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Biomedical subjects

M Mercuri

Publications and source records attributed to M Mercuri.

At least 145 records · Page 8Linked to original sources

Leucocyte behaviour in controlled ischaemia of the calves.

Whole blood filterability and leucocyte behaviour (number, activation, and subfraction filterability rates) were monitored at the earliest stage of peripheral ischaemia in 18 patients with stage II peripheral occlusive arterial disease (PAOD) and 20 matched controls. A model of controlled ischaemia, using exercise to stress leg circulation, was set up and blood samples were taken before exercise, at the onset of calf pain, and at recovery from peak exercise. Leucocytes were counted, separated into their subfractions on a Ficoll-Hypaque density gradient and by adhesion to Petri dishes, and filtered in buffer (like the whole blood suspensions) through 5 microns pore diameter Nucleopore filters. Unfractionated white cells, separated under gravity, with pseudopodia or cytoplasmic irregularities were regarded as activated. The whole blood filterability rate was significantly increased at the onset of calf pain and was associated with significant increases in the number of leucocytes and in the filterability rate of the monocyte subfraction, the latter persisting throughout the recovery period. No significant changes were observed in the other variables monitored, showing that impairments in white cell rheology may be associated with ischaemia.

Aged↗

Age and blood cell rheology.

The identification of the rheological variables responsible for alterations in capillary blood flow caused by the aging process could help explain why the incidence of vascular disease increases with age. Using new techniques for the separation and micropore filtration of the haemocellular subpopulations in 110 subjects aged 21-84 years, the aim of this study was to show to what extent, if any, age influences blood cell deformability. The filterability of mononuclear leucocytes decreased with age (r = 0.25; p less than 0.001), whereas the filterability of polymorphonuclear leucocytes or erythrocytes did not change significantly with age.

Adult↗

Peripheral vascular disease. Rheologic variables during controlled ischemia.

The quantitative and qualitative behavior of hemorheologic factors both at rest and after treadmill exercise in 30 male patients with stage II peripheral vascular disease compared with 20 sex- and age-matched healthy controls have been studied. The aim of our study was to identify functional rheologic markers for peripheral vascular disease. At rest, whole blood viscosity (corrected for hematocrit at both high and low shear rates), fibrinogen levels (4.23 +/- 1.39 vs. 3.23 +/- 1.5), and white blood cell count (7.05 +/- 1.25 vs. 6.03 +/- 1.28) were significantly different between patients and controls. After treadmill exercise, white blood cell counts increased in both patients and controls, whereas only the filterability of mononuclear leukocytes showed a significant variation in the patient group (5.47 +/- 1.54 vs. 7.26 +/- 2.00, p less than 0.002). In this group, mononuclear filterability improved during the recovery period. The results suggest a relation between exercise-induced ischemia of the lower limb and mononuclear filterability in patients with peripheral vascular disease. Mononuclear filterability could be a functional rheologic marker for peripheral vascular disease.

Blood Component Removal↗

Blood cell rheology in acute cerebral infarction.

Recently it has been hypothesized that leukocyte rheology could be a relevant variable of the microcirculation during cerebral ischemia. However, relatively few studies have been carried out on the rheologic behavior of leukocytes in vascular diseases. This study aimed at quantifying the filterability through Nuclepore filters (mean pore diameter 5 microns) of both leukocyte subpopulations and red blood cells in patients with acute stroke compared with age-matched healthy controls. Leukocytes were separated by density into polymorphonuclear and mononuclear cells. Filterability of the red blood cells and polymorphonuclear and mononuclear subpopulations in buffer was measured using a constant-flow and low-positive pressure system. We used one-way analysis of variance, signed rank sum, and simple and multiple regression tests for statistical analysis. Twenty consecutive male patients with acute ischemic infarction were compared with 20 age-matched healthy subjects. Mononuclear cell filterability was impaired in acute stroke (7.26 +/- 2.00) compared with the controls (5.55 +/- 1.23) (p less than 0.01). Polymorphonuclear cell filterability was less, but still significantly (p less than 0.05), impaired in acute infarction (5.75 +/- 0.87 vs. 4.19 +/- 0.43). The results show that leukocyte and, especially, mononuclear cell filterability is impaired in acute infarction, while no differences exist in red blood cell filterability.

Acute Disease↗

Correlation between hemorheologic parameters and carotid atherosclerosis in stroke.

An evaluation of the hemorheologic parameters and an ultrasonographic study of the extracranial carotid tract were performed on 48 patients, age range: sixty to seventy-five years, affected by acute stroke, 23 of whom had hypertension, while 27 were smokers. None of them was suffering from hyperlipidemia, diabetes mellitus, or symptomatic coronary heart or peripheral artery disease. The echotomographic analysis, using B-mode real-time echotomography revealed atherosclerotic lesions in 26 patients. The hemorheologic pattern (hematocrit, fibrinogen, whole blood filterability, whole blood and plasma viscosity) was determined in all the patients three months after the clinical event. Statistical analysis of the results indicates a possible link between atherosclerotic lesions of the extracranial carotid tract and age, fibrinogen levels, and whole blood filterability.

Aged↗

[Whole blood filterability in chronic cerebrovascular disorders: effects of the use of buflomedil hydrochloride].

