EXPERIMENTAL & CLINICAL MEDICINE
1. LURSMANASHVILI Z., GVASALIA T., SHANAVA K.
EXPERIMENTAL MODELING OF CALCULOUS CHOLECYSTITIS AND ITS INFLUENCE ON VARIOUS ORGANS OF DIGESTIVE SYSTEM
Experimental and Clinical Medicine, 2006, N7, (pp.9-11)
Chair of Clinical Anatomy of Georgian State Medical Academy, Tbilisi
The diseases of the cholecystis, and calculous cholecystitis in particular, take the leading part among the pathologies of the digestive system by their frequency and serious clinical presentations.
At the same time, the pancreas, stomach and other organs are involved in this process to various extents. The coincidence of the rate of the diseases of these organs is rather high.
Our aim is to create an experimental model of calculous cholecystitis to study the histological condition of the digestive system organs in a case of this pathology.
A research was conducted with chinchilla rabbits. As a result of the research, various types of changes were found in the organs of the digestive system during calculous cholecystitis.
We are planning to study the morphological condition of the digestive system organs after cholystectomy.
2. BEZARASHVILI B., ZHORZHOLIANI L., GURGENIDZE G.
CLINCAL AND IMMUNOLOGICAL FEATURES OF BRONCHIAL HYPERRESPONSIVENESS FORMATION IN ATOPIC ASTHMATIC CHILDREN
Experimental and Clinical Medicine, 2006, N7, pp.12-14
Diagnostic-treatment center “House of Health”; I. Pagava Institute of Pediatrics;
Institute of Medical Biotechnology of the Georgian AS, Tbilisi, Georgia
56 children with well-documented atopic asthma and 27 healthy volunteers were examined for peripherial blood lymphocyte subsets, serum IgE and anti-lipocortin antibody content in order to determine specific immunologic triggers of bronchial hyperreactivity formation. According to the results of the study, it was revealed a statistically significant elevation of the serum total IgE concentration in the study group, as well as diminution of T-suppressor cell subset. Simultaneousely, here was shown an increase in the determination frequency, as well as marked elevation of serum anti-lipocortin G-immunoglobulines concentration in asthmatic children as compared with the control group . These immunological disorders were hardly associated with bronchial hyperresponsiveness examined by the spirometric investigation.
3. BITSKINASHVILI M., KAKAURIDZE N., MKHEIDZE R.
THE EFFECT OF HYPOLIPIDEMIC DIET IN PATIENTS WITH DIFFERENT PSYCHOLOGICAL STATUS IN THE CONDITIONS OF CHD (CORONARY HEART DISEASE)
Experimental and Clinical Medicine, 2006, N7, pp.14-16
National Center of Therapy, Tbilisi, Georgia
The aim of the study is to determine the effects of hypolipidemic diet in patients with different psychological status in the conditions of CHD.
We investigated 48 men divided into two groups according to their psychological status: I- group – patients with CHD of neurotic type and II- patients with CHD of non-neurotic type.
There revealed a positive correlation between the levels of the lipid spectrum and neurotic scale indices (hypochondria, depression and hysteria .according to MMPI).
Our trial showed that hypolipidemic diet had a low effect in neurotic patients of lipid spectrum.
Conclusions. 1. The positive correlation between atherogenic lipoproteins and indices of neurotic scales indicates that psychological factors play an important role in the development of CHD. 2. High levels of fibrinogen in neurotic patients indicate that such population has a high risk of infarction and stroke. 3. Neurotic patients with CHD have high resistance to hipolipidemic diet. Lipid spectrum in such patients does not decrease signtificantly.
4. SIMONIA G., SAGUIRASHVILI E.
SPECIFICITIES OF ENDOTHELIAL DYSFUNCTION DURING HEART FAILURE DEVELOPMENT
Experimental and Clinical Medicine, 2006, N7, pp.17-20
Department of Internal Medicine, Tbilisi State Medical University, Georgia
Heart failure has yet remained a completely unresolved problem yet. Endothelial dysfunction has been considered as an important factor involved in the development of cardiovascular diseases, and plasma endothelin-1 and NO levels as their prognostic and severity markers. The purpose of the present study was elucidation of the role of endothelial dysfunction in the development of heart failure. A total of 78 patients with heart failure of I-IV (NYHA) functional classes were observed. They were divided into two groups: I group-NYHA I-II and II groupe-NYHA III-IV. Each of these groups was divided into 4 sub-groups in accordance with the ethyological factors. Group I was composed of patients who had myocardial infarction not later then 6 weeks verified by ECG and echocardiography. Patients with chronic heart disease represented group II. Group III was composed of patients with dilated cardiomyopathy. Group IV included patients with acquired and congenital valvular heart disease.
