The local formation of blood pigments

Muir, Robert; Niven, Janet S. F.

doi:10.1002/path.1700410116

Cited by 43 publications

(15 citation statements)

References 7 publications

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“…The successive enzymatic conversion by phagocytes of the ingested hemoglobin (dark red) methemoglobin or hematin (dark brown) to biliverdin (green-blue) and eventually to bilirubin (yellow) is responsible for the characteristic color play in s.c. bruises. Hemosiderin-laden macrophages (brown) may contribute to the color spectrum [4]. Furthermore, the activity of heme oxygenase starts decreasing at the time when most of hemoglobin of these experimental hematomas has disappeared [2].…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, the time (2 days) necessary for the increase of heme oxygenase seems to be dependent on the time needed to mobilize phagocytic cells to the hematoma site as well as on the time needed for enzyme induction in these phagocytic cells. In fact, phagocytes are known to appear in hemorrhagic areas 1 day after injury [4]. After induction of the appropriate lysosomal [1] and microsomal enzymes, the hemoglobin is degraded into its catabolites, bilirubin, iron, and amino acids, which are then gradually re-leased into the extracellular space.…”

Section: Discussionmentioning

confidence: 99%

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Hemoglobin-degrading enzymes in experimental subcutaneous hematomas

Laiho

Tenhunen

1984

Z Rechtsmed

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The activities of heme oxygenase and biliverdin reductase were determined in subcutaneous (s.c.) hematomas of rats after different periods of vital time. The postmortem stabilities of the heme-degrading enzymes were also studied by keeping the rats with vital hematomas for 1-5 days at temperatures of +4 degrees C and +22 degrees C. A tenfold increase of heme oxygenase activity over the starting level was observed in 2-9-day-old vital hematomas, when the specimens were taken immediately after death. Biliverdin reductase showed only negligible changes. Postmortally, heme oxygenase activity started to decrease in hematomas immediately at +22 degrees C and from day 2 on at +4 degrees C.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Hemoglobin-degrading enzymes in experimental subcutaneous hematomas

Laiho

Tenhunen

1984

Z Rechtsmed

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“…Hematoidin crystals are golden-colored under ordinary light microscopy, as noted in the specimen described here (Figure 2). In tissue sections and cytologic specimens, these crystals may appear as (a) fine, small needles arranged radially to form cockleburs of various sizes, usually ranging from 2 p to 25p, but occasionally reaching loop; (b) irregular-shaped, mostly minutesized crystals; (c) minute spheroids, commonly occurring in small aggregates; or (d) monoclinic rhomboidshaped crystals of various sizes (24,25). Under polarizing light microscopy, they present variable birefringence.…”

Section: Discussionmentioning

confidence: 99%

Is it mandatory to examine synovial fluids promptly after arthrocentesis?

Kerolus

Clayburne

1989

Arthritis & Rheumatism

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Fifty synovial fluid (SF) samples from patients with various types of arthritis were examined promptly after joint aspiration and after storage at room temperature (22°C) or at refrigerator temperature (4°C) for 1 hour, 2 hours, 3 hours, 6 hours, 1 day, and 3 days, then weekly for 3 weeks and monthly for 2 months. We found that the leukocyte count (white blood cell [WBC] count) decreased within a few hours. In 4 SF samples from patients with mild inflammation (initial range 3,150-6,200 WBC/mm3), the WBC count decreased into a "noninflammatory" range (<2,000/mm3) within 5-6 hours. In 3 of 5 SF samples that on the first day were found to be laden with crystals of calcium pyrophosphate dihydrate (CPPD), the crystals were much less abundant and were difficult to recognize by the next day. CPPD crystals dissolved completely in all SF samples by 3-8 weeks of the study. Monosodium urate crystals remained detectable throughout the 8 weeks of study, but they became smaller, less birefringent, and less numerous with time. Clumps of apatite-like crystals persisted for several months. Most SF samples initially negative for apatite-like crystals remained negative over time. New, artifactual crystals, including alizarin red S-positive clumps or star-shaped arrays, plate-like structures, positively birefringent Maltese crosses, and hematoidin crystals, developed with time. Because of these observations, we urge prompt examination of SF specimens to avoid the problems of misdiagnosing borderline inflammatory fluids, missing CPPD crystals that dissolve with time, or over-interpreting the findings because of the new, artifactual crystals.Analysis of synovial fluid (SF) is widely recognized as an important part of the diagnostic evaluation of patients with arthritis and joint effusion (1,2). It is particularly important in diagnosing septic arthritis and crystal-induced arthritis (3), and it allows classification of joint diseases into characteristic groups identified by inflammatory, "noninflammatory," or bloody effusions (4). Examinations of SF samples are often delayed for several hours, and when samples are sent for consultational evaluation, the analysis may be delayed for days. There have been few studies of any of the possible consequences of such delays (3, and our concern was that delayed interpretation might lead to important alterations in the constituents of the SF that could change the clinical impression or diagnosis.To explore this possibility, we sequentially examined 50 SF specimens over a 2-month period. We studied fresh samples of SF and then studied the same fluids after storage at room temperature or in the

