The aim of this review was to analyze the diagnostic capabilities of modern methods of medical imaging of lower extremity varicose veins (LEVV). The study is based on an analysis of the results of Russian and international studies published during the period 2012-2015 on various methods of medical imaging of varicose veins. The review is divided into several sections: the significance of the problem, general description of radiological methods of varicose veins visualization, ultrasonic methods, venography, conclusions. An overview will be useful for radiologists and vascular surgeons as a source of information about the possibilities of modern methods of varicose veins visualization and their limitations. Special attention is given to the diagnostic utility of MDCT venography. This information can be used in the educational process, to develop practical recommendations for doctors or serve as a basis for new studies. In this review we present both the results of latest research on LEVV imaging and also the analysis of the problem performed by the authors.

Introduction. Rheumatoid arthritis (RA) affects not only the joints but also other organs. Lung disease is one of the leading manifestations of RA, and detection of these changes remains a diagnostic challenge. Delayed diagnosis of pulmonary involvement in the pathogenesis of RA often leads to development of severe forms which aggravate prognosis and decrease of the quality of life. Identify the characteristics and prognostic significance of CT and SPECT symptoms involving respiratory system in patients with RA depending on the stage of the disease and the destruction of hand joints as detected by MRI. Methods. To evaluate favorable and unfavorable predictors of RA clinical course and detect changes in the lung using modern methods of imaging: magnetic resonance, computed tomography and single-photon emission computed tomography. Results. A set of signs identified by CT and SPECT was analyzed corresponding to the presence of different types of erosions detected by MRI. Pleural adhesions, symptoms of bronchial obstruction (uneven ventilation, «air trap»), and signs of vasculitis were observed in all stages of the disease. With the progression of the disease, bullous emphysema-type deforming bronchitis symptoms and associated comorbid processes in the lung tissue were observed. Conclusions. For all types of active RA in patients with a high frequency revealed signs of bronchial obstruction and concomitant manifestations of vasculitis. These results require the inclusion of X-ray and single photon emission computed tomography of the chest in the algorithm of diagnostic evaluation of the patients with RA to identify and assess changes related primarily to the blood circulation, have prognostic significance and impact on treatment regimen.

Introduction and purpose. Ocular blood flow (OBF) impairment is observed in more than 50 % of all ocular disorders. There is often an association with systemic hemodynamics. To evaluate ophthalmoplethysmographic parameters in normal subjects taking into account individual frequency-response OBF characteristics. Methods. 251 subjects without ophthalmic pathological findings (except incipient cataract in elderly) were examined using ophtalmoplethysmograph OP-A (SKTB Optimed, Moscow, Russia, calibrated by optimized method). Ocular biometry, intraocular pressure, blood pressure (BP), heart rate (HR) were also evaluated. Probands were divided into subgroups by gender and age. Results. The duration of the anacrotic part of the pulse curve ranged between 0.23±0.04 sec and 0.32±0.06 sec; the duration of the catacrotic part of the pulse curve was between 0.58±0.09 sec and 0.75±0.11 sec; the anacrotic/catacrotic ratio ranged between 0.34±0.07 and 0.55±0.1; the systolic increase of ocular anterior segment volume (SIOASV) ranged between 7.35±3.21 μl and 11.15±4.42 μl; SlOASV per minute was between 464.1±153.6 μl and 578.1±175.7 μl. Time characteristics of the plethysmographic curve highly correlate with HR. Conclusions. Ophtalmoplethysmography is a valuable tool for OBF evaluation. Normal OBF ophthalmoplethysmographic parameters vary significantly (ranging between 165.6 and 1388.4 μl/min). OBF evaluation should not be performed without systemic BP and HR examination.

