J.EXPERIMENTAL  &  CLINICAL  MEDICINE

2019, ¹ 1

 

1. N.GONGADZE, L.GABUNIA, M.GVISHIANI, M.MAKHARADZE, M.MIRZIASHVILI

DIURNAL VARIABILITY OF ENDOTHELIAL FUNCTION IN CARDIOVASCULAR DISEASES

Tbilisi State Medical University, Departments of Medical Pharmacology and Therapy N3, Georgia

J. Experimental and Clinical Medicine, 2019, 1, pp-9-16

 

The endothelium function may undergo to time-dependent changes by production of vasoactive agents modulating vasomotor responses, including vasodilatory compounds-prostacyclin, nitric oxide and endothelium derived hyperpolarizing factor, as well as vasoconstrictive substances, such as endothelin-1 (E-1) and endoperoxides. Endothelium dysfunction is associated with an impairment of endothelium-dependent relaxing responses and an enhanced sensitivity to vasoconstrictors. Disrupted circadian rhythm of endothelium function have been implicated in the genesis of different cardiovascular diseases encompassing arterial hypertension, myocardial infarction, cardiac arrhythmias and sudden death.

It has been shown that endothelium dependent vasodilation is subject to a time of day variation which acts as a cardioprotective mechanism to counteract potentially adverse time-dependent changes in hemodynamic parameters, including thrombosis and fibrinolysis. Circadian fluctuation of endothelial function also was described in coronary heart disease, involving of ICAM-1, VCAM-1 and E-Selectin, activated by cytokines – TNF alpha and IL-1. It is believed that circadian variation of E-1 plasma levels is one of the most likely mechanisms involved in reduction in the ischemic threshold in the morning period. Some reports indicate that the hormone melatonin may contribute in part to the diurnal variation in vascular function. It is postulated that disorders in diurnal rhythm of endothelium function may be prediction of increase risk of cardiovascular diseases.

 

2. 1B.CHAKHVADZE, 2E.FEDOTOVA

SURGICAL TREATMENT OF MALIGNANT TUMORS OF THE SMALL INTESTINE

1Quality Assurance Department at Health Center ,,Medina”, Department of Surgery at Batumi Republican Clinical Hospital, Batumi, Georgia;

2Professor of the Russian Academy of Natural History, Northern State Medical University. Arkhangelsk, Severodvinsk City Hospital #2 of Emergency Medical Care, Russia.

J. Experimental and Clinical Medicine, 2019, 1, pp-16-22

 

A review of the literature and 2 author’s observations of primary malignant mesentery tumors of the small intestine is presented. There is a rarity of pathology and the absence of a distinct clinical picture. The main clinical sign is the presence of a palpable tumor. In both observations, the tumors simulated ovarian cystomas. The final diagnosis is made during surgery. Radical removal of tumors were performed. A long-term period was followed up within 4 years after the operation in one patient - there is no data for metastasis and recurrence of the tumor.

 

 

3. M.I.BAYRAMOV, J.M.IBRAQIMOVA

NERVOUS PLEXUS SYMPATIC FIBERS OF OVARIAN ARTERIES

OF WHITE RATS

The department of Human anatomy and medical terminology, Azerbaijan Medical

University; Academician A.Garayev Institute of Physiology of Azerbaijan

National Academy of Sciences, Baku, Azerbaijan

J. Experimental and Clinical Medicine, 2019, 1, pp-22-24

 

The purpose of investigation was study of sympatic nervous structure in wall ovarian arteries of white rats.

Investigation were carried out on 11 female white rats. Sympatic nervous been studied by method of V.N.Shvalov and N.I.Juchkova.

The hystochemical research showed that the wall ovarical arteries of white rats have the good developed sympatic nervous. Noradrenergic nervous structure consist of the fiber different diametres. In wall of ovarian arteries around adventisial shell be found fiber basic large diameter. But in the subadventisial layer be found sympatic fiber, basic middle and little diameter. In the plexus around adventisial layer in wall ovarian arteries dispose usually more even.

