Contacts Center of Innovative Medical Technologies “Victoria Veritas ” Ukraine, 04070, Kyiv,

1. Author– Ulyana B. Lushchyk, MD, PhD, DSc Contacts Center of Innovative Medical Technologies “Victoria Veritas” Ukraine, 04070, Kyiv, Pochayninska Str 28 t. +380444676389 f.+380444676397 E-mail: u.lushchyk@gmail.com feofaniascience@gmail.com www.lushchyk.org.ua www.istyna.kiev.ua

2. Ulyana Bogdanivna Lushchyk Doctor of Medicine A winner of the Ukrainian rating of professional achievements “Leader of Ukraine” (2004) An academician of the European Academy of Natural Sciences (2008) A member of the European Neurological Society A member of the European Society for Microcirculation In practice Ulyana Lushchyk has gained proficiency as: - a neurologist of higher category (2008); - a functional diagnostician (EEG, capillaroscopy, EchoEG, USDG of arteries and veins of the head and the neck, arteries and veins of the upper and lower extremities, US-scanning of vessels in the human organism); - a radiologist (USD of the thyroid gland, of organs of the abdominal cavity, of the musculoskeletal system, organs of the small pelvis, CT, MRT of the brain and spine); - a physician – a coordinator of the first category in health protection (2007); - a legal expert in medical law.

3. In the years 1990–1994 she developed a quite new method of location and clinical interpretation of data obtained from US-dopplerography and US-scanning of the arterial and venous beds in the head and the neck. A little later she developed an ideology for arteriovenous balance and its disorder under any vascular diseases and algorithms for its correction. Ulyana Lushchyk is an initiator of a direction of the vascular angioneurology. Essential researches in this field are based on the principle, which she proposed, for arterial-venous balance in the vascular system of the human and mathematical models for hemodynamics of the living systems. Basic results of the researches have been described in 16 monographs, 128 articles, 2 rational propositions and registered by 9 State patents. Scientific studies of U. Lushchyk represent essential scientific-and- practical aspects of current psychoneurology, efficient diagnostic algorithms for detection of any vascular pathology on preclinical and clinical stages, integrated treatment of cardiovascular and psychoneurological diseases on the basis of individual approach to a patient applying up-to-date methods of demonstrative medicine.

5. Capillary blood circulation provides the transcapillary exchange (metabolism between blood and tissues) and the condition of microcirculation may be an arbiter of welfare in the systemic hemodynamics, because it is the most sensitive link in the vascular system. Words of Zalmanoff A.S. are actual again: “Impairments in the capillary physiology are so widespread and are so often observed that they must not be considered as a secondary phenomenon but on the contrary as the one of the main elements of organic impairments in a patient suffering from any illness” (Zalmanov A.S. “The Secret Wisdom of the Human Organism. The deep Medicine” (Paris, 1985).

6. Capillaroscopy method Capillaroscopy is one of the diagnostic methods that enables to observe functioning of the peripheral section in the cardiac –vascular system of a human in the dermal and mucous integuments. Capillaroscopy is a unique and non- invasive method of in-vivo examination of the smallest vessels: arterioles, venules and capillaries.

7. If capillaries are filled with blood evenly it is an evidence for proper functioning of the whole system heart – arteries- capillaries- veins- heart. As capillaries are forming the microcirculatory bed and present the end link in blood supply system so the visualization of micro-angioarchitectonics and capillaries’ blood filling is the determinative factor in estimation of the sufficient functioning of the whole hemodynamic system.

8. Capillaroscopy provides the observation of the microcirculation condition in dynamics and control the proper prescription of treatment. Regular capillaroscopic examination enables to diagnose microcirculation impairments, to control non-invasively the efficiency of prescribed anti-aggregate therapy for patients with ischemic disease of heart, pancreatic diabetes etc. and also to study the dynamics of microstructures and materials reactions.

9. Main advantages of the smart capillaroscope and the new methodological approach: • Non-invasive, high clearness and demonstration of blood circulation in arterioles and venules. Qualitative visualization of investigating objects. Сomputed enlargement in 100, 200, 400 times. •Possibility of the multiple applications for estimation of organism’s condition in dynamics according to obtained and saved results in the data base after previous observations. Direct control of the influence on a patient’s organism under the continual treatment. Observation of changes in parameters and functioning of the organism’s systems before, during and after the therapy in the real time. •Wide potential for the programmed processing of obtained images for selection of the maximally useful information. When it is required – correction of the video signal by color, brightness, contrast.

