Effect of synthetic physalaemin on splanchnic circulation in dogs

Physalaemin has been reported as one of the most potent vasodilator and hypotensive peptides (1-4). In spite of these studies, however, the effect of the peptide on splanchnic circulation is not known precisely. In the present study, the effect of synthetic physalaemin on superior mesenteric arterial blood flow, portal venous blood flow and pancreatic capillary blood flow was investigated in dogs. Dose dependent increases of superior mesenteric arterial blood flow and portal venous blood flow were induced in response to physalaemin (0.1-10.0 ng/kg). Superior mesenteric arterial blood flow and portal venous blood flow attained maximal increases of 77 +/- 8.9% and 70 +/- 8.6%, respectively, at a dose of 5 ng/kg. Physalaemin caused a dose-related decrease in systemic arterial blood pressure. Pancreatic capillary blood flow did not show significant change with the administration of physalaemin. These data suggest that physalaemin may play some physiological roles in the regulation of splanchnic circulation.     

Determination of the adrenergic response by measurement of catecholamines and activity of dopamine-beta-hydroxylase (D-beta-B) in arterial capillary blood]

Plasma dopamine-beta-hydroxylase activity and catecholamines (adrenaline and noradrenaline) level in venous blood taken from the cubital vein and in arterialized capillary blood taken from the ear lobe were measured before and after a maximal exercise on a treadmill in 14 healthy untrained volunteers. The authors have shown a good correlation between these parameters in venous blood and those in capillary blood. It is concluded that the determination of plasma dopamine-beta-hydroxylase activity and catecholamines level in arterialized capillary blood could be a valid measure of the sympathetic activity.     

Capacity and exchange functions of the kidney blood vessels at various leveles of venous outflow

In perfusion of the cat hemodynamically isolated kidney with a constant blood flow volume, responses of venous vessels to noradrenaline did not depend on the venous outflow pressure level and only involved a diminishing of the blood filling which distinguishes kidneys from other organs. The renal veins' capacity decreased in response to noradrenaline practically completely disappears in high values of the venous outflow pressure. The renal capillary filtration coefficient was shown to equal 0.21 +/- 0.11, whereas the effect of changes in renal vein's pressure on implementation of the microvessels' exchange function in determined by the shifts of capillary hydrostatic pressure.     

Effect of storage temperature and length on fatty acid composition of fingertip blood collected on filter paper

We have compared the fatty acids of the capillary and venous whole blood samples collected on the commercially developed blood collection paper and standard grade filter paper extracted by either the direct methylation or conventional method (including various blood lipids fractions). Also, reproducibility of fatty acids extracted from dried blood on the filter paper after storing at room temperature up to 2 months and at 4°C up to 6 months was assessed. In conclusion, the direct methylation of fingertip blood collected on both brand of papers produced fatty acids that reflected venous blood fatty acids extracted by the conventional method. Of the eight fatty acids evaluated, capillary DHA showed the strongest correlation with DHA of the venous whole lipids as well as various lipid fractions of the plasma and red cells. However, a prolonged storage of blood samples at 4°C had deleterious effect on the qualitative value of fatty acids, especially DHA.     

Interdependency of the oxidizability of lipoproteins and peroxidase activity with base excess, HCO3, pH and magnesium in human venous and capillary blood

As continuous production of free radicals and reactive oxygen species is a normal metabolic process, increased metabolism during exercise/workload should increase free radical generation and oxidative stress. Oxidative stress intensity should then depend on the intensity of metabolic stress effects. Intensity of stress is usually reflected in norepinephrine (NE) levels, which correlate linearly and significantly with changes in blood gases, blood buffer systems, blood electrolytes, blood glucose and lactate [Porta, S., Leitner, G., Heidinger, D., Lang, T., Weiss, U., Smolle, K.H., Hasiba, K., 1997. Magnesium w?hrend der Alpinausbildung bringt um 30% bessere Energieverwertung. Magnesium-Bulletin 19(2), 59-61]. Those parameters were used in an open study design to screen 64 subjects for metabolic stress effects along with their antioxidative capacity using both venous and capillary blood. To compare venous and capillary blood, we took venous blood samples from 12 healthy volunteers and capillary blood from 52 other healthy subjects. To show whether free radical changes indeed go along with metabolic stress effects, we tried to quantify relations between metabolic stress effects and oxidative stress by linear correlations. In conclusion, both venous and capillary blood are suitable for determining at least those parameters of the oxidative state that we used. All significant correlations of peroxidase activity and oxidation lag time (OLT) with pH, bicarbonate (HCO3), base excess (BE) and magnesium (Mg) indicate that free radical production increases with metabolism. Those relationships could help to evaluate the oxidative state more precisely.     

