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INTERNATIONAL CONGRESS OF MEDICAL SCIENCES

VIEWS: 430 PAGES: 340

									           X
INTERNATIONAL CONGRESS
           OF
    MEDICAL SCIENCES

      12 - 15, May
    SOFIA, BULGARIA
OFFICIAL SPONSORS

     SERVIER

  SANOFI AVENTIS

  COMAC MEDICAL

GLAXO SMITH KLINE

       MSD

EDUCATIONAL CENTRE

     ASTELLAS

     DANONNE

      DEVIN
                 ORGANIZING COMMITTEE
Presidents:        Albena Nikolova
                   Radislav Nakov

Secretary Board:   Victoriya Stoyanova
                   Gavril Nakov
                   Dean Nenov


PR & Treasurer     Simeon Andreev


Design, Prepress & Web: Todor Popov


Members:           Sofia Antonova
                   Mariya Iakova
                   Petar Velikov
                   Radina Tsekova
                   Aretina Chachi
                   Blagovesta Radoslavova
                   Mariya Vasileva
                   Yanislava Karusheva
                   Elena Tomova
                   Emil Belinski
                   Yana Pashova
                   Liubov Simeonova
                   Nina Slavova
                   Dimitar Penchev
                   Marta Nikolova

President of AMSB: Deyan Popov
President of Students’ Council: Petar Chavdarovski
                   SCIENTIFIC COMMITTEE
PRECLINIC
Prof. Stoinev
Prof. Lazarov
Dr. Jelev
Dr. Hadjimitova
Dr. Todorova

THERAPY
Assoc. Prof. Bogov
Assoc. Prof. Stoilov
Assoc. Prof. Kamenov
Assoc. Prof. Zhelev
Dr. Nikolova
Dr. Monov
Dr. Sheytanov
Dr. Bakalov
Dr. Petkova
Dr. Shemelekova
Dr. Kostadinova
Dr. Ivanova
Dr. Gospodinova
Dr. Ivanova
Dr. Tomov

SURGERY
Prof. Dimitrova
Prof Yarramov
Dr. Zhivkov
Dr. Taneva
Dr. Goranov
Dr. S Toshev

DENTISTRY
Assoc. Prof. Yordanov
Assoc. Prof. Popova

PUBLIC HEALTH
Dr. Petya Trendafilova

MEDICAL EDUCATION
Assoc. Prof. Alexeev
Dr. Kyneva
                           Programme of ICMS 2011
St.Ekaterina Aula Maxima    Congress Hall I Zdrave           Foyer Zdrave      Congress Hall II Zdrave

                                     12 May 2011 [Thursday]
                                             Registration
                                             15:00 - 19:00
                                    Opening Ceremony and Coctail
                                            19:00 - 20:00
                                   Karaoke evening - Club El Corazon

                                       13 May 2011 [Friday]
     Oral Session                Workshop:
                                                             Registration
      Preclinic I             Ultrasonography
                                                             10:00 - 11:30
     09:00 - 11:00              09:30 - 11:00
                                              Coffee Break
                                               11:00 - 11:15
                                                                                    Workshop:
     Oral Session                                           Poster Session
                              Medical Education                                  Cardiac operation
      Preclinic II                                             Preclinic I
                                11:30 - 13:00                                       techniques
     11:15 - 13:00                                            11:15 - 13:00
                                                                                   11:30 - 12:30
                                                   Lunch
                                               13:00 - 14:00
Workshop: Surgical pro-                                       Poster Session
                            Public Health Session
cedures on lab animals                                          Preclinic II
                                14:00 - 15:00
     14:00 - 15:00                                             14:00- 15:00
                                               Coffee Break
                                                15:00 - 15:15
                                                              Poster Session
                             Dentistry Session
                                                               Preclinic III
                                 15:15 - 17:00
                                                               15:15 - 17:00
                            Sofia by night - Tour in Sofia [Friday - 20:00]
                              Dinner at a typical Bulgarian Restaurant
St.Ekaterina Aula Maxima    Congress Hall I Zdrave               Foyer         Congress Hall II Zdrave

                                       14 May 2011 [Saturday]

     Oral Session          Workshop: Cardiopulmo-
      Therapy I              nary Resuscitation
     9:00 - 11:30                9:00 - 11:30
                                                   Lunch
                                               11:30 - 12:30
     Oral Session          Workshop: First Aid and           Poster Session
       Therapy II             Traffic Incidents                 Therapy I
     12:30 - 15:00              12:30 - 14:00                 12:30 - 14:30
                                               Coffee Break
                                               15:00 - 15:15
     Oral Session            Workshop Surgical               Poster Session
      Therapy III                 Stiching I                    Therapy II
     15:15 - 17:45               15:15 - 16:45                 15:15 - 17:15

                                        15 May 2011 [Sunday]

     Oral Session             Workshop Surgical
      Surgery I                   Stiching II
     9:00 - 11:30                9:00 - 11:00
                                                   Lunch
                                               11:30 - 12:30
     Oral Session                                            Poster Session
                             Workshop: Doctors
       Surgery II                                               Surgery I
                              without borders
     12:30 - 15:00                                            12:30 - 15:00
                                               Coffee Break
                                               15:00 - 15:15
     Oral Session           Workshop: Scientific
      Surgery III           writing and publishing
     15:15 - 17:30               15:15 - 16:45

                        Closing Ceremony: Awarding the best research works
                                           19:00 - 19:30


                     Cocktail Party - Club “Bar At The End Of The Universe” 22:00
WORKSHOPS
Workshop I - “Cardiac Operation” at the Cardiac Surgery Clinic at St. Ekaterina hospital

Workshop II - “Surgical procedures on small laboratory animals for investigation of heamodynam-
ics and renal function” Bogdan Iliev - Laboratory of hemodinamics and renal function,
Department of Physiology, Head: Professor Radoslav Girchev

Workshop III - “How to get the most out of your scientific work?”
Vladimir Nakov - National WHO coordination center for mental health policy.

Workshop IV - “Surgical Stiching”

Workshop V - “Doctors without borders”

Workshop VI - Cardiopulmonary Resuscitation

Workshop VII - First Aid and Traffic Incidents.
SOCIAL PROGRAM
Opening Ceremony and Coctail [Thursday - 19:00]
Karaoke evening - Club El Corazon [Thursday - 22:00]

Sofia by night - Tour in Sofia [Friday - 20:00]
Dinner at a typical Bulgarian Restaurant

Club “Bar At The End Of The Universe” [Cocktail Party] [Sunday- 22:00]
SESSIONS
Preclinic Oral 1
                          VARIATIONS OF VERTEBROBASILAR JUNCTION
Jasmina     Randjelovic   AT ADULT HUMAN CADAVERS DETERMINED
                          PROCESSING DIGITAL IMAGE
                          Features of morphogenesis of rats knee-
Olena       Monina        joint synovium in early postnatal period after
                          introduction of hydrocortisone to the pregnant.
                          CADAVER STUDY - TIBIAL SLOPE OF THE
Ivana       Jovanovic
                          LATERAL TIBIAL CONDYLE
                          MORPHOMETRIC ANALYSIS OF HUMAN
Milan       Bozinovic
                          STERNUM
                          Immunohistochemical examination of
Rostislav   Enev          microglia in rat CNS – complex research of
                          developmental changes
                          Immunohistochemical study of oligodendroglia
Anatoli     Dimitrov
                          during rat development
                          Astrocyte population during the
Nikola      Tomov         postnatal development of rat CNS – an
                          immunohistochemical study
                          The effect of drinks on acid-base equilibrium of
Artem       Alipov
                          a body
                          BIOCHEMICAL FEATURES OF MULTIRESISTANTIC
Maria       Dubrova
                          STRAINS OF STAPHYLOCOCCUS
                          The Effect of Inhibition of Kap?2 by M9M on the
Margarita   Blajeva
                          Nuclear Localization of Huntingtin
                          FERROUS REDUCING ABILITY OF PLASMA,
                          THIOL COMPOUNDS AND LIPID PEROXIDATIVE
Asen        Anastasov
                          PRODUCTS IN PLASMA OF PATIENTS WITH SKIN
                          MALIGNANT MELANOMA
                          The effects of phosphorylation of the PKA-like
Marko       Ristic
                          kinase regulatory subunit in Trypanosoma brucei
                          Influence of different ELF-EMF frequencies on
Nikolina    Nikolova      human skin perfusion in vivo estimated by Laser
                          Doppler Flowmetry (LDF)
                          Transmittance Properties of Organic and Mineral
Nikola      Kyuchukov
                          Photochromic Lenses

Preclinic Oral 2
                          The study of association between factor V leiden
Azadeh      Heidarpour
                          mutation and G6PD deficiency
                         The most reliable MSI markers in diagnosis of
Mahdi       Montazer
                         colorectal cancer
                         Molecular genetic and ultrastructural
Branislav   Rovcanin
                         characteristics of CADASIL disease
                         Allelic Polymorphisms of EcoR V Site at 3 of the
                         VDR Gene: Analysis of the Association between
FATEMEH     Fazeli
                         Gene Polymorphism and Bone Mineral Density in
                         Iranian Postmenopausal Women
                         IMMUNOHISTOCHEMICAL EXAMINATION OF THE
Nenad       Todorovic    LEVEL OF NEUROENDOCRINE DIFFERENTIATION
                         IN COLORECTAL ADENOCANCEROMA
                         THE INFLUENCE OF MEXIDOL ON
Nwokorie    Chibuike     HEMATOLOGICAL PARAMETERS AND GAS-
                         TRANSPORT FUNCTION IN ACUTE BLOOD LOSS
                         A MANIFESTSTION OF ANXIOLYTIC ACTIVITY
Aminian     Mazyar       OF THE NEW DERIVATIVE OF 2-OXOINDOLIN-
                         GLYOXILIC ACID
                         Analysis of antihelmintic mixtures influence on
Strilets    Leonidovna   some parameters of the persons and animals
                         homeostasis.
                         EFFECT OF PROPAFENONE AND IT’S
Dragan      Opacic       DERIVATE ON THE ACONITINE-INDUCED
                         ARRHYTMIAS
                         COMPARISON OF THE EFFECTS OF SINGLE
                         AND CHRONIC CAFFEINE ADMINISTRATION ON
Ivan        Todorov
                         TEMPERATURE OF RATS IN NORM AND WITH
                         MODEL OF DEPRESSION
                         Elastin Gene rs2071307 Single Nucleotide
Kostiv      Mykhailo     Polymorphism and the Risk of Aortic Aneurysm
                         Development
                         Renal excretion of homocysteine after
Deyan       Popov        homocysteine loading in spontaneously
                         hypertensive rats
                         Changes of sympatho-vagal balance during
Orlin       Pavlov       application of [Cav13]N/OFQ(1-13)NH2 in
                         spontaneously hypertensive rats

Preclinic Poster 1
                         Study of Coronary Arteries Using Virtual Model.
Raluca      Stanescu
                         Implication Within Coronary Pathology.
                         Anatomical variations of the extensor indicis
Ivan        Vlasov       proprius muscle and their application in
                         reconstructive surgery of the hand
                           Absence of the foramen spinosum and aberrant
Maria       Atanasova      course of the middle meningeal artery:
                           significant for surgery and practice
                           Anatomical contributions to the topographical
Stefan      Oprea
                           study of the inguinal canal
                           Variable morphology of the suprascapular notch.
Georgi      Georgiev
                           Clinical relevance
                           Radiation Scintigraphy, Biodistribution and EPR
Yanka       Karamalakova   Spectroscopic Ex vivo Correlation of toxicity and
                           antitumor activity of spin-labelled agent SLENU
                           EPR Spectroscopic Correlation of Antimicrobial,
Ekaterina   Georgieva      and Radiomodulatory Properties of Psoralea
                           corylifolia Linn.
                           Na, K РђРўPase ACTIVITY OF PERIPHERAL
Roman       Fafula         BLOOD LYMPHOCYTES IN PATIENTS WITH A
                           RHEUMATOID DISEASES
                           Concentrations of glucose and glycated
Vera        Kazakova       haemoglobin in erythrocytes of patients with
                           different diseases
Dimitar     Penchev        Transplantational Immunology
                           The nitrogen oxide influence on the adaptive
Anna        Svyatodukh     capabilities level of practically healthy young
                           people (18-20 years old) circulatory system
                           Trichinella larvae survival in culture media for in
George      Popov
                           vitro incubation
                           Heart rate variability dynamics during functional
Ekaterina   Popovska       testing in young individuals with family history
                           for cardiovascular risk

Preclinic Poster 2
                           Mathematical model of oscillatory processes of
Zoryana     Fedorovych
                           bioelectrical parameters in early embryogenesis
                           Time dependence of Static Magnetic Field (SMF)
Spasina     Nikolova       on human skin perfusion in vivo estimated by
                           Laser Doppler Flowmetry (LDF)
                           Ion-selective electodes in pharmaceutical
Iaryna      Maliarska
                           analises
                           MUTATIONS OF beta-GLOBINS GENE IN THE
Gunay       Akbarova
                           POPULATION OF AZERBAIJAN
                           NEWLY DEVELOPED ION MODIFIED CALCIUM
Boika       Lilova         PHOSPHATE MATERIALS: EFFECTS ON VIABILITY
                           AND PROLIFERATION OF CULTURED CELLS
                         THE CONDITION OF NITRIC OXIDE SYSTEM
                         UNDER INVETERATE HYPER IMMUNE
Iryna       Surma
                         COMPLEXITY AND ITS CORRECTION BY
                         CORVITINE
                         Cilostazol administration attenuates common
Shima       Majidi
                         bile duct legation induced liver injury in rat.
                         Didactic requirements for the subject
Mariana     Drachuk
                         Information Technology for pharmacists
                         Influence the selective modulator of estrogen
                         receptors (SERM) on expression HSP 70 and
Sergej      pavlov
                         apoptosis in neurons of barks at deprivation the
                         system level of restored glutation in vitro
                         Nitrozine stress and neurological disorders in
Elena       Sokolik      experimental alcohol intoxication and their
                         pharmacological correction by neuropeptides.
                         THE EFFECTS OF METHYL GROUPS OF THE
Naji        almestaka
                         METHYLENE BLUE ON THE INHIBITION
                         Neuroprotective effect of pramiracetam on rats
Andriy      Pavlov
                         brain in the conditions of alloxan diabetes
                         The analysis of influence of nonopioid analgetics
Oleksandr   Nefodov      on the nitric oxide stable metabolites level in
                         experiment
                         Antinociceptive and antiinflammatory effects of
Samireh     Farshchi     Teucrium hyrcanicum aqueous extract in male
                         mice and rats

Preclinic Poster 3
                         THE AMINO ALCOHOL AND SULFONAMIDE WITH
Vitaliy     Palchikov
                         NEUROTROPIC ACTIVITY
Marta       Zayats       Metabolic syndrome: history of question
Georgi      Bogdanov     The effect of kainic acid on TNF-? in rats
                         RISK FACTORS OF DRUGS INTERACTION IN THE
Besarte     Rexhaj       CLINIC OF INTERNAL DISEASES OF UNIVERSITY
                         CLINICAL CENTER OF KOSOVA
                         A role for opioid system in the proconvulsant
Pooneh      Rafsanjani   effects of sildenafil on the pentylenetetrazole-
                         induced clonic seizure in mice
                         Influence of NSAIDs on various concomitant
Valentyna   Opryshko
                         pathological states
                          Possibility for protection with amino acid
                          derivative on decline in cognitive function of
Miroslav     Novoselski
                          rats after early maternal deprivation with social
                          isolation
                          MICROGLIAL ACTIVATION AND EXPRESSION OF
Kiril        Surchev      IL-1? IN DIFFERENT MODELS OF NEUROPATHIC
                          PAIN
                          Nociceptive sensitivity of land snails Helix
                          albescens and regeneration of planarians
Nataliya     Temuryants
                          Dugesia tigrina under weak long-term
                          electromagnetic shielding
                          Angiotensin II and its importance for the
Stela        Valcheva
                          contractile activity of rat pelvic organs
                          Spontaneous and angiotensin II - induced rectal
Zlatina      Vasileva     contractile activity and its modulation by apamin
                          and verapamil
                          The role of interaction between nNOS-derivate
                          nitric oxide and renal nerves on the modulation
Bogdan       Iliev
                          of fast interpulse interval oscillations in
                          conscious rats
                          Investigation of metabolism of exogenous
Silviya      Ruseva
                          Homocysteine in Rat’s plasma
                          WAYS OF BLOOD SUPPLY IN HUMAN FETAL
Ivan         Diskovskyi   RETINA DURING THE PRENATAL PERIOD OF
                          ONTOGENESIS
                          Markers of cardiovascular risk: blood pressure
Vladimir     Pavlov
                          variability and pulse wave velocity

Medical Education Oral
                          Simulation of Measurement of Low Level of
halil        kandemir     Hemoglobin in Blood Using Iron Complex
                          Solutions
                          Global Trends in Higher Medical (Pharmaceutical)
Oleksandra   Lysenko
                          Education
                          INVESTIGATION OF STUDENTS’ ATTITUDE
Teodora      Sakelarova   TOWARD VIRTUAL MODELS FOR E-LEARNING IN
                          MEDICAL CHEMISTRY
                          A BILINGUAL VIRTUAL PATIENT ILLUSTRATES
Avi          Gandhi       THE ACTION OF INHIBITORY DRUGS ON DNA
                          REPLICATION
                          A SITE-TEMPLATE FOR WEB-BASED PROBLEM-
Elisaveta    Trichkova    SOLVING ORIENTED LEARNING IN MEDICAL
                          DISCIPLINES
Medical Education Poster
                        TRAINING SPECIALISTS BASED ON THE
Maria       Vistak
                        MODULAR-RATING TECHNOLOGY
                        Formation of technical thinking in the
Lyubov      Yemchyk
                        preparation of physicians
                        WINDOWS APPLICATION FOR CREATION OF
Lyubka      Markova     INTERACTIVE WEB-BASED TESTS AND VIRTUAL
                        PATIENTS
Asya        Raykova     LET`S READ TOGETHER
                        METHODOLOGICAL PROBLEMS OF CARRYING
                        TEST CONTROL OF BIOPHYSICS FOR MEDICAL
Marianna    Paykush
                        STUDENTS IN THE UNIVERSITIES UNDER
                        CREDIT-MODULE SYSTEM

Surgery Oral 1
                        COMPARISON BETWEEN MECHANICAL
                        AND BIOLOGIC VALVE REPLACEMENT BY
Velina      Yancheva    PATIENTS WITH AORTIC VALVE DISEASE. A
                        JUXTAPOSITION BETWEEN A SINGLE CLINIC
                        AND THE WORLD TENDENCY.
                        ON THE ISSUE OF HEALTH PROTECTION OF PRE-
Sona        Sargsyan    CONSCRIPT AND CONSCRIPT ADOLESCENTS
                        WITH ENT DISEASES
                        Alternative options for Adenoiditis conservative
Maryana     Cherkes
                        therapy in children.
                        FACTORS OF THE ESTABLISHMENT OF MIDDLE
Slavica     Stankovic
                        EAR VENTILATION AFTER ACUTE OTITIS
                        Actual approaches to conservative treatment of
Natalia     Troian
                        uterine leiomyomas
                        The reliability of ultrasound in detecting
CIRJU       DANIELA
                        antenatal malformations
                        The value of interleukin 6 in the diagnosis of
Alexandru   Goganau     chorioamnionitis associated with premature
                        rupture of membranes
                        The problem of poor ovarian response in
Oksana      Gradil
                        reproductology
                        Sialyl-Tn-antigen (STN) expression in ovarian
Nina        Jancic
                        tumors
suheda      algun       Endometriosis
Ivana       Stamenic    Toxicolytical treatment of premature labour
                          The impact of depleted uranium on the female
Marjan       Micic
                          reproductive system
                          Structural and functional changes in ovarium
                          and anterior pituitary gland in thyroidectomised
Kostiv       Vira
                          rats: new insight on treatment of hypothyroid
                          luteal phase insufficiency
                          FREQUENCY OF VAGINAL ADMISSION IN
Aleksandar   Mitrovic
                          HYSTERECTOMY SURGICAL PROCEDURE
                          The role of the extracellular matrix in the
Csaba        Szemcsak
                          invasiveness of low-grade astrocytoma
                          Correlation between fundus changes and
Denissa      Popa         evolution of the fetus in preeclamptic pregnant
                          women
                          First trimester bleeding and the risk of
Maria        Manolea
                          miscarriage
                          HOBNAIL HEMANGIOENDOTHELIOMA (DABSKA
zahra        behnamfar
                          TYPE) OF RIGHT BUTTOCK

Surgery Oral 2
                          NEOADJUVANT CHEMOTHERAPY FOR BREAST
Anton        Khorau
                          CANCER
                          The contribution of fibrobronchoscopic
Costin       Matei        examination in establishing the certain diagnosis
                          of lung cancer
                          Survival among patients with breast cancer may
Ivan         Ivanov       be improved by early diagnoses: conformation
                          of a well known fact
                          POTENTIAL MECHANISMS OF DRUG
Ivan         Mindov
                          RESISTANCE OF MALIGNANT MELANOMA
                          DRY EYE SYNDROME IN PATIENTS AFTER
Myroslava    Maksymtsiv
                          PHACOEMULSIFICATION OF THE CATARACT
                          INTRAOCULAR FACTORS OF ASYMMETRY
Tamara       Moldovan     OF MANIFESTATIONS OF AGE-RELATED
                          MACULODYSTROPHY ON PAIRED EYES
Stefan       Juricic      Compliance in patients with glaucoma
                          RELATIONSHIP BETWEEN CENTRAL CORNEAL
Marija       Jovanovic    THICKNESS AND MYOPIA, HYPERMETROPIA
                          AND ASTIGMATISM
                          Establishment of the knee joint function after
Srdjan       Radojkovic
                          the treatment of knee tuberculosis
                          Imaging of the vertebral venous plexuses in the
Bartlomiej   Urbanski
                          context of percutaneous vertebroplasty
                           A Comparative Study of Human Fibroblast
Ehsan       Fayazzadeh     Growth Factors 1 and 2 in Improvement of
                           Ischemic Skin Flap Survival in Rats
Veronika    Atanasova      Problems for robotic surgery in Bulgaria
                           Epithelial Proliferative Diseases and Risk of
Svetlozar   Tsvetanov
                           Breast Cancer – Incidence and Characteristics
                           THE CONCEPT DOUBLE-LAYER IN TENSION-
Enache      Andreea
                           FREE INGUINAL HERNIAPLASTY
Lungana     Florin         THE MANAGEMENT OF CHRONIC WOUNDS
                           Treatment of traumatic splenic injuries in
Kristina    Dzhuma
                           children
                           Critical appreciation over otomastoiditis
Andra       Mofleanu
                           complications
                           USING ANTI-ADHESION GEL BASED ON
Iryna       Pradosh        METHYLCELLULOSE AT IMPOSING INTESTINAL
                           ANASTOMOSIS IN EXPERIMENT
                           Evaluation of the Mitotic Index as a Therapy
Marko       Gjorgjevski
                           Outcome Prognostic Factor for Meningiomas

Surgery Oral 3
                           Therapeutic Strategies in HER2-positive Breast
Iskra       Bayraktarova
                           Cancer
                           Laparoscopic adrenalectomy for malignant
Mariya      Yakova
                           disease
Alexander   Balev          Retroperitoneal Tumors
Emil        Branchevski    Benign breast disease
                           Influence of Roux-en-Y gastric bypass surgery
Michal      Janik
                           on uric acid level in patients with morbid obesity
                           Klatskin’s tumor- Short-term complications after
Damian      Sujecki
                           liver and bile ducts resection
                           TRANSUMBILICAL LAPAROSCOPIC
Yonko       Georgiev
                           CHOLECYSTECTOMY: THE FIRST 100 CASES
Michal      Rutkowski      Changes in lipid profile after bariatric surgery
                           Pioglitazone attenuates ischemia/reperfusion-
Babak       Hajipour
                           induced liver injury in rats
Andrea      Angi           A SURGICAL APPROACH TO INCISIONAL HERNIA
                           Comparison of traditional surgical and
Zelimir     Jovanovic
                           endovascular treatment of carotid disease
                           Risk Factors Influencing the Short-Term Results
Elena       Arabadzhieva
                           after Surgical Treatment of Pancreatic Cancer
                         Laparoscopic treatment of simple hepatic cyst
Camellia   Zyumbyuleva   using modified transumbilical technique /Case
                         report/
                         The aesthetic ideal for shape and size of breast
Ivaylo     Sabev         during the centuries through the eyes of the
                         artists
                         The evolution of surgery for sagittal
Stiliana   Mihaylova
                         craniosynostosis
                         Ventriculoperitoneal and ventriculoatrial
                         anastomosis as a treatment option for non
Simeon     Georgiev
                         communicating hydrocephalus during the first
                         year of life
Kiril      Ninov         Pharmacoresistant epilepsy is not untreatable
                         Measurement of glycoproteins in prostate
Strahil    Pantev
                         concrements
                         Diabetic foot ulcer is a significant predictor of
Afsaneh    Morteza       silent myocardial ischemia in women with type 2
                         diabetes

Surgery Poster 1
                         Cervical cytology study in premenopausal
DOINA      STEFANESCU
                         women with endometrial hyperplasia
                         The implication of the pathogenic bacterian flora
voinea     bogdan
                         in the Fallopian tube pathology
                         A comparative study of computer tomography
                         angiography and digital subtraction angiography
Mariusz    Tomaniak
                         in the early diagnosis and treatment of
                         intracranial aneurysms.
                         Serum adenosine deaminase activity in
abdolsamad sheikhzadeh   gestational diabetes mellitus and normal
                         pregnancy
                         Immunohistochemical variations in case of
ANDA       DIJMARESCU    pregnancy associated with ovarian tumors - case
                         report
                         Effect of increased maternal body mass index
Elina      Calite
                         (BMI) on pregnancy outcome
                         ALTERATION OF LABOUR PATHOLOGY
                         FREQUENCY IN WOMEN WHO DRINK WATER
Inna       Tykha         CONTAINING CYANOBACTERIA METABOLITES
                         AGAINST THE BACKGROUND OF PREVENTIVE
                         MEASURES
                            MUTATIONS IN CYSTATHIONINE BETA-
Olga         Kulish         SYNTHASE GENE AS RISK FACTOR OF NEURAL
                            TUBE DEFECTS IN UKRAINIAN POPULATION
Milan        Bozinovic      Mobile phone use and risk of glioma in Serbia
                            Effect of monensin and its metal complexes on
Tanya        Zhivkova       viability and proliferation of drug-resistant tumor
                            cells
                            Effect of newly synthesized metal complexes on
Lora         Diakova        viability and proliferation of human glioblastoma
                            cells

Olga         Vinogradskaya Psychological disturbance in Graves orbitopathy

                            THE NEWEST TECHNOLOGIES IN THE EARLY
Marta        Diohenova
                            DIAGNOSTICS OF GLAUCOMA
                            Assesment of functional Outcome following
James        ODonovan
                            treatment for idiopathic adhesive capsulitis
                            Correction of metabolic immunodeficiency
                            in patients with obstructive jaundice
Evgeny       Dyabkin
                            nonneoplastic etiology with using extracorporeal
                            immunocorrection
                            Urinary bladder carcinoma during the 2005 –
selmon       salihaj
                            2009 period of time ( Regional hospital, Peja )
                            The importance of clinical (one-day) surgical
Aleksandar   Mitrovic       treatments of inguinal, umbellical, epigastric and
                            incisional hernia
                            Surgical treatment and management of giant
Asen         Stratev
                            intracranial aneurysms
                            SURGICAL MANAGEMENT OF GROWTH
Ani          Ivanova
                            HORMONE-SECRETING PITUITARY ADENOMAS
                            РЎhronotherapy in treatment of renal colic in
Mariia       Ezhned
                            patients with urolithiasis

Therapy Oral 1
                            DIGITAL ANALYSIS OF THE COLOUR M-MODE
                            EARLY DIASTOLIC LV FLOW - AN INVASIVE
Stefan       Busnatu
                            AND ECHOCARDIOGRAPHIC STUDY OF
                            DIASTOLIC SUCTION –
                            Comparison of N-Terminal pro B-natriuretic
melika       assefi         peptide and echocardiographic indices in
                            patients with mitral regurgitation
                         BLOOD SUPPLY OF HEART VALVES IN NORM
Larysa     Fenoniuk      AND AT ACQUIRED VALVULAR DISEASES OF
                         INFAMMATORY GENESIS
                         Electrocardiographic patterns revealing coronary
                         reperfusion in patients with ST-elevation
Maria      Berechet
                         myocardial infarction receiving thrombolytic
                         therapy. Data from the RO-STEMI registry.
                         Efficacy of cardiac investigations in confirming
Shiama     Balendra
                         cardiac syncope.
                         DIFFIRENTIAL DIGNOSIS BETWEEN TAKOTSUBO
Zornitsa   Shomanova     CARDIOMYOPATHY AND MYOCARDIAL
                         INFARCTION
                         ACUTE MYOCARDIAL INFARCTION AFTER
Tatjana    Lukic         CORONARY REVASCULARISATION IN PATIENTS
                         WITH HYPERCHOLESTEROLEMIA
                         Dynamics of catecholamine-binding property of
                         erythrocytes in patients with different functional
Kyrylo     Mikhaliev
                         clusters of erythrocytes and glucose metabolism
                         profiles
                         BLOOD VESSELS GEOMETRY AND THE
Oxana      Barsukova
                         FORMATION OF ATHEROSCLEROTIC SPOTS
                         Contraindication for the Use of Aesthetic
BAN        KAMOONA
                         Procedures in Different Skin Diseases
                         Observations upon fluorescence diagnosis of
Svetlana   Kavaklieva
                         nonmelanoma skin cancer
                         Psoriasis associated with vitiligo – two clinical
Ivan       Grozdev
                         cases
Iveta      Dencheva      Childhood psoriasis – a clinical case
                         Mycosis fungoides in a male patient with 12-year
Kamelia    Prisadashka
                         remission
                         Skin manifestations of Hyper-IgE syndrome –
Kristina   Semkova
                         hints for a timely diagnosis
Karen      Manuelyan     Two cases of epidermolysis bullosa acquisita
                         A clinical study of erysipelas - clinical features,
irina      yungareva     evolution and comparative characteristics of the
                         disease of different localization
Valeria    Mateeva       Infectious Balanitis- Serie of Clinical Cases
                         Serum cortisol measurements are not helpful
Szymon     Piatek        in assessment of glucocorticoid replacement in
                         adrenal insufficiency.
                        MYOCARDIAL CHANGES UNDER THE
Iuliia    Liubelia      CONDITIONS OF ACUTE ISHEMIA USING THE
                        METHOD OF THE MATRIX ANALYSIS
                        UPPER LIMBS FRACTURE PATTERNS RESULTING
Nada      Santrac
                        FROM FATAL FALLS FROM A HEIGHT
Marija    Randjelovic   Treatment of multiple myeloma

Therapy Oral 2
                        Immunotherapy in recurrent grade III glioma:
Iris      Elens
                        preliminary data
                        Cytomegalovirus Reactivation in
          jahangard     Immunocompetent Patients Admitted to the
                        Intensive Care Unit
                        TREATMENT OF PATIENTS WITH INFLUENZA A
Alina     Naichuk       BY AEROSOL INTERFERON IN COMBINATION
                        WITH PROTEFLAZIDUM
                        The clinical and laboratory characteristics of
Diab      Melli
                        ehrlichiosis infection
                        Efficacy of antiviral therapy of chronic hepatitis
Rima      Melli
                        C in patients with HIV-infection.
                        Study of Negative Effects of Stress on
mahdi     akhbardeh
                        Circulatory System Based on Modern Medicine
                        Disorders of the Stomach in Diabetes Mellitus
Zhanna    Nechipai
                        Type 1 and 2 Patients, Differential Treatment.
                        C – REACTIVE PROTEIN VALUE MESUREMENTS
Nemanja   Ciric         IN ACUTE EXACERBATIONS OF CHRONIC
                        OBSTRUCTIVE PULMONARY DISEASE
                        INCIDENCE OF LIVER CIRRHOSIS
Vladan    Milosevic     COMPLICATIONS IN A RELATION WITH A DE
                        RITIS RATIO LEVEL
                        SOME ASPECTS OF EARLY REVEALING OF
                        CHOLELITHIASIS IN PATIENTS WITH CHRONIC
Yuliya    Marchuk
                        CHOLECYSTITIS COMBINED WITH DIABETES
                        MELLITUS TYPE 2 (GALLSTONES)
                        THE DIAGNOSTIC MEANING OF THE
                        INTERSTOMACH EXPRESS PH-METRY IN
Olga      Siroochenko   PATIENTS WITH GASTROESOPHAGEAL REFLUX
                        DISEASE COMBINED WITH DIABETES MELLITUS
                        TYPE II
                        Interstitial pulmonary fibrosis (IPF) - a case
Zlatina   Dikova
                        report
                            Case Report: Hyperthyroidism due to Subacute
Krasimir    Kostadinov      Thyroiditis - De Quiervain associated with WPW
                            syndrome manifestation.
                            Levels of the hormone of fatty tissue resistin in
                            patients with arterial hypertension depending
Kamiran
                            on manifestation rate of disturbance of
                            carbohydrate metabolism
                            Adrenal cortical cancer- diagnostic and
Lukasz      Moos
                            therapeutic problems. Case report.
                            Toxic influence of thyreostatics on liver function
Anna        Rzemieniuk
                            in a patient with presence of HBs antigen.
                            CARDIOVASCULAR PATHOLOGY AND DIABETES
Veronika    Piskovatska     MELLITUS PSYCHOEMOTIONAL PREDISPOSING
                            AND PRECIPITATING FACTORS
                            EFFECT OF THE USE INSULIN PUMP TREATMENT
Sladjana    Smrzlic         ON MICROALBUMINURIA LEVEL IN PATIENTS
                            WITH TYPE 1 DIABETES
                            Effect of glycemic control on body weight of the
Tamara      Savic
                            newborn in patients with type 1 diabetes
                            Probiotics in the Treatment of Small Intestinal
Radislav    Nakov
                            Bacterial Overgrowth
                            LUNG INFECTIONS IN PATIENTS WITH CYSTIC
Christina   Dryngova
                            FIBROSIS

Therapy Oral 3
                            ANTIBACTERIAL EFFECTS OF CEMBUYA
Dusan       Kekic
                            ORIENTALIS AND BRASSICA OLERACEA
                            ACE-INHIBITORS AND POTASSIUM BALANCE IN
Milena      Jevtic
                            PATIENTS WITH RENAL DISFUNCTION
                            PAINFUL SYMPTOMS AS THE FIRST SIGNS OF
Lidiya      Nevmerzhytska
                            MULTIPLE SCLEROSIS
                            Management of an alpha rhythm – a key to
Tatiana     Makotrova
                            creativity development.
                            Memory disorders in patients with traumatic
Nataliya    Kufterina
                            brain disease
                            ANTIOXIDANT DEFENCE AND THE PROCESSES
                            OF LIPID PEROXIDATION IN THE BLOOD OF
Uliana      Petrova
                            CHILDREN WITH DESTRUCTIVE PATHOLOGY OF
                            THE GASTROINTESTINAL TRACT
                          BROCHIAL HYPERSUSCEPTIBILITI OF
                          CHILDREN AFFLICTED WITH BRONCHIAL
Alla        Halushchynska
                          ASTHMA WITH DIFFERENT TYPES OF
                          INFLAMMATION OF THE RESPIRATORY TRAKTS
                           STATE OF NITRIC OXIDE SYSTEM IN CHILDREN
Denys       Andriychuk
                           WITH ULCER DISEASE
Danka       Milankovic     CONGENITAL ANOPHTHALMOS CASE REPORT
                           CARBAPENEMS IN NEONATAL SEVERE
Nemanja     Avramovic
                           INFECTIONS
                         Procalcitonin and interleukin-6 in the early
Sanam       Mahmoudzadeh prediction of neonatal sepsis, are they
                         correlated?
                           Disorders that occurs in young people with the
Zeljko      Garabinovic
                           problem of substance abuse
Dorokhina   Antonina       Loneliness and personality in modern students
                           DEFINING THE PROFILE OF RESISTANCE OF
                           MYCOBACTERIA IN PATIENTS WITH NEW-ONSET
Olena       Medvetska
                           PULMONARY TUBERCULOSIS, GROUPS OF RISK
                           OF THE DEVELOPMENT OF CHEMORESISTANCE
                           THE COMPARATIVE ANALYSIS OF THE
                           DIAGNOSTIC VALUE OF THE BRONCHIAL
Oksana      Lototska       HYPERSENSITIVITY AND HYPERREACTIVITY TO
                           HISTAMINE IN SCHOOL AGE CHILDREN WITH
                           SEVERE BRONCHIAL ASTHMA
                           Cerebrofacial venous anomalies,sinus
Betul       Macit          pericranii,ocular abnormalities,seizure and
                           developmental delay:report of two patient
                           Floating thrombi- clinical and imaging
Snezhina    Georgieva
                           presentation
                           Early diagnosis of pulmonary embolism(PE)-
Vyara       Draganova      advantages and disadvantages by use of
                           different types of CT.
                           The clinical significance of determining cyclic
                           citrullinated peptide antibodies in the differential
Natasa      Zdraljevic
                           diagnosis of joint involvement in systemic
                           sclerosis
                           CONCEPT OF APPLIED PHYSICAL THERAPY
Gheorghi    Maximov        PROCEDURES DURING SPECIALIZED
                           CONDITIONING CAMP FOR TOP ATHLETES
                           Ethanol intensifies cadmium-induced changes in
Ilona       Dzwilewska     the chemical composition of the bone tissue in
                           rats
Therapy Poster 1
                            The effectiveness of radiofrequency ablation
                            of cavo-tricuspid isthmus in combination with
Koksheneva Igorevna         antiarhythmic drug therapy in patients with lone
                            typical atrial flutter and combined with atrial
                            fibrillation
                            Relationship between combined oral
Katarzyna    Marciniak      contraceptives and baroreflex sensitivity in
                            young healthy women.
                            the explanation of the rise in myocardial
Adrian       Raicu
                            infarction occurrence during summer months
                            USEFULNESS OF ERYTROCYTE RATE AND
                            HEMOGLOBIN LEVEL AT ADMISSION ON SIX-
Nemanja      Opacic
                            MONTHS OUTCOME IN PATIENTS WITH ACUTE
                            CORONARY SYNDROME
                            Morphofunctional peculiarities of red blood cells
Dina         Shorikova      at the patients with an arterial hypertension and
                            chronic heart failure
                            Frequency of hepatitis C virus Genotypes in HCV
Ali          yadollah
                            infected patients from Shahre-Kord, Iran
                            Effect of zinc (II) and iron (III) complexes on
Abdulkadir   Abudalleh      viability and proliferation of virus-transfromerd
                            tumor cells
                            Which skin lupus criteria are of more value in
Sara         Esmaeili       determining the disease: a greater view with the
                            help of direct immune fluorescent (DIF).
                            Investigations on polyamine metabolism of
Valentina    Broshtilova
                            benign keratinocytic proliferations
                            Observation of 100 Men with Urethritis -
Dragan       Dermanov
                            Medical, Social, and Clinical aspects
                            T-helper 1/T-helper 2 and T-helper 17/
Mona         Hedayat        Regulatory T-cell Cytokine Imbalance in Patients
                            with Chronic Heart Failure
                            Diagnostic criteria of septic variant of intestinal
Diana        Tarawneh
                            yersiniosis
Chamil       Edirisooriya   Tuberculosis and HIV infection
                            Study of the prevalence and antibacterial
                            susceptibility pattern of Enteropathogenic
Behnam       Zamanzad       Escherichia coli (EPEC) strains isolated from <5
                            years old diarrheal children hospitalized in Hajar
                            hospital, Shahrekord, Iran -2009
                        EXPERIENCE OF CLINICAL USAGE
                        SPECIFIC HUMAN IMMUNOGLOBULINS IN
Maryna     Iakymenko
                        TREATMENT OF PATIENTS WITH HERPETIC
                        MENINGOENCEPHALITIS
                        Immunologic indices and morphological changes
Iryna      Pankova      of the immune system in patients with bacterial
                        meningitis and meningoencephalitis
                        Comparison between Renal Volume in Type 1
Iviana     Yovchevska
                        and Type 2 Diabetics with Diabetic Nephropathy
                        10-year absolute risks for cardiovascular events
                        and stroke in type 2 diabetes patients by
Snezhina   Dencheva
                        two models - the UKPDS risk engine and the
                        Framingham Cardiac Risk Score
Abdullah   AlSayafi     Cystic Fibrosis
                        Effect of immunomodulators Derinat and Licopid
                        on activity of lyzozyme as a factor of non-
Kughan     Govinden
                        specific immune resistance in Helicobacter Pylori
                        induced peptic ulcer disease.

Therapy poster 2
                        Investigation of C-reactive Protein as a Marker
Radina     Tsekova      of Intestinal Inflammation in Patients with
                        Ulcerative Colitis
                        Hyperhidrosis, dermato - psychosomatic, clinical
Dinko      Stransky
                        and therapeutic aspects
                        QUALITY OF LIFE AMONG CHRONIC
Yasir      Hussaien
                        HEMODIALYSIS PATIENTS
                        Diets and their influence on the different types
Teodor     Aleksiev
                        of renal stones
Alesya     Lysenko      Research of factors of dissatisfaction sleep.
MILOT      HASANI       Neoplastic Trigeminal Neuropathy
                        ANALGESIC EFFECTS OF NEWLY SYNTHESIZED
Mihaela    Ilcheva      HEXAPEPTIDE ANALOGUES OF SELECTIVE
                        LIGAND FOR THE NOCICEPTIN RECEPTOR
                        Effects of naloxone and JTC-801 on analgesic
Mihail     Ganev        activity of novel nociceptin analogues with
                        N-terminal aminophsphate
                        Global gene expression profile of identified
Eszter     Boldog
                        neurogliaform interneurons in the neocortex
                        Output specificity of GABAergic interneurons in
Judith     Baka
                        the rat somatosensory cortex
                              Protective effects of hesperidin against
Amirhossein Ahmadi            genotoxicity induced by 99mTc-MIBI in human
                              cultured lymphocyte cells
                              Comparison of mechanical ventilation regimen in
AhmedSamy MohamedWedn
                              preterm infants with respiratory disorders
                              Anthropometric parameters related to feeding
Haki        Jashari           and socioeconomic status in children under five
                              years old
                              ALLERGY TO CEPHALOSPORIN ANTIBIOTICS IN
Ljubica     Jovanovic
                              CHILDREN
                              The initial presentation of Systemic lupus
amin        saburi
                              erythematosus with Aplastic anemia
                              Differences in anthropometric measures with
Ardita      Baraku            regard to smoking for students of medical
                              sciences
                              Endovascular versus Open surgery in treating
Hristina    Mitkova           peripheral vascular occlusions in patients with
                              diabetic foot
Albena      Nikolova          Anthropometric Study in Bulgarian Adults
                              Demographic and morphologic characteristics of
Viktoriya   Stoyanova
                              patient with atrial fibrillation

Public Health
                              Uptake in seasonal influenza vaccine
Amir        Farshchi          consumption by deprivation of H1N1 influenza
                              vaccine in Iran 2010
                              The influence of internet on youth health and
Ognjen      Bojovic
                              social life
                              Knowledge, Attitude and Practice of Universal
                              Precautions by the Healthcare Personnel in a
Abhinav     Pal
                              tertiary care center in a developing country
                              (India)
                              Trend Analysis of Gastrointestinal Cancer
MOHAMAD     Pourhoseingholi
                              Mortality in Iran
                            Epidemiological features of Gastro-esophageal
Asma        Pourhoseingholi reflux disease in Iran based on general
                            population
                              A cost analysis of functional bowel disorders in
Mohsen      Vahedi
                              Iran: A cross-sectional population-base study
                              Assessment /Evaluation/ of the risk for
Peter       Velikov           development of Type 2 Diabetes Mellitus for the
                              population of Bulgaria.
                               EXPOSURE TO INDOOR AIRPOLLUTION AND
Milan            Jovanovic     APPEARANCE OF RESPIRATORY SYMOTOMS
                               IN FEMALE POPULATION
                               The psychophysiological aspects of
Kateryna         Zavgorodnya
                               communicative stress in medical students
                               NUTRITIONAL STATUS AND INTAKE OF
Jandri           Barnard       SOUTH AFRICAN WOMEN BETWEEN THE
                               AGES 18 AND 22 YEARS

Dentistry Oral
                               Oral health of six- years old children in the
Dorde            Blanusa
                               city area of Kosovska Mitrovica
                               Deformation at compression and recovery
Eugenia          Manak         after deformation of anhydrous elastomer
                               impression materials
                               Kinetic and microbiological study of tooth
Maksim           Shestopalov
                               deca
                               Study of Madelung’s disease as a
Yevgeniya        Vlasenko      particular case of lipomas of maxillofacial
                               region
                               Condition of parodontal tissues of patients
Yury             Ostaev
                               with osteoporosis

Dentistry Poster
                               Amalgam or composite ? Difference of the
Tatjana          Tulumovic
                               view in patients and dentists
                               Effect of different types of retraction thread
Armine           Ambaryan
                               on the degree of gingival recession
                               Macroscopic and microscopic changes of
Maryna           Globenko      teeth for descendants at mother’s
                               hypokinesia
                               Free gingival graft technique for aberrant
Ilian            Andreev       frenulum elimination and gingival tissues
                               augmentation (Case report)
                               APICALLY DISPLACED FLAP FOR CROWN
Denislav         Emilov        LENGTHENING OF TOOTH WITH
                               HORIZONTAL SUBGINGIVAL LESION
Dear Colleagues,

It is a great pleasure for me to address to a young auditory of
medical doctors, dentists, pharmacists, scientists and lecturers.

The International Congress of Medical Science is an important aca-
demic event for students and young doctors. This forum gives the
young scientists the chance to report their achievements, exchange
views, gain experience, strike up a friendship.

It is not easy to explain the way to success in the scientific career.
It needs hard work, analytical mind, watchfulness, enthusiasm
and even good luck. It needs also internal balance that gives the
strength to accept defeat and triumph as well as triumph after
defeat.

The idea and invention in science are individual ability. But as the
scientific process becomes more complicated, the team work in sci-
ence is inevitable. The ability of the team workers in present sci-
ence is a precondition for better results. The international teams
give chance and better atmosphere to every serious scientist and
guarantee the final success of the scientific idea and its international
recognition. The individual success will not be covered by the shade
of the general achievement. The efforts of teams from different
countries, working over one and the same problem, is a very good
practice nowadays.

The mission of every high level university is to stimulate the
students’scientific strive. We are very proud that the Association
of Medical Students in Bulgaria – Sofia together with the Students’
Council of Medical University – Sofia turned the tradional national
students’ scientific sessions into International Congress of Medical
Sciences for students and young doctors. We hope that this initiative
is the basis for establishment of new international scientific teams.

I wish you all fruitfull and successful work and not ending research
enthusiasm!


                           Professor Vanyo Mitev, MD, PhD, DSc
                          Rector of the Medical University - Sofia
Dear Colleagues and Friends,

It is a great pleasure for me as Dean of the Faculty of Medicine – Sofia
and on behalf of the academic community of our Faculty to welcome
you to the 10-th Anniversary International Congress of Medical Sci-
ences for Students and Young Medical Doctors.
We are very proud of the fact that this Forum in May has already be-
come an annual tradition and we are highly honored that our Faculty
will be its host again.
The Faculty of Medicine – Sofia, with a total of over 2000 students, is
the oldest medical school and leading faculty in Bulgaria well-known
for the quality of its student education, post-graduate programs and
medical research. And perhaps this explains the fact that your con-
gress has established high standards of quality of scientific sessions
and workshops. This year the main topics are in the field of pre-clinical
science, as well as clinical studies in the area of therapy, surgery,
medical education public health and dental medicine. The number of
the registered participants – over 450 from 29 countries, is encour-
aging and it promises that this scientific meeting will be carried out
successfully by a distinguished group of dynamic and very talented
medical students and young medical doctors.

Dear Friends,

In the eve of the 24th of May – the Day of the Bulgarian Enlighten-
ment, Culture and Slavonic Alphabet – I would like to wish you a cre-
ative and constructive scientific forum.




May, 2011                          Prof. Marin Marinov, PhD, DMSc
Sofia                                    Dean, Faculty of Medicine
Dear Colleagues and Friends,




It is a great honor and sincere pleasure for me to welcome you to
the 10th Anniversary International Congress of Medical Science for
students and young doctors 2011, Sofia, Bulgaria.

For the last 9 years ICMS has become one of the most important
academic events for students and young doctors in Central and
Eastern Europe. Being not only a tribune where you young scientist
present your yearlong efforts and work but a place where you can
forge friendship and future scientific collaboration.

I am proud to coordinate the preparation for this year special event.
On behalf of the Organising Committee I share with you that we
gave our heart and soul for you to have an amasing experience
during ICMS 2011.




                                                    Yours sincerely,




                                               Albena Nikolova
                                     Co-president of ICMS 2011
Dear Colleagues and Friends,




It is an honour for me to welcome you on the behalf of the As-
sociation of Medical Students in Bulgaria and on the behalf of the
Organizing Committee to the 10th International Congress of Medi-
cal Sciences.

The ICMS is a leading event for research, biomedical sciences and
innovations for medical students and young doctors and one of
the most important and remarkable congresses in Europe of its
kind. This forum provides a platform of international collaborations,
exchange of ideas, and a chance for the young scientists to out-
stand. The ICMS is incentive for every researcher and explorer of
the medical science, it gives impetus to new ideas and inventions,
it contributes to the professional realization of all the participants.

We consider ICMS to be an important initiative for promoting sci-
ence and research but it is also a place where people for future col-
laboration, partnership and friendship could be met.
AMSB and the whole Organizing Committee are proud to welcome
you in Sofia and warmly invite you to share this unique event with
us!

                                                      Yours sincerely,



                                                    Radislav Nakov,


                               AMSB-Sofia President 2010-2011
                                      ICMS 2011 Co-president
Dear Colleagues and Friends,




     It is an honor for me to welcome you on behalf of the Associa-
tion of Medical Students in Bulgaria to the 10th International Con-
gress of Medical Sciences.

     The ICMS is one of the largest biomedical conferences in Eu-
rope and has been one of the main events at the Medical University
- Sofia for many years. It represents an interdisciplinary platform
for international scientific exchange between numerous countries,
students and clinicians from different fields of research and various
cultures. I hope in these intercultural settings you will experience
medical science like never before, exchange innovative ideas and
find partners and friends for life. AMSB and the whole Organizing
Committee are proud to welcome you in Sofia and warmly invite
you to share this unique event with us!




                                                     Yours sincerely,




                                                      Deyan Popov,

                                      AMSB President 2010-2011
Dear colleagues,




        On behalf of the Students’ Council at Medical University-Sofia,
it is my honour to cordially welcome you to the 10th International
Congress of Medical Sciences for medical students and young doctors.
For the last couple of years, it has become one of the largest biomedi-
cal conferences in Europe and its primary aims are not only to offer
a venue for student exchange but also to stimulate international
co-operation between research groups and in this way to strengthen
the European network. Thereby the congress provides a starting point
for talented students to pursue a career in medical research and also
offers all participants many opportunities for learning the latest in
the fields of medicine, dentistry, pharmacology, bioethics and public
health.
I wish you pleasant stay in Sofia and successful participation at the
10th International Congress of Medical Sciences.



              Good Luck!



                                     Sincerely,


                                             Petar Chavdarovski
                      President of Students’ Council 2010-2011
ABSTRACTS
    OF
ICMS SOFIA
   2011
  Abstracts
Preclinic Oral
  Session I
   VARIATIONS OF VERTEBROBASILAR JUNCTION AT ADULT
    HUMAN CADAVERS DETERMINED PROCESSING DIGITAL
                        IMAGE




                                                                                      Anatomy
  Authors: Jasmina Randjelovic, Vladan Milosevic

  University: University of Nis




ICMS 2011 / OP 01 Preclinic
 Abstract:


 There is a practical clinical significance of testing the angle of arterial bifur-
 cation in terms that hemodynamic effects come into play when it comes to
 local changes in vessel geometry of artery branching. Vascular components
 of the vertebrobasilar system are vertebral arteries and basilar artery. Con-
 vergence angle of the vertebral artery is highly variable and precisely for
 this reason it is one of the important hemodynamic factors in facilitating
 vertebrobasilar circulation and predilective place for the development of
 atherosclerosis. Aim: The aim was to determine the size of the convergence
 angle of the verterobasilar arteries junction and lumen of the arteries that
 make it. Materials and methods: The study was conducted at the Institute
 of forensic medicine, faculty of Medicine University of Nis, during the fo-
 rensic autopsy. The research was performed in the period 2006-2010. year
 to 41 extracted human brains (26 males and 15 females, aged 25 to 95
 years, with different causes of death). For the purpose of collecting and
 processing data, the bases of brains with blood vessels were photographed.
 Calibers of left and right vertebral and basilar artery, also as vertebral ar-
 tery convergence angles, were measured by processing digital photographs
 in computer program ImageJ. Results: The angle of convergence of the
 intracranial vertebral artery segment was 48.49 ° ± 23.87. The average
 value of an external diameter of the basilar artery was 4.79 ± 0.86 mm. The
 mean value of an external diameter of the left vertebral artery was 3.41 ±
 0.83 mm and the diameter of the right was 3.29 ± 0.89 mm. Conclusion:
 We found low positive correlation between values of basilar artery diam-
 eters and vertebral arteries diameters individually, as well as between the
 convergence angle value of the vertebral artery and the level of the verte-
 brobasilar junction. Key words: basilar artery, vertebrobasilar junction, the
 angle of convergence




 Keywords: basilar artery, vertebrobasilar junction, the angle of convergence
 Contact authors at: jasmyna88@gmail.com



                                      —35—
               FEATURES OF MORPHOGENESIS OF RATS KNEE-JOINT
              SYNOVIUM IN EARLY POSTNATAL PERIOD AFTER INTRO-
                DUCTION OF HYDROCORTISONE TO THE PREGNANT.
Anatomy




           Authors: Elena Monina


           University: Zaporizhzhya state medical university




          ICMS 2011 / OP 02 Preclinic
           Abstract:
           Introduction. Problem of joint deseases is of great interest and need
           to be solved. Aim: to study the synovium morphogenesis in the early
           postnatal period of ontogenesis after hydrocortisone introduction to the
           pregnant rats in the third period of pregnancy. Materials and methods.
           An experimental animals were injected intramuscular hydrocortisone in
           a dose 10 mgs/kg. Control for other groups of animals were rats which
           physiological solution in equivalent volumes and intact rats. Euthanasia
           of rats was conducted under ether anesthesia on 1, 7, 11, 14, 21, 30,
           45, 60 twenty-four hours after birth. Histological samples of the knee
           joint 5-7 mcm in thick, were stained with the reagent of Schiff, alciane
           blue with the critical concentration of MgCl2 0,6 M. morpho-functional
           features of synovial membrane were examined. Data are treated by the
           method of variation statistics. Results considered reliable at р ? 0,05.
           Results. In newborn rats of all groups forming of knee-joint is not com-
           pleted. Up to 11-th day after birth synovium of experimental animals is
           thicker than in intact. At day 21 after birth in the intact rats the thick-
           ness of synovium is 78,8 ± 3,84 mcm. There are mast cells, located
           directly under synoviocytes, their density of distribution is 33,00 ± 1,23
           cells on conditional unit of area. The thickness of synovium in experi-
           ment is 101,75 ± 7,98 mcm. Absolute number of fibrocytes is -109,75
           ± 10,80, fibroblasts - 70,73 ± 10,80; there are also lymphocytes and
           macrophages. At day 45 after birth in rats after introduction of hydro-
           cortisone the synovium is thickened (123,25 ± 7,38 mcm) as compared
           to control and with 30th day of life. Fibres are located loosely. Relative
           area, occupied with the extracellular matrix is 37,6 ± 0,2%. Relative
           area, occupied by cells is 20,3 ± 0,27 %. The increasing of absolute
           number of mast cells is determined 28,75 ± 1,07. Conclusions. Intro-
           duction of hydrocortisone in the third period of pregnancy influences
           on the morphogenesis of knee-joint synovium at posterity. The abso-
           lute number of mast cells increases on conditional unit of area (100000
           mcm2) of synovium, especially in newborns.
           Keywords: synovial membrane, hydrocortisone, mast cells
           Contact authors at: l_monina@ukr.net



                                            —36—
   CADAVER STUDY - TIBIAL SLOPE OF THE LATERAL TIBIAL
                       CONDYLE




                                                                              Anatomy
  Authors: Ivana Jovanovic,Stefan Juricic,M.Jovanovic,Z.
  Jovanovic,S.Smrzlic,I.Stamenic,T.Savic,D.Opacic,A.Mihailovic,N.
  Banjanin,B.Milosevic,O.Bojovic,M.Micic

  University: Medical University Belgrade



ICMS 2011 / OP 03 Preclinic
 Abstract:
 Introduction: Tibial slope represents one of the most stated ana-
 tomical factors which lead to injury of anterior cruciate ligament. A
 direct determination of tibial slope of medial and lateral condyle on
 a cadaver is usually conditioned by previous preparation of a leg.
 With the help of the “set of parallel bars”, it is possible to deter-
 mine a proximal anatomical tibial axis, without previous prepara-
 tion. Aim: The aim of this study is establishing sex and age differ-
 ences in size of posterior tibial slope on lateral and medial condyle.
 Material and methods: The measurements have been performed
 on the knees of 50 cadavers with an intact anterior cruciate liga-
 ment, without diagnosed gonarthrosis changes on the knee-joint,
 aged 15 to 53. The measuring has been performed by using “set
 of parallel bars “. Tibial slope on the lateral and medial condyle
 of a tibia has been measured. The value of angles is expressed in
 degrees with the accuracy of 1degree. The level of significance is
 set at 0.05. Result: The value of tibial slope obtained by measuring
 cadaver’s knees ranged from 2 to 15 degrees on lateral condyle,
 and -1 to 16 degrees on medial condyle. There is not a statistically
 significant difference between men and women regarding posterior
 tibial slope neither on lateral nor medial condyle (p>0.05 in both
 cases). Within a women’s subgroup there is a statistically signifi-
 cant difference regarding slope on the medial and lateral condyle
 (p<0.05). Conclusion: With the help of the “set of parallel bars” it
 is possible to determine tibial slope on cadaver’s knees direct and
 future studies should examine the reliability of the results obtained
 by using this method. Besides, it has been established that tibial
 slope is larger on medial condyle than on the lateral one regarding
 the material taken from the total population.


Keywords: Tibial slope, anterior cruciate ligament, medial condyle, lateral
condyle
Contact authors at: stefanjuricic@gmail.com

                                    —37—
                   MORPHOMETRIC ANALYSIS OF HUMAN STERNUM
Anatomy




           Authors: Bozinovic Milan. Randjelovic Marija. Milena Stojanovic

           University: University in Nis




          ICMS 2011 / OP 04 Preclinic
           Abstract:
           Introduction: Human sternum is a flat bone. It is composed of the three
           parts: manubrium, body and the xyphoid process. It has a central posi-
           tion on the anterion chest wall, making the articulations with the clavicle
           and the first seven ribs cartilages . The Aim: Objective of the research
           was to determine the morphometrical parameters significant for design-
           ing of the so called parametrical model of the sternum. Materials and
           Methods: The investigation was peformend on 15 sterna from osteologi-
           cal collection of the Medical Faculty Ni?, Department of Anatomy. The
           following morphological parameters were measured: 1.Length of the
           sternum 2.manubrium breadth (2a Maximal manubrium breadth and 2b
           Minimal manubrium breadth) , 3. Leangth of manubrium, 4.breadth of
           manubrium , 5a. length of the sternal body, 5b. breadth of the sternal
           body, 5c. thickness of the sternal body and derived parameters manu-
           brium index (MI) and body of the sternum index (IC) were measured.
           Measurements were peformeed by using the sliding caliper with nonius.
           Results: Minimal value of the sternal length was 13.07cm and maximal
           15.47cm. Mean values of the maximal manubrium breadth were 4.64cm,
           minimal manubrium breadth 3.07cm, length of manubrium 4.75cm; the
           breadth of manubrium was the highest at the level of the manubrio-
           sternal junction and was average 1,14cm; Maximal body length was
           12..9cm and minimal 8.35cm; mean value of the body breadth was
           the highest between the incisures of the IV and V rib cartilages and the
           least between the V and VI incisures.The body thickness was highest on
           the inferior margin of the VI rib cartilage and the least at the inferior
           margin of the VII incisure.Mean velue of manubrium index (IM) was
           0.82 cm and 0.31cm for the corpus of sternum index (IC). Conclusion:
           Parametric model represents a morpholocical approach to the geometry
           modeling of the sternum as a base of CAD technology which serves for
           3D modeling and the preoperative planning of the damage bone recon-
           struction.


           Keywords: sternum, morphometry

           Contact authors at: bozinovic_milan@yahoo.com


                                            —38—
    IMMUNOHISTOCHEMICAL EXAMINATION OF MICROGLIA
    IN RAT CNS – COMPLEX RESEARCH OF DEVELOPMENTAL
                        CHANGES




                                                                           Anatomy
  Authors: Enev R, Godiniachki B, Polyakov I, Stoyanova V,
  Surchev L


  University: Medical University Sofia



ICMS 2011 / OP 05 Preclinic
Abstract:
Immunohistochemical examination of microglia in rat CNS – complex
research of developmental changes Introduction: Microgliocytes are
glial cells that originate from the monocyte-macrophage system and
perform immune functions in the brain. They are found all over the
CNS, mainly around the blood vessels. Microglial activation is a known
factor in the pathogenesis of conditions such as Alzheimers disease
(AD), Parkinsons disease, multiple sclerosis, ischemic and traumatic
brain injury. Recent data reveal that microglia plays dual role in path-
ological conditions, as it expresses both inflammatory and neuropro-
tective factors. Aim: The aim of the present study is qualitative and
quantitative analysis of microglial population in immunohistochemi-
cally stained brains and spinal cords of male albino Wistar rats of age
from one to 90 days. Materials and methods: Male Wistar white rats
at different postnatal ages were used. They were deeply anesthetized
and perfused with a 4% buffered paraformaldehyde. Subsequently the
brains and spinal cords were removed, postfixed, cryoprotected with
25% sucrose and 40 ?m coronal sections from representative parts
were prepared in a freezing microtome. The resulting free-floating
sections from the animals were processed by either Iba 1 immunohis-
tochemistry or Nissl-staining. Immunohistochemical demonstration of
astrocytes was performed using an anti-Iba 1 antibody (Wako) and
the avidin-biotin (ABC) method. Diaminobenzidine tetrahydrochlo-
ride served as a chromogen. Computer-assisted image analysis was
applied to the light microscopic preparations obtained. Results: The
examination of the prepared slides showed rapid changes of quantita-
tive and qualitative characteristics of the microglial population during
the rat postnatal age. Variations in cell density were observed also
in different brain structures in rats of same age. The quantitative
analysis supports these data. Conclusion: Microglial population is a
dynamic cell group, which should be taken into account in future re-
searches in the field of brain pathology and physiology.
Keywords: microglia, immunihistochemistry, cell density
Contact authors at: rostisa@abv.bg


                                 —39—
              IMMUNOHISTOCHEMICAL STUDY OF OLIGODENDROGLIA
                        DURING RAT DEVELOPMENT
Anatomy




           Authors: Dimitrov A, Hristov R, Shumkova M, Surchev L

           University: Medical University Sofia




          ICMS 2011 / OP 06 Preclinic
           Abstract:
           Introduction: Oligodendrocytes or oligodendroglial cells as a part of CNS
           maintain a specific role to normal neuronal processes. They are the product
           of a cell line after a intricate and precisely timed program of proliferation,
           migration, differentiation, and myelination to finally produce the insulat-
           ing sheath of axons (Bradl and Lassmann, 2010). Their plasma membrane
           wraps axons with unique sheath – myelin, providing a support role and
           increasing impulse speed. Reduced oligodendrocyte count and disturbance
           in myelin structure lead to a series of functional alterations. They can cause
           demyelinating diseases such as multiple sclerosis and leukodystrophies on
           one hand and cerebral palsy caused by damage to developing oligodendro-
           cytes in the subcortical brain structures on the other hand. Aim: The aim of
           the present study is qualitative and quantitative analysis of oligodendroglial
           cells localized in spinal cord, brain stem, cerebellum, cerebral cortex and
           subcortical structures. The complex study of the development of oligoden-
           droglial distribution in all these regions will be of use for further investiga-
           tions related to the abovementioned diseases. Materials and Methods: Male
           Wistar albino rats at different ages from birth to maturity were used. The
           animals were anesthetized and perfused with a 4% buffered paraformalde-
           hyde. Their spinal cords and brains were removed, postfixed, cryoprotected
           with 25% sucrose and 40 mcm coronal sections were prepared in a freezing
           microtome. The obtained free-floating sections were processed by either
           2,3-cyclic nucleotide 3-phosphodiesterase (CNPase) immunohistochemistry
           or Nissl-staining. Immunohistochemical demonstration of oligodendrocytes
           was performed using an anti-CNPase antibody (Sigma) and the avidin-biotin
           (ABC) method. Diaminobenzidine tetrahydrochloride served as a chromo-
           gen. Computer-assisted image analysis was applied. Results: Well-defined
           morphological features of oligodendrocytes were clearly observed, as well
           as their changing morphology during postnatal ontogeny. Using image ana-
           lyzing software for counting immunoreactive pixels the changes in quanti-
           tive parameters and in the density distribution of oligodendrocytes were
           demonstrated. Conclusion: The obtained developmental data will improve
           our understanding of oligodendrocyte biology, myelin sheath formation and
           their disturbances associated with major diseases of the nervous system.
           Bradl M, Lassmann H (2010) Oligodendrocytes: biology and pathology. Acta
           Neuropathol 119: 37-53
           Keywords: oligodendrocytes, myelin, immunohistochemistry
           Contact authors at: tolka7a@yahoo.com

                                               —40—
    ASTROCYTE POPULATION DURING THE POSTNATAL DE-
    VELOPMENT OF RAT CNS – AN IMMUNOHISTOCHEMICAL
                        STUDY




                                                                                  Anatomy
  Authors: Tomov N, Polomski P, Semerdzhiev I, Surchev L

  University: Medical University Sofia




ICMS 2011 / OP 07 Preclinic
Abstract:
Introduction: Astroglia comprises of glial cells with a distinct morphology
found throughout the central nervous system, which perform functions such
as biochemical support of neurons, maintenance of the blood-brain barrier
and activity regulation for both glia and neurons. However, there is no infor-
mation how the astrocytes grow to assume their complex morphologies and
how they interact with the developing neuronal circuits (Freeman, 2010).
Although many recent discoveries suggest the importance of astrocytes in
the development of mammalian nervous system as active partakers in the
synaptic activity, no complex study of astrocytic distribution in multiple CNS
regions during the postnatal period has been carried out. Aim: The aim of
the present study is to investigate the postnatal development and distribu-
tion of astrocytes in the brain and spinal cord of Wistar albino rats at repre-
sentative stages from birth to maturity by means of immunohistochemistry
– both qualitatively and quantitatively. Materials and methods: Male Wistar
white rats at different postnatal ages were used. They were deeply anes-
thetized and perfused with a 4% buffered paraformaldehyde. Subsequently
the brains and spinal cords were removed, postfixed, cryoprotected with
25% sucrose and 40 mcm coronal sections from representative parts were
prepared in a freezing microtome. The resulting free-floating sections from
the animals were processed to either glial fibrillary acidic protein (GFAP) im-
munohistochemistry or Nissl-staining. Immunohistochemical demonstration
of astrocytes was performed using an anti-GFAP antibody (Abcam) and the
avidin-biotin (ABC) method. Diaminobenzidine tetrahydrochloride served as
a chromogen. Computer-assisted image analysis was applied to the light
microscopic preparations obtained. Results: Under the microscope GFAP-
immunopositive cells are exposed at all ages investigated. They are dis-
tributed with a different density in the various brain and spinal cord areas.
The morphology of their cell bodies and processes shows a developmental
dynamics. The quantitative analysis illustrates clearly these changes. Con-
clusion: The present data are important for a better understanding of the
astrocyte functions because these cells interact with all other cell types of
the living brain (Nimmerjahn, 2009). Freeman MR (2010) Specification and
morphogenesis of astrocytes. Science 330: 774-778 Nimmerjahn A (2009)
Astrocytes going live: advances and challenges. J Physiol 587: 1639-1647
Keywords: astrocytes, immunohistochemistry, postnatal development
Contact authors at: nitomov@gmail.com


                                    —41—
                 THE EFFECT OF DRINKS ON ACID-BASE EQUILIBRIUM OF A
                                        BODY
Biochemistry




                Authors: Alipov A, Astapovich E,Anashkina E

                University: Gomel state medical university




               ICMS 2011 / OP 08 Preclinic
                Abstract:
                Introduction. Human blood pH is slightly alkaline (7.35 - 7.45). Below or above this
                range means symptoms and disease. The reason acidosis is more common in our so-
                ciety is mostly due to the typical diet, which is far too high in acid producing animal
                products like meat, eggs and dairy, and far too low in alkaline producing foods like
                fresh vegetables, most fruits, peas, beans, lentils, spices, herbs, seeds and nuts. The
                healthy diet should consist of 60% alkaline forming foods and 40% acid forming foods.
                Thus nutrition of fruit and vegetable juices is one way to maintain health, but some
                of them are rather acidic and according to the widely held belief their drinking would
                lead to ulcers and some other stomach diseases. The aim of our investigation was to
                check up the effect of fruit and vegetable juices on gastric juice acidity. Materials and
                methods. We subdivided examined juices and beverages into five categories: (a) citric
                juices, (b) apple juices, (c) vegetable juices, (d) vitamins beverages and (e) carbon-
                ated beverages. Potentiometric method of investigation was applied to measure pH
                and buffer capacity of juices and beverages such as Coca-Cola, white-Cola, Darida and
                Fruit time. The buffer capacities characterize ability of juices and beverages to resist
                the pH changes after addition of acids and bases. In order to determine the effect of
                juices and beverages at gastric juice acidity we measured their volumes required to
                alter the pH of gastric juice by a unit. The obtained data allowed us to calculate the
                buffer capacity of gastric juice by drinks. We named this parameter a resistivity coef-
                ficient of gastric juice. The greater coefficient, the smaller is the effect of drinks on
                gastric juice acidity. Discussion. The obtained data revealed that: (a) most acidic were
                carbonated beverages (pH values in a range 2.7-3.6) and citric juices (pH = 3.2-4.0).
                But they differed greatly in buffer capacity by acids (29 and 48 mmol/L) and by bases
                (10 and 35 mmol/L). As to the resistivity coefficient of gastric juice, it took high val-
                ues for beverages (1.4-6.5 mmol/L) and rather low- for citric juices (0.0063-0.0075
                mmol/L). Thus drinks with approximately identical pH values exhibited different activ-
                ity in affecting acid-base equilibrium in stomach; (b) apple juice acidity was proved to
                be a bit lower than acidity of citric juices (pH=3.5-4.5), but its resistivity coefficient
                of gastric juice was ten times greater in comparison with citric juices and ten times
                smaller in comparison with carbonated beverages; (с) vegetable juices, except to-
                mato, are nearly neutral (pH=6.1-6.3), but their effect at the gastric juice acidity is
                a strongest one: the resistivity coefficient was extremely low (4.7•10-4 – 4.9•10-4
                ), that confirmed the idea that not only pH, but buffer capacity was a parameter that
                signaled about drink effects on gastric juice activity;(d) for all categories of juices pH
                relates to resistivity coefficient of gastric juice according to the equation: coefficient =
                pHx, where x took the values from -0.7 (apple juice) to -4 (vegetable juice). Conclu-
                sion. The experimental data revealed that pH is a powerful but not the only factor ef-
                fecting acid-base equilibrium in gastric juice. More information about this phenomenon
                is given by buffer capacity of gastric juice by a beverage.
                Keywords: buffer capacity of gastric juice ,resistivity coefficient of gastric
                juice , acidosis
                Contact authors at: NE_VA@tut.by

                                                         —42—
   BIOCHEMICAL FEATURES OF MULTIRESISTANTIC STRAINS
                  OF STAPHYLOCOCCUS




                                                                            Biochemistry
                                                                              Anatomy
  Authors: Maria Dubrova

  University: KHNMU




ICMS 2011 / OP 09 Preclinic
Abstract:
Inflamationary diseases in obstetric and gynecology practice are con-
sidered as a serious problem of modern medicine. The conditional-
ly pathogenic microfloras take the leading part in the pathology of
miscarriages. This is concerned to the biological variability of these
microorganisms, the value of its virulence, the ability of persistent
colonization and multiple antibiotic resistance. Thereby, it is necessary
to study particular qualities of the metabolic processes in microor-
ganisms of the urogenital system for a rational therapy. There were
observed 80 women at the age of 18 to 24 (having the anamnesis of
2 or more incidents of abortion in the first trimester). As a result of
observations, 54 staphylococci were extracted from urogenital sys-
tems of pregnant women, while 58% were resistant to more than
5 antibiotics. The maximum resistance between investigated strains
was registered in case of macrolides, the minimum level of resistance
was detected in case of fluoroquinolon. The comparative analysis of
virulence factors and energy processes indicators for extracted strains
showed, that antibiotic-resistant microorganisms have an antilizocym
activity level 1,6 times higher than susceptible strains do. The antibi-
otic-resistant strains have an activity of amdolaza, pyruvate cyclase,
pyruvate dehydrogenaseat 1,5-2,5 times higher than antibiotic-sus-
ceptible ones and ATP concentration is on average 1,5 times higher.
The observed strains also differ by an antioxidant system enzymes
activity: antibiotic-resistant strains showed the catalase activity level
of 11,25 µkat/g of protein, while antibiotic-susceptible achieved only
6,45. Multi-resistant strains also have the higher level of superoxide
dismutase activity (about 26,8 mg/g of protein against 19,05). Thus,
antibiotic-resistant mechanisms formation at clinical staphylococcus
strains is correlated with the energy processes intensification and ris-
ing of antilysozymic and antiox phosphate microbes’ activity level.
These features of antibiotic-resistant strains must be considered dur-
ing the therapy.

Keywords: biological variability of microorganisms, antibiotic resistance
Contact authors at: mariadubrova@yandex.ru


                                  —43—
                    THE EFFECT OF INHIBITION OF KAP?2 BY M9M ON THE
                          NUCLEAR LOCALIZATION OF HUNTINGTIN
Biochemistry




                 Authors: Margarita V. Blajeva, Sarah Allison, Simone Gentles,
                 Anson Leung, and Allan Williamson

                 University: Medical University Sofia




               ICMS 2011 / OP 10 Preclinic
                Abstract:
                Huntington’s disease (HD) is an inherited disease resulting in
                the abnormal CAG triplet repeat content in exon1 of the cod-
                ing region by the HD gene, which eventually leads to death.
                The objective of this study was to propose a mechanism
                through which mutant Huntingtin (Htt) enters the nucleus,
                and determine if the cellular localization of Htt is affected by
                the inhibition of karyopherin?2 (Kap?2) by M9M. M9M and
                mutant Htt were fluorescently labeled in blue and yellow re-
                spectively. The localization of mutant Htt in the presence and
                absence of M9M, as well as that of a positive and a nega-
                tive control, were visualized using fluorescence microscopy.
                Percent nuclear fluorescence was quantified using SimplePCI
                software. A statistically significant reduction in percent nu-
                clear fluorescence of transfected striatal cells containing Htt
                and M9M was identified, indicating that the presence of M9M
                prevents Htt from translocating into the nucleus effectively.
                This finding could lead to the development of new treat-
                ments for Huntington’s disease.




                Keywords: Huntingtons Disease, Huntingtin, karyopherin?2, transloca-
                tion, treatment
                Contact authors at: margarita.blajeva@gmail.com


                                                —44—
    FERROUS REDUCING ABILITY OF PLASMA, THIOL COM-
  POUNDS AND LIPID PEROXIDATIVE PRODUCTS IN PLASMA
      OF PATIENTS WITH SKIN MALIGNANT MELANOMA




                                                                                 Biochemistry
                                                                                   Anatomy
   Authors: Asen Anastasov, Vanya Dincheva, Petya Peeva,
   Tsonka Habib, Tatyana Vlaykova

   University: Trakia University




ICMS 2011 / OP 11 Preclinic
Abstract:
Human malignant melanoma is the most serious of skin cancers. It origi-
nates from skin melanocytes and has an unpredictable clinical course: it
may remain silent for many years after its primary occurrence or it may
behave in a very aggressive way and metastasize early. The melanocytes,
which have a unique function to accomplish, the synthesis and delivering
melanin to keratinocytes, are continuously exposed to intrinsic and extrinsic
sours of ROS. In order to overcome the attack of these reactive biological
species the normal melanocytes are finely tuned via the intrinsic antioxi-
dants and radical properties of melanin. However, it has been proposed that
during melanomagenesis this fine control is lost and inappropriate altera-
tion of the redox state occurs in the transformed cells. Whether the changes
of redox state in melanoma cells affect the systemic balance of oxidant/an-
tioxidant in plasma is not well clarify. In this respect we aimed to determine
some plasma antioxidant characteristics, such as ferrous reducing ability of
plasma (FRAP) and the concentration of total thiols, as well as to assess the
lipid peroxidative products as a marker of the oxidative stress. We evalu-
ated the total antioxidant capacity (FRAP) and the concentration of thiol
compounds and malone dialdehyde (MDA) in plasma of 50 control individu-
als and of 35 patients with malignant melanoma. In conclusion, we suppose
that the occurrence of systemic oxidative stress in patients with metastatic
melanoma may reflect the increased production of ROS due to the impaired
balance in oxidative/antioxidative processes in tumor tissue and mainly
the enhanced and dysregulated melanin synthesis, which consumes great
amount of glutathione and is a big source of large quantity of H2O2. As a
consequence of high ROS level, an abnormal activation of one of the major
redox-sensitive transcriptional factors, NF-kB occurs, which results further
in downstream stress response including an anti-apoptotic effect, how it has
been proposed by Meyskens et al, 2001. Since most of the anticancer drugs
insert their cytotoxic effect by triggering apoptosis cascade, the assumed
suppression of apoptosis in melanoma might be the major cause of the drug
resistance, which is almost universally observed in melanoma.




Keywords: malignant melanoma, FRAP, thiols, MDA
Contact authors at: asen_anastasov@hotmail.com


                                   —45—
            THE EFFECTS OF PHOSPHORYLATION OF THE PKA-LIKE KI-
             NASE REGULATORY SUBUNIT IN TRYPANOSOMA BRUCEI
Biology




            Authors: Marko Ristic, George Githure, Sabine Bachmaier


            University: Medical University of Belgrade




          ICMS 2011 / OP 12 Preclinic
           Abstract:
           INTRODUCTION Trypanosoma brucei is a eukaryotic parasite that belongs
           to the order of kinetoplastida. Subspecies of T. brucei are the causative
           agents of African sleeping sickness, which is transmitted by the tsetse
           fly. This parasite cycles between mammalian hosts and insect vectors
           and therefore encounters environmental changes that require rapid
           adaptation.T. brucei possesses a highly conserved PKA-like kinase. In
           T.brucei this enzyme activated by a drop in temperature (cold shock).
           Cold shock activation of PKA-like kinase (PKAC) is mediated by its regula-
           tory subunit PKAR, which localizes the kinase to the flagellum. In order to
           further understand the role played by this subunit, the aim of this project
           was to generate specific mutations with an emphasis on predicted phos-
           phorylation sites. EXPERIMENTAL APPROACH: We managed site directed
           mutagenesis by PCR to replace the “phosphorylatable” amino acid resi-
           dues with a “non-phosphorylatable” residue in the phosphorylation sites
           shown above. The mutated open reading frames were used to rescue the
           T. brucei PKAR knock out cell line. The acquired cell lines are tested for:
           stability of the holoenzyme (PKAR+PKAC)-Western blot analysis of PKA
           subunit expression,Coimmunoprecipitation, Cold shock activation-In vivo
           kinase reporter assay (VASP assay),Enzyme localization RESULTS West-
           ern blot analysis showed that the mutations we introduced into the PKAR
           sequence did not impair the expression of the protein. The expressed
           mutated proteins had no negative effect on cell viability. In order to ana-
           lyze the activation of the kinase we used an in vivo kinase reporter as-
           say (VASP assay). Upon cold shock, PKA activity is induced in wild type.
           The PKAR KO is not responsive to cold shock. If we now rescue KO with
           mutant PKAR, we expect wildtype, impaired or abolished behaviour. CON-
           CLUSION The expression of PKAR protein is not affected by introducing
           mutations in selected regions. The mutated proteins does not affects cell
           viability. Growth rate in all mutants is not affected except in substrate mu-
           tant, where it is sligltly impaired. Phosphorilation_site_3 mutant showed
           decreased activation of PKA-like kinase similar to KO strain, compared to
           rest of the mutants, which showed no or small reduction of activation.
           Keywords: T.brucei,PKA-kinase,phosphorilation site

           Contact authors at: markor86@yahoo.com


                                             —46—
   INFLUENCE OF DIFFERENT ELF-EMF FREQUENCIES ON HU-
  MAN SKIN PERFUSION IN VIVO ESTIMATED BY LASER DOP-
                 PLER FLOWMETRY (LDF)




                                                                                  Biophysics
                                                                                  Anatomy
  Authors: Nikolova Nikolina, Nikolova S, Traikov L, Antonov I,
  Petrova J.

  University: Medical University Sofia




ICMS 2011 / OP 13 Preclinic
Abstract:
The biological effects of extremely low-frequency electromagnetic fields
(ELF-EMF) have been a subject of research for decades. A beneficial impact
has been found on the process of inflammation, tissue regeneration and
increasing the metabolic activity. We investigate the impact of different fre-
quencies of ELF-EMF on the skin perfusion using Laser-Doppler Flowmetry
(LDF). Laser Doppler Flowmetry (LDF) is an accurate and reliable method
for assessing microcirculatory function and tissue perfussion. LDF on skin
blood flow is based upon measurement of the The product of moving blood
cell’s velocity and their concentration in a certain volume is called tissue
perfusion. This study was designed to estimate frequency dependencies of
localized ELF-EMF exposure. LDF had been applied on the right hand of 25
healthy volunteers, exposed at constant 25 oC ambient temperature to 10
min. ELF-EMF (10, 16, 20 and 50 Hz) (magnetic flux density-20mT). Evalu-
ation of tissue perfusion during 33 min continuously measurements have
been provided. Continuous changes in blood pressure variations and perfu-
sion were measured prior during and after exposure. We also compare the
non-invasive (LDF) data before and after ELF-EMF stimulation with invasive
intravital microscopy (IVM) data (obtained on animals in vivo), during ELF-
EMF stimulation at the tissue. For the evaluation of the condition of micro-
circulatory bed a complex non-parametric statistical analysis were provid-
ed. For decomposition of non-linear complex signal of vasomotion (of blood
vessels) to basic frequencies, FFT and Wavelet MATLAB based analysis were
applied. After time-frequency (wavelet) analysis 5 frequency subintervals,
were set: 0.0095-0.02 Hz; (alpha), 0.02-0.06 Hz; (beta), 0.06-0.15 Hz;
(gamma), 0.9-1.2 Hz; (delta), 1.2-2 Hz; (theta). The subintervals were
related to the specific functional activities of the tissues. Obtained results
obtained by LDF showed that after 10 min 16 Hz ELF-EMF exposure local
blood flow/local perfusion increase significantly. After wavelet analysis there
isn’t significant changes in different frequency subintervals in comparison
with the control as well. By LDF we could not success to detect any signifi-
cant changes in different functional active frequency bands during and after
ELF-EMF exposure at the contrary by IVM we successfully detect significant
changes in alpha and beta waves, respectively related with tissue metabo-
lism and vegetative neural system activity.
Keywords: microcirculation, extremly low frequency electromagnetic
field, LDF
Contact authors at: nina.damjanova@yahoo.com

                                    —47—
               TRANSMITTANCE PROPERTIES OF ORGANIC AND MINERAL
                            PHOTOCHROMIC LENSES
Biophysics




               Authors: Nikola Kyuchukov


               University: Medical University of Sofia




             ICMS 2011 / OP 14 Preclinic
              Abstract:
              Exposure of the eyes to ultraviolet radiation (UVR) is known to
              cause acute photokeratitis and photoconjunctivitis. Past studies
              have shown that there is strong evidence for a causal relationship
              between UVR and squamous cell carcinoma of the cornea and con-
              junctiva. Similarly chronic exposure to UVR has been associated
              with an increased risk of cortical cataract. To protect their eyes from
              sunlight, increasingly more people rely on organic and mineral pho-
              tochromic lenses. These lenses have a unique property to darken
              on exposure to UVR. Photochromic lenses are preferred, because
              they are thought to serve a dual purpose of sunglasses and pre-
              scription glasses. The main goal of this study was to assess wheth-
              er photochromic lenses offer adequate sunlight protection. Due to
              the unique nature of photochromic materials, a special method of
              spectrophotometery had to be devised and used. The transmission
              properties of 22 randomly chosen lenses were measured with a
              spectrophotometer before and after a 2.5 minute-long irradiation
              with a mercury-vapor UV lamp. In the UV-B and UV-C region all of
              the lenses absorbed nearly 100% of the radiation. However in the
              UV-A region the absorbance ranged from 43% to 94% prior to and
              from 50% to 94% following UV exposure. Following UV exposure
              none of the tested photochromic lenses absorbed more than 27%
              from the visible light spectrum. Different photochromic lenses of-
              fer varying levels of eye protection that is not always be adequate.




              Keywords: Photochromic lenses, eye protection

              Contact authors at: ndk2104@columbia.edu


                                              —48—
  Abstracts
Preclinic Oral
  Session II
              THE STUDY OF ASSOCIATION BETWEEN FACTOR V LEIDEN
                        MUTATION AND G6PD DEFICIENCY
Genetics




             Authors: Zohreh Rahimi, Hadi Mozaffari, Azadeh Heidarpour

             University: Kermanshah University of Medical Sciences




           ICMS 2011 / OP 15 Preclinic
            Abstract:
            Introduction G6PD(Glucose 6-phosphat dehydrogenase) deficiency is the
            most common erythrocyte enzymopathy in humans. Factor V Leiden is a
            variant of human factor V that causes a hypercoagulability disorder Aim
            The aim of the present study was to assess the prevalence of these throm-
            bophilic mutations among G6PD deficient individuals from this area. Meth-
            ods In this cross-sectional study,G6PD deficient individuals consisted of 57
            school boys and 3 girls with history of favism and hemolytic anemia. An age
            and sex matched group of healthy individuals, 95 males and 15 females
            were selected and along with G6PD individuals were studied for factor V
            Leiden mutation. DNA was extracted by phenol chloroform method. The
            activity of glucose-6-phosphate dehydrogenase was determined . G6PD
            mutations were identified by a combination of PCR-RFLP technique, single
            strand conformation polymorphism (SSCP) analysis and DNA sequencing.
            The factor V Leiden was detected by PCR-RFLP method , as previously de-
            scribed . Chi-square test is used for matching the variants and we utilized
            SPSS.V.12 for statistical application. Results Among G6PD deficient individ-
            uals there were 3 males carrier of factor V G1691A giving the prevalence of
            5% and allele frequency of 2.5%. Factor V G1691A mutation was detected
            as heterozygous in 3 males out of 110 healthy individuals indicating the
            prevalence of 2.7% and allele frequency of 1.3%. No homozygous fac-
            tor V G1691A and was found. Overal comparing to the healthy individual
            the differences were not statistically significant. Conclusion Compared with
            those without the mutation of factor V Leiden , heterozygous carriers have
            a 7-fold increased risk of venous thrombosis; homozygous individuals have
            a risk that is increased up to 100-fold . It has been indicated that the G6PD
            deficiency could be connected to the venous thrombosis . In the present
            study, the prevalence of factor V Leiden in G6PD individuals tended to be
            higher compared to controls (5% vs. 2.7%) but, the difference was not
            statistically significant. Briefly, our finding indicates that the prevalence of
            factor V Leiden in G6PD deficient individuals is not statistically different
            compared to normal subjects and G6PD deficiency is not associated with
            this thrombophilic mutation in Western Iran.

