[Cardiac remodeling in the light of immune status changes in patients with chronic obstructive pulmonary disease].

The degree of structural and functional heart changes was evaluated by means of Doppler echocardiography in 120 patients with chronic obstructive pulmonary disease (COPD) of different degrees of severity. Conventional immunological laboratory techniques were used in all the patients to evaluate the condition of cell-mediated, humoral, and cytokine-mediated immunity; inflammatory process activity and the degree of endotoxicosis were evaluated by measuring blood levels of acute phase proteins and medium mass molecules. The study showed that the character of heart remodeling depended on COPD severity. Only severe COPD was associated with a significant right atrial enlargement, as well as structural and functional changes in the left heart. The results demonstrated a distinct correlation between the variables of structural and functional condition of the heart and immunity parameters in COPD patients. The variables of right and left ventricular function moderately correlated with inflammatory and endotoxicosis indices. Decompensation of patients with severe COPD and cor pulmonale is accompanied by a pronounced immunodeficiency. An increase in blood levels of cytokines, tumor necrosis factor alpha in particular, may serve as a marker of early stages of chronic heart failure, while an increase in blood levels of interleukin-6 may be a marker of its severity.

[The clinico-diagnostic importance of studying the ferritin content of the blood serum and sputum in pulmonary pathology]. / Kliniko-diagnosticheskoe znachenie issledovaniia soderzhaniia ferritina v syvorotke krovi i v mokrote pri legochnoi patologii.

Immunochemical and radioimmunological assays were used to measure the content of ferritin in blood, sputum and pleural fluid in patients with different pathology as well as in tissues of the pathologically altered lungs from patients who had died of chronic nonspecific pulmonary diseases (CNPD) and lung carcinoma. The measurements of ferritin in blood and sputum provide additional possibilities of recognizing the process activity in CNPD and tuberculosis, in differential diagnosis between lung carcinoma and tuberculosis during comprehensive examination of patients. In the pathologically altered lungs, the greatest content of ferritin was discovered in the areas of pneumofibrosis associated with CNPD, in the stromal structures of the cancerous node.

[Tumor-associated and acute-phase proteins in the diagnosis of cancerous exudative pleurisy]. / Assotsiirovannye s opukholiami i ostrofazovye belki v diagnostike rakovogo ékssudativnogo plevrita.

The examination of 150 patients with pleural exudate of different origin (43 cases of malignant and 107 cases of benign genesis) was made to elucidate diagnostic value of immunochemical serum and pleural fluid estimation of four tumor-associated proteins: carcinoembryonic antigen (CEA), beta 2-microglobulin (beta 2-MG), placental alkaline phosphatase (PAP), ferritin; three acute-phase proteins: C-reactive protein (CRP), lactoferrin, fibrin degradation products (FDP); expression of epithelial membrane antigen (EMA) in e date cells using monoclonal antibodies ICO-25. Determination CEA, beta 2-MG in the serum and pleural fluid, antituberculous an bodies in biological fluids proved diagnostically valuable for verification of pleural exudate characteristics. The discriminant analysis provided formulas for this differential diagnosis. The method identification in pleural fluid of cells expressing EMA with the use of monoclonal antibodies ICO-25 was found to be 2 times more efficient in detection of cancer cells than the standard light microscopy.

[The diagnostic importance of determining tuberculosis antibodies by immunoenzyme analysis in exudative pleurisy]. / Diagnosticheskoe znachenie opredeleniia protivotuberkuleznykh antitel metodom immunofermentnogo analiza pri ékssudativnom plevrite.

High diagnostic value of EIA detection of antituberculous antibodies in recognition of tuberculous pleurisy was established after examination of 58 patients with pleural exudate of different origin (tuberculous, tumor, nonspecific). Tuberculous pleurisy was diagnosed using sonicate M. tuberculosis as the antigen. It is important to determine antituberculous antibodies simultaneously in blood serum and exudate because in such a way it becomes possible to raise the test specificity to 100% in high sensitivity (94.7%).

[Clinical significance of the immunochemical study of serum and tissue proteins of the sputum in pulmonary pathology]. / Klinicheskoe znachenie immunokhimicheskogo issledovaniia syvorotochnykh i tkanevykh belkov v mokrote pri legochnoi patologii.

