State Of Microcirculation Research Articles

STATE OF MICROCIRCULATION AND FREE-RADICAL PROCESSES OF PERIODONTAL TISSUES IN SMOKING DEPENDENT PATIENTS WITH CHRONIC GENERALIZED PERIODONTITIS ASSOCIATED WITH CHRONIC HYPERACID GASTRITIS

The aim: The aim of the work was to determine the state of microcirculation and free radical processes of periodontal tissues in smoking dependent patients with chronic generalized periodontitis associated with chronic hyperacid gastritis. Materials and methods: We examined 90 patients (men and women) aged 25 to 44 years, who were divided into 3 groups: the first group - 48 smoking patients with chronic generalized periodontitis and chronic hyperacid gastritis associated with Helicobacter pylori; the second group - 22 patients with chronic generalized periodontitis and chronic hyperacid gastritis associated with Helicobacter pylori, without the bad habit; the third group - control, consisted of 20 healthy individuals. The smoking patients were randomly divided into two subgroups: patients of the first subgroup (G1.1) received the basic therapy of chronic generalized periodontitis and the proposed treatment and prevention complex; the patients in the second subgroup (G1.2) received basic therapy for chronic generalized periodontitis and ultraphonophoresis with placebo. Results: The use of treatment and prevention complex in smoking dependent patients and patients without the bad habit with chronic generalized periodontitis and chronic hyperacid gastritis associated with Helicobacter pylori demonstrated a positive dynamics of the functional characteristics of microcirculation and the balance in the lipid peroxidation – antioxidant system. Conclusions: So, the use of the proposed treatment and prevention complex had a positive effect on the state of microcirculation and free radical processes of periodontal tissues both at the near and long-term follow up, even under conditions of chronic hyperacid gastritis and the risk factor – smoking.

The use of rehabilitation programs for patients in the early recovery period after total knee arthroplasty

Scientific substantiation of the feasibility of the combined use of low-intensity laser radiation (LILR) and PLFEF in patients after total knee arthroplasty. 90 patients aged from 55 to 80 years after total knee arthroplasty were examined. All patients were randomly assigned to three groups. Patients of the 1st group underwent therapeutic exercises with an instructor and low-intensity laser exposure; in the 2nd group, therapeutic exercises with an instructor, low-intensity laser therapy, and PLFEF were performed without a time interval; patients of the 3rd group received only therapeutic exercises with an instructor. After the course of treatment, a positive dynamics of the state of microcirculation was noted in all patients, which correlated with a significant regression of the pain syndrome and an improvement in the performance of the 10-meter walk test with external support on crutches. However, a more significant decrease in pain intensity after the first procedures and at the end of the course of treatment was found in the group of patients who received complex therapy, which included LILR, PLFEF, and therapeutic exercises. Thus, based on the data of this study, it is possible to recommend the combined use of LILR and PLFEF for the treatment of patients after total knee arthroplasty.

ПЕРФУЗІЙНА ДИСФУНКЦІЯ ПРИ ГОСТРОМУ ПАНКРЕАТИТІ: ПЕРСПЕКТИВНІ НАПРЯМКИ УДОСКОНАЛЕННЯ ДІАГНОСТИКИ ТА СТРАТИФІКАЦІЇ ЗАХВОРЮВАННЯ

Introduction. Acute pancreatitis (AP) is one of the most common diseases of the digestive system that require hospitalization. To date, the problem of stratification and differential diagnosis of AP in the early stages remains unresolved, which encourages the search for new methods of diagnosis and prediction of the severity of AP. Aim. To evaluate the possibility of creating a clinically oriented system of stratification and prognosis of AP on the basis of dynamic changes in microcirculation depending on the duration of the disease and severity of AP. Materials and methods. Assessment of the state of microcirculation (MC) of patients by laser Doppler flowmetry (LDF) was performed with the “LAKK-02” device. Kruskal-Wallis non-parametric analysis of variance and the median test were used to test statistical hypotheses when comparing independent samples. Pairwise comparison of independent samples was performed using the Mann-Whitney U test. Results. The study determined the indicators of MC in patients with different AP severity degrees on the first day of the disease. The microcirculation parameter (MP) in patients with mild, moderate, and severe AP was 3.9; 3.8 and 6.8 perfusion units (p.u.), respectively. The blood flow modulation rate (ơ) was 0.52; 0.54 and 0.69 p.u. in mild, moderate, and severe AP. In our study, the coefficient of variation (Kv) averaged 17.3%; 20.0% and 11.7% in patients with mild, moderate, and severe AP, respectively. Conclusions. LDF in AP is an informative method of diagnosing the state of MC, which is a universal link in all pathophysiological reactions of the organism. Changes of MC in AP depend on the severity of AP and the period of the disease. The pathophysiological microcirculatory phenomena, revealed on the first day of the disease, provide us with the perspectives of early clinical distinguishing the moderate and severe forms of AP from the so-called group of “destructive forms”.

