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Biomedical subjects

N G Khodeli

Publications and source records attributed to N G Khodeli.

7 recordsLinked to original sources

[Effects of early vocational guidance of students at medical faculty of institute of higher education].

Despite the intensive clinical application of the scientific and technological innovations, the effect of the human factor in surgical intervention remains decisive. The existing model of training highly qualified specialists in the residency program does not always render positive results. For this reason, the issue of early orientation and specialization of prospective specialists, starting from the Bachelor's stage, has received considerable attention. The experience of colleagues at the department of human anatomy, topographic anatomy and operative surgery of the medical faculty of Tbilisi State University is based on the example of early professional orientation of the students, and their active attraction in the specialized surgery groups within the department's "student scientific-practical laboratory." The laboratory has united the abdominal, thoracic, microvascular surgery, plastic surgery, anaesthesiology groups and the group of artificial life support. Teaching was carried out on the basic and specialized stages of preparation in the duration of 5 years in conjunction with regular classes at the faculty. The results of this approach included: significantly higher level of knowledge of theoretical foundations and practical skills in various fields of surgical specialty; positive influence on learning process in general, with improved academic performance of students in every surgical discipline; popularisation and promotion of research with active engagement of students in research activities of the department; "painless" adaptation of students in the clinical departments of city hospitals.

Career Choice↗

Biventricular bypass: alternative to univentricular bypass and total artificial heart-bridge.

Left ventricular and biventricular bypasses (LVBs, BVBs) were performed in 102 experiments in sheep, goats, and donkeys. Biventricular bypass was performed in the assisted circulation mode or in the paracorporeal artificial heart bridge (PCAHB) mode when the natural heart fibrillates. During implantation of artificial ventricles instead of a heart-lung bypass, counterpulsation was used. Several types of connective conduits were developed and tested in experiments. The conduits included bifurcational connective pipes that permit "intake" of blood into artificial ventricles from atria and ventricles of the natural heart simultaneously and consequently provide effective blood flow through shunts not depending on the state of the natural heart (acute cardiac weakness or asystole). Monitoring gas content (PO2, PCO2, and pH) in the myocardium of both ventricles suggested development of right ventricular failure under conditions of LVB before hemodynamic changes occurred and confirmed the preferability of BVB over other methods of assisted circulation, as it is most effective and capable of normalizing short-term cardiac disturbances in the course of the 1st 2 days. Survival time of experimental animals (2-3 days for dogs, 5-12 days for sheep, goats, and donkeys) is sufficient to overcome acute cardiac insufficiency. This suggests that BVB in the assisted circulation mode or PCAHB mode can serve as a bridge for cardiac transplantation for the time of search for the available organ.

Animals↗

[Left-ventricular bypass: characteristics of homeostasis].

Experiments were conducted on donkeys to study the peculiarities of homeostasis in establishment of left ventricular bypass (LVB) by means of an artificial heart ventricle (AHV). Preliminary modelling of acute cardiac insufficiency makes the work of the AHV effective and ensures longer survival than that among intact animals. However, arterial hypertension and anemia accompanying prolonged work of the AHV and resulting from the interaction of the last named with the cardiovascular system sharply aggravate homeostasis and the course of LVB and lead to early death of the animals.

Anemia↗

Long-term circulatory and respiratory support using two artificial ventricles and a fluorocarbon oxygenator.

Using a new heart-lung machine developed at our Institute, experiments were conducted on dogs, donkeys, and monkeys, providing complete and assisted artificial circulation, assisted oxygenation, and perfusion preservation of the heart. The new apparatus consists of two sequentially mounted artificial ventricles working in an antiphase mode; blood oxygenation is accomplished by a reusable oxygenator with a fluorocarbon preoxygenator. Experimental results indicate that clinical use of the apparatus is promising and deserves consideration. The conditions of perfusion were close to physiological conditions and provided long-term survival of the animals. Performance in left ventricular bypass was optimized by monitoring myocardial PO2 and the state of the quick-connect/cut-off assemblies.

Animals↗