EXPERIMENTAL  &  CLINICAL  MEDICINE

2007, № 2

1. P. Lunkenheimer1, K. Redmann 1, C. Cryer2, R. Batista3, J. Stanton4,

    P. Niederer5, R. Anderson6

THE DISPARATE INSTANTANEOUS RESPONSE OF THE VENTRICULAR MUSCULATURE TO Я-BLOCKADE AT LOW DOSE

J. Experimental and Clinical Medicine, 2007, 2, pp. 9-16.

Klinik und Poliklinik fьr Thorax-, Herz und GefдЯchirurgie1, Institut fьr Numerische Mathematik2 Universitдt Mьnster, Germany;

Dept of Cardio-Thoracic Surgery, Hospital Geral de Roraima3, Universidade Estadural de Roraima Boa Vista, Brazil;

Dept of Cardiothoracic Surgery, Pretoria Academic Hospital4, Pretoria, South Africa;

Institut fьr Biomedizinische Technik5, ETH und Universitдt Zьrich, Switzerland;

Cardiac Unit, Institute of Child Health6, University College, London, UK.

The ventricular mass is organized as a myocardial mesh, with populations of aggregates with oblique intruding alignment working in an antagonistic fashion compared to those with tangential alignment. Prompted by results from animal experiments showing a disparate response of the two populations of aggregates to negative inotropic medication, we sought to establish whether the aggregates intruding in oblique fashion are more sensitive to Я-blockade than the prevailing population, which is aligned in tangential fashion. This mechanism might help to explain why drugs blocking the Я-receptors improve function of the ventricular pump in the setting of congestive cardiac failure.

On 13 patients studied during open heart surgery, we implanted needle probes to measure forces generated in the ventricular wall, coupling the probes either to myocytes aligned in tangential fashion, or to those intruding obliquely. In a first series of patients, we injected intravenously a total bolus of 40 to 100 mg esmolol, while in a second series, we gave 5, 10, and 20 mg esmolol in three separate boluses.

Forces recorded in the tangentially aligned aggregates decreased insignificantly upon administration of low doses (57.1±12.4 -> 56.6±7.6 mN), whilst forces recorded in the obliquely intruding aggregates in the mean showed a significant decrease (59.3±11.6 -> 47.4±6.4 mN).

The markedly disparate action of drugs blocking Я-receptors at low dosage seems to be related to the disparate amount and time-course of systolic loading of the myocytes depending on their alignment.

2. G.KHECHINASHVILI *, K.OMIADZE**, K.MACHAVARIANI**, N.MITSKEVICH***, M.GEGIA*

PECULIARITIES OF IgE REGULATION AND DELAYED HYPERSENSITIVITY TO TUBERCULINE DURING ACTIVE PULMONARY TUBERCULOSIS, BRONCHIAL ASTHMA AND OTHER FORMS OF ATOPY

J. Experimental and Clinical Medicine, 2007, 2, pp. 16-24.

Georgian fund of tuberculosis and pulmonary diseases*,

Department of allergology and clinical immunology of Tbilisi State Medical University**,

Department of immunology of Iv. Javakhishvili Tbilisi State University***, Georgia

There were examined 75 patients with pulmonary tuberculosis, 40 patients with bronchial asthma and other forms of atopy and 42 patients with pulmonary tuberculosis and accompanied atopic pathology.

With the purpose of determination of general IgE content in blood serum, there was used the immunoenzyme (ELISA) test system with the purpose to determine the onset of latent tuberculous infection and to estimate the quality of specific response of cellular immunity, there was used hypodermic tuberculin (Mantus) test.  The examination was conducted before initiation of treatment and after termination of its whole course.

There was used Epi-Info (Version 3.3.2., Atlanta, USA) computer program for statistical treatment of research material.

It was determined: 1) Tuberculous infection has potential properties of influence and delayed hypersensitization on the IgE adjusting gear.

2) At the time of combination of tuberculosis and atopic disease, this infection has ability to extend the IgE regulation abnormality habitual for atopic pathology. The aforesaid phenomenon did not influence on clinical course of tuberculosis or atopic diseases, therefore its estimation as negative phenomenon must be groundless.

3. Z.ZARNADZE, I.KORINTELI, G.CHAXUNASHVILI, M.INASARIDZE, N.CHANTURAIA

NEUROSONOGRAPHY OF THE PRE-TERM NEONATE

J. Experimental and Clinical Medicine, 2007, 2, pp. 24-27.

TSMU pediatric clinic, Tbilisi, Georgia

Although real-time sonography is an excellent imaging modality for the neonatal brain, examination of the adult brain has been limited.

Neurosonography is the application of ultrasound technology to the diagnosis and follow-up of lesions of the brain and meninges, spinal cord and canal, carotid arteries, eye and orbit.