State of microcirculation in patients with genital condylomas of the anogenital area and characteristics of efficiency of treatment at the period of preoperation

Introduction. Determination of the state of microcirculation in patients with genital warts (GW) of the anogenital area and the effectiveness of correction at the stage of preoperative treatment. 
 The aim of the study. Determination of the state of microcirculation in patients with genital warts (GW) of the anogenital area and the effectiveness of correction at the stage of preoperative treatment. 
 Materials and methods. 105 patients (63 – 60 % women; 42 – 40 % men) with genital warts with anogenital lesions were examined and treated: single acute warts – 36 (34,29 %); multiple acute warts – 66 (62,86 %); giant Bushke-Levenstein warts – 3 (2,86 %.). Control group consisted of 20 healthy people (women 10 – 50 %; men 10 – 50 %). Assessment of local circulatory status was determined by laser Doppler flowmetry with a wavelength of 0,63 μm (in the red range). The indicator of microcirculation (IM) – amplitude of oscillations of blood circulation in real time and its average value (M) were determined; standard deviation (SD) of the amplitude of blood flow fluctuations from the mean value of M; Cv – coefficient of variation - reflects the relationship between perfusion and its variability: Cv = σ / M×100 %
 The examination was performed in two clinical groups during the initial examination, after 2 weeks of preoperative preparation and in the dynamics of observation in the postoperative period. All patients received immunomodulatory, antiviral and topical therapy for two weeks, which included antiseptic and hyaluronic acid. The first group included 70 patients who were prescribed Tivortin Aspartate (L-arginine Aspartate) 2 weeks before surgical treatment. The second group consisted of 35 patients and was comparative in monitoring the effectiveness of treatment. 
 Results and Discussion. The state of microcirculation among healthy subjects was characterized by variability in the amplitude of oscillations with preserved active and passive regulatory mechanisms. 
 In patients with single acute warts, blood circulation corresponded to the spastic form of disorders, which was characterized by: low amplitude of oscillations M – (4,60 ± 0,06) pf.un. (p < 0,05), decrease in SD – (0,56 ± 0,03) pf.un. (p < 0,05) and Cv – (12,23 ± 0,58) % (p > 0,05). Patients with multiple GW were characterized by a hyperemic type of microcirculation, which accompanies the inflammatory process and, but occurs due to decreased venous circulation: M – n (12,29 ± 0,32) pf.un. (p < 0,05), SD – (0,66 ± 0,03) pf.un. (p < 0,05), Cv – (5,52 ± 0,22) % (p < 0,05). In patients with giant Bushke-Levenstein warts, changes in blood flow varied from hyperemic type with values of M – (18,92 ± 0,55) perfusion units (p < 0,05), SD – (0,55 ± 0,21) pf.un. (p < 0,05), Cv – (2,95 ± 1,17) % (p < 0,05); to stagnant in the combination of Bushke-Levenstein warts with necrosis and phlegmon of the perineum: M – (19,81 ± 0,13) pf.un. (p < 0,05), SD – 0,40 pf.un., Cv – 2,0 %.
 Positive changes in microcirculation at the end of preoperative preparation were more pronounced in the first group, where L-arginine aspartate was used, which was manifested in a significant increase in Cv, SD and variability of M. 
 Conclusions. Changes in microcirculation in patients with acute genital warts of the anogenital area are realized in 3 variants: spastic – in patients with single GW, hyperemic - in patients with multiple GW, stagnant, which acquired maximum disorders in patients with giant Bushke-Levenstein warts. 
 L-arginine has a positive effect on microcirculation in the focus, and regardless of the initial type (hyperemic or spastic, stagnant), contributes to its changes towards normalization. This efficiency can be explained from the standpoint of the direct effect of L-arginine as a nitrogen donor on the active mechanisms of regulation of microcirculation. 
 Significant changes in microcirculation towards normalization with less pronounced positive dynamics in patients of the second clinical group, due to the indirect effect on the state of microcirculation due to the influence of systemic antiviral treatment, local therapy on the pathological process.

