high-density lipoprotein levels were elevated in the HM (P = .027) and EHM (P = .021) groups, and low-density lipoprotein levels were lower in the E (P = .010), EMM (P = .025), and EHM (P = .015) groups. Differences between middle and high shear rates of blood viscosity were significant in all treated groups compared with the C group (all P

Salvianolic acid B (SalB) is an active component isolated from Chinese herbal medicine Salvia miltiorrhiza. The aim of this study was to investigate the extent of absolute oral bioavailability (F) of SalB in beagle dogs and the effect on blood viscosity after intravenous and oral administration of Salvianolic acids (SAs). A gradient elution HPLC method was developed and validated to determine the concentration of SalB and its three possible metabolites in plasma. After SAs (180 mg/kg, p.o.; 9 mg/kg, i.v.) were given, the AUCs of SalB were 1680 +/- 670 and 7840 +/- 1140 ng/mL.h, respectively. The F of SalB in dogs was calculated to be only 1.07 +/- 0.43%. The blood viscosity was remarkably decreased after a single intravenous injection of SAs (9 mg/kg). However, no significant change of blood viscosity was observed after a single oral administration of SAs (180 mg/kg). The results suggested that the F of SalB was extremely low and single oral administrated SAs had no effect on ameliorating blood viscosity in beagle dogs.

Objective: Albumin is used routinely as a plasma volume expander in cardiopulmonary bypass operations. The effect of two different concentrations of albumin in Ringer's lactate on blood viscosity was explored in this study., Methods: Ten healthy volunteers (all male) were included in the study, based on their haematocrit levels (42.6 +/- 0.96). Using a heparinised 50-ml syringe, 40 cm(3) of blood were drawn from the antecubital veins of fasting volunteers. Six ml of blood were haemodiluted with 2 ml of albumin (20%), 2 ml of Ringer's lactate containing albumin (1.3%), and 2 ml of Ringer's lactate, in order to simulate cardiopulmonary bypass conditions. Test tubes with the solutions were placed in a 15 degrees C water bath for 25 minutes. Viscosity was measured in the haemodiluted blood samples using an Ostwald viscometer. Relative viscosities of samples were assessed with SPSS software and the ANOVA test., Results: The mean relative viscosity of Ringer's lactate was 4.19 (+/- 0.49), that of Ringer's lactate with 1.3% albumin was 4.30 (+/- 0.31), and of 20% albumin was 7.32 (+/- 0.71). The relative viscosity of Ringer's lactate and Ringer's lactate with 1.3% albumin were statistically similar, but that of 20% albumin was higher than the Ringer's lactate and Ringer's lactate with 1.3% albumin., Conclusion: Albumin is used as a plasma volume expander in priming solutions for cardiopulmonary bypass operations, but its effect on blood viscosity depends on the concentration of albumin used.

Introduction: Hemorheological factors play an important role in the pathomechanism of ischemic cerebrovascular disorders. Abnormal rheological conditions in patients with chronic cerebrovascular disease predispose for recurrent strokes. Vinpocetine (VP), a synthetic ethyl esther of apovincamine, has successfully been used in the treatment of cerebrovascular diseases, in part because of its favourable rheological effects., Patients and Methods: The study investigates the hemorheological changes in 40 patients in the chronic stage of ischemic cardiovascular disease after administration of vinpocetine. All patients received a high dose of intravenous VP in doses gradually increased to l mg/kg/day. In addition, 20 patients (mean age: 61+/-8 years) received 30 mg VP orally for 3 months. The other 20 patients (mean age: 59+/-6 years), who received placebo tablets, served as controls. Hemorheological parameters (hematocrit, plasma fibrinogen, whole blood viscosity, red blood cell aggregation and deformability) were evaluated at 1 and 3 months., Results: The high-dose parenteral VP significantly decreased red blood cell aggregation, plasma and whole blood viscosity (p < 0.05) compared to the initial values. In patients with additional oral treatment, plasma and whole blood viscosities were significantly lower compared to the placebo patients at 3 months (p < 0.05)., Conclusion: Our results confirmed the beneficial rheological effects of high-dose parenteral VP (partially caused by hemodilution) observed previously, and also warrant its long-term oral admission to maintain the beneficial rheological changes.

Objective: This study investigated the thrombolitic effect of Tianma Xinnao capsule and its preliminary mechanism, as well as the effect on coagulation system., Method: Charlton's and Tomihisa's methods were modified to investigate the thrombolytic effect of Tianma Xinnao capsule. The activities of type 1 plasminogen activator inhibitor (PAI-1) and tissue-type plasminogen activator (tPA) in rabbit plasma were assayed by use of ELISA. The effects of Tianma Xinnao capsule were also evaluated on euglobulin lysis time (ELT), prothrombin time (PT), kaolin partial thromboplastin time (KPTT), thrombin time (TT), fibrinogen (Fib) and hemorheology., Result: The results showed that Tianma Xinnao capsule had a dose-dependent thrombolytic effect in rats. Tianma Xinnao capsule at 0.6 and 1.2 g x kg(-1) produced 40% and 50% of reperfusion rate, while obtained 50% and 40% of reocclusion rate; 0.3 g x kg(-1) of Tianma Xinnao capsule, however, had no effect on the reperfusion or reocclusion rate. Tianma Xinnao capsule significantly inhibited PAI-1 activity, while elevated tPA activity in rabbit plasma. Tianma Xinnao capsule markedly prolonged ELT, PT, and KPTT, and decreased Fib level. Tianma Xinnao capsule showed no significant influence on TT or high, medium, or low sheering viscosity., Conclusion: It is indicated that Tianma Xinnao capsule inhibited PAI-1 activity and increased tPA activity, and this property of Tianma Xinnao capsule is assigned to be responsible for the thrombolytic effect.

