[Liver function and pathogenetic therapy for echinococcosis].

This paper contains the results of examining and treating 64 patients with hepatic echinococcosis, treated at the Surgery Unit of the Samarkand Medical Institute Clinic. Forty-five healthy donors of a blood transfusion station formed a control group. There were a total of 109 examined persons. The liver functional status depended on segmental liver involvement by an echinococcal cyst. The cysts were most frequently located in the 7th-8th segments of the liver (32.31%). The number and sizes of cysts also affected the functional status of the cyst-affected liver. The sizes of hepatic cysts varied from 4 to 2 cm. Hepatoprotective agents should be used in different forms of hydatid disease of the liver to correct its function that is changed in multiple and complicated echinococcosis and giant hepatic cysts. They normalize liver function and enzyme activity in the hepatocytes, reduce energy expenditure in the liver, promote hepatocyte regeneration, and convert neutral fats and cholesterol into easily metabolizing forms.

[The epizootology and epidemiology of echinococcosis and paecilomycosis].

Fungi of the genus Paecilomyces, a causative agent of the fungal disease paecilomycosis, have been found in the blood of productive animals (sheep, cattle, pigs, goats) that are carriers of Echinococcus larvocysts. In the Republic of Uzbekistan, the echinococcosis affection of sheep, cattle, pigs, and goats continues to remain high. Domestic fowls (chickens, turkeys, and gooses) have been established to be blood carriers of Paecilomyces fungi, which is also true for wild birds, such as my-lady's-belts, quails, chukars, and crows. The degree of fungal affection has been also established for birds.

[Study of the pathogenesis of paecilomycosis-complicated echinococcosis].

Experiments were carried out on 35 lambs infected with echinococcus eggs taken from canine donors, 5 lambs with echinococcosis, 5 lambs with echinococcosis + paecilomycosis, 5 lambs with coenurosis, 5 with cysticercosis ovis, 5 with alveococcosis, 5 with paecilomycosis, inoculated by the material taken from patients; and 5 healthy lambs formed a control group. Cystic hydatidosis was found to induce substantial cardiovascular changes.

[Cardiac involvement in adults with echinococcosis].

Experiments have established that the first target for echinococcus is the liver and lung and that for pathogenic fungi and protozoa is the heart. Adult patients with hepatic hydatid disease complicated by paecilomycosis have been found to have atypical paecilomycosis-associated myocarditis, the treatment of which was developed by the authors, by using antibiotics, fungicides, and homeopathic remedies.

[Development of a new hydrocarbon extract from the medicinal raw material of Circassian walnut (Juglans regia) and study of its antiparasitic activity].

The authors developed a technology for preparing a hydrocarbon extract from the medicinal raw material of Circassian walnut (Juglans regia), including its green fruits, green leaves, and fresh roots. To prepare the preparation, they obtained for the first time a new extragent called petroleum Russia that was found to contain more than hundred chemical compounds by chromatography mass spectrometry. The new agent was named irillen. Experiments on albino mice and albino rats established that the new agent was low toxic. The lethal doses of irillen were calculated: LD50 was 16377 +/- 457.5 mg/kg; LD16 = 12986.4 mg/kg; LD84 was 18976.6 mg/kg for albino mice; LD50 was 16998.0 +/- 535.4 mg/kg; LD16 = 12875.3 mg/ kg; LD84 = 18583.4 mg/kg for albino rats. The irillen prepared by the authors should be referred to as a low toxic and practically nontoxic agent (Toxicity Class IV and V). Irillen has a broad spectrum of antiparasitic activity. It is effective in treating toxocariasis in dogs, larval alveolar echinococcosis, ascaridiasis, and eimeriasis in chickens, and siphachiasis.

[Immunorehabilitation in patients with paecilomycosis-complicated echinococcosis and asthma].