10. Main advantages of the smart capillaroscope and the new methodological approach: •Possibility of the clinical interpretation of the microcirculation dynamic picture due to the mathematical modelling and obtaining numerical characteristics, which can be as supplementary information from the qualitative assessment of observed virtual sections and represent even slight changes in the quantitative equivalent. •Possibility of having specialists’ consultations for avoidance of a mistake in the interpretation and choosing of treatment tactics owing to the monitor visualization of the microcirculation process. •Possibility of archiving images (static and dynamic) that makes it as an important tool of the demonstrative medicine.

11. The device is equipped with: •optical block; •special system of illumination; •colored digital video camera; •personal computer; •special software.

12. Criteria for capillaries’ estimation Criteria Norm 4th finger right hand left hand Specific gravity of number of capillaries 1. sufficient, 16-20 per 2 mm sufficient, 16-20 per 2 mm Capillary form 2. classical loop classical loop Capillary length 3. middle, 150-250 mkm middle, 150-250 mkm Capillary caliber 4. middle-caliber middle-caliber Capillaries shadows 5. under 20% under 20% 6. Presence of the capillary net like a root like a root child's type child's type adolescent type adolescent type adult's type adult's type 7. By character of branching capillaries are not branched capillaries are not branched 8. Capillary tonus normal tonus normal tonus Arteriolar-venular correspondence of diameters diameters of arterioles and venuls are equal diameters of arterioles and venuls are equal 9.

13. Characteristics of hemodynamics in microvessels Level of blood supply with blood evenly Capillary circulation rate normal Rheological changes of the microcirculatory channel not found Barrier function of the capillary net Optic density of aggregates capillary 2. Perivascular edema not expressed moderately expressed up to 50-80mkm 3. Venous insufficiency not found whole capillary is filled whole capillary is filled with blood evenly 1. 2. normal 3. not found equal in the whole 1. equal in the whole capillary not expressed moderately expressed up to 50-80mkm not found

14. Examples of capillarograms Variants of the norm Capillaries with the middle length and middle-caliber, single abnormal capillaries can be present but no more than 1 per 40-50 capillaries in 10throw.

15. Pathological venous net Non-functioning capillaries-shadows, a threat for formation of the plasmatic capillaries. Sludge-effect with phenomena of breakage in blood supply.

16. , Pathological venous net is on the side of the hemiplegia in a patient of advanced age after insult with expressed congestion and turtuousity of venules, magistral and micro- caliber reserve type of microangioarchitectonics. There is a threat of the secondary insult. Vascular system comes into a phase of the microcirculatory decompensation. bnjhjghg

17. . Micro-thrombing of arterioles. The syndrome of intravascular blood coagulation is possible

18. Application Observation of healthy people who are under influence of external factors (stress, geomagnetic, temperature, meteorological). In patients of psychoneurological, therapeutic, angiological, endocrinological profiles for assessment of congenital and acquired vascular anomalies. Prophylactic control (health state of drivers, railway men, pilots, astronauts etc., who face the high risk due to their jobs). Medicine of catastrophes and resuscitation departments (control of a level of blood circulation restoration after critical states). Insurance medicine (almost immediate determination of the cardio-vascular system condition in the organism of an insurant). Sport medicine (control and dosage of the physical loads during sport trainings).

19. Application In pulmonology: capillaroscopy is recommended when there is bronchial asthma, bronchitis, pneumonia for the control of postcapillary state. Differentiation of venous congestion signs in a form of hyperemia of the postcapillary, or its desolation or congestion in the venous geniculum cause different tactics of treatment. In neurology and psychiatry: as formation of brain capillaries and capillaries of a nail bed are interconnected in the process of embryogenesis it is considered, that a state of capillaries in the nail bed represents microcirculation state and the type of microagioachitectonics formation in the brain. Practically all psychoneurological patients require the investigation of microcirculation state in order to differentiate types of capillary formation by the form, size, density per unit area, domination of classic or atypical forms, presence of capillary nets and arteriovenous shunts.

20. Application In cardiology: capillaroscopy is necessary practically for all nosologies and it represents the cardiovascular system functioning in microcirculatory bed. It diagnoses the sladge-syndrome, the syndrome of capillaries desolation, apparent delay of capillary pulsation, the effect of monetary columns when there are apparent signs of cardiovascular insufficiency. It is for control of changing of capillaroscopic feature that is more informative in the estimation of the effectiveness of prescribed treatment. In endocrinology: in case of pancreatic diabetes, diabetic angiopathy. In pediatrics: observation of children with different diseases from angiodystonia to epilepsy, infantile cerebral paralysis, congenital heart malformations as well as the investigations of their parents for early detection of embryonic pathological type of microangioarchitectonics formation. Very atypical form of capillaries formation of micro-caliber type determines pathological changes in hemodynamic picture; it can easily have failures in the functioning and appears as a background factor for development of a pathology. This aspect must be taken into account when correcting hemodynamic disorders with the purpose to avoid iatrogenia.

21. Thank you for your attention!