EXPERIMENTAL & CLINICAL MEDICINE
2008, ¹ 1
1. PANTSULAIA I., KOBYLIANSKY E.
THE PHENOTYPIC PROFILES OF Cytokines involved in bone and cartilage metabolism
J. Experimental and Clinical Medicine, 2008, 1, pp. 9-12.
Institute of Medical Biotechnology, Tbilisi, Georgia
Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
Bone health, characterized by its mass, density, and microarchitectural qualities, is maintained by a balanced system of remodeling. The lack of these qualities, caused by uncoupling of the remodeling process, leads to bone fragility and an increased risk of fracture. The prime regulator of bone remodeling is the RANK/RANKL/OPG system. The common origin of both bone and immune stem cells is the key to the understanding of this system and its relationship to the nuclear transcription factor kappaB (NFkB) in bone loss and inflammation. The major goal of this study was to characterize the RANK/RANKL/OPG system and evaluate the association between the studied cytokines and bone phenotypes in an apparently healthy ethnically homogeneous sample.
The results of the study shown a statistically significant negative phenotypic correlation between BMD and OPG in both men and women (r=-0.14, r=-0.28, p<0.01 for men and women, respectively), while plasma sRANKL levels were independent of BMD in all groups. After adjusting both variables for age, the correlation between them became statistically insignificant (p>0.05). However, the most remarkable finding of our study is a statistically significant strong association between RANKL/OPG ratio and bone characteristics (BMD, BS, BG) in the group with high RANKL/BMD ratio (>4). Therefore, the RANKL/OPG ratio is the main predictor of changes developed in the bone with aging.
2. ZURABISHVILI K., GONJILASHVILI M., NIKOLISHVILI G., PARTSAKHASHVILI J., JANGAVADZE M.
A NEW METHOD FOR “DIFFICULT” DUODENAL STUMP CLOSURE
J. Experimental and Clinical Medicine, 2008, 1, pp. 12-15.
Clinical Hospital of I.Javakhishvili Tbilisi State University;
Al. Natishvili Institute of Morphology, Tbilisi, Georgia
Stomach resection by Billroth’s II method is often connected with some difficulties because of its very low ability to form a stump. In the world literature, such a stump is called “difficult”. There is a wide choice of methods for solving the problem. Each of them has different disadvantages.
We have developed an original method for “difficult” duodenum stump closure - closing the defect via patching the jejunal loop with interrupted sutures. We tested this new surgical technique in an experiment. 10 mongrel dogs were used in the study. The experimental and morphological data show a successful performance of the surgery and positive postoperative period.
Based on our data, we can conclude that our method is reliable, easy to perform, and what is more important, shortens the operation time. An advantage of this method is that the “lid” of a stump is formed by the three-layered wall of the jejunum, which closes a stump hermetically. We named this method “Duodenojejunopexy”.
3. KILADZE N., CHIRINASHVILI A., SHULAIA T., NIKOLAISHVILI D.
DIAGNOSIS AND MANAGEMENT OF BASAL CELL CARCINOMA
J. Experimental and Clinical Medicine, 2008, 1, pp. 15-18.
Tbilisi State Medical University; National Oncological Center; Dermato-venerology and Aesthetic Medicine Center “Marjani 21”, Tbilisi, Georgia
Basal cell carcinoma is the most common type of malignant non-melanoma skin cancer. It is locally invasive, aggressive and destructive, but has a limited capacity to metastasize. Since a proportion of these tumors are heavily pigmented, clinically they may resemble invasive melanoma. For differential diagnosis of pigmented lesions and particularly for these two types, there was proved dermatoscopy - a non-invasive technique which offers the possibility to visualize multiple morphological features. The aim of this study was to evaluate whether dermatoscopy was useful for diagnosing of basal cell carcinoma, and to consider the possibilities of surgical treatment. There were analyzed 11 cases of basal cell carcinoma, comparing clinical and dermatoscopic showings and conditions, and the prevalence of surgical excision were determined.