20 healthy subjects were included in the control group. The patients with acute inflammation and chronic kidney failure were not involved in the study.
Negative correlation was found between ET-1 and NO plasma levels in total, I and II groups. Positive correlation was found between ET-1 plasma levels and heart failure severity. Negative correlation was found between NO plasma level and LVES(r= -0,4232; p<0,001) LVEDV (r= -0,4440; p<0,001), LVM (r= -0,2613; p<0,001) and positive correlation with EF(r=0,3482; p<0,001). Endothelial dysfunction occurs at the early stages of(I-II) postinfarction heart failure. Plasma levels of ET-1 was significantly increased (1,2±0,5pg/ml) and NO level was significantly decreased (10,1±1,11mm/mg) in the postinfarction group, compared to the ischemic group (p<0,001).
5. KESHELAVA G., MIKADZE I., KAKABADZE Z., ABZIANIDZE G., BRANSHERO A.
A NEW SURGICAL APPROACH TO THE INTERNAL CAROTID AT THE LEVEL OF THE CAROTID CANAL
Experimental and Clinical Medicine, 2006, N7, pp.20-22
Department of Vascular Surgery, Timon Clinic, Marseilles, France;
Ltd Clinic of Angiology–angiosurgery, Tbilisi, Georgia;
Chair of Anatomy, Tbilisi State Medical University, Tbilisi, Georgia
Surgical approach to the internal carotid artery at the base of the skull is a very complex manipulation and is usually performed in the cases of dysplasial, traumal or aneurismal injuries. The crucial stages of such intervention are – luxation of the temporo – mandibular joint (which gives an opportunity to extend the operational area) and milling of the apophyseal pouch of the membrane bone that enables to expose the carotid artery at the level of a vertical segment of the carotid canal.
During operation , VII, IX, X, XI and XII pairs of the cranial nerves must be spared to prevent local neurologic complications in the postoperational period.
Experimental and Clinical Medicine, 2006, N7, pp.23-24
Tbilisi State Medical Academy, Department of Hematology and Transfusiology, Georgia
The purpose of the study was to investigate the hemoreological and paracoagulation conditions in patients with Indolent (INHL)and Aggressive (ANHL) Non-Hodgkin’s Lymphoma (stage II-IV), we also had to determine the risk-group of patients with thrombotic complications and optimization of preventive measures. We have investigated 132 patients with NHL: INHL was found in 38 of them, ANHL - in 94. Among the patients with the involvement of 2 or more extranodal organs, hypercoagulation state was found in 19 with INHL and in 12 ones with ANHL. Patients with hypercoagulation syndrome. Undervent the antithrombotic treatment according to the schedule prepared in advance. Despite hemoreological and coagulation changes in the patients with the involvement of 2 or more extranodal organs, the antithrombotic treatment also was conducted to them. Survival was three times less in ANHL patients and 2 times less in INHL patients.
7. KIRTAVA T., KUPRASHVILI L., GHIRDALADZE D.
DIFFERENTIAL DIAGNOSIS OF HYPOCHROMIC ANEMIA
Experimental and Clinical Medicine, 2006, N7, pp.25-27
Chair of Hematology of TSMU, Tbilisi, Georgia
This publication provides a review of causes of hypochromic anemia and respective nosologies. It sets for the criteria differentiating diagnosis of iron deficiency anemia and anemia developed as a result of omproved iron utilization and reutilization, and thalasemia.
The publication stipulates that in case of hypochromic anemia primarily the association of the disease with iron deficiency must be defined, there after, nosology must be specified, and corresponding pathogenetic treatment performed.
