[Investigation of metabolic paramagnetic centers in the blood of patients with prostate adenocarcinoma prior to and after the plastic orchectomy].

Paramagnetic centers in the blood of patients with prostate adenocarcinoma have been studied prior to and after plastic orchectomy by EPR. It has been shown that significant alterations in blood paramagnetic centers occur after the surgery. These alterations point to an improvement of antioxidant properties of the blood. Specifically, the content of the Fe(3+)-transferrin complexes increased, and the number of inactivated adrenoreceptors, MetHb, and Mn(2+)-containing complexes decreased. It was found that, along with improvement of the antioxidant properties of the blood, a significant decrease in the intensity of lipid peroxidation in the blood of the patients occurs.

[Kidney protein complexes that inhibit gene expression in the nuclei of homotypic cells].

The comparative study of protein complexes (PCs) isolated by alcohol extraction from white rat and human nephrocytes (post-operational material) have been performed. It has been shown that PCs of white rat cells inhibit RNA synthesis in the nuclei of intact as well as nephrectomized (unilateral nephrectomy) animals. The same effect has been shown while studying the PCs of patients with hydronephrotic kidneys. At the same time the inhibition of transcription has not been detected in case of RCC kidney cancer cell PCs. The chromatography studies revealed that the active component of PCs (12 kDa protein factor) which had been detected earlier has not been shown up in cancer cells of human kidney.

[Effects of nebivolol on endothelial dysfunction in patients with diastolic dysfunction of left ventricle].

The aim of our research was to assess the role of vasoactive factors of endothelium (NO and endothelin-1) during diastolic dysfunction of the left ventricle and to determine the effects of nebivolol in the early treatment period of endothelial dysfunction. In the investigation were included 36 male patients (mean age 49+/-6 years) with LVDD due to CAD (22 patients) and essential hypertension (14 patients) as well as in 18 male patients (control group, 12 patients with CAD and 6 with hypertension) without LVDD of matched age, who underwent 2 week treatment with 5 mg nebivolol (Nebilet, Berlin-Chime) . The endothelial dysfunction was assessed by (a) a noninvasive method, brachial artery ultrasound during reactive hyperemia, measured by flow-mediated vasodilatation (FMD), which indirectly reflects the amount of NO and (b) measurement of the amount of ET-1 in the plasma by method of an enzyme-linked immunoassay (ELISA). According to the results of our studies FMD (%) was increased by 73% among the patients with DD of LV whereas among the patients without DD was increased by 66% (p<0,05). Furthermore, statistically none significant decrease of endothelin-1 levels were observed and no difference was found among the groups of patients. Importantly, statistically significant increase of early ventricular filling was found: E/A ratio with Doppler echocardiography at the end of 2 week period treatment reached 1,10+/-0,04 vs. 0,92+/-0,01 before the treatment (p<0,05). Positive correlation was found between FMD (%) and the relaxation capability of the left ventricle (r=0,38, p<0,05). Based on these results we can conclude that endothelial dysfunction might be indicator of LVDD, and by treating the former we can prevent the diastolic dysfunction.

[Sensitivity of PCR method for detection of mycobacteria tuberculosis in patients with lung tuberculosis].

Both hospitalized patients and outpatient clinic patients at the National Centre of Tuberculosis and Lung Diseases of Georgia have been investigated. The group of patients with the tuberculosis of urogenital system, has been studied (newly detected cases), 70 cases in total. The examination of the urine was carried out by the Polymerase Chain Reaction (PCR) method in order to detect Kochi bacillus and by three-time bacterioscopy of urine on acid resistant bacterium. Mycobacterium tuberculosis in urine has been detected in 57 (81,43%) patients by PCR method, and by urine bacterioscopy acid fast bacilli (AFB)(+) in 36 (51,43%) patients. 50 hospitalized patients were examined as a separate group. They had the tuberculosis of lungs and insignificant pathological changes in urogenital system. Among them there was active bacillus secretion in 45 cases by phlegm bacterioscopy AFB(+). Out of 50 patients the mycobacterium tuberculosis in urine was detected in 30 (60%) cases by PCR method. It should be mentioned that according to the urine two-time bacterioscopy, carried out on 50 patients, has not been detected AFB(-) bacillus secretion. It may be concluded that the PCR method is advantageous in detecting of Kochi bacillus in urine. Introduction of this method in medical practice will give us the possibility to determine the risk-group for development of tubercular changes in urinary system associated with lung tuberculosis, in order to control such patients and to carry out the adequate urological examinations.

