Tbilisi State Medical University

Tbilisi, Georgia

Tbilisi State Medical University ) is a leading medical eniversity in Caucasus Region. TSMU was founded as Tbilisi Medical Institute in 1918 and became the Faculty of Medicine within the Tbilisi State University in 1930. Tbilisi State Medical Institute was renamed to Medical University in 1992. Since that University operates as an independent educational institution. Wikipedia.

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Agency: European Commission | Branch: FP7 | Program: CP-FP | Phase: HEALTH-2007-2.2.1-10 | Award Amount: 4.29M | Year: 2009

The recent technical improvements for the study of the cytogenetic basis of disease have led to the identification of many microdeletion and microduplication syndromes. De novo copy number variants (CNVs) are seen more often than expected in autistic patients, and rare chromosomal aberrations are known to account for a small fraction of schizophrenia and bipolar disorder. Recurrent spontaneous mutations at multiple sites across the genome may be a prime cause of these disorders, and the reduced fertility associated particularly with autism and schizophrenia may, through selection pressure, maintain these variants at very low frequency. CNVs are large enough to be identified using cost efficient genome-wide search techniques, such as oligonucleotide arrays. In contrast, rare DNA mutations might confer a large proportion of the overall genetic risk, but cannot be easily identified at the present time. Genetic epidemiology suggests that autism, bipolar disorder, and schizophrenia are highly heritable and share susceptibility genes. However, the results of dense SNP array-based genome wide association scans for these disorders have been disappointing, as no high frequency risk alleles have been identified. The PsychCNVs consortium will apply oligonucleotide arrays for the large-scale interrogation of CNV variation in the human genome, focusing on people with autism and childhood onset schizophrenia and bipolar disorder, where CNVs are likely to be more common. This project follows on logically from our hypothesis-independent genome-wide SNP search for common variants, we now intend to systematically search for large, rare CNVs conferring high risk. The genetic risk conferred by CNVs will be estimated by genotyping samples from 2800 patients, to identify de novo or recent spontaneous mutations. Until low cost whole genome sequencing becomes available this approach offers the best current hope to identify causative genomic variants for these disorders.

Xiao J.,Shanghai Normal University | Xiao J.,University of Würzburg | Xiao J.,Anhui Academy of Applied Technology | Muzashvili T.S.,Tbilisi State Medical University | Georgiev M.I.,Bulgarian Academy of Science
Biotechnology Advances | Year: 2014

The natural flavonoids, especially their glycosides, are the most abundant polyphenols in foods and have diverse bioactivities. The biotransformation of flavonoid aglycones into their glycosides is vital in flavonoid biosynthesis. The main biological strategies that have been used to achieve flavonoid glycosylation in the laboratory involve metabolic pathway engineering and microbial biotransformation. In this review, we summarize the existing knowledge on the production and biotransformation of flavonoid glycosides using biotechnology, as well as the impact of glycosylation on flavonoid bioactivity. Uridine diphosphate glycosyltransferases play key roles in decorating flavonoids with sugars. Modern metabolic engineering and proteomic tools have been used in an integrated fashion to generate numerous structurally diverse flavonoid glycosides. In vitro, enzymatic glycosylation tends to preferentially generate flavonoid 3- and 7- O-glucosides; microorganisms typically convert flavonoids into their 7- O-glycosides and will produce 3- O-glycosides if supplied with flavonoid substrates having a hydroxyl group at the C-3 position. In general, O-glycosylation reduces flavonoid bioactivity. However, C-glycosylation can enhance some of the benefits of flavonoids on human health, including their antioxidant and anti-diabetic potential. © 2014 Elsevier Inc.

Nizharadze N.,Tbilisi State Medical University
Georgian medical news | Year: 2011

