[Evaluation of the reactogenicity and immunogenic potency of combined vaccine "Bubo-Kok" in the immunization of children against diphtheria, tetanus, pertussis and viral hepatitis B]. / Otsenka reaktogennosti i immunogennosti kombinirovannoi vaktsiny "Bubo-Kok" pri immunizatsii detei protiv difterii, stolbniaka, kokliusha i virusnogo gepatita B.

Combined vaccine "Bubo-Kok" is characterized by safety and high immunological activity. The number of postvaccinal reactions in children aged 1 and 2 years, immunized with vaccine "Bubo-Kok", was not statistically different from those in groups of children immunized with adsorbed DPT vaccine, as well with such vaccine in combination with vaccine against hepatitis B. After the completion of the primary course of immunization 100% of children had protective antibody titers against diphtheria, tetanus and hepatitis B. Antibody titers against pertussis, equal to or exceeding protective titers, were found in more than 70% of immunized children. The immunogenic potency of vaccine "Bubo-Kok" with respect to all its components was not inferior to that of adsorbed DPT vaccine and vaccine against hepatitis B, when introduced simultaneously in different areas of the body. Vaccine "Bubo-Kok" successfully passed state trials and was recommended for registration.

[Russian recombinant vaccine against hepatitis B (results of controlled trials)]. / Otechestvennaia rekombinantnaia vaktsina protiv gepatita B (rezul'taty kontroliruemykh ispytanii).

Two yeast recombinant vaccines were compared: the Russian hepatitis B Combiotech vaccine in a dose of 20 mg and the Recombivax-HB vaccine in a dose of 10 mg manufactured in the USA (Merk, Sharp and Dohme Ltd.). Both agents were found safe and low reactogenic. After a course of 3 vaccinations with the Russian vaccine 92.5 to 97.5% subjects vaccinated after the 0-1-2 months and 0-1-6 months protocols had high levels of specific antibodies. In the group vaccinated with the American vaccine, antibodies to HBsAg were found in the sera of 95 to 100% subjects. These results demonstrate high immunological activity of both Russian and American vaccines.

[Surgical treatment of diseases of operated stomach]. / Khirurgicheskoe lechenie boleznei operirovannogo zheludka.

Surgical treatment of 293 patients with diseases of an operated on stomach is analysed. Relapse of peptic ulcer after closure of a perforation was encountered in 170 patients, the dumping syndrome in 54, peptic ulcer of the anastomosis in 60, the afferent loop syndrome in 6, and a rare type of diseases of an operated on stomach in 3 patients. Classification of diseases of an operated on stomach according to the syndromes and differential diagnosis of functional syndromes are presented. Indications for surgical correction depending on the type and severity of the pathological condition were developed. The late-term results were studied in 266 patients. The results were good in 72%, satisfactory in 21%, and poor in 7% of cases. The late-term results in surgical correction of functional syndromes were good in 29%, satisfactory in 51.6%, and poor in 13.5% of patients. Mortality after all repeated operation was 1.3%.

[The therapeutic measures in acute diffuse peritonitis]. / Lechebnye meropriiatiia pri ostrom razlitom peritonite.

Analysis of the observations of 431 patient with acute diffuse peritonitis is presented. Use of intraabdominal flowing lavage is recommended in patients with inflammatory phenomena against the background of moderately pronounced changes in microcirculation in the parietal peritoneum. The maximum clinical effect of hemosorption and lymphosorption was noted at the first 3 days after the operation in cathepsin-D activity in the blood equal to 14-17 activity units/(min.mg) and lymphorrhea over 700 ml/day. Lethality was 18.8%.

[Disorders of immune status in duodenal ulcer complicated by perforation and peritonitis]. / Narushenie immunnogo statusa pri iazvennoi bolezni dvenadtsatiperstnoi kishki, oslozhnënnoi perforatsiei i peritonitom.

The chemotaxic activity of neutrophil granulocytes was studied in 112 patients with duodenal ulcer disease complicated by perforation and peritonitis with a different degree of spreading. Sharp decrease in spontaneous migration of leukocytes (SML) was revealed in generalized peritonitis. In diffuse peritonitis, the index didn't differ from that in normal subjects. In patients with the complicated course of the postoperative period, SML stimulation under the influence of the own serum was noted. At day 3-9 after the operation, the stimulating activity of the humoral factors of immunity was gradually decreasing. Use of the stimulators of migrative activity of phagocytes contributes to normalization of their function. In patients who had the immunocorrigative agents been prescribed, aggravation of peritonitis and purulent-septic complications were noted 1.4-fold less often than in absence of such treatment.

[Prevention of early inflammatory complications after transthoracic interventions and estimation of the degree of immunologic deficiency]. / Profilaktika rannikh vospalitel'nykh oslozhnenii posle trans- torakal'nykh vmeshatel'stv s uchetom vyrazhennosti immunodefitsita.