Carbon monoxide (CO) poisoning is a leading cause of poison-related morbidity and mortality. The severe complication of delayed neuropsychiatric sequelae seriously affects patient's living quality, but its mechanism remains controversial. In this study, we established an animal model by intraperitoneal injection of CO in rabbits at regular interval and kept the carboxyhemoglobin (HbCO) level in blood above 50% for at least 24 h. We investigated the dynamic changes in the hemorheological and coagulative properties of blood taken from venae jugularis interna before CO injection and at 30 min, 1-5 days after the last CO exposure. We found that RBC count, hemoglobin (Hb) concentration, and hematocrit (Hct) increased on 1 day and remained high level till 5 day. Whole blood viscosities at different shear rates decreased significantly at 30 min and then increased 1 day later until day 4. RBC deformation index (DI) and aggregation index decreased at 30 min and recovered to normal on day 3. Plasma viscosity and fibrinogen augmented from 30 min until day 5. Prothrombin time (PT) and active partial thromboplastin time (APTT) prolonged remarkably at 30 min and went back to normal on 3 day, plasma [Ca2+] decreased at 30 min and approached to normal level on 3 day. The level of malondialdehyde (MDA) in RBCs at 30 min was significantly higher than that of control and recovered to normal on day 3. Our results suggest that the changes in hemorheology participate in the development of acute CO poisoning, which may play a role in delayed encephalopathy after acute CO poisoning.

Epidemiologic studies have revealed that pollution by ambient particulates is associated with respiratory and cardiovascular diseases, particularly in older people. Toxicologic sensitivity of nanoparticles in different ages was investigated for the first time to demonstrate and explain an age-related difference in response to manufactured nanoparticles. Young, adult, and old rats physiologically inhaled air containing aerosol of manufactured SiO2 nanoparticles (24.1 mg/m3; 40 min/day) for four weeks. Changes in serum biomarkers, hemorheologic, pulmonary inflammation, heart injury, and pathology in rats of different ages and their corresponding controls were compared. Inhalation of SiO2 nanoparticles under identical conditions caused pulmonary and cardiovascular alterations in old rats, yet less change in young and adult rats, including pulmonary inflammation, myocardial ischemic damage, atrio-ventricular blockage, and increase in fibrinogen concentration and blood viscosity. Old individuals were more sensitive to nanoparticle exposure than the young and adult rats. The risk of causing pulmonary damages was: old > young > adult The risk of cardiovascular disorder was observed only in old age. Our results suggest that different ages may require different biomarkers for identifying pulmonary toxicity during inhalation of nanoparticles.

Objective: Investigate effects of aspirin/dipyridamole and aspirin on blood viscosity (BV) in subjects with hyperhomocystememia (>14 micromol/L) and stable cardiovascular disease (CVD) or >or= 20% risk for CVD were the aims of this study., Method: Forty-seven subjects were treated with 14 days of either aspirin/dipyridamole (25 mg/200 mg twice-daily) or aspirin (81 mg daily). BV was measured from fasting specimens at 37 degrees C from whole blood at shear rates ranging from 1,000 to 1s(-1) by using a scanning capillary viscometer (Rheolog; Rheologics Inc., Exton, Pennsylvania, USA)., Results: Aspirin/dipyridamole was more effective than aspirin therapy in reducing BV at shear rates of 1 s(-1) (-3.03 [-3.88, -2.17] mPas vs. -0.07 [-1.06, 0.92] mPas; P<0.0001) and 2 s(-1) (-1.86 [-2.72, -1.01] mPas vs. -0.21 [-1.20, 0.79] mPas; P=0.0136); however, there were no significant differences in blood viscosity at shear rates of 5 s(-1) to 1000 s(-1). Changes in hematocrit, a major determinant of whole BV, were greater in the aspirin/dipyridamole group than the aspirin group (P=0.043). After hematocrit adjustment, differences in BV between aspirin/dipyridamole and aspirin remained significant at 1s(-1) (-2.78 [-3.68, -1.88] mPas vs. -0.04 [-1.05, 0.98] mPas; P<0.0001) and 2 s(-1) (-1.62 [-2.52, -0.72] mPas vs. -0.17 [-1.19, 0.85] mPas; P=0.0315)., Conclusion: These findings may have important clinical benefits in the CVD prevention and treatment due to the contribution of BV in tissue perfusion and thrombus formation.

Experiments on rats showed that desmopressin in doses recommended for single injections to humans increased erythrocyte aggregation. A close correlation between erythrocyte aggregation index and blood viscosity, on the one hand, and plasma content of acid glycosaminoglycans on the other was detected.

