g.13.1. Internal Diseases
g.13.5. Roentgenology and Radiology
g.13.6. Public Healthcare
8.g.13.1.1. Difficulties in the treatment of patients
with chronic hepatitis C and ulcerative colitis. /T. Gegeshidze,
According to the WHO data, 3-4 million people
worldwide are being affected annually with HCV infection. Official registration
of HCV infection in
8.g.13.1.2. The etiological structure and antibiotic
sensitivity of bacterial prostates. /K. Aphridonidze, M.
Dzagnidze, N. Cholokashvili, E.Mirvelashvili,
In the study, the chronic prostatitis microbe and the prostate secretion of 84 patients were tested bacteriologically. From the prostate secretion of all the patients the microorganisms of different genera were grown up: TRV-38%, Staphylococcus aureus – 35.7%, Enterococcus fecallis – 14.2%, Staphylococcus epidermidis – 11.9%. Gram-positive microbes have high sensitivity to penicillin, makropan and tarivid and resistance to kanamycin, gentamicin and ampicillin.
8.g.13.1.3. Risk assessment and management in case of
asymptomatic high-degree AV blocks. /I. Venkata Kiran Kumar
Raju, K. Jalabadze, K. Etsadashvili,
Permanent pacemaker implantation is a well-established indication for the patients with high degree AV block and syncope, but there are the controversial data about the device implantation for the patients with asymptomatic high degree AV block. We report the case of 56-old patient with accidentally diagnosed asymptomatic high degree AV block, (proximal location) according to surface ECG. During the EP study 6 second- long asystole was developed. This case stresses on misleading interpretation of ECG to assess the risk and further prognosis in such cases.
8.g.13.1.4. Clinical and laboratory peculiarities of
the anthrax infection in
The aim of the study was to evaluate clinical and laboratory peculiarities of the anthrax (infection based on the infectious diseases, AIDS and Clinical Immunology Scientific Centre data. 17 patients underwent follow-up during 2007-2008 years. 14 (82.3%) out of 17 were males and 3 (17,7%) out of 17 were females. In the majority of the patients rout of infection was the contact with the infected animal and/or their products. In one case, the rout of infection was the contact with the contaminated soil (during rural activities In 3 (17.6%) patients the disease progression was mild, in 8 (47.1%) - moderate, and in 6 (35.3%) - severe. The diagnosis was confirmed on the basis of clinical and epidemiological data. Bacteriological and/or PCR analyses of the carbuncle contents were done for the identification of B. anthracis. Patients with mild and moderate severity were treated with oral antibiotics of the ftorquinolone group, namely – ciprofloxacin 1000 mg/day for 10-14 days. In-patients with severe disease combination of two antibiotics-ciprofloxacin and benzyl penicillin were administered. At the parallel I/V transfusion of glucose and electrolytes were managed.
8.g.13.1.5. Comparative results of treatment of
patients with cerebral stroke in neurology department and hospital with a
stroke unit. /I. Verulashvili/.
A comparative analysis of treatment results in patients with an acute stage of cerebral stroke treated in 2007-2008 both in the N. Khipshidze Central University Hospital by a stroke unit, equipped with high-tech equipment and staffed with specialists of a multidiscipline team (158 patients; mean age 56.3±7.5) and in a neurology department of Municipal Hospital #1 (169 patients; mean age 53.83±6.1) was conducted. The obtained data prove the fact that a medical aid to cerebral stroke patients rendered in the hospital with a stroke unit, has apparent advantages: therapy is accompanied by a good regress of a neuralgic deficit (correspondingly 76% to 28%) and somatic complications (correspondingly 7% to 2.5%). Lethality (correspondingly 3.2 to 5.8 lethal events per 100 patients), invalidation and domestic incapability of a patient to the end of the third month of a disease onset are greatly decreased in-patients treated in stroke unit. An advantage of stroke units is that this specialized care can be given to a broad spectrum of patients regardless of the interval after stroke or severity of neurological impairments.
8.g.13.1.6. Acute toxic damage of liver: pathogenesis
and new ways of treatment. /D. Tophuria, R.
Khetsuriani, A. Shukakidze., N. Mzareulishvili, Z. Tophuria, G. Didava/.
Pathomorphological changes of the liver due to the action of numerous toxic agents (CCL4, various medications) are generally manifested by two types of damages, the so called hepatocellular or cytotoxic and cholestasis. In serious toxic damage cases may develop massive necrosis and fulminant liver insufficiency, the most frequent causative toxic substances being halothane, isoniazid, phenytoin and organic solvents. Mammalian mature cells do not have affinity to division and reparative regeneration, but hepatocytes in this case serve as unique objects; oval progenitor cells can proliferate and differentiate both in hapatocyte and bile secreting epithelial cells. These cells are highly resistant to hypoxic conditions and easily cultivate in vitro conditions. By an electron microscopy study of progenitor cells, a high number of oval mitochondrias and endoplasmic reticulum microtubules can be observed. According to these findings, we can postulate that such ultrastructural changes are leading to high functional activity of cells and reparative regeneration process intensity.
In regard to CNS, there are some discrepancies in published data concerning irreversible damages induced by local hyperthermia. We studied sensitivity of cerebral tissue to hyperthermia, its immediate effect, manifested by histological changes and the role of local blood flow, blood rheological properties, and the possible role of free radicals in development of mentioned damages. Through the cranial window local area of cerebral surface was irrigated by artificial CSF heated up to 41, 43 or 450C. Serial brain coronal sections 50 mm thick were analyzed under light microscope. lCBF was measured by the hydrogen clearance method. Blood rheological properties were changed by injection of Dextran T-500 and free radicals existence was controlled by DMSO injection. High sensitivity of cerebral tissue to hyperthermic exposure even at a temperature of 410C has been confirmed. We consider cerebrovascular thrombosis as one of the most significant complication of brain hyperthermia. Deteriorated blood rheological properties aggravates hyperthermia-induced cerebral lesion. Administration of free radicals scavengers can partially lessen hyperthermia induced cerebral lesion.
8.g.13.1.8. Prevalence of depression and anxiety in
postmenopausal women. /T. Gegenava, M.
Gegenava, G. Kavtaradze/.
Depression affects twice as many women as men. Midlife is often considered a period of increased risk for depression in women. Menopause is often believed to be a time when women are more likely to become depressed. This period is associated with gradual declines in estrogen levels. Some studies suggest that changes in estrogen levels are associated with onset of depression. The symptoms of depression in menopause or perimenopause are: two or more weeks of depressed mood, decreased interest or pleasure in activities, change in appetite, change in sleep patterns, fatigue or loss of energy, difficulty concentrating, excessive feeling of guilt or worthlessness, thoughts of suicide, extreme restlessness and irritability. Many symptoms of menopause overlap with symptoms of depression, including problems with sleep, physical symptoms such as hot flashes, fatigue, irritability, anxiety and difficulty concentrating. Research was performed in 88 postmenopausal women. Depression was assessed by the Beck Depression Inventory, which includes 21 questions and assesses the state of patients during the last two weeks. Anxiety was assessed by Spilberger’s State and Trait Anxiety Inventory. Our study demonstrated that depression was revealed at high and moderate degree in postmenopausal women c2 = 11.92 (p=0.008), as well as anxiety was revealed at high degree in this group c2 = 5.73 (p = 0.058). Sleep disorder was found in 75% postmenopausal women. Our study demonstrated that there is a high prevalence of depression and anxiety in postmenopausal women.
8.g.13.1.9. Assessment of heart rate variability in
chronic heart failure. /N. Mamamtavrishvili, P.
Matchavariani, N. Nakashidze, R. Abashidze, L. Burduli, A. Kvirkvelia/.
The making of prognosis of patients with chronic heart failure and the establishment of independent predicators of mortality are among the most urgent clinical objectives. To date it has been established that, together with many factors, the analysis of the state of the neurovegetative control of the heart, in particular, the spectral analysis of heart rate variability (HRV) with long-term (24-hour) ECG recordings, makes it possible to assess the risk of unfavorable outcome in CHF patients. A depression of the heart rate variability indices in patients with chronic heart failure against the norm has been found to be in correlation with the disease severity and may be considered as an independent prognostic marker of the unfavorable outcome.
8.g.13.1.10. Clinical characters and treatment of
varicella-zoster virus infection at the modern stage. /T. Megrelishvili, E. Vashakidze, E. Pachkoria,
Tendency of varicella-zoster virus infection among
children and adults has increased in
8.g.13.1.11. The effect of calcium antagonists to the
amount of monoamines in different structures of the brain of albino rats under
extreme conditions. /A. Mirzayeva, A.
Baghirov, G. Ganiyeva, V. Asmatov, M. Ganiyev/.
Taking into consideration the necessary role of monoamines in the realization of brain functions, the effect of one-time and prolonged administration of calcium antagonists in albino rats under extreme conditions on the amount of monoamines in different structures of brain (norepinefrin, serotonin, dopamine) was studied. Based on the neurochemical study results, it was detected that under extreme conditions, the acute and chronic experiments, the amount of norepinefrin and dopamine decreased and the amount of serotonin increased. Under extreme conditions, upon administration of 25mg/kg verapamil, 10mg/kg amlodipin, 10 mg-kg flunarizin in different structures of the brain (hypothalamus, striate body, frontal cortex) the amount of norepinefrin and dopamine decreased and serotonin increased in acute and chronic experiments.
8.g.13.1.12. Use of cytopathologic methods in modern
pulmonology. /T. Mamaladze, L.
In the 20th century, laboratory diagnosis has undergone revolutionary changes. In cytology one of the most successful automated complex AutocytoPrep, CytoScreen, ThinPrep was implemented. This system is successfully used in pulmonology. A combined cytological analysis of sputum and chest X-ray provides the most accurate diagnosis of lung tumors. It was confirmed by our study that to improve the accuracy of lung tumor diagnosis the chest X-ray and sputum cytology should be applied jointly.
8.g.13.1.13. The etiological structure of viral
The etiological structure of viral hepatitis has been
studied based on the data received in 2001-2008. In the 21st
century, the disease tends to increase. The rate of incidence in 2007-2008, as
compared with 2003-2004, had a 2-fold increase. The incidence of viral
hepatitis type B and C prevails, especially their chronic forms. According the
2007-2008 data, hepatitis type C is considered to be the most common disease.
Its exact Percentage equals to 27.4%. We should point out that mostly an
increase of specific volume for hepatitis type B and C is detected in the
8.g.13.1.14. QT-interval prolongation after
ventricular premature contractions (VPCs). /Mohammed
Haroon Rashid, K. Etsadashvilli, A. Melia, K. Jalabadze,
Long QT syndrome (LQTS) is an inherited ion channelopathy resulting in abnormal ventricular repolarization and abnormal prolongation of QT interval on the ECG. Syncope, fainting, cardiac arrest and sudden death are common manifestations of LQTS; this case report describes a patient with prolonged QT interval after extrasystole and a family history of sudden cardiac deaths.
8.g.13.1.15. Treatment of patients with atypical
chronic cholecystitis by natural factors in Lashichala balneotherapeutic health
resort. /N. Saakashvili,
Chronic cholecystitis is frequently complicated due to changes of secondary development of the cardiovascular system. As the mentioned disease is not subordinated by medical treatment assigned to the cardiovascular system, with the curative purposes we applied "Lashichala" – a mineral water with carbon dioxide of low mineralization, hydrocarbonate and potassium-sodium. 120 patients with chronic non-petrosal cholecystitis were evaluated. After crenotherapy (spa treatment), the majority of the patients (with cardiac syndrome) showed clinic improvement signs: decrease of angina pains, normalization of heart rate, blood pressure, etc.; all the mentioned are correlatively connected with the improvement of subjective and objective indices of the gallbladder. The treatment with "Lashichala" mineral water resulted in a decrease of inflammatory process in the gallbladder, improvement of quality of bile, which consequently decreased the influence of pathological reflexes from the gallbladder to the heart. The "Lashichala" mineral water is ecologically safe and effective means for persons with biliary system disease.
8.g.13.1.16. Prevention and treatment of
gastroduodenitis with new mineral water “Vardzia”. /N. Saakashvili,
For normal functioning of body, the conservation of microelements balance is very important and is possible by means of mineral waters. For the first time, we have studied the effect of carbonic acid hydrocarbonate, sodium chloride mineral water of high mineralization (17.9 g/dm3) "Vardzia" in 20 patients with chronic gastroduodenitis. From its optimal composition by microelements, monotherapy with mineral water "Vardzia" gave rise to the positive dynamics of sickness’ clinical symptoms among the patients and improved mucous membrane structure of duodenum. The physico-chemical, organoleptic features, as well as high curative properties of the mineral water "Vardzia" make it possible to apply this water not only for bowel treatment, but also for preventing asiderotic (iron-deficiency) anemia and atherosclerosis.
8.g.13.1.17. Family case of
8.g.13.1.18. Long-term effect of subchronic manganese
intoxication on the rat’s memory. /A. Shukakidze, R.
Khetsuriani, D. Tophuria, T. Bikashvili, N. Mitagvaria,
The one of the most important aspects of neurotoxicity, induced by manganese excess is the revealing of long-term effects of manganese subchronic intoxication. The effect of a 30-day peroral administration of manganese chloride – MnCl2. 4H2O (10, 20 and 50 mg/kg per day) on adult male albino rats’ memory has been investigated. Before exposure to manganese, the rats were tested in a multi-branch maze (learning of optimal way to get from the start platform to the nest-box). The repeated session of the maze testing was provided both 1 and 90 days after completion of manganese administration. It has been established that everyday manganese administration during 30 days after completion of maze learning and acquisition of automatic behavior skill causes temporal disturbances (increased quantity of mistakes), but more important is statistically significant prolongation of time necessary for maze-test solution. Thus, the mentioned doses of MnCl2. 4H2O do not essentially affect the memory – the animals are able to slowly but completely accomplish the earlier acquired stereotype of behavior.
8.g.13.1.19. The attributive value of risk factors in
forming digestive disorders in adolescents. /M.
The aim of the research was to assess the attributive
value of risk factors of digestive disorders in 14-21 year-aged adolescents.
One-stage epidemiological research was conducted among the medium and late
period adolescent population of
morphological index for cervical carcinoma prediction. /Ts. Gatenadze, J. Ungiadze, O.
Chakhoian, M. Nakashidze,
The aim of the research
is a complex clinical and morphological evaluation of the factors influencing
the development and prediction of cervical carcinoma. The case histories of 505
patients (from 20 to 70 year- old) with I-III clinical stages of primary
cervical carcinoma having undergone a surgical and combined treatment in an
oncology center in
The purpose of the study was to reveal causal relations between infection of the urinogenital tracts by intracellular parasites, the so-called TORCH infections, and the decrease of spermatogenesis. For observation 182 men of the reproductive age (from 22 to 38 years) with oligozoospermia and aspermia, without any complaints or clinical symptoms indicating the existence of the urinogenital tract infections, were selected. Out of those, 131 revealed oligozoospermia, i.e. the quantity of spermatozoons was no higher than 20 mln/ml of the ejaculate, and 51 revealed – aspermia. For examination of some TORCH infections, medical doctors in charge directed 44 oligozoospermia patients and 15 aspermia patients, who respectively constituted the group I and the group II. Examinations were carried out for Chlamydia trachomatis – (Ch.t), Herpes simplex virus – (HSV), Ureaplasma urealiticum - (U.u.), Cytomegalovirus - (CMV), and Mikoplasma hominis – (M.h.). In the group with oligozoospermia, cases of infection by Chlamydias (41.5%) and Herpes virus (51.3%) were frequent, but Ureaplasma (56.5%) was more frequent than any infections. Cytomegalovirus occurred in the least number of cases. The making of any conclusions on the frequency of infections by M.h. is difficult due to the low number of examinations. A similar picture was observed in Group II as well. Following the successful treatment of infections in Group I, 8 patients with Ch.t. and 8 patients with U.u. showed an improved spermogram after several months. Treatment of other infections did not yield tangible results. In Group II spermatogenesis remained without any changes.
High prevalence of allergic rhinitis makes more topical the problem of searching for new, more effective means of treatment of this pathology. 67 patients with allergic rhinitis were examined. 35 of them had a persistent form of pathology and 32 of them – an intermittent form of allergic rhinitis. It has been established that the treatment by vanadium intranasal electrophoresis caused attenuation up to disappearance of the complaint, had a normalizing action on the olfactory nasal function, motor activity of scintillation epithelium of nasal mucosa, and other objective indices of clinical status. The mentioned positive shifts were more pronounced in the patients with an intermittent form of allergic rhinitis.
8.g.13.1.23. The risk of myocardial infarction in out-patients with type II diabetes. /E. Kerimova, V. Azizov, V. Mirzazade/. Georgian Medical News. – 2010. – # 1(178). – pp. 41-45. – rus.; abs.: geo., eng., rus.
The aim of this study was the identification of a risk of myocardial infarction in out-patients with type 2 diabetes. The study was carried out on 340 patients with type 2 diabetes. The risk of ischemic disease was determined during 10 years by PROCAM program. It was found that 178 (52.4%) patients with type 2 diabetes had low risk of development of myocardial infarction, 89 (26.2%) patients with moderate and 73 patients (21.4%) with high risk of myocardial infarction. The following interconnection was determined: the age of the patients(r=+0,46; P<0,001); the family history of diabetes (r=+0,22; P<0,01); smoking (r=+0,23; P<0,01); systolic arterial pressure (r=+0,18; P<0,05); cholesterol (r=+0,20; P<0,01); high-density lipoprotein (r=-0,24; P<0,001); low-density lipoprotein (r=+0,21; P<0,001).
8.g.13.1.24. A correlation of rheological properties of blood, Il-1β and lipid profile in patients with chronic cor pulmonale. /L. Nanijanyan, M. Sargsyan, G. Khachatryan/. Georgian Medical News. – 2010. – # 1(178). – pp. 46-48. – rus.; abs.: geo., eng., rus.
Cor pulmonale is a frequent complication of chronic pulmonary diseases. Despite its long-term study, a number of issues of this problem still remains unsolved and disputable; the diagnosis of the disease at the early stage of development is complicated; its treatment is of little effect, while the death rate is high. This study aims at working-out an algorithm of diagnosis of cor pulmonale on the basis of mathematical modeling and analysis of laboratory data. The worked-out dimensionless coefficients of the most informative indices of the level of blood corpuscles, blood lipids spectrum, and the human interleukin-1β will permit, independently, within the acceptable ranges, diagnosing the early stages of the disease, estimating its dynamics and predicting its further development.
8.g.13.1.25. Dimensionless coefficients counted on the basis of instrumental indices in patients with chronic cor pulmonale. /L. Nanijanyan, M. Sargsyan, G. Khachatryan/. Georgian Medical News. – 2010. – # 1(178). – pp. 48-51. – rus.; abs.: geo., eng., rus.
Cor pulmonary remains one of the actual tasks of modern pulmonogy, cardiology. The aim of the investigation is working-out algorithm diagnoses of cor pulmonary on the grounds of mathematical modeling and analyses of the results of several instrumental indices. The results of the investigation indices showed that worked-out by means of mathematical analyses the dimensionless coefficients permit find out the necessary instrumental indices for CP diagnose. Dimensionless coefficients promote control over the efficiency of treatment and also enable the development of new optimal scheme CP therapy.
8.g.13.1.26. Effects of
neurotoxic lesions of the CA1 region of the hippocampus on place and cue
learning in Morris water maze trial. /G. Maghlakelidze, G.
The aim of the present study was to investigate the effects of neurotoxic lesions of the dorsal CA1 region of the hippocampus on place-cue learning in a Morris water maze task. The injections of ibotenic acid injections to the hippocampal CA1 caused a loss of pyramidal cells in CA1, while saving most of the pyramidal cells in CA3 and granule cells in DG intact. Under conditions of a visible platform training trials, differences in the platform reaching latency between the animals of different groups were not found. When testing was performed under conditions of a submerged platform, the platform finding latency significantly increased (P<0.05). This fact evidences of a deficit of the place learning strategy in the CA1-lesioned rats. The decreased place-bias in the CA1-lesioned rats in the hidden platform training trials compared to the sham-operated rats was significant, but in trials when the animals had to choose between the earlier learned place and the visible platform’s new location, most of them swam first to the old spatial location. The place learning deficit in the CA1-lesioned rats compared to the sham-operated rats was not significant. We suggest that spatial learning deficit caused by the dorsal hippocampus lesions cannot be accounted solely to the loss of dorsal hippocampal CA1 region cells.
8.g.13.1.27. Study of
object learning and reactions to spatial and non-spatial changes in rats with
dentate gyrus lesions. /G. Beselia, G.
In order to investigate the possible involvement of DG in spatial and object recognition memory, we have opted for a non-associative task where no explicit reward was present. Colchicine was used for bilateral DG lesions for its well-known specificity for DG lesion. The colchicine-induced lesions produce severe damage in the granule cells of DG, while minimally affecting pyramidal cells in CA1 and CA3. The main results are as follows: The overall habituation to the familiar environment in the rats with DG lesions was decreased against the sham operated rats. There was no significant impairment in detecting spatial novelty. THE DG lesions did not affect the detection of a novel object placed in a familiar location. Considering both the impaired habituation and the generally intact detection of spatial changes, we suggest that the exploratory activity in relation to the entire environment and to the particular objects is thought to be preserved by diverse nervous substrate, and testing under the given conditions allows for their differential estimation.
8.g.13.1.28. Study of potential cytoprotective activity of different antioxidants. /L. Ratiani, T. Ratiani, G. Sharashenidze, G. Janigashvili, T. Sanikidze/. Georgian Medical News. – 2010. – # 1(178). – pp. 72-77. – rus.; abs.: geo., eng., rus.
It is known that infiltration of atherosclerotic plaques by activated T lymphocytes occurs at the early stage and cytokines produced by those lymphocytes become actively involved in an inflammatory process. Consequently, the preparations capable of stabilization of immune cells will probably be effective for treatment and prevention of atherosclerosis. Intensively proliferated Jurkat leukemia T cell line (human leukemia cell culture) is widely used in scientific and therapeutic research as human T lymphocyte pattern. The aim of the study was to establish the cytoprotective action of different antioxidant preparations on Jurkat cells incubated under oxidative stress conditions. The dose- (100 μl, 50 μl) and time-related decrease of viability of Jurkat cells incubated under high oxidative stress conditions was determined. Low doses of hydrogen peroxide (H2O2) (25 μlm 11 μl) reveal cytotoxicity only during a short-term incubation (8 hours). Vitamins C and E have cytotoxic effects on intact Jurkat cells separately, while Megavite and Phenovin are not characterized by cytotoxicity. Upon simultaneous incubation of Jurkat cells with antioxidants under conditions of a moderate oxidative stress (H2O2 25 μl, 50 μl) all antioxidative preparations (except vitamin C) reveal static activity on viability of Jurkat cells. Upon incubation of Jurkat cells with antioxidants under conditions of an intensive oxidative stress (H2O2 100 μl), the cytoprotective activity of antioxidant preparations is rather low.
8.g.13.1.29. Impact of treatment with intranasal electrophoresis of vanadium on the allergic reactivity and immunological indices in patients with allergic rhinitis. /Sh. Tsiklauri/. Georgian Medical News. – 2010. – #2(179). – pp. 19-26. – rus.; abs.: geo., eng., rus.
67 patients with allergic rhinitis were investigated. Out of these patients, 35 had a persistent form of allergic rhinitis and 32 – an intermittent form of pathology. It has been established that in patients with allergic rhinitis the treatment with intranasal electrophoresis of vanadium strengthens T-cellular immunity, has a desensitization action, increases non-specific resistance of the organism and has a normalizing effect on the indices of humoral immunity. The above positive shifts were more pronounced in the patients with an intermittent form of allergic rhinitis.
8.g.13.1.30. The spirometry findings of
bronco-obstructive syndrome during concomitant intestinal parasitosis. /K. Aliyev, G. Aliyeva,
The aim of research is to study spirometry findings of the broncho-obstructive syndrome (BOS) during a concomitant intestinal parasitosis. 81 patients aged from 5 to 61 years (male 43, female 38) were examined. The patients were divided into 2 groups: group I – 40 patients treated only with a bronchodilator therapy (14 patients with protozoa, 14 – with helminthes, 12 – diseased with a combination of parasites); group II – 41 patient treated with a bronchodilator therapy together with an anti-parasitic therapy (14 patients with protozoa, 17 - with helminthes, 10 - diseased with a combination of parasites). 22 patients with BOS without parasites made a control group. Functional disorders at the initial examination did not significantly differ among the patients with protozoa, helminthes, a combination of parasites and the patients without parasites. A considerable difference was observed in the post-treatment dynamics: the bronchodilator therapy of patients infected with parasites only cannot attain a significant improvement of the external respiratory function indices, whereas in the patients with helminthes many parameters can be found to decrease. The lowest growth of indices was observed in the patients of group I – 2.17/ 5.09% (-6,81min; 10,54max). The highest growth was observed in the patients of group II – 20.26/12.45% (2,77min; 43,85max). An increase in indicators in the post-treatment spirometry of the control group was more moderate against those of the groups I and II – 5.96/ 2.97% (0,39min; 9,59max). Thus, the use of the anti-parasitic therapy in combination with the bronchodilator therapy to treat patients with intestinal parasitosis (group II leads to reliably significant positive dynamics of spirometry findings not only in group I (ð<0.05 by many parameters) but also in the control group (ð<0.01 by many parameters).
8.g.13.1.31. The effect of dorsal hippocampal lesion
upon development of a fixed set in albino rats. /S. Tsagareli, A. Stamateli,
The experiments have been carried out on intact and hippocampectomized white (albino) rats. At the first stage of these experiments, in a two-entrance communicating chamber, behind which a feeding trough was placed, the animals were to develop a food-procuring conditioned reflex for visual stimulus differentiation. The two doors of this chamber were illuminated at different intensity. After the animals had achieved the learning criterion, the development of a fixed set was initiated. At the given stage of the trial, the rats used to be let go in the same direction several times, in particular toward the brightly lit door, after which the doors in the control test were again illuminated at equal intensity. If the animal went up to the cued door, the response was considered to be assimilated, or to be contrasted where it chose the opposite direction. The frequency of the assimilated and contrasted responses was quantitatively established. The experiments confirmed the possibility of development of a fixed set in the rats. It has been established that the gradual character of a fixed set depends upon the stimulus frequency. The intensity of the set is increased in parallel with the stimulus frequency growth. The active role of the dorsal hippocampus in the development of a fixed set has been revealed.
8.g.13.1.32. Postsynaptic responses of the cerebral hemisphere cortex neurons being activated by nociception during stimulation of locus coeruleus. /T. Labakhua, T. Janashia, G. Gedevanishvili/. Georgian Medical News. – 2010. – #2(179). – pp. 46-51. – rus.; abs.: geo., eng., rus.
In acute experiments on curare-administered cats, the effects of stimulation of the locus coeruleus on postsynaptic processes evoked in neurons of the somatosensory cortex by stimulation of nociceptive (intensive stimulation of the tooth pulp) and non-nociceptive (moderate stimulation of the infraorbital nerve and ventro-posteromedial (VPM) nucleus of the thalamus) afferent inputs. Seven cells activated exclusively by nociceptors and ten cells activated by both nociceptive and non-nociceptive effects (hereafter, nociceptive and convergent neurons, respectively) were recorded intracellular. In the neurons of both groups, responses to nociceptive stimulation (of sufficient intensity) looked like in EPSP-spike-IPSP (the latter of significant duration, up to 200-300 msec) complex. Conditioning stimulation of the LC which preceded test stimulus applied to the tooth pulp or VPM nucleus by 100 to 800 msec, induced a 40-60% decrease of the IPSP amplitude only, while maximal effect of the effect, in both cases, was noted within intervals of 300-700 msec between conditioning and test-stimulus. During stimulation of the LC, noradrenaline released via receptor and second messengers, provides postsynaptic modulation of GABA-ergic system, decreasing the IPSP amplitude, which occurs after stimulation of both the tooth pulp and VPM thalamic nucleus. This process may be realized through either pre- or postsynaptic mechanisms.
