Cent Of Hemoglobin Research Articles

Washing of stored red blood cells by an autotransfusion device before transfusion

The use of an autotransfusion device to wash blood of the incision site is increasing. After washing, this blood is retransfused without side effects caused by activated plasma factors and cell release products. This procedure could be extended to washing of donor blood, which may be particularly useful for red blood cells (RBCs) stored for more than 4 weeks that contain high concentrations of free haemoglobin, potassium, lactate and other metabolites. It is not known whether stored RBCs can withstand the cell washing procedure with the use of an autotransfusion device, while keeping their primary functions intact. The objective of this study was to determine the quality of RBCs, after cell washing in comparison to untreated RBCs. RBCs were studied in terms of integrity (free haemoglobin), stored energy (2,3-diphosphoglycerate, adenosine triphosphate), metabolites (lactate, potassium) and physical characteristics (osmotic resistance, aggregability, deformability). After washing, free lactate and potassium were significantly reduced as compared to the levels before washing. The osmotic resistance of RBCs slightly improved, whereas aggregation capacity reduced after washing. Fifteen per cent of haemoglobin was lost during washing. The deformability and free haemoglobin levels remained unchanged. Washing stored blood before transfusion may be of benefit, because the waste products are effectively removed from the stored RBC.

Association of Sickle Cell Disease, Priapism, Exchange Transfusion and Neurological Events: Aspen Syndrome

Priapism and acute neurological events are believed to be unrelated complications of sickle cell hemoglobinopathy. We describe a syndrome based on our experience and a review of the literature of significant neurological events after partial exchange transfusion to treat priapism in sicklemic patients. Severe headache is often the initiating symptom of this complex. The ensuing neurological events range from seizure activity to obtundation requiring ventilatory support. The proposed pathophysiology of these neurological events is related to cerebral ischemia after an acute increase in per cent total hemoglobin, concomitant decrease in per cent hemoglobin S and subsequent release of vasoactive substances during penile detumescence. We have termed this constellation of events the ASPEN syndrome, an eponym for association of sickle cell disease, priapism, exchange transfusion and neurological events. Early recognition and aggressive medical management resulted in complete reversal of neurological sequela.

Characterization of a Modified, Stroma-Free Hemoglobin Solution as an Oxygen-Carrying Plasma Substitute

A new infusion solution prepared from stroma-free, crosslinked and pyridoxalated hemoglobin is described. The characteristics of which have been adapted to the functions of native, intra-erythrocyte hemoglobin. The solution contains 8.5 per cent weight per volume of glutardialdehyde modified hemoglobin with a mean molecular weight (Mn) of 200,000 Dalton. The non-crosslinked fraction constitutes 15 per cent of the total hemoglobin. The p50 of 27 torr at pH 7.4 (plasma pH) corresponds to the value for the intra-erythrocyte hemoglobin at pH 7.25. The oncotic pressure is adjusted to 28 torr by the addition of 2.5 per cent weight per volume of human albumin. The methemoglobin content is less than 5 per cent of the total hemoglobin and remains constant for one year. The relative viscosity of the 8.5 per cent hemoglobin solution is 3.0 and, thus, is lower than the viscosity of blood. The intravascular half-life was determined in chimpanzees as about 16 hours. On the basis of available data, this hemoglobin solution may be suitable for clinical use as oxygen carrying plasma substitute.

Influence of delayed bleeding on sensory characteristics of beef

Sensory characteristics of bovine longissimus dorsi and biceps femoris muscles from 30 heifers exsanguinated 0, 3 or 6 min after stunning and 36 steers exsanguinated 0, 3 or 30 min after stunning were evaluated to determine if delayed bleeding influenced palatability. More blood was retained in carcasses of animals where exsanguination was delayed after stunning than in control animals, but no consistent differences existed for total pigment or per cent hemoglobin in muscle. Tenderness, juiciness, flavor, shear values and cooking loss were not affected by treatment.

