Microcirculation in Circulatory Disorders

Nowadays, a knowledge of the microcirculation has become essential for a thorough understanding of the mechanism of organ disorders. In Osaka on 1-2 August 1987, a conference on microcirculatory disorders was held as the Satellite Symposium of the Fourth World Congress for Microcircu­ lation and to mark the tenth anniversary of the National Cardiovascular Center of Japan. It was an opportune time for such a meeting, which drew the attendance of biomedical scientists and clinicians from many different parts of the world. The pathophysiological significance of the microcirculation in ischemia and disease was elucidated with lively pre­ sentations dealing with both experimental and clinical aspects. The present volume summarizes the proceedings of that symposium. A review is made of recent advances in microvascular disorders, follow­ ing which cerebral, myocardial, and peripheral tissue ischemia, multiple organ failure, gastroenterological disorders, and methodology are closely examined. We wish to express our thanks to our contributors, who obliged us by submitting their manuscripts within the time limit. We are grateful to Prof. Masaharu Tsuchiya, President of the Fourth World Congress for Microcirculation, who generously allowed these proceedings to be pub­ lished. We would also like to thank Dr. Syoten Oka, Dr. Hiroshi Abe, Dr. Teruo Omae, Prof. Takenobu Kamada, Dr. Hiroshi Sakakibara, Dr. Tohru Sawada, and other members of the organizing committee. We are also obliged to Drs. Nobuko Tsushima, Nobuhiro Sato, Hiroaki Naritomi, and Ryu Nakayama for organizing the session symposia.

1 Recent Progress in Microcirculatory Disorders.- Microcirculation in Health and Disease.- Microvascular Flow Disturbances: Rheological Aspects.- Microvascular Regulation: Normal Function and Disturbance in Disease.- Oxygen Delivery and Microcirculation in the Brain.- Microvascular Permeability: Its Disturbance in Disease.- Microcirculation Dysfunction in an Environment of Weightlessness.- 2 Multiple Organ Failure.- How Hyperoxemia May Lead to Ischemia in Multiple Organs and Possibly to Organ Failure.- Multiple Organ Failure in Low Cardiac Output Syndrome After Cardiac Surgery.- Deteriorating Defense Mechanism for Bacterial Infection and High Incidence of Endotoxemia in Surgical Patients Developing MOF.- Prediction and Diagnosis of Low Cardiac Output Syndrome After Open-Heart Surgery: An Echocardiographic Study.- The Effect of Multiple Organ Failure on the Regulation of the Circulation with Special Reference to the Microcirculation.- Hemorheological and Coagulofibrinolytic Aspects in Multiple Organ Failure After Open Heart Surgery.- Organ Failure and Disseminated Intravascular Coagulation.- Microrheological Aspects: Their Crucial Role in Multiple Organ Failure.- Histopathological Study of Multiple Organ Failure Following Open Heart Surgery.- Multiple Organ Failure: Clinical Implications to Macro- and Microcirculation.- 3 Gastroenterological Disorders.- Structural Alterations of Mucosal Microvascular System in Human Chronic Gastritis.- Chemical Mediators in Ethanol-Induced Increased Jejunal Microvascular Permeability.- Gastric Microvascular Effects of the Pro-ulcerogenic Mediator PAF-Acether.- Gastric Microcirculatory Changes Associated with Physicochemical and Ionic Mediators.- Metabolic and Myogenic Control of Gastric Mucosal Blood Flow.- Leukocyte Adherence in Hepatic Microcirculation in Ischemia Reperfusion.- Role of the Hepatic Microcirculation in the Pathogenesis and Development of Alcoholic Liver Disease: Possible Involvement of Hyper-catecholaminemia in Alcoholic Liver Damage.- Abnormalities in the Hepatic Sinusoids: Pathological Basis of Self-perpetuation of Liver Cirrhosis.- Observation of Microcirculatory Disorders of the Hemorrhagic Rat Liver by Use of Fluorescence-Stained Gamma Globulins.- 4 Cerebral Ischemia and Hyperemia.- Cerebral Hemoconcentration Following Blood Flow Reduction in the Gerbil.- Plasma and Red Blood Cell in Focal Cerebral Ischemia: Differential Visualization with Double-Fluorescence Technique.- Cerebral Blood Volume Reactivity to Hypercapnia Measured by 11C-Labeled Carboxyhemoglobin and Positron Emission Tomography.- Capillary Density in Stroke Regions of the Living Human Brain.