C-KIT-positive multipolar cells in human penile erectile tissue: expression of
connexin 43 and relation to trabecular smooth muscle Cells. /S. Ückert, G. Kedia, I. Satzger, U. Gaismar,
M. Sohn, M. Kuczyk, P. Hedlund,
The aim of this study was to evaluate the hypothesis that interstitial cells might play a role in controlling and synchronizing via gap junctions the electrical activity of smooth muscle cells. The expression and distribution of interstitial cells in human penile erectile tissue was evaluated to determine whether or not cavernous interstitial cells express the gap junction protein connexin 43. Specimens of human corpus cavernosum were excised from full preparations of human penises. Cryostat sections (10 µm to 15 µm) of formaldehyde-fixated tissue segments were incubated using a double-labelling technique with antibodies directed against smooth muscle α-actin, C-KIT, and connexin 43. Then, sections were exposed to secondary antibodies. Visualization was commenced by means of laser fluorescence microscopy. Double-staining techniques revealed immunosignals specific for C-KIT (transmembrane receptor protein) and connexin 43 (gap junction protein) in multipolar cells located adjacent to smooth muscle cells. The number of C-KIT-positive cells was significantly lower within the smooth musculature than within bundles of connective tissue surrounding smooth muscle cells of corpus cavernosum or cavernous arteries. Our findings demonstrate the distribution of c-kit- and connexin 43-positive interstitial cells in the connective tissue and smooth musculature of the corpus cavernosum. Additional studies are needed in order to evaluate further the ultrastructure of human penile erectile tissue and enable the identification of gap junctions mediating direct cell-to-cell communication.
efficacy of atorvastatin in the case of paroxysmal atrial fibrillation in
patients with ischemic heart disease. /G.
Dundua, G. Abuladze,
The purpose of the study was to estimate the efficacy of atorvastatin in complex treatment with antiarrhythmic drugs against the background of an ischemic heart disease in patients with paroxysmal atrial fibrillation (AF). The investigation was conducted on 65 patients (37-72 years old) during 2 years. Two groups were composed. Group I included 28 patients who underwent an anti arrhythmic treatment on the background of standard therapy. Group II was composed of 37 patients who underwent a combined treatment with therapy by atorvastatin (at a 10-20mg daily dose). During period of investigation AF was observed in 32% of patients in Group I and in 14% of patients in Group II. It was revealed that the complex therapy with atorvastatin minimizes the episodes of AF.
8.g.13.1.35. Tolerance induced by non-opioid analgesic microinjections into rat’s periaqueductal gray and nucleus raphe. /N. Tsiklauri, I.Nozadze, G. Ghurtskaia, V. Berishvili, E. Abzianidze, M. Tsagareli/. Georgian Medical News. – 2010. – #3(180). – pp. 47-55. - eng.; abs.: geo., eng., rus.
Several lines of investigations have shown that the microinjection of non-opioid analgesics, non-steroidal anti-inflammatory drugs (NSAIDs) in the midbrain periaqueductal gray matter (PAG) induces antinociception with some effects of tolerance. Our recent findings also have shown the same effects of tolerance in intraperitoneal (i.p.) injections of analgin (metamizol), ketorolac, and xefocam. Moreover, just recently, we have shown that microinjection of three NSAIDs analgin, ketorolac and xefocam into the central nucleus of amygdala produces tolerance to these drugs and cross-tolerance to morphine. The present study was designed to examine whether together with analgin, microinjection of another type of NSAIDs clodifen, ketorolac and xefocam into the PAG and the nucleus raphe magnus (NRM) leads to the development of tolerance in male rats. The experiments were carried out on experimental and control (with saline) white male rats by the models of tail-flick (TF, to the stimulation of focusing light beam) and hot plate (HP, paw withdrawal) tests. For microinjections of NSAIDs stainless steel guide cannula was implanted into the PAG and NRM by the stereotaxic atlas. Latency increase of these reflexes indicated the degree of antinociception. Analysis of variance with post-hoc Dunnet Multiple Comparison Test was used for statistical evaluations. Our study showed that microinjection of NSAIDs into the PAG produced antinociception as revealed by a latency increase in TF and HP compared to the baseline control with saline microinjected into the same nucleus. However, when these drugs microinjection subsequent testing also took place in the following days the antinociceptive effects progressively diminished so that on the 4th and especially the 5th experimental days the TF and HP latencies were similar to the averaged control baseline for rats that received repeated (5 days) injections of only saline. On the 5th day, one hour after of NSAIDs testing, experimental groups of rats received i.p. Injections of μ-opioid antagonist naloxone and we did not reveal significant alterations in TP and HP latencies in non-opioid tolerant rats as well as in control animals. Microinjections of NSAIDs into the NRM also produced antinociception as revealed by a latency increase in TF and HP compared to the baseline control of as in intact rats so with saline microinjected ones into the same nucleus. Subsequent NSAIDs microinjections caused progressively less antinociception, so by day 4 there was no effect, similar to saline microinjections (baseline control) for both the TF and the HP tests, except analgin. The later did not show complete tolerance even on the 5th experimental day. Special control experiments showed that post-treatment with naloxone in RVM diminished NSAID-induced antinociception on the first and second experimental days and impeded the development of tolerance to the antinociceptive effect of NSAIDs. Obtained results underscore the strong convergence of antinociceptive mechanisms of opioids and non-opioids, particularly NSAIDs in the PAG-RVM downstream circuit in the acute effect of and the development of tolerance to both types of analgesics. On the other hand, our data confirm the results of other authors that NSAIDs are in close relation with endogenous opioids and the tolerance to these non-opioid drugs probably depends on opioid tolerance.
8.g.13.1.36. Correction of oxidative stress in the rat brain cortical cellular culture with vitamins E and C. /D. Davitashvili, D. Museridze, I. Svanidze, N. Pavliashvili, T. Sanikidze/. Georgian Medical News. – 2010. – #3(180). – pp. 56-60. - rus.; abs.: geo., eng., rus.
The oxidative stress-induced alteration in concentration of oxygen, lipid and nitrogen free radicals in the cultured brain cortex of newborn albino rats and its correction with vitamins E and C were investigated. Modeling the oxidative stress was achieved with addition of Í2Î2 into the nutrient medium. In order to prevent an oxidative stress-induced cytotoxic effect, concomitantly with Í2Î2, vitamins E and C were added into the nutrient medium. Oxygen, lipid and nitrogen free radicals were registered by the Electron Paramagnetic Resonance (EPR) method and spin-traps. The data obtained in our study revealed decreasing of intensity of NO content and increasing of spin trapped superoxide - (O2-) and lipoperoxide-radicals (LOO.) in explants of brain cortex of the newborn albino rats cultured under oxidative stress conditions. These changes were attenuated following the action of vitamins E and C (decreasing of intensity of EPR signals of O2- and LOO, increasing of free NO content).
Interrelation of the lipid status with staging of breast cancer. /N. Kebadze, U. Gabunia,
The lipid status of 30 women (38-64 years) with breast cancer (stages I-II A, B) was investigated. Selection and distribution of patients in groups occurred on the basis of the accepted classification by the size, invasiveness and presence of metastases. The main changes in the lipid formula of blood included increased levels of total cholesterol and low-density lipoproteins’ cholesterol. The relationship between dislipoproteinemia and invasiveness was revealed. Thus, these changes can be considered as a predictor of growth, distribution, and correction of lipid homeostasis (dietary and drug) as a primary factor of secondary preventive maintenance of breast cancer.
8.g.13.1.38. Influence of some simple phenols on biochemical and morphological indices of rat blood. /B. Arziani, Ts. Chikhladze, N.Gumbaridze, G. Lekishvili/. Georgian Medical News. – 2010. – #3(180). – pp. 69-76. - rus.; abs.: geo., eng., rus.
Influence of various doses of xenobiotics on several biological and morphological indices of rat blood has been studied. It was established that intraperitoneal injections of the investigated phenols influenced biochemical indices of rat blood, specific to the particular phenolic compound. The strongest effect was observed in the case of 4-nitrophenol and the weakest one in the case of hydroquinone; it evidences strong toxicity of 4-nitrophenol and the antioxidant properties of hydroquinone. Influence of various doses of phenol, 4-nitrophenol and hydroquinone on the change of structural indices of the constituents of blood has been studied. Importance of the immune system for selection of adaptation pathways of the organism has been demonstrated. A correlation between the administered concentration of the investigated phenols and several biochemical and morphological indices of blood has been established.
Peculiarities of atherosclerosis developed after Chlamydia infection and
behaviour of some hematological and biochemical parameters. /M. Emukhvari, M. Akhvlediani, T. Bukia, N.
The aim of our study was to establish diagnostically informative criteria of hematological and biochemical analyses and their combinations as well as to establish a relationship between Chlamydia pneumoniae and atherosclerosis. This is to be done for the purpose of establishing the entire pathogenesis of carotid and coronary atherosclerosis and inflammation. The investigation of Chlamydia pneumoniae infection is proved to be a possible risk factor for the carotid atherosclerosis developed in adults that makes the course of atherosclerosis heavier. As a result of the atherosclerotic process, changes in the blood laboratory parameters were more expressed in the group of patients having repeated cases of pneumonia in childhood.
The aim of the study was to establish mechanisms of bilirubin oxidation and their involvement in the physiological and pathological processes in the living body (EPR study of photoradiated bilirubin). The photosensitized formation of free radical of bilirubin with g=2.003 and max H=1.0mTl, under action of blue light with max =450 nm by means of electronic spin resonance (ESR) was shown. Irradiation of sample in vacuum by visible light does not cause formation of free radicals. Irradiation of powder of bilirubin and also its solution in chloroform leads to formation of the radical of bilirubin. An analysis of a spectrum (ESR) as powder, also its solution in chloroform, that induces free-radical signal shows that it belongs to bilirubin rather than to the solvent. Irradiation of the bilirubin chloroform solution causes max=650 nm lines in the absorption spectrum that is characteristic of the absorption spectrum of solutions in the biliverdin chloroform.
8.g.13.1.41. Therapeutic bronchoscopy in critical patients with ventilator-associated pneumonia. /Z. Kheladze, S. Jaiani, B. Tsutskiridze, Zv. Kheladze, G. Chakhunashvili, D. Chakhunashvili/. Georgian Medical News. – 2010. – #4(181). – pp. 17-23. – rus.; abs.: geo., eng., rus.
The study material is based on the experimental treatment of broncho-pulmonary derangements, including ventilator-associated pneumonias (VAP). 105 critically ill patients were studied. The authors recommend methods of prevention and treatment of these types of pathologies, which are based on the therapeutic fiber-optic bronchoscopy with the use of different curative mixtures. The more satisfying course of pathological processes, a decrease of clinical presentations and manifestations of intoxication, an indisputable improvement in the course of disease, and a reduction in average length of treatment prove the advantages of this method. An important economical effect is also achieved due to the reduction of the length of stay and the use of costly drugs and diagnosticums. The achieved results allow us to recommend the widespread use of the therapeutic fiber-optical bronchoscopy in patients with acute diseases of lungs, particularly with VAP. The expressed efficiency, reliability and the important economical effect are the basic advantages of this method.
8.g.13.1.42. Clinical and demographic analysis of a prehospital diagnosis of myocardial infarction in Adjara in 2006-2008. /N. Tsintsadze/. Georgian Medical News. – 2010. – #4(181). – pp. 33-42. – rus.; abs.: geo., eng., rus.
The goal of the investigation is to study the results of a prehospital diagnosis of myocardial infarction in 519 patients of different gender and age. Myocardial infarction was atypical in 27.8.0% and typical in 72.0% of patients. Late diagnosis of typical and atypical MI made 13.4% and 21.2% respectively. No statistically significant differences were found in the frequency of diagnostic errors in different demographic groups of the patients. For the three years of the study, a tendency for an MI overdiagnosis was observed, especially in young patients and males. The cases of late diagnosis were equal in both males and females. A reduction of hypo and rise in overdiagnosis during the three years was, generally, conditioned by an atypical course iof the disease.
8.g.13.1.43. Atrial myxomas: histopathologic variants. /Z. Tsagareli, Z. Bakhutashvili, F. Phrangishvili, L. Gogiashvili, M. Dgebuadze/. Georgian Medical News. – 2010. – #4(181). – pp. 63-66. – rus.; abs.: geo., eng., rus.
Atrial myxomas are rare, usually benign, intracardiac tumors composed of mucopolysaccharides. Almost all myxomas are found attached to the endocardium in the atria with vast majority being on the left side and can be removed by surgical resection. Two rare cases of myxomas ablated from the left atrial cavity are presented. Surgical correction is curative with a low operative mortality and an excellent long-term prognosis. Tumor morphology and histological appearance are presented. The effect of age on the left atria morphology was observed.
8.g.13.1.44. On a hypothetic model of the involvement of the immune system in the proliferation of cells and dissemination of tumors. /D. Sephiashvili/. Georgian Medical News. – 2010. – #4(181). – pp. 67-71. – rus.; abs.: geo., eng., rus.
Tumor cells lose their ability of apoptosis. It makes one think that phagocytes which absorb malignant cells are themselves transformable into cancer cells. It is not excluded that the cloning–transposition of the cells absorbed by phagocytes is carried out within a norm and participates in the cell renovation (reparation-regeneration) and differentiation process. The role of transposition in the metastasis of tumor cells and in the etiopathogenesis is to be determined. An experimental proof of transposition will assist in development of new approaches to the treatment of various diseases, including tumor pathologies.
8.g.13.1.45. Criteria development for making
a working program of a Critical Care Medicine clinic. /D. Tabaghua, Z. Kheladze, Zv. Kheladze,
The Critical Care Medicine clinic’s 20-year long experience has been studied and summarized for elaborating a long-term development program to enable each critical care medicine clinic better plan its operations and make them more cost-effective. The study data included: the admission rate and distribution of patients according to seasons, months, weeks and days, as well as according to the critical state. The study results show that maximum admission by seasons was fixed in spring (27%; by months - in May (10%); by weeks – in the first week of the month (27%); and by hours - during 18-24 hrs (35%). The maximum mortality rate by seasons was observed in spring (28%); by months - in April and December (12%). The nervous system pathologies prevailed (24%); the percentage of cardiovascular, respiratory and digestive system pathologies was almost equal - 9, 8 and 8% respectively. The maximum mortality (36%) was observed in the case of the nervous system pathologies; also high mortality (20%) was observed during traumas
8.g.13.1.46. An experimental research in the efficacy of using saffron extract in treating ocular pathologies. /P. Shukurova, R. Babaev/. Georgian Medical News. – 2010. – #5(182). – pp. 38-42. – eng.; abs.: geo., eng., rus.
The aim of the present research was to study the mechanism of efficacy and therapeutic action of a saffron extract (Crocus sativus L.) during retinal degeneration and a light corneal injury. Experiments on Chinchilla rabbits were conducted to evaluate the state of free radical-based oxidation of the retina and its electric activity. The experimental retinal degeneration was found to be accompanied with the deterioration of all the electroretinogram parameters and the free radical-based retinal oxidation stirring up. The conducted experimental study allows concluding that the saffron extract’s antioxidation function plays a crucial role in its therapeutic action and serves as a pathogenic basis for its application in visual impairments of various origins.
8.g.13.1.47. Primary chlamydial infection correlates with high level of serum interleukin 12 (IL-12). /N. Shavlakadze, B. Gorgoshidze/. Georgian Medical News. – 2010. – #5(182). – pp. 46-50. – eng.; abs.: geo., eng., rus.
According to the existing data, cytokines actively participate in the pathogenesis of chlamydial infection. However, the role of IL-12 in chlamydiosis development has not been studied yet. The aim of our research is to define the role of IL-12 in the pathogenesis of the disease. The levels of IL-12, IL-4 and IFN-γ were determined in 27 healthy and 56 Chlamydia-infected individuals by using sandwich ELISA in vitro. An enzyme-linked immunosorbent assay, direct and indirect immunoflourescence were used for laboratory testing of Chlamydia. A statistical analysis of the results showed that the level of IL-12 was raised in the serum of some patients compared to the control group. The patients demonstrating high levels of IL-12 also had high levels of IFN-γ and low to normal levels of IL-4. The high levels of IL-12 were mainly in the patients with primary chlamydial infection. Thus, IL-12 may participate in the development of the primary immune response to Chlamydia, in particular in the Th1 direction.
The aim of this study
was to identify the effectiveness of a modern complex of roentgenological,
endoscopic, functional, citomorphologic and immunological methods in diagnosis
of alveolitis. Between May-June 2002 and July-August 2003, a single-stage
diagnosis was conducted among 1192 workers (400 in Siasan broiler factory, 391
8.g.13.1.49. Influence of
carbamazepine on kindling grades in depressive and non-Depressive rats. /M. Barbakadze, I. Bilanishvili, M.
has been clinically established that epilepsy and depression frequently
represent a comorbid pair. Most investigators consider epilepsy as a cause of
such emotional disorders as anxiety and depression. On the other hand, some
anti-epileptic drugs were found to aggravate the depressive state, even to a
suicidal outcome. Bearing in mind these findings, we endeavoured an
experimental study on laboratory rats, 25% of which display an inborn
depressive behaviour. An anti-epileptic drug to be tested was carbamazepine,
while the epileptic state was elicited by means of the kindling method.
Selection of animals was made with the Porsolt’s forced swimming test. Seven
rats had clear depression-like traits; the same number of the non-depressive
animals served as controls. Along with the inherently depressive rats, the
third group of animals was used, in which depression was elicited with the
immobilisation stress procedure (exogenous depression). Epileptization of the rats
was performed with sub-threshold electrical stimulation of the ventral
hippocampus. The rapid kindling paradigm has been implemented in these
experiments (40 stimulations in one day). Following development of epileptic
state up to the grades 4-5 according to the
8.g.13.1.50. The efficacy of propafenone treatment of supraventricular tachycardia. /T. Chachua, G. Abuladze, M. Nebieridze/. Georgian Medical News. – 2010. – #6(183). – pp. 18-21. – rus.; abs.: geo., eng., rus.
Drug therapy remains one
of the main methods of treatment of patients with supraventricular paroxysmal
tachycardia, which involves the prevention attacks of cardiac arrhythmias.
Drugs of choice for termination and prevention of paroxysmal supraventricular
tachycardia in the absence of pronounced signs of structural myocardial damage
are antiarrhythmic IC class drugs (Propafenone–Propanorm, Promed CS,
8.g.13.1.51. Microbiological investigation of diabetic foot infections. /D. Chikviladze, Kh. Gachechiladze, M. Mikeladze, D. Metreveli, D. Avazashvili/. Georgian Medical News.– 2010.– #6(183). – pp. 22-26. – rus.; abs.: geo., eng., rus.
The aim of the article was to determine the structure of infections agents in diabetic foot infections and their sensibility to antibiotics. The total of 295 microbial isolates was obtained from 115 patients with confirmed diabetic foot infection, treated in 2005-2009. Of these, aerobes were found in 92.88%, anaerobes - in 7.12%. Microbial associations, various aerobic bacteria were found in 58.49% of cases, associations of aerobes with anaerobes - in 17.92% of cases; microbial monocultures were isolated from 21.70% of patients. The most common gram-positive infectious organism of diabetic foot infection was S. aureus, while the gram-negative - P. aeroginosa. A share of methicillin-resistant S. aureus strains was 57.52%. In 95.57% of cases S. aureus strains were sensitive to vancomicin. The strains of P. aeruginosa were highly resistant to all the investigated antibiotics. The Enterobactericeae family pathogens have shown high sensitivity to carbapenemes (95.96%). It is concluded that the success of antimicrobial therapy depends on a correct choice of an antibiotic, which is based on timely detection of the infection’s etiology and determination of the separated microbial agent‘s sensitivity to antimicrobial drugs, considering the pharmacokinetic features of the chosen drug.
8.g.13.1.52. Effects of
the uncompetitive NMDA receptor antagonist memantine on recognition memory in
rats. /M. Dashniani, M. Burjanadze, G. Beselia,
Memantine is an NMDA receptor antagonist that has been recently approved in EU for the treatment of moderate to severe Alzheimer’s disease. The previous studies have not allowed for the evaluation of the possible effects of this drug at therapeutic doses on different forms of memory. To address this question, we administered memantine to adult rats, using 2.5 or 5 mg/kg doses to evaluate their effects on open field activity and recognition memory. Memantine or saline was administered daily by intraperitoneal injection during 5 days. The memantine treatment was found to produce a dose-related suppression of total ambulation. There was no significant memory impairment in the rats treated with the 2.5 mg/kg memantine. However, the 5 mg/kg intraperitoneal dose of memantine disrupted both the recognition memory and locomotor behaviors. It can be supposed that the therapeutic effects of memantine in patients with Alzheimer disease are attributable to its interaction with other neurotransmitter systems.
Noradrenergic modulation of convulsive activity. /T. Chachua, I. Bilanishvili,
The mechanisms underlying pathogenesis of epileptic responses have been insufficiently studied. Therefore, determination of the structures, transmitters and receptors of the brain, which putatively produce the development and intensity modulation of convulsions, is of much importance. The locus coeruleus is a noradrenergic structure and an endogenous modulator of epilepsy, which role determination in the course of seizure activities is an important problem of epileptology. The goal of the study was to assess the importance of the noradrenergic synapses in the development of the local hippocampal convulsive activity. Studies were carried out on adult rats, under conditions of an acute experiment. The effects of microinjections of agonist (clonidine) and antagonist (yohimbine) of the -2 adrenergic receptors on the course of local hippocampal convulsive responses (without behavioral manifestation) have been evaluated. It was found that microinjection of -2 adrenergic receptors' agonist conditioned blockage of the local hippocampal convulsions, while the -2 adrenergic receptors' antagonist increased the convulsive activity. It is suggested that the effects of locus coeruleus are conditioned by activation of the -2 adrenergic receptors.
8.g.13.1.54. The nitric oxide production in monocytes and macrophages in patients infected with Chlamydia trachomatis depends on the amount of cytokines. /N. Shavlakadze, B. Gorgoshidze/. Georgian Medical News. – 2010. – #6(183). – pp. 40-45. – rus.; abs.: geo., eng., rus.
We studied the NO production in the peripheral blood monocytes in patient infected with Chlamydia trachomatis and in the macrophages located in the Chlamydia-caused inflammation centers. With this aim we have investigated 132 patients with chlamydiosis and 85 probands for control group. The infections were identified by IFA, IFU and PCR. The 20-ml venal blood of the patients was examined and the Versant’s solution was used to excrete monocytes, microphages being excreted from the urethra and cervix areas. The monocyte and macrophage cultures were distributed according to different schemes. The statistic elaboration of the results showed that the monocytes in the peripheral blood and the macrophages in the infected area actually secreted NO. Its induction depends on IFN gamma and TNF alpha amounts (correlation coefficients: 0.98, p<0.05). The process increases especially under the joint influence of these cytokine (correlation coefficients: 0.91, p<0,001). The process seems to be considerably subdued in the Chlamydia-infected patients (correlation coefficients: - 0.97, p<0.05). The patients seem to be affected significantly by the additional factors.
C. trachomatis is a gram-negative bacteria infecting most organs of the urogenital tract and harming greatly the female or male reproductive field. Moreover, as this is not the limit of its destructive nature, it can form a favorable ground for developing ulcer and tumor processes. As observed, it is characterized of a special chronization ability, which is developed irrespective of the mighty immune humoral and cell-mediated immune response of the host. T(CD4) lymphocytes and their products – cytokines are also known to be directly involved into these processes. IL-17 and its regulator IL-23 are among them. Our study aimed at investigating the above two cytokines in the patients chlamydiosis. We have investigated 56 Chlamydia- infected patients; 31 non-infected patients who were the carriers of a different pathology flora and 21 healthy donors. The investigation covered some impaired localities as well as the whole organism. To attaint the objective, we analyzed the clinical-anamnesis data and carried out the appropriate instrumental, laboratorial and immunological researches. Stating the chlamydia infection was carried on with the serological and immunofluorescence and PCR methods. The study of IL-17 and IL-23 is carried out by the ELISA and RT-PCR methods. Based on a statistical analysis of the obtained results, it may be concluded that IL-17 occurs in almost all the patients infected with chlamydia – their organs or systemic environment compared with the patients of non-chlamydia infection (97% against 21%, P<0,05). At the same time, IL-17 has been measured by higher parameters, than IL-23. The highest parameters of IL-17 were recorded in the patients having acute chlamydiosis in the impaired localities, also in the patients having arthritis and antiovary antibodies, IL-23 in a reliably increased amount was recorded in the metaplasia-prone patients. The obtained data are a direct indication of the real participation of IL-17 and IL-23 in the immune pathogenesis of chlamydiosis.
features of complete blood count in the geriatric population in the
north-western part of
The present work is
devoted to the study of complete blood count in the geriatric population in the
north–western part of
Insulin resistance and the resulting hyperinsulinemia is a set of heart disease risk factors that increase the chance of developing arterial hypertension – a key symptom of metabolic syndrome (MS). The basic role in pathogenesis of ÀH at ÌS belongs to insulin resistance (IR) and is caused by its compensative hyperinsulinemia (HI) in a combination with accompanying metabolic infringements. In addition, during ÌS evident dislipidemia develops, in particular an increase in the ÒH level, the general XS, LPLD and a decrease in LPHD. Recently, one more theory of AH pathogenesis with adiposity has been discussed, according to which the AP growth is caused by an increase in the leptin level in these patients. Thus, the AH pathogenesis in patients with metabolic variations and risk factors is very combined, varied and requires differentiated and multilateral methods of treatment.
8.g.13.1.58. The impact of thyroid diseases
on bone metabolism and fracture risk. /M. Amashukeli, E.
Giorgadze, M. Tsagareli, N. Nozadze,
Osteoporosis is a
systemic skeletal disease characterized by low bone mass and
micro-architectural deterioration of bone tissue, leading to enhanced bone
fragility and a consequent increase in fracture risk. One of the leading causes
of secondary osteoporosis is thyroid diseases; this fact is of special
8.g.13.1.59. Epidemiological assessment of
the hepatitis B and C infectious disease markers in
The article deals with
an estimation of spreading of the subclinical form of hepatitis B and C viruses
in the healthy adult inhabitants of Baku and Nakhchivan cities by detection of
frequency of revealing serological markers of HBV (HBsAg) and HCV (anti-HCV)
infections. By means of a meta-analysis the results previously received in
several seroepidemiological studies among healthy inhabitants of these cities
are generalized. Average HBsAg and anti-HCV detection rate has made - 3.0% and
4.0%, respectively. Based on the above results, the
8.g.13.1.60. Unexpected increase in the cases
of bacterial meningitis in the 2009 summer in
In the 2009 summer,
during a period from 20 June to 31 August, 32 patients with the clinical
diagnosis of bacterial meningitis were hospitalized in two hospitals of
8.g.13.1.61. Immunohistochemical expression of BRCA1 protein in invasive ductal carcinoma of the breast. /G. Burkadze, O. Khardzeishvili, M. Gudadze, G. Tsikhiseli, G. Turashvili/. Georgian Medical News. – 2010. – #7-8(184-185). – pp. 51-60 – eng.; abs.: geo., eng., rus.
Immunohistochemically detected BRCA1 positivity has been reported to indicate the presence of full-length functional protein, while immunohistochemical negativity may be a result of sporadic BRCA1 mutation. We set out to study the immunohistochemical expression of BRCA1 protein in breast cancer and assess associations with lymph node status, histologic grade and expression of other biomarkers. We examined 100 patients aged from 21 to 71 years diagnosed with invasive ductal carcinoma. Immunohistochemistry was performed using anti-BRCA1, ER, PR, HER2/neu, and Ki-67 (MIB-1) antibodies. Cytoplasmic or nuclear-cytoplasmic BRCA1 expression was identified in a total of 64 breast cancer patients. None of the breast cancer tissue samples showed solely nuclear BRCA1 immunoreactivity. BRCA1 expression was associated with higher histologic grade, and majority of BRCA1-positive patients were below 50 years of age. Most BRCA1-negative patients had intermediate grade tumors. BRCA1 expression was positively associated with ER and PR positivity, and negatively associated with HER2/neu overexpression. Although immunohistochemistry can be an inexpensive and valuable preliminary method for detecting the BRCA1 status, BRCA1 protein localization is a complex issue. Well designed studies are needed to further investigate the performance of various anti-BRCA1 antibodies in formalin- fixed paraffin-embedded tissue samples, assess their association with BRCA1 gene mutations and determine clinical usefulness of BRCA1 immunohistochemistry.
We studied the glands of the 130 persons, victims from the casual reasons (a trauma, an asphyxia, etc.) from newborn to senile age; we investigated different variants of bladder gland forms, the changes in different parts of the organ’s wall (proximal, average, distal one-third) from the newborn period to senile age by the method of macro-microscopy and morphometry of the total specimens of the urinary bladder. The glands were preliminarily stained with the 0.05% methylene dark blue solution by the Sinelnikov’s method and by hematoxilin and eozin. The glands were investigated with the application of stereo binocular microscope MBS-9. The statistical data processing included the calculation of arithmetic-mean values, their errors, confidential intervals (excel). The view of the human urinary bladder glands in the macro-microscopy investigation is different. The glands have roundish, oval, ribbon forms. The form of the glands in the different parts of human urinary bladder (proximal, middle and distal) is different. In the micro-topography the glands have proximal-distal changes; the number of glands increases in the proximal- distal direction together with the content of complex glands (the glands with 3, 4 and more initial parts).