4. GONGADZE N., KEZELI T.
CHANGES IN BIOELECTRIC ACTIVITY OF HEART, VEGETATIVE-NERVOUS CONTROL FUNCTION AND HOMEOSTATIC REGULATION OF CIRCULATION DURING EPINEPHRINE-INDUCED CARDIAC INJURY
J. Experimental and Clinical Medicine, 2008, 1, pp. 18-22.
Department of Pharmacology, Tbilisi State Medical University, Georgia
Experiments have been carried out on 42 rabbits with epinephrine-induced cardiac injury. Baroreflex cardiochronotropic, vagal and sympathetic components, vegetative nervous control and ECG changes were estimated after 24-hour, 5- and 10-day heart injury. It was shown that heart muscle damage was accompanied with developing arrythmias and reducing of baroreflex vagal and sympathetic components sensitivity, which was correlated with a decrease of the vagal efferent fibre activity. These changes were more markedly revealed in the late step of myocardial damage. It is suggested that epinephrine–induced cardiac injury causes disturbances in the vegetative nervous control of the heart and in the homeostatic regulation of the circulation.
5. Verulashvili I., Kortushvili M.
Postherpetic neuralgia: pathogenesis, tratment and prevention
J. Experimental and Clinical Medicine, 2008, 1, pp. 22-25.
Department of Neurology, TSMU Central Clinic, Tbilisi, Georgia
Herpes zoster is a common disease primarily affecting the elderly. Although some individuals experience no symptoms beyond the duration of acute infection, many develop chronic pain - postherpetic neuralgia (PHN), which is the commonest complication of herpes zoster infection and remains notoriously difficult to treat, once established. It may persist until death and has major implications for quality of life and use of healthcare resources. Predictors for the development of PHN are present during acute disease, and should indicate the need for the use of preventive therapy. In the Neurology Department of TSMU Central Clinic, 42 patients (mean age 56±10.2) with PHN were treated from 2004 through 2007 by aciclovir (2000-2400 mg/d during 8 days) plus a 2-week titration period to a maximum dosage of 1800 mg/d of gabagamma (gabapentin) matching to 20 patients of the control group with aciclovir + anticonvulsant carbamazepine (600-1200 mg/d). Treatment of acute shingles within 72 hours of rash onset by systemic antivirals plus antoconvulsants reduced the incidence of postherpetic neuralgia by about 62.2% against 12.1% in the control group. At the present time, the use of antiviral and certain anticonvulsant drugs (aciclovir + gabagamma), combined with psychosocial support, seem most effective, but are far from perfect.
6. TZIKLAURI M., MANJAVIDZE N., KACITADZE G., ABESADZE M.
STATE OF health of REFUGEE CHILDREN FROM ABKHAZIA
J. Experimental and Clinical Medicine, 2008, 1, pp. 25-27.
Department of Pediatrics TSMU;
Department of Immunology and Microbiology of TSMU, Georgia
There was held an investigation of the health status of 6-15 years old 800 refugee children from Abkhazia. This investigation suggested that 43.5% of the children had somatic and psycho-emotional dysfunctions. Those having psycho-emotional dysfunctions mostly manifested psycho-neurological dysfunctions too.
7. BUBASHVILI M., RIGVAVA S., GOGIASHVILI D., KARUKHNISHVILI M.,
VARDZELASHVILI N., NATIDZE M., LASAREISHVILI B., MAGLAKELIDZE T.,
GUBELADZE L., KAVTARADZE L.
METHODICAL APPROACH TO THE DEVELOPMENT OF CREATING A COMBINED ANTI - ANTHRAX PREPARATION
J. Experimental and Clinical Medicine, 2008, 1, pp. 27-30.
(Report 1. Creation of antibacterial anti-anthrax hyperimmune serum and study of its activity)
G. Eliava Institute of Bacteriophage, Microbiology and Virology, Tbilisi, Georgia
The work is designed to search novel preventive and therapeutic tools against Anthrax and develop new approaches in this direction. A comparative study of antigenic and immunogenic activity of the following vaccinal strains of B.anthracis STI-1; 55 and 34F2 (not forming capsules) and 71/12 the 2 nd vaccine of Zenkovsky (capsule-forming) has been performed. Experimental model for creating antibacterial, antitoxic and anti-capsular hyperimmune serum of Anthrax was developed on the rabbits. The evidences of the antibacterial activity of the sera obtained after the 1st cycle of indirect hemagglutination reaction, as well as by the double radial immunodiffusion method are given in the present part of the work. The growth of antibody titers reached the maximal peak on the 48 th day after injection. The highest titer was observed in the group immunized with vaccine STI-1, and less intensive process of the antibody formation occurred in the group immunized with bacterial antigen 55.