The aim of this study was to compare the cardioprotective effects of salvianolic acid B (Sal B) and the angiotension-converting enzyme inhibitor, benazepril, in rats with chronic myocardial infarction (MI) that resulted from a coronary artery ligation for 4 weeks. The rats were divided into four groups: those undergoing a sham operation; a MI group; a MI+SalB group (100 mg/kg by a gavage, once a day for 4 weeks); a MI+benazepril group (10 mg/kg by a gavage, once a day for 4 weeks). The following parameters were measured: echocardiographic, hemodynamic and hemorheological changes, angiogenesis, infarct size and cardiac remodeling and the messenger ribonucleic acid (mRNA) of vascular endothelium growth factor (VEGF). Rats treated with SalB or benazepril manifested the following: (1) marked improvements in echocardiographic, hemodynamic and hemorheological parameters; (2) significant reduction of infarct size; (3) significantly attenuated heart, kidney and lung hypertrophies, left ventricular (LV) dilatation and fibrosis. The unique effects of SalB were angiogenesis and augmented VEGF expression in the border and remote noninfarcted left ventricular area. These results suggest that both SalB and benazepril exerted beneficial cardioprotective effects in our experimental system, but that the modality of Sal B was different from that of benazepril. The additional beneficial effects of Sal B relative to benazpril, augmenting VEGF expression and promoting angiogenesis, may result in improved myocardial microcirculation.

Aim: Cardiac infarction is one of the main causes of death in both developing and developed countries over past decades. Currently available approaches for treating patients with this disease are not satisfactory. Traditional Chinese medicines have been increasingly paid attention to. The aim of this study was to characterize the dynamic protective effects of Guanxin No. 2 decoction (GX II) on cardiac dysfunction combined with the blood viscosity and myocardial hypertrophy parameters in myocardial infarction (MI) rats., Methods: Male Sprague-Dawley rats (180-200 g) were randomly divided into three groups: sham-operated, coronary artery ligation (CAL), and CAL plus GX II (GX II, 10.0 g raw materials/kg/d, bid, p.o.). The experiment was carried out at 4 time points as the 3rd, 7th, 14th, and 28th day after ligation., Result: It was found that on the one hand, GX II could significantly improve the heart function, and remarkably decrease infarct size and inhibit ventricular remodeling. On the other hand, GX II showed some unique effects such as angiogenesis which was induced in the left ventricular tissue. This result was consistent with the finding of an augmented vascular endothelial growth factor (VEGF) expression in this area., Conclusions: The studies demonstrated that GX II exerted extensively beneficial cardioprotective effect on CAL rats, it might stimulate angiogenesis of ischemic region to compensate blood supply to the heart via upregulated VEGF expression.

It has been previously shown that alcohol induces the damage of pancreatic parenchyma tissue, but the mechanism of this damage is still poorly understood. Assuming that oxygen radical damage may be the involved, we measured markers of oxidative damage in pancreatic tissue, blood serum, plasma, and whole blood of rats with early-stage alcohol-induced acute pancreatitis. Thirty-eight male Wistar rats were divided into three groups: the control group (group 1), the acute pancreatitis group 1 day (group 2), and 3 days (group 3) after the injection of ethyl alcohol into the common biliary duct, respectively. The levels of Fe in tissue and serum, whole blood viscosity, plasma viscosity, fibrinogen and homocysteine (Hcy) levels, erythrocyte and plasma malondialdehyde (MDA), and tissue and plasma protein carbonyl levels were found to be significantly higher in groups 2 and 3 than in group 1. However, the levels of reduced glutathione (GSH) in tissue and erythrocytes were significantly lower in groups 2 and 3 than in group 1. These results suggest that elevated Fe levels in serum and pancreatic tissue in rats with early-stage alcohol-induced acute pancreatitis is associated with various hemorheological changes and with oxidative damage of the pancreas.

Unlabelled: Hemorheologic and hemostatic parameters are known to be altered in cerebrovascular diseases. Statin therapy is an effective treatment in the prevention of ischemic stroke, the beneficial effects may also involve lipid-independent mechanisms., Aims: In their publication the authors review the references based on the effect of atorvastatin on stroke prevention, hemorheologic and hemostatic parameters, referred to in their previous study, investigating the short-term effect of low-dose atorvastatin on hemorheologic parameters, and endothelial dysfunction, platelet aggregation., Methods: 27 chronic cerebrovascular patients (mean age: 61 +/- 8 years) with hyperlipidemia were investigated for serum lipid levels, hemorheologic parameters (hematocrit, plasma fibrinogen level, plasma and whole blood viscosity, red blood cell aggregation and deformability) and platelet aggregation at baseline, and after one and three months treatment with 10 mg atorvastatin daily. Endothelial dysfunction, characterized by von Willebrand factor activity was measured before and after 1-month treatment., Results: The mean decrease of plasma total cholesterol level was 28% both after 1 and 3 months ( p < 0.001), that of LDL-cholesterol was 40% and 38% ( p < 0.001) compared to baseline values. Atorvastatin significantly improved whole blood viscosity after 3-month treatment and red blood cell deformability even after 1-month treatment ( p < 0.05). Collagen induced platelet aggregation provided a significant ( p < 0.001) decrease compared to that of baseline values beside unaltered antiplatelet therapy. Von Willebrand factor activity was also improved significantly ( p < 0.05) after 1-month treatment., Conclusions: Data of the literature and findings of the authors show that the beneficial effects of atorvastatin are complex. Besides lipid lowering, atorvastatin can improve hemorheologic parameters, platelet aggregation and endothelial dysfunction after short-term and low-dose therapy.