Paecilomycosis is a new type of systemic mycosis caused by different species of fungi of the genus Paecilomyces. Paecilomycosis-complicated echinococcosis and asthma run a severe course. A complication of mycosis is accompanied by secondary immunodeficiency. A good result was obtained in the treatment of ill children by using the fungicide diflucan and the immunomodulator polyoxidonium. In the examinees with paecilomycosis-complicated echinococcosis, secondary immunodeficiency was characterized by a statistical significant reduction in the blood levels of the lymphoid cells CD3+, CD4+, CD8+, CD16+, CD21+, by phagocytosis, a decrease in its quantitative parameters, and an increase in the counts of immunoglobulins and circulating immunocomplexes. To normalize the immune status in patients with paecilomycosis-complicated echinococcosis, it is expedient to postsurgicallyuse fungicides, such as nizoral, diflucan, orungal, mycosyst, and the immunomodulators polyoxidonium and irillen.

[Transformation of the fungus Paecilomyces variotii and the causes of host cell lysis at the boundary with a fungal mycelium-containing Echinococcus capsule].

Experiments were carried out on animal species. The experiments used 30-day chicks, 80 rats, and 70 rabbits. Three hundred and twenty-nine patients with echinococcus complicated by paecilomycosis were meticulously examined. The fungi of the genus Paecilomyces undergo two transformation directions: the saprotrophic mycelial form of the fungus Paecilomyces variotii transforms to the tissue parasitic one as a globular form of spherules that transforms to the mycelial form in larval Echinococcus infection because the cyst capsule is a favorable environment for growth of fungal mycelia. The growth and aggressiveness of larval Echinococcus in the human lung are associated with the fact that fungal mycelial fibrous tunic contains Paecilomyces that have been first used to isolate active hyaluronidase that lyses host cells. Pulmonary echinococcosis complicated by the tissue form of paecilomycosis can be complicated by the mycelial form of the fungus of the genus Paecilomyces, by afflicting the nails and skin of patients, which requires particular treatment after surgery for hydatid disease. The chicks that had been brooded in an incubator and grown under special conditions to rule out fungal infection were first contaminated with the fungal mycelium labeled with methionine, sodium sulfate, sodium phosphate, or iodine. Each chick received 0.5 g of the labeled fungal mycelium. Regardless of the contamination mode, all the chicks from 3 groups were infected with Paecilomyces; the spherules exhibited labeled isotopes. Thus, it has been first conclusively proven that the diagnosis of paecilomycosis based on the blood detection of fungal globular spherules is valid and easy-to-use in any health care facility.

[Amino acid exchange in paeci lomycosis-complicated echinococcosis].

The authors have detected atypical paecilomycosis-associated myocarditis with impaired amino acid exchange and pain syndrome for the first time. At first, pain occurs in the chest and radiates into the axilla, to the left arm to the finger tips, by paralyzing the arm. In some patients, pain manifests itself in both arms with radiation to the belly, by accompanying by fainting. The skin is wet, cold; the pulse is frequent and of poor volume and difficult-to-count. Heart pain spreads into the armpit and down the arm, by making the fingers numb. Attempts to use current analgesics (movalis, sirdalud, nimesil, morphine) in combination with fungicides (diflucan, mycosist, orungal) have failed to yield positive results. The homeopathic drug Latrodectus mactans, prepared from caracurt venom, in combination with the authors' designed diet and other homeopathic agents have relieved pain syndrome and normalized amino acid exchange, which offered possibilities for successful surgical treatment for echinococcosis with later recovery.

[Experimental rationale for a procedure for correction of the residual cavity in hydatidectomy].

Thirty-six piglets (15 days old) were inoculated with Echinococcus according to the authors' procedure. Hepatic hydatid cyst growth in the piglets was ultrasonographically monitored 3 months after inoculation. In 15 piglets, the size of hepatic hydatid cysts was as high as 6.5 x 8.5 cm 5 months after infection. The cavity of larvocystic fibrous capsule was eliminated, by inverting the resection margins inward with interrupted catgut sutures. For content aspiration, the cystic bed was occasionally drained by a polyvinyl chloride tube with two side holes, which was brought outward through an individual incision. Thesubhepatic area was also drained by a "cigar" tampon through an individual incision. The wound healed in layers, tightly. Marginal resection of the liver was performed to stimulate regenerative processes in the resected area.

[Echinococcosis complicated by paecilomycosis].

