[Several mechanisms of immunological adaptation in the etiology of subacute infectious endocarditis]. / O nekotorykh mekhanizmakh immunologicheskoi adaptatsii pri razvitii podostrogo infektsionnogo éndokardita.

The paper deals with the possibility of identifying the persons predisposed to the development of subacute septic endocarditis (SSE), with the prediction of the course of the disease and the clarification of reasons for the inefficiency of antibacterial therapy. The studies performed revealed the impairment of cooperative interaction of the immune system, which prevents it from fulfilling its main task, i.e. to make an immunological surveillance over the maintenance of internal constancy. Imperfection of this function in SSE patients and rheumatic heart diseases is based on the body's sharply limited adaptation which results from the genetically determined low values of the immune functional reserve realizable by the level of intracellular energy processes which are substantially lower in SSE patients, as evidenced by the studies conducted. This is very important for predicting whether it may develop in some patients with rheumatic diseases. The necessity of using large doses of antibiotics decreases the activity of intracellular processes to a greater extent, aggravating primarily phagocytic function, as reflected in the efficiency of antibiotic therapy.

[Comparative studies of immunologic characteristics in plasmapheresis and hemosorption in patients with purulent diseases of the lungs and pleura]. / Sravnitel'naia kharakteristika immunologicheskikh pokazatelei pri plazmafereze i gemosorbtsii u bol'nykh gnoinymi zaboleva- niiami legkikh i plevry.

The article deals with the comparative characteristics of the changes in immunological indices in 40 patients with non-specific purulent diseases of the lungs and pleura when plasmapheresis and hemosorption were included in the complex of therapeutic measures. The changes were found to be hetero-directional in character: a non-specific effect of immunostimulation in hemosorption, and immunodepression, particularly marked in the first 24 hours, in plasmapheresis. The post-aggressive reaction after plasmapheresis is either absent or delayed significantly, which makes it possible to conduct detoxification in extremely grave conditions of the patients without making the mechanisms of the post-aggressive reaction operative, as observed in performance of hemosorption.

[Circulating immune complexes and immunoglobulins A, M and G in the mother-fetus system in normal pregnancy and gestosis]. / Tsirkuliruiushchie immunnye kompleksy i immunoglobuliny A, M, G v sisteme mat'-plod pri fiziologicheskoi beremennosti i gestoze.

Circulating immune complexes (CIC) and immunoglobulins A, M, and G were measured in the maternal peripheral blood, mixed umbilical blood, and amniotic fluid in women with normal pregnancy and gestosis. CIC concentrations in the examined fluids did not surpass the levels typical of healthy donors. Maternal blood CIC levels were higher in gestosis than in normal pregnancy, and CIC levels in the umbilical blood and amniotic fluid were always lower than in maternal blood serum. IgG levels were found the most shifted. These data evidence changes of the humoral immunity in normal pregnancy, this being, probably, one of the mechanisms providing its favorable course.

[Immunological properties of the amniotic fluid in physiological pregnancy and gestoses]. / Immunologicheskie svoistva okoloplodnoi zhidkosti pri fiziologicheskoi beremennosti i gestozakh.

Immunologic analysis of the amniotic fluid included measurements of immunoglobulins A and M, circulating immune complexes, rheumatoid and antinuclear factors, immunophoresis and electrophoresis, and tests for the presence of donor lymphocytes, Changed immunologic parameters of the amniotic fluid indicate a complicated course of pregnancy, development of gestosis among other things. Basing on their findings, the authors suggest that gestosis involve dysfunction of the adaptive mechanisms, that may result from disordered interactions of the immunity system components.

[Use of immunomodulators and low-frequency ultrasonics for prevention of acute postoperative pleural empyema]. / Primenenie immunomoduliatorov i nizkochestotnogo ul'trazvuka dlia profilaktiki ostroi posleoperatsionnoi émpiemy plevry.

Many methods for the prevention of acute postoperative pyothorax have been suggested, but no tendency towards a reduction of its frequency has been noted in the recent years. A group of 100 patients with various diseases of the lungs (malignant tumors, abscesses, bronchiectases) was examined. They were divided into 3 groups according to the degree of the risk of development of acute postoperative pyothorax: with increased, moderate, and high risk. The first group consisted of 20 patients who were given small doses of immunomodulators Dibazole and Dekaris in the pre- and postoperative periods. Control of the immunity indices was conducted in the preoperative period and on days 14 and 21 after the operation. Intraoperative treatment of the pleura with low-frequency ultrasound was applied in the second group of 40 patients. Fourty patients of the third group were treated by a complex of both of the above-mentioned preventive methods. The control group was made up of 347 patients with a similar condition but not treated by the special methods of prevention. All of the 447 patients underwent radical operations. Analysis of the results of the study showed that acute postoperative pyothorax developed in 8.65% of patients in the control group in which immunoprophylaxis and intraoperative treatment of the pleura with low-frequency ultrasound were not applied. Acute postoperative pyothorax developed in 1% of cases in the main group.

[Hyperbaric oxygenation in the comprehensive therapy of patients with rheumatoid arthritis (clinico-immunologic study)]. / Giperbaricheskaia oksigenatsiia v kompleksnom lechenii bol'nykh revmatoidnym artritom (kliniko-immunologicheskoe issledovanie).