The modern pathobiochemical explanation of the old clinical finding, i.e. that the occurrence of the thromboembolic complications in cancer patients is significantly higher, starts to be clarified on the basis of recent knowledge regarding the role of cancer procoagulant, the expressed tissue factor and the changes in the clotting and fibrinolytic systems. Furthermore, the presently used chemotherapeutic agents have activating effects of the coagulation system as well. The details of these phenomena, the frequently used drugs and their pathobiochemical effects are detailed in this publication. Finally, it gives an outlook regarding the new adjuvant, beneficial effects of the direct anticoagulants in malignancies.

Objective: To investigate the effect of Mailuoning injectable powder on experimental vascular occlusion angeitides in rats., Methods: Rats were injected laurostearic acid into arteria cruralis to induce the model of experimental vascular occlusion angeitides, then we observed the changes of objective sign of rats, and analysed throm ranking through pathological section under electro-microscope., Results: Mailuoning injectable powder could decrease the quantity of throm in blood vessel, and improve hemorrheoiogy., Conclusion: The results show that Mailuoning injectable powder has obvious therapeutical effect on experimental vascular occlusion angeitides in rats, and its mechanism may be related to the anti-throm in blood vessel and improving hemorrheology.

Kawasaki Disease (KD) is an acute febrile systemic vasculitis of unknown etiology that primarily affects children younger than five years of age. The most reliable treatment for acute-phase KD is the combination of aspirin and high dose (2g/kg) intravenous immunoglobulin (IVIG) therapy. However, IVIG therapy is occasionally associated with serious thromboembolism, probably because of a rapid increase in plasma IgG concentration. Therefore, patients with KD, who are associated with endothelial impairment, are not free from the risk of thromboembolism associated with IVIG therapy. High levels of IgG, immune complex formation, and increased platelet aggregation could increase blood viscosity after IVIG infusion. Increased serum viscosity reduces arterial and capillary blood flow, leading to thrombosis. We have previously reported that single high-dose IVIG therapy for acute KD raises plasma viscosity. Although there is scarce epidemiological information as to the prevalence of thromboembolism associated with IVIG therapy, the occurrence of these complications must be taken into consideration. This article also includes relevant patents on this topic.

In the present study, we compared cardioprotective effects of salvianolic acid B (Sal B) and the angiotension-converting enzyme inhibitor, benazepril, in rats with large myocardial infarction (MI). The large MI was produced by coronary artery ligation for 4 weeks in rats. The rats were divided into the following groups: sham operation; MI; MI + Sal B (100 mg/kg by a gavage, once a day for 4 weeks) and MI + benazepril (1 mg/kg by a gavage, once a day for 4 weeks). Echocardiogram, hemodynamic and hemorheological changes, angiogenesis, infarct size and cardiac remodeling, as well as messenger ribonucleic acid (mRNA) of vascular endothelium growth factor (VEGF) were measured. The following similar effects were observed in MI rats treated with Sal B and benazepril: (1) a marked improvement of echocardiographic, hemodynamic and hemorheological parameters, (2) significant reduction of infarct size, (3) significantly attenuated heart hypertrophy, left ventricular (LV) dilatation and fibrosis. The unique effects of Sal B were: angiogenesis and augmented VEGF expression in the border and remote noninfarcted LV area. These results suggest that Sal B and benazepril exerted beneficial cardioprotective effects. However, Sal B enforced some different modality than benazepril, which might improve myocardial microcirculation by augmenting VEGF expression and promoting angiogenesis besides similar effects to benazepril.

Previous studies suggest that treatment with icariin (ICA) combined with Panax notoginseng saponins (PNS) improved behavior and cholinergic system disorders followed by amyloid beta-peptide(25-35) lateral ventricle injection in rats. The present study investigated whether administration of ICA + PNS had preventive and therapeutic effects on bilateral common carotid arteries (CCA) occlusion-induced cerebral ischemia-reperfusion (IR) injury in rats. Male Sprague-Dawley rats were divided randomly as follows: sham-operated, i.g. vehicle, ICA (5 mg/kg), PNS (40 mg/kg), ICA + PNS (2.5 + 20, 5 + 40 or 10 + 80 mg/kg), and ergoloid mesylate as a positive control (0.45 mg/kg) in model rats. Treatment was performed once a day for 7 days prior to ischemia. The rats were subjected to transient global IR induced by CCA occlusion in combination with intraperitoneal injection of sodium nitroprusside (2.0 mg/kg), then treated with ICA + PNS for another 14 days continuously. ICA + PNS significantly improved the rat passive avoidance task in step-down paradigms, and spatial cognition in the eight-arm radial maze, concomitant with an improvement of blood viscosity. Increased lipid peroxidation in brain after IR injury was observed, MDA being 0.56 +/- 0.10 nmol/mg prot vs 0.48 +/- 0.06 nmol/mg prot in the vehicle control (p < 0.05). Treatment with ICA + PNS 2.5 + 10, 5 + 40, 10 + 80 mg/kg produced a marked reduction in the MDA level to 0.46 +/- 0.06, 0.42 +/- 0.09 and 0.45 +/- 0.08 nmol/mg prot, respectively vs 0.56 +/- 0.10 nmol/mg prot in IR injury only control (p < 0.05, p < 0.01). A decrease in superoxide dismutase activity was observed in the brain of IR rats (the SOD activity being 72.75 +/- 4.62 U/mg prot vs 80.97 +/- 6.06 U/mg prot in control, p < 0.05). ICA + PNS 5 + 40 mg/kg prevented the IR injury mediated fall in superoxide dismutase activity being 78.90 +/- 6.61 U/mg prot versus 72.75 +/- 4.62 U/mg prot (p < 0.05). ICA + PNS tended to attenuate apoptosis in hippocampal CA1 pyramidal neurons. Either ICA or PNS treatment alone did not obviously improve cognitive impairment (except that lipid peroxidation was reduced by PNS-treatment). The results indicated that ICA + PNS may ameliorate learning and memory deficit and blood viscosity by protecting neurons from oxidative stress in ischemic brain.

