[Dynamics of free-radical oxidation in suppurative otitis media]. / Dinamika svobodno-radikal'nogo okisleniia pri gnoino-vospalitel'nykh zabolevaniiakh srednego ukha.

The dynamics of indicators of free-radical oxidation in various purulent-inflammatory diseases of the middle ear in 280 patients was studied. Significant violations of the processes of free radical oxidation in the serum of blood were taken for the patients, the degree of which depends entirely on the severity and nature of the inflammation. A complex treatment with the use of antioxidant therapy in 280 patients was carried out. Positive results were obtained, confirmed by clinical and laboratory indicators. The pathogenetic significance and dependence of the course of purulent-inflammatory diseases of the middle ear on the processes of free radical oxidation was established, which was reflected in the determination of the duration of treatment of various forms of both acute and chronic otitis media.

[Oxidative stress as an indicator of metabolic disorders in the pathogenesis of cerebral stroke]. / Okislitel'nyi stress ­ indikator metabolicheskikh narushenii v patogeneze mozgovogo insul'ta.

AIM: To verify the oxidative stress as an indicator of metabolic disorders in the complex pathogenesis of hemorrhagic and ischemic stroke. MATERIAL AND METHODS: The study included 50 hemorrhagic stroke patients and 50 ischemic stroke patients. A control group consisted of 20 age-matched healthy subjects. In total 12 biochemical parameters, including blood indicators, indicators of free-radical oxidation (ketodiens, diene conjugates, malonic aldehyde, bityrosin, Schiff bases) and endogenous system antioxidant defense (vitamin E, reduced glutathione, total antioxidative activity, superoxide dismutase, glutathione peroxidase, glutathione reductase, catalase) were determined. RESULTS: An increase in free-radical oxidation of lipids and proteins as well as functional imbalance in non-enzymatic and enzymatic links of endogenous antioxidant defense system were found in patients with hemorrhagic stroke and ischemic stroke compared to controls. CONCLUSION: The findings obtained in the study have made it possible to identify two factors in the oxidative stress formation in hemorrhagic and ischemic stroke that will extend the knowledge about the pathogenesis of this severe vascular process.

[The features of multiple sclerosis pathological progression verified by the dynamics of biochemical markers of oxidative stress]. / Osobennost' techeniya patologicheskogo protsessa pri rasseyannom skleroze, podtverzhdennaya dinamikoi biokhimicheskikh markerov okislitel'nogo stressa.

AIM: To analyze the features of multiple sclerosis (MS) pathological progression by the parameters of oxidative stress and antioxidant defense system (ADS). MATERIAL AND METHODS: The study included 220 patients with different clinical forms and phases of MS who were examined and divided into four clinical groups. The intensity of lipid and protein free-radical oxidation (FRO) was evaluated by the level of ketodienes, diene conjugates, malondialdehyde, and Schiff bases. The functioning of the endogenous AFS was assessed by activity of the following markers: vitamin E, general and non-protein SH-groups, which represented the nonenzymatic AFS segment. The enzymatic segment markers were superoxide dismutase, glutathione peroxidase, and glutathione reductase. RESULTS AND CONCLUSION: Significant differences in the oxidative stress intensity in patients with different clinical forms and phases of MS were revealed. The results have made it possible not only to identify oxidative stress in the MS course in the evidence-based practice but also to confirm the continuity of pathological process of this disease.

[Biochemical markers of oxidative stress in different forms and phases of multiple sclerosis].

OBJECTIVE: To verify a role of oxidative stress in the pathogenesis of multiple sclerosis (MS) and to develop oxidative stress prognostic criteria of disease course and treatment recommendations. MATERIAL AND METHODS: We examined 220 patients with different clinical forms and phases of MS. The lipid and protein free-radical oxidation markers were measured using the following parameters: ketodienes, diene conjugates, malondialdehyde, and Schiff bases. The functioning of the endogenous antioxidant defense system was assessed using y the activity of vitamin E, general and non-protein SH-groups, which represented the nonenzymatic segment of the antioxidant defense system. The enzymatic segment markers were superoxide dismutase, glutathione peroxidase, and glutathione reductase. RESULTS AND CONCLUSION: The findings revealed significant differences in the oxidative stress intensity indices in patients with different clinical forms and phases of MS, which made it possible to predict disease progression and prescribe the complex antioxidant treatment in the evidence-based practice.

[Clinical efficacy of immunostimulating drugs in treatment of purulent infections].

81 patients with the acute soft tissue purulent infections were divided in 4 groups and treated with the use of traditional means without immunostimulating drugs; with immunoglobulins; with derinate and combination of both, respectively. The last treatment modality demonstrated maximal clinical efficacy. That is the decrease of the wound contamination period and inflammatory process; acceleration of granulation and epithelization. Clinical recovery was accompanied by marked positive changes of cell and humoral immune status.