- SPECT Measurements of Regional Cerebral Blood Flow, Blood Volume, and Hematocrit in Stroke.- Endothelium-Dependent Relaxing Factors in Brain Microvessels.- Role of Oxygen Free Radicals in Focal Brain Ischemia.- Microcirculatory and Ionic Responses to Ischemia in the Mongolian Gerbil.- Postischemic Hyperemia.- Remote Hyperemia After Focal Cerebral Ischemia: Disinhibition Mechanism of Remote Hyperemia.- Cerebral Hyperemia and Breakthrough During Hypertension.- Maintenance of Constant Cerebral Blood Volume by Veni-Arterial Reflex.- Bordering Zone Hyperemia and Glucose Metabolism in Experimental Cerebral Ischemia.- 5 Myocardial Ischemia.- Influence of Myocardial Contraction on Coronary Microcirculation: Techniques and Results.- Changes in Coronary Microcirculation in Acute Ischemia.- Flow Characteristics in Poststenotic Regions of the Human Coronary Artery Assessed by 20-MHz 80-Channel Pulsed Doppler Velocimetry.- Coronary Collateral Circulation in Acute and Chronic Myocardial Ischemia.- Granulocyte Capillary Plugging in Myocardial Ischemia.- Nonesterified Fatty Acid Metabolism and Membrane Disorders in Myocardial Ischemia and Reperfusion.- Hemodynamic Factors Influencing Regional Ischemia and Infarction of the Myocardium: Difference Between Right and Left Ventricular Myocardial Infarction.- Chronic Changes in the Canine Myocardium After Coronary Microembolization.- Stenosis of Intramyocardial Small Arteries in Hearts with Hypertrophic Cardiomyopathy and Hypertensive Hearts.- 6 Ischemia of Peripheral Tissues.- Microcirculatory Studies on Epidural Spinal Cord Electrical Stimulation in Patients with Severe Lower Limb Ischemia.- Microcirculation of Canine Hindlimbs in Hemorrhagic Hypotension.- Impaired Microcirculation in Patients with Peripheral Vascular Disease: Pathophysiological and Therapeutic Aspects.- Nailfold Capillary Abnormalities in Patients with Connective Tissue Diseases.- The Interaction of Immune Complexes in Microcirculatory Impairment in Patients with Vasculitis.- Decubital Ulcers of Pads Induced by Hyperlipidemia in the Rabbit.- Microangiopathy in Diabetes Mellitus.- Microcirculation in Diabetic Gangrene.- 7 Methodology for Microvascular Disorders.- Regulation of Plasma Membrane Ca-Pump ATPase of Vascular Smooth Muscle by cGMP.- Molecular Regulation of Calcium, Calmodulin-Dependent Myosin Phosphorylation.- Erythrocyte Aggregation Induced by Immunoglobulin G and Related Macromolecules Studied with Rheoscope-Image Analyzer-Computer System.- Blood Pressure in Mesenteric Microvessels of Normotensive and Hypertensive Rats: Application of a Servo-Nulling Micropressure System.- Analysis of Diameter and Flow Velocity Changes in Small Pulmonary Vessels During Regional Alveolar Hypercapnia.- Measuring the Dimensions of a Thin Cylindrical Vessel by Processing Ultrasonic Reflections with an MEM Cepstrum.- Alterations in Membrane Fluidity of Hypertension Determined by an Electron Spin Resonance Method.- Assessment of Systemic and Regional Blood Flows with the Radioactive Microsphere-Reference Sample Method in Rats.- Angiotensin Converting Enzyme Activity in Brain Microvessels of Rats.- Assessment of the Adequacy of Mucosal Oxygenation in Patients with Intraluminally Located Silicone Tonomitors.- Comparative Studies on Microcirculation of the Pancreas in Anesthetized and Conscious Dogs.- Cerebral Microvascular Reserve for Hyperemia.- Correlation of Conjunctival Oxygen Tension with Carotid Artery Blood Flow During Hemorrhagic Hypotension.- Changes in Cerebral Regional Blood Flow and Tissue Oxygen Tension During Hemorrhagic Shock and Post-Cerebral Circulatory Arrest.- A Combined Method for Immunohistochemistry and Autoradiographic Measurement of Focal Cerebral Blood Flow in Investigation of Pathophysiological Roles of Microcirculation in Cerebral Ischemia.- Evaluation of the Behavior of Cerebral Blood Flow and Hemorheological Parameters with Infusions of Hydroxyethyl Starch and Low Molecular Weight Dextran in Normal Baboons.- Evaluation of Blood Flow Velocity Waveforms in Intramyocardial Artery and Vein by Laser Doppler Velocimeter with an Optical Fiber.- Determinants of Myocardial Oxygen Demand: Total Mechanical Energy and Contractility.- Pathophysiology of Acute Embolization of Small Coronary Arteries: Detrimental Effects of Oxygen-Free Radicals.- Author Index.