            Keywords: G6PD, Factor V leiden, thrombophilic mutation,enzymopathy

            Contact authors at: azadeh.heidarpour@yahoo.com


                                                —50—
     THE MOST RELIABLE MSI MARKERS IN DIAGNOSIS OF
                   COLORECTAL CANCER




                                                                                 Anatomy
                                                                                 Genetics
  Authors: Mahdi Montazer Haghighi, Atena Irani Shemirani , Sa-
  man Milanizadeh, Mohammad Yghoob Taleghani, Zahra Akbari,
  Seyed Reza Fatemi, Mohammad Reza Zali

  University: Shahid Beheshti



ICMS 2011 / OP 16 Preclinic
Abstract:
Introduction and aim: Colorectal cancer is one of the most common can-
cers among both men and women. The incidence of CRC is lower in Iran
than in Western countries, being the fifth and third most common cancer
in men and women. Nevertheless, its incidence in Iran has been increased
dramatically. The great majority (80%) of patients with colorectal cancer
have sporadic disease with no evidence of having inherited the disorder.
In the remaining 20%, a potentially definable genetic component exists.
Microsatellites have an increased risk for expansion or contraction during
DNA replication. Approximately 90 percent of HNPCC-associated colorectal
cancers show MSI. Therefore, MSI testing of HNPCC is the first step in the
evaluation of an individual or family suspected of having this disorder. MSI
may also be seen in approximately 15 percent of sporadic colorectal can-
cers. The aim of this study was to examine the most frequent MSI mononu-
cleotide markers among five more useful markers due to set up new smaller
panel the simplest diagnostic strategy for identification of patients with HN-
PCC and sporadic CRC in our population. Methods: 80 sporadic CRC and
76 HNPCC biopsies were examined.MSI was performed using five quasi-
mononucleotide markers. The markers, NR-27, NR-21, NR-24, BAT-25, and
BAT-26, were amplified by pentaplex PCR. MSI assay was carried out by
capillary electrophoresis. Fragment analysis were done using gene mapping
software. Results: Microsatellite instability assay revealed that 11.5 % and
22.3% MSI in sporadic CRC and HNPCC, respectively. Among the mononu-
cletide markers NR-21 showed the most frequent in sporadic CRC (60%)
and HNPCC (88.2 %). NR-24 was in the second position. Moreover, the
frequencies of markers were as bellow: NR-24 (27.3%), BAT-25 (18.2%) in
sporadic CRC and NR-24 (64.7%), BAT-26 (29.4%), BAT-25 (23.5%), NR-
24 (23.5%) in HNPCC. Conclusions: Our findings showed that NR-21 and
NR-24 are the most frequent mononucleotide markers in the both groups.
Thereby, they would be useful markers for early detection of individuals
with HNPCC or sporadic CRC. Furthermore, they could be consider in a
smaller panel for MSI assay in the both groups in our population




Keywords: Colorectal cancer,MSI,Mononucleotide Markers
Contact authors at: mah_haghighi@hotmail.com


                                   —51—
               MOLECULAR GENETIC AND ULTRASTRUCTURAL CHARAC-
                        TERISTICS OF CADASIL DISEASE
Genetics




             Authors: Branislav Rovcanin, Dusan Kekic, Ivana Novakovic,
             Vesna Lackovic

             University: Medical University of Belgrade




           ICMS 2011 / OP 17 Preclinic
            Abstract:
            Introduction: Cerebral Autosomal Dominant Arteriopathy with Sub-
            cortical Infarcts and Leucoencephalopathy (CADASIL) is an inher-
            ited vascular disorder affecting predominantly central nervous sys-
            tem. Main patohistological entity is granular osmiophilic material
            (GOM) which is deposited in the external basal lamina of vascular
            smooth muscle cells. CADASIL is caused by mutations of NOTCH3
            gene. CADASIL if often misdiagnosed and overlooked in its ear-
            ly stages which represents a significant clinical problem. Aim: To
            determine genetical and ultrastructural properties of patients who
            were assumed to have CADASIL according to clinical presentation.
            Methods: Skin samples were obtained using biopsy of deltoid re-
            gion. Exons 2-6 of NOTCH3 gene were amplified by PCR method
            and subsequently sequenced. GOM deposits were identified using
            transmission electron microscopy. Results: Four different mutations
            which determine CADASIL disease were detected among described
            patients. GOM deposits are located in the extracellular space be-
            tween degenerating smooth muscle cells or in the invaginations of
            thickened basal lamina. Conclusion: This study demonstrated im-
            portance of electron microscopy analysis of skin bioptates for CA-
            DASIL diagnosis which was verified with genetic testing for NOTCH3
            mutations. Since electron microscopy examination is easy to per-
            form, highly specific and relatively sensitive diagnostic method for
            CADASIL diagnosis it can be considered as a method of first choice.




            Keywords: CADASIL, NOTCH3 mutations, GOM

            Contact authors at: rovcaninb@yahoo.com


                                          —52—
    ALLELIC POLYMORPHISMS OF ECOR V SITE AT 3 OF THE
     VDR GENE: ANALYSIS OF THE ASSOCIATION BETWEEN




                                                                       Molecular Biology
    GENE POLYMORPHISM AND BONE MINERAL DENSITY IN
            IRANIAN POSTMENOPAUSAL WOMEN




                                                                          Anatomy
  Authors: Fatemeh Sadat Fazeli, Mina Ebrahimi-Rad, Pezhman
  Fard-Esfahani, Reza Saghiri, Mohammed Mehdie Emam, Zahra
  Nourmohammadi, Parinaz Saidi, Fatemeh Mirkhani

  University: University of Tehran



ICMS 2011 / OP 18 Preclinic
Abstract:
Introduction: Osteoporosis is a systemic skeletal disease with low
bone mass density (BMD) and increased bone fragility . BMD is
under the control of a large number of genes including Vitamin D
Receptor (VDR). VDR gene has different polymorphism site. EcoR
V site is cited at intron 8 of the gene. This study was to assess
the correlation between VDR- EcoR V genotypes with osteoporosis
in the postmenopausal women. Materials & Methods: 451 Women
enrolled into the study with accurate clinical evaluation and filled
questionnaire(222 healthy control and 229 patients). Statistical
analysis was performed using SPSS 18. The alleles and genotypes
frequencies were determined in both Normal population and case
group. The association between the specific genotypes and the
low BMD and the disease was analyzed by using X2 and One Way
ANOVA Result: No significant difference was found between the
EcoR V geneotypes in healthy control group and patients. There
was no association between EcoR V genotypes and the low BMD.
Conclusions: As osteoporosis is affected by several other factors
such as other genes, race, life style and environmental conditions,
so a bigger study with more samples might be needed for precise
conclusion. It might also be considered that in the studied com-
munity, the EcoRV genotype had no correlation with low BMD in
postmenopausal women.




Keywords: BMD, Osteoporosis, VDR, Genotyping
Contact authors at: fazeli.fatemeh@yahoo.com


                               —53—
                IMMUNOHISTOCHEMICAL EXAMINATION OF THE LEVEL
               OF NEUROENDOCRINE DIFFERENTIATION IN COLORECTAL
                              ADENOCANCEROMA
Pathology




              Authors: Nenad Todorovic, Snezana Milosevic

              University: Medical University of East Sarajevo




            ICMS 2011 / OP 19 Preclinic
             Abstract:
             Introduction: Colorectal carcinoma is the third most common cancer in
             both sexes and it is the second most common cause of mortality in devel-
             oped countries. Neuroendocrine cells, which are produced by endoder-
             mal stem cell, represent 2% of the total number of epithelial cells of the
             colon. They produce hormones and biogenic amines, and also regulate
             numerous physiological processes in the colon such as stem cells divi-
             sion, absorption and intestine motility. Aim: Analysis of the function of
             neuroendocrine cells in colorectal adenocarcinoma. Methods: Represent-
             ative samples of necrotic cancer tissue are fixed in 10% formalin and em-
             bedded in paraffin blocks. Expression detection of chromogranin (CHR) is
             done by streptavidin-biotin-peroksidase method, according to standard
             LSAB+ procedure (DAKO). According to the percentage of cancer cells
             which showed positive immunohistochemical reaction, the samples were
             divided into three groups: group 1 – there were no cells which showed
             expression of chromogranin A, group 2 – less than 10% of cancer cells
             showed positive immunohistochemical reaction; group 3 – more than
             10% of cancer cells showed positive immunohistochemical reaction. Re-
             sults: The positive expression CHR (groups 2 and 3) was noticed in 72
             (80%) of respondents. There was no expression CHR in 18 (20%) of
             respondents. In group of patients who showed positive immunohisto-
             chemical reaction with CHR, the high level of expression (group 3) was
             noticed in 49 (54.4%), whereas 23 (25.6%) of them had the moderate
             expression. There is a statistically significant difference of expression in
             patients treated surgically at II and III stage of disease and at T3a/b and
             T3c/d stage, but not at T2 and T3 stage of local disease development.
             Conclusion: There is a positive correlation between expression CHR-A
             and the disease stage, T stage of disease and the number of lymph nodes
             with metastases. There is no correlation between expression CHT-A and
             histologic, nuclear gradus of the cancer and the tumor size.



             Keywords: Colorectal adenocarcinoma ,Neuroendocrine cells,
             chromogranin,disease stage.
             Contact authors at: sone_88@yahoo.com


                                               —54—
  THE INFLUENCE OF MEXIDOL ON HEMATOLOGICAL PARAM-
   ETERS AND GAS-TRANSPORT FUNCTION IN ACUTE BLOOD
                        LOSS




                                                                            Pharmacology
                                                                              Anatomy
  Authors: Nwokorie Chibuike, Nchege Chinedum, Byakuno Wilson


  University: Higher State Education Establishment of Ukraine




ICMS 2011 / OP 20 Preclinic
Abstract:
It is known, that mexidol is potent synthetic antioxidant. The drug is
3-oxypiridine derivative containing succinate. Mexidol has antihypoxic
properties, anxiolytic action, nootropic and neuroprotective effects. The
drug is used to treat ischemic stroke, chronic disturbances of brain
blood circulation, etc. It also may be used in surgical pathology (car-
dio-vascular surgeries, acute peritonitis, and pancreatitis). The data of
experimental investigations show that mexidol is effective against con-
sequences of acute blood loss. However a question about the mecha-
nism of mexidol’s action under such conditions remains not decided.
Research purpose is to study the influence of mexidol on hematological
parameters and gas-transport function in acute blood loss. Albino male
rats were used in experiments. A loss of 25% of blood volume was
designed by the punction of heart cavities. The heart was punctated
under the general anesthesia as a standard experimental procedure.
Mexidol (100 mg/kg) was administered to animals intraperitoneally im-
mediately after the loss of blood. Ferrum-Lek (0,15 ml/kg) was used
as a reference preparation. In the samples of arterial blood obtained
24 hrs after that, it was determined partial pressure of oxygen (pO2),
partial pressure of carbon dioxide (pCO2), saturation of hemoglobin
by oxygen (SaO2) as well as a count of red blood cells (RBC), hemo-
globin (HB), and hematocrit (HCT). It was shown that blood loss is
characterized by significant decrease in RBC, HB and HCT and also by
lowering of pO2 (21%) without significant changes of pCO2 and SaO2
in a comparison with intact animals. Under the influence of mexidol,
RBC increases in 8%, HB – in 9%, and HCT – in 9% as compared to
blood loss. At the same time, pO2 decreases in 44%, SaO2 reduces in
25%; but pCO2 enhances in 41%. Ferrum-Lek displays the similar ac-
tion on hematological parameters and gas-transport function of blood,
except the absence of any changes in pCO2. The data obtained may
be explained on the basis of mexidol’s intervention in central links of
regulation of hemodynamics and respiration under the conditions of
acute blood loss.
Keywords: exidol, blood loss, red blood cells, gas transport
Contact authors at: vazhnichaya@ukr.net


                                  —55—
                  A MANIFESTSTION OF ANXIOLYTIC ACTIVITY OF THE NEW
                      DERIVATIVE OF 2-OXOINDOLIN-GLYOXILIC ACID
Pharmacology




                 Authors: Aminian Mazyar

                 University: Higher State Education Establishment of Ukraine




               ICMS 2011 / OP 21 Preclinic
                Abstract:
                New 2-oxoindol derivatives are intensively studied nowdays. Among them
                biologically active substances (BAS) with antihypoxic, cardioprotective and
                diuretic activity are found, however screening of neurotropic properties was
                not carried out earlier. Research purpose is to study the influence of amide
                derivative of 2-oxoindolin-glyoxilic acid on the resistance of laboratory ani-
                mals to stress. The researched substance was administered to albino male
                rats intraperitoneally in a dose of 15 mg/kg of body weight. Before and after
                the administration of BAS, animals’ behavioral reactions were determined
                in an open field test. At other group of rats after the administration of
                oxoindolin-glyoxilic acid derivative, it was designed an acute immobilization
                stress by H. Selye (3 hours). After the stress exposure, the animals were
                undergone to euthanasia under the intraperitoneal narcosis. The weight of
                thymus and adrenal glands as well as gastric ulcers formation were studied.
                At modeling an open field test, it has been revealed that at animals received
                2-oxoindolin-glyoxilic acid derivative the amount of crossed squares has
                twice decreased in a comparison with such at the start of experiment. At
                them, the amount of goings out to the center of a field was decreased in 3.5
                times. It was observed the reduction of standing-ups in 4.8 times and acts
                of grooming – in 1.4 times. It was testified that the investigated substance
                significantly inhibits both horizontal and vertical motor activity. At study
                of stress, it has been established, that 2-oxoindolin-glyoxilic acid deriva-
                tive prevented an involution of thymus, a hypertrophy of adrenal glands
                and a formation of peptic ulcers in the stomach which naturally accompany
                the development of a stress-syndrome. In particular, on a background of
                researched substance administration, the weight of adrenal glands was in
                2 times less, and the weight of thymus – in 1.5 times more than the same
                at stress without pharmacological correction. On the expressiveness, the
                action of the investigated derivative was similar to effect of diazepam which
                was used as a reference preparation. The specified effects can be regarded
                as display anxiolytic activity, characteristic for central nervous system in-
                hibitors such as neuroleptics and anxiolytics.



                Keywords: 2-oxoindolin-glyoxilic acid, stress, behavioral reactions
                Contact authors at: eugene55555@yandex.ru



                                                   —56—
   ANALYSIS OF ANTIHELMINTIC MIXTURES INFLUENCE ON
     SOME PARAMETERS OF THE PERSONS AND ANIMALS
                     HOMEOSTASIS




                                                                                      Pharmacology
                                                                                        Anatomy
  Authors: Strilets Oxana


  University: Northern State Medical University




ICMS 2011 / OP 22 Preclinic
Abstract:
Analysis of anthelmintic mixtures influence on some parameters of the persons
and animals homeostasis. Strilets O.L., Savyolova J.M., Zykova N.N., Demen-
shtejn N.V., Nezgovorov D.V., Nazarenko N.A., Dyogteva G.N. Northern State
Medical University(NSMU), Arkhangelsk, Russian Federation. According to the
WHO data in the world, more than 4,5 million people are affected by parasitic
diseases. In Arkhangelsk region (Russia) annually, helminthiasis (enterobiasis
96,7 %) consist 87,5 % of parasitic diseases, that corresponds to the Russian
rates (to Sergiev V.P., etc., 2008). Therefore one of medicine actual problems is
search for effective antihelmintic preparation. Authors have developed mixture
from 6 plants with (nucleus)in a mixture-tansy ordinary The purpose of research
was analysis of antihelmintic mixtures influence on some parameters of the per-
sons and animals homeostasis. In the capacity of volunteers have been involved
3rd year students of NSMU of both sexs (30 person). Mixture as 10 % infusion
, prepared according to requirements of XI Pharmacopoeia (1999) appointed
per os 2 times day in the general doze 4,2 gr to 1 kg of weight within 14 days.
Research was authorized by Committee on Ethics NSMU from 19.01.2009. By
set of standard reactants were defined (before and after experience) parameters
of blood: hemoglobin, leukocytes, thrombocytes , erythrocyte sedimentation
rate, transaminase (ALT,AST.LDH, urea, kreatine, whole protein, alkaline phos-
phatase, total bilirubin. In experiences 20 white nonpedigreed rats of both sexes,
by weight 110-120 gr.110-120 gr of weight have been used, which injected 10
% mixture infusion in a doze 42 г on 1 kg of weight during 14 days Saline was
injected to the control group . After rats slaughtering under etherized blood
film and thymus’s imprints were registered and painted by standard techniques.
Calculation of cells carried out under a microscope, at increase х 200. Statistical
treatment carried out on Students coefficient. Experiences have shown, that at
healthy volunteers, hematologic and biochemical parameters after a rate of mix-
tures intake remained within the limits of age norms in 100 % of cases with all
examined. During injection of infusion to rats in a doze in 10 times exceeding to
the doze, recommended volunteers, decrease of number of neutrophils, bloods
monocytes on 38 % and 92 % accordingly, with increase in leukocytes at 34 %
in relation to the control was registered. In thymus: reduction of plasmocytes
quantity on 49,4 % and growth (in 5,37 times) lymphoblasts , that testifies
about increase of toxicity in reply to increase of a doze and demands the further
studying of reaction of other immunocompetent organs.


Keywords: Vegetative antihelmintic mixtures
Contact authors at: strilets.oksana@yandex.ru


                                      —57—
                    EFFECT OF PROPAFENONE AND IT’S DERIVATE ON THE
                            ACONITINE-INDUCED ARRHYTMIAS
Pharmacology




                Authors: Dragan Opacic, Branka Ivkovic, Dragana Protic, Sote
                Vladimirov, Ljiljana Gojkovic-Bukarica, Marjan Toncev

                University: University Of Belgrade




               ICMS 2011 / OP 23 Preclinic
                Abstract:
                Introduction: Propafenone is one of the most commonly used drugs for the
                treatment of cardiac arrhythmias. Propafenone is a class Ic antiarrhythmic
                agent which main mechanism is blocking the Na+ channels. 5PF-PF is newly
                synthesized derivate of propafenone with modifications in the benzyl moiety
                designed on the basis of pre QSAR and pharmacophoric studies. Aim: The
                aim of this study was to examine whether propafenone and its novel deri-
                vate given immediately before beginning of arrhythmia lead to reparation
                of cardiac rhythm, or accelerate the development of arrhythmias. Materials
                and methods: Experiments were done on three groups of Wistar rats: control
                group and two experimental groups (there were 8 rats in each groups). Ar-
                rhythmia was induced by intra-venous administration of aconitine. Control
                group was administered aconitine only, while first experimental group was
                administered propafenone intravenously and second group was administered
                5PF-PF intravenously 5 minutes before aconitine. Changes in heart rhythm
                were monitored by continuous ECG for a period of 25 minutes from the time
                of aconitine administration. Experiments were done in accordance with good
                laboratory practice. Results: Both tested substances strongly inhibited aconi-
                tine-induced tachycardia, but there was no statistically significant difference
                between them. Propafenone decreased the occurrence of atrial arrhythmias
                more than 5PF-PF. Ventricular and life threatening arrhythmias occurrence
                was decreased by propafenone while increased by 5PF-PF compared to con-
                trol group. The overall mortality rate was reduced by propafenone while in
                group premedicated with 5PF-PF was statistically significantly increased. The
                on-set times of all types of arrhythmias were prolonged by propafenone, but
                reduced by 5PF-PF. Conclusion: Propafenone has a positive effect on the con-
                trol of heart rhythm, while its novel derivate 5PF-PF showed significant ar-
                rhythmogenic effect. In accordance with that we had reached a conclusion
                that even small changes in chemical structure of propafenone lead to signifi-
                cant changes on its effects on heart rhythm. This gives us the opportunity to
                further synthesizing and testing of substances modify the drug and achieve
                the improvement of its pharmacological characteristics. FUNDING: Our work
                has been supported by Scientific Research Grants from the Ministry of Science
                Serbia (TP20027).

                Keywords:propafenone, antiarrhythmic effect, rats, aconitine

                Contact authors at: d.opacic@yahoo.com


                                                   —58—
   COMPARISON OF THE EFFECTS OF SINGLE AND CHRONIC
   CAFFEINE ADMINISTRATION ON TEMPERATURE OF RATS
        IN NORM AND WITH MODEL OF DEPRESSION




                                                                                 Pharmacology
                                                                                   Anatomy
  Authors: Ivan Todorov, Milen Hristov, Kamelia Stanoeva, Rumen
  Nikolov, Krassimira Yakimova

  University: Medical University Sofia




ICMS 2011 / OP 24 Preclinic
Abstract:
Introduction: Mammalian thermoregulation involves a number of neuro-
transmitting mechanisms including the recently described role of purines.
The nonselective adenosine antagonist caffeine is known to influence rats`
core body temperature in a dose-dependent manner. Meanwhile body tem-
perature and responses to its modulators alter under stress conditions. Aim:
The purpose of this project was to compare the temperature responses af-
ter single and chronic administration of caffeine on normal rats and on rats
with experimental model of depression. Materials and Methods: The studies
were conducted with male Wistar rats in norm and after 30-day stress fac-
tors exposure for acute administration and 5-week stress factors exposure
for chronic administration as an experimental model of depression. During
the experiment the animals were maintained on a standard 12h light/dark
cycle at a temperature of 22+/-1 C. Caffeine was administered intraperito-
neally in 2, 20 and 40mg/kg doses for the study of single caffeine admin-
istration and in 8 mg/kg/day for the chronic one. Core body temperature
was monitored via rectal thermistor probes TX8 and multichannel ther-
morecorder Thermex16 in 30-min intervals following drug administration or
start of temperature detection in chronic treatment. Results: Single caffeine
administration in 2, 20 and 40 mg/kg doses caused a dose-dependent hy-
perthermia in normal rats. The effects were observed in the first three de-
tection intervals with a maximum reached at the 60th min. Caffeine in these
doses caused a lasting hyperthermia in rats with experimental model of
depression. The effect reached a maximum on the 60th min and continued
until the 150th min. Chronic caffeine administration caused hyperthermia in
both in normal rats and rats with experimental model of depression which in
the latter was statistically significant (P < 0,05). The effects were observed
at 30th, 60th and 90th min after application of thermistors. Conclusions and
Discussion: Single and chronic caffeine administration induce an increase
in body temperature in both normal and depressed rats with a prolonga-
tion of the effect on the latter. These responses are observed in relatively
low single doses or in chronic low-dosis treatment. The experimental data
confirms the role of purines in thermoregulations in both normal conditions
and under stress.

Keywords: caffeine, thermoregulation, depression, rats
Contact authors at: kamelia.stanoeva@gmail.com


                                   —59—
             ELASTIN GENE RS2071307 SINGLE NUCLEOTIDE POLYMOR-
              PHISM AND THE RISK OF AORTIC ANEURYSM DEVELOP-
                                    MENT
Genetics




            Authors: Kostiv M.Y., Dosenko V.E., Zaharova V.P., Moibenko O.O.

            University: NMU




           ICMS 2011 / OP 25 Preclinic
            Abstract:
            Aortic aneurysm(AA) is one of the major cardiovascular
            causes of death among the Ukrainian people. Objective: To
            determine the presence of elastin gene single nucleotide
            polymorphism(SNP) rs2071307 in the Ukrainian popula-
            tion and to establish the SNP relationship with AA. Methods:
            We used the method of polymerase chain reaction real time
            (PCR-RT), histological examination of the aortic wall (stain-
            ing by Weihert -Van Giezon) and the statistical analysis of the
            results using chi-square Pearson’s criterion. SNP rs2071307
            and the morphological structure of the aortic wall were eval-
            uated in 100 patients with AA and in 92 healthy people. Re-
            sults: It was found that the rates of adenine / guanine and
            guanine / guanine genotypes of elastin gene were higher
            in patients with AA than in healthy subjects. Morphological
            changes in the aortic wall (degradation of elastic fibres, col-
            lagen fibres growth) were more significant in patients with
            SNP rs2071307.




            Keywords: aortic aneurysm, single nucleotide polymorphism, elastin,
            polymerase chain reaction real time
            Contact authors at: mkostiv@ukr.net


                                            —60—
  RENAL EXCRETION OF HOMOCYSTEINE AFTER HOMOCYSTE-
   INE LOADING IN SPONTANEOUSLY HYPERTENSIVE RATS




                                                                                  Physiology
                                                                                   Anatomy
  Authors: Popov DM, Ognianova S, Angelov H, Iliev B, Ruseva S,
  Vasileva A
  University: Medical University Sofia




ICMS 2011 / OP 26 Preclinic
Abstract:
Our study compared renal excretion of homocysteine after homocysteine load-
ing between normotensive Wistar rats (WR) and spontaneously hypertensive
rats (SHR). Experiments were performed in four groups consisted of 7 ani-
mals each. The animals included in first (WR) and third group (SHR) received
drinking water, whereas rats in second (WR+Hcy) and four group (SHR+Hcy)
received stable isotope labeled homocysteine (Hcy-d4) 3.47 mg/day, dissolved
in drinking water in the course of 5 days. The animals were housed in meta-
bolic cages in standard conditions: 22 0C, 12/12 h light/dark cycle, with free
access to food and liquid. Urine collection was performed on the fifth day of
the experiment in the course of 6 hours between 8.00-14.00 h. Urine flow
rate was measured gravimetrically. The urine and plasma concentration of
labeled (Hcy-d4) and endogenous homocysteine were measured by electro-
spray ionization in positive mode on an LTQ Orbitrap Discovery (ThermoFisher,
Germany) connected to a Surveyor HPLC system (ThermoFisher, Germany).
Quantitative analyses were performed using the “selected ion monitoring”
mode with external calibration. Data acquisition and processing were per-
formed with Xcalibur software. Urine excretions of labeled, endogenous and
total homocysteine were calculated. In control condition urine flow rate and
plasma concentration of homocysteine did not differ between WR and SHR:
2.31±0.37 and 2.23±0.35 µl/min/100 g b.w.; 14.15±2.43 and 14.48±2.43
µmol/l, respectively. However, urine concentration and excretion of homo-
cysteine in WR were higher in comparison to SHR: 10.24±1.77 vs. 5.13±0.74
µmol/l and 21.26±3.29 vs.10.90±1.61 nmol/min/100 g b.w., (p<0.05). Five
days after application of Hcy-d4 urine flow rate did not change in both WR and
SHR: 2.23±0.35 and 2.09±0.35 µl/min/100 g b.w.. The concentration and
excretion of endogenous homocysteine were not affected as a result of homo-
cysteine loading in WR and SHR. The urine concentration and excretion of Hcy-
d4 in SHR were lover in comparison to WR: 2.28±0.40 vs. 4.27±0.85 µmol/l,
(p<0.05) and 7.05±1.30 vs. 4.05±0.51 nmol/min/100 g b.w., (p<0.05). The
established lower excretion of endogenous as well as labeled homocysteine in
SHR is probably a result of action of specific mechanism for renal excretion of
homocysteine in SHR, most probably responsible for maintenance of adequate
plasma homocysteine level.
Acknowledgements: This work was supported by grant №3C/2009, Medical
Research Council, Medical University - Sofia
Keywords: caffeine, homocysteine, renal excretion, SHR
Contact authors at: popovdeyan@gmail.com


                                    —61—
               CHANGES OF SYMPATHO-VAGAL BALANCE DURING APPLI-
               CATION OF [CAV13]N/OFQ(1-13)NH2 IN SPONTANEOUSLY
                               HYPERTENSIVE RATS
Physiology




              Authors: Pavlov O, Iliev B, Popov DM, Atanasova K

              University: Medical University Sofia




             ICMS 2011 / OP 27 Preclinic
              Abstract:
              This study investigate the effects of the newly synthetized nociceptin analog
              [Cav13]N/OFQ(1-13)NH2 on the sympatho-vagal balance in spontaneously
              hypertensive rats (SHR), (n=10). As a normotensive controls were use Wistar
              rats (n=10). The sympatho-vagal balance was determined by the ratio (PMF/
              PHF) between the spectral power in mid (PMF) and high frequency (PHF) band
              of interpulse interval spectrograms, derived by Fast Fourier Transform algo-
              rithm in graphical programming environment LabView 3.1.1.. The interpulse
              interval was calculated in terms of the time between two consecutive diastolic
              minimums of the blood pressure wave. Blood pressure wave was registered
              directly by Acknowledge 3.8 software, through a femoral artery catheter dur-
              ing a control period and after intravenous bolus applications (100 nmol/kg) of
              [Cav13]N/OFQ(1-13)NH2 in the course of 90 minutes within nine consecutive
              10 minute intervals. The baseline values of PMF as well as ratio PMF/PHF in
              SHR were lower in comparison to normotensive Wistar rats, (p<0.05). The
              PMF/PHF ratio in normotensive rats increased during application of nociceptin
              analog from 0.75±0.06 to 1.16±0.13, (p<0.05) in sixth and to 1.13±0.28,
              (p<0.05) in seventh 10 min long intervals, respectively. In SHR, [Cav13]N/
              OFQ(1-13)NH2 lead to an increase of sympatho-vagal balance immediately
              after its application from 0.53±0.05 to 0.96±0.09 ms2, (p<0.01) in the first
              interval and this level remained the same until the end of the experiment,
              (p<0.01). The changes in sympatho-vagal balance, provoked by the applica-
              tion of [Cav13]N/OFQ(1-13)NH2 in Wistar rats as well as in SHR are result
              mainly of changes in sympathetically mediated fluctuations of interpulse inter-
              val. The differences in response to nociceptin analog application between nor-
              motensive and spontaneously hypertensive rats were displayed in the dynamic
              and duration of the effects on PMF/PHF ratio. In normotensive rats [Cav13]N/
              OFQ(1-13)NH2 increased PMF in intervals within 20-70 min, whereas PMF/PHF
              ratio increased only for 20 min, within 50-70 min. In SHR, [Cav13]N/OFQ(1-
              13)NH2 displaced sympatho-vagal balance immediately and continuously, as
              a result of an increase of sympathetic mediated fluctuations. Most probably,
              this is due to typical for spontaneously hypertensive rats higher basal level of
              sympathetic nerve activity.
              Acknowledgements: This work was supported by Grant №ВУ-Л-205/2006 from
              National Science Fund.

              Keywords:heart rate variability, nociceptin analog, SHR

              Contact authors at: popovdeyan@gmail.com


                                                  —62—
   Abstracts
Preclinic Poster
   Session I
             STUDY OF CORONARY ARTERIES USING VIRTUAL MODEL.
                 IMPLICATION WITHIN CORONARY PATHOLOGY.
Anatomy




            Authors: Raluca Stanescu , Preda Camelia

            University: University of Medicine and Pharmacy Craiova




          ICMS 2011 / PP 01 Preclinic
           Abstract:
           Within coronarian lesions genesis, the parietal solicitation
           to pressing stress is well-known. In the present study, we
           proposed to analyze the relationship between the anatom-
           ic distribution of coronarian arteries and the topography of
           maximal stress areas. Material and method: taking into con-
           sideration the observations made after dissecting coronary
           arteries in 31 cases (didactic preparations or necropsies)
           correlated to data highly approved by specialty literature, we
           conceived a standard anatomic pattern for 3D distribution of
           coronary arteries. This pattern was virtually reproduced, us-
           ing the technique offered by a CAD programs pack. The pat-
           tern was subjected to a mechanic simulation (intra luminal
           pressure), analyzing the parietal stresses on various parts.
           Results and discussions: the gradient of parietal mechanic
           stress at intra luminal pressure significantly differs from one
           arthery to another and, across the same arthery, from origin
           to end point, which may influence incidence and localization
           of atheroma plaques. Conclusion: more and more perfected
           medical imagistic techniques, corelated to computherized
           simulation methods, may allow early detection of atheroma
           plaques and appreciate lesion evolution.




           Keywords:Coronary Vessels, Coronary Artery Disease, Computer Simula-
           tion.
           Contact authors at: raluca.stanescu@ymail.com


                                          —64—
    ANATOMICAL VARIATIONS OF THE EXTENSOR INDICIS
   PROPRIUS MUSCLE AND THEIR APPLICATION IN RECON-
           STRUCTIVE SURGERY OF THE HAND




                                                                             Anatomy
  Authors: I. Vlasov, G.P. Georgiev, L. Jelev

  University: Medical University Sofia




ICMS 2011 / PP 02 Preclinic
Abstract:
Anatomical variations of the extensor indicis proprius muscle and
their application in reconstructive surgery of the hand I. Vlasov,
G.P. Georgiev1, L. Jelev Department of Anatomy, Histology and
Embryology, Medical University of Sofia, BG-1431 Sofia, Bulgar-
ia 1University Hospital of Orthopaedics “Prof. B. Boychev” Sofia,
Medical University of Sofia, BG-1614, Bulgaria The extensor indicis
proprius muscle (EIP) is a narrow, elongated skeletal muscle in the
deep layer of the dorsal forearm, placed medial to, and parallel
with, the extensor pollicis longus muscle. It arises from the distal
third of the dorsal part of the body of ulna and runs through the
fourth tendon compartment together with the extensor digitorum
muscle, from where it projects into the dorsal aponeurosis of the
index finger. Its tendon goes to the index finger, which it extends.
Different variations of this muscle have been described in the lit-
erature: absence; duplication; additional tendons for the index and
other fingers; duplication of its tendon coexisting with an accessory
slip from the common extensor; an origin from the radius, carpus,
and interosseous ligament; insertion by fascia to the back of the
hand or into the posterior annular ligament; union with extensor
medii digiti muscle. Some of these variations were detected during
our study. Variations of the EIP have definite applications in hand
surgery. Additional tendons could be transferred for correction of
abduction deformity of the small finger and for restoration of thumb
extension after ruptures of the extensor pollicis longus due to trau-
ma or secondary to rheumatoid arthritis.




Keywords: extensor indicis proprius, variations, reconstructive surgery of
the hand
Contact authors at: stylios_rnb@abv.bg


                                  —65—
              ABSENCE OF THE FORAMEN SPINOSUM AND ABERRANT
              COURSE OF THE MIDDLE MENINGEAL ARTERY: SIGNIFI-
                      CANT FOR SURGERY AND PRACTICE
Anatomy




           Authors: Maria Atanasova, Lazar Jelev, Georgi P. Georgiev

           University: Medical University Sofia




          ICMS 2011 / PP 03 Preclinic
           Abstract:
           On the superior surface of the skull base, within the middle cranial
           fossa, three basic foramina exist – foramen rotundum, foramen
           ovale and foramen spinosum. The latter usually contains the larg-
           est artery supplying the dura mater – the middle meningeal artery.
           The main branches of this artery formed well visible sulci on the
           skull bones. However, in some exceptional cases, the foramen spi-
           nosum could not be found. This condition is basically caused by an
           interesting variation in the course of the middle meningeal artery.
           Studying 80 macerated human skulls from the collection available
           at the Department of Anatomy at the Medical University of Sofia,
           we came across a rare case of bilateral absence of the foramen
           spinosum. The arterial sulci, corresponding to the main branches
           of the middle meningeal artery were well detectable and we traced
           them to the superior orbital fissure. This could be explained with a
           possible origin from the ophthalmic artery. To reveal the branching
           pattern of the artery we made in addition a plaster cast of the cor-
           responding skull surface. The variations of the middle meningeal
           artery concern its branches, origin, dimensions and anastomoses.
           According to literature, the reported absence of the foramen spino-
           sum and corresponding variant origin of the artery occur in only 1%
           of the human population. The reported arterial variations could be
           of clinical significance in fractures of squamous and petrous parts of
           the temporal bones and in different surgical interventions.




           Keywords: middle meningeal artery, foramen spinosum , absence
           Contact authors at: at_mariya@yahoo.com



                                          —66—
   ANATOMICAL CONTRIBUTIONS TO THE TOPOGRAPHICAL
            STUDY OF THE INGUINAL CANAL




                                                                                   Anatomy
  Authors: Oprea I. Stefan; Pantu Cosmin; Badoiu Silviu; Mihai
  Enyedi
  University: University of medicine and pharmacy Carol Davila
  Bucuresti




ICMS 2011 / PP 04 Preclinic
Abstract:
Introduction: When the young surgeons are operating in the inguinal re-
gion, are focuses especially on the anatomy of inguinal canal. This atitude
is understandeble regarding the complexity of this zone. Unfortunately, a
lot of surgical incidents, like a lot of other surgical technique problems, can
be solved only by knowing very well the relations regarding the inguinal
region. Objectives: Our objectives are to highlight some structures that are
rarely seen in corpse, such as the pyramidal muscle, suspensory ligament
and adminiculum liniae alba, but also vascular relations of great clinical
importance. Material and method: We dissected the inguinal region in four
cadavers and the resulted regions and structures were photographed by us-
ing a high resolution digital camera. Results: In our study we succeeded, by
careful dissection, to highlight the structures that are rarely seen in corpse,
such as the pyramidal muscle, suspensory ligament and adminiculum liniae
alba and highlighting the relations of surgical vascular risk : corona mortis,
defined as the vascular connections between the obturator and external
iliac systems, retrosimphyseal vascular plan , inferior epigastric artery and
its relations with the external iliac vessels. In terms of intra-abdominal rela-
tions, we highlighted the importance of regions and structures in endoscop-
ic surgery of inguinal hernias. We have to point the transversalis fascia and
parietal peritoneum, iliopubic tract, one of the most important relation in
endoscopic surgery of inguinal hernias and intertesticulodiferential trigon,
as critical areas of risk in endoscopic surgery inguinal hernias. Also, sur-
geons dealing with direct, indirect, femoral, or obturator hernias need to be
aware of critical, life threatening, vascular anastomoses. Conslusions: We
believe that our paper highlights the necessity of a well knowledge of the
inguinal region anatomy and it shapes a good work material for any young
practitioner who is interested in surgical treatment, clasical or endescopic,
of the inguinal hernia.




Keywords: INGUINAL REGION, INGUINAL HERNIAS, DISSECTION.

Contact authors at:stefan88o@yahoo.com


                                    —67—
            VARIABLE MORPHOLOGY OF THE SUPRASCAPULAR NOTCH.
                          CLINICAL RELEVANCE
Anatomy




           Authors: I. Vlasov, L. Jelev, G.P. Georgiev

           University: Medical University Sofia




          ICMS 2011 / PP 05 Preclinic
           Abstract:
           Variable morphology of the suprascapular notch. Clinical relevance
           I. Vlasov, L. Jelev, G.P. Georgiev1 Department of Anatomy, Histol-
           ogy and Embryology, Medical University of Sofia, BG-1431 Sofia,
           Bulgaria 1University Hospital of Orthopaedics “Prof. B. Boychev”
           Sofia, Medical University of Sofia, BG-1614, Bulgaria Poster Ac-
           cording to basic anatomical descriptions, along its course to the
           infraspinatous fossa, the suprascapular nerve passes through a
           narrow space on the superior border of the scapula, called the su-
           prascapular notch. In fact, however, there is great diversity in its
           shape and size. Because the suprascapular nerve could be injured
           at this site, the aim of the present study is to examine in details
           the anatomical characteristics of suprascapular notch. The morpho-
           logical features of suprascapular notch have been examined in 80
           shoulder blades (40 - left and 40 - right) from the autopsy material
           available at the Department of Anatomy, Histology and Embryol-
           ogy, Medical University of Sofia. In our bone series, the supras-
           capular notch have been found absent, in the “U”shape, reversed
           “?”shape, nearly closed “?”shape, or as a complete opening on the
           superior scapular border (the suprascapular foramen). Some rare
           shapes were also observed. The size of the notches was carefully
           measured and analyzed. This anatomic information is important in
           the management of entrapment neuropathy of the suprascapular
           nerve and some arthroscopic procedures in the shoulder region.




           Keywords: suprascapular notch, variations
           Contact authors at: georgievgp@yahoo.com



                                         —68—
   RADIATION SCINTIGRAPHY, BIODISTRIBUTION AND EPR
  SPECTROSCOPIC EX VIVO CORRELATION OF TOXICITY AND
   ANTITUMOR ACTIVITY OF SPIN-LABELLED AGENT SLENU




                                                                                 Biochemistry
                                                                                   Anatomy
  Authors: Yanka Karamalakova, Krishna Chuttani , Anil K. Mishra,
  Antoaneta Zheleva, Vesselina Gadjeva

  University: Trakia University




ICMS 2011 / PP 06 Preclinic
Abstract:
INTRODUCTION: New compound with antioxidant and antitumor properties
1-ethyl-1-nitroso-3-[4-(2,2,6,6-tetramethylpiperidine-1-oxyl)]-urea SLENU, a
spin-labelled analogue of the anticancer drug CCNU, was synthesized in our
laboratory. SLENU exhibited in vivo lower general toxicity and higher anti-
cancer activity against some experimental tumor models -lymphomas, glio-
mas, and solid tumors and melanomas in comparison to those of its analogue
CCNU. The aim of the present research was after single treatment by SLENU
or CCNU to study and compare: first the levels of ROS production in healthy
mice by direct Electron Paramagnetic Resonance (EPR) ex vivo spin trapping
technique and second to investigate the biodistribution in healthy and tumor
(Ehrlich Ascitis tumour cells) bearing animals (ROI=67%) by Radiolabelling
with 99mTc-isotops and following Scintigraphic image. METHODS: The Elec-
tron Paramagnetic Resonance (EPR) measurements were performed at room
temperature (18-23 0C) on an X-band, EMX-micro, spectrometer Bruker, Ger-
many with standard Resonator. Data were analysed by Bruker WIN-EPR and
Simphonia software (± statistically significant <0.05).The Radiolabelling on
SLENU, Biodistribution and Gamma Scintigraphy of 99mTc-isotops methods
were estimated by (ITLC-SG), (PAW R/H), mice dissection after 1h, 2h, 4h,
and 24h post injection and after using Ehrlich Ascitis tumor cells line (% ID/
g<0.05). RESULTS: The levels of ROS products were registered in liver and
kidney homogenates of mice treated by SLENU and were compared to that
of the controls and CCNU treated mice. These results were explain by the
formerly reported in vitro an excellent superoxide anion radical scavenging
activity (SSA). Post injection on CCNU (% ID/g<46.4, g<2.92), and on SLENU
(% ID/g<43.6, g<4.04), (1h) Biodistribution in liver and another organs were
registered. Data on post implanted period on Ehrlich Ascitis tumour cells in
the thigh of the mice (ROI=62%) were registered and analysed. CONCLU-
SION: Based on lower levels of ROS products, registered by direct Electron
Paramagnetic Resonance (EPR) method and the new data from Radiolabelling,
Biodistribution, and Gamma Scintigraphy methods was reported that spin la-
beled analogue of the anticancer drug CCNU nitrosourea-SLENU was selected
for further toxicological and onco -pharmacological studies, alone and with
combination with natural isolated herbal antioxidants.


Keywords: EPR, Radiolabelling, Scintigraphy, CCNU, SLENU, tumor line

Contact authors at:ykaramalakova@abv.bg


                                   —69—
                  EPR SPECTROSCOPIC CORRELATION OF ANTIMICROBIAL,
                    AND RADIOMODULATORY PROPERTIES OF PSORALEA
                                 CORYLIFOLIA LINN.
Biochemistry




                Authors: AS Dhaker, Y Karamalakova, R Kumar, RK Sharma, S
                Sultana, V Gadjeva, Rajesh Arora, A Zheleva

                University: Trakia University




               ICMS 2011 / PP 07 Preclinic
                Abstract:
                Background Development of radiation countermeasure (RCM) agents for human
                applications is an area of immense interest for radiation biologists since there
                is no non-toxic, yet efficient RCM agent available that can reduce the deleteri-
                ous effects of ionizing radiation and is effective in a military rescue setting. In
                post-irradiation scenarios, opportunistic infections pose a grave threat to hu-
                mans. There has been a paradigm shift towards natural products as a reliable
                alternative to molecular radioprotectors in recent years due to their effective
                and non-toxic nature and ability to act in post-irradiation scenarios as well due
                to their immunomodulatory properties. P. corylifolia is an Asian medicinal plant
                with manifold uses in medicine. It possesses antioxidant, antitumoral, immu-
                nomodulatory and anti-inflammatory activities, which are relevant to radiopro-
                tection, and thus formed the scientific basis for undertaking the present studies.
                Methods Aqueous extract of Psoralea corylifolia seeds were investigated for its
                antimicrobial activity in the pathogenic bacterial species, ability to scavenge free
                radicals and its ability to modulate radiation-induced damage to pBR322. All
                Electron Paramagnetic Resonance (EPR) measurements were performed at room
                temperature (18-230C) on an X-band EMXmicro, spectrometer Bruker, Germany
                with standard Resonator. Data were analysed by Bruker WIN-EPR and Simpho-
                nia software (± statistically significant <0.05). Results The pathogenic strains
                tested Escherichia coli, Staphylococcus aureus, Proteus mirabilis, Pseudomonas
                aeruginosa and Enterococcus faecium were inhibited by the aqueous extract of
                Psoralea corylifolia seeds, while Bacillus cereus, Shigella dysenteriae, Salmonella
                typhii, Vibrio cholera and Actinomyces viscosus were not. Densitometric analysis
                of pBR322 DNA pre-treated (before 1h) with P. corylifolia seeds extract and then
                irradiated (0.25 KGy) revealed that the extract at a concentration of 25µg/ml
                contributed in retention of 56% the supercoiled form, which was significantly
                higher than that produced in quercetin treated group. At higher doses, P. coryli-
                folia enhanced the radiation-induced pBR322 plasmid DNA damage; acting as a
                radiosensitizer. By the EPR spectroscopy study a good DPPH radical scavenging
                capacity for P. corylifolia seeds extract was demonstrated. Conclusion The anti-
                microbial effect of Psoralea corylifolia seeds could be attributed to the presence
                of numerous secondary metabolites specially alkaloids eg. bakuchiol possesses
                antibacterial properties. The broad spectrum of radiomodulatory and antimicro-
                bial properties exhibited by Psoralea corylifolia indicate its potential as a potent
                modulator of radioresponse in a postirradiation setting, thereby making it useful
                for rescue missions.
                Keywords: EPR, Psoralea Linn., Radiomodulatory Properties, DNA
                Contact authors at: ekaterina.DGeorgieva@gmail.com


                                                      —70—
   NA, K АТPASE ACTIVITY OF PERIPHERAL BLOOD LYMPHO-
     CYTES IN PATIENTS WITH A RHEUMATOID DISEASES




                                                                                     Biochemistry
                                                                                       Anatomy
  Authors: Roman Fafula


  University: Lviv National Medical University, Ukraine




ICMS 2011 / PP 08 Preclinic
Abstract:
Increase of the rheumatic disease is happening worldwide. According to WHO,
rheumatoid arthritis affects more than 20 million persons on the planet. How-
ever, official statistics varies greatly from unofficial one. Treatment of rheuma-
toid diseases remain important and unsolved problem in practical medicine.
The problems of their early diagnosis and pharmacotherapy are also important
to modern rheumatology. Since the intracellular metabolism of lymphocytes
is based on the physiologically reflected ability of these cells to react quickly
to any changes in the body homeostasis the modulation of enzymes activ-
ity in lymphocytes occurs earlier than morphological and biochemical blood
parameters (Oltra A.M et al., 2001; Lugovskuy S. et al., 2002). That is why
we can assume that blood lymphocytes can be convenient, adequate and ac-
tual model for studing many processes, including the pathomorphological and
biochemical changes that occur in patients with rheumatoid diseases. Most
studies of functional activity of lymphocytes can be associated with the esti-
mation of prognosis of rheumatoid diseases. From the position of the modern
biomembranology many diseases are associated with changes in biomembrane
structure and functions. The membrane bond proteins including integral Na,
K АТPase have an important role in membrane functioning. Therefore, the
scientific research has aim to identify the functional activity of Na, K АТPase
transport systems in normal and pathological lymphocytes (patients with rheu-
matic diseases). The research was carried out on the 20 patients with rheu-
matoid diseases (rheumatoid arthritis and spondyloarthritis). Peripheral blood
lymphocytes were isolated using Fikoll-triumbrast concentration gradient. The
activity of Na, K АТPase was determined on the saponin-permeabilized lym-
phocytes. Na, K АТPase activity was estimated spectrophotometrically at 660
nm using Rathbun method (Rathbun W. et al., 1969). We have shown the de-
crease of ouabain-sensitive Na, K ATPase enzyme activity in 68,2% in patients
with rheumatic diseases in comparison to the practically healthy donors. The
dynamics of Na, K ATPase enzyme activity changes is observed after patient’s
treatment. The analysis of Na, K ATPase enzyme activity changes on the pa-
tients’ age also has been carried out. More drastic Na, K ATPase enzyme activ-
ity changes is observed in young patients.



Keywords: rheumatoid diseases, peripheral blood lymphocytes, Na, K
АТPase, membrane transport
Contact authors at: roman_fafula@ukr.net


                                     —71—
                  CONCENTRATIONS OF GLUCOSE AND GLYCATED HAEMO-
                 GLOBIN IN ERYTHROCYTES OF PATIENTS WITH DIFFERENT
                                     DISEASES
Biochemistry




                Authors: Kazakova V.V., Yolkina N.M., Ilyas CHACHOUA, Lucik
                E.G., Zagnoenko N.E., Konoshenko S.V.

                University: Crimean state medical university named after S.I.
                Georgievskiy



               ICMS 2011 / PP 09 Preclinic
                Abstract:
                The identification of biochemical changes in the human body in different diseases is one
                of aims of modern biomedical sciences. Due to the fact that erythrocytes represent the
                most accessible material for study and perform a number of vital functions, their compre-
                hensive study continue to be actual. Previous studies have shown that in several diseases,
                erythrocytes are involved in the pathological process, change their structural and function
                proprieties and biochemical state. However, despite the extensive studies carried out in this
                area, biochemical changes in red blood cells still poorly understood in different diseases.
                In the present study, we studied the concentration of glucose and glycated hemoglobin in
                the haemolysate of erythrocytes of patients with: chronic post-traumatic osteomyelitis (25
                patients), patients with cirrhosis (30 patients) and patients with cardiomyopathies (25 pa-
                tients). The control group consisted of healthy donors (35 persons). The haemolysate was
                obtained according to the method described by Drabkin. The concentration of glucose in the
                haemolysate of erythrocytes was measured by ortho-toluidine method. Glycated hemoglobin
                was measured by spectrophotometric method (based on the reaction with thiobarbituric
                acid). Statistic data was performed using Student t-criterion. As shown in our study, there
                is a decrease in concentration of glucose in the erythrocytes of patients with chronic post-
                traumatic osteomyelitis (21% lower by comparison with the control group). In the eryth-
                rocytes of patients with cirrhosis and patients with cardiomyopathies, it was shown also a
                changes in the concentration of glucose, but these changes have had a different character. By
                comparison with the first group of patients in the other groups, the concentration of glucose
                in the erythrocytes was increased when compared with the control group (106,2% higher in
                patients with cirrhosis and 43% higher in patients with cardiomyopathies). The changes in
                the concentration of glucose in the erythrocytes was accompanied by changes in the con-
                centrations of glycated hemoglobin. In patients with chronic post-traumatic osteomyelitis
                and in patients with cardiomyopathies was observed a trend towards increased in levels of
                glycated hemoglobin, by comparison with the control group (4,07±0,15% in the group of
                patients with chronic post-traumatic osteomyelitis, 4,1±0,2% in the group of patients with
                cardiomyopathies, and 3,9± 0,3% in the control group). In the erythrocytes of patients with
                cirrhosis, the levels of glycated hemoglobin was 5,75 ±0,35% which is 47,4% higher than in
                the control group. The increase in the levels of glycated hemoglobin deserves attention, as it
                is related to changes in the efficiency of oxygen transport function of hemoglobin. Thus, only
                in the situation of cirrhosis, changes in the concentration of glucose and glycated hemoglobin
                are unidirectional, and the increase in the levels of glucose in erythrocytes correlates with the
                increasing in concentration of glycated hemoglobin. In chronic post-traumatic osteomyelitis
                and cardiomyopathies, such correlation is absent, that may have a correlation with the dif-
                ferences in the intensity of metabolic pathways of utilization of glucose in the erythrocytes
                (glycolysis and pentose phosphate pathways). We don’t expect the action of reactive oxygen
                species, which have shown an extensive generation in many diseases. It is possible that,
                under these conditions, the part of glucose molecule was degradated, and these processes
                are dependent from the type of pathology.


                Keywords:glycated haemoglobin, glucose, RBC
                Contact authors at: olgaukraine2004@yahoo.com


                                                           —72—
                 TRANSPLANTATIONAL IMMUNOLOGY




                                                                                     Anatomy
                                                                                     Biology
  Authors: Dimitar Krastev Penchev


  University: Medical University of Sofia




ICMS 2011 / PP 10 Preclinic
Abstract:
Introduction: The scientific project “Transplantational Immunology”, presented
in three aspects, seeks to provide enough information about transplantology
and its development. Aspect one contains information about transplantology
(what does transplantation mean , immunosuppressive therapy, graft rejection
etc.), which can be useful to medical doctors, medical students and patients.
Aspect two, which is the social aspect of the project, tries to make an inquiry
and based on the data collected in this inquiry, to determine the social com-
mitment of the Bulgarian citizens to the problems of the transplantology. Part
of the social aspect of the project is to organize a campaign, in which to inform
the people about the problems of transplantology and make people more con-
cerned about them. Aspect three refers to extracting information from the Pa-
tient Case Reports (PCR) of the transplant patients. Coming from the nature of
the project, the PCRs are related to the immunosuppressive therapy and other
important data from the transplanted patients’ transplantations. Project’s goal:
The projects main goal is to provide information about transplantology, to
determine the level of social commitment of the Bulgarian society with the
problems of transplantology, like the lack of donors, to determine the profile of
the potential donor and, last but not least, based on the information from the
PCRs, to analyze the status of transplantology in Bulgaria and to decide if it has
future in our country. Methods: In order to accomplish the goals of the project,
set in the three aspects, variable and reliable sources of information must
be found, analyze of the inquiries, campaigns and PCRs must be carried out.
Results: The results from the inquiries, conducted in the project’s campaigns,
determine the level of social commitment of the Bulgarian society, the profile
of the potential donor, and reveal some of the problems of transplantology in
Bulgaria. The PCRs reveal the great success rate of transplantology in Bulgaria
and also the big progress in conditioning, immunosuppressive therapy and
coordinating all the separate units, which take part in a transplantation, which
Bulgaria’s transplantology has made. Conclusion: Enough reliable information
was collected for publishing this scientific work. Based on the results from
inquiries and campaigns, conducted from volunteers, some interesting conclu-
sions were made. Patient Case Reports give ground to claim, that transplan-
tology in Bulgaria has good methods, used not only in Europe, but all around
the globe. Transplantology in Bulgaria has a past, present and a bright future!

Keywords: Transplantation,Immunology,donation

Contact authors at: epsmusic@abv.bg


                                     —73—
               THE NITROGEN OXIDE INFLUENCE ON THE ADAPTIVE
              CAPABILITIES LEVEL OF PRACTICALLY HEALTHY YOUNG
                PEOPLE (18-20 YEARS OLD) CIRCULATORY SYSTEM
Biology




            Authors: Anna Svyatodukh

            University: Zaporozhian National University




          ICMS 2011 / PP 11 Preclinic
           Abstract:
           Topicality. It is known that the subtantial growth of morbidity among dif-
           ferent classes of the population is related to decreasing of general adaptive
           capabilities, displaying of dysadaptation effects and disturbance of normal
           functioning of physiological mechanisms which ensure full-fledged form of
           adaptation to unfavorable external influences. It is experimentally proved
           that majority of chronic diseases is directly associated with deterioration of
           functional state of systems and organs responsible for NO synthesis in an
           organism which is the regulator of general adaptive capabilities of an or-
           ganism ensuring its optimal adaptation and health maintenance. Research
           objective is analyzing of NO synthesis system significance in provision of
           cardiovascular system adaptive capabilities of almost healthy persons of
           both sexes at the age of 18-20. Research methods. Methods of electrocar-
           diography, echocardiography, biochemical blood plasma examination and
           test with reactive hyperaemia by D.S. Celermajer’s method were used in
           the research for the estimation of adaptive capabilities and circulatory sys-
           tem functional state, heart structural-functional organization and NO syn-
           thesis system state. Mathematical analysis methods were applied for ob-
           tained results processing using the Student’s t-criterion and the correlation
           analysis. Research results allow stating that the optimal level of circulatory
           system adaptive capabilities is registered in case of evident expression of
           activity of oxidative (with the participation of constitutive NOS) and nitrite
           reductase salvage ways of NO synthesis with simultaneous inducible NOS
           activity decreasing. The sexual differences in nature of functional state of
           NO synthesis system were ascertained for the first time. At this age higher
           level of functioning of the present system is registered among male repre-
           sentatives. The positive influence of NO on the adaptive capabilities level of
           circulatory system is ensured at the expense of “postsynaptic potentiation”
           effects, the braking influence of gamma-aminobutyric acid as one of prod-
           ucts of NO synthesis and heart diastolic function increasing. Conclusion.
           The ascertained nature correlation the adaptive capabilities of circulatory
           system and state of NO synthesis system can be used for the creation of
           secure system of physiological monitoring of human’s health status.


           Keywords: Adaptive capabilities of cardiovascular system, nitrogen oxide
           synthesis system, monitoring of human’s health
           Contact authors at: anna120183@inbox.ru

                                              —74—
   TRICHINELLA LARVAE SURVIVAL IN CULTURE MEDIA FOR
                 IN VITRO INCUBATION




                                                                   Anatomy
                                                                   Biology
  Authors: Popov G., Zafirova M., Mihalev K., Sabit Z., Velev V

  University: Medical University of Sofia




ICMS 2011 / PP 12 Preclinic
Abstract:
Genus Trichinella is composed of parasitic nematodes that
cause severe disease in humans and animals known as trich-
inosis. Larvae of the parasite survive briefly in the intestinal
mucosa and for years into the cells of skeletal muscle. We
used the muscle larvae of Trichinella spiralis, evidenced by
PCR, to determine their chances of survival in vitro in dif-
ferent environments and under different temperature con-
ditions. During the operation, we modify known enzymatic
method for the isolation of larvae, as we did it faster and
cheaper.




Keywords: Trichinella, survival, in vitro

Contact authors at: coffee_v@mail.bg


                                   —75—
               HEART RATE VARIABILITY DYNAMICS DURING FUNCTION-
                AL TESTING IN YOUNG INDIVIDUALS WITH FAMILY HIS-
                         TORY FOR CARDIOVASCULAR RISK
Physiology




               Authors: Ekaterina Popovska, Deyan Nenov, Vladimir Pavlov

               University: Medical University of Sofia




             ICMS 2011 / PP 13 Preclinic
              Abstract:
              Aim. Our results are part of a complex study of the cardiovascular variability
              in young normotensive offspring of parents with cardiovascular pathology in
              response to functional testing.
              Methods. Seventy individuals were divided into two groups: normotensive
              subjects with positive family history for cardiovascular risk (N+) and their
              age matched controls (N-). They were subjected to the orthostatic test (OT)
              and to the deep breathing test (DBT). OT comprised three 5 min periods of
              initial supine position, standing upright and recovery. DBT was carried out
              in supine position: 5 min baseline, 1 minute of controlled deep breathing (6
              cycles) and 5 min recovery. A large group of those patients were tested for
              a second time for confirmation of the observed data.
              Continuous electrocardiogram was recorded by means of the Biopac MP100
              or iCardio digitizer. Data were analyzed with the help of Acknowledge, MIS
              2000 and iCardio software. Heart rate variability (HRV) was estimated using
              fast Fourier transform (FFT) and wavelet transform analysis (WT).
              Results. During OT FFT HRV differed between the two groups, e.g. the base-
              line index of autonomic balance was significantly higher in (N+) – 2.5 vs.
              1.3 (p<0.01); normalized indices of HRV showed significant difference as
              well (p<0.01). Those data persisted during the repeated testing. DBT also
              revealed significant differences between (N+) and (N-) individuals, it pro-
              duced larger stimulation of HRV in (N-) than in (N+) (p<0.001). Discussion.
              The functional tests OT (sympathetic challenge) and DBT (parasympathetic
              stimulus) revealed the existence of minor yet persisting alterations in the
              autonomic cardiovascular balance, a sympathetic predominance, in the
              young normotensive offspring of parents with cardiovascular pathology. In
              addition, we have shown the advantages in the application of WT analysis in
              case of short-term instantaneous changes of HRV as in DBT.

              Acknowledgement: This study was supported by Grant DO 02-26/2009 (N
              Bg-SK 201) of the Bulgarian Fund for Scientific Research and was carried
              out by the supervision of Associate Professor Nina Belova, MD, PhD.



              Keywords: Orthostatic test; Deep breathing test; Heart rate variability;
              Cardiovascular autonomic function.
              Contact authors at:

                                                 —76—
   Abstracts
Preclinic Poster
   Session II
                MATHEMATICAL MODEL OF OSCILLATORY PROCESSES OF
                BIOELECTRICAL PARAMETERS IN EARLY EMBRYOGENESIS
Biophysics




               Authors: Z.Ya. Fedorovych, E.I. Lychkovscyj

               University: LNMU




             ICMS 2011 / PP 14 Preclinic
              Abstract:
              Graph teory is used to investigate the behaviour three types
              of Na+, K+ та Cl- ions in early embryo development. It was
              purposed the way of describing the interaction of ions by
              the untypical Lotka-Volterra equations. The aim of the work
              was to build a model that describ the mechanism of oscilla-
              tory processes of bioelectrical parameters of Misgurnus fos-
              silis blastomeres. Methods. This section contains a descrip-
              tion of physiological systems with the main principle used in
              the formulation of mathematical models, detailed descrip-
              tion, and discussion of model equations. The equilibrium so-
              dium, potasium, and chlorine potentials changes according
              with concentration changes of Na +, K +, Cl- ions in the cell
              and out of the cell were determined. It was found that the
              ions concentration changes is a major regulator of nonlinear
              spatial-temporal dynamics on the membrane surface; Debye
              length and the surface potentials on both sides of the plasma
              membrane have dynamic characteristics, that is oscillation
              in nature. The teoretical and valid values of trancemembrane
              potentials have calculated. The time changes of transmem-
              brane potential are modeled for early loach embryo develop-
              ment. Design results confirm sufficient plenitude of repre-
              sented mathematical model and it adequacy to the certain
              real processes on the early embryo development.




              Keywords: mathematical models, ion regulation, plasma membrane
              Contact authors at: zoryana.ivanytska@gmail.com


                                            —78—
   TIME DEPENDENCE OF STATIC MAGNETIC FIELD (SMF) ON
    HUMAN SKIN PERFUSION IN VIVO ESTIMATED BY LASER
               DOPPLER FLOWMETRY (LDF)




                                                                                Biophysics
                                                                                Anatomy
  Authors: Nikolova Spasina; Nikolova N.; Traikov L.; Antonov I.
  Petrova J.

  University: Medical University of Sofia




ICMS 2011 / PP 15 Preclinic
Abstract:
Past studies suggest that magnetic therapy can have a significant effect on
multiple physiological processes. The effect of suppression on the inflam-
matory process, decreasing of inflammatory and stress markers in blood
plasma, improve of the processes of regeneration and wound healing, all
those are manifestation of SMF action. But the exact mechanism by which
SMF induces physiological changes in biological systems, still remains un-
clear. Also a modulated effect on high or low vascular tone was observed af-
ter SMF action. The increased vascular tone showed a significant vasodilator
effect after static magnetic field action. Regulatory pathways of vasomotor
activity of the blood vessels, rhythmic oscillations or vascular tone, caused
by local changes in smooth muscle constriction and dilation, have not well
defined mechanism. Laser Doppler Flowmetry (LDF) is an accurate and reli-
able method for assessing microcirculatory function. LDF on skin blood flow
is based upon measurement of the Doppler frequency shift in monochro-
matic laser light which is backscattered from moving objects; analysis of
this shift in backscattered light from living tissue gives a relative measure
of blood cell movement, thus average blood flow in a volume of tissue. The
product of moving blood cell’s velocity and their concentration in a cer-
tain volume is called tissue perfusion. This study is designed to estimate
a time dependencies of localized SMF exposure on the tissue perfusion at
25 healthy volunteers, 33 min continuous changes in perfusion of extremi-
ties were measured prior and after 10, 15 and 30 min SMF (magnetic flux
density-20mT) right arm exposure at constant ambient temperature. We
also compare the non-invasive (LDF) data before and after SMF stimula-
tion with invasive intravital microscopy (IVM) data (obtained on animals in
vivo), during SMF stimulation at the tissue. Result showed that 30 min 20
mT SMF exposure lead to statistically significant increase of tissue perfu-
sion estimated by LDF. As a conclusion we can assume that 10 and 15 min
exposure time periods are no significant for biological effects manifestation
and probably SMF exposure for 30 min with 20 mT flux density is associated
with specific parametric window of biological effects of physiotherapeutic
magnetic fields.

Keywords: Perfussion; static magnetic field; Laser Doppler flowmetry

Contact authors at: spasina_nikolova@yahoo.com


                                   —79—
                     ION-SELECTIVE ELECTODES IN PHARMACEUTICAL
                                      ANALISES
Biophysics




               Authors: Maliarska I., Drachuk M., Fedorovych Z.

               University: LNMU




             ICMS 2011 / PP 16 Preclinic
              Abstract:
              Due to novadays quantity methods of analises of biologicaly
              active substances in sybstances and prepared drug forms
              are limited. Known methods such as optical methods, which
              require analysis for significant time and very expensive rea-
              gents; chromatographic methods require sophisticated and
              expensive equipment. Therefore the use of sensors that re-
              act to changing analyte concentration in the studied objects
              corresponding to the size of the signal generated. Thus,
              application of ion-selective electrodes is important. Ion-
              selective electrodes applications in pharmaceutical analysis
              is determained by the tight dependence on the quality of
              the finished dosage forms, the relative ease of obtaining the
              membranes with defined-characteristics, broad domain se-
              lectivity, which depend on the composition of membranes.
              Thus, the application of ion-selective electrodes having high
              sensitivity, minimal reagent consumption, low value instru-
              ments and equipment costs can be recommended for the
              development of methods of chemical analysis of biologicaly
              active substances of ionic nature.




              Keywords: Ion-selective electodes, biologicaly active substance, method.
              Contact authors at: yaryna-angel@rambler.ru


                                              —80—
  MUTATIONS OF BETA-GLOBINS GENE IN THE POPULATION
                   OF AZERBAIJAN




                                                                                 Anatomy
                                                                                 Genetics
  Authors: Gunay Akbarova


  University: Baku State University




ICMS 2011 / PP 17 Preclinic
Abstract:
The beta-thalassemia base is present among all types thalassemia. About
3% of the worlds populations, including some regions of Azerbaijan, are
carriers of pathological beta-hemoglobin gene (beta-GG). The cases of
beta-thalassemia have been revealed in the Saatli and Salyan regions of
Azerbaijan by screening - programs. The high-temperature allele-specific
amplification method with a principle of polymerase chain reaction (PCR) for
identification of the mutation types of beta-GG on Thermal cycler BioCycler
(Roche, USA) was used. The electrophoresis method hemoglobin on acetate
- cellulose pellicle on a device EPS3501XL (USA) and an analytical method
of hemoglobin isoelectrofocusing in poliacrilamide-ampholine plates with
рН-3,5-9,5, on device a Multiphor II (USA) for specification of the clinical
diagnosis of patients are used. Molecular research of beta-GG have allowed
for the identification of four types of mutations:beta+-IVS-1-110(G-А),
beta0-codon8(-AA), beta0-IVS-2-1(G-A), beta+-IVS-1-5(G-S). In one of
the families of Saatli mutation beta+-IVS-1-5(G-S) in a heterozygote con-
ditions identified in the mother, heterozygosis on mutation beta+-IVS-1-
110(G-А) is determined in the father. Their children had the compound’s
condition with genotype beta+-IVS-1-5(G-S)/beta+-IVS-1-110(G-А). In
Salyan three types of a mutations on beta-thalassemia: beta+-IVS-1-
110(G-А), beta0-IVS-2-1(G-А) and beta0-codon8(-AA) are identified. Eight
adult heterozygosis, five children - three of which homozygous on beta+-
IVS-1-110 (G-А) and beta0-IVS-2-1(G-А), and two of the children with the
compound condition on the established types of mutations were identified.
Frequency of mutations beta-GG in Saatli - beta+-IVS-1-110(G-А) - 6,52
%, beta+-IVS-1-5(G-S) - 6,52 %, in Salyan - beta+-IVS-1-110(G-А) -
19,57 %, beta0-codon8(-AA) - 4,35 %, beta0-IVS-2-1(G-A) - 10,87 %. Re-
sults testify to high frequency of the distribution of beta-thalassemia in the
investigated regions, connected to partial and full absence expression of the
beta-globins gene. Molecular-genetic diagnostics has allowed to be identify
heterozygosis and compounds on the given mutations. These mutations
are often the cause of fatal hemolytic crises for women with corresponding
genotypes during pregnancy and childbirth.

Keywords: beta-thalassemia, mutation, PCR, genotype, Azerbaijan

Contact authors at: akperova_science@mail.ru


                                   —81—
               NEWLY DEVELOPED ION MODIFIED CALCIUM PHOSPHATE
               MATERIALS: EFFECTS ON VIABILITY AND PROLIFERATION
                               OF CULTURED CELLS
Pathology




              Authors: Boyka Andonova-Lilova, Lora Dyakova, Tanya Zhivkova,
              Orlin Alexandrov, Milena Georgieva, George Miloshev, Danail Mar-
              tinov, Stefka Tepavitcharova, Elena Stoykova, Radostina Alexan-
              drova
              University: Sofia University st. Kliment Ohridski



            ICMS 2011 / PP 18 Preclinic
             Abstract:
             Introduction Bone disease is a serious health condition that directly
             impacts on the quality of life of sufferers, particularly among the
             aged. Although autogenous bone grafts are still considered the gold
             standard for bone replacement and allogenic bone grafts are widely
             used, several biomaterials (metals, calcium phosphate ceramics,
             bioactive glasses, polymers, composites) have been developed with
             more or less clinical success. That is why in orthopedic applications
             there is a significant need and demand for the development of a
             bone substitute that is bioactive and exhibits material properties
             (mechanical and surface) comparable with those of natural, healthy
             bone. Aim The aim of the study presented here was to evaluate
             the effect of newly developed Mg- and/or Zn-modified calcium phos-
             phates (Mg-CPs; Zn-CPs) on cell viability and proliferation using in-
             vitro tests with SBF (simulated body fluid). Materials and methods
             Eight calcium phosphate materials were prepared and their chemi-
             cal and physical properties were characterized. The effects of these
             compounds on cultured human (Lep embryonic cell line) and murine
             (primary bone marrow, NIH 3T3 fibroblasts) cells were studied af-
             ter 72h and 144 h of treatment using MTT test, neutral red uptake
             cytotoxicity technique, crystal violet staining, trypan blue dye exclu-
             sion method, double staining with acridine orange and propidium
             iodide and Comet assay (single cell gel electrophoresis) at neutral
             pH. Results The results obtained revealed that: i) Mg-modified cal-
             cium phosphate materials are less cytotoxic as compared to Zn-CPs;
             ii) murine bone marrow cells are relatively more sensitive to the
             influence of the compounds investigated. Conclusion Although the
             preliminary studies with MG-CPs are very promising, additional in-
             vestigations are required to clarify better the biocompatibility of the
             materials examined as well as their osteoconductivity and osteoin-
             ductivity.
             Keywords: biocompatibility, bone implants, Mg, calcium phosphates, cell
             cultures
             Contact authors at: boika_andonova@hotmail.com

                                             —82—
  THE CONDITION OF NITRIC OXIDE SYSTEM UNDER INVET-
  ERATE HYPER IMMUNE COMPLEXITY AND ITS CORRECTION
                    BY CORVITINE




                                                                                  Pathology
                                                                                  Anatomy
  Authors: Surma Iryna

  University: Danylo Halytsky Lviv National Medical University




ICMS 2011 / PP 19 Preclinic
Abstract:
Relevance. Within the structure of allergic diseases, the ranking place is set
by the illnesses which pathogenesis is dominated by hyper immune com-
plexity. Many researches focus their efforts on the examination of illnesses
primarily caused by the intensified concentration of circulating immune com-
plexes. In due respect, specimen that involve antioxidant and membrane-
protective attributes are of great concern; these include bioflavonoids. Aim.
The aim of this research study consists in the examination of the impact
of corvitine on fermentative activity of nitric oxide synthases and the level
of stabile metabolites, i.e. nitrite-and nitrate-anions in blood serum under
inveterate hyper immune complexity. Materials and methods. Experiments
were carried out with 20 sexually mature scrub white male rats weighing
200-250 g. each, which were fed by standard diet of animal quarters (re-
tainer). Inveterate hyper immune complexity was recreated in accordance
with the method forwarded by C Cochrane and D Koffer. Rodents featured
by simulated inveterate hyper immune complexity process were injected
with corvitine. The activity of nitric oxide synthases and the level of stabile
metabolites were determined by spectrophotometric method. Results. The
development of inveterate hyper immune complexity is accompanied by the
changes of indicators of nitric oxide system. There is an evident increase in
the activity of inducible synthase of nitric oxide (iNOS) by 2.3 times com-
pared to intact rodents. The activity of constitutive synthase of nitric oxide
(cNOS) is inhibited almost by 1-2 times. Secondary to such changes is the
increase in the level of nitrite-anion by 5.5 times, and nitrate-anon – by
1.4 times, accordingly. The application of corvitine in rodents featured by
hyper immune complex syndrome caused the decrease in iNOS activity by
1.4 times and increase in cNOS level by 3 times. Instead, the contents of
stable metabolites in serum decreased, as well as the level of nitrite-anion
– by 2 times, and nitrate-anon – by 1.6 times, accordingly. Conclusion.
Hence, corvitine reduces the activity of inducible NO-synthase and the level
of nitrite-anion, which provides grounds for further experimental research
aimed at the correction of inveterate hyper immune complex syndrome, as
well as the probability of treatment of the pathological process.

Keywords: hyper immune complexity,bioflavonoids,nitrite-and nitrate-
anions
Contact authors at: surma@lviv.gu.net


                                    —83—
                 CILOSTAZOL ADMINISTRATION ATTENUATES COMMON
                 BILE DUCT LEGATION INDUCED LIVER INJURY IN RAT.
Pathology




             Authors: Shima Majidi-Hamze Majidi-babak Hajipour-Mohammad
             Reza Hemmati

             University: Tabriz university of medical sciences




            ICMS 2011 / PP 20 Preclinic
             Abstract:
             Cholestasis, is a common pathophysiological process in many dis-
             eases causing accumulation of toxic bile salts within the liver. Bile
             duct legation (BDL) causes complete blockage of cholesterol excre-
             tion, and it is well known that hyperlipidemia develops in obstruc-
             tive jaundice. It has been proposed that antioxidants, which may
             restore the cellular defense mechanism and block lipid peroxidation
             and cell injury .Cilostazol has antioxidant properties and Its prin-
             cipal actions include inhibition of platelet aggregation, thrombosis,
             and vasorelaxation anti-proliferative effects. are utilized in treating
             peripheral arterial disease. In This research we studied the effect of
             Cilostazol administration on BDL rats. Male wistar rats were divided
             into four groups, as follows: group 1: sham (n = 11); group 2: BDL
             (n = 11); group 3: BDL receiving cilostazol +vehicle (n = 11) ;group
             4: BDL plus vehicle(n = 11). Biliary cirrhosis was induced in ani-
             mals by double legation and division of the common bile duct. At 8th
             day after surgery the animals were anesthetized and blood sampled
             for obtaining plasma and liver was harvested for performing path-
             ologic and biochemical studies. Levels of ALT, AST, LDH and TNF?
             were higher in group 2 comparing to other groups significantly. The
             scores of the ductular proliferation ,Fibrosis ,number of Apoptic cells
             and Hepatic malondialdehyde content in group 2 were higher than
             3 other groups significantly. In conclusion, results have shown that
             cilostazol provides protection against cholestatic-induced injury in
             rat liver. The results suggest that cilostazol has potential therapeutic
             and liver-protective effects based on multitarget mechanism through
             anti-inflammatory and anti-oxidant pathways, and may be helpful
             in the treatment of patients experiencing cholestatic complications.




             Keywords: biocompatibility, bone implants, Mg, calcium phosphates, cell
             cultures
             Contact authors at: boika_andonova@hotmail.com

                                             —84—
    DIDACTIC REQUIREMENTS FOR THE SUBJECT INFORMA-
           TION TECHNOLOGY FOR PHARMACISTS




                                                                                  Pharmacy
                                                                                  Anatomy
  Authors: Drachuk Mariana, Fedorovych Zoryana

  University: LNMU




ICMS 2011 / PP 21 Preclinic
Abstract:
Wide implementation of computer technologies makes new requirements
for training. Nowadays the greatest success achieved those pharmaceuti-
cal enterprises that use new technologies in analysis of medicine clinical
trials. Special attention should be paid to modern information systems that
allow contact between pharmaceutical companies and medical institutions.
Using modern technologies requires a combination of a classical methods
of teaching with new approaches to the training of pharmacists’s. Informa-
tion Technology is cource in the curricula for the training of pharmacists’s.
Contents of this discipline must constantly improve, given the emergence of
new technologies and requirements of the employer. Information Technol-
ogy program have to include material about pc basics operating systems,
computer software, designing, databases, and system analysis in pharma-
cy. The aim of work was literature analises and practical experience with the
use of information technology in the training of pharmacists’s. The analises
and practical experience with the use of information technology in the train-
ing of pharmacists’s shows that organization of the training process have to
apply main didactic principles, that are gradually, successively, continuity,
the specialist training should be targeted to specific aims, formed func-
tional algorithm based on many-stage computer control. Pharmacy practice
focused on the following types of professional activity: control technique
and rational application of medicines by patients, informing doctors and
patients about new medicines, information systems application that make
relationship between pharmaceutical manufacturers and health care insti-
tutions, instrumental, hardware , software and pharmaceuticals, providing
advanced medical technologies as a single process that integrates the in-
tellectual potential of specialists of different science fields and technology,
likelihood of success or failure of new preparation for certain mathemati-
cal models, to study the therapeutic possibilities of products that have the
same pharmacological properties, drug development directions, and other.
The mentioned activities have to be implemented in the training process
in the preparation of pharmacists based on the model of professional and
personal qualities.

Keywords: Information Technology, training, pharmacists

Contact authors at: maryashka0503@gmail.com


                                    —85—
                   INFLUENCE THE SELECTIVE MODULATOR OF ESTROGEN
                 RECEPTORS (SERM) ON EXPRESSION HSP 70 AND APOPTO-
                 SIS IN NEURONS OF BARKS AT DEPRIVATION THE SYSTEM
Pharmacology



                        LEVEL OF RESTORED GLUTATION IN VITRO


                Authors: Pavlov S.V., Belenichev I.F.

                University: Zaporizhzhia State Medical University




               ICMS 2011 / PP 22 Preclinic
                Abstract:
                Influence the selective modulator of estrogen receptors (SERM) on ex-
                pression HSP 70 and apoptosis in neurons of barks at deprivation the
                system level of restored glutation in vitro Pavlov S.V. (the head is pro-
                fessor Belenichev I.F.) Zaporozhye state medical university, 69035,
                Ukraine, Zaporozhye, Majacovskij street, 26 ifb.1914@mail.ru Objective
                of research: it has been established by us on model of cerebral ischemia
                neuroprotective activity of the selective modulator of estrogen receptors
                (SERM) – (Z)-2 [4 (1,2-difenil-1-butenil) phenoxy]-N, N-diethyletanamid
                citrat. The problem of the given research – to estimate influence SERM
                on progress аpoptosis of neurons of the barks of rats in vitro at deficiency
                restored glutation. Methods: neurons of barks allocated extemporal from
                the brain of two weeks-old white not purebred rats. Deficiency of glutation
                caused introduction in neurons? suspension dinitrochlor benzen (DNCB, 1
                mM), D, L-butionin-S.R-sulfoxicam (BSO, 500 microns). Agents have been
                chosen on capacity to influence endocellular synthesis glutation. Apopto-
                sis changed neurons revealed on painting with etidium bromide, expres-
                sion HSP 70 and р53 defined by method immunobloting. Investigated
                preparation brought in suspension of neurons in concentration – 10-5 M.
                Results: decrease the level glutation introduction in neurons? suspension
                BSO and DNCB led to decrease expression of antistress proteins HSP 70,
                to increase expression р53 and to increase in 2,7 times fraction of apop-
                tosis changed cells. Introduction in the incubatory tests containing vari-
                ous agents (DNCB and BSO) SERM led to increase expression of HSP 70,
                to decrease р53 and to reduction of fraction apoptosis changed neurons.
                Conclusion: tiol-disulfid balance modulate expression of the protective
                proteins HSP 70 which are playing a major part in protection of neurons
                from oxidative stress. Deficiency restored glutation and accumulation in
                system of its oxidized equivalents leads to suppression of protective sys-
                tems of neurons and to initiation neuroapoptosis. SERM carry out effective
                protection from initiated by deficiency glutation neuronal apoptosis. The
                mechanism of similar action SERM is research.


                Keywords: cerebral ischemia , neurons, modulator of estrogen receptors
                Contact authors at: baronai@mail.ru


                                                  —86—
     NITROZINE STRESS AND NEUROLOGICAL DISORDERS
    IN EXPERIMENTAL ALCOHOL INTOXICATION AND THEIR
    PHARMACOLOGICAL CORRECTION BY NEUROPEPTIDES.




                                                                           Pharmacology
                                                                             Anatomy
  Authors: Elena Sokolik


  University: Zaporizhzhia State Medical University




ICMS 2011 / PP 23 Preclinic
Abstract:
Objectives.The article aims to provide a comparative estimation of
Cerebrocurin, Cortexin and Cerebrolisin neuroprotective effect on
the outcome of experimental chronic alcoholism in rats. Methods.
50 Wistar rats were subjected to transient, experimental chronic
alcoholism and were randomly assigned to 5 groups (n=10 each):
(1) Intact, (2) Control, (3) Cerebricurin, (4) Cortexin, (5) Cere-
brolisin. Investigated preparations were administered during 14
days parenteraly after 30-days violent alcoholization. Functional
deficits were quantified by daily neurological examinations (Garcia
et al., 1995); rats behavior was quantified in the test of Passive
Avoidance Conditioned Response (PACR). Nitrotirosine value were
measured after treatment. Results. Against a background of chron-
ic alcohol intoxication in rats, we have promoted indicators nitrozile
proteins in plasma and brain reflecting the activation processes of
nitrozine stress in each groups. We have conducted interrelations
between the level of nitrotirozine in rat brain and the manifesta-
tions of neurological deficit in scores on McGrow in the control
group at the end of the experiment. Conclusions. The most active
drug was Cerebrocurin, which demonstrated a significant reduction
of nitrotirozine in plasma and especially in the brain of the rats rela-
tive vs vehicle-treated controls and normalized neurological status.
This is an experimental justification for inclusion Cerebrocurin in
traditional model of treatment of chronic alcoholism.




Keywords: neurons, alkoholization, nitrozine stress, neuroprotection.

Contact authors at: sokolikep@gmail.com


                                 —87—
                    THE EFFECTS OF METHYL GROUPS OF THE METHYLENE
                                BLUE ON THE INHIBITION
Pharmacology




                Authors: Naji Al Mestaka, Abdulla S. Al Mansouri , Ali Mahdi
                Alahbabi, Abrar S. Ashour, Mark Wainwright and Murat Oz
                University: United Arab Emirates University




               ICMS 2011 / PP 24 Preclinic
                Abstract:
                Introduction Phenothiazine dyes such as MB have been widely used in various
                clinical applications ranging from the treatment of methemoglobinemia and ma-
                laria to the anatomical visualization of various tissues during surgery (Wain-
                wright and Crossley, 2005). In recent years, MB has also been reported to have
                therapeutic effects in Alzheimer Disease (AD) and psychosis; brain disorders
                associated with cognitive deficits (for a review Oz et al., 2009). Aim Investigated
                the effects of demethylated and methylated derivatives of MB on the function of
                the cloned human a7 subunit of the nAChR expressed in Xenopus oocytes by us-
                ing the two-electrode voltage-clamp technique. Methods Oocytes were removed
                surgically from Xenopus laevis, dissected in a solution containing (in mM): NaCl,
                88; KCl, 1; NaHCO3, 2.4; MgSO4, 0.8; HEPES, 10 (pH 7.5) and stored 2-7 days
                in modified Barths solution (MBS) containing (in mM): NaCl, 88; KCl, 1; NaHCO3,
                2.4; Ca(NO3)2, 0.3; CaCl2, 0.9; MgSO4, 0.8; HEPES, 10 (pH 7.5), supplement-
                ed with sodium pyruvate 2 mM, penicillin 10,000 IU/L, streptomycin 10 mg/L,
                gentamicin 50 mg/L, and theophylline 0.5 mM. Oocytes were placed in a 0.2 ml
                recording chamber and superfused at a constant rate of 3-5 ml/min. The bath-
                ing solution consisted of (in mM): NaCl, 95; KCl, 2; CaCl2, 2; and HEPES 5 (pH
                7.5). The cells were impaled with two glass microelectrodes filled with 3 M KCl
                (1-10 M?) and voltage clamped routinely at a holding potential of -70 mV using
                a GeneClamp-500 amplifier (Axon Instruments Inc., Burlingame, CA). Current
                responses were recorded digitally. Compounds were applied externally by addi-
                tion to the superfusate. Stock solutions of drugs were prepared in distilled water.
                Synthesis of cRNA: The cDNA clone of the chick nACh?7 subunit was provided
                by Dr. Lindstrom (University of Pennsylvania, PA). Capped cRNA transcripts were
                synthesized in vitro using a mMESSAGE mMACHINE kit from Ambion (Austin,
                TX) and analyzed on 1.2 % formaldehyde agarose gel to check the size and the
                quality of the transcripts. Results the results demonstrate that the metabolites,
                demethylated and methylated derivatives of MB inhibit differentially the func-
                tion of human a7-nAChRs expressed in Xenopus oocytes. Conclusion In earlier
                investigations, we found that MB inhibits the function of a7-nACh receptors. In
                the present study, we have tested the effects of demethylated and methylated
                derivatives of MB on the function of human a7-nACh receptors expressed in
                Xenopus oocytes. In conclusion, these results demonstrate that the metabolites,
                demethylated and methylated derivatives of MB inhibit differentially the function
                of human a7-nAChRs expressed in Xenopus oocytes.

                Keywords:
                Contact authors at:


                                                     —88—
   NEUROPROTECTIVE EFFECT OF PRAMIRACETAM ON RATS
     BRAIN IN THE CONDITIONS OF ALLOXAN DIABETES




                                                                         Pharmacology
                                                                           Anatomy
  Authors: Zhylyuk V.I., Lievykh A.E., Pavlov A.I.