Introduction and purpose. Retinal vein occlusion (RVO) accounts for 60 % of cases of all acute vascular ophthalmic events with a global prevalence of 0.2-2 %. Lately, the RVO prevalence in young adults steadily increases. Impair-ments of ocular hemodynamics are considered to be its leading risk factors, and ocular blood flow depends on systemic hemodynamic condition. To evaluate the relation between systemic hemodynamics and ocular blood flow in RVO in young and middle-aged adults. Methods. The study included 18 patients with RVO and 30 persons without ophthalmic pathological findings. In all patients, routine ophthalmic examination was performed, as well as an additional ocular blood flow assessment (ophthalmoplethysmography, ophthalmorheography, ophthalmosphygmography, and fluorescein angiography [FA]). 24-hour blood pressure (BP) monitoring was performed to estimate systemic hemodynamics. Results and discussion. Statistically significant differences (p<0.05) between groups were noted in ophthalmoplethysmography, ophthalmoreography, ophthalmosphygmography, and retinal thickness in macular area. There was a direct correlation between choroidal thickness and ophthalmoplethysmography and ophthalmoreography indices (r>0.7 and r>0.2). FA showed zones of peripheral retinal ischemia with a mean area of 159.02 mm². A relation between evaluated parameters and those of 24-hour BP monitoring was not found. However, non-dippers showed a tendency towards a lower hemodynamic parameters and increased choroidal thickness. Conclusions. In young and middle-aged patients, predominantly ischemic RVO occurs, with specific peripheral localization of retinal ischemia. In patients before the age of 50, one of the main risk factors for peripheral ischemic RVO is the ocular blood flow impairment. A positive correlation was established between the ocular blood flow and the pattern of choroidal thickness changes. It is suggested that most significant ocular blood flow changes are typical for non-dippers.

The aim of the study. To evaluate individual variability of skin microcirculation (MC) in patients with arterial hypertension (AH) and characteristics of microvascular (MV) reaction to hypotensive impact from the view of blood distribution. Material and methods. Microcirculation of forearm skin in 176 patients with AH stage 2 was studied by laser doppler flowmetry (LDF). All the patients were divided into 2 groups: 1 - with low (n=46) value of MV resistance and 2 - with high (n=130) value of MV resistance. 90 patients out of the total amount (also divided into the same 2 groups - 25 people in the first group and 65 people in the second) had another study of MC after sublingual taking of 20 mg of corinfar. Results. The results revealed controversial MC skin picture with high blood filling of MV canal and reduced MV tone in the first group and high value of MV tone with hemoperfusion limitation in the second group in patients with AH and the same blood pressure (BP). Reduction in the first group can be caused by redistribution of a minute blood volume kept on a high level in the condition of elevated total peripheral resistance (TPR) (the so called central blood bypass). In this case the skin where a part of a cardiac output goes to serves as a depot. Increase of intravascular resistance in the skin of patients from the second group is caused by prevalence of TPR in hemodynamic mechanisms of BP elevation. Whereas constriction of microcirculation vessel is observed not only in the abdominal vessel area (which is the main area responsible for TPR formation) but also in the other areas, particularly in the skin. Corresponding BP decrease in groups of patients under the influence of corinfar was accompanied by bidirectional shifts of MC values: vasodilation in the second group and vasoconstriction in the first group of patients. It happens due to more balanced bloodflow distribution in the vessel areas more responsible for TPR formation as a result of vasodilation under the influence of corinfar.

Introduction and aim. Currently, the study of the pathogenesis of rosacea is very important on disorders of microcirculation. Due to the feature of the structure of the eyelid skin microcirculation disorders learning in this area seems an urgent task. The aim of the study was to study the microcirculation of the face skin and eyelid skin in patients with rosacea by laser Doppler flowmetry (LDF) before and after treatment with tacrolimus ointment 0.1 % and 15 % azelaic acid gel, Blefarogel 2 and Blefaroloson. Mathereals and methods. The study involved 70 patients with different clinical forms of rosacea. Patients surveyed microcirculation in the skin of the face and eyelid skin by laser Doppler flowmetry. Patients were divided into 2 groups: who applied 0.1 % tacrolimus ointment on the skin of the face and eyelids and who applied 15 % azelaic acid gel on the face skin, Blefarogel 2 and Blefaroloson on the eyelid skin. A month study was conducted again to measure the effectiveness of the therapy. Results and discussion. Patients with rosacea marked increase in IM (index of microcirculation) in the face skin and the affected eyelid skin. The study of amplitude-frequency spectrum of LDF-grams of the face skin revealed stagnation in the arterial and in the affected eyelids skin - in the venous link microvasculature. In both groups of patients background therapy showed a significant improvement of microcirculation parameters. Conclusions. Laser Doppler flowmetry is an effective method for the investigation of violations of the microcirculation in the skin and the affected eyelid skin in rosacea, as well as to evaluate the effectiveness of therapy in these patients.

