The review is devoted to microcirculatory disorders in local cold injury and simultaneous endothelial dysfunction. The features of endocrine activity of endothelium, cytokine activity, expression of the main molecules of intercellular adhesion and the phenomenon of lymphocytic-platelet adhesion, metabolism of nitric oxide, the state of the microcirculatory bed of the victims in different periods of injury were described.

In this review, the stepwise mechanism of vascularization of retrogradely torn away endometrial tissue into the abdominal cavity during the formation of endometrioid heterotopy is described. The necessity of the formation of a specific microenvironment and functional rearrangement of endometrial tissue, based on the interaction of endometrial mesenchymal stem cells with peritoneal macrophages, is shown, which is the basis of adaptation to hypoxia and survival in new conditions. Attention is also paid to the similarity of tissue adaptation for endometriosis and tumor growth. The activation mechanisms for the synthesis of a number of angiogenic factors and their significance in the process of vascularization of endometrial tissue, as one of the key links in the pathogenesis of endometriosis, are highlighted. In addition, the example of the peritoneal localization of the endometriosis focus reflects the sequence of the formation of the vascular component of the communication system: an increase in vascular density in the tissue of the implantation area; vascularization of endometrioid heterotopy tissue due to angiogenesis; and the final stage of formation of the vascular network of the endometrial focus - vasculogenesis (as a mechanism for the formation of the microvasculature with the participation of circulating endothelial progenitor cells). Subsequently, the synthesis of angiogenic factors continues and actively contributes to the remodeling and increase in vascular density in the heterotopic tissue. The most important is that the increase in vascular density occurs mainly due to the immature pericyte-unprotected vessels of the microvasculature. These features constitute a fundamental basis for the diagnosis of endometriosis through the qualitative and quantitative determination of some factors in the peritoneal fluid, reflecting activation of vascularization, and for future methods of treating endometriosis by activating an angiostatic effect in the area of the pathologycal focus.

The vascular endothelium is a heterogeneous structure with diverse functions, being an active metabolic system. Endothelial cells mediate inflammatory and immune processes, regulate leukocyte adhesion, permeability and vascular tone, participate in the hemostasis system, stimulate the processes of angiogenesis. Endothelial dysfunction can initiate individual disorders, but more often it is a universal link in the pathogenesis of many diseases. Currently, endothelial dysfunction is presented as an imbalance between the production of vasodilating, angioprotective, antiproliferative factors, on the one hand, and vasoconstrictive, prothrombotic, proliferative factors, on the other hand. The manifestations of endothelial dysfunction, the direction and severity of these changes may vary depending on the disease. The review provides examples of combined endothelial disorders in the most studied and common diseases (essential hypertension, type 2 diabetes, systemic diseases of the connective tissue, atherosclerosis, and malignant tumors). Despite the presence of rare cases of isolated endothelial dysfunction, it can be argued that in the absolute majority of diseases, endothelial dysfunction has combined type of violations. The allocation of individual endothelial disorder spectra, typical for a specific disease, is problematic, due to the universality and nonspecificity of the manifestations of endothelial dysfunction. These conclusions allow us to return to the origins of this problem, considering endothelial dysfunction as a holistic concept, not limited to a certain range of its disorders.

Introduction. Chronic tissue ischemia appeared due to obliterating atherosclerosis of lower extremities arteries (OALEA) enhances diabetic microangiopathy making prognosis worse. Due to fundamental biological importance of microcirculation (MC), the study of tissue blood flow in case of this pathology receives huge theoretical value.

Purpose of the study was to reveal features of skin MC in patients with diabetes mellitus type II (DM) with OALEA in comparison with the same group of patients without DM.

Material and methods. The study involved 111 males with claudication IIB stage and ancle-brachial index (ABI) ≤0.85, which were randomized into two groups equal in age and main clinical and anamnesis data (Gr.1 –without DM (n=77) and Gr.2 – with DM (n=34)). Skin MC was examined using Laser Doppler Flowmetry.