8.g.13.1.63. Prevention of errors and complications in the formation of esophageal layer-by-layer apparatus anastomosis. /O. Ghibradze, M. Gurgenidze, G. Bakuradze, D. Tevdoradze, M. Samsonia/. Georgian Medical News. – 2010. – #9(186). – pp. 7-13 rus.; abs.: geo., eng., rus.
The aim of the research is to analyze the outcome of treatment of patients with cardioesophageal cancer. Subtotal resection of esophagus with gastrectomy was performed on 3 patients. On 9 patients the resection of esophagus with gastrectomy from left thoracophrenolaparotomy was performed. Gastrectomy with resection of abdominal part of esophagus was performed on 10 patients. Transhiatal mediastinal lymphadenectomy S2D2 was carried out in all cases. The esophageal anastomosis has been formed by circular apparatus EEA and SPTU. The functional condition of anastomosis was investigated by X-ray, endoscopical and endo-sonographical methods in the postoperative period. The complications caused by technical errors of esophageal anastomosis were reviewed. The regeneration of circular anastomosis depends of adequate blood supply of anastomosis, observance of safety rules of imposing circular anastomosis. Reasonable application of circular apparatus, the refined techniques of imposing anastomosis, X-ray, endoscopical and endo-sonographical research methods decrease complications and promote recovery.
8.g.13.1.64. Dominated EEG patterns and their prognostic value in coma caused by traumatic brain injury. /M. Beridze, M. Khaburzania, R. Shakarishvili, D. Kazaishvili/. Georgian Medical News. – 2010. – #9(186). – pp. 28-33. – eng.; abs.: geo., eng., rus.
The study aimed at investigating dominated EEG patterns in traumatic coma of different severity and elucidating their prognostic value for outcome of disease within a month. A total of 53 coma patients with severe traumatic brain injury have been investigated. Exclusion criteria comprised the patients needing the neurosurgical intervention due to hemorrhage. Brain injury was visualized by conventional CT at admission. The level of consciousness was evaluated by Glasgow Coma Scale (GCS). Patients were divided in 5 groups according to GCS. Electrophysiological investigations were performed on 5th day from development of coma by application of 16-channel computer encephalography. Outcome of coma (death, vegetative state, recovery) was evaluated within month from disease onset. According to dominated EEG background activity patterns the 1st group (GCS=4) showed the delta EEG pattern in 50 % of patients, the beta EEG pattern- in 33.4% and the alpha EEG pattern – in 16.6%. The 2nd group (GCS=5) revealed the delta EEG in 40%, the beta EEG- in 6.7% and the theta EEG - in 53.3%. The 3rd group (GCS=6) showed the delta EEG pattern in 27.8% and the theta EEG pattern- in 72.2%. In 4th group (GCS=7) the theta EEG pattern found in 77.7% and the beta EEG pattern in 22.3%. The 5th group (GCS=8) revealed the theta EEG activity in 80% and beta EEG activity –in 20%. Positive correlation was found between the GCS and the frequency of theta EEG pattern (r=+0.62; p<0.05). Positive correlation was established between the frequency of delta EEG pattern, death and persistent vegetative state (r=+0.57 and r=+0.16 respectively, p<0.05) within month. Positive correlation was established between the frequency of delta EEG pattern and the size of brain injury (r=+0.3; p=0.04). Multinomial logistic regression revealed the significance of brain lesion size, GCS and EEG pattern for functional outcome of coma. In severe traumatic coma patients, the delta EEG pattern is associated with the deep coma state and predicts the poor functional outcome within a month.
8.g.13.1.65. Pulmonary hypertension in female patients with cardiovascular and respiratory tract disease. /M. Gegenava, T. Gegenava, G. Kavtaradze/. Georgian Medical News. – 2010. – #9(186). – pp. 34-37. – eng.; abs.: geo., eng., rus.
Pulmonary arterial hypertension (PAH) is defined as a group of disease characterized of a progressive increase of pulmonary vascular resistance (PVR) leading to right ventricular failure. The aim of our study was to determine the frequency of PAH in female patients with cardiovascular and pulmonary tract disease. The research was performed on 80 postmenopausal women (mean age, 54±3 yr). They were divided into groups according to the main disease: 1. Chronic obstructive pulmonary disease COPD n=16. 2. Acute pneumonia n=23. 3. Cardiovascular disease n=25. This group was compared with the control group (nonpostmenopausal women). In postmenopausal women high level of PAH by echocardiographic trial was manifested in patients with cardiovascular disease n=17 (68%); In cases of pneumonia n=13; 56,5% (P<0.001) and in COPD n=12; 75% (P=0.001). There wasn’t revealed significant level of pulmonary hypertension in nonpostmenopausal women (P=0.001). By transthoracic echocardiography tricuspidal regurgitation (TR), right atrial (RA) and right ventricular (RV) dilatation was showed in every patient with important degree of PH. By electrocardiography (ECG) signs of RV and RA hypertrophy were expressed in great majority of patients with high degree of PH. Furthermore, RV hypertrophy revealed in n=64 (80%) of patients and right deviation of axis in n=60 (75%). The results have indicated that PAH is widely extended in postmenopausal period, when the protective effects of oestrogens on the endothelium decrease. The problem is urgent and needs particular attention. Early diagnosis and treatment of pulmonary hypertension make it possible to control cardiovascular and pulmonary disease and avoid complications.
8.g.13.1.66. Enterohemorrhagic E. coli and
hemolytic-uremic syndrome in
It is important to
consider that between July-October 2009 in the Pathology Center of Infectious
8.g.13.1.67. Epidemiologic peculiarities of infections
caused by the hepatitis B and C viruses among lung tuberculosis patients. /M. Mamedov,
The article presents the results of serological investigation for presence of specific markers of hepatitis B (HBV) and hepatitis C (HCV) infections in serum samples obtained from 600 patients with acute and chronic forms of lung tuberculosis (LT) and in control group I – 600 healthy adults and in control group II - 796 patients with somatic pathology from a multiprofile hospital. It has been established that among LT patients the frequency of revealing HBsAg and anti-HCV is statistically steady; similar indicators are among persons from both control groups. The frequency of revealing of these markers in patients with chronic forms of LT is considerably higher than the in patients with acute forms of LT. At the same time, both infections in patients with LT were often presented in the form of subclinical hepatitis identified by increase in the aminotransferase activity in blood.
8.g.13.1.68. The efficacy of topical drugs in the
treatment of non-inflammatory acne vulgaris. /N.
Merkviladze, T. Gaidamashvili, P. Tushurashvili, E. Ekaladze,
Treatment of acne vulgaris still remains a pressing problem. The purpose of the research was to study the treatment and side effects of topical drugs – Diacneal and Skinoren in patients with non-inflammatory acne vulgaris. The results of the research have confirmed the swift and stable treatment effect of both preparations being expressed in a decrease in the number and size of comedonal and papulo-comedonal formations, actually without side effects. Thus, in spite of divergence of either chemical composition or mechanism of action, both, Diacneal and Skinoren, may be recommended as a very good choice for monotherapy of non-inflammatory acne vulgaris.
8.g.13.1.69. Parameters of innate immunity manifested
in clinical and subclinical forms of infections caused by hepatitis B and C
viruses. /A. Guliyeva, M.
Mamedov, A. Dadasheva,
The authors determined parameters of innate immunity (IIM) in patients with acute and chronic forms of viral hepatitis B and C and in persons with subclinical infections caused by hepatitis B and C viruses. The results obtained demonstrated that the clinically manifested (acute and chronic) and subclinical forms of infections caused by hepatitis B and C viruses were accompanied by the development of IIM depression. At the same time, the signs of IIM depression in the patients with clinically manifested forms of infections were expressed in higher degree than in the persons with subclinical forms of infections.
8.g.13.1.70. The evaluation of nitrogen metabolism and
the reactivity of the organism in patients with dry skin. /N. Tsiskarishvili, A. Katsitadze,
It is known that in norm horny layer of the epidermis is able to retain water due to the presence of hygroscopic substances inside corneocytes in the form of so-called natural moisturizing factors (NMF), consisting of free amino acids and their derivatives, which are formed during the decay of filaggrin as well as lactic acid, urea, sugars, and intercellular lipid membranes, creating a barrier that prevents transepidermal water loss. At the same time, the results of recent studies have shown that urea - a kind of natural antioxidant that protects tissues from the accumulation of aggressive forms of oxygen. It is able to stabilize the lysosomal membranes, thus preventing autolysis of cells. The ability of urea at low concentrations to modify the reactivity of functional groups of proteins leads to conformational changes of immunoglobulin, which has an inhibitory effect on the immune system, including the diminishing impact on the development of reaginic type reactions. Urea has anti-inflammatory, hyposensitizing, and antioxidant effect. Based on the above the aim of this study was to determine the content of urea and some indicators of cellular and humoral immunity in case of chronic dermatoses, accompanied by dryness of the skin. Indicators of nitrogen metabolism of blood serum (urea. ammonia), some parameters of cellular and humoral immunity were studied in 27 patients, who according to nosological units were distributed as follows: atopic dermatitis (12), psoriasis (7), xerosis (8). In the study of the concentration of urea in the blood, and some indicators of cellular immunity, as well as the content of immunoglobulin E in the blood of our patients a decrease in the number of T-lymphocytes, mainly due to T – suppressor and raising the level of immunoglobulin E have been revealed. Specific patterns of changes in these parameters, depending on nosological unit, severity of disease and degree of dryness of the skin have also been observed.
8.g.13.1.71. Traditional Chinese medicine in diagnosis and treatment of fibromyalgia syndrome. /R. Aliyev, T. Vieth, G. Gaiger/. Georgian Medical News. – 2010. – #11(188). – pp. 38-45. – rus.; abs.: geo., eng., rus.
Fibromyalgia syndrome (FS) is known for the difficulties arising from classification. The accompanying pain in skeletal muscles, myofascial peri-articular structures and a number of polymorphic symptoms cannot be separated into complexes of symptoms. The application of principles of traditional Chinese medicine (TCM) helps in analyzing the symptoms of FS to detect a leading syndrome and thereby establish an individual therapy. Medical histories and objective examinations of 25 patients with FS and 22 patients with vertebrogenic pain syndromes were analyzed according to TCM. A questionnaire was used to determine the leading constitutional type according to the 5-elements-theory. Analyses of the results showed that 83% of patients with FS were of constitutional type of the element earth. The following syndromes were found to be important in FS: 1) liver-Qi-stagnation, 2) Yin and blood deficiency of the liver, 3) Yang-weakness of the spleen and kidney, 4) Yin-weakness of the kidney. Applying TCM for FS allows for separating a group of symptoms and thus individual therapy. The determination of the constitutional type according to the 5-elements-theory may be used for a better understanding of the disharmony pattern.
8.g.13.1.73. Orexinergic system and pathophysiology of
epilepsy. /N. Doreuli, M. Alania,
Neuropeptids orexins, also known as the hypocretins, are expressed in the lateral hypothalamus. Orexin-containing cells project widely throughout the brains, are crucial for the regulation of wakefulness and dysfunction of this system is associated with pathophysiology of narcolepsy-cataplexy. Orexin neurons play an important role in motivation, feeding and adaptive behaviors. Distribution of orexinergic receptors in the hippocampus tended to the ideas that orexins might be involved in the functions relating to the hippocampus. Effects of neuropeptide orexin-A on epileptiform activity in hippocampal slices were investigated. 500µm thick hippocampal slices from 8-10 week-old rodents were used. Field excitatory postsynaptic potential (pop-FEPSP) and population spike in CA1 of hippocamopus were registered using standard protocol of in vitro electrophysiological experiments. Initial slope of the FEPSP and amplitude of II pop-spike were measured. Bursting neurons in CA3 were recorded in modified saline. We have found that orexin-A decrease duration/amplitude of multiple discharges of pop-spikes and inhibits spontaneous epileptiform after discharges induced by bicuculline methiodide in CA1. Orexin-A also modulates the frequency of discharges of bursting neurons in CA3. Our results suggest possible involvement of orexinergic system in antiepileptic action.
8.g.13.1.74. The Level of fluoxetine in blood plasma
and washed from erythrocyte supernatant. /D.
Zurabashvili, I. Giorgobiani, M. Arveladze, I. Gamkhrelidze,
Antidepressant fluoxetine and their major therapeutically active metabolite Norfluoxetine was monitored in albumen and glicoprotein of blood plasma and washed from erythrocyte supernatant. In the paper we describe rapid and reliable method using high-performance liquid chromatography for simultaneous measurement of plasma and supernatant concentration of fluoxetine and norfluoxetine. The described method has been successfully used in clinical and laboratory cases. Large inter-individual variations in plasma and supernatant concentrations of fluoxetine and its major metabolites have been shown. In albumen fractions of blood plasma the level of fluoxetine is higher then in supernatant. A successful development of the clinico-pharmacokinetic direction at the present stage is due to improvement and standardization of methods of clinical and pharmacokinetic examination, which help to ensure a reliable pretreatment identification of the patients potentially sensitive to pharmacotherapy with antidepressants.
8.g.13.1.75. Quantitative Changes of Schwann and mast cells in the process of peripheral nerve regeneration. /T. Giorgadze, R. Rukhadze, S. Giorgadze, N. Gujabidze, N. Tevzadze/. Georgian Medical News. – 2010. – #11(188). – pp. 84-88. – rus.; abs.: geo., eng., rus.
One of the most common problems in the fields of orthopedic surgery and neurology is that of the injured peripheral nerve. Injured nerve fibers in the adult mammalian peripheral nervous system can and often do regenerate, thereby restoring at least some lost functions. During the past decade enormous progress has been made in the understanding of the cellular events and molecular changes during degeneration and regeneration of peripheral nerves. However, our knowledge of the regulatory mechanisms and signaling cascades underlying the complex molecular regeneration program is still very limited despite an enormous amount of new experimental data. Injure to peripheral nerve initiates a complex cascade of signals involving neurons, glia and cells of the immune system. The question of what cells are responsible for nerve survival and tissue repair mechanisms after injury remains controversial. Although it has largely been demonstrated that macrophages and Schwann cells play important roles in degrading and removing myelin few data have been reported regarding mast cells in Wallerian degeneration. The present study has been designed to evaluate the correlation between Schwann and mast cells during regeneration of the injured peripheral nerve. Animals were divided into two groups: experimental and intact rats. The left sciatic nerve was separated from the surrounding tissue, was transected in its mid-thigh portion and sewed up. Sewed sciatic nerves were obtained and used for morphological and Immunocytochemical observation 2 and 12 day, and 1 month after transection. Our experimental data reveals that the mast cells, as well as Schwann cells, play a pivotal role in regeneration process after injury. The correlation between the changes of quantity of Schwann cells and mast cells during the regeneration of injured peripheral nerve was not revealed.
8.g.13.1.76. Comparative evaluation of indicators of local, humoral immunity and nonspecific resistance in patients with different pathology of the cervix. /A. Harutyunyan/. Georgian Medical News. – 2011. - #1(190). - pp. 7-15. – rus.; abs.: geo., eng., rus.
A comparative evaluation of some indicators of immune system and analysis of the dependence of these parameters (correlation) are carried out to identify interrelated mechanisms. The observed changes in the concentrations of indicators of immune system and the correlation between cytokines, humoral immunity and nonspecific resistance in cervical mucus in patients with cervical pathology demonstrate the complex, interrelated and changing interactions of the local immune system at various stages of development of the pathological process of the cervix.
8.g.13.1.77. Novelties in treatment approach of poly-neoplasias developed during thyroid pathologies. /T. Makaridze, K. Mardaleishvili/. Georgian Medical News. – 2010. – #11(188). – pp. 15-20. – rus.; abs.: geo., eng., rus.
The publication discusses the pathogenic mechanisms developed during concordance of malignant tumors of the thyroid gland and reproductive systems and dishormonal hyperplasias, also functional disturbances which accompany the thyroid gland diseases and the principles of treatment during synchronic and metachronic manifestations. The treatment of polyneoplasias by "neurotransmitive control” is proposed. Importance of thyroid suppressive therapy is assessed. The efficacy of thyrotrophic hormone suppression by neurotransmitters in prevention of malignant tumors of reproductive system is reported.
8.g.13.1.78. The prognostic significance of heart rate variability in patients with diabetes mellitus type 2 against the background of ischemic heart disease and arterial hypertension. /G. Tabidze, O. Leonidze, L. Basiladze, A. Tsibadze/. Georgian Medical News. - 2011. - #1(190). pp. 33-36. – rus.; abs.: geo., eng., rus.
In recent decades the special attention has been given to the heart rate variability (HRV) to assess the prognosis of the patients with cardiovascular diseases. There were studied 47 male with arterial hypertension and heart failure, by which the HRV was researched. In the group of patients with diabetes mellitus (DM) type 2, ischemic heart disease (IHD), arterial hypertension (AH) and heart failure (HF), the heart rate variability (HRV) has been considerably lower in comparison with the group of patients iwithout DM. The initial activation of the sympathetic nervous system in the group of patients with DM, IHD, AH and HF, we can speak about the expected progression of heart failure even before occurrence of any significant changes of central hemodynamics. It has been established that the higher is the functional class of heart failure the more revealed are sympathetic influences and worse is the heart rate variability.
Because of importance of early diagnosis of the antiphospholypid syndrome (APS) we present two case histories from clinical practice of the Scientific-Practical Center of Rheumatology. The first clinical case (male, born in 1961, diagnosed with systemic lupus erythematosus and secondary APS) shows that verification of diagnosis in men is much harder than in women. The patient was diagnosed with secondary APS only 8 years after the onset of the disease. The second clinical case (female, born 1959, diagnosed with primary APS) is interesting because during many years the patient was diagnosed with SLE and secondary APS. We performed careful analysis of the case and made the diagnosis of primary antiphospholipid syndrome. Nowadays the patient is given an adequate treatment and his health is stable, but the risk of recurrent thrombosis still remains. Presented case histories show the variety of clinical symptoms and the complexity of diagnosis of APS.
8.g.13.1.80. Opioid sensitivity of nucleus
raphe magnus after analgesia by non-steroidal anti-inflammatory drugs. /I. Nozadze,
N. Tsiklauri, G. Ghurtskaia,
Our recent investigations have shown that microinjection of three non-steroidal anti-inflammatory drugs (NSAIDs), analgin, ketorolac and xefocam, into the central nucleus of amygdala produces tolerance to these drugs and cross-tolerance to morphine. We have observed the same phenomenon in midbrain periaqueductal grey matter and nucleus raphe magnus. The medullar nucleus raphe magnus (NRM) is one of important parts of CNS circuit that controls nociceptive transmission at the level of spinal cord. It is functionally involved in descending pain modulation, and mainly consists of serotoninergic neurons. The aim of this study was to examine opioid sensitivity of NSAIDs action in NRM of male rats. For this purpose 30 minutes later of NSAIDs administrations we microinjected μ-opioid antagonist naloxone and tested rats for tail flick and hot plate latencies. Our investigation showed that microinjection of naloxone in NRM significantly decreased antinociceptive effects of NSAIDs at the first day in the TF and HP latencies. At the second day, naloxone generally had trend effects in both TF and HP tests. These results strongly support the suggestion on endogenous opioid involvement in NSAIDs antinociception and tolerance. On the other hand, our evidence confirms once more that NRM is involved in the descending pain control circuit inhibiting spinal nocifensive reflexes.
8.g.13.1.81. Changes of redox processes in liver under PV-88 during an experimental hemorrhagic shock. /Gr. Sulaberidze, M. Ghvaladze, G. Didava, B. Kotchlamazashvili, M. Chkhaidze, T. Gegeshidze/. Georgian Medical News. – 2011. - #1(190). – pp. 65-69. – rus.; abs.: geo., eng., rus.
PV-88 is the Ca2+ L channel blocker from pyrrole compounds that was used on the 60th minute of a hemorrhagic shock (HS) modeled by the Wiggers-Feine method (intravenous administration, 3 mg/kg). The mean arterial pressure was 40 mmHg. The effects were studied on the 80th minute after blood letting. Blood was exfused 40 ml/kg. Effect of PV-88 on redox processes in liver was studied. Experiments were carried out on male cats. Right lobe of the liver and the metabolic indices: ATP, CO, NAD, NADP, ALP, SDH, LDH were studied with the use of histochemistry (Pearse). Investigations have shown that on 80th minute after PV-88 administration CO (p<0.05), NADP (p<0.05), ALP (p<0.001), SDH (p<0.05), and LDH (p>0.05) were increased, while ATP (p<0.001) and NAD (p<0.001) were decreased. Increase in LDH was not statistically significant. According to the results of investigations, after administration of PV-88 at HS 60 on the 80th minute the oxygen concentration in the liver and the aerobic process increased respectively.
8.g.13.1.82. Cytokine regulation in patients
with brain tumors. /L. Haroutunian, Z. Ter-Pogossian,
The aim of the study was to investigate serum levels, as well as the ability to produce in vitro, some pro-inflammatory and anti-inflammatory cytokines in patients with brain tumors (BT). Serum concentrations of IFN-gamma, IFN-alpha, TNF-alpha, IL-4, IL-6, IL-8, and RA IL-1 were determined in 17 patients with brain tumors, and in 21 healthy donors. The results showed that baseline levels of cytokines studied was above normal in most patients (78%) had the highest rates of IFN-gamma. During the whole observation period, slightly higher in patients compared with healthy individuals (t=1,8) was the content of IFN-alpha. Serum concentrations of IL-4 in patients before treatment were significantly higher than in control group (p<0,01), remaining at about the same level, and after treatment. Levels of Rail-1, IL-6 and IL-8 in patients before treatment were within normal limits, while remaining unchanged at the end of the survey. Indicators induced in vitro production of cytokines studied to some extent correlated with their serum levels. Hyperproduction in vitro IFN-gamma was observed in 61% of patients, low production - 28% of patients, and only in 11% of cases, these figures were within normal limits. In patients with malignant brain tumors were identified violations of serum levels and production of cytokines studied. The most significant was the increase of PHA-induced production of IFN-gamma, which was not reduced by the end of treatment. High serum and, in particular, PHA-induced levels of IFN-gamma at the end of treatment may be recommended as an additional criterion for immunodiagnosis in a dynamic laboratory monitoring.
8.g.13.1.83. Epidemiological aspects of
breast cancer in women in major cities of the
cancer is the most frequent type of cancer among women and is a leading cause
of cancer death among women in the
The aim of the study was a comparative evaluation of surgical treatment and complex pre- and postoperative pleoptic, orthoptic, diploptic treatment of non-accommodated concomitant strabismus and identification of the optimum age for surgical treatment of strabismus. The 75 patients (from 2 to 10 years old) with manifested concomitant convergent strabismus were divided into two groups: patients operated at the age from 2 to 4 years old; patients operated at the age of 4-10 years). The 75 of patients operated at the age from 2 to 4 years old, which underwent orthoptic-diploptic treatment pre- and postoperatively got binocular vision showed the full recovery in only 40% of the cases of the same age-group undergone the surgical treatment in combination with the direct occlusion. Binocular vision was achieved in 68% of the patients operated at the age of 4-10 years with complex treatment, and in 25% in the patients of the same age group with surgical treatment plus occlusion. The findings showed the efficacy of complex treatment as well as pre and postoperative pleoptic-orthoptic-diploptic treatment of strabismus and direct occlusion. Thus, the results of this study suggest that the delay of surgical treatment limits the ability to obtain optimal results.
8.g.13.1.85. Sporadic pancreatic head sarcoidosis: a rare clinical case analysis. /M. Tsintsadze, T. Beridze, U. Volker, G. Loppel, R. Schauer/. Georgian Medical News. – 2011. - #2(191). - pp. 26-32. – rus.; abs.: geo., eng., rus.
Systemic sarcoidosis is an autoimmune disease with a prevalence of 40 per 100.000 people which mostly affects young adults. It is characterized of non-caseous granulomatous changes of interstitial tissue, predominantly in the lungs. Extrapulmonal sarcoidosis has been described in every organ but is present only in 1-5% with pancreatic involvement. Furthermore, sarcoidosis leading to a symptomatic mass in the pancreas is extremely rare and must be differentiated from cancer and pancreatitis. For therapy, it is crucial to find the right diagnosis before planning an operation. Otherwise a radical surgery may lead to an unwanted outcome.
8.g.13.1.86. Prevention of insult with nondirective
anticoagulant therapy by warfarin (warfarex) in patients with atrial
fibrillation. /G. Abuladze,
The aim of the study was to estimate efficiency and safety of treatment by non-direct anticoagulant - warfarex in the patients with persistent and paroxysmal forms of AF for the prevention of thromboembolic complications. 55 patients between 37 and 75 years old with atrial fibrillation (AF) were investigated. Follow-up was 2 years. Primary diseases were post myocardic cardiosclerosis, cardiomyopathy, IHD, arterial hypertension. The patients with persistent form of AF underwent treatment by warfarex. In the case of paroxysmal form of AF patients were prescribed warfarex during the first 48 hours from the beginning of paroxysm and for 3-4 weeks after cardioversion. The dose of warfarex was chosen according to the International Normalized Ratio (2.0-3.0). The results of the study show that warfarex is effective and safe for the prevention of thromboembolic complications in the case of persistent and paroxysmal forms of AF.
8.g.13.1.87. Study of self-regulating
behavior at different stages of psychogenic stress before the formation of
depressive-like state in rats. /T. Matitaishvili, T.
Domianidze, K. Tchitchinadze,
During last decades abnormalities of the neuro-psychic sphere have become a topic of great interest. Among them an important place takes depression. Psychogenic factors are commonly the most frequent cause of a depressive condition and until now the study of the so-called transitional period (from the beginning of stressor action till the formation of depressive state) continues to be an actual task of scientific research. This in mind, we studied the self-regulating behavior in rats in different stages of psychogenic stress until the formation of a depression-like condition. To access the behavioral changes, the "open field” test, FST (forced swimming test, "Porsolt” test) and TST (tail suspension test) were used. We also registered behavioral indices while applying stressors. Stress was applied in a modified shuttle chamber. At the very beginning of the study (the first stage of stress - alarm) an animal was forced to develop a reaction of active avoidance on metronome beats (100 beats per second), later, after its fixation, the same reaction was developed on tone (500 Hz). Then simultaneous testing of two developed reactions of active avoidance was performed (the second stage of stress). After the long-term application of stressors (48 days) the second stage of stress proceeds into the deep (the third) one. On this stage animals showed decreased motor activity in the "open field” test, decreased mobility in FST and TST, changes being statistically valid. All behavioral changes indicating depression-like condition in the animals were normalized after per os administration of antidepressant Fluoxetine at doses of 40 mg/kg. The results obtained in the study confirm that on different stages of psychogenic stress changes in behavioral indices are natural and self-regulating. They appear to be compensatory as only on their exhaustion the depression-like condition is formed.
8.g.13.1.88. Anti-diabetic activity of
berberin and extract obtained from the bark of Phållodendron Lavalei, introduced in the subtropical
The goal of the study
was to identify anti-diabetic impact of berberin and extract obtained from the
bark of Ðhållodendron Lavalei introduced in the subtropical
8.g.13.1.89. Changes of metabolic indices
caused by berberin and extract obtained from the bark of Ðhållodendron Lavalei
introduced in the subtropical regions of
The goal of the study
was to identify changes in lipid metabolism, functional condition of liver and
kidney influenced by berberin and extract, obtained from the bark of Ðhållodendron Lavalei,
introduced in sub tropic regions of
8.g.13.1.90. In vivo investigation of the
effect of extracellular ubiquitin effect on liver histoarchitectonics. /R. Sujashvili, E. Bakuradze,
Ubiquitin is a small regulatory protein of living cells. It affects almost all cellular processes. Investigation of ubiquitin is very important for discovering the new therapeutics for different heavy human diseases. The main goal of the work was to reveal the effect of extracellular ubiquitin on liver histoarchitectonics of mature and immature white rats. The obtained data indicate the inefficiency of used doses - 200μg/ml and 500 μg/ml - of extracellular ubiquitin single and multiple in vivo injections to evident changes of histoarchitectonics of immature and mature white rat liver. Further investigation of the in vivo injection effects on the histoarchitectonics of intact and damaged liver and hepatocyte cell cycle regulation by immunological assays seems to be actual and interesting.
8.g.13.1.91. Optimization of venous return during the anhepatic phase of experimental liver transplantation. /E. Azmaipharashvili, M. Geldiashvili, Z. Chkhaidze, N. Khodeli, O. Philishvili, G. Tomadze, M. Jangavadze, J. Phartsakhashvili, D. Kordzaia/. Experimental and Clinical Medicine. – 2010. - #1(56). - pp. 9-14. – geo.; abs.: eng.