Local anesthesia forms the foundation of pain control techniques in clinical dentistry. Within the rich local anesthetic drugs available in dentistry for the prevention and management of pain 4% articaine solutions achieve highest level of anesthetic potency and lowest systemic toxicity in all clinical situations, prior to its superlative physicochemical characteristics and the pharmacological profile. These are - low lipid solubility, high plasma protein binding rate, fast metabolization, fast elimination half time; low blood level. Articaine inactivates in both ways: in the liver and the blood serum. It has good spreading through tissues. Thus, articaine seems to be the local anesthetic of first choice in tissues with suppurative inflammation, for adults, children (over 4), elderly, pregnant women, breastfeeding women, patients suffering from hepatic disorders and renal function impairment. In Articaine solutions (1: 200,000) epinephrine is in low concentration, thus in patients at high risk adverse responses are maximally decreased. In these patients articaine should be used with careful consideration of risk/benefit ratio. Articaine solutions must not be used in persons who are allergic or hypersensitive to sulphite, due to content of Sodium metabisulfite as vasoconstrictor's antioxidant in it. Incidence of serious adverse effects related to dental anesthesia with articaine is very low. Toxic reactions are usually due to an inadvertent intravascular injection or use of excessive dose. To avoid overdoses maximum recommendation dose (MRD) must not be exceeded and aspiration test always performed prior all LA injections. In these article we introduce new graphs providing a quick and effect way to determine maximum LA dose. If the overdose reactions develop, adherence to the basic step of emergency management with end to a successful outcome in virtually all cases.

Ratiani L.,Tbilisi State Medical University
Georgian medical news | Year: 2012

Several factors are contributing to menopausal hypertensión; the role of estrogens in patogénesis of hypertensión in menopausal women have not completely established. The aim of the present investigation was to study some aspects of the role of estrogens in the pathogenesis of hypertension during menopause. 93 women with hypertension, who are referred to the Central Clinic of Tbilisi State Medical University (Georgia) during 2009-2011 were investigated. Women were divided into 2 groups: 1 - reproducvtive age group (43 patients); 2 - menopause age group (50 patients). In each group we investigated estradiole, oxygen (O2-), lipid (LOO.) reactive species, NO and endotheline content and antioxidant enzymes (SOD, catalase, GR) activity. The results of study reveal increased of superoxide - and lipoperoxide - radicals, as well as of endothelin sontent in blood of menopausal women, while concentration of free nitric oxide decreased; at the same time activity of catalase increased (by 50%), GR reduced significantly (by 38%) and SOD's activity didn't change in comparision to reproductive aged group. Negative correlation between the HbNO and estradiole content in blood of reproductive aged women was established (r=-0,60, p=0.03); no dependence between these two parameters in menopausal aged women was revealed (r=-0, 29, p=0,12). It was concluded, that in women of reproductive age probability and risk of hypertension grows in the presence of additional risk factors, such as oxidative stress and/or fluctuations in estrogen's level towards insufficiency, which leads to reduction of nitric oxide content due to its oxidative transformation in peroxinitrite, or enhanced inclusion in HbNO complexes, whereas development of hypertension in postmenopausal women may develop by different mechanisms, might including inflammation.

Kikodze N.,Tbilisi State Medical University
Georgian medical news | Year: 2013

Type 1 diabetes (T1D) is an inflammatory disease of the pancreatic islet, in which insulin-producing β-cells are preferentially destroyed to varying degrees by the concerted action of autoreactive T-cells and monocytic cells. Th1-type cytokines (IL-2 and IFN-γ) correlate with T1D, whereas Th2 (IL-4 and IL-10), Th3 (TGF-β), and T regulatory cell-type cytokines (IL-10 and TGF-β) correlate with protection from T1D. An altered balance between the proinflammatory and regulatory T-cell responses, in which T regulatory cells lose the battle, leads to T1D. The aim of current study was to determine the role of CD4+CD25+ regulatory T cells and cytokines: IFN-γ, IL-6, TNF-α, IL-10, IL-4, IL-17 in pathogenesis of T1D.The study was carried out on 71 patients suffering from T1D at the department of endocrinology, Tbilisi State Medical University and Diabetic Children Association. The circulating levels of (IFN-γ, IL-6, TNF-α, IL-10, IL-4, IL-17) were determined by ELISA according manufactures' protocol (R&D Systems Inc., USA). Tregs - CD4+CD25+ frequency was determined on cytofluorometer (BD FACSCalibur flow cytometer, USA). Statistical analysis was performed by using STATISTICA 8.0 for PC (Statsoft Inc., Minneapolis, USA) and Mann-Whitney U-test. Our study revealed significant decrease of IL-6, TNF-α, IL-10 and IL-4 plasma levels (1.197-, 1.188-, 1.504- and 1.840-times respectively) and increase of IL-17 plasma level (2.311-times) on the background of almost unchanged frequency of Tregs in patients with type 1 diabetes. In T1D patients CD4+CD25+ Tregs frequency did not correlate with diabetes duration and positivly correlated with age and IL-4. We supposed that decreased level of IL-4 and IL-10 reflects inhibited functional activity of these cells. We suggested that shifted balance of Th17/Tregs towards inflammatory IL-17 producing cells and decreased levels of suppressive cytokines IL-4 and IL-10 play crucial role in T1D. Future studies are needed to clarify changes in which subsets of heterogenous population of regulatory cells are associated with diabetes duration and how the therapy affects their frequency and function.