 

 

4. N.PAVLIASHVILI, N.GAMKRELIDZE, N.BEZHITASHVILI, M.TOPURIDZE, D.DELIBASHVILI

EFFECTS OF RBC RESISTANCE AND HEMATOCRIT CHANGES ON BLOOD RHEOLOGY DURING CRUSH SYNDROME

Department of Pathophysiology, Tbilisi State Medical University, Georgia

J. Experimental and Clinical Medicine, 2019, 1, pp-24-28

 

The purpose of the research was to determine the role of erythrocytes mechanical and osmotic resistance, the role of hematocrit changes in microcirculatory disturbances during crush-syndrome.

The experiment was conducted on 200-250 gr. mass 60 rats. The modeling was conducted in different regimens of compression and decompression periods.

The results showed that in compression and especially in the decompression period RBC mechanical and osmotic resistance is decreased along with the increase in the hematocrit ratio, causing profound disturbances of blood rheological properties and microcirculation.

 

5. B.CHAKHVADZE, A.BERIDZE, T.CHAKHVADZE

TAR-PLASTIC

I.Borchashvili Health Center “Medina”, Batumi, Georgia

J. Experimental and Clinical Medicine, 2019, 1, pp-28-34

 

The surgical treatment of large stomach hysteria is still very important today. The main goal is to avoid compartment-syndrome and functionally optimal reconstruction.

Purpose of the work: Improve the results of surgical treatment of large stomach ulcers (W3-4) patients using TAR (transverses abdominis muscle release) method of rear septic plasma.

Materials and methods. The results of three surgical surgical treatment, which have large stomach (W3-4) hernias, are presented. All three patients underwent rear septic plastics using TAR method. In two cases, full reconstruction of the abdominal wall was carried out, in the case of a very large amount of postoperative hernia, and in addition to proper diagnosis of muscles, it was necessary to conduct omentectomy and so on, bridging technique to use.

Results. Postoperative results were satisfactory. There was no place for the development of the ischemia of the compartment-syndrome or the abdominal wall of the abdomen. The functional results of the plastic were satisfactory.

Conclusion. The selection of a hernia plastic method for ventral hernings should be individual for each patient, but the use of rear septic plastics, especially the TAR method, allows for the optimal - anatomical and physiological reconstruction of the abdominal wall.

 

6. E.MIRZIASHVILI, N.CHUMBURIDZE-ARESHIDZE, Z.AVALIANI, S.MARDALEISHVILI, T.AVALIANI, M.MIRZIASHVILI

OCULAR SIDE EFFECTS OF ANTI-TUBERCULOSIS DRUGS

National Center for Tuberculosis and Lung Diseases, Tbilisi, Georgia

J. Experimental and Clinical Medicine, 2019, 1, pp-34-37

 

Medications used to treat multidrug-resistant and regular TB, namely Linezolid and Ethambutol, cause loss of vision, changes in the retina and lenses. Toxicity can adversely affect the vision and leads to irreversible alterations. It is essential to calculate drug dosage accurately, or replace prescribed medicines with the drugs that will not affect vision and the condition of lenses and retina.

 

7. A.GAPRINDASHVILI, D.BERASHVILI, G.MIKAIA, N.ANTELAVA,

K.MULKIJANIAN, A.BAKURIDZE

PHARMACOTECHNICAL EVALUATION OF CLAYS SPREAD IN ADJARA REGION

Tbilisi State Medical University, Georgia

J. Experimental and Clinical Medicine, 2019, 1, pp-37-43

 

Georgia is reach of useful endemic resources, which are not untapped but is not studied also. Their reveal, study and develop using methods is one of the most important issues as in Modern Medicine also in Cosmetology. No one from the Earth’s resources has such a broad, important and versatile use as clays. They  are widely used in medicine and cosmetology – as a natural as well processed form, they are used: in Balneology and Resorts Therapy, for treatment of bone-joint and rheumatic disease, various types of skin diseases, besides it’s very interesting to use them as an auxiliary means and a base in various soft and solid medicinal forms.

Adjara is one of the most interesting regions of the clay resources. Here, a local population and many tourists use clays arbitrarily, despite the fact that their chemical composition and medical properties have not been studied and it’s only on the traditional medicine level. In the literature available to us, we have not found the data about the clays widespread in Adjara Region. That’s why the most actual problem in medicine and pharmacy is to research the clays widespread in Adjara for further usage in medicine and cosmetology.

