Lectin histochemical study of cholangiocarcinoma arising from stone-bearing intrahepatic bile duct

With the purpose of studying changes in the expression of glycoconjugate structures in cholangiocarcinoma and the nonneoplastic epithelium of stone-bearing intrahepatic bile ducts, a panel of 12 biotinylated lectins were used on formalin-fixed, paraffin-embedded tissue sections from 13 patients who had undergone surgical resection of cholangiocarcinoma and on nonneoplastic stone-bearing intrahepatic bile ducts from 10 patients. Of the 13 patients with cholangiocarcinoma 10 had hepatolithiasis and 3 did not. Among the 12 lectins, only wheat germ agglutinin (WGA) stained the cholangiocarcinoma and nonneoplastic epithelium of the stone-bearing intrahepatic bile duct. All nonneoplastic epithelia of stone-bearing intrahepatic bile ducts were stained heavily and homogeneously by WGA, the GlcNAC-specific lectin. The high columnar epithelium of both intramural and extramural glands was stained in the supranuclear region, while the low columnar epithelium of serous acini was stained in the whole cytoplasm. cytoplasm. In the well-differentiated cholangiocarcinoma, the WGA weakly stained the neoplastic cells in the supranuclear region, while it stained the luminal cytoplasmic membrane heavily. In the poorly-differentiated cholangiocarcinoma, about 50% of cancer cells were stained with WGA. The carcinoma was moderately stained in the cytoplasm. Less reactivity and a lower percentage of cells stained with lectin were found in cholangiocarcinomas when compared to nonneoplastic epithelia. This led us to conclude that there is a dramatic decrease in lectin-binding carbohydrate structures associated with cholangiocarcinoma progression.

Photosensitized inhibition of growth factor-regulated protein kinases by hypericin

The naphthodianthrone hypericin causes a photosensitized inhibition of protein kinases involved in growth factor signalling pathways. Nanomolar concentrations of hypericin inhibit the protein tyrosine kinase activities (PTK) of the epidermal growth factor receptor and the insulin receptor, while being ineffective towards the cytosolic protein tyrosine kinases Lyn, Fgr, TPK-IIB and CSK. Photosensitized inhibition by hypericin is not restricted to receptor-PTKs since the Ser/Thr protein kinases (protein kinase CK-2, protein kinase C and mitogen-activated kinase) are also extremely sensitive to inhibition (IC50 value for protein kinase CK-2 = 6 nM). A comparison of the hypericin-mediated inhibition of the epidermal growth factor-receptor PTK and protein kinase CK-2 revealed that the inhibition is irreversible, strictly dependent upon irradiation of the enzyme-inhibitor complex with fluorescent light and likely mediated by the formation of radical intermediates (type I mechanism). Although the exact molecular basis for the selectivity of enzyme inhibition by hypericin remains unknown, our results suggest that distantly related protein kinases could still share common reactive domains for the interaction with hypericin.

A lectin histochemical study of intrahepatic ducts in patients with hepatolithiasis

A panel of 12 biotinylated lectins was used to investigate the diversity of glycoconjugate on the epithelium of stone-containing intrahepatic bile ducts and compared to controls. Among the 12 lectins, only WGA (wheat germ agglutinin) and Con A (concanavalin agglutinin) stained the epithelium of stone-containing intrahepatic ducts. Con A, a glucose/mannose-specific lectin, bound weakly on the epithelium of the stone-bearing intrahepatic duct in 10 of the 25 specimens, but none of the controls. All stone-containing intrahepatic bile ducts were stained heavily and homogenously by WGA, the N-acetylglucosamine-specific lectin. The high columnar epithelia of both intramural and extramural glands were stained in the supranuclear region, while the serous acini of extramural glands were stained in whole cytoplasm. The epithelium of intrahepatic ducts from the controls was stained weakly by WGA only. The WGA receptors were not abolished by pretreatment of neuraminidase. This led us to conclude that the stone-containing intrahepatic ducts were rich in N-acetylglucosamine and the heavy and homogenous staining with WGA will be indicative of hypersecretion of mucus from stone-bearing intrahepatic bile ducts.

