Моrphometric investigations of the blood vessels of skin and muscles in patients, suffering an ischemic form of the diabetic foot syndrome


Keywords: diabetes mellitus; diabetic foot syndrome; diabetic microangiopathy

Abstract

Objective. To study a quantitative criteria of affection of blood vessels in the skin and muscles in patients, suffering an ischemic form (IF) of diabetic foot syndrome (DFS) and to determine on their base a diabetic microangiopathy degree (DMAP).

Маterials and methods. The probes of paraffin blocks of the skin and muscles were selected in 49 patients, suffering a Type II diabetes mellitus (DM) and IF of DFS on background of stenotic-occlusive affection of the lower extremities arteries, who were treated in the Centre of Vascular Surgery of Clinical Hospital «Feofaniya» in 2014 – 2017 yrs. For comparison the probes of the skin and muscles were selected in 10 patients, who did not have systemic diseases.

There were conducted histological and immunohistochemical investigations for detection of a Type IV collagen – marker of basal membranes, VEGF – vascular endothelial growth factor; CD31 – marker of endothelial cells, and of a smooth muscles аctin. The diameters and density of the blood vessels in the skin and muscles were measured and compared.

Results. Characteristic changes of morphometric indices of the hemomicrocirculatiry bed (HMCB) of vessels in the skin and muscles in DMAP, what permits to detect its degree.

Conclusion

  1. There were determined a quantitative indices, which have changed, depending on course and compensation of DM: density of the HMCB vessels in a papillary layer of the skin; the thickness of basal membranes of the blood vessels; diameter of the vessel’s lumen in HMCB.
  2. There are characteristic qualitative changes in tissues: a basal membrane of epidermis smoothing, its modulation in some sites; rising of expression of receptors towards Vegf (Vegfr-1); rising of the actin level expression in the blood vessels, including those in capillaries; uneven expression of CD31 in the blood vessels.
  3. Basing on the obtained summarized data, concerning qualitative and quantitative changes in HMCB of skin and muscles, criteria were elaborated for determination of the skin and muscles DMAP degree, what may be applied to create the algorithm for complex treatment of patients, suffering IF of DFS.

References

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4. Schram MT, Stehouwer CD. Endothelial dysfunction, cellular adhesion molecules and the metabolic syndrome. Horm Metab Res. 2005 Apr;37 Suppl 1:49-55. doi: 10.1055/s-2005-861363.

5. Wasserman J, Maddox J, Racz M, Petronic-Rosic V. Update on Immunohistochemical Methods Relevant to Dermatopathology. Archives of Pathology & Laboratory Medicine. 2009;7(133):1053-61. doi: 10.1043/1543-2165-133.7.1053.

6. Petrov SV, Rajhlin NT. Rukovodstvo po immunohimicheskoj diagnostike opuholej cheloveka pod redakciej 3 izdanie dopolnennoe i pererabotannoe. Kazan: Izd-vo «Titul», 2004; 456 р. [In Russian].

Author Biographies


S. M. Didenko, Clinical Hospital «Feofaniya» of the State Affairs Management, Kyiv,

Sergii N. Didenko, PHD, vascular surgeon,

department of vascular surgery,

 Clinical Hospital «Feofaniya»

 21 Zabolotnogo Str., 03143, Kyiv, Ukraina,

 +38 (044) 259–65–74

  hirurgdidenko@gmail.com

 ORCID: http://orcid.org/0000-0002-3115-7524


V. V. Boyko, Zaytsev Institute of General and Urgent Surgery, Kharkiv

Valeriy Boyko – MD, Doctor of medical sciences, professor,

 Director V.T. Zaycev Institute of General and Urgent Surgery

61018, Ukraine, Kharkov, v’ezd Balakireva, 1.

057-349-41-25.

https://orcid.org/0000-0002-9274-2153 


Yu. V. Ivanova, Zaytsev Institute of General and Urgent Surgery, Kharkiv

Yulia Ivanova – MD, Doctor of medical sciences, 

Principal Research Scientist

Department of surgical infectionsV.T. Zaycev Institute of General and Urgent Surgery

61018, Ukraine, Kharkov, v’ezd Balakireva, 1.

057-349-41-94.

guionxnamnu@mail.ru

https://orcid.org/0000-0001-8773-6827


V. Yu. Subbotin, Clinical Hospital «Feofaniya» of the State Affairs Management, Kyiv

Subbotin V.U., vascular surgeon,

head of the Center of Vascular Surgery,

 Clinical Hospital «Feofaniya».

21 Zabolotnogo Str., 03143, Kyiv, Ukraina, tel.: +38 (044) 259-67-70

vitaliksub@ukr.net

ORCID:0000-0002-1538-7004


O. V. Kalenska, Clinical Hospital «Feofaniya» of the State Affairs Management, Kyiv,

Kalenska O.V., PhD,

head of the pathoanatomical department,

Clinical Hospital «Feofaniya».

21 Zabolotnogo Str., 03143, Kyiv, Ukraina, tel.: +38 (044) 259-67-38

E-mail: ovkalenska@ukr.net

ORCID: 0000-0002-5925-3067


L. V. Kalenska, Clinical Hospital «Feofaniya» of the State Affairs Management, Kyiv,

Kalenska L.V., pathologist

pathoanatomical department,

Clinical Hospital «Feofaniya».

21 Zabolotnogo Str., 03143, Kyiv, Ukraina, tel.: +38 (044) 259-67-38

E-mail: lvkalenska@ukr.net

ORCID:0000-0002-4296-8357


I. M. Savytska, Shalimov National Institute of Surgery and Transplantology, Kyiv

Savytska I.M., PhD,

 senior researcher,

Department of Experimental Surgery,

Shalimov Nacional Institute of Surgeri and Transplantation

30, Geroyev Sevastopolya str., Kyiv, Ukraine, 03680

irinasavitska@ukr.net/ 0975100401

 https://orcid.org/0000-0002-2749-7825
Published
2018-08-30
How to Cite
Didenko, S. M., Boyko, V. V., Ivanova, Y. V., Subbotin, V. Y., Kalenska, O. V., Kalenska, L. V., & Savytska, I. M. (2018). Моrphometric investigations of the blood vessels of skin and muscles in patients, suffering an ischemic form of the diabetic foot syndrome. Klinicheskaia Khirurgiia, 85(8), 33-37. https://doi.org/10.26779/2522-1396.2018.08.33
Section
General Problems of Surgery

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