[Detection of mycobacteria tuberculosis in patients with urogenital tuberculosis by PCR method].

The study was carried out in hospital patients as well as in outpatients at the National Centre of Tuberculosis and Lung Diseases of Georgia (2002-2004). The group consisting of 32 patients with tuberculosis of urogenital system has been studied (newly detected forms). Except clinical laboratory, culture and X-ray contrast methods, two additional methods were used in testing of this group of patients. The examination of their urine, at the same time, was carried out by the Polymerase Chain Reaction method in order to detect Kochi bacillus and by three-time bacterioscopy of urine for acid resistant bacteria. Mycobacterium tuberculosis in urine has been detected in 26 (81,25%) patients by PCR method, and by urine bacterioscopy--acid fast bacilli (AFB+) in 18 (56,25%) patients. The histo-morphological investigation of specimens obtained by surgery confirmed the TB diagnosis in all patients. This study on patients suspected of Tuberculosis of genital-urinary system gives us an opportunity to update the diagnostic algorithm by including the modern molecular methods. This algorithm will help in timely detection of Tuberculosis, in selection of adequate therapy and in prevention of the further progression of the disease.

[Comparative study of the influence of renal endogenic factors on the proliferation activity of epithelial cells].

The proliferation activity of monolayer culture of Madin Darby Canine Kidney (MDSK) cells is suppressed by a thermostable protein factor of renal tissue of white rats and of humans. Under the influence of renal factors (RF), a decrease in cell number, and suppression of DNA synthesis and mitotic activity in MDCK cells occur. The inhibition of proliferative activity of cultured cells under the influence of RF was substantiated also by MTT assay. It was established that the inhibitory influence of RF is stipulated by suppression of RNA synthesis. It follows that RF may inhibit division of MDCK cells via suppression of gene expression in G1-phase. Similar factors were obtained from renal cells of different systematic groups of organisms (snail, frog, fish, pigeon, guinea pig, swine).

[The results of the diversion of urine into a large-intestine reservoir]. / Rezul'taty derivatsii mochi v tolstokishechnyi rezervuar.

Cystectomy for bladder cancer with derivation of the urine into the colon was performed in 35 patients (30 males and 5 females). Postoperative lethality was 11.4% (4 patients). The best outcomes in cases of partial and/or complete failure of the ileocecal valve were obtained when forming the invaginate in the stomal ileum. Examination following the surgery was conducted in 31 patients. Of them, preoperative passage from the upper urinary tracts was impaired in 22 (71%) because of the tumor spread into the ostium urethritis. Postoperative defect from the upper urinary tracts was recorded in 7 (22.6%) patients, while normal function of the kidney was registered in 24 out of 31 patients (77.4%). A complete retention of the urine was achieved in 27 of 31 patients (87.1%). With time, the capacity of the colon reservoir increased up to 750 +/- 57.9 ml to the end of the second postoperative year. The right part of the colon, cecum or ascending colon as well as the proximal third of the transverse colon as the reservoir served satisfactorily.

[A method for forming a large-intestine reservoir for the urine]. / Metodika formirovaniia dlia mochi tolstokishechnogo rezervuara.

Eighteen patients with cancer of the urinary bladder underwent cystectomy with formation of a large intestinal reservoir for urine. The terminal large intestinal portion, 15-20 cm, the cecum, the ascending colon, and the hepatic angle of the colon were excluded to produce a reservoir from the intestinal tube. Appendectomy was performed. The continuity of the intestinal tube was restored via ileotransversostomy. The ureters were retroperitoneally grafted into the cecum by using antireflux and antistricture techniques. The ileocecal valve was clinico-anatomically examined. A device restraining urine was formed on an individual basis in relation to the function of Bauhin's valve. Cutaneous urinostoma ("dry") was formed epicutaneously in the right iliac region below the umbilicus. Three patients died in the postoperative period. Complete urine keeping was observed in 14 of 15 patients. The maximal capacity of the reservoir is 500 ml, the pressure is 30-40 cm H2O. Homeostasis and intestinal function were found to be normal.