Transurethral microwave thermotherapy (TUMT) for benign prostatic hyperplasia (BPH)--our first 100 cases

One hundred consecutive cases treated by Transurethral Microwave Thermotherapy (TUMT) since October 1991 were analysed to assess its efficacy and safety. Out of these, 28 were in urinary retention. Patients were selected based on Madsen Symptom Score (MSS), Uroflowmetry, Transrectal Ultrasound Scanning (TRUS) plus biopsy and flexible cystoscopy. In the non-retention group, symptomatic improvement was 81%; mean MSS dropped from 13.6 to 2.6 at one year. Objective improvement was less marked: mean peak urine flowrate (PFR) (+45%), mean residual volume (-63%) and mean prostatic volume (-15%). 8.3% had failed TUMT requiring TURP. In the retention group, 79% was able to void freely after TUMT. Fourteen percent underwent TURP. Based on given criteria, the overall response rate for MSS and PFR averaged 71% at 3 months, 72% at 6 months and 84% at 1 year. Sixty-seven percent of patients who responded to a phone interview were satisfied with TUMT treatment. Minimal morbidity was encountered: temporary retention for non-retention group (24%), UTI (9%), haematuria (7%), impotence (2%) and fistula (1%). There was no treatment-related death. The results showed that TUMT is a viable alternative and safe treatment of BPH.

[Vitamin A status in patients with cholelithiasis]

In order to assess the status of vitamin A and determine the frequency of vitamin A deficiency in adults with cholelithiasis, we measured plasma vitamin A levels in 40 healthy subjects and 64 patients with cholelithiasis. Among them, 40 were icteric and the remaining 24 were anicteric. Vitamin A levels were determined in biopsied liver tissues in 26 patients with cholelithiasis. Plasma levels of vitamin A in patients with cholelithiasis was significantly lower than that of healthy subjects (P < 0.05). A significant difference of vitamin A in liver tissue was noted between these two patient groups (P < 0.05). The frequency of vitamin A deficiency, defined as a plasma vitamin a level below 90 micrograms/dl, was 50% (32/64) in cholelithiasis patients, 65% (26/40) in jaundiced patients, and 25% (6/24) in jaundice-free patients. We conclude that biochemical deficiency of vitamin A occurs in patients with cholelithiasis. We suggest that vitamin A should be evaluated in patients with cholelithiasis, and an effective therapy should be initiated to prevent vitamin A deficiency.

Study of lysosomal changes in rat pancreas after ingesting monosodium L-glutamate

An experiment was conducted on 54 male Wistar rats (36 experimental, 18 controls) to study adverse effects of monosodium L-glutamate (MSG) on pancreatic acinar cells by measuring the qualitative and quantitative changes in acid phosphatase (ACPase) in these cells. Various concentrations of aqueous MSG were given to rats for various durations (Group I, 1% MSG for 1 month; Group II, 1% MSG for 1 week; Group III, 0.5% MSG for 1 week; Group IV, 0.2% MSG for 1 week; Group V, 0.1% MSG for 1 week; Group VI, 0.05% MSG for 1 week). The pancreas was then removed from each specimen for electron microscopic examination, cytochemical localization of ACPase, and cell fractionation for quantitative measurement of ACPase. Serum level of ACPase was determined in these animals before removal of the pancreas. The ultrastructural changes in pancreatic acinar cells revealed an increase in the number and size of autophagic vacuoles and various sizes of myelin figures in the cytoplasm and interstitial space. Dilatation of rough endoplasmic reticulum, swollen mitochondria, and altered zymogen granules were occasionally found. These changes occurred most often in Group I rats, which ingested 1% MSG for 1 month. The changes became less prominent as the dose of MSG administered was lessened. A reaction product of ACPase could also be seen in autophagic vacuoles in Group I rats. Regarding quantitative measurement, the serum level of ACPase for Group I rats was markedly higher than that of the controls and was statistically significant (20.52 +/- 4.92 vs. 12.62 +/- 4.13 U/L; p < 0.05)(ABSTRACT TRUNCATED AT 250 WORDS)

Evaluation of choledochojejunostomy with subcutaneous jejunostomy for treatment of intrahepatic stones

Twenty-nine patients, 16 males and 13 females, with intrahepatic stones were treated by choledochojejunostomy with subcutaneous jejunostomy after choledocholithotomy in cases where the common bile duct was dilated more than 2 cm in diameter. This surgical technique consists of putting a segment of jejunum in the subcutaneous area with a jejunostomy after finishing the choledochojejunostomy. If the stone recurs years later, this loop of jejunum will offer a route for inserting the scope while producing the fistulotomy under local anesthesia. These patients became symptomless soon after removal of the residual stone by postoperative choledochoscope. After more than five years of follow-up study, seven cases (24.1%) had reflux cholangitis and among them, four patients had recurrent stones. Reopening of the fistulotomy was carried out under local anesthesia, and the choledochoscope was inserted into the bile duct through the jejunum for removal of those recurrent stones. We believe that this surgical technique is very effective for the treatment of patients with recurrent intrahepatic stones without the necessity of major laparotomy.