Buflomedil chlorhydrate is a newly synthesized molecule with a notable effect of vasodilatation even on cerebral blood vessels. It is effective in the treatment of Chronic Cerebrovascular Disorders (CCVD) as it reduces membrane rigidity in red blood cells. Since, however, new techniques for the evaluation of this haemorheological parameter suggest it may no longer be considered the sole expression of whole blood filterability we decided to monitor the haemorheological effect of Buflomedil once again. The aim of this random blind vs. Placebo study was to monitor whole blood filterability (Reid and coll., 1976) and its main determinants (hematocrit, leucocyte count, fibrinogen levels, plasma viscosity and red blood cell deformability) in 20 (10 male and 10 female) CCVD patients (Ad Hoc Committee, Paris, 1980), aged between 66 and 75 years of age before and after intravenous injection in bolus of 150 mg Buflomedil chlorhydrate. Our results showed a significant increase in whole blood filterability, confirming those of recent studies on other molecules with a known effect on the haemorheological pattern but not only on the plasticity of red blood cells. Further studies are therefore necessary to define the rheological activity of this drug more precisely.

Aged↗

Effects of 3-glucosaminoglycan sulfate on hemorheologic parameters in hyperlipidemic peripheral vascular disease (PVD) patients: a preliminary double-blind crossover study.

The effects of 3-glucosaminoglycan sulfate on lipids and the hemorheologic parameters were observed in a preliminary double-blind crossover study in 30 hyperlipidemic peripheral vascular disease (PVD) patients. Parenteral administration of the test drug was associated with a reduction in serum lipids, especially in triglyceride levels, and a lowering of fibrinogen, plasma viscosity, and whole blood viscosity levels. These effects justify the drug's use in the treatment of PVD, especially when associated with hypertriglyceridemia and hemorheologic disturbances.

Adult↗

Peripheral vascular disease: role of leucocyte rheology and activation during controlled ischemia.

Leucocytes have been implicated in the development of tissue ischaemia. No studies on leucocyte rheology and activation in the earliest stages of controlled ischaemia in Peripheral Vascular Disease (PVD) exist. Blood samples were taken from 15 PVD patients and 15 matched controls before and after treadmill exercise (5 mins/2 km/hr/12% slope). Leucocytes were separated by density and adherence into their granulocyte, lymphocyte and monocyte sub-populations and their filterability rates through 5 micron diameter pore filters were measured. Leucocyte activation as observed under a light microscopy was monitored. Compared to controls, calf pain in the PVD patients was associated with a significant (p less than 0.001) increase (+22%) in monocyte filterability but not in leucocyte activation.

Arterial Occlusive Diseases↗

Evolutionary trends in carotid atherosclerotic plaques: results of a two-year follow-up study using an ultrasound imaging system.

A two-year follow-up on 118 atherosclerotic lesions of the extracranial carotid tract observed in 70 patients was carried out using real-time high-resolution echotomography. The following plaque characteristics were monitored: the echogenic patterns (soft, intermediate, hard, and mixed), the surface aspects, and the degree of stenosis. The aim of the study was to evaluate plaque evolution, in relation both to the degree of vessel stenosis produced and to the echostructural characteristics of the lesion. After two years 68% of the lesions remained unchanged while the degree of vessel stenosis increased in 32%; no case of regression was observed. Intrinsic factors appearing to condition an increase in degree of stenosis were "mixed" and "hard" echogenic pattern, an irregular lesion surface, and an initial degree of stenosis of more than 50%. A modification in the echogenic pattern, which generally tended to progress toward more highly reflecting echogenic levels was observed in 27% of the lesions studied.

Aged↗

Hemorheologic factors in the postacute phase of ischemic stroke.

Clinical and hemorheologic data were recorded in a homogeneous group of 72 patients (age range sixty-one to seventy years), suffering from ischemic stroke with an onset of less than eight hours, confirmed clinically and by computerized tomography. A quantitative neurologic analysis and the following hemorheologic parameters were monitored for twenty weeks following the acute episode: fibrinogen, total proteins, albumin, hematocrit, leukocyte and platelet counts, whole blood filterability (WBF), red blood cell deformability (RBCD), and blood plasma, and serum viscosity. The results show a significant decrease in hematocrit values parallel to the clinical neurologic improvement and a significant increase in RBCD in the patients with the better clinical recovery. These data confirm the role of hemorheologic parameters in the clinical follow-up of cerebrovascular disorders.

Acute Disease↗

Extracranial carotid atherosclerosis evaluation and stroke occurrence: role of the echotomographic analysis.

High-resolution real-time echotomography was used in a longitudinal study on 118 atherosclerotic plaques of the extracranial carotid tract with the aim of identifying those most likely to cause a cerebrovascular event. Seventy patients (average age 61 +/- 7 years), referred to our Clinical Vascular Laboratory because suffering from transient cerebral ischemic attacks (TIA), coronary heart disease (CHD, peripheral artery disease (PAD), or cervical bruits (CB), were followed up for two years. Medical treatment remained that of the referring physician. Ten patients suffered from clinical events caused by stroke, TIA, and/or carotid occlusion during the follow-up. The echostructural profile of the lesions most often correlated with the clinical event was characterized by a mixed or hard echogenic pattern, and irregular surface, and an initial vascular stenosis of more than 50%.

Aged↗