The state of microcirculation with different perfusion intensity in the pulp and periodontal in young patients with functional disorders of the masticatory apparatus against the background of connective tissue dysplasia

The state of microcirculation of the periodontal and dental pulp can be used to identify and assess early signs of inflammation and chronic pain in the diagnosis of temporomandibular joint dysfunction syndrome (TMJ).
 The aim of the work was to evaluate typical microcirculation disorders (MCC) and mechanisms of perfusion regulation at different intensities in the pulp and periodontal of intact mandibular teeth in patients with TMJ dysfunction syndrome on the background of connective tissue dysplasia (DST).
 Material and methods. The main characteristics of the MCC of periodontal and pulp of intact teeth were studied by laser Doppler flowmetry in patients with TMJ dysfunction syndrome, united in the main (with DST) and control (without DST) groups.
 Results and discussion. A comparative analysis of the characteristics of MCC in the studied groups was carried out, taking into account different ranges of perfusion intensity values in the pulp and periodontal. Typical MCC disorders and the values of the ischemic index were determined at different perfusion intensity in the periodontal and in the pulp. Based on their analysis, differences in the mechanisms of regulation in patients from the control and main groups were revealed. Statistical verification of the reliability of the obtained results was carried out.
 Conclusions. It is shown that the nature of the distribution of patients across three ranges of values of MCC indicators is significantly different in the studied groups. A different relationship between the nature of MCC and the intensity of perfusion was revealed. It is concluded that the distinctive functional features of MCC in periodontal and dental pulp in patients of the studied groups are determined by the presence of DST, differences in the control of perfusion modulations, high functional activity of sympathetic calving of the autonomic nervous system with pronounced depression of cellular and humoral links of immunity.

Laser doppler flowmetry as the advanced non-invasive method of evaluation оf microcirculation status in patients with diabetes mellitus

Currently, the problem of diabetes mellitus (DM) is one of the most important medical and social challenges worldwide. This is primarily due to the widespread prevalence of the disease and tendency to further increase in the incidence of diabetes mellitus.Systemic microcirculatory disorders play an impor­tant role in the pathogenesis of DM complications. They lead to the development of microangiopathy and neuropathy through the primary lesion of vessels involved in the blood supply of the peripheral parts of the nervous system. Currently, less than one-third of physicians recognize signs of peripheral neuropathy associated with diabetes. Untimely diagnosis contributes significantly to high morbidity, disability, and mortality.The authorinvestigates the experience of the use of laser Doppler flowmetry (LDF) in clinical practice as a method of studying the state of the microcirculatory bed in patients with diabetes mellitus.LDF is a non-invasive quantitative method of microcirculation assessment; its capabilities include the analysis of microcirculatory rhythms and functional testing with different types of provocative effects, which provides with investigating the state of regulatory mechanisms of microcirculation. The prevention and treatment of various microcirculatory disorders is one of the most important problems of medical practice. The difficulties of studying the microcirculation are caused by the very small size of microvessels and strong ramification of intra-organic vascular networks. The use of LDF in scientific research will make it possible toreveal the DM-specific changes in microcir­culatory bed functioning. The findings of some studies suggest that microcirculatory disorders are not only a pathogenetic link in the development of complications, but they are also observed in patients with early disorders of carbohydrate metabolism and may precede the manifestation of diabetes. However, the method has not yet become widespread in clinical practice.

Evaluation of changes in laser Doppler flowmetry indices in patients with a combined subtype of rosacea under the influence of a course of complex phototherapy