8. SHULAIA T., KILADZE N.
Correction of mineral metabolism in pathogenetic treatment of alopecia areata
J. Experimental and Clinical Medicine, 2008, 1, pp. 30-34.
Department of Dermatovenereology, Tbilisi State Medical University
Dermatovenereology and Aesthetic Medicine Center “Marjani 21”, Tbilisi, Georgia
Alopecia areata is a common form of non-scarring alopecia that appears equally in males and females of any age, and affects about 1% of the population. The disorder is usually characterized by limited alopecic patches on the scalp. More severe forms may affect the entire scalp (alopecia totalis) or body (alopecia universalis). Dysbalance of trace elements is considered to be the important factor in its pathogenesis.
25 patients in the 4-36 years age range with various extents of alopecia areata on the head and face were included in the trail. 11 patients had been unsuccessfully treated before for several months with topical sensitizers, all others were untreated. Trace elements were studied by the spectral roentgeno-fluorescence method. In accordance with the received showing, all the patients were treated by mesotherapy and physiotherapy methods with positive results, and without any undesirable side effects.
9. PATARAIA M., KORSANTIA B., KÎUPRADZE S., SEKHNIASHVILI TS.
IMMUNOMODULATING EFFECTS OF PLAFERON-LB AND PHENOWINE DURING PHYSICAL OVERSTRAIN IN RATS
J. Experimental and Clinical Medicine, 2008, 1, pp. 34-36.
Institute of Medical Biotechnology, Tbilisi, Georgia
Physical overload renders an appreciable influence on the condition of the immune homeostasis of a white rat organism. Even a moderate unitary load - swimming - was enough to lower the activity of interferon about 63.6 U/ml (control) to 21.2 U/ml. During swimming «to satiety» aIFN activity dropped to 15.6 U/ml. Under the conditions of plaferonotherapy, on the 10th day of “trainings” aIFN reached 76.8 U/ml that appeared to be higher than in the groups without plaferon (52.9 U/ml) and in the control group (63.6 U/ml).
The conducted researches make it possible to conclude that plaferon (especially in complex with phenowine) is able to neutralize immunosuppressive actions of physical overstrain.
10. CABULOVH., TALISHINSKI R., KHECHINASHVILI T., JASHI M.
AN AnamnesIs-based study of prevalence and peculiarity of THE course OF allergic rhinitis in pediatric patients
J. Experimental and Clinical Medicine, 2008, 1, pp. 36-51.
Department of ENT, Azerbaijan State Medical University, Baku
Department of ENT, Tbilisi State Medical University, Georgia
We report the results of a study performed to investigate risk-factors conditioning manifestation and peculiarities of the clinical course of allergic rhinitis (AR) in 1021 children dwelling in various regions of Azerbaijan. The study data included anamneses carried out on the basis of a standard questionnaire within the framework of the international program (ISSC).
It has been detected that AR is marked by diverse clinical course in different regions and is significantly more common in urban areas. Among the indicated risk factors we point out the allergic condition of the organism, lifestyle, dietary habits, genetic predisposition. The aforesaid factors are commonly observed in alpine, rural and semi-arid regions.
Healthcare providers should counsel the population at more regular intervals. Special attention should be paid to the anamnesis result.
The total of these measures makes it possible to detect the disease at an early stage, identify risk-factors conditioning manifestation of the disease, adopt proper preventive measures, and eventually eradicate the risk-factors.