Davitashvili D.,Tbilisi State Medical University
Georgian medical news | Year: 2012

Present research aimed at investigation of the role of several inflammatory cytokines and free toxic radicals in Multiple Sclerosis (MS) course and disability progression as well as factors that can assist to the early transition of Relapse Remitting MS (RRMS) in Secondary Progressive MS (SPMS). Totally 22 MS patients, 14 RRMS and 8 SMPS have been investigated. Age at disease onset, disease duration, number of relapses and the Kurtzke Expanded Disability Status Scale (EDSS) scores were collected. Control comprised 10 healthy volunteers matched for age and sex. Brain was visualized by Magnetic Resonance Tomography (MRT- Siemens AVANTO-1.5-Tesla). Blood pro-inflammatory cytokines were detected by Enzyme Linked immunosorbent Assay (ELISA). Blood free toxic radicals and antioxidant enzymes were detected by Electron Paramagnetic Resonance Method (EPR). Statistics was performed using the SPSS-11.0. Blood pro- and anti-inflammatory factors (γ-Interferon, IL-6, IL-10) were elevated in MS patients against control. Increased blood IL-6 and IL-10 found in RRMS as compared to SPMS, while γ-interferon was higher in SPMS (p<0.000). Blood EPR specters of Lypoperoxiradical (LOO-) and superoxide anion (O2-) were increased in SPMS patients compared to RRMS and control. Blood EPR specters of antioxidant enzymes: superoxidismutase (SOD), catalase (CAT) and Glutathione reductase (GR) found elevated in RRMS against SPMS and control. Positive correlation was found between γ-interferon and EDSS (r=+0.52 p<0.05) in SPMS and negative correlation established between SOD and CAT and EDSS (r=-0.84 and r=-0.60 respectively, p<0.05) in RRMS. Multiple logistic regression toward the brain MRI Injury volume proved significance of C reactive protein, γ-interferon and CAT. Present research suggested that the state of endogenous protection system and blood content of antioxidant enzymes (CAT, SOD) in MS patients could play a significant role for early progression of RRMS in SPMS.

Mania M.,Tbilisi State Medical University
Georgian medical news | Year: 2011

Valproic acid (VPA) is an anticonvulsant and mood-stabilizing drug for the long-term treatment. It is established that VPA has number of side effects affecting metabolic and endocrine system, like weight gain, hyperinsulinemia, changes in sex hormones, dyslipidemia, hyperleptinemia and etc. But the data are not sufficient to judge if VPA treatment can induce metabolic syndrome. Our aim was to investigate metabolic syndrome frequency in VPA-treated (n=11) and CBZ-treated (n=13) patients with epilepsy and in drug-free healthy subjects (n=11). We diagnosed metabolic syndrome according to Adult Treatment Panel III criteria (ATP III). We took blood samples for analysing triglyceride, HDL cholesterol and fasting glucose. Waist circumference and blood pressure was measured as well. Our data revealed that metabolic syndrome is relatively frequent in VPA-treated patients group (45,5%) compared with CBZ group and controls (15.4% and 27.3% respectively) (p<0,5). BMI did not differ between study groups. According to our preliminary data VPA monotherapy increases the risk of metabolic syndrome in patients with epilepsy, but BMI did not differ between VPA monotherapy study group, CBZ monotherapy study group and controls.

