Ascorbic acid is an indispensable participant in most metabolic
processes [1]. It is passively absorbed in the intestine (diffusion,
osmosis) along with water and chlorides, but active transport
of vitamin is possible, similar to glucose transport [2]. With the
insolvency of the bauhinia valve (NBZ) and the development of the
syndrome of excessive microbial colonization of the small intestine,
the absorption function of the latter suffers avitaminosis “C”
develops. One of the objective and accessible screening methods
for the determination of vitamin C deficiency was the formulation
of a canned sample for capillary resistance [3]. The occurrence of
petechial rash after this test allowed to judge the presence and
degree of hypovitaminosis. The appearance of petechiae, their size
and shape are determined by the degree of “vulnerability” of the
capillary wall of the dermis [4]. In the body there is a strong direct
positive relationship between the degree of capillary strength and
the level of vitamin “C” in the blood [5]. We have proposed a method
for determining the “C” vitamin status by a capillary resistometer.
The principle of operation of the device is as follows. When creating
negative pressure inside a special nozzle applied to the skin of the
forearm, petechiae of various sizes and shapes appear. The size and
shape of petechiae are determined by the degree of “vulnerability”
of the capillary walls of the reticular layer of the dermis, which, in
turn, is closely related to the level of vitamin C in the blood.
To create a capillary resistometer apparatus for determining
the “C” vitamin status in patients with the failure of the bauhinia
valve and after its correction.
The device we developed (RF patent for useful model No.
87889 “Capillary Resistometer” dated January 19, 2009) consists
of the following elements that form a closed medium during
operation: a metal nozzle on the skin; differential pressure gauge;
discharge system. The characteristics of the nozzle correspond to
the characteristics of the glass jar (the inner diameter of the funnel
is equal to 15.8 mm), which makes it possible to apply standard
data (Table 1) to evaluate the results obtained. An electronic
manometer “Testo 506”, produced in Germany, certificate No.
23187, registration number 17270-06, measurement range is +/-
2 atm, is used as a differential pressure gauge. The display of the
gauge displays the load cell in 6 units of measurement (mm Hg.
Art., Mm aq. Art., Atm., Pa, etc.). The pressure gauge is connected
via plastic tubes through a tee to the system, followed by pressure
measurement during the test. As a discharge system, a Jané syringe
and a holding rod are used to maintain a constant level of discharge
in the system. The general view of the device and its functional
elements is shown in Figure 1. A capillary resistometer is used
as follows: when a metal nozzle is applied to the inner surface
of the upper third of the patient’s forearm, air is sucked out of
the closed tube system of the device using a syringe. The degree
of discharge is controlled by an electronic differential pressure
gauge. At achievement of the necessary pressure in system (240
mm of mercury.) The clip connecting the nozzle and the syringe is
imposed. Aged 3 minutes. In case of accidental depressurization
of the system (as evidenced by a change in pressure), the nozzle
is applied to the skin again. After the exposure time expires, the vacuum stops, the device is removed from the patient’s skin. The
result is registered and its subsequent assessment (Table 1). For
the objectification of the obtained data and their estimated results,
we proposed a processing algorithm that implies:
Table 1: Evaluation results canned samples.
1. Conducting a sample with a capillary resistometer (Figure
1, Figure 2a & 2b);
Figure 2: The result of the test: a - the appearance of skin
petechiae; b - petechiae at magnification (x15).
2. Morphometry of petechiae obtained using the Image Tool
v. 3.0 (Figure 3).
Figure 3: Petechiae morphometry using the Image Tool
v. 3.0 (final): result of computer processing of petechiae
images.
3. Statistical processing of the obtained results of
morphometry
We carried out tests on capillary resistance using the
developed device and the scheme in 30 patients with proven
NBZ. Hypovitaminosis “C” was detected in all, and in 17 patients
the severity of hypovitaminosis “C” was assessed as moderate
and severe. We also studied the “C” vitamin status in 14 patients
in the long-term (1 to 2 years) after bauginoplasty. In 9 patients
hypovitaminosis was absent, in 5 patients had a mild severity.
Findings:
1. “C” vitamin deficiency plays an important role in NBZ,
causing manifestation of secondary associated conditions,
such as exacerbation of reflux disease, peptic ulcer disease, IBS,
vegetative-vascular disorders, bronchial asthma, dermatosis,
hemorrhage syndrome.
2. The obtained first results suggest that the operation of
Bauhinoplasty, being radical in relation to the functional and
anatomical insufficiency of the Bauhinini valve, has a positive
effect on the “C” vitamin status of the patient.
Berezov TT, Korovkin BF (2002) Biological chemistry. Medicine. pp. 2667.
Davis M, Austin J, Patridge D (1999) Vitamin C - chemistry and biochemistry. pp. 304.
Martinchik AN, Maev IV, Petukhov AB (2002) Nutrition of a person Fundamentals of Nutriciology. pp. 186.
(1984) Methods for assessing and controlling vitamin security of the population. pp.
Sumtsov BM (1978) Natural compounds of vitamin C and the possibility of its binding to proteins / Vitamins and the body's reactivity: works Mosk. about the nature testers. pp. 132.