Changes of lipid peroxide levels in blood and liver tissue of patients with obstructive jaundice

Plasma lipid peroxide levels, hereafter referred to as PLP levels, were measured in a group of 40 apparently healthy controls and 64 cholelithiasis patients, 40 with and 24 without jaundice. Hepatic lipid peroxide (HLP) levels were also measured in 26 patients, 15 with and 11 without jaundice. There was a significantly higher mean concentration of PLP in the jaundiced patients than in the control or jaundice-free cases. However, the difference in PLP levels between the jaundice-free and the control cases was insignificant. Meanwhile, patients with jaundice had significantly higher HLP levels than those without jaundice. In the jaundiced cases, the increased PLP and HLP levels were clearly related to the serum levels of bilirubin respectively. In addition, the HLP levels were positively correlated with the PLP levels; however, in the non-jaundiced cases, there was little evidence of these two relationships. Patients with or without jaundice had lower plasma vitamin E levels in comparison to the control cases. The correlation of plasma vitamin E and PLP levels was weak in all of the jaundiced. However, when we subdivided the jaundiced into two groups, the correlation was strong in those with plasma vitamin E levels < 8.5 micrograms/ml, while the correlation was weak in those with plasma vitamin E levels > 8.5 micrograms/ml. Consequently, these results suggest that there is an involvement of lipid peroxidation in liver cells damaged by obstructive jaundice in cholelithiasis patients and there exists a negative correlation between low vitamin E and lipid peroxide levels in plasma.

Extracorporeal shockwave lithotripsy for treatment of intrahepatic stones: in vitro and in vivo studies

In vitro, bile duct stones, mostly comprising calcium bilirubinate, are readily fragmented by extracorporeal shockwave lithotripsy (ESWL). In the case of intrahepatic stones, ESWL is effective if the stones float freely in the bile, but if the stones completely fill, or are impacted within, the hepatic duct or bile duct, attempts at fragmentation will end in failure. Three patients with intrahepatic stones were treated with ESWL, and effectively fragmented. The stone fragments passed out spontaneously through T-tube sinus tract, PTDC sinus tract and the sphincter of Oddi as shown in the second cholangiogram. No specific complication was noted in our experimental and clinical experience. We believe that ESWL for fragmentation of biliary stones is technically reliable. The problem of the passage of these fragmented stones is considered; if necessary, it can be overcome by endoscopic means.

Giant ectopic pelvic spleen: report of a case and review of the literature

We report a case of giant ectopic pelvic spleen combined with an accessory spleen and confirmed by liver-spleen scan, angiography, magnetic resonance imaging, and surgical findings. In various reviews of the literature, no ectopic pelvic spleen larger than this one has been reported.

Levels of plasma lipid peroxides before and after choledocholithotomy in patients with obstructive jaundice

Plasma lipid peroxide levels were measured in a group of 40 healthy controls and 11 patients with jaundice. In the case of these 11 patients, we checked the plasma lipid peroxide concentrations prior to and after choledocholithotomy. Before choledocholithotomy, there were significantly higher mean concentrations of plasma lipid peroxides and bilirubin in patients with jaundice than in the control cases (11.8 +/- 2.3 vs. 2.0 +/- 0.1 nmol/ml and 10.3 +/- 1.82 vs. 0.7 +/- 0.03 mg/dl, respectively, P < 0.05). In addition, patients with jaundice had lower plasma vitamin E levels in comparison to the controls (8.2 +/- 0.6 vs. 12.2 +/- 0.5 micrograms/ml, P < 0.05). In patients with jaundice, the increased plasma lipid peroxides were clearly related to the serum levels of bilirubin (r = 0.87, P < 0.05). After surgery, the higher plasma levels of lipid peroxide and bilirubin were reduced markedly (11.8 +/- 2.3 vs. 3.7 +/- 0.4 nmol/ml and 10.3 +/- 1.82 vs. 3.1 +/- 0.47 mg/dl, respectively, P < 0.05) with the restoration of bile flow which was associated with improvement in liver function tests. Consequently, these results suggest that there is an involvement of lipid peroxidation in liver cells damaged by obstructive jaundice in patients with cholelithiasis, and that these high plasma lipid peroxide levels may correlate with the severity of the disease.