BACKGROUND: The development of new methods for the treatment of rosacea, as well as a combination of various methods of physiotherapy, is of scientific and practical interest. In this work, the assessment of changes in microcirculation indices under complex phototherapy has been carried out.
 AIMS: Тo assess changes in microcirculation indices in patients with a combination of rosacea subtypes according to laser Doppler flowmetry under a course of complex phototherapy.
 MATERIAL AND METHODS: In 20172020 a randomized controlled study of 130 patients with a combination of rosacea subtypes. All patients were divided into 4 groups. In each separate group, laser therapy and 1% metronidazole cream were used (group I); phototherapy and 1% metronidazole cream (group II); complex photolaser therapy and 1% metronidazole cream (group III); in the comparison group (group IV), patients show only 1% metronidazole cream. The treatment, the duration of which was 3 months, included 6 sessions with an interval of 2 weeks. The effectiveness of therapy was assessed according to the data of laser Doppler flowmetry, reflecting changes in the hemodynamics of the microvasculature in the affected skin areas.
 RESULTS: The developed complex method, including exposure to intense pulsed light (intense pulsed light, IPL) 5201100 nm in combination with submillisecond neodymium laser radiation 1064 nm (submilisecond Nd: YAG laser 1064 nm) and daily application of 1% metronidazole cream showed the most pronounced improvement in the state of microcirculation according to laser Doppler flowmetry in comparison with the rest groups. Against the background of the course of complex phototherapy for all patients with the combined subtype of rosacea, statistically significant changes were in the volume of blood flow, modulation coefficients, coefficient of variation. On the contrary, no statistically significant changes were found in the ranges corresponding to active regulatory factors endothelial, neurogenic, myogenic, and passive respiratory and cardiac, as well as in the T index.
 CONCLUSION: After the course of complex phototherapy in the group of patients with a combination of rosacea subtypes, there was a decrease in the severity of clinical manifestations of diseases, as well as an improvement in the main indicators of microcirculation according to laser Doppler flowmetry.

Bedside determination of microcirculatory oxygen delivery and uptake: a prospective observational clinical study for proof of principle

Assessment of microcirculatory functional capacity is considered to be of prime importance for therapy guidance and outcome prediction in critically ill intensive care patients. Here, we show determination of skin microcirculatory oxygen delivery and consumption rates to be a feasible approach at the patient’s bedside. Real time laser-doppler flowmetry (LDF) and white light spectrophotometry (WLS) were used for assessment of thenar skin microperfusion, regional Hb and postcapillary venous oxygen saturation before and after forearm ischemia. Adapted Fick’s principle equations allowed for calculation of microcirculatory oxygen delivery and uptake. Patient groups with expected different microcirculatory status were compared [control (n = 20), sepsis-1/2 definition criteria identified SIRS (n = 10) and septic shock patients (n = 20), and the latter group further classified according to sepsis-3 definition criteria in sepsis (n = 10) and septic shock (n = 10)], respectively. In otherwise healthy controls, microcirculatory oxygen delivery and uptake approximately doubled after ischemia with maximum values (mDO2max and mVO2max) significantly lower in SIRS or septic patient groups, respectively. Scatter plots of mVO2max and mDO2max values defined a region of unphysiological low values not observed in control but in critically ill patients with the percentage of dots within this region being highest in septic shock patients. LDF and WLS combined with vasoocclusive testing reveals significant differences in microcirculatory oxygen delivery and uptake capacity between control and critically ill patients. As a clinically feasible technique for bedside determination of microcirculatory oxygen delivery and uptake, LDF and WLS combined with vasoocclusive testing holds promise for monitoring of disease progression and/or guidance of therapy at the microcirculatory level to be tested in further clinical trials.ClinicalTrials.gov: NCT01530932.

Endothelial Microvascular Dysfunction and Its Relationship with Haptoglobin Levels in Patients with Different Phenotypes of Chronic Heart Failure

Aim. To study the relationship between the level of haptoglobin and the main indicators of microcirculation (MC) in patients with different phenotypes of chronic heart failure (CHF).Materials and methods. Patients with different phenotypes of functional class II-IV chronic heart failure according to NYHA (n=80) underwent a general clinical examination, determination of the serum haptoglobin level by enzyme-linked immunosorbent assay, as well as an assessment of the MC state on the medial surface of the upper third of the leg by laser Doppler flowmetry (LDF).Results. Patients with CHF included patients with preserved left ventricular ejection fraction (HFpEF; n=27, intermediate ejection fraction (HFmrEF; n=25) and reduced ejection fraction (HFrEF; n=28). The median value of haptoglobin in the HFpEF group was 1387.6 [ 747.5; 1946.9] mg/l, in the HFmrEF group was 1583.4 [818.9; 2201.4] mg/l, in the HFrEF group was 968.5 [509.5; 1324.4] mg/l. Correlation analysis revealed statistically significant relationships between haptoglobin and the amplitudes of the endothelial frequency range (Ae) in the groups of HFmrEF (r=-0.628, 95% confidence interval [CI] -0.256; -0.825, p=0.003) and HFrEF (r=-0.503, 95% CI -0.089; -0.803, p=0.02). A negative relationship between the haptoglobin level and Kv and σ was revealed, as well as a formula for calculating the value of haptoglobin was obtained, which is predicted on the basis of the amplitude index of the endothelial frequency range: [haptoglobin]=1787-(4053×Ae).Conclusion. The multifactorial effect of haptoglobin is realized in the central and peripheral mechanisms of MC regulation. Low values of haptoglobin in blood plasma should be considered as a potential marker for the development of complications and used in a comprehensive assessment of the state of patients with CHF. Evaluation of the diagnostic and prognostic significance of haptoglobin, especially in patients with HFmrEF, requires further study.