To assess the effectiveness of different schemes of veno-venous bypass during the anhepatic phase (AP) of experimental liver transplantation, experiments have been performed on 8 male dogs weighing 15–20 kg. After hepatectomy, a pump-driven venous bypass from the infrahepatic segment of the caudal vena cava and portal vein was conducted into the brachiocephalic vein (I group; n=4) or the suprahepatic segment of the caudal vena cava (II group; n=4). Hemodynamics was monitored for 3 hours. During the entire AP in the I group the pressure in the cranial venous system was increasing (p>0.05), while the blood flow index was decreasing (p<0.05); the same parameters in the II group were maintained unchanged. The obtained results confirm that veno-venous bypass into the suprahepatic segment of the caudal vena cava can be considered as more physiologic and can prolong a safe AP up to 3 hours.
ჰ8.g.13.1.92. Comparative influence of
β-blockers on the liver
under conditions of acute toxic hepatitis induced by acetaminophen. /L. Gabunia, I. Khabeishvili, N. Kvernadze,
The effects of non-selective β-blocker propranolol, selective β-blocker bisoprolol and non-selective β-blocker with additional vasodilatatory properties - carvedilol on the functional parameters and morphology of the liver during the paracetamol-induced acute toxic hepatitis have been studied. The experimental results have shown that hapatotoxicity is not a characteristic side effect for all types of β-blockers. Propranolol worsens, bisoprolol has no effect and carvedilol slightly but still improves the functional parameters of the liver in case of acute toxic hepatitis. The positive treatment effect of carvedilol on hepatocytes could be explained by its antioxidant or Ca-antagonist properties. Investigation of functional parameters of the liver before treatment course with propranolol is strongly recommended, especially in patients suffering with liver insufficiency.
The study represents an analysis of thirty years’ experience in phage therapy of surgical infections, which proves that the phage therapy does not represent an alternative for antibiotic therapy but has a summary or synergistic effect. Unlike antibiotics, the acquired resistance of bacteria to phages is rare and the primary resistance is usually to commercial preparations. This kind of resistance is surmountable by using selected or adapted bacteriophages against isolated bacterial strains. Antibiotic resistance is not related to the resistance to bacteriophages. Possibility of using bacteriophages locally is advantageous due to their reproductive ability in the wound and stability to enzymatic inactivation and dilution. Therefore, local bacteriophage therapy can cause the inhibition of infection in ischemic-neuropathic, granulation, sclerotic tissues and extensive wounds, where systemic antibiotics cannot achieve therapeutic concentration. Phage therapy and prophylactics of soft tissue gunshot wounds on battlefield (Abkhazia 1992-1993) prolongs the "golden” period for wound care, decreases the chances for tissue infection by 14-4% and treatment of purulent wounds by 6-8 days. Bacteriophages were successfully used for environmental and personnel sanitation in surgical and critical care wards due to its high efficacy and low price. The reason why bacteriophages are not still used as a potent antibacterial means is subjective as well as there is lack of information in clinical bacteriophage therapy. Further research in this field should be planned according to the evidence based medicine standards, to answer the questions about phage dynamics and phage kinetics during therapy of surgical infections, as well as the mathematic modelling of correlative relationship between quantitative bacteriology and bacteriophages.
This study has been conducted to detect the histological changes that could be inducted in the liver of Wistar rats. Animals were killed one month after injection. The results showed several morphological alterations in liver tissues (granular and vacuole dystrophy), changes in micro-circular channel, inflammatory the injury of liver histology over a short time in alloxan diabetic rat.
8.g.13.1.95. Cytokines and their role in the development of cardiovascular system diseases. /N. Mamamtavrishvili, N. Silagava, M. Dzamukashvili, N. Gelashvili, N. Zarnadze/. Experimental and Clinical Medicine. – 2010. - #2(57). - pp. 32-35. – geo.; abs.: eng.
The role of cytokines in the development of cardiovascular organic pathologies is shown in the reviewed article. One of the main factors which affect the progress of ischemic heart diseases along with hemodynamic abolition is the activation of inflammatory reactions with participation of preinflammatory cytokines. Changes in the levels of cytokines are associated with the disease progression, as well as with its outcome. There is also shown the need for new preparations along with the presence of "traditional preparations”.
8.g.13.1.96. Alterations of gonadal
axis and concentration of sexual steroids in the phenol-intoxicated male
organism. /E. Melikadze, T. Kvatchadze,
It is known that the male reproduction system is too sensitive to the impact of environmental conditions. One of such endocrine deregulators is phenol. An experiment was conducted on 60 adult male albino rats (body mass 200-250g). Each animal experienced phenol intoxication daily during 15 days in a special closed cabin. On the 60th day the animals were decapitated, and afterward in the blood serum was defined the alternation of the concentration of the gonadotropic hormones LH, FSH and sexual steroids - testosterone, estrone, estradiol - by means of the immunoenzymatic method. Significant alternations in the hormones concentration were revealed during the experiment: it was revealed that LH did not stimulate testosterone secretion; conversely, it decreased, while the estrogen concentration increased. The mentioned data enable us to conclude that the impact of phenol vapor caused disorders in the male reproduction function.
8.g.13.1.97. Age-related changes of cholesterol index in erythrocyte membrane and their Influence on deformability of erythrocytes. /M. Arabuli, R. Khetsuriani, A. Shukakidze, D. Tophuria, N. Tchlikadze, I. Kirvalidze/. Experimental and Clinical Medicine. – 2010. - #3(58). - pp. 40-43. – geo.; abs.: rus., eng.
The research objective was to study age-related changes of the index of erythrocyte membrane cholesterol and their influence on the deformability of erythrocytes. Studies have been performed in 3 age groups: new-borns (umbilical cord blood), adults (22-30 years old) and elderly people (75-89 years old). Based on the results, we can assume that erythrocyte deformability depends on the cholesterol index of the erythrocyte membrane, and with less cholesterol the deformability of erythrocytes increases. Erythrocyte deformability in new-borns is high, which is due to the low content of cholesterol in their membranes. Deformability is higher also in the elderly, because in their membranes cholesterol is less then in the membranes of adults.
8.g.13.1.98. Treatment of chronic
prostatitis in light of concomitant cardiovascular disease. /A. Bakuridze,
B. Iakobadze, N. Shavdia,
Given the favourable impact of á-adrenoblockers on the prostate function in order to improve blood circulation in the organ, the preparation "Kardura” (2 mg once per day) was prescribed to 20 patients with chronic elderly prostatitis-associated cardiovascular problems and disuretic disorders. In the complex treatment of uretroprostatitis, the activity of the immune system increased, indicators of the pituitary-gonadal system became settled, which makes it possible to recommend Kardura for the treatment of prostatitis in the elderly.
8.g.13.1.99. The action of biflazim
on the hypophyseal-gonadal and hypophyseal-adrenal systems during
non-gonorrheal urethritis. /A. Bakuridze, B. Iakobadze, N. Shavdia,
To investigate the efficacy of thrombin-biflazim, the preparation was given per os after meals to 34 patients with non-specific urethritis complicated with scrotal inflammation. Biflazim was effective to resolve gonadal inflammation and pathospermia. Biflazim did not affect prolactemia, reduced follitropin and luteotropin to the normal level, increased the level of testosterone and estradiol in the blood, and regulated the function of gluco- and mineral cortical hormones.
8.g.13.1.100. Morphological changes developed in rat pancreatic islets during alloxan diabetes and after the effect of plaferon. /I. Latsabidze/. Experimental and Clinical Medicine. - 2010. - #3(58). - pp. 12-15. – geo.; abs.: eng.
We have studied sclerotic changes developed in rat pancreatic islets at different stages of alloxan diabetes and after treatment with Plaferon. At the later term of alloxan diabetes, the infiltration of islets with fibroblasts, lymphocytes, plasmocytes, and collagen fibers takes place. In animals treated with plaferon the activation of macrophages occurs and at the same time collagen lysis is marked. It facilitates the movement of insular granules towards the capillary, which is revealing of the compensatory-adaptation process.
8.g.13.1.101. Immunotropic effects of the preparation eskus-gel in the complex treatment of arthritis. /T. Ghlonti, B. Korsantia, K. Ghlonti/. Experimental and Clinical Medicine. – 2010. - #5(60). - pp. 18-22. rus.; res.:eng.
The ointment eskus-gel possessing anti-inflammatory, analgesic and local antiseptic properties is widely used to treat arthritis caused by various diseases or injuries. For the first time the immunotropic effect of the drug for pain in the knee joint was tested. The results showed a more rapid normalization of the immune status of patients, especially – of the interferon system against the control group. The immune response dynamics depended on the treatment efficacy.
8.g.13.1.102. Some clinical-cardiologic
indices in patients with chronic tonsillitis and rheumatic carditis. /I. Kekelidze, T. Khechinashvili, N. Jashi,
A diagnosis of chronic tonsillitis is frequently associated with certain difficulties. At the same time, the solution of diagnostic problems of tonsilogenic cardiac lesions is of major importance in both theoretical and practical medicine. Therefore, the authors of the conducted study have tried to work out efficient methods of diagnosing, prevention and treatment of chronic tonsillitis and rheumatic carditis. For this reason, based on the methods of clinical and echodopplerography, 86 subjects, aged 11-45 years, have been studied. As a result: a) close interrelation between the above-mentioned pathological conditions was determined, b) accurate subsidiary methods of differential diagnosis were developed; c) rational therapeutic tactics, including surgical and conservative means of treatment, and timely preventive measures against the disease and its complications were worked out.
8.g.13.1.103. Modern literary data concerning pancreatic cancer treatment. /L. Basiladze, A. Tsalughelashvili, Z. Chomakhashvili/. Experimental and Clinical Medicine. – 2010. - #6(61). - pp. 41-48. – geo.; abs.: eng.
The authors have studies 103 literary sources, the bulk of which was published after 2000. The object of the study is the data concerning the epidemiology, etiology, clinic, diagnosis of cancer pancreatic and all kinds of cancer treatment. On the basis of their study and analysis, the authors has concluded that the study of pancreatic cancer is to start from the very beginning, that is the results existing at the current stage should be analyzed and the ways of their improvement via available methods should be implemented.
8.g.13.1.104. Morphological characteristic of
fibroblasts in different histological types of colon and breast cancer. /T. Ghvamichava, I. Gachechiladze, T. Matchavariani,
The Investigation showed an active process in the stromal elements of malignant tumors. The growth and proliferation in the fibroblasts of malignant tumors were determined. The changes in the stromal elements are supposed to be one of the reasons for malignant tumor spread and growth.
A study of the symmetry and order of the spinal cord nervous trunks allows to suggest that the connection of the thoracal nerves with the branchial, lumbar and sacral plexuses displays a tendency of the human nervous system to develop the torso size reduction and upper extremity lengthening. The same appears less characteristic of the sympathetic nervous system. However, such tendency is observed in its separate component – stellate ganglions of the branchial plexus, i.e. the system has some connection with the human extremities innervation.
8.g.13.1.106. Functional anatomy of intercostal muscles given biomechanical principles. /Z. Katsitadze, M. Abesadze/. Experimental and Clinical Medicine. – 2010. - #6(61). - pp. 13-17.- geo.; abs.: eng.
A century long dispute on the role of the external and internal intercostal muscles in the process of respiration is still topical. Some of the authors consider them synergists, the others – antagonists. As the authors of this article note, the dispute was caused by the fact that all the above-mentioned researches were based on the data of electromyography, according to which both types of muscles during inspiration and expiration showed equally positive impulsation which must be considered a display of reciprocal interaction. The authors of the article, using a method of the biomechanical analysis, have proved the antagonism of the external and internal intercostal muscles during respiration.
8.g.13.1.107. Exfoliative cytology in
diagnostics of basal cell carcinoma. /N. Kiladze,
Basal cell carcinoma is the most common type of malignant non-melanoma skin cancer. It is locally invasive, aggressive and destructive, but has limited capacity to metastasize. Since the proportions of these tumors are heavily pigmented, clinically they may resemble invasive melanoma. The aim of this study was to evaluate the reliability of the cytological method of examination, and comparison of results with pathomorphologic data and dermatoscopic picture. 98 cases of pigmental basal cell carcinoma were analyzed, and it was proved that exfoliative cytology may become the method of choice as it has high sensitivity and specificity and as well numerous advantages to offer the patient and dermatologist working in an outpatient clinic.
8.g.13.1.108. Detection of maspin and
mammaglobin transcripts as circulating tumor cell markers in peripheral blood
samples from patients with invasive ductal carcinoma of different malignancy
potential and molecular phenotype. /G.Burkadze, Z. Avaliani,
The presence of lymph nodes and distant metastases is the most powerful prognostic factor for patients with invasive ductal carcinoma (IDC) of the breast. Nowadays, there is growing evidence that the detection of circulating tumor cells (CTC) in peripheral blood samples might serve as one of the important markers of metastatic potential, prognosis and relapse of IDC. Maspin and mammaglobin transcripts in blood are frequently used as reliable markers for CTC. The aim of our study was to evaluate CTC in peripheral blood samples from patients with IDC of different malignancy potential and molecular phenotype, using maspin and mammaglobin transcripts as CTC markers. Neither maspin nor mammaglobin transcripts were detected in the I and IV group patients. Both maspin and mammaglobin transcripts were detected in one patient from group II and 7 patients from group III. Only mammaglobin transcript was detected in one patient from group II and also one patient from group III. The only CTC - positive patient in group II was Her2-/ER/PR- as well as 6 CTC, positive patients from group III. One CTC positive patient from group III was Her2+/ER/PR-. Both mammaglobin positive patients from II and group III were Her2+/ER/PR-. In conclusion, CTC is more likely to be detected in patients with Her2-/ER/PR- IDC. This might be useful for evaluation of prognostic and predictive factors in patients with IDC. This study was supported by the research grant from the Georgia National Science Foundation #GNSF/ST08/6-461.
8.g.13.1.109. Primary intracranial
gliomas: biological "behaviour”. /T. Mermanishvili, T. Jorbenadze,
The studies have clearly shown that the degree of malignancy of glial tumours depends on their origin (astrocytic, oligodendroglial and ependymal), as well as on the age and sex of patients. Along with clinical parameters, these morphological data can contribute to the selection of optimal prognosis and treatment for disease.
8.g.13.1.110. Variants of division of the hepatic artery in the liver portal. /N. Zosidze, G. Tsetskhladze, Z. Chomakhashvili, R. Bolkvadze/. Experimental and Clinical Medicine. – 2011. - #1. - pp. 34-38. – geo.; abs.: eng.
According to the results of the conducted anatomic research the authors have come to the conclusion that in cases when the left branch of the hepatic artery did not divide in the portal area (3.7%) and the additional left artery of liver was revealed as the only source for supplying the left part with arterial blood (2,5%), the only one artery existed in the distal part of the left portal complex. In the distal part of the left portal complex, in 81.2% of cases two arteries were revealed (arteries of II and III segments), in 11.3% - three arteries (trifurcation type division of either the left branch of the hepatic artery or of the left additional artery), whereas in 1.3% - four arteries were found (trifurcation type division of the hepatic artery’s left branch and the left additional artery). In this part of the right portal complex, in 87.5% of cases the lobe vein is accompanied by the right branch of the hepatic artery, in 2.5% by the - right paramedial and lateral arteries, in 1.3% - by the right sector and bladder arteries. In the rest 8.75% there were right additional and IV segment arteries, out of which in 7.5% the IV segment artery was coming from the right branch of the hepatic artery. The middle part of the right portal complex in 37.5% contained only the right lobe branch of the portal vein, while in 62.5% there were two sector veins in this area.
8.g.13.1.111. The effect of electromagnetic field
and vegetable preparation "Seratonus” on the active avoidance reaction. /G. Iordanishvili, M. Nikolaishvili, T. Museliani,
G. Jiqia, M. Tchitchakhua, K. Archvadze,
The electromagnetic field of communication frequency evolves in rats a strong emotional reaction of fear in response to the electric irritation. Chaotic movements and emotional activity of the experimental rats caused by fear prevent them from forming a stable response to the light-induced irritation in the nerve structures and between the complexes of nerve structures responsible for the avoidance reaction to a painful irritation, conditioning the reaction deliverance from ailing irritation. Feeding the animals with the amino-acidic preparation "Seratonus” removes the reaction of fear, decreases pain, intensifies attention, and positively influences the animals’ behaviour in the reflex avoidance reaction acquisition process.
8.g.13.1.112. The effect of marigold
extract on experimental diabetes mellitus. /M. Esaiashvili, N. Gogia, T. Meladze,
Diabetes is a chronic metabolic disorder that continues to be a major health problem worldwide. Many studies suggest a central role for oxidative stress in the pathogenesis of this multi-faceted metabolic disorder. This has prompted to investigate antioxidants as a complementary therapeutic approach. Tagetes patula L. is one of the French marigold groups of the Asteraceae family. It is recognised in folklore for its medicinal and pesticide properties. Marigold flowers produce lutein ester and patuletin, which have antioxidant activity. We performed a diabetes study in mice exposed to streptozotocin and antioxidant, marigold extract. Summarizing the experimental results obtained in mice treated with STZ, we can conclude that an antioxidant, marigold extract reduces blood glucose level, increases lifetime, and can, therefore, be used as a complementary therapeutic agent.
8.g.13.1.113. Determination of hereditary characteristics of thyroid gland disease based on research of family forms. /N. Zosidze, T. Lezhava, G. Tsetskhladze, Z. Chomakhashvili, R. Bolkvadze/. Experimental and Clinical Medicine. – 2011. - #1. - pp. 47-48. – geo.; abs.: eng.
The article aims at determining the hereditary characteristics of the thyroid gland disease based on family forms. The patients with a high index of composition of variable metaphases were subjected to a treatment course that resulted in a reduction in the rate of abnormalities and their approximation to the norm (3.3%). In the mentioned groups, indices were corrected after the therapy course had been over.
8.g.13.1.114. Orexin-A to inhibit
bicuculline-induced multiple discharges in CA-1 field and modulate the activity
of bursting neurons in CA-3 field of hippocampal slices. /N. Doreuli, M. Alania, G. Vashalomidze,
The effects of neuropeptide orexin-A on the epileptiform activity in hippocampal slices were investigated. Orexin-A was found to decrease the duration/amplitude of multiple discharges of population spikes and to inhibit the spontaneous epileptiform after-discharges induced by bicuculline methiodide. Analyses of the effects of orexin-A on the spontaneous activity of bursting neurons in CA-3 of hippocampus has revealed that orexin-A modulates the bursting frequency of these neurons by inhibiting neurons with high-frequency bursting discharges and by increasing activity in silent or slow active neurons. Our results suggest a possible involvement of orexinergic system in antiepileptic action.
8.g.13.1.115. Age-related alterations of some
physical characteristics of red blood cells. /T. Sanikidze, M. Arabuli, G.
Lomsadze/. Materials of
Aim of the study – establishment of some age related physical characteristics of red blood cells. Eritrocytes’ deformability, intracellular concentration of Na+, K+ ions, and cells diameter in different groups (I group – 22-30 year, II group – 75 – 89 group) of men-volunteers were studied. As a result, it was established that in the red blood cells of young volunteers the intracellular content of K+, Na+ ions was lower than in the aged volunteers, due to s decrease in cellular energotores with age. Age-related alterations of the ions content induces the disorders of the cellular osmotic balance, swelling and increasing diameter of the erythrocytes. As a result, in the aged volunteers their deformability decreases.
8.g.13.1.116. Reasons of pro-inflammatory
cytokines elevation in chronic heart failure. /N. Bregadze-Tabagari, L. Tvildiani, T. Talakvadze,
The aim of this study was the investigation of TNF-α and IL-6 levels in blood serum and clinical-laboratory parameters of the "protein-energy” status in patients with chronic heart failure (CHF) of different functional classes (FC) and etiology. A group of 95 patients with CHF was divided into 2 subgroups: (by etiology – ischemic/non-ischemic: 50/45 and functional classes – II/III/IV: 32/40/23 respectively). We studied TNF-α, IL-6, albumin, total protein, iron, creatinine, ferritin, BMI, lymphocyte differential count, also T3; T4, T3/T4. Our data indicate statistically significant elevation of TNF-α and IL-6 with increasing the FC and decreasing "protein-energetically” status. It may be concluded that one of the possible reasons of cytokines expression is protein insufficiency in cellular nutrition.
8.g.13.1.117. The pathomorphological,
pathophysiological and psycho-physiological equivalents of psychosomatic
pathology. /L. Ninoshvili/.
Psychosomatic diseases are unique and distinctive: they invade human organism, disband the unity of body cover. This time, the agent of disease provoker is not a substrate or a physico-chemical agent. The frequency of psychic stresses and resultant psychosomatic deviation in very great today: the pathologies clearly associated with mental stressed have increased. The frequency of suicides has risen by 60% during the last 50 years. The affective-cognitive structure is always corporeally reflected, or has a material impress- the somatic substratum equivalent, which, in this case, means the brain problems caused by the nerve-cell dysfunction. This is expressed by an acute excitation and increased activity of nerve cells in a definite section and/or interconnected sections of the brain. Such activation of the cells is always followed by a rise in arterial blood pressure. The brain tissue responds to it by swelling of the local microscopic level, which is expressed by the formation around blood vessels of some "clouds", or the so-called "muffs". Finally, after some time, this results in the formation of demyelination loci, slowing down and deteriorating the excitation processes of the nervous fibers in the damaged places. As a result, disintegration of the excessive mediator or its recapture is impeded and cathecholamines flow out through perivuscular liquor ducts. The brain cortex inhibitor GABAergic interneurons fall victim to the cathecholamines’ aggression. Thus, it can be rightly to speak of the involvement of all the sections of CNS in the psychosomatic pathology development process.
8.g.13.1.118. Mechanisms of preventions of a sudden cardial death in patients with old myocardial infarction. /A. Isakadze, G. Eliava/. Gaenati Herald. – 2010. – vol. 3, #4. – pp. 22-33. – geo.; abs.: geo.; eng., rus.
A high risk of a sudden cardial death in patients with old myocardial infarction urges to look for new alternative ways of treatment. The pathologic mechanisms of development of a sudden cardial death promote to the development of electrical non-stability both in the zone of myocardial infarction and outside it, leading finally, to the provoking of a ''malignant'' arrhytmia. According to literary data, in addition to the use of a cardioverter-defibrillator, the utilization of ethyl esters of omega-3 fatty acids is recommended for reducing the risk of a sudden cardial death. As clinical observations show, they have physiological cardioprotective effects. A study of the current state of the aforesaid question has shown the necessity of further research in the problems of a sudden cardial death in order to ascertain the limits of the reversible pathophysiological upheavals during 6 hours after detection of acute symptoms, when the patient’s can be still saved.
During pathologic condition of the organism and the lung proper, the adaptation-compensation transformation of tissue metabolism and gaseous exchange take place, requiring additional energy spending. The effects of the expired air, hypoxia and bronchial asthma condition provoke transformanion of the redox process, the restoraion of generation of macroergic admixtures that are necessary for the formation of surface-active components of the surfactant and bronchial secretion of the lungs.
The progress achieved in the cell structure study has conditioned a substantial rapprochement of morphology and biochemistry. The weaker are the compensatory-adaptive reactions on noxious agents, the more expressed is the correlation between the morphological changes and dysfunctions and the clinical presentation.
8.g.13.1.121. The Morgan-Adams-Stokes syndrome and difference of its signs from signs of an epilepsy attack. /D. Gugeshashvili, G. Eliava/. Gaenati Herald. – 2010. – vol. 3, #4. – pp. 48-54. – geo.; abs.: geo.; eng., rus.
The number of disorders requiring the assistance of a pacemaker has widened. Lately it is being also used in the cases when chronotropic and dromotropic preparations are used for various occasions. The Morgan-Adams-Stokes syndrome is the most frequent expression of a circulatory collapse. In contrast to an epilepsy seizure, it is not characterized by aura, salivation, foaming at the mouth, but by a change of complexion. Prognosis depend on a timely beginning of electrocardiac stimulation in the case of the Morgan-Adams-Stoke syndrome recurrent attacks.
In most cases, the type of anemia in the structure of disease should be identified. Identification of the pathogenic mechanisms promotes to the conduct of an adequate therapy. The chronic hypoxia and circulatory dysfunction can provoke a heart failure. Identification of the dysfunctions dependent on the localization of hemodynamic disorders will be identified in various body organs and parts.
A significant variability in the spread of arterial hypertension in individual populations is conditioned by a whole series of factors: ethnic, socio-economic, etc. Upon conduct of treatment and preventive activities and forming patient groups, both systolic and diastolic arterial pressure should be taken into account. Given high myocardial ischemia mortality, isolated systolic arterial hypertension should be prioritized as the main cause of the above.
The evolutionary principles have been detected in salivary glands, the essence of which consists in assuming a reinforcing function in the creation of a material substratum and additional functions in duplication of other organs.
8.g.13.1.125. Structural and functional changes of
lungs in an antenatal and postnatal ontogenesis. /D. Kobeshavidze,
In addition to breathing, lungs have other functions as well, such, for example, as the taking part in heat regulation, secretary function, and protective function. The maximum quantity of bronchial rows is achievable by the sixteen-week development upon embryonic development of lungs. Intensive “alveolization” is characteristic of newborns till the age of five. In a postnatal ontogenesis, the development of lungs is characterized of both the growing of acinuses and the continuous transformation of all their structures.
8.g.13.1.126. Perspectives of use of balloon coronary angioplasty and coronary artery bypass grafting during different manifestations of ischemic heart disease. /D. Gugeshashvili, G. Eliava/. Gaenati Herald. – 2010. – vol. 3, #3. – pp. 85-90. – geo.; abs.: geo.; eng., rus.
In addition to drug treatment, coronary angiography is recommended for patients with a severe angina, in order that balloon coronary angioplasty or coronary artery bypass are conducted according to the degree and character of the damage of coronary arteries. The use of early revasculization technologies improves both the short-term and long-term prognosis.
8.g.13.1.127. Characteristics of a change in the cardiovascular system state during patent Botallo’s duct lumen of different size. /D. Gugeshashvili, G. Eliava/. Gaenati Herald. – 2010. – vol. 3, #3. – pp. 91-96. – geo.; abs.: geo.; eng., rus.
Congenital malformations are anomalies of the embryonic development of heart. One of the frequent anomalies is the patent Botallo’s duct functioning in the embryonic period. When the Botallo’s duct has a small lumen, the decompensation effects are not manifested for a long time. When the duct is large, the prognosis is unreliable, this being associated with the development of a septic process in the duct and its further transfer to both the valves and the development of decompensation.
8.g.13.1.128. Novel approaches to the prevention of
chronic kidney disease in patients with the metabolic syndrome. /N. Khipshidze, T. Gamezardashvili/. Bulletin of the
The metabolic syndrome
(MS) is a major public health threat. Individuals with MS are at increased risk
for development of chronic kidney disease (CKD). Despite effective medical
interventions that have targeted vascular renin-angiotensin system (RAS)
blockade, the prevalence of CKD remains considerably high. Few studies have
directly compared the
8.g.13.1.129. Effects of DASH and sodium-restricted
diets on blood pressure in the normotensive elderly. /I. Andronikashvili, G. Simonia,
During the past century, the evidence for the risks imposed on human health by excess salt consumption was compelling. The causal relation between habitual dietary salt intake and blood pressure has been established through experimental, epidemiological, migration, and intervention studies. The aim of the work was to select from persons having normal arterial pressure the salt sensitive ones and using DASH and sodium-restricted diets to set the perspective for the development of preventive measures. Salt sensitivity was assessed in normotensive 54 young and 68 elderly males. Accordingly salt sensitive subjects were divided into two groups in accordance with age. Salt sensitivity was assessed by the difference of mean arterial pressure (MAP) on high (200 mmol/day) vs. low (40 mmol/day) salt diet. Compliance with the diet was confirmed by measurement of 24-hour urinary sodium excretion during the last 2 days of both weeks. As was mentioned, both the DASH diet and DASH diet with lower sodium intake caused mean arterial pressure decrease, but the combination of the DASH diet plus lower sodium intake consistently produced the greatest mean reductions in blood pressure with peak levels in the elderly. Based on our results, we can suggest that in spite of the fact that diet modifications cannot influence the genetic nature of salt sensitivity, it can lower the mean arterial pressure in normotensive salt sensitive individuals, thus creating the possibility of its use for hypertension prevention.
8.g.13.1.130. A new method of conservative residual
OME treatment. /S. Khechinashvili, M.