This study sought to determine the frequency of clinically significant abnormal findings on neuroimaging using neurosonography (NS) in infants.

4. ZAKARAIA Ts., NAVDARASHVILI A., MOSIDZE A., CHIKOVANI T., KAJAIA M., BARNABISHVILI N., JAVAKHISHVILI G.

COMPARATIVE CHARACTERIZATION OF BRUCELLOSIS SERODIAGNOSIS

J. Experimental and Clinical Medicine, 2007, 2, pp. 27-28.

S.Virsaladze Research Institute of Parasitology and Tropical Medicine, Tbilisi, Georgia

Brucellosis still is a  widespread zoonosic disease in Georgia. Several immunological tests: Brucelloslide test, Heldson, Write tests and enzime immunoassays for the determination of IgM and IgG antibodies against Brucella have been studied in 100 patients. Sensitivity and specificity were calculated. The sensitivity and specificity of Write and Brucelloslide tests were 100%. The sensitivity of Heldson was 100%, but the specificity of Heldson – 98%.

5. JAFAROV CH., HAJIYEV N.

SURGICAL TACTICS IN LUNG ECHINOCOCCOSIS

J. Experimental and Clinical Medicine, 2007, 2, pp. 28-30.

General Surgery Department, AMU, Baku

There were analyzed the results of surgical treatment of 74 patients with lung echinococcosis. A complicated form of the disease was noted in 40 (54.1%) patients. Diagnosis was estimated by means of complex basic clinical, laboratorial and instrumental methods of investigation. In 61 (82.4%) patients diagnosis was established by means of X-ray investigation. For differential diagnosis of parasitic cyst CT was applied to 13 patients. All the patients were operated. Organ-retaining operations were possible for 56 (75.7%) patients. Lung resection was carried out in 18 cases (24.3%): 7 of them were segmental, 11 - lobectomy.

6 patients with double sided lung lesions were operated consecutively from each side with 1.5-4 months interval.  Different postoperative complications were noted in 23%. 2 of 74 operated patients died.

6. CHOMAKHASHVILI Z., PUTKARADZE M., BERIDZE A., KHAZHALIA T., MIKELADZE S., TSETSKHLADZE D., PUTKARADZE S.

MORPHOLOGICAL CHANGES IN SPLENIC AUTOTRANSPLANT AND THEIR ADJUSTABILITY TO THE IMMUNE CHANGES IN SPLEEN (AN EXPERIMENTAL STUDY)

J. Experimental and Clinical Medicine, 2007, 2, pp. 30-35.

Batumi Scientific-Practical Centre for Clinical Morphology, Georgia

The present article researches interrelations between morphological changes in splenic autotransplant and immune changes. The authors used parallel research methods. Based on the conducted research, the authors prove that splenic autotransplantation is a rational method for correction of postoperative immune deficit. The method makes it available to completely correct negative changes that have occurred due to splenectomy by the 180th day after the operation. Considering that immune and morphologic changes occur simultaneously after autotransplantation, it allows a doctor to view all morphological changes in the transplant without a special research.

7. SHERVASHIDZE M., TSABUTASHVILI A., BARABADZE K., AKHVLEDIANI I.

THE EXPOSURE OF RISK-FACTORS IN CHILDREN WITH RECURRENT RESPIRATORY TRACT INFECTION

J. Experimental and Clinical Medicine, 2007, 2, pp. 35-38.

Iv.Javakhishvili Tbilisi State University, Chair of  Pediatrics; I.Pagava Research Institute of Pediatrics,  Tbilisi Georgia

Recurrent lower and upper respiratory tract infections in children and adults constitute a major global health problem. The goal of our study was to expose the attributable risk (AR) and Odds Ratio in children with recurrent respiratory tract infections. 200 children were under the observation (100 - healthy, 100 - with recurrent respiratory tract infection). The age of the children ranged between 1-6 years. The study was conducted by simple randomization (“case-control”-method). Statistical analysis was carried out on the basis of SPSS v. 10. Program. The result of our study is given in the table.

The risk factors of recurrent respiratory tract infections are: cigarette smoking, asphyxia, pathological pregnancy, pathological child-birth and artificial feeding.

8. E.KHARKHELI,  Z.KEVANISHVILI, O.DAVITASHVILI

ACUTE VESTIBULAR DYSFUNCTION: DIAGNOSIS AND TREATMENT CASE HISTORY

J. Experimental and Clinical Medicine, 2007, 2, pp. 38-41.

Centre of Audiology and Hearing Rehabilitation, Tbilisi, Georgia

Vestibular dysfunction remains an actual problem of the medicine. Vertigo, nausea, vomiting, nystagmus, postural instabilities are its principal manifestations. The success in the treatment of vestibular abnormalities depends on the precise diagnostics. Different tests and procedures are utilized for this purpose. Unfortunately, due to similarity of the symptoms of peripheral and central vestibular disorders the determination of a site and extent of vestibular lesions is sometimes complicated. In ambiguous cases other methods, e.g. magnetic resonance imaging, MRI, computer tomography, CT, and dopplerography of blood vessels are being applied. We will review here a characteristic case history of the patient suffering from the vestibular dysfunction.