  University: Dnipropetrovsk state medical academy




ICMS 2011 / PP 25 Preclinic
Abstract:
Negative influence of oxidative stress on function of central nerv-
ous system cells in the conditions of a diabetes mellitus plays the
leading role in a pathogenesis of an ischemic stroke, transient is-
chemic attacks and a vascular dementia. The aim of this study was
to examine the effects of pramiracetam (300 mg/kg) on cognitive
functions and activity of lipids and proteins peroxidation in alloxan-
diabetic rats. 33 adult male Wistar rats were divided into three
groups: control, diabetic and diabetic-pramiracetam treated group.
Diabetes mellitus was induced by a single injection of alloxan
monohydrate (150 mg/kg body weight, subcutaneous). The lev-
els of malone dialdehyde (MDA), aldehydephenylhydrazones (APH)
and ketonphenylhydrazones (KPH), and also activity of superoxide
dismutase (SOD) were determined spectrophotometrically in ho-
mogenates of cerebral cortex and hippocampus. Diabetes forma-
tion leads to disturbances of spatial memory, impairment of train-
ing processes and conservation of a memory trace. Treatment with
pramiracetam promotes mastering and conservation of conditional
skill, shows distinct anti-amnestic effect, reduces spatial memory
deficiency of rats with this pathology. Intragastric introduction of
pramiracetam promoted depression of MDA levels in cerebral cortex
and hippocampus on 23,4% (р<0,05) and 48,7% (р<0,05) accord-
ingly. Also APH and KPH concentrations decreased in cerebral cor-
tex on 28,3% (р<0,05) and 27,4% (р<0,05) accordingly, and KPH
concentration in hippocampus decreased in 1,23 times (р<0,05).
The specified changes characterised by rising of SOD activity in
cerebral cortex and hippocampus on 38,5% (р<0,05) and 34,6%
(р<0,05) accordingly. Тhis study demonstrates that pramiracetam
protects the neuronal tissue against the diabetic oxidative damage.

Keywords: diabetes mellitus, nootropic drugs, brain, oxidative stress

Contact authors at: zhylyuk@ua.fm


                                  —89—
                  THE ANALYSIS OF INFLUENCE OF NONOPIOID ANALGET-
                 ICS ON THE NITRIC OXIDE STABLE METABOLITES LEVEL IN
                                     EXPERIMENT
Pharmacology




                Authors: O.O. Nefodov, A.E. Lievykh, O.V. Makarenko,
                M.I. Stefanik

                University: Dnepropetrovsk state medical academy




               ICMS 2011 / PP 26 Preclinic
                Abstract:
                Use of nonopioid analgetics in pain pharmacotherapy is the classics of mod-
                ern treatment. As it is known, due to inhibition of cyclooxygenase the ma-
                jority of effects of non-steroidal anti-inflammatory drugs (NSAIDs) are real-
                ised. NSAIDs were shown in our previous researches to possess spasmolytic
                properties of different degree of manifestation. We were interested by the
                fact of participation of nitric oxide in miotropic component of nonopioid an-
                algetics action. It is generally accepted that NO participates in formation of
                painful perception and is the pronociceptive agent. Although on some liter-
                ary sources these data are refuted and nitric oxide is considered as the acti-
                vator of endogenous antinociceptive systems. For our researches we used a
                method of estimation of nitric oxide stable metabolites by Griss in serum of
                white nonlinear rats. Investigated nonopioid analgetics (diclofenac sodium,
                dexketoprofen, ketorolac, metamizol, meloxicam, lornoxicam, parecoxib)
                were introduced animals within 8 days. The control group received saline
                0,1 ml/100g of body weight. All investigated preparations were shown to
                increase nitric oxide stable metabolites level in a greater or lesser degree.
                The most expressed effect showed dexketoprofen (5 mg/kg) and meloxicam
                (1 mg/kg) - 371,1% (Р < 0,05) and 360,1% (Р < 0,05) accordingly in com-
                parison with the control. Dexketoprofen (2,5 mg/kg), diclofenac sodium (10
                mg/kg) and metamizol (200 mg/kg) increased investigated components by
                325,3% (Р < 0,05), 274,5% (Р < 0,05) and 219% (Р < 0,05) accordingly. A
                little smaller, but significant increasing showed diclofenac sodium (5 mg/kg)
                (200,7%; Р < 0,05), ketorolac (10 mg/kg) (169%; Р < 0,05), ketorolac (5
                mg/kg) (156,3%; Р < 0,05), parecoxib (1 mg/kg) (122,1%; Р < 0,05) and
                lornoxicam (0,3 mg/kg) (112,6%; Р < 0,05) in comparison with the control.
                Thus, the results of our researches indicate that investigated nonopioid an-
                algetics increase nitric oxide stable metabolites level. These data can be the
                ground of NSAIDs spasmolytic action research and further to be used for
                rationalization of pharmacotherapy of painful syndromes of various genesis.




                Keywords: NSAIDs, pain, nitric oxide
                Contact authors at: nefedov911@rambler.ru


                                                   —90—
    ANTINOCICEPTIVE AND ANTIINFLAMMATORY EFFECTS
   OF TEUCRIUM HYRCANICUM AQUEOUS EXTRACT IN MALE
                    MICE AND RATS




                                                                         Pharmacology
                                                                           Anatomy
  Authors: Amir Farshchi, Samireh Farshchi, Boheireh
  Farshchi,Sepideh Farshchi

  University: Tehran University of Medical Sciences




ICMS 2011 / PP 27 Preclinic
Abstract:
Introduction: The aim of this study was to investigate the antinoci-
ceptive and antiinflammatory effects of Teucrium hyrcanicum aque-
ous extract in male mice and rats. Methods: To assess the anti-
inflammatory effect, we used carrageenan- and dextran-induced
paw oedema and for determination of the antinociceptive effect,
acetic acid-induced writhing, tail flick and formalin pain tests were
used. Results: The extract of T. hyrcanicum (50–200 mg/kg) and
acetylsalicylic acid (100 mg/kg) produced a significant inhibition of
the second phase response in the formalin pain model (P<0.01),
while only the high dose of the extract (200 mg/kg) showed an
analgesic effect in the first phase. The extract also inhibited acetic
acid-induced abdominal writhes in a dose-dependent manner. The
tail flick latency was dose dependently enhanced by the extract but
this was significantly lower than that produced by morphine 10 mg/
kg (P<0.05). The extract (25–250 mg/kg) administered 1 h before
carrageenan-induced paw swelling produced a dose dependent in-
hibition of the oedema. No effect was observed with the dextran-
induced oedema model. Conclusion: The obtained data suggest
antiinflammatory and analgesic effects for the aqueous extract of
Teucrium hyrcanicum, which may be mediated via both peripheral
and central mechanisms. The presence of alkaloids, flavonoids and
triterpenoids might be responsible for the antiinflammatory activity
of this plant.




Keywords: Teucrium hyrcanicum, Antinociceptive, Anti-inflammatory,

Contact authors at: mir.farshchi@yahoo.com


                                —91—
   Abstracts
Preclinic Poster
  Session III
    THE AMINO ALCOHOL AND SULFONAMIDE WITH NEURO-
                   TROPIC ACTIVITY




                                                                             Pharmacology
                                                                               Anatomy
  Authors: H.T. Zlenko, L.I. Kasyan, V.A. Palchikov, I.S. Prishlyak,
  S.V. Tretyakov

  University: Dnepropetrovsk National University




ICMS 2011 / PP 28 Preclinic
Abstract:
Objectives. The wide use of sulfonamides in modern medicine makes
these compounds a hot research topic. A limited number of substances
having sulfonamide and hydroxy groups at bordering carbon atoms
and showing nice solubility in water are presently known. The purpose
of this work was to study two novelly synthesized sulfolane-containing
compounds from the aspect of their neurotropic activity. Fore-men-
tioned substances were obtained by using stereochemically pure endo-
2-aminomethylnorbornene, 3,4-epoxisulfolane and hydroxy sulfochlo-
ride based upon it. Methods. Experiments were carried out on adult
white mice of both genders weighing 20-30 g. Acute toxicity of com-
pounds (LD50) was measured by Litchfield & Wilcoxon method in Pro-
zorovsky V.B. (1962) modification. It reached 734 and 1006 mg/kg for
the sulfonamide and amino alcohol respectively. Analgetic and anticon-
vulsive effects were studied following the methods of “hot plate” and
corasole-induced convulsions. Antihypoxic activity was evaluated using
the model of normobaric arterial hypoxic hypoxia in a confined space.
Tranquilizer action of preparations was investigated under the test of
increase in duration of barbiturate dream caused by the hexenale. Ac-
tivity was estimated in % in relation to the control group of animals.
Results. The sulfonamide was ascertained to be preeminently active re-
garding all types of neurotropic activity possessing clearly defined tran-
quilizing (127%) and analgetic (145%) effects. Concerning the convul-
sive action of compounds under investigation, inversion was observed.
The amino alcohol showed proconvulsive activity (35%) whereas the
sulfonamide possessed distinct anticonvulsive action (50%). Along with
properties described, both compounds showed minor antihypoxic activ-
ity (up to 13%). Conclusions. Thus, it was revealed that sulfonamide
group inclusion substantially expands opportunities of using novel com-
pounds as potential neurotropic means.


Keywords: AMINO ALCOHOL, SULFONAMIDE, NEUROTROPIC ACTIVITY
Contact authors at: palchikoff@mail.ru



                                  —93—
                        METABOLIC SYNDROME: HISTORY OF QUESTION
Pharmacology




                Authors: M. Zayats

                University: Danylo Halytski Lviv National Medical University




               ICMS 2011 / PP 29 Preclinic
                Abstract:
                A metabolic syndrome (MS) is a complex of pathologies, that combine
                factors of cardio-vessels risk, mainly: arterial hyperpiesis (AH), abdom-
                inal obesity, lipidemia and insulin resistance. Aim of work: systematiza-
                tion of information of domestic and foreign literature concerning history
                of study of the metabolic syndrome. Bibliographic, analytical, histor-
                ical methods are used. Results. In 1922 the well-known researcher
                Lang G.V., who studied the MS whole his life, pointed relation between
                obesity, increase of arterial pressure, the type II diabetes (T2D), the
                changes of lipid composition of blood and violation of glucose tolerance.
                In 1926 Myasnikov A. and Grotel D. specified on frequent combination
                of hypercholestery, hyperuricemia with obesity and AH. In 1945 in the
                Langs clinic his employees – Golubeeva N. and Pavlovska L. during
                determination of glucose tolerance put the diagnose of T2D in 70 from
                180 patients with AH at (39%) In 1981 Hanefeld M. and Leoonardt W.
                suggested a term “metabolic syndrome” for cases of combination of
                different metabolic changes. In 1988 Reaven G. on the basis of his own
                observations and generalization of researches of other authors sug-
                gested hypothesis according to which the insulin resistance, abdominal
                obesity, AH, lipidemia and ischaemic heart disease are the display of
                the same pathological state. This state was called the “Syndrome X”. In
                1992 year S. Haffner suggested a term “Insulin Resistance Syndrome”,
                as such, that represents the mechanism of this state in the best way. In
                1993 year M. Resnick presents his vision of development of “Syndrome
                X”. He introduced a concept of «generalized of cardio-vessels meta-
                bolic disease», which is expressed by AH, T2D, obesity, atherosclero-
                sis, hypertrophy of the left ventricle. Starting from 1990th the term
                “metabolic syndrome” is used. Conclusion. Nowadays it is not found a
                consensus in the question of the unique criteria of metabolic syndrome.
                Therefore for such diagnosis doctors apply criteria, offered by World
                Health Organisation, 1998), National Cholesterol Education Program,
                USA, 2001) and International Diabetes Federation, 2005.

                Keywords: metabolic syndrome , arterial hyperpiesis , criteria for meta-
                bolic syndrome
                Contact authors at: martazayats@ukr.net

                                                 —94—
           THE EFFECT OF KAINIC ACID ON TNF IN RATS




                                                                  Pharmacology
                                                                    Anatomy
  Authors: Bogdanov, G., Boyadjieva, N.

  University:Medical University Sofia




ICMS 2011 / PP 30 Preclinic
Abstract:
Microglia plays a role in regulation of brain functions includ-
ing pathogenesis of epilepsy. There was data indicating that
the activated microglia produced TNF-?. The aim of this
study is to investigate the effect of epileptogenic substance
kainic acid on TNF-?. In this study were used 18 male rats
divided in 3 groups: first one – control, second – treated
with kainic acid (5mg/kg i.p.), and third – treated with the
same dose of kainic acid as the second group plus minocyc-
lin. The rats developed chronic epilepsy. Then the rats were
anesthetized and the blood and various organs were taken.
The plasma levels of TNF-? were determined in pg/ml plas-
ma by ELISA kit for rat TNF-?. The results demonstrated that
the kainic acid increased TNF-? concentrations in plasma.
The rats treated with kainic acid plus minocyclin showed no
difference in plasma TNF-? levels as compared with controls.
Minocyclin inhibited the effect of kainic acid on TNF-?. Our
data suggests that there is an increase of TNF-? during de-
velopment of experimental epilepsy in rats. Moreover, the
data indicated that minocyclin may prevent the development
of microglia activation and release of TNF-?.




Keywords: microglia, kainic acid, minocyclin, TNF-?

Contact authors at: dr.georgi.bogdanov@gmail.com


                                 —95—
                 RISK FACTORS OF DRUGS INTERACTION IN THE CLINIC OF
                 INTERNAL DISEASES OF UNIVERSITY CLINICAL CENTER OF
                                      KOSOVA
Pharmacology




                 Authors:Besarte Rexhaj,Fatbardha Rexhaj,Vjosa Rexhepi,Milot
                 Hasani,Arta Zeka

                 University: University of Prishtina




               ICMS 2011 / PP 31 Preclinic
                Abstract:
                Introduction:In many health institutions of different countries the
                frenquency of drug interaction appears as a problem.In different
                countries,drug interaction with fatal outcome varies from 2.2%
                to 30% of the total hospitalized people. Goal:This study was car-
                ried out to analizy risk factors present in drugs interaction at the
                Clinic Center of Kosova(CID-UCCK). Material and methods:In ret-
                rospective study of serial cases,we analyzed 300 patient treatment
                histories in CID-UCCK,selected according to probability theory.
                We analyzed the frequency of drugs interaction through multiple
                logic analysis of regression .Possible risk factors included age of
                the patients,gender(where we took male sex as a constant),the
                unit of the hospital and the number of medications taken at the
                same time.We expressed the results of this analysis through Odds
                Ratio and rehabilitee interval with significanace of 95%(95% CI).
                Results:Politherapy was applied in relatively high frequency(15.7%).
                On the average,every pacient was treated with three different med-
                ications at the same time.The age of the patient and the number of
                medications that they were treated with have significant influence
                of frenquency of drugs interaction presence(OR=1.2,95% CI 1.O-
                1.8 p<0.001,respectively OR=2.1,95% CI 1.5-2.2,p<0.001,for the
                number of medications).Gender and the unit they were treated in
                had no significant influence as a risk facyor on manifestation of
                drugs interaction. Conclusion:Poipharmacy is the most important
                factor in the increase of risk for manifestation of drugs interaction
                in CID-UCCK.With smaller influence ,but still significant ,is also the
                age of the patients.




                Keywords:
                Contact authors at: milooss@msn.com


                                               —96—
    A ROLE FOR OPIOID SYSTEM IN THE PROCONVULSANT
   EFFECTS OF SILDENAFIL ON THE PENTYLENETETRAZOLE-
            INDUCED CLONIC SEIZURE IN MICE




                                                                  Pharmacology
                                                                    Anatomy
  Authors: Laleh Montaser-Kouhsari, Borna Payandemehr, Taha
  Gholipour, Pouya Ziai, Pooneh Nabavizadeh, Abbas Ghasemi, Ar-
  ash Bahremand, Mehdi Ghasemi, and Ahmad Reza Dehpour
  University:Shahid Beheshti Medical University




ICMS 2011 / PP 32 Preclinic
Abstract:
There are several lines of evidence that opioidergic and ni-
trergic systems could modulate the seizure threshold. We
previously have shown that sildenafil had proconvulsant ef-
fects in a model of clonic seizure induced by pentylenetet-
razole (PTZ) or bicuculline. In the present study, we exam-
ined whether the opioid system participates in the action of
sildenafil on the PTZ-induced clonic seizures in mice. Silde-
nafil (1, 5, 10 and 20 mg/kg, i.p.) significantly decreased
the seizure threshold in a dose-dependent manner, whereas
morphine had both anticonvulsant and proconvulsant effects
at low (0.5, 1, and 3 mg/kg, s.c.) and high (60 mg/kg, s.c.)
doses. A sub-effective dose of sildenafil (5 mg/kg) combined
with a dose of morphine (7.5 mg/kg) which was sub-effec-
tive for its proconvulsant effects significantly decreased the
seizure threshold. Although naltrexone at 0.5 and 1 mg/kg
had no effect on the seizure threshold, it significantly pre-
vented both the proconvulsant effects of sildenafil as well as
the anticonvulsant and proconvulsant effects of morphine
on the PTZ-induced seizure thresholds. Our data suggested
a role for opioidergic system in the proconvulsant effects of
sildenafil on the PTZ-induced clonic seizures in mice.




Keywords:

Contact authors at: luckypo0oh@gmail.com


                              —97—
                 INFLUENCE OF NSAIDS ON VARIOUS CONCOMITANT PATH-
                                  OLOGICAL STATES
Pharmacology




                Authors:Mamchur V.I., Opryshko V.I., Khomyak N.V., Nefedov
                O.O., Lievykh A.E., Kravchenko K.O., Kunik A.V.

                University: Dnepropetrovsk state medical academy




               ICMS 2011 / PP 33 Preclinic
                Abstract:
                Introduction Presence of pain syndrome requires, as a rule, administration of
                analgesic drugs. From clinical point of view it should be taken into account that
                pain of different origin is the most frequent syndrome which accompanies a
                lot of diseases. And also it could be comorbid with other pathological states
                (e.g., epilepsy, depression, diabetes mellitus, coronary heart disease). In this
                case a question about influence of analgesic drugs on course of these diseases
                emerges. Aim Aim of this work was to research effects of nonsteroidal anti-
                inflammatory drugs (NSAIDs) used under different concomitant pathological
                states (increased convulsive readiness of brain, depression, spasms of smooth
                muscles, disturbances of platelet aggregation). Methods Different methods
                of experimental research were used such as study of paroxysms on model of
                pentylenetetrazol convulsions, behavioural despair test (Porsolt test), tail sus-
                pension test, myographic recording of contractile activity of smooth muscles of
                blood vessels, optical platelet aggregometry. Results Research on animals with
                pentylenetetrazol-induced convulsions has shown that a number of analgesic
                drugs (parecoxib, celecoxib, paracetamol, lornoxicam, analben, benzofurocaine)
                possess certain anticonvulsive effect. At the same time ketoprofen, diclofenac,
                ketorolac render proconvulsive activity. It has been established that diclofenac,
                metamizole and paracetamol (inhibitor of COX-3 mainly located in CNS) have
                the most expressed antidepressant and anxiolytic activity. Meloxicam (1 mg/
                kg) showed prodepressant effects. All analgesic drugs have spasmolytic activ-
                ity of various degree that is independent of COX-selectivity. It has been ascer-
                tained that different NSAIDs render both stimulatory and inhibitory influence
                on platelets functional activity. Proaggregatory properties were shown not to be
                class-specific effect of COX-2 selective drugs. Meloxicam and parecoxib depress
                platelet aggregation, but nimesulide and especially rofecoxib, on the contrary,
                render proaggregatory effect. Dose-dependent change of direction of influence
                on platelet aggregative ability is characteristic for celecoxib. In dose 10 mg/
                kg it shows clear proaggregatory properties, but in dose 50 mg/kg celecoxib
                has opposite effect. Conclusion Thus NSAIDs exert influence not only on pain
                syndrome and can modulate course of various pathological states. Patients with
                different concomitant diseases should be prescribed analgesic drugs individually,
                with care and only for short terms.



                Keywords: NSAIDs, convulsions, depression, spasms, platelet aggrega-
                tion
                Contact authors at: dsma@ua.fm

                                                    —98—
    POSSIBILITY FOR PROTECTION WITH AMINO ACID DE-
   RIVATIVE ON DECLINE IN COGNITIVE FUNCTION OF RATS
     AFTER EARLY MATERNAL DEPRIVATION WITH SOCIAL




                                                                                   Pharmacology
                       ISOLATION




                                                                                     Anatomy
  Authors: Miroslav Novoselski, Eleonora Encheva, Lyubka Tanche-
  va, Veselin Petkov, Radoslav Klisurov

  University: MU-Sofia




ICMS 2011 / PP 34 Preclinic
Abstract:
The importance of early life stress for mental health is well known, but
the underlying neurobiological mechanisms are not clear. Perinatal stress
exposure in rodents affects critical periods of brain development that per-
sistently alter structural, emotional and neuroendocrine parameters in adult
offspring. Newly synthesized L-valine derivatives demonstrated significant
neuroprotective effect on adult rats in our earlier studies, but they may be
useful also in young animals. The purpose of study was to examine pos-
sibility to modulate early life stress via amino acid application in female and
male rat offspring after 5 weeks of maternal deprivation and social isolation.
Methods: Wistar male and female rats were deprived from their mothers
on the 21 day after birth. They were also hosted in isolated cages for 5
weeks. Last 5 days some of them received а newly synthesized compound
(L- valine derivative) in daily dose 150 mg/kg i p for 5 days. The cogni-
tive functions on the 24h after the last drug application were studied- the
exploratory activity and learning and memory (on the 1st and on the 24th
hour). Control group was treated with Ol. Helianthi (same vol.). Results: 5
weeks maternal deprivation combined with social isolation produced sig-
nificant cognitive changes both in male and female rats. In comparison to
the control animals the exploratory activity and processes of learning and
memory were seriously damaged. More significant was the effect in male
(about 50%) than in female rats (28- 38%). The L-valine derivative with
neuroprotective effect in adult rats had improving effect on learning and
memory and exploratory activity in male and female offspring with mater-
nal deprivation and social isolation. The protective effect of the compound
was better in male (by 45%), than female rats (by 25%). Early environ-
ment was proven to have a critical influence on the cognitive function and
neural plasticity. A period of 5 weeks of maternal deprivation along with
social isolation seriously affected cognitive functions in Wistar rats in a sex-
dependent manner. Pharmacological modulation of declined cognitive func-
tion of rats with maternal deprivation using new L-valine derivatives can be
a successful approach. Possibility for protection with amino acid derivative
on decline in cognitive function of rats after early maternal deprivation with
social isolation.
Keywords: Neuroprotection, Amino acids, Animal models, Memory and
cognitive disorders, Stress
Contact authors at: stealt@gbg.bg


                                    —99—
                   MICROGLIAL ACTIVATION AND EXPRESSION OF IL-1? IN
                        DIFFERENT MODELS OF NEUROPATHIC PAIN
Pharmacology




                Authors: K. Surchev, M. Vlaskovska

                University: MU-Sofia




               ICMS 2011 / PP 35 Preclinic
                Abstract:
                Microglia have dual role in diverse neurologic pathologies and can
                be both destructive and protective, depending on whether micro-
                glia release neurotoxic factors (e.g., TNF-?, IL-1?, reactive oxygen
                species) or neuroprotective factors (e.g., growth factors BDNF, NGF,
                bFGF)1. Growing evidence has shown that glial cells and interleu-
                kin-1? are activated in spinal cord and contribute to the development
                of inflammatory and neuropathic pain. The purpose of this study
                was to provide evidence for involvement of activated microglia and
                upregulated interleukin-1? in spinal cord in models of neuropathic
                pain. Male Wistar rats underwent chronic constriction injury (CCI or
                Bennett model) and streptozotocin-induced diabetes (Diabetic neu-
                ropathic pain model - single i.p. injection of 70 mg/kg streptozotocin
                (plasma glucose concentrations ?15 mmol/l)). Plantar heat and von
                Frey tests were used to measure nociceptive thresholds for verifica-
                tion of development of neuropathic pain. Spinal microglial activation
                was evaluated by OX42 (complement receptor type 3/CD11b). Dou-
                ble labeling of IL-1? with OX42 for co-localizations in dorsal horns
                were used. CCI and STZ-diabetic rats displayed significant tactile and
                thermal allodynia compared with control rats. In CCI rats significant
                microglial activation was observed in dorsal horn mainly ipsilateral
                of constriction of n. ischiadicus. Dorsal funiculus was also involved in
                microglial activation. Slightly activated microglia was determined in
                dorsal horn in spinal cord in diabetic rats compared with that in the
                na?ve rats. In both modes double label of OX42 and IL-1? did not
                show co-localization. The results of the present study suggest that
                spinal OX42 expression has a more important role in the develop-
                ment of neuropathic pain in CCI model than in diabetic neuropathic
                pain model. 1. Suter M R, Wen YR, I Decosterd and RR Ji. Neuron Glia
                Biol. 2007; 3(3): 255–268. Acknowledge ments: This investigation
                was supported by Medical University Sofia (Project 20/2010).
                Keywords: spinal cord, microglial activation, chronic constriction injury,
                streptozotocin-induced diabetes
                Contact authors at: surchev@gmail.com

                                                 —100—
    NOCICEPTIVE SENSITIVITY OF LAND SNAILS HELIX AL-
   BESCENS AND REGENERATION OF PLANARIANS DUGESIA
    TIGRINA UNDER WEAK LONG-TERM ELECTROMAGNETIC
                      SHIELDING




                                                                                            Physiology
                                                                                             Anatomy
  Authors: N.A. Temuryants, A.S. Kostyuk, N.A. Demtsun, N.S.
  Yarmolyuk and K.N. Tumanyants

  University: Taurida National V.I. Vernadsky University




ICMS 2011 / PP 36 Preclinic
Abstract:
Introduction. The study of efficacy of weak electromagnetic field (EMF) is an important
area of biophysical research. The interest is two-prong: first, the role of ambient EMF
must be determined; secondly, from the practical standpoint, it is interesting to know
how weak EMF affects various organisms. For investigating the effects of shielding
one needs objects distinguished by simplicity, economy, high reactivity. These proper-
ties are possessed by regenerating planarians and nociception of land snails, which
are successfully use for studying the biological action of EMF of various parameters.
Aim. The goal of this study was to observe nociception in snails Helix albescens and
regeneration of planarians Dugesia tigrina during a long-term exposure to weak elec-
tromagnetic shielding (EMS). Methods. A 2x3x2 m room, constructed of a double-layer
Dynamo steel, served as a shielding chamber. The shielding ratio, as measured by a
ferrite core magnetometer, was 4.375 in the vertical component and 20 in the hori-
zontal component. Results. Analysis of dynamic changes in the efficiency coefficient
allowed us to find phase changes in nociceptive sensitivity of the shielded snails. Phase
I – comprised a 15.25% (P<0.001) elevation in sensitivity (days 1 to 6) (hyperan-
algesia). Phase II comprised a gradual 20.93% (P<0.001) reduction of nociceptive
sensitivity (days 7 to 16), e.g. a development of the analgesic effect. Phase III com-
prised the return of the studied parameters to baseline, e.g. loss of the analgesic ef-
fect. Phase IV – stabilization of nociceptive sensitivity at a new threshold that is 2-9%
higher than the baseline threshold. We established that EMS changes the intensity of
regeneration processes as dependent on the season of the year. The efficiency coef-
ficient in each season changed in the same manner. In winter the value grew in these
observation terms to 50%, in summer the value – only to 15%. In the autumn season
the stimulating effect was noted after a four-day latent period and pronounced more
than in summer, but less than in winter. In spring we disclosed a tendency took place
to suppression of regeneration. Long-term weak EMS also causes alterations in the
infradian rhythmicity of the nociceptive sensitivity of land snails and regeneration of
planarians, such as changes in power spectra, phase shift and a tendency to amplitude
changes. Thus, long-term weak EMS lead to the development of desynchronosis. Con-
clusion. Apparently, an important role in the effects of shielding is played not only by
attenuation of the intensity of static and alternating magnetic fields of certain ranges
but also by a change of their relationship, i.e. change of the whole spectrum of acting
EMF. This conclusion is confirmed also by the differences in the results obtained in mu-
boxes and Helmholtz coils. In this way, the results of conducted investigations testify
to the biological effectiveness and important ecological role of ambient EMF.




Keywords: Electromagnetic shielding, nociceptive sensitivity, regenera-
tion
Contact authors at: timur@crimea.edu


                                        —101—
                  ANGIOTENSIN II AND ITS IMPORTANCE FOR THE CON-
                      TRACTILE ACTIVITY OF RAT PELVIC ORGANS
Physiology




              Authors: Stela Valcheva , Yancho Valchanov, Rosen Iliev, Petya
              Hadzhibozheva, Tsvetelin Georgiev

              University: Trakia University




             ICMS 2011 / PP 37 Preclinic
              Abstract:
              Introduction: Angiotensin II (ang II) is described primarily as a vasocon-
              strictor peptide. More recent studies show that its effect extends over a
              number of organs, not only in the cardiovascular system. Angiotensin
              receptors have been described in urinary system, gastrointestinal tract,
              reproductive system. In the literature there is insufficient data about the
              effects of ang II on smooth muscle organs in the pelvic cavity, such as
              urinary bladder, uterus and rectum. Aim: The present study was designed
              to investigate the effects of Ang II on isolated longitudinal strips from rat
              uterus, urinary bladder and rectum in “in vitro” experiments and also to
              compare and analyze in detail the obtained responses by using a time-
              parameters of smooth muscle contraction (SMC). Materials and meth-
              ods: Longitudinal strips from urinary bladder, uterine horns and rectum
              of Wistar rats were used for in vitro recording of Ang II-induced con-
              tractions. The obtained contraction curves were compared by applying
              of some time-parameters. Results: In treatment with 1 ?mol of ang II,
              all of the preparations developed tonic responses with an average am-
              plitude as follows: urinary bladder 1.73±0.26g, uterus 4.15±0.92g and
              rectum 4.22±0.46g. The integrated force of the SMC (AUC) was greatest
              in the preparations from uterine horns. With regard to the time-param-
              eters characterizing the different phases of the SMC, the contractions of
              the rectum and the bladder showed no statistically significant differences
              between each other. Conclusion: The application of time-parameters con-
              tributes significantly to the clarification of the phases of the contractile
              response. The obtained results showed that, although the different am-
              plitude, the urinary bladder and the rectal contractions occur in a similar
              manner. This probably is determined by the fact that the two organs have
              a reservoir function. For its part, the response of the uterus to ang II can
              be characterized as a more inert. The study of the ang II effects on the
              contractile activity of organs from the pelvic cavity is necessary, as the
              importance of this peptide is proved for the development of a number of
              conditions such as internal anal sphincter incontinence, urinary bladder
              overactivity and myometrium hypertrophy.

              Keywords: Angiotensin II, uterus, urinary bladder, rectum
              Contact authors at: stela_vi@abv.bg


                                                —102—
   SPONTANEOUS AND ANGIOTENSIN II - INDUCED RECTAL
   CONTRACTILE ACTIVITY AND ITS MODULATION BY APA-
                 MIN AND VERAPAMIL




                                                                         Physiology
                                                                          Anatomy
  Authors: Zlatina Vasileva, Ivan Mindov, Rosen Iliev, Tsvetelin
  Georgiev, Petya Hadzhibozheva

  University: Trakia University




ICMS 2011 / PP 38 Preclinic
Abstract:
Introduction: The rectum, as one of the distal segments from the
gastrointestinal tract, is not a subject for extensive investigations,
although the study of its activity could be useful in revealing the
regulatory pathways involved in the control of the rectal function.
The rectal contractile activity can be influenced by the modulation
of the ion currents through the different ion channels of the smooth
muscle cells, and by a number of regulatory peptides, particularly
angiotensin II (ang II). Aim: The purpose of this study was to in-
vestigate the effects of the calcium channel blocker Verapamil and
the effect of small conductance potassium channel blocker Apamin
on spontaneous and induced by ang II contractions of isolated rat
rectum. Materials and methods: Longitudinal strips from the rec-
tum of Wistar rats were used for in vitro recording of spontane-
ous and ang II - induced contractions. The effects of the channel
blockers Verapamil and Apamin were tested in both types of con-
tractions. Results: The application of 100 nmol apamin statistically
significant increased the spontaneous activity of the rectum. The
amplitude of the phasic contractions rised from 1.28 ± 0.28 g to
3.28 ± 0.45 g. Ang II – induced contractions (4.22 ± 0.46 g) were
completely suppressed in the presence of 1 µmol verapamil . Con-
clusions: Small-conductance potassium channels play an important
role in the regulation of spontaneous activity of the rectum. Cal-
cium channels have a crucial role in the realization of the rectal
tonic responses. Both of the ion channels blockers are well known
in medicine and are widely used in treatment of cardiovascular and
nervous disorders, respectively. Therefore, their application could
lead to disorders in the normal rectal function.



Keywords: Angiotensin II, Apamin, Verapamil, Rectum, Contraction
Contact authors at: zuzan4eto89@abv.bg



                               —103—
                 THE ROLE OF INTERACTION BETWEEN NNOS-DERIVATE
                NITRIC OXIDE AND RENAL NERVES ON THE MODULATION
                OF FAST INTERPULSE INTERVAL OSCILLATIONS IN CON-
                                   SCIOUS RATS
Physiology




              Authors: Iliev B, Ognyanova S, Popov DM

              University: Medical University Sofia




             ICMS 2011 / PP 39 Preclinic
              Abstract:
              The aim of the current study was to investigate the role of interaction be-
              tween renal nerves and nNOS-derivate nitric oxide on interpulse interval
              variability in conscious Wistar rats. Experiments were carried out on two
              experimental groups: Wistar rats with intact renal nerves (n=10) and bi-
              laterally renal denervated Wistar rats (n=10). The animals were housed in
              standard conditions: 22 0C, 12/12 h light/dark cycle, with free access to
              food and tap water. The bilateral renal denervation (BRD) was performed
              through a flank incision by cutting all visible nerves around the renal ves-
              sels. For blood pressure registration and for application of selective nitric
              oxide synthase inhibitor 7-Nitroindazole (7NI) in dose 2 mg/kg/h catheters
              were inserted 24 hours before experiments in femoral artery and vein, re-
              spectively. All surgical manipulations were performed under general anaes-
              thesia (Nembutal 35 mg/kg, i.p.). The arterial blood pressure wave was
              registered directly by a blood pressure transducer Gould Statham P23ID,
              connected to data acquisition system Biopac MP100WS during 40 min long
              control period and 20 min after 7NI application for 40 min. The interpulse
              interval (IPI) was calculated in terms of the time between two consecutive
              diastolic minimums of the blood pressure wave by Acknowledge 3.8 soft-
              ware. In IPI spectrograms derived in graphical programming environment
              LabView 3.1.1, through Fast Fourier Transform (FFT) algorithm the spectral
              power (P) in low (LF: 20-195 mHz), mid (MF: 195-605 mHz) and high (HF:
              605-3000 mHz) frequency band was estimated. The sympatho-vagal bal-
              ance was determined by the relation PMF/PHF in the IPI spectrograms. The
              BRD did not change spectral characteristics of IPI. In rats with intact renal
              nerves nNOS inhibition did not affect PLF or PHF. However, it leads to a de-
              crease of PMF from 1.33±0.34 to 0.44±0.06 ms2, (p<0.05). As a results
              of decrease of PMF during nNOS inhibition, PMF/PHF ratio decreased from
              0.73±0.06 to 0.41 ±0.03, (p<0.05). The application of 7NI in rats with BRD
              did not affect fast oscillations of interpulse interval. The modulating action
              of nNOS-derivate nitric oxide on the fast interpulse interval oscillations is
              realized with the involvement of renal nerves.
              Acknowledgment: This work was supported by grant №1/2010, Medical Re-
              search Counsel, Medical University - Sofia

              Keywords: heart rate variability, nNOS, renal nerves
              Contact authors at: bogdan.b.iliev@gmail.com


                                                —104—
   INVESTIGATION OF METABOLISM OF EXOGENOUS HOMO-
               CYSTEINE IN RAT’S PLASMA




                                                                                       Physiology
                                                                                        Anatomy
  Authors: Ruseva S, Vasileva A, Popov DM, Angelov H

  University: Medical University Sofia




ICMS 2011 / PP 40 Preclinic
Abstract:
Homocysteine (Hcy) is a sulfur containing amino acid with important physiologi-
cal functions and high biological significance. Elevated plasma homocysteine
concentration is regarded as an independent risk indicator for cardiovascular
events and is associated with various diseases including renal dysfunction and
neuronal diseases. Elevations of plasma Hcy may often be caused by one or
more unhealthy lifestyle factors that influence vitamin status or metabolism,
such as high alcohol consumption, low nutritional intake of vitamins and lack of
physical exercises. There are no investigations about the possibility of a relation-
ship between elevated levels of Hcy and its intake from dietary sources.
The aim in this study is to investigate metabolism of exogenous Hcy in rat’s
plasma by mass spectrometry using stable isotope labeling.
Experiments were performed in four groups consisted of 7 animals each. The
animals included in first (WR) and third group (SHR) received drinking water,
whereas rats in second (WR+Hcy) and four group (SHR+Hcy) received stable
isotope labeled homocysteine (Hcy- d4) 3.47 mg/day, dissolved in drinking water
in the course of 5 day. The plasma was analyzed for homocysteine, cysteine, me-
thionine, glutathione, SAH, AdoMet and their stable isotopes. All analysis were
carried out on LTQ Orbitrap® Discovery equipped with Surveyor® HPLC system
and IonMax® electrospray ionization module (ThetmoScientific Co, USA). Data
acquisition and processing were carried out with XCalibur® software package.
The analyses show that exogenous Hcy is metabolized in rats. Obtained data
shows that it metabolized by both transmethylation cycle and transsulfonation
cycle, because we detected metabolites of exogenous homocysteine – isotope
loaded cysteine and methionine in rat’s plasma. Concentration of plasma content
of isotope labeled homocysteine was quantified. We also calculated cysteine and
methionine percent ratio to cysteine and methionine. There is evidence that
isotope loaded cysteine is metabolized to glutathione and probably it is involved
in protein synthesis.
The results of our study show that exogenous homocysteine is metabolized in
the same way as endogenous homocysteine. Thus, consuming food and bever-
ages with high content of homocysteine would lead to influence in health status
in patients with metabolic or genetic damage of the homocysteine metabolism.

Acknowledgements: This work was supported by grant №3C/2009, Medical Re-
search Council, Medical University - Sofia
Keywords: homocysteine, plasma, metabolism, mass spectrometryCon-
tact authors at:



                                     —105—
              WAYS OF BLOOD SUPPLY IN HUMAN FETAL RETINA DUR-
                 ING THE PRENATAL PERIOD OF ONTOGENESIS
Anatomy




            Authors: Ivan Diskovskyi, Ulyana Pidvalna, Solomia Sergiychuk

            University: Lvin National Medical University




          ICMS 2011 / PP 41 Preclinic
           Abstract:
           Actuality. Fundamental studies of retinal features and ways of its blood supply
           are essential for successful solution modern ophthalmology problems. Despite
           the actuality and importance of the problems of structural and functional fea-
           tures of the eyeball and its vascular blood supply in the prenatal period of on-
           togenesis only sporadic information is published. Aim. Establish the structural
           features of retinal vasculature in the second trimester prenatal period of human
           ontogenesis Materials and methods. The study was done on the 10 human fetal
           (14-22 weeks of fetal development). Material research is represented by prepa-
           rations from human fetal eyes with injected vascular flow. Examined material
           for study the development of retinal vasculature is obtained from the gyneco-
           logical department of clinical hospitals of the Lviv city. In 5 cases the pregnancy
           was not complicated and finished as a result of mechanical injury. In 5 cases the
           pregnancy was complicated by concomitant diseases of pregnant women; preg-
           nancy interrupted artificially. Age of embryos calculated as largest parietal heel
           size by means of tables. For injection of the vascular blood flow the injecting
           mass of eye was used (aqueous suspension of casein-oil gas soot). Lightening
           of eyes membranes was performed in glycerol with 96% ethanol. Preparations
           were studied and photographed under a microscope with increasing 200 x. Re-
           sults. In the second trimester of intrauterine growth the blood supply in retina
           is not well-formed. In neuro cells layers of the retina the vascularis pools were
           not found. Retina layers which are adjacent to the choroid, fed by diffusion of
           nutrients from the choroid. In the beginning of second trimester the choroid
           arteries are formed, but choriocapillary layer has the look of separate island,
           vascular plexus around the optic nerve disc is formed. The central retinal artery
           is formed, branches of which provide blood supply to the inner retina layers
           formed by the second and third neurons. At the end of second trimester forma-
           tion of arterial circle around the optic nerve is finished. Around the optic nerve
           disk the branches of the central retinal artery anastomose with back short cili-
           ary arteries, resulting in a closed arterial circle around the optic nerve. Conclu-
           sions. In the second trimester of intrauterine fetal development the formation of
           retinal blood supply is completed, including the formation of capillary networks
           of arterial shell and arterial vascular circle of optic nerve disc.




           Keywords: retina, blood supply, prenatal period o ontogenesis
           Contact authors at: diskovskuy@ukr.net


                                               —106—
   MARKERS OF CARDIOVASCULAR RISK: BLOOD PRESSURE
        VARIABILITY AND PULSE WAVE VELOCITY




                                                                                 Physiology
                                                                                  Anatomy
  Authors: Vladimir Pavlov, Deyan Nenov, Ekaterina Popovska

  University: Medical University Sofia




ICMS 2011 / PP 42 Preclinic
Abstract:
Aim. This study is part of a complex investigation of cardiovascular variabil-
ity during functional testing of young normotensive individuals with fam-
ily history for increased cardiovascular risk (arterial hypertension, obesity,
diabetes, and end organ damage – myocardial infarction, brain stroke). The
idea was to find suitable markers that might be used for screening of sub-
jects at higher risk and for primary prevention.
Methods. Seventy individuals were divided into two groups: normotensive
subjects with positive family history for cardiovascular risk (N+) and their
age matched controls (N-). They were subjected to a well known sympa-
thetic challenge – the orthostatic test (OT). A large group of these patients
were tested for a second time in order to monitor the consistency of the ob-
served data. OT comprised of three 5 minute experimental periods: supine,
active upright and supine recovery.
Continuous beat to beat finger blood pressure using Finapress (Ohmeda
1300) and ECG were recorded. In addition, in order to assess arterial wall
characteristics brachial and ankle plethysmograms were registered. All
data were digitized with a Biopac MP100 device. Blood pressure variability
(BPV), spontaneous baroreflex sensitivity (SBRS) and brachial- ankle pulse
wave velocity (ba-PWV) were analyzed using Acknowledge and MIS2000
software.
Results. BPV was higher in (N+) as compared to (N-) – at baseline 46 vs. 21
mm Hg2, during OT – 113 vs. 78 mm Hg2. Ba-PWV was significantly higher
in (N+) as compared to (N-) (p<0.01) both at rest and after OT. These re-
sults were confirmed by the repeated testing.
Discussion. The higher BPV might be interpreted as a marker of altered ba-
roreflex sensitivity in (N+). This finding was supported by the ba-PWV data.
Our results evidence the existence of subtle yet consistent alterations in
the autonomic regulation of the cardiovascular function in young individuals
with family history for cardiovascular risk.
Acknowledgement: This study was supported by Grant DO 02-26/2009 (N
Bg-SK 201) of the Bulgarian Fund for Scientific Research and was carried
out by the supervision of Associate Professor Nina Belova, MD, PhD.

Keywords: Orthostatic test; Blood pressure variability; Pulse wave veloc-
ity; Cardiovascular autonomic function.
Contact authors at:


                                   —107—
   Abstracts
Medical Education
  Oral Session
   SIMULATION OF MEASUREMENT OF LOW LEVEL OF HEMO-
     GLOBIN IN BLOOD USING IRON COMPLEX SOLUTIONS




                                                                                Medical Education
                                                                                   Anatomy
  Authors: Halil Kandemir, Ali Can Gunes, M.Matova, Ts.Tsanova

  University: Medical University Sofia




ICMS 2011 / 0P 01 Medical Education
Abstract:
Introduction: Hemoglobin is responsible for transporting oxygen from the
lungs to the body tissues where it is utilized for energy metabolism. Meas-
uring level of hemoglobin in the blood is important for diagnosing and treat-
ing patients. The internationally adapted method for quantitative determi-
nation of hemoglobin in human blood uses a hazardous cyanmethemoglobin
reagent. A simulation measurement of hemoglobin based on a laboratory
exercise freely available on the web page of Truman State University Chem-
lab Guide is used in the present study. Aim: This experiment should help
the first year medical students to: 1) assess the hemoglobin level in blood;
2) learn and understand UV-VIS spectrophotometry; 3) accurately present
and interpret the experimental data in graphic form. Methods: The JEN-
WAY 6400 spectrophotometer is used to measure the light absorbed by the
samples in the present study. The best fit curve equation for the experi-
mental data points is calculated with the computer statistical program Orig-
inPro8. Results: This simulation uses solutions containing iron thiocyanate
[Fe(SCN)]2+ as a red color iron complex instead of hemoglobin. According
to literature data iron thiocyanate reagent appears to have a moderate tox-
icity. The stock solution of the red iron complex is made in a way to have
the greatest absorbance at 540 nm. A set of standard solutions with very
low concentrations of iron thiocyanate is prepared. The measured absorb-
ance of each standard solution follows Beer-Lambert law at 540 nm. The
experimental points are used to build the calibration graph absorbance ver-
sus concentration. A straight line, passing through the origin best fits the
plotted data points. The computer calculated linear regression equation is
significant (F-test=150) and has a high correlation coefficient (R2=0.97).
The unknown hemoglobin concentrations in blood are read from the cali-
bration graph and calculated from the linear regression equation. The re-
sults indicate low level of hemoglobin. Conclusion: The present simulation
measurement of hemoglobin level prevents first year students from actually
analyzing blood and working with toxic reagents. This study is a helpful
attempt at the teaching process of medical students who are in their first
steps in clinical experience.

Keywords: hemoglobin level, spectrophotometry, Beer-Lambert law

Contact authors at: daltonreis_han@hotmail.com


                                      —109—
                      GLOBAL TRENDS IN HIGHER MEDICAL (PHARMACEUTICAL)
                                          EDUCATION
Medical Education




                     Authors: Oleksandra Yu. Lysenko, Yaroslav V. Tsekhmister

                     University: National O.O. Bohomolets Medical University




                    ICMS 2011 / 0P 02 Medical Education
                     Abstract:
                     Objectives: to clarify the problems of scientific studing and implementation
                     of psycho-pedagogical and social priorities in the process of optimal model of
                     higher medical (pharmaceutical) education. Methods: concept-comparative,
                     structure-systemic analysis; questioning; statistics. In the XXI century in the
                     agenda of international forums as a priority was put a public health problem.
                     More than a third of indicators outlined in the Millennium Declaration on de-
                     velopment adopted by the UN Millennium Summit aimed at improving public
                     health. Health systems of different countries face the task of improving the
                     structural and functional models of care due to increasing population needs
                     for affordable and qualitive health care. Reform process must be carried out in
                     medical (pharmaceutical) industry which is possible if the political leadership
                     and highly skilled health workers are available. Therefore, restructuring of the
                     system of doctors and pharmacists training is necessary. However, there are
                     serious problems of resource stability and financial security of the training sec-
                     tor system, the modernization of medical (pharmaceutical) education is getting
                     complicated by the crisis in the global economy. World Conference on Medical
                     Education (Edinburgh, 1988) identified four levels of organizational structure
                     to increase its quality: global, regional, national, and institutional. Eight of the
                     twelve principles of the Edinburgh Declaration are affecting the reform of medi-
                     cal education at school. Training of doctors and pharmacists involves a complex
                     set of special arrangements which are agreed with aims and objectives of higher
                     education policy of the institution. In terms of active development of world sci-
                     ence and health standards it requires changes in educational paradigms, chang-
                     ing the education on the intellectual and cognitive development of young people
                     that will facilitate obtaining professional skills according with the requirements
                     of modern society. Conclusion: medical (pharmaceutical) education should first
                     focus on students and not the subjects, should not overload the curriculum and
                     programs; need to differentiate between the two key parts – basic and clinical
                     science, providing integrative interdisciplinary cooperation and multidisciplinary
                     approach to their study; it is really important to pay attention at searching
                     methods, determining and solving certain fundamental and clinical problems,
                     using appropriate methods of training and assessing students.




                     Keywords: optimal model of higher medical (pharmaceutical) education,
                     Contact authors at: Lusenko_88@mail.ru


                                                          —110—
   INVESTIGATION OF STUDENTS’ ATTITUDE TOWARD VIR-
   TUAL MODELS FOR E-LEARNING IN MEDICAL CHEMISTRY




                                                                                      Medical Education
                                                                                         Anatomy
  Authors: Teodora Sakelarova, Tanya Monova

  University: Medical University Sofia




ICMS 2011 / 0P 03 Medical Education
Abstract:
Introduction The Global Standards in Medical Education demand “the evalu-
ation and effective use of information and communication technology in the
educational programme for self-learning and accessing information”. The term
“virtual models” includes computer animations, molecular visualizations and
videos, representing real chemical processes, experiments and phenomena
that may be used by students in medical chemistry. The aim is to explore and
present the students’ opinion on virtual models developed for medical chem-
istry education. Methods The video material was shot in the laboratory during
performance of real experiments. The movies were prepared using Sony Vegas
Pro 7.0 video editing software and Sony Sound Forge 7.0 audio editing soft-
ware. Visualization of molecules was made by ChemOffice Ultra v.10. Ques-
tionnaire was used to get the students’ opinion. Results The selected topics
have been modeled and broadcasted as short videos and animations. Virtual
models represent most of the chemical processes studied in laboratory practice
and 3D visualization of molecules. Chemistry understanding relies on making
sense of the invisible. Many students consider it is difficult to navigate properly
between four levels of chemistry understanding: macroscopic, microscopic,
symbolic and process levels. Visual models help them to reach higher level of
conceptual understanding and navigation between different levels when us-
ing computerized molecular models. Video is used for pre-laboratory activities
because it shows real experiments in authentic environment. Students use
virtual models when preparing for laboratory exercises during their self-study.
They interact with video models whenever, wherever, and however, so learning
becomes more flexible. Users can stop, go back and forward, watch again, and
choose specific video fragments for better understanding. The virtual models
are relevant to the style of thinking and perception of the new generation of
learners, named “net-generation” or “digital natives” who are used to get in-
formation and learn from the computer screen. Conclusion Virtual models help
students to consolidate basic concepts. It allows them to reflect on clinical
application of the chemical processes studied in medical education. Acknowl-
edgements: The support of the Council of Medical Science at the Medical uni-
versity of Sofia is acknowledged (7-I/2009/26.03.2010).



Keywords: Medical education, Medical chemistry, Virtual models, Stu-
dents’ understanding
Contact authors at: tedy111@abv.bg


                                      —111—
                      A BILINGUAL VIRTUAL PATIENT ILLUSTRATES THE ACTION
                            OF INHIBITORY DRUGS ON DNA REPLICATION
Medical Education




                     Authors: Avi Gandhi and Ganka Kossekova

                     University: Medical University Sofia




                    ICMS 2011 / 0P 04 Medical Education
                     Abstract:
                     Introduction World Global Standards in Medical education recommend integra-
                     tion of theoretical sciences with clinical practice as well as constant develop-
                     ment and innovation of electronic resources. The bilingual Master Programme in
                     Medicine at the Medical University of Sofia poses a further challenge to prepare
                     these resources in both Bulgarian and English languages. Aim The purpose is to
                     prepare the English version of a virtual patient illustrating the action of inhibi-
                     tory drugs on DNA replication in cancer cells. Methods Searching of information
                     was carried out by Google and PubMed. Data for the clinical case were entered
                     into Windows-based application for the generation of tests and simulations of
                     virtual patients. The simulation of the virtual patient can be accessed online or
                     offline. Results Biochemistry of DNA metabolism is a very important and difficult
                     section for preclinical students. To solve the clinical case with monoclonal gam-
                     mopathy the student must have an acquired and a well comprehended knowl-
                     edge on DNA synthesis, damage and repair mechanisms. He should review
                     what electrophoresis is and know how serum protein profiles are related with
                     some diseases and used in diagnostics. To differentiate between the best alter-
                     native diagnosis (monoclonal gammopathy) and the incorrect or inferior deci-
                     sions (distractors such as polyclonal gammopathy, liver cirrhosis, etc.), the stu-
                     dent must get new information. The simulation focuses on the action of drugs
                     inhibiting DNA replication in cancer cells. It also helps in learning the structural
                     formulas and significance of several drugs: doxycycline, doxofylline, doxoru-
                     bicin, and daunorubicin. He should also revise his knowledge on or find informa-
                     tion about cisplatine, azidothymidine, methotrexate, dexrasoxan, ciprofloxacin,
                     erythropoietin, azithromycin, and their mechanisms of action. The student must
                     also be familiar with the side effects of doxorubicin (such as cardiomyopathy,
                     inhibition of the immune system, and dysfunction of the reproductive system).
                     Conclusion This simulation of a virtual patient with monoclonal gammopathy is
                     useful for medical and pharmaceutical students. Working with this interactive
                     patient facilitates integration of knowledge from Chemistry, Biochemistry, clini-
                     cal practice, and Pharmacology. Acknowledgements: The financial support of
                     the Council of Medical Science in MU-Sofia is gratefully acknowledged (7-Infra-
                     structure project/2009/26.03.2010).




                     Keywords: virtual patient, DNA, inhibitors of DNA replication, monoclonal
                     gammopathy
                     Contact authors at: avigandhimd@gmail.com

                                                          —112—
    A SITE-TEMPLATE FOR WEB-BASED PROBLEM-SOLVING
       ORIENTED LEARNING IN MEDICAL DISCIPLINES




                                                                                        Medical Education
                                                                                           Anatomy
  Authors: Elisaveta Trichkova and Ganka Kossekova

  University: Medical University Sofia




ICMS 2011 / 0P 05 Medical Education
Abstract:
Introduction The university Web-based system for distance learning enables
teachers to use the latest achievements of ICT to design and deliver modern
courses in medical disciplines. The system was used to implement a problem-
solving oriented learning in Medical Biochemistry and it was assessed as a
successful new pedagogical model. Aim In order to multiply the positive results
among other medical disciplines, the purpose is to describe the advantages of
a new empty PHP-based site-template with the same characteristics as the
site “Interactive Biochemistry – Sofia” at http://biochemistry.mu-sofia.bg.
Methods The application is based on free software products with open code:
operation system Linux, Apache Web server, MySQL database, and PHP pro-
gramming language. Results The empty site-template is targeted at teachers
from different medical disciplines to facilitate them in uploading traditional and
interactive teaching resources. This is important considering students of today,
named the “net generation”. The site has two separate interfaces – for stu-
dents and administrative one for teachers. Using the administrative interface
teachers without programming skills can easily publish lectures as a source of
knowledge, interactive tests for (self)-assessment of theoretical knowledge
and interactive virtual patients to facilitate creation of problem-solving skills.
Other useful modules are Glossary, Assignments, Virtual models (video-films,
animations), Information about the authors, Information about the course
(annotation, topic programs, schedules, etc.). Teachers can edit and add new
menu titles in all modules. All components of a Web-based course are created
using common browsers (Internet Explorer, Mozilla Firefox) to enter the neces-
sary data. Inbuilt text editor allows insertion of multimedia files, flash files, im-
ages, and document files, creation of links within and between course sections,
links to external sources. Conclusion Courses created at present by using the
university Web-based system are example for integration of latest achieve-
ments in the specific discipline (modern content), ICT (Web-environment),
Pedagogy (flexible learning) and Medicine (problem-based learning using vir-
tual patients). Further usage of the system in different medical disciplines is
worthwhile. For more information call 0889883381 in University Electronic In-
formation and Educational Center. Acknowledgements: The financial support of
the Council of Medical Science in MU-Sofia is gratefully acknowledged (Grant:
7th infrastructural project-2009/26.03.2010).

Keywords: Web-based system, distance learning, interactive tests, vir-
tual patients
Contact authors at: etrichkova@gmail.com


                                      —113—
   Abstracts
Medical Education
 Poster Session
  TRAINING SPECIALISTS BASED ON THE MODULAR-RATING
                     TECHNOLOGY




                                                                             Medical Education
                                                                                Anatomy
  Authors: Maria Vistak

  University: Lviv National Medical University




ICMS 2011 / PP 01 Medical Education
Abstract:
Direction in the future, the current trend of intensification of life, the
emergence of new socio-economic realities, including labor market,
need to develop new models of educational training, which will be
able to provide sustainable development of civilization. The aim of
our study is the allocation of professional and methodological com-
petencies and develop a method of successfully forming a personal-
ity oriented training in the use of modular-rating technology. Modu-
lar training proved successful in a way that provides separation of
disciplines in a relatively small component modules, which created
opportunities of educational development for individual student.
Summing the individual-oriented activities of students was carried
out by the criteria of the Bolonian process. According to the pro-
fessional content and teaching methods the competence-oriented
education in a module-rating system provides development system
of tasks. Contents of the first group task was aimed at fostering
intellectual skills, generalized skills. Contents of the second group
of tasks is subject to the study of biophysics teaching for medical
students. The third group of tasks applied in practice. This complex,
varying in complexity of tasks, which included the second group of
tasks and objectives aimed at the perception of teaching experi-
ence. Analysis of the results of our study allows to draw conclu-
sions about what methodical system of individually-based learning
module-based on the modular-rating technology provides a more
successful professional and methodological training. The system of
individually-oriented tasks is a means of improving future teacher
of discipline Medical and Biological Physics.




Keywords: modular-rating technology, training, medical and biological
physics
Contact authors at: vistak_maria@ukr.net


                                      —115—
                       FORMATION OF TECHNICAL THINKING IN THE PREPARA-
                                     TION OF PHYSICIANS
Medical Education




                     Authors: Lyubov Yemchyk, Maria Vistak

                     University: Lviv National Medical University




                    ICMS 2011 / PP 02 Medical Education
                     Abstract:
                     The state of modern medicine requires intellectual development of
                     specialists and technical creative thinking. This will allow skillfully
                     use modern medical equipment and use new technologies in medi-
                     cal practice. In the process of studying of physics the general and
                     technical basis of knowledge are formed. An important condition
                     of technical thinking is the relation between theoretical knowledge
                     and practical action. Students should be able to think of images of
                     objects in space dynamics. Creative thinking is not without knowl-
                     edge and ability to operate technical concepts that link the nature
                     laws and medical practice in particular. Using professionally ori-
                     ented laboratory work in physics (such as identifying the resilience
                     of resilience, studying the changes in pulse rate during physical
                     exercises etc.) shows to students the perspectives of the usage of
                     obtained results in future practice. Formation of thinking goes in
                     stages, so doing any task, one must possess the knowledge and to
                     develop the algorithm of work. Professional formation of the medi-
                     cal professional, the development of his/her intellect, technical and
                     logical thinking depends on the interaction of psychological and
                     didactic training aspects. Well-chosen methods of training give an
                     opportunity to obtain the necessary professional information and
                     also engage in self-study and self-formation as a future profession-
                     al. Medical and biological physics, medical informatics are sciences
                     which give the understanding of information and biophysical as-
                     pects of modern diagnostic and treatment methods, form the style
                     of scientific thinking and affect the competitiveness of the future
                     professionals. Thus, the educational process in physics, medical
                     and biological physics, medical informatics is integration of physics,
                     mathematics, biology, chemistry, medicine, science and technol-
                     ogy, formation of style of thinking.

                     Keywords: technical thinking, medical education, biophysics
                     Contact authors at: l_fed@ukr.net


                                                          —116—
  WINDOWS APPLICATION FOR CREATION OF INTERACTIVE
       WEB-BASED TESTS AND VIRTUAL PATIENTS




                                                                                     Medical Education
                                                                                        Anatomy
  Authors: Lyubka Markova and Ganka Kossekova

  University: Medical University Sofia




ICMS 2011 / PP 03 Medical Education
Abstract:
Introduction To facilitate implementation of problem-solving oriented e-learn-
ing in medical disciplines a structural and technological upgrading of the Web-
based virtual educational environment was done in the Medical University of
Sofia within the 7th Infrastructural project/2009/2010. Aim The purpose is
to describe the advantages of one of the modules of the University system,
namely the JavaScript-HTML module, for which a new administrative interface
has been developed. Methods The application is developed with the program-
ming language C#, using the integrated development environment Microsoft
Visual Studio. The tests and simulations of virtual patients are accessed by
Internet Explorer offline or online if uploaded to the University server. Results
The function of this Windows application is to allow easy creation of new Web-
based interactive tests and simulations of virtual patients. It permits to create
new units using items from existing tests and simulations. These can be ex-
ported into HTML and JavaScript files, which can be run by the students using
the browser Internet Explorer. Another useful option is the import of previ-
ously created HTML-JavaScript tests and simulations, which can then be edited
and updated. Important advantage is the possibility to save the data in XML-
format. This allows editing of the units until they are finally completed. The
application allows simultaneous export of several units. It is also possible to do
a step by step generation and running of the corresponding test or simulation
before the total export of the results. The interface for entering of the data is
easy, friendly and intuitive. The data include questions, answers, comments,
answer weights, and data for transitions between the screens, history of the
disease, authors and other metadata, etc. Pictures are easily inserted, as well
as links to additional information and instructions as well as links to external
resources. Conclusion The application is a useful tool which allows the teach-
ers to create Web-based tests and simulation of virtual patients offline, which
can be run both offline and online using Internet Explorer. Acknowledgements:
The financial support of the Council of Medical Science in MU-Sofia is gratefully
acknowledged (Grant: 7th infrastructural project-2009/26.03.2010).




Keywords: virtual educational environment, interactive tests, virtual
patients, JavaScript-HTML module, administrative interface.
Contact authors at: kalina628@gmail.com


                                      —117—
                                             LET`S READ TOGETHER
Medical Education




                     Authors: Raykova. A.N., Kachovski C.E, Stoyanov V.R., Dryngova
                     H.S., Naydenova A.I., Edreva V.B.

                     University: Medical University Pleven




                    ICMS 2011 / PP 04 Medical Education
                     Abstract:
                     Aim: The infectious diseases were faithful companion to
                     mankind from antiquity to present day. This is why we set a
                     goal to discover literary pieces of work, which one way or an-
                     other , are connected or inspired by severe life-threatening
                     infections. Materials and Methods: We present quotes form
                     great pieces of work (“Damned souls”, “Anna Karenina”,
                     “King rat”, “Forever Amber” and etc.) from great writers (D.
                     Dimov, A. Tolstoy, J. Clavell, K. Winsor and etc.) describing
                     some bacterial infections, as well as information regarding
                     specific characteristics of their causers – morphology, physi-
                     ology, cultural characteristics, treatment and prophylaxis.
                     Conclusion: In our opinion, a physician should have not only
                     good medical education, but also a wide range of knowledge
                     for the surrounding world.




                     Keywords: literature bacterial infections knowledge
                     Contact authors at:profane_corpse@yahoo.com


                                                          —118—
   METHODOLOGICAL PROBLEMS OF CARRYING TEST CON-
   TROL OF BIOPHYSICS FOR MEDICAL STUDENTS IN THE




                                                                                       Medical Education
      UNIVERSITIES UNDER CREDIT-MODULE SYSTEM




                                                                                          Anatomy
  Authors: Marianna Paykush

  University: Lviv National Medical University




ICMS 2011 / PP 05 Medical Education
Abstract:
The modern paradigm of education is changing from knowledge to competence,
the evaluation technologies are changing as well accordingly. The development
of various kinds of pedagogical control stimulates learning and cognitive ac-
tivity of students. Because of that there is a growing need for strengthening
basic didactic factors that affect the quality of basic and professional training of
future specialists.Growing amount of scientific information, new approaches to
the interpretation of phenomena and concepts, lack of comprehensive general
education of students show a number of contradictions between traditional
forms of presenting contents of the syllabus and requirements for its adop-
tion. Search for ways to optimize the educational process and improving the
quality of knowledge of students of higher medical school leads to the conclu-
sion that pedagogical success largely depends on the mastering by the future
medical specialists the main basic terminological concepts, laws and theories
that are used in Biophysics. As shown by experience, the current test control
of students knowledge of Biophysics constitutes one of the most important and
at the same time the weakest links of the learning process in higher medical
school. Because of lack of formulation and evaluation of tests and the need for
its implementation, finding effective evaluation models and optimal mecha-
nisms for their implementation is necessary. The main purpose of monitor-
ing is to determine the quality of mastering the learning material under the
prevailing degree of skills goals and objectives of the subject, establishing the
adequacy of selected methods and means of teaching this discipline. A higher
level of knowledge allows more finely distinguish between the phenomena and
concepts that student with a lower level shall deem as identical. In addition,
students with high levels of knowledge find similarity where others do not no-
tice it. Testing control has to meet the following requirements: • objectivity; •
consistency; • systematicity; • individual and differentiated approach; • opti-
mality; • professional direction. Problems of preparation and carrying the test
control of Biophysics: correlation of learning material level with its teaching
methods; providing the balance between different kinds of students activities,
lack of communicative orientation of studying material, ensuring the interests
of students to read the proposed material.



Keywords: medical education, carring test control
Contact authors at:



                                      —119—
  Abstracts
   Surgery
Oral Session I
    COMPARISON BETWEEN MECHANICAL AND BIOLOGIC
   VALVE REPLACEMENT BY PATIENTS WITH AORTIC VALVE
   DISEASE. A JUXTAPOSITION BETWEEN A SINGLE CLINIC




                                                                             Cardiac Surgery
                AND THE WORLD TENDENCY.




                                                                                Anatomy
  Authors: Yancheva V., Nikolov D. , Grigorova V.

  University: Medical University Sofia




ICMS 2011 / OP 01 Surgery
Abstract:
The question whether to implant a mechanical or biologic valve
in certain groups of patients with aortic valve disease has been
widely discussed through the years and still not definitely resolved.
Both valves have evolved over the last 40 years. The mechanical
valves are dependable, offer good hemodynamic performance for
the patient and theoretically unlimited durability. At the same time
they have an absolute requirement for long-term anticoagulation,
which can lead to further complications. The tissue valves perform
very well as well, especially with the newest anti-mineralization and
preservation techniques. They have a low rate of serious thrombo-
embolism, essential lack of thrombosis, and freedom from antico-
agulant hemorrhage. Their durability is longer now, but still about
10% after 10 years and 20% after 15 years may need repeat valve
surgery due to structural failure of the biological tissue and stress-
related fatigue injuries. The aim of our project is to juxtapose the
latest tendency in valve surgery in North America and Europe with
the results in our clinic. We studied a total number of 384 patients
with aortic valve disease who underwent aortic valve replacement
with both mechanical and tissue valves and compared them by dif-
ferent factors. We present statistics for a period of four subsequent
years comparable with most of the world clinics data. In conclusion
we discuss the choice of a valve type, which should be adapted to
each individual patient depending on age, life expectancy, valve
size, cardiac and non cardiac co-morbidities, patient preference,
and ability to take anticoagulants, lifestyle, risk of bleeding and risk
of re-operation. Late outcomes of modern prosthetic valves remain
suboptimal. The most appropriate valve substitute in some cases is
still a source of much controversy.


Keywords: mechanical aortic valve, biological aortic valve, clinical data,
indications, outcomes
Contact authors at: velina.yancheva@gmail.com


                                  —121—
           ON THE ISSUE OF HEALTH PROTECTION OF PRE-CON-
          SCRIPT AND CONSCRIPT ADOLESCENTS WITH ENT DIS-
                               EASES
ENT




       Authors: Sargsyan S.A.

       University: Yereva State Medical University




      ICMS 2011 / OP 02 Surgery
       Abstract:
       ON THE ISSUE OF HEALTH PROTECTION OF PRE-CONSCRIPT AND CONSCRIPT
       ADOLESCENTS WITH ENT DISEASES Sargsyan S.A. Yerevan State Medical
       University after Mkhitar Heratsi, ENT Diseases Department, Armenia Social,
       political and economic changes, taken place in Armenia at the end of the 20th
       century, negatively influenced the health of young generation, which needs
       special attention of medical professionals. Though the health of military age
       young males is of crucial importance, this extremely significant public health
       problem isn’t nowadays worked out well enough and practical aspect of pub-
       lic health doesn’t have a reliable system for its complete development. The
       general aim of this investigation was to give the characteristic features of ENT
       pathology among pre–conscript and conscript age adolescents in Yerevan. This
       part of our investigation is focused on the assessment of provided treatment
       efficiency among the above mentioned contingent. In 2004-2009, 1907 pre-
       conscript and conscript age adolescents sent for ENT examination by military
       commissariats from 4 administrative units in Yerevan have been involved in
       the research, and 1690 of which have been diagnosed with different ENT dis-
       eases. After ENT diseases diagnosing, military commissariats later sent some
       of the conscripts to in-patient medical centers for further treatment. The data
       obtained showed that the number of males sent for treatment increased during
       the six year period of the study. Thus 24 adolescents were sent for the treat-
       ment in 2004, which made 9.68% of the examined during that year conscripts,
       in 2005 and 2006 it made correspondingly 13.44% and 30.25%. During the
       last 3 years of our investigation the number of adolescents sent for treatment
       continued to increase and made from 44% to 48% of the examined conscripts
       for each year. Totally 559 conscripts from 1690 adolescents were sent for
       treatment, which made 33.08%. It should be noted that some of the adoles-
       cents refused to undergo treatment and in the end 336 received surgical and
       21 of them conservative treatment. Conclusion: According to our data we can
       conclude that during 6 years of our investigation only 1/3 of the pre-conscript
       and conscript adolescents were sent by military commissariats for the treat-
       ment. A part of them refused to undergo the treatment and in the end only 1/5
       of the adolescents received conservative and/or surgical treatment.



       Keywords: Pre –conscript and conscript age adolescents, ENT-pathology,
       health protection
       Contact authors at: sargsyansona11@mail.ru

                                          —122—
  ALTERNATIVE OPTIONS FOR ADENOIDITIS CONSERVATIVE
                THERAPY IN CHILDREN.




                                                                                Anatomy
  Authors: Maryana Cherkes




                                                                                 ENT
  University: Danylo Halytsky Lviv Medical University




ICMS 2011 / OP 03 Surgery
Abstract:
Introduction. Adenoiditis is the inflammation of the adenoid tissue which
is more common in children. Recent research, in particular immunological,
treat lymphoepithelial rings of pharynx as active components of the im-
mune system with special functions, which are to be preserved in the child’s
organism with the exception of cases when they turn into source of infection
and cause other organs pathology and can’t be treated conservatively. Aim.
Checking the effectiveness of adenoiditis conservative therapy in children
by means of polyvalent piobacteriophage as a monotherapy. Methods. 50
Children, aged 3.5 – 7 years, have been treated for acute adenoiditis. Acute
adenoiditis was detected in 26 children, acute condition of chronic adenoidi-
tis – in 24 children. Among them there were 34 boys and 16 girls. Polyva-
lent piobacteriphage was prescribed for nasopharyngeal rinsing twice a day,
2 ml in each nostril as a monotherapy. Medical treatment lasted 10 days.
The sick received the assessment of general condition; ENT-examination,
including nasal and nasopharyngeal endoscopy; acoustic tympanometry in
dynamics; microbiological analysis of the nasofarynx lymphoid tissue exu-
dates. Normal flora was detected in 19 children, opportunistic flora – in
31 children Results. At the beginning of the treatment children or their
parents complained about difficulties with nasal breathing (100%), runny
nose (92%), coughing (76%), diminished hearing (24%). After 3-5 days of
the drug’s use the symptoms reduced by half, after 7 days – not consider-
able, after 10 days - minimal. The fifth - seventh day of treatment was
marked by the disappearance of purulent discharge from nose and back
wall of the throat. By the beginning of the treatment 32 children (64%) had
the second-degree adenoids, 18 children (36%) – third-degree adenoids.
After the course of treatment 5 children (10%) had the adenoids decreased
to first degree, and third-degree adenoids were present just in 7 children
(14%). There were no bacteriophage side effects. Conclusions. Polyvalent
pyobacteriphage is quite effective medication for acute Adenoiditis con-
servative therapy. Bacteriophage is well accepted by small patients, has
no side effects, copes with the most dangerous causative agents of upper
airways diseases, and doesn’t contribute to the development of antibiotics
resistance.
Keywords: adenoids. adenoiditis, bacteriophage
Contact authors at: maryana.cherkes@gmail.com



                                  —123—
        FACTORS OF THE ESTABLISHMENT OF MIDDLE EAR VENTI-
                    LATION AFTER ACUTE OTITIS
ENT




       Authors: Stankovic Slavica,Stanic Ante

       University: Medical University of Belgrade




      ICMS 2011 / OP 04 Surgery
       Abstract:
       FACTORS OF THE ESTABLISHMENT OF MIDDLE EAR VENTILATION AFTER
       ACUTE OTITIS Authors: Slavica Stankovi?,Ante Stani? Menthor: Prof.Dr
       Sne?ana Je?i? Clinic for Otorhinolaryngology and Maxillofacial Surgery,
       Clinical Center of Serbia, School of Medicine, University of Belgrade, Serbia
       Introduction : Acute otitis media (AOM) is an inflammation of the middle
       ear, which is clinically characterized by the presence of secretions in the
       tympanic cavity and it is followed by signs and symptoms of ear infections:
       protrusion and possible perforation of the tympanic membrane, otalgia, se-
       cretion which can be purulent and fever. It has a high incidence in childrens
       population and potentially dangerous complications. Almost all children
       have one or more episodes of illness before the age of 6 years. Objective :
       The objective of this study is to examine the association between risk fac-
       tors and the establishment of middle ear ventilation and recovery. Material
       and metodhs : The research included 21 children aged 1 to 10 years with
       a confirmed diagnosis of acute otitis media. Examined data on risk factors
       we obtained on the basis of heteroanamnesis and clinical examination. All
       the patients underwent otomicroscopy and tympanometry testing of af-
       fected ear and healthy ear on several occasions. The data were analyzed
       by descriptive and analytical statistics. Results : The results of our study
       with the participation of 21 children, 12 girls (57.1%) and 9 boys (42.9%)
       showed that there is statistical association between relapse and recovery
       (p=0.035). Other risk factors that we examined were less associated with
       recovery. Conclusion : In our study we tried to clarify the association be-
       tween risk factors for the development of AOM and establishment of venti-
       lation after middle ear disease and concluded that the frequent recurrence
       proved to be statistically significant predictor of difficulties in establishing
       the function of the Eustachian tube. Key words : Acute otitis media (OMA),
       risk factors, tympanogram,children




       Keywords: Acute otitis media (OMA), risk factors, tympanogram,children
       Contact authors at: slavicavhan@yahoo.com


                                          —124—
   ACTUAL APPROACHES TO CONSERVATIVE TREATMENT OF
                UTERINE LEIOMYOMAS




                                                                              Gynaecology
                                                                               Anatomy
  Authors: N.S. Troian, Y.G. Drupp, S.N. Tutov D.V. Podoliaka E.V.
  Olshevskaya

  University: Donetsk national medical university named by
  M.Gorkiy



ICMS 2011 / OP 05 Surgery
Abstract:
The purpose of the present study was to investigate the efficacy of Zola-
dex depot 3.6 mg (goserelin acetate) treatment of patients with uterine
myomas of different size and location and optimization the use terms
of Zoladex therapy before surgical treatment for uterine fibroids. The
investigation comprised 19 patients aged 27-47 years, distributed into 2
groups. The first group included 10 patients with uterine myomas, whom
the Zoladex depot was administered every 28 days for 3 months. The
control group included 9 patients with leiomyomas, whom the Zoladex
depot was administered every 28 days for 2 months. Hematologic tests
and ultrasonographic evaluation of uterine volume were performed be-
fore and after treatment. Hemoglobin and iron levels similarly increased
in both groups after therapy,.Uterine volume similarly decreased in both
groups. No patient had menorrhagia or pelvic pain at the end of therapy.
Ultrasonographic showed the statistically significant decrease in the total
volume of the uterus after the Zoladex second injection from 501.4 to
290.1 cm3, and more pronounced decrease in total mass in the control
group (after the Zoladex third injection) from 507.1 to 230.9 cm3.The
obtained results point to efficacy of Zoladex in decreasing the volumes
of both myomas and uterus by more than 50%, which correlates with lit-
erature data. The treatment was well tolerated. In conclusion, we want to
say that Gonadotropin-releasing hormone agonists administration is an
effective and safe preoperative treatment for women with uterine leio-
myomas. Thus, we concluded that the use of two depot forms of Zoladex
in the complex preparation for surgical treatment of patients with uterine
fibroids as much as in the use of three depot-forms, leads to a reduction
of uterus, reducing complaints associated with fibroids, the improvement
of hematological parameters, reduced difficulty in performing surgery,
reduces the number of bed-days postoperative patients stay in hospital.
Given the price aspects of drugs, reducing the number of depot-forms
used in the preoperative period may substantially reduce the cost of
treatment, which opens prospects for wider use of Zoladex.

Keywords: leiomyomas, Zoladex, preoperative treatment
Contact authors at: natalusik777@mail.ru



                                 —125—
                 THE RELIABILITY OF ULTRASOUND IN DETECTING ANTE-
                               NATAL MALFORMATIONS
Gynaecology




               Authors: Maria-Daniela Cirju, Denissa Popa, Alexandru-Marian
               Goganau, Bogdan-Nicolae Cirju, Magda Manolea, Cristina Stefa-
               nescu
               University: University of Medicine and Pharmacy Craiova




              ICMS 2011 / OP 06 Surgery
               Abstract:
               Introduction The strategy to improve the detection of fetal anoma-
               lies is reliable, but has to be targeted to the establishment of three
               ultrasonographic examinations for a basic antenatal care, enhanced
               importance of first trimester screening and a high program of edu-
               cation of sonographers. Aim The aim of this study is to evaluate
               through a retrospective study, the efficiency of ultrasound in de-
               tecting antenatal malformations in low-risk populations of pregnant
               women by routine screening, and to compare whether systematic
               strictly timed screening of all pregnancies would improve the de-
               tection of major fetal anomalies. Methods We took in account in
               our study two groups of pregnant women: the screening group
               (N=476) that consisted in one ultrasound screening examination
               between the 18th and 22th weeks of gestation and the control
               group (N=460) that had ultrasound examination any time during
               pregnancy. We studied the reliability of ultrasound in detecting an-
               tenatal malformations by recording all congenital anomalies and
               the gestational age of anomaly recognition. Results From the whole
               number of 936 pregnancies, in 16 (1,7%) cases were detected fetal
               anomalies. In the screening group the detection rate was 44,4%
               and in the control group the detection rate was 28,5%. None of the
               cases in the control group was diagnosticated before 22th weeks
               of gestation. Conclusion The early detection of fetal defects and
               chromosomal anomalies, bring more arguments for routine screen-
               ing. Detection rates could be improved by routine scanning, better
               ultrasound equipment and training, and by the introduction of ma-
               ternal biochemical screening tests.




               Keywords: ultrasonographic,malformations,antenatal,screening,pregnan
               cies,chromosomal
               Contact authors at: daniela.cirju@yahoo.com

                                             —126—
  THE VALUE OF INTERLEUKIN 6 IN THE DIAGNOSIS OF CHO-
  RIOAMNIONITIS ASSOCIATED WITH PREMATURE RUPTURE
                     OF MEMBRANES




                                                                        Gynaecology
                                                                         Anatomy
  Authors: Alexandru Marian Goganau, Denissa Popa, Daniela
  Cirju, T. Daianu, B. Voinea, B. Cirju

  University: University of Medicine and Pharmacy of Craiova




ICMS 2011 / OP 07 Surgery
Abstract:
Objectives: The fluctuation of cytokines in amniotic fluid may show
an infectious process. We studied in 288 cases, the titer of IL-6 and
IL-8 in the same amniotic fluid samples immediately after rupture
of membranes and after 12 hours. Methods: Samples of amniotic
fluid were compared with a martor group.In order to determine
IL-6 and IL-8 values we used the test ELISA. The sensitivity test
was less than 11ng/ml for IL-6 and 1ng/ml for IL-8. Technology
was recommended by protocol. Results: We found an increased
of IL-8 titer, but especially for IL-6, within 12 hours of premature
rupture of membranes. There is a correlation between increasing
concentration of interleukins and time of membrane rupture, but
this growth is strongest for IL-6. The increase was significant for
IL-6 Conclusion: There is a parallelism between the increase of IL-6
and IL-8 in amniotic fluid, depending on the time of rupture of
membranes and microbial colonization. Increase is significant for
IL-6. The increased level of IL-6 could be considered a diagnostic
method for chorioamnionitis, beyond a predictive factor for of pre-
mature birth.




Keywords:Interleukin 6, chorioamnionitis, premature rupture of mem-
branes, premature birth, cytokines, ELISA
Contact authors at: goganau_alex@yahoo.com


                               —127—
                  THE PROBLEM OF POOR OVARIAN RESPONSE IN REPRO-
                                    DUCTOLOGY
Gynaecology




               Authors: Gradil O.G.

               University: Kharkiv national medical university




              ICMS 2011 / OP 08 Surgery
               Abstract:
               Infertility is one of the most pressing problem in the world, each
               year an increasing number of infertile couples. Аt this point in the
               world invited to the set of methods for its solution. However, with
               the development of reproductive technologies and overcoming the
               difficulties new problems arise. One of them, the most unexplored,
               is the poor ovarian response. Neither ART program can not be ef-
               fective without getting enough quality eggs. Therefore, the solution
               of this problem is our goal. To determine reliable predictors of poor
               ovarian response. Comparative characteristics of different methods
               of forecasting. Selection of effective schemes to stimulate ovulation
               in patients with high risk of poor response. The study involved 65
               women with infertility after therapeutic and diagnostic laparoscopy.
               All had clinical, biochemical, gomonal (FSH, AMH, inhibin B), ul-
               trasound studies and histological examination of ovarian tissue (a
               score of primordial pool). According to the results pathohistological
               study was divided into 3 groups of patients. 1st group, whose level
               of follicles in 1 mm3 from 0 to 5, 2nd group 6-11, 3d group of 12 or
               more. In the 3d group a poor response only occurs in 5% of cases,
               whereas in the 2nd and 3rd groups of 34% and 100% respectively,
               which correlated with worse clinical outcomes. Indicator that most
               accurately compared with hormonal studies shows the risk of poor
               ovarian response is to assess ovarian reserve by histological exami-
               nation. The number of follicles less than 11/ mm3 is a predictor of
               poor ovarian response. These patients need a short protocol stimu-
               lation with releasing hormone antagonists. 1st group of patients
               should be offered ICSI and consider of donation.




               Keywords: poor ovarian response, ovarian reserve

               Contact authors at: ultraneos@mail.ru

                                             —128—
  SIALYL-TN-ANTIGEN (STN) EXPRESSION IN OVARIAN TU-
                        MORS




                                                                       Gynaecology
                                                                        Anatomy
  Authors: Nina Jancic, Danijela Peric

  University: University of Nis




ICMS 2011 / OP 09 Surgery
Abstract:
Introduction Sialyl-Tn-antigen (STN) belongs to the group of carbo-
hidrate antigens present in the cell membrane and is a product of
early glycosilation. STN detected by monoclonal antibody TKH2 was
uniformly found in the stomach, duodenum, bronchus, uterus, sali-
vary gland and other organs. Aim The objective of this study was to
examine the expression and distribution of STN in ovarian mucinous
and serous tumors. Material and methods Archival tissue from 120
cases of ovarian mucinous (n=60) and serous (n=60) tumors was
examined. The mucinous group contained benign mucinous tumors
(n=20), borderline (n=20) and mucinous cystadenocarcinomas
(n=20). The serous tumors group contained benign serous tumors
(n=20), borderline tumors (n=20) and serous adenocarcinomas
(n=20). All samples were routinely stained by H&E method and
immunhistochemically by ABC technique with monoclonal TKH2 an-
tibody. Results Weak or strong STN-antigen expression was present
in all ovarian mucinous tumors (benign with or without dysplasia
as well as malignant types of various degree of differentiation).
The antigen expression was observed throughout the cytoplasm
of cancer cells and in the apical cytoplasm and luminal contents of
some glands. The incidence and intensity of staining for sialyl-Tn
antigen were higher in malignant tumors than in borderline tumors.
Benign serous tumors showed multifocal reactivity to STN-antigen
that was always in inverse proportion with the degree of dysplasia.
STN antigen expression was not noted in other serous tumors. The
presence of STN-antigen was verified in stromal endothelial cells
of all examined tumors, while the normal ovarian tissue showed a
complete absence of this marker. Conclusion Our results indicate
that STN antigen accumulation is an early event in malign transfor-
mation of mucinous ovarian tumors.
Keywords:ovarian tumors, ovarian neoplasm, Sialyl-Tn-antigen , immu-
nohistochemistry,
Contact authors at: ninajancic@live.com.au


                               —129—
                                          ENDOMETRIOSIS
Gynaecology




               Authors: SUHEDA ALGUN,husna algun,ale abraham

               University:      Medical University Sofia




              ICMS 2011 / OP 10 Surgery
               Abstract:
               Endometriosis is the abnormal growth of cells (endometrial cells)
               similar to those that form the inside of the uterus, but in a loca-
               tion outside of the uterus. Endometrial cells are cells that are shed
               each month during menstruation. The cells of endometriosis attach
               themselves to tissue outside the uterus and are called endometriosis
               implants. These implants are most commonly found on the ovaries,
               the Fallopian tubes, outer surfaces of the uterus or intestines, and on
               the surface lining of the pelvic cavity. They can also be found in the
               vagina, cervix, and bladder, although less commonly than other loca-
               tions in the pelvis. Rarely, endometriosis implants can occur outside
               the pelvis, on the liver, in old surgery scars, and even in or around
               the lung or brain. Endometrial implants, while they can cause prob-
               lems, are benign (not cancerous) Endometriosis affects women in
               their reproductive years. The exact prevalence of endometriosis is
               not known, since many women may have the condition and have
               no symptoms. Endometriosis is estimated to affect over one million
               women (estimates range from 3% to 18% of women) in the United
               States. It is one of the leading causes of pelvic pain and reasons
               for laparoscopic surgery and hysterectomy in this country. Estimates
               suggest that between 20% to 50% of women being treated for in-
               fertility have endometriosis, and up to 80% of women with chronic
               pelvic pain may be affected. While most cases of endometriosis are
               diagnosed in women aged around 25-35 years, endometriosis has
               been reported in girls as young as 11 years of age. Endometriosis
               is rare in postmenopausal women. Endometriosis is more commonly
               found in white women as compared with African American and Asian
               women. Studies further suggest that endometriosis is most common
               in taller, thin women with a low body mass index (BMI). Delaying
               pregnancy until an older age is also believed to increase the risk of
               developing endometriosis.

               Keywords:uterus,abnormal growth
               Contact authors at: ultraneos@mail.ru


                                              —130—
      TOXICOLYTICAL TREATMENT OF PREMATURE LABOUR




                                                                           Gynaecology
                                                                            Anatomy
  Authors: Stamenic Ivana,Stosic Ljubica,Jovanovic
  Marija,Naumovic Bojan,Jovanovic Ivana,Garabinovic
  Zeljko,Santrac Nada,Banjanin Nikolina,Jovanovic Ljubica,Helga
  Denc,Mitrovic Aleksandar,Bogicevic Aleksandar
  University: Medical University of Belgrade



ICMS 2011 / OP 11 Surgery
Abstract:
Introduction: Preterm labour is one of the most actual problems of
modern perinatal medicine, and by definition it is a birth occurring
between 20 and 37 gestational weeks. Application of tocolytisis so
far proved most effective in the treatment of this problem. Objec-
tive: To examine the influence of tocolytic treatment in patients
with preterm labour. Material and methods: The investigation in-
cluded 65 patients with preterm labor, and applied tocolysis via
intravenous (iv). Results: Testing showed that in all patients tocol-
ityc therapy was successful. In our surveyed average of gestational
weeks (GV) on admission was 25.43 ± 6 weeks and therapy was
continued on average 5.98 ± 6.1 days. This data on the GV further
gains in importance since the treatment failed, and thus prolonged
labor in the early stages preterm labour. 13.8% of patients had a
baby in the period 72-96h, but the pregnant women were between
32-35, and GV is therapy enough for them delayed delivery. The
therapy did not affect positive personal history, previous births, or
abortions (spontaneous and intentional). In addition, 42 patients
were received additional therapy (utrogestan, partusisten, dexam-
etazon, progesterone) but because of all the patients primary ther-
apy (i.v tocolysis) was effective, we can not say that the therapy
had more influence. Conclusion: Results sugegest that therapy with
i.v. tocolysis was effective in preterm deliveries in our study and
the main therapeutic approach in the treatment of premature birth
and reduce perinatal mortality and morbidity.