Gedevanishvili, N. Sharashenidze,
Nonsurgical conservative therapy was used for residual OME (otitis media with effusion) treatment. In this article OME is considered as chronic secretory salpingootitis. Secretory salpingootitis in all patients studied developed in consequence of acute otitis media (AOM). Patients were distributed in 4 groups and were treated by instillation of Sinuforte/Nasodren spray (standardized Cyclamen tuber sap, S/N) in both nostrils once daily for 10 days. The results of S/N monotherapy were compared with outcomes of combined S/N/antibiotic, and standard antibiotic/decongestant therapy. Results indicate that treatment based on administration of S/N as a constituent of the therapy is associated with a significant clinical benefit. Outcomes in S/N monotherapy group and combined S/N/antibiotic group were obviously more favorable than in the group to which the standard method of conservative OME treatment was applied. Clinically proved curative outcomes of salpingootitis in humans treated with S/N could be explained by prompt reflex discharge from hyperplastic/hypertrophic glands, resulting reduction in edematous state of the mucosal lining in the auditory tube, opening of the pharyngeal orifice of the tube and consequent facilitated propulsion of exudates out of tubar, and respectively, middle ear cavities. In other words, beneficial outcome is achieved due to effective draining of middle ear cavity by inherent, natural way. These results permit to consider topically applied S/N as an adequate stimulus for physiologic reflex discharge of inflammatory secretions out of the auditory tube and for its frequent opening.
8.g.13.1.131. Assessment of functional relationship
between the arterial pressure and heart rate variability in patients with
arterial hypertension. /M. Janiashvili, T.
Matcharashvili/. Bulletin of the
The report presents the results of an analysis of functional relationship between arterial pressure and heart rate variations in patients with arterial hypertension. We used the method of mutual information calculation, which enables to assess both linear and nonlinear correlations in analyzed data. It was found that functional relationship between systolic and diastolic pressure increases at the first and second stages of arterial hypertension, while at the third stage of disease it decreases to the initial value. On the other hand, changes in the extent of functional relationship between arterial pressure and heart rate variability were not detected at increased severity of arterial hypertension.
8.g.13.1.132. Diabetes mellitus and impaired glucose tolerance among patients with coronary heart disease. /G. Chapidze, S. Kapanadze, N. Dolidze, N. Latsabidze, N. Meshveliani/. Critical Care & Catastrophe Medicine. – 2009. - #5. – eng.; abs.: eng., geo.
Diabetes mellitus (DM)
and impaired glucose tolerance (IGT) are associated with increased
cardiovascular disease (CVD) morbidity and mortality. DM and IGT prevalence and
their relation to other risk factors were investigated among coronary heart
disease (CHD) patients. 250 In- and outpatients with CHD visited or/and
admitted to the
According to the Critical Care Medicine Institute, 659 patients with stroke, 49.1% of which were with ischemic heart and 50.9% - hemorrhagic stroke were treated. The coma degree in all the patients was GCS-8 and less; general mortality constituted 49.3%, stroke mortality - 26.5%, and that of hemorrhagic stroke - 71.3%. The stroke treatment standard included respiratory therapy (SIMV, PS & PC modes), accompanied with a moderate hyperventilation and control of acid-base balance markers, magnesium and polyelectrolyte therapy, enteral/tube feeding (400 kcal/kg/24 hrs), etc. In addition to traditional therapy, the progenitor precursor commitment was managed by nitroglycerine, electric current and plasma beams (Zv.Kheladze, et al "New usage of electro impulses generator”, patent, 2008.07.01 #4857; Zv.Khelade at all. "New usage of plasma flow producer”, patent 2008.06.26 #4825, Z.Kheladze, Zv.Kheladze “New usage of nitroglycerin”, patent of 2008.07.11 # P4858). In the course of the therapy, it was established that the management of commitment of progenitor precursors improves the critical state treatment results, especially in patients with ischemic heart disease. In particular, the treatment reduces lethality and disability, shortens the length and cost of the treatment.
At the bi-directional A-V and V-A blockade of fourth degree accompanied with various frequencies of atrial and ventricular rhythm several kinds of transient cohesion of atrial and ventricular cycles that determined quantitative characteristics of hemodynamic loading on myocardium, its contractility and systolic output were detected. The sizeable change (decrease or increase) of ventricular rate in comparison with atrial rhythm leads to a reduction in the absolute number of hemodynamically effective atrial systoles and prodigal pattern of the heart functioning. During this pathology, the maximum number of hemodynamically effective atrial systoles is formed only if the length of the atriums and ventricles cycle is equal. Many compensatory mechanisms in the pathological regime of myocardium have been studied. They elucidate the formation of the pathological clinical symptoms, which develop in patients with the mentioned abnormalities.
In the Critical Care Medicine Institute the number of old-aged critical patients during last three years has markedly increased. Only in 2000-2009 hospitalized were 152 critical patients from 81 to 101 years of age (average age – 89.6). The treatment of one patient on average costs USD 1678.5. The most frequent diagnosis was stroke, the ischemic stroke being prevailed. Patients were subjected to artificial pulmonary ventilation and other therapeutic measures, including the progenitor precursors’ commitment therapy. General mortality rate made 48%; the highest death rate was registered in the cases of various shocks and acute stroke, making 49.4% and 30-80% respectively. The mortality was the lowest during the hypovolemic shock. In old-aged critical patients’ group the "ventilator adaptation syndrome” was typical. Also of importance were the question of selection of the optimum dosage of drugs, plurality of concomitant diseases and other peculiarities. The analysis shows the efficiency of the intensive care in old-aged critical patients.
The breast cancer of the
IV stage is morphologically and clinically heterogeneous disease. However, it
is less clear how clinical features relate to tumor characteristics and
histological specificity in critical and non-critical female patients. In
accordance with these goals, it was necessary to accomplish a
morpho-epidemiological research in
8.g.13.1.137. Two cases of the neuroleptic
malignant syndrome. /Z. Kheladze, Ts.
The neuroleptic malignant syndrome was first described by Dr. Delei in 1960. It is caused by negative side-effect of the neuroleptic and anti-psychotic drugs. The frequency of the neuroleptic malignant syndrome makes about 3-27%, the mortality rate being 40%. The neuroleptic malignant syndrome’s pathogenesis is dysfunction of the central, dopamine and sympathetic nervous system and skeleton muscle membrane, etc. It diagnosed based on antecedent anamnesis, past drug, life and family history and clinical presentation. The treatment program includes muscle relaxants and dopaminergic drugs, psychotropic activity decreasing medications, plasmapheresis, hormonotherapy, brain anti-edema, nosotropic, routine infusion therapy, etc.
The effect of various electrical versions of ventricular tachycardia on cardiohemodynamics has been studied.
The present work is another attempt to study the pathogenesis of hemorrhagic stroke; the analysis is based on the several well-known facts in medical practice and the experimental data. Sudden, uncontrolled changes of arterial blood pressure results in recurrent hemorrhage, ICP growth and perfusion blood pressure reduction. For arterial blood pressure correction ganglioblockers and peripheral venodilatatores should be used. Sudden decrease of intracranial pressure leads to sharp expansion of vascular diameter prior to hydrodynamic attacks (for example due to lumbar puncture). It may be one of the reasons of sudden deterioration of neurological status. Also likely to be assumed, that a strong headache due to aneurysm rupture is caused by blood intrusion into the ventricular system.
8.g.13.1.140. Subconscious management problems in the critical care medicine. /Z. Kheladze, G. Bakaia, T. Kurtsikidze, M. Dvalidze/. Critical Care & Catastrophe Medicine. – 2010. - #6. – eng.; abs.: eng., geo.
The aim of the first part of the research was to find out the Midazolam’s effect on rats movement activity and behavior. The research was performed on white, male 250- 300 g rats. In the clinical part of the research, 12 adult patients were observed with an attempt to manage their subconscious. The results obtained found Midazolam to be an effective and desired sedative agent for managing the subconscious. This does not exclude usage of other agents for the purpose.
A variable spectrum of psycho-mental symptoms developed due to hepatic insufficiency, disruption of communication between the body and the environment, the digestive and the nervous systems is given. 106 patients with different gastrointestinal pathologies, divided into 4 groups and 19 patients of the control group were observed. The study results are given and the following conclusions made: The damage of neuromatrix and linguistic matrix under the impact of external (environmental, verbal, nonverbal) and internal (dismetabolic) factors and deformation of those matrixes are formed at different levels (interpersonal, mind-body, etc.). Hepatic encephalopathy is not a pathology caused by the liver failure. The full-blown picture of HE may be produced by verbal or nonverbal influence on the patient’s brain – through deformation of the linguistic code.
8.g.13.1.142. The hepatoprotective effect of verapamil
during a hemorrhagic shock in an experiment. /M.
Gvaladze, T. Gegeshidze, Gr. Sulaberidze, G. Didava, M. Chkhaidze,
During hypoxic state, especially for the period of
hemorrhagic shock, lyses of liver parenchymal cell membranes occur due to
calcium ion excess. Membrane protection from such a pathologic process is
theoretically possible through blockage of the calcium L channels, namely – by
verapamil. The later was utilized to study its hepatoprotective effect.
Modeling of the hemorrhagic shock was performed by Wiggers-Feine method. Blood
was exfused from sedated male cats (nembutal 40mg/kg, intravenous blood
exfusion 40ml/kg) till arterial blood flow dropped to 40 mm/Hg (HS60). During
artificial ventilation - 130-150 ml/min/kg in the period of 1 hour, pH in the
arterial blood was 7.35-7.45, PO2 – 90mm/Hg; the airflow measurement
was controlled by the “
Description of blood flow only by means of Navier-Stoke equation is impossible currently, since hemodynamics in large arteries is unsteady, with the flow separation and waveform propagation of the viscoclastic mass. The purpose of the present paper is to study the influence of arterial pulse on blood flow. Pulse pressure is increasing stain rate at the contiguous flow layers. At the circular sites in protodiastola flow separation and wave superposition promote to high net flow. At the circular sites flow wave interference and reflection constrain the endothelial boundary layer to shift.
We retrospectively analyzed diagnoses of all inpatients (34), of whom non-epileptic seizures (NES) have been identified in the Epilepsy Centre during a period of 12 months. NES of psychogenic origin (82.4%) prevailed over physiologic NES (17.6%) and conversion-somatoform disorders (ICD-10) were the most frequent diagnostic in the first group (71.4%), whereas neurally mediated syncope – in the latter (50%). There was a female predominance (20/14) in the whole group. Evidence of coexisting epilepsy was found in 3 cases, all of them in the group with conversion-somatoform disorders. Our data indicate that psychiatric as well as cardiologic evaluation of patients with treatment-refractory or undiagnosed seizures can clarify the final diagnosis.
8.g.13.1.145. The quantitative estimation of cerebral blood flow in patients with severe traumatic brain injury. /R. Fanarjian/. Georgian Journal of Radiology. - 2010. - #1-2 (34-35) – pp. 16-19. - eng.; abs.: rus.
Our study of cerebral blood flow in severe traumatic brain injury is an example of the effective use of TCD in the daily practice of neurological and neurosurgical hospitals. High self-descriptiveness, relative simplicity and non-invasive usage allow monitoring of cerebral hemodynamics and identifying efficiency of the conducted pharmacotherapy. The obtained quantitative data can serve as criteria for prediction of outcomes. Many aspects of pathophysiological mechanisms of blood flow alterations in severe head injury require further research. A combination of clinical data and highly informative methods of study is required to identify effective methods for their correction.
encephatolopathy induced by synthetic psychostimulants. /M. Okujava, M. Janelidze, I.Khatiashvili,
In the last two decades the use of a "designer drug” - methcathinone (otherwise known as Jeff or Ephedrine) has increased in Eastern European countries. This psychoactive substance is synthesized from widely available and relatively cheap ingredients – over-the-counter drugs, which contain ephedrine and potassium permanganate. The increasing number of patients with chronic use of methacthinone having addressed our department indicates on the threatening scale of the problem. During the last 4 years we have investigated 32 patients with chronic intravenous use of methcathinone. The duration of the substance abuse ranged from 1.5 month to 3 years. The frequency of indication ranged from 1 injection per week to 4 injections per day. The most common symptoms were: bradykinesia, postural disturbance, ataxia, dysarthria, dysphonia, hypometric vertical saccades, dystonia (mostly of the face and lower extremities), apathy and cognitive decline. Disability of the patients was evaluated using Schwab and England Scale. Twelve cases showed deep disability (Scwab and England Scale <50%). Patients from this group needed assistance during their daily activities due to the evident ataxia and postural disturbances. Substance abuse with the duration of more than 6 months was associated with stable strong disability which was not regressing despite the cessation of the drug abuse and the treatment with the L-dopa medications. All patients underwent MRI of the brain.
8.g.13.1.147. Primary intracranial astrocytic
neoplasms: some epidemiologic considerations.
/T. Mermanishvili, Ò. Jorbenadze,
The aim of our study was
to perform à hospital-based
epidemiological analysis of primary intracranial astrocytomas in
8.g.13.1.148. Òhå role of mammography in the diagnosis of breast pathologies in males. /T. Daraselia, Ê. Gigauri, Ò. Chagnelia/. Georgian Journal of Radiology. - 2010. - #1-2 (34-35) – pp. 62-66. - geo.; abs.: eng.
Gynecomasty in males gives a vivid clinical picture of steroid hormone imbalance caused with absolute and relative hyperestrogenemia. In males the tumor of mammary gland is ïît frequent ïàd it needs differentiated diagnostics other than the nodular form of gynecomasty. Early diagnostics of the tumor has the decisive meaning from the viewpoint of the treatment and prognosis of the disease, but the screening program is ïît provided for the early stage of revealing of the pathology of mammary glands in males and the mammography is usually made àt later period after revealing of the clinical sings.
8.g.13.1.149. Analysis of data of dysbacteriosis
syndromes in patients with diarrhea, constipation and mixed symptomatology. /I. Giorgadze, N. Tophuria, M. Giorgadze, N.
Balarjishvili, N. Cholokashvili, L. Tkemaladze/. Proceedings of the
In the classification of WHO, dysbacteriosis or disbios is considered to be not a separate nosologic unit but a syndrome and, therefore, secondary. It is supposed that there is a direct connection between the symptoms of dysbacteriosis and gastrointestinal diseases - diarrhea, constipation and their combinations. The goal of this study was to establish which of the symptoms was leading in patients with dysbacteriosis syndrome - diarrhea, constipation or their alteration and average clinical manifestation. Total of 1040 patients were investigated. Only dysbacteriosis or decay from normal flora was revealed in 814 cases. In cases of dysbacteriosis the quantity of the patients with diarrhea symptoms significantly exceeds the quantity of the patients with constipation and combined symptoms in the whole contingent of the patients as well as in the patients with dysbacteriosis during the changes in one, two, three or all the four representatives (bifidumbacter, lactobacteria, enterococci and intestinal bacillus). In age groups - children’s contingent - cases of symptoms of diarrhea were revealed twice more than in adults. So, in patients with dysbacteriosis syndrome, the symptoms of diarrhea were more as compared to constipation and mixed symptomatology.
8.g.13.1.150. Microbiological diagnosis of mixed
anaerobic-aerobic infections during complicated Infections. /M. Giorgadze/. Proceedings of the
Treatment of wounds is one of the pressing problems that are hard to solve. Totally, we have investigated 35 cases in dogs of random breed. In the first group, the animals with symptoms of mixed anaerobic-aerobic infections were included, 11 of them had infection of abdominal cavity, 13 - inflammation of soft tissue. In the second group, the operated animals with symptoms of peritonitis and generalized infection were included. Using bacteriological analysis, in 22 animals of the first group obligate anaerobic bacteria were found, 20 of them from peritoneum, and 14 animals had them in the mediastinum area and pleural cavity; 10 of bacterial isolation was in case of soft tissue infection. Gram-positive bacteria and cocci were sensitive to most antibiotics, but aminoglycosides. Staphylococci are sensitive to monomycin, streptomycin, tetracycline, macrolides. E. coli was still sensitive to aminoglycosides, but penicillin group antibiotics are losing their efficacy.
8.g.13.1.151. Alteration of blood redox-status during
cholelithic disease in postmenopausal women. /M.
Shengelia, N. Gogebashvili,
Cholelithic disease is one of the most widespread diseases of the digestive tract. Taking into attention that the cholelithic production often is associated with the inflammatory and other processes connected with oxidative stress, we have proposed that the alterations of oxidative metabolism and formation of signal molecules - reactive oxygen and nitrogen species are very important pathogenetic links in the pathogenesis of the cholelithic disease. The aim of our study was the establishment of alterations of blood’s redox-status during the cholelithic disease in postmenopausal women. As a result of our studies, we have shown that during the cholelithic disease in postmenopausal women an oxidative degree of blood ceruloplasmin increases, and Fe3+- transferrin content decreases which points to the disorders of the one of the links of blood antioxidant system, which is favorable for alteration of redox-homeostasis and injury of membrane structures in patients’ body. This is revealed by increasing the content of products of lipoperoxidation (Mn2+ions, lipoperoxides, superoxides). Under oxidative stress conditions it is possible to excess oxidation of natural antioxidants (bilirubin), which is accomplishing for the development of inflammatory processes and cholelithic formation.
8.g.13.1.152. The effect treatment with
intranasal electrophoresis of vanadium on the function of external breathing in
patients with allergic rhinitis. /Sh. Tsiklauri/.
Proceedings of the
Total of 67 patients have been examined, out of which 35 patients had a persistent form of allergic rhinitis. 32 patients had an intermittent form of allergic rhinitis. It has been established that treatment with intranasal electrophoresis of vanadium induced expressed improvement of bronchial permeability in these patients, as well as increase of reserve possibilities of lungs and decrease, up to complete elimination, of arterial and venous hypoxemia. The above-mentioned positive shifts were significant in patients with intermittent form of allergic rhinitis.
8.g.13.1.153. Effectiveness and safety of early treatment by ezetimibe and statins in patients with acute coronary syndrome. /N. Khipshidze, Th. Gegenava, K. Nadaraia/. Cardiology and Internal Medicine. - 2010 - ¹ 3-4(31-32). . – pp. 9-12. – ;
According to our study, for patients with NSTE-ACS, a ezetimibe/atorvastatin combination provided superior lipid-lowering efficacy vs doubling the statin doze. After 16 weeks of study, superior clinical benefit was revealed on nonfatal MI and unstable angina that requires hospitalization, although without a statistically reliable difference on the frequency of coronary death, coronary revascularization and nonfatal stroke.
The acute coronary syndrome (ACS) is a topical and significant problem nowadays. Development of ACS predicts transfer of chronic ischemic disease into the acute phase and is the most frequent reason of hospitalization. Evaluation of risks of patients with acute coronary syndrome has shown that the main factors associated with in-hospital mortality and development of cardiovascular diseases are: age (70-80 year); ST-segment elevation, myocardial infarction and heart failure. Diabetes and age - 60-69 years are associated with the average risk, and 40-59 years – with the low one.
8.g.13.1.155. Surgical treatment of heart failure caused by
coronary heart disease and severe valvular pathology (case report).
/E.Pirvelashvili, L. Janelidze,
Severe mitral and tricuspid regurgitation associated with myocardial ischemia is a Class I indication for cardiac surgery. Mitral and tricuspid annuloplasty or mitral valve replacements are performed during coronary bypass surgery with the aim of improving the patient´s ventricular function and clinical symptoms. The purpose of this case is to review the role of cardiac surgery in the management of such combined pathological conditions.
Resistant arterial hypertension is diagnosed when the target tension according to the optimal treatment with a three-component scheme (including thiazid diuretics) is not achieved or the treatment with a four- component (or more) scheme is effective. Arterial hypertension with corrected reasons and/or forms which need motivated additional research also belong to resistant hypertension. Distribution of resistant arterial hypertension is high - 10-30% of patients with arterial hypertension have this form. Elimination of the reasons of pseudo-persistency, correction of secondary reasons of arterial hypertension and effective treatment improve the prognosis of arterial hypertension.
8.g.13.1.157. Crohn’s disease and Melkersson-Rosenthal
syndrome. /Kh. Pachkoria, M. Abesadze, S. Kemoklidze, M. Kikvidze,
The Melkersson-Rosenthal syndrome (MRS) is a rare condition characterized of a triad of recurrent oral-facial swelling, commonly affecting lips, intermittent facial nerve palsy and tongue changes (lingua plicate). Oligosymptomatic forms are more common. The authors observed 2 women with a classic triad of MRS. In the first case, treatment with corticosteriod was successful, but after 5 months swelling relapsed. In the second case, diagnosis of jejunal Crohn’s disease (CD) and Melkersson-Rosenthal syndrome were established. Treatment with corsticosteroid (Medrol) was successful, but lip and facial swelling relapsed and hirsutism and obesity were detected.
8.g.13.1.158. Liver function and outcome in patients with chronic heart failure: abnormal elevation of serum hepatic enzyme and therapeutic efficacy of NAD-containing drugs. /M.Rogava, T. Bochorishvili, K. Kapanadze, E.Berberashvili/. Cardiology and Internal Medicine. - 2010 - ¹ 3-4(31-32). - pp. 33-37. - ;
Therapy of Nadcin in patients with heart failure and
preserved left ventricle function and Adenocin in patients with pronounced
contractile dysfunction leads to a pronounced improvement of NYHA FC of CHF and
exercise capacity. Cardiac deremodeling and
Since the first publications about the metabolic syndrome, a large amount of data about its clinical significance has appeared. A series of investigations have demonstrated the important role of this syndrome in the development of diabetes mellitus, coronary heart disease, atherosclerosis and arterial hypertension, often accompanied by dangerous complications. Nevertheless, controversial points still exist regarding diagnostic criteria, which allow us to identify metabolic syndrome in scientific studies and routine practice. In this review we made an attempt to analyze different approaches to this problem in light of results of contemporary investigations.
CF is a chronic multi-system disorder characterized by recurrent endobronchial infections, progressive obstructive pulmonary disease and pancreatic insufficiency with intestinal malabsorbtion. We investigated 38 children with CF aged from 1 month to 14 years who were hospitalized in pediatric clinic of TSMU. The sweat chloride test (chloride concentration 60) was used to diagnose CF. The investigation showed that in 38 patients 25 were with combined and 13 with pulmonary form of CF. The study revealed a marked depression of immunity characterized by reduction of quantity: of CD3, CD4, CD19-lymphocytes and the concentration of IgG, IgA, IgM. Parameters of interferon-producing leukocyte function were studied in vitro using the Soloviev-Bektenirov technique. Patients with CF received complex treatment, which included: Creon, Bronchodilatators, Mucolitic agents, and Antibiotics, Imudon, URS-19, vitamine for correction of immune system. There were also used nutrition and kinesis therapy.
Allergic rhinitis is a global health problem. It influences social life, sleep, study, and work process. In 1999 as a result of activities of WHO, a document ARIA was adopted, which was a recommendation with special significance for specialists and professionals, also general profile doctors. The ARIA update started in 2004, although the 1999 ARIA work group recommendations are still in force.
8.g.13.1.162. Damage of the
cardiovascular system during juvenile rheumatoid arthritis. /G. Chakhunashvili,
Juvenile rheumatoid arthritis is urgent nowadays and it is extremely interesting to forecast further disorders of organ systems. The article deals with modern literary discussions about the damage of the cardiovascular system during juvenile rheumatoid arthritis. Our literary discussion proves once more that the cardiovascular system’s damage plays a great part in the development of juvenile rheumatoid arthritis. It needs proper attention and treatment in the early stages. Often the cardiovascular system’s damage develops without any symptoms; therefore, routine cardiologic examination should serve as a basis for prognostication and monitoring of these patients.
The article describes the treatment of a 14-year aged patient having addressed the clinic with severe sternal and back pain and diagnosed with an acute myoppericarditis.
Switching early from IV
It is known that taenia solium, taenia saginata, trichinella spiralis, diphyllobothrium latum and some other parasites are correlated with eating undercooked or raw meat (pork, beef, fish). We studied the relationship between different blood groups of humans with eating meat and meaty food. As a result of our research, it was revealed that humans with the blood group (A) or (O) are less predisposed to eating meat and meaty food than people with the other groups of blood. Given this, we think that the above-mentioned category of humans are less liable to such infections as taeniasis, trichinosis, etc.
8.g.13.1.166. Endothelium-dependent regulation of the tone of brain
blood vessels. /N. Mitagvaria, E. Bibiluri, M. Nebieridze, M. Darbaidze, E. Sukhishvili,
N. Sakhvarelidze, M. Devdariani, L. Gobechia/. Scientific Works of
The role of endothelium in the local regulation of vascular tone is considered.
8.g.13.1.167. Pathomorphological, pathophysiological and
psychophysiological equivalents of psychosomatic pathologies. /L. Ninoshvili/.
Scientific Works of
The article deals with the involvement of all sections of the central neural system into pathological psychosomatic and morphological processes during maldevelopment of psychosomatic pathologies.
The halogenated preparations used in medical practice - sodium and potassium chlorides, bromides, iodides, iodine - are discussed and characterized.
The Mesenteric neoplasm (case report). /L.
Akhmeteli, L. Saghinashvili, L. Dzneladze/. Collection of Scientific Works of
The mesenteric neoplasm is one of the rarest
abdominal tumors. Since the first report of a mesenteric neoplasm by the
Italian anatomist Benevieni in 1907, only about 820 cases have been reported.
Schwannomas (malignant neurilemomas) are benign neurogenic tumors that arise
from Schwann cells, which are the cells forming nerve sheaths (neurolemma).
They may involve all peripheral, cranial or autonomic nerves. Schwannomas are
very homogeneous tumors and they typically appear as a solitary, well
encapsulated and smooth surfaced round mass. They are usually benign,
relatively slow-growing. Abdominal schwannoma may cause diagnostic problems
because clinical symptoms are misleading or uncharacteristic even if the tumor
is large. Our case-report involves a 62 years old woman who was admitted to the
emergency service in a heavy condition with acute cerebral dishaemia, ischemic
stroke, fibrillation arrhythmia, diabetes mellitus (II). On the 3-rd day
generalised abdominal tenderness and muscle spasm was noted.
Two cases of complicated gastric MALT lymphoma. /L. Gophodze, G. Tomadze,
G. Asatiani, Z. Demetrashvili, G.Chikobava, A. Megreladze/. Collection of Scientific Works of
Helicobacter pylori infection plays a central role in the development of gastric MALT-type (mucosa-associated lymphoid tissue) lymphoma. Invasion and destruction of the gastric epithelium with the development of so-called lympho-epithelial lesions is the most important diagnostic criterion. We reported 2 cases of complicated gastric MALT lymphoma. In the first case it was the destruction and perforation of stomach body, with diffuse purulent peritonitis, in the second one – ulceration of small curvature and profuse gastro-duodenal bleeding. In both cases gastrectomy was performed. The phenotype of MALT-type lymphoma was identical to non-neoplastic B-lymphocytes of the marginal zone (CD20+). Individual therapy is strongly dependent from histological type and lymphoma stadium. Postoperative therapy includes H. pylori eradication as a rule.
Intrastromal corneal ring segments in keratoconus treatment. /M. Dvali,
To describe the visual, refractive, and corneal aberrometric outcomes, topography maps and OCT images in the eyes of keratoconic patients that underwent implantation of KeraRing Intrastromal corneal ring segments (ISCRS) and modified ISCRS – KeraBow. Setting/Venue: Tbilisi State Medical University, eye clinic "Akhali Mzera” Tbilisi, Georgia This prospective analysis comprised eyes with grade I, II or grade III corneal ectasia (keratoconus, ectasia after Lasik), as well as patients with mild to moderated myopia with abnormal corneal topography maps that had ISCRS implantation using standard technology. Visual, refractive, and corneal aberrometric outcomes were analysed over follow up period of one to seven years. ICL (Staar Surg.) implantation was combined with ISCRS in presence of High Myopia and Keratoconus. Statistical analysis included preoperative and postoperative UCVA, BCVA and keratometry (K) values. The mean UCVA improved from 0.04-0.2 preoperatively to 0.2-1.0 postoperatively and the mean BCVA, from 0.4 to 0.6 respectively; One month postoperatively, there was a statistically significant reduction in sphere. At 6 months, there was a statistically significant reduction in manifest cylinder. That was consistent with the significant reduction in corneal astigmatic aberration. Corneal topography showed corneal flattening in all eyes. The maximum K value changed from 45.5 – 58.4 D preoperatively to 43.5 to 52.1 D postoperatively, the changes were statistically significant. After implantation of the both models, the UCVA and BCVA were improved in eyes with keratoconus. There was significant postoperative corneal flattening that remained stable over the follow-up period. Implantation of ISCRS is a measure of vision correction in patients with mild or moderate myopia and abnormal corneal topography, which makes the laser correction inexpedient. Important results were received in keratoconic patient with myopia using combination of ICL and ISCRS implantation as well.
8.g.13.1.172. Influence of
halothane on emotion, behaviour and adaptation ability of a rat against the
background of the midazolam premedication. /Z. Vadachkoria, L. Dzidziguri, E. Mitaishvili, G.