Chipashvili N.,Tbilisi State Medical University
Georgian medical news | Year: 2011

Gemination and fusion are anomalies in size, shape and structure of teeth. Gemination more frequently affects the primary teeth, but it may occur in permanent dentitions, usually in the incisor region. Geminated teeth are typically disfigured in appearance due to irregularities of the enamel. Fused teeth can have separated pulpal space, one pulp chamber and two canals or take the form of a large bifid crown with one pulpal space. It is hard to differentiate between fusion and gemination, especially if the supernumerary tooth bud is fused with the adjacent one. Usually, fusion may be differentiated from germination by a reduced number of teeth. An exception is in the unusual case in which the fusion is between a supernumerary tooth and normal tooth. A 20-year-old male referred to us at - "UniDent" - Dental Clinic, Training and Research Center. The patient complained about the large, unusual maxillary central incisors, lip irritation and aesthetic problems. According clinical examination and radiological findings, clinical diagnose was - bilateral germination of central incisors. Several treatment methods have been described in the literature with respect to the different types and morphological variations of fused and geminated teeth, including endodontic, direct\indirect restorative, surgical, periodontal and/or orthodontic treatment. Our patient has demanded for better aesthetics and he choose the treatment option to make two separate PFM crowns. In the beginning of treatment, the length of tooth 11 was 9.5mm, after prosthodontic treatment it has become 11.5mm. For tooth 21, it was 9.9 millimeter and became - 10.8 mm, while the primary width of right central incisor appeared 13.2 millimeter and was narrowed until 10.8 mm. 12.8 mm was the - width of left central incisor, which finally became - 10.4 mm. Despite the considerable number of cases reported in the literature, the differential diagnosis between these abnormalities is very difficult, as well as, to find guideline of proper outcome of treatment therapy of abovementioned abnormalities. That's why, the aesthetic rehabilitation of doubled teeth, has been suggested, to depend upon the patient's desires, but at the same time, avoid treatment plans with aggressive management.

Kenchadze R.,Tbilisi State Medical University
Georgian medical news | Year: 2011

It should be emphasized that at the present stage there is no consensus achieved regarding the etiopathogenesis of BMS. Almost all researchers point to lots of factors, simultaneously participating in genesis and development of BMS and at the same time most of them agreed on one - psychological factors play a crucial role in formation and maintenance of painful sensations. The aim of the study was the identification of psychological or psychiatric deviations (changes) among the patients with BMS to perform an adequate differentiated therapy. Clinico-psychological examination (dentist, neurologist, psychiatrist) was carried out in 39 patients from 46 to 70 years of age. Among them women - 36 and men - 3. To identify clinical types of BMS a classification of P.J. Lamey (1996) was used and as a result, depression, insomnia, cancerophobia, severe neurologic disorders, phobic syndrome were revealed. Three main categories - a chronic somatoform dysfunction (23 cases), chronic vegetative disorders (8), and chronic pain phenomenon (12) were identified. Only in one case was revealed a paranoid syndrome. Alongside with the well-known scheme of treatment (antidepressants, anticonvulsants, or neuroleptics) Psychotherapy was conducted, while EEG-feed back (Biofeed back, Neurofeed back) method was used for the first time. A number of important decisions were made the most important of which are the following: BMS - must be regarded as a psychosomatic problem rather than a psychiatric disorder. In addition to psychotherapy, using of EEG - feedback method greatly improved patients' condition and in 4 cases BMS clinical manifestations were evened-out completely.

Gegenava T.,Tbilisi State Medical University
Georgian medical news | Year: 2011

Some studies have reported that depression is associated with higher levels of C-reactive protein (CRP) a marker of systemic inflammation that has been shown consistently to predict coronary heart disease risk. The aim of our study was to investigate the association between history of depressive episode and anxiety and presence of low-grade systemic inflammation as measured by serum CRP in postoperative period of coronary angioplasty and aorto-coronary bypass graft surgery. The research was performed in 80 patients (n = 80), mean age 60 ± 15 years. These patients have no high cholesterol level, high body mass index and n = 64 (80%) of them are no smoker. To evaluate depression we used Beck depression scale. Anxiety was assessed by the Spilberger State-trait anxiety scale. CRP was measured in venous blood. Results show that increased level of C-reactive protein was found in aorto-coronary bypass graft surgery group n = 28 (70%), in angioplasty group C-reactive protein n = 12 (30%); χ2 = 6.40 p = 0.012. In angioplasty group patients who had increased level of CRP had high degree of depression p = 0.001. In these group was revealed high degree of trait anxiety p < 0.001 too. In aorto-coronary bypass surgery group elevated level of CRP was associated with high degree of depression p = 0.001. Our study demonstrated association between depression, anxiety and increased C-reactive protein level. Inflammation, the key regulator of CRP synthesis, plays a pivotal role in atherothrombotic cardiovascular disease. Our findings have important implications for explaining the pathophysiological mechanisms of cardiovascular disease.

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