Results. Patients with DM had statistically important lowering of blood flow oscillatory amplitude in myogenic (34,5 %) and endothelial (27,8 %) frequency ranges in comparison with the alternative group. Together with the growth of myogenic tone (63,5 [38,6; 123,4] vs 43,6 [28,9; 75,0] u), it reflects depression of vasolytic features and constriction of precapillary segment of the bloodstream. The study revealed significant limitation (18,9 %) of nutritional blood flow and increase of the intensity of arterial and venous bypass grafting in patients of Gr.2 (2,6 [1,8; 4,0 vs 2,0 [1,2; 3,0] u) in Gr. 1.

Conclusion. The studied patients had monotype MC alterations. However, they are more pronounced in patients with DM; it worsens the disease prognosis.

The most important benefit that imaging provides to a patient with ischemic stroke is the rapid identification of those patients who are most likely to benefit from emergency treatment. This group includes patients who suffer from severe neurological symptoms due to the occlusion of the main artery, and those who are candidates for recanalization by intravenous thrombolysis or intra-arterial intervention to remove blockage.

Objective – to assess the sensitivity and significance of computed tomography and magnetic resonance imaging in early diagnosis of infarction foci.

Material and methods. The results of radiologic studies of 89 patients with a clinical picture, suspected of acute ischemic cerebral circulation disorders, received in the first 24 hours from the moment of development of neurological symptoms were analyzed.

Results. As a result of our study, it was shown that in the first group of patients received in the first 4.5 h from the moment of development of neurological symptoms of CT-signs of stroke were not detected in 16 (76 %) of 21 patients, while those received in the first 24 h from the moment of development of neurological symptoms of CT-signs of stroke were not detected in 14 (28 %) of 50 patients, determined by the symptom of strengthening of the artery, loss of differentiation between gray and white matter of the brain, smoothness of cortical furrows and the appearance of a zone of reduced densitometric density brain substances (<22HU). The difficulties of diagnosis in some patients on CT were the size and localization of ischemic areas (lacunar, stem strokes). In group II of 18 patients of the study, native MRI revealed signs of ischemic areas in 10 patients out of 10, complex CT and MRI to determined areas of hypoperfusion in 8 patients out of 8.

Conclusion. CT is the most widely used imaging technique for cerebral infarction with high sensitivity to intracerebral hemorrhage, high specificity in ischemia, but low sensitivity to the detection of ischemic changes is a limiting factor. The data obtained confirm that MRI is a reliable method of diagnosing ischemic stroke. The most sensitive in the diagnosis of ischemic changes in the acute stage of development by using DWI (b1000).

Introduction. The authors attract the attention of readers to the reactions of micro- and macrocirculation in response to «acute» smoking. The aim was to study the effects of «acute» smoking on hemodynamic parameters and microcirculation in young, practically healthy individuals and patients with coronary artery disease.

Material and methods. By means of computer-assisted videobiomicroscopy we examined smokers practically healthy young people (n=47), and patients with stable ischemic heart disease (n=48). Microvascular reactions were studied in a sample with «acute» smoking: Initially, 1, 15 and 30 min after smoking 1 cigarette, the blood pressure (BP) and pulse rate (PR) were measured in parallel.

Results. In response to smoking, 6 types of microvessel reactions were registered in the young. In 40.42 % of the surveyed, arteriole dilated, which persisted for up to 30 min of observation. In patients with coronary artery disease, 4 types of microvessel reactions in response to smoking were recorded, which persisted until 30 min of observation. Arteriole dilation was observed in 18.5 % of patients.

Conclusion. Multidirectional reactions of microvessels in response to smoking of one cigarette, in young healthy individuals and in patients with IHD were revealed. The expansion of resistive microvessels in response to smoking requires further indepth research and may provide new insights into the pathogenesis of cardiovascular diseases, which may not be evident from more traditional macrocirculation studies.

Introduction. Diabetic neuropathy is the most wide-spread complication of diabetes mellitus and neuropathy is steadily progressing even with compensation of the underlying disease. The search of the new methods of treatment and diagnosis of neuropathy is required. Diabetic autonomic neuropathy lies in the base of early morbidity and mortality of diabetic patients.

We estimated the potential of High-frequency Ultrasonic Dopplerography for diagnosis of autonomic neuropathy. Material and methods. 26 diabetic patients with sensorimotor neuropathy were examined. Microvascular blood flow of finger skin was assessed at rest as well as in functional tests: with cold impact and occlusion (cuff). Cardiac autonomic neuropathy was assessed using several cardiovascular autonomic reflex tests as a gold standard of diagnosis. Diagnostic values of microvascular blood flow test in detecting of cardiac autonomic neuropathy staging were evaluated in comparing with traditional modalities.