An analysis of the results of the examination and treatment of 379 patients undergoing transthoracic interventions showed that the use of the target-aimed selective immunomodulation, short-term antibacterial prophylaxis, inhibitors of arachidonic acid metabolites, active elimination of the circulating immune complexes and medium-weight molecular peptides and adequate local analgesia after the interventions providing normalization of the laryngeal reflex and early activation of the patients permitted the incidence of the pulmonary complications to be decreased by 2.5 times, pleural complications by 1.7 times, suppuration of the postoperative wound by 1.8 times and the total expenses by 25.6 per cent.

[Use of external drainage of the thoracic duct and lymphosorption in the complex treatment of acute diffuse peritonitis]. / Primenenie naruzhnogo drenirovaniia grudnogo protoka i limfosorbtsii v kompleksnom lechenii ostrogo razlitogo peritonita.

In 47 patients with acute generalized peritonitis in the complex of therapeutic measures, the external drainage of the thoracic duct (EDTD) with subsequent lymphosorption (LS) was used. The effectiveness of treatment was judged about by the lymph and blood toxicity, and as well by contents of peptides with the molecular mass of from 300 to 1000 dalton. In favourable course of the postoperative period, the increase in lymph debit and decrease in proteolytic enzyme activity in the lymph and blood were noted. The use of EDTD and LS in the complex with the other methods of treatment permitted to achieve a clinical effect in 76.6% of cases.

[Clinico-morphological characteristics of acute pancreatitis and its complications]. / Kliniko-morfologicheskaia kharakteristika ostrogo pankreatita i ego oslozhnenii.

The results of treatment of 6681 patients with acute pancreatitis (AP) were analysed. Operated on were 554 patients with AP, among them, 260-with acute destructive pancreatitis (ADP). Total lethality was 1.6%, the postoperative one-20.2%. In ADP, the postoperative lethality was 28%. Mild forms of the AP course were characterized by constancy of the clinical symptoms and their rapid involution, severe forms of the disease (destructive pancreatitis)--by progressive periodicity and intensity of clinical signs. A morphologic pattern of the different forms of AP is described. It was established that at the early period of the disease, patients died mainly from posthemorrhagic anemia, anemia with intoxication, at the late period--predominantly from different purulent and necrotic complications.

[Effect of native vitamin A metabolites and their 4-oxo derivatives on formation of specific cytolytic T lymphocytes]. / Vliianie prirodnykh metabolitov vitamina A i ikh 4-oksoproizvodnykh na obrazovanie spetsificheskikh tsitoliticheskikh T-limfotsitov.

Immunomodulating effect of some structural derivatives of retinoic acid (RA) on formation of specific cytolytic T lymphocytes (T killers) was studied in mixed cell culture of spleen lymphocytes from allogenic mice. Native vitamin A metabolites (RA, 13-cis-RA) and the structure-like substances (C15-C20-retinoids and others) at 10(-6) = 10(-7) M concentrations increased 2-2.5-fold the formation of T killers in vitro after stimulation of the lymphocytes by suboptimal doses of allogenic X-ray irradiated cells, the lymphocyte proliferation was inhibited in the mixed culture at 10(-5) M and higher concentrations of the substances. Optimal concentrations of retinoids did not increase the 3H-thymidine incorporation into DNA of lymphocytes stimulated by alloantigens or mutagens. The data obtained suggest that the previously found antitumoral efficiency of the compounds studied may be due to stimulation of specific cellular immunity.

[Surgical-anatomical basis for plastic repair of the remaining pleural cavity after pulmonectomy with lobar displacement of the other lung]. / Anatomo-khirurchicheskoe obosnovanie plastiki ostatochnoi plevral'noi polosti posle pul'monéktomii peremeshcheniem doli drugogo legkogo.

Anatomo-surgical opportunities for a displacement of a lung to the operation side after pneumonectomy for the plasty of the remaining pleural cavity were studied in 17 corpses and 25 animal (dogs). The space between the sternum and mediastinum organs at the level of the II-IV ribs in human was shown to be of size enabling a lung lobe to be displaced to the opposite side as a wide "wedge". After pneumonectomy the cavity was partly filled with the pulmonary tissue and the bronchus stump of the removed lung was covered.

[Selection of a method and surgical tactics in late repeated operations on the lungs and pleura]. / Vybor metoda i khirurgicheskaia tekhnika pozdnykh povtornykh operatsii na legkikh i plevre.

The experience with the surgical treatment of 97 patients subjected to late repeated operations on the lungs and pleura is generalized in this work. 68% of these patients had pleural empyema and bronchial fistulae. The authors prefer the radical surgery to pulmonectomy, pleuropulmonectomy, decortication, lung resection and repeated amputation of the main bronchus. Fatality in the late repeated operations was noted in 3.09% of cases and complications--in 10.3%.

[Complications and lethality after operations on the lungs]. / Oslozhneniia i letal'nost' posle operatsii na legkikh.

The analysis of the lethality (4.8%) and postoperative complications (2.3%) following 740 lung operations was carried out. The authors developed methods of early preclinical diagnosis of intrapleural complications through the studies of neutrophilic leucocytes histochemical indices and biochemical and cytological changes of postoperative pleural extravasate.