Priorov Central Research Institute of Traumatology and Orthopedics

Moscow, Russia

Priorov Central Research Institute of Traumatology and Orthopedics

Moscow, Russia

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Novikova I.N.,State UniversityEducation Science Production Complex | Dunaev A.V.,State UniversityEducation Science Production Complex | Sidorov V.V.,LAZMA Research and Production Company | Krupatkin A.I.,Priorov Central Research Institute of Traumatology and Orthopedics
Human Physiology | Year: 2015

The time course of changes in the parameters of microcirculatory–tissue systems (MTSs) during the cold pressor test (CPT) was investigated in 32 conventionally healthy volunteers by noninvasive optical methods of laser Doppler flowmetry (LDF), tissue reflectance oximetry (TRO), and pulse oximetry. Depending on the oxygen consumption recovery rate in the CPT, the subjects were conventionally divided into two groups, one with a normal physiology and the other with a tendency to vascular spasm and lack of functional recovery of the MTSs. Blood flow oscillations were analyzed in detail to identify the possible causes of vascular spasm. The causes might include a distortion of the tone-shaping myogenic mechanisms that regulate resistive microvessels, blood congestion in microcirculation, or a combination of both of the factors. The CPT used to assess the MTS function was assumed to report the MTS reserve and to detect a propensity for vascular spasm at a preclinical stage, thus being of a potential applied significance. © 2015, Pleiades Publishing, Inc.


Krupatkin A.I.,Priorov Central Research Institute of Traumatology and Orthopedics
Zhurnal Nevrologii i Psihiatrii imeni S.S. Korsakova | Year: 2013

Information aspects of tissue microcirculation were investigated in 64 patients with complex regional pain syndrome after sympathectomy using a wavelet-analysis of skin microvascular blood flow oscillations. The early reorganization of information in the trophotropic direction at the level of microvascular tissue systems, its predomination and conservation along the microvascular networks facilitate the optimal realization of adaptive reactions and, as a result, lead to the best treatment efficacy. In these cases, the complete elimination of disease and achievement of excellent treatment results are possible. The best treatment efficacy could not be reached without the above-mentioned information changes. On the contrary, the predomination and conservation of ergotropic information in the early stages after surgery predicted worse outcomes of sympathectomy. Tissue desympathisation is not required for the formation of trophotropic purposefulness of information in microvascular networks; it is enough to achieve a certain threshold to decrease the sympathetic activity.


Krupatkin A.I.,Priorov Central Research Institute of Traumatology and Orthopedics
Zhurnal Nevrologii i Psihiatrii imeni S.S. Korsakova | Year: 2014

Objectives. To study the involvement of sensory peptidergic fibers in the posttraumatic regional pain syndrome (RPS). Material and methods. We examined 57 patients with distal radial bone fractures (27 with noncomplicated fractures and 30 with the development of posttraumatic RPS) using computed thermography and laser Doppler flowmetry (LDF) with wavelet-analysis of skin blood flow oscillations. Results. It has been shown that neurogenic inflammation, along with sensory peptidergic fibers activation, is an early component of posttraumatic RPS. Thermographic and LDF criteria for early diagnosis of posttraumatic RPS during the 1st month after the injury are singled out. Conclusion. The microvascular blood flow oscillatory structures, reflected sensory peptidergic activation and inflammatory sympatholysis are the most effective diagnostic signs (diagnostic effectiveness is 91.2%).


Merculov M.V.,Priorov Central Research Institute of Traumatology and Orthopedics | Golubev I.O.,Priorov Central Research Institute of Traumatology and Orthopedics | Krupatkin A.I.,Priorov Central Research Institute of Traumatology and Orthopedics
Human Physiology | Year: 2015

86 patients with posttraumatic defects of the median and ulnar nerves were examined. Autoneuroplasty was performed in all patients: in 42 patients, in combination with sympathectomy (thoracoscopic clipping of the Th3–Th4 sympathetic trunk ganglia); in 44 patients, without sympathectomy. Ultrasonography of nerve trunks, stimulation electroneuromyography, computer thermography, and laser Doppler flowmetry with a spectral wavelet analysis of blood flow oscillations were used in the examination. It was demonstrated that sympathectomy has a positive activating effect on the recovery of innervation and tissue trophism in the process of posttraumatic regeneration of peripheral nerves. A combination of autoneuroplasty with sympathectomy promotes a more complete recovery of motor and sensory nerve fibers, normalization of blood flow in the microvascular bed, and thermal topography of the damaged limb segment, including those in the area of previously denervated tissues. © 2015, Pleiades Publishing, Inc.


Krupatkin A.I.,Priorov Central Research Institute of Traumatology and Orthopedics
Human Physiology | Year: 2010

The key role of information processes for ensuring the optimal sanogenesis in humans was shown by the wavelet-analysis of skin microvascular blood flow oscillations in 64 patients with complex regional pain syndrome after sympathectomy. The early reorganization of information in the trophotropic direction at the level of microvascular tissue systems, and its predominance and preservation along the microvascular networks facilitate optimal adaptive reactions and, as a result, are conducive to maximum treatment efficiency. In these cases, the complete elimination of disease and the achievement of excellent treatment results are possible. The maximum treatment efficiency could not be reached without the above-mentioned informational changes. On the contrary, the predominance and preservation of ergotropic information in the early periods after surgery were unfavorable for the prediction of the clinical outcome of sympathectomy. Tissue sympathectomy is not required for the formation of the trophotropic type of information exchange in microvascular networks; it is enough to achieve a certain threshold of a sympathetic activity decrease. The results obtained may be useful for investigating the physiological mechanisms of informational treatment technologies (homeopathy etc.). © 2010 Pleiades Publishing, Ltd.