Keywords:preterm labour, i.v. tocolysis, perinatal morbidity and mortal-
ity
Contact authors at: silvester_macketina@yahoo.com


                                 —131—
                 THE IMPACT OF DEPLETED URANIUM ON THE FEMALE RE-
                                PRODUCTIVE SYSTEM
Gynaecology




               Authors: Marjan Micic, Stefan Juricic, Ivana Jovanovic,Ognjen
               Bojovic
               University: Medical University Pristina




              ICMS 2011 / OP 12 Surgery
               Abstract:
               Introduction. On the theritory of Kosovo and Metohia during NATO
               air attack, it is dropped, according to informations of army of Ser-
               bia, about 21.000 kg poor uranium, which acts like a poison and
               radioactive substance. Aim.The basic aim that in future prospective
               study the most objective will recognize a imortance effects of poor
               uranium on health conditions of population and women, but espe-
               cially of pregnant women and newborns on theritory of Kosovo and
               Metohia. Material and methods. Results of this our retrospective
               studies which is accompanied from the first of January 2.000 to the
               thirty-first od Decembre 2.006 year show that a frequency on the
               average 7,24%, the biggest in 2.000 year- 10.9%. The frequency
               of stillborn prematurus was on the average about 13%, the biggest
               in 2.001 year-29.4% we noticed the increased frequency a malig-
               nant disseases (0.27%) from total examinated women in relation
               to period after bombing. Because of aethiolgy this and other patho-
               logical conditions multifactorial, authors suggested questionnaire
               which will use in future period in examination this patient. Conclu-
               sion. Basic of getting results we will be able to take on measures
               for better saving theirs healthy.




               Keywords:Poor uranium, pregnancy, newborns
               Contact authors at: Marjanmicic@gmail.com


                                             —132—
    STRUCTURAL AND FUNCTIONAL CHANGES IN OVARIUM
  AND ANTERIOR PITUITARY GLAND IN THYROIDECTOMISED
   RATS: NEW INSIGHT ON TREATMENT OF HYPOTHYROID
             LUTEAL PHASE INSUFFICIENCY




                                                                  Gynaecology
                                                                   Anatomy
  Authors: Kostiv Vira

  University: National O.Bogomolets medical University




ICMS 2011 / OP 13 Surgery
Abstract:
Hypothyroidism is an endocrine syndrome that affects far
more women than men and has an important influence on
the female ovarian cycle, often leading to infertility. The aim
was to study the morphological and functional features of
the ovaria and the anterior pituitary gland on different terms
of hypothyroidism and after the L-thyroxin or L-thyroxin and
calcitonin administration. A morphological base of hypothy-
roid luteal phase insufficiency is the picture of progressive
steroid hormones’ synthesis and secretion disturbance in the
corpus luteum, hypersecretion in lactotrophs of the anterior
pituitary gland. L-thyroxin administration do not lead to the
complete normalization of ovarian and pituitary morphol-
ogy. Administration of calcitonin with L-thyroxin is effective
in postoperative hypothyroidism as it conserves the ovarian
corpus luteum ultrastructure, positively changes the mor-
phometric data of lipid inclusions in luteal cells, prevents
prolactin hypersecretion and hyperproduction in lactotrophs
of the anterior pituitary gland.




Keywords:
Contact authors at:



                            —133—
                 FREQUENCY OF VAGINAL ADMISSION IN HYSTERECTOMY
                               SURGICAL PROCEDURE
Gynaecology




               Authors: Aleksandar Mitrovic,Dragan Opacic,Ognjen
               Bojovic,Marija Mitrovic,Nikola Banjanin,Bojana
               Milosevic,Aleksandar Mihailovic,Sladjana Smrzlic,Ivana
               Stamenic,Tamara Savic,Stefan Juricic,Zelimir Jovanovic
               University: Medical University Belgrade



              ICMS 2011 / OP 14 Surgery
               Abstract:
               Introduction. Hysterectomy is a surgical procedure by which the
               uterus is partly or totally moved out of a woman body. Gynecologi-
               cal surgery have two ways of intervention: abdominal and vaginal.
               There are absolute indications for one of the mentioned interven-
               tions, and on the other side those which don t need exactly vaginal
               or abdominal intervention. Aim. The aim of this research was to
               show the most common indications, methods of interventions and
               complications at hysterectomies in GOC-Narodni front. Materials
               and methods. The research was carried on 160 female patients
               with conducted hysterectomy. The first group was the patients with
               already done abdominal hysterectomy and the second group was
               the patients with already done vaginal hysterectomy. For the data
               processing was used the method of descriptive statistics. Results.
               The average age of analised patients was 56,86 years. From 160
               patients in the case of 133 was conducted abdominal, and in the
               case of 27 was conducted vaginal hysterectomy. The abdominal
               hysterectomies can be done in tree ways: in 72 (54,2%) cases was
               used the classical method, in 41 (30,8%) method by Aldridge and
               in 20 (15%) method by Wertheim-Meigs. The most common indica-
               tion for classical hysterectomy was carcinoma ovarii (33,3%), for
               method by Aldridge was polymiomata uteri (43,9%) and the abso-
               lute indication for the method by Werthaim-Meigs was carcinoma
               cervicis uteri (100%). Conclusion. Whenever the indications give
               you possibility, it is better to stimulate the vaginal hysterectomy.
               The percentage of vaginal hysterectomy may rise with the better
               trained ginecologists. In the reality this is posible and needed, and
               everything in the best interest of our ginecological patients, so the
               results should come with the better training of young doctors in
               this area.

               Keywords:abdominal hysterectomy, vaginal hysterectomy, indications,
               complications
               Contact authors at: aleksandar83nbg@yahoo.com

                                              —134—
   THE ROLE OF THE EXTRACELLULAR MATRIX IN THE INVA-
         SIVENESS OF LOW-GRADE ASTROCYTOMA




                                                                           Neurosurgery
                                                                            Anatomy
  Authors: Csaba David Szemcsak, Almos Klekner MD/PhD

  University: University of Debrecen




ICMS 2011 / OP 15 Surgery
Abstract:
The extent of tumor removal determines the effectiveness of post-
operative oncotherapy. This is especially true for primary brain tu-
mors, where peritumoral invasion usually makes radical resection
impossible. The aim of this study was to identify molecules that are
responsible for the extensive peritumoral invasiveness of low-grade
astrocytoma. mRNA expression of 26 extracellular matrix (ECM)
molecules reported to play active roles in peritumoral infiltration
was determined in tissue samples from grade II astrocytoma,
schwannoma, intracerebral metastases of non-small cell lung can-
cer (NSCLC) and normal brain. Immunohistochemical staining for
brevican, neurocan, tenascin-C and versican was also performed
for each tumor group. Comparing astrocytoma to metastasis,
schwannoma and normal brain; and metastasis and schwannoma
to normal brain, 22, 17, 20, 21, and 19 molecules, respectively,
were found to be significantly overexpressed at the mRNA level.
Brevican, neurocan, tenascin-C and versican were found to be as-
sociated with the peritumoral invasiveness of low-grade astrocy-
toma. Furthermore, cluster analysis of mRNA expression of the in-
vasion-related ECM components showed a specific gene expression
pattern for each histological group. Immunohistochemical staining
confirmed the results of the mRNA analysis at the protein level.
Determination of the invasive phenotype of tumors at the gene ex-
pression level might help resolve problems during differential diag-
noses especially in case of biopsy. Brevican, neurocan, tenascin-C
and versican expression were found to correlate with the invasive
phenotype of low-grade astrocytoma, and these molecules can po-
tentially serve as targets for anti-invasion therapy.



Keywords: astrocytoma, brain metastasis, extracellular matrix, invasion,
schwannoma
Contact authors at: szemics@gmail.com


                                —135—
                CORRELATION BETWEEN FUNDUS CHANGES AND EVOLU-
               TION OF THE FETUS IN PREECLAMPTIC PREGNANT WOMEN
Obstetrics




              Authors: Denissa-Greta Popa, Alex. Goganau, Daniela Cirju, B.
              Voinea, D. Plesan, Magdalena Manolea, Lorena Dijmarescu

              University:      Medical University Craiova




             ICMS 2011 / OP 16 Surgery
              Abstract:
              Introduction In pregnant preeclamptic women with elevated BP are
              described changes in the fundus and a intrauterine growth restric-
              tion. Aim The study of the correlation between changes in the eye
              fundus, BP values and the evolution of intrauterine fetus. Methods
              We used a retrospective study that included 64 women with preg-
              nancy induced hypertension (PIH), in which was rated eye fundus
              and BP values. The evolution of the intrauterine fetus was assessed
              by ultrasound monitoring according to gestation age, birth weight
              and Apgar score. Pregnant women with preterm delivery, eclamp-
              sia, intrauterine fetal death or systemic disease were excluded
              from the study. Results Changes in the fundus were found in 16%
              of patients who had an SBP of 180 ± 22 mmHg and a DBP of 105
              ± 15 mmHg.In pregnant women with BP values of 140 ± 8 mmHg
              and 90 ± 9 mmHg we have not found changes in the fundus. These
              were the two groups of study. The evolution of the fetus was the
              same in both groups of study, regardless of changes in the fundus.
              Ultrasound monitoring of the fetus showed an intrauterine growth
              restriction (IUGR) in pregnant women in the first study group who
              had elevated blood pressures and in 7% of pregnant women in the
              second study group. Apgar score <8 was observed in pregnant
              women that had elevated blood pressure. Conclusion Fundus evalu-
              ation in pregnant women with PIH may be a marker of the evolution
              and occurrence of fetal complications, probably because vascular
              ischemia causes also placental modification with subsequent IUGR.




              Keywords:preeclampsia,fundus modification

              Contact authors at: popadenissa@yahoo.com

                                             —136—
   FIRST TRIMESTER BLEEDING AND THE RISK OF MISCAR-
                        RIAGE




                                                                         Obstetrics
                                                                         Anatomy
  Authors: Manolea M, Dijmarescu L, Gavrila A, Iliescu D, Voinea
  B, Stefanescu C, Linoiu R, Novac L

  University: UMF Craiova




ICMS 2011 / OP 17 Surgery
Abstract:
Aim: To evaluate the association between first-trimester bleeding
and miscarriage, this study characterizes first trimester bleeding,
setting aside bleeding that occurs at time of miscarriage. Methods:
We have studied until today 86 pregnant women with the gesta-
tional age between 5 and 12 weeks; the maternal age was 18 to
40 years. The characteristics of the bleeding we took in account
were: timing, heaviness, duration, aspect (color), and associated
pain. Echographic examinations were made to all the patients in
order to exclude other causes of vaginal bleeding than the intrau-
terine pregnancy, like ectopic pregnancy and gestational tropho-
blastic disease. Results: 20 of the pregnant women (approximately
23%) reported bleeding but only 2 of those (10%) reported heavy
bleeding. Of the spotting and light bleeding 26% were associated
with pain. Among heavy episodes 55% were associated with pain.
Most episodes lasted less than 3 days, and most occurred between
gestational weeks 5 to 8. Two of the women with bleeding (10%) 7
of those without bleeding (approximately 12%) presented miscar-
riage. Conclusion: Heavy bleeding in the first trimester, particularly
when accompanied by pain, is associated with higher risk of mis-
carriage. Spotting and light episodes, especially if lasting only 1-2
days, are not. Bleeding is most likely to be observed around the
time of the luteal-placental shift, consistent with the hypothesis
that bleeding is a marker for placental dysfunction.




Keywords: miscarriage, vaginal bleeding
Contact authors at: manoleamaria@gmail.com



                               —137—
              HOBNAIL HEMANGIOENDOTHELIOMA (DABSKA TYPE) OF
                             RIGHT BUTTOCK
Oncology




            Authors: Dr. Ben Razavi S. 1, Dr. Moghimi M 2, Dr.Akhavan A.3,
            Behnamfar Z.4

            University:      SHAHEED SADOUGHI MEDICAL UNIVERSITY




           ICMS 2011 / OP 18 Surgery
            Abstract:
            Purpose: Dabska tumor (DT) is a very rare neoplasm with favora-
            ble prognosis. Originally described in 1969 by Maria Dabska. So
            far two cases of hemangioendothelioma (spindle cell and multi-
            focal hemangioendothelioma of bone) have been reported from
            Iran. However, this is the first case of DT reported from this coun-
            try. Patient and method: We present the case of 7 -year-old boy
            from Saravan-Iran diagnosed with DT. Results: The patient was a
            7-year-old boy admitted with a firm mass in the right upper thigh
            region. Physical examination had showed a band of dark brown
            lesions with pinkish borders and pasty nature measuring 17.5?15
            ?5 cm. MRI was suggested followed by incisional biopsy. Results
            of incisional biopsy showed hemangioendothelioma, an indication
            for surgical operation. During a three-hour operation, the entire
            mass and outer fascia of posterior compartment of the thigh was
            cross-sectionally deeply resected.Post-resection pathologic studies
            proved the tumor to be of DT.Postoperation the patient underwent
            radiotherapy employing cobalt machine. Conclusion: DT is a very
            rare neoplasm with no ethnic or racial predilection and because of
            the age of the patients range from birth to 83 years, it should be
            considered as a differential diagnosis of vascular neoplasms.




            Keywords: Dabska tumor, hobnail hemangioendothelioma, endovascular
            papillary angioendothelioma.
            Contact authors at: z_behnamfar@yahoo.com

                                          —138—
  Abstracts
   Surgery
Oral Session II
                 NEOADJUVANT CHEMOTHERAPY FOR BREAST CANCER
Oncology




            Authors: Anton Khorau


            University: Grodno state medical university




           ICMS 2011 / OP 19 Surgery
            Abstract:
            The purpose of our research was the estimation of efficiency of neoadjuvant
            chemotherapy in patients with breast cancer, estimation of possible toxic ef-
            fects of chemotherapy, influence of primary systemic preoperative therapy
            on the postoperative period at patients. 25 patients with locally advanced
            breast cancer were included in this study. Locally advanced breast cancer
            was defined as (T2-4N0-3M0), according to the tumour-node-metastasis
            (TNM) classification. Methods: treatment: cyclophosphamide, doxorubicin,
            and 5-flurouracil (CAF) regimen—that is, intravenous cyclophosphamide
            500 mg/m2, intravenous doxorubicin 50 mg/m2, and intravenous 5-fluoro-
            uracil 500 mg/m2, all repeated every 21 days, 2 to 4 courses (on the aver-
            age 3). After neoadjuvant chemotherapy to all patients radical operation
            on a breast has been made. Action of chemotherapy on a tumour studied
            in dynamics (prior to the beginning of courses neoadjuvant chemotherapy
            and before operation) on its linear sizes by palpation, ultrasonic and mam-
            mography. The estimation of efficiency of treatment was spent by criteria
            RECIST. Quality of a life of patients estimated on a scale Karnovsky, and
            toxicity of chemotherapy - with partial use of criteria CTC-NCIC. Results: As
            have shown our researches, the general objective answer on neoadjuvant
            chemotherapy is revealed at 18 patients (72 %), stabilisation - at 7 (28
            %), cancer progressing were not. Thus the general objective answer was
            observed at Т2 at 10 patients (83 %), at Т3 - at 5 (62,5 %) and at Т4 - at
            3 (60 %). At morphological studying of macropreparations full disappear-
            ance of all tumoral cells after neoadjuvant chemotherapy is registered at
            5 patients (20 %). Full regress of a tumour at Т2-Т3 is noted at 16 % of
            patients, at Т4 - at 4 %. Toxicity of chemotherapy was 1-2 degrees of side
            medical effects. It is established, that the chemotherapy did not render
            negative influence of the early postoperative period and did not extend
            treatment terms. Conclusion: Neoadjuvant chemotherapy can achieve a
            high objective response rate in patients with locally advanced breast cancer.
            The regimen thus enables breast conservation surgery to be performed on
            patients who are initially not suitable for this procedure.



            Keywords: breast cancer, neoadjuvant chemotherapy, objective response

            Contact authors at: anti-11@yandex.ru

                                              —140—
   THE CONTRIBUTION OF FIBROBRONCHOSCOPIC EXAMI-
   NATION IN ESTABLISHING THE CERTAIN DIAGNOSIS OF
                     LUNG CANCER




                                                                       Oncology
                                                                       Anatomy
  Authors: Costin Ioan Matei, Belgin Asan, Theodor Cruceana, Ana
  Hoinarescu, Alexandru Ionescu, Stefan Oprea, Adrian Dan Raicu,
  Alexandra Tambu
  University: University of Medicine and Pharmacy Carol Davila,
  Bucharest



ICMS 2011 / OP 20 Surgery
Abstract:
Introduction: Lung cancer is a malignant disease consisting of un-
controlled cell growth in tissues of the lung. This abnormal growth
sometimes leads to metastasis, the tumoral invasion of adjacent
tissue or infiltration outside of the lungs. Lung cancer is the most
common cause of cancer-related death in both men and women.
It is held responsible for more than 1 million deaths worldwide
annually. Objectives: The purpose of the study is to point out the
importance of the fibrobronchoscopic examination in establish-
ing the certain diagnosis of lung cancer. Materials and Methods:
A retrospective study carried out on 64 patients (with 8 of them
featuring metastatic processes) hospitalized in Tudor Vladimirescu
Pneumophtysiology Hospital during 01.01.2009-30.10.2010. One
of the used diagnosis methods was fibrobronchoscopy Results: The
majority of patients were male, aged over 40 years, while 8 of
them were under 40 years old. All of them were symptomatic when
hospitalized. Hemoptysis was seen in 51 of the patients, while 24
complained of chest pain (13 patients suffered from both). Fibro-
bronchoscopy was performed out on each patient and samples
were taken for cytological analyses and pathological anatomy. The
cytological examination was conclusive in 52,63 % of the cases
while the pathological examination led to clear results in 40% of
the cases Conclusions: There is a growth in the number of malig-
nant neoplasms and the debut of the disease now occurs at young-
er ages. Fibrobronchoscopy is very useful for establishing a correct
diagnosis and an efficient treatment. The cytological and anatomo-
pathological examinations are an important addition to the images
obtained by carrying out bronchoscopy.



Keywords: bronchopulmonary cancer, bronchofibroscopy, cytological
examination, histopathological examination
Contact authors at: co_mti@yahoo.com


                               —141—
              SURVIVAL AMONG PATIENTS WITH BREAST CANCER MAY
              BE IMPROVED BY EARLY DIAGNOSES: CONFORMATION OF
                             A WELL KNOWN FACT
Oncology




            Authors: Ivanov I, Popovska S, Betova T

            University: Medical University Pleven




           ICMS 2011 / OP 21 Surgery
            Abstract:
            Invasive breast carcinomas are treated according to standard and widely
            accepted protocols. Decisions on the treatment are largely based on path-
            omorphological variables that determine decreased survival. Aim of the
            study was to examine the impact of pathomorphological variables on sur-
            vival in patients treated according to standard protocols in order to access
            passible targets for treatment optimization. Patients and methods: A total
            of 130 randomly selected patients, treated for invasive breast cancer, were
            studied retrospectively. Prognostic factors including axillary nodal status
            (pN), tumor size (pT), tumor grade (G) and lymphatic vascular invasion
            (LVI) and predictive factors including ER/PR and Her2/neu status were re-
            vealed. Clinical management of the patients was based on standard algo-
            rithms consistent with the patient’s age, stage and ER/PR status and Her2/
            neu expression. To access the studied variables for prognostic significance,
            univariate analysis was conducted using the Kaplan-Meier method, where
            statistical significance of differences in the cumulative survival curves be-
            tween groups was evaluated by the long-rank test (p<0.05 was considered
            significant). The mean observation time of the studied patients was 38.58
            months (range, 2-60 months). Results: Results demonstrated that only tu-
            mor size (pT) had significant impact on survival at random population of
            patients, who had undergone conventional treatment. It was found that in-
            vasive tumors <2 cm (pT1) were associated with significantly better overall
            survival compared to patients with tumors larger than 2 cm in size or tumor
            extending to the skin or the chest wall (pT2-4) p=0.0025; n=74. Discus-
            sion: Only tumor size remained prognostic for overall survival while other
            prognostic factors had probably lost their impact as a result of a more ag-
            gressive treatment that patients received when adverse prognostic factors
            were present. Increased survival in breast cancer may be achieved by early
            diagnoses (diagnosis of smaller tumors) and in time treatment.




            Keywords: breast cancer, survival,
            Contact authors at: posledenzalez@yahoo.com


                                              —142—
    POTENTIAL MECHANISMS OF DRUG RESISTANCE OF MA-
                  LIGNANT MELANOMA




                                                                                 Oncology
                                                                                 Anatomy
  Authors: Ivan Mindov, Kristiyan Naydenov, Petya Peeva, Tatyana
  Vlaykova
  University: Trakia University




ICMS 2011 / OP 22 Surgery
Abstract:
POTENTIAL MECHANISMS OF DRUG RESISTANCE OF MALIGNANT MELANO-
MA 1,2Ivan Mindov, 1,2Kristiyan Naydenov, 3Petya Peeva, 2Tatyana Vlayk-
ova 1Undergraduate students from Study group in Biochemistry, 2Dept.
Chemistry and Biochemistry, Medical Faculty, Trakia University, Stara Zag-
ora, 3Oncology Center, Stara Zagora, Bulgaria Abstract Melanoma is the
most serious, aggressive and life-threatening form of skin cancer. Early
stage melanoma is almost completely curable by surgery, however once
the distant metastases occur, the prognosis is poor with a median survival
of 6 to 8 months, and with less than 11% of patients being alive after 2
years. This poor prognosis largely results from resistance to conventional
chemotherapy, namely cytotoxic drugs. The underlying cellular resistance
mechanisms involved in the chemoresistance of melanoma have not been
fully clarified; however the altered drug transport, xenobiotic-metaboliz-
ing enzyme activation, enhanced DNA repair, decreased expression and
topoizomerses and Ras- mutations have been proposed to be most likely
implicated in development of the drug-resistant phenotype. In addition,
because most anti-cancer drugs exert their cytotoxic effect on susceptible
cells through induction of apoptosis, the deficiency in the apoptotic cascade
is assumed as a relevant mechanism of drug resistance in melanoma, espe-
cially considered the reported inherited low levels of spontaneous apoptosis
observed in cells within melanoma lesions. Previously, we also reported
that the lack of expression of the key anti-apoptotic protein Bcl-2 is associ-
ated with the response to a combined chemoimmunotherapy of advanced
metastatic melanoma and could be a predictor of response to this type of
therapy. In the current report we attempt to summarize the basic knowl-
edge and evidences concerning the relevance of intracellular/extracellular
drug transport, induction of variety enzyme systems involved in DNA repair
and biotransformation of the drugs, and the defects at multiple levels of the
apoptotic pathways, as factors for melanoma drug resistance Key words:
malignant melanoma, drug-resistance, mechanisms, apoptosis




Keywords: malignant melanoma, drug-resistance, mechanisms, apopto-
sis
Contact authors at: tvlaykov@mf.uni-sz.bg


                                   —143—
                 DRY EYE SYNDROME IN PATIENTS AFTER PHACOEMULSIFI-
                              CATION OF THE CATARACT
Ophtalmology




                Authors: Maksymtsiv M.L., Kosar S.L., Senyshyn V.I.

                University: Lviv National Medical Uviversity




               ICMS 2011 / OP 23 Surgery
                Abstract:
                Actuality. During recent years ophthalmologists and scientists pay more
                attention on the «dry eye syndrome» or keratoconjunctivitis sicca (KCS),
                its pathogenesis, clinic and treatment. Among the causes we can mention
                cataract surgeries, because of: - age category of the patients (mostly older
                than 60 years), since tearproduction decreases within age; - micro-incisions
                that damage hundreds of receptors and cut the nerve fibers; - the usage
                of local anesthesia; - the usage of eye drops in pre- and postoperational
                period that contain preservatives; - prolonged exposure of the light from
                the microscope. The purpose of this work was to evaluate the state of the
                tear film in the patients after phacoemulsification of the cataract. Materials
                and methods of the investigation. 54 patients were under investigation: 32
                women and 22 men; age 50-60 years – 15 patients, 60-70y. – 25 patients,
                70-80y. – 14 patients. All the patients didn’t have any other ophthalmic
                pathology. Before surgery KCS was manifested in 39 patients (72,2%): Ist
                stage of KCS – in 29 patients (74%), IIa st. – in 10 (26%). For evaluation of
                the parameters of the tear film we did such tests: Schirmer test I, tear film
                break-up time, staining of cornea with fluorescein and conjunctiva with rose
                bengal, lipidinterference. We valued lacrimal meniscus and lid-parallel con-
                junctival folds in lower-temporal segment by means of biomicroscopy. Re-
                sults. In postoperative period KCS was revealed in all the patients: Ist stage
                in 42 patients (78%), IIa st. in 11 patients (20%), IIb st. – in 1 patient
                (2%). The patients were examined on the 3rd and 7 th day after surgery
                and in 3 months. All of the patients received replacement monotherapy by
                means of artificial drops of low viscosity 3-6 times per day on the 1st stage
                of KCS and the combination of low viscose and gel structure artificial drops
                and if necessary on the background of regeneration and magnetotherapy
                at stage II of KCS. This treatment during 3 months considerably lessen
                the signs of «dry eye» in 44 patients (81,5%) and completely eliminated
                them in 10 patients (18,5%). Conclusion: we have shown the effect of the
                cataract surgery on the appearance and course of the «dry eye syndrome»,
                which indicates the expediency of conducting replacement therapy by «ar-
                tificial tears» in postoperative period in all the patients.


                Keywords:dry eye syndrome, keratoconjunctivitis sicca, phacoemulsifica-
                tion of cataract, tear film.
                Contact authors at: myrosjam@gmail.com

                                                  —144—
   INTRAOCULAR FACTORS OF ASYMMETRY OF MANIFESTA-
   TIONS OF AGE-RELATED MACULODYSTROPHY ON PAIRED
                         EYES




                                                                       Ophtalmology
                                                                         Anatomy
  Authors: T.Y. Moldovan, O.D. Rudkovska


  University: Bukovinian State Medical University




ICMS 2011 / OP 24 Surgery
Abstract:
Introduction. Age-related maculodystrophy is cause №1 of eye-
sight disability in developed countries of the world. Among unfa-
vourable factors (the age over 40 years, the female gender, low
quality food, smoking) an important role is played by a hyperme-
tropic refraction of patient. The object: to investigate refraction
in patients with asymmetric manifestations of age-related macu-
lodystrophy on paired eyes. Material and methods. We have ex-
amined 42 patients with dry and exudative forms of age-related
maculodystrophy on paired eyes. The age of patients ranged from
51 to 76 years 30 women, 12 men. All the patients have undergone
a complete ophthalmologic examination, including skiascopy and
refractometry against a background cycloplegia. Results. All the
patients have been diagnosed as having hypermetropic refraction
of a mind and medium degree, a lesser degree of hypermetropia
being observed on the eyes with a dry form of age-related maculo-
dystrophy (up to 2.0 D), a higher degree (up to 4.0 D) on the eyes
with an exudative form of age-related maculodystrophy. Conclu-
sion. To our point of view, asymmetric tension of accommodation
on paired eyes with various degrees of hypermetropia may play a
certain role in a progression of dystrophic processes on the retina.
It is advisable to prescribe a complete and permanent correction of
refraction anomalies to patients with age-related maculodystrophy
and longsightedness.




Keywords: Age-related maculodystrophy, hypermetropia

Contact authors at: Moldovan.Tamara@bigmir.net


                              —145—
                          COMPLIANCE IN PATIENTS WITH GLAUCOMA
Ophtalmology




                Authors: Stefan Juricic,I.Jovanovic,O.Bojovic,Lj.Jovanovic,M.
                Jovanovic,N.Banjanin,A.Mitrovic,A.Bogicevic,N.Santrac,B.
                Naumovic,Z.Garabinovic,H.Denc,M.Micic

                University: Medical Uviversity Belgrade



               ICMS 2011 / OP 25 Surgery
                Abstract:
                Introduction: Glaucoma is a group of disorders, whose main char-
                acteristic is optic nerve head damage followed by progressive vi-
                sion deterioration. This disease can not be definitively cured, but
                can be kept under control with the proper treatment. The main aim
                of treatment is to preserve vision and quality of life of the patient.
                Compliance serves to see how well patients adhere to the their
                doctors recommendations. Objective: Determination of parameters
                that tell of compliance with prescribed therapy. Materials and meth-
                ods: This is a cross section study. Patients who are diagnosed with
                glaucoma were asked to fill out questionnaires related to the use
                of drugs. At the same time an ophthalmologist filled a question-
                naire on the general impression of whether the patient is compliant
                or not. Results: Out of 100 patients regularly (daily) applied eye
                drops 77 (77%), 19 (19%) occasionally, while 4 patients did not
                use their eye drops. By the opinion of ophthalmologists, twenty-
                one (21%) of them were not compliant. Reasons for not applying
                therapy are usually forgetfulness (17%), the fact that taking eye
                drops interferes with their daily activities (7%), not knowing how to
                apply the eye drops (5%), and allergies (reported in two patients).
                Conclusion: The results of this study suggest that almost a fifth of
                patients treated for glaucoma is noncompliantn. Ways to improve
                compliance in glaucoma include taking more time for review and
                discussion with the patient in order to thoroughly explain the na-
                ture of the disease and the importance of regular treatment and
                persistent individual therapy fitting for each patient.




                Keywords:glaucoma, compliance, therapy
                Contact authors at: ivana.jovanovic012@gmail.com


                                              —146—
   RELATIONSHIP BETWEEN CENTRAL CORNEAL THICKNESS
     AND MYOPIA, HYPERMETROPIA AND ASTIGMATISM




                                                                        Ophtalmology
                                                                          Anatomy
  Authors: Marija Jovanovic,Zelimir Jovanovic,Tamara
  Savic,Sladjana Smrzlic,Mirjana Jovanovic,Ognjen Bojovic,Ivana
  Stamenic,Stefan Juricic,Dragan Opacic,Aleksandar
  Mihailovic,Bojana Milosevic,Nikola Banjanin

  University: Medical Uviversity Belgrade


ICMS 2011 / OP 26 Surgery
Abstract:
Introduction: Central corneal thickness (CCT) is an important in-
dicator of the cornea health status. Represents Different factors
can affect on the CCT: acute and chronic diseases of the cornea,
age, sex, refractive anomalies. The aim: The aim was to examine
the relation between CCT and the level of refractive anomalies.
Materials and methods: cross-sectional study includes 37 patients
(74 eyes), 22 men and 15 women, mean age 37 ± 20.51 years.
Respondents are divided into three groups by type and degree of
refractive anomalies . The first group consisted of patients with
myopia and astigmatism of less than 2.0 D (n = 16). The second
group consisted of patients with hipermetropia and astigmatism of
less than 2 D (n = 12). The third group consisted of patients with
astigmatism equal to or greater than 2.0 D (n = 9). Ophthalmologic
examination was performed, determining refractive anomalies and
curvature of the cornea using an automatic refractometer, a subjec-
tive test of refractive anomalies measured with Snellen charts. CCT
was measured using ultrasonic pahimeter. The data were analyzed
statistically. Results: In hypermetropia group, CCT was greater in
men population. The difference was statistically significant (p =
0.051). In all of three groups of the curvature of the cornea was
higher in men population. The difference was statistically signifi-
cant (P <0.001) Conclusion: CCT is an independent parameter, and
it is not associated with parameters of refraction of the eye, so the
CCT should be measured in each case of clinical practice.




Keywords: CCT, corneal curvature, myopia, hypermetropia, astigmatism

Contact authors at: cvrlisa@gmail.com


                               —147—
                  ESTABLISHMENT OF THE KNEE JOINT FUNCTION AFTER
                       THE TREATMENT OF KNEE TUBERCULOSIS
Orthopedics




               Authors: S. Radojkovic, T. Tulumovic, V. Pauker, R. Gavric

               University: Medical faculty of Banja Luka




              ICMS 2011 / OP 27 Surgery
               Abstract:
               Abstract: Objective: To evaluate the role of knee surgery treat-
               ment of total joint tuberculosis (TB) of adolescence. Methods: We
               are using a case study to present the form of TB at a 19 year old
               patient. Results: Patient is diagnosed as having TB on the basis
               of preoperative clinical manifestations and laboratory results, TB
               being confirmed postoperatively by arthroscopy and pathological
               examination. Specimen from the patient was confirmed as tuber-
               culosis by pathological examination. Patient was followed-up for 24
               months postoperatively. Patient was treated with knee arthroscopy
               surgery and postoperative medication and no relapses occurred
               over the duration of follow-up. The range of movement of the knee
               joint remained at 70°–110°. Conclusion: Diagnosis and treatment
               of adolescent TB is different from that of other TB patients. Arthro-
               scopically assisted treatment of adolescent knee joint TB has the
               advantages of early diagnosis, minimization of trauma, thorough
               clearance and rapid recovery. Early treatment with arthroscopically
               assisted debridement, early rehabilitation and postoperative medi-
               cation can preserve maximal function of knee joint and avoid ar-
               throdesis. This is an ideal method for the treatment of adolescent
               knee TB.




               Keywords:knee , joint function, tuberculosis
               Contact authors at:srdjan.r@mybhc.org


                                               —148—
   IMAGING OF THE VERTEBRAL VENOUS PLEXUSES IN THE
      CONTEXT OF PERCUTANEOUS VERTEBROPLASTY




                                                                                 Orthopedics
                                                                                  Anatomy
  Authors: Bartomiej Urbanski, Marcin Majewski, Marta Zbala,
  Wojciech Popiojek
  University: Medical University of Warsaw




ICMS 2011 / OP 28 Surgery
Abstract:
Introduction: Percutaneous vertebroplasty is an invasive, image-guided
therapy used to relieve pain from a vertebral body fracture. It has been
used for osteoporotic or pathological fractures. Bone cement is injected
though a needle into a fractured vertebral body. Complication after injec-
tion such as pulmonary emboli may occur when the cement leaks into the
veins. Aim: The authors aimed to describe the anatomy of the vertebral and
paravertebral venous system and to establish its clinical and technical impli-
cations, in order to better understand and anticipate complications that are
related to the application of bone cement. Methods: 40 vertebral levels of
patients from the Department of Neurosurgery were evaluated. All patients
underwent contrast-enhanced MR venography (CE-MRV). Imaging was per-
formed without breath-hold. MR images were evaluated in consensus by
three observers. All available MR images were scrutinized for the presence
of venous structures. Results: We found two main vascular systems – the
internal venous plexuses, which consisted of vessels within the vertebral
canal, and the external venous plexuses which surrounded the lumbar
spine. These vertebral venous plexuses were connected by the intraosseous
vertebral veins and the foraminal veins. The intraosseous veins were well
analyzed in the axial plane and appeared in a tree-like configuration. The
trunk of the tree was the basivertebral vein (85%) as single vein (38,2%)
with mean diameter 1,61 mm, two large veins (53%) or 3 veins (8,8%),
which led to the transverse plexus (97,5%) with mean diameter 1,68 mm.
The radial ventral veins (35%) as the branches of the tree appeared as 1
vein – 42,9% , 2 veins – 35,7%, 4 veins – 14,3% and 6 veins – 7,1% and
led to the lumbar veins – 92,5%. Conclusions: This study demonstrate the
importance of anatomical knowledge of lumbar venous drainage system. It
helps to predict the possible patterns of the bone cement leakage and thus
anticipate the complications of percutaneous vertebroplasty which can be
very dangerous for the patients. We suppose that a bigger diameter of the
venous drainage facilitates the cement leakage. Furthermore, CE-MRV is
a good and safe method of vertebral venous system imaging and could be
used before every procedure of vertebroplasty.

Keywords: percutaneous vertebroplasty, MR venography, vertebral ve-
nous plexuses
Contact authors at: urbanski.bartlomiej@gmail.com


                                   —149—
                     A COMPARATIVE STUDY OF HUMAN FIBROBLAST GROWTH
                      FACTORS 1 AND 2 IN IMPROVEMENT OF ISCHEMIC SKIN
                                   FLAP SURVIVAL IN RATS
Plastic Surgery




                   Authors: Ehsan Fayazzadeh, Mohammad Reza Rafie, Sadrollah
                   Motamed, Maryam Sotoudeh

                   University: Tehran University of Medical Sciences




                  ICMS 2011 / OP 29 Surgery
                   Abstract:
                   INTRODUCTION: Impaired wound healing and subsequent necrosis as a re-
                   sult of insufficient perfusion in ischemic tissues such as skin flaps is one ma-
                   jor cause of complications in plastic surgery. AIM: The effects of fibroblast
                   growth factors 1 or 2 on increasing cutaneous vasculature and preventing
                   distal skin flap necrosis were tested and compared with each other in an
                   experimental study in rats. METHODS: 30 Sprague-Dawley adult male rats
                   were allocated into 3 groups (n=10) and 2x8 cm dorsal random pattern skin
                   flaps were raised after four daily subdermal injections of normal saline (con-
                   trol group), fibroblast growth factor 1 (FGF-1 group; 2.5 µg/day), or fibro-
                   blast growth factor 2 (FGF-2 group; 2.5 µg/day) at distal half of the desig-
                   nated flap areas. Skin flap viability, tissue perfusion and angiogenesis were
                   evaluated on day 10 after elevation using planimetric analysis, laser Dop-
                   pler study and histological examination. Quantitative data were analyzed by
                   ANOVA test with Bonferroni post hoc for multiple comparisons. RESULTS:
                   The extent of skin flap discoloration and necrosis compared between the
                   three groups revealed that administrations of fibroblast growth factors 1
                   and 2 significantly decrease the percentage of flap necrosis (FGF-1 group=
                   24.16%±9.95%; FGF-2 group= 7.67%±1.79%) and improve the percent-
                   age of ischemic but survivable area (FGF-1 group= 25.55%±7.10%; FGF-2
                   group= 32.36%±4.34%) comparing to the control samples (control group
                   necrosis= 41.07%±7.01%; control group ischemia= 4.54%±3.08%; p val-
                   ues <0.001). Meanwhile, the differences between these factors in terms
                   of preventing skin flap necrosis and improving ischemia were also mean-
                   ingful (p values less than 0.001 and 0.05, respectively). The number of
                   visible blood vessel sections was also higher in FGF-1 and FGF-2 groups
                   than in the control group (FGF-1 group= 43.50±15.22; FGF-2 group=
                   51.75±5.47; control group= 38.60±4.83); however, the difference among
                   the test groups was not statistically significant (p= 0.09). CONCLUSION:
                   The results of present study suggest that, while fibroblast growth factor 2
                   is still much more potent than fibroblast growth factor 1, treatment with
                   either of these drugs could be very effective in increasing the survival of
                   surgical flaps at risk (length to width ratio >3) when other therapeutic op-
                   tions may not be considered.

                   Keywords:knee , joint function, tuberculosis
                   Contact authors at:srdjan.r@mybhc.org


                                                      —150—
           PROBLEMS FOR ROBOTIC SURGERY IN BULGARIA




                                                                                                              Anatomy
                                                                                                              Surgery
   Authors: Veronika Ivanova


   University: BAS




ICMS 2011 / OP 30 Surgery
Abstract:
Introduction: For a long time robotic systems are applied in the surgical rooms for minimal invasive
surgical interventions. Robot-assisted surgery has been achieved in various fields of minimal invasive
surgery in appendectomy, cardiotomy, laparoscopy etc. by the daVinci surgical system. Many surgical
procedures have been performed until now applying traditional laparoscopic technique today may
be performed more quickly and easily by the daVinci. Intelligent control can filter hand tremor and
increase accuracy by motion scaling. Instruments can have more degrees of freedom yielding higher
dexterity. The main benefits for the patients are: shorter hospital stay – a majority of patients are
discharged on the same day or 1-day after the procedure, less pain, less risk of infections. Robot-
assisted surgery is also performed in Bulgaria by the daVinchi. What are the main problems for
robotic surgery in Bulgaria and can they be solved? Is it profitable to buy and apply such an expen-
sive system for Bulgaria? Aim: The main target of this discussion is to analyze the state of robotic
surgery in Bulgaria as well as to identify the most important disadvantages and at the same time to
suggest new ideas and solutions for the improvement of our health-care. Methods and Materials: The
investigation of the daVinchi system shows that the high cost is a major disadvantage which is as-
sociated with this system: The average base cost of the System is 1.5 million dollars. Approximately
160,000dollars maintenance cost a year. Operating room cost, 150 dollars per hour. Hospital stay
cost, 600dollars per day. Time away from work, 120dollars per day. High-tech system has performed
over 300 operations for nearly three years. Another main problem in this direction: required addi-
tional training of the medical staff in Strasbourg which is too expensive. In Bulgaria only one team
has been trained to work with this system and only one surgical intervention could be performed per
day. The daVinchi has been applied in various fields of minimal invasive surgery but in Bulgaria only
in gynecology. The countrys first robotic surgery to remove kidney was performed only at the end
of last year. The instruments for robot surgery are indicated to have some technological deficiencies
the main of which is the difficult measurement of grasping force and the surgeon lacks tactile feed-
back. The sterility is also difficult for the variety of plays. The strings are easily wearable and require
constant replacement. The daVinchi instruments can’t be pre-programmed. Robot- instruments need
technical improvement. Another important problem of the daVinchi instruments is that they are too
expensive. Results:Technical and pricing problems about the instruments can be solved by engineer-
ing teams in Bulgaria. If Bulgaria produces robot-tools then their costs will be significantly lower.
Better solution is the daVinchi instruments to be made modular. Besides the system there is need to
create multidisciplinary medical team in advance s. In Bulgaria the daVinchi system can be applied in
various fields of minimal invasive surgery such as appendectomy, cardiotomy, laparoscopy etc. Train-
ing surgical boxes can be created. It will create conditions for training of surgeons and significantly
reduce the cost and time of their training. Probably a good advertisement of this treatment could
be made in neighboring states - Serbia, Kosovo, Albania, Macedonia, Greece, even Romania. There
are many people with surgical problems, and they pay very much for all medical services( as their
own capabilities in this regard are extremely limited), and if there are at least a dozen patients a
month from these countries we will be able to cover supplies and other patients - from our country.
Conclusion: This paper discusses the problems about robotic surgery in Bulgaria. Here are solutions
to technical and pricing problems on the instruments of the daVinci system which this article shows.
In Bulgaria engineers and surgeons should work together to translate the clinical problem description
into technological design specification with the aim of developing an instrument that enhances the
dexterity of the surgeon while having an intuitive interface. The lack of communication between engi-
neers and medical staff forming a barrier to the development of technological advances in medicine.
The lack of communication may delay the introduction of new instruments and devices in medicine
despite suitable technology now being available.




                                                —151—
                EPITHELIAL PROLIFERATIVE DISEASES AND RISK OF
               BREAST CANCER – INCIDENCE AND CHARACTERISTICS
Surgery




           Authors: Svetlozar Tsvetanov, Aleksandra Dimitrova, Emil
           Branchevski, Ivan Inkov

           University: Medical University of Sofia




          ICMS 2011 / OP 31 Surgery
           Abstract:
           The great heterogeneity of benign breast diseases and the lack
           of established standardized criteria for their classification in our
           country makes it difficult to assess the potential risk of developing
           cancer. In the present study, conducted over an one-year period
           (2010), 393 cases of histologically confirmed fibrocystic disease of
           the breast were evaluated. The internationally accepted classifica-
           tion of the fibrocystic processes of the breast of D. Page and W.
           Dupont was used. According to their potential risk of subsequent
           development of breast cancer the patients were grouped as hav-
           ing: 1. Nonproliferative processes (relative risk = 1.0) - 282 cases
           2. Hyperplasia (ductal and lobular) without atypia (low risk of 1.5
           to 2 times) - 98 cases 3. Atypical hyperplasia (moderate risk of
           4-5 times) - 13 cases The findings suggest the need of adopting
           an accepted classification to clearly define the different risk groups
           for the purpose of an adequate post-operative follow-up, aiming at
           prevention and early detection of breast cancer.




           Keywords: : Surgery; benign breast diseases; classification; cancer
           Contact authors at:btlmct@hotmail.com


                                           —152—
  THE CONCEPT ”DOUBLE-LAYER” IN TENSION-FREE INGUI-
                 NAL HERNIAPLASTY




                                                                                  Anatomy
                                                                                  Surgery
  Authors: EENACHE ANDREEA LORENA, LUNGANA MIHAI FLORIN,
  SILOSI C.A, SILOSI ISABELA

  University: University of Medecine and Pharmacy of Craiova




ICMS 2011 / OP 32 Surgery
Abstract:
Objective: Evaluate the results obtained from the use of prothetic memory
Hertra controlled type 0 in the tension-free inguinal herniaplasty, respecting
the concept, the double layer. Method: The study included patients operated
on between 01/01/2008 to 01/01/2010 who underwent inguinal hernia-
plasty tension free, double-layer with Hertra 0 polypropylene mesh. The re-
sults were compared with those obtained in patients who have practiced the
process Lichtenstein, pliable polypropylene mesh multidirectional elasticity
and patients who have used other surgical procedures. Supra-aponeurotic
drainage was routinely used for a period between 24-72 hours after sur-
gery. Results: There were two cases of recurrence after Lichtenstein proce-
dure, two cases of rejection of the net in place procedures with malleable.
Postoperative pain was much reduced, almost absent in the case of the
patient mobilization using Hertra 0 bare wire mesh and greater intensity to
processes with fixed malleable wire mesh, regardless of the position of in-
sertion, immediate and late postoperative comfort is best for the first tech-
nical. There were three of postoperative wound infection, resolved without
prosthesis removal. Conclusions: Initial results on the use of controlled pro-
thetic memory highlights the following advantages: Location mesh remains
perfect after stretched, without a tendency to curl or twist, maintained their
anatomical size and shape (dimensional stability pay), lack of suture in the
net, giving the ideal ease stiffness intraoperative handling, tensile strength,
ideal porosity for fibroblast growth, improved postoperative comfort of the
patient and a lower relapse rate compared to cases in which we used pro-
cedures pliable mesh, fixed with absorbable thread.




Keywords: tension-free inguinal herniaplasty, Hertra 0 polypropylene
mesh.
Contact authors at: andreea.lorena.enache@gmail.com


                                   —153—
                       THE MANAGEMENT OF CHRONIC WOUNDS
Surgery




           Authors: LUNGANA MIHAI FLORIN, ENACHE ANDREEA LORENA,
           SILOSI C.A, SILOSI ISABELA

           University: University of Medecine and Pharmacy of Craiova




          ICMS 2011 / OP 33 Surgery
           Abstract:
           Major changes occurred in the treatment of wounds are caused
           by the progress of scientific knowledge, healing processes and in-
           novations made by firms producing material for local treatment of
           wounds. Modern treatment of wounds began to be accepted world-
           wide as a concept in wound care since 1960. Dressings used since
           new in current practice should be history. Objective-purpose to
           analise to new methods of chronic wounds includind debridement,
           reduce/eliminate odour, haemostasis, exudates management, pain
           control/relief, rehydrate, control/eliminate bacteria, protect. Mate-
           rial and methods: Study for 54 patients between 01.01.2010 –
           30.12.2010 at Military Surgery Clinic Emergency Hospital Craio-
           va with pressure ulcers, leg ulcer, diabetic foot were distributed
           depending on the category of the age, urban/rural. The dressing
           categories used for patients are alginates (manage exudates, de-
           bridate), hydrocolloids (rehydrate, debride), hydrofibres (manage
           exudates, debride), hydrogels (rehydrate, debride), adsorbents
           (manage exudate), antibacterial (control local infection), deodour-
           ising (odour control), non-adherents (minimise trauma and pain),
           passive wound dressings, interactive wound dressings. Results are
           cororated to finalise a good lecture of the future. Conclusion- the
           main ideal dressing consist of maintain humidity, manage exudate
           , allow gaseous exchange, provide thermal insulation, be imperme-
           able to bacteria, free of toxic particles and/or wound contaminants,
           atraumatic, be acceptable to the patient, conformable, minimise/
           manage pain, cost and clinically effective- useful to meet these
           conditions for each method used.




           Keywords: : chronic wounds, dressing categories
           Contact authors at: aenka_2003@yahoo.com


                                         —154—
   TREATMENT OF TRAUMATIC SPLENIC INJURIES IN CHIL-
                       DREN




                                                                                 Anatomy
                                                                                 Surgery
  Authors: Dzhuma K.A.

  University: National Bogomolets medical university




ICMS 2011 / OP 34 Surgery
Abstract:
Introduction. The percentage of abdominal cavity organs trauma in children
is 20% of all traumatic injuries, among them occurrence of traumatic splen-
ic injuries (TSI) is 30-50%. Until recently the only effective radical meth-
od of treatment children with TSI was spleenectomy. The mortality rate
in such children, especially with multiply and associated injuries, reached
19% without disposition to reduction. The rate of postoperative compli-
cations was 15-20%, the 50% of them were pyo-septic. (Williams M.D.,
2005; Potoka D.A., 2002). The aim of the study was to find out efficient
surgical management of children with TSI. Methods. To the investigation
were included 115 children with TSI. The causes of splenic injuries were:
traffic accidents (n=62 (53,91%)), fall from a height (n=25 (21,74%)),
home accidents (concussions and hits) (n=14 (12,17%)), accidents during
a sport games (n=12 (10,44%)), stab and incised wounds (n=2 (1,74%)).
During the hospitalization, to all traumatized children has been applied a
full complex of physical and instrumental examination. Results. 23 patients
were managed conservatively by traditional haemostatic therapy, which in-
cluded inhibitors of fibrinolysis (e.g. Dicynone). If standard conservative
methodic didn’t produced positive results, it has been combined (in 33 pa-
tients) with pharmacotherapy, focused on reducing portal venous pressure
– vasoconstrictor Somatostatin or its synthetic analog Octreotide were pre-
scribed. In 2 cases Desmopressin additionally has been used. Splenectomy
was performed in 9 children. In 43 patients, if there was no possibility to
preserve the spleen, its tissues were transplanted to the epiploon after sple-
nectomy. Among the other organ-preserving operations, the atypical resec-
tion of spleen has been performed in 3 patients. The splenorrhaphy has
been performed in 2 patients suffering the spleen’s upper pole and middle
segment’s parenchyma rupture. In different cases it has been performed
with either teflon gasket or omental graft. In the distant period in 39,13%
children perfect results of treatment were achieved, in 33,91% - good, in
2,61% - unsatisfactory. Conclusions. The organ-preserving principle and
rational program of complex treatment of children with TSI assures lower-
ing of posttraumatic complications rate and improvement of life quality of
patients in distant period.
Keywords: spleen, trauma, children, management
Contact authors at: kristina.med@mail.ru



                                   —155—
            CRITICAL APPRECIATION OVER OTOMASTOIDITIS COMPLI-
                                 CATIONS
Surgery




           Authors: Mofleanu Andra Lavinia

           University: UMFCV




          ICMS 2011 / OP 35 Surgery
           Abstract:
           Purpose of the paper: the importance of classical methods of
           diagnosis and treatment in acute and chronic otomastoiditis.
           Material and method: the analysis of hospitalization papers
           and surgeries register regarding the motives of hospitaliza-
           tion, possibilities of the debut of the disease, otic clinical
           exam, audiological and imagistic investigations and thera-
           peutic methods Results: the presentation of patients with
           otomastoiditis regarding the otic lesions, functional exam,
           decades of age and type of surgical intervention Conclusion:
           chronic otomastoiditis led to radical surgical intervention




           Keywords: : otomastoiditis
           Contact authors at: aenka_2003@yahoo.com


                                       —156—
 USING ANTI-ADHESION GEL BASED ON METHYLCELLULOSE
 AT IMPOSING INTESTINAL ANASTOMOSIS IN EXPERIMENT




                                                                                 Anatomy
                                                                                 Surgery
  Authors: Pradosh I.M. / Byk P.L./ leshchyshyn I.M./ Mishalov
  V.G.

  University: National O.O.Bohomolets Medical University, Kyiv




ICMS 2011 / OP 36 Surgery
Abstract:
Aim of Research: to estimate possibility and consequences of application of
anti-adhesion gel on the basis of methylcellulose at imposition of intestinal
anastomoses in the rats. Methods: A Total of 20 of Wistar rats of middle
age 12,2±1,1 months, weighing 209,6+4,3 g. was used. The resection of
1sm of middle department of small intestine is executed with imposition of
anastomosis «end–to-end» by two-layer prolene 9/0 interrupted sutures.
A control group was made by 10 rats which the resection of anastomosis
is executed with proceeding in continuity of intestine by an anastomosis
«end-to- end». 10 rats to which after a resection and repeated imposition
of anastomosis an intestine was treated anti-adhesion gel on the basis of
methylcellulose Mezogel in an amount 0,5 ml entered in a basic group. In
both groups estimated presence of complications in a postoperative period,
possibility of anastomoses, expressed of adhesional process in 2 weeks
and features of regeneration in the place of anastomosis at histological
research. Antibiotic therapy in both groups did not conduct. Results. In a
control group there was insolvency of anastomosis in one rat through ileus
which arose up on 8 days after an operation. 2 control zoons had ileus on
10 and 14 days, suppuration of postoperative surgical wound - for 2 zoons,
in 5 zoons – postoperative period without complications. Single connec-
tions – for 2 zoons, adhesional conglomerate – in 5 zoons, ileus - for 3
rats. Histological: 4 zoons have anastomoses with the expressed leukocytal
infiltration. In the basic group of insolvency of anastomosis and ileus was
not marked, suppuration of postoperative surgical wound for 3 zoons, sup-
puration of wound + interloopback abscess – for one zoon, in 6 zoons post-
operative period without complications. Single connections – in 5 zoons, an
adhesional conglomerate is 0 zoons. Histological: anastomoses are with the
expressed leukocytal infiltration in 5 zoons. Conclusion: In applying anti-ad-
hesion gel in rats is not marked inconsistency of intestinal anastomoses and
adhesive intestinal obstruction. Applications anti-adhesion gel increases the
incidence of septic complications from the postoperative surgical wound.




Keywords: ANTI-ADHESION GEL, intestinal anastomoses ,METHYLCEL-
LULOSE
Contact authors at: Irina.Pradosh@gmail.com


                                   —157—
             EVALUATION OF THE MITOTIC INDEX AS A THERAPY OUT-
                 COME PROGNOSTIC FACTOR FOR MENINGIOMAS
Surgery




           Authors: Marko Gjorgjevski


           University: Ss. Cyril and Methodius




          ICMS 2011 / OP 37 Surgery
           Abstract:
           Introduction: Meningiomas are relatively frequent neoplastic intracranial le-
           sions, both globally and in the Macedonian population, and as such, are
           associated with a high degree of disability, epileptic manifestations, loss
           of work competence, social discomfort and a generally lowered quality of
           life. These may also end fatally. They comprise 14.3-19% of all primary in-
           tracranial neoplasms, and location-wise, 60-70% present near the cerebral
           falx, along the sphenoidal bone and along the cranial convexity. Histologi-
           cally, there are numerous classification groups, but generally they consist
           of: Classic (sintitial, fibrous, transitional), angioblastic, atypical and ma-
           lign meningiomas. The therapy of choice for the symptomatic meningioma
           is surgery, while radiotherapy is often deemed ineffective. Materials and
           Methods: A retrospective study / analysis of 40 successive, randomly se-
           lected patients, initially diagnosed with intracranial supra and infratentorial
           meningiomas (Inclusive criteria). Exclusive criteria are patients diagnosed
           with spinal-canal meningiomas. Survival and time without recurrence, ac-
           cording to the mitotic index of the tumor, will be systematized and analyzed
           using Kaplan – Meyer estimator. Results: Patients diagnosed with WHO I
           meningiomas showed a significantly higher median time of survival without
           recurrence ( 33.7 months), as well as a lower percentage of patients with
           recurrences – 28.12%, compared with patients diagnosed with WHO II and
           WHO III classification group meningiomas (20.5 and 18.0 months, as well
           as 40% and 66.6% patients with recurrence, respectively. Discussion: Pa-
           tients diagnosed with WHO I meningioma have much lower chance of tumor
           recurrence, as well as a longer survival without a recurrence. This shows
           the importance of proper mitotic index analysis and WHO classification,
           which improves the therapy outcome and prognosis.




           Keywords: :Meningioma, Mitotic Index, Simpson Resection, Tumor Re-
           currence
           Contact authors at: marko.gjorgjevski@gmail.com

                                             —158—
  Abstracts
   Surgery
Oral Session III
              THERAPEUTIC STRATEGIES IN HER2-POSITIVE BREAST
                                 CANCER
Surgery




           Authors: Iskra Bayraktarova, Dima Gjorgjeska, Magdalena Jaki-
           movska, Alexander Gerasimov, Dr. Manol Sokolov, Prof. Dr. Nikolai
           Yarumov

           University: Medical University of Sofia



          ICMS 2011 / OP 38 Surgery
           Abstract:
           Background Breast cancer is the most often diagnosed malignancy in wom-
           en. According to the National Cancer Register for 2005 the newly found
           cases were 3534 with a morbidity of 88.7 per 100 000, and a steady ten-
           dency of increase. Immunohistochemical studies show that approximately
           one fifth of all cases are HER2 positive, and respond poorly to standard
           treatment. Methods We made a retrospective study of all the operated pa-
           tients over the last two years in Second Surgery Clinic in Alexandrovska
           Hospital to gather a sample of the operational behavior. We then selected
           60 patients without metastatic disease and with a normal left ventricular
           ejection fraction (>=55%), and followed their subsequent adjuvant therapy
           as prescribed in the National Oncology Centre. Results We found that on a
           clinical level, the type of operation performed doesn’t depend on the age of
           the patient and the type of carcinoma as much as on the size of the forma-
           tion and the clinical stage. The subsequent format of the adjuvant therapy
           depends on the antigen expression and the widely accepted protocols. We
           established that 11 patients were proven HER2 positive and received trastu-
           zumab (Herceptin) in addition to the standard breast cancer therapy (FEC +
           radiotherapy). Conclusion The Bulgarian clinical practices strictly adhere to
           the accepted international protocols. The FISH-established antigen expres-
           sion corresponds to the published statistics, as do the survival rates and the
           length of the non-disease period. In the future, it might be worth looking
           into new, combination therapies for HER2 positive carcinoma, which seem
           to lead to better results.




           Keywords: Breast Cancer, HER2 positive, surgery, oncology, trastuzumab

           Contact authors at: i.bayraktarova@yahoo.com

                                             —160—
       LAPAROSCOPIC ADRENALECTOMY FOR MALIGNANT
                        DISEASE




                                                                                            Anatomy
                                                                                            Surgery
  Authors: Yakova M., Litsova G., Doynov T., Belcheva T., Alex-
  androva E., Sokolov M. MD, Assoc. Prof. Todorov G. MD, Prof.
  Yaramov N.,MD, PhD,DSc

  University: Medical University of Sofia



ICMS 2011 / OP 39 Surgery
Abstract:
Malignant primary or secondary adrenal tumors are uncommon. Advances in imaging
have improved early detection of primary and metastatic adrenal tumors. For most
of them early surgery with adrenalectomy is the only means of cure. Laparoscopic
resection is the gold standard for treatment of benign adrenal lesions. Laparoscopic
resection of malignant lesions, however is controversial.
Although controversy exists on this issue, the increasing experience in laparoscopic
surgery extends the indication for laparoscopic adrenalectomy to potentially malignant
and to metastatic adrenal tumours.
The aim of this study is to evaluate the feasibility and еfficiency of laparoscopic ap-
proach used for treatment of adrenal malignant disease.
MATERIAL AND METHODS:
We retrospectively analyzed 19 patients who underwent laparoscopic adrenalectomy
for malignant disease between June 2005 and January 2011, in the Clinic of Surgery,
IInd Surgery Department, University Hospital “ Alexandrovska”, Sofia. The laparo-
scopic approach was retroperitoneal in all cases. A follow up was done in the clinic. The
mean follow up period was 44 months (2-60months).
RESULTS:
All nineteen patients underwent retroperitoneal endoscopic adrenalectomy(REA) . Fif-
teen patient had metastatic tumors, four patients had adrenal carcinoma. Mean age
was 52, 45 (41-67) years. The relationship between male and female was 14/5. The
average sizes of lesions was 4, 9 cm (3-7). Four patients required conversion to lum-
botomy. The average duration of surgery was 113, 33 min (70 to 180 min). There
were no postoperative complications and no mortality. Average length of hospital stay
was 3.2 days (2-5). Disease free interval (DFI) in patients with metachronic metastasis
was in average 11, 79 months (3-75). At the end of the follow up period there were no
port –side metastasis or local recurrence. All but three patients were alive.
CONCLUSION:
Our results clearly indicate that a laparoscopic adrenalectomy for the treatment of
adrenal malignancy can be performed with an acceptable outcome as a minimally
invasive method in carefully selected patients.
A review of the literature demonstrates the safety and efficacy of laparoscopic adre-
nalectomy for solitary adrenal tumors and our results confirm this. In primary adrenal
malignancies, the laparoscopic approach should be considered cautiously, only when it
can achieve complete tumor resection with an intact adrenal capsule. Conversion to an
open procedure should be an early decision. Good preoperative evaluating can lower
the cases of conversion to an open surgery.




                                        —161—
                               RETROPERITONEAL TUMORS
Surgery




           Authors: Yaramov N.,Sokolov M.,Balev A.,Dimitrov I.,Gechev
           D.,Sevova T.,Angelov A., Krastev H.

           University: Medical University of Sofia




          ICMS 2011 / OP 40 Surgery
           Abstract:
           Retroperitoneal tumors are rare tumors that can be either benign or ma-
           lignant. They originate from mesenquimatous tissue. They often involve
           important anatomical structures to a different extent - main retroperitoneal
           vessels and organs, which determines the type of surgical interventions-
           radical or palliative. About 80 per cent of the neoplasms are malignant,
           the rest are benign. People of all ages suffer equally and there isn’t any
           statistical difference between the number of male and female patients. The
           are many theories for the etiology of retroperitoneal tumors but none of
           them is completely proven at the present moment. They consist of adipose
           tissue, vascular elements, skeletal and smooth muscular tissue. There are
           three different types of retroperitoneal neoplasms : mesodermal , terato-
           sarcomas, neural tumors. As said above, each of them can be both benign
           and malignant. In most of the cases there aren’t any significant symptoms
           apart from fatigue, abdominal discomfort, headache, fever and progres-
           sive loss of apetite and weight, depending on the nature of the tumor. The
           pain is most commonly localized in the lumbo-sacral area. The tumor can
           cause urinary disorders. In patients with advanced neoplasms there could
           be a significant symmetrical or asymmetrical enlargement in the abdominal
           region. The most commonly used techniques for the diagnostics of the dis-
           ease is the radiography, CT and MRI. The treatment depends on the type of
           the lesion. Surgical treatment is the main approach applied to both benign
           and malignant tumors. In case of malignancy the combination of extirpa-
           tion, chemo and radiotherapy is advised. Our survey includes 65 people, 55
           per cent of which males, 45 per cent females. In most of the cases - 80%
           of the tumors were of malignant origin. All of them were treated surgically.




           Keywords: retroperitoneal, tumor, symptoms, treatment

           Contact authors at: ivaylo.dimitrov87@gmail.com

                                            —162—
                        BENIGN BREAST DISEASE




                                                                       Anatomy
                                                                       Surgery
  Authors: Emil Branchevski, Ivan Inkov, Alexandra Dimitrova,
  Svetlozar Tsvetanov

  University: Medical University of Sofia




ICMS 2011 / OP 41 Surgery
Abstract:
Benign Breast Disease. Analysis of 393 biopsies. The goal of the
present study was to analyze the results from 393 breast biopsies
performed in one year (2010) in the thoracic surgery clinic – MMA,
Sofia, for benign breast disease. The patients ranged from 16 to 79
years of age, and represent 63% of all operated for breast disease.
Operative excision was performed after preliminary evaluation in-
cluding clinical examination, diagnostic imaging (echo or mammog-
raphy) and cytological examination of material from fine needle
aspiration biopsy (FNAB). The results from the microscopical ex-
amination of the surgical biopsies showed 39 cases with 3 or more
patomorfological conditions, 296 –with two, and 88 – with only
one benign breast disease. The most common histological findings
were nonproliferative processes of the breast in 282 (71,75%) pa-
tients, followed by proliferative breast disease without atypia - 98
(24,94%) patients and proliferative breast disease with atypical hy-
perplasia in 13 (3,31%) cases. Benign breast diseases are grouped
according to the risk of subsequent development of cancer. These
results are discussed in conjunction with data from literature and
internationally accepted standardized criteria for classification of
benign breast disease.




Keywords: surgery, benign breast disease, cancer, atypia
Contact authors at: emilbranchevski@yahoo.com



                                —163—
            INFLUENCE OF ROUX-EN-Y GASTRIC BYPASS SURGERY ON
             URIC ACID LEVEL IN PATIENTS WITH MORBID OBESITY
Surgery




           Authors: Janik Michal; Sujecki Damian; Rutkowski Michal; Janik
           Piotr

           University: Warsaw Medical Univeristy




          ICMS 2011 / OP 42 Surgery
           Abstract:
           Introduction: High serum uric acid level is a common metabolic dis-
           order among patients with obesity. It is also related to high risk for
           the development of gout. Moreover, increased serum uric acid level
           is significantly associated with, the risk of cardiovascular mortality.
           Aim: The aim of our study was to estimate the influence of Roux-
           en-Y gastric bypass operation on serum uric acid level in patients
           with BMI >35. Methods: The data of 38 patients operated on from
           2008 to 2009 were analysed retrospectively. Serum uric acid level
           was measured prior to operation and at the 3, 6, 9, 12 months. The
           data were analysed using Statisitca 9.0PL. Results: The mean age
           of the 38 patients was 43±12 years; 79% were women, the mean
           BMI before surgery was 48±7 kg/m2 and decreased to 32±8 kg/
           m2 at 12 month (p<0,05). Serum uric acid level decreased form
           6,3 ±1,2 mg/dL to 4,6 ±1,4 mg/dL (p>0,05) at 12 month. The pa-
           tients were asymptomatic during the whole follow up period. CON-
           CLUSION: The results of our study have shown the decrease in
           serum uric acid level after Roux-en-Y gastric bypass with statistical
           significance during the 12 month follow-up.




           Keywords: uric acid, serum uric acid level, Roux-en-Y gastric bypass,
           bariatric surgery, obesity, morbid obesity, bariatrics
           Contact authors at: janiken@gmail.com

                                           —164—
  KLATSKIN’S TUMOR- SHORT-TERM COMPLICATIONS AFTER
            LIVER AND BILE DUCTS RESECTION




                                                                                  Anatomy
                                                                                  Surgery
  Authors: Sujecki Damian, Grat Michal, Boltuc Adam, Grzegorc-
  zyk Karolina, Szczedowski Dawid

  University: Medical Uniwersity of Warsaw




ICMS 2011 / OP 43 Surgery
Abstract:
Background: Klatskin’s tumor is a cancer of bile ducts localized in the liver
hili. Treatment is based on resection of the bile ducts and liver resection.
This extensive surgery is associated with a significant number of complica-
tions and mortality. Aims: The aim of this study was to estimate the rate,
type and risk factors of short-term complications related to resection of liver
and bile ducts due to Klatskin’s tumor. Methods: 30 patients after liver and
bile duct resection due to Klatskin’s tumor between 2004 and 2009 were
included in this retrospective study. Mean age was 54.1 ± 11.5 years, 15
were male. 28 patients underwent Roux en Y hepaticojejunostomy. Bilateral
bile duct resection including common bile duct was performed in 26 cases
( 86.7%), isolated left hepatic duct resection in 3 ( 10%) and right in 1 (
3.3% ). Resection of bile ducts associated left hemihepatectomy in 15 (
50% ) cases, right hemihepatectomy in 11 ( 36.7% ) and left lateral biseg-
mentectomy in 4 (13.3% ). Morbidity, mortality and postoperative hospi-
talization was estimated. Statistical analysis was performed using SPSS v.
17.0. Results: 2 patients ( 6.7% ) died in the postoperative period, first due
to postoperative bleeding and the second due to multiorgan failure. Overall
morbidity was 60% ( 18 of 30 ). 6 patients developed postoperative liver
failure. There were 5 postoperative heamorrhages, out of which 4 required
relaparotomy. 1 patients suffered from both. Other complications included
wound infection (1), eventration (1), uninfected fluid collection (2), bile
leak (2). Mean postoperative hospitalization was 18.3±12.8 days. No sta-
tistically significant influence on postoperative hospitalization, morbidity or
mortality was noted concerning age, gender, size of the tumor and type
of resection. Conclusions: Liver and bile duct resection due to Klatskin’s
tumor is associated with a major risk of complications and death. Severe
complications including intraabdominal bleeding requiring laparotomy and
postoperative remnant liver failure were most frequent.




Keywords: Klatskins tumor, liver and bile duct resection

Contact authors at: damian.sujecki@yahoo.pl


                                   —165—
             TRANSUMBILICAL LAPAROSCOPIC CHOLECYSTECTOMY:
                          THE FIRST 100 CASES
Surgery




           Authors: Anatoly Karashmalakov, Alexander Julianov, Yonko
           Georgiev

           University: Tracian University




          ICMS 2011 / OP 44 Surgery
           Abstract:
           ABSTRACT Bakcground: Laparoscopic cholecystectomy (LC) is gen-
           erally accepted as a standard treatment of cholelythiasis. However
           there are trends to further minimize surgical trauma and to im-
           prove cosmetic results by performing LC through a single transum-
           bilical incision. The aim of this study was to evaluate the learning
           curve and results of first 100 nonselected patients, treated with
           transumbilical laparoscopic cholecystectomy (TC) performed by a
           single surgical team. Patients and methods: between April’2009
           and December’2010 100 consecutive patients with gallbladder
           diseases were operated by the same team using previously pub-
           lished original modification of the surgical technique. Results: TC
           was performed in 100 unselected consecutive patients. The mean
           age of the patients was 52 yrs, 65% of the patients were females.
           According to the diagnosis 69% patients had chronic cholecystitis
           and 31% had acute cholecystitis. There were 2 (2%) conversions
           to standard LC and 3 conversion to laparotomy (3%). The mean
           operating time was 78 min (range 40-120 min). Conclusion: TC can
           safely and rapidly replace standard LC in everyday surgical prac-
           tice. The conversion rate of TC is comparable with the standard LC,
           but the operating time is still longer in TC.




           Keywords: laparoscopic cholecystectomy, transumbilical cholecystec-
           tomy, conversion rate, operating time
           Contact authors at: yonko_georgiev@abv.bg

                                          —166—
   CHANGES IN LIPID PROFILE AFTER BARIATRIC SURGERY




                                                                                 Anatomy
                                                                                 Surgery
  Authors: Rutkowski Michal, Janik Michal, Janik Piotr , Sujecki
  Damian

  University: Medical Uniwersity of Warsaw




ICMS 2011 / OP 45 Surgery
Abstract:
BACKGROUND: The lipid profile is a group of tests that determine the risk
of coronary heart disease. Obesity is also associated with the cardiovascular
diseases, which are the main cause of death in Poland. We hypothesised
that in addition to weight reduction bariatric surgery will also improve lipid
profile. OBJECTIVE: The aim of our investigation was to estimate the influ-
ence of the Roux-en-Y gastric bypass and laparoscopic sleeve gastrectomy
on the lipid profile. METHODS: The data of 42 patients (8 men, 34 women)
operated on between 2008 until 2009 were retrospectively analysed. Among
the analysed patients, 28 were after Roux-en-Y gastric bypass and 14 after
laparoscopic sleeve gastrectomy. Patients were evaluated before operation
and after 3, 6 and 12 months. During the follow up blood levels of total
cholesterol, high-density lipoprotein (HDL) and triglyceryde were measured
and low-density lipoprotein (LDL) and total cholesterol/HDL ratio were es-
timeted. The data were analysed using Statistica 9.0Pl. RESULTS: Most of
the patients were 44 years old, with the BMI at the level of 47 kg/m2,
29% was diabetic and 64% was hypertensive. Significant improvement oc-
curred in all studied cardiovascular biomarkers: TC, HDL, LDL, HDL/TC ratio
and triglyceride level. Total cholesterol decreased from 177,4 +/-28,4mg/
dl to 156,5 +/-34,4 mg/dl at 12 months (p<0,05) ; LDL level decreased
from 101,3 +/-21,9 mg/dl to 82,1 +/-29,6 mg/dl at 12 months (p<0,05) ;
HDL level increased from 45,2 +/-10,9 mg/dl to 55,2 +/-17,0 mg/dl at 12
months (p<0,05) ; triglyceride level decreased from 153,6 +/-45,4 mg/dl
to 86,7 +/-27,7 mg/dl at 12 months (p<0,05). Total cholesterol/HDL ratio
decreased from 4,0 +/-1,0 to 2,9 +/-0,8 at 12 months (p<0,05). CONCLU-
SION: The results of our study have proved the influence of bariatric opera-
tions on lipid profile. The improvement of all studied parameters has been
registered after bariatric operation with statistical significance.




Keywords: Gastric bypass; Sleeve gastrectomy ; Lipids; Obesity
Contact authors at: misiekrut@gmail.com



                                   —167—
              PIOGLITAZONE ATTENUATES ISCHEMIA/REPERFUSION-
                       INDUCED LIVER INJURY IN RATS
Surgery




           Authors: Babak Hajipour-Mohammad Hossein Somi-Naser
           Ahmadi Asl-Rasoul Estakhri-Alireza Nour Azar-Mohammad Reza
           Nasiri zade.
           University: Islamic Azad University




          ICMS 2011 / OP 46 Surgery
           Abstract:
           INTRODUCTION: Hepatic ischemia/reperfusion (I/R) injury leads to free
           radical generation and acute inflammatory responses that cause liver dam-
           age, an important problem for liver transplantation. Pioglitazone is known
           to protect I/R injury in various tissues; however, the mechanism of cyto-
           protection is not well understood. This study investigated the effects of
           pioglitazone administration in a warm hepatic I/R model on tumor necro-
           sis factor (TNF)-alpha level, tissue injury, and antioxidant enzyme activity.
           MATERIALS AND METHODS: Eighty wistar strain rats were divided into 4
           groups (n = 20): Group 1 sham hosts; Group 2 hepatic I/R; Group 3 he-
           patic I/R + pioglitazone (10 mg/kg); and Group 4 hepatic I/R + vehicle.
           Rat livers were subjected to 30 minutes of ischemia followed by 6 hours of
           reperfusion. After reperfusion rats were humanely killed to obtain liver tis-
           sue to study glutathione peroxidase (GPx), superoxide dysmutase (SOD),
           malondialdehyde (MDA) levels and for histopathologic assessment. TNF-al-
           pha, aspartate aminotransferase (AST), and alanine aminotransferase (ALT)
           were measured in serum. RESULTS: Pioglitazone pretreatment significantly
           reduced liver enzyme content (ALT, 176.80 +/- 13.75 vs 235.28 +/- 31.92
           and AST, 748.20 +/- 79.29 vs 944.85 +/- 101.87) and TNF-alpha level
           (9:8.60 +/- 8.67 vs 138.28 +/- 9.99) after I/R compared with the control
           group. MDA level (3.02 +/- 0.37 vs 4.36 +/- 0.38) and hepatocytic degen-
           eration were reduced in the pioglitazone-treated group. GPx (2.40 +/- 0.25
           vs 1.36 +/- 0.31) and SOD activity (2.22 +/- 0.30 vs 1.40 +/- 0.35) were
           significantly higher in the pioglitazone-treated group compared with the
           control group. CONCLUSION: The present study showed that pioglitazone
           administration improved hepatic I/R injury that was associated with en-
           hanced antioxidant enzyme activities and suppression of TNF-alpha, ALT,
           and AST levels. Because peroxisome proliferator-activated receptor-gamma
           agonists are widely used to treat diabetic patients, it may be relatively easy
           to expand their clinical indication. However, further investigations will be
           required to delineate protective mechanisms by which pioglitazone attenu-
           ates hepatic tissue injury after I/R.




                                             —168—
        A SURGICAL APPROACH TO INCISIONAL HERNIA




                                                                                 Anatomy
                                                                                 Surgery
  Authors: ANDREA ANGI

  University: University of medicine and pharmacy Cluj




ICMS 2011 / OP 47 Surgery
Abstract:
INTRODUCTION: Incisional hernia is a long-term complication of laparoto-
my. Its exact frequency varies according to different authors, but is always
around 10%. AIM: The aim of the present study was to assess whether
there is a correlation between certain risk factors or surgical technique and
complications. METHODS: This retrospective study included 280 patients,
undergoing repair for incisional hernias at the 2nd Surgical Clinic in Cluj-
Napoca, during a period of 5 years, from 2004 to 2009. Demographic data,
risk factors, associated pathology, surgical data, complications, and surgi-
cal techniques were evaluated. Operative notes and a postoperative course
were analyzed using the medical record and the Fisher Test was performed.
RESULTS: From all the risk factors presented, obesity was the most com-
mon (68.5%), and was associated significantly with the complication rate
for all cases (R=1.996, p=0.02). Cough, vomiting and sneezing represented
26.5% of the risk factors, and a statistically relevant correlation with the
complication rate was proved (R=1.569, p=0.05). Diabetes also proved to
be associated with the complication rate (R=1.784, p=0.04). The compli-
cation rate of reparation technique by placing a mesh was compared with
using a suture technique, and the correlation was significantly relevant
(p=0.03). CONCLUSIONS: Obesity, diabetes, cough, vomiting and sneez-
ing proved to influence significantly the complication rate, and the analyses
proved that associated pathology is a risk factor, as it increased the rate of
complications. As a result, it is of great importance to investigate correctly
each patient, in order to reveal any situations that may influence the medi-
cal attitude, and not last his further evolution. Also the surgical technique
used for reparation (mesh or suture), influenced the complication rate, so
these parameters are to be considered when dealing with an incisional her-
nia.




Keywords: hernia, complications, risk factors.
Contact authors at: dea_o_scumpete@yahoo.com



                                   —169—
            COMPARISON OF TRADITIONAL SURGICAL AND ENDOVAS-
                  CULAR TREATMENT OF CAROTID DISEASE
Surgery




           Authors: Zelimir Jovanovic,Nada Santrac, Aleksandar Mitrovic,
           Nikolina Banjanin, Aleksandar Bogicevic, Bojan Naumovic, Zeljko
           Garabinovic, Ljubica Jovanovic, Helga Denc, Ivana Jovanovic,
           Marija Jovanovic
           University: Medical University Belgrade



          ICMS 2011 / OP 48 Surgery
           Abstract:
           Introduction: Ischemic brain lesions may be due to stenosis or occlusion
           of internal carotid artery (ICA). The most common manifestationes are:
           transient ischemic attack, reversible ischemic neurological deficit and cer-
           ebrovascular stroke. Surgical revascularization of the brain is indicated in
           patients with hemodynamically significant stenosis, can be achieved by
           using endarterectomy (EA) and transluminalne percutaneous angioplasty
           (PTA) ACI. Aim: The aim of this study is to compare two different options
           in carotid artery disease treatment: open surgery and percutaneous trans-
           luminal angioplasty with implantation of stent. Material and methods: This
           retrospective study included 100 patients who were divided in two groups.
           We analyzed the indications for surgical revaskularisation of ICA, the ap-
           pearance of stenosis, occlusion, pre-made interventions, comorbidity and
           risk factors. Results: Before revascularisation in the group of patients who
           performed EA, CVI is very frequent, and in PTA group we frequently find
           TIA, the difference was significant. There is a difference in the percent-
           age of patients with opposit carotid stenosis in EA group compared to the
           PTA group. In the PTA group was a significant percentage of patients with
           carotid occlusion of opposite ICA. Patients without intervention on the ca-
           rotid are majority in EA group, and in PTA group was statistically signifikant
           number of those who operated ipsilateral carotid artery. Conclusion: EA is
           frequently used in patients who preoperatively manifested CVI, with the
           opposite carotid stenosis and in patients without intervention on the carotid
           artery. PTA is used more in patients who were preoperatively experienced
           a TIA, with the opposite carotid artery occlusion and those who operated
           ipsilateral carotid artery. Comorbidity and risk factors do not give priority to
           any of these methods.




           Keywords:Endarterectomy, Percutaneous transluminal angioplasty, Ca-
           rotid disease
           Contact authors at: drzex@live.com

                                              —170—
   RISK FACTORS INFLUENCING THE SHORT-TERM RESULTS
    AFTER SURGICAL TREATMENT OF PANCREATIC CANCER




                                                                                  Anatomy
                                                                                  Surgery
  Authors: Arabadzhieva, E., Simonova, L., Bonev, S., Ionkov, A.,
  Dimitrova, V

  University: Medical Uniwersity Sofia




ICMS 2011 / OP 49 Surgery
Abstract:
Introduction: Pancreatic cancer is the fifth leading cause of cancer-related
mortality in Bulgaria for 2008 and one of the leading causes of cancer death
in USA and the developed countries, becoming so a major worldwide public
health problem. It is one of the most aggressive human malignancies with
poor prognosis and less than 5 % patient 5-year survival. Aim: to evaluate
importance of choice of surgical strategy and to identify factors that may
influence on short-term postoperative results. Materials and Methods: A
11 – year retrospective study was performed. Between 1999 and 2009,
833 patients with pancreatic cancer were surgically treated in Department
of General and Hepatopancreatic Surgery of University Hospital “Alexan-
drovska”. Clinical data, surgical procedures and the following morbidity and
mortality were recorded on standardized forms and the risk factors were in-
vestigated with SPSS-13. Results: Radical treatment is performed in 35,7%
of patients with pancreatic cancer - 219 duodenohemipancreatectomies, 27
left subtotal pancreatectomies and 51 left hemipancreatectomies. Vascular
reconstructions and different liver resections in some of these patients were
carried out. 491 patients with pancreatic cancer underwent palliative proce-
dures (58.9%) which included different types of derivative operations and
gangliectomies. Mortality and morbidity rates were 7,56% and 18,74%.
The statistical analysis shows that preoperative values of T-BIL, D-BIL, ALP
and operative blood loss are significant prognostic factors influencing short-
term postoperative results. Operative techniques of prosthetic anastomoses
(like “perdue” drainages) decrease risk of occurrence of postoperative com-
plications. Conclusion: Surgical resection is the only potentionally curative
treatment for pancreatic cancer. The exact diagnosis and the aggressive
surgical strategy are related with increasing resectability rate. Optimizing of
surgical techniques correlates with decreasing rates of postoperative mor-
tality and morbidity.




Keywords: pancreatic cancer, risk factors, morbidity, mortality, treatment
strategy
Contact authors at: elena_arabadjieva@abv.bg


                                   —171—
            LAPAROSCOPIC TREATMENT OF SIMPLE HEPATIC CYST US-
                 ING MODIFIED TRANSUMBILICAL TECHNIQUE
                             /CASE REPORT/
Surgery




           Authors: Karashmalakov A., Julianov A., Zyumbyuleva C. Trakia
           University, Medical Faculty, Stara Zagora, Department of General
           Surgery Presenting author: Zyumbyuleva C.
           University: Trakia University




          ICMS 2011 / OP 50 Surgery
           Abstract:
           Introduction: Treatment of the hepatic non-parasitic cyst is required
           in the cases of symptomatic cyst and the surgery is the mainstay
           of therapy. The laparoscopic fenestration became a “gold stand-
           ard”. Laparoscopic fenestration was first reported in 1991. Over
           the last 10 years, single incision laparoscopic surgery /SILS/ as a
           rapidly advancing technique in laparoscopic surgery has replaced
           the standard multi port laparoscopic technique. Aims: To evaluate
           feasibility, safety and benefits of treatment of simple hepatic cyst,
           using our modified transumbilical laparoscopic technique. Materials
           and Method: A 56-years-old woman with symptomatic hepatic cyst
           was laparoscopicaly treated. We used our modified transumbilical
           laparoscopic technique: a single continuous incision within the um-
           bilical folds, 2 ports placed trough the incision (one 10 mm camera
           port and one 5 mm working port), a single 10-mm 30°camera and
           standard laparoscopic instruments. The retracting suture through
           the abdominal wall was applied to achieve a good exposure. Re-
           sults: The patient had an uncomplicated postoperative period. Af-
           ter a year of the operation our patient has no detected recurrence
           of the disease and no visible scars. Conclusion: The results sug-
           gest that our modified transumbilical laparoscopic technique can
           be safely performed to treat a simple hepatic cyst by surgeons
           experienced in laparoscopic surgery, without adding additional cost
           to the procedure with excellent cosmetic result.




           Keywords:simple hepatic cyst, laparoscopic fenestration, modified tran-
           sumbilical technique
           Contact authors at: z_camellia@rocketmail.com

                                           —172—
   THE AESTHETIC IDEAL FOR SHAPE AND SIZE OF BREAST
  DURING THE CENTURIES THROUGH THE EYES OF THE ART-
                         ISTS




                                                                                 Anatomy
                                                                                 Surgery
  Authors: Ivaylo Sabev(1.), Ivelina Petrova(1.), Krista Kirova(2.),
  Phelim McConigly(3.), Viktoria Velcheva(1.), Svetlana Mateva(1.),
  Neslihan Kobaner(1.), Tashko Deliiski(4.)

  University: Medical University of Pleven



ICMS 2011 / OP 51 Surgery
Abstract:
1.Surgery Circle, Oncology Center – Medical University of Pleven, Bulgaria
2.The National Academy of Arts - Sofia, Bulgaria 3.Academy of Fine Arts -
Vienna, Austria, 4.Oncology Center(Professor, Head of Department ) - Medi-
cal University of Pleven, Bulgaria Introduction:

The study about the development of perception of breast as an organ, play-
ing a large role in building of the aesthetic ideal of the human body is con-
sidered as interesting in historical and medical aspect. Aim: To investigate
how the aesthetic ideal for shape and size of breast has evolved during the
centuries through the eyes of the artists since the dawn of mankind up to
nowadays. Methods: Visual assessment of shape, size and presence of pto-
sis of women`s breasts depicted in 205 works of art is made of 11 variant
system, constructed and maintained by us for purposes of clinical practice
in planning and conducting the oncoplastic operations of breast. Results:
The study found out that in each period of art breasts are presented in
a similar variant of shape, size and presence of ptosis. Primeval man de-
picted breasts big, artists of Egyptian, Greek, Gothic art, Baroque and Ro-
coco - small, and artists of the Renaissance, Neoclassicism, Romanticism,
Impressionism, Surrealism, Cubism, Modernism and Fauvists - moderate
volume, teardrop shape. Artists of Realism and some Post-Impressionists,
and symbolists show breast volumetric with moderate ptosis - trends found
in some areas of today`s film and pop art. Conclusion: The aesthetic ideal
for shape and size of breast during the centuries through the eyes of the
artists is variable. The trend is towards a progressive increase in the volume
of depicted breast.