8. GURGENIDZE G., GZIRISHVILI M., LABARTKAVA D., MIKABERIDZE M., URUSHADZE N.
PROPHYLAXIC OF ATOPIC BRONCHIAL ASTHMA ACUTE PERIOD AND ITS TREATMENT WITH THE METHOD OF LOCAL IMMUNOTHERAPY
Experimental and Clinical Medicine, 2006, N7, pp.27-30
Institute of Medical Biotechnology, Georgian AS, Tbilisi, Georgia
The method of sublingualin immunotherapy with tabletic allergens is very effective for the treatment of atopic bronchial asthma. After the treatment, there is observed the decrease of immynoglobulins along with reagent activition and the incerease of Gelass of immunoglobulins.
9. SHVELIDZE KH., BREGVADZE N., MAMATSASHVILI I., NAPETVARIDZE R., TABAGARI S. ()
THE LEUKOCYTE COUNT AND ITS RELATIONSHIP WITH SOME CORONARY RISK FACTORS IN PATIENTS WITH METABOLIC SYNDROME
Experimental and Clinical Medicine, 2006, N7, pp.30-33
Department of Therapy N3 of TSMU; High Medical School “AIETI”, Tbilisi, Georgia
Background. An elevated (even within the normal range) leukocyte count (WBS) is associated with cardiovascular risk factors and with an increased risk of metabolic syndrome(MS). It is not clear whether the leukocyte count (also a risk factor for cardiovascular disease) is significantly dependent or not on the presence of MS. The goal of our study was to investigate the influence of MS presence on leukocyte count in patient with unstable angina.
Methods and Results. Patients with unstable angina were divided into groups +MS and -MS. Leukocyte count was significantly higher in the MS group. When stratified patients with MS and without it into tertiles based on admission WBC count, we found a significant relationship between WBC and abdominal girth. In the MS patient group Atherogenic Index of plasma (AIP – log TG/ HDL-C) was significantly higher (p< 0.05).
Conclusion. Visceral adiposity, and not subcutaneous fat is associated with MS. WBC count and AIP are higher in MS patients, and more aggressive and general risk factor modification treatment may be indicated in these patients.
10. ESAKIA A., BREGVADZE N., TABAGARI S., NAPETVARIDZE R., EMKHVARI T., ESAKIA N.
IMPACT OF THE METABOLIC SYNDROME ON LEFT VENTRICULAR STRUCTURE AND FUNCTION IN ISCHEMIC HEART DISEASE PATIENTS
Experimental and Clinical Medicine, 2006, N7, pp.34-37
Department of Therapy N3 of TSMU; High Medical School “AIETI”, Department of Endocrinology and Metabology of TSMU, Tbilisi, Georgia
Background. Metabolic Syndrome (MS) is increasingly recognized as an important cardiovascular risk factor, but its influence on left ventricular (LV) mass and function has not been specifically addressed.
Methods and results. We studied 80 unstable angina pectoris patients - 54 with MS and 26 without it. Echocardiographic LVM and LVM indexed by body surface area (LVMI) were investigated. Patients were divided into quartiles of LVMI; a significant interaction was a documented between LVMI and LVEF in the MS group. LVM and LVMI was associated with a greated LVMI in women (p<0,05 ), but not in men.
Conclusion. MS has a different impact on LV hypertrophy in men and women. The effect of MS is more pronounced in women. MS group needing intensive secondary prevention because such a large independent risk factor as LVH is generally neglected.
11. DAVITURI M., KARSELADZE R., BIGVAVA T.
PSYCHOCARACTERISTIC PECULIARITIES IN CHILDREN WITH BRONCHIAL ASTHMA
Experimental and Clinical Medicine, 2006, N7, pp.37-42
Institute of Pediatrics, Children’s Clinic N1, Tbilisi, Georgia
In children with bronchial asthma, according to the results of meta-analysis, the risk of the development of depressive syndromes is high and much sharper than in case of other chronic pathologies – Bennet (1994).
According to the data from Klinnert (2000), anxiety and emotional lability in primary school children correlate with the asthma sympthoms. Asthma exacerbation coincides in time with the emotional overcharge.
Based upon the goal of the work, there have been studied psychocharacteristic peculiarities of children with bronchial asthma (anxiety level, character accentuation and assessment of an actual emotional state) with respect of the age (15-17) and disease duration.
