[Diagnostic possibilities of multilayer computer tomography in blunt abdominal trauma].

The purpose of our study was to determine MDCT diagnostic possibility in blunt abdominal trauma. Our work was based on MDCT results of 84 blunt abdominal trauma patients with stable hemodynamic status (28 (33.3%) female and 56 (66.6%) male). Age ranges from 17 up to 64 years. The CT scan showed obvious organ and system injuries in 82 poly-trauma patients. Injuries of craniocerebral region, also of facial bones, chest and spine were determined in two patients; in one of which, however, it was not possible to differentiate subcapsular spleen hematoma accurately because of left upper joint metallic holder artifacts. In second patient the liver injury was accurately diagnosed, but there were visualization problems caused by the massive retroperitoneal hematoma from right adrenal gland injury. The investigation showed that sensitivity of CT scan data was 98%, specificity-97% and accuracy rate-98%. All above mentioned clearly states the importance of MDCT in the emergency department. MDCT ensures precise diagnosis in maximally short period of time and thereby helps to choose proper treatment and decreases post-traumatic complications.

[The role and place of helical ct for preporative diagnosis of acute appendicitis].

The goal of our study was to ascertain the role and place of helical CT for preoperative diagnosis of acute appendicitis. Our study relied upon the results of helical CT scans of 60 patients, which were diagnosed probable acute appendicitis based upon clinical signs. Of these 60 patients 49 (81,6%) were female, 11 (18,4%) male. For all patients laboratory studies of blood were made, 31 patients were examined by ultrasonography. Among this group the diagnosis of acute appendicitis was verified by CT scan in 41 patients. In the case of 5 patients the scan was equivocal because of smaller amount of omentum; in this subgroup of 5 patients (5% overall) three were given radiocontrast dye, and two (3,3% overall) were not. In 11 (18,3%) cases the diagnosis of acute appendicitis was not verified, and in three cases the diagnosis was incorrect. According to data of our study and intraoperative data analysis, sensitivity of this method approaches 93% and the specificity - 92%, and overall diagnostic accuracy 93%. Helical CT may be stated as diagnostic method of choice in the diagnosis of acute appendicitis. It is helpful in clinical decision making, and reducing the amount of false appendectomies.

[The role of the cellular immunity in the process of the operative wound healing].

Phagocyte ability of the cells of connective tissue has an essential role in the development of the immune response. The Kavetski test has been applied on 199 patients with different types of the laparotomy wounds (average age - 14-74 years) in order to detect the intensity of the phagocytosis. Based on the peculiarity of the wound process flow, two groups of the patients have been distinguished. The first group (132 patients) included the patients with primary intention of laparotomy wounds; while the second group included 67 patients with complicated dynamics of the wound process (healing by secondary intention, total or partial suppuration, inflammatory infiltrate, ligature fistulas, serous hemorrhagic effusion from the wound). The percentage of the above mentioned groups by the principal disease, volume and type of the surgical intervention, type of the anesthesia, age, follow-up time and method of treatment were about the equal. Our study showed that the phagocytic intensity positively correlated with the laparotomy wound healing: higher level of the phagocytosis was associated with the less number of the frequency of complications of wound healing.

[Oxidative homeostasis of organism during mechanical jaundice].

The aim of our research was the study of the intensity of the oxidative homeostasis of the organism during the mechanical jaundice. From the results of our study it follows that during the cholestasis the violation of the balance between pro-and antioxidant blood system takes place in the patient's blood. The latter is manifested in the blood EPR spectrum in the considerable increase (about 47%) of the intensity of the EPR oxidated ceruloplazmin signal, in the decrease of the intensity of the EPR signal Fe3+ transferin (on 16%), in the increase of the contents of promoters of the free-radical oxidation of ions Fe2+ and Mn2+. As it follows from the results of our researches, the considerable increase of the contents of the free nitrogen oxide is observed during the mechanical jaundice. So it can be concluded, that the intensification of the free-radical processes and the emanation of the protective antioxidant enzyme systems takes place in the organism. Consequently, activation of the peroxide oxidation processes takes place, which disrupts cell membrane integrity and leads to the development of the irreversible tissue injuries.

[Prognostic possibilities of immunogenetic markers application in adhesive disease of abdominal cavity].

Modern knowledge concerning adhesive disease of abdominal cavity is imperfect, that's why it is necessary to discover new and effective methods of investigation of the disease to improve prophylactic and treatment measures. There was studied up the distribution of the HLA system antigens in adhesive disease, markers of predisposition to the disease occurrence were revealed. The HLA typing results in 52 patients of Georgian nationality, suffering adhesive disease of abdominal cavity, are presented. Trustworthy increase of frequency of the HLA antigens Al, B15, B21 revealing was noted in patients in comparison with such in control group. According to the relative risk criterion, maximal possibility of the adhesive illness occurrence was connected with HLA-B15 antigen. It may be concluded that in Georgian population antigen HLA-B15 constitutes a genetic marker of the adhesive illness occurrence.

[HLA system antigens in peptic ulcer patients]. / Antigeny sistemy HLA u bol'nykh iazvennoi bolezn'iu.

A study is presented of 105 Georgian patients (age: 24-69 years) with duodenal ulcer. Typing of HLA-A, B, and C antigens was carried out by a set of sera of the Leningrad Research Institute of Hematology and Blood Transfusion. It was found that finding in patients of Georgian origin with duodenal ulcer differ from similar examinations in other ethnic groups indicating the possibility to judge on the population heterogeneity of association of the HLA system with duodenal ulcer.