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[Status of microcirculation and rheological properties of blood in patients with cerebral circulatory disorders].

Microcirculation and rheological properties of blood were investigated over time on the basis of the findings of biomicroscopy of the bulbar conjunctiva in 61 patients with different stages of circulatory encephalopathy in the presence of arterial hypertension and atherosclerosis. Rheological properties of blood were changed at all stages of disease. Correlations between the ability of erythrocytes to aggregation and the degree of their intravascular aggregation by the findings of biomicroscopy of the bulbar conjunctiva were not found. The importance of investigation of the intravascular aggregation of erythrocytes and theological properties of blood for assessment of the cerebral vascular microcirculation, control of therapy, and verification of some aspects of the mechanism of action of various drugs was shown.

Adult↗

Immunohistological analysis of intravascular agglutination in a case of ABO incompatible blood transfusion by means of mixed cell agglutination reaction.

Applicability of the mixed cell agglutination reaction (MCAR of Davidsohn) in histological examination was tested in a case of ABO incompatible blood transfusion, who had died of severe head injury two days after an accident. Massively disseminated intravascular aggregation of erythrocytes was identified as immune agglutination by the modified method of MCAR (ISHIYAMA & OKADA) with precise knowledge of topographic isoantigen localization in tissues. The immune specific agglutination mimics intravascular changes such as hyperemia, stagnation and hemorrhage derived from various circulatory disturbances obtained in routine autopsy materials.

ABO Blood-Group System↗

[Microcirculatory and hemostatic disturbances in patients with influenza and respiratory infections aggravated with coexisting diseases].

Microcirculatory disorders (MD) and hemostasis (HS) were studied in patients with influenza and acute respiratory viral infection (ARVI). The patients also suffered from ischemic heart disease (IHD), essential hypertension (EH) and diabetes mellitus (DM). Among 241 patients 63.9% were middle-aged and old. 45 patients under 60 years of age without coexisting diseases served control. In acute influenza and ARVI the majority of the postcapillary veins and capillaries were affected with sludge syndrome, there were marked perivascular and vascular changes. Convalescence was accompanied with reduced permeability and intravascular aggregation of erythrocytes, microvessels improved tonicity. HS responded to the acute infections with depression of fibrinolysis, in convalescence platelet aggregation activated. IHD patients had disseminated intravascular red cell aggregation, slowing of the microflow, hypercoagulation. Patients with postmyocardial infarction cardiosclerosis (PIC) had more severe affection of microcirculation and hemostasis in convalescence. In hypertensive patients microcirculation and hemostasis were similar to those with IHD. In diabetics platelet aggregation improved but sludge phenomenon and slow blood flow persisted. Thus, ARVI for IHD, EH DM patients are a risk factor for the disease aggravation. In influenza and ARVI, IHD patients, especially with PIC and EH are contraindicated active physical exercise, intake of dysaggregant drugs is desirable. Diabetics should take drugs improving blood rheology early in acute period of ARVI.

Acute Disease↗

[Various aspects of the interrelations between blood phospholipids, blood coagulation and microcirculation in chronic bronchitis].

Studies of conjunctival microcirculation, thromboelastographic coagulation (as assessed by 8 parameters) and plasma phospholipid spectrum (with 8 fractions obtained), carried out in 136 patients with acute phases of chronic bronchitis, have demonstrated considerable disorders of microcirculation, hypercoagulation and shifts of blood phospholipid spectrum. Marked perivascular disorders were matched by increased levels of plasma lysophosphatidylcholines, which promote increased capillary permeability. Intravascular changes (erythrocyte aggregation and sludging, intermittent flow and stasis of blood) were accompanied by established hypercoagulation and increased phosphatidylethanolamines, producing a coagulating effect. A drop in plasma phosphatidylcholines is a symptom of disrupted synthesis of this phospholipid class in the lungs, and a disorder of pulmonary surfactant structure and function. The level of phosphatidylserins, conducive to histamine release by mast cells, rose in patients with the bronchospastic syndrome. Shifts in other phospholipid fractions, typical for different types and stages of chronic bronchitis, have also been demonstrated. Basically, the magnitude of shifts was greater prior to treatment in the majority of parameters.

Adolescent↗

Vascular changes in duodenal mucosa in shigellosis and cholera.

Vascular endothelial cells are highly specialized cells with numerous sensory and modulator functions. Our previous studies show extensive microvascular changes in rectal mucosal vasculature of patients with acute infective diarrhea (Mathan and Mathan 1985a, Gut 26:710-717). We looked for changes in the duodenal mucosal vasculature in two naturally occurring diarrheal infections: shigellosis and cholera. Duodenal mucosal biopsies from 14 patients with shigellosis, 12 patients with cholera, and 10 healthy volunteers were examined under the electron microscope. There were extensive microvascular changes in the duodenum in shigellosis and cholera. Congestion and dilatation of capillaries and venules, stagnation of blood, thinning of the endothelial lining, and platelet clumping were commonly seen in both conditions. Endothelial damage was also common to both conditions but was mild to moderate in cholera and severe in shigellosis with frank hemorrhage, frequent formation of stress fibers, widening of intercellular spaces, cytoplasmic blebbing, cell fragmentation, and intravascular thrombosis. Erythrocyte aggregates, platelet aggregates, and leucocyte plugging lead to capillary obstruction. The arterioles were severely constricted. These changes in the endothelial lining of the microvasculature could contribute to the pathogenesis of the disease resulting in peripheral vascular insufficiency, inadequate oxygen delivery to intestine, and organ dysfunction. The factors influencing these changes, their implications, and possible therapeutic interventions are discussed.

Arterioles↗