Abstract. The aim was to study the contents TGFα, TGFβ1 and VEGF in blood of patients with local frostbites. 50 men with local frostbites of extremities (II-IV degree) in the age up to 17-45 years old were examined. The patients were classified depending on the time elapsing post-lesion (group 1, early reactive period; group 2, late reactive period; group 3, granulation and epithelization of lesions). Quantitative determination of TGFα, TGFβ1 and VEGF in blood was performed by ELISA techniques. Blood samples were taken at early, late reactive periods and at period of epithelization of local frostbites. It was revealed that the contents of TGFα, TGFβ1 and VEGF were increased in patients’ blood at later terms after local frostbites. VEGF contents in blood of the frostbite patients increased to higher degrees than the values of TGFα and TGFβ1. An imbalance between TGFα, TGFβ1 and VEGF contents in frostbites was observed in cases of lagging repair and unfavorable clinical course. (Med. Immunol., vol. 10, N 4-5, pp 483-485).

Abstract. Cytokines provide important connecting links between immunity, blood clotting, and nonspecific resistance that become altered in local frostbites. The aim of study was to determine the contents of cytokines in blood of patients with local frostbites at various terms following the lesion. Fifty patients, 17 to 50 years old, with frostbites of extremities (grade II to IV) were under observation. Arterial and venous blood, as well as venous blood from damaged and intact extremities were examined. Cytokine concentrations were determined using ELISA technique. It was shown that blood concentrations of TNFα, IL-1β, IL-4, IL-8 and IL-18 reached their maximum at early reactive period of the trauma (a 2.3- to 19-fold increase). IL-1β concentration exceeded appropriate control values during all the periods of local frostbites. IL 18 levels were increased at early reactive period of the trauma. IL-1β and IL-8 concentration at pre-reactive period proved to be higher in arterial blood of damaged extremities, than in effluent venous blood. Both during early and late reactive periods, the levels of pro-inflammatory cytokines in effluent blood from damaged extremities were 1.2- to 8-fold higher than in venous blood from intact extremities, whereas IL-4 levels were 2- to 5-fold lower.

Using laser Doppler flowmetry comparative evaluation of microcirculatory condition and regulatory components of vascular tone in lower limbs was carried out in 40 patients with local cold injuries in late reactive period and 12 reconvalescents with trophic disturbances. Microcirculation index decreased in all patients while neurogenous and myogenous vascular tone increased. Peak oscillation amplitude decreased in the endothelial range. At the same time in reconvalescents changes in passive regulatory components of vascular tone increase and frequency of peak amplitude neurogenous variation decrease. Thus, cold impact results in stable changes of microcirculation and therefore in dysthrophic changes in affected tissues.

The condition of the microcirculatory bed in frostbitten tissues has the decisive importance in the course of the injury. The objective of the work was to investigate the dynamics of the parameters of microcirculation in patients with an endured local frostbite injury of the upper extremities. Evaluated were oscillations of the bloodstream by means of laser Doppler flowmetry. The study was carried out in a total of sixty 18-to-45-year-old patients presenting with a degree II-IV local frostbite injury of the upper extremities at various periods of the injury. In the prereactive period, when there are no significant deviations of the blood-flow oscillation parameters, using the occlusion test makes it possible to reveal alterations in the condition of the microcirculatory bed. The early and late reactive periods of a localfrostbite injury of the upper limbs are characterized by an increase in the neurogenic and myogenic components of vascular tonicity, as well as the by-pass index, thus suggesting a vascular spasm and increased by-pass blood flow. Degree II-IV frostbites of the upper extremities in the early and late reactive periods of the injury are accompanied by decreased reactivity of the vascular wall in response to occlusion, decreased potential of the active mechanisms of regulation of vascular tonicity, and maintenance of an adequate tissue blood circulation, with a 1.5-2-fold decrease in the blood flow reserve. The revealed alterations in the parameters of microcirculation and regulation of vascular tonicity explain a lingering course of the wound process in frostbites. Using the method of laser Doppler flowmetry makes it possible to determine the condition of microcirculation and vascular tonicity, to evaluate efficiency of the methods of treatment, and to predict the course of frostbite.

The state of the microcirculation bed was assessed by the method of laser Doppler flowmetry in 40 patients with frostbites of lower extremities of the II-IV stages. In the proximal zone segments there was less inflow of blood to the arterial bed, increased neurogenic and myogenic components of vascular tone, decreased nutritive and, in a less degree, shunt blood flow. In aggravation of the injury severity the changes in question become more pronounced.

During evaluation of the functional condition of the platelets in patients with frostbites revealed was the reduction in the intensity, velocity and capacity of platelet aggregation, which makes it possible to propose their functional immaturity in the low temperature trauma. As a result, the course of the traumatic process often becomes protracted with a slow-motion character.

As a result of the carried studies of 150 patients with the acute general cold injury there has been revealed a direct strong relationship between rectal temperature decrease and glucose level in blood of patients. The lower the rectal temperature was, the more significantly the glucose concentration decreased. Dynamics of rectal temperature restoration is connected with normalization of glucose in blood of patients.

In patients with local frostbites in early reactive period well over in blood contents of endothelial cell. The damage of endothelium brings about necrosis, inflammation and growth in blood level of cytokines