Keywords: breast aesthetic, art
Contact authors at: ivaylo.sabev@yahoo.com



                                   —173—
            THE EVOLUTION OF SURGERY FOR SAGITTAL CRANIOSYN-
                                OSTOSIS
Surgery




           Authors: S. Mihaylova, A. Stratev, K. Ninov, K. Georgiev, D. Fer-
           dinandov, Y. Enchev, V. Bussarsky

           University: Medical Univesity Sofia




          ICMS 2011 / OP 52 Surgery
           Abstract:
           Introduction. The precipitate closure of cranial sutures in newborns,
           known as craniosynostosis, is followed by a compensatory expand-
           ing of the skull vault from the side of the unaffected ones, and
           thus leading to predictable skull deformations. Premature closure
           of the sagittal suture results in a long head termed scaphocephaly
           or dolichocephaly and represents the most common form of synos-
           tosis with a share of 45-60%.
           Aim. The aim of this study was to review the evolution of the surgi-
           cal treatment of scaphocephaly and to present a newly-developed
           by K. Georgiev et al. operative technique in the Clinic of Neurosur-
           gery, University Hospital “Sv. Ivan Rilski”.
           Material and Methods. During a period of 5 years (2006-2010), out
           of 59 consequent patients (pts) with craniosynostosis, 31 (48%)
           were diagnosed with dolichocephaly. From those pts, 24 were op-
           erated by the technique of K.Georgiev et al. In the group 20 pts
           (83%) were male and 4 pts (17%) – female, with a median age at
           the time of surgery of 9,5 months (ranging from 2 to 19 months).
           Results. The presented contemporary operative technique demon-
           strated immediate correction in the shape of the head in the early
           postoperative period with reduced anterior-posterior diameter and
           increased biparietal diameter. The procedure-related morbidity and
           mortality in the series were zero.
           Conclusion. The deformation of the skull may cause brain compres-
           sion and in some cases psycho-motor maldevelopment of the child.
           The main purpose of the surgery is timely correction of the skull
           shape, because of cosmetic reasons and normal socialization of the
           individual. Hence, the surgical technique of K. Georgiev et al. due
           to the evident and immediate normalization of the skull vault is
           extremely valuable.

           Keywords:Sagittal craniosynostosis, skull deformations, scaphocephaly,
           dolichocephaly
           Contact authors at:

                                          —174—
  VENTRICULOPERITONEAL AND VENTRICULOATRIAL ANAS-
   TOMOSIS AS A TREATMENT OPTION FOR NON COMMUNI-
    CATING HYDROCEPHALUS DURING THE FIRST YEAR OF
                        LIFE




                                                                        Anatomy
                                                                        Surgery
  Authors: S. Georgiev, N. Tomov, A. Ivanova, Y. Karusheva, S.
  Todorov, A. Dimitrov, S. Mihaylova, D. Ferdinandov, Y. Enchev, V.
  Bussarsky
  University: Medical Univesity Sofia




ICMS 2011 / OP 53 Surgery
Abstract:
Introduction.
The non-communicating hydrocephalus varies in clinical manifes-
tation and management with age. The aim of our study was to
analyze the clinical presentation and surgical management of these
lesions in the first year of life.

Material and Methods.
We reviewed 53 consecutive patients with the diagnosis of non-
communicating hydrocephalus, aged from birth to 1 year, who were
operated on in the Clinic of Neurosurgery at University Hospital „Sv.
Ivan Rilski“, Sofia, Bulgaria for the period of January 2006 - Sep-
tember 2010.

Results.
The median age of the studied group was 5 months. Most frequent
were the following symptoms and signs: enlarged head circumfer-
ence or a rapid increase in the head size; a bulging “soft spot” on
the top of the head; vomitting; sleepiness; irritability; seizures;
downward fixed eyes (sunsetting of the eyes) and delayed men-
tal development. Ventriculoperitoneal anastomosis was executed
in 79% of the children and ventriculoatrial anastomosis in 14%.
Postoperatively 44 children had improvement in their neurological
state, there was morbidity in 4 patients and mortality in 1.

Conclusion
The instant diagnosis and the accurate and precise surgical treat-
ment of non-communicating hydrocephalus in children younger
than 1 year is crucial for their future development.




                               —175—
              PHARMACORESISTANT EPILEPSY IS NOT UNTREATABLE
Surgery




           Authors:K. Ninov, S. Mihaylova, N. Tomov, I. Petrova, A. Stratev,
           K. Minkin, P. Dimova, D. Ferdinandov, V. Bussarsky

           University: Medical Univesity Sofia




          ICMS 2011 / OP 54 Surgery
           Abstract:
           Introduction. The precipitate closure of cranial sutures in newborns,
           known as craniosynostosis, is followed by a compensatory expand-
           ing of the skull vault from the side of the unaffected ones, and
           thus leading to predictable skull deformations. Premature closure
           of the sagittal suture results in a long head termed scaphocephaly
           or dolichocephaly and represents the most common form of synos-
           tosis with a share of 45-60%.
           Aim. The aim of this study was to review the evolution of the surgi-
           cal treatment of scaphocephaly and to present a newly-developed
           by K. Georgiev et al. operative technique in the Clinic of Neurosur-
           gery, University Hospital “Sv. Ivan Rilski”.
           Material and Methods. During a period of 5 years (2006-2010), out
           of 59 consequent patients (pts) with craniosynostosis, 31 (48%)
           were diagnosed with dolichocephaly. From those pts, 24 were op-
           erated by the technique of K.Georgiev et al. In the group 20 pts
           (83%) were male and 4 pts (17%) – female, with a median age at
           the time of surgery of 9,5 months (ranging from 2 to 19 months).
           Results. The presented contemporary operative technique demon-
           strated immediate correction in the shape of the head in the early
           postoperative period with reduced anterior-posterior diameter and
           increased biparietal diameter. The procedure-related morbidity and
           mortality in the series were zero.
           Conclusion. The deformation of the skull may cause brain compres-
           sion and in some cases psycho-motor maldevelopment of the child.
           The main purpose of the surgery is timely correction of the skull
           shape, because of cosmetic reasons and normal socialization of the
           individual. Hence, the surgical technique of K. Georgiev et al. due
           to the evident and immediate normalization of the skull vault is
           extremely valuable.




                                         —176—
    MEASUREMENT OF GLYCOPROTEINS IN PROSTATE CON-
                      CREMENTS




                                                                        Anatomy
                                                                        Urology
  Authors: Prof.Dr. Maria Ivanova, Strahil Pantev, Filip Dikov

  University: Medical Univesity Sofia




ICMS 2011 / OP 55 Surgery
Abstract:
A well-known scientific fact is that conditions leading to the forma-
tion of the so-called “ prostate bodies” are created during inflam-
matory processes affecting the prostate gland. These bodies trans-
form into concrements after the sedimentation of calcium salts on
them in an environment with a ph>7. Our studies have shown that
these concrements can be divided in two groups according to their
chemical composition: the first are formed from calcium hydrogen
phosphate (CaHPO4.2H2O) and the second are formed from a mix-
ture of calcium hydrogen phosphate (CaHPO4?2H2O) and calcium
oxalate dihydrate (CaC2O4.2H2O). Furthermore, our studies on the
content of glycoproteins (protein-carbohydrate complexes) have
revealed that glycoproteins are contained in a higher concentration
in the second (mixed) group of concrements.




Keywords: prostate concrements, matrix theory, glycoproteins
Contact authors at: strapan@gmail.com



                               —177—
             DIABETIC FOOT ULCER IS A SIGNIFICANT PREDICTOR OF
             SILENT MYOCARDIAL ISCHEMIA IN WOMEN WITH TYPE 2
                                 DIABETES
Surgery




           Authors: Afsaneh Morteza, Manouchehr Nakhjavani, Yaser Jenab,

           University: Tehran University of Medical Science




          ICMS 2011 / OP 56 Surgery
           Abstract:
           Introduction: Screening silent myocardial ischemia in asymptomat-
           ic patients with type 2 diabetes is still controversial. The purpose of
           the present study was to define the value of diabetic foot ulcer in
           the prediction of silent myocardial ischemia in asymptomatic men
           and women with type 2 diabetes. Methods: We performed a cross
           sectional study on 150 diabetic patients with diabetic foot ulcer,
           as cases, and 90 diabetic patients, without the history of any type
           of diabetic foot disease, as controls. Presence of silent myocardial
           ischemia was assessed by dipyridamole single-photon emission-
           computed tomography myocardial perfusion (SPECT) imaging with
           thallium-201. Results: Patients with diabetic foot ulcer had a longer
           diabetes duration, a higher serum HbA1C, and a lower a serum high
           density lipoprotein cholesterol levels, compared to patients without
           diabetic foot ulcer. There were a greater number of women with
           silent myocardial ischemia (28 (44.4%) vs. 28 (32.2%); p<0.05)
           in patients with diabetic foot disease. There were a greater num-
           ber of men with silent myocardial ischemia compared to women
           (10(21.3%) vs. 2 (4.7%); p<0.05) in patients without diabetic foot
           disease. Logistic regression analysis demonstrated that the odds
           ratio of having silent myocardial ischemia was 2.96 in women with
           diabetic foot, 0.18 in women without diabetic foot and 1.75 in men
           with diabetic foot compared to men without diabetic foot. Discus-
           sion: Women with diabetic foot ulcer are at an increased risk of
           having silent myocardial ischemia, compared to male counterparts.




                                          —178—
  Abstracts
Surgery Poster
  Abstracts
Surgery Poster
  CERVICAL CYTOLOGY STUDY IN PREMENOPAUSAL WOMEN
            WITH ENDOMETRIAL HYPERPLASIA




                                                                          Gynaecology
                                                                           Anatomy
  Authors: D.C.Stefanescu, S.Cotarcea, R.Linoiu, L.Dijmarescu,
  L.Novac


  University: UMF CRAIOVA



ICMS 2011 / PP 01 Surgery
 Abstract:

 Introduction:The most common presenting symptom of endome-
 trial hyperplasia is abnormal uterine bleeding. This includes men-
 orrhagia, intermenstrual bleeding, postmenopausal bleeding and
 irregular bleeding . Endometrial hyperplasia affects both premeno-
 pausal and postmenopausal women, accounting for approximately
 15% - 20% of cases of women presenting with postmenopausal
 bleeding. As previously discussed, endometrial hyperplasia is de-
 fined as a proliferation of glands of irregular shape and size with an
 increase in the gland to stroma ratio. It is further categorised into
 simple and complex, based on the complexity and crowding of the
 glandular architecture. Method: We have selected 52 patients aged
 44-55 years with excessive menstrual disorders, where uterine cu-
 rettage was performed for biopsic and hemostatic purposes. Be-
 sides cervical bleeding, cytology was used to harvest at a distance
 of endometrial biopsy. Endometrial biopsy results: 10(19,2%)
 patients had endometrium with estrogen influence (glandulo-
 cystic hyperplasia), 13(25%) patients had simple adenomatous
 hyperplasia,medium adenomatous hyperplasia in 21(40,4%) pa-
 tients, , two patients(3,8%)-aggravated adenomatous hyperplasia,
 6(11,5%) patients, combined endometrial hyperplasia (simple and
 atypical) and 1(1,9%) patient presented atypical endometrium.
 Citotumorale examinations of the cervix smears showed para-
 bazale cells and atrophic phenomena.In the study group, 5 patients
 showed L-SIL lesions and two patients H-SIL lesions. Conclusions:
 Excessive menstrual disorders is associated with endometrial hy-
 perplasia in various stages and often with atrophy of cervical squa-
 mous epithelium in the absence of cell type premalignant lesions.


Keywords: ENDOMETRIAL HYPERPLASIA, CERVICAL ATROPHY

Contact authors at: stefanescudoinacristina@yahoo.com

                                —181—
                THE IMPLICATION OF THE PATHOGENIC BACTERIAN FLORA
                         IN THE FALLOPIAN TUBE PATHOLOGY
Gynaecology




               Authors: B. Voinea, Alex. Goganau, Bogdan Cirju, D. Plesan,
               Lorena Dijmarescu, Magdalena Manolea


               University: Umf Craiova



              ICMS 2011 / PP 02 Surgery
               Abstract:

                  Introduction Tubal inflammatory processes remain responsible,
               in a high percentage, for the installation of secondary sterility and
               ectopic pregnancy. It is therefore necessary to study changes that
               occur in salpingitis. Methods We performed a retrospective and
               prospective study of tubal pathology in 257 cases, 86 cases with
               severe tubal pathology and the remaining 171 cases associated
               with severe cases requiring surgery. Considering the implication of
               the pathogenic flora in the tubal inflammatory processes we made
               bacteriological endocervical samplings on 126 cases and on 62
               cases we harvested bacteriological samples from the tubal lumen
               during the surgical intervention. Results The Fallopian tube pathol-
               ogy was present in 27,78 % cases, most of the cases appearing
               on women with ages ranging from 16 to 29 years. The acute sal-
               pingitis was observed at other surgical intervention made for other
               gynecological pathology.The cases of acute or chronic salpingitis
               were accompanied by salpingian congestion or fibrous adhesions.
               Of the 126 cases we haversted and accomplished one bacterio-
               logical endocervical exam,on 86 cases ( 68,25% ) we founded one
               infection of the inferior genital tract,being involved more infectious
               agents who could have involvement in the pathogeny of the sal-
               pingitis. Conclusions Unfortunately, the study of the salpinx is lim-
               ited, because the histological analysis can be made only by their
               ablation,intervention which is not possible on cases suspected to
               have an inflammatory pathology.Remains that the extrapolation of
               the results obtained by the achieving of studies like this to be con-
               sidered in the future in order to evaluate a case suspected of hav-
               ing an inflammatory salpingian pathology.


               Keywords: tubal inflammatory processes , salpingitis,pathogenic flora

               Contact authors at: voineadbogdan@yahoo.com


                                                 —182—
   A COMPARATIVE STUDY OF COMPUTER TOMOGRAPHY AN-
   GIOGRAPHY AND DIGITAL SUBTRACTION ANGIOGRAPHY
  IN THE EARLY DIAGNOSIS AND TREATMENT OF INTRACRA-




                                                                                  Neurosurgery
                   NIAL ANEURYSMS.




                                                                                   Anatomy
  Authors: Mariusz Tomaniak, Bartlomiej Urbanski, Stanislaw Szlu-
  fik, Marta Zebala


  University: Medical University of Warsaw



ICMS 2011 / PP 03 Surgery
 Abstract:
 INTRODUCTION: CT angiography (CTA) has been used for the early diag-
 nosis of ruptured intracranial aneurysms whereas digital subtraction an-
 giography (DSA) is the accepted diagnostic procedure for the assessment
 of intracranial aneurysms and for the preoperative treatment planning of
 patients suffering from subarachnoid haemorrhage (SAH). However, DSA is
 not the most valuable diagnostic method in all cases of aneurysms. The re-
 ported rate of negative angiography in SAH ranges from 10 to 20%. AIMS:
 The aim of our study was to evaluate the diagnostic value of CTA in com-
 parison with DSA and with surgical findings for the detection of intracranial
 aneurysms (IA). MATERIAL AND METHODS: A retrospective analysis was
 performed of 328 patients with the diagnosis of subarachnoid haemorrhage,
 who underwent open aneurysm repair or preservative treatment between
 January 2006 and December 2008. Eighteen cases were selected, as diag-
 nosed with the use of both CTA and DSA for the detection of aneurysms.
 From the group, 9 patients (median age 46±8 years) were treated us-
 ing neurosurgical intervention and 9 patients (median age 53±16,9 years)
 were qualified to preservative therapy. The data was evaluated with the
 use of statistical analysis. RESULTS: Comparison of demographic data, pre-
 operative aneurysm anatomic features revealed no significant differences.
 Overall rate of diagnostic use of CTA and DSA in the verification of aneu-
 rysm diagnosis showed, that more frequently firstly used is CTA (mean
 time 0,27±0,59 day, p>0,15), whereas DSA is also used, but as the second
 tool, for the diagnostic confirmation (mean time 0,44±0,63 day,p>0,15).
 It is correlated with the accuracy of CTA and DSA in detection of IA, which
 were appropriately 91% in all aneurysms in CTA (ACoA-67%,MCA-100%,
 PCoA-100%) and 63,6% in all aneurysms in DSA (ACoA-100%, MCA-
 60%,PCoA-100%), p=0,118. CONCLUSIONS: CTA can be used not only as
 the first diagnostic tool, but also as a control for diagnostic procedure when
 DSA was used firstly but the localization of aneurysm was not found or un-
 sure. CTA is nowadays the best choice of diagnostic tool for detection rate
 in AcoA and MCA bifurcation aneurysms. However some locations of IA still
 may remain problematic.


Keywords: intracranial aneurysms, computer tomography angiography, digi-
tal subtraction angiography
Contact authors at: mariusz.tomaniak@interia.pl

                                   —183—
               SERUM ADENOSINE DEAMINASE ACTIVITY IN GESTATION-
                  AL DIABETES MELLITUS AND NORMAL PREGNANCY
Obstetrics




              Authors: Sheikhzadeh A, Mokhtari M, Hashemi M, Yaghmaei M,
              Molashahi F, Niazi A, Ghavami S.


              University: Umf Craiova



             ICMS 2011 / PP 04 Surgery
              Abstract:

                 Abstract PURPOSE: To our knowledge, there is no report regard-
              ing adenosine deaminase activity (ADA) in gestational diabetes
              mellitus (GDM). The aim of the present study was to investigate the
              level of serum ADA activity in normal pregnancy, GDM and normal
              non-pregnant women. METHODS: The serum catalytic concentra-
              tion of ADA was measured in samples of 20 GDM, 40 normal preg-
              nant and 20 non-pregnant healthy women. RESULTS: Adenosine
              deaminase activity was significantly higher in GDM (24.30 +/- 8.04
              IU/L) and pregnant women (23.88 +/- 8.66 IU/L) than those of nor-
              mal non-pregnant individuals (11.85 +/- 3.23 IU/L) (P < 0.0001),
              but the ADA level was not significantly different from GDM and
              normal pregnant women (P = 0.97). CONCLUSIONS: Adenosine
              deaminase activity was significantly higher in GDM and pregnant
              individuals than normal group in this study. Previous reports in this
              field are contentious; therefore, ADA activity could be regulated in
              different population by immunologic and genetic factors.




              Keywords: adenosine deaminase activity , gestational diabetes mellitus

              Contact authors at: vaheid2002005@gmail.com


                                               —184—
     IMMUNOHISTOCHEMICAL VARIATIONS IN CASE OF
  PREGNANCY ASSOCIATED WITH OVARIAN TUMORS - CASE
                      REPORT




                                                                                      Obstetrics
                                                                                      Anatomy
  Authors: L. Dijmarescu, L. Novac, S. Cotarcea, M. Manolea T.
  Tanase, A. Comanescu, R. Lanoiu,S. Neamtu, S. Cerga


  University: Medical University of Warsaw



ICMS 2011 / PP 05 Surgery
 Abstract:
 Abstract. Ovarian tumors diagnosed during pregnancy put the major prob-
 lems of differential diagnosis of benign / malignant as well as deciding
 the optimal therapeutic solution Case report. A 27 years old patient as
 been registered by a specialist doctor for 25 weeks pregnancy in evolu-
 tion and a multilocular ovarian tumor by 52/38 mm with mixed echo part
 solid / liquid, with thick septa. Dispense CA125 (38muI), TAG 72 in normal,
 slightly alkaline phosphatase decreased. The patient is monitored monthly
 by ultrasound noticing an increase in ovarian volume (up to 122/113mm),
 with slight change of resistivity and pulsatility index. CA-125 increased to
 55muI. At 38 weeks, it performed cesarian section and left anexectomy,and
 extract a fetus by 3200g, Apgar scores 8 It is done extemporaneously ex-
 amination of the tumor and the level of CA125 determination is made, TAG
 72 and alkaline phosphatase in fluid intrachistic, obtaining a value of CA125
 over cut-off device. We mention that the patient is part of a study started
 in our clinic who tries to establish a relationship between serum levelas s of
 tumor antigens and tumor intrachistic level of fluid. Histopathology shows
 the microscopic appearance of multilocular cyst with edema and bleeding
 microfocare, endocervical type metaplasia. Concluzie.Ca125 is an immuno-
 histochemical marker for the diagnosis of ovarian tumors poorly associated
 with pregnancy, unable to establish a cut-off value in this situation. Also
 could not yet determine if there is a correlation between the serum and the
 fluid intrachistic of antigens, but the above cut-off device to intrachistic fluid
 CA125 represents a new direction for research




Keywords: CA 125, pregnancy

Contact authors at: c_dijmarescu@yahoo.com

                                     —185—
                   EFFECT OF INCREASED MATERNAL BODY MASS INDEX
                            (BMI) ON PREGNANCY OUTCOME
Obstetrics




              Authors: Elina Calite, Zane Melluma



              University: Riga Stradins University



             ICMS 2011 / PP 06 Surgery
              Abstract:

                 INTRODUCTION: Maternal overweight and obesity can result in
              adverse pregnancy outcomes both for women and fetuses. These
              include for example gestational diabetes mellitus, preeclampsia,
              lower Apgar score and macrosomia. Delivery complications may
              include excessive blood loss, shoulder dystocia as well as fetal
              distress. AIM: review and analyze case records of overweight and
              obese pregnant women in comparison with normal BMI women and
              determine main pregnancy and delivery complications. MATERI-
              ALS AND METHODS: 793 case-records were reviewed, exclusion
              criteria were underweight BMI (<19.8) and normal BMI (19.8-
              26.0), elective caesarian section, twin pregnancy and case records
              with incomplete information. Inclusion criteria fulfilled 193 case
              records, 94 women with overweight and obesity (BMI>26.1and
              >29.1 resp.) and the control group of 99 women with normal BMI.
              RESULTS: Compared to women with normal BMI, overweight and
              obese women were at significantly higher risk of preeclampsia
              (p=0.03), arterial hypertension (p=0.00) and gestational diabe-
              tes mellitus (p=0.0202). Overweight and obese women more likely
              have higher parity (p=0.0019) and gain less weight during preg-
              nancy (p=0.0001) in comparison to women with normal BMI. There
              was no statistically significant difference in gestational week of first
              antenatal visit, anaemia graviditarum, newborn weight and Apgar
              score assessment, placental mass, operative time and blood loss
              neither in vaginal delivery nor in caesarian section. CONCLUSION:
              women who are obese and overweight have an increased risk of
              gestational diabetes mellitus, preeclampsia and arterial hyperten-
              sion.


              Keywords: BMI, overweight, obesity, pregnancy outcome

              Contact authors at: elinaca@inbox.lv


                                              —186—
     ALTERATION OF LABOUR PATHOLOGY FREQUENCY IN
   WOMEN WHO DRINK WATER CONTAINING CYANOBACTE-
   RIA METABOLITES AGAINST THE BACKGROUND OF PRE-
                  VENTIVE MEASURES




                                                                                Obstetrics
                                                                                Anatomy
  Authors: I.A. Tykha



  University: Kharkov Medical Academy of Postgraduate Education



ICMS 2011 / PP 07 Surgery
 Abstract:
 The spreading of toxic “water bloom” in fresh water connected with an in-
 tensive reproduction of cyanobacteria takes form of a global problem. Toxic
 bloom is considered to be a national disaster in Norway, Finland, England,
 Sweden and several other countries. According to the data of Ukrainian
 Research Studies Institute of Environmental Issues (the city of Kharkov,
 Ukraine) the water from reservoirs which are used for central water supply
 in the town of Chuguev, Kharkov district is blooming. Other researchers and
 our experimental investigations proved the influence of toxins on cardio-
 vascular and immune systems, liver functioning and other human body or-
 gans. The aim of this study is to compare the peculiarities of labour course
 in women living in Chuguev against the background of performed preven-
 tive measures and without them. The material of the study are 287 labour
 histories from the maternity patients of Chuguev who underwent preven-
 tive measures (enterosorbents and polyvitamin complexes) during their
 pregnancy (2008-2009y.y), – group Chuguev-2, and 275 labour histories
 of women who were not prescribed preventive measures (2006) – group
 Chuguev-1. Comparative group – cohort living in the town of Bogodukhov,
 where this factor is absent as artesian water is used there. The results of
 the study. Against the background of performed preventive treatment the
 group Chuguev-2 showed a significant reduction in the frequency of differ-
 ent labour complications to 29,9% in comparison to 46,9%, as in the group
 Chuguev-1, however, the structure of this pathology remained unchanged.
 The most frequent pathologies are premature or early bursting of waters
 (in the group Chuguev-1 – in 20,4%, in the group Chuguev-2 – in 16,1%),
 postnatal anaemia (16,3% and 12,4% correspondingly), hypotonic uter-
 ine bleeding (6,1% and 2,8% correspondingly). There was a reduction in
 frequency of premature detachment of placenta, there was a particular re-
 duction in the prevalence of secundines defects, hysterocervicorrhesis and
 perineal rupture, acute fetal distress, and we did not register any case of
 primary and secondary uterine inertia in the group Chuguev-2 with 2% in
 the group Chuguev-1. Thus, it is possible to conclude, that the performed
 preventive measures can reduce toxic effect of cyanobacteria and reduce
 the level of complications during labour.

Keywords: pregnancy, water, cyanobacteria, prevention.

Contact authors at:Pliten_oksana@mail.ru

                                  —187—
                 MUTATIONS IN CYSTATHIONINE BETA-SYNTHASE GENE
               AS RISK FACTOR OF NEURAL TUBE DEFECTS IN UKRAINIAN
                                   POPULATION
Obstetrics




              Authors: V.Zaporozhan, V.Marrichereda, O.Kulish



              University: Riga Stradins University



             ICMS 2011 / PP 08 Surgery
              Abstract:

                Etiology of neural tube defects (NTD) is unknown but some facts
              indicate the presence of a strong genetic contribution. Folate path-
              way gene polymorphisms lead to decreasing activity of enzymes
              and cell proliferation and differentiation disorder. Mutations of cys-
              tathionine beta-synthase (CBS) gene also result in hyperhomocyst-
              einemia and, consequently, a direct embryotoxical effect. In order
              to evaluate the role of CBS gene polymorphism and there interac-
              tion in NTD, we genotyped 42 women from South of Ukraine who
              have had an NTD-affected pregnancy. A possible impact of chemi-
              cals, widely differing therapeutic drugs, environmental contami-
              nants, pollutants, infectious agents, teratogens, solvents, maternal
              hyperthermia, use of valproate by epileptic women during pregnan-
              cy, deficiency and excess of certain nutrients and chronic maternal
              diseases (e.g. diabetes mellitus) were excluded in these cases of
              NTD. Age of women was from 19 to 42 years (mean age - 26,
              6?4,6 years). Pregnancies associated with NTD were complicated
              by threatened abortion (n = 15, 35,7%), growth retardation (n =
              6; 14,3%), iron deficiency anemia (n = 17, 40,5%). T833S/844 ins
              1968 heterozygote mutation of СВS gene was found in 5 (11,9%)
              women. Fetal anencephaly was found in 2 (40%) women with the
              said mutation, spina bifida – in 2 (40%) cases and occipital en-
              cephalocele – in 1 (20%) case. Thus, polymorphism of CBS gene
              seems to be associated with the risk of NTD in Ukranian population,
              and it would be consequent to investigate polymorphisms of other
              folate pathway genes to better understand molecular and genetic
              mechanisms in the etiology of NTD.



              Keywords: neural tube defects, cystathionine beta-synthase

              Contact authors at: villirial2006@rambler.ru


                                               —188—
      MOBILE PHONE USE AND RISK OF GLIOMA IN SERBIA




                                                                                Oncology
                                                                                Anatomy
  Authors: Milan Bozinovic. Marija Randjelovic



  University: University in Nis



ICMS 2011 / PP 09 Surgery
 Abstract:
 Objective: To investigate the risk of glioma in adults in relation to mobile
 phone use. Setting: Five areas on the south Serbia. Participants: 96 people
 aged 18 to 79 years diagnosed with a glioma from 1 October 2007 to 31
 January 2011 and 170 controls randomly selected from general practitioner
 lists. Main outcome measures: Odds ratios for risk of glioma in relation to
 mobile phone use. Results: the overall odds ratio for regular phone use
 was 0.92 (95% confidence interval 0.76 to 1.11). There was no relation for
 risk of glioma and time since first use, lifetime years of use, and cumula-
 tive number of calls and hours of use. Conclusion: Use of a mobile phone,
 either in the short or medium term, is not associated with an increased risk
 of glioma




Keywords: mobile phone, glioma, risk

Contact authors at: bozinovic_milan@isic.org

                                  —189—
              EFFECT OF MONENSIN AND ITS METAL COMPLEXES ON VI-
               ABILITY AND PROLIFERATION OF DRUG-RESISTANT TU-
                                  MOR CELLS
Oncology




            Authors: T. Zhivkova, R Alexandrova, B. Andonova-Lilova, L.
            Dyakova, I. Pantcheva-Kadreva, M. Mitewa


            University: Bulgarian Academy of Sciences, IEMPAM



           ICMS 2011 / PP 10 Surgery
            Abstract:

              Introduction. Monensin, an antibiotic produced by fermentation of a
            strain of Streptomyces cinnamonensis, is a carboxylic Na(+)/H+ iono-
            phore used worldwide in veterinary medicine as a growth promoter in
            beef cattle and feed additive against coccidiosis in chickens and pigs.
            The antineoplastic activity of this compound was reported for cell lines
            established from various malignancies. It was found in our previous
            investigations that metal complexes of monensin decrease significantly
            viability and proliferation of cultured human and animal tumor cells.
            Aim. The aim of the study presented here was to evaluate the puta-
            tive anticancer activity of metal (II) complexes of monensin on mul-
            tidrug resistant tumor cells. Materials and methods. Four complexes
            of monensin with Co(II), Ca(II), Mg(II) and Mn(II) were studied. The
            experiments were performed using human squamous cell carcinoma
            permanent cell line (A431) and multidrug resistant clones isolated
            from the same cell line that express MDR1 (A431-MDR), MRP (A431-
            MRP) or ABCG2 (A431- ABCG2) gene. The investigations were car-
            ried out by MTT test. Results. Applied at concentrations of 1-25 µg/
            ml the compounds investigated decreased in a time-and concentration
            dependent manner the viability and proliferation of the treated cells.
            In some cases (the complex of Mn with monensin) the sensitivity of
            the parental cell line (A431) was found to be very close to those of
            the resistant clones (A431-MDR and A431-MRP). On the other hand,
            the Ca(II) complex of monensin was shown to be more active in A431
            cells as compared to A431-MDR and A431-MRP cells. Conclusion: The
            metal complexes of monensin are promising cytotoxic and cytostatic
            agents effective in drug sensitive as well as in drug resistant tumor
            cells. Additional experiments are required to clarify better the potential
            antineoplastic activity of these compounds and their mechanism(s) of
            action. Acknowledgement. Supported by Grant DO-02-84/2008, Na-
            tional Science Fund, Bulgaria.
            Keywords: monensin, metal complexes, multidrug resistant tumor cells,
            cytotoxic activity
            Contact authors at: tani413@abv.bg


                                            —190—
     EFFECT OF NEWLY SYNTHESIZED METAL COMPLEXES ON
    VIABILITY AND PROLIFERATION OF HUMAN GLIOBLAS-
                      TOMA CELLS




                                                                                    Oncology
                                                                                    Anatomy
  Authors: L. Dyakova, T. Zhivkova, R. Kalfin, L. Patron, O. Costi-
  sor, R. Alexandrova


  University: Bulgarian Academy of Sciences, Institute of Neuro-
  biology


ICMS 2011 / PP 11 Surgery
 Abstract:
 During the last few decades cis-diammine-dichlorplatinum (II) (cisplatin)
 has developed into one of the most frequently used and most effective anti-
 tumor drugs for the treatment of solid carcinomas. The discovery of cispla-
 tin has stimulated the search for new metal compounds with antineoplastic
 properties. Gliomas are the most frequent primary neoplasms of the central
 nervous system (CNS) in adults and their treatment is one of the major
 challenges in current oncology. The aim of the study presented here was to
 evaluate the effect of newly synthesized metal complexes on viability and
 proliferation of cultured human glioblastoma cells. The 8 MGBA permanent
 cell line established from human glioblastoma multiforme was used as an
 experimental model in our investigations. The following compounds were
 examined: i) 16 complexes of Zn(II), Cu(II), Co(II), Ni(II) and La(III) with
 cholic acids; ii) 6 mixed ligand complexes of Cu(I,II), Co(II) and Fe (II,III);
 iii) 20 complexes of Cu (I, II); Co(II), Ni(II) and Fe(II,III) with Mannich bas-
 es N,N’-bis(4-antipyrylmethyl)-piperazine (BAMP) or N,N’-tetra-(antipyryl-
 1-methyl)-1,2-diaminoethane (TAMEN); iii) 8 complexes of Co(II), Cu(II),
 Zn(II) and Ni(II) with piroxicam and meloxicam. The experiments were
 performed using MTT test, neutral red uptake cytotoxicity assay, crystal
 violet staining, trypan blue dye exclusion method, colony forming method,
 single cell gel electrophoresis, double staining with acridine orange and pro-
 pidium iodide. The results obtained revealed that applied at concentrations
 of 1-200 µg/ml some of the compounds decreased significantly the viability
 and proliferation of the treated cells. The most active among the complexes
 investigated was found to be the mixed ligand complex of Cu(I,II) Cu2B-
 AMPdipyCl4 (dipy = 2,2-dipyridyl). The cytotoxic concentration 50 (CC50)
 of this compound was found to be 4-23 µg/ml (depending on the method
 used). Cu2BAMPdipyCl4 inhibited completely the colony-forming ability of 8
 MGBA glioblastoma cells administered at concentrations ? 7.5 µg/ml.




Keywords: glioblastoma multiforme, cell line, metal complexes, antitumor
activity
Contact authors at: ldiakova13@gmail.com

                                    —191—
                 PSYCHOLOGICAL DISTURBANCE IN GRAVES ORBITOPATHY
Ophtalmology




                Authors: Vinogradskaya O., Lipatov D., Fadeyev V.



                University: I.M. Sechenov First Moscow State Medical University



               ICMS 2011 / PP 12 Surgery
                Abstract:

                  Introduction: General health-related quality of life (HRQoL) is de-
                creased in patients with Graves’ Orbitopathy (GO). It was observed
                that anxiety and depression were more frequent in GO patients than
                in reference population. Aim: To assess the quality of life in Graves’
                Orbitopathy. Methods: 37 patients (8 males, 29 females) with varying
                degrees of severity and activity of GO participated in the study. Twen-
                ty-seven normal subjects served as controls. Measurements HRQoL,
                Depression were assessed by the 36-item Short Form and Beck De-
                pression Rating Scale. Results: Physical Component Summary (PCS)
                score was lower in patients with GO than in controls (median PCS: 43,2
                [39,2; 48,1] vs. 51,2 [45,1; 56,2]; p=0,028) as well as Mental Com-
                ponent Summary (MCS) was (median MCS: 41,7 [35,8; 48,7] vs. 48,7
                [42,0; 53,6]; p=0,037). Applying the Beck Depression Rating Scale, it
                was observed that depression was more frequent in GO patients than
                in controls group (78,4 and 40,7%, respectively). Conclusion: Psycho-
                social morbidity is present in GO patients, which negatively affects QoL.
                The patients are not only physically ill, they also feel emotional dis-
                tress. HRQoL questionnaires can identify patients who are in need of
                further counselling.




                Keywords: Graves orbitopathy, quality of life, psychological disturbance

                Contact authors at: studyx@mail.ru


                                                  —192—
      THE NEWEST TECHNOLOGIES IN THE EARLY DIAGNOS-
                    TICS OF GLAUCOMA




                                                                                   Ophtalmology
                                                                                     Anatomy
  Authors:Diohenova M.A., Kravets B.B.



  University: Bulgarian Academy of Sciences, Institute of Neuro-
  biology


ICMS 2011 / PP 13 Surgery
 Abstract:
 Introduction. Glaucoma takes the second place among all the causes of
 blindness and is on the same position in the rating of the invaliding diseases
 all over the world. The problem in the glaucoma diagnostics is that the
 structure changes of the visual analyzer always start before functional. Op-
 tical Coherence Tomography (OCT) allows to image three-dimensional index
 of optic nerve disc including its size, contour and shape, state of excavation,
 neuroretinal zonule and also the changes of the retinal nerve fiber layer.
 Purpose. To discover the glaucomatous lesion of visual analyzer before clini-
 cal manifestation of the disease. Objectives and results of the investigation.
 30 patients of one age without any compatible pathology of the back seg-
 ment of the eye. Data registration was conducted by means of Topcon 3-D
 OCT 100. Patients were divided into 3 groups. 1st group (5 persons) was
 formed by the patients without any ophthalmic pathology (control group).
 2nd group (13 persons) came to the doctor for the first time with the com-
 plaints specific for glaucoma. In 92% (12 people – 9eyes) we revealed high
 IOP, defects in vision field, essential changes in the structure of optic nerve
 disc. By the results of the examination we diagnosed glaucoma in these
 patients. The 3rd group (12 persons) included patients that came to the
 clinic with prophylactic purpose. In 17% (2 persons – 3 eyes) datas of the
 day tonometry and static perymetry were within age norm, but OCT results
 showed local thinning of nerve fiber layer, and expansion of the excavation
 of the disc. We can’t say with confidence whether in these patients has
 started glaucomatous process or not, but by means of OCT we can suspect
 glaucoma and begin monitoring these patients. Conclusion. Investigation of
 the structure of the optic nerve disc on the microscopic level with OCT is a
 unique possibility, because it allows to manifest neurodegenerative lesion
 before functional changes and also to conduct monitoring of progressing of
 the disease in glaucoma patient.




Keywords: GLAUCOMA, OCT

Contact authors at: diohenova@ukr.net

                                   —193—
                     ASSESMENT OF FUNCTIONAL OUTCOME FOLLOWING
                    TREATMENT FOR IDIOPATHIC ADHESIVE CAPSULITIS
Orthopedics




               Authors: James O Donovan, Birgit Hanusch, Matthew Brown,
               Raymond Liow


               University: I.M. Sechenov First Moscow State Medical University



              ICMS 2011 / PP 14 Surgery
               Abstract:

                 Aim: Adhesive capsulitis (frozen shoulder) is a debilitating condition.
               Its aetiology is still unclear and there is no consensus on the most ef-
               fective treatment. This retrospective study investigates the mid-term
               functional outcome of one treatment protocol. Methods: Patients diag-
               nosed with idiopathic adhesive capsulitis treated by one orthopaedic
               surgeon between 2004-2008, were identified from outpatient clinic let-
               ters. All patients had initially received conservative treatment, consist-
               ing of physiotherapy with capsular stretches and subacromial injec-
               tions. Patients in whom conservative treatment failed underwent an
               arthroscopic capsular release. At a minimum of two years following
               diagnosis patients were sent the Oxford Shoulder Score (OSS), West-
               ern Ontario Rotator Cuff Index (WORC) and a satisfaction questionnaire
               by post. In addition case notes were reviewed and type of treatment
               and range of movement (ROM) recorded. Results: 60 patients with the
               diagnosis of idiopathic adhesive capsulitis were identified. 42 patients
               (70%) returned the completed questionnaires. Range of movement
               data was available from 43 (72%). Mean OSS was 41.52 (SD 10.6)
               and mean WORC 307.26 (SD 437.1). Analysis showed that patients in
               whom conservative treatment was successful had significantly better
               functional outcome scores in OSS and WORC and better ROM than pa-
               tients who underwent surgery. Overall 33 patients (79%) were satisfied
               or very satisfied with the outcome of their treatment. Conclusion: Pa-
               tients who respond to conservative treatment have a better functional
               outcome than patients who undergo surgery following failed conserva-
               tive treatment. Further studies are needed to directly compare the two
               types of treatment.




               Keywords: Frozen Shoulder, functional outcome

               Contact authors at: higherstandards@hotmail.co.uk


                                               —194—
    CORRECTION OF METABOLIC IMMUNODEFICIENCY IN PA-
   TIENTS WITH OBSTRUCTIVE JAUNDICE NONNEOPLASTIC
   ETIOLOGY WITH USING EXTRACORPOREAL IMMUNOCOR-
                       RECTION




                                                                                 Anatomy
                                                                                 Surgery
  Authors: Dyabkin E.V., Vinnik Yu.S., Dunaevskaya S.S.



  University: Krasnoyarsk State Medical University



ICMS 2011 / PP 15 Surgery
 Abstract:
 Aim of research. To increase efficiency of results after operational treat-
 ment and immunocorrecting therapy of patiens with obstructive jaundice
 nonneoplastic etiology, to reduce mortality, to decrease duration of stay-
 ing patients in hospital. Materials and methods. We determined indicators
 of leukogram, indicators of humoral, cellular links of immunite in work for
 rating immune status of patients. 43 patients with jaundice nonneoplastic
 etiology were under observation. Surgery was made in various terms after
 reception in hospital to patients. There surgery are laparatomy, holedoholi-
 totomia, establishment of drainage of choledoch. Patients were divided on
 3 groups. The 1st group – patients witch got traditional intensive therapy
 in after surgery – thearm. The second group – got 1% 1ml glutoxim, witch
 injected intravenously together with traditional therapy. The 3th group – the
 patients witch got 1% 1ml glutoxim, witch injected intravenously previ-
 ously incubated with 20 ml of autologous blood in during 30 min, 1 time in
 day, course of therapy – 5 sessions addition to treatment. Results. Patients
 of first group had leukocytocitosis, monocytosis, lymphopenia, T-immuno-
 deficiencyon of light degree, reduction of indicator of immunoregulatory
 index by reduction of T–helpers and increase of T-supressors, indicator IgA
 increse in humoral link on 5 day after therapy. Patients of the second group
 had lymphocytosis and monocytosis, but unlike the first group of patients,
 the total number of leukocytes was close to normal. T-immunodeficiency
 light degree preserved, but the level of lymphocytes and immunoregula-
 tory index increased by increasing the level of T-helper cells and decrease
 T-suppressors. The indicators leucogram tend to the norm in patients of
 the third group. Little T-immunodeficiency preserved, although rates of T-
 helper cells have increased rates respectively of T-suppressors decreased,
 immunoregulatory index approaches the normal, humoral link also within
 normal limits. Conclusions. The proposed method can effectively influence
 the immune system through the establishment of immunocompetent cells
 in high concentrations immunocorrector - glutoxim. The degree of immu-
 nodeficiency condition during obstructive jaundice nonneoplastic etiology
 decreased and thus the effectiveness of treatment to increase, mortality
 decreased, length of hospital stay decreased as a result, the impact on the
 metabolic and energetic processes in immunocompetent cells.
Keywords: obstructive jaundice nonneoplastic etiology, T-immunodeficiency,
glutoxim
Contact authors at: dyabkyn@mail.ru

                                   —195—
            URINARY BLADDER CARCINOMA DURING THE 2005 – 2009
                PERIOD OF TIME ( REGIONAL HOSPITAL, PEJA )
Urology




           Authors: selmon salihaj



           University: UNIVERSITY OF PRISTINA



          ICMS 2011 / PP 16 Surgery
           Abstract:

            Introduction : The urinary bladder tumor is frequent, the fourth –
           ranked male tumor. 90% belongs to the TCC , cracinoma plancellular
           5 %, adenocarcinoma 1-2 %, and 2 % Ca undefined. The incidence of
           this cancer is increasing, but mortality is being reduced thanks to the
           early diagnosis and treatman methods. The tumor is three to four times
           more common in men than in women. While diagnosing cancer, ap-
           proximately 85 % is localized in the urinary bladder, while 15 % of the
           cases are notified by metastasis. The treatman of this cancer depends
           on many factors , the tumos stage, grade, localization, frequency, re-
           lapses. The risc factors are, smoking, saharin and coffe, metabolites
           of triptofan, oncogeny viruses, genetic factors, irritations and chronic
           urinary tract infections. Aim of the study : presentation for the urinary
           bladder carcinoma diagnosed and treated in the urology ward in Peja
           in the 2005 – 2009 time period, examination frequency in relation to
           other pathologies. To analyze the incidence , influental factors, diag-
           nostic methodology and comparison of date. Material and methods :
           Diagnostic methods were : history, ultrasound of abdomen and urinary
           bladder, UIV, pelvic CT- scan, bladder cistoscopy, biopsy of the blad-
           der and RTG. Results: During the analyse period, a total of 103 cases
           have been diagnosed with urinary bladder cancer , of wich 83 male/81
           %, - and female 20 / 19 %. Ratio m : f is 4:1 favoring males. Tobacco
           abusers were 70 patient /67.9%. Within a year and average of 20 cases
           were dgainosted. Average year 67 years. The most frequent symptoms
           were: hematuria, dysuric obstacles and lumbar pain. Hematuria was
           present in 80 patients / 77%. Conclusions : The number of patients
           with this carcinoma is increasing in comparison with a research that
           was done several years ago in this department. The relapse rate has
           reduced following therapy. The most frequent intervenation in superfi-
           cial carcinoma is TUR.

           Keywords: salihaj

           Contact authors at: moni_s1@hotmail.com


                                           —196—
      THE IMPORTANCE OF CLINICAL (ONE-DAY) SURGICAL
     TREATMENTS OF INGUINAL, UMBELLICAL, EPIGASTRIC
                 AND INCISIONAL HERNIA




                                                                                 Anatomy
                                                                                 Surgery
  Authors: Aleksandar B. Mitrovic, Nemanja Opacic, Nikola Panic,
  Milan Popivoda


  University: University of Belgrade



ICMS 2011 / PP 17 Surgery
 Abstract:
 Introduction Hernia operations are among the most frequent surgical proce-
 dures performed in General Surgery Departments. The introduction of new
 procedures using prosthetic polypropelene implants has allowed for new
 surgical non-tension techniques to be developed which further allow that
 hernia surgeries are performed in clinical circumstances effectively causing
 very few complications and recurrences. Aim Main objective is to present
 information related to clinical and hospital surgery (surgery duration and
 early and delayed complications), compare them using Hi Square Test and
 establish whether clinical surgical treatments of hernia can satisfy the de-
 mands of traditional hospital surgery of hernia. Methods This case study
 is based on information gathered from the registers of patients surgically
 treated for abdominal wall hernias performed in the 7th Depatment of the
 Institute for Digestive Diseases, Clinical Center of Serbia in the period be-
 tween 2003 and 2009. Results Average duration of clinical hernia surgery
 was 50 minutes, inguinal hernia 82 minutes, umbellical hernia 92 minutes,
 epigastric hernia 76 minutes and post-incisional hernia 147 minutes. Av-
 erage follow up of all clinically treated patients was 17.2 months (1-60),
 compared to 31.2 months for patients treated in hospitals (1-60). The over-
 all occurence of early post-surgical complications after performing clinical
 surgery was 6,5% (26/401). The overall occurence of early post-surgical
 complications after performing hospital surgery was 16% (83/519). The
 overall clinical surgery recurrence was 0% (0/401) and hospital surgery
 0,96% (5/519). Conclusion Based on success parameters consisting of the
 duration of the surgical procedure, early and delayed post-surgical compli-
 cations, the conclusion of this study is that there is no difference between
 the clinical and hospital surgeries of abdominal hernias. Clinical surgery of
 hernia saves medical and economic resources and should therefore, pro-
 vided all technical, medical and social requirements are met, have priority
 over the standard hospital hernia treatment.




Keywords: hernia, clinical (one-day) surgery, hospital surgery, post-surgical
complications
Contact authors at: aleksandarbmitrovic@gmail.com

                                   —197—
             SURGICAL TREATMENT AND MANAGEMENT OF GIANT IN-
                          TRACRANIAL ANEURYSMS
Surgery




           Authors: A. Stratev, S. Mihaylova, M. Milev, A. Ivanova,
           G. Nakov, K.Ninov, D. Ferdinandov, V. Bussarsky

           University: Medical University Sofia




          ICMS 2011 / PP 18 Surgery
           Abstract:
           Introduction Intracranial aneurysms larger than 2,5 cm in diameter are
           classified as giant aneurysms. They represent 3-13% of all intracranial
           aneurysms. Specific characteristics, concerning management include:
           presentation as a tumor; less likelihood to rupture and tendency to en-
           large. They define treatment difficulties such as: thrombosis prevents
           clip application; broadening of the neck can cause involvement of the
           parental or perforating arteries.
           Aim The aim of this study is to present our data, concerning clini-
           cal manifestation, surgical treatment of the giant aneurysms and early
           postoperative outcome.
           Matherial and methods We studied 30 patients (pts) (11 men and 19
           women) for the period 2006 – 2010, diagnosed with giant intracranial
           aneurysm and operated on in the Clinic of Neurosurgery, University
           Hospital “Sv. Ivan Rilski”. We made a retrospective analysis based on
           our data compared to the literature.
           Results The most common symptoms were: headaches (22%), optochi-
           asmatic syndrome (15%), paresis and paralysis (12%), SAH and mass
           effect (9% each), epileptic seizures (8%) and others. CT and MRI were
           the main diagnostic methods (45%), followed by 3D CT-angiography
           (29%) and DSA (26%). The aneurysms were predominantly localized
           on the ICA (56%), MCA (25%) and ACoA (13%). Pterional approach
           was used in 84% of the cases and suboccipital in 4%. In 43% of the
           cases the aneurysms were partially thrombosed, 7% fully and the rest
           presented with no signs of thrombosis. Surgical clipping was achieved
           in 46% and wrapping was done in 29%. Endovascular treatment was
           applied in 6%. The rest 19% of the pts refused or were not indicated for
           treatment. Improvement was achieved in 54% of the pts, 7% of them
           didn’t show any improvement and 39% (11 pts) had complications af-
           ter the operation; 9 of which lead to a lethal end.
           Conclusion Having in mind specific characteristics of the pathology, the
           results indicate that the best surgical approach is pterional and surgical
           clipping is by far the most appropriate mode of treatment. Given the
           high mortality risk, the percentage shown of patients with improve-
           ment is significant.


                                           —198—
   SURGICAL MANAGEMENT OF GROWTH HORMONE-SECRET-
              ING PITUITARY ADENOMAS




                                                                                Anatomy
                                                                                Surgery
  Authors: A. Ivanova, S. Mihaylova, A. Stratev, K. Ninov,
  G. Nakov, A.Hadjiyanev, D. Ferdinandov, V.Bussarsky


  University: Medical University Sofia



ICMS 2011 / PP 19 Surgery
 Abstract:

 Introduction Pituitary adenomas account for 15% of intracranial masses. On
 the other hand, somatotrophic adenomas are 15% of hormone-producing
 pituitary tumors. As a result of growth hormone (GH) secretion, these pitui-
 tary adenomas have a characteristic clinical manifestation. In adults, they
 cause a constellation of symptoms, the most frequent and easily detectable
 of which is acromegaly.
 Aim This study describes the clinical manifestation, assesses the surgical
 management techniques and describes the rates of recurrence of GH-se-
 creting pituitary adenomas.
 Materials and Methods We performed retrospective analysis of 94 cases of
 GH-secreting pituitary adenomas from the Neurosurgery Clinic of University
 Hospital „Sv. Ivan Rilski” between the year 2006 and the year 2010.
 Results The medical records of all 94 patients (55 female and 39 male) were
 analyzed. The peak incidence was 48.4 years for females and 42.5 years
 for males. The most common clinical manifestation was acromegaly – in
 97.9% of cases. Other symptoms were headache – in 53.2% and visual
 impairment – in 36.2%. Of all adenomas, 76.6% were intrasellar, 18.1%
 were intrasellar and suprasellar, 2.1% were intrasellar and parasellar and
 3.2% were intrasellar, suprasellar and parasellar. In 53.2% of cases MRI
 was used as a sole imaging method. Both CT and MRI were used in 46.8%
 of cases. Elevated levels of GH were established in 91.5% of patients. IGF-
 1 elevation was detected in 43.6% of all cases. Transsphenoidal approach
 was used in 93 cases, transcranial approach – only in 1 case. An endoscopic
 inspection was performed in 69.1% of all surgeries. Early postoperative
 improvement of symptoms was visible in 88.3% of cases, 11.7% had no
 recorded early improvement. Short-term postoperative diabetes insipidus
 was established in 5.3% of cases.
 Conclusion Surgical resection of GH-secreting adenomas proved to be a
 successful treatment. In the 5-year period only 3 patients (3.2%) were re-
 admitted due to tumor recurrence. A high percentage (88.3%) of patients
 had early postoperative improvement of symptoms. The progression of ac-
 romegaly was halted.




                                  —199—
             СHRONOTHERAPY IN TREATMENT OF RENAL COLIC IN PA-
                       TIENTS WITH UROLITHIASIS
Urology




           Authors: Ezhned M.A., Zaitsev V.I., Sviatska L.V.



           University: Bukovinian State Medical University



          ICMS 2011 / PP 20 Surgery
           Abstract:

           On the basis of chronorhythmologic peculiarities studied in 40 patients
           with urolithiasis complicated by renal colic (RС) a chronorhythmologi-
           cally substantiated dosage schedule of analgetic and spasmolytic drugs
           has been proposed. After the treatment the number of complications
           diminishes by 70 % and duration of a patient’s staying in the hospital
           by 40,8 %. Objectives. To study the chronorhythmological peculiarities
           of RC for patients with urolithiasis and to compare efficiency of chrono-
           rhythmologic scheme of RC conservative treatment with generally ac-
           cepted scheme. Materials and methods. 110 patients (basic group)
           admitted to the urological department of the regional clinical hospital
           with urolithiasis complicated by RC (female 73%, male 27%) were ex-
           amined. Basic group was divided into two subgroups: first - 90 patients
           received the standard therapy, second - 20 patients were treated ac-
           cording to chronorhythmologic scheme. Results and discussion. RC has
           been proved to have clear chronorhythmological peculiarities: majority
           of patients presented RC between 3 a.m. and 4 a.m. (35%) contrary
           to 5% of RC between 6 a.m.and 2 p.m. The majority of patients with
           maximal point according to VAS (8-10) was observed at night hours.
           According to these facts we suggested the chronorhythmologic scheme
           of RC conservative treatment. The drugs with different pharmacologic
           properties were used to prevent RC relapse and its complications. We
           introduced drugs at 6, 9 and 12 p.m. According to this scheme 20 pa-
           tients were treated. An average staying in the hospital was 7,2 days,
           that is 40,8% less than in case of standard scheme, which lasted 12,4
           days. The complication rate decreased to 8% and RC relapse – to 18%.
           Due to that we redused the amount of drugs administered and the cost
           of RC treatment.




           Keywords: urolithiasis, renal colic, chronorhythms, chronotherapy, pharma-
           coeconomics.
           Contact authors at: mariyaejned@mail.ru


                                            —200—
 Abstracts
Tharapy Oral
  Session I
 Abstracts
Tharapy Oral
  Session I
   DIGITAL ANALYSIS OF THE COLOUR M-MODE EARLY DIA-
  STOLIC LV FLOW - AN INVASIVE AND ECHOCARDIOGRAPH-
             IC STUDY OF DIASTOLIC SUCTION




                                                                                                Cardiology
                                                                                                 Anatomy
  Authors: Busnatu S.S. , Dr. Paun N., Prof. Dr. Nanea T




  University: Carol Davila Bucharest


ICMS 2011 / OP 01 Therapy
 Abstract:
 INTRODUCTION:The protodiastolic filling is governed by the intraventricular gradient,
 developed between the base and the apex of LV as a result of elastic recoil (diastolic
 suction phenomenon = DS). Studies of DS demonstrated the relationship between
 the myocardial contraction and the protodiastolic filling (between systole and dias-
 tole). Until now, DS has been studied invasively on animals. AIMS: find a noninvasive
 method for studying the DS by assessing the early diastolic intraventricular pressional
 gradients; thus we conceive a software for the off line analysis of the protodiastolic fill-
 ing flow obtained at Colour M-Mode. MATERIALS AND METHOD: 1 - We used a Hewlett
 Packard Sonos 1500 echocardiograph. The 4 C and 2C images were acquired with a
 2.5 MHz array probe; we selected the early diastolic flow imagines at Colour M-Mode.
 The sections were made through the middle of the filling tract along the line connect-
 ing the center of the mitral annulus with the LV apex. The images obtained were then
 converted to bmp files. The Colour M-Mode images are chosen because they depict the
 velocity of erythrocytes in connection with time and space, parameters used in cal-
 culating the pressional gradients with the Navier-Stokes equation (which governs the
 three-dimensional flow of incompressible fluids). By simplifying this equation we got
 the unidimensional Euler s equation which, after integration along a direction of blood
 flow from base to apex, allowed non-invasive estimation of the pressional differences.
 The 30 normal subjects, age 54 + / - 12 years, 62% men were examined echocar-
 dio-graphicaly (clinical examination, resting and exercise ECG, echocardiography,all
 normal). Thus, were calculated: relative pressures (RP) at any point within the early
 diastolic flow; pressure differences between the base and apex (SG= suction gradi-
 ent); the delay time (TIPmin=the time interval between the moments of minimum
 pressures at the base and the apex. 2 - In order to evaluate the new method, the
 cardiac catheterization was performed – gold standard for haemodinamical measure-
 ments - and then the results from both methods were compaired. RESULTS: Showed
 no statistically significant differences between the two methods. RPbase 3.72 + / - 0.8
 mmHg at cardiac catheterization and 3.36 + / - 1,2 mmHg (p >0.01); RPapex 1.27 +
 / - 0.32 mmHg respectively 1.04 + / - 0.38 mmHg (p > 0.01), SG was 3.25 + / - 0.7
 mmHg, respectively 3.32 + / - 0.8 mmHg (p > 0.01), and TIPmin was 38 + / - 4 ms
 compared to 38 + / - 5 ms (p > 0.05). CONCLUSIONS: The noninvasive estimation of
 pressure gradients and the time indexes using a digital analyzing of the early diastolic
 Colour M-Mode flow with an off line special software, designed for this purpose, proved
 to be as good as the invasive method in studying the complex phenomenon that char-
 acterize the heart function.




Keywords: gradients, diastolic suction
Contact authors at: busnatustefan@yahoo.com


                                         —203—
                COMPARISON OF N-TERMINAL PRO B-NATRIURETIC PEP-
                TIDE AND ECHOCARDIOGRAPHIC INDICES IN PATIENTS
                          WITH MITRAL REGURGITATION
Cardiology




              Authors: Shokoufeh hajsadeghi , Niloufar Samiei , Masoud
              Moradi,Maleki Majid, Ladan Kashani, Afsaneh Amani, Arezoo
              Salami,Melika Assefi,Negin Farsi

              University: Tehran University of Medical Sciences



             ICMS 2011 / OP 02 Therapy
              Abstract:

                 Introduction Echocardiographic indices can form the basis of the
              diagnosis of systolic and diastolic left ventricular (LV) dysfunction
              in patients with Mitral regurgitation (MR). However, using echocar-
              diography alone may bring us to a diagnostic pitfall. The aim of this
              study was to compare N-Terminal pro B-natriuretic peptide (BNP)
              and echocardiographic indices in patients with mitral regurgita-
              tion. Methods: 2D and Doppler echocardiography and BNP serum
              level were obtained from 54 patients with organic mild, moderate
              and severe MR. Results BNP levels were increased with symptoms
              in patients with mitral regurgitation (NYHAI: 5.7±1.1, NYHAII:
              6.9±1.5, NYHAIII: 8.3±2 pg/ml, P<0.001).BNP plasma level were
              significantly correlated with MPI(myocardial performance index)
              (r =0.399, P = 0.004) , and following echocardiographic indices:
              LVEDV (r = 0.45, P < 0.001), LVESV (r = 0.54, P < 0.001), LVEDD
              (r = 0.48, P < 0.001), LVESD (r = 0.54, P < 0.001),dp/dt (r =
              -0.32, P = 0.019) and SPAP(r = 0.4, P = 0.006). Conclusion The
              present study showed that BNP may be useful in patients with MR
              and may confirm echocardiographic indices.




              KKeywords: N-Terminal pro B-natriuretic peptide, echocardiographic indices,
              mitral regurgitation
              Contact authors at: melika_assefi@yahoo.com


                                               —204—
   BLOOD SUPPLY OF HEART VALVES IN NORM AND AT AC-
  QUIRED VALVULAR DISEASES OF INFAMMATORY GENESIS




                                                                                   Cardiology
                                                                                    Anatomy
  Authors: L.Y. Fedoniuk, T.A.Semenyuk, O.V. Vaskan



  University: Bukovinian State Medical University



ICMS 2011 / OP 03 Therapy
 Abstract:
 Introduction. The vascularity ratio of heart valves in norm and at acquired
 valvular diseases is dependent on patient’s age, pathological process and
 morphological peculiarities of cardiac valves. Aim. To determine features of
 blood vessels changes in heart valves at acquired valvular diseases of in-
 flammatory genesis. Data and methods. The research is made on 885 heart
 valves. The macroscopic, microscopic and immunohistochemical methods
 were used. Results. Investigations of heart valves in norm was detected
 that cusps of atria-ventricular valves had blood vessels in 24% cases. Ves-
 sels pass into cusps accompanied by striated cardiac muscle fibers. In the
 bases of cusps essentially the grate arterial and venous blood vessels were
 placed. They made branches of narrow loops of capillary network. In aortic
 valve was detected that vessels are small in diameter. Short branches of
 vessels were finished by irregularly shaped loops of capillaries in the base
 of cusp and didn’t penetrate into the free part of it. At the investigation of
 heart valves in patients with acquired valvular diseases of inflammatory
 genesis the blood vessels were found in 73% cases. The determined blood
 vessels in heart valves were differ each other in diversity of histological
 structure of their wall. The thin-walled and thick-walled arteries were visu-
 alized among them. Some blood vessels were with fibrosis without signs
 of tissue activity, in other were determined signs of hyperemia, leukocyte
 infiltration and proliferation of blood vessel wall elements. The thickening
 of wall is because of fibromuscular proliferation with following tunica intima
 fibrosis and tunica media hypertrophy. These changes are accompanied by
 perivascular fibrosis. The leukocyte infiltration of blood vessels and perivas-
 cular spaces were represented by macrophages, lymphocytes and polymor-
 phic-nucleated leukocytes. Summary. The amount of blood vessels in cusps
 of valves increases at pathology. This gives rise for researchers the ability
 insist that, in norm the amount of blood vessels in cusps of valves is low.




Keywords:Heart valves, morphology, blood supply

Contact authors at: Fedoniuk.Larysa@bigmir.net

                                   —205—
                 ELECTROCARDIOGRAPHIC PATTERNS REVEALING CORO-
                 NARY REPERFUSION IN PATIENTS WITH ST-ELEVATION
                 MYOCARDIAL INFARCTION RECEIVING THROMBOLYTIC
                    THERAPY. DATA FROM THE RO-STEMI REGISTRY.
Cardiology




              Authors: Maria BERECHET ,Gabriel TATU-CHITOIU, Ana – Maria
              CIOROIU


              University: UMF CAROL DAVILA BUCURESTI



             ICMS 2011 / OP 04 Therapy
              Background. Decreasing of the ST-segment elevation by more than 50%
              from the initial value is a well-known noninvasive criteria of reperfusion
              in patients (pts) with ST-elevation myocardial infarction (STEMI) receiv-
              ing thrombolytics. Objective. To assess and classify the QRS-ST-T patterns
              in thrombolysed STEMI pts showing ECG criteria of reperfusion. Methods.
              The Romanian registry for STEMI enrolled 19510 pts between 1.01.1997–
              31.12.2009. This study was performed on 1608 consecutive STEMI pts with
              thrombolysis within the first 12 hours after the STEMI onset and showing
              non-invasive criteria of reperfusion as follows: 1. rapid cessation of the
              chest pain; 2. decreasing of the ST-elevation by more than 50% within
              the first 180 min. after the onset of thrombolysis; 3. rapid increase of the
              CK-MB with a peak within the first 12 hours after thrombolysis. ECGs were
              recorded before the onset of thrombolysis and every 15 min. for the next
              180 min. Results. three ECG patterns were seen in pts showing ECG criteria
              of reperfusion according to the development of the Q wave: 1. without Q
              wave (216 pts, 13.43%); 2. rapid development of the Q wave within the
              first 180 min. after thrombolysis (81.40%); 3. Late development (after 24
              hours) of Q wave (77 pts, 4,78%). Pattern 3 was only seen in pts with in-
              ferior STEMI. Inside of each pattern we identify two sub-patterns according
              to the behaviour of the T wave: a. T wave became negative; b. T wave re-
              mained positive. As consequence the complete classification of the ECG pat-
              terns suggesting reperfusion were: Pattern 1a: 116 pts. 7.21%; 1b: 106,
              6.59% pts; 2a: 868 pts, 53.98%; 2b: 441 pts, 27.42%; 3a: 53 pts, 3.29%;
              3b:24 pts, 1.49%). Conclusion. Although the ST-segment decreasing by
              more 50% is the common denominator suggesting a successful coronary
              reperfusion, the ECG behavior is not homogenous. In more than 86% of
              pts. the Q wave also appears either early (81.40%) or late (4,78%). The T
              wave becomes negative in 64.50% and remains positive in 35.50% of pts.
              The assessment of the prognostic significance of the different ECG patterns
              revealing reperfusion needs a larger number of patients.




              KKeywords: ST-elevation myocardial infarction ,Thrombolysis, Reperfusion

              Contact authors at: mariah0687@yahoo.com


                                               —206—
  EFFICACY OF CARDIAC INVESTIGATIONS IN CONFIRMING
                  CARDIAC SYNCOPE.




                                                                                    Cardiology
                                                                                     Anatomy
  Authors: Simran Chaudhri, Sarneet Singh, Shiama Balendra,
  Abdul-Majeed Salmasi.


  University: Imperial College



ICMS 2011 / OP 05 Therapy
 Abstract:
 Introduction: Syncope is a transient loss of consciousness that is followed
 by spontaneous recovery. It accounts for a significant number of emer-
 gency and hospital admissions. Cardiology clinics often receive referrals of
 patients with syncopal or pre-syncopal (feeling faint/dizzy) episodes. Aims:
 We aim to investigate the efficacy of cardiac investigations in confirming
 true syncope. Methods: The records of consecutive 56 patients referred
 from a general practioner with the criterion of “syncope” to a single com-
 munity cardiology clinic over a period of 12 months were retrospectively
 studied. Patients underwent full clinical examination, resting ECG, echocar-
 diography and Holter monitoring. Results: Only 55% of the patients report-
 ed true syncope while the rest (n=25) reported only pre-syncopal episodes.
 Left ventricular hypertrophy (LVH) was found to correlate with true syncope
 (p>0.05). Of those patients presenting with syncope, 80% had echocar-
 diography-identifed LVH versus 50% of those who had presyncope. Holter
 monitoring did not reveal more rhythm abnormalities in patients presenting
 with syncope than pre-syncope. However 75% of the patients having Holter
 abnormalities also had echo-identified abnormalities. The majority (73%) of
 patients with LVH had hypertension. 88% of patients with hypertension and
 LVH were receiving antihypertensive medications. No significant differences
 were found in the ECG abnormalities or echo-detected dilated left atrium
 between the patients presenting with syncope and those presenting with
 pre-syncope. Conclusion: Resting ECG and Holter monitoring were equally
 abnormal in patients with true syncope and those with pre-syncope. The
 echocardiographic finding of LVH was more common in patients presenting
 with syncope than those with pre-syncope. Adverse effect of antihyperten-
 sive medications in patients with LVH is one potential explanation of these
 results. Echocardiography should be conducted in all patients presenting
 with cardiac syncope. Additionally, GPs should only refer patients as having
 syncope if there is LoC. Referral should be within 24 hours to a cardiac cen-
 tre in the presence of risk factors. Patients with no risk factors and histories
 suggestive of alternative diagnoses are often inappropriately referred to the
 cardiology clinic.


Keywords:Syncope, Echocardiography, Holter, ECG

Contact authors at: sib09@ic.ac.uk

                                    —207—
                DIFFIRENTIAL DIGNOSIS BETWEEN TAKOTSUBO CARDIO-
                      MYOPATHY AND MYOCARDIAL INFARCTION
Cardiology




              Authors: Zornitsa Shomanova



              University: Trakia University Stara Zagora



             ICMS 2011 / OP 06 Therapy
              INTRODUCTION: Acute myocardial infarction (AMI) is a syndrome, which
              is a result of a sudden interruption of the blood flow in some of the coro-
              nary arteries and leads to ischemic necrosis of the myocardium. The clinical
              presentation of Takotsubo cardiomyopathy (TC) is very similar to the clinical
              presentation of myocardial infarction, but the difference is the absence of
              occluded coronary arteries and the most important thing – this cardiomyo-
              pathy is transient: there is no evidence of organic leasion after the acute
              phase has passed. In opposite to myocardial infarction, of which the ethi-
              ologic risk factors and pathophysiologic mechanisms are well known, the
              ethiology of TC is unknown and the pathophysiologic mechanisms are only
              supposed. The factors stress, sex and catecholamine are supposed to play
              an important role in this syndrome. The clinical presentation of AMI and TC
              is almost alike – sudden onset, chest pain and dyspnea. The most impor-
              tant diagnostic measures in order to differentiate correctly the two patholo-
              gies with almost identical clinical presentation, are echocardiography and
              angiography. They show the pathognomonic mark of TC – the ballooning
              of the heart apex as well as the absence of occluded coronary arteries by
              angiography. Also in TC there are only light to moderate elevation of tro-
              ponins and the ECG changes normalize promptly. AIM: This presentation
              is meant to direct student’s and doctor’s attention to a rare syndrome that
              causes difficulties in distinguishing it from a very serious disease like AMI.
              CONCLUSION: To distinguish TC from AMI is not only important for the
              physicians, who have to diagnose and treat the disease right, but also for
              the patients and their mental wellbeing. The diagnosis myocardial infarction
              is very stressful to the patient but not always right. When TC is diagnosed
              correctly and the patient knows, that this is a transient disease, and that
              there will be no organic changes on their heart so there is no necessity to
              take any medication after the patient leaves the hospital, the patient will be
              calmed more easily and be able to recover much faster.




              Keywords:Takotsubo cardiomyopathy, myocardial infarction, differential
              diagnosis
              Contact authors at: zshomanova@hotmail.com


                                                —208—
   ACUTE MYOCARDIAL INFARCTION AFTER CORONARY RE-
  VASCULARISATION IN PATIENTS WITH HYPERCHOLESTER-
                       OLEMIA




                                                                            Cardiology
                                                                             Anatomy
  Authors: Tatjana Lukic, Dragan Opacic, O. Bojovic, N. Santrac,
  A. Mitrovic, N. Banjanin, A. Bogicevic, B. Naumovic, Z. Gara-
  binovic, Lj. Jovanovic, H. Denc, I. Jovanovic, M. Jovanovic, dr
  Predrag Mitrovic

  University: University Of Belgrade


ICMS 2011 / OP 07 Therapy
 Abstract:
 Introduction: It is well known that the long-term fate of bypass
 vein grafts is principally determined by graft atherosclerosis. The
 process appears related to coronary risk factors (smoking, hy-
 pertension, hyperlipidemia, diabetes mellitus, obesity and family
 history). The Aim: The aim of this study was to analyze differ-
 ences between acute myocardial infarction (AMI) in patients with
 and without hypercholesterolemia after previous coronary artery
 bypass grafting (CABG). Materials and methods: In 6-year follow-
 up period, we analyzed 160 patients (pts) divided in two groups.
 The first group was consisted of 34 pts with hypercholesterolemia
 and AMI after prior CABG and control group of 126 pts without
 hypercholesterolemia and with AMI after prior CABG. The pts with
 early perioperative AMI were excluded from the study. Results:
 There was no difference in age, gender, risk factors for coronary
 disease, CABG-AMI interval, preadmission medications, infarct size
 and non-Q wave infarction. Prior AMI had 44.1% pts in group with
 hypercholesterolemia vs 32.5% pts in control group (p=0.0006).
 Patients in examined group had more often post CABG angina pec-
 toris (67.6% vs 36.5%, p=0.0011), anterior (61.8% vs 30.2%,
 p=0.0007) and inferior (35.3% vs 54.8%, p=0.0439) myocardial
 infarction. Patients with hypercholesterolemia had more often 2-
 and 3-vessel disease (p<0.01). Conclusion: Hypercholesterolemia
 independently related to increased coronary disease. Patients with
 hypercholesterolemia have more mulivessel disease than pts with-
 out hypercholesterolemia, and they have high risk for a poor out-
 come in acute myocardial infarction after coronary artery bypass
 grafting.



Keywords: acute myocardial infarction, revascularization, hypercholester-
olemia, prognosis
Contact authors at: d.opacic@ymail.com

                                  —209—
                DYNAMICS OF CATECHOLAMINE-BINDING PROPERTY OF
               ERYTHROCYTES IN PATIENTS WITH DIFFERENT FUNCTION-
                AL CLUSTERS OF ERYTHROCYTES AND GLUCOSE METABO-
                                  LISM PROFILES
Cardiology




              Authors: Mikhaliev K.O., Kolomoiets M.Yu., Chursina T.Ya.,
              Tkach I.P., Suprun L.M.


              University: Bukovinian State Medical University



             ICMS 2011 / OP 08 Therapy
              Introduction. Functional properties (FP) of erythrocyte (E) membrane, such
              as catecholamine binding (CBP), play important role in microcirculatory dis-
              turbances in patients (pts) with arterial hypertension (H), ischemic heart
              disease (IHD) and disorders of glucose (G) metabolism, including diabetes
              mellitus type 2 (DM2). Lack is known about CBP depending on E and G me-
              tabolism profiles, which could reflect prognostic heterogeneity of H/IHD pts.
              Aim of study was to determine dynamics of CBP in H/IHD pts with different
              E functional clusters and G metabolism profiles (normal fasting G (NFG),
              elevated fasting G (EFG), impaired G tolerance (IGT) and DM2). Methods.
              We enrolled 86 male pts with H/IHD (mean age 60±9 y) and different G
              metabolism profiles: NGF (n=48), EFG (n=5), IGT (n=15) and DM2 (n=18).
              FP E (ratio of deformability (DI) and viscosity indexes (VI) and CBP were
              measured according to standards and expressed in units (U). Data are ex-
              pressed as median (Me) with range and analyzed by non-parametric meth-
              ods with p-value < 0,05 to be considered statistically significant. Pts were
              stratified according to FP E profile (above or lower Me of DI/VI) and glu-
              cose metabolism profile (with or without metabolic disturbances (MD) and
              divided into 4 groups (GR): GR1 (FPE above Me without MD, n=17); GR2
              (FPE above Me with MD, n=26); GR3 (FPE lower Me without MD, n=23)
              and GR4 (FPE lower Me with MD, n=20). Results. Cohort mean vale of DI/
              VI 0,44 (0,28-0,70) determined the division of pts into clusters with better
              and worse FP of E. CBP was significantly higher in GR4 comparing with GP1,
              2 and 3: 205,0 (150,8-243,2); 267,9 (196,4-351,8); 305,5 (214,6-332,2)
              and 286,0 (191,2-344,1) U respectively (p < 0,05). Conclusion. CBP is
              reduced in H/IHD pts with worse FPE and G metabolism disturbances. This
              prognostic unfavorable cohort requires performing of correction of FP of E
              membrane in order to improve microcirculation.




              Keywords: Catecholamine, erythrocyte, glucose, metabolism

              Contact authors at: mihalevk@gmail.com


                                                —210—
  BLOOD VESSELS GEOMETRY AND THE FORMATION OF ATH-
                 EROSCLEROTIC SPOTS




                                                                                             Cardiology
                                                                                              Anatomy
  Authors: Oxana Barsukova, Ivan Golovko, Dmitry Sivakov, Nikita
  Bagrov


  University: Gomel State Medical University



ICMS 2011 / OP 09 Therapy
 Abstract:
 Introduction. Atherosclerosis is one of the principal reason for people death but still
 there is no a sole theory that describe all aspects of this disease. There are different
 approaches to origin of atherosclerosis. Among them there is a theory that takes the
 trauma of blood vessels walls as the main factor of atherosclerotic spots formation.
 This theory is supported by physical postulates. According to the laws of hydrodynam-
 ics the alteration in the direction of blood stream is responsible for blood pressure de-
 pression. Such a depression initiates some swirling that is the main reason for vessels
 trauma. The damaged walls are the areas with the high risk of atherosclerotic spots
 growth. The aim of our investigation was to prove the main statements this theory
 using both hydrodynamic calculations and experimental data about cholesterol and
 calcium content in atherosclerotic spots. Materials and methods. We developed two
 models of a blood system that differ in their geometry. In the first model the angles
 under which the vessels branches from aorta were in the range 20-600, in the second
 model – 60-900. In order to appreciate the peculiarity of blood stream at branched
 points we used the hydrodynamics laws to calculate the depression of blood pressure
 at them. Vasebach’s, Darsi’s and Borda’s equations were applied to compute the in-
 crease in resistance to blood flow at the branch points. The determination of choles-
 terol and calcium content in atherosclerotic spots were produced in colloidal solutions
 prepared by spots ultra sonic degradation method. Cholesterol concentrations were
 measured by enzymatic photometry and calcium concentrations – by comlexonometric
 titration. Discussions. The hydrodynamic calculations proved that the small values of
 blood pressure depression corresponded to the small branched angels while the larger
 values of blood depression were initiated by larger angels. Thus at the point of aorta
 bifurcation the blood pressure depression is 11 mm in model 1 and 15 mm in model 2.
 In kidney arteries the values of depressions were 7 and 9 mm in model 1 and model
 2 respectively. The content of cholesterol and calcium in spots was sufficiently higher
 in model 2 in comparison with model 1. For example, in kidney arteries cholesterol
 level was 25.5 % in model 2 and only 9.97 % in model 1. The same relationship was
 determined for calcium level: 1.14% in model 2 and only 0.9 % in model 1. The ob-
 tained data revealed that the growth of atherosclerotic spots with the high content of
 cholesterol and calcium corresponded to the segments of blood vessels distinguished
 by a sufficient blood pressure depression. Conclusion. The combined data received by
 hydrodynamic calculations and experimental determination of cholesterol and calcium
 in atherosclerotic spots proved a linkage between geometry of blood vessels and prob-
 ability of these spots formation.




Keywords: Atherosclerosis, hydrodynamic calculations, models of a blood
system
Contact authors at: shulgali@tut.by

                                        —211—
                 CONTRAINDICATION FOR THE USE OF AESTHETIC PROCE-
                        DURES IN DIFFERENT SKIN DISEASES
Dermatology




               Authors:      B. Kamoona ; J. Kazandjieva



               University: ALEKSANDROVSKA UNIVERSITY HOSPITAL



              ICMS 2011 / OP 10 Therapy
               Abstract:

               The skin diseases contraindicated(contr.) for aesthetic procedures(A.P.)
               could be divided in three groups:1. skin diseases contr. for every A.P. 2. skin
               diseases with contr. for one or more A.P. 3. skin diseases with contraversial
               relation to aesthetic treatment.Some skin diseases are postulated as contr.
               for all A.P. To this group belonged almost all infectious diseases like herpes,
               shingles, impetigo, and intertrigo. Not so well known contr. for dermabra-
               sion, chemical peels and laser resurfacing are skin diseases with expressed
               Koebner phenomenon like psoriasis and lichen planus. After the aforemen-
               tioned procedures patients with rosacea, seborrheic dermatitis and atopic
               dermatitis may be at an increased risk for postoperative complications. A
               question that has given rise to much controversy is the laser treatment of
               heamangiomas. Controversy also play a pivotal role in the light and laser
               therapy for acne. The awarness of the contr. for the application of the A.P.
               will help overcoming the preventable complications of thier use.




               Keywords: aesthetic procedures, contraindication, skin diseases

               Contact authors at: kamouna_ban@yahoo.com


                                                 —212—
     OBSERVATIONS UPON FLUORESCENCE DIAGNOSIS OF
              NONMELANOMA SKIN CANCER




                                                                                  Dermatology
                                                                                   Anatomy
  Authors: S. Kavaklieva, A. Stoimenov, L. Miteva



  University: Medical University of Sofia



ICMS 2011 / OP 11 Therapy
 Abstract:
 Abstract Basal cell carcinoma (BCC) is one of the most frequent malignan-
 cies in the general population. Its best treatment option is the complete
 excision of the lesion. BCCs frequently extend beyond their visible borders.
 Therefore, the goal of surgical therapy is to eradicate both clinically appar-
 ent tumor and its microscopic extension into the surrounding normal-ap-
 pearing skin. The most accurate technique of determining the actual extent
 of skin cancer is through the use of Mohs micrographic surgery. However,
 the method is labour intensive, time consuming and costly. The need for
 complementary non-invasive techniques for detection and accurate demar-
 cation of BCC at an early stage is increasing. Apart from non-invasive high
 resolution skin imaging techniques in vivo, such as dermatoscopy, optical
 coherence tomography and high frequency ultrasound, fluorescence-based
 techniques can be exploited for non-invasive diagnostic purposes and pre-
 operative planning in the management of nonmelanoma skin cancers. The
 main indications of fluorescent diagnosis (FD) are the delineation of clini-
 cally ill-defined skin tumors and the control of the efficacy of other tumor
 therapies. In convntional FD the naked eye and a Wood lamp are used as a
 simple light source that is an invaluable tool in practice of dermatology. We
 evaluated 64 patients with nonmelanoma skin cancer including basal cell
 carcinoma (n=57, 38.3%), squamous cell carcinoma (n=5, 3.4%), Bowen
 disease (n=2, 1.3%) and 1 patient with seborrheic keratosis. Most of the
 tumors were located on the face (n=35, 23.5%) and were of nodular clinical
 type (n=19, 12.8%). All of the tumors showed red fluorescence after aplica-
 tion of ?-aminolevulinic acid under occlusion for 3-4 hours and irradiation
 with Wood’s light (UV A, 365 nm). Most of the tumors showed fluorescence
 according to the clinical borders (n=57, 88%), two of the basal cell carcino-
 mas showed fluorescence beyond the clinical margins (n=2, 3%), and some
 of the tumors with clinically ill-defined borders were well delineated by red
 fluorescence (n=4, 6%). Squamous cell carcinomas showed less intensive
 fluorescence (n=2, 3%). FD is a new and promising diagnostic tool for de-
 lineation of tumor borders in order to plan a surgical excision as well as to
 control previous treatment option.


Keywords: fluorescence diagnosis, nonmelanoma skin cancer

Contact authors at: kavaklieva@gmail.com

                                   —213—
                PSORIASIS ASSOCIATED WITH VITILIGO – TWO CLINICAL
                                     CASES
Dermatology




               Authors:      I.Grozdev, I. Dencheva, I. Botev, E. Petrova, L. Miteva



               University: Medical University of Sofia



              ICMS 2011 / OP 12 Therapy
               Abstract:

               Psoriasis and vitiligo are common dermatoses that occur in 1-3% of the
               general population, respectively. There have been several reports of the
               concurrence of these diseases in the literature. We report two clinical cases
               of coexisting psoriasis and vitiligo and discuss the pathogenic realation-
               ship between the two diseases. The first patient was 60-year-old man with
               4-year history of psoriasis. His vitiligo first appeared in early childhood.
               The second patient was 60-year-old man having suffered from psoriasis
               for more than 35 years. His vitiligo developed 10 years later on the sites
               of his psoriasis lesions. For their psoriasis both patients were treated with
               phototherapy, topical corticosteroids, dithranol, and emollients with good
               therapeutic response. We reviewed the literature for reports on coexistence
               of the two diseases and studies suggesting their common pathogenic rela-
               tionship. Coexisting psoriasis and vitiligo is not an unusual phenomenon.
               Cytokines such as tumor-necrosing factor alpha (TNF-alpha) may play a
               key role in the pathogenesis of the coexistence of the two diseases. Further
               investigations should be done to determine whether each disease is inde-
               pendent or if they both have a common pathogenesis.




               Keywords: psoriasis, vitiligo

               Contact authors at: igrozdev77@gmail.com


                                                 —214—
             CHILDHOOD PSORIASIS – A CLINICAL CASE




                                                                                Dermatology
                                                                                 Anatomy
  Authors: I. Dencheva, I. Grozdev, I. Botev, E. Petrova, L. Miteva



  University: Medical University of Sofia



ICMS 2011 / OP 13 Therapy
 Abstract:

 Psoriasis is a common dermatosis in children with about one third of all
 patients having onset of disease in the first or second decade of life. We
 report a clinical case of childhood psoriasis and discuss the clinical and
 therapeutic aspects of the disease in children. We present a 16-year-old
 male patient with guttate psoriasis. He has been treated with 16 sessions of
 selective UV phototherapy with a good therapeutic effect. Topical combina-
 tion calcipotriol/betamethasone dipropionate ointment has been used for
 maintenance therapy. Childhood psoriasis is a special challenge to derma-
 tologists. Management of these patients has to include effective and safe
 therapeutic modalities, supportive care and consider quality of life issues
 like psychological stigmas.




Keywords: psoriasis, children

Contact authors at: iv.dencheva@abv.bg

                                  —215—
                 MYCOSIS FUNGOIDES IN A MALE PATIENT WITH 12-YEAR
                                    REMISSION
Dermatology




               Authors: K. Prisadashka, M. Balabanova, I. Botev, E. Petrova, I.
               Grozdev, L. Miteva

               University: Medical University of Sofia




              ICMS 2011 / OP 14 Therapy
               Abstract:

               Mycosis fungoides is the most common cutaneous T-cell lymphoma and
               represents about 50-60% of all cutaneous lymphomas. It occurs more fre-
               quently in men than in women (male-to-female ratio of 2:1) and it is more
               common in black than in white patients (incidence ratio = 1.6). We present
               a 76-year-old male patient who has had history of atopic dermatitis for a
               long time. In 1998 the patient presented with erythoderma. The skin bi-
               opsy at that time revealed mycosis fungoides. Methotrexate therapy was
               administered for 6 months leading to 12-year clinical remission maintained
               with topical agents. In 2010 the patient presented with infiltrated erythe-
               matous plaques in axillar and inguinal folds, and extensor areas of upper
               extremities. Neither lymphadenopathy nor evidence of Sezary’s cell in pe-
               ripheral blood were detected. Immunohistochemical verification confirmed
               diagnosis of mycosis fungoides. After clinical, histological, and immunohis-
               tochemical investigation, IB stage of mycosis fungoides was determined.
               Non-aggressive treatment with phototherapy and emollients was initiated.
               Mycosis fungoides is a cutaneous T-cell lymphoma that should be clinically,
               histologically, and immunohistochemically verified. This would determine its
               appropriate staging and treatment.




               Keywords: mycosis fungoides, methotrexate

               Contact authors at: kamelia_prisadashka@abv.bg


                                                —216—
  SKIN MANIFESTATIONS OF HYPER-IGE SYNDROME – HINTS
               FOR A TIMELY DIAGNOSIS




                                                                                   Dermatology
                                                                                    Anatomy
  Authors: Semkova K, Petrova E, Botev I, Grozdev I, Miteva L



  University: Medical University of Sofia



ICMS 2011 / OP 15 Therapy
 Abstract:

 Hyperimmunoglobulin E syndrome (HIES), also known as Job’s syndrome,
 is a rare immunodeficiency that presents clinically with triad of recurrent
 skin and pulmonary infections, elevated IgE and eczematous reactions.
 Other abnormalities, including a distinctive facial appearance, fractures fol-
 lowing minor trauma, scoliosis, hyperextensive joints, and the retention of
 deciduous teeth are also observed in most patients. The clinical features
 develop gradually over the years. Timely diagnosis is important as these pa-
 tients necessitate close monitoring for potential musculoskeletal abnormali-
 ties and chronic prophylaxis with antibiotics. Atopic-eczema like dermatitis
 with an onset in the newborn period is common and usually the earliest
 presenting feature of the disease. Staphylococcus aureus infection and ab-
 scesses follow the eczema and appear in early childhood. The initial pres-
 entation could also be a non-specific papulo-pustular eruption distributed
 on the scalp, face, neck, axillae and diaper area. In most cases patients are
 misdiagnosed as having other skin conditions and mistreated accordingly.
 The wide spectrum of findings calls for a multidisciplinary approach and
 all involved specialists, including dermatologists, infectologists, ortopaedics
 specialists, surgeons and dentists, should be familiar with the set of skin
 presentations in order to make a timely diagnosis. We report a case of HIES
 seen and followed-up at our clinic and review the current literature with
 an emphasis on early detection and interpretation of cutaneous signs and
 symptoms as specific diagnostic markers. Recognition and understanding of
 these early skin manifestations of hyper-IgE syndrome could ensure earlier
 diagnosis and hence an institution of adequate treatment and prophylactic
 measures..