Myocardial Perfusion in Hypoplastic Left Heart Syndrome

The status of the systemic right ventricular coronary microcirculation in hypoplastic left heart syndrome (HLHS) is largely unknown. It is presumed that the systemic right ventricle's coronary microcirculation exhibits unique pathophysiological characteristics of HLHS in Fontan circulation. The present study sought to quantify myocardial blood flow by cardiac magnetic resonance imaging and evaluate the determinants of microvascular coronary dysfunction and myocardial ischemia in HLHS. One hundred nineteen HLHS patients (median age, 4.80 years) and 34 healthy volunteers (median age, 5.50 years) underwent follow-up cardiac magnetic resonance imaging ≈1.8 years after total cavopulmonary connection. Right ventricle volumes and function, myocardial perfusion, diffuse fibrosis, and late gadolinium enhancement were assessed in 4 anatomic HLHS subtypes. Myocardial blood flow (MBF) was quantified at rest and during adenosine-induced hyperemia. Coronary conductance was estimated from MBF at rest and catheter-based measurements of mean aortic pressure (n=99). Hyperemic MBF in the systemic ventricle was lower in HLHS compared with controls (1.89±0.57 versus 2.70±0.84 mL/g per min; P<0.001), while MBF at rest normalized by the rate-pressure product, was similar (1.25±0.36 versus 1.19±0.33; P=0.446). Independent risk factors for a reduced hyperemic MBF were an HLHS subtype with mitral stenosis and aortic atresia (P=0.017), late gadolinium enhancement (P=0.042), right ventricular diastolic dysfunction (P=0.005), and increasing age at total cavopulmonary connection (P=0.022). The coronary conductance correlated negatively with systemic blood oxygen saturation (r, -0.29; P=0.02). The frequency of late gadolinium enhancement increased with age at total cavopulmonary connection (P=0.014). The coronary microcirculation of the systemic ventricle in young HLHS patients shows significant differences compared with controls. These hypothesis-generating findings on HLHS-specific risk factors for microvascular dysfunction suggest a potential benefit from early relief of frank cyanosis by total cavopulmonary connection.

Comparative characteristics of the effectiveness of complex therapy in the surgical treatment of acute condyloma of the anogenital region with the use of drugs - nitrogen donors

The paper presents comparative data on the effectiveness of complex treatment of acute condyloma of the anogenital region (n = 105). Destruction of genital warts was performed surgically, preceded by immunomodulatory and antiviral systemic therapy and local treatment with antiseptic measures and hyaluronic acid, which continued in the postoperative period. Patients of the first group (n = 70) were added to the complex therapy drug - nitrogen donor L - arginine. Efficacy control consisted of subjective assessment and patient complaints; objective determination of the clinical condition, the course of the postoperative period, assessment of the state of microcirculation; laboratory dynamics of interleukin levels; the presence of recurrence of the disease. The use of nitrogen donor (L-arginine) in complex therapy allows to eliminate subjective symptoms, signs of secondary bacterial contamination in the preoperative period, postoperative pain, post-traumatic stress and to provide a significantly higher rate of epithelization, which optimizes the patient's stay. prognosis for recurrence of AW. The obtained results showed a significantly higher efficiency of complex treatment of acute genital warts of the anogenital region in the group of patients receiving a nitrogen donor L - arginine. In the group of patients receiving L-arginine (n = 70), there were 2 (2,86 %) relapses. In the control (n = 35) group – 3 (8,57 %) (p &lt; 0.05).

