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Red blood cells in humans—and most other mammals—have a tendency to form aggregates with a characteristic face-to-face morphology, similar to a stack of coins. Known as rouleaux, these aggregates are a normally occurring phenomenon and have a major impact on blood rheology. What is the underlying mechanism that produces this pattern? Does this really happen in blood circulation? And do these rouleaux formations have a useful function? The first book to offer a comprehensive review of the subject, Red Blood Cell Aggregation tackles these and other questions related to red blood cell (RBC) aggregates. The book covers basic, clinical, and physiological aspects of this important biophysical phenomenon and integrates these areas with concepts in bioengineering. It brings together state-of-the-art research on the determinants, mechanisms, and measurement and effects of RBC aggregation as well as on variations and comparative aspects. After an introductory overview, the book outlines factors and conditions that affect RBC aggregation. It presents the two hypotheses—the bridging model and the depletion model—that provide potential mechanisms for the adhesive forces that lead to the regular packing of the cells in rouleaux formations. The book also reviews the methods used to quantify RBC aggregation in vitro, focusing on their importance in clinical practice. Chapters discuss the effect of RBC aggregation on the in vitro rheology of blood as well as on tube flow. The book also looks at what happens in the circulation when red blood cells aggregate and examines variations due to physiological and pathophysiological challenges. The concluding chapter explores the formation of red blood cell aggregates in other mammals. Written by leading researchers in the field, this is an invaluable resource for basic science, medical, and clinical researchers; graduate students; and clinicians interested in mammalian red blood cells.
This publication primarily focuses on the macro- and micro-rheological behavior of blood and its formed elements, on interactions between the formed elements and blood vessel walls, and on the microvascular aspects of hemodynamics. Since many aspects of hemorheology and hemodynamics are affected by disease or clinical states, these effects are discussed as are hyperviscosity syndromes, therapy for disturbed blood rheology, and methods in hemorheology and hemodynamics. Sections of the Handbook include History of Hemorheology; Hemorheology, covering basic aspects, blood composition, blood rheology, cell mechanics, pathophysiology, methods and comparative studies; Hemodynamics, covering basic principles, microcirculation, in vivo effects, endothelium and methods; and Clinical Aspects of Hemorheology, covering hyperviscosity, clinical significance and treatment. The goal is to foster greater interchange between workers in the fields so as to promote collaborative efforts and, hopefully, improved health. In selecting topics for this handbook the editors have attempted to provide a general overview of both basic science and clinical hemorheology and hemodynamics. Hemorheology and hemodynamics are closely related, the former dealing with all aspects of the flow and interactions of the individual blood cells mostly studied in vitro, the latter with the in vivo relationships among vessel architecture, driving pressure, flow rate and shear stress. The linkage between the in vitro and in vivo research described in the book will be of interest to both basic science and clinical investigators. The editors of the handbook have each been active in the fields of bio- and hemorheology for many years, and have published extensively. They have successfully achieved their objective to publish a well-written and well-edited handbook that will be valuable for researchers and students in the field.
Te practice of intensive care medicine is at the very forefront of titration of treatment andmonitoringresponse. Te substrateofthiscareisthe criticallyill patientwho,by defnition, is at the limits of his or her physiologic reserve. Such patients need immediate, aggressive but balanced life-altering interventions to minimize the detrimental aspects of acute illness and hasten recovery. Treatmentdecisionsandresponsetotherapyareusually assessed by measures of physiologic function, such as assessed by cardio-respiratory monitoring. However, how one uses such information is ofen unclear and rarely supported by prospective clinical trials. In reality, the bedside clinician is forced to rely primarily on physiologic principles in determining the best treatments and response to therapy. However, the physiologic foundation present in practicing physicians is uneven and occasionally supported more by habit or prior training than science. A series of short papers published in Intensive Care Medicine since 2002 under the heading Physiologic Notes attempts to capture the essence of the physiologic perspectives that underpin both our understanding of disease and response to therapy. Tis present volume combines the complete list of these Physiologic Notes up until July 2006 with the ass o cia t ed r e vie w a r tic les o v er t h e s a m e in t er val t ha t a ls o addr ess e d t hes e cen tral issues.