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“…Although the color of blood is red, due to the hemoglobin molecule, the appearance of extravasated blood within the skin varies according its oxygenation and the depth of its location below the skin's surface [3][4][5][6]. When blood is released into the skin as a result of trauma, there is an ensuing inflammatory reaction: hemoglobin is catabolized into the yellow pigment bilirubin [7,8] and the golden-brown pigment hemosiderin. Eventually, bilirubin and hemosiderin are removed by the macrophages and a healing reaction follows with a gradual fading of color.…”

Section: Introductionmentioning

confidence: 99%

Use of reflectance spectrophotometry and colorimetry in a general linear model for the determination of the age of bruises

Hughes¹,

Langlois

2010

Forensic Sci Med Pathol

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Bruises can have medicolegal significance such that the age of a bruise may be an important issue. This study sought to determine if colorimetry or reflectance spectrophotometry could be employed to objectively estimate the age of bruises. Based on a previously described method, reflectance spectrophotometric scans were obtained from bruises using a Cary 100 Bio spectrophotometer fitted with a fibre-optic reflectance probe. Measurements were taken from the bruise and a control area. Software was used to calculate the first derivative at 490 and 480 nm; the proportion of oxygenated hemoglobin was calculated using an isobestic point method and a software application converted the scan data into colorimetry data. In addition, data on factors that might be associated with the determination of the age of a bruise: subject age, subject sex, degree of trauma, bruise size, skin color, body build, and depth of bruise were recorded. From 147 subjects, 233 reflectance spectrophotometry scans were obtained for analysis. The age of the bruises ranged from 0.5 to 231.5 h. A General Linear Model analysis method was used. This revealed that colorimetric measurement of the yellowness of a bruise accounted for 13% of the bruise age. By incorporation of the other recorded data (as above), yellowness could predict up to 32% of the age of a bruise-implying that 68% of the variation was dependent on other factors. However, critical appraisal of the model revealed that the colorimetry method of determining the age of a bruise was affected by skin tone and required a measure of the proportion of oxygenated hemoglobin, which is obtained by spectrophotometric methods. Using spectrophotometry, the first derivative at 490 nm alone accounted for 18% of the bruise age estimate. When additional factors (subject sex, bruise depth and oxygenation of hemoglobin) were included in the General Linear Model this increased to 31%-implying that 69% of the variation was dependent on other factors. This indicates that spectrophotometry would be of more use that colorimetry for assessing the age of bruises, but the spectrophotometric method used needs to be refined to provide useful data regarding the estimated age of a bruise. Such refinements might include the use of multiple readings or utilizing a comprehensive mathematical model of the optics of skin.

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The local formation of blood pigments

Cited by 43 publications

References 7 publications

Hemoglobin-degrading enzymes in experimental subcutaneous hematomas

Hemoglobin-degrading enzymes in experimental subcutaneous hematomas

Is it mandatory to examine synovial fluids promptly after arthrocentesis?

Use of reflectance spectrophotometry and colorimetry in a general linear model for the determination of the age of bruises

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