Goal. Determining the causes of age-related decrease of blood flow velocity (BFV) in the middle cerebral artery (MCA) in healthy subjects and in patients during surgical lengthening of stunted limbs. Methods. BFV in MCA was determined by transcranial Doppler. The analysis of the indicator in functional muscle sample of 30 healthy people 18-60 years old and 30 patients 3-62 years of lagging in the growth of one of the lower limbs in the course of its operational extension. As an indicator of cerebral autoregulation used swing changes BFV indicators during the second holding muscle functional test. Results. The age-related reduction in flow rate in the middle cerebral artery was more pronounced in patients with disorders of the musculoskeletal system. At the same time, the average value of the magnitude of blood flow velocity index changes during the functional test in healthy individuals older than 10 years, as well as in patients before treatment and during the fixation is stable (17-25 %). Conclusion. Age-related decline in the BFV at MCA is a prerequisite for the preservation of cerebral autoregulation. Disorders of cerebral autoregulation in patients undergoing distraction of limbs greatly reduces their tolerance to physical exercise.

Purpose. To study the parameters of peripheral and central blood pressure as well as the vascular rigidity parameters in pregnant women with physiological pregnancy and hypertensive disorders. Materials and methods. ABPM was performed using BPLab Vasotens system («Petr Telegin», Russia). The device allows to determine the propagation time of the reflected wave (RWTT), augmentation index in the brachial artery (AIx) and aorta (AIxao), arterial stiffness index (ASI), the parameters of the central blood pressure (BP). The data of 116 women in 30-39 week gestation were analyzed. The groups were: normotensive women (N), n = 42, arterial hypertension existing before pregnancy (AHBP), n = 30, gestational arterial hypertension (GAH), n = 24, and preeclampsia (PE), n = 20. Differences were considered significant at p<0.05. Results. The circadian rhythm of the central arterial blood pressure and indicators of rigidity was revealed in pregnant women regardless of normotensive or hypertensive status. The studied parameters were significantly higher in the group of pregnant women with GAH and PE compared to N and AHBP. The correlation between RWTT and AIx, AIx and AIxao was found. Conclusions. Data obtained by daily monitoring of central blood pressure and arterial stiffness can be used as additional indicators for the diagnosis of hypertension in pregnant women.

Introduction and purpose. Vascular response to mechanical stimuli, namely transmural pressure (Bayliss effect) and wall shear stress (response to blood flow), play an important role in regulation of vascular tone. The purpose of the work was to study an influence of hypoxia on the vessel radius and blood flow control by response to shear stress. Methodology/approach. Mathematical simulation was used. The model is based on published data of experiments on small cerebral arteries of rats. The main assumptions of the model are: 1) the vessel is a thin wall cylinder; 2) the radius is controlled by two parameters: concentration of free calcium ions in the cytoplasm of the smooth muscle cells and concentration of nitric oxide (NO) in the smooth muscle layer; 3) the rate of NO production by endothelium is proportional to modulus of shear stress on the vessel wall. The apparent blood viscosity is calculated using the solution of the problem of two-layer flow. The numerical experiments were performed in Turbo Pascal. The main results and discussion. The dependence of vessel tone regulation by response to altered shear stress on oxygen tension is caused by dependence of NO synthesis in endothelium and NO consumption on oxygen concentration. As it follows from mathematical simulation, hypoxia reduces the role of mechanogenic regulation, and the increase of the wall sensitivity to NO makes this effect more appreciable. Calculations performed for typical value of cerebral vessel response to shear stress, show that the fall in oxygen tension from 100 to 30 per cent leads to decrease in diameter by 6 %, in blood flow rate by 11 %. The rheological factors prevent flow rate diminution, but their contribution is very small: less than 3 %. The fall in oxygen tension reduces NO production rate by endothelial cells and NO concentration in the vessel wall. At strong hypoxia (reduction in oxygen tension from 100 to 30 % and less) NO concentration in smooth muscle layer drops by more than 15 %. Conclusions. Hypoxia decreases NO-dependent vessel response to altered shear rate. This effect increases with the value of vessel response to shear stress. The rheological factors impede the decrease of this response.