Ocena stanu mikrokrążenia na podstawie stymulacji oscylacji miogennych przez przejściowe niedokrwienie

Microcirculation oscillations, known as flowmotion, are a well-recognized feature of blood flow through blood vessels. There is evidence that impaired microvascular flow can be a symptom of a variety of diseases, including diabetes, cancer and cardiovascular disease, as well as neurodegenerative and autoimmune diseases. The innovative Flow Mediated Skin Fluorescence (FMSF) technique enables direct and precise monitoring of microcirculation oscillations, giving a qualitative and quantitative picture of the microcirculatory status of the organism. The HS (Hypoxia Sensitivity) parameter, determined by the FMSF technique, allows to quantify the degree of sensitivity of the organism to hypoxia by measuring stimulation of myogenic oscillations by transient hypoxia. It is assumed that an organism’s sensitivity to hypoxia may be regulated by genetic factors, but many studies indicate a significant role of hypoxia-inducible factor (HIF) in such response. The HS parameter seems to reflect a level of stabilized HIF-1α during the transient hypoxia caused by temporary occlusion of the brachial artery. The HS parameter can be used to predict development of the diseases accompanied by hypoxia. Based on the relationship between the innate immune response and hypoxia it can also be used to predict the severity of the disease such as coronavirus disease 2019 (COVID-19) infection. A good response to hypoxia (high values of HS parameter) can predispose the individuals to endurance training (long-distance running, climbing etc. ). Amateurs’ physical activity should also be undertaken based on the microcirculatory response to hypoxia. The FMSF technique allows to detect microcirculation disorders at an early stage in order to identify patients for preventive or therapeutic intervention, or for further more accurate and complex diagnostic tests.

Корекція ендотеліальної дисфункції та порушень мікроциркуляції в пацієнтів із критичною ішемією нижніх кінцівок та високим ризиком розвитку реперфузійно-реоксигенаційних ускладнень

Актуальність. Епідеміологічні дослідження свідчать, що критична ішемія нижніх кінцівок трапляється в 500–1000 пацієнтів на один мільйон населення на рік. В Україні щорічно проводиться близько 10 000 реконструктивних операцій із приводу оклюзійних уражень артерій нижніх кінцівок. Одночасно щорічно виконується близько 8–10 тис. ампутацій нижніх кінцівок на ґрунті атеросклерозу. Метою дослідження було вивчення можливості корекції ендотеліальної дисфункції та порушень мікроциркуляції в пацієнтів із хронічною критичною ішемією нижніх кінцівок та високим ризиком розвитку реперфузійно-реоксигенаційних ускладнень після реконструктивних операцій. Матеріали та методи. В основу роботи покладено аналіз комплексного обстеження та хірургічного лікування 220 хворих на облітеручий атеросклероз аорти та магістральних артерій нижніх кінцівок. Ендотеліальну дисфункцію оцінювали шляхом визначення рівня маркерів: Р-селектину, Е-селектину, тканинного активатора плазміногену, ендотеліну-1, молекули адгезії судинного ендотелію 1-го типу, циркулюючих ендотеліальних клітин. Результати. Порівнюючи рівень ендотеліальної дисфунції та стан мікроциркуляції в ранньому післяопераційному періоді в пацієнтів із спеціальною доопераційною підготовкою й без такої, можна говорити про потребу та ефективність перед­операційного застосування бета-блокатора небівололу, інгібітора АПФ периндоприлу аргініну та L-аргініну. Висновки. Застосування в передопераційному періоді бета-блокатора небівололу, інгібітора АПФ периндоприлу аргініну, L-аргініну та сольового гіперосмотичного гіпертонічного розчину декстрану в пацієнтів із високим ризиком реперфузійно-реоксигенаційних ускладнень дає можливість запобігти значним порушенням при розвитку ендотеліальної дисфункції та погіршенню функціонування мікроциркуляторного русла й забезпечити оксигенацію тканин на рівні 5,04 ± ,37 мм рт.ст. після реваскуляризації нижніх кінцівок.

Study on the Value of DCE-MRI in Differentiating Glossitis and Tongue Cancer and the Intratumour Heterogeneity.