[Immune status of patients with exacerbation of chronic suppurative otitis media and its correction].

The authors report results of a clinical and immunological study involving 38 patients with exacerbation of chronic suppurative otitis media. It has demonstrated high immunological and clinical efficiency of combined treatment with derinate (an agent stimulating local immunity) and high molecular-weight polypeptide polyoxidonium. It is concluded that inclusion of these drugs in combined therapy of chronic suppurative otitis media increases its immunological and clinical effectiveness and allows duration of patients' hospitalization to be reduced.

[Prognostic significance of typical immune reactions in myocardial infarction].

AIM: To ascertain the role of typical reactions of the immune system in early prognostication of congestive cardiac failure (CCF) in patients with primary transmural anterior myocardial infarction (MI) in the postinfarction period. MATERIAL AND METHODS: Typical immune reactions were studied for a year after the disease onset. A total of 228 males aged 40-60 years (mean age 53.8 +/- 4.1 years) with primary Q-wave MI of anterior location without accompanying diseases or allergy, with comparable volumes of myocardial necrosis were included in the trial. The control group consisted of 35 healthy men aged 40 to 60 years (mean age 52.9 +/- 4.3 years). Morphofunctional characteristics of the heart were studied by Doppler echocardiography within a month since MI onset and a year after MI. Immunological examination performed on MI day 1, 15 and 25 included determination by tests of the first-second level by R. V. Petrov of the count of leukocytes, lymphocytes, T-cells, T-helpers, T-suppressors (CD3+, CD4+, CD9+), zero lymphocytes, immunoglobulins, circulating immune complexes, complement by 50% hemodialysis, phagocyte index and count. Statistical processing included parametrical and non-parametrical criteria, correlation-regression analysis, criterion chi-square. The index of diagnostic significance Kj was calculated. Also, frequency and graphic analyses were made. RESULTS: The analysis of immunological disorders in patients with five variants of primary Q-wave MI (LV aneurism with moderate dilatation of the cavity, aneurism of the heart in combination with L V cavity dilation with CDR >60 mm and development of mitral regurgitation >2 degrees, prevalence of LV diastolic dysfunction, progressive dilatation of the heart cavities with development of mitral of degree 2-3 and tricuspidal of degree 1-2 insufficiency, compensated hemodynamics without essential changes of the LV and LA) has established the same type of immune reactions to the pathological process manifesting with a fall in the count of absolute and relative count of lymphocytes, T-cells, T-helpers, B-lymphocytes, complement, phagocytic index, suppression index. These changes were accompanied with increased count of T-suppressors, zero-lymphocytes, CIC, immunoglobulins, leucointoxication index. The immunological examination of the patients showed that all morphofunctional variants of the myocardium correlated with suppression of immune reaction in the following order: compensated aneurism of the LV (18 parameters), diastolic dysfunction of the LV (11), progressive dilatation of the heart cavities (8), aneurism of the LV (6), marked dilatation of the heart cavities (4). Patients with pronounced dynamics of the regenerative processes had suppression of cellular immunity of the second degree, in positive hemodynamics there were characteristic changes in T-suppressor link of immunity in accumulation of zero lymphocytes. Patients with poor outcome of primary Q-MI had the same formula of immune parameters: reduced count of T-helpers, high values of T-suppressors and CIC. Thus, the data show that low count of T-helpers, common T-cells, high level of T-suppressors or zero-cells during post-MI month 1 are related with compensated regeneration of the cardiac muscle. If the patients have deviation of the regulatory index and accumulation of CIC, they have poor prognosis. Regarding the time since MI (1, 15 or 25 days), the following regulation was seen: patients with compensated hemodynamics have 4 decreased and 1 increased parameters of immune status; patients with pathological myocardial remodeling have stimulation of at least 5-6 parameters of the immune status. CONCLUSION: Myocardial remodeling of the LV proceeds within the first year after development of myocardial necrosis; outcomes of myocardial restoration correlate with severity of immune disorders forming 2-3 weeks after MI, suppression of cell reactions agrees with compensated hemodynamics; accumulation of CIC in blood points to the risk of pathological remodeling of the left ventricle and post-MI cardiac failure.

[Immunological disorders and correction of them in surgical patients with atherosclerosis obliterance].

Atherosclerosis obliterance and critical lower limb ischemia lead to immunodeficiency and disbalance of T- and B- components of immune system. Surgical treatment doesn't eliminate but in a number of cases aggravates immune disorders. Immunocorrection stimulates anti-infectious protection. Indications to different variants of immunocorrection are formulated.

