Hyperchromia (HYPOCHROMIA, here are only chemical features of)

HYPERCHROMIA, HYPOCHROMIA, here are only chemical features of constitution. In hypertensive asthenics, cholesteremia is normal, as is in renal hypertension. In diabetes, in severe cases (with acidosis), the amount of cholesterol in the blood may increase strongly along with other lipoids; a fact connected with the process of improper burning of fats. The influence of infectious-toxic factors. Acute febrile diseases (typhoid fever and others) cause, in the first period, a decrease, and in the period of recovery, a slight increase of cholesterol in the blood. This is interesting in connection with the fact that cholesterol is attributed detoxifying properties with respect to bacterial toxins. In chronic infectious diseases, the matter is more complicated. In tuberculosis, cholesterol in the blood usually does not change. In syphilis in the II and III stages there is a tendency to hypercholesterolemia, apparently only with extensive skin manifestations. Syphilis of the aorta and gummatous hepatitis are not accompanied by hypercholesterolemia. Yet, in no other disease in man is there such high cholesteremia as in "lipoid" nephrosis (up to 10%), whether syphilitic, tuberculous, or of another nature. The urine in this case also contains a mixture of cholesterol in the form of doubly refracting crystals. In the tubules, lipid infiltration is observed. Cholesterol metabolism in nephrosis is disturbed not in isolation, but there is a general change in the colloidal state of proteins and other substances (Munk). Glomerulonephritis is not accompanied by hypercholesterolemia. Severe anemias, especially pernicious anemia, are accompanied by a sharp impoverishment of the blood with cholesterol (up to 0.6%). Cholesterol plays a role in the matter of protecting cells from certain physical and chemical influences (for example, it increases the resistance of red blood cells with respect to hemolytic poisons). Cholesteremia also decreases after hemorrhages, in secondary anemias. Hypocholesterolemia in anemia goes parallel with the decrease in the number of red blood cells, and it is possible that it depends on the redistribution of lipoids between plasma, red cells, and tissues. The data set forth note only characteristic fluctuations of cholesteremia, but in individual cases they may or may not be present or they may be of an opposite character. Cholesteremia is only a witness to deeper processes of cholesterol metabolism, its level depends on the colloidal-chemical conditions of the environment, and its meaning will become clearer upon its study in combination with the metabolism of other substances of the blood and tissues.

HYPERCHROMIA, HYPOCHROMIA [hyperchrom(emia), hypochrom(emia)], increase, resp. decrease of the quantity of Hb in the erythrocytes of the blood. The content of Hb in erythrocytes is determined by calculating the so-called color index (Farbeindex) by the formula:

found quantity of Hb found quantity of erythr. Color. index

'

--------- i.e. color.index = color.index = normal quantity of Hb ' normal quantity of erythr. found quantity of Hb n % of normal ~ found quantity of erythr. in % of normal' found quantity of Hb in % , or, simpler: doubled, found quantity of erythr. in hundreds of thousands. In the norm, color index = 1. In pathological cases it may decrease (to 0.5 and lower) - hypochromia, sometimes it increases (to 1.5 and higher) - hyperchromia. The calculation of the color index has great significance in clinical practice. Its fluctuations in anemias served as the basis for their subdivision into hypochromic anemias (with color index < 1) and hyperchromic anemias (with color index > 1). To hypochromic anemias belong: chlorosis, anemias after hemorrhages, in malignant tumors, infectious diseases, anemias from animal parasites (except the broad tapeworm, which causes anemia of the hyperchromic type) and others. Hypochromic anemia is also caused by some hemolytic poisons (pyrogallol, toluenediamine and others). To hyperchromic anemias belong the so-called pernicious anemia, anemia caused by cancer metastases in the bone marrow and some hemolytic poisons (for example: K3SO3, nitrobenzene, hydroxylamine, pyridine and others), anaemia pseudoleukaemica infantum, some cases of hemolytic jaundice, botryose anemia and anemia in lymphatic leukemias. Hyperchromia is also observed in embryonic blood and in hypothyroidism. Speaking of hyper-, hypochromia, one usually has in mind the change in the absolute content of Hb in the erythrocyte, not taking into account the volume of the corpuscle and the degree of its saturation with Hb (relative color index, saturation index, Sattigungsindex). The latter is calculated by determining the volume of erythrocytes. The volume of erythrocytes occupies in the norm about 44% of whole blood (in men 46%, in women 42%). The saturation index (relative index) is calculated in the same way as the absolute index (Farbeindex), substituting in the above-mentioned formula instead of quantitative relations of erythrocytes their volumetric relations, i.e.: found quantity of Hb found % of volume of erythrocytes _ normal quantity of Hb '

norm. % of volume. In the norm, saturation index = 1. Alder, Naegeli (Alder, Naegeli) and others use the following simple formula for determining the saturation index: found quantity of hemoglobin in % found % of volume of erythrocytes By this formula, saturation index is considered in the norm = -°-=2.27. The average volume of erythrocyte is determined by dividing the volume of erythrocytes located in a unit volume of blood by their quantity in the same unit volume; in the norm, the average volume of erythrocytes is - 0.44 cu. mm ₀₀ " equal to -^Гооо1ю(Г"^{= 88}&lt;" The cause of hyperchromia in cases of hyperchromic anemias is the increase of the average volume of erythrocytes (macrocytosis) to 150/ and more. Relative hyperchromia, i.e. increase of saturation of hemoglobin in each unit volume of erythrocyte, is almost not observed. All anemias (including anemias with color index > 1) proceed with relative normo- or hypochromia. Hyperchromia is by no means rare, and pathogenetically this phenomenon must be linked with phenomena of intensified regeneration, at which the bone marrow throws into the blood larger (resp. rich in hemoglobin) erythrocytes. This takes place in erythropoiesis of the type of early embryonic (embryo, pernicious anemia) and of the later type (blood poisons, hemolytic and childhood anemias) (Naegeli).-Hypochromia is in no way connected with the average volume of erythrocyte. Often one can note in the same stained preparation, along with erythrocytes of normal color and single hyperchromic ones, also forms very pale ("shadows").-See also Hypochromia.