Extracts of Gymnemy sylvestre (GS) exhibit hemorheological activity. The most pronounced effect was observed for GL extract in 25 wt % concentration, which (i) induced a decrease in the viscosity of blood and washed erythrocyte suspensions in the entire range of shear rates by a factor of 1,3 (ii) reduced the degree of deformability of red blood cells, (iii) increased the degree of osmotic resistance of erythrocytes by 21.3%, (iv) increased the intensity of fluorescence of DSM+ probe in erythrocyte suspensions by a factor of 1.5, and (v) decreased the degree of anisotropy, thus generally improving the viscoelastic properties of the erythrocyte membrane and preventing the thrombocyte aggregation. In this respect, the GS extract activity exceeded that of Tanakan.

Objective: To investigate the synergistic effect of salvianolic acids (Sals) and tanshinones (Tans), to compare the pharmacodynamic effect of Danshen co-microemulsion, salvianolic acids microemulsion, tanshinones microemulsion, tanshinones suspension and blank microemulsion on hemorheology in rats with hyperlipidemia., Methods: Fat milk was administered to SD rats in the morning for 23 days, and drugs were given in the afternoon since the 13th day. On the 14th day, the blood viscosity, haematocrit and platelet aggregation were determined., Results: Both Tans and Sals could inhibit the platelet aggregation, and decrease the blood viscosity. The effect of Sals on the decrease of blood viscosity was much more significant than that of other groups. And Tans could significantly inhibit the platelet aggregation than others. Compared to Tans or Sals used separately, co-administration of Tans and Sals at the same time could decrease the blood viscosity and inhibit the platelet aggregation significantly., Conclusion: As a new drug carrier, the microemulsion system can increase tanshinone solubility dramatically and improve its bioavailability. And co-mecroemulsion of Tans and Sals can produce the synergy of Tans and Sals preferably and are much more efficient than either Tans microemulsion or Sals microemulsion used alone.

It has been shown that benidipine, a long-lasting calcium (Ca) channel blocker, may exert its protective effect against vascular disorders by increasing nitric oxide (NO) production. The purpose of the present study was to investigate whether orally administered benidipine might influence the membrane function in patients with essential hypertension. We measured the membrane fluidity of erythrocytes by using an electron paramagnetic resonance (EPR) and spin-labeling method. In the preliminary study using erythrocytes obtained from healthy volunteers, benidipine decreased the order parameter (S) for 5-nitroxide stearate (5-NS) and the peak height ratio (ho/h-1) for 16-NS in the EPR spectra in vitro. The finding indicated that benidipine increased the membrane fluidity and improved the microviscosity of erythrocytes. In addition, it was demonstrated that the effect of benidipine on membrane fluidity of erythrocytes was significantly potentiated by the NO-substrate, L-arginine. In the separate series of the study, we observed that orally administered benidipine for 4 weeks significantly increased the membrane fluidity of erythrocytes with a concomitant increase in plasma NO metabolite levels in hypertensive subjects. The results of the present study demonstrated that benidipine might increase the membrane fluidity and improve the microviscosity of erythrocytes both in vitro and in vivo, to some extent, by the NO-dependent mechanism. Furthermore, it is strongly suggested that orally administered benidipine might have a beneficial effect on the rheologic behavior of erythrocytes and the improvement of the microcirculation in hypertensive subjects.

Background: Fluid therapy induces haemodilution related to plasma volume expansion. The aim of our study was to compare haemodilution after a single hydroxyethyl starches (HES) 130/0.4 infusion in two groups of patients, one with and one without sepsis. We hypothesized that a single HES challenge would induce similar sustained haemodilution in both groups., Methods: In this prospective preliminary study, patients predicted to require a single further volume-expander infusion were included immediately before receiving 500 ml of 6% HES 130/0.4 over a 15-min period. No additional fluid was administered over the next 8 h. Haematocrit, and serum albumin and protein were determined immediately before HES infusion then after 1, 2, 3, 4, and 8 h., Results: Twelve patients were included in each group. In both groups, all three haemodilution markers had significantly lower values after 1 h than at baseline. None of the values after 1 and 3 h differed significantly between the two groups. Neither did any of the other study variables show significant differences between the groups with and without sepsis., Conclusion: We found that a starch-based compound was as effective in inducing haemodilution in patients with sepsis as in controls without sepsis, suggesting that HES may remain within the intravascular space even in patients with sepsis. Haemodilution parameters such as haematocrit, serum albumin and serum protein are useful for assessing the duration of plasma volume expansion induced by fluid therapy in critically ill patients.