Arginine induced insulin release in patients with newly onset non-insulin-dependent diabetes mellitus

To examine the release of insulin in response to oral glucose, intravenous glucagon and intravenous arginine, we measured the levels of plasma glucose, immuno-reactive insulin (IRI) and C-peptide levels on fasting and following an oral glucose loading (OGTT), intravenous glucagon (GON) and arginine (ARG) infusion test in nine newly diagnosed non-insulin dependent diabetics. Their ages ranged from 38 to 65. The fasting plasma glucose and hemoglobin A1c levels were 240 +/- 14 mg/dl (Mean +/- SEM) and 10.7 +/- 0.54%, respectively. Mean values of the peak C-peptide/fasting C-peptide ratio and peak IRI/fasting IRI ratio were significantly increased, as compared with the basal level (P < 0.05), but not significantly different from those of the OGTT, GON and ARG test. In conclusion, the effect of arginine-induced insulin secretion in non-insulin dependent diabetes mellitus is as good as those of glucose or glucagon.

[The management of obstructive jaundice caused by pancreatic head carcinoma and periampullary carcinoma]

We had treated 115 patients with malignant obstructive jaundice, including 69 pancreatic head carcinoma and 46 periampullary carcinoma during the period between 1982 and 1991. In the 115 jaundiced patients 33 had undergone pancreaticoduodenectomy, 50 had bypass operation and the remaining 32 patients undergone percutaneous transhepatic biliary drainage (PTBD) only. No operative mortality happened for the 33 pancreaticoduodenectomies. Postoperative complications occurred in 12 patients. Leakage from the choledochojejunostomy was the most often occurred complications, it was found in 7 patients (21.2%). Intraabdominal abscesses happened in six patients (18.2%) which recovered by treating with ultrasound-guided catheteral drainage. Leakage from pancreaticojejunostomy was also found in five patients (15.2%), the complication recovered uneventfully after administration of total parenteral nutrition and good abdominal drainage. Twenty-two out 33 patients with pancreaticoduodenectomy received preoperative biliary drainage. However, despite preoperative biliary drainage, 10 of 22 patients (45.5%) still suffered postoperative complications. It implied that hyperbilirubinemia would trend to carry a high postoperative morbility. The prognosis for our patients with pancreatic head carcinoma was extremely poor. The mean survival period for all of them was not exceeding 12 months. Those who had PTBD as the sole treatment had the shortest survival period, which was 3.4 +/- 3.1 months only. On the other hand, the mean survival period for those who had periampullary cancer and had pancreaticoduodenectomy was 35.5 +/- 27.2 months, while it was 13.3 +/- 10.1 and 11.8 +/- 10.0 months for those having bypass operation and PTBD respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

Assessment of serum and bile levels of CA19-9 and CA125 in cholangitis and bile duct carcinoma

In this study, CA19-9 and CA125 in serum and bile were measured to evaluate their diagnostic value in cholangitis and bile duct carcinoma. Patients were classified into three groups: group A, the control group, had cholelithiasis without infection (n = 23), group B had acute cholangitis (n = 25) and group C had bile duct carcinoma without bacterial infection (n = 18). All patients had undergone surgery, and bile and serum of the patients were measured for the two tumour markers by radio-immunoassay. The positivity rate for serum CA19-9 was 4.4% in the control group, 28.0% in group B and 61.1% in group C. The positivity rates for serum CA125 in groups control, B and C were 0%, 4% and 27.78% respectively. The diagnostic accuracy for bile duct carcinoma was 67.4% for both CA19-9 or CA125. The concentration of CA19-9 in bile was more than 1200 ng/mL in 72% of patients with acute cholangitis, in 61.1% of all patients with bile duct carcinoma and 0% in the control group. The frequency of concentrations of CA125 in bile greater than 200 ng/mL was 38.89% in bile duct carcinoma and none was observed in the control or acute cholangitis groups. In conclusion, the concentration of CA19-9 was increased not only by the tumour itself, but also by infection. In the diagnosis of bile duct carcinomas, the sensitivity of CA125 was low but its specificity was very high.