Continuous capillary blood collection by means of cooling of the wound]

By cooling of a capillary wound to 5 degrees C it is possible to obtain blood continuously without anticoagulants. Thus it is possible to measure blood constituents (like bilirubin, glucose, gases, cellular elements etc.) over longer periods of time in patients for whom indwelling venous catheters are not feasible.     

Venous and capillary blood hematocrit at rest and following submaximal exercise.

The purpose of this study was to determine if finger tip capillary blood hematocrit is a valid estimate of anticubital venous blood hematocrit at rest and after submaximal exercise. Simultaneous samples of finger tip cpaillary and venous blood were drawn from thirty-one subjects (15 males, 16 females) before and after a 15 min submaximal exercise on a bicycle ergometer. Venous and capillary blood hcts. were 42.0% +/- 3.9 and 42.0% +/- 3.5 respectively before exercise and 43.3% +/- 3.5 and 42% +/- 3.8 after exercise (X +/- s). The regression equation for predicting venous hct. from finger tip capillary blood after exercise was: Hctv = 0.87 Hctc + 6.44 with r = 0.95 (P less than 0.05). The results indicate that the finger tip capillary microhematocrit method is a valid indicator of venous blood hct. following exercise.     

A commercial whole blood glucose biosensor with a low sensitivity to hematocrit based on an impregnated porous carbon electrode

Erythrocytes (red blood cells) are a major source of response variation in biosensor electrodes expected to operate in whole blood. Such a blood-to-plasma difference (hematocrit effect) must be minimized for those sensors directed towards the hospital market where wide variations in hematocrit can be seen. Typically, many current glucose sensors demonstrate a decreasing response to the analyte in the presence of increasing hematocrit levels. A sensor electrode for glucose is described which displays a reduced sensitivity to changes in hematocrit. The working electrode comprises a base porous conducting carbon layer, which is impregnated with a mixture including glucose oxidase and a ferrocene redox mediator. The base carbon layer has a void volume of 50%, an average pore diameter of less than 0.1 microm and a thickness of about 20 microm. The interior void volume of the base carbon layer is filled entirely with a substantial proportion of the impregnating mixture such that very little remains on the exterior. The resulting impregnated porous electrode excludes erythrocytes and is consequently capable of operating acceptably in venous, capillary, arterial and neonatal blood over a wide hematocrit range of 20-70%.     

Myocutaneous flap ischemia: flow dynamics following venous and arterial obstruction.

To further clarify the pathogenesis of the poorer prognosis in skin flaps exposed to venous stasis compared with arterial insufficiency, a microsphere study was conducted in bilateral rectus abdominis island flaps in seven pigs. The relationship between capillary blood flow and arteriovenous (A-V) shunting was studied during progressive 1-hour intervals of arterial insufficiency and venous stasis and during 3 hours of reperfusion. Under controlled conditions, total blood flow was reduced from 100 percent to both 50 and 25 percent by application of an adjustable clamp on the artery supplying one flap and on the vein draining the contralateral flap. The relative distribution between A-V shunt flow and capillary blood flow was different in arterial insufficiency when compared with venous stasis at both the 50 percent and the 25 percent blood flow levels. In the arterial insufficiency flaps, the A-V shunt flow and capillary blood flow shared the total blood flow in the following percentages: 64/36 (at 100 percent total blood flow), 44/56 (at 50 percent total blood flow level), and 22/78 (at 25 percent total blood flow level). In the venous stasis flaps, the A-V shunt flow and the capillary blood flow shared the total blood flow in percentages of 70/30, 66/34, and 55/45, respectively. Hence, in arterial insufficiency flaps, capillary blood flow was spared by a relatively greater decline in A-V shunting compared with venous stasis flaps. Redistribution of capillary blood flow from subcutaneous tissue to muscle was observed, whereas blood flow was equally distributed throughout the length of the flaps at all flow levels.(ABSTRACT TRUNCATED AT 250 WORDS)     