11. CHOMAKHASHVILI Z., PHUTKARADZE M., CHIKHLADZE Z., KHAZHALIA T. , MIKELADZE A.
SURGICAL ANATOMY OF HEPATIC LOBULAR PORTAL COMPLEXES
J. Experimental and Clinical Medicine, 2008, 1, pp. 40-45.
Theoretical and Practical Centre of Clinical Pathology, Batumi, Georgia
A retrospective analysis of the research of lobular portal complexes variations clearly demonstrates that in the portal complexes located in the hepatic porta region, the portal vein or sectoral branch may be supplied by one or several branches of the general hepatic artery (these branches don’t irrigate the anatomical part to which the portal vein belongs). But at the same time it is quite possible that the transposition of the origin points of blood vessels and bile ducts occur, making the structure of portal complexes much more complicated.
For the purpose of investigation of the indicated subject, there was researched anatomical material - 80 specimens of the hepatic-duodenal ligament and inferior vena cava with their hepatic section, using the corrosion and half corrosion methods for specimen preparation.
On the basis of the research, the authors conclude the following: 1. For a temporary suppression of the left portal complex, its middle one-third part is the most appropriate. 2. For a temporary suppression of the right portal complex, its proximal one-third part is the most appropriate.
12. GIGAURI T., SAAKAASHVILI L., KOBAIDZE A., BAKRADZE G., ROSTIASHVILI N., MCHEDLISHVILI L.
importance of computer spirometry in diagnosis and
treatment of bronchial asthma
J. Experimental and Clinical Medicine, 2008, 1, pp. 45-48.
Medical Center “Healthy Future”, Tbilisi, Georgia
The urgency of bronchial asthma grows day by day. Bronchial asthma with allergic reactions proceeding similarly to other diseases represents a significant problem of public health services which renders serious influence on quality and social, and economic standard of living of the population.
For this reason diagnosis and treatment of this disease at its early stage are important.
The purpose of our research was studying function of the lungs by means of computer spirometry: to fix a level of the disease, to monitor the course of the illness, and also to estimate the treatment results.
The results of our researches confirm that functional research of external breath is important not only for diagnosis of illnesses of the respiratory ways, but also for the estimation of the condition of sick children in dynamics. Research accuracy enables a more purposeful and differential approach to the treatment of this illness and checking efficiency of the lead procedures during its treatment.
13.CHOMAKHASHVILI Z., PHUTKARADZE M., MIKELADZE M., KHAZHALIA T.
STRUCTURAL FEATURES OF CONNECTIVE TISSUE IN THE SULCI OF HEPATIC VISCERAL SURFACE
J. Experimental and Clinical Medicine, 2008, 1, pp. 48-51.
Theoretic and Practical Centre of Clinical Pathology Batumi, Georgia
Structural peculiarities of the connective tissue of the hepatic surface sulci are considered in detail. There is stated that fibrous coverings of the liver visceral surface sulci are thickened, turn into each other uninterruptedly, and are represented as the accordingly named laminae in the article. The portal and vesical laminae are the thickest ones of all the identified connective laminae. Dissection of the fresh wandering specimens demonstrated that connective tissue of liver sulci together with the blood vessels and bile ducts can be dissected out of the organ parenchyma as the whole formation shaped like letter “H”.
From the viewpoint of operative intervention, the separation of this formation from liver tissue by the blunt way is quite possible, for there is no risk to damage the fine portal tracts of the liver porta.