The causes and management of lower GI bleeding: a study based on clinical observations at Hanyang University Hospital

During the period of the study, lower GI bleeding patients comprised a constant 1.6% of the total admitted patients at Hanyang University Hospital annually. There were no statistically significant changes according to year. The 970 cases were classified as follows: hemorrhoid and anal fissure 65.5%, malignant neoplasm 21.1% (rectal cancer 16.9%, sigmoid colon cancer 3.3%, anal cancer 0.9%), benign neoplasm 4.2%, ulcerative colitis 3.3%, infectious colitis 2.3%, ischemic colitis 1.8%, radiation colitis 1.3%, diverticulosis 0.3%, and others 0.2%. Ulcerative colitis and rectosigmoid cancer showed increasing trends, while other disease groups showed no change in the occurrence rate. Hemorrhoid and anal fissure developed mostly in the 30s age group, benign polyp and ulcerative colitis in the 40s age group, malignant neoplasm in the 50s age group, and ischemic colitis and radiation colitis in the 60s age group. There was no sexual predominance of lower GI bleeding. About 10% of the patients admitted to the hospital needed transfusions, particularly patients with ulcerative colitis (21.9%) and radiation colitis (23.1%). 20.2% of the patients improved with supportive measures and medical treatment and 79.8% underwent surgical operation. In particular, 51.2% of the patients with benign neoplasm underwent polypectomies.

Pyogenic liver abscess: multivariate analysis of risk factors

Seventy-three patients with pyogenic liver abscess during the year 1978-1988 were studied in the Kaohsiung Medical College Hospital. The overall mortality rate was 19.2% in this study. By using univariate analysis, it was revealed that clinical jaundice, pleural effusion, bilobar abscess, profound hypoalbuminemia (less than 2.5 g/dl), hyperbilirubinemia (less than 2 mg/dl), elevated level of serum AST (greater than 100 IU/L), alkaline phosphatase (greater than 150 IU/L), and marked leukocytosis (greater than 20,000 mm3) were associated with a higher mortality rate. Multivariate stepwise logistic regression analysis detected only 3 factors of marked leukocytosis (greater than 20,000 mm3), profound hypoalbuminemia (less than 2.5 g/dl), and presence of pleural effusion with independent significance in predicting mortality. Meanwhile, it was also revealed that the laboratory data could not predict a risk factor to mortality unless they became markedly abnormal.

Effects of low-density lipoprotein from normal rabbits on hypercholesterolemia and the development of atherosclerosis

To clarify whether or not normal LDL separated from normal rabbits is atherogenic, 0.75 mg of normal LDL-cholesterol in 6 ml of 0.85% saline and 6 ml of saline alone were injected every day for 5 weeks into the auricular vein of two groups of rabbits, respectively. The inoculated rabbits were fed a standard diet containing 0.5 and 1% cholesterol. Blood was drawn before injection and at 1, 2, 3 and 5 week intervals thereafter. After 5 weeks, all rabbits were sacrificed. Following exsanguination, the aorta was stained by Sudan III. The Sudan III staining was more extensive in rabbits injected with saline than in those that received LDL. In addition, plasma cholesterol, plasma phospholipid, VLDL-cholesterol and LDL-cholesterol levels were lower in LDL-injected rabbits than in those injected with saline. But HDL-cholesterol levels were not significantly different between LDL-cholesterol and saline-injected rabbits. Although the exact cause of antiatherogenic effect of normal LDL is not clear, it seems reasonable to suggest that at least some normal LDL acts as a 'good' lipoprotein, namely antiatherogenic lipoprotein, in our experimental protocol.

Percutaneous post-operative choledochofiberscopic lithotripsy for residual biliary stones

A total of 5,116 post-operative percutaneous choledochofiberscopy (POC) sessions were performed on 739 patients with residual bile duct stones between 1980 and 1988. These residual stones were detected and removed by choledochoscopy. The success rate of non-surgical stone removal using POC was 100% for residual common duct stones and required 414 treatment sessions in this group of 168 patients. The success rate was 92.2% (525/569) for patients with residual intrahepatic stones; in this group a total of 4,694 treatment sessions were needed. Two patients with residual cystic duct stones were also successfully treated with POC. The distribution of residual intrahepatic stones was as follows: 166 (29.2%) in the right hepatic duct, 255 (44.8%) in the left hepatic duct and 148 (26.0%) in both hepatic ducts. Complications after POC were minimal and subsided after conservative treatment except in 2 patients. One patient had hemobilia and another a large subphrenic abscess, which required surgical drainage. Choledochofiberscopic electrohydraulic shock-wave lithotripsy was effective treatment for large stones and was well tolerated. Residual stones in Oriental gallstone disease are not preventable, and we believe that POC should be the first choice for these patients. Many of the problems associated with residual stones can be overcome by this method and good results achieved.