Monitoring of fetus with osteogenesis imperfecta and severe anemia

The patient was a 27-year-old woman, gravida 3, para 2, with two previous normal term deliveries. The blood was type 0, Rh positive, with no abnormal antibodies. The prenatal course was unremarkable until 26 weeks of gestation when she complained of spotting. Examination revealed the cervix to be 80 per cent effaced and 1 cm. dilated. A cerclage was placed on the cervix and she was treated with bed rest. At 36 weeks of gestation spontaneous contractions ensued and the cerclage was removed. Fetal monitoring revealed a base-line heart rate of 160 b.p.m. with a beat-to-beat variability of up to 12 b.p.m. Contractions registered every three and a half minutes and the peak of each contraction was followed by a typical late deceleration. The severity of bradycardia varied from 10 to 50 b.p.m. and its duration ranged from 80 to 200 seconds. In addition to the uniform patterns of late fetal bradycardia there were wide and erratic shifts of the base-line from 160 down to 65 b.p.m. for three to five minutes unassociated with contractions. To confirm the presence of a congenital malformation, an abdominal roentgenogram was obtained and it revealed the characteristic skeletal hypomineralization and the multiple intrauterine fractures of osteogenesis imperfecta. A female infant, weighing four pounds and nine ounces, was delivered by cesarean section. The newborn infant had severe deformities due to the fractures and marked hydrops and died 15 minutes after birth. Cord blood evaluation revealed: hemoglobin, 8.4 Gm.; hematocrit, 27.5 per cent: reticulocytes, 14.7 per cent; a negative direct Coombs test was 100 per cent hemoglobin F on electrophoresis.

Enhancement of Fibrinolysis in Rabbits Exposed to Low and Moderate Levels of Carbon Monoxide Inhibited by Epsilon Amino Caproic Acid

The first (control) group of rabbits breathed ambient air whereas the second was exposed to low level carbon monoxide (CO, 50 ppm by volume) for 24 hr continuously for 8 weeks. The third group was exposed to 300 ppm CO for 4 weeks. The fourth group was exposed to 300 ppm CO for the same period of time as the third group but in addition they were also given epsilon amino caproic acid (EACA) orally, and the results compared to Group III. Per cent oxyhemoglobin (HbO2), per cent hemoglobin (Hb) and per cent carboxyhemoglobin (HbCO) were monitored in all groups. Tests of fibrinolysis were monitored and showed acceleration of the whole blood clot lysis and euglobulin lysis times (ELT). A fibrin plate test confirmed the increased lysis and serum fibrin and/or fibrinogen degradation products (FDP) were elevated in the CO exposed animals. No changes were observed in the same tests in the rabbits exposed to ambient air. The fourth group of animals receiving EACA showed inhibition of lysis and decrease in serum FDP. Alpha-1-antitrypsin and alpha-2-macroglobulin assays in all groups showed no change. Microscopic examination of the large vessels in these test groups showed endothelial damage which indicates a possible source for a plasminogen activator release, or lead to action of Hageman factor and activated plasma plasminogen proactivator.

Oxygen transport during erythropoietic response to moderate blood loss.

Abstract The removal of 250 to 750 ml of blood over one to three weeks' time from nine normal nonsmoking males produced, one to three weeks later, slightly decreased hemoglobin concentrations (mean, 16.2 to 15.0 g per 100 ml). Oxygen pressure at 50 per cent hemoglobin saturation with oxygen (P50) increased from 27.9 to 29.8 torr (mean values) and was significantly correlated (p less than 0.005) with an average increase of erythrocyte glutamic oxalacetic transaminase activity from 4.4 to 5.4 U per gram of hemoglobin, indicating increased numbers of young erythrocytes. 2,3-diphosphoglycerate did not change (mean, 13.1 to 13.0 μmoles per gram of hemoglobin). The improved oxygen unloading afforded by the increased P50 thus seems to have more than compensated for the reduced hemoglobin concentration so that cardiac output could decrease and still maintain an unchanged normal mixed venous oxygen pressure.

Acquired hemoglobin H disease.

