Hemoglobin-based blood substitutes and the hazards of blood radicals

Cell-free hemoglobins, chemically altered or genetically expressed in microbial host systems, have been developed as oxygen-carrying therapeutics. Sitedirected modifications are introduced and serve to stabilize the protein molecules in a tetrameric and/or a polymeric functional form. Animal studies, as well as recent clinical studies, have suggested these proteins probably deliver oxygen to tissues. However, concerns still persist regarding the interference of hemoglobin and its oxidation products with the vascular redox balance, potentially impeding its clinical usefulness. This article reviews our current understanding of heme-mediated toxicities and some of the emerging protective strategies used to overcome hemoglobin side reactions.     

Hemoglobin-based blood substitutes and the hazards of blood radicals

Cell-free hemoglobins, chemically altered or genetically expressed in microbial host systems, have been developed as oxygen-carrying therapeutics. Sitedirected modifications are introduced and serve to stabilize the protein molecules in a tetrameric and/or a polymeric functional form. Animal studies, as well as recent clinical studies, have suggested these proteins probably deliver oxygen to tissues. However, concerns still persist regarding the interference of hemoglobin and its oxidation products with the vascular redox balance, potentially impeding its clinical usefulness. This article reviews our current understanding of heme-mediated toxicities and some of the emerging protective strategies used to overcome hemoglobin side reactions.     

Scanning microcalorimetry of the blood

The age dependence of haemoglobin denaturation temperature in the composition of erythrocytes is established. Children have a much more expressed correlation of this temperature depending on the type and stage of disease than the adult. It is found that children ill with leukemia have haemoglobin, the value of heat denaturation of which is decreased about 15-25% in relation to the norm. Tests are created. They allow to reveal leukemia by heat parameters of haemoglobin denaturation of the whole blood.     

Ambulatory blood pressure monitoring: assessing the diurnal variation of blood pressure

The purposes of this paper are to examine the effects of activity, situation of measurement, mood, and occupation on the daily variation of blood pressure and to discuss the potential utility of ambulatory blood pressure monitoring in physical anthropological studies. The subjects of the blood pressure variability study are 125 men who were referred to the Hypertension Center at New York Hospital--Cornell Medical Center for evaluation of hypertension. There were 1,386 blood pressure measurements from these subjects available for study, which were taken using noninvasive ambulatory blood pressure monitoring techniques. Pressures were transformed to z scores using the subject's daily mean pressure and standard deviation to assess the relative elevation during the experience of the various factors. The results show that activity and mood are the most significant sources of blood pressure variation (P less than .005) and are additive. Occupation, which may be an indicator of social class in this population, also modified the mood effects. Because ambulatory blood pressure monitors obtain many readings over a day under a variety of circumstances, their use can improve epidemiological and human biological studies of the inheritance and variability of blood pressure. Ambulatory blood pressure monitoring is an important new tool in the study of human biological variation.     

Clinical anatomy of the blood spaces and blood vessels surrounding the siphon of the internal carotid artery

The anterior blood space of the cavernous sinus is situated anterolateral to the carotid siphon in 70%, anterior to it in 15%, and lateral to it in 15%. Its height, depth, and mediolateral breadth were measured. The mean distance between the carotid siphon and the skin at the supraorbital foramen was measured with 63 (52.4-71.4) mm. The drainage of the orbital veins was studied and described as well as the area of origin and first course of the ophthalmic artery and its clinical importance.     

Introduction to the blood coagulation cascade and cloning of blood coagulation factors

The coagulation cascade that occurs in mammalian plasma involves a large number of plasma proteins that participate in a stepwise manner and eventually give rise to the formation of thrombin. This enzyme then converts fibrinogen to an insoluble fibrin clot. This series of reactions involves a number of glycoproteins that particupate as enzymes as well as cofactors. These proteins that circulate in the blood in a precursor or zymogen form are multifunctional proteins that share many common segments or domains. One group includes the vitamin K-dependent glycoproteins (prothrombin, factor IX, factor X, and protein C) that show considerable homology in both their amino acid sequences and their gene structures. The proteins that participate in the contact or early phase of the blood coagulation cascade include plasma prekallikrein, factor XII, and factor IX. The amino-terminal regions of both factor XI and plasma prekallikrein contain four tandem repeats of about 90 amino acids, and these tandem repeats show considerable amino acid sequence homology. Factor XII contains four different domains in the amino-terminai region of the protein, including a kringle structure, two growth factor domains, and type I and type II finger domains. The finger domains were first identified in fibronectin. The carboxyl-terminal portion of plasma prekallikrein, factor XII, and factor XI contains the serine or protease portion of the molecule. These various plasma proteins that share common domains appear to have evolved by gene shuffling that may have, in some cases, involved introns.     

