[Ofloxacin in comprehensive treatment of infections in burn patients]. / Ofloksatsin v kompleksnom lechenii infektsii u obozhzhennykh.

The experience with ofloxacin in the prophylaxis and treatment of infected burn wounds in 40 patients was investigated. High clinical and microbiological efficacy of the drug was stated (82.5 and 83 per cent respectively). The highest efficacy of ofloxacin was observed when the burned area did not exceed 25 per cent of the body surface. It was concluded that the prophylactic use of the drug during acute burn toxemia was not expedient.

Prophylactic use of human endotoxin-core hyperimmune gammaglobulin to prevent endotoxaemia in colostrum-deprived, gnotobiotic lambs challenged orally with Escherichia coli.

The efficacy of human IgG polyclonal antibody to endotoxin-core in preventing endotoxaemia and subsequent disease was studied in colostrum-deprived gnotobiotic lambs challenged orally at about 5 h old with 10(9) cfu Escherichia coli. Human endotoxin-core hyperimmune gammaglobulin was given intravenously to 5 lambs at 1.9 g IgG/kg bodyweight prior to challenge. Human albumin was given intravenously to 3 control lambs. Bacteraemia was observed in all lambs, but the incidence was lower (P < 0.01) and the onset later (P < 0.05) in gammaglobulin pre-treated lambs. These lambs showed no signs of disease, whereas clinical endotoxaemia, manifesting as watery mouth disease, was diagnosed in 2 of the 3 control lambs which were killed between 18 and 22 h after challenge. Thus, prophylactic treatment of colostrum-deprived lambs with human IgG enriched in endotoxin-core antibodies was effective in reducing the degree of bacteraemia and preventing endotoxaemia, leukopenia and clinical disease following oral challenge with E. coli.

Hyperthermia induces IL-1 alpha but does not decrease release of IL-1 alpha or TNF-alpha after endotoxin.

Heat treatments administered prior to the onset of sepsis or endotoxemia markedly increase survival. A potential mechanism for the beneficial effect of heat could be effects on IL-1 alpha and TNF-alpha, important mediators of sepsis and endotoxemia. Administration of IL-1 or TNF prior to development of sepsis and endotoxemia increases survival; thus, prophylactic heat treatments may protect by releasing IL-1 or TNF. Paradoxically, an alternative mechanism of protection of prophylactic heat treatments could be to decrease the amount of IL-1 and TNF released during sepsis or endotoxemia. Cells pretreated with heat do not produce as much IL-1 or TNF in response to endotoxin as cells that have not been pretreated with heat. The purpose of this investigation was to determine if hyperthermia caused release of cytokines and/or blunted the rise in cytokines occurring after endotoxin. Mice were anesthetized with ketamine/xylazine and immersed in a water bath at 37.0 or 42.0 degrees C for sham or heat treatments. At 6-7 h after recovery from anesthesia and immersion, sham and heat-treated mice were injected with Escherichia coli endotoxin. Both heat-treated and sham mice had elevated plasma IL-1 alpha 2 h after anesthesia and immersion but IL-1 alpha was approximately 3-fold greater in the heated mice, 732 +/- 50 vs. 256 +/- 76 pg/ml (p < 0.01). Blood samples obtained after endotoxin revealed no difference in levels of TNF-alpha (5477 +/- 742 vs. 6514 +/- 652 pg/ml) or IL-1 alpha (546 +/- 72 vs. 603 +/- 121 pg/ml) in the sham vs. heated mice.(ABSTRACT TRUNCATED AT 250 WORDS)

[Effect of da cheng qi decoction co. on endotoxemia in obstructive jaundice].

The role of da cheng qi decoction co. (DCQDC) in preventing endotoxemia in obstructive jaundice has been investigated. A prospective study was performed on 43 consecutive patients with obstructive jaundice undergoing surgery. 24 patients were given oral DCQDC before operation and were compared with 19 jaundiced control patients and 17 non-jaundiced control patients. The incidence of endotoxemia was reduced in perioperative portal (P less than 0.05) and postoperative systemic (P less than 0.01) blood samples in the DCQDC treated group, and a significant fall of the postoperative 24h creatinine clearance (P less than 0.01) and the plasma fibronectin level (P less than 0.01) occurred in jaundiced controls compared with the DCQDC treated group. DCQDC may reduce endotoxin absorption by a reduction or alteration of gut flora thereby reducing the endotoxin pool available for absorption as well as by a direct effect on endotoxin. Result of this study indicated that DCQDC had a beneficial effect on endotoxemia or outcome in obstructive jaundice.

[Photomodification of autologous blood in surgery]. / Fotomodifikatsiia autokrovi v khirurgii.

The use of the method of autologous blood photomodification in surgery is discussed on basis of generalized experience of the Leningrad Research-Practical Center of Blood Photomodification (3,000 procedures conducted in over 2,000 patients). The current state of the problem, the main mechanisms of the therapeutic action of the procedure, and the clinical efficacy of the method in various surgical diseases are dealt with. The possible complications and the means of their prevention are deal with. The methodological aspects of research are discussed. The authors define the main problems which must be solved in order to raise the efficacy of using photomodification of autologous blood in surgery.