Abstract Although hemoglobin H disease is usually inherited, similar syndromes may be acquired. In a 73-year-old woman of British descent with a myeloproliferative syndrome characterized by striking megakaryocytic hyperplasia and thrombocytosis, we also found hemolytic anemia with hypochromia, microcytosis, marked poikilocytosis and 20 per cent hemoglobin H (beta4). Incubation with brilliant cresyl blue produced inclusions in 60 per cent of the red cells. Hematologic studies before the onset of this illness gave normal results. In vitro studies of globinchain synthesis revealed a marked decrease of alpha-chain production similar to that found in hereditary hemoglobin H disease. The alpha/beta ratio of radioactivities was 0.13, demonstrating a severe imbalance of globin synthesis. Studies of the patient's two children gave normal results. Hematologic and globin synthesis in this acquired disorder is similar to those of its hereditary counterpart.

A Study of the Sickling Phenomenon and Oxygen Dissociation Curve in Patients with Hemoglobins SS, SD, SF and SC

Abstract 1. Data on pO2, T50, n values and per cent of sickle cells were obtained in patients with hemoglobins SS, SD, SF (S-thalassemia) and SC. In general the per cent of sickle cells was proportional to the per cent of hemoglobin S. The number of sickle cells was, however, influenced by the other type of hemoglobin present and by the pO2. Values for T50 were greater than normal, and values for n were less than normal. 2. The effect of therapy with O2, CO2, NaHCO3 and MgSO4 on the per cent of sickle cells in arterial and venous blood was determined. Only inhalation of O2 reduced the per cent of sickle cells. 3. The rate of sickle cell formation and its reversal were determined under conditions of deoxygenation and oxygenation. These were found to be a function of the type of hemoglobin combinations present. 4. The oxygen dissociation curves were found to be shifted to the right of the normal curve indicating a decreased affinity for oxygen. In two patients the Bohr effect was determined and found to be normal.

The effect of host pregnancy on the reproductive capability of the tsetse fly, Glossina morsitans, in captivity

The reproductive capability as measured over a period of approximately 60 days was not significantly different in two groups of laboratory-hatched and -reared, fertilized female Glossina morsitans: one group being fed exclusively on a pregnant female guinea pig and the other on a male guinea pig. However, the male guinea pig-fed flies produced significantly larger pupae than the pregnant female-fed flies. The blood of the male guinea pig contained 16·0 per cent of haemoglobin, while that of the pregnant female contained 14·5 per cent. The rate of excretion of blood meals was the same in both groups of flies, and it is estimated that the difference in protein content of the blood from the male and pregnant female guinea pigs was sufficient to account for the difference in pupal weights recorded. An estimate of the amount of protein available to the fertilized female fly for the development of its larva has been made; the calculations are based upon the difference in mean meal size between fertilized and unfertilized female flies maintained under identical conditions. The values obtained accord well with estimations made of the total protein content of newly deposited pupae, and it is concluded that approximately 30 per cent of the ingested blood is directed towards the development of the larva in utero. The relative significance of hormones and protein content of the blood of natural hosts is discussed in terms of the seasonal fluctuation in size of tsetse flies in the field and in terms of the laboratory maintenance of Glossina morsitans.

Hemoglobin I in an American Negro family: structural and hematologic studies.

Abstract An American Negro family is described, in which the mother and two children have hemoglobin I trait, each with 24 to 28 per cent hemoglobin I. In all three of these subjects, target cells comprise about 10 per cent of the erythrocyte population. No other hematologic abnormality was found in the parents and their five examined children. In tests with 4 per cent sodium metabisulfite, changes resembling sickling occurred in the erythrocytes of all seven members of the family and also in five unrelated individuals who are homozygous for hemoglobin A. On structural analysis, the substitution in this sample of hemoglobin I is α 16 lys → glu, as was previously found in one other sample of hemoglobin I (I Philadelphia).