ObjectiveDCE-MRI is an imaging technique that reflects the blood perfusion status of the tissue’s microcirculation. The purpose of this article is to explore the clinical value of dynamic contrast-enhanced (DCE)-MRI in distinguishing benign and malignant tongue lesions and the internal heterogeneity of a tumour.MethodsThe patients were divided into a tongue cancer group (22 patients) and a glossitis group (7 patients) based on the pathology results. All of the patients underwent DCE-MRI examination.ResultsThe results of this study showed that the volume transfer constant (Ktrans), rate constant (Kep), contrast enhancement ratio (CER) and initial area under the gadolinium contrast agent concentration time curve (IAUGG) values of the tongue cancer group were significantly higher than those of the glossitis group, and the difference was statistically significant (P < 0.05). However, the extravascular extracellular volume fraction (Ve), fractional plasma volume (fPV), maximum slope (MaxSlope), and bolus arrival time (BAT) values measured by DCE-MRI in the tongue cancer group were not significantly different from those in the glossitis group (P > 0.05). The results of this study showed that the Ktrans, Kep, and IAUGG values measured by DCE-MRI had a good ability to distinguish tongue inflammation from tumours and Ktrans threshold of 0.484 has the best discriminative ability among them. The mean Ktrans values of stage I–II lesions were significantly higher than that of stage III–IV lesion (p = 0.045).ConclusionDCE-MRI is effective in distinguishing between benign and malignant tongue lesions and the internal heterogeneity of the tumour; it is worth following up in a larger study.Clinical Registration NumberResearch registry 6393.

Effect of liraglutide dose on efficacy of correcting microcirculatory disorders in absolute insulin deficiency of albino rats

The objective was to study the dose-dependent effects of glucagon-like peptide-1 receptor agonist, liraglutide, on microcirculation in white rats under the alloxan-induced insulin deficiency. Materials and Methods. Our study was carried out on 70 white rats, divided into four groups: 20 intact control animals; 20 animals of the comparison group with alloxan-induced diabetes; 10 animals with insulin deficiency, injected with liraglutide at a dose of 0.2 mg/kg per day (treatment group No. 1); and 20 animals with insulin deficiency treated with liraglutide at a dose of 0.4 mg/kg per day (treatment group No. 2). Diabetic status, skin perfusion of the posterior limb and mechanisms of blood flow modulation were assessed in all groups of animals. Results. It was established that administering liraglutide at a dose of 0.4 mg/kg per day allowed achieving complete normalization of carbohydrate metabolism in rats with alloxan-induced insulin deficiency, thereby more effectively improving the state of microcirculation, compared with a dose of 0.2 mg/kg per day. Conclusion. The efficacy of correcting the microcirculatory disorders with liraglutide correlates with correcting the carbohydrate metabolism in rats with insulin deficiency and depends on liraglutide dose. The dose-dependent effect is achieved by the endothelial mechanism of flow modulation in microcirculation. However, the restoration of the vascular tone neurogenic component is independent of liraglutide dose.

BIOMICROSCOPY OF THE CAPILLARY FLOW - INTERDISCIPLINARY APPROACH AND EFFECTIVENESS OF PATHOLOGICAL CONDITIONS DIAGNOSTICS

The goal – to evaluate the features and diagnostic value of the capillary bedbiomicroscopy results in various pathological conditions.Material and methods. The paper presents data on microcirculation study in patientsof various ages (adults and children) with different somatic pathologies (with diabetesmellitus, arterial hypertension, chronic gastroduodenitis, acute bronchitis) comparedwith healthy persons. The state of microcirculation was recorded using a digital USBmicroscope and evaluated by qualitative and semi quantitative assessment.Results. In patients with diabetes, the most changes in the form of capillariesand venules microaneurism, reduction of the functioning vessels number, slowingblood flow, decrease of arteriolo-venular coefficient were registered. In arterialhypertension, the signs of an increase in peripheral resistance were dominated, andin inflammatory diseases of the gastroduodenal zone and during bronchitis there wasa slowing of blood flow in arterioles and capillaries, an increase in the vascularity ofarterioles and the erythrocytes adhesion inside vessels.Conclusions. Biomicroscopy is simple and informative method for studyingmicrocirculation both chronic and acute diseases, the volume and nature of violationspredominantly depends on the type of pathology, its severity and duration.

The microcirculation (MC) and surfactant importance in lung pathology under experimental atherosclerosis (EA)

Background and Aims: Surfactant is a pneumoprotein that is synthesized by type II alveolar cells (AC) and increased circulating level is known as a risk factore aggravation of CHD, but only a few study is concerned of the lung structural changes. The aim of this work is a study of MC and surfactant state influence in lung under EA.