An actual emotional state of the children with bronchial asthma was being studied by the Lucher’s color test in L.N.Sobchick modification which gave us the ability to reveal definite tendencies of individual-personal features.
The amount of high anxiety among those with bronchial asthma made up 60% which significantly exceeded the quantity of such persons among the healthy ones (25% of the healthy children).
In the children with bronchial asthma, despite the “polarity” of accentuation, psychological peculiarities were accompanied by a high personal anxiety which prevented an adolescent from the adequate reaction to the influence of unfavorable factors and promoted its formation as a pathological process.
FUNCTIONAL STATUS OF THE LIVER IN PATIENTS WITH NON-HODGKIN’S LYMPHOMA
Experimental and Clinical Medicine, 2006, N7, pp.42-46
Department of Hematology and Transfusiology of Tbilisi State Medical Academy, Georgia
On the basis of the data obtained we can suppose that liver injury plays a significant role in the final results of treatment of non-Hodgkin’s lymphoma. Lethal outcome was significantly lower in the patients whose liver was mildly or moderately injured despite the highly aggressive process of cancer and active chemotherapy treatment in comparison to those patients whose clinical and laboratory signs of liver injury were markedly expressed. In this group, there was a high lethality of patients due to liver failure.
All the above mentioned proves that the evaluation of liver functional status is very important to choose the corresponding chemotherapy and hepatotrophic treatment for the improvement of the final results of treatment.
13. M. KHVADAGIANI
ULTRASOUND IN THE DIAGNOSIS OF MAXILLARY SINUSITIS
Experimental and Clinical Medicine, 2006, N7, pp.46-49
Clinic of Otorhinolaringology, Tbilisi Medical Academy, Georgia
Rhinosinusitis is one of the most common health problems, with significant direct medical costs and severe impact on lower airway disease and general health outcome.
The diagnosis of maxillary sinusitis (MS) is based most often only on the symptoms and clinical examination. This practice leads to many false positive diagnoses and unnecessary use of antibiotics. Sinus ultrasound has been suggested as a means to improve the accuracy of MS diagnosis. We studied the symptoms, signs, sinus radiography and ultrasound (B-mode) findings in patients with rhinosinusitis. A total of 223 patients (age 5-75) were recruited to the study: 91(41%) women and 132 (59%) men.
The sensitivity of ultrasound compared to radiography was 93%, and specificity was 98%. After practice and training primary care physicians can perform sinus ultrasound examination as accurately as specialists do.
14. MERMANISHVILI T., GABUNIA U.
GENDER IN PREDICTION OF INTRACRANIAL MENINGIOMAS BIOLOGICAL BEHAVIOUR
Experimental and Clinical Medicine, 2006, N7, pp.49-51
P.Sarajishvili Institute of Neurology, Tbilisi;
A.Natishvili Institute of Experimental Morphology, Georgian AS, Tbilisi, Georgia
The diagnostic criteria for prediction of intracranial meningiomas behaviour are not clearly identified. We made it our objective to study the frequency of development and recurrence of intracranial meningiomas in the gender aspect. We consider that this data will enable us to define the biologic behaviour of the above-mentioned tumors. We reviewed 134 cases (87 women and 47 men) of completely removed intracranial meningiomas. 10-year recurrence was found in 46 cases (21 women and 25 men). The grade of tumor was assessed according to the World Health Organization classification (1997). We reviewed mitotic figures in 10 high-power fields and calculated the mitotic index (MI). MI was identified as a number of mitosis in 1000 tumor cells. Our data suggest that biological behaviour of intracranial meningiomas has obvious relationship with patients gender and age.
15. KHABEISHVILI G., SHABURISHVILI T., VASHAKIDZE Z.
COMBINED USE OF DOBUTAMINE STRESSE CHOCARDIOGRAPHY AND TRANSESOPHAGEAL STIMULATION STRESS TEST FOR ASSESSING TREATMENT EFFICACY IN POST-STROKE PATIENTS
Experimental and Clinical Medicine, 2006, N7, pp.52-56
Department of Intensive Cardiology, Clinic N2, TSMU, Georgia
Hibernating myocardium represent still viable akinetic or hypokinetic segments of the left ventricular segment are. This viability can be detected either by the persistence of metabolic activity within the regions of dysfunctional myocardium or by demonstrating improvement in the contraction of the hibernating myocardial segment with appropriate stimulation, such as inotropic stimulation. The improvement in function would not have occurred if the dysfunction had been due to myocardial infarction and scarring. None of the available methods for the detection of myocardial viability is clearly superior to others. Such methods include dobutamine stress echocardiography, thallium-201 redistribution study, imaging with technetium-99m sestamibi, and positron-emission tomography with agents that detect residual metabolic activity.
