[Evolution of the carboxyhemoglobinemia and methemoglobinemia during endoscopic resection: An observational study]. / Évolution de la carboxyhémoglobinémie et de la méthémoglobinémie lors de résections endoscopiques : une étude observationnelle.

AIM OF THE STUDY: Combustion of organic tissues due to endoscopic resection could induce methemoglobin (MetHb) and carboxyhemoglobin (COHb) formation. The aim of this study is to evaluate MetHb and COHb formation in patients undergoing prostatic or bladder endoscopic procedures. METHODS: COHb and MetHb measurements were performed in 44 patients at the beginning and end of the procedure. A third measurement was done in patients who stayed more than one hour in the recovery room. Means were compared using Student t-test, simple regressions were used for quantitative variables and ANOVA for categorical variables. Multiple linear regressions were used for multivariate analysis. RESULTS: COHb increased by 0.5±0.9 % (95 % CI: 0.2 to 0.7 % P=0.001). MetHb increase was 0.0±0.4 % (95 % CI: -0.1 to 0.2 % P=0.552). In univariate analysis, the variables associated with COHb increase are the length of surgery, the amount of irrigation fluid and location (prostate or bladder) of the procedure. In the multivariate model, COHb increase is associated with the amount of liquid and the location. CONCLUSION: MetHb did not increase during endoscopic surgery. In contrast, COHb increases, and can, in some patients, exceed 2-4 %. This could be responsible for a decreased angina threshold in patients with ischemic heart disease. LEVEL OF EVIDENCE: 4.

[Effect of selenium on resistance of hemoglobin to photooxidative processes].

On an example of a guinea pig it is shown that exogenous selenium (0.5 mg Na2SeO3 per 1 kg of the animal weight) during 2-hour exposition in the animal organism increases the resistance to the photo-induced oxidation of haemoglobin in erythrocyte lysates without additional stimulation of glutathione peroxidase mechanism of haemoglobin protection by exogenous selenium. It is shown that the saturation of haemoglobin fractions by selenium hampers the oxidative modification of haemoglobin. Using pregnancy of women as a natural model of selenium-deficiency condition, it has been shown that physiological debilitation of saturation erythrocytes with selenium, including haemoglobin fractions of lysates erythrocytes caused debilitation of resistance of haemoglobin to photooxidative destruction. Under these conditions not only activity of enzyme glutathione peroxidise in erythrocyte lysates, but also the peroxidase activity of haemoglobin (in the presence of glutathione) were decreased. It is more characteristic of erythrocyte lysates with a less content of selenium, i.e. for the erythrocytes of women on late terms of pregnancy that testifies to the presence of certain relation between haemoglobin saturation with selenium and its peroxidase activity (in the presence of glutathione).

Methemoglobin formation during laser induced photothermolysis of vascular skin lesions.

BACKGROUND AND OBJECTIVE: Monitoring dynamic changes during laser induced photothermolysis of vascular skin lesions is essential for obtaining an optimal therapeutic result. Rapid photoinduced thermal damage occurs at a threshold temperature of about 70 degrees C. It is therefore, relevant to identify markers to indicate if this threshold temperature has been reached. Methemoglobin, which is formed by a photo-induced oxidation of hemoglobin, indicates that the temperature has reached this threshold value. This study presents a proof of concept of a method for monitoring the in vivo presence of methemoglobin immediately after laser exposure. STUDY DESIGN/MATERIALS AND METHODS: The present study was designed to investigate the in vivo temperature dependence of hemoglobin absorption in the 450-800 nm spectrum range. In vivo diffuse reflectance measurements of port-wine stain (PWS) and telangiectasia were performed prior to, and immediately after, laser treatment with a pulsed dye laser (PDL) at 585 nm wavelength. RESULTS: In vivo measurements following laser treatment of vascular skin lesions showed an immediate increase in the optical absorption of blood. This effect, caused by thermal stress, is a result of an increased dermal blood volume fraction and methemoglobin formation. The effect is light dose dependent, and reflectance spectra revealed methemoglobin formation in patients treated with fluences above 5 J/cm2 at 585 nm wavelength. CONCLUSIONS: It was proved that methemoglobin can be measured in vivo by reflectance spectroscopy. Measurements of the average methemoglobin concentrations immediately after laser exposure may be a valuable diagnostic tool to verify that the blood temperature has been sufficiently high to induce thermal damage to the vessel wall.