Keywords: hyper-IgE syndrome, atopic eczema-like dermatitis, markers for
early diagnosis
Contact authors at: kristina_semkova@yahoo.com

                                   —217—
                   TWO CASES OF EPIDERMOLYSIS BULLOSA ACQUISITA
Dermatology




               Authors: Karen Manuelyan, Kossara Drenovska, Snejina Vassi-
               leva


               University: Medical University of Sofia



              ICMS 2011 / OP 16 Therapy
               Abstract:

               Epidermolysis bullosa acquisita (EBA) is a very rare autoimmune
               bullous disease of the skin and mucous membranes. Its incidence
               in Europe is 0.2/million/year. Clinically EBA is characterized by blis-
               ters, scars and milia formation primarily at the trauma-prone ar-
               eas. The immunological feature of EBA is the presence of IgG and,
               less often, IgA autoantibodies against type VII collagen, the main
               component of anchoring fibrils that connect the lamina densa to the
               papillary dermis. Autoantibodies together with trauma or other fac-
               tors contribute to subepidermal blister formation. We present two
               women aged 77 and 80 years, who were admitted to the dermatol-
               ogy department on the very same day with previously undiagnosed
               skin disorders which showed very similar clinical features. These
               included scattered bullae and erosions on the trunk and extremi-
               ties, as well as large solitary medallion-like erythematous macules
               with milia within their borders in the presternal area. Histological
               and immunofluorescent examination of biopsy specimen and serum
               lead to the diagnosis of EBA in both cases. Having in mind the low
               incidence of EBA it was almost an improbable coincidence to diag-
               nose two people with this extremely rare disease on the same day.




               Keywords: epidermolysis bullosa acquisita, law of series

               Contact authors at: klm_derm@yahoo.com


                                                —218—
  A CLINICAL STUDY OF ERYSIPELAS - CLINICAL FEATURES,
  EVOLUTION AND COMPARATIVE CHARACTERISTICS OF THE
          DISEASE OF DIFFERENT LOCALIZATION




                                                                          Dermatology
                                                                           Anatomy
  Authors: I. Yungareva, K. Semkova, S. Marina



  University: Medical University of Sofia



ICMS 2011 / OP 17 Therapy
 Abstract:

 Research of 686 patients with erysipelas diagnosed during a 5-year
 period at a University dermatology clinic in Sofia is presented. There
 is a significant increase the proportion suffering from erysipelas
 occurred in older individuals: 42% for 2005 and 66.6% for 2010
 are diseased over 60 years of age. Chronic and recurrent forms of
 erysipelas increased from 14.4% to 33.1%. There is a decrease
 of primary erysipelas of 63.0% to 41.4%. Localization of the ery-
 sipelas was observed predominantly in lower limbs. Erythematous
 local forms of erysipelas were predominating. There is a tendency
 towards an increase in hemorrhagic forms almost 2 times including
 primary erysipelas. The incdence of complications such as abscess,
 phlegmon, lymphostasis has increased more than 2 times. Patients
 with moderate form of erysipelas are 45%, of them 28% lower ex-
 tremities. Erythematous-bullous and bullous-he*morrhagic forms
 observed in lower limbs. In cases with recurrent erysipelas was
 found insufficient antibiotic prophylaxis.The clinical pathway re-
 stricts treatment within 7 days and requires its continuation in the
 home. Hospitalization worst forms has been extended by 4-5 days
 beyond clinical pathway.




Keywords: erysipelas

Contact authors at: iri@abv.bg

                                 —219—
                    INFECTIOUS BALANITIS- SERIE OF CLINICAL CASES
Dermatology




               Authors: Mateeva V., Mitev A., Velinov Ts.



               University: Medical University of Sofia



              ICMS 2011 / OP 18 Therapy
               Abstract:

               Background: Balanitis is defined as inflammation of the glans pe-
               nis, often involving the prepuce (balanoposthitis). It is a common
               condition due to a wide variety of causes with infection being the
               most frequent and several microorganisms reported. The clinical
               aspect is often non specific. The management of balanoposthitis
               remains a clinical challenge. Objective: To evaluate the prevalence
               of infectious balanitis, its management, clinical features, laboratory
               procedures and treatment options Methods: One hundred thirteen
               patients with infectious balanitis were evaluated 2008- 2010. Labo-
               ratory data were collected. Results: Balanitis has been confirmed by
               cultural studies in all patients. Blood agar and Sabouraud cultures
               have been used. The aerobic etiological agents that have been iso-
               lated were Gardnerella, Candida spp., Strep. B spp. , Strep. Agalac-
               tiae and Staph. aureus. An Antibiogram study has been conducted
               in each case. Penicillin, Doxicyclin, Rifampicin and Cyprofloxacin
               were used. Conclusions: Balanitis is a common condition in the
               sexually active males. The clinical aspect has little predictive value
               on the infection agent that has been isolated by cultural methods.




               Keywords: Balanitis, infection, etiology

               Contact authors at: val_mat1@yahoo.fr


                                                 —220—
   SERUM CORTISOL MEASUREMENTS ARE NOT HELPFUL IN
   ASSESSMENT OF GLUCOCORTICOID REPLACEMENT IN AD-
                 RENAL INSUFFICIENCY.




                                                                              Endocrinology
                                                                                Anatomy
  Authors: Szymon Piatek, Beata Szymanska



  University: Medical University of Warsaw



ICMS 2011 / OP 19 Therapy
 Abstract:

 Introduction: The assessment of glucocorticoid replacement in ad-
 renal insufficiency (AI) relies on clinical judgement and mostly de-
 pends on physician’s experience. To find more objective method,
 few trials based on the serum cortisol measurements were under-
 taken. Aim: To investigate whether the serum cortisol measure-
 ment are of value in assessing the quality of glucocorticoid replace-
 ment. Methods: 21 patients (12 men, 9 women, age 20-65 years)
 with primary (n=12) and secondary (n=9) adrenal insufficiency
 were qualified to the study. Patients were on stable replacement
 with a dose of 25-30 mg hydrocortisone, additionally patients with
 primary AI took 50 µg of fludrocortison. Serum cortisol was meas-
 ured before and after the morning hydrocortisone dose in 0’, 120’
 and 240’. According to the previous data, as a proper replacement
 we considered the serum cortisol level 7-14 µg/dl in 240’. Clinical
 status was estimated on the basis of a questionnaire with symp-
 toms of hypocortisolism (-1 point/symptom) or hypercortisolism
 (+1point/symptom). Patients scored between -2 and +2 were con-
 sidered as well replaced. Results: 13 patients were considered as
 well replaced clinically. Among them there were 10 with serum cor-
 tisol between 7-14 µg/dl, 2 patients with serum cortisol level over
 14 µg/dl, 1 patient under 7 µg/dl). 8 patients were regarded as not
 properly replaced clinically. Among them there were 4 with serum
 cortisol between the level 7-14µg/dl, 2 patients with serum cortisol
 level over 14 µg/dl , 2 patients with the level under 7 µg/dl). There
 was no correlation between clinical score and serum cortisol level.
 Conclusion: Serum cortisol measurements are not helpful in as-
 sessment of the glucocorticoid replacement in adrenal insufficiency.


Keywords: adrenal insufficiency, glucocorticoid replacement, cortisol meas-
urement
Contact authors at: airszymon@o2.pl

                                  —221—
                          MYOCARDIAL CHANGES UNDER THE CONDITIONS OF
                          ACUTE ISHEMIA USING THE METHOD OF THE MATRIX
Forensic Medicine


                                            ANALYSIS



                     Authors:      I.V.Liubelia, N.O.Maksymchuk, O.J. Wanchulyak



                     University: Bukovinian State Medical University



                    ICMS 2011 / OP 20 Therapy
                     Abstract:

                     Introduction. The contractile apparatus of cordiomiocytes consists of fibrillar
                     myosin, subunit actin and other proteins. Due to its structure myosin pos-
                     sesses the properties of liquid crystals, in particular, the ability to change
                     the plane of polarization of coherent light. The functioning of the contractile
                     apparatus is implemented owing to ATP whose formation requires oxygen.
                     Since cells are short of oxygen in ischemia, we assume that this will result
                     in structural change of the contractile apparatus. The object of investigation
                     was to study the structural changes in myocardium in acute ischemia. Meth-
                     ods. For the sake of investigation myocardial sections of corpses of both
                     sexes aged 20-40 years were used. Material samples were taken 6 hours
                     after the onset of clinical symptoms of diseases and subsequent death. The
                     material was divided into two groups: with ischemic heart disease (17 spec-
                     imens) and with acute coronary insufficiency (14 specimens). Radiating was
                     performed by means of a parallel beam He– Ne laser with further processing
                     with the aid of the MATLAB 2010 program employing the method of ma-
                     trix analysis. Results. Following results of comparative study of values and
                     ranges of correlation in ischemic heart disease there were mean 0,29 0,016,
                     dispersion 0,21 0,024, asymmetry 0,13 0,015, excess 0,62 0,066, in acute
                     coronary insufficiency mean 0,31 0,014, dispersion 0,14 0,015, asymmetry
                     0,11 0,012, excess 0,51 0,057. From the data obtained experimental stud-
                     ies of the statistical structure of the distributions of extreme values of the
                     phase element Mueller matrix of myocardial tissue of both types follows an
                     objective opportunity to differentiate causes of death and diagnosis of acute
                     coronary insufficiency. Conclusion. The statistical method of matrix analysis
                     has made it possible to show characteristic images of acute and chronic
                     ischemia obtained by laser polarimetry. This method provides the means to
                     differentiate and identify both acute and chronic ischemia.




                     Keywords: Myocardium, method of the matrix analysis, acute ischemia,
                     structural changes
                     Contact authors at: Iuliia.Liubelia@bigmir.net


                                                       —222—
   UPPER LIMBS FRACTURE PATTERNS RESULTING FROM FA-
                TAL FALLS FROM A HEIGHT




                                                                                     Forensic Medicine
                                                                                         Anatomy
  Authors: Nada Santrac,Dragan Opacic,Stefan Juricic,Ognjen
  Bojovic,Ivana Stamenic,Aleksandar Mihailovic,Bojana
  Milosevic,Nikola Banjanin,Zelimir Jovanovic,supervisor:prof.dr
  Tatjana Atanasijevic
  University: Medical University of Belgrade



ICMS 2011 / OP 21 Therapy
 Abstract:

 High falls injuries represent a special form of blunt trauma and one of the
 most common injuries at work. The upper limbs fractures (ULFs) in falling
 from heights result from the extremities and the ground surface interaction,
 thus ULFs may indicate the way body hits the ground. The aim of this study
 was to determine upper limbs fracture patterns, more precisely the location
 and the type of the bone fractures (Fs), in correlation with the fall height
 (FH). A retrospective analysis of year 2008 and 2009 autopsy records of
 fatalities due to high falls was conducted at the Belgrade’s Forensic Medicine
 Institute. Considering OTA (Orthopaedic Trauma Association) classification,
 we noted all upper limbs long bones fractures (humerus, radius and ulna),
 their location (proximal, diaphyseal and distal third), as well as the type
 (simple or multifragmentary fracture). All the data were sorted and ana-
 lyzed within three groups of heights: up to 7 meters, 7-30 meters and over
 30 meters. The collective included 98 fatalities (69 males, 29 females), with
 a mean age of 54.30 ± 16.43 years. Approximately 90% of falls occurred
 from heights not exceeding 30 meters, while ULFs were present in 16%
 of falls. A significant correlation between FH and the ULFs localization and
 type was found. In the first group (FH up to 7 meters), there were mostly
 unilateral, simple Fs located on the diaphyseal and distal third of one of
 the forearm bones. Injuries in the second group (FH from 7 to 30 meters)
 were more extensive. Simple uni/bilateral forearm Fs were associated with
 uni/bilateral diaphyseal and distal upper arm Fs. In the third group (FH
 over 30 meters), uni/bilateral proximal and diaphyseal Fs of upper arms
 were accompanied by bilateral, multifragmentary forearm Fs. This research
 confirmed that the location and type of upper limb fractures determine sig-
 nificantly the fall height, and therefore may indicate the way body hits the
 ground. All the results given in this paper confirm previous research data
 on fracture patterns resulting from fatal falls from a height. These findings
 can facilitate clinical practice, especially when it comes to accidental injuries
 in children.



Keywords: falls from a height, upper limbs, fracture patterns

Contact authors at: santrac.nada@gmail.com

                                    —223—
                               TREATMENT OF MULTIPLE MYELOMA
Haematology




               Authors: Randjelovic Marija, Randjelovic Jelena, Rakic Sanela



               University: Medical University Of Nis



              ICMS 2011 / OP 22 Therapy
               Abstract:

               Introduction: Multiple myeloma (MM) is a malignant form of B-cell prolifera-
               tive disease characterized by proliferation and accumulation of malignant
               plasma cells in bone marrow which produce and/or release the abnormal
               amounts of immunoglobulin or immunoglobulin fragments. MM involves
               complications that transforms course of the disease and negatively affects
               the quality of life and resulting by poor prognosis and reducing the lifetime.
               Remissions for more than 3 years are achieved in about 5% of all patients.
               The aim of this study was to determine: • if stage of disease determines
               effectiveness of therapeutic modality who have been applied; •
               possible differences in achieving a positive therapeutic effect between pa-
               tients having complications of underlying disease with patients without this
               complications • which chemotherapeutic protocol achieves the most optimal
               therapeutic effect; •        the percentage of patients who entered into re-
               mission and the length of its duration. Material and methods: Retrospective
               study included 44 patients, both genders, mean age 64.93±9.1 treated
               from MM at the Department of Hematology, Clinical Center in Nis between
               2007-2010. The results are presented as average values (x), standard de-
               viation (SD) and percentage values (%). Nonparametric X2 test, and re-
               gression method test was used where values for p<0, 05 i p<0, 01 were de-
               clared for statistic, or high statistic significant. Results: There were higher
               achievement of remission in patients without complications in the MM stage
               I (83.3%), than in MM stage III (62,5%); It was the same outcome in
               patients with complications- remission was reached in 75% in MM stage I,
               while in MM stage III it was 44,45% . There was statistic significant differ-
               ence into response to therapy (X2>3.18, p<0.05).The most optimal thera-
               peutic effect was achieved with VAD protocol (34, 09%). Duration of remis-
               sion in MM stage I was 3.45±1.85 years, and in MM stage III 1.29±0.29
               years (p<0.05) Conclusion: Multiple myeloma is a malignant disease with
               the best remission achievement in the first stage of clinical disease without
               the appearance of complications attached to the underlying disease with
               duration remission longer than three years. The most optimal therapeutic
               effect achieves VAD protocol.
               Keywords: multiple myeloma, remission, therapeutic prognosis

               Contact authors at: ranmar22@yahoo.com


                                                 —224—
  IMMUNOTHERAPY IN RECURRENT GRADE III GLIOMA: PRE-
                   LIMINARY DATA




                                                                                 Immunology
                                                                                   Anatomy
  Authors: Elens Iris, Pauwels Femke, De Vleeschouwer Steven,
  Van Gool Stefaan


  University: Catholic University Leuven



ICMS 2011 / OP 23 Therapy
 Abstract:

 Introduction Grade III gliomas affect every year 0,67 per 100.000 people.
 Despite surgery, radiotherapy and chemotherapy, 5-year survival ranges
 around 30-38% and 11-28% for grade III oligodendrogliomas and astrocy-
 tomas respectively. At the time of recurrence, life-expectancy becomes ex-
 tremely poor. Immunotherapy (IT) is a novel treatment modality for grade
 IV gliomas. We here investigated its safety and efficacy in recurrent Ana-
 plastic astrocytomas (AA), Anaplastic oligodendroglioma (AOD) and Ana-
 plastic Oligoastrocytoma (AOA) and compared progression-free and overall
 survival (PFS/OS) with available data on Temozolomide (TMZ) treatment.
 Materials and Methods Relapsed grade III glioma in 39 patients (age 7-69,
 3 patients <16 years) were excised. The medical history of patients with AA
 was in median 79,1 and 7,3 months shorter than that of patients with AOD
 and AOA respectively. Total resection was obtained in 63, 23 and 37% of
 AA, AOD and AOA respectively. All patients underwent leukapheresis. Den-
 dritic cells were differentiated out of monocytes and were loaded with tumor
 proteins. The vaccines were injected intradermally. For historical controls
 a medline search was performed and critically appraised. Results Patients
 received 4-16 vaccines. Median PFS and OS for patients with AA were 4,6
 resp. 20,5 months. Median PFS and OS for patients with AOD were 3,4 resp.
 18,8 months. PFS and OS for AOA patients were 7,8 and 13,3 respectively.
 In comparison to historical controls with TMZ treatment, the median PFS
 was equal, while the median OS of vaccinated patients seemed prolonged.
 Moreover, grade III/IV toxicities reported upon TMZ treatment were absent
 in patients receiving immunotherapy. Conclusions In our patient group, sur-
 vival data of > 24 months were observed, in contrast to the literature. The
 survival benefit seems more clear in patients with AA. However also more
 total resections were performed in this group. We observed a trend towards
 a better OS but not PFS as compared to TMZ. This study provides the first
 description of IT in recurrent grade III glioma as a safe and feasible treat-
 ment modality.



Keywords: Recurrent anaplastic glioma, Immunotherapy, Temozolomide

Contact authors at: iris.elens@student.kuleuven.be

                                   —225—
                          CYTOMEGALOVIRUS REACTIVATION IN IMMUNOCOMPE-
                         TENT PATIENTS ADMITTED TO THE INTENSIVE CARE UNIT
Infectious diseases




                       Authors: razieh jahangard.mohammadghasem jahangard



                       University: tehran medical university



                      ICMS 2011 / OP 24 Therapy
                       Abstract:

                       Introduction: Cytomegalovirus (CMV), a deoxyribonucleic acid virus belong-
                       ing to the herpes family, is a common viral infection affecting 60 to 100%
                       of all individuals by adulthood, depending on geographic and socioeconomic
                       factors. Following CMV infection, as evident by CMV seropositivity, the virus
                       remains latent in T lymphocytes throughout the persons life. CMV reactiva-
                       tion, as a consequence of impaired cell-mediated immunity, has been as-
                       sociated with increased mortality in immunocompromised individuals. The
                       purpose of the present study was to evaluate CMV reactivation and its asso-
                       ciated risk factors as well as its impact on mortality among immunocompe-
                       tent patients admitted to intensive care units (ICU). Materials and Method:
                       We prospectively assessed quantitative plasma CMV DNA by weekly real-
                       time polymerase chain reaction (PCR) in a cohort of 132 CMV-seropositive
                       immunocompetent adults admitted to ICU between March 2009 and April
                       2010. Clinical measurements were assessed by personnel blinded to CMV
                       PCR results. Risk factors for CMV reactivation and its association with hos-
                       pital and ICU length of stay were assessed by multivariable logistic regres-
                       sion and proportional odds models. Result: One hundred thirty two patients
                       were enrolled in the present study. The overall rate of active CMV infection
                       was 34% (P < 0.0001), which was increased to 42.2% among those who
                       were hospitalized for ?7 days (P < 0.001). The overall mortality rate associ-
                       ated with active CMV infection was 1.93 times higher than that without CMV
                       infection (p = 0.001). The strongest risk factors for CMV viremia were older
                       age, male gender, severe sepsis, care in a trauma or burn ICU (compared
                       to medical or coronary ICU), blood product transfusion, and mechanical
                       ventilation. Conclusions: CMV reactivation occurs frequently in immuno-
                       competent patients admitted to ICU, especially in those with ICU stay more
                       tan7 days. Accordingly, mortality rate is significantly increased with active
                       CMV infection.




                       Keywords: CMV,Immunocompetent Patients ,Intensive Care Unit

                       Contact authors at: drjahangard@yahoo.com


                                                         —226—
    TREATMENT OF PATIENTS WITH INFLUENZA A BY AERO-
    SOL INTERFERON IN COMBINATION WITH PROTEFLAZI-




                                                                                  Infectious diseases
                         DUM




                                                                                       Anatomy
  Authors: Alina Naichuk, Vasyl Moskaliuk, Vasyl Sorokhan



  University: Bukovinian State Medical University



ICMS 2011 / OP 25 Therapy
 Abstract:

 Introduction. The treatment of patients with influenza A makes consider-
 able difficulties. Particular attention is paid on the nonspecific prophylaxis
 associated with increased activity of natural mechanisms of protection using
 antiviral and immunotropic drugs. Purpose of the study. To study the effect
 of standard treatment and aerosol interferon in combination with prote-
 flazidum on the dynamics of clinical symptoms in patients with influenza
 A. Material and methods. 30 patients with influenza A were examined and
 treated. All patients were 18 to 21 years old military men. With the purpose
 of study efficiency of the proposed treatment, the patients were divided on
 2 subgroups: the patients of I subgroup received standard treatment, which
 included nonsteroidal anti-inflammatory drugs, mucolytic agent, antihista-
 mines, vitamins; the patients of II subgroup received inhalations of aerosol
 interferon (laferon) in a dose of 500000 UN once a day for the first three
 days of illness with proteflazidum in a dose 10 drops PO 3 times a day for an
 hour after meals for 10 days. The administration of aerosol interferon was
 done by compressor nebulizer. Study results. The treatment of patients with
 influenza A by aerosol interferon in combination with proteflazidum caused
 the considerable improvement of general condition of patients within 3 days
 of illness compared with patients who received only standard treatment.
 The fever, weakness, runny nose, cough were disappeared to the greatest
 extent in more than 60% of patients. The symptoms such as hyperemia of
 the mucous membrane of oropharynx, swollen lymph nodes, conjunctivitis
 were disappeared the slowest in 13,3-26,6% of patients. Nevertheless, at
 the 4-6th day of illness, these symptoms disappeared in most patients,
 while in patients who received standard treatment lymphadenopathy con-
 tinued to remain in 100% of patients. Total frequency of symptoms disap-
 pearance within 1-3 days of illness on the background of standard treat-
 ment was (13,0 ± 4,7)%, proposed treatment - (46,6 ± 6,8)%. Conclusion.
 Treatment of patients with influenza A by laferon in a dose of 500000 UN
 in combination with proteflazidum caused the considerable improvement of
 general condition of patients within 3 days of illness compared with patients
 who received only standard treatment.

Keywords: Influenza, clinical signs, laferon, proteflazidum, standard treat-
ment
Contact authors at: Naichuk.Alina@bigmir.net

                                   —227—
                          THE CLINICAL AND LABORATORY CHARACTERISTICS OF
                                       EHRLICHIOSIS INFECTION
Infectious diseases




                       Authors: Kozko V. M, Jurko K.V., Melli D.M.


                       University: Kharkiv National Medical University




                      ICMS 2011 / OP 26 Therapy
                       Abstract:

                       The clinical and laboratory characteristics of ehrlichiosis infection Kozko V.
                       M, Jurko K.V., Melli D.M., Melli G. S. Kharkov National Medical University,
                       Ukraine Purpose. Investigation of the clinical picture and laboratory diag-
                       nostics of ehrlichiosis. Methods. The researches were performed by the de-
                       partment of infectious diseases KNMU. The study included 68 patients. In
                       14 patients ehrlichiosis has been confirmed by microscopical, cultural meth-
                       ods and method of PCR-detection. From them 9 - men, and 5 – women.
                       The middle age of patients was 42,22 years. Results. In 8 patients (57,1 %)
                       a mixed infection of ehrlichiosis and Lyme disease was observed. Patients
                       with ehrlichiosis complained of fever – in 85,7 % of cases, headache (78,6
                       %), myalgia (64,3 %), appetite loss (57,1 %), general weakness (64,3 %).
                       Pain in the epigastric area of the stomach (35,7 %), nausea (42,8 %), vom-
                       iting (21,4 %), diarrhea (21,4 %), the phenomena of catarrhal pharyngitis
                       (28,6 %) were more rare symptoms. More rarely, maculopapular rash – in
                       2 patients (14,3 %), lymphadenopathy – in 4 patients (28,6 %) were ob-
                       served. 9 patients (64,2 %) with ehrlichiosis developed leukopenia, throm-
                       bocytopenia, – in 9 patients (64,2 %), anemia – in 8 (57,1 % of cases). In
                       blood serum growth of the AsAT level – in 12 patients (85,7 % of cases),
                       the AlAT – in 7 (50 %) are defined. Together with the Scientific Research
                       Institute of I.I.Mechnikov we conducted a research of samples of blood of
                       patients with ehrlichiosis. During light and fluorescent microscopy in granu-
                       locytes and blood monocytes intracytoplasmic morula-like formations are
                       appeared, which are probably the diagnostic criterion of ehrlichiosis. In the
                       experimental test line of promyelocytic suspension of human cells Hl-60
                       the potential effectiveness of the method of accumulation of ehrlichiosis
                       agents to identify the ability of this pathogen to induce morula formation
                       is confirmed. Conclusions. Positive results of the PCR-detection of Ehrlichia
                       in samples of blood from infected people, homogenates of ticks, infected
                       cells Hl-60 confirm that the territory of east region of Ukraine is a circula-
                       tion area of Ehrlichia, which are capable of causing corresponding infectious
                       diseases of people.

                       Keywords: Erlichiosis

                       Contact authors at: diabmelli@yahoo.com


                                                         —228—
    EFFICACY OF ANTIVIRAL THERAPY OF CHRONIC HEPATI-
          TIS C IN PATIENTS WITH HIV-INFECTION




                                                                                 Infectious diseases
                                                                                      Anatomy
  Authors: O.Е. Bondar , R.Melli



  University: Kharkiv National Medical University



ICMS 2011 / OP 27 Therapy
 Abstract:
 Efficacy of antiviral therapy of chronic hepatitis C in patients with HIV-
 infection. Mentor: О.Е. Bondar Authors: R.Melli, O.Е. Bondar Introduction:
 the frequency of hepatitis C virus infection (HCV-infection) among HIV-
 infected in the Eastern Europe makes 47,7 %. The development of schemes
 of highly active antiretroviral therapy (HААRТ) has allowed to considerably
 reduce morbidity and death rate among HIV-infected patients. Now patients
 with coinfection HCV/HIV in the foreground have complications of diseases
 of the liver related to the chronic HCV-infection. Research objective: the
 estimation of efficacy of antiviral therapy (AVT) with pegylated interferon
 (PEG-IFN) and ribavirin in patients having chronic hepatitis C (CHC) with
 HIV-infection. Object and research methods: we examined 20 patients with
 the diagnosis: HIV-infection, 3 clinical stage. Chronic hepatitis C, HCV RNA
 (+), moderate degree of activity. Among them 4 men, 16 women , aver-
 age age was 35,1±2,2 year. Genotype HCV 1A/В was defined in 40 % of
 patients, 3А - in 60 % of patients. Chronic hepatitis B was diagnosed in
 two patients , twelve patients were taking drugs intravenously. Prior to the
 beginning of AVT patients received first-line HAART : 2 nucleoside reverse
 transcriptase inhibitors (NRTIs)+ 1 non-nucleoside reverse transcriptase
 inhibitor (NNRTI) during 12-18 months, level of CD4 was more or equal to
 350cells per microliter, HIV viral load and clinical sympoms of a HIV-infec-
 tion were absent. Along with HAART patients received PEG-IFN alpha2а in
 a dose of 180 microgram once per week (10 persons) or PEG-IFN alpha2b
 1,5 microgram/kg/week (10 persons) in a combination with ribavirin 800-
 1200 mg daily for 48 weeks. Results of research: biochemical response was
 achieved in 14 patients (70 %); early viral response (EVR) – in 12 patients
 (60 %); sustained viral response (SVR) – in 10 patients (50 %); relapse
 – in 2 patients (10 %); nonresponse – in 2 patients (10 %); termination
 of therapy because of side-effects before 12 weeks of treatment – in 6 pa-
 tients (30 %). Conclusions: use of combined AVT with PEG-IFN and ribavirin
 in patients having CHC with HIV-infection has allowed to reach SVR in 50
 % of patients. Tactics of AVT of HIV-infection in patients with HIV-infection
 is defined by the level of CD4, presence of replication and genotype of HCV,
 viral load, histologic changes in the liver, presence of contraindications.

Keywords:     Hepatitis C, HIV-infection

Contact authors at: lalalula@rambler.ru

                                   —229—
                         STUDY OF NEGATIVE EFFECTS OF STRESS ON CIRCULA-
                             TORY SYSTEM BASED ON MODERN MEDICINE
Internal Medicine




                     Authors: Mahdi Akhbardeh


                     University: Medical University of Bodton




                    ICMS 2011 / OP 28 Therapy
                     Abstract:
                     Introduction: Analyzing direct and indirect effects of stress on coronary vessels and heart
                     muscles in short and long terms In stressful conditions, increase of cortisol level will result
                     in inflammation increase of heart muscle, valves and internal walls of coronary vessels,
                     respectively. Increase of noradrenalin level may result in increase of blood pressure and
                     arrhythmia. In short term, it may lead to cardiac arrest or arrhythmia, infarctions result-
                     ing from inflammations and increase of erythrocytes density. Cardiac insufficiency resulted
                     from necrosis of heart muscles due to catabolism of albuminoid cells of heart muscles and
                     decrease of blood supply of tissues by the heart muscles because of damaging of heart mus-
                     cle and possibility of damaging of the related valves considering increase of inflammation
                     resulted from increase of blood cortisol are observed in long term. Increase of cortisol hor-
                     mone level corresponds with decrease of testosterone and HGH level. These two hormones
                     play significant roles in anabolism of proteins structure. Decreasing of these two hormones
                     may has important effects on atrophy of muscular tissues of heart and, finally decrease of
                     blood pumping role of the heart. Increase of these cells inflammation and possibility of being
                     attacked by blood pressure diseases because of repetitive exude of cortisol and noradrenalin
                     and finally increase of possibility of vessels obstruction will be observed due to (1) hardening
                     and damaging of coronary vessels because of increase of blood pressure, damaging of capil-
                     laries walls, increase of inflammation of internal parts of coronary vessels, and calcification
                     due to increase of inflammations and inflexibility of capillaries walls resulting from increase
                     of the two above-mentioned hormones, (2) increase of inflammation internal capillaries and
                     calcification, (3) increase of erythrocytes density because of stress. All three factors, col-
                     lectively or separately, severely increase heart failure in long term. Conclusion: Stress plays
                     a significant role in cardiovascular problems. It is possible to clarify this problem through
                     modern medicine and prevent its unwanted effects via use of appropriate methods. Not only
                     stress can lead to individuals’ death in short term considering the related causes, but also it
                     may have considerable effects on circulatory system in long term. This research opens new
                     horizons considering ambiguities found in relationship between mental pressures and wide
                     range of cardiovascular problems, although this relationship was known for years but its
                     quality was completely unclear. - Stress: 1- Increase of cortisol in blood plasma a) Increase
                     on inflammation b) Increase of triglyceride & cholesterol c) Little increase of blood pressure
                     d) Catabolism of heart muscles e) Decrease of serum & plasmatic level of testosterone and
                     growth hormones 2- Increase of noradrenalin a)             Marked increase of blood pressure
                     b)           Arrhythmia Increase of inflammations resulted from increase of cortisol in blood
                     1-           Increase of coronary vessels obstruction a) Because of increase of internal calcifi-
                     cation b) Damage of vessels wall cells and finally hardening and decreasing of flexibility 2-
                     Decrease of heart pumping a)        Due to death of heart muscles cells and finally possibility of
                     being attacked by heart insufficiency b)        Damage of molecular structure of cardiac valves,
                     creating problem in their function, and possibility of heart failure due to lack of oxygen in
                     heart muscles



                     Keywords: Stress, changes in hormones levels, vessels obstruction, increase
                     of blood pressure, molecular damage, increase of inflammations
                     Contact authors at: mahdi_akhbardeh14@yahoo.com


                                                                —230—
      DISORDERS OF THE STOMACH IN DIABETES MELLITUS
      TYPE 1 AND 2 PATIENTS, DIFFERENTIAL TREATMENT




                                                                                  Internal Medicine
                                                                                      Anatomy
  Authors:      Nechipai Zhanna, Khukhlina Oksana, Voevidka Ok-
  sana


  University: Bukovinian State Medical University



ICMS 2011 / OP 29 Therapy
 Abstract:
 Introduction. The investigation include a complex study of main risk factors
 of diabetic gastropathy (DGP) development – metabolic (hyperlipidemia,
 hyperglycemia, insulin resistance), endoscopic features, gastric motor ac-
 tivity. Research purpose. The research purpose is to study endoscopic fea-
 tures and motor function disorders of the stomach in patients with DGP,
 to prove the influence of lipoflavon (550mg of lecitin and 15mg kverce-
 tin), korargin (L-arginine), rebamipid (mucogen). Material and methods.
 120 patients with DGP, developed on background of type 1 (45 persons)
 and 2 (55 persons) diabetes mellitus (DM) in the dynamics of the treat-
 ment by lipoflavon, korargin and rebamipid were examined. A control group
 was made by 20 patients with DM type 1 and 2 without symptoms of DGP
 and 30 practically healthy persons. The investigation includes a complex
 study of the endoscopic, histological features of DGP, gastric motor activ-
 ity. The patients of the first group (control) (20 persons) got hypoglycemic
 medicine: metformin or insulin – depending on type of DM and vitamins B.
 Patients of second group (basic) (100 persons) got metformin or insulin –
 depending on type of DM, lipoflavon and korargin during a month in case of
 atrophic gastritis DM type 2 or lipoflavon combined with rebamipid and anti-
 Helicobacter Pylori therapy in case of erosive gastritis DM type 1. Research
 results. 68% patients of the basic group DM type 1 had superficial gastritis
 including 33% with erosive gastritis. 59% of patients of basic group DM
 type 2 had atrophic gastritis. 65% of the patients of basic group DM type 2
 had delayed gastric emptying, 87% of basic group DM type 1 had acceler-
 ated motor function of the stomach. Application of lipoflavon and korargin
 reduced the features of the atrophy on 78%, improved motor function on
 87%. Application of lipoflavon and rebamipid decreased stomach disorders
 on 81%, reduced the erosive features of gastritis in 93% of patients. Con-
 clusions. As a result of application of lipoflavon, rebamipid and korargin the
 removal of stomach disorders, strengthening of gastric emptying, decreas-
 ing of diabetic microangiopathy was attained.




Keywords: Diabetic gastropathy, lipoflavon, rebamipid, korargin

Contact authors at: zhanna.doc@bigmir.net

                                   —231—
                       C – REACTIVE PROTEIN VALUE MESUREMENTS IN ACUTE
                      EXACERBATIONS OF CHRONIC OBSTRUCTIVE PULMONARY
Internal Medicine


                                            DISEASE



                     Authors: Nemanja Ciric, Predrag Jovanovic, Vladimir Stojiljko-
                     vic, Slavko Zivkovic, Marko Ciric


                     University: Medical University of Nis



                    ICMS 2011 / OP 30 Therapy
                     Abstract:
                     Introduction: It’s been shown that C – reactive protein (CRP) can
                     be a useful indicator of acute medical conditions, including exacer-
                     bations of chronic obstructive pulmonary disease (AECOPD). Aim:
                     The measurements of CRP values as a marker of bacterial acute
                     exacerbations of chronic obstructive pulmonary disease (AECOPD)
                     and evaluation of a correlation between raised CRP levels and leu-
                     cocytes count. Methods: The patients with AECOPD (786) that were
                     treated in Clinic for Lung Disease and TB in Nis were analyzed.
                     They were categorized according to causes of AECOPD. All of these
                     patients had measurements of CRP, leukocytes, chest X – ray and
                     sputum bacteriological analysis. Results: The causing factors of AE-
                     COPD: unknown (group A), bacterial infection of tracheobronchial
                     tree (group B), pneumonia (group C) and some other conditions
                     (heart failure or cancer) group D. The mean CRP levels were el-
                     evated in groups A, B, C (A vs. B p=0.002; B vs. C p=0.0001). The
                     CRP levels were positively correlated with leucocytes count in all
                     of these groups (p=0.0001). Conclusion: The findings of increased
                     serum CRP value might indicate a bacterial infection of AECOPD,
                     and it correlates with increased serum leucocytes count.




                     Keywords: COPD exacerbation, CRP, bacterial infection of tracheobronchial
                     tree
                     Contact authors at: polygarh@gmail.com


                                                      —232—
    INCIDENCE OF LIVER CIRRHOSIS COMPLICATIONS IN A
          RELATION WITH A DE RITIS RATIO LEVEL




                                                                                      Internal Medicine
                                                                                          Anatomy
  Authors:       Vladan Milosevic, Jasmina Randjelovic



  University: Medical University of Nis



ICMS 2011 / OP 31 Therapy
 Abstract:
 Introduction: Alcoholic liver cirrhosis is a diffuse process with the character-
 istics of fibrosis and the conversion of normal liver architecture into struc-
 turally abnormal nodes with the lack of lobular organization (WHO). De Ritis
 ratio (AST/ALT ratio) is a very useful parameter in differentiating causes of
 liver damage. When it is over 2, it indicates alcoholic origin of liver cirrhosis.
 When it is less than 1, it indicates viral etiology. Aim: The aim was to deter-
 mine the relationship between the level of De Ritis ratio and the incidence
 of complications in male and female patients with liver cirrhosis. Materials
 and methods: The study was conducted at the Department of Gastroenter-
 ology and Hepatology at Clinical Center of Nis in a period of 1.1.2010 to
 1.8.2010. In the aim of this study was used a group of 54 patients of both
 sexes. There were 40 males (47%) and 14 females (26%), with average
 age 57.83±10.82 years, with a diagnosis of liver cirrhosis. Results: De Ritis
 ratio less than 1 was found in 17% of patients, more frequent in females
 (p<0.025). Values of De Ritis ratio between 1 and 2 was presented in 57%,
 equal at both sexes, and the values over 2 was observed in 26% of patients,
 more frequent in males (p<0.025). Complications were presented at the
 percentage of 81%, more frequent in males (p<0.001). Conclusion: With
 increasing values of the De Ritis ratio beyond 2, the manifestation trend of
 cirrhotic complications was in decline. With increasing values of the De Ritis
 ratio from less than 1 to more than 2, the manifestation trend of cirrhotic
 complications were increasing. There was more frequently manifestation of
 some cirrhotic complications in males. Also, De Ritis ratio was proportionally
 higher in males than in females. Key words: Liver cirrhosis, De Ritis ratio,
 cirrhotic complications




Keywords:      Liver cirrhosis, De Ritis ratio, cirrhotic complications

Contact authors at: milovladan@gmail.com

                                      —233—
                      SOME ASPECTS OF EARLY REVEALING OF CHOLELITHIASIS
                      IN PATIENTS WITH CHRONIC CHOLECYSTITIS COMBINED
Internal Medicine


                          WITH DIABETES MELLITUS TYPE 2 (GALLSTONES)



                     Authors: Y.F. Marchuk, O.I. Fediv



                     University: Bukovinian State Medical University



                    ICMS 2011 / OP 32 Therapy
                     Abstract:
                     Taking into consideration the great importance of disorders metabolism by
                     diabetes mellitus and cholelithiasis, it is of great value the investigation of
                     interrelations of their pathological processes. The aim of our investigation
                     was to establish peculiarities of phase data disorders of bile in patients
                     with chronic acalculous cholecystitis combined with diabetes mellitus type
                     2. There were used such methods of investigation: clinical, biochemical, in-
                     strumental, micro-, macroscopic, statistical. Material and methods. Detailed
                     clinical investigation was carried out with 10 patients with chronic acalcu-
                     lous cholecystitis combined with diabetes mellitus type 2 (1st main group),
                     10 patients with chronic acalculous cholecystitis (2nd group) and 10 almost
                     healthy patients. Results. Comparative investigations of statistic, correla-
                     tive and fractal parameters, which characterized phase distributions in laser
                     images of bile specimens of patients with chronic cholecystitis combined
                     with diabetes mellitus have given further results. From achieved data from
                     laser images of bile in patients of all groups and healthy people we could
                     say that the most informative diagnostic value data for revealing gallstone
                     disease were dispersion, asymmetry, excess, which characterized phase al-
                     location. There were defined further diapason changes statistic moments
                     of 1-4 order of laser images of bile between group of healthy people and
                     investigated groups of patients: dispersion (increase in 1,5-2,1), asymme-
                     try (increased in 3-16), excess (increased in 3-12). The usage of statistic
                     analysis of phase distribution in laser images of bile by different diseases
                     makes possible differentiation of bile peculiarities in patients with combined
                     pathology. Conclusions: 1. There is proposed model of formation of phase
                     distribution in images of bile layers like process of coordinate modulation of
                     laser ionization by bile liquid-crystal formations. There are analyzed differ-
                     ent variants of transformation the last in firm-crystals (calculi). 2.
                     There is shown, that the most informative for early revealing of cholelithi-
                     asis are dispersion, asymmetry, excess, which characterize phase distribu-
                     tion of laser image of bile. The usage of statistic analysis of phase images
                     of bile by different types pathology make possible differentiation of bile
                     changes in patients with combined pathology.

                     Keywords: Bile, diabetes mellitus, chronic cholecystitis

                     Contact authors at: Marchuk.Yuliya@bigmir.net


                                                       —234—
   THE DIAGNOSTIC MEANING OF THE INTERSTOMACH EX-
  PRESS PH-METRY IN PATIENTS WITH GASTROESOPHAGEAL




                                                                                 Internal Medicine
   REFLUX DISEASE COMBINED WITH DIABETES MELLITUS
                        TYPE II




                                                                                     Anatomy
  Authors: Siroochenko O.M., Kohanyuk Iu.V., Fediv O.I., Gon-
  charuk L.M.


  University: Bukovinian State Medical University



ICMS 2011 / OP 33 Therapy
 Abstract:
 Introduction.The pathological effects of the gastric content in patients with
 gastroesophageal reflux (HER) is already noticed at the first sign of viola-
 tion of the protective mechanisms of gastric mucosa. The results of the
 treatment of the sphincter disorders in patients with HER depend on the
 recognition and removal of the reasons that caused the problems. The re-
 search of the mechanisms of HER, as one of the aggression factors of the
 inflammatory-destructive changes in the esophagus depending on the state
 of gastroduodenal content pH is an important problem of gastroenterology.
 The aim of our study was to examine the indicators of the basal express
 pH-metry and esophagogastroduodenoskopy (EFHDS) in patients with gas-
 troesophageal reflux disease (HERD) and diabetes mellitus (DM) type II.
 Materials and methods. The research was conducted in the regional clini-
 cal hospital and regional endocrinology clinic of Chernivtsi. We examined
 18 patients with HERD and concomitant DM type II aged 42 to 66 years,
 and 10 healthy persons aged 39 to 59 years. The difference by gender
 between groups of patients and healthy people, was not significant. All the
 patients except general clinical, laboratory and instrumental examinations
 were examined with EFHDS and interstomach express pH-metry with the
 results showing the basal topographical pH-metry. Results. The endoscopic
 examination results showed that the frequency of the detection of ulcer-
 ous defects of mucosa of esophagus (27.8% of patients) with catarrhal
 phenomena similar amount of cases (27.8% of patients) and the mucosa
 was not changed at 44.4% patients. The research of the indicators of the
 basal express pH-metry showed that among the examined patients 66.7%
 was with expressed hiperacydity, 22.3% - with moderate hiperacydity, 11%
 - with normoacydity. Conclusion. Thus, the above changes of the EFHDS
 and express pH-metry in patients with HERD necessitate the pathogeneti-
 cally justified differential treatment of detected violations irrespective of
 concomitant pathology.




Keywords:     Gastroesophageal reflux, diabetes mellitus, mucosa

Contact authors at: Siroochenko.Olga@bigmir.net

                                   —235—
                       INTERSTITIAL PULMONARY FIBROSIS (IPF) - A CASE RE-
                                            PORT
Internal Medicine




                     Authors: Dikova Zl 1, Glogovska P 2, Ignatova T 2, Betova T 3,
                     Marinova P 4


                     University: Medical University of Pleven



                    ICMS 2011 / OP 34 Therapy
                     Abstract:
                     1.MU – Pleven, Bulgaria 2.Clinic for Pneumonology and Phthisiatry, Univer-
                     sity Hospital, Pleven 3.Department Pathology, University Hospital, Pleven
                     4.Diagnostic Center Alpha Medical,University Hospital “Ruzinov”, Bratislava,
                     Slovak republic Introduction: Idiopathic pulmonary fibrosis (IPF) represents
                     a subgroup of Idiopathic interstitial pneumonias (IIP), which are charac-
                     terized by inflammation and fibrosis of the pulmonary parenchyma. Aim:
                     A description of clinical case of IPF and a brief review of literature are
                     presented. Case-report: A 68-years old female, was hospitalized due to
                     progressive dyspnea, cough and mucopurulent sputum that started 4 years
                     before the initial presentation. In addition, there is a clinical history for sig-
                     nificant to weight loss during the last 6 months. At the time of admission
                     the patient had fever (37.5 oC). As a risk factor of work environment was
                     considered the presence of zinc vapor. During physical examination of the
                     respiratory system, emphysematous chest, diminished vesicular breathing,
                     wheezing and crackles bilaterally, especially at the lung bases were found.
                     Chest radiography, computer tomography (CT), fibro bronchoscopy were
                     made, followed by surgery biopsy. The histological finding was significant
                     for chronic nonspecific fibrosis alveolitis. Treatment with prednisolone was
                     administrated. After 3 years of follow up the patient is still alive with no
                     signs of severe progression of the disease. Conclusion: IPF is a rare disease
                     with poor prognosis and mean length of survival after diagnosis is 3.2–5
                     years. The presenting clinical feature is progressive dyspnea and a careful
                     attitude is required with the onset of complain.




                     Keywords: Interstitial pulmonary fibrosis (IPF), case-report

                     Contact authors at: zlati.dikova@gmail.com


                                                         —236—
  CASE REPORT: HYPERTHYROIDISM DUE TO SUBACUTE THY-
   ROIDITIS - DE QUIERVAIN ASSOCIATED WITH WPW SYN-




                                                                                Internal Medicine
                  DROME MANIFESTATION




                                                                                    Anatomy
  Authors: Krasimir Kostadinov, Cvetomir Evgeniev Kachovski, dr.
  Krasimir Angelov, dr. Vera Jordanova


  University: Sofia University St Kliment Ohridski



ICMS 2011 / OP 35 Therapy
 Abstract:
 Introduction: 30-year old female patient is admitted in hospital with clini-
 cal and laboratory findings of pneumonia, de Quervains thyroiditis along
 with sinus tachycardia with intermittent Wolff-Parkinson-White (WPW) syn-
 drome. Aim: To study the correlation between the manifestation of the pre-
 excitation of the ventricles of the heart – WPW syndrome (pre-excitation
 of the ventricles due to an accessory pathway connecting the atria and the
 ventricles (bundle of Kent) with ECG findings of delta wave and short PQ
 interval) and levels of FТ4 and TSH. Materials and methods: During the
 hospitalization in December 2010 and the following ambulatory treatment
 of the patient were carried out series of test monitoring the levels of FT4,
 TSH and ECGs and Holter-ECG 24h monitoring, demonstrating connection
 between the tested hormones and the manifestation of the pre-excitation
 of the ventricles due to the presence of bundle of Kent. Discussion: There
 are rare cases described in the literature of patients with thyrotoxicosis
 and WPW syndrome. Transient electrocardiographic changes of pre-exci-
 tation of the ventricles due to accessory pathway between the atria and
 the ventricles become visible in hyperthyroid state and disappear after the
 thyrotoxic phase is controlled. The two conditions are generally viewed as
 separate, occurring in the same patient only by chance, because thyrotoxi-
 cosis, trough changes in metabolism can lead to manifestation of hidden ac-
 cessory pathway between the atria and the ventricles, but cannot cause the
 formation of a new one. The pre-excitation syndrome in this patient is found
 for the first time in association with the De Quervains thyroiditis and the
 hyperthyroid state. After the treatment with Propranolol, Propafenon, thy-
 rostatics and after the normalization of the levels of thyroid hormones, ECG
 recordings show the absence of delta wave PQ interval with normal length,
 due to normalization of the excitability of cardiomyocytes and down-regu-
 lation of the ?1-receptors. Results and conclusion: Increased metabolism
 in a hyperthyroid state influences directly and indirectly through increased
 sympathetic activity the excitability and conducting capacity of the normal
 electrical conduction system of the heart and these of a hidden accessory
 conducting pathway between the atria and ventricles if present and may
 cause its manifestation.

Keywords: WPW,Wolff-Parkinson-White, De Quervain, thyroiditis, thyrotoxi-
cosis
Contact authors at: john_black@abv.bg

                                  —237—
                       LEVELS OF THE HORMONE OF FATTY TISSUE RESISTIN IN
                       PATIENTS WITH ARTERIAL HYPERTENSION DEPENDING
Internal Medicine


                      ON MANIFESTATION RATE OF DISTURBANCE OF CARBOHY-
                                       DRATE METABOLISM


                     Authors: K. Al Khadzh Khasan, V.V.Shkolnik, G.S. Melli



                     University: Kharkiv National Medical University



                    ICMS 2011 / OP 36 Therapy
                     Abstract:
                     The purpose of our work was studying of interrelation of level of glucose
                     and resistin in patients with essential hypertension (EH) depending on pres-
                     ence of insulin resistance (IR) or diabetes mellitus type 2 (DMT2). Materials
                     and methods: 105 patients (55 men and 50 women) have taken part in the
                     research. The patients were divided into 3 groups. The representatives of
                     the 1st group were practically healthy persons (n=19), 2nd group - patients
                     with IR and EH (n=45), 3rd group – patients with DMT2 and EH (n=41).
                     Resistin level was determined by immunoenzymatic method, fasting blood
                     glucose test was performed by means of glucose oxidase method. Results:
                     study of resistin level has allowed to reveal that in the 3rd group it corre-
                     sponded (22,7 ± 6,2) ng/ml and was reliably higher than in control group
                     (11,1 ± 2,3) ng/ml; р <0,05), in the 2nd group the level was (18,4 ± 5,4)
                     ng/ml, р <0,05, but resistin levels between 2nd and 3rd group did not dif-
                     fer reliably (p>0,05). The study of carbohydrate metabolism has shown
                     distinct differences in the glucose level in patients from the 1-st group and
                     has made (4,5 ± 0,32) mmol/l, and in patients having EH with IR (5,5 ±
                     0,23) mmol/l (р <0,05), in patients of the 3rd group (5,9 ± 0,32) mmol/l,
                     reliably different from the control group (р <0,05), there was no distinct
                     difference between the 2nd and the 3rd group (p>0,05). The resistin level
                     in patients with (EH+ DMT2) negatively correlates with the concentration
                     of blood glucose (r = - 0,35, р <0,05). Blood glucose level in patients with
                     DMT2 insignificantly differs from normal levels though in patients there was
                     already defined IR in comparison with the 1st group. Conclusions: the level
                     of resistin circulating in blood was considerably higher as compared to the
                     glucose concentration, confirming that higher levels of resistin are associ-
                     ated with carbohydrate metabolism disturbances.




                     Keywords: Resistin

                     Contact authors at: kamiran@yandex.ru


                                                       —238—
    ADRENAL CORTICAL CANCER- DIAGNOSTIC AND THERA-
             PEUTIC PROBLEMS. CASE REPORT.




                                                                                      Internal Medicine
                                                                                          Anatomy
  Authors: Lukasz Moos, Anna Rzemieniuk, Magdalena Kozak



  University: Silesian Medical University



ICMS 2011 / OP 37 Therapy
 Abstract:
 INTRODUCTION Adrenal cortical cancer (ACC) is a rare tumour that accounts for
 only 0.02% of all cancers. It is common for patients with ACC to have distant
 metastases. Often, the physicians who first diagnose patients with ACC have no
 prior experience with the disease. This cancer has a bimodal age distribution,
 with peaks in the first and fifth decades of life. ACC is usually non-functional
 in adults. AIM The aim of the study is to present difficulties that may occur
 while diagnosing a patient with a pathological mass found in the adrenal gland.
 METHODS A case report based on analysis of female patient’s history that ena-
 bled to present the diagnostic and treatment process. RESULTS A 42-year-old
 female presented with complaints of constant pain localized to the right upper
 abdominal quadrant, nausea and constipation for 3 weeks. Ultrasononography
 of the abdomen revealed a large, solid mass in right adrenal gland. Due to con-
 firm the diagnosis patient was admitted to the Endocrine Diseases Unit of the
 Internal Diseases and Oncologic Chemotherapy Department, Silesian Medical
 University in Katowice. MRI showed a tumour of an uncertain nature. In dif-
 ferential diagnosis following were taken into consideration: pheochromocytoma,
 adrenal adenoma complicated by bleeding, metastatic cancer or adrenal cancer.
 Hormonal parameters (serum ACTH, cortisole profile, adrenaline,noradrenaline,
 aldosterone levels,plasma renin activity, urinary concentration of vanillylmandel-
 ic acid, metanephrines, aldosterone and free cortisole in 24hrs urine collection)
 were normal. The patient was subjected to adrenalectomy. Histopathological
 and immunohistochemical examination revealed the diagnosis of non-functional
 ACC with necrosis. After the surgery hormone levels were still within reference
 ranges. Mitotane treatment was started. Follow-up revealed a need of re-oper-
 ation because of disease’s recurrence-a mass localized in region of inferior vena
 cava. Histopathological examination of the mass showed carcinomatous lesions
 with necrosis and suppurative chronic active inflammation. CT scans revealed
 ascites,metastases in lungs and retroperitoneal lymph nodes. Chemotherapy
 was administered and resulted in an improvement in patient’s general condition.
 CONCLUSIONS Reported case proves that finding a mass in adrenal glands re-
 quires detailed diagnosing. Histopathological examination is essential to confirm
 the diagnosis of adrenal cortical cancer. In presented case it was possible after
 adrenalectomy.




Keywords: ACC, adrenal cortical cancer, adrenal glands

Contact authors at: lukaszmoos@gmail.com

                                     —239—
                        TOXIC INFLUENCE OF THYREOSTATICS ON LIVER FUNC-
                         TION IN A PATIENT WITH PRESENCE OF HBS ANTIGEN
Internal Medicine




                     Authors: Anna Rzemieniuk, Lukasz Moos



                     University: Silesian Medical Unoversity



                    ICMS 2011 / OP 38 Therapy
                     Abstract:
                     INTRODUCTION Toxic side effects of thyreostactics are well known, among
                     them- toxic influence on liver function. Should the laboratory tests in jaun-
                     diced patient who takes thyreostatics for hyperthyroidism be limited only
                     to biochemical liver function tests? In presented case we point also at dif-
                     ferent causes of jaundice that can co-exist with toxic liver damage caused
                     by thyreostatic AIM The aim of the study is to emphasize the significance
                     of performing basal liver function tests as well as viral hepatitis markers in
                     patients with jaundice. METHODS An analysis of male patient’s history. RE-
                     SULTS A 48-year-old male patient was admitted to the Endocrine Diseases
                     Unit of the Internal Diseases and Oncologic Chemotherapy Department,
                     Silesian Medical University in Katowice in February 2009 with confirmed
                     diagnosis of hyperthyroidism. In pharmacological treatment thyrosol, pro-
                     pranolol, opipramol and vitamin B6 were used. On the 3rd day after admis-
                     sion patient started to complain of severe pain in the right upper quadrant
                     of abdomen and became jaundiced. Laboratory investigations revealed el-
                     evated level of bilirubin (128 umol/l [normal <17,1 umol/l]) and increased
                     activity of liver enzymes: ALT (854 U/L [normal <40 U/L]), AST (696 U/L
                     [normal <42 U/L]), GGTP (307 U/L [normal <24 U/L], ALP 130 U/L [nor-
                     mal <92 U/L]). Viral hepatitis test showed presence of HBs antigen but
                     with no evidence of new, active infection (low level of anti-HBc antibodies
                     in IgM class). Ultrasonography showed an enlarged, normoechogenic liver
                     (156 mm in right midclavicular line) and choledochus duct (9 mm). CT and
                     cholangio-MR confirmed these findings. CONCLUSIONS This case indicates
                     at necessity of performing basal liver hepatitis markers in patients with
                     jaundice. Fixing attention only on toxic liver failure, suggested in laboratory
                     investigations and clinical status of the patient, may result in omission of
                     proper diagnosis and aggravate viral infection. There is a possibility that in
                     reported case a presence of hepatitis B virus was an aggravating factor for
                     thyrostatics’ toxic influence on liver function.




                     Keywords: thyreostactics, HBs antigen, hyperthyroidism

                     Contact authors at: annarzemieniuk@interia.pl


                                                       —240—
   CARDIOVASCULAR PATHOLOGY AND DIABETES MELLITUS
   PSYCHOEMOTIONAL PREDISPOSING AND PRECIPITATING




                                                                                        Internal Medicine
                      FACTORS




                                                                                            Anatomy
  Authors: Veronika Piskovatska, Oksana Petrenko



  University: Odessa national medical university



ICMS 2011 / OP 39 Therapy
 Abstract:
 Cardiovascular diseases (CD), accompanied with type 2 diabetes mellitus (DM)
 cause almost a half of all deaths in Europe. Psychosocial environment is de-
 clared by World Health Organization as secondary risk factor in development
 and further CD and DM progression. Controversies of combinations of emotional,
 behavioral and social characteristics, proper to patients with cardiovascular dis-
 eases and DM remain unsolved and actual. The study aimed to define peculiari-
 ties of personality and behavior in patients with various combinations of arterial
 hypertension (AH), ischemic heart disease (IHD) and type 2 DM and to figure
 out significant differences in investigated groups. 4 groups of patients were en-
 rolled, each consisted of 15 patients: patients with AH; AH and IHD combina-
 tion; AH and DM combination; AH, IHD and DM combination. In all four groups
 patients were carrying out Wartegg graphic test (WGT) and Lusher color test
 (LCT) short variant with its further digital evaluation. According to results of LCT
 in AH patients red and dark blue were the most favored dominating colors; WGT
 showed prevalence of agitation, anxiety, explosiveness, egocentricity. In AH, IHD
 group green color dominated, WGT demonstrated insecurity and social isolation
 tendency, exorbitant perception of problems. There were no statistically vera-
 cious difference between average quantity of gained points in these two groups
 3,42±0,68 and 3,54±0,57 correspondingly. In patients with AH, DM green and
 dark-blue colors were dominating; WGT showed anxiety and self-insecurity. In
 AH, IHD, DM group yellow color was the most favored; WGT showed denial
 reference to the own disease, willing to escape from the reality accompanied
 by illness. Digital evaluation of LCT demonstrated veracious difference between
 these two groups AH, DM - 1,9±0,72; AH, IHD, DM - 2,92±0,87. Due to the
 gained results emotional disturbances related to certain combination of diseases
 are present in patients with combined cardiovascular and endocrine pathology.
 Paying attention on significant psychoemotional feedback found out during this
 study, proper diagnostic of psychological problems and rational psychocorrective
 methods can be applied in groups of patients with combined cardiovascular and
 endocrine pathology.




Keywords: diabetes, cardiovascular pathology, psychoemotional state

Contact authors at: vprl@mail.ru

                                      —241—
                      EFFECT OF THE USE INSULIN PUMP TREATMENT ON MICRO-
                      ALBUMINURIA LEVEL IN PATIENTS WITH TYPE 1 DIABETES
Internal Medicine




                     Authors: Smrzlic Sladjana; Stosic Ljubica; Santrac Nada;
                     Mitrovic Aleksandar; Banjanin Nikolina; Bogicevic Aleksandar;
                     Jovanovic Marija; Jovanovic Ivana; Bojovic Ognjen; Jovanovic
                     Ljubica;Garabinovic Zeljko
                     University: Medical University of Belgrade



                    ICMS 2011 / OP 40 Therapy
                     Abstract:
                     Introducation: Diabetic nephropathy is the leading cause of mortality and
                     morbidity in patients with type 1 diabetes. The most valid parameter de-
                     velopment of diabetic nephropathy is microalbuminuria, and many studies
                     have shown that poor glycemic control is one of the most important fac-
                     tors leading to the progress of diabetic nephropathy. Aim: Examine the ef-
                     fect of insulin pump therapy in patients with type 1 diabetes on improving
                     the level of microalbuminuria and improvement glycemic control Material
                     and methods: Study included 79 patients with type 1 diabetes. To all pa-
                     tients both in the conventional therapy and the insulin pump therapy we
                     measured levels of Hb1Ac (immunoassay method), levels of microalbumi-
                     nuria (immunonephelometry) and body weight. Results: Using insulin pump
                     therapy has achieved a very significant reduction Hb1Ac (p<0.001). Also,
                     the value of microalbuminuria was statistically lower in group patients on
                     insulin pump therapy compared to patients on conventional therapy with 4
                     doses of insulin (p<0.05) and as a percentage view, the reduction is even
                     44% on the current therapy. At the same time, even at 37% of patients
                     there was normalization of microalbuminuria (p<0.05) which is associated
                     with improvement glycemic control. Also, proteinuria was established in 7
                     patients on treatment with 4 doses of insulin and there was a regression
                     in the range macroalbuminuria on therapy using insulin pump. Conclusion:
                     The results suggest that insulin pump therapy is more effective in achieving
                     optimal glycemic control. In addition, pump therapy has proved effective in
                     reducing the values of microalbuminuria, and in some cases the normaliza-
                     tion value of this marker for diabetic nephropathy.




                     Keywords: diabetic nephropathy, type 1 diabetes, insulin pump, micoalbumi-
                     nuria
                     Contact authors at: ssmrzlic@gmail.com


                                                      —242—
   EFFECT OF GLYCEMIC CONTROL ON BODY WEIGHT OF THE
       NEWBORN IN PATIENTS WITH TYPE 1 DIABETES




                                                                                Internal Medicine
                                                                                    Anatomy
  Authors: Tamara Savic,Nada Santrac,Aleksandar
  Mitrovic,Nikolina Banjanin,Aleksandar Bogicevic,Bojan
  Naumovic,Zeljko Garabinovic,Ljubica Jovanovic,Helga Denc,Ivana
  Jovanovic,Marija Jovanovic
  University: Medical University of Belgrade



ICMS 2011 / OP 41 Therapy
 Abstract:
 Background: Pregnancy in patients with type 1 diabetes (T1D) is signifi-
 cantly associated with adverse outcomes for both mother and the newborn,
 especially the increased risk of fetal macrosomy. Aim: The aim of our study
 was to analyse changes in fasting and postprandial glucose, HbA1c levels,
 body weight (BW) before, and increment of BW during pregnancy in pa-
 tients with T1D and newborn’s birth weight. Material and methods: Study
 included 40 pregnant women with T1D on intensive insulin therapy (IIT):
 conventional intensive insulin therapy and insulin pump therapy. Fasting,
 postprandial glycemia, HbA1c levels and BW were measurement before
 conception and during pregnancy. Results: Fasting, postprandial glycemia
 and HbA1c levels were significantly lower in the third trimester compared to
 the conception in both therapeutic regimens of IIT (7.45 +/- 0.4 vs. 6.1 +/-
 0.3mmol / l, p<0.01; 9.1+/-0.5 vs 6.8+/-0.4mmol/l, p<0.01; 8.48+/-0.44
 vs 6.90+/-0.46%, p<0.01). The total daily dose of insulin was significantly
 higher during the third trimester of pregnancy (39.5+/-13.0 vs 60.5+/-
 19.5U/day, p<0.01) in both therapeutic regimens of IIT. Linear regression
 analysis revealed that the dominant influence on BW of newborn has weeks
 of gestation on delivery, the increment of BW of patients during pregnancy,
 as well as the level of HbA1c in the third trimester of pregnancy (p<0.01).
 Conclusion: Our results indicate that the optimal glycemic control in the
 third trimester, with a moderate gain of BW in women with T1D in preg-
 nancy may prevent the development of fetal macrosomy and consequently
 unwanted outcomes of pregnancy, both for mother and newborn.




Keywords: T1D, pregnancy, fetal macrosomy, metabolic control.

Contact authors at: tamarce84@yahoo.co.uk

                                  —243—
                        PROBIOTICS IN THE TREATMENT OF SMALL INTESTINAL
                                    BACTERIAL OVERGROWTH
Internal Medicine




                     Authors: Nakov R, Tsekova R, Nakov V


                     University: Medical University of Sofia




                    ICMS 2011 / OP 42 Therapy
                     Abstract:
                     INTRODUCTION: Over 10% of the population in the developed countries
                     suffers from chronic diarrhea. One of the most frequent reasons for this
                     is the gut disbiosis, especially the small intestinal bacterial overgrowth
                     (SIBO). The condition is defined as an excessive growth of non-specific for
                     the small intestine microbial flora. During the last years, probiotics have
                     found a place in the treatment of SIBO.
                     AIM: The purpose of this study is to evaluate the use of probiotics in pa-
                     tients with SIBO.
                     MATHERIALS AND METHODS: The present study enrolled 22 patients with
                     SIBO (14 females and 8 males ; age range 24-62, median 43,2), investi-
                     gated in the Department of Gastroenterology , University Hospital “Tsaritsa
                     Yoanna-ISUL” in Sofia for the period from October 2010 to February 2011.
                     The diagnosis SIBO was accepted on the basis of the conventional criteria
                     of the made hydrogen breath test (HBT) with lactulose: high baseline of
                     the exhaled hydrogen, an early peak showing the meeting of the substrate
                     with the abnormal flora in the small intestine, a second peak showing the
                     entering of the substrate in the caecum (oro-caecal transit time). When the
                     diagnosis was concluded, in all the patients was performed an outpatient
                     treatment with the new Bulgarian probiotic product- Enteric Ecol (produced
                     by Kendy Pharma) in a dosage of two capsules trice a day for 20 days. After
                     finishing the treatment a control HBT was conducted. Clinical evaluation of
                     the existing symptoms(diarrhea, abdominal pain, dyspepsia) were carried
                     out before and after the therapy.
                     RESULTS: The most common clinical symptom in the patients, dyspepsia,
                     observed in all of them (100%) decreased statistically reliable - persisted
                     just in five patients (23%) after the treatment.
                     Diarrhea, was observed in 16 patients (73%) before the treatment -re-
                     mained just in four (18%). Slightly was affected the abdominal pain: 17
                     patients (77%) in the beginning persisted to 7 (32%). Regarding the val-
                     ues of the exhaled hydrogen, a statistically significant decrease after the
                     therapy was observed in all major controlled points, as follows: baseline
                     mean levels of 25,8 + / - 13,3 ppm before treatment to 11,3 + / - 7,5 ppm
                     after treatment, early peak of 60 + / - 23,9 ppm to 31.5 + / -16, 7 ppm
                     and colonic response of 73,1 + / -24,2 ppm to 40,8 + / -20,3 ppm.
                     CONCLUSION: The used probiotic product - Enteric Ecol showed excellent
                     results in the treatment of patients with SIBO, both in terms of clinical
                     symptoms and in reducing the amount of the exhaled hydrogen.

                                                      —244—
                                                                                    Microbiology and Virology
    LUNG INFECTIONS IN PATIENTS WITH CYSTIC FIBROSIS




                                                                                           Anatomy
  Authors: Dryngova H.S.; Rajkova A.N.; Kachovski C.E; Stoyanov
  V.R.; Naydenova,A.I.; Edreva V.B. (Clinical Microbiology Group)


  University: Medical University of Pleven



ICMS 2011 / OP 43 Therapy
 Abstract:
 Aim: To study lower respiratory track specimens from patients with CF, de-
 termine the etiology of the infections and the susceptibility to antimicrobial
 drugs of the most commonly isolated pathogens. Materials and Methods:
 Since Sep. 2009 to May 2010 we studied 16 patients with CF aging from 4
 months to 30 years. We studied 25 samples from respiratory tract and 1
 from gastrointestinal tract. The identification of the isolated strains was per-
 formed by conventional test, mini API, VITEC2 (bio Merieux, France). Sus-
 ceptibility to antimicrobial agents was performed by disk diffusion method
 according to the recommendation of CLSI or by MICs. Results: Two of the
 samples showed a normal flora of the lower respiratory tract. Altogether
 there were isolated 29 strains from 15 patients. Nine of them were Gram-
 positive and 20 Gram-negative bacteria. All of the Gram-positive bacteria
 was identified as Staphylococcus aureus. The majority of the Gram-nega-
 tive strains were identified as Pseudomonas aeruginosa (12 strains).Three
 of the others was recognized as H. influezae ,other three as E. coli and two
 as Candida albicans. P. aeruginosa was isolated from patients of different
 age but predominantly from those over 5 years in age. It showed good anti-
 microbial susceptibility and had some phenotype characteristics that highly
 distinguished them from the commonly isolated. S. aureus also showed a
 good antimicrobial susceptibility but no phenotype differences. Conclusion:
 Microorganisms isolated from lower respiratory tract varies and changes
 when monitored for long period of time. Gram (-) organisms are dominant,
 especially P. aeruginosa. P. aeruginosa showed unusual phenotype charac-
 teristics..




Keywords: Cystic Fibrosis (CF), P. aeruginosa, Respiratory tract infections

Contact authors at: christina.dryngova@hotmail.com

                                    —245—
Microbiology and Virology

                               ANTIBACTERIAL EFFECTS OF CEMBUYA ORIENTALIS AND
                                              BRASSICA OLERACEA




                             Authors: Kekic D., Rovcanin B., Stukalov M., Mitrovic Lj., Veseli-
                             novic Lj.


                             University: Medical University of Belgrade



                            ICMS 2011 / OP 44 Therapy
                             Abstract:
                             INTRODUCTION: Bacterial infection, in nowhere days, are not so dangerous
                             and deadly thanks to a great number of antibiotics that protects us from
                             them. Yet, more and more multi-resistant forms appear, against whom we
                             have very limited opportunities to fight. Therefore, new forms of antibiot-
                             ics must constantly be discovered, whether they are natural or synthetic,
                             so we can be up to date with dealing against new multi-resistant forms of
                             bacteria. AIM: The aim was to determine possible antibacterial effects of
                             Cembuya orientalis and Brassica oleracea on Streptococcus ?-haemolyti-
                             cus and Staphylococcus aureus which were isolated as nosocomial bacte-
                             rial strain. METHODS: Clinical isolates of Streptococcus ?-haemolyticus and
                             Staphylococcus aureus were used as model microorganisms. Disk diffusion
                             method of antibiogram was used for accessing and characterization of an-
                             tibacterial activities of Cembuya orientalis and Brassica oleracea macer-
                             ates and extracts. Extracts were obtained from different tea constituents
                             on whom Cembuya orientalis was cultivated. RESULTS: Antibacterial effect
                             of Cembuya orientalis was shown on both bacterial strains, which altered
                             between different cultivation constituents. Results of antibiograms showed
                             that there is no antibacterial effect of Brassica oleracea on both model mi-
                             croorganisms. CONCLUSION: Cembuya orientalis showed good effects on
                             both bacterial cultures, so it can be used for treatment. We found that Bras-
                             sica oleracea does not have antibacterial effect. KEY WORDS: Antibacterial
                             effect, Cembuya orientalis, Brassica oleracea, Streptococcus ?-haemolyti-
                             cus, Staphylococcus aureus




                             Keywords: Antibacterial effect, Cembuya orientalis, Brassica oleracea, Strep-
                             tococcus ?-haemolyticus, Staphylococcus aureus
                             Contact authors at: dusan_vk@yahoo.com


                                                               —246—
  ACE-INHIBITORS AND POTASSIUM BALANCE IN PATIENTS
              WITH RENAL DISFUNCTION




                                                                                   Nephrology
                                                                                    Anatomy
  Authors:Milena Jevtic, Milan Jovanovic



  University: Medical University of Nis



ICMS 2011 / OP 45 Therapy
 Abstract:
 Introduction:ACE-inhibitors constrain the converting of inactive angioten-
 sine I to highly active angiotensine II. This machanism enables lowering
 arterial blood pressure. The use of ACE-inhitors with patients suffering from
 renal insufifency can cause hyperkaliemia. The aim of study:The aim of
 this study is to investigate the change in balance of potassium in the group
 of patients suffering from renal insufficiency an arterial hypertension both
 were treated with the ACE-inhibitors. Materials and methods:There are 50
 patients of both sexes, 42-77 years old. The test that were performed were
 measuring the level of potassium in serum, level of potassium in urine,
 excretion of potassium during the period of 24 hours, as well as monitor-
 ing the level of creatinin in serum and urine. Results:A noticeable differ-
 ence between the group of values of serum-potassium in clinical and the
 once in control group were obtained(4,6±0,1 mmol/l and 4,3±0,2 mmol/l)
 (р=0,05).. Similary, a remarkable distination in surveling the level of potas-
 sium in urine has also occurred(24,3±4,53 mmol/l and 33,2±8,36 mmol/l)
 (р=0,01).. Conclusion:The result of analysis have shown that there are
 changes in potassium balance amoung the patients with arterial hyperten-
 sion and those suffering renal insufficiency. Furthermore, patients having
 the change of renal funtion excreted the smaller amounts of potassium,
 and that is directly releted to two causes. The first one reason is lower level
 of glomerular filtration. And the second one is the lower level of activity of
 aldosteron on distal renal tubules.




Keywords: ACE-inhibitors, potassium balance,arterial hypertension.

Contact authors at: milenapk@beotel.net

                                   —247—
                PAINFUL SYMPTOMS AS THE FIRST SIGNS OF MULTIPLE
                                  SCLEROSIS
Neurology




             Authors: Nevmerzhytska L., Vinychuk S., Matyushko M.



             University: National O.O.Bohomolets Medical University



            ICMS 2011 / OP 46 Therapy
             Abstract:
             There is a supposition that multiple sclerosis (MS) can cause many prob-
             lems except the pain. But it is not a complete reality. According to various
             authors, patients with MS noted different character of pain at the beginning
             of the disease or during its course. Often there were headache, trigeminal
             pain, pain in the different parts of spine (radicular pain) and pain in the
             joints in patients with MS. Purpose: To explore the first manifestations of
             MS, which were accompanied by painful syndromes. Object and methods:
             Retrospective analysis of medical documentation of patients with MS, that
             were hospitalized to the 3rd neurological department of Kyiv clinical hospital
             №4 during 2010 year. Results: 212 patients with MS were treated in the
             3rd neurological department of Kyiv clinical hospital №4 during 2010 year.
             Among them there were 65 patients (30.7%) that noticed the first sings of
             disease from deterioration of vision, (40 patients (18.8%) had retro-bulbar
             neuritis, and another 15 patients (7.1%) had reduction of visual acuity in
             one or both eyes). 103 patients (48.6%) noticed onset of the disease from
             weakness feeling and numbing in the legs, which sometimes were accom-
             panied by feeling of “pyrosis” and “crawling ants” in the distal parts of the
             lower extremities. The disease started with acute neuropathy of facial nerve
             in 19 patients (9.0%) and pain in the 2nd and 3rd rami of trigeminal nerve
             in 7 patients (3.3%), which patients often falsely connected with tooth pain.
             There was a spinal pain as the onset of the disease in 18 patients (8.4%),
             in 9 (4.2%) patients it was localized in the cervical part and in another 9
             patients it was in lumbar part. These patients came to neurologist, where
             they got the diagnosis like “Osteochondrosis of the spine” or “Cervical or
             lumbosacral radiculitis”. During later examination after deterioration of pa-
             tients` state the focuses of demyelination were detected in magnetic reso-
             nance imaging. Conclusion: 1. Young persons’ trigeminal neuralgias should
             alert neurologists until demyelinating diseases in patients are excluded. 2.
             Young people’s vertebrogenic diseases can be the first sign of multiple scle-
             rosis.




             Keywords: multiple sclerosis, trigeminal pain, trigeminal neuralgias, verte-
             brogenic diseases
             Contact authors at: ambrella08@mail.ru


                                               —248—
  MANAGEMENT OF AN ALPHA RHYTHM – A KEY TO CREATIV-
                 ITY DEVELOPMENT.




                                                                                   Neurology
                                                                                   Anatomy
  Authors: Makotrova T, Chephranova Zh, Makotrova G


  University: Belgorod State University




ICMS 2011 / OP 47 Therapy
 Abstract:
 Creativity it is a process of creation new. In this process are involved ge-
 netic premises, a quality of communication through all sense organs and
 experience of long-term memory. Research objective was studying of for-
 mation of rhythms at the decision of creative problems at pupils with dif-
 ferent level of the creative abilities and the alarm. We observed two groups
 of schoolboys (16-17 years). The first group (control) – 69 persons, had
 high and very high indicators of creative qualities of the person by results of
 testing (Gilford, Torrens). The second group – 73 persons, had low and the
 average level of creative qualities of the person. There were three experi-
 mental conditions. In the first case registered standard EEG. In the second
 case analysed EEG in the course of the decision of creative problems. In
 the third condition the decision of creative problems was accompanied by
 music in Baroque taste with a rhythm about 60 blows in a minute, influ-
 encing alpha rhythm formation. Tasks involved use of figurative and logic
 thinking and memory. For analysis EEG it was used 18-channel EEG-16С.
 Also it was spent plural regression analysis for definition of communica-
 tions of rhythms with creativity indicators. In control group alpha rhythm
 registered of the average amplitude. In the second group beta activity had
 low and high-frequency character, average amplitude - 47 (64 %). Under
 the second condition alpha activity took place in 36 (49 %) cases of ex-
 perimental group. Flattening and delay the alpha rhythm mainly in control
 group was observed. Decision of the creative problems accompanied by
 music the index of duration of an alpha rhythm of mainly right hemisphere
 which activity prevails at the reference to long-term memory increased in
 two groups. The alpha rhythm prevailed in occipital, parietal and temporal
 areas at all investigated, but is different type. And in control group 13 (19
 %) schoolboys the teta-rhythm was registered. Thus, the alpha rhythm is
 not only a medicine from stress, but also can promote development of the
 creative abilities. It is have an important role in process restoration long-
 term memory. One of the most important components is the motivation.




Keywords: Creativity, EEG, alpha rhythm

Contact authors at: jeunefille_@mail.ru

                                   —249—
                 MEMORY DISORDERS IN PATIENTS WITH TRAUMATIC
                               BRAIN DISEASE
Neurology




             Authors: Kufterina N.S.



             University: Kharkiv National Medical University



            ICMS 2011 / OP 48 Therapy
             Abstract:
             Aim: memory disturbances studying in patients with the cer-
             ebral defeats of traumatic nature and their specific isolation for
             the defeats of different localization. Materials and methods: We
             have inspected 48 patients with traumatic brain injury (TBI) con-
             sequences, which were treated in the Kharkiv regional hospital. In
             20 patients the damaged center was located in the left hemisphere
             (LH), in 18 patients - in the right hemisphere (RH) and in 10 people
             were observed double-sided frontal defeats. Also there were in-
             spected 25 almost healthy people. For all patients were used clini-
             cal- neurologic, neuro-physiological (EEG, EP), neuropsy-chological
             (subs-test of Wexler, Luria’s procedure) investigations, CT and MRT
             of the brain. All data were statistically processed. Results: Pa-
             tients complained on headache (91,6%), vertigo (35,4%), general
             weakness (83,3%), worsening in memory (87,4%), in attention
             (75,0%); reduction in sight (77,1%), rumor (64,6%), convulsive
             assaults (37,5%), apathy and sleepiness (22,9%). Accordantly to
             the neuropsychological investigation, the total volume of reproduc-
             tion in patients with the TBI consequences was lower than in the
             control group (p<0,05). Worse fulfillment of tests was obtained
             with the defeats of antero-posterior divisions of RH (contraction of
             the volume of reproduction, the growth of the difference between
             the represented and total number of produced elements). The diffi-
             culties of restructuring predominated with the double-sided frontal
             defeats and the defeats of frontal divisions of RH. Neuropsychologi-
             cal symptoms were exceeded the area of the defeats localization
             of the defeats, verified instrumental. Conclusions: Traumatic brain
             disease occurs the disturbance of all forms of memory, which pre-
             dominance depends on localization of stricken area.

             Keywords: traumatic brain injury, memory, cognitive disorders

             Contact authors at: nataly_kufterina@rambler.ru


                                              —250—
    ANTIOXIDANT DEFENCE AND THE PROCESSES OF LIPID
    PEROXIDATION IN THE BLOOD OF CHILDREN WITH DE-
     STRUCTIVE PATHOLOGY OF THE GASTROINTESTINAL
                        TRACT




                                                                                Pediatrics
                                                                                Anatomy
  Authors: Uliana Petrova



  University: Bukovinian State Medical University



ICMS 2011 / OP 49 Therapy
 Abstract:
 Introduction. At present it is known that lipid peroxidation is a universal
 mechanism of an inhibition of the resistance of the mucous coat of the
 gastroduodenal zone and a depletion of the antioxidant system. In this con-
 nection the object of our research was an evaluation of the content of lipid
 peroxidation products and an investigation of the condition of children’s
 blood antioxidant system with destructive pathology of the gastrointestinal
 tract. Material and methods. 55 children, aged 7-18, with an erosive ulcer-
 ous lesion of the gastroduodenal zone, were examined. The control group
 consisted of 51 healthy children of the same age. The malonic aldehyde
 content test is based on a reaction with thiobarbituric acid. The content of
 the oxidative modification of the blood plasma protein was evoluated by the
 reaction with 2,4-dinitrophenylhydrazine. The method of evaluating reduced
 glutathione in blood is based on the oxidation of reduced glutathione by po-
 tassium iodide. The principle of the method of evaluating blood catalase is
 based on the ability of hydrogen peroxide to form a stable stained complex
 with molybdenum salts. The activity of blood plasma ceruloplasmin was de-
 termined by Revin’s modified method. Results. The blood malonic aldehyde
 content of patients with an erosive ulcerous lesion of the stomach and duo-
 denum is 22,9±3,4 µm/l; oxidative modification of proteins - 3,1±0,3 units
 of optical density/ml, at the same time, the results in the control group
 are 13,4±0,9 µm/l and 2,2±0,2 units of optical density/ml. The enzymatic
 level of antioxidant blood system of children with destructive pathology
 is the following: reduced glutathione-0,9±0,2 µm/ml, catalase-15,3±2,9
 µm/min/l, and ceruloplasmin-415,4±47,5 mg/l. These indices are lower in
 comparison with the control group (reduced glutathione-1,2±0,2 µm/ml,
 catalase - 23,7±1,4 µm/min/l, and ceruloplasmin-550,0±23,9 mg/l). Con-
 clusions 1. The obtained findings have demonstrated that an activation of
 the processes of lipid peroxidation is marked in the blood of children with
 an erosive-ulcerous lesion of the gastroduodenal zone against a background
 of inhibited antioxidant system. 2. It is necessary to include medications
 enhancing the body’s antioxidant defence into a course of multimodality
 treatment of an erosive-ulcerous lesion of the gastroduodenal zone of chil-
 dren’s age.

Keywords: Lipid peroxidation, antioxidant defense, erosive-ulcerous lesion,
gastrointestinal tract
Contact authors at: Petrova.Uliana@bigmir.net

                                  —251—
               BROCHIAL HYPERSUSCEPTIBILITI OF CHILDREN AFFLICT-
               ED WITH BRONCHIAL ASTHMA WITH DIFFERENT TYPES OF
                    INFLAMMATION OF THE RESPIRATORY TRAKTS
Pediatrics




              Authors:      Alla Halushchynska



              University: Bukovinian State Medical University



             ICMS 2011 / OP 50 Therapy
              Abstract:
              INTRODUCTION. The object of the research was to study the indices
              of nonspecific hypersusceptibiliti of the bronchi (HSB) with different
              types of inflammation of the respiratory tracts (TIRT). MATERIAL AND
              METHODS. 60 school age children afflicted with bronchial asthma (BA)
              were examined and divided into two clinical groups on the basis of a
              cytological examination of the sputum. The first group consisted of
              patients with eosinopilic TIRT (30 patients), the second one with none-
              osinophilic TIRT (30 patients). All the patients underwent a cytological
              analysis of the sputum and a bronchial challenge test with histamine
              during the postictal period. Upon an HSB enhancement a decrease of
              the provocative concentration (PC20H) and a dose (PD20H) of hista-
              mine was noted, whereas with an elevation of their hyperreactivity – an
              increase of the dose-dependent curve (DDC). Eosinophilic TIRT was
              verified in the presence of 3% and more of eosinophilic leukocytes in
              the sputum. RESULTS. A comparative analysis of the HSB indices in
              children with different TIRTs based on the challenge test with hista-
              mine showed that they did not differ essentially. Thus, the HSB indices
              in patients with eosinophilic BA made up: PC20H, mg/ml – 1,8+0,55;
              PD20H, mg – 0,55+0,16; DDC, c.u. – 2,01+0,15, whereas with neu-
              trophilic TIRT respectively: PC20H – 1,58+0,37; PD20H – 0,51+0,17;
              DDC – 2,13+0,26 (P>0,05). But a tendency toward more marked sus-
              ceptibility of the bronchi to histamine in children with eosinophilic TIRT
              is noted (PD20H < 0,15 mg in these patients was observed 1,7 times
              more often than in children with neutrophilic TIRT), and a positive
              correlation of the HSB indices with a relative number of lymphocytes
              (r=0,59) was established as well. CONCLUSION. Thus, non speciphic
              HSB to histamine in patients with BA does not depend essentially on
              the nature of their inflammation. After all, more pronounced HSB to
              histamine occurred somewhat more often in children with eosinophilic
              TIRT.

              Keywords: Bronchial asthma, sputum

              Contact authors at: Halushchynska.Alla@bigmir.net


                                              —252—
   STATE OF NITRIC OXIDE SYSTEM IN CHILDREN WITH UL-
                      CER DISEASE




                                                                                    Pediatrics
                                                                                    Anatomy
  Authors: Andriychuk D.R., Sorokman T.V., Ivashchuk H.O.



  University: Bukovinian State Medical University



ICMS 2011 / OP 51 Therapy
 Abstract:
 Introduction: Nitric oxide (NO) is now substantial evidence indicating a
 broad profile of actions for nitric oxide in the regulation of different physi-
 ological and pathological processes. Aim: improve efficacy of diagnostics
 and prognosis of stomach and duodenum ulcer disease course in children
 on the basis of complex elaboration of clinical and pathological criteria of
 its formation. Material and methods. Clinical investigation was conducted
 in 47 children with ulcer disease aged from 7 to 18 years and they formed
 the main group of investigation and 35 healthy children of the same age
 (control group). Results. There was established that in children with ulcer
 disease of stomach and duodenum level of nitric oxide both in plasma and
 in saliva was reliably increased comparatively with control group in 1,5
 (р<0,05). Level of nitric oxide was reliably increased during division of chil-
 dren of the main group according to the age comparatively to the control
 group (р<0,05). The last tendency made possible definition of nitric oxide
 irrespective of age, as these data were stable according to the age. Level of
 nitric oxide was reliably decreased in plasma relatively children of the main
 group by absence of Helicobacter pylori in mucous membrane of stomach
 and duodenum. This is evidence that nitric oxide molecule has strong anti-
 germ properties to Helicobacter pylori infection. We have defined reduce of
 nitric oxide concentration by size of ulcer defect more than 6 mm relatively
 to group, where the size of defect was 1-2 mm (р<0,05). Conclusion. There
 was investigated that nitric oxide level in healthy children was in plasma
 15,78±8,2 mcmol/l, in saliva – 56,46±8,2 mcmol/l. In children with ulcer
 disease of stomach and duodenum NO concentration in plasma and saliva
 was reliably. There was established that nitric oxide level in biological fluids
 increased by presence of Helicobacter pylori infection, decreased by severe
 course of disease, didn’t depend on child’s age, ulcer defect localization.