The suggested method is the investigation of hibernating myocardium in patient with CAD and impaired LV function by accurate measuring of lusitropic (relaxation) capacity of myocardium by combination of dobutamine stress echocardiography and transesophageal stimulation stress test. 100 patients were investigated. All patients had MI 6 or more months before the investigation. The patients were divided in to 2, A and B groups, depending on the results. Group A includes patient with reliable difference between stroke volume index and end diastolic volume measured during this two methods when the heart rate was 100 and 110 per minute. Group B includes patents when this data was unreliable. All these patient were investigated 6 months after revascularization therapy (PTCA or GABS). We observed >15% increasing of SVI in 33 patient out of 50 in group A and only in 9 out of 47 in group B. The percentage of intraoperative and postoperative complications in group B was reliably higher than in group A.
We suggest that the combination of dobutamine stress echocardiography and transesophageal stimulation stress test is a cheep convenient and reliable method for assessing myocardial viability in patient with CAD and impaired LV function. The difference between stroke volume index and end diastolic volume measured during these two methods when the heart rate was 100 and 110 per minute is the reliable data for estimating the efficacy of revascularization in patients with chronic occlusion or high grade stenosis of the coronary arteries.
16. ABULADZE T., NEMSADZE G., GERSAMIA G.
PROGNOSTIC SIGNIFICANCE OF ER, PR, AND HER-2/NEU RECEPTORS IN WOMEN OF REPRODUCTIVE AGE WITH BREAST CANCER
Experimental and Clinical Medicine, 2006, N7, pp.57-59
A.Gvamichava National Center of Oncology, Tbilisi, Georgia
Clinical data of 98 breast-cancer patients treated in the mammology department of The National Cancer Center of Georgia from 2000 to 2005 were studied. In all of them levels of specific tumor markers such as ER, PR and HER-2/Neu were revealed. On the basis of the results obtained prognosis of the disease was defined and treatment tactics was chosen.
It has been established that the expression of ER, PR and HER-2/Neu tumor markers correlates with a degree of malignancy of breast cancer. Steroid receptor status is a significant prognostic factor and evaluation of marker-expression levels in the patients with early stage breast cancer facilitates the choice of adequate tactics of treatment: hormonotherapy, chemotherapy, radiotherapy or combined treatment.
17. MELIQIA T., JHVANIA M.
DEFINITION OF HEMATOLOGIC AND IMMUNOLOGIC INDICES DURING POST-VACCINATION REACTIONS AND COMPLICATIONS IN CHILDREN
Experimental and Clinical Medicine, 2006, N7, pp.59-62
Faculty of Specialization In Pedonosology, Pediatric Clinic of TSMU, Tbilisi, Georgia
The purpose of the work is to define hematologic and immunologic indices during post-vaccination complications of the respiratory system and rheumatic diseases.
The work has been executed on the basis of retrospective analysis of laboratory and immunologic indices of 87 children from the pediatric clinic aged 3 to 14 years. 41 among them had complications of diseases of the respiratory system and 46 – of rheumatic diseases. 108 persons of the same age were selected as a control group. Statistical processing of the quantitative data included calculation of average arithmetical values and of standard deviation. Authentic distinctions between the groups were estimated according to the Student’s coefficient. Mathematical supply was accomplished via SPSS® 11.5 (Statistical Software Package).
We have studied hematologic indices: leukointoxication, leukocyte immunoreactivity index, nuclear shift index, neutrophil-monocytic, lymphocyte-monocytic, resistance index, lymphocyte-eosinophilic, leukocyte shift index and immunologic indices: B/T, IgM/B, IgG/B, IgA/B, IgG+IgA+IgM.
Our results showed that during all the post-vaccination complications there is a marked increase in the average meanings of hematologic and immunologic indices.