Results. Cardiac autonomic neuropathy was found for all patients and definite/confirmed staging in 61.5 % cases. Initial parameters of microvascular blood flow velocity were significantly decreased in all patients in comparing with control (Vam= = (1.9±0.22); (1.7±0.51) and (6.7±0.51) sm/s in patients with early cardiac autonomic neuropathy, definite/confirmed staging and control subjects respectively, p<0.05). Microvascular blood flow functional testes had great informational content for diagnosis of autonomic neuropathy (sensitivity – 100 and 58 %, specify – 50 and 80 % respectively). The algorithm of diabetic patients examination was offered for early diagnosis of autonomic neuropathy staging.

Conclusions. High-frequency Ultrasonic Dopplerography allowed to separate of cardiac autonomic neuropathy stages. This study is necessary to continue for revealing of all method possibilities.

Purpose of the study – to determine the relationship between the main factors of cardiovascular risk and arterial rigidity in young people.

Material and methods. The evaluation of factors of cardiovascular risk and arterial rigidity in 100 people aged 22±8.3 years, followed by correlation analysis of dependence.

Results. The study revealed a correlation with the body mass index, with the pulse wave velocity (r=0.36; p=0.013) and the presence of complaints of a cardiac and cerebral nature (r=0.386; p=0.011).

Conclusion. Young people have a prerequisite for the development of cardiovascular diseases, based on an assessment of the combination of arterial stiffness and cardiovascular risk factors.

The purpose of the work is to determine the conditions that ensure the formation of a stable thrombus in the femoral vein of rats with photodynamic damage.

Material and methods. The experiments were carried out on male Wistar rats weighing 250–270 g. A photosensitizer (FS) Bengal rose (ACROS ORGANICS, USA) (BR) was administered intravenously at a dose of 17 mg/kg and after 60 minutes a vascular clamp was applied to the femoral vein. Distal to clamping, a 30-minute laser irradiation of a vein was performed (DPSS diode laser, Republic of South Korea, 532 nm, 60 mW, irradiation area – 1 mm2 ). The clamp was removed after 90 min after cessation of irradiation. The blood flow was recorded by the method of high-frequency Doppler ultrasound (MinimaxDoppler-K Russia). Cessation of blood flow was considered as an indicator of occlusion of femoral vein.

Results. Rats, after the clamp was removed, had no blood flow in the irradiated veins, and after 24 hours it was not restored. Histology revealed severe damage of all layers of the vascular wall and the formation of a blood clot filling the lumen of the vessel. After a 30-minute irradiation without clamping the vein, the blood flow was maintained, although damage to the vascular wall was detected. Introduction of BR and clipping of the vessel without irradiation caused minimal damage to the vascular wall and did not lead to thrombosis.

The relevance of the study is connected with the modern point of view that endothelial dysfunction may be the cause of such socially significant diseases as atherosclerosis, diabetes, varicose veins, etc. The aim of the work is to study the morphofunctional peculiarities of the endothelium of the cardiovascular vessels of the mature rat using Willebrand factor (vWF) immunohistochemistry.

Material and methods. We used mature Wistar rats (n = 12). Polyclonal rabbit antibodies were used for the immunohistochemical detection of vWF. The reaction was carried out on paraffin sections, made through the whole heart.

Results. It was shown that the immunopositive reaction to vWF (vWF+ ) in the endothelium of different regions of the rat heart is not uniform. A tendency was found to weaken the vWF+ reaction in the direction from the base of the heart to its apex. Most functionally active endothelial cells with signs of exocytosis were observed in the aortic root, the large coronary arteries of the epicardium, the fibrous ring, the valves and the subaortal cone. vWF+ was less pronounced in the endothelium lining the atrial and ventricular cavities and in the myocardial capillaries.

Conclusions. Using immunohistochemical detection of the vWF, the endothelium features of different parts of the rat heart were identified. Structural features due to increased secretion of vascular endothelial cells of the heart were revealed. Further research in this direction may be important to explain the mechanisms and diagnosis of endothelial dysfunction.