Whole blood O2 equilibrium curves (OEC) were measured in 46 Peruvians native to high altitude (4,540 m) and in 25 sea-level controls. A method was employed that records the entire OEC from 0 to 150 Torr with constant pH and PCO2. The data were analyzed by fitting the Adair equation describing the successive oxygenation of hemoglobin. At pH 7.4 the PO2 at which hemoglobin is half-saturated with O2 (P50) was significantly higher in the high-altitude population (31.2 +/- 1.9 Torr) than in controls (29.2 +/- 1.8 Torr, P less than 0.001). The acid-base status of the high-altitude subjects, however, was that of compensated respiratory alkalosis (plasma pH 7.439 +/- 0.065), and when the P50's were corrected to the subjects' plasma pH the values (30.1 +/- 2.2 Torr) could no longer be distinguished from the controls. We conclude that, on the average, increased P50 resulting from increased red cell 2,3-diphosphyoglycerate concentration at high altitude is offset by compensated respiratory alkalosis with the net result that the position of the OEC more closely approaches that of sea-level humans than has hitherto been thought. Considerable variation exists in P50, both at sea level and high altitude. This variation might have important consequences for acclimatization and survival under adverse environmental conditions.

Male rats were raised from birth in either continuous light (LL) or in 14 h light/10 h dark per day (LD) at 22 +/- 1 degree C. Food and water were administered ad libitum. Groups of rats were killed by decapitation at 14, 20, 25, 35, 41, 45, 51, 55, 58, 63, and 79 days of age. Testicular (TW), ventral prostate (VPW), and seminal vesicle (SVW) weights were measured. Serum concentrations of follicle stimulating hormone (FSH), luteinizing hormone (LH), prolactin (PRL), and androgens were quantified by radioimmunoassay. Results indicate no significant change in TW or spermatogenesis. Spermatozoa were first seen in the lumen of 10% of seminiferous tubules at 35 days of age in both LD and LL rats and by 42 days of age, 80% of tubules from both LD and LL rats contained spermatozoa in the lumen. A highly significant depression in accessory structure development (VPW, SVW) was observed as a result of LL exposure. Serum FSH levels in LL rats were depressed on days 45, 51, 55, and 58 but elevated at 79. Serum PRL concentrations were elevated in LL rats on days 41, 55, 58, 63, and 79, whereas serum androgen levels were depressed on days 58, 63, and 79. Results suggest that exposure to LL results in delayed maturation of the accessory structures in the reproductive system of the male rat possibly as a result of reduced FSH or elevated PRL levels, which in turn may modify the rate and pattern of LH and/or androgen secretion.

Ten patients with sickle cell anemia underwent partial exchange transfusion with hemoglobin-A-containing cells using a technique that allowed hemoglobin concentration and blood volume to remain constant. The mean fraction of hemoglobin-A in these patients increased from 9% to 55%, but the mean hemoglobin concentration increased by only 1.44 g/dl. The exchange resulted in a large improvement in submaximal exercise capacity: the mean of the anaerobic threshold (the work at which lactic acid begins to accumulate in the blood) increased from 68 to 114 W. The mean work performed at a heart rate of 170/min, an estimation of maximal work capacity, increased from 128 to 187 W. Improved exercise performance after partial exchange transfusion may result from the superior flow properties of hemoglobin-A-containing red cells. Furthermore, we believe that exercise testing in sickle cell anemia has great potential utility as a means to monitor therapy and to evaluate the benefits of exchange transfusion.

Partial exchange transfusion is used to manage several of the complications of sickle cell anemia. Automated exchanges have been performed successfully in thirteen homozygous (SS) sickle cell patients and in one patient with hemoglobin SC. Although the expected acute increase in whole blood oxygen affinity occurred in each patient, there was no clinical evidence of detrimental effects during or immediately after each procedure, and in each case the patient was unchanged or improved when evaluated by exercise testing. By using a discontinuous-flow cell separator, it is possible to decrease the time required to achieve a 50 per cent exchange in an adult to approximately two hours. Transfusion of blood with an antigenic marker permits rapid evaluation of exchange efficiency during the procedure. When partial exchange transfusion is indicated, the discontinuous-flow cell separator provides a safe, rapid, and effective procedure.

The erythrocytes of 14 conditioned horses participating in a 157-km endurance ride (requiring 14-21 h) were examined before the ride, immediately upon entering the 44-91-, and 130-km rest stops, and at the finish. At the first rest stop (44 km), the mean erythrocyte count increased 41% (P less than 0.001), the mean hematocrit (Hct) increased 30% (P less than 0.001) and the mean hemoglobin (Hb) increased 33% ( P less than 0.001). Although subsequent mean erythrocyte counts, Hct, and Hb values remained significantly elevated above controls, the values decreased 9-9% from the 4-km values later in the ride. These changes suggest a lost of red cells mass during the prolonged exercise. Spiculated red blood cells that increased markedly in number during exercise were also observed in these conditioned horses. The appearance of an increased number of spiculated red cells with exercise was associated with corresponding changes in red cell indices.