Mosidze, E. Bakuradze, I. Modebadze, D. Dzidziguri/. Collection of Scientific Works of
Influence of halothane on behavioral parametrs and adaptation ability of experimental animals has been studied. The high level research activity has been determined in all three groups in the first three days of experiment. The adaptation to environment has been revealed in control group after 2 days from sham operation and halothane anaesthesia while the high level of research activity has been maintained in the test group. The adaptation and decreasing of fear has been detected in the control group on the 5th day of experiment. The high level research activity in the test group indicates to the difficulties in adaptation and space orientation. It is established that decreasing of adaptation ability and difficulties in space orientation in rat are stipulated by suppression of inhibitory neurotransmission in hippocampal CA3 filed. The Modulating influence of midazolam on secretion of GABA from these cells has also been shown.
Malignant hypertension is considered as an emergency hypertensive (in comparison with hypertonic crisis) case, which had already caused such injuries of target organs as retinopathy of III-IV degree. Malignant hypertension is characterised by arterial hypertension with neuroretinal symptoms and progressive loss of renal function. It can develop de novo in so far normotensive persons as well as on the basis of already preexisting hypertension. A control of the blood pressure is an indispensable need in the other treatment of the malignant hypertension. Only through the consistent and long-term antihypertensive treatment can be reached partial feedback or even only a little relief. A Screening concerning a secondary cause of the hypertension is absolutely necessary above all with younger patients.
structure of urethritis in men detected by modern technologies of
microbiological research. /E. Kikacheishvili, M.
Dzagnidze, I. Dgebuadze,
Microbiocenosis of urethritis is a permanently changing ecosystem. It depends on various factors, so in clinical microbiology is very important to control both quorum of causative agents and their sensitivity to new and old antimicrobial preparations. Along with theoretical purposes, that has a wide practical application. The aim of this research was to study the etiology of urethritis in men, using high quality standard bacteriological technology-‘bio-merieux”. (Api and ATB test). The study of materials taken from 80 patients with chronic recurrent disease showed that the dominant causative agents (in 32,5% of cases) in S. epidermidis, the second place occupies S. aureus (17.5%), then follow: E.faecalis, Corynebacterium spp, C. freundii. Monoinfections were determined in 78.5% of cases, and mixed infections - in 22,5%. S. epidermidis+P.mirabilis was most frequently detected. The study of sensitivity spectrum showed that main causative agent - staphylococcus - revealed a high sensitivity to Gentamicine, Monocycline, Teicoplanine, Rifampicine, Nitrofurantoine and resistance against Norfloxacine, Levofloxacine, Oxacilline, Tetracycline and Penicillin.
8.g.13.1.175. Comparison of
concomitant non-accommodated convergent strabismus treatment methods. /M. Kikolashvili, D. Shengelia, L. Tsomaia/. Collection of Scientific
A retrospective cohorative research carried out on children (n=70), aged 1 to 10 years. The children have manifested concomitant convergent strabismus. This cohort of patients, according to their age, was divided into 2 clinical groups and subgroups. The first group included the patients who underwent surgical treatment and occlusion. In the second group, there were patients who underwent pre- and post operative pleopto-orthopto-diploptic treatment. The analysis of research showed the complete repairing of binocular vision and development of fusial reserves occurred in children who had undergone complex treatment (pre- and post operative pleopto-orthopto-dipliptic). It is important to note that late surgical treatment decreases the ability to reach perfect results.
pancreatoduodenal zone cancer. /N. Lomidze, I. Tsereteli, O. Urushadze, G. Nemsadze, V. Kaloiani, Z. Manijashvili, I. Latsabidze/. Collection of Scientific
Pancreatic cancer is the third leading neoplasm of the gastrointestinal system and has a dismal prognosis. Primary carcinoma of the duodenum is rare and uncommon neoplasm that represents less than 0.5% of all gastrointestinal malignancies. The aim of this study is to access patients with pancreatic, duodenal and periampullary cancers. 61 patients from N. Khipshidze Central Clinic (1995-2010) were investigated. 5 of them with a duodenal cancer, 12 – with a periampullary cancer, 14 – with a cancer of distal part of choledocus and 30 - with a pancreas head cancer. Mean age of patients was 42-72. From studied population pancreatoduodenal resection were performed on 16 (57%) patients (2004-2010) and 12 (43%) received palliative treatment. From 28 patient 3 of them had duodenal cancer and whipple procedure was done. Pathomorfological study proved adenocarcinoma in 2 of cases and neiroendocrinal carcinoma – in 1 case. From 5 patients with distal cholangiocarcinoma 3 of them received Whipple procedure. Pancreatoduodenal resection and limphodisection D2 were done in 4 patients with periampullary carcinoma. From 16 patients with pancreas head cancer 5 of them received Whipple procedure with D2 limphodisection. The majority of patients with pancreatic head cancer are poor candidates for resection at the time of diagnosis due to early development of distant metastases and/or major infiltrations of adjacent structures; patients with cholangiocarcinomas and duodenal cancers appear to be better candidates for Whipple procedure. Duodenopancreatectomy gave a longer survival time than duodenal resection in patients with duodenal cancer.
dysfunctions in patients with ageing male syndrome: modern view of the
pProblem. /Z. Marshania, G.
Bochorishvili, T. Ivanishvili/. Collection of Scientific
The objective of this article was to study the problem of sexual dysfunctions in patients with the ageing male syndrome based on modern medical scientific sources. This syndrome is very frequently accompanied with erectile dysfunction, which originates from functional and not organic reversible damage of cavernous arteries. Along with complex treatment of sexual dysfunctions (FDES-5 inhibitors, testosterone-therapy, psychotherapy, surgical interference, intracavernouse injections, adaptogens, biostimulators, local decompression, physiotherapy), it is necessary to take into consideration accompanying diseases (insufficiency of penile cavernous corps‘ blood vessels, diabetes, heart diseases, mental disorders) and diversification of forms of sexual pleasure of ageing couples through widening acceptance range, increase of activeness of a sexual partner and prolongation of sexual foreplay for the purpose of ensuring mutual adaptation of couples in regards to changed sexual requirements.
8.g.13.1.178. The effect of an
extract obtained from cortex of Phellodendron lavalei introduced in the
subtropical zone of Georgia on the blood glucose level and glucose tolerance
test in mice. /M. Meskheli,
We studied the effect of an extract obtained from the cortex of Phellodendron lavalei introduced in the subtropical zone of Georgia – Kobuleti on the blood glucose level and glucose tolerance test in mice. Measurements of glucose level in blood were provided by the glucometer Gluco Lab-auto-coding. According to the study results, the extract is characterized of hypoglycemic activity, in particular it improves glucose tolerance and reduces the blood glucose level in mice. Further investigation of the efficacy and of the mechanisms of action of different parts of Phellodendron lavalei in experimental models of diabetes is essential for solving the problem of using Phellodendron lavalei as a plant raw material for hypoglycemic drugs.
active substances of the Allium genus onion and their pharmacological action. /L. Mskhiladze, M.
Maisashvili, D. Tchintcharadze , J.
Kuchukhidze/. Collection of Scientific
Intensive chemical and pharmacological
investigation of Allium species has been conducted by Italian, French, English,
American, Indian, Chinese and Japanese scientists lately. They are
characterized of anticancer, antimicrobial and anti-atherosclerosis activity.
Taking into account the above, further study of the Allium species grown in
8.g.13.1.180. Intestinal and
extra-intestinal manifestations of Crohn’s disease. /S. Kemoklidze, B.
Ratchvelishvili, Kh. Pachkoria, L.
Dzneladze, E. Adamia, I. Tavzarashvili/. Collection of Scientific Works of
The authors report the intestinal and extra-intestinal manifestations of Crohn’s disease. The Intestinal manifestations, including aphthous mouth ulcers, entero-enteral, entero-vesical, entero-cutaneus and perianal fistulas, bleeding, obstruction and malignant transformation. The extraintestinal manifestations include: pyoderma gangrenosum, the Syogren’s syndrome polyarthritis, spondylarthritis, lupus eruthematose and the Melkersson-Rosenthal syndrome.
hepatoprotective effect of PV-88 during hemorrhagic shock in experiment. /M. Gvaladze, Gr.
Sulaberidze, G. Didava, M. Chkhaidze,
During hypoxic state, especially for the
period of hemorrhagic shock, lyses of liver parenchymal cell membranes occur
due to calcium ion excess. Membrane protection from such a pathologic process
is theoretically possible through blockage of the calcium L channels, namely –
by Verapamil and PV-88. The latter was utilized to study its hepatoprotective
effect. Modelling of the hemorrhagic shock was performed by Wiggers-Feine
method. Blood was exfused from sedated male cats (nembutal 40mg/kg, intravenous
blood exfusion 40ml/kg) till arterial blood flow drops to 40mm/Hg (HS60).
During artificial ventilation - 130-150 ml/min/kg in the period of 1 hour, Ph
in the arterial blood was 7.35-7.45, P02 – 90mm/Hg, airflow measurement was
controlled by the
8.g.13.1.182. The role of
scleral weakness and thinness in progressive myopia. /D. Shengelia, A. Bakuridze, V. Beliashvili/.
Collection of Scientific Works of
Scleral biomechanical weakness and thinness are known to be one of the main factors in the pathogenesis of progressive myopia. We tested changes in axial length of the eyes, in far and near distance, in patients with low, middle and high grades myopia. Statistically significant differences were considered when p < 0.05. The study shows the widest variation in the axial length in the middle grade of myopic patients. The analysis of biomechanical considerations in the axial length presented here is a very helpful to choose the adequate method for treatment of myopia.
8.g.13.1.183. Using the active
points of the feet, pulse current, as well as phonophoresis of the lumbar
region in non-drug treatment regimen for itching. /N. Tsiskarishvili, A.
It is known that in number of pathogenic factors that cause itchy skin, psycho-emotional, stressful situations play an important role; they can provoke the development of neurosis, asthenia, and chronic fatigue syndrome. That is why the proposed method of drug-free deliverance from itching using individual the mind-body workout exercises to affect the active points of the feet, therapeutic electronarcosis, phonophoresis of lumbar region, appears exclusively relevant. The study followed 27 patients aged from 18 to 65 years with the following nosology: prurigo (10), diffuse neurodermatitis (7); limited neurodermatitis (5); pregnant itching (5). Disease duration ranged from several months to 5 years. The comparison group was homogeneous in the number of patients, nosological units and duration of the disease. The degree of pruritus was assessed on 4-point scale. Patients’ control group received a sedative therapy, desensitization means, corticosteroids. Patients were observed during treatment (21-28 days) and for 1 month after therapy. In the test group compared with control group skin itching subsided considerably faster (on average 4 days) and, accordingly, at an earlier date could renounce the use of antihistamines, sedatives. 87% of patients from the study group pointed to the improvement of the general emotional state, reducing severity of depression related to the skin condition, which unconditionally indicates an improvement in quality of their life. The findings generally indicate a high clinical efficacy of the proposed psychophysical exercises, therapeutic electronarcosis and phonophoresis in the treatment of itchy skin dermatoses.
methods of exudative otitis media treatment. /Sh. Japaridze, L. Lomidze,
The research was conducted in Otorinolaringology Department of TSMU during 2009-2010 years. Altogether 132 patients (age – 3-59 years) with exudative otitis media were investigated. Diagnosis was estimated with help of otoscopy, tympanometry and audiometry. The patients were divided into 4 groups: In I group were 23 patients; in II group – 59 patients; in III group – 20 and in IV group – 30 patients. Duration of the disease was from 1 month to 7 years. Treatment of exudative otitis in tested patients was conducted in three stages. Surgical intervention, shunting of tympani, has been done only in 30 patients from investigated 132 patients.
8.g.13.1.185. Some Issues of
diagnostics and treatment of chronic maxillary sinusitis. /Sh. Japaridze, T. Khechinashvili,
Chronic paranasal sinusitis, including maxillary sinusitis, nowadays is marked with the tendency of high incidence rate and severe complications. 52 from 14 to 75-year old subjects with different duration periods (from 1 to 10 years) of the disease have been studied for the development of rational methods of treatment and of differential diagnostic strategy. The patients under observation underwent routine and modern (CT) roentgenographic investigation, cytological, bacteriological, both local and general immunity tests. On the basis of the performed studies in case of chronic presence of allergic component, close interrelation between those parametres and imbalance of immune status was revealed. The obtained results suggest the necessity to develop more rational and effective curative methods, namely the complex use of immunomodulatory preparations along with other medicinal remedies both before and after conservative and radical treatment.
8.g.13.1.186. Investigation of cardiac
autoantibodies for detection of cardiovascular system damage in children with
recurrent respiratory tract diseases. /K. Barabadze, A.
Tsabutashvili, N. Adamia/, Second International
Congress of Respiratory Association of
According to statistical
data, the frequency of cardiac diseases increases in the world, including
Sarcoidosis is a multisystem disorder of unknown aetiology characterized histologically by non-caseating granulomatous inflammation in the affected organs. In 90% of cases damage of lungs was revealed. In approximately 1/3 of cases, the disease starts gradually (chronic form), in other cases – acutely or without symptoms. Two clinical forms of acute sarcoidosis are singled out. Chronic from of the disease shows itself gradually, with episodic relapses and remissions. As a result of progress of the disease gradually develop expressed, sometimes dangerous for life, changes of lung function. The paper provides data on the classification, clinical manifestations, course, treatment, and follow-up of intrathoracic sarcoidosis.
8.g.13.1.188. Anti-leukotrienes in
treatment of patients with seasonal allergic rhinitis. /M. Kherkheulidze, N. Khavlashvili, E. Kandelaki,
The aim of the study was to assess the effectiveness of anti-leukotrienes preventive treatment on the course of seasonal allergic rhinitis. Observational study included 48 patients aged 6-12 years, who were divided into 2 groups. I (main group) comprised 28 patients with the already diagnosed seasonal allergic rhinitis, who received the montelukast once per day starting 10-14 days earlier before onset of allergic season and II group - 20 patients with clinical picture of seasonal rhinitis without any previous treatment. Quality of life (PRQLQ, published by E. Juniper) nasal symptom severity scores and total nasal symptom score and correlation of symptom severity scores to quality of life questioner in both groups was evaluated. The study shows that the most frequent symptom in both groups was nasal secretion, but most serious or disturbing symptom that affects quality of life was nasal obstruction. The result showed correlation between severity of rhinitis, nasal symptom scoring and quality of life. The study highlights effectiveness of using anti-leukotrienes in treatment for improvement of nasal symptom scores as well as quality of life of patients with seasonal rhinitis.
8.g.13.1.189. Analysis of a dynamic cardiac
rate system on the basis of computer imaging methods. /I. Chkheidze, M. Berishvili, L. Tokhadze/.
Graphic methods of research of a dynamic cardiac rate system, which demonstrate a difference in change of indicators for healthy and sick patients are considered. A research of cardiac rate dynamics has shown that application of the presented methods allows to carry out an analysis of properties of the medical and biologic system and the imaging character of the algorithms realized in the MathCad program package, considerably simplifies understanding of features of dynamic behavior of the system, its perception and assists doctors in the establishment of the objective diagnosis.
8.g.13.1.190. The effect of calcium
antagonists on the products obtained through lipid peroxidation in different
brain structures of white rats under emergency conditions. /A. Baghirov, A. Mirzayeva, G. Ganiyeva, V. Asmatov,
For formation of free radical processes in the body, emergency conditions and different widely applied medicines are given a more important role. Stress factors and permanent drug therapy cause an increase in MSS through lipid peroxidation. Based on the above, the authors investigated pro- or antioxidant features of frequently applied drugs. Neurochemical tests have found that under emergency conditions, both in acute and chronic experiments, an increase in the amount of lipid peroxidation products in the brain structures is observed. According to the conducted study, the calcium channel antagonists, such as verapamil, amlodipin, flunarizin, have a slight effect on the formation of the lipid peroxidation products in different structures of brain and display an antioxidant effect.
8.g.13.1.191. Depression in
hemodialysis-dependent patients. /T. Gegenava, M.
Gegenava, G. Kavtaradze, M. Sutidze/.
Depression plays a crucial role in the progression of chronic medical illnesses. Amongst all psychiatric disorders, depression is the most important and common in patients with ESRD. Depression in dialysis–dependent patients effects mortality and rate of hospitalizations. It has been suggested that approximately 20- 30% of the ESRD population suffer from depression. The somatic characteristic of depression is similar to symptoms of uremia like anorexia, sleep disturbance, fatigue, gastrointestinal disorders and pain. Due to this overlap of symptoms of uremia with depression it is usually neglected, under diagnosed and remain untreated. This study was conducted in hemodialysis units of N. Khipshidze Central Clinic in a period between March 1 and May 1, 2009. The number of patients made 40 (14 women and 26 men). The average age was 35, the duration of hemodialysis - 2-8 years. The diagnosis of the patients and the cause of hospitalization was ESRD. The Beck Depression Inventory, (BDI-II) comprising 21 items, which is considered to be the most valid test for assessment of depression, was filled out by the patients. Depression was revealed in the majority of patients n=30 (75%). Moderate and severe depression was revealed in 22.5% of the patients, while the majority had mild depression n=21 (52.5%). Anemia, hyponatremia, hypopospatemia were also revealed in our study. It is known that these symptoms have statistically significant relationship with depression. Findings offer that depression is the most spread psychosomatic disorder among renal dialysis patients. Treatment options should entail psychological treatment.
8.g.13.1.192. The importance of
rectoscopy and colonoscopy during ulcerative colitis. /G. Tatishvili, B. Chakvetadze/.
All scientific data and own experience in specialized hospital is indicative of too late and insufficient diagnostics of ulcerative colitis in its ambulatory stage. That is why endoscopy at different stages of disease has very important practical meaning. The diagnostic importance of rectoscopy grows without preliminary preparation of the intestine, together with biopsy. Colonoscopy makes it possible to speak about the process localization and spread, its activity and the intestine wall involvement in the process.
8.g.13.1.193. The tactics of treating
stress ulcers in the pulmonary ventilation-dependent patients. /Z. Kheladze,
851 patients’ histories that were in a critical condition and on mechanical ventilation have been analyzed. The bleeding from stress ulcers was detected in 48 patients (5.6%). The urgent endoscopical service was created in our clinic, which gives us the opportunity to make treating-diagnostic endoscopy 24 hours a day. Together with standard methods, plasma ray therapy was also used in the treatment course. As a result, the treatment efficiency has significantly increased.
8.g.13.1.194. Clinical-hemodynamic and anti-ischemic effects Ivabradine and Nebivolol Ischemic Heart Disease with Left Ventricular Disfunction. /G. Abuladze, A. Kvirkvelia, M. Nebieridze, T. Chachua, G.Dundua/. Georgian Medical News. - 2010. - #10 (187). – pp. 24-27. – rus.; abs.: geo., eng., rus.
The aim of this study
was to examine the effectiveness of Ivabradine (available under the brandnames
of Procoralan, Coralan, Corlentor, Coraxan, "Servier”,
8.g.13.1.195. "Comet tail” artefact in diagnosis of pulmonary congestion in patients with diastolic heart failure. /M. Tsverava, D.Tsverava/. Georgian Medical News. - 2010. - #10 (187). – pp. 28-35. – eng.; abs.: geo., eng., rus.
The aim of this study was to evaluate the importance of thoracic ultrasound examination in diagnosis of DHF. Total of 380 patients with HF were evaluated. 86 patients had diastolic HF (group 1) and 294 patients had systolic HF (group 2). The control, group 3, consisted of 155 patients with left ventricular diastolic dysfunction but without HF. HF patients did not take any medication before ultrasound examination. All patients underwent thoracic X-ray and ultrasound examination. Sonographic examination of the lung was done with 3,0-4,0 MgHz convex or sector probe, from 10 points on thoracic wall (cross points of mid-clavicular line II, IV and V intercostal spaces and anterior axilar line with IV and V spaces), which corresponded to the projection of lower, middle and upper lobes of the right lung and upper and lower lobes of the left lung. During pulmonary ultrasound examination, 95.5% of patients with HF had the "comet tail phenomenon”, which was registered only in 35.5% patients without HF (p>0,001). In DHF group, the "comet tail phenomenon” was registered in 91.9% and in systolic HF group in 96.6% patients. In 81.4% of patients with DHF the "comet tail phenomenon” was registered from 3 and more registration points. In the control group, the "comet tail” was registered from more than 3 points only in 2 (1.3%) patients. The best results in diagnosis of DHF can be achieved if we take "3 and more registration points” as a reference point for diagnosis of pulmonary congestion (sensitivity - 0,911, specificity - 0,942, positive predictive value 0,975). In patients with diastolic HF during pulmonary ultrasound examination significantly often was registered the "comet tail phenomenon”. The count of registration points from the thoracic wall of the "comet tail phenomenon” 3 and > is sensitive and specific sign of HF. We think that lung sonography offers a new method for the diagnosis of decompensated diastolic HF at bedside and may provide important information.
8.g.13.1.196. Results of conservative treatment of achillodynia with application of micro-current therapy. /R. Aliyev, G. Muslimov, G. Gaiger/. Georgian Medical News. - 2010. - #10 (187). – pp. 35-42. – eng.; abs.: geo., eng., rus.
Achillodynia is described as expression of chronic pain in the Achilles tendon. Pain in the Achilles tendon can be the cause of wear and tear in the tendon tissue or as a result of inflammation of the peritendineum, the underlying bursa and/or the tendon insertion at the heel bone. It often occurs after sporting unusual stress and is healed after a complex conservative treatment by rest, (partial) relief and physical exercise within several weeks to months. The aim was to turn knowledge on the effectiveness of complex conservative treatment measures, in particular to gain by additional stimulation in the treatment of Achilles tendon. 20 patients with a diagnosis of achillodynia were treated 05-2009 to 12-2009 in the orthopedic outpatient therapy center with the help of the extra, micro-current therapy (CellVAS® device) and a complex conservative treatment measures. The analysis was conducted using a questionnaire, clinical examinations, magnetic resonance imaging (MRI) and a radiological examination of the Achilles tendon with the ankle joint. At the beginning and end of the intervention to the Board of subjective symptoms scores (NRS scale) and assessment of treatment results by the doctor for 4-step rating scale were collected. The study compares the treatment response in Achillodynia from a control group. The average age of patients was 46.3 years at the time of treatment. Of these patients: 14 (70%) were females and 6 (30%) male. Of 20 patients were 8 (40%) patients with very good, 7 (35%) patients with good, two (10%) patients with satisfactory and three (15%) patients with poor results. In addition, 17 of 20 patients (85%) with conservative treatment measures were satisfied, 3 patients (15%) were dissatisfied. The subjective assessment of the complaints numerical rating scale (NRS scale) improved significantly (p <0.001) from 8.9 to 2.3 points after treatment. An objective evaluation by the attending physician based on various clinical parameters was assessed in 75% of the cases as good or very good. The study shows that the described complex conservative therapy is the integration of a micro-current treatment is a very good method for the treatment of Achillodynia/Achilles tendon disorders in athletes. The primary goal of treatment is to achieve freedom from pain and was achieved consistently, as the subjective assessment of the complaints was proved using the NRS scale. The high patient satisfaction with the treatment suggests in addition, any therapy must keep in action the long-term development of athletes in mind. In individual must be questioned what treatment method for long-term sports development but also the health history (this is not inevitably always the same) is an advantage. The conservative treatment seems to be advantageous because it leaves open for therapy-resistant complaints, the option of surgical treatment, and has generally very good chance of recovery.
8.g.13.1.197. Effects of Oxytocin on
behaviour and memory in rats subjected to chronic restrained stress. /M. Kunchulia, T. Bolkvadze, M. Zhvania,
We studied whether 21 days of restraint chronic stress would affect the contextual fear conditioning, a memory task with hippocampal-dependent components and anxiety-like behavior in the open field, and to determine whether oxytocin treatment could prevent the chronic stress induced memory and emotional disturbances. Restraint-stressed rats were injected daily (21 days) with oxytocin (1 mg/kg) or saline then tested in open field (day 22) and contextual fear conditioning task (days 23-24). Our data demonstrate that chronic restraint stress induces some behavioral changes in both saline-treated and oxytocin-treated animals. Particularly, in the open field the animals both groups were characterized by hyper-locomotion. However, oxytocin-treated animals spent more time in the inner area of the open field, which indicates to decreased anxiety- related behaviour in oxytocin-treated animals versus the saline-treated ones. In additional restraint stress decreased freezing reaction to context, irrespective of whether oxytocin was given or not. Our findings indicate that during stress OT may be involved in the regulation of emotional behavior and memory via different ways. The elucidation of corresponding mechanisms is of great importance.
8.g.13.1.198. The influence of
Fluoxetine on noradrenergetic neurotransmitters of brain cortex. /D. Zurabashvili, I. Giorgobiani, M. Arveladze, I.
The aim of this work was to evaluate the hypothesis that the second-generation antidepressant might play a role in controlling the activity of noradrenalergic neurotransmitters. The paper details the pharmacological profile of antidepressant drug Fluoxetine with high affinity for 5-HT receptor, and explains how the antidepressant activity chances noradrenalin reuptake inhibitor-medications. Brain cortexes of 20 rabbits were analyzed by high-performance liquid chromatography. The conducted quantitative and qualitative analyzes show that antidepressant activity of Fluoxetine could be mediated by the synergistic effects on the serotoninergic and noradrenergic receptor pathways. Major depressive disorders are heterogeneous monoamine condition. Our studies have demonstrated fluoxetine efficacy and safety for treatment of major depressive disorders.
8.g.13.1.199. Increased lipid peroxidation inhibits regulation of erythropoiesis in patients with pancreatic diabetes. /M.Feyzullayev/. Experimental and Clinical Medicine. – 2010. - #1(56). - pp. 27-29. – rus.; abs.: eng.
23 insulin-dependent patients with pancreatic diabetes and 20 healthy donors (13 men and 10 women aged 16 to 60) were observed. The illness duration varied from 1 month to 20 years. The investigation results showed that during hyperglycemia (20.5mmol/l) an increase of the quantity of lipid peroxidation (POL) was marked in the patients with ID PD in comparison with the control (0.19/0.49st.unit). The results of the analysis showed some increase in the POL concentration which caused damage to the structure of the erythrocytes, and the decrease in the haemoglobin quantity from 140g/l to 128g/l (p<0.05). Blood diffluence resulted in the impairment of erythrocyte differentiation and in the further maturation of the peripheral blood elements. Due to this unusual method of therapy, the compensation of carbohydrate metabolism and normalization of erythropoiesis have been achieved in the patients with ID PD.
8.g.13.1.200. The efficacy of treatment for chronic nonspecific lung diseases by the methods of non-drug therapy according to follow-up studies. /N. Faradjeva/. Experimental and Clinical Medicine. – 2010. - #1(56). - pp. 38-40. - rus.; abs.: eng.
131 patients have been examined: 69 patients with infection-dependent bronchial asthma (IDBA); 37 – with moderately severe, 32 - with severe and persistent illness; 63 patients – with chronic bronchitis (CB); 31 patients with chronic purulent non-obstructive bronchitis (CPNOB), and 32 - with chronic purulent obstructive bronchitis (CPOB). 67 patients of the basic group (35 with IDBA and 32 with CB) received the combination of drug therapy (DT), halotherapy (HT) and endobronchial exposure (EBE) with sessions of various durations, and a general course of treatment depending on the form and severity of the clinical course of the disease. The control consisted of 65 patients receiving only MT. The analysis of follow-up studies has shown a considerable clinical effect in both nosological groups under the combination of MT and HT/EBE.
8.g.13.1.201. A comparative
analysis of the main risk factors of coronary heart disease in the
Data concerning the
prevalence of the main factors of coronary heart disease (CHD) among the
8.g.13.1.202. Prevalence of CHD
risk factors separately and in various combinations among the
sampling of unorganized male and female inhabitants of
8.g.13.1.203. Spread of the risk factors of coronary heart disease among the patients with rheumatoid arthritis. /N. Zamanov/. Experimental and Clinical Medicine. – 2010. - #1(56). - pp. 49-53. – rus.; res.:eng.
125 patients with rheumatoid arthritis (RA) were involved in the investigation. Among the classical risk factors of coronary heart disease (CHD) smoking was not marked among the woman, and among the men has made 90%. Arterial hypertension was found in 44.4% of the patients with RA. Serious changes were determined in the lipid-protein blood spectrum. The risk factors of CHD are marked basically in patients with seropositive form of RA. A positive correlative communication was detected between such CHD risk factors as anemia, arterial hypertension, C-reactive protein level. CHD risk factors in a greater degree were increased in the patients whose RA continued more than 5 years. The level of fibrinogen depends more on the duration of the disease, and the level of C-reactive protein – on the degree of RA activity.
8.g.13.1.204. Correction of psycho-emotional frustration in patients with bronchial asthma during halotherapy. /N. Farajeva/. Experimental and Clinical Medicine. – 2010. - #2(57). - pp. 50-53. – rus.; abs.: eng.