ERRATUM

AbstractOn page 892 of the December 1965 issue of Blood (Vol. XXVI, No. 6), P. Lauf was unintentionally omitted as co-author of Abstract #52 presented at the Eighth Annual Meeting of the American Society of Hematology. The complete abstract is reprinted below.HETEROGENEITY OF WATER-SOLUBLE PROTEIN COMPONENTS OF THE RED CELL MEMBRANE. M. D. Poulik and P. Lauf (Introduced by W. W. Zuelzer°), Child Research Center of Michigan, Detroit, Mich.Separation and isolation of the structural components of the red cell stroma was undertaken. Hemoglobin-free stroma (1-3 per cent hemoglobin per dry weight) of the major blood groups was prepared and water-soluble protein was extracted with nbutanol-water at -2 C. The yield was increased by reductive cleavage of the stroma prior to extraction. A, B, M and N blood group activity was demonstrated by hemagglutination inhibition technic in the water-soluble material. The Rho (D)-activity was destroyed by reductive cleavage or by butanol extraction alone. The water-soluble material was subjected to chromatography on Sephadex G-200, and 2 well-defined peaks were separated. Ultraviolet spectra of the starting material and those obtained with the 2 peaks showed that a separation of a lipid-like material was affected. Peak A contained most of the protein and was immunologically active. This chromatographically homogeneous material of peak A was found to be heterogeneous by starch gel electrophoresis conducted in the presence of urea and mercaptoethanol. The effect of several lipid solvents on the electrophoretic patterns was also investigated. A highly negative-charged subcomponent was separated from all the major blood groups. Chemical and immunologic data will be discussed.

Effect of exercise and training on the blood of normal and splenectomized rats.

The immediate and chronic effects of exercise on hematocrit, hemoglobin and red cell fragility have been studied in splenectomized and sham-operated rats. The training program consisted of an initial 35 minute swim in water at 35 ° C. The duration of the swim was increased 5 minutes per day until reaching 60 minutes and continued for 42 days. Splenectomization had no effect on organ weights, hemoglobin content, hematocrit or red cell fragility. The adrenals and heart ventricles of the trained animals were heavier, whereas their livers and spleens were significantly smaller. Training had no effect on per cent hemoglobin or hematocrit, however, red cells from trained animals were less resistant to osmotic pressure. No differences in hemoglobin or hematocrits were found between splenectomized and sham-operated animals immediately after exercise. It is concluded that in the rat the spleen does not make a significant contribution to these components of blood during exercise.

The Providence Hospital Blood Conservation Program

In 1953, the Medical Staff adopted in its bylaws “Indications for Blood Transfusion,” which are in brief as follows: 1. To replace needed whole blood volume; 2. For oxygen transport, (A) Anemic patient, otherwise well, must have seven or less Gm. per cent of hemoglobin, (B) Anemic patient with complications affecting oxygenation or is to undergo anesthesia may be transfused if the hemoglobin is less than 10 Gm. per cent; 3. Exchange transfusion, and 4. Fresh whole blood is indicated only in rare instances of dyscrasias where a labile element is important. In the period from 1953 to 1960, the application of these indications has resulted in a decreasing “use factor” (units transfused annually divided by the number of patients) from 0.237 to 0.110. The benefits achieved are the following: Limits the transfusions to patients having valid medical indications, protects the patients from the hazards of unnecessary transfusions, and eases the burden of donor recruitment and blood collection.

Hepato-splenic schistosomiasis in mice.

SummaryA syndrome that closely resembles hepatosplenic schistosomiasis in humans developed in mice following infection with Schistosoma mansoni. Data obtained from the infected mice suggest that the pathogenesis of the syndrome was related to the penetration of the portal canals of the liver by large numbers of schistosome eggs which incite granulomatous reactions and obstruction of portal blood flow. This in turn produces portal hypertension and the development of congestive hepato-splenomegaly, esophageal varices and ascites. Histologically there was little damage to the liver parenchyma, which is further borne out by very little liver function test derangement. A severe anemia developed in some of the infected mice (4 to 6 gm per cent hemoglobin).

A Modification of the Spectrophotometric Determination of Carbon Monoxide in Blood Enabling Direct Determination of Per Cent Hemoglobin Saturation

Abstract A modification of the spectrophotometric method for the determination of carbon monoxide in blood has been presented that enables direct determination of per cent hemoglobin saturation with an overall experimental error of 3 per cent.

The development in vitro of particles from cytoplasm. II. Particles from hemoglobin and deoxyribonucleic acid.