Two hundred and thirty-six echinococcosis patients aged 17 to 70 years were examined for paecilomycosis. Seventy-five subjects of different ages who were considered to be clinically healthy were prepared as a control. Of them who had physiological parameters of blood fungi, 24 subjects, including 9 subjects aged 17 to 23 years and 15 subjects aged 15 to 30 years, were eligible. The other examinees were patients with paecilomycosis of varying stages. Nizoral, fluconazole, diflucan, orungal, mycosyst, and teknazol, which have been tested by the authors, are proposed for use in paecilomycosis-complicated echinococcosis prior to and after surgery. It is advisable to use one fungicide. In this respect, the authors have conducted clinical trials that have yielded positive results.

[Antimicrobial, echinococcidial and immunostimulating properties of the drug Cheblin-SK-1]. / Protivomikrobnye, protivoékhinokokkoznye i immunostimuliruiushchie svoistva preparata Cheblin-SK-1.

The antimicrobial properties of the drug Cheblin-CK-1 (CCK-1) were determined in mice intraabdominally inoculated with Proteus mirabilis-4691 in a dose of 140-200 million daily cultured microbial bodies. Its comparison agent was ampicillin. CCK-1 was found to act as an antibiotic similar to ampicillin in its effects. The antimicrobial activity of CCK-1 against Staphylococcus aureus and Escherichia coli isolated from the contents of echinococcal cysts from patients operated on was also established. Its echinococcidial activity was found in experiments on the cotton rats and piglets inocculated with echinococci. CCK-1 was also tested on volunteers. Before surgery, 186 patients with echinococcosis took the drug and 26 patients with the same disease did not and they served as controls. At first the drug suppressed the growth of parasitic larvocysts with destruction and death of 85-95% of germinal elements of larvocysts and then killed parasites. In patients receiving a complete course of its therapy, protein and amino acid metabolisms restored, followed by immunity recovery.

[Mediastinal echinococcosis]. / Ekhinokokkoz sredosteniia.

Among 29,875 autopsies 59 cases of mediastinal echinococcosis were revealed. Among 4178 patients with thoracic echinococcosis 55 patients had mediastinal echinococcosis. All the patients were operated, most of them underwent ideal ecinococcectomy. Intraoperative prophylaxis of echinococcosis was performed: plearal cavity was treated by low-frequency ultrasound and glycerin. 7 examined patients demonstrated reduction of immune and phagocytosis indices in blood (DC3+, CD4+, CD8+, CD16+, CD21+). Increase of immunoglobulines A, M, G and circulating immune complexes was revealed. Reactions of scolexprecipitation and lymphocytes antigen-fixing were positive.

[Immunity induced by immunomodulators during echinococcal immunosuppression]. / Immunitet pri vvedenii immunomoduliatorov na fone ékhinokokkovoi immunosupressii.

The echinococcal immunosuppression induced in experimental mice by a human parasite strain is accompanied by immunosuppression, whereby the administration of immunomodulants favors normalization of the cell and humoral immunity chains. Among a series of preparations studied, the best results were obtained for polyoxidonium: in the case of immunosuppression induced by cyclophosphan, polyoxidonium administration led normalization of the cell and humoral immunity and the phagocytosis of neutrophils and macrophages.

[An improvement in a new method for the surgical treatment of echinococcosis]. / Sovershenstvovanie novogo sposoba khirurgicheskogo lecheniia ékhinokokkoza.

Parasitic cysts were intraoperatively treated with glycerol in 179 patients with echinococcosis at various sites and 3% hydrogen peroxide in 165 patients with hepatic echinococcosis. Experiments on 60 cotton rats experimentally infected with Echinococcus alveolaris and 156 albino mice with E. granulosus provided evidence for the surgical use of 80-100% glycerol or 3% hydrogen peroxide to treat the cysts. Intraoperative glycerol treatment of cysts in patients with complicated hepatic echinococcosis fails to normalize amino acid metabolism, as well as immunity even a year postoperatively. The glycerol method has no contraindications for pulmonary and hepatic echinococcosis. Hydrogen peroxide has a damaging effect on all germinal elements of both E. alveolaris and E. granulosus. The authors recommend that 3% hydrogen peroxide should be intraoperatively used for treatment of cysts. After surgery, there is a tendency for amino acid metabolism to become normal in such patients.