[Problem of specific and nonspecific factors in the induction and regulation of immunological reactions].

The functional unity of the specific and nonspecific mechanisms of immunological reactions has been shown on the basis of our own investigations and the published data. As revealed in this study, during the formation of immune response smooth transition from the nonspecific level to the specific one occurs. First, the factors of nonspecific protection are switched on, then intermediate reactions develop, further antibodies are synthesized, etc. At any level of immune response its regulation by nonspecific immunomodulators is possible, their influence controlled by a complex of reactions of the neuroendocrine system, also carrying the elements of nonspecificity and specificity.

[Correction of immunologic reactivity depending on ABO system antigens in patients with purulent infections of soft tissue and shigellosis]. / Korrektsiia immunologicheskoi reaktivnosti v zavisimosti ot antigenov sistemy ABO u bol'nykh s gnoinoi infektsiei miagkikh tkanei i shigellezom.

The immunological study of more than 300 patients with purulent infection of soft tissues and shigellosis was carried out. The character and manifestation of the immunocorrecting action of sodium nucleinate were found to depend on the antigens of the AB0 system, which proved to be different in various type of pathology.

[Efficiency of immune correction in patients with chronic traumatic mandibular osteomyelitis]. / Osobennosti immunnykh rasstroistv i éffektivnost' ikh korrektsii u bol'nykh s khronicheskim travmaticheskim osteomielitom nizhnei cheliusti.

The effect of a new immunomodulator neovir was studied in 35 patients with chronic traumatic mandibular osteomyelitis. The immune status and clinical parameters notably improved.

[Impaired immune response associated with ABO antigen system in patients with purulent abscesses and dysentery]. / Assotsiatsiia rasstroistv immunologicheskoi reaktivnosti s antigenami sistemy ABO u bol'nykh s gnoinymi abstsessami i dizenteriei.

On the basis of a considerable number of facts--the results of the immunological survey of 197 patients with purulent infections of soft tissues and 103 shigellosis patients--the character and manifestation of immunological disturbances were found to depend on the genetic markers of blood (antigens of the AB0 system) which proved to differ in different type of pathology in patients.

[Blood group-dependent efficiency of immunological correction in patients with chronic purulent otitis media]. / Zavisimost' éffektivnosti immunokorrektsii ot grupp krovi u bol'nykh khronicheskim gnoinym srednim otitom.

Clinical and immunological investigations were performed in 300 patients with otitis media chronica purulenta. The patients, aged 16-65 years, received immunocorrectors in addition to basic postoperative therapy consisting of antibiotics and antihistamine drugs. The highest immunocorrective effect was registered in patients with blood group AI, the weakest in those with blood group AB(IV). Blood group B(III) and A(II) were the second and the third.

[The characteristics of the clinical manifestations and treatment of chronic obstructive bronchitis in patients with hepatobiliary system diseases and pseudoallergy]. / Osobennosti klinicheskikh proiavlenii i lecheniia khronicheskogo obstruktivnogo bronkhita u bol'nykh s zabolevaniiami gepatobiliarnoi sistemy i psevdoallergiei.

Routine clinical, laboratory, instrumental and immunological examinations in 105 patients have established that hepatobiliary disorders occur 2.2 times more frequently in patients with chronic obstructive bronchitis (COB) and pseudoallergy than in those without pseudoallergy. To correct negative effects of pseudoallergy, conventional therapy was combined with enterosorbent polyphepan, spasmolytic nospa and cholagogic allochol used alone or in different combinations. The highest benefit for COB patients was achieved in using combination of polyphepan + nospa + allochol.

[Available methods of evaluation and correction of immune disorders in patients]. / Dostupnye metody otsenki i korrektsii immunnykh narushenii u bol'nykh.

A three-stage scheme for detecting and correcting immunodeficiency is proposed. The first stage is the interview from which the physician may suspect secondary immunodeficiency, the second is assessment of changes in the leukogram, and the third stage is correction of immune disorders with consideration for the immunodeficiency syndrome(s) detected.

[Methods for assessing the efficacy of immunocorrection]. / Metody otsenki éffektivnosti immunokorrektsii.

The use immunocorrective remedies has become a topical problem due to the insufficient effectiveness of the treatment of many chronic diseases (including chronic purulent otitis), manifested by the suppression of initial immunological disturbances. Still the principles of the prescription of the above-mentioned remedies have not yet been sufficiently worked out. The present work deals with the use and approval of the methods for the evaluation of the effectiveness of immunocorrective therapy, the determination of the targets of action, the proper effect of modulation, changes in the degree of its manifestation.