Impaired skin microcirculation and blood rheology in patients with monoclonal gammapathy.

Hemorheological disturbances in patients with monoclonal gammapathies are widely known, but there is little information about microcirculation in these patients. The following study was performed to examine skin microcirculation and its relationship with blood rheology. We analysed both haematological and hemorheological parameters (blood and plasma viscosity, aggregation index and filterability of 1 ml of whole blood) and skin microcirculation in 46 patients with monoclonal gammapathy and 22 healthy controls. Microcirculation on dorsal aspect of the hand was examined with laser Doppler flowmeter. We measured resting flow and biological zero and maximal flow during postischemic hyperaemic reaction after one minute occlusion on the arm. The same parameters were estimated for CMBC (concentration of moving blood cells). Patients with monoclonal gammapathy are characterised by statistically higher whole blood and plasma viscosities and other hemorheological parameters and disturbed skin microcirculation expressed as statistically significant lower resting flux and impaired reaction for temporary occlusion.

[Examination of skin microcirculation with laser-Doppler flowmetry in patients with essential hypertension]. / Wykorzystanie wlosniczkowej przeplywometrii laserowej do oceny stanu mikrokrazenia skórnego u chorych na nadcisnienie tetnicze samoistne.

The estimation of microcirculatory parameters in patients with essential hypertension and in normotensic control group was the aim of this study. The study group consisted of 14 patients with essential hypertension confirmed by 24-hours ABP. 10 healthy patients served as control group. The flow in the skin microcirculation was measured by laser-Doppler flowmeter (PF-3, PERIMED) on dorsal part of the palm. Microcirculatory indices were registered in resting conditions, during one-minute occlusion reaction and during reactive hyperemia. The following indices were calculated: resting flow, biological zero, maximal flow, time to maximal flow, ratio of maximal to resting flow, ratio of resting flow to biological zero and ratio of maximal flow to biological zero. Skin microcirculation was highly disturbed in patients with essential hypertension. It was expressed by significantly higher biological zero and longer time to maximal flow.

[Five cases of acquired pure red cell aplasia]. / Piec przypadków nabytej wybiórczej aplazji ukladu czerwonokrwinkowego.

Acquired pure red cell aplasia is rare disorder of hematopoiesis. Because of the variety of reasons for PRCA optimal treatment is based on highly specialistic diagnostics. Both humoral and cellular mechanisms are involved in the pathogenesis of PRCA. Corticosteroids, cyclosporin A, high-dose intravenous immunoglobulin therapy are recommended in PRCA. Treatment failures may be successfully managed with antihuman thymocyte globulin, cyclophosphamide or azathioprine. We describe also the lots of five patients with this disorder.

[Laser Doppler flowmetry--a new promising technique for assessment of the microcirculation]. / Wlosniczkowa przeplywometria laserowa--nowa obiecujaca metoda badania mikrokrazeniowa.

The laser Doppler flowmetry is a new technique for evaluating microcirculation. It is based on the Doppler phenomenon-reflected light changes its frequency when it interacts with moving objects such as red blood cells. The source of light is 2 mW He-Ne laser. The light penetrates into the tissue to the depth of 1 mm, and measures microvascular blood flow throughout it. This technique is objective, harmless even during prolonged exposition, repeatable, and very sensitive even to small changes in the blood flow. Because of difficulties with determination of the perfusion normal values and several factors disturbing microcirculation, the most objective results are obtained with dynamic tests. They measure a response of microcirculation to local ischemia, cooling or given medicines. A disadvantage is its high sensitivity to motion-produced disturbances. Laser Doppler flowmetry may be used not only in scientific investigations. It is of diagnostic value in plastic surgery, vascular surgery, dermatology, internal medicine, dentistry, and neurology.