[Treatment of hydatid cysts' residual cavities (experimental and clinical study)]. / Obrabotka polosti kist pri gidatidnom ékhinokokkoze (éksperimental'no-klinicheskoe issledovanie).

Experimental series of 60 cotton rats and 150 white mice infected with echinococcus showed that 80-100% glycerin and 3% peroxide solution were effective scolicidal solutions for inactivation of the parasite. 344 patients have been operated on for hydatid disease with inactivation of the parasite by means of these scolicidal solutions. Glycerin during the surgical management of the hydatid cysts is effective and harmless in uncomplicated hydatid liver disease and any hydatid pulmonary cysts. Glycerin is contraindicated in complicated hydatid liver disease because of immunity disturbance. In complicated hydatid liver disease management of the hydatid cysts by 3% peroxide is effective and harmless. It is necessary to correct the hydatid liver disease patients' immunity in the preoperative and postoperative periods. Tactivin and antiechinococcus drug SK-1 are effective immunomodulators in hydatid liver disease.

[Homeopathic preparation Cheblin-CK-1 in the pathogenetic therapy of echinococcosis]. / Ispol'zovanie gomeopaticheskogo preparata Cheblin-CK-1 v patogeneticheskoi terapii ékhinokokkoza.

This study was experimental and clinical. The experiments were made on 80 cotton rats. The clinical study covered 289 patients operated on for echinococcosis. Earlier studies indicated that echinococcosis is accompanied by secondary immunodeficiency and amino acid metabolic disorders. The homeopathic drug Cheblin-CK-1 used normalized amino acid metabolism 40 days after treatment in these patients. The same properties were displayed by homeopathic drugs.

[Experimental echinococcosis and alveococcosis and a trial of the preparation SK-1]. / Eksperimental'nyi ékhinokokkoz i al'veokokkoz i ispytanie preparata SK-1.

In autobred albino mice, the maximum nonlethal dose of the agent CK-1 was established, which was 19.0 g/kg, the agent was nontoxic. Cotton rats aged 30-45 days were infected by alveococcosis from a donor rat. The methods and formulas developed by Mikhailitsin et al. were used during experiments and investigations. At the beginning of treatment, 5 rats were found to have a great deal of parasitic larvocysts (PL) 10 days after infection. Eight rats formed a control group, 8 were treated with CK-1 in a constantly increasing doses of 0.1, 0.26, and 0.34 g/kg for 3 weeks. Following 40 days of infection, the animals were anesthesized and CK-1 was ascertained to have a high antialveococcal activity: the index of suppressed PL growth was 90.23 to 92.74%. In 14 piglets aged 1 month, infected by echinococcosis strains and treated CK-1 in high doses, was established to cause echinococcal death. In 14 puppies, the agent was highly effective in strobular echinococcosis.

[Experimentally inoculated human echinococcosis in piglets and a trial of the therapeutic preparation SK-1]. / Eksperimental'nyi implantirovannyi porosiatam ékhinokokkoz ot cheloveka i ispytanie lechebnogo preparata SK-1.

Experiments were made on 26-month-old piglets divided into 4 groups: Groups 1 and 4 included 5 piglets and Groups 2 and 3 comprised 8 animals. The piglets from Groups 1, 2, and 3 were peritoneally inoculated with 5000 protoscolices and acephalocysts of Echinococcus from patients with echinococcosis who had been operated on. On postinoculation day 60, Group 1 piglets were killed to measure the baseline weight of parasitic larvocysts (PL) developed by that time. On postinoculation day 61, Group 3 piglets continuously received feed in combination with CK-1 within 3 weeks. The mean daily doses of the agent were 0.05, 0.10, 0.25 g/kg, respectively. On day 91 following inoculation, all the animals were killed and dissected. The studies were made by using the procedures and formulas [9]. The growth suppression index for PL was 94.50, 92.39, and 96 for Groups 1, 2, and 3, respectively. Significant destruction of embryonic elements was revealed in 75-85% of PL in each treated animals. There was a tendency for blood indices to become normal in the treated animals. The acute toxicity of CK-1 was examined in outbred white mice, albino rats, chickens, piglets. The maximum non-lethal dose of CK-1 was 19 g/kg for white mice. The agent showed a low toxicity.