Introduction and purpose. Proliferative vitreoretinopathy (PVR) is caused by retinal damage and increased permeability of the blood-ocular barrier. Activation of inflammation, cell migration and proliferation leading to the membrane formation on the surface of the retina in the lesion area, causes blindness. After surgical removal of all membranes the frequency of PVR recurrence is 30 % on average. Therapeutic approaches are not developed. Since inflammation plays a key role in PVR formation, the aim of our study was to justify the use of non-steroidal anti-inflammatory drug lornoxicam for prevention of the development of proliferative vitreoretinopathy. Materials and methods. The work was performed on rats. PVR was modeled by intravitreal injection of dispase, 0,015 U/μl. Intravitreal administration of lornoxicam was performed 20 minutes later, 8 mg/ml. Volume of injections was 2 μl. On the second and the third day of the experiment we performed intraperitoneal injections of the drug in a dose of 230 mg/kg. Intact animals were used as a control group. Enucleation of the eyes was performed on the first, third, seventh and 42th day of the experiment. Results. Lornoxicam reduced the inflammatory response caused by the dispase introduction. It shifted the start of retinal remodeling from the first to the third day of the experiment, restrained a formation of «rosette» structures in the retina (p<0.05), decreased the rate of destruction of photoreceptors by 34 % (p<0.05) and caused twofold decrease (p<0.05) in the severity of photoreceptor changes. Throughout the experiment, the thickness of retinal and choroidal layers among the treated animals was the same as the thickness of retina and choroid of intact rats. The dispase introduction was accompanied by fibrous membrane formation during the period from 7th to 42th day after the beginning of the experiment. Lornoxicam decreased the incidence of membrane formation by 43 % (p<0.05), and the membranes were smaller and contained less fibrotic components. Conclusions. The use of lornoxicam during early period of PVR development reduced the manifestation of signs of inflammation in the eye: it controlled retinal remodeling at all stages of the disease, decreased the incidences of membrane formation by 43 % and significantly reduced the intensity of fibrotic processes in the membranes.

Introduction and purpose. It is known that ischemia influences on endothelial reactions, changes metabolic and myogenic mechanisms of cerebral blood flow regulation. But the role of local neurogenic mechanisms of regulation in change of cerebral vessels reactions after ischemia is finally not found out. The aim of the current study was to examine the pial vessels reactivity in response to a brain surface irrigation by norepinephrine solution in rats, subjected to transient global cerebral ischemia, at 2, 7, 14 and 21 days after ischemia. Materials and methods. Transient global cerebral ischemia was induced in anesthetized Wistar rats by clamping of both common carotid arteries for 12 min with simultaneous controlled hypotension to 45±3 mm Hg, followed by blood reinfusion and recovering from anesthesia. Four different groups of rats were re-anesthetized at 2, 7, 14 or 21 days after ischemia and subjected to microvascular studies using in-vivo video microscopy method. The diameter changes of pial arteries and veins in response to norepinephrine were measured. Results and discussion. It was established that cerebral ischemia led to increase number of the constrictions to norepinephrine mainly at the vessels to relating to group of small pial arteries and arterioles and pial veins of the 3-rd generation. Reactivity changes were observed in all time points studied. This changes probably is connected with caused by ischemia the increase in reactivity and sensitivity of pial vessels adrenoceptors. The greatest changes are noted in 14 days after ischemia. The use of non-selective α-adrenergic antagonist - nicergoline at ischemic and intact rats, led to increase number of the constrictions to norepinephrine. But at ischemic rats decrease was more considerable. And number of dilation reactions to norepinephrine at ischemic rats was also above. It can indicate to increase of adrenoceptors reactivity and sensitivity. Conclusions. Thus, transient global cerebral ischemia cause marked and long lasting (3 weeks) increase in pial vessels reactivity in response to norepinephrine, that is probably connected with increase of adrenoceptors reactivity and sensitivity.