18. CHKHIKVISHVILI I., GOGIA N., KORSANTIA B.
COMPARISON OF ANTIOXIDANT ACTIVITIES OF FOOD PRODUCTS WITH HIGH POLYPHENOL CONTENT
Experimental and Clinical Medicine, 2006, N7, pp.62-65
Institute of Medical Biothecnology, Tbilisi, Georgia
The obtained results suggest that antioxidant activities were arranged in the following order: coffee > green tea > orange > juice > red wine. Addition of milk does not change antioxidant activity, but lemon juice reduces this activity. Tangerine juice with stevia sweetener is a three times stronger antioxidant than the juice with sugar sweetener. Among apple sorts more antioxidant activity has “Antonovka”. This investigations reveal the possibility of standardization of food products and their protection from falsification.
19. KHARISCHARISHVILI I., GORGOSHIDZE B.
ANALYSIS OF HAIR MICROELEMENT COMPOSITION BY THE METHOD OF X-RAY FLUORESCENT SPECTROMETRY AND ITS IMPORTANCE IN EARLY DIAGNOSIS AND TREATMENT OF DISEASES
Experimental and Clinical Medicine, 2006, N7, pp.65-67
Association of Georgian Nutritiologists, Tbilisi, Georgia
In the publication is discussed the importance of the examination of microelement composition of the hair by the x-ray fluorescent spectrometry method for evaluating the body trace elements, and is developed the practical importance of early diagnosis and treatment of chronic intoxications and somatic diseases.
20.. ZARNADZE Z., KORINTELI I., ARABULI M., ALADASHVILI L., KUCHAIDZE N., PAPIDZE K.
THE ACTION OF LASER ON THE FORMED ELEMENTS OF THE BLOOD ACCORDING TO THE ASPECTS OF EVIDENCE-BASED MEDICINE
Experimental and Clinical Medicine, 2006, N7, pp.67-69
Tbilisi State Medical University, Tbilisi, Georgia
Extracorporeal method of irradiation using laser appears to be a method of “shock” therapy promoting an increase of the protective function of the cell, in particular, erythrocyte. Such significant elements as homeostasis, compensatory-adaptation mechanisms etc. represent the fundament of “shock” therapy. In response to the impact blood cells show their properties directed to the intensification of defense functions of the organism.
21. GUDUSHAURI M., NISHNIANIDZE T.
EARLY DIAGNOSIS AND PROPHYLAXY OF OSSEOUS-CARTILAGINOUS EXOSTOSES
Experimental and Clinical Medicine, 2006, N7, pp.69-72
O.Gudushauri National Medical Center, Tbilisi, Georgia
The authors have carried out a complex clinical, rentgenologic and morphological- immunohistochemical research of 102 patients; 95 of them had benign osteochondrous tumor of long cortical bones, and the remained 7 patients had secondary chondrosarcoma. Significant complex diagnostic and algorithm were worked out for adequate and effective surgical intervention. By means of the above-mentioned measures it is possible to attain the full recovery of the patient, rehabilitation of his her capability to work and effective methods of prophylaxis.
22. DOGONADZE S., GORDEZIANY M., NINUA N., SANIKIDZE T.
CHANGES IN ANTIOXIDANT ENZYMES ACTIVITY DURING VIRAL POLYNEUROPATHY
Experimental and Clinical Medicine, 2006, N7, pp.73-75
Department of Neurological diseases of Tbilisi State Medical University, Georgia
Nowadays there exist abundant evidence pointing to the important role of oxidative stress in the pathogenesis of inflammatory neurological diseases, especially during Guillain-Barre syndrome (GBS). Under inflammatory conditions concomitant to GBS, the content of oxygen and nitrogen reactive species increases sharply and in its turn promotes changes of antioxidant enzymes activity.
We aimed to determine changes of antioxidant enzymes activity during viral polyneuropathy. The results of our study revealed a disturbed balance between pro- and antioxidant systems of blood during viral polyneuropathy manifested by increasing of catalasa activity (by 59%), decreasing of SOD (by 20%), and GR (by 70%) activity as compared with the control level.
Under the conditions of oxygen free radicals accumulation and inactivation of antioxidant defense mechanisms in the body, free radical oxidation, especially peroxidation processes, may be intensified. That promotes the injury of myelin sheath and activation of dymeilinizaton of the peripheral nerves.