Symptomatic capillary telangiectasia of the pons and intracerebral developmental venous anomaly - A rare association

Various combinations of vascular malformations of the brain in one lesion have been reported, while others seem to be very rare. In this report, the authors discuss the case of a coexistence of an capillary telangiectasia of the pons and intracerebral venous anomaly. To our knowledge, this is the first report of coexistence of a capillary telangiectasia of the pons and intracerebral venous anomaly apparted from each other. These discrete vascular malformations of the brain raise attention on possible interrelations in the pathogenesis of these entities. We report a case of pontine capillary telangiectasia and intracerebral venous anomaly in a 42-year-old woman with a right side facial palsy. Hight field magnetic resonance imaging suggested presence of a capillary telangiectasia of the pons. Another lesion in the left frontal gyrus was attributable to the venous anomaly. Along with neuroradiological findings, results of the somatosensor evoked potentials, brain stem auditory potentials, laboratory analysis including blood, cerebrospinal fluid and urine investigation are demonstrated. Awareness of the magnetic resonance imaging finding of the capillary telangiectasias and of the venous anomalies may help in defining clinical correlates of this vascular malformations, while the follow up of these malformations might help to asses risk of vascular rupture. We and others previously selects capillary telangiectasia and venous anomaly in two discrete entities. Coexistence of these malformations in the brain apparted from each other appear to be very rare and raise attention on possible interactions in their natural history and pathogenesis.     

Experimental studies in the survival of venous island flaps without arterial inflow

The authors have studied the effects of various circulatory settings on flap survival. The dog model was used to study the survival of venous flaps without arterial inflow both as island and free flaps. Venous flaps were compared with arterial flaps without venous outflow and standard island flaps with arterial inflow and venous outflow. Attempts were made to study their vascular morphology and blood gas changes. The venous flaps without arterial inflow survived with normal hair growth and wound healing, as did the standard island flaps. These observations suggest that capillary diffusion can occur without the continuous flow of blood through a capillary. Several possible mechanisms to explain survival of the venous flaps without arterial inflow were discussed. These observations could be important in providing an animal model to study microcirculation and a possible new area for microsurgical transfer of a skin flap.     

Pseudohypoglycemia: a Cause for Unreliable Finger-Stick Glucose Measurements

ObjectiveTo identify patients with an inaccurate diagnosis of hypoglycemia and discuss predisposing factors.MethodsWe describe our patient’s clinical presentation, laboratory work-up, hospital course, and follow-up and review similar cases from the literature.ResultsA 27-year-old woman with Raynaud phenomenon was admitted because of symptomatic hypoglycemia. Physical examination showed tremulousness, sweating, and the classic Raynaud color changes of the hands during episodic symptoms. A 72-hour fast revealed finger-stick capillary glucose values ranging from 32 to 45 mg/dL on multiple occasions, while concurrent plasma glucose values were consistently 1.5 to 2 times higher. Capillary measurements of glucose performed in the arms and legs at room temperature and after warming of each extremity disclosed an increase in glucose levels from a range of 35 to 52 mg/dL at room temperature to a range of 82 to 100 mg/dL after warming, confirming a discordance between capillary and venous blood results. The diagnosis of pseudohypoglycemia was made. Pseudohypoglycemia has been reported in patients with Raynaud phenomenon, peripheral vascular disease, and shock and may result from increased glucose extraction by the tissues because of low capillary flow and increased glucose transit time.ConclusionPseudohypoglycemia should be suspected in the setting of impaired microcirculation and can be confirmed by readily available means. (Endocr Pract. 2008;14:337-339)     

The effects of chemical kinetics on oxygen delivery to tissue.