Капилляроскопия как скрининговое обследование сосудов при сахарном диабете. Обзор литературы

Nailfold capillaroscopy is currently one of the highly informative methods for assessing the state of microcirculation. The advantages are ease of implementation, non-invasiveness, accessibility of the research object, instant visualization of the microvasculature, painlessness. The object of the study is the nailfold capillaries of the fingers or toes, due to their horizontal position in relation to the surface of the body, which makes it possible to evaluate the capillary throughout. Many authors have shown pronounced microvascular anomalies in type 1 and type 2 diabetes mellitus: tortuosity and dilation of capillaries, a decrease in their density, microhemorrhages, avascular zones, ectasias and aneurysms, newly formed capillaries; a relationship with the duration and compensation of diabetes mellitus as well as the severity of diabetic retinopathy was revealed. Thus, nailfold capillaroscopy can be used as a method for diagnosing and predicting diabetic retinopathy in patients with diabetes mellitus with the aim of early detection of initial changes in the microvasculature and timely retinopathy treatment. Key words: capillaroscopy; nailfold; diabetes mellitus.

Influence of interference of light and laser technologies on microcirculation in involutive changes of skin

In a study of 115 patients, the effect of the interference of IPL exposure using filters of 640 nm and 560 nm and the use of an erbium fractional laser with a wavelength of 1565 nm on microcirculation in patients with involutive skin changes was studied. The basis of all reparative processes is the microcirculatory link, as a unit of the trophic system of the skin. Studying the effect of phototechnologies and laser fractional exposure on microcirculation, based on the results of these studies, it is possible to develop algorithms for patient management, including additional treatment methods, as well as an algorithm for standardizing procedures, including the multiplicity and number of procedures. These studies can be the starting point for the introduction of standards that will reduce the number of complications, as well as increase the clinical effectiveness of the treatment, which will make the method more widely available. The assessment of the state of microcirculation was carried out using the method of laser Doppler flowmetry (LDF), using the mathematical analysis of the wavelet transform. Under the influence of the interference of IPL exposure using filters of 640 nm and 560 nm and the use of an erbium fractional laser with a wavelength of 1565 nm, a positive dynamics of the parameters of all parts of the microcirculation was revealed according to the LDF data. In women with spastic type of MC, the initially increased neurogenic and myogenic tone of the arterioles decreased, and endothelial function improved. In women with hyperemic type of MC, there was an improvement in neurogenic tone, correction of endothelial dysfunction, and elimination of congestion in the venular link of MC. However, the above changes were more noticeable in patients with hyperemic type of MC.

Microcirculation disorders in association with eNOS (C774T) gene polymorphism in the progression of acute pancreatitis

Aim. To determine the role of microcirculation disorders in association with the C774T polymorphism of the eNOS gene in the progression of acute pancreatitis. Materials and methods. We investigated 90 patients with acute pancreatitis. In 30 patients of group 1, a mild course of acute pancreatitis was noted, in 30 patients in group 2 – moderate severity of the disease, in 30 patients in group 3 – severe acute pancreatitis. The state of microcirculation was evaluated by LACK-02 apparatus (NPO “Lazma”, Russia). The molecular genetic testing of eNOS gene polymorphism ( C774T ) was performed using DNA samples (isolated from peripheral blood) by real-time polymerase chain reaction (CFX96 Touch™ Real-time PCR Detection System, USA). The study design is prospective. The evidence level – II. Results . It has been established that in the early stages of acute pancreatitis occur microcirculatory disorders (a depression of the microcirculation index, coefficient of variation, and microcirculation efficiency index), which associated with the severity of the disease. In mild and moderate forms, these changes were stopped by using standard therapy to sixth day of illness. In patients with acute severe pancreatitis these changes persisted. It should be noted that microcirculation disorders were more significant in patients with the T774T polymorphism of the eNOS gene. The most frequent (56.3 %, C' = 0.880, p = 0.001) such pathological phenomena were registered in severe form of the disease, which is an important argument for adjusting personalized therapy. Conclusion. The presence of T774T polymorphism of the eNOS gene in patients with acute pancreatitis, associated with an increased level of nitric oxide production, leads to the development of microcirculatory disorders, which should be recognized as one of the risk factors for disease progression and development of complications.