L.O., a 29-year-old female, returning home after the work suddenly became a dizzy. She staggered to the bathroom and vomited repeatedly. During following 48 hours she suffered from vertigo, dizziness, nausea, and vomiting. The symptoms subsided when she remained motionless in the bed. After 48 hours, she addressed our institution. Otoneurological approaches for the initial inspection included hearing investigation, electronystagmography, ENG, and movement coordination procedures. A special questionnaire has been filled in parallel, describing the history and essence of complains. On the next day she returned for dopplerography and MRI, her earlier symptoms was being persisted.

9. SHIOSHVILI D., SHIOSHVILI T.

ELABORATION OF AN IMPROVED METHOD OF NEPHROPTOSIS SURGICAL TREATMENT IN EXPERIMENTS ON DOGS

J. Experimental and Clinical Medicine, 2007, 2, pp. 41-45.

Department of Urology, Tbilisi State Medical University, Georgia

Objectives: The aim of this work was the elaboration of experimental model for more reliable nephropexy.

Materials and methods: Experiments were performed on thirty-five mongrel dogs divided into three groups. In the first group of dogs the right kidney was separated under general anesthesia, in its subcapsular tunnels the Tension-free Vaginal (TV) tape made of polypropylene was inserted and knotted to the 12th rib. The excretory function and micromorphological state of the kidneys were being examined during six months. In the second (control) group only subcapsular tunnels were created followed by micromorphological examination of the kidneys. In the third group after fixing the kidney, as described above, the durability of fixation was evaluated by means of a dynamometry.

Results: The TV tape inserted subcapsularly and knotted to the 12th rib caused a light aseptic inflammation which resulted in the firm adhesion of the tape to the fibrous capsule and the external surface of the kidney and their safe fixation which can stand an effort up to 6.6±0.4 kg.

Conclusion: The above-described method of nephropexy can be recommended for clinical use by means of open, laparoscopic or retroperitoneoscopic approaches.

10. GVAZAVA T. MARGVELASHVILI B.

EPIDEMIOLOGICAL PARAMETERS OF DISEASES OF A MUCOSA OF AN ORAL CAVITY

AT A HAEMOPHILIA IN GEORGIA

J. Experimental and Clinical Medicine, 2007, 2, pp. 45-47.

G..Mukhadze Institute of Hematology and Transfusiology, Tbilisi, Georgia

On the basis of the research of 224 patients with various forms of hemophilia, aged 2-64 years (from the contingent of the Research Institute of Hematology and Transfusiology), there has been studied the structure of the inflammatory diseases of mouth mucosa during hemophilia in Georgia. The research material was statistically treated with the help of the package of applied programs SPSS 11.5.

The prevalence of gingivitis in the population of the hemophilic patients in 2002 made up 72.32%, the percentage of paradontosis was 37.50%; in 2005, the prevalence of gingivitis was 80.72%, paradontosis made up 77.10%, parodontitis – 30.12%. The highest index of angiostaxis was detected in Tbilisi. Among the regions dominated Imereti, Qvemo Kartli, Shida Kartli. There were noted no significant differences in the diseases of oral cavity mucosa. In the group of A-form hemophilia the highest parameter of the oral cavity diseases is detected for paradontosis, and in B group – for parodontitis; the lowest – in A-form group – for gingivitis and in B group – for paradontosis.

Parodontitis, paradontosis, and gingivitis do not show any significant correlation with the forms of hemophilia.

11. ARABULI M., KHECURIANI R., KHOMERIKI  C., KIPHIANI T., SANIKIDZE T.

AGE-RELATED CHANGES IN THE ACTIVITY OF THE ERYTHROCYTE ANTIOXIDANT ENZIMES

J. Experimental and Clinical Medicine, 2007, 2, pp. 47-49.

Tbilisi State Medical University, Georgia

The objective of the research was to study age-related changes in the activity of the erythrocyte antioxidant enzymes. Studies have been conducted for three age groups: newborns (umbilical cord blood), adults (22-30 years old) and the elderly (75-89 years old). Based on the results, we can assume that the activity of antioxidant enzymes is higher in the erythrocytes of elderly persons than in newborns. The insufficiency of the antioxidant system is conducive to intensive formation of methemoglobin in newborns’ blood. The increasing activity of the antioxidant enzymes SOD, GR and G-6-PDG of aged persons seems to be a compensatory mechanism against excessively reactive oxygen in old age, and this process ensures the maintenance of hemolysis intensity within physiological ranges.