The extract from Panax ginseng has been reported to improve the microcirculation in various organs. However, the mechanisms underlying this phenomenon are still poorly understood. In the present study, using the rheological properties of erythrocytes as an index, we have screened the components of Panax ginseng extract and identified Rg(2) and Rh(1) as the active ingredients. These two ginsenosides prevented the oxidative stress-induced elevation of erythrocyte suspension viscosity and the impairment of erythrocyte elongation in response to shear stress. Rg(2) and Rh(1) ginsenosides did not have antioxidant activity in an aqueous phase and did not inhibit the peroxidation of membrane lipids, either. However, they inhibited the oxidation-induced decrease of SH-groups in band 3 (anion exchanger-1), one of the important structural proteins of the erythrocyte membrane, but not in other structural proteins: bands 1 and 2 (spectrins), band 4.2 or band 5 (actin). These results suggest that ginsenosides Rg(2) and Rh(1) protect the rheological functions of erythrocytes against oxidative stress by preventing the oxidation of SH-groups in band 3 protein.

Objective: To investigate the effects on blood fat and viscosity of Naoxinqing tablet., Methods: 66 patients of primary hyperlipoidemia were randomly divided into three groups. The first group was treated by Naoxinqing tablet, the second group was treated by Naoxinqing and combined with half dose Simvastatin, the third group was treated by full dose Simvastatin. Then the clinical effect, fasting plasma lipid, the index of blood viscosity and side effect of the three group' patients were compared after 8 weeks., Results: The index of blood fat improved obviously after treatment of the three groups ( P < 0.05, P < 0. 01), group 2 and 3 were significantly superior to group 1 (P < 0.05), and no significance between group 2 and 3 (P > 0.05)., Conclusions: The Naoxinqing tablet can improve the metabolism of blood fat, decrease blood viscosity obviously and treat hyperlipoidemia effectively with little side effect.

Introduction: Preoperative hemodilution is an established practice that is applied to reduce surgical blood loss. It has been proposed that polyethylene glycol (PEG) surface decorated proteins such as PEG-conjugated human serum albumin may be used as non-oxygen-carrying plasma expanders. The purpose of this study was to determine whether there is any difference in survival time after severe hemorrhagic shock following extreme hemodilution using a conventional hydroxyethyl starch (HES)-based plasma expander or PEG-albumin., Methods: Experiments were performed using the hamster skinfold window preparation. Human serum albumin that was surface decorated with PEG was compared with Voluven 6% (Fresenius Kabi, Austria; a starch solution that is of low molecular weight and has a low degree of substitution; HES). These plasma expanders were used for a 50% (blood volume) exchange transfusion to simulate preoperative hemodilution. Exchange transfusion was followed by a 60% (blood volume) hemorrhage to reproduce a severe surgical bleed over a 1 hour period. Observation of the animal was continued for another hour during the shock phase., Results: The PEG-albumin group exhibited significantly greater survival rate than did the HES group, in which none of the animals survived the hemorrhage phase of the experiment. Among the treatment groups there were no changes in mean arterial pressure and heart rate from baseline after hemodilution. Both groups experienced gradual increases in arterial oxygen tension and disturbance in acid-base balance, but this response was more pronounced in the HES group during the shock period. Mean arterial pressure remained elevated after the initial hemorrhage period in the PEG-albumin group but not in the HES group. Maintenance of a greater mean arterial pressure during the initial stages of hemorrhage is proposed to be in part due to the improved volume expansion with PEG-albumin, as indicated by the significant decrease in systemic hematocrit compared with the HES group. PEG-albumin treatment yielded higher functional capillary density during the initial stages of hemorrhage as compared with HES treatment., Conclusion: The ability of PEG-albumin to prolong maintenance of microvascular function better than HES is a finding that would be significant in a clinical setting involving preoperative blood management and extreme blood loss.

