[Surgical sepsis. II. Effectiveness of immune therapy with recombinant interleukin-2]. / Khirurgicheskii sepsis. Soobshchenie 2. Effektivnost' immunoterapii rekombinantnym interleikinom-2.

Two methods of administration of Roncoleukin were used as two subcutaneous injections in dose of 500,000 units with a 3 day interval and in the regimen of extracorporeal immunotherapy. The use of Roncoleukin resulted in the clinical improvement in 83% of patients and in the detoxicating and immunocorrecting effects in 77.3 and 60% respectively which was reliably different from analogous indices (33.4%, 45% and 7.5%) in the placebo group. Other values of the prognosed lethality being equal, the real 28-day lethality in the placebo group was 21.5%, while the using of Roncoleukin allowed the level of lethality of patients with surgical sepsis to become 3.8 times lower, including the subgroup of patients with severe sepsis from 50 to 13.6%. The trials performed showed the drug Roncoleukin to be endurable and not toxic and allowed to determine the indications and contraindications to using cytokin therapy in the complex treatment of pyo-septic diseases.

[Surgical sepsis. Part I. Immunologic markers of systemic inflammatory reaction]. / Khirurgicheskii sepsis. Chast' I. Immunologicheskie markery sistemnoi vospalitel'noi reaktsii.

The aim of the work was to develop accessible methods of laboratory diagnosis of the systemic inflammatory reaction, based on an assessment of biological (inflammatory and immunosuppressive) activity of serum of surgical sepsis patients (n = 104). The investigation has shown that surgical sepsis patients are characterized by marked immune dysfunctions, immunosuppressive bioactivity of blood serum being detected in most patients (in 65.6%) beginning from the earliest stages of the development of the sepsis process. It was found that in patients with dominating suppressive activity of serum the immune disturbances were more pronounced and in every second case they were of combined type. The authors propose to use the degree of the immunosuppressive potential of serum factors as the key classification sign determining the presence of CARS-positive or CARS-negative phenotype in such patients. The results obtained suggest that it is expedient for complex therapy of surgical sepsis to include immunocorrection aimed at the weakening of immunosuppresive action of antiinflammatory mediators and shift of the balance towards the reinforcement of activity of proinflammatory ones (IL-12, IL-1) and Th-1 cytokines (IL-2, IFN-g).

[Use of calcium channel blockers for prophylaxis of multiple organ failure in acute destructive pancreatitis]. / Blokatory kal'tsievykh kanalov v profilaktike poliorgannoi nedostatochnosti pri destruktivnom pankreatite.

The purpose of this study was to investigate effectiveness of the usage of calcium channels blockers and plasmaleukopheresis in prophylaxis of the syndrome of polyorganic insufficiency (SPI) in patients with acute destructive pancreatitis. 30 patients operated on for pancreonecrosis were divided into 2 groups: study group (13 patients) and control one (17 patients) matched for sex, age, extent and character of changes in the pancreas. Taking into account a substantial role of hyperactive neutrophils in pathogenesis of SPI, Verapamil (dose of 0.5 mg/kg/day) and discrete plasmaleukopheresis were included in the complex of treatment for patients of the study group. Effectiveness of the treatment was assessed according to the quantity of complications, lethality values of leukocytosis and leukocyte index of intoxication (LII) as well as by the scale of the severity of sepsis (SSS). Complicated postoperative course was seen in 41.18% of cases in the control group and 23.07%--in the study one. Lethality in the control group made up 11.8% (2 patients); there were no lethal outcomes in the study group. Anearlier decrease in leukocytes count, LII and SSS in the study group was significant. The conclusion is made on effectiveness of the use of calcium channels blockers and discrete plasmaleukopheresis for prophylaxis of SPI in acute destructive pancreatitis.