A comparative study of cefotaxime sodium versus a combination of cefapirin and gentamicin in the prophylactic treatment of patients undergoing cholecystectomy

This was a randomized open evaluation of claforan vs. combination treatment of cefapirin + gentamicin. Patients taking part in the study were randomized in 3 parallel groups: 3 x 1 g claforan given during a period of 24 h (regimen I) was compared to 1 x 1 g claforan given at the time of incision (regimen II) and to a combination of cefapirin + gentamicin given in divided doses for 5 days (regimen III). Sixty-five patients (31 males and 34 females) aged between 23 and 76 years, who underwent cholecystectomy, were included in the study. There were no significant differences between the study groups in terms of sex, age, height, weight, diagnosis, aggravating factors and clinical condition of patients. Sixty of sixty-five patients noted "cholelithiasis" as diagnosis. The majority of patients documented an acute exacerbation of chronic condition. Twenty-three patients documented concomitant diseases/conditions or aggravating factors. The most frequent were: Diabetes mellitus, jaundice and clonorchiasis. During the study no additional administration of antibiotics or other concurrent treatment was recorded. Tolerance of the test substances was noted as "good" by 63 patients and satisfactory in 2 patients. In 3 patients (one patient in each treatment group) a postoperative wound infection was documented. One patient from regimen II with wound infection, therefore, received more than 1 g claforan. Postoperative hemoglobin decreased in all 3 groups (p less than 0.05). BUN decreased in the regimen group I (p less than 0.05) and increased together with creatinine in the group of regimen III (p less than 0.05). No side effects were documented in any treatment groups. The use of a single or three doses of claforan was more convenient and simple than the combination regimen. Less laboratory adverse effects (renal function) were also noted in claforan treated patients than the combination of cefapirin + gentamicin group.

Intestinal apolipoprotein B-48 synthesis and lymphatic cholesterol transport are lower in swine fed high fat, high cholesterol diet with soy protein than with casein

Effects of dietary proteins on intestinal lipoproteins were studied in 8 Yorkshire swine fed a high fat, high cholesterol diet with either casein or soy protein. After 5 weeks of feeding, the casein group exhibited moderately elevated levels of serum cholesterol (334 +/- 46 mg/dl). The soy protein group showed significantly less hypercholesterolemia as compared to the casein group (122 +/- 8 mg/dl). Swine were subjected to cannulation of mesenteric lymph duct under halothane anesthesia. A single dose of 250 microCi [14C]cholesterol and 10 mCi [3H]leucine was infused into the upper jejunum 2 h after one-fifth of daily food was given. The 3-h lymphatic transport of cholesterol in casein-fed swine was significantly higher than in those fed soy protein. Triglyceride transport values were similar in the 2 groups. The [3H]leucine incorporation study revealed that transport of apo B-48 bore a significant positive relationship to transport of cholesterol in both chylomicron and VLDL fractions of mesenteric lymph. A greater apo B-48 secretion with higher specific activity was probably responsible for the greater transport of cholesterol in chylomicrons in casein-fed than in soy protein-fed swine. Similarly, the transport of lymph VLDL cholesterol in swine fed casein or soy protein paralleled the amount of accompanying apo B-48. Dietary proteins probably influence the intestinal synthesis of apo B-48 which in turn affects cholesterol transport into the lymphatics.

[Erythrocyte deformability in experimental state and diseased RBC]

By Reid's functional test of erythrocyte deformability, the filtration time of 1 ml 5% erythrocyte suspension through a 5 micron nucleopore membrane was measured from 18 normal people and 19 patients with thalassemia. In the control group, the filtration time at 37.0 degrees C and pH 7.4 was 3.26 +/- 0.38 sec. Erythrocyte deformability was constant while blood temperature stayed between 35.0 degrees C and 42.0 degrees C. However the erythrocyte filtration time prolonged as the blood became alkaline or incubated for more than 2 hours. The filtration time of blood was 4.56 +/- 1.02 sec for thalassemia patients, significantly different (p less than 0.01) as comparing to the normal control group. Poor deformability in diseased blood could be explained by membrane defect. Erythrocyte deformability is a good rheological indicator if the physiological conditions of blood is controlled well.