23. KAKONASHVILI A., SHIOSHVILI T.
THE COMPLEX TREATMENT OF PEYRONIE’S DISEASE
Experimental and Clinical Medicine, 2006, N7, pp.75-79
Department of Urology, State Medical Academy, Tbilisi, Georgia
Objectives. The aim of this work was the evaluation of clinical results of the use of buccal mucosa for replacement of Peyronie’s disease plaque.
Twenty-six patients with Peyronie’s disease were under observation. All the patients underwent the following investigation before and periodically within 3 years after the treatment: International Index of Erectile Function (IIIEF-5), manual examination of plaque, autophotography of erect penis, conventional and power color Doppler sonography of penis, Peno-Brachial Index (PBI) before its increase (IPBI) after the intracavernous injection of papaverin, Peak Systolic Velocity (PSV), end diastolic velocity (EDV), Resistance Index (RI), Sexual Encounter Profile questions (SEP-2 and SEP-3), measurement of penile length and curvature angle in the phase of rigidity. After stabilization in plaque’s development (mean time 2.0 ± 0.1 years) the patients underwent a surgery by means of excision of plaque and its replacement by free autograft of buccal mucosa.
After the surgical treatment (with mean follow up observation of 3.2 ± 0.1 years) in 24 patients out of 26 (92.3%) the complete straightening of penis occurred, in two (7.7%) a partial reduction of erectile power were observed.
Buccal mucosa showed high properties of adaptation and revascularization, good anatomical and functional clinical results by replacement of indurative plaque, it kept a stable elasticity without shrinkage; the method is simple and can be recommanded for wide use in clinics for surgical treatment of Peyronie’s disease.
24. ABZIANIDZE G., MIKADZE I., ABZIANIDZE T., VARDOSANIDZE T.
IMPORTANCE OF PRIMARY CLINICAL MANIFESTATION OF VASCULAR ATHEROSCLEROSIS IN LOWER EXTREMITIES
Experimental and Clinical Medicine, 2006, N7, pp.80-82
Ltd Clinic of Angiology and Angiosurgery, Tbilisi, Georgia
Results of the treatment of patients with obliting atherosclerosis of lower extremities are reviewed in the article. Among them some had an early stage of chronic ischemia (1 stage), primary clinical manifestations (2 stage), obliting atherosclerosis together with circulatory decompensation in lower extremity (2b stage), and critical ischemia with circulatory decompensation in the extremity (3-4 stages). For most of the patients (23,9%) it was necessary to undergo high amputation of an extremity. In 65,2%, along with active conservative treatment, amputations of feet, toes, and necrectomies were performed. In 6,5% of cases patients refrained from vascular reconstruction operations, and at this stage only in 4,4% of cases aorta-bifemoral prosthesis were performed.
Effective results are shown at early stages of vascular atherosclerosis. Patients consulted the angiologist because of light complaints about getting easily tired when walking up stairs or up-slope, also with certain sense of discomfort in the calf muscle area. In such cases duplexscanning showed thickening of femoral and sural arteries with slight atherosclerotic and stenosal changes. It’s quite easy to stop these processes by modern methods of conservative treatment.
25. NIORADZE G., TOPURIA I., GAGUA R.
ANALYSIS OF SOME HEMATOLOGIC AND BIOCHEMICAL INDICES OF SMALL CELL LUNG CARCINOMA
Experimental and Clinical Medicine, 2006, N7, pp.83-87
A.Gvamichava National Center of Oncology, Tbilisi, Georgia
With the use of multivariation statistical analysis of 185 patients with small cell lung carcinoma it has been ascertained that changes in the hemogram of some biochemical parameters such as albumin, globulins, alkaline phosphatase have a significant influence on the prognosis of the disease. Quantitative and qualitative changes in formed elements of blood, stable high rates of erythrocyte sedimentation reaction, as well as elevation of both alkaline phosphatase and globulin, and decrease of albumin concentration make worse prognosis. Overall and median survival rates of patients with normal hematological and biochemical parameters are different from those of the patients with abnormal parameters. Difference is statistically reliable (p<0,05). Accordingly, values different from norm should be considered as risk factors. The above-mentioned results should be taken into account for the evaluation of prognostic factors and choice of most effective treatment methods.