The research objective was to define the antidepressant effect of halotherapy (HT) in the complex treatment of bronchial asthma. 73 patients with heavy persisting infectious-dependent bronchial asthma (IDBA) have been examined and treated. The basic group patients received also HÒ in combination with drug therapy (DT). The patients receiving only DT comprised the control group. The results of the research carried out showed that only 42.2 % of the patients receiving only DT recovered from psychoemotional frustration by the end of a 25-day course of treatment, whereas a complex treatment including HÒ completely corrected the condition of 90.9 % of the patients in 12 days of treatment.
characteristics of endotheliocytes in practically healthy people. /N.
The endothelium of healthy people has been studied by light and electron microscopy. The endothelial structure can be described as endocrine tissue.
8.g.13.1.206. Pilot study of
primary prevention and screening on environmental factors in pathogenesis of
Sjogren’s syndrome associated salivary and lacrimal gland lesions. /T. Chachibaia, E. Aptsiauri, I. Bulia, A.
Sjogren’s syndrome is
chronic autoimmune inflammatory rheumatic disease that attacks exocrine, i.e.
salivary and lachrymal glands, causing such complication such as dryness of
mouth and eye in affected individuals. Mainly is diagnosed among women
population in 90% of cases. Sjogren’s syndrome affects mainly women in their
40-50s, though younger age onset is also characteristic. Later disease is
progressed and other organs are involved as well. There is substantial risk of
development of malignant lymphomas and characterised by 44-fold increased risk
compared to general population. Environmental factors are thought to trigger
inflammation in individuals with a genetic redisposition for the disease.
Primary prevention of Sjogren’s syndrome is directed to increase awareness of
harmful environmental conditions, which may be avoidable, also to educate
recognition of early warning symptoms of this condition. Timely diagnosed
lesion is better treatable and late onset complications are also preventable.
The aim of "Georgian Sjogren Association” is to perform screening and
provide prevention of Sjogren’s syndrome in
8.g.13.1.207. The dynamics of
incidence of salmonellosis in
We have studied the
dynamics of incidence of salmonellosis in
8.g.13.1.208. Suitable usage of camelyn in treatment of osteoarthritis and osteochondrosis by means of ultraphonophoresis and electrophoresis. /N. Saakashvili, T. Chilingarishvili, N. Jakobia, K. Maghlakelidze, G. Chikovani, I. Malazonia, M. Lomidze, M. Natsvlishvili, I. Kvinikadze, N. Kvinikadze/. Experimental and Clinical Medicine. – 2010. - #4(59). - pp. 59-61. –geo.; abs.: eng., rus.
Camelyn is a
biologically active preparatipn produced by the Georgian famous surgeon
Benedikte Maghlakelidze in the mid-20th century from special, ecologically safe
Kolkhis honey. After a lot of clinical and experimental trials, it was
determined that Camelyn had immunomodulate, antioxidant and antiinflamatory
action. Osteoarthritis and osteochondrosis are the most common medical problems
in the world. It’s the number one cause of disability in
8.g.13.1.209. ”Dualler-G” - new
approach to the treatment of allergy. /T. Tchumburidze, Z. Bendeliani,
Epidemiological data reflect a significantly increased percentage of population suffering from allergic diseases. Especially it concerns allergic reactions influenced by industrial and biological factors. Allergic reaction plays the leading role in pathogenesis of dermatitis, and mechanisms of such reactions are based on release of histamine and serotonin. The development of a drug with both antihistaminic and antiserotoninic activity was the goal of this study. Drugs with close chemical structure and pharmacological activity were selected from derivates of quinuclidin carbinols. This differences in pharmacological activity of different compounds make Dualler-G a new antiallergic drug with antihistamine and antiserotonine activity. The goal of the study was clinical trail of Dualler-G in patients with dermatitis. The obtained data suggest that Dualler-G shows high effectiveness in the treatment of different types of dermatosis. The effect of Dualler-G, an original antiallergic drug, was evaluated in patients displaying different kinds of dermatosis (urticarea, neirodermatitis, lichen rubber planus, eczema). A total of 22 patients diagnosed with dermatitis were randomized to receive in an open fashion 60 mg of Dualler-G per day, for 2 weeks. Efficacy was assessed according to the global improvement rating of elements on skin or itching as symptoms or signs. Patients treatment with Dualler-G (cases of urticarea, neirodermitis and lichen rubber planus) had superior improvements in thei symptoms (elements on skin and itching) compared to controls along the 2-week trial, but not in the cases of eczema. However, cases of eczema level of eosinophils were reduced as well as the severity of symptoms. The clinical course of the patients treated with Dualler-G tended to be significantly better then that of the patients treated with other antiallergic preparations, and the symptoms were significantly correlated in the Dualler-G treated group. These data suggest that Dualler-G positively effects the symptoms (skin elements and itching) in patients with different kinds of dermatosis, and its efficacy is much higher against other drugs.
8.g.13.1.210. Metabolic effects of
Nebivolol in patients with type II diabetes. /G.
Tabidze, T. Tsibadze, N. Kobaladze,
A novel super selective -blocker with NO-modulating activity Nebivolol used as an antihypertensive drug in patients with non-insulin-dependent diabetes exerted good hypotensive effect which was not associated with negative changes of the lipid spectrum.
8.g.13.1.211. Specifications of community acquired pneumonia based on the findings of the Therapy Clinic of Georgian Patriarchate. /R. Tabukashvili, V. Kapetivadze, N. Gegeshidze, Kh. Tsaava/. Experimental and Clinical Medicine. - 2010. - #4(59). - pp. 68-70. – geo.; abs.: eng., rus.
The purpose of the research was to reveal peculiarities of the course of community acquired pneumonia. During 2007-2010, 427 patients were studied. The main group of the patients was dated from III class of PORT-scale. We found that the number of community acquired pneumonia cases tended to increase by years. In 2008, 15.98% from all admitted patients was diagnosed; the number of patients with bilateral pneumonia made 17.36%. In 2009, the figure amounted to 25.82% and 40.76%; in 2010, during three months – to 40.34% and 55.20%. An increase in complications of the community acquired pneumonia was also detected, especially in the form of pleurisy. Bacteriological investigations showed that the spectrum of pathogenic organisms had not changed in the last ten years. These findings are corroborated by statistically trustworthy studies as well.
Arterial hypertension, as one of the important cardiovascular risk-factors, still remains one of the most important medical subjects, including women. Only a small percentage of patients know that they have hypertension, and even less number of people are treated appropriately. The healthy lifestyle is the most important for primary and secondary prevention of cardiovascular diseases. The desired effect is often reached with a complex medical treatment. Despite of women’s systematic involvement in clinical trials, it still remains difficult to formulate specialized recommendations, because the percentage of woman is still not representational. A better knowledge of the pathological mechanisms leading the postmenopausal women to hypertension will assist in elaborating more proper and rational treatment.
8.g.13.1.213. Dislipoidemia in a
family physician practice. /A. Isakadze, Sh.
Dislipoidemia is one of the most important risk factors of cardiovascular diseases. The priority of prevention of cardiovascular diseases is to reduce the number of patients with high cholesterol levels. A way of solving this task is to enhance the patients’ awareness of the target levels of lipid metabolic parameters and the necessity of their regular monitoring. The awareness of the level of cholesterol and its atherogenic fractions was assessed in a group of 222 patients who considered themselves apparently healthy. In these patients, the parameters of lipid and carbohydrate metabolism were determined and blood pressures and anthropometric indices were measured. The study group demonstrated high prevalence of dyslipoidemia and metabolic syndrome and low awareness of the values of the lipid spectrum, which generates the necessity of performing further studies to develop goal-oriented preventive programs, including educational ones.
8.g.13.1.214. Fe-askangel and its
application for treatment of iron-deficiency anemia. /T. Gabelia, L. Japaridze, N.Beridze
E. Salukvadze, T. Kvernadze,
A physico-chemical method of adsorption modification of superfine askangel (Askana, Ozurgeti, Georgia) with the coordination compound Fe (II)-fructose has been developed. The results of the investigation show that the adsorption of Fe (II)-fructose on the superfine askangel has a physical character. On the basis of the clinical tests, the possibility of application of Fe-askangel as an effective blood restorative agent for treatment of iron-deficiency anemia has been shown.
8.g.13.1.215. The effects of Berberin
obtained from Ðhållodendron Lavalei introduced in sub-tropical areas of
The effects of Berberin
were studied on blood glucose level and on glucose tolerance in an experiment
with mice. Berberin is obtained from Ðhållodendron Lavalei,
the plant introduced in the subtropical areas of
8.g.13.1.216. Microbiological investigation of suppurative skin infections. /D. Chikviladze, Kh. Gachechiladze, D. Metreveli, M. Mikeladze/. Experimental and Clinical Medicine. - 2010. - #4(59). - pp. 101-103. – rus.; abs.: eng., geo.
The article represents the results of investigations of feasible agents of suppurative skin infections (furunculosis, carbunculosis) and their sensibleness/resistance to various groups of antibiotics. During investigation were studied 95 strains of S. aureus, obtained from patients (age ranged from 25 to 60 years) which suffered from furunculosis and carbunculosis and were treated in 2005-2008. Sensibleness and resistance of obtained strains to antibiotics of different groups were studied using the method of serial dilutions in agar. High frequency of sensibleness of the obtained S. aureus strains was found to vancomycin (98.8%), linezolid (96.4%), netilmicin (94.4%), trimetroprime/sulphametocxazol (93.8%) and also to antibiotics for local use - fusidic acid (97.9%) and mupirocin (98.5%). High frequency of resistance of the obtained strains was found to ciprofloxacin (42.1%), tetracycline (51.8%), chloramphenicole (38.5%), clindamicine (28.2%), erythromycin (53.8%), gentamicin (60.3%), oxacilline (46.3%), levofloxacine (43.6%), lincomycine (53.8%), rifampicine (40.1%). 55.5% were methicillin-resistance staphylococcus (MRSA). Polyresistant were only 47.3% of the obtained S. aureus strains. The effectiveness of empiric antibiotic therapy of skin infections depends on local data about antibiotic resistance.
8.g.13.1.217. Ethiology role of some viruses in prevalence of bronchial asthma. /N. Barnabishvili, P. Gamtsemlidze, M. Mirtskhulava, Z. Barbakadze, Z. Phkhaladze, N. Mirtskhulava, K. Zaridze/. Experimental and Clinical Medicine. - 2010. - #4(59). - pp. 143-145. – geo.; abs.: eng., rus.
160 children aged 2-16
diseased with bronchial asthma were observed in
8.g.13.1.218. Balneo-extension therapy
in rehabilitation of patients with osteoartrosis. /G. Shavianidze, M. Shavianidze, G. Lomidze,
Osteoarthrosis is a degenerate-dystrophic disease of the joints, one of major factors of its generation are loadings. The researches carried out by us have allowed developing a new method - extension of joints, with inclusion in a complex balneotherapy, including resort balneotherapy in Tskhaltubo. The extension of joints has demanded the working out of treatment techniques and the adaptation to the patented atmospheric and underwater applications. The obtained direct and remote results have revealed that a rehabilitation course of bottom finiteness sick of underwater horizontal extension in the conditions of a resort, authentically exceeded results of other complexes; at "dry” extension of the expressed anti-inflammatory effect at patients with sinovite is noted. The received results have allowed to prove scientifically expediency of application extension at is degenerate-dystrophic diseases of joints and to create the new rehabilitation complexes including extension of joints, balneotherapy and resort treatment.
8.g.13.1.219. The automated control system of laboratory research for transmissible diseases. /Sh. Tsanava, M. Chokheli, G. Mgeladze, A. Egoyan, M. Mirtskhulava, P. Imnadze/. Experimental and Clinical Medicine. - 2010. - #4(59). - pp. 149-151. – geo.; abs.: eng., rus.
The work discusses the
structure and basic principles of an automated control system for laboratory
research (ACSLR) developed in the
8.g.13.1.220. Study of antimicrobial properties of iron polyphosphate and perspective of its usage. /I. Karalashvili, N. Klarjeishvili, N. Jabishvili, S. Urotadze, I. Javashvili/. Experimental and Clinical Medicine. – 2010. - #4(59). - pp. 44-46. – geo.; abs.: eng., rus.
Antimicrobial and viral properties of inorganic polymer compounds of iron polyphosphate have been studied. In order to detect bactericidal and viral properties, the effect of different concentration of iron polyphosphate solution on viruses and microorganisms was studied. According to the results, it was determined that a solution of iron polyphosphate is characterized of antimicrobial property and deodorization ability. Iron polyphosphate is ecologically harmless, contains iron and phosphate ions and represents a pink solution with no smell.
Under observation were 87 4-year students aged 21-25 of the stomatology faculty. All the students were examined and their case histories were obtained. In the specially made cards, complaints of the students regarding the rising of tonus of masseters, toothache, gum scratching, headache and aches in the area of temple-lower jaw joint were entered. As a result of the research, it was revealed that 7 (8%) out of 87 students complained of scraping teeth, especially at night, followed with toothache and headache, bleeding gums, stretching of muscles in the morning. Objectively, the myotonic research revealed the rising of tonus of chewing and temple muscles. Roentgen logically the symptoms of teeth overloading were observed. Based on model studies of the mentioned 7 students 4(6%), it was revealed that on the upper and lower jaw the grinding teeth were mentioned as cone wearing. They were provided with physiotherapeutic, psychological, drug and orthopedic therapy. In 3-4 months after the treatment, as a result of repeated researches, it was revealed that the chewing and temple muscle tonus was in norm. Roentgen logically, the symptoms of functional overload were not mentioned. The students no longer complained of headaches and toothaches, scraping teeth, overload of muscles. Thus, parafunction of masseters – bruxism – treatment has to be complex. Particularly, it has to include the psychotherapeutic, physiotherapeutic and orthopedic methods.
Depression is not generally listed as a complication of diabetes. However, it can be one of the most common and dangerous complications. The rate of depression in diabetics is much higher than in general population. Diabetics with major depression have a high rate of recurrent depressive episodes within the following five years. A depressed person may not have the energy or motivation to maintain good diabetic management. Depression is frequently associated with unhealthy appetite changes. Suicidal diabetic adolescents have constant access to potentially lethal doses of insulin. Symptoms of Depression: These are based on the Diagnostic and Statistical Manual of the American Psychiatric Association, 4th Edition (DSM-4): a) Depressed mood for most of the day; b) Decreased pleasure in normal activities; c) Sleeping difficulties or significantly increased demand of sleep; d) Gaining or losing weight; e) Feelings of guilt or worthlessness; f) Low energy level; g) Difficulties in concentrating and making decisions; h) Suicidal thoughts. We have observed 100 people aged 13-70 (50 women and 50 men). The rate of depression and reactive anxiety are registered with the help of psychometric tests according to the scale of depression (BDi). The average period of the illness is 6-5 years. The age of the illness debut is 15 years. The presented diagnosis has been determined according to MKGB (2003) criteria. We have asserted that 52% of the patients observed are depressed, among them 45.2% has light form, 26.8% - medium form, and 21% - severe form. We should note here that this indicator among unmarried people is very low, especially among women. 10% expose the suicide ideas, among them 7% is categorical, which, we think, is very dangerous. The majority of the depressed people do not work. There have been major advances in the treatment of depression. There are specific medications and specific psychotherapy techniques that have been shown to help depression. Often individuals do well with a combination of antidepressant treatment and psychotherapy. Be sure that your clinician is willing to take the time to communicate with your diabetes team. Ideally, the mental health clinician should be familiar with your type of diabetes.
8.g.13.1.223. Distribution of Rh-Hr blood group
antigens, alleles and haplotypes in the mountain district of Adjara (
Rh-Hr blood group antigens represent a genetically stably determined trait being of many-sided biological and clinical significance. Blood group antigens are either sugars or proteins, and they are attached to various components in the red blood cell membrane. The indigenous Adjarian population (105 subjects) was investigated for Rh-Hr red blood group markers. Five erythrocytic group antigens (C, c, D, E, e) were studied by immunoserological methods. The obtained results were statistically processed. Maximum frequency distribution of the e antigen was found (100%), being followed in frequency by the c antigen (89%). The frequency of the D antigen made up 82%, and that of the d antigen - 18%. The frequency of the c antigen made up 61%, that of the E antigen - 23%. Six Rh-phenotypic groups of various frequencies were fixed. The CcDee phenotype is the most characteristic of the said district population. Its distribution frequency amounts to 38%.
Depression is a state of low mood and aversion to activity. A depressed person experiences or displays these symptoms. In the course of supervision and antidepressant treatment, 30 patients with chronic dorsalgia estimated the contribution of depression to the overall picture of the disease. Along with the complaints about lasting back pains, a high level of depression and alarm was marked in the patients. Sleep disturbances, vegetative dysfunction and the expressed decrease in quality of life came to light as well. Psychometric tests allowed revealing the symptoms of depression in 90 % of the patients. All patients received a course of antidepressant treatment two times a day for 6 weeks. Along with a considerable reduction of depression symptoms and alarm, therapy reduced the expression of muscular dysfunction and pain syndrome authentically. At the initial stages of treatment, positive dynamics concerning vegetative dysfunctions, sleep disorders and low quality of life was marked. The research results confirmed the fact of depression prevalence among the patients with chronic dorsalgia and its negative influence on the course of pain syndrome. Antidepressants of high efficiency and safety are shown during treatment associated with chronic back pains along with depression, for they positively influence the basic syndrome.
8.g.13.1.225. Prognostic and developed
scenarios of H1N1 flu pandemic. /R. Khakhnelidze, T.
Iakobadze, Kh. Katamadze,
A realistic picture of the H1N1 flu 2009 pandemic was developed according to a moderate scenario. The highest intensity of the flu pandemic cases was reported in places with population diversity. The epidemic wave provoked by the flu pandemic lasted 6 weeks. The peak of the epidemic wave lasted about 2 weeks. The incidence rate was higher in adolescents under 15 years of age than in other age groups. In the age groups under 1 year and 1-4 years, the numbers of cases were accordingly 8789 and 7167. Compared with seasonal influenza, the highest incidence rate was in age group 20-29 (the number of cases was 1954). The incidence rate was lower in the people of and over 60 years old, as it was predicted, taking into consideration the circulation period of A (H1N1) virus subgroups. Early influenza-associated hospitalizations and good management reduced the complications and death rate. Intensive therapy and artificial lung ventilation were used for hospitalized patients - accordingly 5% and 1.1%. Mortality rate was high among 20-59 years old patients. Other somatic diseases or chronic infections accompanied the flu.
8.g.13.1.226. Correlation of Kell and Mn erythrocyte blood group antigens and alleles with uterine and breast cancer. /I. Nakashidze, L. Akhvlediani, M. Nagervadze/. Experimental and Clinical Medicine. – 2010. - #5(60). - pp. 36-40. – geo.; abs.: eng.
Our investigation shows a certain correlation between concentrations of M and K alleles of blood minor group antigens and uterine and breast cancer. As is well known, blood group antigens have peculiarities in genitography, which need to be considered along with the other risk factors. The given quantity of investigated samples is not enough; therefore, the investigation is to be continued.
8.g.13.1.227. Structural and quantitative disorders of chromosomes during endemic, sporadic and multinodular goitre. /N. Zosidze, K. Jibladze, Sh. Photskhishvili/. Experimental and Clinical Medicine. – 2010. - #5(60). – pp. 40-43. – geo.; res.:eng.
In the development of thyroid gland diseases, a certain role is performed by genetic factors. We have studied the spectrum of structural and quantitative disorders during endemic, sporadic, and multinodular goitre. During the above-stated forms of the thyroid gland disease, the instability of chromosomes is revealed through the structural disorders expressed by high frequency chromosomes.
We have investigated features of the pelvis of Georgian females. In our study we used the pelvis classification of W.Caldwell and H.Moloy (1933) (they selected four types of the pelvis: gynecoid, android, platipeloid and anthropoid). The characteristics of women’s physical development were estimated by the indices of body length (by R.Martin, 1928) and weight, and women’s constitutional type was determined by the classification of I.Galant (1927). Characteristics of the physical development of newborn children were also investigated. 450 practically healthy women at the age of 17-44 were investigated according to the method known as external pelviometry, adopted in obstetric practice. 218 women had the gynecoid type pelvis, 232 women’s pelvis were contracted to different extents. According to the constitutional type: gynecoid pelves were mostly typical of the mesosomic women, and contracted pelves were typical of the women having leptosomic constitution.
8.g.13.1.229. Primary oligodendroglial intracranial
tumors: some epidemiologic considerations. /T.
Mermanishvili, T. Jorbenadze,
The aim of our study was
to perform a hospital-based epidemiological analysis of primary
oligodendroglial intracranial tumors in
Clinical studies are
based on an analysis of the results of a survey and surgical treatment of 147
patients with adrenal tumors who were treated from 1994 to 2009 in the RMC
An algorithm of trans-anal extraction of rectal foreign bodies and proctologic aid characteristics are analyzed. The algorithm and its related in-hospital manipulations are discussed in detail. The application of the algorithm in 17 cases has yielded positive results.
8.g.13.2.3. Therapeutic approach
during upper gastrointestinal tract bleeding. /L. Akhmeteli, L. Saghinashvili,
305 cases of upper gastrointestinal bleeding from 2005 till 2008 in Surgery department of Khipshidze University Clinic of Tbilisi State Medical University are discussed. The number of endoscopies made 09.36%, electrocoagulation – 56.7%, repeated endoscopy - 3.66%, re-coagulation - 4.04%. The number of surgical interventions made 5.25%, lethality – 1.31%. Thus, despite of significantly increased cases of upper gastro-intestinal bleeding, the number of surgical interventions was low. This can be explained by a wide application of the therapeutic endoscopy technique and modern effective drugs.
8.g.13.2.4. Hernioplasty by
Ramirez technique. /I. Gelashvili, N. Lomidze,
Postoperative ventral hernia has always been one of
the most complex options in herniology. In the
8.g.13.2.5. The role of endogenic toxemia
in the pathogenesis of a traumatic disease. /G.
Gvasalia, L. Saghinashvili, Z. Dzneladze/.
In the current study, 271 cases of trauma fixed at Acad. N. Khipshidze University Central Clinic in 2004 – 2008 were considered and main markers of endogenic toxemia syndrome were studied. The obtained results show endogenic intoxication to be the main cause of pathogenesis and thanatogenesis of a traumatic disease. The article deals with different manifestations of intoxication during the first hours of the injury, at the early shock stage and in the post-shock stage. From the aspect of clinical practice, it should be emphasized that formal compensation of hemodynamic data not only stop disturbances of homeostasis caused at shock but deepens them at a definite stage of the post-aggressive period. The severity index of operational intervention is more increased after performing a simultaneous surgery on two or more zones than in the case of a stage-by-stage delay of these surgeries.
The aim of the study was to determine specifics of a trauma structure under a big city conditions. For this purpose, 271 cases of traumatic diseases were analyzed given the posttraumatic shock and hypotension duration. The obtained results prove the shock and surgical infection problems to be the priority ones during bodily injuries, which determine in general the early or late lethality during an injury.
8.g.13.2.7. Acute injury of
testicular appendages in children. /G. Davitaia, R.
The aim of the study was early identification of acute injury of testicular appendages and elaboration of its effective surgical and main pathogenic therapeutic principles. 63 boys aged 0-15 with nonspecific orchiepididymitis were investigated during 2005-2008 years in the surgical department of TSSU. An acute injury of testicular appendages was confirmed in 82.5% of patients (52 cases) on the basis of clinical investigation and surgical intervention. An analysis of performed clinical-laboratory, radiological and morphological investigations revealed that the nature of the injury depended on the stage of the disease and a degree of the organ’s involvement in the pathological process. Timely diagnostics of acute injury of testicular appendages is the basis for differential, complex treatment, which consists of urgent surgical intervention and postoperative pathogenic therapy (prevention of inflammation and ischemia), prophylaxis of hormonal and spermatogenesis dysfunction. A conservative treatment of the acute injury of testicular appendages is ineffective. The indications of surgical intervention are: (1) acute clinical symptomatology with ultrasound confirmation or without it; (2) minimal clinical manifestation, when ultrasound reveals the signs of inflammation and fluid accumulation in testicles; (3) the bigger is the size of testicular appendages, the more urgent is surgical intervention; (4) minimum clinical signs cannot serve as contraindication of a surgical intervention.
Pancreatic cancer is the third leading neoplasm of the gastrointestinal system and has a dismal prognosis. Primary carcinoma of the duodenum is the rare and uncommon neoplasm that represents less than 0.5% of all gastrointestinal malignancies. The aim of this study is to access patients with pancreatic, duodenal and periampullary cancers. The majority of patients with pancreatic head cancer are poor candidates for resection at the time of diagnosis due to early development of distant metastases and/or major infiltrations of adjacent structures; patients with cholangiocarcinomas and duodenal cancers appear to be better candidates for Whipple procedure. Duodenopancreatectomy gave a longer survival time than duodenal resection in patients with duodenal cancer.
hernioplasty using Proceed mesh. /N. Lomidze,
Ventral hernia is most prevalent among surgical pathologies. Its surgical management is still very topical. In recent years, the Proceed composite mesh has been created for intra-abdominal ventral hernia recovery. It is biologically tolerable, inert, is resistant to infections, characterized with elasticity, molecular penetration and mechanical resistance. Compared to Prolene mesh, it has minimal risk of seroma development, infection and abortion of the mesh.
catheterization of lung abscess under conditions of fiber-optic bronchoscopy
and contrast study. /N. Lomidze, D.
The successful treatment of a lung abscess requires a technique that should be atraumatic, exclude the bond of the abscess cavity with the pleural cavity and soft tissues, ensure a reusable approach to the abscess cavity with the frequency necessary for effective influence of the microflora and adequate debridement and drainage of the purulent cavity contents. The closest to the said requirements is bronchoscopy performed under local anesthesia. The technique was used to treat 20 patients with acute (18) and chronic (2) lung abscess. The authors conclude that the prolonged transnasal drainage of the lung abscess saves patients from the repeated and frequent bronchoscopy examinations, reduces the period of recovery and treatment expenses.
development stages in inguinal hernia treatment. /N. Mzareulishvili, T. Akhmeteli., R. Khetsuriani,
First steps in radical treatment of inguinal hernias
were taken by Risel in 1877, who started the treatment of inguinal hernias by
opening the inguinal canal. The pioneer of radical herniology is
Lucas-Championniere 1885; his method consists in the following: after
herniotomy and forming inguinal canal walls by muscle-aponeurotical linings, a
radical treatment of inguinal hernias begins. Inguinal hernias pathogenetical
treatment was presented by Baxter in (1893) and
transhepatic biliary stenting – topical technical aspects. /M. Mizandari, G. Spanderashvili, A. Mtvaradze, L.
Baindurashvili, G. Nemsadze/.
Our purpose was to present the percutaneal transhepatic biliary stenting (PTBS) technique. PTBS procedure was successfully performed in 14 (73.7%) cases; in the rest 5 (26.3%) cases we failed conducting the guidewire through the obstruction and so procedure was not fulfilled. In 3 (75.0%) of 4 self-expandable stents the complete expansion needed balloon inflation; In 4 to 8 weeks period after the PTBS in 4 (28.6%) cases of successfully fulfilled 14 PTBS stent potency loss was documented and PTBD was performed to those patients. PTBS after preliminarily performed PTBD is safe and effective technique and should be widely used in patients with inoperable malignant biliary obstruction. PTBS might be performed using cholecystostomy fistula also; in the cases of benign biliary obstruction, indications for PTBS are limited.
imaging-guided mediastinal lymph node core biopsy – technique, advantages and
complications. /M. Mizandari, D.
Maghalashvili, A. Mtvaradze, G. Nemsadze, G. Spanderashvili, L.
Our purpose was guidance techniques, approaches, possible complications of percutaneal imaging guided mediastinal lymph node core biopsy (PIGMLNCB) are outlined PIGMLNCB is effective and minimally invasive; other techniques for mediastinal lymph node core biopsy should be used only in PIGMLNCB failure cases. The advantages of ultrasound guidance are possibility of real-time imaging, non-invasiveness and cost-effectiveness; this technique cannot be used in posterior mediastinum. The advantage of CT guidance is the possibility of visualization of all thoracic structures. When the adequate guidance technique is used, PIGMLNCB is a safe procedure and should be recommended for wide use if appropriate indications are determined. Ultrasound should be used for procedure guidance if the ‘target” can be adequately imaged by this technique.
8.g.13.2.14. New trend in endoscopic
surgery: transvaginal appendectomy. /T. Tabutsadze,
Natural Orifice Transluminal Endoscopic Surgery (NOTES) is a new method of mini-invasive surgery, which involves passing surgical instruments and a tiny camera through a natural orifice, such as the mouth, vagina, urethra or rectum, which provides an access to the desired organ. The method is approved due to its benefits – less pain, quicker recoveries, fewer complications, and no scar. Here are discussed 3 operations of transvaginal appendectomy. The operations were made without any technical difficulties or complications. No gynecological or surgical problems or any complications were detected during the observation period. NOTES – non-scar surgery is a new trend and takes endoscopic surgery one step further. The procedure is safe, physiological and precise. We think that in case of suitable technical support in the near future NOTES will replace not only conventional medicine but laparoscopic surgery technology as well.
mini-laparotomy in the surgical treatment of purulent peritonitis and
retroperitoneal space pyo-necrotic damage. /G.
