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The hemoglobin concentrations during pregnancy in Filipinos belonging to the upper income group, who were prescribed 105 mg elemental iron daily, and who had acceptable levels of transferrin saturation, were examined in an attempt to define normal levels. The hemoglobin concentrations for each trimester followed a Gaussian distribution. The hemoglobin values equal to the mean minus one standard deviation were 11.4 gm/dl for the first trimester and 10.4 gm/dl for the second and third trimesters. Using these values as the lower limits of normal, in one group of pregnant women the prevalence of anemia during the last two trimesters was found lower than that obtained when WHO levels for normal were used. Groups of women with hemoglobin of 10.4 to 10.9 gm/dl (classified anemic by WHO criteria but normal in the present study) and those with 11.0 gm/dl and above could not be distinguished on the basis of their serum ferritin levels nor on the degree of decrease in their hemoglobin concentration during pregnancy. Many subjects in both groups, however, had serum ferritin levels less than 12 ng/ml which indicate poor iron stores. It might be desirable in future studies to determine the hemoglobin cut-off point that will delineate subjects who are both non-anemic and adequate in iron stores using serum ferritin levels as criterion for the latter.

1. The haemoglobin, haematocrit, transferrin and serum iron of a group of 418 healthy medical students, aging from 18 till 25 years, were determined. The mean Hb for the male students was 9.4 +/- 0.63 mmol/l, for the female students 8.7 +/- 0.56 mmol/l. 2. The correlations between Hb, Ht, SeFe and transferrin have been investigated. A positive correlation exists between Hb and SeFe and Ht and SeFe.

Haemoglobin (Hb) and transferrin (Tf) types were determined in 760 Finnsheep and correlated with the reduced glutathione (GSH) levels of packed erythrocytes. The gene frequencies of the two haemoglobin alleles A and B were: HbA = 0.748 and HbB = 0.252. Five transferrin alleles were found: A, B, C, D and E, with gene frequencies of 0.056, 0.226, 0.620, 0.075 and 0.023, respectively. The Hb B group had significantly higher GSH levels and lower haematocrit values than heterozygotes (Hb AB) and homozygote (Hb AA). There was no significant difference in GSH concentration among the haemoglobin types in lambs. Erythrocyte glutathione levels of Tf BC ewes were significantly higher than the levels in sheep with other transferrin types, whereas young lambs of Tf AB types had the highest GSH levels. The significance of these findings is discussed.

This paper reviews and reports the results of experiments on the mechanism by which iron is delivered from extracellular transferrin to reticulocyte mitochondria in which haem is synthesized. It is suggested that transferrin donates the iron directly to mitochondria. Transferrin seems to be bound to mitochondria during the process of iron release. When the release of iron from transferrin is blocked by haem, the iron-transferrin complex remains bound to mitochondria so that the total amount of transferrin molecules associated with mitochondria increases in haem-treated reticulocytes. This also leads to an increase in the number of transferrin molecules in the cytosol. In haem-deficient reticulocytes, the rate of dissociation of iron from transferrin is accelerated and the uptake of iron by mitochondria is increased. When the synthesis of haem is inhibited, the non-haem iron in the cytosol (i.e. mainly low-molecular-weight and ferritin iron) comes from mitochondria. Greater amounts of non-haem iron can also be induced in reticulocytes incubated with highly saturated transferrin but, in this case, iron does not seem to be accumulated in mitochondria. These results represent an experimental basis for the elucidation of the excessive non-haem iron accumulation in erythroid cells observed in various clinical conditions.

In order to obtain some information about the state of hydration and possible haematological changes in patients with delirium tremens (grade 3) and related clinical states (grade 2) various clinico-chemical variables were measured at the time of admission and repeatedly until clinical recovery from the psychotic state. In grade 3 patients plasma protein concentration, blood haemoglobin concentration, blood haematocrit and erythrocyte count decreased between admission and recovery probably reflecting a slight haemodilution. The changes were all within the normal range for the variables and there was thus no indication of hypo- or hypervolemia. Delirium tremens patients without concomitant somatic diseases should not be routinely treated with intravenous fluid therapy. In grade 2 patients no statistically significant changes occurred in the above mentioned variables. In the grade 3 patients there was a dramatic (100%) increase in plasma iron concentration between admission and the subsequent morning and this was probably related to the elimination of ethanol from the body. In grade 2 patients, where the initial blood alcohol concentration was lower than in grade 3 patients, no change in plasma iron concentration occurred. A statistically significant increase in reticulocyte count between admission and recovery in both grade 3 and grade 2 patients probably reflected the recovery of haemopoietic tissue from the insult of the preceding ethanol intoxication. The same may be true for the prevailing anisocytosis, whereas the trend towards leucocytosis may be due to unspecific stress during the ethanol withdrawal reaction. The rapid changes in some of the clinico-chemical variables stress the importance of initiating investigational procedures immediately at the hour of admission.