Krupatkin A.I.,Priorov Central Research Institute of Traumatology and Orthopedics
Human Physiology | Year: 2010

Laser Doppler flowmetry with wavelet analysis of oscillations of the blood flow in the glabrous skin of the second and fifth fingertips of 30 healthy individuals and 57 patients before and after median and ulnar nerve sutures (n = 29) and after hand sympathectomy (n = 28). Information processes in microvascular networks include both the stationary and oscillatory components. This study is the first to apply wavelet analysis of the blood flow oscillatory organization to studying the dynamics of information processes in microcirculatory networks. A methodological approach was proposed to estimate the total quantity of information, the value and semantic features of different information channels and the information regime (multichannel or resonance) in microcirculatory networks. The deficit of both general information and its content (particularly, of external information), a decrease in the accessibility to the information and the system of self-organization were typical during the denervation syndrome. The semantic information signs changes mainly after sympathectomy. The dynamics of the information process reflects the functional significance of microcirculation in the course of nerve regeneration and skin reinnervation. The increment in information quantity with trophic content occurred at the preimpulse stage of nerve regeneration; it corresponds to the quantitative development of skin microvascular networks for trophic support of reinnervation. The semantic information content was predominantly modulated at the impulse stage due to the increase in homeostatic control intensity. Information peculiarities in the transitional period (from the preimpulse to impulse stage) included a decrease in sporadic processes, an increase in determinism in the system control, the predomination of the trophic content assimilation with the increment in the myogenic activity proper, and the possibility of both multichannel and resonance regimes. The general biological law of the antientropic importance of information for decreasing stochastic processes and the system control support has been confirmed. © A.I. Krupatkin, 2010.


Krupatkin A.I.,Priorov Central Research Institute of Traumatology and Orthopedics
Human Physiology | Year: 2012

The first objective diagnosis of sympathetically maintained forms of pain employing laser Doppler flowmetry (LDF) and specifically targeted at detecting sensory-sympathetic coupling in the skin has been developed and tested in 49 patients with the posttraumatic complex regional pain syndrome. Sensory-sympathetic coupling was diagnosed as a combination of sympathetic vasomotor activity and the presence of sensory peptidergic blood flow oscillations in a frequency band of 0.047-0.069 Hz in the LDF wavelet spectrum. The results of the LDF diagnosis were compared with the clinical evaluation of sympathetically maintained pain carried out after desympathization surgery (thoracoscopic clipping above and below the Th3 ganglion of the sympathetic chain in 33 patients and perivascular sympathectomy at the level of the brachial vascular bundle in 16 patients). The sensitivity of preoperative LDF diagnosis was 90.2%; the specificity was 87.5%; the positive predictive value was 97.3%; the negative predictive value was 63.6%; and the diagnostic efficiency was 89.8%. © 2012 Pleiades Publishing, Ltd.


Krupatkin A.I.,Priorov Central Research Institute of Traumatology and Orthopedics
Human Physiology | Year: 2012

Laser Doppler flowmetry, laser spectrophotometry of oxygen saturation, and the fluorescence determination of the NADH/FAD ratio were carried out in 30 subjects in the upper limb skin zones with and without arteriolovenular anastomoses (AVAs). It was demonstrated that the wavelet-analysis of oxygen saturation and blood flow oscillations in microvessels was an efficient approach to noninvasive estimation of the skin oxygen extraction (OE) and oxygen consumption (OC) rates. OE = (SaO 2 - SvO 2)/SaO 2, where SaO 2 (%) and SvO 2 (%) are the oxygen saturations of arterial and venular blood, respectively. If the cardiac (A c, perfusion units, p. u.) to respiratory rhythm amplitude (A r, p. u.) ratio A c/A r ≤ 1, SvO 2 = SO 2. If A c/A r > 1, SvO 2 = SO 2/(A c/A r). OC = M nutr (SaO 2 - SvO 2) in p. u. · %O 2, where M nutr is the nutritive blood flow value in p. u. M nutr = M/SI, where SI is the shunting index of blood flow in microvessels. The perfusion, OE, and OC values were higher in the skin with AVAs than in the skin without AVAs. The perfusion and oxygen saturation values were more variable in the skin with AVAs. The oxygen diffusing from the tiniest arterioles and capillaries is the most important for tissue metabolism. The contribution of the total perfusion and the oxygen diffusion from arterioles to tissue metabolism increased under the tissue ischemia conditions. © 2012 Pleiades Publishing, Ltd.


Krupatkin A.I.,Priorov Central Research Institute of Traumatology and Orthopedics
Human Physiology | Year: 2011

A novel methodology of quantitative estimation of the information value in microvascular networks is proposed. The methodology has been developed on the basis of the results of wavelet analysis of skin blood flow oscillations measured by means of laser Doppler flowmetry (LDF) in 30 healthy subjects and 56 patients with hand diseases or consequences of hand injuries. The method is based on the calculation of the relative indices of information preservation, dominance of the preserved information, and information effectiveness. The deviation from the multistable information regimen is the largest in the case of resonance oscillations: the total information quantity is significantly decreased; however, the preservation of dominant information and its effectiveness are improved. The preservation of trophic myogenic information predominates upon reduction of sympathetic influences. An increase in the number of information channels increases only the information quantity, whereas the degree of its preservation varies. Sensory peptidergic nerve fibers are activated in response to local heating of the dorsal forearm skin to 34°C. This information is the most effective at the beginning of the heating, when the blood flow increases to a plateau. The blood flow oscillations represented in the wavelet spectrum of microcirculatory oscillations serve as operators based on effective information. These oscillations not only play the hemodynamic role, but also carry information in microvascular networks. © 2011 Pleiades Publishing, Ltd.

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