At this stage of study, our purpose was: to evaluation pharmacotechnical features of clays spread in Adjara. In particular, we determined: the fractial content and particle size of samples, density, humidity, fluidity, Petrographic studies and X-ray diffraction, consistence of micro and macro elements, existence of amino and fatty acids. After this was separated clay Beshumi and was studied its Antimicrobial activity and safety and general toxicity on rets and white mice. Has been developed method of preparation Emulgel on base of clay Beshumi, and was researched its pharmacological activityon the model of the mouse skin thermal burn. Established that clay Beshumi has antimicrobial effect and is not characterized by local action: acute and subtle toxicity, local irritation, allergic, harmful and systemic action on internal organs.

 

8. T.KVARATSKHELIA1, L.TSIKLAURI2

BIOAVAILABILITY ENHANCEMENT OF BIOFLAVONOID USING BIODEGRADABLE POLYMERIC MATERIALS

1St. Andrew the first-called Georgian University of the patriarchate of Georgia,

2TSMU I.Kutateladze Pharmacochemistry Institute, Tbilisi, Georgia

J. Experimental and Clinical Medicine, 2019, 1, pp-43-48

 

Several polymers have been reported to modulate drug absorption by inhibition of intestinal P-glycoprotein (P-gp). The aim of the present study was to study the effect of different polymers on the intestinal absorption of nephroprotective bioflavonoid Kaempferol 3-robinoside 7- rhamnoside (KRR). Our previous investigations suggested that P-gp, located in the intestinal epithelial cells may be responsible for enhanced efflux and decreased influx of KRR in Caco-2 cell lines. 

The permeation enhancing effect of polymers on tested compound could be shown via the transport studies on Caco-2 cell monolayers. In experiments were used polymer systems such as chitosan-glutathione, Polyacrylic acid - glutathione and glutathione alone. The reversible effects on barrier properties and opening the intestinal tight junctions of KRR alone or in co-presence of polymers were investigated by measuring the transepithelial electrical resistance (TEER) values across the Caco-2 cells.

The transport experiments showed that absorptive transport of KRR in presence of chitosan-glutathione conjugate was 1.36-fold improved and basolateral to apical efflux was significantly decreased (2.79±0.91 fold) than pure KRR. Contrariwise, the glutathione and Polyacrylic acid - glutathione showed no significant effect at all.

Combination of KRR with poly(acrylic acid)-glutathione conjugate reduced the TEER value by opening the tight junctions more substantially (76%) than with glutathione modified chitosan (80%) or glutathione (84%). Removal of compounds caused a gradual reaper of TEER indicating that the loss of barrier integrity was a reversible process.

These data suggested that chitosan-glutathione conjugate showed promising results and could promote transport of tested flavonoid across the Caco-2 cell monolayer.

 

 

9. E.PAATASHVILI, P.IMNADZE, L.JABIDZE

FACTORS AFFECTING IMMUNIZATION COVERAGE IN GEORGIA

Iv.Javakhishvili Tbilisi State University, Faculty of Medicine, Tbilisi, Georgia

J. Experimental and Clinical Medicine, 2019, 1, pp-48-53

 

Immunization is the most cost-effective and accessible service of health carethat benefits millions of survived lives every year and prevents heavy illnesses globally. Georgia achieved significant progress and nowadays, immunization coverage for most vaccine-preventable diseases increased. However, the country still faces challenges with maintaining the targeted rate of 95 percent routine vaccination coverage and eliminate measles.

The qualitative research studied factors that influence uptake and delivery of vaccination services in the country and revealed the recommendations that are important evidences to strengthen immunization system.

 

10. L. GABUNIA, SH. KHETSURIANI, N. GAMKRELIDZE, L. SUJASHVILI, L. RUKHADZE

REVIEW OF IATROGENIC DISEASES OF DIFFERENT ORIGIN

Scientific Research Skills Center, Tbilisi State Medical University

J. Experimental and Clinical Medicine, 2019, 1, pp-53-57

 

Diseases of iatrogenic are different enough. They may arise after diagnostic, therapeutic, surgical and other types of intervention. Diseases can become the causative factor for patients’ morbidity, prolonged hospitalization and increased mortality rate.  Iatrogenic diseases are specifically spread among geriatric and low social income patients. Prevention of iatrogenic diseases is one of the major priorities of healthcare system which implies “first do no harm” principle.