14. KHODELI N., CHKHAIDZE Z., PARTSAKHASHVILI J., METREVELI L., MDIVANI N., LIPARTELIANI L., DGEBUADZE A., PILISHVILI O.
THE EXPERIENCE OF HIGH MEDICAL SCHOOL STUDENDS EARLY JOINING TO THE EXPERIMENTAL SURGERY ELEMENTS
J. Experimental and Clinical Medicine, 2008, 1, pp. 51-55.
Scientific-Training Center of the Experimental Surgery, Institute of Morphology
Department of Anatomy, Javakhishvili State University, Tbilisi, Georgia
The formation of high class surgery specialists has specific difficulties in the Georgian medical high schools. These problems are associated with the reforms in the education system, poor material-technical base of medical schools, inaccessibility of the expensive methods of training and poorly-paid hard intellectual work of surgeons. These factors suppressed the motivation of students in the choice of surgical specialties. For adaptation of the educational process with modern conditions of the social-economic realities, there has been developed new methods and forms to stimulate the motivation of students for intensification of training and perfection of surgical skills. 30 students (III-VI years of education) were involved in the surgical trainings. For the first 2 years, the students were developing their skills on dummies and biotissues. The next 2 years - trainings in the experimental researches on animals, with mastering the skills of restoration and preservation of the vital organ functions. The intensive surgical training is possible only in specialized settings, such is the Scientific-training center of experimental surgery. At the end of the undergraduate study, it allows to reach high level skills in basic surgical manipulations and practical habits.
15. RODONAIA S., BARABADZE K., AKHVLEDIANI I., DANELIA M.
INF_Y NEOPTERIN INDICES – DIAGNOSTIC MARKER IN PATHOGENESIS OF NONSPECIFIC DISEASES OF RESPIRATORY SYSTEM
J. Experimental and Clinical Medicine, 2008, 1, pp. 55-59.
Department of Pediatrics, Medical Faculty, I. Javakhishvili TSU
The effective treatment requires to diagnose a disease in time, on the earliest stage. About 30.000 diseases are known today, and adequate diagnosing is possible only in 1/3 part of them. There aren’t tests to determine the course and treatment monitoring of lots of severe diseases. Modern technology and the present day know-how will support the creation of a new diagnostic way, which will play a vital role in the monitoring of diagnosis and effective treatment of many diseases.
Neopterin indices are able to support a differential diagnosis between viral and bacterial infections. In contrast to highly increased neopterin level in the patients with viral infections, patients with bacterial infections usually have normal or only slightly increased quantities of neopterin. It could be shown that neopterin measures are even better able to distinguish between acute viral or bacterial infection than blood sedimentation rate or leukocyte counts.
16. DVALI M., TSINTSADZE N,, SIRBILADZE B.
Keratoconus – Problem, Diagnosis, Treatment
J. Experimental and Clinical Medicine, 2008, 1, pp. 59-60.
Tbilisi State Medical University, Georgia
Purpose - to evaluate the efficacy, stability and predictability of keratoconus treatment through implantation of intrastromal corneal segments, as well as corneal collagen cross-linking with riboflavin.
Method. 299 eyes of 155 patients underwent implantation of intrastromal corneal segments (ISCS), and 18 eyes of 16 patients – corneal collagen cross-linking with riboflavin. SE ranged from -1.0 to -11.0 D, and astigmatism – 3.5 to 7.5 D. The main outcome measures were: UCVA, BCVA, refraction, K values, corneal topography.
Results. The resulted postoperative measurements were compared to the preoperative data. ISCS implantation resulted in the important reduction of astigmatism, steep and average keratometry, and critical parameters of the posterior corneal surface. Corneal collagen cross-linking with riboflavin actually did not make any essential differences.
Conclusion. ISCR implantation improves UCVA, BSCVA, and all the main parameters of corneal topography; it enables to impact the cornea mechanically, to reshape it, flattening its central optical zone. Presumably collagen cross-linking creates changes at the molecular level, decreases corneal elasticity, preventing process progression.
17. DVALI M.L., TSINTSADZE N.A., SIRBILADZE B.V.
SURGICAL TREATMENT FOR HIGH AMETROPIAS
J. Experimental and Clinical Medicine, 2008, 1, pp. 60-61.
Tbilisi State Medical University, Georgia
Purpose - to report safety and predictability of an alternative sequence of the bioptic procedure.
Method. A bioptic procedure has been conducted using phakic and pseudophakic IOLs (primary implantation after cataract surgery), followed by LASIK. A corneal flap was the first step followed by lens implantation approximately 3 days later, and by laser ablation of the stromal bed approximately 3 months later. There were treated fifty eyes that were either myopic or hyperopic. The SE for the myopic group was -11.20 ± 3.007, and for the hyperopic one +6.25 ± 2.156, a mean follow-up covered 35.68 ± 13.5 months.