The first book to provide a physical perspective of blood microcirculation Draws attention to the potential of this physical approach for novel applications in medicine Edited by specialists in this field, with chapter contributions from subject area specialists
Hemolysis during filtration through micropores studied by Chien et al. [I] showed a dependence on pressure gradient and pore diameter that, at the time of publication, did not permit an easy interpretation of the hemolytic mechanism. Acting on the assumption that thresholds of hemolysis are easier to correlate with physical forces than extents of hemolysis, we performed a series of experi ments repeating some of the conditions reported in [I] and then focusing on low L1P in order to define better the thresholds of hemolysis for several pore sizes. Employing a model of a deformed red cell shape at the pore entrance (based on micropipette observations) we related the force field in the fluid to a biaxial tension in the membrane. The threshold for lysis correlated with a membrane tension of 30 dynes/cm. This quantity is in agreement with lysis data from a number of other investigators employing a variety of mechanisms for introduc ing membrane tension. The sequence of events represented here is: a. Fluid forces and pressure gradients deform the cell into a new, elongated shape. b. Extent of deformation becomes limited by the resistance of the cell mem brane to undergo an increase in area. c. Fluid forces and pressure gradients acting on the deformed cell membrane cause an increase in biaxial tension in the membrane. d. When the strain caused by this tension causes pores to open in the membrane, the threshold for hemolysis has been reached [2].
The Encyclopedia of Exercise Medicine is intelligently structured, easy accessible and user-friendly: A-Z format, clear, concise language and uniform essay structure as well as extensive cross references between keywords and related articles enables efficient searches in a user-friendly manner both for experts and newcomers. It is intended to be a comprehensive up-to-date data base on the adaptation of the human body to exercise and on the therapeutic use of exercise with up to 2,000 keywords. It covers all aspects within the full range of modern exercise medicine of each particular scientific discipline (cancer, parasitology, aging, etc.). This includes information on methodological approaches to measuring the principle components of motor fitness, and practical aspects of their enhancement by trainings regimes as well as by nutrition and the application of drugs. Such a wide range of entries, all written by leading experts in their respective fields, will therefore address both the basic/clinical scientist as well as the practitioner. Moreover, the Encyclopedia of Exercise Medicine is aimed at people in related fields, health care professionals, physiotherapists, trainers, students, informed athletes and interested laypersons. It is available both in print and as a fully searchable and hyperlinked electronic online edition.
The rheology of dense red blood cell suspensions is investigated via computer simulations based on the lattice Boltzmann, the immersed boundary, and the finite element methods. The red blood cells are treated as extended and deformable particles immersed in the ambient fluid. In the first part of the work, the numerical model and strategies for stress evaluation are discussed. In the second part, the behavior of the suspensions in simple shear flow is studied for different volume fractions, particle deformabilities, and shear rates. Shear thinning behavior is recovered. The existence of a shear-induced transition from a tumbling to a tank-treading motion is demonstrated. The transition can be parameterized by a single quantity, namely the effective capillary number. It is the ratio of the suspension stress and the characteristic particle membrane stress. At the transition point, a strong increase in the orientational order of the red blood cells and a significant decrease of the particle diffusivity are observed. However, the average cell deformation shows no signature of the transition.
This book is devoted to the red blood cell membrane, its structure and function, and abnormalities in disease states. It presents a well-documented and well-illustrated comprehensive picture of clinical manifestations of red blood cell disorders.
Haemorheology is the study of how the blood, the blood cells and the vessels can function and interact as parts of the living organism. It is presented in this text as a sensitive tool for the recognition of the functional evidences and defects of blood flow.