Glutathione protects chemokine-scavenging and antioxidative defense functions in human RBCs.

Oxidant stress, in vivo or in vitro, is known to induce oxidative changes in human red blood cells (RBCs). Our objective was to examine the effect of augmenting RBC glutathione (GSH) synthesis on 1) degenerative protein loss and 2) RBC chemokine- and free radical-scavenging functions in the oxidatively stressed human RBCs by using banked RBCs as a model. Packed RBCs were stored up to 84 days at 1-6 degrees C in Adsol or in the experimental additive solution (Adsol fortified with glutamine, glycine, and N-acetyl-L-cysteine). Supplementing the conventional additive with GSH precursor amino acids improved RBC GSH synthesis and maintenance. The rise in RBC gamma-glutamylcysteine ligase activity was directly proportional to the GSH content and inversely proportional to extracellular homocysteine concentration, methemoglobin formation, and losses of the RBC proteins band 3, band 4.1, band 4.2, glyceraldehyde-3-phosphate dehydrogenase, and Duffy antigen (P < 0.01). Reduced loss of Duffy antigen correlated well with a decrease in chemokine RANTES (regulated upon activation, normal T-cell expressed, and secreted) concentration. We conclude that the concomitant loss of GSH and proteins in oxidatively stressed RBCs can compromise RBC scavenging function. Upregulating GSH synthesis can protect RBC scavenging (free radical and chemokine) function. These results have implications not only in a transfusion setting but also in conditions like diabetes and sickle cell anemia, in which RBCs are subjected to chronic/acute oxidant stresses.

[Correction of alimentary methemoglobinemia in children of preschool age by inclusion in the diet of products rich in antioxidants, vitamins and dietary fiber]. / Korrektsiia alimentarnoi metgemoglobinemii u detei doshkol'nogo vozrasta vkliucheniem v ratsion produktov, bogatykh antioksidantami, vitaminami i pishchevymi voloknami.

Supplementation of children diet with food enriched by vitamins, antioxidants and dietary fiber food (beverage 'Zolotoy shar', bread with addition of bran, 'doctorskije' rolls inhibited or normalized the lipid peroxidation of cell membranes, methemoglobin production and increased some indices of humoral immunity. The results allow to recommend the studied special food for prophylactic use for children dietary intake in regions of ecological pollution.

Oxygen radical-induced erythrocyte hemolysis by neutrophils. Critical role of iron and lactoferrin.