There is evidence that hyperlipidemia can induce hemorheological and microcirculatory disturbances. Myakuryu, a Chinese traditional medicine is efficacious in promoting lipid metabolism and protecting oxidative stress, but whether this drug can ameliorate rheologic disturbances caused by hyperlipidemia is still unknown. The present study was conducted to investigate the effects of myakuryu on hemorheological and microcirculatory disturbances induced by hyperlipidemia. Wistar rats were divided into a group on control diet (n=8) and a group on high-fat diet (HFD, n=44). Eight weeks later, plasma triglyceride (TG) and total cholesterol (TC) were determined. Sixteen animals with the highest levels of hyperlipidemia from the HFD group were randomly divided into two sub-groups: the untreated hyperlipidemia group (n=8) and the group treated with myakuryu (n=8). At the end of the sixteenth week, rheological and microcirculatory parameters were measured. Chemical analysis showed that myakuryu treatment caused significant reductions of plasma TG and TC levels (P<0.01), and the cholesterol/phospholipid ratio in the erythrocyte membrane (P<0.05). Rheological and microcirculatory measurements showed that myakuryu treatment led to a significant decrease in the erythrocyte aggregation index, plasma viscosity and blood viscosity at shear rates of 50, 100 and 150 s(-1) and in adherent leukocytes in mesenteric venules. There was a significant increase in erythrocyte deformation, electrophoretic mobility, membrane fluidity and F-actin content in the erythrocyte membrane as well as in red cell velocity in mesenteric venules. Our findings suggest that myakuryu treatment can improve blood flow and reduce adherent leukocytes in the venules of rats fed with HFD by ameliorating blood viscosity, erythrocyte deformability and aggregation, and other hemorheological characteristics.

Background: Because the tongue is an organ known for its excellent blood supply, ischaemic lingual necrosis is extremely rare within clinical everyday life. Acute lingual circulatory disturbances can result from impairment of venous drainage or more often from ischaemic arterial occlusion. Due to permanent function loss of the tongue, apparent lingual necrosis may lead to severe mutilation of the patient. While vasculitis of the lingual arteries in temporal arteritis is said to be the most frequent causation of tongue necrosis, diagnosing the underlying disease of lingual ischaemia may sometimes be challenging for the clinician., Patients and Methods: We present the first reported case of a spontaneous lingual necrosis in a patient with rheumatoid arthritis, due to polyclonal gammopathy with extensive hyperviscosity syndrome and local vasculitis., Results: Clinical symptoms, diagnosis and therapy of tongue necrosis are presented in a case report. Besides an overview on the disorder of hyperviscosity syndrome, the discussion will illustrate pathogenetic, diagnostic and therapeutic considerations of lingual ischaemia. The international medical literature is reviewed to summarize the causes of tongue necroses that are described up to now. The particular importance of temporal arteritis Horton for the otolaryngologist in general and for the development of lingual necrosis in particular is highlighted., Conclusions: Apart from the presentation of the first reported case of lingual necrosis in rheumatoid hyperviscosity syndrome, the intention of this article is to draw the clinician's attention on the fundamental aspects of lingual ischaemia and of temporal arteritis.

The association between testosterone-replacement therapy and cardiovascular risk remains unclear with most reports suggesting a neutral or possibly beneficial effect of the hormone in men and women. However, several cardiovascular complications including hypertension, cardiomyopathy, stroke, pulmonary embolism, fatal and nonfatal arrhythmias, and myocardial infarction have been reported with supraphysiologic doses of anabolic steroids. We report a case of an acute ST-segment elevation myocardial infarction in a patient with traditional cardiac risk factors using supraphysiologic doses of supplemental, intramuscular testosterone. In addition, this patient also had polycythemia, likely secondary to high-dose testosterone. The patient underwent successful percutaneous intervention of the right coronary artery. Phlebotomy was used to treat the polycythemia acutely. We suggest that the chronic and recent "stacked" use of intramuscular testosterone as well as the resultant polycythemia and likely increased plasma viscosity may have been contributing factors to this cardiovascular event, in addition to traditional coronary risk factors. Physicians and patients should be aware of the clinical consequences of anabolic steroid abuse.

Alpha macroglobulins (AM) are plasma proteins whose main function is to inactivate proteinases, protecting the tissues from the action of these enzymes. AM have influence on plasma viscosity (PV) and binds monofluorophosphate (MFP), which disturbs its homeostasis. The aim of this work was to evaluate whether the administration with MFP could modify blood viscosity. AM levels (micromol/l), PV (mPa.s), viscosity of red blood cells suspensions in NaCl 9 g/l (VES) and in autologue plasma (VEP) were measured in fifty-day old rats after a single dose of 80 micromol MFP or after 30 days of treatment with 80 micromol of MFP. Relative viscosity (RV) was calculated as the ratio VEP/PV. AM and PV increased significantly after 30 min of an oral dose of MFP. Controls (n=6), AM: 19.65+/-0.85, PV: 1.39+/-0.01, treated (n=6), AM: 22.88+/-0.75 (p<0.05), PV: 1.76+/-0.14 (p<0.05). After 30 days of treatment with MFP, AM and PV increased significantly. Controls (n=6), AM: 10.76+/-1.33, PV: 1.19+/-0.04, treated (n=6), AM: 17.66+/-1.27 (p<0.05), PV: 1.38+/-0.03 (p<0.05). The treatment with MFP modifies neither the VEP nor the RV. These results would indicate that AM and/or MFP did not interact with erythrocyte membrane and did not modify erythrocyte deformability.