A mathematical model has been formulated to analyze the effect of nonequilibrium kinetics on oxygen delivery to tissue. The model takes into account molecular diffusion, facilitated diffusion in the capillary blood, convection, chemical kinetics of O2 with hemoglobin, and the rate of metabolic consumption. A line iterative technique is described to solve numerically the resulting coupled system of nonlinear partial differential equations with physiologically relevant boundary and entrance conditions. With nonequilibrium kinetics the end-capillary PO2 is found to be lower than that in the venous blood. The effect is more pronounced during hypoxia and anemia. It is found that the tissue PO2 at the lethal corner decreases with the decrease in blood velocity, arterial PO2, hemoglobin concentration, P50, and increase in COHb concentration or metabolic rate, while the difference between end-capillary PO2 and venous PO2 increases, which reflects the effect of nonequilibrium kinetics on the delivery of O2 to tissue. Thus, the consideration of venous PO2 as an indicator of tissue PO2 in clinical and experimental studies may be questionable.     

Comparison of Venous and Capillary Differential Leukocyte Counts Using a Standard Hematology Analyzer and a Novel Microfluidic Impedance Cytometer

Capillary blood sampling has been identified as a potentially suitable technique for use in diagnostic testing of the full blood count (FBC) at the point-of-care (POC), for which a recent need has been highlighted. In this study we assess the accuracy of capillary blood counts and evaluate the potential of a miniaturized cytometer developed for POC testing. Differential leukocyte counts in the normal clinical range from fingerprick (capillary) and venous blood samples were measured and compared using a standard hematology analyzer. The accuracy of our novel microfluidic impedance cytometer (MIC) was then tested by comparing same-site measurements to those obtained with the standard analyzer. The concordance between measurements of fingerprick and venous blood samples using the standard hematology analyzer was high, with no clinically relevant differences observed between the mean differential leukocyte counts. Concordance data between the MIC and the standard analyzer on same-site measurements presented significantly lower leukocyte counts determined by the MIC. This systematic undercount was consistent across the measured (normal) concentration range, suggesting that an internal correction factor could be applied. Differential leukocyte counts obtained from fingerprick samples accurately reflect those from venous blood, which confirms the potential of capillary blood sampling for POC testing of the FBC. Furthermore, the MIC device demonstrated here presents a realistic technology for the future development of FBC and related tests for use at the site of patient care.     

The reduction in hepatic insulin clearance after oral glucose is not mediated by gastric inhibitory polypeptide (GIP)

Since the C-peptide/insulin ratio is reduced after oral glucose ingestion, the incretin hormone gastric inhibitory polypeptide (GIP) has been assumed to decrease hepatic insulin extraction. It was the aim of the present study to evaluate the effects of GIP on insulin extraction. Seventy-eight healthy subjects (27 male, 51 female, 43+/-11 years) were subjected to (a). an oral glucose tolerance test and (b). an intravenous injection of 20 pmol GIP/kg body weight, with capillary and venous blood samples collected over 30 min for insulin, C-peptide and GIP (specific immunoassays). Following GIP administration, plasma concentrations of total and intact GIP reached to peak levels of 80+/-7 and 54+/-5 pmol/l, respectively (p<0.0001). The rise in insulin after oral glucose and after intravenous GIP administration significantly exceeded the rise in C-peptide (p<0.0001). Estimating insulin extraction from the total integrated insulin and C-peptide concentrations (AUCs), only the oral glucose load (p<0.0001), but not the intravenous GIP administration (p=0.18) significantly reduced insulin clearance. Therefore, insulin clearance is reduced after an oral glucose load. This effect does not appear to be mediated by GIP.     

Comparative study of sodium, potassium, ionized calcium, urea and creatinine circadian rhythm documented in samples of capillary and venous blood from healthy subjects

Circadian rhythms of sodium, potassium, ionized calcium, creatinine and urea concentrations were determined in venous and capillary blood of practically healthy volunteers (10 women and 8 men). Electrolytes were determined on the ionoselective analyzer Microlyte (KONE, Finland). Circadian rhythmicity of parameters was revealed in venous and capillary blood by means of group-mean cosinor analysis. Acrophases of the rhythms occurred in the late evening (Na) or in the first (K, venous ionized Ca) and in the second half (creatinine, urea) of sleep. Circadian rhythms of electrolytes (except ionized Ca rhythm) and final products of nitrous metabolism in capillary blood turned out to be the markers of the corresponding indices rhythms of venous blood.     