Tatishvili, B. Chakvetadze/.
The problem of standardization of acute peritonitis and pancreonecrosis is the oldest and widespread problem of contaminated surgery. Post-operational lethality is up to 5 to 50%. In the past years, to resolve this problem a lot of methods were used. We used "chess" mini-laparotomy and lumbotomy for treating purulent peritonitis and retroperitoneal space pyo-necrotic damage on our 5 patients. These methods, despite on few observations, are seemed to be promising and need additional observations and study.
8.g.13.2.16. Modern methods of
chronic rhinitis treatment. /Sh. Japaridze, L.
Lomidze, M. Jashi, T. Khetchinashvili,
180 patients with chronic rhinitis were treated at the ENT department of TSMU during 2006-2007; out of them 100 were treated with ultrasound disintegration, 70 patients – with radiofrequency disintegration and 10 patients - with sub-mucosul resection of the lower conch. According to the research results, the disintegration methods of ultrasound as radiofrequency types are less traumatic, less bloody and most effective. Furthermore, radiofrequency influence is more preferential between the two types of disintegration methods.
8.g.13.2.17. Incidence and risk
factors of nosocomial infections in the post-operative period in Georgian
population with congenital heart diseases. /M. Lomtadze, M. Chkhaidze, E. Mgeladze,
Nosocomial infections still remain a serious problem in patients undergoing open heart surgery. The aim of the study was to determine the incidence, etiology and main risk factors of nosocomial infections (NI) following cardiac surgery in the population with congenital heart diseases. A retrospective case study was conducted. 387 patients with congenital heart disease (CHD), who underwent cardiac surgery from January 2007 to December 2008, were studied. The age of the most patients was up to 15 years; 73 patients (18.8%) were older than 15. All 387 patients underwent a cardiac surgery. The rate of NI was 16%. The most common infections were bloodstream infections (BSI) (7.75%) and respiratory tract infections (7%), respectively. The rate of NI was higher in patients under 1 year of age, after urgent surgery and urgent re-operation, long cardiopulmonary bypass (CPB) and aortic cross-clamp time, also in patients with prolonged mechanical ventilation, massive haemotransfusion, with open heart bone after surgery, reintubation, hospitalization in another hospital during last three month. It was concluded that the most common nosocomial infection after cardiac surgery congenital heart diseases in Georgian population was blood stream infection. The main risk factors of NI in the same setting were age under 1 year, urgent surgery, urgent re-operation, long CPB and aortic cross-clamp time, long duration of mechanical ventilation, massive haemotransfusion, open heart bone after surgery, reintubation, hospitalization in another hospital during last three month.
8.g.13.2.18. Treatment of postoperative esophageal leak by active drainage procedure (case report). /M. Kiladze, H. Vasadze, N. Chkhetia, E. Nadiradze, E. Phkhakadze/. Georgian Medical News. – 2010. – # 1(178). – pp. 11-14. – rus.; abs.: geo., eng., rus.
Postoperative esophageal leak is still a very serious and complex problem associated with poor results because of considerable morbidity and mortality rate. We described the case of successful treatment of suture line leak of a 53-year-old patient after resection of a big size epiphrenic diverticulum. Traditional right-sided transthoracic approach in 7th intercostal space with dissection, exposure and resection of diverticulum by stapler with 40F bougie within the esophagus was performed with reinforcement of suture line. On 6th postoperative day the control water-soluble contrast X-ray examination was done and pleural effusion and suture line disruption was found. Immediately under X-ray control the large diameter chest tube (Ch24) was inserted and periesophageal mediastinum as well as pleural cavity was drained and active aspiration with simultaneously irrigation/lavage procedures was started. Parallel fasting, systemic antibiotic therapy was started and feeding balloon catheter gastrostomy by Stamm was created. The healing process of the leak was controlled every week by water-soluble contrast swallow and the chest drain tubes were twice changed (Ch20 and Ch14) during the treatment. The complete healing and closure of the leak was achieved after 2,5 month of starting the treatment by using this method. Our case have demonstrated, that aggressive conservative treatment approach with combination of: active and adequate drainage of the leak site, systemic antibiotic therapy, nutritional support by feeding gastrostomy with frequent radiologic examinations for monitoring of healing process is the effective and safe treatment of esophageal leaks.
Obturator hernias are extremely rare in surgical practice. Only about 600 cases are described in the world medical literature. To diagnose obturator hernia is very complicated. Hernial protrusion is not often observed. The strangulation of obturator hernia is accompanied by rapidly developing symptoms of intestinal obstruction, which is usually an indication for emergency surgery. The article analyzes two clinical cases of strangulated obturator hernia and one traumatic eventration and strangulation of small intestine in the obturator ring ruined by trauma. In all cases the indication of surgery was clinical picture of a growing intestinal obstruction or acute abdomen. Only in one case, despite the prevailing clinical picture of acute intestinal obstruction in the light of anamnesis and the accompanying neurological symptoms before the operation could be suspected strangulated obturator hernia, which was confirmed during surgery. As it was mentioned above, in doubtful cases to clarify the diagnosis should be applied other methods of examination of patients, including computed tomography.
8.g.13.2.20. Endoscopic treatment in critical patients with upper gastrointestinal bleeding. /Z. Kheladze, S. Jaiani, B. Tsutskiridze, Zv. Kheladze, G. Chakhunashvili, D. Chakhunashvili/. Georgian Medical News. – 2010. – #3(180). – pp. 7-13. – rus.; abs.: geo., eng., rus.
The goal of the current research was to ascertain the optimal methods of an endoscopic haemostasis in critical care patients with GDB. The research was conducted on critically ill patients. The different endoscopic methods of treatment: injectional hemostasis, irrigation with local hemostatics, thermo coagulation, and combined method were used. Treatment with injectional hemostasis resulted in hemostasis in 75% of patients. Irrigation with local hemostatics was conducted using the local hemostatic agent caprofer and (or) 10% solution of epsylonaminocapronal acid. The final hemostasis was achieved in the 90% of the cases; bleeding was stopped in 85% of the cases when the hemorrhages occurred from chronic ulcers. The effect of thermo coagulation method was 80-85%. Combined method of treatment (combination of the irrigation with caprofer and thermo coagulation) helped to achieve 95% of the final hemostasis in critically ill patients. The achieved results certify that the combined use of caprofer and method of electro coagulation in critical care patients with GDB is very perspective. Simultaneously with this, it is also recommended to use anti-segregation therapy with blockers of proton pomp and boosting the defense of the mucous tissue with high doses of mucogen.
8.g.13.2.21. Determining factors of effectiveness of extracorporeal shock wave lithotripsy in ureteral stones: Results of own Investigation. /M. Manukyan/. Georgian Medical News. – 2010. – #4(181). – pp. 7-13. – rus.; abs.: geo., eng., rus.
The purpose of the present study is to investigate main determining factors of effectiveness of extracorporeal shock wave lithotripsy (ESWL) in urethral stones and the influence of these factors on the number of necessary sessions of ESWL procedure. The problem presents a special interest for insurance medicine, as the number of sessions has a direct impact on the cost and length of treatment. The present investigation included 162 patients with urolithiasis having stones in urethra. To find out determining factors of effectiveness of ESWL in urethral stones the following factors were considered: size, localization, radio-opacity of stone, its duration of stay in urethra, the degree of dilation of upper urinary tract. The influence of mentioned factors on the number of necessary ESWL sessions was investigated. On the basis of the present study a conclusion can be made that the principal factors determining the clinical efficacy of ESWL in urethral stones are the stone size, condition of upper urinary tract and stone radio-opacity. The level of localization of the stone in urethra has no influence on ESWL efficacy. Therefore in case of large size stones, their long stay in urethra and significant disorders of urodynamics in upper urinary tract, in marked radioopacity of stones more than one session of ESWL is required. In such cases, we recommend to consider other less invasive methods of treatment of urethral stones (ureterorenoscopy or percutaneous urethra lithotripsy).
8.g.13.2.22. Probability of development of "Steinstrasse” (stone street) depending on the number of extracorporeal shock-wave lithotripsy in ureteral stones. /M. Manukyan/. Georgian Medical News. – 2010. – #4(181). – pp. 13-17. – rus.; abs.: geo., eng., rus.
One of the complications of extracorporeal shock wave lithotripsy (ESWL) is the urethral obstruction by large stone fragments and formation of "Steinstrasse”. The present study aims at the investigation of the probability of development of "Steinstrasse” depending on the number of ESWL sessions in urethral stone treatment. 162 patients with urinary tract stone disease having urethral stones were included in the present study. Based on the results of the present study it is stated, that the probability of formation of "Steinstrasse” increases along with the number of ESWL sessions. Therefore, in such cases more intensive follow-up is necessary after ESWL for prompt detection of "Steinstrasse” formation and prevention of possible complications.
8.g.13.2.23. Influence of stone size, location and impaction on the success of ureteroscopic pneumolithotripsy. /H. Ciftci, M. Savas, A. Altunkol, E. Yeni, A. Verit, B. Chelepkolu/. Georgian Medical News. – 2010. – #6(183). – pp. 7-12. – rus.; abs.: geo., eng., rus.
This study was conducted on 336 patients that had undergone ureteroscopic pneumolithotripsy for ureteric stones between August 2005 and June 2008. Patient data were analyzed with respect to stone localization, size and impaction. All ureterorenoscopic procedures were performed under general anesthesia using a 9.5F rigid ureteroscope. A plain film of the kidney ureteral bladder was performed on the first postoperative day and week 4 to evaluate treatment efficacy. Patient age was 42, 63±15 (14-77) yr. Mean stone size for all groups was 9.77±4mm (5-20 mm). A total of 336 patients were treated with ureteroscopic pneumolithotripsy, 129 female and 207 male. The overall initial success rate was 85.71%. The success rate of ureteroscopic pneumolithotripsy, proximal, middle and distal urethra, for stone location, 76.54%, 85.48%, 90.74%, for Stone size (>10 mm) 54%, 77%, 88 % and for Stone impaction; 50%, 75,6%, 85,4% respectively. There was a statistically significant difference between stone free rates with respect to the proximal ureter stone, increasing stone size (>10 mm) and stone impaction (p<0.05) and a positive correlation with the operative complication rate. It is concluded that it is possible to achieve high success and low complication rates in pneumolithotripsy for distal ureteral stones. Nevertheless, the success rate decreases and complication rate increases with stone locations close to the proximal urethra. Complication rate increases with increasing stone size and/or impacted ureteral stones.
8.g.13.2.24. Familial adenomatous polyposis of colon. /N. Grigolia, G. Giorgobiani, G. Chkhaidze, Sh. Bolatashvili, G. Grigolia/. Georgian Medical News. – 2010. – #7-8(184-185). – pp. 21-26 – rus.; abs.: geo., eng., rus.
At present the only treatment of familial diffuse polyposis is total colectomy and ileorectal anastomosis. Two cases of familial diffuse polyposis are analyzed. The first case: 18 year old man with diffuse polyposis of colon. The second case: 41 year old man with diffuse familial polyposis of colon, liver abscess in segment V, and fistula between the abscess and the colon. In the both cases a radical proctocolectomy with the good, newest results was performed. The patient underwent proctocolectomy with the ileoanal anastomosis with S-shaped ileal reservoir with ileostoma.
8.g.13.2.25. Characteristic of
cytopathological changes in urine after extracorporeal shock-wave lithotripsy. /A. Grabsky, A. Muradyan, M. Aghayan,
The aim of the study is to assess the damage to the urothelium caused by shock waves through cytological examination of the urinary sediment in patients who had ESWL. Study included 100 otherwise healthy first-time stone-formers aged 20 to 50, who underwent ESWL on Modulit SLK machine. Urinary samples were taken before and immediately after ESWL, in two days and on the fourth day after ESWL. Control group included 20 healthy individuals. The urine was centrifuged, smears fixed by conventional MGG method and stained by azure-eosine using Pappenheim’s method. Cytogram data analysis was performed using morphometric methods, allowing for qualitative and quantitative cell characteristics be translated into digital form. Student t-criterion was used for statistical evaluation of the difference of derived figure parameters. The authors put the stress on destructives processes. In order to rule out biased assessment of the cytograms, morphometric examination of urinary sediment was performed. Averaged value of the total cell index was calculated with one of the forms of cytopathology and deduced heterogeneity of cytological indices within a particular group /Σep (where is the average value of the total cell index with one of the forms of cytopathology within the whole sampling, Σep is the total number epithelial cells). The sum of absolute indices of cytological changes is considered as "destruction index” (DI), which reflects accumulated pathological changes in epithelial cells: DI=/Σep + /Σep. Immediately after ESWL a statistically valid (p±0.01) significant increase in DI is registered. In two hours after the session DI is decreased, but remains rather high, and almost normalizes by the fourth day. We also explored the specificity particular for each term of examination, expressed by cytological changes. Examination of indices of heterogeneity within a group with moderately expressed destructive changes (/Σep) revealed that these digital values even in healthy men are slightly above zero (0.15±0.03). Just after ESWL values rise to 0.6±0.1, then slowly decrease to 0.4±0.1 (2 hours after) and 0.25±0.07 (four days after). As to parameters specific to deep cellular changes (/Σep), it is equal to zero healthy men, rises after ESWL, then decreases in two hours and almost normalizes by fourth day. Digital values for this parameter are several orders lower than for parameters of cells with moderate changes. Study results indicate that epithelial lining of the upper urinary tract undergoes cytopathological changes of different degrees, still they are of transitory and reversible nature, which is proven by urinary sediment cytogram performed on the fourth post-procedure day.
8.g.13.2.26. Roentgenoendosñopic surgery of the complicated forms of urolithiasis
with accompanying diabetes mellitus. /M. Aghayan,
Contact lithotripsy and nephrolithoextraction allows saving the patients from staghorn stones without having recourse to traumatic open surgical modalities. Percutaneous removal of staghorn stones with the use of rigid-lens nephroscopes presents as an effective and less-invasive treatment option with minimal amount of intra- and postoperative complications, which is particularly important in case of presence of accompanying diabetes mellitus.
The aim of present investigation was the determination of specific pharmacological (wound healing) properties and the evaluation of possible irritant, allergenic and toxic effects of GF-6 – a novel protective agent for skin mechanical and burn wounds. In mouse excisional wound model GF-6 (topically 0.1 ml per wound) exhibited the ability to accelerate scab rejection and full re-epithelization in test wounds with no signs of bacterial contamination. GF-6 caused no irritation responses such as erythema, oedema, dotted hemorrhage, hyperkeratosis, hyperplasia, alopecia and scaling in 14-day acute dermal irritation test. As well no signs of skin hypersensitivity (itch, erythema, oedema), and histological alteration (ulceration, dotted hemorrhage, changed capillary lumen, damaged hair follicle) were observed in skin application test at all time points during the 14-day observation period, evidencing that GF-6 is non-allergenic. In subchronic dermal toxicity 90-day study of five-fold concentrated GF-6 no statistically significant changes in respiratory, circulatory, autonomic and central nervous system, somatomotor activity and behavior patterns were detected. The results of hematological study testified to no influence of the GF-6 90-day application on blood formed elements. Thus, GF-6 should be considered non-toxic, non-irritant, non-allergenic wound healing and wound protecting agent.
8.g.13.2.28. Surgical management of patients with complicated peptic ulcer disease. /A.Ghirdaladze, B.Mosidze, G.Elisabedashvili, T.Jorbenadze/. Georgian Medical News. – 2010. – #11(188).. – pp. 7-15. – rus.; abs.: geo., eng., rus.
The article presents the results of medical treatment after peptic ulcer surgery. I group - 59 patients with late complications after peptic ulcer surgery and II group - 16 patients with complications of peptic ulcer disease, operated in presence of absolute indications. 13C-UBT and RUT of biopsy material were used to diagnose Hp infection. HP positive patients received antibacterial treatment. After 1 month from the end of therapy and 1 year after HP eradication control investigations by 13C-UBT and endoscopy were performed. 77.3% of all and 84,4% of early non treated patients were Hp positive. All patients (of I and II gr.), who followed control testing after antibacterial treatment were finally detected as Hp negative. In I group, control endoscopy revealed epitelization or scarring of ulcer and reduction of inflammatory changes in gastric and duodenal mucosa in all 44 cases of eradication of HP infection (in 2 patients with peptic ulcer of GEA ulcer relapsed in later). In II group, in 8 patients, who received antibacterial treatment additionally to surgical method, any late complications after surgery were not revealed. In other 6 HP positive patients: 2 – ulcer recurrence and 2 – development of chronic gastritis of operated stomach were noted, which required the treatment of HP infection in future. It is concluded that 1) surgery does not change HP-status of patients and HP infection retains in more than 80% of cases; 2) ulcer recurrence, chronic gastritis of operated stomach or its stump are associated with Hp and regress after Hp eradication; 3) progression of gastritis into atrophic remain after surgery, which increases risk of cancer development and there is possibility of its regression after antibacterial treatment of Hp infection. The recommendations were worked out: 1) perforated, bleeding or stenosing ulcer must be treated only by ulceroraphy, suturing or pyloroplasty respectively, added with subsequent Hp eradication therapy for the prevention of late complications after peptic ulcer surgery; 2) vagotomy or partial gastrectomy must be a forced intervention in cases of decompensate pylorostenosis, resistant to treatment ulcers, as ulcers non-healing or recurring after adequate conservative treatment. Subsequent verification and eradication of HP infection are necessary.
8.g.13.2.29. Original method of
Cesarean section operation and its role in the prevention of obstetric
complications. /Sh. Koridze, N. Kintraia, D. Jintcharadze , A.
The authors made an
analysis of archival material of 1577 case histories of the patients who were
subjected to Cesarean section operation at
8.g.13.2.30. Some aspects of classification and treatment strategy of iatrogenic bile duct injury. /B. Agayev, Q. Muslimov, G. Aliyeva, T. Ibrahimov, V. Alizade/. Georgian Medical News. – 2010. – #11(188). – pp. 65-74. – rus.; abs.: geo., eng., rus.
Iatrogenic bile duct injury continues to be an important clinical problem, resulting in serious morbidity and occasional mortality. None of the classification system is universally accepted and worldwide used, as each has its own limitation. The article reviews various classification systems of bile duct injury. Traditionally, biliary injuries have been classified using the Bismuth's classification. This classification does not encompass the whole spectrum of injuries during laparoscopic cholecystectomy. Strasberg’s classification made Bismuth’s classification much more comprehensive by including various other types of extrahepatic bile duct injuries. Our own classification is simple enough, embraces the majority possible variants of bile duct injuries and is convenient in clinical use.
8.g.13.2.31. Articaine – the best choice among local dental anesthetics. /N.Nizharadze, M. Mamaladze, N.Tchipashvili, D.Vadachkoria/. Georgian Medical News. – 2011. - #1(190). – pp. 15-23. – eng.; abs.: geo., eng., rus.
Local anesthesia enjoys priority among pain control techniques in clinical dentistry. Among a wide choice of local anesthetic drugs available in dentistry for the prevention and management of pain 4% articaine solutions achieve highest level of the anesthetic potency and lowest systemic toxicity in all clinical situations, conditioned by its superlative physicochemical characteristics and the pharmacological profile. These are - low lipid solubility, high plasma protein binding rate, fast metabolization, fast elimination half time; low blood level. Articaine inactivates in both ways: in the liver and the blood serum. It has good spreading through tissues. Thus, articaine seems to be the local anesthetic of first choice in tissues with suppurative inflammation, for adults, children (over 4), elderly, pregnant women, breastfeeding women, patients suffering from hepatic disorders and renal function impairment. In Articaine solutions (1:200 000) epinephrine is in low concentration, thus in patients at high risk adverse responses are maximally decreased. In these patients articaine should be used with careful consideration of risk/benefit ratio. Articaine solutions must not be used in persons who are allergic or hypersensitive to sulphite, due to content of sodium metabisulfite as vasoconstrictor’s antioxidant in it. Incidence of serious adverse effects related to dental anesthesia with articaine is very low. Toxic reactions are usually due to an inadvertent intravascular injection or use of excessive dose. To avoid overdoses maximum recommendation dose (MRD) must not be exceeded and aspiration test always performed prior all LA injections. In these article we introduce new graphs providing a quick and effect way to determine maximum LA dose. Where side-effects are developed, an adherence to adequate medical aid will ensure complete rehabilitation of the patient in all cases.
8.g.13.2.32. The characteristics of various forms of complicated surgery infections of the diabetic foot syndrome and their antibacterial treatment. /A. Kistauri, G. Devidze, M. Jibladze/. Georgian Medical News. – 2011. - #1(190). – pp. 28-32. – rus.; abs.: geo., eng., rus.
In case of neuropathic forms, infection is the cause of tissue necrosis, while in the case of neuroischemic forms it is critical ischemia. Antibacterial therapy is desirable in all cases of the neuroischemic form, independently of the signs of infection. However, in the case of neuropathic forms, a course of antibiotics is prescribed only in case of the associated infection. The infected neuroischemic ulcer is characterized of acute development (infection+ischemia), unlike the infected neuropathic, ulcer. The researches showed that 42 patients (40%) suffered from neuropathic form and 63(60%) – from neuroischemic form. In purulent zones, anaerobic flora was revealed in 77.3%, aerobic flora – 17.7%; the rise of microflora was not indicated in 5% of cases. Most often, with 43.6% St. aureus was found out, and from the association of microbes – St. aureus + Str. pyogenes – 8.7%. The level of bacterial pollution was high, varying within 105 to 1012. The highest sensibility was shown towards Tienam (98.9%). The most acceptable and productive form of treatment turned out to be the combination phtorchinolyns+aminoglycosides. Out of 105 patients, 34 amputations were performed + 6 tall, 10 large (more than a half) and 18 small (up to the middle of the foot). In 71 cases, we successfully managed to stop infectious processes and avoid amputation.
8.g.13.2.33. Original technique
for left hemicolectomy. /B. Archvadze,
An original technique for left hemicolectomy is proposed in this article. The originality of the technique lies in the fact that the anastomosis between the afferent or oral portion of the bowel and the efferent limb provides, through the retained mucosa, protection of all layers of the anastomosis from faecal masses for 6-7 days after the surgery. During this period, the tract is emptied via a drained colostomy. Necrosis of the retained mucosa within the anastomosis and functioning of the anastomosis occur on the 5-7th days after the surgery. We performed left hemicolectomy on 75 patients using the above-described technique. There were no cases of suture failure of the anastomosis in the post-operative period.
8.g.13.2.34. Protective treatment of
peptic ulcer complicated with erosive hemorrhage. /A. Gugutsidze, M. Kheladze, D. Gugutsidze, G.
Gogiberidze/. Materials of
The peptic ulcer complicated with erosive hemorrhage is met in 15% of the disease. Early and active treatment of hemorrhage guarantees hemorrhage stop in 95%. Treatment foresees special regime, diet, sedative and antimicrobial treatment. In the rest 5%, the disease is coped with surgically.
8.g.13.2.35. The modern tenets of talipes valgus X-ray
diagnosis and surgery treatment. /Z. Avazashvili,
It is stated than none of the methods used in the treatment of talipes valgus is universal. The operational method shall be selected in consideration of all elements. The article covers main etiologic, intrinsic and extrinsic factors of talipes valgus and minor influence of pes planus (flat feet) îï its formation. All the talipes valgus causative elements, such as medial bursa, proximal phalanx valgus, angle increase between first and second metatarsal bones, first metatarsal interphalangeal joint congruence, sesamoid bones inferior dislocation, hallux pronation should bå surgically treated. The article describes Õ-ãàó examination and roentgenometry methods, strain levels, surgery treatment selection criterion according to the deformity type. Nowadays the following surgery treatment methods àãå being used: reconstruction of the first metatarsal interphalangeal joint soft tissues; proximal and distal parts osteotomy of the first metatarsal bone; sphenoid bone osteotomy; sphenoid metatarsal joint arthrodesis; first metatarsal interphalangeal joint arthrodesis; excision arthroplasty; endoprosthesis replacement. Summarizing the article, the authors conclude that talipes valgus surgery mode should bå chosen taking into consideration all elements (talipes valgus and first and second metatarsal bones angle, hallux pronation, first metatarsal bone distal metaphysic angle, medial bursa, inferior dislocation, age of the patient and etc.).
8.g.13.2.36. The essential meaning of
toracoscopic sympatectomy during the reaction of peripheral arteritis diseases. /K. Kashibadze, A.
In the 60s peripheral
arteritis occlusion disease was widely cured with waist and thoracic
sympatectomy, although in the 80s, due to non grade state of curing and the
high traumatic operations, the above-mentioned amount of operations was notably
reduced. In spite of pharmacological improvement, in a case of peripheral
artery disease the results are not believable. The object of author’s research
included toracoscopic sympatectomy in parallel with drug-curing. In 2003-2009,
44 patients with the Reino’s syndrome disease were treated by vazoprostan in
the of surgery department of
8.g.13.2.37. Analysis of results
obtained by means of modern surgical methods in the treatment of bilateral
bullous emphysema. /L. Katsarava, V.
Katsarava, B. Oniani/. Proceedings of the
Our study was devoted to the improvement of the tactics of surgical treatment of the patients with bilateral bullous pulmonary emphysema (pneumonectasis). We analyzed the results of surgical treatment, obtained on 32 patients with bilateral bullous pulmonary emphysema, which had been performed in the thoracoabdominal surgery clinic in 1998-2008. The age of the patients varied from 16 to 64 years. X-ay and CT examinations were carried out to all patients. The single-stage operations with the transsternal approach were performed in 18 cases, while not single-stage bilateral operations with minimally invasive methods were performed in 20 cases. Considering the results, the following should be noted: a bilateral operation with the transsternal approach is the method of choice in case of large (more than 10 cm) and giant pulmonary cysts, in other cases the best method of choice is single-stage bilateral operations using the minimally invasive methods.
8.g.13.2.38. Modified method of
cesarean section operation and its role in the prevention of obstetric
complications. /Sh. Koridze, T.
Kanchaveli, D. Jintcharadze , A. Koridze,
The authors made an analysis of archival material of
1577 case histories of the patients who were subjected to cesarean section
Nowadays non-stretching hernioplasty with flat polymeric net are successfully used in practice. We have studied the treatment of 17 patients in the Medical Center Imedi in 2008. It was settled that the method of Lichtenstein is preferential and it reduces in-hospital treatment by 3-5 days.
disease: pathogenesis, clinical aspects and treatment principles. /T. Abuladze, G. Korkelia, K. Shapatava, T.
Ivanishvili, B. Berishvili/. Collection of Scientific
Hemorrhoidal disease is the most frequent pathology of anorectal region. It develops as a result of vascular abnormality or a stretch and rupture of hemorrhoids fixating tendon. Principles of treatment depend on accurate collection of the illness history, physical and endoscopic procedures. Pharmacotherapy with phlebotropic drugs is efficient in acute and chronic forms of I, II and partially III stages of the disease. Ligation with latex rings, infrared photocoagulation and doplerometric desarterisation are minimally invasive and less radical methods of the disease correction. The choice of treatment depends on the stage and clinical manifestation of a disease. Sclerotherapy becomes a less approved method of treatment nowadays. The classic Miligan-Morgan hemorrhoidectomy and Parks operation are the radical methods of choice. The Whitehead modification is a surgery for IV stage of the disease. The Longos surgery is an efficient outcome of modern technologies and needs some further modifications.
splenic rupture: report of three cases. /G.
Azmaipharashvili, G. Tomadze, A. Megreladze, Z. Demetrashvili,
First case of non-traumatic spleen rupture was described by Rokitansky in 1861. The most common reason of splenic rupture is trauma. The aim of this article is to present three cases of non-traumatic splenic rupture, which is a rare abdominal emergency that requires immediate diagnosis and prompt surgical treatment. Main reasons of non-traumatic rupture of spleen are: malaria, leukaemia, sepsis, hemodialysis etc. Since 2006 year three cases of non-traumatic splenic were described including anamnesis, symptoms, aetiology, method of diagnosis and laparotomy findings. There were two males and one female with mean age 48 years (47-49 years). We report two cases of septic spleen due to peritonitis (one was on peritoneal dialysis) and one case of peritoneal dialysis and splenomegaly. Splenectomy has been performed in all cases. Two patients died because of progression of main disease, one discharged without complication on peritoneal dialysis. Non-traumatic spleen rupture is rare and dangerous for life surgical condition, which needs immediate diagnosis and emergency operation. In two of our cases rupture of septic spleen was provocated probably due to intra-abdominal hypertension.