Background: Pathologic hemorheological parameters and increased platelet aggregation in association with other risk factors significantly increase the possibility of the development of ischemia. Acetylsalicylic acid (ASA) is an effective antithrombotic agent, which prevents a variety of cardiovascular diseases., Objectives: The aim of our present study was to compare the hemorheological parameters of patients with effective platelet inhibition by ASA to those with ineffective one., Methods: 2045 patients taking 100 mg ASA daily were involved in our study (1255 males, mean age: 63+/-11 yrs, 790 females, mean age: 63+/-12 yrs). To exclude the effect of risk profile, previous diseases and medication, 323 patients (197 males, mean age 60+/-13 yrs and 126 females, mean age 60+/-12 yrs) were selected from the examined group with matching parameters. Blood was taken after an overnight fast between 8:00 and 9:00 a.m. Platelet aggregation was measured in Carat TX-4 optical platelet aggregometer. Blood hematocrit was measured by Heraeus microhematocrit centrifuge and red blood cell aggregation was detected by Myrenne aggregometer. Plasma fibrinogen was measured by Clauss' method. Plasma and whole blood viscosities were measured in Hevimet 40 capillary viscosimeter., Results: Patients with effective ASA inhibition had significantly lower plasma fibrinogen level (p<0.05) and red blood cell aggregation values both in the heterogenous and the selected populations (p<0.01). The other hemorheological parameters were not statistically different in the two groups., Conclusion: The background of ineffective ASA medication has not yet been fully elucidated. Higher fibrinogen concentration increases red blood cell aggregation and can also result in increased platelet aggregation. Thus, increased plasma fibrinogen level may play an important role in the in vitro and in vivo platelet resistance to ASA.

Hemorheological changes due to intravenous gammaglobulin (IVIg) administration have been considered to influence blood viscosity and this way the blood flow in microcirculation. The study was carried out in the group of 10 patients with various neurological disorders (seven with polyradiculoneuropathy, two suffering from myasthenia and one with multiple sclerosis). Patients were treated routinely with intravenous gammaglobulin infusion (Sandoglobulin, Sandoz, 24 g a day in the course of 5 days therapy). The following hemorheological factors were estimated: relative blood viscosity, plasma viscosity, red cell deformability and erythrocytes aggregation. For rheological examination the microviscosimeter Low Shear 40 (Contraves) was used. Each patient was examined two times: before treatment initiation and at the end of therapy after five days. At the comparison of first and last measurements a significant increase of plasma viscosity (p<0.04) was found, whereas erythrocyte deformability was significantly improved (p<0.05). The value of relative blood viscosity at shear rate of 0.1 s(-1) was significantly decreased (p<0.05) and statistically unchanged at other studied shear rates. The results suggest an existence of a protective feedback mechanism in the studied group of patients which has been exemplified by the red cell elasticity improvement.

The present study was conducted to investigate whether hydroxysafflor yellow A (HSYA) has a protective effect on acute and chronic heart failure (AHF/CHF) induced by ligation of the left anterior descending coronary artery for 3 h and 8 weeks, respectively. The rats were divided into the following groups: sham operation, coronary artery ligation (CAL), CAL+HSYA (100 mg kg(-1) by gavage) and CAL+diltiazem (20 mg kg(-1) by gavage). In the AHF model, heart function, as determined by haemodynamic studies and echocardiography, was improved significantly by pretreatment with HSYA or diltiazem. Significant reductions in elevated serum creatine phosphokinase, lactate dehydrogenase, malondialdehyde (MDA), glutamic oxalacetic transaminase, glutamic pyruvic transaminase and blood viscosity were observed, and the activity of serum superoxide dismutase (SOD) was enhanced (all P<0.01). In the CHF model, HSYA and diltiazem restored abnormal heart function, and completely suppressed the elevated plasma atrial natriuretic polypeptide (ANP) and endothelin-1 (ET-1), serum and left-ventricular tissue inducible nitric oxide (NO) synthase (iNOS), NO and MDA, and improved the decrease in SOD. HSYA and diltiazem improved cardiac performance in AHF and reduced cardiac remodelling in CHF by reducing tissue weight indices: left ventricular weight/body weight (BW), right ventricular weight/BW, kidney weight/BW and lung weight/BW, and attenuating increases in infarct size, inner diameter of the left ventricle and collagen volume fraction in non-infarcted areas, and the decrease in mean wall thickness of infarcted myocardium. These results suggest that HSYA exerted beneficial actions in cardiac performance in models of both AHF and CHF, mainly by suppressing ET-1, iNOS and oxidative stress in infarcted tissue.

A group of 15 chronic opioid addicts (DA) with mean age 26.5+/-7.3 years was studied by means of a rotational Contraves Low Shear 30 viscometer and the results have been compared with a control group of 19 healthy subjects. It was found that the mean whole blood viscosity values of the investigated group of heroin abusers (n=15) were elevated compared to that of healthy persons (n=19) over the whole shear rate range and fell by more than ten orders of magnitude (Savov et al., 2006). The present investigation uses the coefficients of the models of Ostwald-de-Walle (power law) and Herschel-Bulkley law, which describe whole blood flow curves (tau-gamma) within the shear rates range from 10(-2) to 10(2) s(-1) and itself incorporate whole blood viscosity data in the entire shear rate range. A significant difference in the mean yield shear stress tau(0) values of the drug abusers' group compared to the controls was found. A strong positive linear correlation was determined between the parameters of RBC aggregation in the group of heroin addicts confirming our previous results (Ivanov and Antonova, 2005; Savov, Zvetkova et al., 2007; Savov, Antonova et al., 2007) for intensive RBC and platelet aggregation and morphological changes in DA group.