Keywords: Nitric oxide, ulcer disease, Helicobacter pylori

Contact authors at:Andriychuk.Denys@bigmir.net

                                    —253—
                        CONGENITAL ANOPHTHALMOS CASE REPORT
Pediatrics




              Authors: Danka D. Milankovic?, N.S. Avramovic?, O. Bojovic?,
              Scientific: S.Z. Avramovic4


              University: Medical University of Belgrade



             ICMS 2011 / OP 52 Therapy
              Abstract:
              INTRODUCTION: Congenital anophthalmos is a rare anomaly with
              prevalence of 3 on 100000 newborns. Anophthalmos can be primary,
              secondary and consecutive. Optical primordium is missing in primary
              anophthalmos, in secondary there is a total anomaly or suppression in
              development of frontal neural tube, and consecutive is a consequence
              of trauma or surgery. Clinical anophthalmos is determined by total ab-
              sence of eye bulb without histological confirmation. AIMS: The aim is
              to present a male term newborn with congenital anophthalmos from
              normal, regularly controlled, pregnancy. CASE: The infant had 3350g
              on birth, Apgar score 9-10. Clinical finding was normal, but the eyes
              were firmly shut, the bulbs could not be palpated, and the possibility
              of their absence was made. On ophthalmologic examination the bulbs
              were not found. Ultrasound showed no echo from the bulbs. Radiogra-
              phy showed smaller eye sockets than normal, ovoid shaped. CNS ultra-
              sound was normal. Cariogram was normal 46,xy. CONCLUSIONS: Com-
              plete anophthalmos is very rare. Usually the rudimentary eye bulbs can
              be seen which in our patient did not exist. For the diagnosis of true
              anophthalmos it is necessary to determine the absence of neuroecto-
              derm, retinae, optical nerve and meningea in orbital cavity, which can
              be performed only on autopsy. Therefore, in praxis, we use the term
              clinical anophthalmos. Our patient had bilateral absence of eye bulbs.
              That could be classified as primary anophthalmos by Mann. The child
              was sent at the clinic for eye prosthetic for further treatment. It is
              important to say that with ultrasound examination from third month
              of pregnancy we can suspect on cryptophthalmos and anophthalmos
              with the eye-size normogram for gestation age, if they are under the
              normal values.




              Keywords:congenital anophthalmos, anomaly, neonatus, eye

              Contact authors at: dankambg@yahoo.com


                                             —254—
       CARBAPENEMS IN NEONATAL SEVERE INFECTIONS




                                                                                 Pediatrics
                                                                                 Anatomy
  Authors: Nemanja S. Avramovic?, D.D. Milankovic?, I.T.Karadzic
  ?, Scientific: L.Z. Hajnal Avramovic?


  University: Institute for Medical Research of Belgrade



ICMS 2011 / OP 53 Therapy
 Abstract:
 INTRODUCTION: Neonatal sepsis is a life-threatening emergency and any
 delay in treatment may cause death. In suspected sepsis, empirical anti-
 biotic therapy should begin immediatly after cultures have been obtained
 without awaiting results. Last decade multidrug-resistant (MDR) extend-
 ed-spectrum ? lactamase-producing bacteria (ESBL) have emerged as a
 common problem globaly in the NICU. AIMS: The aim of our report is to
 demonstrate the efficacy and safety of carbapenems in treatment of se-
 vere infectiones in the newborns due to this organisms. METODS: A retro-
 spective study was undertaken of 72 neonates admitted to NICU suspected
 on neonatal sepsis. The clinical profile and outcome in each patient was
 obtained from the case notes. In 23 neonates, gestational age of 30- 39
 weeks and birth weight of 1250-3100 grams with severe infections due to
 MDR Escherichia coli, Klebsiellae pneumoniae and Serratia spp, we used
 meropenem as monotherapy as a second choice because of deterioration
 during conventional treatment. Efficacy and the incidence of drug-relat-
 ed adverse events was observed RESULTS: We observed 23 (18-78,26%
 praemature and 5-21,74% term infants) with severe infections: pneumonia
 (5/23), necrotising enterocolitis (NEC) (5/23), urinary tract infection (UTI)
 (6/23), and septicemia alone (7/23). Bacterial pathogenes were isolated
 preatreatment in 14 (60,80%) of patients: MDR E.coli in 5 (35,71%), Kleb-
 siellae pneumoniae i 7 (50,00%), and Serratia spp in 2 (14,28%) cases. All
 were susceptible to meropenem in vivo and resistant to ampicillin, amoxi-
 cillin, cefazolin, cefotaxime, ceftazidime, ceftriaxone and aminoglycosides.
 In 9/14 (64,28%) isolation of MDR gram-negative bacteria was associated
 with praematurity and in 3/14 (21,43%) prolonged rupture of membranes.
 Assisted ventilation was needed in 3 (13,04) neonates, 1 ( 4,35%) of them
 died. None of drug related adverse events was registrated except slight
 decrease in number of thrombocytes. CONCLUSIONS: These results dem-
 onstrate the efficacy and safety of meropenem in the treatment of severe
 infectione in newborns due to multiresistant gram-negative bacteria.




Keywords: carbapenem, neonatus, infection, sepsis, MDR, ESBL

Contact authors at: haralampijexxl@gmail.com

                                   —255—
                PROCALCITONIN AND INTERLEUKIN-6 IN THE EARLY PRE-
                DICTION OF NEONATAL SEPSIS, ARE THEY CORRELATED?
Pediatrics




              Authors: Dr. Abdollahi MD Dr. Mahmoudzadeh Dr. Morteza MD



              University: Tehran University of Medical Sciences



             ICMS 2011 / OP 54 Therapy
              Abstract:
              Introduction: Neonatal sepsis is a major problem which causes mor-
              talities and severe morbidities in neonatal units. The clinical signs are
              nonspecific; therefore highly reliable diagnostic markers are required.
              Recently procalcitonin (PCT) has acquired an important role in the diag-
              nosis of infection in neonates. We aimed to assess the value of simul-
              taneous measurement of PCT and interleukin-6 (IL-6) along with the
              other values of sepsis screening. Material & methods: We performed a
              follow up study on 95 neonates who were below 12 h age, had clini-
              cal signs of sepsis, or maternal risk factors of sepsis. Neonates with
              congenital malformations and infection (TORCH) were excluded. Neo-
              nates were assigned to 4 groups including “proven early-onset sepsis”,
              “clinical early-onset sepsis”, “negative infectious status”, and “uncer-
              tain infectious status” by considering clinical signs and sepsis screen-
              ing. Blood samples were obtained within the first 12 h and repeated
              between 24 and 36 h of age for determination of PCT, IL-6, C reactive
              protein (CRP), White blood cell count, and CBC diff. Results: Infect-
              ed neonates had a higher serum PCT (4.393 vs. 0.575, P<0.01), IL-6
              (177.33 vs. 45.94, P< 0.01) and CRP (2.978 vs. 0.887, P< 0.01) levels
              than patients without sepsis. Likewise patients with clinical evidence
              of sepsis had higher values of PCT (1.847 vs. 1.746, P< 0.01), IL-6
              (120.68 vs. 75.87, P< 0.01) and CRP (2.736 vs. 1.45, P< 0.01) com-
              pared to patients with uncertain sepsis. Moreover patients with blood
              culture positive sepsis had higher values of PCT (4.393 vs. 1.847, P<
              0.01), IL-6 (177.33 vs. 120.68, P< 0.01) and CRP (2.978 vs. 2.736, P<
              0.01) compared to patients with clinical sepsis. Serum PCT levels were
              significantly correlated with serum IL-6 levels in patients with no sepsis
              and uncertain sepsis (r=0.529, P<0.05 and r=0.521, P<0.01 respec-
              tively). Conclusion: PCT is a good and efficacious serum marker in the
              prediction of early neonatal sepsis. Combined with IL-6 and CRP, PCT is
              a good marker for the prediction of neonatal sepsis.

              Keywords:procalcitonin, interleukin-6, neonatal sepsis

              Contact authors at: sanam.mahmoudzadeh@gmail.com


                                                —256—
    DISORDERS THAT OCCURS IN YOUNG PEOPLE WITH THE
             PROBLEM OF SUBSTANCE ABUSE




                                                                        Psychiatry
                                                                        Anatomy
  Authors: Zeljko Garabinovic, S. Smrzlic, I. Stameni?, T. Savic,
  D. Opacic, S. Juricic, A. Mihailovic, N. Banjanin, B. Milosevic, O.
  Bojovic, M. Jovanovic, Z. Jovanovic

  University: Medical University of Belgrade



ICMS 2011 / OP 55 Therapy
 Abstract:
 Introduction: The comorbidity of substance abuse and behavior
 disorders is becoming a world wide trend. More and more people
 of different age are becoming dependent of various types of sub-
 stances and in the same time get also behavioural changes. Aim:
 In this work we used the retrospective study type to evaluate the
 possible statistical importance between substance abuse and be-
 havioural changes.Material and methods: The study was obtained
 in The Institute for mental health, using retrospective epidemio-
 logic analysis of 172 young people with problems caused by abuse
 of psychoactive substances that were treated in a period between
 2006. and 2010., and investigating a simultaneous presence of oth-
 er problems of mental health. Results: It is noticed the increase of
 disorders caused by abuse of psychoactive substances, by alcohol
 (F10)-16,81%, as well as canabinoides (F12)-6,51%, and by more
 psychoactive substances together (F19)-75,54%. It is noticed in-
 creased frequency of simultaneous presence two or more differ-
 ent problems, and especially simultaneous presence of (F10-F19)
 together with F92 (mixed emotional and behaviour problems) and
 Z62 (other education problems). Conclusion: We concluded that we
 can find a significant correlation between psychosocial disorders
 on one side, and consequential disorder of behavior and disorder
 caused by usage of psychoactive substances on the other side.




Keywords: abuse of psychoactive substances, the young, disorder

Contact authors at: zeljkogarabinovic@gmail.com

                                 —257—
                 LONELINESS AND PERSONALITY IN MODERN STUDENTS
Psychology




              Authors: Dorokhina Antonina



              University: NMU O.O. Bogomoltsa



             ICMS 2011 / OP 56 Therapy
              Abstract:
              Loneliness is a negative state, marked by a sense of isolation. One feels that
              something is missing. Talent, financial success, fame, even adoration, offers
              no protection from the subjective experience. Loneliness is not about being
              alone, it is about not feeling connected. Does it occur in human’s physiol-
              ogy? Even pictures of human beings, our brains respond in a distinctly
              different way than they do when we see any other type of object. Recent
              studies demonstrate that the social environment can actually modulate RNA
              transcription, influencing the way cells replicate. That is why the chief aim
              of the study was to determine if there is any relevant connection between
              the feeling loneliness and personal qualities in modern students. Personality
              and loneliness were measured using the Big Five Inventory (John, Donahue
              and Kentle, 1991) and the revised UCLA Loneliness Scale (Russell, Peplau
              and Cutrona, 1980) respectively. Mental health was measured by 12 items
              in the General Health Questionnaire (GHQ-12) designed by Goldberg, 1978.
              Results of this study revealed that a total of 53% respondents exhibited
              the mean level of feeling lonely, only 10% displayed contentment of so-
              cial connection. Furthermore, 9% of medical students showed indications
              of mental health problems; there were found high levels of nervousness
              (48% of respondents), agreeableness (19%), extraversion and conscien-
              tiousness (15%). This data gives reasons to suppose that loneliness is one
              of the most significant predictor in explaining mental health problems and
              understanding factors contributing to stress among students. The paper
              shows that despite all the persuasive evidence of our need for connection,
              and the clear demonstration of the influence of connection on our physi-
              ology, today persists an epidemic of disconnection. Nevertheless, it does
              not make an evident case for significant relation between personality and
              loneliness. Such results may be due to the fact that there were other fac-
              tors which might contribute to feeling lonely among medical students. More
              fundamental research needed to study the problem; whereas the existential
              psychology maintains that loneliness is inevitably so far as our subjective
              experience of reality can never be fully shared.



              Keywords:Loneliness, personality, mental health, medical students

              Contact authors at: doksana22@bk.ru


                                                —258—
    DEFINING THE PROFILE OF RESISTANCE OF MYCOBAC-
   TERIA IN PATIENTS WITH NEW-ONSET PULMONARY TU-
   BERCULOSIS, GROUPS OF RISK OF THE DEVELOPMENT OF
                   CHEMORESISTANCE




                                                                                  Pulmology
                                                                                   Anatomy
  Authors: Medvetska Olena, Yeremenchuk Inha, Herman Antoni-
  na, Pidverbetskyi Oleg


  University: Bukovinian State Medical University



ICMS 2011 / OP 57 Therapy
 Abstract:
 Introduction. An increase of drug resistance rate of mycobacteria (MBT)
 over the last 10-15 years, particularly to isoniazid and rifampicin and their
 combination, in isolated cases and to the majority of antituberculous drugs
 (ATDS) among persons with a preveiosly ineffectively treated process de-
 termines the acute and topical character of the problem of treating mul-
 tiresistant pulmonary tuberculosis (MRPT). Aim of the research. The object
 of our research was determining the resistance of MBT in patients with
 newly diagnosed pulmonary tuberculosis (NDPT) who form risk groups of
 the development of chemoresistant tuberculosis. Materials and Methods.
 The study includes 43 patients with NDPT with the presence of bacteriodis-
 charge, undergoing in patient treatment at the Chernivtsi TB Dispensary
 during the II-nd half of 2008 – the I-st half of 2010. Results. Bacterial dis-
 charge was identified in all the patients by means of the smear microscopy
 technique with further inoculation. MBT resistance to ATDS was primarily
 determined in 2-6 months. Having studies the profile of multiresistance
 of MBT strains isolated from bacteriodischargers with NDPT treated at the
 Chernivtsi Regional TB Dispensary, it should be noted that resistance to
 two basic drags (HR) was revealed 27.9% of the cases, to three 3-х HR+S
 – 13,9%, HR+Z – 4,7%, HR+E – 4,7%, HR+Et – 2,3%, HR+K – 2,3%
 and four HR+SE – 16,3, HR+SZ – 6,9%, HR+ZEt – 4,7% АМБП and to
 five HR+SEZ – 11,6%, HR+SEEt – 4,7% chemotherapeutic drugs. Further
 analysis of the nature of resistance revealed by us has made it possible to
 ascertain that the highest share in the pattern of multiresistance of MBT
 strains among 43 patients under study (except isoniazid and rifampicin) is
 broadened resistance of MBT which is established in 67.4% of the patients
 and is formed at the expense of resistance to streptomycin – in 53.5% of
 the patients, pyrazinamide – 27.9%, ethambutol – 37.2%. Conclusion. In
 our view, this means that the drugs of the I-st series lose their efficacy and
 in order to provide a valuable therapeutic regiment in such patients it is
 expedient to use, except II-nd series drags, antibacterial agents of a broad
 spectrum possessing antituberculous properties, in particular respiratory
 fluoroquinolones, macrolides and other compounds.


Keywords: Newly diagnosed tuberculosis, multiresistance tuberculous myco-
bacteria, chemoresistance
Contact authors at: Medvetska.Olena@bigmir.net

                                   —259—
              THE COMPARATIVE ANALYSIS OF THE DIAGNOSTIC VALUE
              OF THE BRONCHIAL HYPERSENSITIVITY AND HYPERREAC-
               TIVITY TO HISTAMINE IN SCHOOL AGE CHILDREN WITH
                           SEVERE BRONCHIAL ASTHMA
Pulmology




             Authors: Oksana Lototska



             University: Bukovinian State Medical University



            ICMS 2011 / OP 58 Therapy
             Abstract:
             INTRODUCTION. Activity of start controlling therapy of bronchial asthma
             (BA) depends on the severity of disease in children. One of the factors
             which determine the severity of asthma is bronchial hyperresponsiveness
             (BHR), which includes hypersensitivity (HSB) and hyperreaktivity (HRB) of
             the bronchi, but the comparative diagnostic value of these indices in assess-
             ing asthma severity in children is not established. MATERIAL AND METH-
             ODS. Was formed two clinical groups: the first consisted of 31 patients with
             severe asthma, the second - 31 patients with moderate form of the disease.
             The groups were comparable according to the principal clinical parameters.
             All the children were examined after asthma exacerbation and the withdraw-
             al of the drugs could changethe test results. In observed children evaluated
             the bronchial hyperresponsiveness to nonspecific irritants with the help of
             histamine inhalation tests. RESULTS. There was noted that in children with
             severe asthma the provocative concentration of histamine, which led to the
             20% decrease of the FEV1 (PC20H) was lower (0,5±0,07mg/ml) than in
             patients with moderate asthma (2,9±0,5mg/ml, P<0,01). The decrease of
             the threshold concentration of histamine less than 1.1 mg/ml verified the
             presence of severe asthma with a test sensitivity 96,8% (95% СІ– 83,3-
             99,9) and specificity 71% (95% СІ–52,0 - 85,8). Under the indices of the
             dose depending curve (DDC), which showd the HRB > 2.2 conditional units
             the possibility of the severe asthma in patient was characterised with test
             sensitivity - 74,2% (95%CI - 55,4-88,1) and specificity - 90,3% (95%CI
             - 74,3-98,0). CONCLUSION. The increased nonspecific bronchial sensitiv-
             ity and reactivity were in childrens with severe asthma (PC20H - 0,5±0,07
             mg / ml, DDC - 2.4c.u.) in comparison with the patients who suffereution
             moderate asthma (PC20H – 2,9±0,5mg/ml, P<0,01 and DDC - 1,8±0,2
             c.u., P <0,01).




             Keywords:Bronchial asthma, bronchial hypersensitivity and hyperreactivity,
             diagnostic value, histamine
             Contact authors at: Oksana.Lototska@bigmir.net


                                               —260—
        CEREBROFACIAL VENOUS ANOMALIES,SINUS
   PERICRANII,OCULAR ABNORMALITIES,SEIZURE AND DE-
      VELOPMENTAL DELAY:REPORT OF TWO PATIENT




                                                                                  Radiology
                                                                                  Anatomy
  Authors: Betul Macit,Ahmad Alomari,John Mulliken



  University: Instanbul University



ICMS 2011 / OP 59 Therapy
 Abstract:
 INTRODUCTION Sinus pericranii, an abnormal communication between the
 intracranial dural sinuses and anomalous scalp vein, has also been reported
 with major intracranial vascular and cerebral anomalies. In this communi-
 cation, we report 2 patients with cerebrofacial venous anomalies including
 sinus pericranii, in association with ocular abnormalities, seizures and minor
 developmental delay. CASE REPORT Patient 1 An 8-year-old boy was re-
 ferred to our Vascular Anomalies Center for treatment of cerebrofacial vas-
 cular anomalies. The patient was born with a vascular “birthmark” on the
 forehead and around the left eye, and he had a medically-controlled seizure
 disorder. On physical examination, the left orbit and globe were small with
 compromised visual acuity, proptosis, ptosis, glaucoma and miosis. Patient
 2 A 3-year-old boy was referred to our Vascular Anomalies Center for evalu-
 ation of a left facial venous malformation. The child had minor developmen-
 tal delay with attention deficit disorder, learning disabilities and delayed
 speech.He had a medically-controlled seizure disorder. CONCLUS?ON In
 conclusion, the combination of cerebrofacial vascular anomalies with sinus
 pericranii, ocular abnormalities, seizures and developmental delay might
 represent a rare association that has not been previously appreciated in the
 medical literature.




Keywords: vascular anomalies,sinus pericranii

Contact authors at: btlmct@hotmail.com

                                   —261—
              FLOATING THROMBI- CLINICAL AND IMAGING PRESENTA-
                                    TION
Radiology




             Authors: T. Monovska, S. Georgieva. N. Hristovski, G. Kirova



             University: Bukovinian State Medical University



            ICMS 2011 / OP 60 Therapy
             Abstract:
             A floating thrombus within vessels with fast blood flow as aorta and large
             supraaortic vessels is a rare condition that is generally detected in the
             course of cerebral, visceral, or peripheral embolization. However such freely
             fluctuating thrombi are increasingly recognized thanks to the widespread
             use of non-invasive diagnostic techniques as Doppler US, MDCT and CEM-
             RA. Goal: -To describe the clinical presentation and US/MDCTA findings in 8
             operative proved cases of so called floating thrombus. -To discuss the pre-
             sumable pathogenetic factors, explaining this rare phenomenon. Material
             and Methods: The clinical, imaging and laboratory findings in eight cases
             with floating thrombi that extended throughout aortic arch and/or large
             supraaortic vessels are presented. In all cases the diagnosis was detected
             during Doppler US and MDCT. All imaging findings were confirmed by op-
             eration and microscopy. Results: Most of the cases, except one, have been
             examined because of recurrent or incidental ischemic vascular events. In
             three of them the free-floating clots were based on ulcerated atheromatous
             plaques. In one patient the finding was accidental and no vessel wall pathol-
             ogy was seen intraoperatively. In all eight patients there was an intralumi-
             nal defect in the fast flowing vessel, partly attached to the vessel wall with
             large freely floating tail. Conclusions: We present eight cases of floating
             thrombi, visualized by Doppler US and/or MDCT, who underwent surgery
             and have been proved intraoperatively. The knowledge of imaging findings
             is of great importance in order to ensure adequate and effective treatment
             for these patients.




             Keywords:Floating Thrombus, Doppler US, Aortic Arch, MDCT, intraluminal
             defect
             Contact authors at: snejibg@hotmail.com


                                               —262—
    EARLY DIAGNOSIS OF PULMONARY EMBOLISM(PE)-AD-
    VANTAGES AND DISADVANTAGES BY USE OF DIFFERENT
                      TYPES OF CT




                                                                                        Radiology
                                                                                        Anatomy
  Authors:       Draganova V.D. ,Baleva D.B. ,Balev B.



  University: Medical University of Varna



ICMS 2011 / OP 61 Therapy
 Abstract:
 Introduction: Pulmonary embolism is the sudden blocking of the pulmonary ar-
 tery by a collection of solid material brought through the bloodstream (embo-
 lus)—usually a blood clot (thrombus) or rarely other foreign material. Mortality for
 acute pulmonary embolism can be broken down into 2 categories: massive pul-
 monary embolism and nonmassive pulmonary embolism.First is defined as pre-
 senting with a systolic arterial pressure less than 90 mm Hg. According two large
 international studies, this accounted for 4-4.5% of the patients. Nonmassive pul-
 monary embolism is defined as having a systolic arterial pressure greater than or
 equal to 90 mm Hg. It’s the more common presentation for pulmonary embolism
 and accounts for 95.5-96% of the patients. Signs and symptoms can vary from
 person to person, but commonly include sudden and unexplained shortness of
 breath, chest pain and a cough that may bring up blood-tinged sputum. Aim: The
 diagnosis of pulmonary embolism is missed in approximately 400,000 patients
 in the United States per year; approximately 100,000 deaths could be prevented
 with early and correct diagnosis and appropriate treatment. Methods: Diagnos-
 tic management algorithm includes:physical examination,electocardiography,ch
 est X-ray with typical signs(first diagnostic level);cardiac ECHO,D-dimers,venous
 leg imaging (second diagnostic level) and V|Q-scanning,spiral computerised to-
 mography and pulmonary angiography (third diagnostic level). Results: Attached
 images of clinical cases of patients,examined in the CT Radiology Department
 of the University Hospital “St. Marina”-Varna,Bulgaria. Conclusion: Helical CT is
 being increasingly utilized for the evaluation of suspected pulmonary embolism
 (PE). Proper scan interpretation depends on the awareness of several diagnostic
 pitfalls that may simulate PE, including normal bronchovascular structures such
 as pulmonary veins, bronchi, and lymph nodes, technical considerations such as
 improper bolus timing and streak artifacts, and patient-related factors such as
 motion artifacts, pulmonary arterial catheters, and vascular shunts.Helical CT is
 a procedure of choice due to the short examination time,lower invasiveness,less
 radiation exposure(it can be used by pregnant women),sensitivity 53-100% and
 specifity-83-100%.Single disadvantage of the method is the inability to preview
 subsegmental branches of a.pulmonalis.In all these cases multiplex CT help to
 set the correct diagnosis. The depiction occurs on 3 different sectional levels and
 permits intuitive navigating into the slices themselves.




Keywords: pulmonary embolism,helical CT,multiplex CT

Contact authors at: faith_i_am@abv.bg

                                      —263—
                   THE CLINICAL SIGNIFICANCE OF DETERMINING CYCLIC
                  CITRULLINATED PEPTIDE ANTIBODIES IN THE DIFFEREN-
                   TIAL DIAGNOSIS OF JOINT INVOLVEMENT IN SYSTEMIC
Rheumatology



                                      SCLEROSIS


                Authors: Natasa Zdraljevic, Marina Randjelovic, Vladimir Sto-
                jilkovic


                University: University of Nis



               ICMS 2011 / OP 62 Therapy
                Abstract:
                Introduction: Anti-citrullinated peptide antibodies (ACPA) have an important role
                in rheumatoid arthritis (RA) diagnosis. ACPA are present in 80% RA patients
                serums. They are highly specific, and are known as erosive arthritis develop-
                ment predictors. Few studies have researched the frequency of ACPA in SSc,
                and their possible role in SSc has not been explained yet. Aim: To determine the
                prevalence of ACPA in SSc patients, and to assess association between the pres-
                ence of ACPA, radiographic features and SSc clinical manifestations. Methods:
                The study included 45 SSc patients, mean age 51.07±14.18 years (41 female,
                4 male). The control group (CG) included 28 healthy controls. All the sclero-
                derma patients underwent clinical evaluation for the presence of arthralgias,
                arthritis and flexion contractures. Clinical features including pulmonary, cardiac,
                esophageal and renal manifestations were analyzed. The presence of ACPA was
                evaluated with commercially available enzyme-linked immunosorbent assay kit
                Intec. The serological tests recorded presence of antinuclear antibodies (ANA),
                anticentromere antibodies (ACA) (immunofluorescence on HEP2 cells) and an-
                titopoisomerase I antibodies (counter immunoelectrophoresis). Standard hands
                and wrists radiographies were obtained and evaluated. Results: ACPA positivity
                was found in 10/45 patients (22.22%). All the CG patients were negative for
                ACPA. Joint involvement: arthralgias in 36/45 SSc patients (80%), arthritis in
                9/45 (20%), and flexion contractures in 16/45 (35.55%). We found statisti-
                cally significant association between ACPA and arthritis (p=0.017). There was
                no association between organ involvement and ACPA positivity. ANA were posi-
                tive in 35/45 (77.77%), ACA in 10/45 (22.22%), antitopoisomerase I antibodies
                in 8/45 (17.77%) and RF in 8/45 SSc patients (17.77%). Statisticaly signifi-
                cant association was found between ACPA and antitopoisomerase I antibodies
                (p=0.008). Radographic changes: subcutaneous calcinosis in 13/45 (28.88%),
                digital tuft resorption in 10/45 (22,22%), juxtaarticular osteoporosis in 13/45
                (28,88%), marginal erosions in 11/45 (24,44%) were found in SSc patients.
                We found statistically significant association between ACPA and juxtaarticular
                osteoporosis (p=0.022) and ACPA and marginal erosions (p=0.048). Conclusion:
                Our results show an important association of ACPA positivity and arthritis in SSc.
                High titer of ACPA may be useful for diagnosis of overlap syndrome - SSc and RA
                and for appropriate treatment.



                Keywords:systemic sclerosis, anti-citrullinated peptide antibodies, arthritis

                Contact authors at: nanulina13@hotmail.com


                                                    —264—
  CONCEPT OF APPLIED PHYSICAL THERAPY PROCEDURES
 DURING SPECIALIZED CONDITIONING CAMP FOR TOP ATH-
                       LETES




                                                                                             Sports Medicine
                                                                                                Anatomy
  Authors: Gheorghi Konstantinov Maximov



  University: Medical University of Sofia



ICMS 2011 / OP 63 Therapy
 Abstract:
 Physical therapy (physiotherapy) is one of the most ancient branches of medicine.
 Even in remote past humans used it as a method of choice in the treatment of vari-
 ous diseases. Physical therapy is divided into several main lines involving electro-
 therapy (electric muscle stimulation), magnetotherapy, phototherapy, laser therapy,
 ultrasound therapy, inhalation and aeroionotherapy, kinesitherapy, mechanotherapy,
 massages, reflexotherapy, hydrotherapy, thermotherapy (heat therapy), climate ther-
 apy, balneotherapy, physical prophylaxis and rehabilitation. Sport involves workouts
 that can be daily or frequent and whose purpose is to achieve certain goal in various
 conditions that largely differ from those of the normal daily routine. Most often people
 practice sports for pleasure, for participation in competitions, for personal improve-
 ment, for skills development or for reasons somewhere in between. The European
 Sports Charter (2001, revised) defines sport as “all forms of physical activity which,
 through casual or organized participation, aim at expressing or improving physical
 fitness and mental well-being, forming social relationships or obtaining results in com-
 petition at all levels”. Athletics is considered as Olimpic sport №1 and one of the most
 popular sport in the world. Bulgaria has long traditions and great history in this impor-
 tant sport. The elaboration, employment and administration of a specialized physical
 therapy program for the recovery of professional athletes during specialized, training
 and/or conditioning camps can play a vital role for the future success of our country
 in athletic events on European, World and Olympic scale. Being best conditioned for
 the competition is the basis of the sportsperson’s success when he/she aspires at high
 sports achievement. Most often, conditioning for a competition is performed in the
 course of specialized sports camps or planned micro- and macro cycles of the training
 process. The application of physical therapy procedures is particularly important and
 of basic significance for the recovery of bodily skills and the improvement of the physi-
 ological and vital signs of sportspersons under heavy training pressure. The purpose of
 this presentation is to introduce a detailed schedule and program for physical therapy,
 rehabilitation and stimulation procedures which will not only provide quality, fast and
 effective recovery of the physiological capabilities of the body during the specialized
 athletic training camp but will so condition and stimulate the organism that the player
 won’t feel the burden of augmenting workouts and will improve his/her achievements
 with every workout in the course of the training camp. The elaboration of the sched-
 ule and program of the specialized athletic training camp involves the administration
 of seven physical therapy procedure types, namely, mechanotherapy, hydrotherapy,
 balneotherapy, kinesitherapy, massages, climate therapy and aeroionotherapy. Special
 emphasis is placed on sleep as part of the compensatory and recovery mechanisms of
 the living organism. Comment with brief analysis of the role and need of sex life for
 the top athletes during a training camp is provided.

Keywords: applied physical therapy, athletes, training, recovery, specialized
conditioning camp
Contact authors at: neuromaxi@yahoo.com

                                        —265—
                 ETHANOL INTENSIFIES CADMIUM-INDUCED CHANGES IN
                  THE CHEMICAL COMPOSITION OF THE BONE TISSUE IN
                                      RATS
Toxicology




              Authors: Dzwilewska Ilona, Brzoska Malgorzata M., Galazyn-
              Sidorczuk Malgorzata


              University: Medical University of Bialystok



             ICMS 2011 / OP 64 Therapy
              Abstract:
              Chronic exposure to cadmium (Cd) and excessive ethanol consump-
              tion have been recognized as the risk factors for bone damage. Due
              to common exposure of the general population to cadmium, some al-
              cohol abusers may be environmentally and/or occupationally exposed
              to excessive amounts of this toxic heavy metal. However, the impact
              of concomitant action of cadmium and ethanol on the skeleton has not
              been investigated up until now. The aim of this study was to investigate
              whether excessive consumption of ethanol under exposure to cadmium
              modifies this toxic metal-caused changes in the chemical composition
              of the bone tissue. For this purpose the content of organic and mineral
              components, including calcium, magnesium, zinc, copper and phos-
              phates, in the bone tissue isolated from the proximal end of the tibia
              (trabecular bone) of the male Wistar rats treated with 50 mg Cd/l in
              drinking water for 16 weeks (since the 5th week of their life) or/and
              ethanol (orally by gastric gavage) in the dose of 5 g/kg b.wt/24 h for
              12 weeks (since the 9th week of their life) was estimated. The ratio of
              mineral to organic components was calculated. The exposure to cad-
              mium alone caused changes in the chemical composition of the bone
              tissue. The bone content of organic components increased, whereas
              the content of minerals and the ratio of mineral to organic compo-
              nents decreased. Administration of ethanol alone and under exposure
              to cadmium influenced the bone chemical composition. Ethanol intensi-
              fied the cadmium-induced changes in the chemical composition of the
              bone tissue. Since changes in the bone content of both organic and
              mineral components have a direct impact on the bone biomechanical
              properties, the results of the study allow for the conclusion that exces-
              sive ethanol consumption under exposure to cadmium may weaken the
              bone strength and enhance the risk of fractures via intensification of
              the negative impact of this metal on the content of both mineral and
              organic components.

              Keywords:cadmium; ethanol; bone tissue; organic components; mineral
              components
              Contact authors at: idadi@wp.pl


                                              —266—
  Abstracts
   Therapy
Poster Session
                 THE EFFECTIVENESS OF RADIOFREQUENCY ABLATION OF
                 CAVO-TRICUSPID ISTHMUS IN COMBINATION WITH AN-
                 TIARHYTHMIC DRUG THERAPY IN PATIENTS WITH LONE
                 TYPICAL ATRIAL FLUTTER AND COMBINED WITH ATRIAL
Cardiology



                                   FIBRILLATION

              Authors: Koksheneva Z.I., Sokolov S.F., Golytsin S.P., Maykov
              E.B., Shlevkov N.B.


              University: Cardiology Research Institute after Myasnikow



             ICMS 2011 / PP 01 Therapy
              Abstract:
              In patients with lone istmus-dependant atrial flutter (IDAFl) radiofrequency
              ablation of cavo-tricuspid isthmus (RFA CTI) is currently a therapy of choice.
              When IDAFl is combined with atrial fibrillation (AF) the therapeutic approach
              is ill-defined. One can suppose that in patients with IDAFl combined with AF
              RFA CTI as an initial phase of non-pharmacologial treatment can not only
              positively affect the frequency of the recurrence of AF, but also affect the
              effectiveness of atiarhythmic drug therapy (ADT) following RFA CTI. Meth-
              ods: 44 patients included in the study (male – 22, female-12, mean age
              60,9±8,7 years). 16 – lone IDAFl (4-persistent, 12-paroxismal)-I group,
              15 - IDAFl combined with AF (6-persistent, 9-paroxismal)-II group, 13 -
              drug-induced IDAFl (Ic and III class ADT) (3-persistent, 10-paroxismal)-
              III group, all with antiarhythmic drug use experience. All underwent RFA
              CTI. After RFA in case of first recurrence of arrhythmia there was ADT with
              sotalol, bisoprolol and class Ic drug Allapinine or Flecainide initiated. The
              follow-up period formed 6 months. Results: By the 1 month of follow-up in
              II group 86.7% had no recurrence, in III group – 76.9%. By the 3 month –
              II-80%, III -61,5%. By the 6 month – 73.3% (4 patients without ADT-25%)
              and 30.8% (2 patients without ADT-15.4%), respectively. When comparing
              patients with a history of AF by the 6 month in II group the number of re-
              currence episodes was smaller than in III group (Cox’s F-test, p=0.03). In
              I group during whole follow-up period 87.5% patients had no recurrence,
              taking no ADT. In all cases AF was the only type of the recurrent arrhythmia.
              In all patients initially having persistent course it has transformed to parox-
              ysmal. Conclusions: In case of lone IDAFl RFA showed 100% in elimination
              of IDAFL and confirmed a first-line therapy status. In patients with IDAFl
              combined with AF and in drug-induced IDAFl RFA of cavo-tricuspid isthmus
              raises the effectiveness of ADT. Considering a statistically significant dif-
              ference in effectiveness of RFA between such patients (group II and III)
              only for II group RFA and subsequent ADT if needed can be considered a
              first-line therapy. In III group further trials are needed with larger samples.




              Keywords:Atrial flutter, atrial fibrillation, radiofrequency ablation

              Contact authors at: zinakok@rambler.ru


                                                  —268—
   RELATIONSHIP BETWEEN COMBINED ORAL CONTRACEP-
  TIVES AND BAROREFLEX SENSITIVITY IN YOUNG HEALTHY
                       WOMEN




                                                                              Cardiology
                                                                               Anatomy
  Authors: Michal Klapcinski, Anna Wilczak, Katarzyna Marciniak



  University: Wroclaw Medical University



ICMS 2011 / PP 02 Therapy
 Abstract:
 Background: There is evidence suggesting physiological links between au-
 tonomic nervous and endocrine systems. Derivate of estrogens and ge-
 stagens included in combined oral contraceptives (COC) modify the me-
 tabolism of endogenous sex steroid hormones. The aim of the study was to
 examine if there was a difference in baroreflex sensitivity (BRS) assessed
 in young healthy women taking vs. not-taking COC. Methods: We examined
 53 women (age: 23±3 years, BMI: 22.3±2.8 kg/m2) taking COC for ? 3
 months (COC-group) and 113 women (age: 24±4 years, BMI: 22.0±3.1
 kg/m2) not-taking COC for ?3 months (n-COC-group). All examined women
 were between the 4th and the 8th day of menstrual cycle (MC) and the MC
 length was between 21 and 35 days. BRS was assessed using the sequence
 (BRS-Seq, ms/mmHg) and the controlled breathing methods (BRS-CtBr,
 ms/mmHg). Results: There were no significant differences in: age, body
 mass, height, BMI, WHR, waist circumference and the consecutive cycle day
 on the day of examination (all p>0.05) between 2 study groups. BRS-CtBr
 was higher in a n-COC-group as compared to a COC-group (20.00±6.28
 ms/mmHg vs. 18.07±6.57 ms/mmHg, p=0.04) and there was a trend to-
 ward the higher BRS-Seq in a n-COC-group as compared to a COC-group
 (19.47±7.85 ms/mmHg vs. 16.95±5.76 ms/mmHg, p=0.12). In a n-COC-
 group there was an averse relations between BRS-CtBr and age (r=-0.23,
 p=0.02) and the consecutive cycle day on the day of examination (r=-0.18,
 p=0.07) and a trend toward higher BRS-Seq in those with the longer MC
 (r=0.16, p=0.0953). Conclusions: Lower BRS found woman taking COC
 may suggest that the suppression of endogenous hormones caused by COC
 impairs baroreflex response in the control of cardiovascular system.




Keywords: Baroreflex, COC, endogenous hormons

Contact authors at: kasia.marciniak@o2.pl

                                 —269—
                THE EXPLANATION OF THE RISE IN MYOCARDIAL INFARC-
                TION OCCURRENCE DURING SUMMER MONTHS FIBRILLA-
                                      TION
Cardiology




              Authors: Adrian Dan Raicu, Alexandru Ionescu, Costin Ioan
              Matei

              University: University Of Medicine And Farmacy Carol
              Davila,Bucharest



             ICMS 2011 / PP 03 Therapy
              Abstract:
              Introduction: Cardiovascular ailments are the main cause of death in Roma-
              nia. Acute myocardial infarction consists of the necrosis of cardiomyocites,
              which is often due to prolongued myocardial ischemia (caused by an unbal-
              ance between the oxygen intake and the oxygen need of the myocardium).
              Myocardial necrosis can also be the result of the occlusion of a coronary
              artery by intracoronary thrombosis, which complicates the evolution of an
              anterior atherosclerotic lesion. There are also cases in which myocardial
              infraction is produced independently from coronary atherosclerosis (about
              10% of the cases). Aim: The purpose of this study is to establish the causes
              which lead to STEMI (ST elevation myocardial infarction). The study has
              been carried out on 174 patients with STEMI, hospitalised in the Curtea de
              Arges, Romania city hospital during 2007-2010. Materials and methods: In
              order to correctly diagnose a STEMI, one should seek the following three
              aspects: 1.         The clinical manifestations- retrosternal or epigastric pain
              which doesn’t alleviate after nitroglycerin intake 2. An          electrocardio-
              graph is mandatory, as it shows the level of elevation of the ST segment
              and in which derivation it has occurred 3.      Laboratory analyses show a
              pathological increase of myocardial necrosis enzymes. Results: The study
              shows that the main risk factor for triggering an acute myocardial infarction
              was high blood pressure, followed by tobacco smoking, dyslipidemia, obe-
              sity, diabetes mellitus. Patients who already suffered a myocardial infarction
              were also at a greater risk. But beside these classic risk factors, we noticed
              that there are more cases of myocardial infarction during summer months
              (June-August). Thermoregulation processes are no longer efficient during
              hot weather periods and cause high blood pressure. With some people be-
              ing very sensitive to weather conditions, physical exertion can aggravate
              the ischemial disease and a myocardial infarction is often produced. Con-
              clusion: The patients were treated with thrombolytical agents, conventional
              medication and/or transfer to a hospital with percutaneous coronary inter-
              vention facilities. A more aggressive management of STEMI patients was
              found to be necessary.



              Keywords:myocardial infarction, causes, thermoregulation, heat

              Contact authors at: addy_raicu@yahoo.com


                                                 —270—
    USEFULNESS OF ERYTROCYTE RATE AND HEMOGLOBIN
   LEVEL AT ADMISSION ON SIX-MONTHS OUTCOME IN PA-
        TIENTS WITH ACUTE CORONARY SYNDROME




                                                                                  Cardiology
                                                                                   Anatomy
  Authors: Nemanja Opacic, Aleksandar B. Mitrovic, Bojana Pau-
  novic


  University: Medical University of Belgrade



ICMS 2011 / PP 04 Therapy
 Abstract:
 Introduction Acute coronary syndrome (ACS) is group of clinical signs and
 symptoms related to ishemic heart disease. It contains acute miocardial in-
 farction (MI) with or without ST elevation (STE) and unstable angina pectoris.
 Anemia at admission is common at patients with acute coronary syndrome.
 Aim The aim was to determine the influence of admission hemoglobin level
 and erytrocyte rate on six months prognosis in patients with acute coronary
 syndrome. Methods This retrospective study involved 52 consecutive ACS
 patients who were admitted to coronary care unit at Clinical Hospital Center
 Zemun, Belgrade, Serbia during 2008-09. They were divided in two groups
 according to hemoglobin level or erytrocyte rate. Results This study con-
 cured 32 women and 20 men (p>0.05). Anemia at admission was at 23 pa-
 tients (44.2%), 11 (47.8%) men and 12 (52.2%) women (p>0.05). Among
 anemic patients recorded higher frequency of STEMI (7, 30.4%, p>0.05)
 and unstable angina pectoris (10, 43.5%, p>0.05) while non-anemic pa-
 tients had higher frequency of NSTEMI (11, 37.9%, p>0.05). Six months
 mortality was 11.5% (6 patients). By using the chi-square test we found
 no statistically significant independent association between low hemoglobin
 concentrations and erytrocyte rate on the six months prognosis. Conclusion
 The results in this study shows that six months prognosis in patients with
 acute coronary syndrome is not directly dedicated to hemoglobin level and
 erytrocyte rate at admission in coronary care unit.




Keywords: anemia, acute coronary sundrome, six months outcome

Contact authors at: abm@doctor.com

                                   —271—
                 MORPHOFUNCTIONAL PECULIARITIES OF RED BLOOD
                CELLS AT THE PATIENTS WITH AN ARTERIAL HYPERTEN-
                         SION AND CHRONIC HEART FAILURE
Cardiology




              Authors: Shorikova D., Shorikov E,



              University: Bucovinian State Medical University



             ICMS 2011 / PP 05 Therapy
              Abstract:
              Introduction. The anaemic syndrome (AS) is one of the important factors for
              the prognosis of chronic heart failure (CHF) in our days (Framingham Study,
              SOLVD). The important aspect of pathogenesis of CHF is the disturbances
              of microcirculation which depends on rheological characteristics of blood
              that has based on morphofunctional peculiarities of red blood cells. Aim.
              The aim is to estimate the morphofunctional peculiarities of red blood cells
              at the patients with an arterial hypertension and chronic heart failure Meth-
              ods. It was inspected 87 patients with hypertensive disease (HD) II stage,
              33 patients with HD III stage and CHF IIa and 27 patients with HDІІІСFІІа
              and concomitant anaemic syndrome. All patients have reseached due to
              Guidelines of European Society of Cardiologists. The morphofunctional pe-
              culiarities of red blood cells such as viscosity of erythrocytes (VE) and index
              of erythrocytes’ deformability (IED) were estimated with using the method
              of Fedorova Z. and Kotovshchikova M. Results. The reliable decline of IED
              (р<0,05) and increase of VE (р<0,05) was set at patients with HDІІІСFІІа
              in comparing to HDІІ without the clinical signs of HF. At the same time, at
              the patients with HDІІІСFІІа and concomitant AS more considerable de-
              cline of erythrocytes’ deformability was set on relationship to other groups
              of patients (р<0,05). On the other side, the viscosity of erythrocytes was
              reliably lower at the group with anaemic syndrome (р<0,05) . Conclusion.
              The disturbances of morphofunctional properties of erythrocytes take place
              at the the patients with hypertensive disease, that is expressed in the de-
              cline of its deformability and increase of the viscosity. On the other side,
              the anaemic syndrome that worsens the prognosis for the patients with
              hypertensive disease and chronic heart failure characterized by the reli-
              able decrease worsening of erythrocytes’ deformability by comparison to
              uncomplicated HD.




              Keywords: hypertensive disease, heart failure, deformability, viscosity,
              erythrocytes
              Contact authors at: dreugene@opensvit.ua


                                                —272—
    FREQUENCY OF HEPATITIS C VIRUS GENOTYPES IN HCV
       INFECTED PATIENTS FROM SHAHRE-KORD, IRAN




                                                                                  Clinical Virology
                                                                                      Anatomy
  Authors: 1- Ali Karimi (Ph.D), 2-Reza Imani (M.D.) 3-Mohhame
  Kardi (MSc)


  University: Shahre-Kord University of medical Sciences



ICMS 2011 / PP 06 Therapy
 Abstract:
 Background and aims: Hepatitis C virus (HCV) is the major causative agent
 of non-A and non-B viral hepatitis with large genetic variability. Viral geno-
 type, and viral load are the factors associated with disease progression
 following HCV infection and treatment response varies according to geno-
 type. There fore, this study was aimed to determine HCV genotypes in
 a group of patients from Shahre-Kord, Iran. Methods: In this descriptive
 cross-sectional study, serum samples from 80 patients suspected with HCV
 infection who reffered to Hajar Hospital of Shahre-Kord between 2009 and
 2010 were analyzed for HCV RNA. Amplification products obtained from
 the patients subsequently were subjected to genotyping using type specific
 primers and commercial RT-PCR based kit. Results: HCV PCR products were
 obtained from 17 0f the 80 (21.25%) patients studied. The most frequently
 found genotype was genotype 3a, presented in 11 0f 17 (64.7%). 3 0f 17
 (17.6%) was corresponded to genotype 1a. 1 0f 17, (5.8%) corresponded
 to genotypes 1b and 2, each. 1 of 17 (5.8%) found to be infected with
 mixed genotypes of 1a+3a. Conclusion: The most frequent HCV genotypes
 in Shahre-Kord are 3a, and 1a.




Keywords: Hepatitis C virus genotyping, reverse transcriptase, polymerase
chain reaction
Contact authors at: kakarimi63@yahoo.com

                                   —273—
                        EFFECT OF ZINC (II) AND IRON (III) COMPLEXES ON VI-
                       ABILITY AND PROLIFERATION OF VIRUS-TRANSFROMERD
Clinical Virology


                                            TUMOR CELLS



                     Authors: Abdulkadir Abudalleh, Tania Zhivkova, Boyka Andono-
                     va-Lilova, Lora Diakova, E. Stoylkova, Marin Alexandrov, Gabriela
                     Marinescu, Dana Culita, Luminita Patron, Radostina Alexandrova

                     University: Sofia University St. Kliment Ohridski



                    ICMS 2011 / PP 07 Therapy
                     Abstract:
                     Introduction. Zinc and iron are essential elements that take part in many
                     key biological processes supporting life. There are data that some zinc and
                     iron compounds possess promising anticancer properties in vitro and/or
                     in vivo. The aim of the study presented here was to evaluate the effect
                     of newly synthesized zinc (II) and iron (III) complexes on viability and
                     proliferation of cultured virus-transformed tumor cells Materials and meth-
                     ods. The following zinc (II) and iron (III) complexes were synthesized and
                     their physical and chemical characteristics were determined: Zn(MorfBig)
                     Cl3,    Zn(Metf)2Cl2.3CH3OH,        [Zn(MorphBig)(Metf)Cl]Cl,    [Fe(Metf)3]
                     (NO3)3.CH3OH, [Fe(MorfBig)(Metf)(H2O)2](NO3)3, [Fe(MorfBig)2(H2O)2]
                     Cl3.2C2H5OH (where MorphBig = morpholine biguanide hydrochloride and
                     Metf = metformin hydrochloride). The experiments were performed us-
                     ing 3 permanent cell lines: LSCC-SF-Mc29 and LSCC-PR2-Mc29 (chicken
                     hepatoma induced by the myelocytomatosis virus Mc29) that express v-
                     myc oncogene and LSR-SF-SR (rat sarcoma induced by Rous sarcoma virus
                     strain Schmidt Ruppin) that carry v-src oncogene. The investigations were
                     carried out by MTT test (which reflects damage to mitochondria), neutral
                     red uptake cytotoxicity assay (indicates damage to lysosomes and Golgi
                     apparatus), crystal violet staining (nuclear staining) and double staining
                     with acridine orange and propidium iodide. The results obtained revealed
                     that applied at concentrations of 10-200 ?g/ml for 24h, 48h and 72h, the
                     complexes investigated decreased in a time- and concentration-dependent
                     manner the viability and proliferation of cultured tumor cells. Conclusion
                     The metal complexes examined were found to be more pronounced cyto-
                     toxic and cytostatic agents as compared to the ligands alone. Additional
                     experiments are required to clarify better the antineoplastic potential of
                     these compounds.




                     Keywords: zinc, iron, virus-transformed tumor cells, cytotoxic/antiprolifera-
                     tive activity
                     Contact authors at: alkader78mah@yahoo.com


                                                       —274—
     WHICH SKIN LUPUS CRITERIA ARE OF MORE VALUE IN
    DETERMINING THE DISEASE: A GREATER VIEW WITH THE
        HELP OF DIRECT IMMUNE FLUORESCENT (DIF).




                                                                                                                                    Dermatology
                                                                                                                                     Anatomy
   Authors: Sara Esmaeili, Saeed Shoar, prof. normohammad



   University: Tehran University of Medical Sciences



ICMS 2011 / PP 08 Therapy
 Abstract:
 Back Ground Genetic, hormones, and environment play altogether to give birth to lupus erythematous (LE); LE is clini-
 cally divided to three classes: systemic lupus with acute onset, sub- acute cutaneous type, and a chronic discoid form
 (discoid lupus erythematous [DLE]). Occurring two to three times more often than SLE, cutaneous lupus is a variant of LE
 being able to bother the patients’ daily life It is mentioned that the diagnosis will come out when clinical manifestations
 (symptoms), serology (auto antibodies detected by sensitive rather than specific enzyme-linked immunosorbent assay
 [ELISA]), and pathology (histopathological changes in the skin lesions’ sampling) all are correlated to each other .There
 are although some unanswered here that if these all have any beneficial over the others. Our study here aims to find
 out the prevalence of each pathologic criterion and to determine the benefits of these criteria over the other ways with
 a special attention to the direct immuno?uorescence (DIF) test to reach a more accurate diagnosis on cutaneous lupus
 erythematous particularly DLE. Methods All the patients with a pathologically confirmed diagnosis of skin lupus referring
 to Razi hospital of Tehran were included in the study between 2008 and 2010. Pathologic samples were extracted from
 the medical records of patients and assessed by the faculties under the light microscopy for the histopathological features
 of the DLE; lupus band test was also evaluated on these and recorded as positive or negative result based on the pat-
 tern of antibodies, complement, and membrane attack complex deposition in dermo- epidermal junction to see if it is of
 any benefit over the other pathologic criteria in confirming a clinical diagnosis of DLE. Data were analyzed by Statistical
 Package for the Social Sciences (SPSS) and cross tab software to find the relationship between each criterion; of all his-
 topathologic features, hyperkeratosis, follicular atrophy, follicular plaque, and basements membrane thickness increasing
 were in a single group, superficial and deep peri vascular infiltration in another category, and peri vascular, peri follicular,
 and paracrine were included in a separated one. Overall results were used in bringing out a series of pathologic criteria
 for accurate diagnosis of cutaneous lupus. Differential diagnoses similar clinically to cutaneous LE were also assessed to
 find out the prevalence of their histopathological differences. Test results from DIF were also another aspect of the study
 which was evaluated for its prevalence to see the efficacy. Results: 61.4 % was belonged to female, and the rest 38.6%
 of male. In 58.6% of the patients, DLE had been the first diagnosis associating with 23.4% in the second rank, 4.1% in
 the third, 1.4% fourth, 0.7% fifth, and in 11% of the cases, it had not been among the diagnoses. Also DIF was reported
 positive in 49% of the cases with 25% IgG, 33% IgM, and 42% C3 all deposited in the dermo- epidermal junction. The
 frequency of histopathologic features in samples is summarized in table 1 regardless of the sequence they have appeared
 at the field. Other differential diagnoses are shown in table 2. Also in 36.6% of the cases, the presenting symptom was
 plaque, 16.6% papule, 15.9% erythematous lesion,10.3% patch, 5.5% alopecia, 4.8% pigmentation, 2.1% nodule, and
 other 0.7% scar, rash, blister, macula, erosion, hypopigmentation, and vesicles. We analyzed data using SPSS and cross
 tab software to connect the features of three groups to each other to see which combination can bring a more accurate
 diagnosis. In one direction, hyperkeratosis and follicular atrophy were seen in 65% of the cases with hyperkeratosis and
 follicular plaque in 66%, hyperkeratosis and basements membrane thickness increasing in 100%, follicular atrophy and
 follicular plaque in 64%, follicular atrophy and basements membrane thickness increasing in 47%, and follicular plaque
 and basements membrane thickness increasing 58%; in the other category, we observed superficial and deep perivas-
 cular infiltration in 95% of the samples; and at the third last one, superficial perivascular and perifolicular infiltration
 were observed in 99% of the cases with paracrine and perivascular infiltration in 97%, and perifolicular and paracrine in
 90.9%. Other analysis was done to find out the relations between these categories; it showed that hyperkeratosis and
 superficial perivascular infiltration are seen in 94.5%, follicular atrophy and superficial perivascular infiltration in 79%,
 follicular plaque with superficial perivascular infiltration in 96.4% while with reflective in 89.2%, superficial perivascular
 infiltration and basements membrane thickness increasing in 100%, basements membrane thickness increasing and deep
 perivascular infiltration in 88%, and deep perivascular infiltration with superficial perivascular, perifolicular, and paracrine
 infiltration in 95.10%, 87.5%, and 90.9%, respectively. Conclusion: The most prevalent finding was perivascular infil-
 tration which is in absolute correlation with other studies. When looking from one aspect to the frequency of the histo-
 pathologic features and consider them with one direction, hyperkeratosis and basement membrane thickness increasing
 altogether in association with one or two other features of this category, superficial and deep perivascular infiltration
 in association with one or two other features of other categories, and superficiaAs these analytical combinations show,
 we can mention that superficial perivascular infiltration along with hyperkeratosis, and basements membrane thickness
 increasing and deep perivascular infiltration, perifolicular infiltration and paracrine infiltration could be considered as
 cutaneous lupus diagnostic criteria.




Keywords: lupus criteria ,direct immune fluorescent

Contact authors at: sara_es64@yahoo.com

                                                         —275—
                   INVESTIGATIONS ON POLYAMINE METABOLISM OF BE-
                        NIGN KERATINOCYTIC PROLIFERATIONS
Dermatology




               Authors: Valentina Broshtilova



               University: Medical University of Sofia



              ICMS 2011 / PP 09 Therapy
               Abstract:
               Polyamines – putrescine, spermidine and spermine are polycationic com-
               pounds ubiquitous for all living organisms. They are essential for the cell
               growth and differentiation, the control of cell cycle progress, apoptosis, and
               cancerogenesis. Accumulated scientific evidence suggests the central role
               of polyamines in the processes of keratinocytic proliferation, differentiation,
               and regulation. Objective: to elucidate the polyamine metabolic changes
               that occur in benign keratinocytic proliferation. Fifty eight patients were
               enrolled in the study, 31 with psoriasis vulgaris, which has been referred
               to as a model of benign keratinocytic proliferation, and 27-healthy con-
               trols. Method: an original, innovative chromatographic method was used to
               detect the levels of putrescine, spermidine, and spermine in all skin sam-
               ples. Results were significantly proven (p<0.05). No difference was found
               between the polyamines levels of non-lesional psoriatic skin and healthy
               controls. Psoriatic lesions showed a two-time higher concentration of all
               polyamines in lesional, compared to non-lesional skin. Spermine had the
               highest concentration and highest proliferation trend, which demonstrated
               the importance of propylamine synthesis in the pathogenesis of psoriasis.
               Spermine highest concentrations suggested the leading role of adenosine
               methionine decarboxylase (AMDC) in the pathogenesis of benign keratino-
               cytic proliferations. Conclusions: non-involved psoriatic skin did not show
               latent changes in polyamine metabolism. Psoriatic lesions demontrated a
               two-time inhancement of polyamine metabolism. The highest level of sper-
               mine proved the crutial role of AMDC in the polyamine metabolism changes
               in psoriasis. Future therapeutic approaches should be focused on reduction
               of exogenic spermine intake, utilizing new spermine blockers, and synthesis
               of AMDC inhibitors.




               Keywords: spermine, spermidine, putrescine, psoriasis

               Contact authors at:broshtolova@mail.bg


                                                 —276—
  OBSERVATION OF 100 MEN WITH URETHRITIS - MEDICAL,
            SOCIAL, AND CLINICAL ASPECTS




                                                                               Dermatology
                                                                                Anatomy
  Authors: D. Dermanov, G. Pehlivanov, L. Miteva



  University: Medical University of Sofia



ICMS 2011 / PP 10 Therapy
 Abstract:
 Observation of 100 Men with Urethritis Medical,Social and Clinical Aspects
 D.Dermanov,G.Pehlivanov,L.Miteva Introduction: In Alexandrovska Hospi-
 tal Dermatology and Venereology University Clinic,Venereology Sector 100
 male patients between 15 and 81 years of age having different forms of
 Urethritis have been observed. Aim: To name medical,social and clinical as-
 pects for men with urethrites. Methods and Results: For 38% of the patients
 the things were not as they should be both psychologically and socially,and
 the quality of live was disturbed. In 45% of cases the complications are
 due to delayed and inadequate diagnostics. Inadequate treatment was the
 reason for 22% of complications. Clinical forma are 1:3 (acute : gleet/
 chronic/). 18% of observed patients had gonococcal urethrites,and 28%-
 chla- midia urethrites. Conclusions: The authors believe that urethrites
 should be managed mainly by dermatology and venereology structures and
 use others experts’ (urologists,gyne- cologists,and specialists in internal
 diseases) help.




Keywords: Patients, Observed, Urethrites, Socially

Contact authors at: dragan_dermanov@abv.bg

                                  —277—
                T-HELPER 1/T-HELPER 2 AND T-HELPER 17/ REGULATORY
               T-CELL CYTOKINE IMBALANCE IN PATIENTS WITH CHRON-
                                IC HEART FAILURE
Immunology




              Authors: Hedayat M, Fazeli Dehkordy S, Mahmoudi MJ



              University: Tehran University of Medical Sciences



             ICMS 2011 / PP 11 Therapy
              Abstract:
              Introduction: Immune activation plays a significant role in the development
              and progression of chronic heart failure (CHF). Several lines of evidence
              support the role of innate immune responses; however, the pathophysio-
              logic role of adaptive immune responses is not well identified. Aim: The aim
              of the present study was to evaluate the T-helper (Th) 1, Th2, Th17, and
              regulatory T (Treg) cell-related cytokines in patients with CHF. Methods:
              Eighty six patients with angiographically confirmed coronary artery disease
              and ejection fraction of less than 40% and 95 age- and gender- matched
              healthy volunteers were enrolled. Plasma levels of Th1 (IL-12, IL-2, IFN-?),
              Th2 (IL-4), Th17 (IL-23, IL-17), and Treg (IL-10, TGF-?) related cytokines
              were measured by an enzyme-linked immunosorbent assay (ELISA). Re-
              sults: Patients with CHF had increased plasma concentrations of IL-12, IL-2,
              IFN-?, IL-23, and IL-17. Plasma levels of TGF-? and IL-10 were significantly
              decreased in CHF patients. IL-4 level did not differ between CHF and control
              subjects. The abnormalities in the cytokine profile were most pronounced in
              CHF patients with NYHA functional class IV compared to patients with less
              severe disease. Conclusion: The results indicated that Th1/Th2 and Th17/
              Treg imbalances exist in patients with CHF. Marked Th1 and Th17 responses
              might contribute to the inflammatory milieu in the context of the failing
              heart. Intervention preventing unwanted T-cell activation could represent a
              new therapeutic target in patients with CHF.




              Keywords: T-helper, T-regulatory, Cytokines, Heart Failure

              Contact authors at:mona_hedayat@yahoo.com


                                               —278—
   DIAGNOSTIC CRITERIA OF SEPTIC VARIANT OF INTESTI-
                   NAL YERSINIOSIS




                                                                                     Infectious Diseases
                                                                                          Anatomy
  Authors: V. Kozko, N. Merkulova, V. Tkachenko, D. Tarawneh



  University: Kharkiv National Medical University



ICMS 2011 / PP 12 Therapy
 Abstract:
 Introduction: The diagnosis of intestinal yersiniosis is still a challenge for
 the doctor. This explains by the large number of clinical forms of the dis-
 ease, the similarity with numerous infectious and noninfectious diseases.
 Depending on the predominance of lesions of various organs, such clinical
 form can be singled out: abdominal, generalized (including septic variant),
 secondary focal, articulate, anginous and other. Only the clinical recognition
 of the disease is not enough. This particularly applies to septic variant of the
 generalized form, which often runs hard with a fatal outcome. Aim: To iden-
 tify the most informative diagnostic criteria of septic variant of intestinal ye-
 rsiniosis. Methods: clinical, epidemiological, laboratory, instrumental, spe-
 cific. Results: Septic variant of the generalized form of yersiniosis resembles
 sepsis. Often such variant occurs in the presence of concomitant diseases
 (tuberculosis, HIV infection, alcoholism, hematologic and endocrine diseas-
 es). The typical clinical signs of the presence of severe prolonged acyclic
 disease course are high fever of hectic type with chill and profuse sweats,
 severe intoxication, polyarthralgias, often hemorrhagic, or of other pattern,
 exanthema, hepatosplenomegaly, and sometimes jaundice and abdominal
 pain, watery stool. Together with these symptoms, pneumonia, pyelone-
 phritis, myocarditis, arthritis, enterocolitis, sore throat, lymphadenopathy,
 meningoencephalitis can be identified. The laboratory criteria: anemia, neu-
 trophilic leukocytosis with a shift to the left of leukocyte formula, and a
 significant increase in ESR. Depending on the nature and localization of
 lesions there observed changes of other relevant laboratory parameters.
 Hepatosplenomegaly is confirmed by ultrasound scan. The methods of spe-
 cific diagnosis of intestinal yersiniosis: hemoculture of causative agent, se-
 rological methods (IHA, ELISA) and molecular biology methods (PCR) are
 used. Conclusion: For recognition of a septic variant of intestinal yersiniosis
 all possible diagnostic criteria are advisable to use: clinical, laboratory, in-
 strumental. The use of specific diagnostic methods allows us to establish
 the etiology of sepsis and diagnose septic variant of intestinal yersiniosis,
 which is of consequence for therapeutic tactics of the disease. Based on the
 fact that this form of intestinal yersiniosis often develops in patients with
 immunodeficiencies, such patients should be screened for HIV infection.

Keywords: intestinal yersiniosis

Contact authors at: t_diana@ukr.net

                                    —279—
                                       TUBERCULOSIS AND HIV INFECTION
Infectious Diseases




                       Authors: Chamil Uddhika Hewa Edirisooriya, Olga Iurchenko



                       University: Kharkov National Medical University



                      ICMS 2011 / PP 13 Therapy
                       Abstract:
                       Tuberculosis and HIV infection: magnification of the problem in Kharkiv
                       region. Kharkiv National Medical University, Kharkiv, Ukraine Introduction:
                       Despite of the state and society efforts, the situation with diffusion of HIV
                       infection in Ukraine remains disturbing. The HIV infected structure practi-
                       cally coincides with structure for the new cases of tuberculosis. Able-bodied
                       middle aged males, social non-adopted persons and persons with the risk
                       factors of behavior prevailed. Aim: Real estimation of an epidemic situation
                       in Kharkov region for carrying out of preventive measures against TB. Meth-
                       ods: Among 3460 patients with co-infection tuberculosis/HIV 2448 were
                       males and 1012 were females at the age of 25-49. Any of them were sent
                       to antituberculous wards by the regional center of struggle against AIDS,
                       123 persons were examined in antituberculosis wards at their self wish and
                       3337 persons have been examined due to referral made by health work-
                       ers. Among the examined patients 2752 patients had behavioral factors of
                       the high risk to be HIV-infected. Results: During the study 89 patients with
                       co-infection tuberculosis/HIV were found out. Among them 58 men and 31
                       women were at the age of 35-54. Prevailing site of tuberculosis was pulmo-
                       nary tuberculosis (77.53%). The active forms of pulmonary tuberculosis in
                       co-infection tuberculosis/HIV were diagnosed in 69 patients (45 men and
                       24 women). Bacilli excretion was found in 52 patients (58.43%). 39 men
                       and 13 women were among them. Conclusion: 1. Priority of HIV-infected
                       group among other groups of the high risk to develop tuberculosis proves
                       necessity of creation of uniform information base for their monitoring. 2.
                       Tuberculosis is the main secondary disease in HIV-infected persons and
                       is the main cause of their death in a stage of AIDS. It demands the joint
                       coordinated efforts of antituberculosis service and the service of the strug-
                       gle against AIDS to prevent and made the diagnosis of TB in HIV-infected
                       persons in time. 3. HIV/AIDS is the most threatened factor supporting epi-
                       demic of a TB. Therefore the basic settlement of the problem is isoniazid
                       chemoprophylaxis in HIV infected persons.




                       Keywords: Tuberculosis

                       Contact authors at: profchamil789@gmail.com


                                                         —280—
  STUDY OF THE PREVALENCE AND ANTIBACTERIAL SUSCEP-
  TIBILITY PATTERN OF ENTEROPATHOGENIC ESCHERICHIA




                                                                                  Infectious Diseases
  COLI (EPEC) STRAINS ISOLATED FROM <5 YEARS OLD DI-
   ARRHEAL CHILDREN HOSPITALIZED IN HAJAR HOSPITAL,
                SHAHREKORD, IRAN -2009




                                                                                       Anatomy
  Authors: Behnam Zamanzad



  University: University of Shahrekord



ICMS 2011 / PP 14 Therapy
 Abstract:
 Background: Enteropathogenic Escherichia coli (EPEC) strains are of the
 most important diarrheagenic agents in develouping countries. This study
 aims to determine the common serotypes and antibacterial susceptibility
 pattern of EPEC strains isolated from <5 years old diarrheal children hos-
 pitalized in Shahre-kord Hajar Hospital in first six months of 2009. Mate-
 rial and method: A total of 50 rectal swabs collected from <5 years old
 diarrheal children with diarrhea were obtained. Also, 50 rectal swabs from
 outpatient children without history of diarrhea and gasteroentritis were ob-
 tained as control group. Stool samples were cultured on differential media
 and incubated overnight in 35?C. Standard biochemical tests (IMVIC) were
 used for identification of bacteria. Confirmation of isolated bacteria as EPEC
 strains was performed with specific antisera (Bahar Afshan-Tehran) using
 slide agglutination method. Besides, antibacterial susceptibility pattern of
 13 EPEC isolates against some common antibiotics: cephalotin, ampicillin,
 nalidixic acid, sulfamethoxazol- trimethoprim, gentamicin, ceftriaxone, cip-
 rofloxacine and nitrofurantoin was evaluated using disk diffusion method.
 Results: EPEC strains were isolated from 26% of the children with diarrhea
 (13 patients) compared with 4% of children without diarrhea (2 cases). No
 significant relation was presented between prevalence of EPEC strains and
 age, sex, and patient?s duration of diarrhea. Fifty percent of the EPEC iso-
 lates were belong to O44, O125, O126 and O128 serogroups, 33.3% were
 belong to O20, O114 serogroups and 16.6% to O26, O55 and O111 sero-
 groups. Nitrofurantoin, ciprofloxacine and gentamicin were the most effec-
 tive antibiotics against EPEC bacteria. Conclusion: The prevalence of EPEC
 shows the importance role of these strains in causing of acute diarrhea in
 children. Then, application of routine diagnostic tests for identification and
 serogrouping of EPEC strains in bacteriologic laboratories is recommended.




Keywords: Children Acute diarrhea, Enteropathogenic Escherchia Coli, Slide
agglutination test
Contact authors at: bzamanzad@yahoo.com

                                   —281—
                         EXPERIENCE OF CLINICAL USAGE SPECIFIC HUMAN IM-
Infectious Diseases

                        MUNOGLOBULINS IN TREATMENT OF PATIENTS WITH HER-
                                  PETIC MENINGOENCEPHALITIS



                       Authors: Iakymenko M.N. Zagorodneva O.V., Sokhan A.V., Kopi-
                       ychenko Y.I.


                       University: Kharkiv National Medical University



                      ICMS 2011 / PP 15 Therapy
                       Abstract:
                       Topicality: Herpetic encephalitis (HE) amounts 10 - 20% of all viral lesions
                       of the central nervous system and it strikes people of all ages. The Aim:
                       To optimize the treatment of patients with herpetic meningoencephali-
                       tis. Methods: During 6 years we had observed 57 patients with herpetic
                       meningoencephalitis. Patients were divided into 3 groups according to the
                       treatment they had received. The first group (I) (15 patients) - received
                       antiviral therapy by acyclovir (zoviraks, medovir) and by specific human
                       immunoglobulin G against herpes simplex virus (Biopharma firms) of the
                       first or second type (depending on the etiology of the disease), immunosup-
                       pressive therapy, the second group (II ) (19 patients) – received antiviral
                       therapy by acyclovir and pathogenetic therapy, the third group (III) (21
                       patients) – received only pathogenetic therapy. The Results: The severity
                       of the disease was caused not only by intoxicational and meningeal symp-
                       toms but by symptoms of central nervous system lesions which are the
                       forefront and occurred the most part of patients without reference to sever-
                       ity. All patients were complained of severe headaches (most of them in the
                       fronto-temporal region), nausea, repeated vomiting, poor appetite, general
                       weakness and a fever. In the neurological status patients had not only cer-
                       ebral disorders (like soporous state ) but focal CNS symptoms lesions too.
                       The Bulbar syndromes, pathological reflexes of Babinskij, Openheym and
                       Rossolimo appeared only on the 5th-7th day of disease and were accom-
                       panied by stiff neck, by Kernih symptom (almost a one-third of patients).
                       So comparing the Ist and the IInd group the duration of the symptoms was
                       significantly lower in the first group than in the other one. Duration of fever
                       decreased on 20%, nausea –on 50% , vomiting – on 36%, headache – on
                       42%, meningeal symptoms – on 10%, focal symptoms – on 30%, the sani-
                       tation of cerebrospinal fluid – on 25%.The mortality in the Ist group was on
                       10% lower than in the IInd one. Conclusions Analyzing the disease process
                       of different groups shows that prescribing of antiherpetic specific human
                       immunoglobulin in the complex with acyclovir therapy much better effects
                       on the treatment of pations with herpetic meningoecephalitis.



                       Keywords: Herpetic encephalitis, the treatment, antiherpetic specific human
                       immunoglobulin
                       Contact authors at: analitt@yandex.ru


                                                         —282—
   IMMUNOLOGIC INDICES AND MORPHOLOGICAL CHANGES
    OF THE IMMUNE SYSTEM IN PATIENTS WITH BACTERIAL




                                                                                 Infectious Diseases
   MENINGITIS AND MENINGOENCEPHALITIS SHAHREKORD,
                      IRAN -2009




                                                                                      Anatomy
  Authors: Pankova I,Zagorodneva O, Sokhan A, Kopiychenko Y.



  University: Kharkiv National Medical University



ICMS 2011 / PP 16 Therapy
 Abstract:
 Introduction: In modern conditions clinical displays of meningococcal and
 pneumococcal meningitis and meningoencephalitis are characterized by
 development of severe disordes of the central nervous system therefore
 search of an original cause of weak resistance is necessary. Methods: im-
 munological, immunohistochemical. Results: diagnostic criteria for early
 prognosis of clinical course in patients with bacterial meningitis and menin-
 goencephalitis were established using of immunological examination. The
 changes of T-cells, humoral and phagocytic immunity (decrease of CD3,
 CD4, CD8, Ig, complement, phagocytic activity of the neutrophils) were de-
 termined in meningococcal and pneumococcal meningitis and meningoen-
 cephalitis and were more expressed in pneumococcal infection. There was
 normalization of the majority of immunogram indices in moderate course
 and improvement of them in severe course during convalescence. Consid-
 erable devastation of lymphoid tissue in the thymus, spleen and lymphatic
 nodes with insufficiency of the macrophagal link and decrease synthesis
 of the IL-1 and TNF-a were revealed. Foci of destruction without develop-
 ment of inflammatory reaction in the brain were found in 33,3% cases of
 pneumococcal meningoencephalitis. DIC-syndrome was associated with de-
 crease by synthesis of the IL-1 and TNF-a. Discussion: At severe and very
 severe clinical course of meningococcal and pneumococcal meningitis and
 meningoencephalitis ability of an organism of patients to end of inflamma-
 tory reaction, restoration of the damaged structures and normalization im-
 mune and a homeostasis as a whole is insufficient for an absolute recovery.
 Therefore there is a question on necessity of application of preparations for
 correction of immunological infringements.




Keywords: meningitis, meningoencephalitis,immunological examination

Contact authors at: irenie88@bigmir.net

                                   —283—
                         COMPARISON BETWEEN RENAL VOLUME IN TYPE 1 AND
                          TYPE 2 DIABETICS WITH DIABETIC NEPHROPATHY
Internal Medicine




                     Authors: Iviana Yovchevska, Evgenya Peneva



                     University: Medical University of Sofia



                    ICMS 2011 / PP 17 Therapy
                     Abstract:
                     Objective Both, type 1 diabetes mellitus (insulin-dependent diabetes mellitus)
                     and type 2 diabetes mellitus (non-insulin-dependent diabetes mellitus) lead to
                     diabetic nephropathy. Although postulated mechanisms for development of dia-
                     betic nephropathy are the same - hyperglycemia (causing hyperfiltration and
                     renal injury), advanced glycosylation products and activation of cytokines; the
                     different pathogenic development mechanisms of the two types of diabetes are
                     suggesting some variations in the progression of the related microvascular com-
                     plications. The aim of the present study is to compare renal volume in type 1 and
                     type 2 diabetics, with diabetic nephropathy and mild renal insufficiency. Methods
                     Ten patients with type 1 diabetes mellitus and ten patients with type 2 diabetes
                     mellitus, with mild renal insufficiency, were studied. Subjects were recruited in
                     the following way: the first ten consecutive patients in their fifties who were
                     treated in the Nephrology Consulting Unit in 2010. Glomerular filtration rate,
                     proteinuria and renal volume were examined. In the ultrasonographic examina-
                     tion of the renal volume, the formula for an ellipsoid was applied, as follows: vol-
                     ume = length x width x thickness x /6, where volume is measured in milliliters.
                     The mean renal volumes of two groups were compared using one-way ANOVA
                     F-test. Statistical significance was inferred at p<0.05. Results The average age
                     for the two patient groups (55.3 ± 2.3 years for type 1 versus 56.1 ± 2.5 years
                     for type 2) was not significantly different. There was no statistical difference
                     between glomerular filtration rate (74 ± 8.3 ml/min for type 1 vs. 77 ± 8.1 for
                     type 2). The total renal volume of the two kidneys of the type 1 diabetic patients
                     was significantly larger - 355 ± 34 ml as compared to 320 ± 39 ml of the type
                     2 diabetics. In the group of type 2 diabetes mellitus, the duration of hyperten-
                     sion was significantly longer – 15.2 ± 4.1 years vs. 11.1 ± 3.4 years for type 1.
                     In the type 2 diabetes mellitus patients’ group, the decrease of the kidney vol-
                     ume was in straight relationship with the duration of hypertension. Conclusions
                     There is a difference between renal volume in type 1 and type 2 diabetics, with
                     diabetic nephropathy with mild renal insufficiency. This suggests that in type 2
                     diabetic patients, factors other than diabetic glomerulosclerosis are also part of
                     the causes for the development of renal failure. One of these is supposed to be
                     the arterial hypertension causing hypertensive nephrosclerosis.




                     Keywords: diabetic nephropathy, renal volume, renal insufficiency

                     Contact authors at: iviana@dir.bg


                                                          —284—
  10-YEAR ABSOLUTE RISKS FOR CARDIOVASCULAR EVENTS
  AND STROKE IN TYPE 2 DIABETES PATIENTS BY TWO MOD-




                                                                                   Internal Medicine
    ELS - THE UKPDS RISK ENGINE AND THE FRAMINGHAM
                   CARDIAC RISK SCORE




                                                                                       Anatomy
  Authors: Snejina Dencheva, Assoc.Prof.Mihail Boyanov



  University: Medical University of Sofia



ICMS 2011 / PP 18 Therapy
 Abstract:
 Introduction: A number of models have been developed to calculate an indi-
 vidual’s risk for coronary heart disease (CHD) and stroke. Aim: To calculate
 the individual cardiovascular risk in type 2 diabetics by two validated tools –
 the United Kingdom Prospective Diabetes Study (UKPDS) risk equation and
 the Framingham Cardiac Risk Score (FCRS). Methods: 144 type 2 diabetes
 inpatients participated – 99 women (mean age 63.3 ± 12.3 years) and 55
 men (mean age 58.9 ± 10.8 years). The data were collected from hospital
 records and included age, diabetes duration, systolic (SBP) and diastolic
 blood pressure (DBP), glycated hemoglobin A1c (HbA1c), total and HDL-
 cholesterol. No data were available about smoking and atrial fibrillation,
 therefore all analyses were performed as if they were absent. The UKPDS
 risk engine version 2.0 and the FCRS were applied. Results: In women the
 10-year absolute risks for CHD, fatal CHD and stroke (UKPDS risk engine)
 were < 15 % in 48.5 %, 59.6 %, 67.7 % respectively, between 15 and 20
 % – in 7.1 %, 15.1 % and 10.1 %, between 20 and 30 % - in 17.2 %, 6.1
 % and 7.0 %, and ? 30 % - in 33.2 %, 19.2 % and 15.2 %. In men the
 corresponding frequencies for risks < 15 % were 32.7%, 50.9 % and 72.7
 % (CHD, fatal CHD and stroke), for risks between 15 and 20 % - 12.8 %,
 13.7 % and 9.1 %, for risks between 20 and 30 % - 16.3 %, 3.8 % and 7.3
 %, and for risks above 30 % - 32.2 %, 32.7 % and 10.9 %. The FCRS was
 below 10 % in 18.4 % of the women and in 20.8 % of men, between 10
 and 20 in 59.9 % (women) and 52.8 % (men), and above 30 – in 20.7 %
 (women) and 26.4 % (men). Conclusion: About half of the studied women
 and only ? of the men were at low risk for vascular events. Our data empha-
 size the need for individualized risk assessment in type 2 diabetes patients.




Keywords: type 2 diabetes, cardiovascular risk, risk equations, stratification

Contact authors at: snejina_dencheva@hotmail.com

                                   —285—
    IMMUNOMODULATORS DERINAT® AND LICOPID® ON
   ACTIVITY OF LYZOZYME AS A FACTOR OF NON-SPECIFIC




                                                                                Internal Medicine
  IMMUNE RESISTANCE IN HELICOBACTER PYLORI INDUCED
                 PEPTIC ULCER DISEASE.




                                                                                    Anatomy
  Authors: V.V Kuzin, Valentina V. Dugina, Kughan Govinden



  University: Nizhny Novgorod State Medical Academy



ICMS 2011 / PP 20 Therapy
 Abstract:
 Introduction: Widespread antibiotic-resistant strains of Helicobacter
 Pylori(HP) have appeared which causes more difficulty in eradication. This
 research is conducted to study efficiency of immunomodulators in HP eradi-
 cation and improvement of immune system. Objectives: 1. To investigate
 the influence of immunomodulators Licopid® (a synthetic bacterial prepa-
 ration) and Derinat® (a preparation of nucleic acid) in combination with
 antihelicobacter quadro-scheme therapy(QST) on efficiency of eradication
 in patients with peptic ulcer disease(PUD)caused by HP. 2. To reveal inter-
 relation of lysozyme activity for the given group of patients. Methods: 1.
 This research is carried out on 70 patients within the age range of 20-55
 years with PUD of stomach and duodenum caused by HP. 2. Depending on
 types of received therapy, three groups of patients have been allocated:-
 (a) Group A (control group) consisting of 20 patients receiving quadro-
 scheme therapy(QST) consisting of bismuth colloidal subcitrate, omepraz
 ole,amoxicilin,furazolidon. (b) Group B of 25 patients receiving QST with
 Licopid® (c) Group C of 25 patients receiving QST with Derinat® 3. Be-
 fore and six weeks after application of preparations, the histomorphological
 tests of biopsy material taken endoscopically from stomach and duodenum
 and biotests(nephelometry) of saliva and gastric juice from patients are
 done. Results: Six weeks after treatment, cytological tests reveals eradica-
 tion is less expressed and presence of HP coccal forms in Group A. In Group
 B and C the parameter of eradication is essentially above and coccal forms
 are absent. The increase of lyzozyme activity in saliva is observed in Group
 C (12, 3 % compared to initial level) and Group B(8.1%). The least increase
 lysozyme activity has been revealed in Group A. At application of Derinat®
 and Licopid® the tendency of lysozyme increase is marked in gastric juice
 about 7.4 % for Group C and 3.6 % for application Group B. In control
 group, the lowest activity of lysozyme is marked. Conclusion: Application
 of immunomodulators Derinat® and Licopid® on background of antihelico-
 bacter QST leads to increased eradication of HP. Usage of immunomodula-
 tors with QST tends to increase activity of lysozyme in saliva and gastric
 juice, more expressed at application Derinat®.


Keywords: Immunomodulators, peptic ulcer disease, eradication, immuno-
globulin, lyzozyme
Contact authors at: kughan_cpr@yahoo.com

                                  —287—
                        INVESTIGATION OF C-REACTIVE PROTEIN AS A MARKER
                       OF INTESTINAL INFLAMMATION IN PATIENTS WITH UL-
Gastroenterology


                                       CERATIVE COLITIS



                    Authors: Tsekova R, Nakov R, Stoyanova V, Nikolova A,
                    Penchev P


                    University: Medical University of Sofia



                   ICMS 2011 / PP 21 Therapy
                    Abstract:
                    INTRODUCTION: Diagnosis and evaluation of intestinal inflammation in
                    many cases is a real challenge. “Gold standard” in this respect is en-
                    doscopy with histological evaluation of inflammation. However, this is
                    not always possible, especially if the small intestine is affected - an area
                    unavailable for testing with standard endoscopy to this moment. For this
                    reason several laboratory markers are used to assess the inflammatory
                    process. Nowadays, the most frequently used of these is the C-reactive
                    protein (CRP).

                    AIM: Our aim is to investigate the role of CRP as a marker of intestinal
                    inflammation in patients with ulcerative colitis (UC).

                    MATERIALS AND METHODS: This study enrolled 41 patients (22 females
                    and 19 males ; age range 19-64, median 42,6), studied in the Depart-
                    ment of Gastroenterology , University Hospital “Tsaritsa Yoanna-ISUL” in
                    Sofia for the period from September 2010 to February 2011. The diagno-
                    sis UC was made on the basis of the generally accepted endoscopic and
                    histological criteria. CRP was investigated by high sensitive immunoturbo
                    dimetric test.

                    RESULTS: 31of the studied patients were with clinical, endoscopic and
                    histological evidence of active inflammation, while 10 were in remission
                    (without disease activity). CRP was elevated (above cut off level of 0,6
                    mg / dl) in 17 (55%) patients with active disease, whereas it was nega-
                    tive (below 0,6mg/dl) in 14 (45%) of this group. All of the patients in
                    remission were with a negative CRP. The statistical analyses of the results
                    shows that CRP has a sensitivity of 54.84%, specificity of 100%, PPV -
                    100% and NPV- 41,67%.

                    CONCLUSION: The widely used in the clinical practice CRP showed rela-
                    tively low sensitivity for assessing the activity of intestinal inflammation
                    in patients with UC.
                    Keywords: CRP, UC, intestinal inflammation

                    Contact authors at: radina_93@mail.bg


                                                     —288—
  HYPERHIDROSIS, DERMATO - PSYCHOSOMATIC, CLINICAL
             AND THERAPEUTIC ASPECTS




                                                                                   Hyperhidrosis
                                                                                     Anatomy
  Authors: Stransky, D., Miteva, L.



  University: Medical University of Sofia



ICMS 2011 / PP 22 Therapy
 Abstract:
 This review is focused on the latest clinical apsects and literature concerning
 the treatment of hyperhidrosis in psihodermatological and classical aspect,
 with emphasis on the use of botulinum toxin. Consider the impact of dif-
 ferent methods of psycho-therapy on (1) cutaneous manifestations of psy-
 chiatric illnesses, and (2) psychiatric associations of certain skin diseases
 caused by psychosomatic factors. Track and current trends in the use of
 psychotropic medication in the treatment of psychiatric disorders, combined
 with dermatological diseases.




Keywords: hyperhidrosis, psychosomatics, botulinum toxin

Contact authors at: dr.stransky@gmail.com

                                   —289—
                  QUALITY OF LIFE AMONG CHRONIC HEMODIALYSIS PA-
                                      TIENTS
Nephrology




              Authors: H.Yasir, Prof. Tetyana Ospanovna



              University: Kharkiv National Medical University



             ICMS 2011 / PP 23 Therapy
              Abstract:
              INTRODUCTION: End-Stage Renal Disease (ESRD) is a non curable condi-
              tion for which life long renal replacement therapy is required. Since trans-
              plantation of a kidney is not possible many patients receive dialysis therapy
              .Studies on the quality of life of dialysis patients have not yielded consistent
              results with respect to the impact of diseases and treatment. Quality of
              life (QOL) is an important parameter of the adequacy in dialysis patients.
              METHOD: The study was conducted in dialysis unit of Kahrkiv Region Clini-
              cal Nephro-Urological Center. A total of 132 patients who received regular
              hem dialysis were included.132 patients mean age 40.3±1.24 years have
              been treated on regular hemodialysis 4 hours 2-3 times per week. Dialysis
              age was 30.4±3.2months.They were clinically stable with a mean ktv 1.18
              ±0.2 62% of patients were under anti-hypersensitive treatment. Patients
              completed the KDQOL-36 TM.KDQOL-36tm disease targeted items focus
              on particular health related concerns of individual with kidney disease and
              on dialysis, symptoms and problems, Effects of kidney disease, Burden of
              kidney disease. KDQOL-36 tm also includes a SF-12 physical- health com-
              posite and SF-12 mental health composite. Questionnaire was done before
              starting of regular hemodialysis in every 6 months, 2 questionnaire was
              done after 6 months after staring HD, indicating better quality of life due to
              decreased parameter effects and burden of kidney disease and increased
              physical health composite parameter is better to 10 % and mental health
              composite is better up to 4.7%. RESULTS: Results shown a significant im-
              pairment of quality of life in HD Patients compared to General population for
              all parameters except mental health (P? 0.05) Higher age and co morbidity
              were associated with lower quality of life. Hypersensitivity patients who
              received ACEI Enalopril had higher quality of life. Patients who received
              erythropoietin (EPO) “EPREX” had higher quality of life. CONCLUSION: We
              conclude, early referral and treatment of patients is needed help main-
              tain quality of life by treating anemia, managing co-morbidity, and preven-
              tion.KDQOL-36 tm can be applied in evaluating of the ESRD treatment.
              K=adequacy of HD Kt/v= calculate by urea in urine. Nearly 2% KDQOL
              =kidney disease and quality of life.