Potential ratios among blood levels of various blood proteins in the cord blood of healthy newborn infants

The authors have studied the correlations between IgA, IgG, IgM, C3c, C4, alpha 1-AGP and the total proteins, total globulins, alpha 1, alpha 2-globulins in normal newborn cord blood. The results indicate some significant correlations between C3c and C4, C3c, C4 and alpha 1-AGP, C3c, C4, alpha 1 1/2AGP and alpha 2-globulins, C4 and beta-globulins, C3c and alpha 1-AGP. The most significant finding has been inverse correlation between IgA and alpha 1, alpha 2-globulins, total globulins and total proteins.     

Clinical use of blood,blood components and blood products.

The goal of modern transfusion therapy is to provide appropriate replacement therapy with blood components as opposed to whole blood for patients with specific hematologic deficiencies. A prerequisite of component therapy is, therefore, correct identification of the deficiency. Appropriate use of components avoids many of the hazards associated with the use of whole blood, and at the same time makes maximal use of this valuable resource. Blood components separated from whole blood soon after collection and appropriately stored can, in combination, provide all the factors present in fresh whole blood. Red cell concentrates prepared from multiple packs have a hematocrit of approximately 70%. They may be stored for up to 3 weeks at 4 degrees C and are recommended for most situations requiring red cell transfusions. Platelet concentrates, which can be stored for up to 72 hours at 22 degrees C, may be used for thrombocytopenic patients. Fresh frozen plasma, stored plasma, cryoprecipitated factor VIII, factor VIII concentrate and factor IX complex concentrate are available for the proper treatment of patients with hemorrhagic disorders due to coagulation factor deficiencies. Similarly, albumin and immune serum globulin are available for their oncotic and antibody properties respectively. Thus, the availability and appropriate use of the various blood products allows not only optimal transfusion therapy for each patient, but also fuller utilization of national blood resources.     

Cutaneous blood supply of the penis

Twelve male cadaver specimens were injected with a latex solution to define the cutaneous blood supply of the penis. The cutaneous blood supply of the penile shaft is derived solely from a pair of axial arteries running in the dartos layer. Additional deep perforating arteries from the dorsal penile artery and corporal vessels supply the glans and subcoronal region. An understanding of this anatomy allows one to develop safely a variety of penile skin flaps for difficult reconstructive problems.     

Hyperventilation-induced changes of the blood picture

In a controlled study of 11 male volunteers the following changes (means +/- SD) were observed in venous blood during (D) and 75 min after (A) a period of 20 min of voluntary hyperventilation in comparison with before (B) hyperventilation (P values referring to the difference between D and B) erythrocyte count 5.18 +/- 0.17 X 10(6) (B), 5.70 +/- 0.21 X 10(6) (D) (P less than 0.001), and 5.18 +/- 0.16 X 10(6)/microliter (A); hemoglobin 15.7 +/- 0.6 (B), 17.2 +/- 0.7 (D) (P less than 0.001), and 15.8 +/- 0.6 g/dl (A); centrifuged hematocrit 46.6 +/- 1.0 (B), 50.4 +/- 1.7 (D) (P less than 0.001), and 47.0 +/- 1.8% (A). The platelets increased from 159 +/- 30 X 10(3) (B) to 205 +/- 40 X 10(3) (D) (P less than 0.001) and returned to 157 +/- 26 X 10(3)/microliter (A). The leukocytes (WBC) were 4,210 +/- 630 (B), 6,220 +/- 1,660 (D) (P less than 0.001), and 6,190 +/- 1,870/microliter (A) (P less than 0.002, as compared with B). The rise of WBC during hyperventilation was mainly due to a 83% increase of lymphocytes, whereas a 93% increase of neutrophil leukocytes accounted for the increased WBC 75 min posthyperventilation. The increase of the ratio of band forms to segmented neutrophils from 9 (B) to 19% (A) (P less than 0.01) indicates that band forms were released from the bone marrow. The results show that WBC and platelets can be mobilized by hyperventilation by as yet unidentified mechanisms.     

The blood flow of the brain

The rigidity of the skull and the inertial characteristics and incompressibility of its contents cause the elastic cerebral arteries and veins to act over brief periods of time like rigid tubes of relatively small diameter. Poiseuille's law is applicable to their behavior. The use of this law, in combination with the fact that, during brief intervals, the total volume of the cerebral arteries and veins remains constant, permits derivation of a mathematical expression for the average arterial flow in terms of an average arterial radius. The differentiated equation has five positive roots which represent maxima and minima of the average flow in terms of the average arterial radius. The theoretical results have physiological implications and potential clinical usefulness, which are discussed.     

Tyrosine hydroxylase of the blood leukocytes

Tyrosine hydroxylase activity has been established in blood plasma leucocytes of rat, cat and man. Tyrosine precursors and some nuclear erythroid cells. GFU-GM did hydroxylase activity in leucocytes shows the Km for tyrosine inhibited by high concentrations of L6 tyrosine (substrate inhibition), alpha-methyl-para-tyrosine dopamine. The kinetic properties of leucocyte tyrosine hydroxylase are qualitatively similar to the properties of brain tyrosine hydroxylase.