 

11. T.KVARATSKHELIA1, L.TSIKLAURI2

THE TRANSPORT OF NEPHROPROTECTIVE BIOFLAVONOID THROUGH POLARIZED MONOLAYERS OF CACO-2 CELLS

1St. Andrew the first-called Georgian University of the patriarchate of Georgia,

2TSMU I.Kutateladze Pharmacochemistry Institute, Tbilisi, Georgia

J. Experimental and Clinical Medicine, 2019, 1, pp-57-61

 

Intestinal drug efflux mediated by P-glycoproteins (P-gp) is widely accepted reason for low or variable oral administration. Substrates of P-gp can be chemically diverse compounds such as flavonoids, alkaloids etc. The aim of the present work was to study the role intestine barriers on bioavailability of nephroprotective bioflavonoid Kaempferol 3-robinoside 7- rhamnoside (KRR). Permeation studies were performed using a human colon adenocarcinoma cell lines (Caco-2) as models of the intestinal epithelium. Apparent permeability coefficients (Papp) as well as efflux ratios (secretory Papp/ absorptive Papp) were calculated and compared with values gained from experiments with well-established P-gp inhibitor verapamil.

The transport experiments showed bidirectional permeability of tested compound across Caco-2 cells; the absorption of KRR in the secretory direction was an order of magnitude more than that observed in the absorptive direction. The co-presence of verapamil, the absorptive transport increased, while the secretory decreased. The study suggests that P-gp, located in the intestinal epithelial cells may be responsible for enhanced efflux and decreased influx of KRR in Caco-2 cell lines. In conclusion, the therapeutic efficacy of KRR may be improved by the use of excipients as absorption enhancers and multidrug resistance (MDR) modulators in formulations.

 

 

12. Ts.I.TSISKARISHVILI, A.KATSITADZE, N.V.TSISKARISHVILI,

N.I.TSISKARISHVILI, L.CHITANAVA

FEATURES OF THE CYTOKINE STATUS OF PATIENTS WITH ROSACEA

Tbilisi State Medical University:

Department  Dermatology  and  Venerology , Georgia

J. Experimental and Clinical Medicine, 2019, 1, pp-61-65

 

Rosacea is considered as a multifactorial disease with a significant number of exogenous and endogenous factors. The relationship of immune mechanisms with the clinical manifestations of the disease remains insufficiently studied. When conducting repeated histological and laboratory studies, it was established that rosacea is an inflammatory disease with activation of the processes of neoangiogenesis and vasodilation under the influence of vasoactive peptides. The most significant peptide is the vascular endothelial growth factor (VEGF), a cytokine that causes expansion and formation of new vessels.

The aim of the study was to establish the characteristics of the cytokine status and the value of the concentration of VEGF in patients with various clinical forms and the severity of rosacea. The study included 45 patients with rosacea aged 18 to 65 years old with a disease prevalence of 1 to 10 years. In all patients, the diagnosis was made on the basis of the main and additional clinical signs of dermatosis.

Patients were distributed according to the severity of the disease mild degree -15; moderate severity 25, patients with severe rosacea 5.

The mite Demodexfolliculorum was identified by microscopy. The concentration of cytokines (IL-2, IL-6, IL-8, VEGF) in patients with various clinical forms of rosacea was determined by enzyme immunoassay. The results were expressed in pg / ml. The control group consisted of 15 healthy individuals. Statistical data processing was performed using the Statistica for Windows 6.0 application package. Differences were considered significant at p <0.05. Analysis of the obtained results showed that endothelial dysfunction forms in the blood serum simultaneously with changes in the cytokine profile in all examined patients, and when the activity of the processes of angiogenesis is impaired, the angiogenesis activation factor accumulates in the bloodstream, and its content increases.

Thus, modern ideas about the molecular mechanism of rosacea development and the results of our research allow us to attribute this disease to the group of angioproliferative diseases, which are based on the activation of inflammation and angiogenesis.