              Keywords: HD= hemodialysis. ESRD=End Stage Renal Disease

              Contact authors at: bollinenivr@yahoo.com


                                                 —290—
   DIETS AND THEIR INFLUENCE ON THE DIFFERENT TYPES
                    OF RENAL STONES




                                                                               Nephrology
                                                                                Anatomy
  Authors: Aleksiev T.S.; Kiprova D.K.; Kachovski C.E.; Raykova
  A.N.; Garev L. MD


  University: Medical University of Pleven



ICMS 2011 / PP 24 Therapy
 Abstract:
 Introduction: Bulgaria is endemic area of renal stone disease (RSD). Pa-
 tients are approximately 400,000, so it is considered to be a significant
 public health problem. Aim: We observe dietotherapy and its results on the
 treatment of the different types of renal stones. Methods: 21 patients with
 renal stone disease were studied and divided into 3 groups depending on
 the type of the stones. The screening was performed using: Physical ex-
 amination, urine blood, ultrasound and survey. Results: After the study on
 patients with RSD, we found a positive response in the patients who were
 following the diet. Conclusion: Diet is an important part of the treatment
 of RSD and significantly reduces the subsequent formation of new stones.




Keywords: Diet, renal stones

Contact authors at:teodor_alexiev@abv.bg

                                  —291—
                   RESEARCH OF FACTORS OF DISSATISFACTION SLEEP
Neurology




             Authors: Lysenko A.V., Dyachkova A.V.



             University: Belgorod State University



            ICMS 2011 / PP 25 Therapy
             Abstract:
             Introduction. Life in modern technological society make for stress and neu-
             roses. As a result, there is an infringement of human mental protection, in-
             creasing the number of neuroses and as a result, the breakdown of adapta-
             tion processes in the organism. Aim: Research the factors of dissatisfaction
             night sleep. Objectives. 1. Determine the correlation of dissatisfied night
             sleep in different groups. 2. Establish the main factors affecting the quality
             of sleep. 3. Detect the presence of daytime sleep in humans, dissatisfied
             night sleep. Methods. 603 people were interviewed using the questionnaire
             Questionnaire of sleep and dreams (Cigan V.N., 1998). Of these, 319 (53%),
             225 women (60.32%) and 94 men (41%) were dissatisfied with their night
             sleep. All of them were divided into groups: 18-29 years - 171 (53.6%);
             30-59 years - 107 (33.5%); 60-74 years and older - 56 (17.5%) Results.
             We are reviewed the factors that most frequently present in the group of
             dissatisfied night sleep: daytime sleepiness - 260 (81,5%), headache in the
             morning - 185 (58%), awakening every night - 134 (42,0%), sleep more 30
             minutes - 134 (42,0%), the impact of dreams on his life note 113 (35,4%),
             eating an hour before bedtime - 113 (35,4%), snoring - 64 (20,1%), tak-
             ing plenty of fluids before going to sleep (more than 3 cups) - 74 (23,2%)
             and waking up several times a week - 68 (21,3%). Of the 319 persons 192
             have daytime sleep (60,2%). Conclusion. 1. Number of females prevails
             over men in the subjective assessment of the quality of nighttime sleep.
             2. The main factors which influence on the subjective assessment of sleep
             quality are: drowsiness, headache, frequent night waking, prolonged sleep,
             the effect of dreams, taking food and fluids an hour before sleep, snoring,
             what is clinical evidence of psycho-emotional disorders. 3. Of the group of
             dissatisfied night sleep (319) 60,2% offset bad night sleep daytime sleep.




             Keywords: sleep quality; factors of dissatisfaction; sleep.

             Contact authors at: lisenok_5515@mail.ru


                                                —292—
              NEOPLASTIC TRIGEMINAL NEUROPATHY




                                                                                 Neurology
                                                                                 Anatomy
  Authors: Milot Hasani,Besarte Rexhaj,Fatbardha
  Rexhaj,Gazmend Gashi,Vjosa Rexhepi,Haki Jashari


  University: Medical University of Prishtina



ICMS 2011 / PP 26 Therapy
 Abstract:
 Neoplastic Trigeminal Neuropathy The importatce of tgrigeminal neoropa-
 thy can be explaind by the fact that trgieminal neuropathy can appeared
 as a primary malignity illnes or repetition to patients with former neoplatic
 process.These manifestations are very risky and the prognosis is poor .
 the project includes the cases with neoplastic trigeminal neuropathy in the
 Neorologic Clinic of the Unicersity Clinic Center of Kosova in Prishtina dur-
 ing the period 2007-2009. We present 4 cases of NTN.In 3 of them there
 were antecedents from tumors: 2 males and the female that have had a
 tumor before the manifestation of Trigeminal Neouropathy, while the 4 -th
 case was diagnosed during the exploration after tha primary neuropathic
 lesion of trigeminal nerve. The female 48 years old had breast cancer before
 6 years while the 1-st male 52 had lip tumor before 3 years, the second-
 ary 70 prostatic tumor and the 3-rd 35 glioblastoma . The patients were
 treated with carbamazepin and aminotriptilin immediatly for pains releasing
 together with chemotherapy . The prognosis was very poor beacuese three
 of them have dead and the female is still with treatment .




Keywords: Trigeminal Malignant NEUROPATHY,Neoplasms

Contact authors at:milothasani@hotmail.com

                                   —293—
               ANALGESIC EFFECTS OF NEWLY SYNTHESIZED HEXAPEP-
               TIDE ANALOGUES OF SELECTIVE LIGAND FOR THE NOCI-
                               CEPTIN RECEPTOR
Neurology




             Authors: Mihaela Ilcheva, Mihail Ganev, Lubomir Traikov, Elena
             Dzhambazova, Adriana Bocheva


             University: Medical University of Sofia



            ICMS 2011 / PP 27 Therapy
             Abstract:
             Pain is frequently observed symptom of various diseases. Some of the
             greatest achievements in medicine in theoretical and in clinical aspect are
             connected with the research on pain and especially on the development of
             analgesic drugs. Nociceptin/Orphanin FQ (N/OFQ) is a heptadecapeptide
             which has been found to play a direct role on pain perception. This peptide
             is an endogenous ligand of the nociceptin opioid peptide (NOP) receptor,
             previously referred to as “orphan” receptor, structurally and functionally
             related to the classical opioid receptors. Also the hexapeptide Ac-RYYRWK-
             NH2 is shown to be a selective ligand for the NOP with marked analgesic
             effect. With a view to developing ligands for the NOP with more potent
             analgesic activity, new series of N-modified analogues of the Ac-RYYRWK-
             NH2 were synthesized. For this purpose, for the first time ?-aminophos-
             phonic acids will be introduced in the peptide sequence. The new hexapep-
             tides analogues have been synthesised with C?,?-disubstituted cyclic amino
             phosphonates at position 1, using SPPS Fmoc-chemistry. Their effects on
             nociception were examined in male Wistar rats by two nociceptive tests -
             paw-pressure (PP) and hot-plate (HP). The compounds were administrated
             intraperitoneally (i.p.). The results showed that some of newly synthesized
             hexapeptide analogues have strong analgesic activity compared to the ref-
             erent compound Ac-RYYRWK-NH2 in both tests used and mechano- and
             thermo-receptors are involved. Acknowledgment: The research was sup-
             ported by Grant №845 (DTK 02/61) of the National Research Fund, Sofia,
             Bulgaria.




             Keywords: pain, nociceptin receptor, hexapeptide analogues, SPPS

             Contact authors at: mi6ita@abv.bg


                                              —294—
   EFFECTS OF NALOXONE AND JTC-801 ON ANALGESIC AC-
   TIVITY OF NOVEL NOCICEPTIN ANALOGUES WITH N-TER-
                 MINAL AMINOPHSPHATE




                                                                                   Neurology
                                                                                   Anatomy
  Authors: Mihail Ganev, Lubomir Traikov, Elena Dzhambazova,
  Adriana Bocheva1


  University: Medical University of Sofia



ICMS 2011 / PP 28 Therapy
 Abstract:
 Bioactive peptides are important starting structures for the development
 of potential therapeutic agents. They bind to different receptors (opioid,
 non-opioid or both) and are involved in the physiological control of various
 functions, among which nociception is particularly emphasized. Some of the
 greatest achievements in medicine in theoretical and in clinical aspect are
 connected with the research on pain. Nociceptin/Orphanin FQ (N/OFQ) is a
 heptadecapeptide which has been found to play a direct role on pain per-
 ception. This peptide is an endogenous ligand of the nociceptin opioid pep-
 tide (NOP) receptor, previously referred to as “orphan” receptor, structurally
 and functionally related to the classical opioid receptors. The purpose of the
 present study was to examine the effects of naloxone (Nal) and JTC-801
 (NOP receptor antagonist) in the analgesic activity of N-modified with cyclic
 aminophosphonates at position 1 analogues of the N/OFQ. All peptides (10
 µg/kg), Nal (1 mg/kg) and JTC-801 (0,5 mg/kg) were injected intraperito-
 neally in male Wistar rats. All drugs were dissolved in saline. Antinociceptive
 effects were evaluated by paw-pressure (PP) test and statistically accessed
 by ANOVA. The results showed that newly synthesized analogues signifi-
 cantly increased the pain threshold in PP test compared to the control. Nal
 injected 20 min or JTC-801 – 10 min before peptides significantly decreased
 the analgesic effects of investigated peptides more pronounced in the first
 compound. We suggest that analgesic effects of N/OFQ analogues with cy-
 clic aminophosphonate moiety are influenced by non-selective inhibitor of
 opioid receptors and inhibitor of NOP receptor.




Keywords: Naloxone, JTC-801, Nociceptin analogues

Contact authors at: zucha@abv.bg

                                   —295—
               GLOBAL GENE EXPRESSION PROFILE OF IDENTIFIED NEU-
                 ROGLIAFORM INTERNEURONS IN THE NEOCORTEX
Neurology




             Authors: Eszter Boldog, N?ra Farag?, M?rton R?zsa, Enik?
             V?mos, Szabolcs Ol?h, Viktor Szemenyei, S?ndor Lovas, L?szl?
             Pusk?s, G?bor Tam?s

             University: University of Szeged



            ICMS 2011 / PP 29 Therapy
             Abstract:
             Neurogliaform cells (NGFCs) are cortical GABAergic interneurons charac-
             terized by ?-actinin 2, GABAAdelta ?receptor content and unitary volume
             transmission leading to slow GABAA and GABAB receptor mediated re-
             sponses. Such functional distinction is expected to be based on the con-
             certed action of several genes active specifically in NGFCs. We analyzed the
             global gene expression profile of NGFCs and applied a harvesting procedure
             standardized for single cell PCR. Combining whole cell recordings and post
             hoc light microscopic assessment to identify NGFCs (n=30) from rats (P22-
             40), RNA from harvested cytoplasms was amplified and hybridized onto a
             rat DNA-microarray. Out of 26209 genes, we identified 1143 transcripts that
             exhibited significantly (p<0.001) higher expression in NGFCs compared to
             controls. In addition, we tested the expression profile of 40 out of the 1143
             NGFC specific transcripts with quantitative real-time PCR thus validating
             the gene chip analysis. Among the NGFC specific transcripts, we confirmed
             known markers for NGFCs (GABAAdelta, ?-actinin 2), and in addition, neu-
             rotransmitter receptor subtypes undetected in NGFCs to date. Whole cell
             electrophysiological experiments and immunocytochemistry confirmed the
             action of dopamine receptor subtypes not reported previously in NGFCs.
             These initial results confirm that global gene expression profiling combined
             with functional characterization is routinely feasible in identified cortical in-
             terneurons.




             Keywords: cortex, interneuron, single cell PCR, DNA-microarray

             Contact authors at: happyeszti@freemail.hu


                                                —296—
   OUTPUT SPECIFICITY OF GABAERGIC INTERNEURONS IN
            THE RAT SOMATOSENSORY CORTEX




                                                                                      Neurology
                                                                                      Anatomy
  Authors: Judith Baka, Enik? V?mos, M?rton R?zsa, Gergely
  Koml?si, Szabolcs Ol?h, G?bor Moln?r, J?nos Szabadics, G?bor
  Tam?s

  University: University of Szeged



ICMS 2011 / PP 30 Therapy
 Abstract:
 The output of GABAergic cells in the cerebral cortex is distributed among
 pyramidal cells and interneurons and distinct interneuron types evolved
 to form connections selectively with pyramidal cells and GABAergic cells,
 respectively. We tested 13087 connections between simultaneously whole
 cell patch clamp recorded neurons recorded during the last 12 years in
 supragranular layers of the somatosensory cortex of the rat (P18-35). This
 database yielded 2632 monosynaptic connections involving 4956 neurons.
 Based on firing and morphological characteristics, we classified the record-
 ed neurons into the following 7 populations: pyramidal cells, neurogliaform
 cells, Martinotti cells, basket cells, regular spiking cells, axo-axonic cells and
 irregular spiking cells. Most types of interneurons innervated both pyarmi-
 dal and GABAergic cells, but axo-axonic cells provided output selectively
 to pyramidal neurons. In addition, we found that irregular spiking cells in-
 nervated GABAergic interneurons exclusively (25 postsynaptic interneurons
 out of 175 tested), none of the simultaneously recorded pyramidal cells
 (n=237) received input from irregular spiking cells (chi square = 33.581;
 p < 0.0001). We found no sign of morphological heterogeneity among ir-
 regular spiking cells which were characterized by a narrow columnar axonal
 pattern. In conclusion, we identified a homogeneous interneuron population
 which selectively innervates GABAergic cells in supragranular layers of the
 somatosensory cortex.




Keywords: cortex, GABAergic interneurons, pyramidal cells, electrophysiol-
ogy
Contact authors at: judith.baka@gmail.com

                                     —297—
                       PROTECTIVE EFFECTS OF HESPERIDIN AGAINST GENO-
                     TOXICITY INDUCED BY 99MTC-MIBI IN HUMAN CULTURED
Nuclear Medicine


                                     LYMPHOCYTE CELLS



                    Authors: Amirhossein Ahmadi, Seyed Jalal Hosseinimehr



                    University: Mazandaran University of Medical Sciences



                   ICMS 2011 / PP 31 Therapy
                    Abstract:
                    In this study we firstly investigated the genotoxicity induced by 99mTc-
                    MIBI in cultured human lymphocytes at the same concentration used in
                    patients. we secondly evaluated the radioprotective effects of hesperidin as
                    a flavonoid which protects against the genotoxic effects of 99mTc-MIBI in
                    human cultured lymphocytes.In the former step, Radioactivity doses were
                    determined in whole blood at 5 min post-injection of 20 mCi 99mTc-MIBI
                    in patients. Subsequently, whole blood of human volunteers was incubated
                    with 1, 2.3, 4 or 8 ?Ci 99mTc-MIBI. After 30-min incubation, the lympho-
                    cytes were stimulated with a mitogen to assay for micronuclei in cytokine-
                    sis-blocked binucleated cells. In the later step, Whole blood samples from
                    human volunteers were incubated with hesperidin at doses of 10, 50 and
                    100 micro mol. After 1 h of incubation, the lymphocytes were incubated
                    with 99mTc-MIBI (200 micro Ci/2 ml) for 3 h. The lymphocyte cultures
                    were then mitogenically stimulated to allow for evaluation of the number
                    of micronuclei in cytokinesis-blocked binucleated cells.The frequency of mi-
                    cronuclei in samples treated with this radiopharmaceutical up to 2-fold (8
                    micro Ci) the concentration of 99mTc-MIBI normally found in the blood of
                    patients was not more than in control lymphocyte cultures. In addition,
                    Incubation of lymphocytes with 99mTc-MIBI at this high dose induces ad-
                    ditional genotoxicity and shown by increases in micronuclei frequency in
                    human lymphocytes. Hesperidin at these doses significantly reduced the
                    micronuclei frequency in cultured lymphocytes. The maximum protective
                    effect and greatest decrease in micronuclei frequency occurred when cul-
                    tures were incubated with a 100 micro mol dose of 65% hesperidin. The
                    results showed that there was not any increased induction of micronuclei
                    in lymphocytes incubated with 99mTc-MIBI at the radioactivity doses used
                    for diagnostic purposes. On the other hand, the results indicate a protective
                    role for hesperidin against the genetic damage and side effects induced by
                    radiopharmaceutical administration.




                    Keywords: 99mTc-MIBI; Genotoxicity; Micronucleus; Hesperidin

                    Contact authors at: amirhossein_pharma@yahoo.com


                                                      —298—
  COMPARISON OF MECHANICAL VENTILATION REGIMEN IN
    PRETERM INFANTS WITH RESPIRATORY DISORDERS




                                                                                Pediatrics
                                                                                Anatomy
  Authors: Ahmed Samy, Bollineni Vikram rao, Prof.Olena Riga



  University: Kharkiv National Medical University



ICMS 2011 / PP 32 Therapy
 Abstract:
 AIM: To improve mortality and morbidity rate in preterm infants who were
 admitted to neonatal intensive care unit with respiratory disorders. MA-
 TERIALS AND METHODS: The study was conducted in neonatology unit of
 Kharkov regional hospital. Retrospective analyses of total 27 preterm in-
 fants were included in the study. Out of 27 neonates 12 (44%) died and
 15(55%) survived categorized as 1 and 2 groups. The study was carried
 out focusing on maternal anamnesis (multiple pregnancies- MP, infection
 pathology- IP, pre-eclampsia- PE), character of delivery (caesarian section-
 CS, placenta abruption- PA) and fetal anamnesis data (hypoxic ischemic
 encephalopathy- HIE, intracranial hemorrhage- ICH, brain circulation in-
 sufficiency- BCI, brain edema- BE, severe asphyxia- SA) were postulated
 the results. RESULTS: The 1 group of mean birth weight 3000±840 with
 mean gestational age 24±37 with maternal anamnesis MP-26%, IP-33%,
 PE-26%. Character of delivery showed with CS- 53%, PA- 46%, and fetal
 anamnesis data HIE- 93%, SA- 60%, ICH- 93%, BCI- 53%, BE-86% were
 revealed where as in 2 group of mean birth weight 2700±1000 with mean
 gestational age 28±37 with maternal anamnesis MP- 9%, IP- 36%, PE-
 36%. Character of delivery data CS- 45%, PA- 27%, and fetal anamnesis
 HIE- 81%, SA- 9%, ICH- 27%, BCI- 22%, BE- 36% were revealed. Venti-
 lator settings varied with individual cases but generally the ventilator was
 set initially at a peak end expiratory pressure (PEEP) of 4-5 cm H2O, peak
 inspiratory pressure (PIP) of 18-20 cm H20, rate of 50/min and an Fi02
 sufficient to maintain 02 saturation greater than 90%. CONCLUSION: The
 judicial use of neonatal intensive care measures in a developing country can
 results in a reduction on morbidity and mortality. Survival rates increased
 with increasing birth weight and gestational age and decreasing complica-
 tions. However to maximize on benefits evidence based management poli-
 cies and protocols must be developed and implemented. The focus should
 begin with obstetric measures for the prevention of preterm delivery, close
 monitoring of high risk pregnancies and judicious use of tocolytics.




Keywords: Pre-eclampsia, Hypoxic ischemic encepahlopathy

Contact authors at: vikram_992003@yahoo.co.in

                                  —299—
                 ANTHROPOMETRIC PARAMETERS RELATED TO FEEDING
                AND SOCIOECONOMIC STATUS IN CHILDREN UNDER FIVE
                                  YEARS OLD
Pediatrics




              Authors: H.B. Jashari, D.B.Jashari, S.R.Salihaj, M.G.Hasani,
              B.M.Bajraj, M.Sertolli ,MSc B.A. Jashari


              University: University of Pristina



             ICMS 2011 / PP 33 Therapy
              Abstract:
              Introduction: Growth and development of a child depends on internal and ex-
              ternal factors. The most important external factor is feeding. Anthropometric
              parameters are influenced by the way of feeding as well as by the influence of
              other factors like the social economic conditions and maternal smoking. The
              objective of this study was to assess the relationship of feeding and socioeco-
              nomic status with anthropometric parameters in children in a region of Kosovo.
              Materials & Methods: We recruited 600 healthy children aged less than 5 years
              during January till September 2004 in a region of Kosovo, 5 years after war.
              Measurements of body weight, length and the perimeter of the head and subcu-
              taneous fat tissue were done. Gained values were elaborated in statistical form
              and are compared with the percentile of 50 (P 50) of standard values of WHO.
              Based in the mean income of Kosova we classified the socioeconomic status in
              three levels: bad, medium and good conditions. Results: Overall, 600 children
              were researched, 330 males and 270 females. The mean body weight was 3395
              g. Mean child weight at birth was 3004g when the mothers were smokers and
              3410g when mothers were non-smokers. The children that were breast fed had
              gained 826g per month, those fed with mixed feeding 725g per month and chil-
              dren fed in artificial way gained 629g per month. Overall 371 children had the
              body weight under the standard value, 79.8% of children with bad economic
              conditions, 62.9% with medium economic conditions and 39.6% with good con-
              ditions. Breast fed children grew 15.6cm per 6 months, while those with artificial
              feeding grew 12 cm per 6 months and those with mixed feeding grew for 10.9
              cm per 6 months. Economic conditions did not have any significance in children
              growth. Head perimeter did not differ in any case from standard value. Subcuta-
              neous fat tissue was in general very low developed. 36.5% of exanimate had not
              so good developed tissue, 7.8% in norm and 35.7% very bad developed tissue.
              Feeding and economic standards had a significant influence on development of
              this tissue. Conclusion: We conclude that breast feeding influences the body
              weight and length while the economic conditions influence only the body weight.
              This research showed that the children under 5 in this region of Kosovo were fed
              and developed under the standard values. These results did not match with the
              UNICEF research which showed that the children of Kosovo under 5 years old
              were overweight.



              Keywords: anthropometric parameters, feeding, socioeconomic status,
              Kosova
              Contact authors at: the.kickz@hotmail.com


                                                  —300—
  ALLERGY TO CEPHALOSPORIN ANTIBIOTICS IN CHILDREN




                                                                                   Pediatrics
                                                                                   Anatomy
  Authors: Ljubica Jovanovic, Mirjana Jovanovic, Nina Jovanovic,
  Stefan Juricic, Zelimir Jovanovic, Ognjen Bojovic, Tamara Savic,
  Dragan Opacic, Aleksandar Mihailovic, Nikola Banjanin, Bojana
  Milosevic
  University: Medical University of Belgrade



ICMS 2011 / PP 34 Therapy
 Abstract:
 Introduction: Cephalosporins are beta- lactam antibiotics which are widely
 used in the treatment of a variety of infections in children. Those antibiotics
 have a high risk factor to induce allergic reactions. All those allergic reac-
 tions caused by this drug are complex because the hapten determinants
 of cephalosporins are not yet known. Goal: The goal of this research was
 to determine the incidence of allergic reactions on cephalosporin medica-
 ments, and the frequency of cross-reactions between different cephalospor-
 in drugs. Materials and methods: The study included 79 children, aged from
 just a few months to the age of adulthood who were a subject to research
 for a period of almost four years. Diagnostics of alergic reactions were con-
 ducted under ENDA/EAACI guide for the diagnosis of suspected allergic
 reactions to beta-lactam antibiotics. The procedure included: skin testing
 (prick, intradermal and patch test), in vitro tests (quantitative measure-
 ment of specific IgE antibodies) and drug provocation test. Results: Allergy
 to cephalosporin medicaments were found in 22 of 79 children (27.85%).
 Most of them were allergic to ceftriaxon and cephalexin, while a smaller
 number of proven allergic reaction to cefprozil, cefaklor, cefixime and ce-
 fotaxime. Cross-reaction was not found in any of the children. Conclusion:
 Our study showed the prevalence of allergy to cephalosporins of 27.85% in
 the studied population of children. The data indicates that the third genera-
 tion cephalosporins were most common causes of allergic reactions, within
 which also cefalosporines of first generation represent also a significant
 role.




Keywords: allergy, young, children, antibiotics, cross-reactivity

Contact authors at: ljuborhi@yahoo.com

                                   —301—
                    THE INITIAL PRESENTATION OF SYSTEMIC LUPUS ERY-
                           THEMATOSUS WITH APLASTIC ANEMIA
Rheumatology




                Authors: saburi amin , bayat noushin , alireza sadat , alishiri
                gh.hosein


                University: University of Baghiyatallah



               ICMS 2011 / PP 35 Therapy
                Abstract:
                Introduction: Hematologic disorder is common with connective tissue disor-
                ders that most prevalent of them is anemia due to chronic disease. Aplastic
                anemia is a so rare but catastrophic and momentous complication of sys-
                temic lupus erythematosus (SLE). Furthermore first presentation of SLE
                via aplastic anemia is extinct. Review of English literatures displayed just
                23 cases of acquired AA secondary to SLE. Case presentation: We report a
                26 year old female who presented with menometrorrhagia, malaise, myal-
                gia and fatigue, malar rash, history of both wrists arthritis with significant
                morning stiffnesssince 2 years ago (that have been disregarded with previ-
                ous physician), history of photosensitivity that in laboratory data has pancy-
                topenia, positive antinuclear antibody (ANA) and anti ds DNA anti body and
                she fulfill diagnostic lupus criteria’s (American collection of rheumatology
                criteria). Bone marrow aspiration and biopsy shown aplastic anemia specifi-
                cations that rationalized her pancytopenia. We have excluded other causes
                of aplastic anemia (such as microbial or environmental causes) then lupus
                treatment started. High-dose methylprednisolone therapy (pulse) had been
                successful in controlling the pancytopenia in first step but blood elements
                reduced rapidly. Other medication such as cyclophosphamide and cyclo-
                sporine were not effective .Several pack cell and FFP prescript for 2 weeks
                but peripheral blood destruction debarred blood to reach normal range. She
                referred for bone marrow transplantation. Conclusion: anemia is common
                in SLE but another supplementary blood examination (such as Bone marrow
                biopsy) must be done to exclude aplastic anemia or other important hema-
                tologic disorder in all cases of pancytopenia associated with SLE.




                Keywords: asystemic lupus erythematosus, aplastic anemia, pancytopenia

                Contact authors at: aminsaburi@yahoo.com


                                                  —302—
  DIFFERENCES IN ANTHROPOMETRIC MEASURES WITH RE-
  GARD TO SMOKING FOR STUDENTS OF MEDICAL SCIENCES




                                                                                   Sports Medicine
                                                                                      Anatomy
  Authors: Baraku A., Krasniqi B., Rrusta A., Balaj M. & Baraku E.



  University: Medical University of Rezonanca



ICMS 2011 / PP 36 Therapy
 Abstract:
 Introduction: Various studies report anthropometric differences with regard
 to smoking. The aim of this study was to confirm if such differences ex-
 ist for students of the Tetova State University by evaluating height and
 weight with respect to smoking, gender and type of studies. The purpose of
 such confirmation is to establish information which can be used in smoking
 prevention/cessation programs. Methods: Self-reported height and weight
 were anonymously obtained from Pharmacy and Dentistry university stu-
 dents in year 2009. The modalities were analyzed for the total group and
 for smokers; and presented by gender and type of university studies. Sta-
 tistical parameters used were smoking prevalence, structure according to
 modalities, average, and standard deviation. Parametric data were tested
 with the use of T-test, while correlation was tested with Chi-square test.
 Validity scale was set for p<0.01 and p<0.05. Results: 31% from 84 re-
 spondents that declared body height, and 27.5% of 91 respondents that
 declared body weight, were smokers. For both modalities, smoking preva-
 lence is higher among male respectively dentistry students in comparison
 to female respectively pharmacy students. Smoking prevalence displays
 positive trend for each of modalities- in the overall group, by gender and by
 the type of studies. On average, the total group height (171.9 cm, SD=9.0)
 and weight (63.9 kg, SD=12.2) is lower than smokers’ height (175.8 cm,
 SD=8.9) and weight (72.4 kg, SD=12.1). Both modalities displayed similar
 behavior when comparing by gender and by the type of studies each, with
 higher values for male respectively dentistry students. Conclusions: Among
 respondents, smokers are taller and heavier. The results correspond to find-
 ings in literature for other target populations. Since prevalence of smok-
 ing displays positive trend, further research on causes of smoking among
 medical students is imperative, since they are well informed of harms of
 smoking. Also, it is important to initiate tailored health education programs
 to achieve healthy lifestyle of the students; the student participants will ac-
 tively be involved in process of having health lifestyle and not just passive
 listeners of the health lectures.



Keywords: smoking, students, Tetovo, height, weight

Contact authors at: arditabaraku@yahoo.com

                                   —303—
                  ENDOVASCULAR VERSUS OPEN SURGERY IN TREATING
                PERIPHERAL VASCULAR OCCLUSIONS IN PATIENTS WITH
                                 DIABETIC FOOT
Cardiology




              Authors: HristinaMitkova, ElisavetaTrifonova, ZeynepaByaleva


              University: Medical University of Sofia




             ICMS 2011 / PP 37 Therapy
             Abstract:
             Introduction: According to the WHO and İnternational Working group on the Diabetic
             Foot ¨ diabetic foot ¨ is defined as the foot of diabetic patient with ulceration, infec-
             tion and/or destruction of the deep tissues, associated with neurological abnormalities
             and various degrees of peripheral vascular disease in the lower limb. Percutaneous or
             Open? Whether the access should be gained through percutaneous needle puncture
             or open exposure was an unrewarding preoccupation that was based upon an arbitrary
             division of labor. This dilemma was prompted by that most vascular workshops were
             prepared to carry out percutaneous exposure or open exposure, but not both. Vascu-
             lar specialists are now facile with both methods of access, and the vascular workshop
             should be set up to handle the full range of approaches.
             Aim: Prooving that endovascular and vascular surgical approach in treating peripheral
             vascular occlusions are not warring but mutually advantageous methods.
             Methods: Patients with diabetic foot, identified as having circulatory insufficiency of
             the lower extremity, are potential candidates for revascularization. The decision to
             proceed to intervention and the type of it (including a revascularization procedure or
             a major amputation) depends on the location of the arterial lesion (proximal versus
             distal), the adequacy of run-off arteries, the local expertise and the resources, the
             magnitude of the proposed intervention, the comorbidities, and last but not least what
             is best for the patient. For example, there is no point offering major intervention to a
             patient with extensive gangrene, however, this can lower the level of amputation in
             order to get away with a below rather than an above-the-knee amputation. Finally, any
             decision for local amputation or debridement should be preceded by, or combined with,
             a revascularization procedure.
             Revascularization open surgeries in the aorto-iliac segment include aorto-iliac endar-
             terectomy, aorto-bi-iliac or aorto-bi-femoral bypass, and extraanatomical procedures,
             such as axillo-femoral or femoro-femoral bypass. Common femoral bifurcation dis-
             ease, quite common in diabetics, has been traditionally treated with femoral endar-
             terectomy and patch profundoplasty. These open surgical procedures are major and
             lengthy operations requiring general or regional anaesthesia and diabetic pose a major
             cardiovascular risk.
             The advent of endovascular surgery has resulted in achieving percutaneous revascu-
             larization via a remote access. Thus, isolated aortic disease can be treated by aortic
             stenting via the femoral or, rarely, the brachial route. Combined aortic and iliac disease
             can be treated by aortic and bilateral iliac stents. İsolated common iliac disease can be
             treated by balloon angioplasty (PTA) and/or stenting.The endovascular treatment of
             stenotic and occlusive disease of the superficial femoral artery is a challenge for PTA
             due to type and number of lesions, poor run-off and critical ischaemia. The usefulness
             of PTA is limited by elastic recoil and high risk flow-limiting dissection.

             Results: PTA stenosis after the 1-year shows 77%, PTA occlusion 65%, PTA+stent
             stenosis 75 %, PTA+stent occlusion 73%.

             Conclusion: Management of the diabetic foot demands a multidisciplinary approach.

                                                     —304—
       ANTHROPOMETRIC STUDY IN BULGARIAN ADULTS




                                                                             Endocrinology
                                                                               Anatomy
  Authors: Nikolova A, Blajeva M, Velikov P, Stoyanova V, Nakov R,
  Cekova R, Handjiev Sv


  University: Medical University of Sofia



ICMS 2011 / PP 38 Therapy
 Abstract:
 Background: Obesity is a chronic metabolic disease which preva-
 lence steadily increases during the past decades. In Bulgaria,
 60% of the adult population is overweight and 20% is obese.
 Obesity increases the risk of morbidity and premature death from
 diabetes type 2, cardio-vascular complications, cancer and other
 diseases. Therefore, the aim of our study was to investigate the
 incidence of obesity among adult population in Sofia, Bulgaria.
 Materials and Methods: Anthropometric data (body weight,
 height, waist circumference, body mass index) were collected for
 636 subjects (382 females, 254 males) with a mean age of 38.6
 years. Body composition (fat mass) was measured by imped-
 ance apparatus. Waist circumference was used to estimate the
 cardiovascular risk in the studied population. The mean values
 of the parameters were as follows: 70.25 kg (weight), 170.4 cm
 (height), 24.5 kg/m2 (BMI), 82.3 cm (waist circumference), and
 28.2% (fat mass). The studied population was divided in two
 groups according to their age: group 1 (15-35 years), and group
 2 (36-65 years).
 Results: The results showed that men had a statistically signifi-
 cant greater body weight in comparison with women from group 1
 and group 2 (p<0.0001). In addition, men had statistically signifi-
 cant greater fat mass tissue (p<0.0001), greater waist circumfer-
 ence (p<0.0001) and BMI (p<0.0001) in comparison to women.
 Furthermore, it was found that the older subjects were more
 overweight than the younger one.
 Conclusion: Our study demonstrated the prevalence of overweight
 in the studied male population of Bulgarian adults. Moreover, the
 age seemed to be a significant risk factor for development of car-
 diovascular complications.

Keywords: BMI, waist circumference, fat mass, cardiovascular complications

Contact authors at: albena.nikolova@yahoo.com

                                 —305—
                  DEMOGRAPHIC AND MORPHOLOGIC CHARACTERISTICS
                      OF PATIENT WITH ATRIAL FIBRILLATION
Cardiology




              Authors: Stoyanova V, Nikolova A, Nakov R, Cekova R, Naydenov
              S, Donova


              University: Medical University of Sofia



             ICMS 2011 / PP 39 Therapy
              Abstract:
              Background: Atrial fibrillation (AF) is a chronic, irregular atrial rhythm, the
              AV node responds intermittently hence an irregular ventrical rate. If they
              aren’t primed reliably by the atria, cardiac output drops by 10-20%. AF is
              common in elderly patients. The main risk is embolic stroke. The aim of our
              study is to estimate the risk profile and morphologic structural changes in
              patients with AF.
              Materials and Methods: Retrospective research was made in which were in-
              cluded 99 patients (42 males and 57 females) with paroxysmal, permanent
              and persistent AF. Patients were on mean age of 65,5±10.1 (from 45,0 to
              96,0). The period for following the patients is from January to December
              2010. We analyzed demographic determinates as age, gender, risk fac-
              tors for heart and non-heart complications, morphologic changes in the
              cardiac structures, complications that occurred and therapy. The statistics
              were made based on the data that we gathered. What we had out of the
              patient history was age, gender, left atrium (49,0±8.8), forced capacity
              (49,6±15.4), right ventrical (30,5±4.5), septum (13,2±1.7), therapy, hy-
              pertension, diabetes, COPD, ischemic hearth disease. The type of the AF
              in the patients was random 9 of them was with paroxysmal AF (9.3%), 15
              - with permanent (15.5%) and 73 – with persistent (75.3%). Only 11 of
              the patient was with newfound AF, the other 83 was with an long time diag-
              nosed AF. Some of the patients was on anticoagulant therapy. We looked for
              patients with vascular accidents.
              Results: The results are about to show what part of the studied popula-
              tion was on anticoagulant therapy. Moreover, what is the percentage of the
              patients with vascular accidents. In addition, we are going to compare the
              percentage of the patients who are on therapy with the percentage of the
              patient who had complications of the AF.
              Conclusion: AF is observed in 100% of the population and it is a serious
              medical and social problem. The study shows whether the anticoagulant
              therapy reduces the risk of vascular accidents.




              Keywords: atrial fibrillation, atrium, anticoagulant therapy, vascular compli-
              cations
              Contact authors at: viktoriqgs@yahoo.com


                                                 —306—
 Abstracts
Public Health
  Session
                   UPTAKE IN SEASONAL INFLUENZA VACCINE CONSUMP-
                  TION BY DEPRIVATION OF H1N1 INFLUENZA VACCINE IN
                                     IRAN 2010
Epidemiology




                Authors: Amir Farshchi,Samireh Farshchi,Boheireh
                farshchi,Sepideh Farshchi


                University: Islamic Azad University



               ICMS 2011 / OP 01 Public Health
                Abstract:
                Background: Influenza A is currently the greatest pandemic disease threat
                to humankind. The availability of pandemic vaccine influenza H1N1 will be
                delayed by several months because of the requirements for vaccine formu-
                lation and production lead-time. Furthermore, it is probable that insufficient
                production capacity will restrict global access to the vaccine, at least during
                the first phase of the pandemic. The aim of this study was to investigate
                the uptake in seasonal influenza vaccine consumption by deprivation of
                H1N1 influenza vaccine in Iran 2010. Methods: Data on vaccines consump-
                tion 2006–2010 were extracted from the databases of the health system
                research (HSR) in Ministry Of Health (MOH). The full research database
                currently contains the records of seasonal influenza vaccine consumption in
                the last 5 years. The rates of consumption between each two consequence
                years were evaluated and compared. Results: Consumption of seasonal in-
                fluenza vaccine measured by this series of surveys was 431822 in year
                2006. Seasonal influenza vaccine consumption reached 2255000 in the lat-
                est year 2010. This uptake was higher than the uptake in the other years.
                The first rate measured was 17% and the current rate was 190%. In last
                year examined, the total use of seasonal influenza vaccine increased ex-
                tremely in Iran. Conclusion: In Iran, the overall rate of seasonal influenza
                vaccine consumption increased in year 2010 compared to previous years
                and this uptake was not evidence base. The pandemic influenza H1N1 may
                have had a direct influence on the increased vaccination rates. It is neces-
                sary to give more information to the people on seasonal influenza vaccines
                and about the adverse effects of inadequate use of influenza vaccines and
                urge people not to use influenza vaccines without prescriptions.




                Keywords: H1N1 influenza, vaccine, pandemic, Iran

                Contact authors at: amam_far@yahoo.com


                                                  —308—
  THE INFLUENCE OF INTERNET ON YOUTH HEALTH AND SO-
                       CIAL LIFE




                                                                               Epidemiology
                                                                                 Anatomy
  Authors: O. Bojovic,N. Dimitrijevic,T. Kam?eva,N. Santrac,N.
  Avramovic,Nikolina Banjanin,A. BogicevicB. Naumovic,S.
  Smrzlic,S.Juricic,H.Denc,I.Jovanovic,M.Jovanovic,D.Opacic.Super-
  visor: Prof. Dr I.Dimitrijevic
  University: Medical University of Belgrade



ICMS 2011 / OP 02 Public Health
 Abstract:
 Introduction: Internet is a modern trend in computer and electronic sci-
 ences and represents a new sphere in our lives. It has a huge number of
 benefits but also a large number of bad sides. Aim: The aim of our study
 was to determine the influence of internet and computer gaming on social
 and health aspects of life among 170 elementary school students between
 the 6th and 8th grade in two elementary schools in Belgrade, Serbia.
 Methods: In this study we have used a ESPAD like questionnaire provided
 by our scientific supervisor of our work called : „Internet dependence
 questionnaire“. Results: In our study through 30 questions with multiple
 choice and fill in fields, we examined the knowledge and impact of internet
 and on line gaming on social and well as health status for our examined
 students. Results showed that there is a significant impact of internet
 on social life and behavioral alterations on a large number of examined
 students. There is also a significant number of students whos priority in
 every day life has been altered from social and family life to virtual life
 and on line community. Conclusion: Modern inventions may help our life,
 prolong our existence and make our global community become larger,
 but we should also be aware of all the possible risks which can alter our
 perception, change our interpersonal relations and make changes on the
 behavior and wellness of our youth.




Keywords: Youth, internet, influence, behavior, alterations

Contact authors at: ognjen236@yahoo.com

                                   —309—
                   KNOWLEDGE, ATTITUDE AND PRACTICE OF UNIVERSAL
                 PRECAUTIONS BY THE HEALTHCARE PERSONNEL IN A TER-
                 TIARY CARE CENTER IN A DEVELOPING COUNTRY (INDIA)
Epidemiology




                Authors: Dr. Abhinav Pal, Dr.M Mukhyaprana Prabhu



                University: Manipal university



               ICMS 2011 / OP 03 Public Health
                Abstract:
                Introduction: Universal Basic Precautions (UBP) are neither well understood
                nor implemented by Health professionals who are at a relatively higher
                risk due to constant exposure to blood and blood products. The situation
                is alarming in developing countries like India where there has been a con-
                stant rise in number of cases of HIV and HBV. Objectives: To find out the
                Knowledge, Attitude and Practice of universal basic precautionary meas-
                ures among medical personnel in Kasturba Hospital, Manipal, India. Design:
                Cross sectional type of study carried out over two months. Setting: Kastur-
                ba Hospital, Manipal, India – a tertiary care facility placed in a rural setting
                attached to a teaching Medical College. Participants: 120 health profession-
                als including Medical and Paramedical staff Method: Structured question-
                naires were administered, after obtaining prior written informed consent
                from them. Result: Results showed that alleged knowledge did not match
                actual tested knowledge (100% versus 65%). Similar results are seen with
                Practice- 97% alleged vs. 69% actually practiced, also 37% agreed to re-
                capping of needles. 94% agreed that working in hospital is dangerous and
                53% were very worried about the needlestick injuries they had although
                The provision of sharps containers was high. In comparison, Paramedical
                staff practiced UBP more than Medical staff (74% vs. 44%), while Medical
                Staff was found to be more knowledgeable. Conclusion: The study shows
                the need for Kasturba Hospital, a tertiary care facility to develop and imple-
                ment specific policies on the practice of UBP, training of health care provid-
                ers and ensuring the consistent supply of protective materials.




                Keywords: Universal precautions, UBP, social medicine, kap, HIV, AIDS,
                hepatitis, epidemiology, public health
                Contact authors at: abhinavpal@gmail.com


                                                   —310—
    TREND ANALYSIS OF GASTROINTESTINAL CANCER MOR-
                     TALITY IN IRAN




                                                                              Epidemmiology
                                                                                 Anatomy
  Authors: Mohamad Amin Pourhoseingholi, Alireza Abadi, Gemma
  Gatta, Mohammad Reza Zali


  University: Shahid Beheshti Mdical University



ICMS 2011 / OP 04 Public Health
 Abstract:
 BACKGROUND/AIM: Cancer is the third most common cause of death in
 Iran. Gastrointestinal (GI) cancer is the most important causes of mortal-
 ity due to cancer. With regards to cancer mortality, data are important to
 monitor the effects of screening program, earlier diagnosis, demographic
 data and other prognostic factors. The aim of this study was to evaluate
 the mortality rates and trends from GI cancer in Iranian population dur-
 ing a period of almost a decade, i.e. from 1995 to 2003. MATERIALS AND
 METHODS: National death Statistic Reported by the Ministry of Health
 and Medical Education (MOH&ME) from 1995 to 2003, stratified by age
 group, sex, and cause of death are included in this analysis. Colorectal
 cancer (CRC) [ICD-9; 153-154], Gastric cancer (GC) [ICD-9; 151], Pan-
 creas cancer (PC) [ICD-9; 25], Esophageal cancer (EC) [ICD-9; C15] and
 Hepatocellular carcinoma (HCC) [ICD-9; 20] were expressed as the an-
 nual mortality rates/100,000, general and/or per gender, and age group.
 RESULTS: The general mortality rate of CRC slightly increased during the
 years under study and the general mortality rates of GC and EC showed
 a sharp increasing. In contrast, the age standardized mortality rate of PC
 decreased slightly during the years under the study. The rate of HCC mor-
 tality moderately increased. All mortality rates were higher for male than
 female. CONCLUSION: Our study indicated remarkable increasing trends
 in burden of GI cancer in Iran specifically for CRC and GC. Developing for
 a GC and EC for both primary prevention and early detection programs
 and providing the facilities for CRC screening, would be the options to
 control the mortality and burden of GI cancers in the future.




Keywords: Colorectal Cancer, Gastric Cancer, Esophageal Cancer, Pancreas
Cancer, Hepatocellular carcinoma, Mortality, Trend Analysis
Contact authors at: amin_phg@yahoo.com

                                  —311—
                   EPIDEMIOLOGICAL FEATURES OF GASTRO-ESOPHAGEAL
                   REFLUX DISEASE IN IRAN BASED ON GENERAL POPULA-
                                         TION
Epidemiology




                Authors: Asma Pourhoseingholi, Mohsen Vahedi, Bijan Moghimi-
                Dehkordi, Mohammad Rostami Nejad, Azadeh Safaee,Mohamad
                Reza Zali

                University: Shahid Beheshti University of Medical Science



               ICMS 2011 / OP 05 Public Health
                Abstract:
                Introduction: Gastro-esophageal reflux disease (GERD) is a common and
                chronic problem and using different definitions, characterized by heartburn
                and regurgitation symptoms varies in different populations. Recent reports
                from developing countries indicate increment in the incidence and preva-
                lence of the disease over the past. GERD has a significant impact on patients
                quality of life and imposes a large financial burden on the health care sys-
                tem So many studies were published regarding this disorder in last years.
                Conventionally, endoscopy is used for diagnosis of this disease. But when
                symptoms of gastro-esophageal reflux disease are typical and the patient
                responds to therapy, no diagnostic tests are necessary to verify the diagno-
                sis. Aim: The aim of this study was to evaluate the epidemiology of GERD
                base on population study in Tehran providence. Methods: This study was a
                cross-sectional household survey conducted from May 2006 to December
                2007 in Tehran province, Iran. Participants completed a valid gastro-esoph-
                ageal reflux Questionnaire. The questionnaire included personal and family
                characteristics such as age, gender, and educational status. In addition,
                interviewers asked them regarding 10 GI symptoms. Results: Altogether
                18180 individuals participated in this cross-sectional study. The mean ± SD
                age of participant was 38.7 ± 17.1 and 9072 (49.9%) were women. The
                prevalence of GERD was 8.85 (8.43-9.26). There was significant relation-
                ship between age, sex, marital and educational status with GERD. GERD
                symptoms were more common in women, older people, individuals with low
                education and married people. There was overlap between GERD, irritable
                bowel syndrome (IBS) and uninvestigated dyspepsia (UD). Conclusion: Ac-
                cording to our finding although the prevalence of GERD in our population is
                less than other studies, this prevalence is increasing in recent years.




                Keywords: Gastro-esophageal reflux disease, population-based, Epidemio-
                logical feature
                Contact authors at: asma_phg@yahoo.com


                                                  —312—
   A COST ANALYSIS OF FUNCTIONAL BOWEL DISORDERS IN
    IRAN: A CROSS-SECTIONAL POPULATION-BASE STUDY




                                                                                   Epidemmiology
                                                                                      Anatomy
  Authors: Mohsen Vahedi, Bijan Moghimi-Dehkordi, Babak Kho-
  shkrood Mansoori, Mohammad Amin Pourhoseingholi, Azadeh
  Safaee, Manijeh Habibi, Asma Pourhoseingholi, Mohammad Reza
  Zali
  University: Shahid Beheshti University of Medical Science



ICMS 2011 / OP 06 Public Health
 Abstract:
 Introduction: Functional bowel disorders (FBD) are functional gastrointes-
 tinal disorders with symptoms attributable to the mid- or lower gastro-
 intestinal tract. They include irritable bowel syndrome (IBS), functional
 abdominal bloating (FAB), functional constipation (FC), functional diarrhea
 (FD), and unspecified functional bowel disorder (UFBD). The diagnosis
 always presumes the absence of a structural or biochemical explanation
 for the symptoms, and it is based mainly on symptom evaluation and
 clinical criteria, as well as the ruling out of organic disturbances Aim: To
 study the costs related to IBS, FC, FD, FAB and U-FBD in Tehran. Methods:
 From May 2006 to December 2007, a cross-sectional study conducted in
 Tehran province; including 18180 persons with GI symptoms drawn up
 randomly and interviewed using a valid questionnaire. The frequency of
 health resource utilization (i.e. physician visit, hospitalization, and medica-
 tions) and productivity loss (days off work) due to IBS, FC, FD, FAB and
 U-FBD symptoms in the past 6 months were recorded. Cost of illness per
 person per 6 months was estimated in purchasing power parity dollars
 (PPP$). Results: IBS was found in 166, FC in 435, FD in 49, FAB in 271
 patients and U-FBD in 979. The mean 6-months total cost of IBS, FC, FD,
 FAB and U-FBD were around 160.05, 146.83, 42.24, 95.64 and 103.29
 per patient. The highest proportions of direct costs were due to physician
 visit. The smallest proportion of costs was due to laboratory tests. Most
 indirect costs are due to cumulative productivity loss caused by the days
 with low functionality. Conclusion: Costs were affected by disease severity
 (increased). Hospitalization and physician visits were the dominant cost of
 disease that could be minimized by revision of the insurance industry in
 Iran.




Keywords: irritable bowel syndrome; functional constipation; functional
diarrhea; functional abdominal bloating; cost analysis
Contact authors at: mohsenvahedi540@gmail.com

                                   —313—
                  ASSESSMENT OF THE RISK FOR DEVELOPMENT OF TYPE 2
                  DIABETES MELLITUS FOR THE POPULATION OF BULGARIA
Epidemiology




                Authors: Velikov P., Nikolova A., Ivanov G.



                University: Medical University of Sofia



               ICMS 2011 / OP 07 Public Health
                Abstract:
                Introduction
                Diabetes Mellitus Type 2 is a metabolic disorder that currently afflicts more
                than 150 million people worldwide or 520 000 people in Bulgaria and the
                number increases every day. Although there are many medications on the
                market the disorder is incurable and can only be managed so far with prop-
                er diet and exercise regimen.
                Aim
                The purpose of the study is to assess the risk for the Bulgarian population
                for development of Type 2 Diabetes Mellitus.
                Methods
                On occasion of the World Diabetes Day we examined 352 citizens in Bul-
                garia’s capital Sofia for some of the greater risk factors, which are directly
                linked to development of Type 2 Diabetes. As important we considered Age,
                Obesity (assessed by Body Mass Index, Percentage of Body Mass Tissue and
                Waist to Hip Ratio), the presence of medical conditions (such as hyperten-
                sion disorder) and genetics (assessed by a familial history of Diabetes). For
                the statistical evaluation we used SPSS 19.
                Results
                Of the examined population 110 are male and 241 are female.
                The average age of the examined is 50.85 with the age females being
                slightly higher than the one of males (51.82 to 48.74).
                The mean Body Mass Index for the population is 26.67 for females and
                27.14 for males. The average percentage of Body Mass Tissue is with 26.53
                for males and 33.38 for females. The average WHR for females is 1.31 +-
                0.08and for males is 0.92 +- 0.09. From these results we can conclude that
                the examined population is predominantly obese.
                99 of the examined presently have hypertension - 29 males and 70 females.
                100 of the population announced a 1 or 2 degree relative with Type 2 Dia-
                betes and two already have Type 2 Diabetes.
                Conclusion
                From the data that we gathered we can conclude that the Bulgarian popula-
                tion is at a high risk for developing Type 2 Diabetes.

                Keywords:Type 2 Diabetes, risk factors, Bulgarian nation.

                Contact authors at: p.velikov@ymail.com


                                                  —314—
   EXPOSURE TO INDOOR AIRPOLLUTION AND APPEARANCE
    OF RESPIRATORY SYMOTOMS IN FEMALE POPULATION




                                                                             Epidemmiology
                                                                                Anatomy
  Authors: Milan Jovanovic, Milena Jevtic



  University: University of Nis



ICMS 2011 / OP 08 Public Health
 Abstract:
 Introduction: The objective of this paper was to estimate the prevalence
 of respiratory symptoms in women who exposed different source of
 indoor air pollution. Aim: Aim of this study was to evaluate the exposure
 to the indoor air pollution on respiratory symptoms in females. Material
 and methods: Subjects were 352 women, aged 20-40, nonsmokers and
 profesionally not been exposed to harmful agents. Results: . Data on the
 exposure to indoor air pollution were obtained from the standard ques-
 tionnaire prepared by WHO. The women were interviewed about respira-
 tory symptoms, too. Conclusion: The results showed that examines from
 exposed group had statisticaly higher prevalence of respiratory symptoms.




Keywords: indoor air pollution, female, respiratory symptoms.

Contact authors at: milanfenix@yahoo.com

                                  —315—
                    THE PSYCHOPHYSIOLOGICAL ASPECTS OF COMMUNICA-
                            TIVE STRESS IN MEDICAL STUDENTS
Epidemiology




                Authors: Zavgorodnya Kateryna



                University: Crimea State Medical University



               ICMS 2011 / OP 09 Public Health
                Abstract:
                A disturbing trend in student health is the reported increase in student
                stress nationwide. When stress becomes excessive, students experience
                physical and psychological impairment. This study investigated the interre-
                lationship among hostility, aggression, fear, haemodynamic and heart rate
                variability parameters and communicative stress among 389 medical stu-
                dents by age, gender, specialization and ethnic origin. Buss-Durkee Hostility
                Inventory; Questionnaire of hierarchical structure of actual personal fears;
                The method of communicative sets investigation; The test of neurologi-
                cal and-behavioral adaptation by Bechterev; The method of communicative
                barrier diagnostics were used and reogram and heart rate variability were
                analyzed. Results showed that most students were in the state of commu-
                nicative stress: 58,5% students had the depressive disposition; 34% were
                at risk to get the borderline psychological dysfunction. In 49% of students
                emotions tend to complicate communication. Significant differences were
                revealed in students from different faculties and year of studies. Levels of
                aggression and fear were higher in first and sixth year grade students with
                the prevalence of physical and verbal aggression (p<0,05, Mann–Whitney
                U test). Correlations between the heart rate variability and haemodynamic
                parameters and psychological characteristics were determined (0,32 ).




                Keywords: Stress, agression, fear, cardiovascular system, autonomic nerv-
                ous system
                Contact authors at: stcatz@mail.ru


                                                  —316—
    NUTRITIONAL STATUS AND INTAKE OF SOUTH AFRICAN
       WOMEN BETWEEN THE AGES 18 AND 22 YEARS




                                                                                Epidemmiology
                                                                                   Anatomy
  Authors: JE Barnard, CC Grant, PS Wood, N De Villiers



  University: University of Pretoria



ICMS 2011 / OP 10 Public Health
 Abstract:
 Objective: The aim of this study was to determine the nutritional status of
 a representative group (n=51) of young South African women, between
 the ages 18 and 22 years. Methods: A 24-hour recall combined with a
 food frequency questionnaire was completed by the participants. The di-
 etary information obtained was processed using FoodFinder3 to obtain the
 nutrient intake of the population and results were statistically analysed by
 SAS statistical to compare regular intake to the standard Recommended
 Daily Allowance (RDA) recommendations. Results: The total energy (kJ)
 intake in females (9551.94;4937.41) indicated no significant difference
 (p>0.05) when compared to the RDA of 9205 for the same age group.
 There were no significant difference (p>0.05) found in the % total protein
 energy intake and the % fat intake consisting of SFA (saturated fatty
 acids). However the total % fat energy intake was significant (p<0.05)
 higher in the females (3.67;11.61), whilst the MUFA (monounsaturated
 fatty acids) and PUFA (polyunsaturated fatty acids) intake also showed a
 significant difference (p<0.05). The CHO (carbohydrates) energy intake
 was significant lower (p<0.05) in females (-3.14;10.99). Results for
 the analysis of mineral intake (Ca - Calcium, Fe - Iron) compared to the
 RDA, reported significant lower (p<0.05) Ca (-546.21;477.17) and Fe
 (-2.7969;6.7131) intake in females. Conclusion: Results indicated that the
 fat intake of women are significantly higher than the RDA, while lower val-
 ues than RDA were found for CHO, Ca, Fe, Biotin, Vitamin D and Vitamin
 E, which can indicate an increased risk of osteoporosis and Fe-deficiency
 anaemia. This can be prevented with adequate intake of Ca, vitamin D and
 Fe in the form of food sources or supplementation. Total fat intake also
 need to be reduced to decrease the risk of heart disease and hypertension
 later in life, especially as research has ranked the South African popula-
 tion as the third most obese in the world (after the US and UK) and this
 need to be dealt with great urgency to help improve the nutritional health
 status of women in South Africa.




Keywords: Nutrition, women, anaemia, osteoporosis, heart disease, South
Africa
Contact authors at: jandri.barnard@gmail.com

                                  —317—
 Abstracts
 Dentistry
Oral Session
   ORAL HEALTH OF SIX- YEARS OLD CHILDREN IN THE CITY
             AREA OF KOSOVSKA MITROVICA




                                                                                 Anatomy
                                                                                 Dentistry
  Authors: Dorde Blanusa



  University: Medical University of Pristina



ICMS 2011 / OP 01 Dentistry
 Abstract:
 Introduction. Today, dental caries remains one of the most common
 diseases in the world. So, preventive dentistry became one of the most
 important parts of modern dentistry, which can guarantee the success in
 oral health. The aim of study was to declare caries etiological factors at
 first, than to confirm the oral status of primary teeth and the status of
 the first constant molars of six- years old children in city area of Kosovska
 Mitrovica, and than to explain to parents and their children the importance
 of oral hygiene and oral health. Material and methods. At the beginning of
 our examination, we dispensed opinion polls to the parents. It was con-
 sisted out of 13 questions about oral hygiene, their children nutrition and
 about parents knowledge in oral health. After we got parents approval,
 we controlled 40 six- years old children following the WHO principles. We
 paid more attention to first constant molars. At the end, we delivered a
 speech about oral hygiene and oral health to the children and to their par-
 ents. Results. Analyzing the opinion polls, we determined the main caries
 etiological factors. We analyzed the status we got, determined dtmf index
 of primary teeth, and distinguished the first constant molar status. Some
 of the most interesting cases are demonstrated. Conclusion. According to
 professional results, we can determine that the oral health of six- years
 old children in the city area of Kosovska Mitrovica is concerned and, at the
 same time, the parents knowledge about the importance of oral health of
 their children is really low.




Keywords: Caries, Oral health, First constant molars

Contact authors at: blanusha_1985@yahoo.com

                                   —319—
                DEFORMATION AT COMPRESSION AND RECOVERY AFTER
               DEFORMATION OF ANHYDROUS ELASTOMER IMPRESSION
                                 MATERIALS
Dentistry




             Authors: Manak Eugenia



             University: BSMU



            ICMS 2011 / OP 02 Dentistry
             Abstract:
             Object of investigation: silicone impression materials of 4 types of tenacity
             of automatic and manual mixing. And for comparison purposes of mechani-
             cal properties impression materials have been used irreversible elastomeric
             materials of alginete type. Aim of investigation is comparative estimation
             of mechanical properties elastomeric impression materials. Methodology:
             estimation of mechanical properties elastomeric impression materials, the
             comparative characteristic of deformation at compression and restoration
             after deformation elastomeric impression materials and irreversible elasto-
             meric materials of alginete type, statistic analysis. Results of work: is testify
             that universal device for an estimation of mechanical properties elastomeric
             impression materials provides test specifications according to standard ISO
             4823 and allows to conduct with a split-hair accuracy deformation research-
             es at compression and restoration after deformation. Deformation indica-
             tors at compression and restoration after deformation impression materials
             correspond to requirements ISO 4823.




             Keywords: IMPRESSION MATERIAL, DEFORMATION AT COMPRESSION, RES-
             TORATION AFTER DEFORMATION, TENACITY TYPE, SILICONES, ALGINETE.
             Contact authors at:jenny.manak@gmail.com


                                                —320—
   KINETIC AND MICROBIOLOGICAL STUDY OF TOOTH DECA




                                                                                                   Anatomy
                                                                                                   Dentistry
  Authors: Shestopalov M, Shestopalova E



  University: Gomel state medical university



ICMS 2011 / OP 03 Dentistry
 Abstract:
 Introduction. Tooth decay is a disease process where acidic waste products created by oral
 bacteria cause damage to the hard (mineralized) tissues of a tooth. Today, caries remains
 one of the most common diseases throughout the world. Worldwide, most children and
 an estimated ninety percent of adults have experienced caries, with the disease most
 prevalent in Asian and Latin American countries and least prevalent in African countries. An
 effective way to prevent tooth decay is oral hygiene. The aim of our investigation was to
 compare the effectiveness of toothpastes of different categories, using both kinetic and mi-
 crobiological approaches. Materials and methods. The toothpastes on study were: 32 pearls
 (Belarus), Kedrovaya (Belarus), Silca (Germany), Astera (USA), Senquel Active (India),
 Colgate (Ukraine), Blend-a-med (Ukraine), Faberlic (Russia). To compare their effectiveness
 in maintaining the tooth enamel from decay we immersed teeth into 0.1 mol/L hydrochloric
 acid solution that contained 0.5 grams of toothpaste, and examined their dissolving process
 by taking samples through fixed time terms with later analyses of calcium in them. Calcium
 content was determined by complexonometric titration method. The obtained data allowed
 us to calculate three kinetic parameters that characterize pastes effectivity: inductive
 period, the rate constant of teeth dissolution and half-life of teeth enamel. Kinetic studies
 were carried out simultaneously with the effects of toothpastes on the micro flora of the
 oral cavity. Since two groups of bacteria are responsible for initiating caries: Streptococcus
 mutans and Lactobacillus, we studied the growth of their colonies after cleaning the teeth
 by different toothpastes. Discussion. The experimental data revealed that the kinetic curves
 that characterized the dissolving process of tooth enamel can be subdivided into three seg-
 ments: (a) the inductive period (the rate of dissolution is zero), (b) the period of intensive
 dissolution (rapid increase in calcium concentration), (c) the period of constant calcium
 concentration (the dissolving process came to the end or reached the equilibrium state). We
 proved the first-order kinetics for tooth enamel dissolution and calculated the rate constants
 of this process and half-life of teeth. The inductive periods of most pastes were in a range
 20-40 minutes; the rate constants varied from 0.065 to 0.0125 min-1 and teeth half-life
 took the values from 11 to 56 minutes. For comparison, the rate constant of unprotected
 tooth was 0.081 min-1 and its half was only 8.6 minutes. Clearly that toothpastes protest
 enamel from decay. The calculations revealed that rate constants are directly proportional
 to the inductive periods of teeth destruction: the greater inductive period, the lower the
 rate of teeth mineral component dissolution. We proved the correlation between kinetic
 characteristics of toothpastes and their antibacterial activity. The pastes responsible for the
 maximum decrease in the rate of teeth destruction were most effective in suppressing the
 growth of micro flora in oral cavity. For example, Senquel Active (rate constant 0.018 min-
 1) 100 times reduced the growth of micro flora, while Silca (rate constant 0.045 min-1) 10
 times reduced its growth only. Conclusions. We developed the method of comparing the
 effectiveness of toothpastes, which includes the kinetic and microbiological approaches to
 the test object.



Keywords: kinetic and microbiological approaches, half-life of teeth, induc-
tive period
Contact authors at: n.valentina.a@gmail.com

                                           —321—
                STUDY OF MADELUNG’S DISEASE AS A PARTICULAR CASE
                      OF LIPOMAS OF MAXILLOFACIAL REGION
Dentistry




             Authors: Vlasenko Y.O., Grygorov S.M., Rak O.V.



             University: Kharkiv National Medical University



            ICMS 2011 / OP 04 Dentistry
             Abstract:
             Lipomas are the most widespread benign neoplasms of face and neck.
             They occur as single nodes (lipomas) and diffuse lipomatosis, and develop
             asymptomatically for a long time, especially if they are not visually acces-
             sible. Symmetric excrescences of adipose tissue chiefly in the neck region,
             called Madelung’s disease, present a special interest. During 2007-2010
             years 42 patients with lipomas of maxillofacial region were examined and
             treated in the clinic of maxillofacial surgery of Kharkiv National Medical
             University. Among them there were 12 with lipomas localized in the neck
             region, 26 – in the facial region, 4 – with annular lipomas (Madelung’s
             disease). Patients with lipomas of face and neck (single neoplasms) were
             aged 20-55, mainly female (57,9%), in most cases somatically healthy. All
             patients with annular lipoma of neck were aged 47-59, male, with hyper-
             sthenic bodybuild, alcohol abusers; revealed were subcompensated car-
             diovascular insufficiency, susceptibility to hypertension, and left ventricular
             hypertrophy. According to classification of process extension (V.M.Topalo,
             1992), in 2 patients lipomatous nodes were related to the 2nd degree (as
             occupying the anterior surface of neck on both sides), and in the other 2
             patients – 3rd - 4th degree (as spreading to the anterior surface of chest,
             behind the jugular notch, to the posterior surface of neck and superior third
             of back). All patients were surgically treated. By the 2nd degree of exten-
             sion the lipomatous nodes were extracted simultaneously from a broad col-
             larform incision on the anterior neck surface. By the 3rd - 4th degree the
             operation was carried out in three stages with a month intervals between
             them. Lipomatous excrescences were removed from the anterior surface of
             neck, parotid and occipital regions. Corrective and substitutive treatment
             was carried out in postoperative period. After a year neither relapse nor
             intermuscular excrescence were detected. The cosmetic result was satisfac-
             tory. Thus, our observations confirm the data concerning affection by annu-
             lar lipoma of male mainly, aged more than 40, alcohol abusers. Taking into
             consideration the concomitant diseases and constitutional features, such
             patients require correction of life-providing systems. On the assumption of
             classification of process extension, surgical treatment should be carried out
             in stages.
             Keywords: lipoma, Madelung`s disease

             Contact authors at:vlasenko91@mail.ru


                                               —322—
  CONDITION OF PARODONTAL TISSUES OF PATIENTS WITH
                   OSTEOPOROSIS




                                                                                 Anatomy
                                                                                 Dentistry
  Authors: Ostaev Yury Alexandrovich., Siukaeva Tamara Nug-
  zarovna, Khetagurov Soslan Kazbekovich, Toboev Georgiy
  Vladimirovich.

  University: North Ossetian State Medical Academy



ICMS 2011 / OP 05 Dentistry
 Abstract:
 Introduction. Traditionally the problem of diagnostics and treatment of
 osteoporosis is being explored by rheumatologists, in some cases endo-
 crinologists and gynecologists. However in practice the rate of paroden-
 tium pathology in patients with osteoporosis makes up around more than
 70%. But unfortunately osteoporosis in most cases is revealed when it is
 rather late. Aim.Consequently parodentium pathology serves as a reason
 for patient’s diagnosis in terms of early finding out whether they acquire
 osteoporosis or not . Material and methods: Thirty patients of both sex
 have been examined aged from 37-65. They were divided into 2 groups.
 The second group was control group actually. Total clinical examina-
 tion was employed. The information was gathered in terms of patients’s
 complaints, anamnesis of the main illness, taken medicines, examination
 for defining the exact body weight, it’s index, taking clinical and biochemi-
 cal blood analysis. The density of bone tissue was defined by dual-energy
 X-ray absorptiometry scanning. Stomatological examination was based on
 the definition of number of missing teeth, teeth injured by caries. Quantity
 of treated teeth. The state of parodontal tissues we defined by analys-
 ing parodontal indexes and clinical picture and complaints of patients
 . As a supplemental method orthopantomogram was used. Summary.
 After comparing the results of examination in both groups we found out
 that pathological changes in parodentium of patiens with loss of mineral
 density in peripheric skeleton were much more expressed in patients with
 osteoporosis. And what is the most important the harder the condition
 of parodontal tissues was the more marked the loss of mineral density in
 peripheral bone tissue was. Conclusion.In almost every patient with MPK
 there was detected any form of parodentium tissue affliction. The level
 of afflicted area is expanding when losing MPK is increasing in peripheric
 skeleton. So the densitometry of bone tissue in patients with parodontal
 diseases is a good measure in early revealing the osteoporosis and getting
 control over it!




Keywords: Osteoporosis

Contact authors at: darendorf@yandex.ru

                                   —323—
   Abstracts
Dentistry Poster
    Session
   AMALGAM OR COMPOSITE ? DIFFERENCE OF THE VIEW IN
               PATIENTS AND DENTISTS




                                                                                  Anatomy
                                                                                  Dentistry
  Authors: Tatjana Tulumovic ; Srdjan Radojkovic



  University: Medical faculty of Banja Luka



ICMS 2011 / PP 01 Dentistry
 Abstract:
 Introduction: Dental amalgam is the most commonly used dental restora-
 tive material used for fillings. First introduced in France and it contains a
 mixture of mercury with at least one other metal. Amalgam has been the
 restorative method of choice for many years due to its low cost, ease of
 application, strength, durability and effects. Factors that have led to recent
 decline in use are a lingering concern about detrimental health issues ,
 aesthetics , and environmental pollution. Dental composites, also called
 white fillings, are a group of restorative materials used in dentistry. As
 with other composite materials, a dental composite typically consists of
 a resin-based matrix Objective: We took 40 medical students and placed
 them in the aspect of choice between two types of fillings. One who
 chose amalgam fillings as their personal choice were used to compare the
 aesthetic, anatomical and practical aspect to the other composite fillings
 of the cavities we did due the past year. Also students ( patients ) did
 the procedures on themselves and we followed the quality and hygienic
 standard of oral cavity in the students of this project to compare them
 professionally as the “ moral and professional “ referent value to the other
 random patients ( walk in citizens ) we have outside of the project . Due
 the 3 months follow up on our patients (students) we found the following
 results. Result: Of the 40 students, only 7 chose amalgam fillings. All of
 them chose to do the filling on the first or second molars. The amalgam
 filled cavities showed the high level of stability and high endurance in the
 following period of time and as their aesthetic purpose was diminishing the
 composite fillings are more practical in the aesthetic view because they
 imitate the color of the tooth. Conclusion: Amalgam fillings are cheaper
 and require more of the drilling also less physical work on the cavity dur-
 ing the process of filling.We will show that newer materials are the way
 of dental innovation, al thou they require sometimes more work they are
 better for the subjects.




Keywords: Amalgam, composite, tooth, choice

Contact authors at: dr_srx@hotmail.com

                                   —325—
               EFFECT OF DIFFERENT TYPES OF RETRACTION THREAD ON
                       THE DEGREE OF GINGIVAL RECESSION
Dentistry




             Authors: Ambaryan A.A.



             University: North - Ossetian State Medical Academy



            ICMS 2011 / PP 02 Dentistry
             Abstract:
             Retraction of the gums - is responsible of the procedures required to obtain
             a more accurate impression of the production of indirect restorations. In
             this regard, it is necessary to choose such retraction threads and retraction
             of the technique, which has brought to minimize tissue traumatism and
             would eliminate the irreversible loss of soft tissue height. Aim this work
             was to determine: what types of retraction fibers are best used in work,
             at what time they need to be placed in thedentogingival sulcus to provide
             sufficient retraction of the gums without causing its recession. To determine
             problem we used the data of a sociological survey of dentists of the city of
             Vladikavkaz. Used the data of a sociological survey of dentists conducted
             by the magazine Operative Dentistry, concerning the problem of choosing
             yarns with different impregnation. We also conducted an experiment on
             animals, clarifying the dependence of gingival recession on the composition
             of threads and impregnating time finding it in the gingival sulcus. Socio-
             logical survey showed: 96% of orthopedists use in the method of retrac-
             tion. Of these threads Gingi-Pak enjoys 83%, 11% use other means for
             retraction. Among doctors according to instructions of the manufacturer
             24% of dentists - orthopedists, the remaining 76% leave the thread for a
             longer time.The experimental part of research was conducted on rats . The
             survey found that thread without impregnation practically does not cause
             gingival recession, regardless of their residence time in the gingival sulcus.
             Threads, soaked in epinephrine and thread impregnated with aluminum
             chloride causing a small recession in the range of 2 microns, respectively, if
             the work instructions. if the thread is up to 40-60 minutes - the recession
             will be significant, leading to an aesthetic defect. The magnitude of the re-
             cession will be significant from the thread impregnated with aluminum chlo-
             ride, rather than from the filament, impregnated with epinephrine. Thereby
             for gingival recession affects the composition of thread and thread stay in
             the gingival sulcus. Clarified the effectiveness and the degree of retraction
             of the recession, which occur when using threads. Correct technique retrac-
             tion guarantee successful retraction.



             Keywords: retraction thread, gingival recession, the degree of recession

             Contact authors at: armina9191@mail.ru


                                               —326—
    MACROSCOPIC AND MICROSCOPIC CHANGES OF TEETH
      FOR DESCENDANTS AT MOTHER’S HYPOKINESIA




                                                                                Anatomy
                                                                                Dentistry
  Authors: Globenko Maryna



  University: Kharkiv National Medical University



ICMS 2011 / PP 03 Dentistry
 Abstract:
 The problem of hypokinesia is referred to list of the actual problems in a
 modern society. Sedentary life is often peculiar to pregnant women. There
 is no information in scientific literature about how women’s hypokinesia
 can affect her child’s state of teeth health. The aim of this part of the
 research is to discover the influence of mother’s hypokinesia on changes
 of her children’s teeth. The experiment was carried out on 12 female rats
 and 52 their descendants of Vistar’s breed. Prospective mothers were
 divided into 2 groups: the control (C) and the group, that was kept in
 hypokinesia’s conditions (HK). The females of group C were kept in the
 cage (40?60 cm), they gave birth to 25 descendants . The females of HK
 group were kept in the cage that was three times smaller, they gave birth
 to 27 descendants. In 3-months age the descendants were taken out
 the experiment by the decapitation way. The upper and lower jaws with
 denture were committed in 10% solution of formaldehyde. Then rat’s jaws
 were separated out and discovered by macroscopic way with the help of
 stereo loupe MBC-9. After formaldehyde’s fixation, decalcification and fill-
 ing with celloidin- paraffin there were produced microslides with hematox-
 ylin-eosin’s colouring. Histological research was carried out with micro-
 scope Axiostar-plus. In the course of research it was revealed that there
 is a trustworthy decrease of length of corner teeth’s crowns (7.5±0.11
 mm-gr.C, 7,09±0,29 mm-gr. HK, p?0,05). The slant of corner teeth of
 rats from group HK also is decreased (gr.C 3,70±0,08 mm, and gr. HK
 3,32±0,15 mm, p?0,05). High frequency of dental caries lesions is noted
 in gr. HK (gr.C ? 1,6±0,49 affected teeth at 1 animal, gr. HK- 2,25±0,34).
 It is microscopically observed that the length of the dentinal tubules in
 gr. HK there is 25% fewer dental tubules than in gr.C, and the thickness
 of the walls dentinal tubule is also reduced. In conclusion we can say that
 hypokinetic conditions of mother’s life during gestation of descendants
 leads to the appearance of symptoms of hypoplasticity of dental apparatus
 of adult descendants and their susceptibility to dental caries.




Keywords: Hypokinesia, descendants, teeth

Contact authors at: Globenko_M@mail.ru

                                  —327—
               FREE GINGIVAL GRAFT TECHNIQUE FOR ABERRANT FREN-
               ULUM ELIMINATION AND GINGIVAL TISSUES AUGMENTA-
                              TION (CASE REPORT)
Dentistry




             Authors: Andreev I., Chr. Popova, A. Mlachkova



             University: Medical University - Sofia



            ICMS 2011 / PP 04 Dentistry
             Abstract:
             Summary BACKGROUND: Some of the most important functional goals in
             the treatment of mucogingival problems are arresting the progression of
             gingival recession and improving the ability for plaque control. Proper mu-
             cogingival therapy should lead to gingival augmentation and creation a ves-
             tibule with adequate depth in the regions with insufficient attached gingival
             tissues and attachment loss. The contemporary opinion is that even if it’s
             possible to maintain the gingival health in the areas with insufficient or ab-
             sent attached gingiva, the regions with less than 2mm attached gingival tis-
             sues are at increased risk of gingival recessions, attachment loss and bone
             loss . Free gingival graft technique is considered to be the most efficient
             in regions with lack of attached gingival tissues and in cases when ortho-
             dontic treatment or restorations with subgingival preparations are planned.
             The main disadvantages of this technique are the presence of two wound
             areas and the limitations associated with the amount of the donor tissue.
             CASE PRESENTATION: A clinical case of gingival recessions of mandibu-
             lar central incisors with horizontal alveolar bone loss combined with root
             sensitivity, shallow vestibulum, high frenulum attachment and ineffective
             plaque control it is presented. These mugogingival discrepancies present
             a high risk of progression of the gingival retraction and attachment loss.
             The measured values of the clinical attachment level are 31- 5mm; 41-4
             mm and the teeth have respectively 31- 3mm; 41-2mm recession. The free
             gingival graft technique for augmentation of the attached gingival tissues
             was perfomed with exact adaptation of the donor tissue at the prepared
             recipient area. RESULT: The augmentation of the attached tissues using the
             free gingival graft technique led to significant gain of attached gingiva in the
             treated region. CONCLUSION: Presented surgery procedure is indicated in
             situations with inadequate vestibule depth and small alveolar bone height.
             The results from application of technique of free gingival graft demonstrate
             successful augmentation of attached gingiva and stabilizing the periodontal
             attachment at the area with loss of alveolar bone and progressive loss of
             periodontal attachment.



             Keywords: attached gingival tissues, mucogingival problem, free gingival
             graft, attachment loss
             Contact authors at: feidrota@abv.bg


                                                —328—
  APICALLY DISPLACED FLAP FOR CROWN LENGTHENING OF
      TOOTH WITH HORIZONTAL SUBGINGIVAL LESION




                                                                                Anatomy
                                                                                Dentistry
  Authors: Chr. Popova, D. Emilov, M. Georgieva



  University: Medical uUniversity - Sofia



ICMS 2011 / PP 05 Dentistry
 Abstract:
 Background: Apically displaced flaps are often used to resolve the problem
 of subgingival fractures and lesions that need crown lengthening for the
 restorative therapy of teeth. The advantage of this technique is gain of
 attached gingiva. Materials and methods: A case of 21 year old man with
 horizontal subgingival lesion is presented. After treatment of the general-
 ized plaque-induced gingivitis, a gingivectomy for performance of re-treat-
 ment of root canals was made. The periodontal surgery technique included
 apically displaced flap for crown lengthening and intra-operative re-
 inforced restoration. Results: A few months after the surgery the gingival
 tissues are stable and healthy. There is gain of attached gingiva. A defini-
 tive restoration (dental crown) is planned. Conclusion: Apically displaced
 flaps are often used for crown lengthening. The results are predictable.




Keywords: apically displaced flap, crown lengthening, subgingival lesion

Contact authors at: denislavemilov@gmail.com

                                  —329—
Index
surname        name          pages
Abudalleh      Abdulkadir     274
Ahmadi         Amirhossein    298
Akbarova       Gunay           81
Akhbardeh      Mahdi          230
Aleksiev       Teodor         291
Algun          Suheda         130
Alipov         Artem           42
AlKhadzhKhasan Kamiran        238
Almestaka      Naji            88
AlSayafi       Abdullah       286
Ambaryan       Armine         326
Anastasov      Asen            45
Andreea        Enache         153
Andreev        Ilian          328
Andriychuk     Denys          253
Angi           Andrea         169
Antonina       Dorokhina      258
Arabadzhieva   Elena          171
Assefi         Melika         204
Atanasova      Maria           66
Atanasova      Veronika       151
Avramovic      Nemanja        255
Baka           Judith         297
Balendra       Shiama         207
Balev          Alexander      162
Baraku         Ardita         303
Barnard        Jandri         317
Barsukova      Oxana          211
Bayraktarova   Iskra          160
Behnamfar      Zahra          138
Berechet       Maria          206
Blajeva        Margarita       44
Blanusa        Dorde       319
Bogdan         Voinea      182
Bogdanov       Georgi      95
Bojovic        Ognjen      309
Boldog         Eszter      296
Bozinovic      Milan       38
Bozinovic      Milan       189
Branchevski    Emil        163
Broshtilova    Valentina   276
Busnatu        Stefan      203
Calite         Elina       186
Cherkes        Maryana     123
Chibuike       Nwokorie    55
Ciric          Nemanja     232
Daniela        Cirju       126
Dencheva       Iveta       215
Dencheva       Snezhina    285
Dermanov       Dragan      277
Diakova        Lora        191
Dijmarescu     Anda        185
Dikova         Zlatina     236
Dimitrov       Anatoli     40
Diohenova      Marta       193
Diskovskyi     Ivan        106
Drachuk        Mariana     85
Draganova      Vyara       263
Dryngova       Christina   245
Dubrova        Maria       43
Dyabkin        Evgeny      195
Dzhuma         Kristina    155
Dzwilewska     Ilona       266
Edirisooriya   Chamil      280
Elens          Iris        225
Emilov         Denislav    329
Enev            Rostislav    39
Esmaeili        Sara         275
Ezhned          Mariia       200
Fafula          Roman        71
Farshchi        Samireh      91
Farshchi        Amir         308
Fayazzadeh      Ehsan        150
Fazeli          Fatemeh      53
Fedorovych      Zoryana      78
Fenoniuk        Larysa       205
Florin          Lungana      154
Gandhi          Avi          112
Ganev           Mihail       295
Garabinovic     Zeljko       257
Georgiev        Georgi       68
Georgiev        Yonko        166
Georgiev        Simeon       175
Georgieva       Ekaterina    70
Georgieva       Snezhina     262
Gjorgjevski     Marko        158
Globenko        Maryna       327
Goganau         Alexandru    127
Govinden        Kughan       287
Gradil          Oksana       128
Grozdev         Ivan         214
Hajipour        Babak        168
Halushchynska   Alla         252
Hasani          Milot        293
Hedayat         Mona         278
Heidarpour      Azadeh       50
Hussaien        Yasir        290
Iakymenko       Maryna       282
Igorevna        Koksheneva   268
Ilcheva         Mihaela      294
Iliev          Bogdan       104
Ivanov         Ivan         142
Ivanova        Ani          199
               Moham-
Jahangard                   226
               madghasem
Jancic         Nina         129
Janik          Michal       164
Jashari        Haki         300
Jevtic         Milena       247
Jovanovic      Ivana        37
Jovanovic      Marija       147
Jovanovic      Zelimir      170
Jovanovic      Ljubica      301
Jovanovic      Milan        315
Juricic        Stefan       146
Kamoona        Ban          212
Kandemir       Halil        109
Karamalakova   Yanka        69
Kavaklieva     Svetlana     213
Kazakova       Vera         72
Kekic          Dusan        246
Khorau         Anton        140
Kostadinov     Krasimir     237
Kufterina      Nataliya     250
Kulish         Olga         188
Kyuchukov      Nikola       48
Leonidovna     Strilets     57
Lilova         Boika        82
Liubelia       Iuliia       222
Lototska       Oksana       260
Lukic          Tatjana      209
Lysenko        Oleksandra   110
Lysenko        Alesya       292
Macit          Betul        261
Mahmoudzadeh   Sanam        256
Majidi        Shima        84
Makotrova     Tatiana      249
Maksymtsiv    Myroslava    144
Maliarska     Iaryna       80
Manak         Eugenia      320
Manolea       Maria        137
Manuelyan     Karen        218
Marchuk       Yuliya       234
Marciniak     Katarzyna    269
Markova       Lyubka       117
Mateeva       Valeria      220
Matei         Costin       141
Maximov       Gheorghi     265
Mazyar        Aminian      56
Medvetska     Olena        259
Melli         Diab         228
Melli         Rima         229
Micic         Marjan       132
Mihaylova     Stiliana     174
Mikhaliev     Kyrylo       210
Milankovic    Danka        254
Milosevic     Vladan       233
Mindov        Ivan         143
Mitkova       Hristina     304
Mitrovic      Aleksandar   134
Mitrovic      Aleksandar   197
Mofleanu      Andra        156
MohamedWedn   AhmedSamy    299
Moldovan      Tamara       145
Monina        Olena        36
Montazer      Mahdi        51
Moos          Lukasz       239
Morteza       Afsaneh      178
Mykhailo      Kostiv       60
Naichuk           Alina       227
Nakov             Radislav    244
Nechipai          Zhanna      231
Nefodov           Oleksandr   90
Nevmerzhytska     Lidiya      248
Nikolova          Nikolina    47
Nikolova          Spasina     79
Nikolova          Albena      305
Ninov             Kiril       176
Novoselski        Miroslav    99
ODonovan          James       194
Opacic            Dragan      58
Opacic            Nemanja     271
Oprea             Stefan      67
Opryshko          Valentyna   98
Ostaev            Yury        323
Pal               Abhinav     310
Palchikov         Vitaliy     93
Pankova           Iryna       283
Pantev            Strahil     177
Pavlov            Orlin       62
Pavlov            Sergej      86
Pavlov            Andriy      89
Pavlov            Vladimir    107
Paykush           Marianna    119
Penchev           Dimitar     73
Petrova           Uliana      251
Piatek            Szymon      221
Piskovatska       Veronika    241
Popa              Denissa     136
Popov             Deyan       61
Popov             George      75
Popovska          Ekaterina   76
Pourhoseingholi   Mohamad     311
Pourhoseingholi   Asma         312
Pradosh           Iryna        157
Prisadashka       Kamelia      216
Radojkovic        Srdjan       148
Rafsanjani        Pooneh       97
Raicu             Adrian       270
Randjelovic       Jasmina      35
Randjelovic       Marija       224
Raykova           Asya         118
Rexhaj            Besarte      96
Ristic            Marko        46
Rovcanin          Branislav    52
Ruseva            Silviya      105
Rutkowski         Michal       167
Rzemieniuk        Anna         240
Sabev             Ivaylo       173
Saburi            Amin         302
Sakelarova        Teodora      111
Salihaj           Selmon       196
Santrac           Nada         223
Sargsyan          Sona         122
Savic             Tamara       243
Semkova           Kristina     217
Sheikhzadeh       Abdolsamad   184
Shestopalov       Maksim       321
Shomanova         Zornitsa     208
Shorikova         Dina         272
Siroochenko       Olga         235
Smrzlic           Sladjana     242
Sokolik           Elena        87
Stamenic          Ivana        131
Stanescu          Raluca       64
Stankovic         Slavica      124
Stefanescu        Doina        181
Stoyanova       Viktoriya    306
Stransky        Dinko        289
Stratev         Asen         198
Sujecki         Damian       165
Surchev         Kiril        100
Surma           Iryna        83
Svyatodukh      Anna         74
Szemcsak        Csaba        135
Tarawneh        Diana        279
Temuryants      Nataliya     101
Todorov         Ivan         59
Todorovic       Nenad        54
Tomaniak        Mariusz      183
Tomov           Nikola       41
Trichkova       Elisaveta    113
Troian          Natalia      125
Tsekova         Radina       288
Tsvetanov       Svetlozar    152
Tulumovic       Tatjana      325
Tykha           Inna         187
Urbanski        Bartlomiej   149
Vahedi          Mohsen       313
Valcheva        Stela        102
Vasileva        Zlatina      103
Velikov         Petar        314
Vinogradskaya   Olga         192
Vira            Kostiv       133
Vistak          Maria        115
Vlasenko        Yevgeniya    322
Vlasov          Ivan         65
Yadollah        Ali          273
Yakova          Mariya       161
Yancheva        Velina       121
Yemchyk         Lyubov       116
Yovchevska    Iviana     284
Yungareva     Irina      219
Zamanzad      Behnam     281
Zavgorodnya   Kateryna   316
Zayats        Marta      94
Zdraljevic    Natasa     264
Zhivkova      Tanya      190
Zyumbyuleva   Camellia   172
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10 - 13 MAY 2011

								
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