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The red blood cells stack up like coins. http://en.wikipedia.org/wiki/Rouleaux
Autoagglutination should also be distinguished from "Rouleaux formation" wherein normal blood tends to form stacks on keeping, which disperses on dilution with normal saline.
Rouleaux refers to the stacking of red blood cells (erythrocytes) in human blood. Rouleaux formation is enhanced in the presence of increased plasma proteins, leading to an increased erythrocyte sedimentation rate (ESR).
When rouleaux formation is truly present, it is caused by an increase in cathodal proteins, such as immunoglobulins and fibrinogen.And the fibrinogen is not present in blood in vivo*This is not true. Fibrinogen is secreted by liver and is present in blood. The reason rouleaux do not form in vivo is that they only form under low shear stress conditions. With blood flow, the cross-sectional fluid velocity gradient in the blood vessel results in shear stress levels that exceed the threshold for rouleaux formation.
Multiple Myeloma
Rouleaux formation occurs when red blood cells form rolls or stacks. If not due to an artifact, such as a result of not preparing the blood smear soon enough after placing the blood on the slide, it may be due to the presence of high concentrations of abnormal globulins or fibrinogen. This formation is found in multiple myeloma and macroglobulinemia.
clinical importance of pleural recess
This question probably is spelled wrong (roulex). A rouleaux formation is: A stacklike arrangement of red blood cells in blood or in diluted suspensions of blood in which their biconcave surfaces are next to each other.
There is a great clinical significance of calcification. Calcification can lead to things like kidney stones that are very painful.
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Clinical significance of cortical thickening of the femur
look for a paper being published in "The Oncologist" later this year (2008)