For 35 of 50 patients with rheumatoid arthritis traditional drug therapy was a minor success for a long time. Without any modifications of the drug therapy every patient went through a course of hyperbaric oxygenation (HBO): 21 sessions under 1.7 ata for 40 min. Good clinical results both immediate and remote have been obtained. The effect of HBO on the immune system of the patients has intensified the suppressive function of T-lymphocytes (especially with systemic symptoms of the disease), normalized cell-bound immunity and decreased the serum concentration in immune complexes.

[The immunomodulators levamisole and dibazole in the prevention of acute postoperative pleural empyema as one method of preoperative preparation]. / Immunomoduliatory levamizol i diabazol v profilaktike ostrykh posleoperatsionnykh émpiem plevry kak odin i metodov predoperatsionnoi podgotovki.

Numerous methodologies had been suggested to prevent postoperative pyothorax, but the tendency towards reduction in the incidence of this condition couldn't be seen. Forty patients with different lung diseases (malignant tumours, abscesses, bronchiectases) were examined. Twenty patients received low-dose levamisole and dibazole pre- and postoperatively, while to the remaining 20 patients these immunomodulators were not administered. All the 40 patients underwent radical operations. Immunoassay was undertaken in both groups in the preoperative period and at days 7, 14, and 21 postoperatively. As a result it was found that the group of patients devoid of immunoprophylaxis showed development of pyothorax in 5 percent of the cases. The groups of patients exposed to preventive measures including low doses of levamisole and dibazole did not show septic complications in the pleural cavity.

[The morphological and clinico-immunological characteristics of 2 types of myasthenia]. / Morfologicheskaia i kliniko-immunologicheskaia kharakteristika dvukh tipov miastenii.

The thymus is studied morphologically in 139 cases of myasthenia (with no thymic neoplasia). Hyperplasia of true thymic parenchyma (without its intralobular perivascular spaces) was observed in 28%, no change in 40% and atrophy in 32% of cases. Two types of the disease were distinguished on the basis of morphological and clinico-immunological parameters: the 1st type with a hyperplastic or normal thymic parenchyma and the 2nd type with its atrophy. These types probably differ in their pathogenesis. The outcome of the thymectomy in patients with the 1st type of myasthenia is most favourable, while in patients with the 2nd type the outcome in 42% of patients is either satisfactory or unfavourable.

[T-activin in multimodal treatment of systemic lupus erythematosus in children]. / Taktivin v kompleksnoi terapii sistemnoi krasnoi volchanki u detei.

The efficacy of taktivin was examined by comparison of the time-course of changes in cellular immunity, the course of the underlying disease and the incidence of infectious complications in two groups of patients with systemic lupus erythematosus (SLE). The first group included 49 patients aged 8 to 15 years receiving taktivin, the second one 34 children of the same age not given immunomodulatory therapy. The morphofunctional status of the thymus was studied in 9 cases on autopsy. The prolonged treatment with taktivin (for 4 weeks and over) resulted in an increase of the number of patients with the improved health status and reduction of SLE activity, in a rise of the content of serum thymic factor, activation of the processes of T lymphocyte differentiation, in an increase of the lymphocyte count in patients with secondary infection, activation of phagocytosis, rise of bactericidal activity of the serum, which entailed the elimination and prevention of the development of secondary infectious complications. Taktivin promotes the normalization of the thymic structure and exerts a replacement effect.

[The physiological adaptation functions of cellular and humoral immunity in patients with phlegmons of the maxillofacial area]. / Adaptatsionno-fiziologicheskie funktsii kletochnogo i gumoral'nogo immuniteta u bol'nykh s flegmonami cheliustno-litsevoi oblasti.

In order to evaluate the necessity in immunocorrective therapy the patients with maxillofacial phlegmons were tested for their cellular and humoral immunity. A slight increase or decrease in immunity indices before surgery in several patients were not beyond the physiological norm. Postoperative repetitive investigations the immune parameters attained the mean levels or even went higher without immune-correcting therapy. The above changes are characteristic of the peculiarities of cellular and humoral immunity in individual patients and do not require any interference into the immune system.

[Pathogenesis of the cytopenia syndrome in patients with cirrhosis of the liver complicated by portal hypertension]. / Patogenez tsitopenicheskogo sindroma u bol'nykh tsirrozom pecheni, oslozhennym portal'noi gipertenziei.

One of the main causes of cytopenia and cellular immunodeficiency in patients with cirrhosis of the liver and portal hypertension is increased portal pressure, which, in turn, induces increased storage of formed elements in the spleen. Shunting operations producing a stable decompressive effect correct cytopenia similar to splenectomy but at the same time are devoid of the menacing postoperative complications characteristic of splenectomy.

[The theophylline test in the evaluation of the state of cellular immunity in children with different clinical courses of systemic lupus erythematosus]. / Teofillinovyi test v otsenke sostoianiia kletochnogo immuniteta u detei s razlichnym klinicheskim techeniem sistemnoi krasnoi volchanki.

An inverse reaction of T-lymphocytes to theophylline is sometimes observed in children with systemic lupus erythematosus. In this case the disease runs a more benign course and is less resistant to prednisolone therapy. The theophylline test is recommended for the prediction of the disease course.