Human neutrophils (PMN), when stimulated with such chemotaxins as phorbol myristate acetate (PMA), destroy erythrocytes and other targets. Cytotoxicity depends on PMN-generated reactive oxygen metabolites, yet the exact toxic specie and its mode of production is a matter of some dispute. Using 51Cr-labeled erythrocytes as targets, we compared various reactive-O2 generating systems for their abilities to lyse erythrocytes as well as to oxidize hemoglobin to methemoglobin. PMA-activated PMNs or xanthine oxidase plus acetaldehyde were added to target erythrocytes in amounts that provided similar levels of superoxide. PMNs lysed 68.3 +/- 2.9% (SEM) of targets, whereas the xanthine oxidase system was virtually impotent (2.3 +/- 0.8%). In contrast, methemoglobin formation by xanthine oxidase plus acetaldehyde was significantly greater than that caused by stimulated PMNs (P less than 0.001). A similar dichotomy was noted with added reagent H2O2 or the H2O2-generating system, glucose plus glucose oxidase; neither of these caused 51Cr release, but induced 10-70% methemoglobin formation. Thus, although O2- and H2O2 can cross the erythrocyte membrane and rapidly oxidize hemoglobin, they do so evidently without damaging the cell membrane. That a granule constituent of PMNs is required to promote target cell lysis was suggested by the fact that agranular PMN cytoplasts (neutroplasts), although added to generate equal amounts of O2- as intact PMNs, were significantly less lytic to target erythrocytes (P less than 0.01). Iron was shown to be directly involved in lytic efficiency by supplementation studies with 2 microM iron citrate; such supplementation increased PMN cytotoxicity by approximately 30%, but had much less effect on erythrocyte lysis by neutroplasts (approximately 3% increase), and no effect on lysis in the enzymatic oxygen radical-generating systems. These results suggest a critical role for an iron-liganding moiety that is abundantly present in PMN, marginally so in neutroplasts, and not at all in purified enzymatic systems--a moiety that we presume catalyzes very toxic O2 specie generation in the vicinity of juxtaposed erythrocyte targets. The obvious candidate is lactoferrin (LF), and indeed, antilactoferrin IgG, but not nonspecific IgG, reduced PMN cytotoxicity by greater than 85%. Re-adding 10(-8) M pure LF to neutroplasts increased their ability to promote hemolysis by 48.4 +/- 0.9%--to a level near that of intact PMNs. We conclude that O-2 and H2O2 are not sufficient to mediate target cell lysis, but require iron bound to LF, which, in turn, probably generates and focuses toxic O2 radicals, such as OH, to target membrane sites.

The effect of ascorbic acid on sodium nitrite-induced methemoglobin formation in glucose-6-phosphate dehydrogenase-deficient erythrocytes.

Ascorbic acid significantly reduced the occurrence of sodium nitrite-induced methemoglobin (METHB) formation in a dose-dependent manner in erythrocytes from glucose-6-phosphate dehydrogenase (G-6-PD)-deficient humans in vitro. The ascorbic acid treatment, however, also decreased levels of reduced GSH in a dose-dependent manner, a response indicative of oxidant stress to the erythrocyte membrane. The latter findings are inconsistent with the hypothesis that ascorbic acid supplementation in G-6-PD-deficient humans may help compensate for inherently low levels of erythrocyte GSH. Finally, the ascorbic acid-induced reduction of METHB values, while of statistical significance, does not appear to be of clinical significance.

Dietary selenium and age-related susceptibility of rat erythrocytes to oxidative damage.

The effects of age and dietary selenium on cellular susceptibility to oxidative stress were studied in rat erythrocytes. Young (26 or 40 days) and mature adult (11 or 15 months) male rats were fed a Torula yeast-based low selenium and low vitamin E diet supplemented with either 0, 1.0 to 2.0 ppm selenium (as sodium selenite) for 5 weeks. The rates of spontaneous hemolysis amd methemoglobin formation and levels of glutathione (GSH), glucose-6-phosphate (G6P) dehydrogenase, but not of GSH peroxidase, GSH reductase, superoxide dismutase and catalase were significantly higher in the erythrocytes of young rats than in those of the adults. Adult rats, however, had higher levels of plasma vitamin E and GSH peroxidase than those of the young group. Dietary selenium markedly increased activity of plasma GSH peroxidase and partially retarded the rates of hemolysis and methomoglobin formation, but it had no significant effect on the erythrocyte levels of GSH, GSH reductase, catalse, G6P dehydrogenase and superoxide dismutase or plasma vitamin E levels of young rats. Except of GSH peroxidase activity, dietary selenium had no significant effect on any other measurements made in the erythrocytes or plasma of adult rats. The results suggest that the ability of adult rats. The results suggest that the ability of adult rats to retain higher levels of vitamin E and selenium than the young rats may be partly responsible for the increased resistance of their erythrocytes against oxidative stress.