Lactate concentration differences in plasma, whole blood, capillary finger blood and erythrocytes during submaximal graded exercise in humans

The aim of the study was to investigate the distribution of lactate in plasma, whole blood, erythrocytes, and capillary finger blood, before and during submaximal exercise. Ten healthy male subjects performed submaximal graded cycle ergometer exercise for 20-25 min. Venous blood samples and capillary finger blood samples were taken before exercise and every 5th min during exercise for lactate determination. The plasma lactate concentration was significantly higher (P less than 0.001, approximately 50%) than in the erythrocytes. This difference was not altered by the venous blood lactate concentration or exercise intensity. A significant difference (P less than 0.01) in lactate concentration was also found between capillary whole blood and venous whole blood. It was concluded that direct comparisons between lactate in capillary finger blood, venous whole blood and plasma could not be made.     

Blood gas analysis of bovine fetal capillary blood during stage II labor

The aim of this study was to determine whether blood gas variables in fetal capillary blood during the last 30 min of stage II labor can be used to diagnose fetal asphyxia. Twenty-five newborn calves were used to investigate the correlation between capillary blood gas values obtained from the dorsolateral aspect of the distal pastern and those in arterial and venous blood. The pH, partial pressure of oxygen, partial pressure of carbon dioxide, concentration of bicarbonate, base excess and oxygen saturation were determined. The bicarbonate concentration (arterial, r=0.759; venous, r=0.766; both P<0.0001) and base excess (arterial, r=0.730; venous, r=0.807; both P<0.0001) had the highest correlations. Fetal capillary blood was collected during the last 30 min of stage II labor and the results of blood gas analysis were compared with those of arterial and venous blood collected immediately after birth in 38 calves. The pH (arterial, r=0.806; venous, r=0.885; both P<0.0001) and base excess (arterial, r=0.822; venous, r=0.871; both P<0.0001) had the highest correlations. The pH and base excess were significantly lower after birth than during the last 30 min of stage II labor. The severity of fetal acidosis during stage II labor can be easily and reliably determined using the pH or base excess of fetal capillary blood.     

Capillary-venous differences of free plasma catecholamines at rest and during graded exercise

Levels of free plasma catecholamines were simultaneously determined in 10 cyclists using capillary blood from one ear lobe and venous blood from one cubital vein. Catecholamine concentrations were higher in the ear lobe blood than in the venous blood at rest and during graded exercise. Average differences amounted to 1.7 nmol X 1(-1) (dopamine), 2.1 nmol X 1(-1) (noradrenaline) and 1.9 nmol X 1(-1) (adrenaline) at rest and increased only to 8.8 nmol X 1(-1) for noradrenaline during exercise. We assume that higher concentrations of dopamine and adrenaline in the capillary blood point to a significant neuronal release of these catecholamines, similar to noradrenaline. Catecholamine concentrations in capillary blood may better reflect sympathetic drive and delivery of catecholamines to the circulation than the concentrations in venous blood.     

Principles of the structuro-functional organization of the hemomicrocirculatory bed of the intramural nervous plexuses of organs of the gastrointestinal tract of mammals

The work deals with one of the least elaborated aspects on the system of microcirculation and is performed, taking into account the functions of histo-hematic and intertissue barriers. For this certain new original investigation methods have been developed, adequate to the problems discussed. The module principle of organization with a distinct functional specialization of the ganglionar and truncal vascular micromodules has been stated. The working principle of each module is based on functional interaction of the intra- and extraneural capillary systems; this is ensured by mechanisms of the blood stream redistribution: by arteriolar, precapillary and prevenular sphincters and by pathways of the shunt blood stream. A high stability of the blood stream in the vascular constructions studied is explained as a possibility of counterstream gas exchange between the arterial and venous blood in the truncal vascular micromodule.