Biochemical alterations in blood in obliterative atherosclerosis.

Biocheniical alterations in blood due to pathologic chaiges in the legs are difficult to detect when the blood samples are taken from the cubital vein. In the reported investigations biochemical properties of this blood are compared with those of the venous blood flowing out from a leg affected by obliterative atheroselerosis. A THEROMATOUS processes developing iii the walls of the arteries as well as any consequent tissue ischemia necessarily produce biochemical alterations in the blood. The changes in the venous blood draining from the area affected by such atherosclerotic lesions become more difficult to detect, as this blood mixes with that from regions without vascu-lar changes. Therefore venous blood from the leg, affected by obliterative atherosclerosis was eompared with venous blood of the upper extremity showing no detectable vascular changes. Oxygen saturation (Vail Slyke method), serum protein level (refractometer) and its electrophoretic spectrum (paper elec-trophoresis), lipoproteins, serum cholesterol (Zlatkis), and total lipids (Swahln), serum glutamic-oxalacetic and glutamie-pyruvic transaminases activity (Reitman and Frenk-el), serum aldolase activity (Lehninger, Bruns), proteolytic activity of plasma and total blood (Balachowski and Balachowski), and amino acid levels (Folin) and composition in the blood serum (paper circular chroma-tograplhy) were exanmined. No signrifieanit differences +s were found in these components of the blood takeni from upper and lower extremities of healthy .control subjects. In 25 patients suffering from ob-literative atherosclerosis of lower extremities, the total protein level showed no changes, but hypoalbuminemnia and hyperglol)uliniemia (especially gamma) were commoimly fouiid. Only the alpha1 globulin level was constant, and alwzNays within normal ranges (table 1). The lil)oproteiii index was found to be increased iii one quarter of the eases and was high more often iii patients witli geieralized atherosele-r osis. It should be noted that, on the coiI-trarv, in Buerger 's disease the lipoproteiii index is always normal. No differences were obtained between the protein and lipoproteiii l)atterns iii the blood samples taken from the leg and the arm. W\\e (lid not observe ainy eharacteristie alterations in the cholesterol level. The total lipid level was increased in one thirdl of the cases. This findinlg was, however, independent of the degree of morbid change and of the vein from which the blood was taken. An increase in the plasma transaminiase activity was found in these eases. This was more marked and more constant in the venous blood of the affeeted leg than of the healthy arm, which suggests that a necrotic …