Spherical particles, 1 to 10 microns in diameter, resulted from the incubation at 37 degrees C. of distilled water lysates of erythrocytes with deoxyribonucleic acid (DNA). The particles consisted of 88 per cent hemoglobin and 12 per cent DNA (dry weight basis). An unknown factor, presumably an enzyme, present only in fresh red cell lysates, was required for particle development. Particle size was a function of the pH of the reaction mixture. The pH range was 4.8-5.8. It was possible to trap extraneous proteins and polysaccharides in pockets within the hemoglobin particles during their development to the exclusion of some of the hemoglobin. The amount of any one substance so trapped was proportional to its concentration in the reaction mixture. Some practical applications of the particles, as a means for making particulate various soluble substances (enzymes, antigens, antibiotics), are suggested.

Relationship of platelet serotonin to disturbances of clotting and hemostasis.

The presence of serotonin (5-hydroxytryptamine) in high concentration in platelets and its absence from normal platelet-free plasma suggest the possibility that this vasoconstrictor substance may play a role in hemostatic mechanisms. Platelet serotonin content measured by a fluorometric method in 94 patients showed an average content of 0.22 µg./ml. blood. In none of the disease groups studied, including hypertension, was a significant alteration found in platelet serotonin. However, the administration of reserpine resulted in a marked and prolonged depletion of platelet serotonin that was not accompanied by any significant change in any of the clotting factors. The in vitro addition of serotonin in amounts up to 50 µg./ml. also failed to alter any of the clotting factors studied. Platelet serotonin did not correlate with diagnosis, age, weight, blood pressure, cephalin-fluocculation, or capillary fragility. However, markedly anemic patients (below 10 Gm. per cent hemoglobin) and patients whose blood urea nitrogen was above 30 mg. per cent, tended to have a low platelet serotonin content.

Pulmonary Resection for Aspergillus Abscess of the Lung

L. V. Seton Hospital Case No. 2186. This 55 year old Puerto Rican seamstress was admitted to Seton Hospital on November 19, 1953. At age 20 she had a gunshot wound of the left chest associated with hemoptysis. She did not seek medical treatment at that time. In October, 1953, she had “flu” and on October 27, 1953 she again had an episode of hemoptysis for which she was admitted to Lincoln Hospital in New York City. Chest x-ray film at that time was reported as showing pleural thickening at the left apex and infiltration in the right subclavicular region. Her sputum was negative for acid fast bacilli. She was placed on bed rest and on November 19, 1953, she was transferred to Seton Hospital where admission x-ray film showed infiltration in the right apical and subapical regions. One sputum on January 26, 1954 was reported as showing acid fast bacilli on culture but eight other sputum examinations and three gastrics were negative. Her sedimentation rate was 42 mm./hr.; urine was negative for sugar and albumin but showed some coarse granular casts; Loughlin test was negative; she had 4.6 million red blood cells with 87 per cent hemoglobin and 7,550 white blood cells.

Ability of normal and sickle-cell haemoglobins to form complexes.

THE electrophoretic examination of haemoglobin samples from Africans with sickle-cell trait, collected by one of us (Griffiths1), showed that the mobilities were not constant and did not agree with values reported by other observers (for example, Pauling et al. 2). Among nine specimens we found values ranging from − 1.6 to − 3.0 × 10−5 cm./sec./V./cm. for the normal haemoglobin component and from − 1.2 to − 2.4 × 10−5 cm./sec./V./cm. for the sickle-cell component. Seven normal haemoglobin samples gave values between − 1.7 and − 3.8 × 10−5 cm./sec./V./cm. Not only did the mobility vary from individual to individual, but also samples taken from one subject varied from time to time. The values were all determined by electrophoresis in the Tiselius apparatus at a concentration of about 1.5 per cent of haemoglobin, prepared by Drabkin's method3, in phosphate buffer at pH. 7.5 and ionic strength 0.1. Similar variations in mobility were shown by paper electrophoresis. The variations were not due to technical errors, because replicate determinations with a given specimen of blood gave concordant results. The absence of methaemoglobin or similar derivatives was shown by spectroscopic examination.