 

13. T.MURTAZASHVILI1, N.MITAGVARIA2, K.SIVSIVADZE1

STUDY OF SAFETY AND EFFICCY OF CAMELIN EYE DROPS

 1Tbilisi State Medical University Faculty of Pharmacy;

2Ivane Beritashvili Center of Experimental Biomedicine; Tbilisi, Georgia

J. Experimental and Clinical Medicine, 2019, 1, pp-65-69

 

In the 50s of the XX century Dr. Benedict Maghlakelidze developed the preparation Camelyn on the basis of experimental and clinical trials. The author was receiving preparation on the basis of carbohydrate fraction, derived from natural honey.

Since 2006, five dosage forms of Camelyn have been registered on the Georgian pharmaceutical market. These forms are used for treatment of different diseases as immunomodulatory and antimicrobial agents.

In this paper is described, examination on safety of  Camelyn Eye Drops, which was conducted in the Biomedical Research Laboratory Biomed. Also has been done ant oxidative activity, which is basis of products efficacy.

Tests did not reveal lethal outcomes in either rabbits or white rats. No changes in integral and specific (or habitual) reactions were observed in behavioral tests in white rats.

Based on the results of performed studies and their qualitative and quantitative objective evaluations, we can definitely confirm complete ophthalmic safety of Camelyn eye drops application in both - rabbits and white laboratory rats.

 

14. N.G.KURDIANI,  N.T.TSAGAREISHVILI, G.A.MIKAIA, M.D.DADEGASHVILI, D.G.ZODELAVA

DEVELOPMENT OF PHAGOGEL - TOPICAL PREPARATION WITH ANTIBACTERIAL ACTIVITY

Department of Pharmaceutical Technology, Faculty of Pharmacy, Tbilisi State Medical University;

Nano BIO Test Laboratory, Tbilisi, Georgia

J. Experimental and Clinical Medicine, 2019, 1, pp-69-73

 

The bacteriophages, also known informally as the phages (term derived from Greek jagw”  - “to devour”)  are the viruses that selectively damage bacterial cells. One of the fields of application of the phages is an antibacterial therapy – an alternative to conventional antibiotic treatments for bacterial infection [1,3].

In recent years, there has been an increasing interest in  phage therapy: the species and strain specificity of  bacteriophages allows targeting  of specific microorganisms and makes it unlikely that harmless or useful bacteria will be killed when fighting an infection, thus ensures the preservation of normal microflora; the possibility to use mixture of phages with different specificity allows destruction of various bacteria simultaneously; their role is significant in the treatment of antibiotic-resistant infections; together with these, phages tend to be more successful than antibiotics in  penetration through polysaccharide layers of microorganisms [2,4,5].

 

15. S.KRAVEISHVILI, N.SHONIA, Z.SAKVARELIDZE, N.SAKVARELIDZE, N.ZAUTASHVILI

CHARACTERISTICS OF A DOWEL STUMP-LIKE ENCLOSURE MODELING IN CASE OF THE THIRD DEGREE OF PATHOLOGICAL DEPRECIATION

TSSU Department of Orthopedic Dentistry and the Sub-branch of Jaw-face Orthopedics, Phantom Orthopedic Dentistry; Dental Clinic Ltd “Dentalisi”, Tbilisi, Georgia

J. Experimental and Clinical Medicine, 2019, 1, pp-73-77

 

Perfecting the methods of the damaged crown of a tooth reconstruction is an ongoing issue.

Depreciation of the crown by 2/3 is often followed by the decrease of the cavity volume of the tooth.  Partial or total obliteration of the root canal (canals), caused by the lamination of the replaceable (irregular) dentine, in return complicates the process of producing the stump-like enclosure.

There is a relentless process of research on materials and methods to perfect the enclosure reproduction, which became the goal of this study.

As research material we chose the most commonly used material on the market of dentistry – polymer-monomeric self-solidifying plastic “Pattern Resin” LS (GS, Japan) and standard dowels - “unclip” (Dentsply Maillefer, Switzerland). As the comparing material we used the traditional modeling wax.

The results of the study demonstrated that during the III degree depreciation, in producing the faultless reproduction of the dowel stump-like enclosure, cast from chrome-cobalt, priority should be given to the polymer-monomeric self-solidifying plastic “Pattern Resin” LS (GS, Japan) and standard dowels - “unclip” (Dentsply Maillefer, Switzerland).