Results. No intraoperative or postoperative complications occurred. Postoperatively, mean MRSE was -0.356 ± 0.519 for the myopic group, 0.042 ± 0.62 for the hyperopic, and -0.36 ± 0.377 for the pseudophakic group (mean values were calculated according to the results obtained at the last follow-up examination). Postoperative UCVA was 20/20 or better in 81.2%. No eyes experienced a loss of BSCVA postoperatively.
Conclusion. Bioptics is a safe and predictable method of treatment for high ametropias. Candidates for this procedure have a high refractive error with astigmatism, surpassing the abilities of excimer laser refractive surgery, and corneal thickness which does not allow full treatment of the refractive error.
18. KARCHAVA G., PETRIASHVILI E.
Study and application of sanitary-hygienic parameters of “Kus”-lake water in SANITATION actions of recreational zone
J. Experimental and Clinical Medicine, 2008, 1, pp. 61-63.
Sukhumi State University, Faculty of Exact and Natural Sciences, Georgia
The thermal regime of “Turtle” lake completely submits to the seasonal changes of air temperature, but normal oxygen saturation of the lake is of great importance in zooplancton formation. After the research, it’s quite clear that the absolute quantity and quality of oxygen in the water is much higher in July and August, than in October and January - that is caused by water-flowers. Taking into account these information, “Turtle” lake should be considered as the most important place for the local population for fishing and active rest, and thus, this study is of great importance from the sanitary standpoint.
19. DVALI M., TSINTSADZE N., SIRBILADZE B., CERCVADZE O.
Advanced Possibilities of Cataract Surgeries
J. Experimental and Clinical Medicine, 2008, 1, pp. 63-64.
Tbilisi State Medical University, Georgia
Purpose - Clinical approbation of advanced cataract surgeries: assessment of indications and contraindications, surgery effectiveness, patients’ selection.
Method. 16 eyes of 8 patients aged 50-70 underwent phacoemulsification with the help of multifocal (AcrySof Restor-Alcon) or accommodative (Tetraflex-Lenstec) IOLs.
Results. UCVA before the operation was <0.2 in all the cases, after the operation UCVA ranged 0.8-1.0 and SE from -0.5 to +0.5 D. In spite of presbyopic age, none of the patients needed glasses for reading.
20. PETRIASHVILI E., KARCHAVA G.
PARAMETERS of radionuclide Migration in the SOIL AS HYGIENIC/SANITARY INDICES OF POLLUTION
J. Experimental and Clinical Medicine, 2008, 1, pp. 64-66.
Sokhumi State University, Faculty of Exact and Natural Sciences, Georgia
Radionuclide migration in different soil types and their effect on the population of west Georgia indicate that transition of radionuclide from the surrounding into plants is connected with the contents of potassium and calcium in the ground. Presence of radionuclide in the soil of all types suggests that nature TAKES slack paces similar to that in the nuclear reactor that requires the annual study of physico-chemical parameters of this soil type.
21. DVALI M., KHOMERIKI T.
LAcrimal Plugs In Dry Eye Syndrome
J. Experimental and Clinical Medicine, 2008, 1, pp. 66-67.
Tbilisi State Medical University, Georgia
Today, the dry eye syndrome is one of the pathologies widely spread throughout the whole world - it has attracted great interest of ophthalmologists.
According to the literature, 8 million Japaneses and 10 million Americans suffer from the symptoms of this syndrome, of which the main are: irritation, feeling of a foreign body or sand in the eye, itching, blurring of vision.
If dryness degree is high, and the frequency of instillation of artificial tears is high enough, it makes the patient uncomfortable. Nowadays, widely used are lacrimal plugs of various forms and sizes, made of different materials. There are 2 types of lacrimal plugs: short-term - collagen (for 3.6 months) and permanent – silicone, hydrophilic/hydrophobic acrylic polymer plugs.
190 lacrimal plugs of different types have been implanted at our clinic for the last 2 years: short-term - collagen – 28 and permanent - silicone – 32, hydrophylic - 62, hydrophobic - 68.
Our experience displayed the advantage of hydrophobic acrylic polymer plug (Smart Plug) – it’s easily implanted and highly efficient.