The content of normal serum proteins, acute phase (C-reactive protein, pregnancy-associated alpha 2-glycoprotein) and tissue proteins (ferritin, nonspecific tissue esterase) was studied in the sputum of 256 patients with different pulmonary pathology, over time using immunochemical methods. Protein elimination with the sputum was shown to depend upon the nature and gravity of bronchitis and pulmonary destruction. Analysis of the qualitative composition of the sputum proteins and their content can be used in pulmonology for differential diagnosis and assessment of a course of pulmonary diseases.

[Stimulation of the synthesis of C-reactive protein using pyrogenal in non-neoplastic diseases and cancer of the lungs]. / Stimuliatsiia sinteza C-reaktivnogo proteina pirogenalom pri nezlokachestvennykh zabolevaniiakh i rake legkikh.

Method of immunodiffusion titration of rabbit monospecific antiserum (The I. M. Mechnikov Central Research Institute of Vaccines and Sera of the USSR Ministry of Health) in agar was used to measure blood C-reactive protein (C-RP) level in patients with acute pneumonia (32), protracted pneumonia or activation of chronic non-specific lung pathology (101) and lung cancer (153) after a 3-4-week course of complex antiinflammatory treatment and a 10-14-day course of immunostimulation with pyrogenal (The N. F. Gamaleya Research Institute of Epidemiology and Microbiology). A decrease in the incidence (from 81.2% to 14.2%) and level (from 1.4 +/- 0.3 to 0.3 +/- 0.03 mg%) of C-RP was observed in cases of non-tumor pathology whereas in patients with lung cancer those values rose in step with tumor progression (from 72.2% and 0.4 +/- 0.07 mg% at stage I to 96.3% and 1.2 +/- 0.12 mg% at stage IV). Treatment with pyrogenal allowed to identify C-RP in patients with false-negative reaction in all subgroups. Two-week dynamic C-RP curves characterizing non-tumor and tumor pathology of the lung were plotted.

[Current approaches to conservative therapy of acute infectious lung destruction]. / Sovremennye podkhody k konservativnomu lecheniiu ostrykh infektsionnykh destruktsii lëgkikh.

Differential programs of conservative treatment (antibacterial in combination with sanatorium) including correction of immune deficiency, detoxication, quantum hemotherapy resulted in appreciable responses in 84.8% out of 894 patients with acute destruction of the lungs. Radical surgery was performed in 67 (7.5%) patients. Specific features of the treatment according to intensive conservative schemes are presented for 484 patients with acute pulmonary abscess, 282 with staphylococcal pulmonary destruction, 106 with septic pulmonary destruction and 22 with pulmonary gangrene. Total lethality reached 7.7%.

[Plasma fibronectin in gastric and duodenal ulcer]. / Plazmennyi fibronektin pri iazvennoi bolezni zheludka i dvenadtsatiperstnoi kishki.

Solid phase enzyme immunoassay was made to measure fibronectin in blood plasma of 132 patients with ulcer and healthy controls. Exacerbations of ulcer occurred in a significant lowering of fibronectin concentration which tended to an increase with ulcer healing. In the scarring phase fibronectin levels returned to normal. A local stimulating action of a plasma fibronectin preparation on scarring of the ulcer defect is validated.

[Prospects of etiological diagnosis of bronchitis]. / Vozmozhnosti etiologicheskoi diagnostiki bronchita.

Serum antibodies to soft tissue elements, levels of elastase, trypsin, trypsin inhibitor, alpha(2)-macroglobulin were measured to make a differential diagnosis of dust with nonoccupational bronchitis. For dust and nondust bronchitis titers of antibodies to collagen and elastin were different, serum enzymatic activity changed as a result of reduced concentration of trypsin and high elastase in dust bronchitis patients. Using the above results facilitates etiological diagnosis of bronchitis in workers exposed to dust by immunological methods as well as expertise of occupational bronchopulmonary pathology.

[Clinico-diagnostic role of ferritin and lactoferrin assays in benign and malignant affections of lungs and pleura]. / Kliniko-diagnosticheskoe znachenie issledovanii ferritina i laktoferrina pri dobrokachestvennykh i zlokachestvennykh porazheniiakh legkikh i plevry.

Immunochemical tests of blood sera from 160 healthy residents of the town of Astrakhan were performed to determine standard quantities of ferritin and lactoferrin in the serum. Examinations of the saliva from 280 healthy subjects provided the frequency of occurrence and levels of excretory lactoferrin. These iron-containing proteins were also assessed in different biosubstrates (blood serum, sputum, saliva, pleural fluid, lung tissues) from 550 patients with benign and malignant lesions of the lungs and pleura. Tests for ferritin and lactoferrin proved useful in evaluation of bronchopulmonary inflammation activity, early detection of pulmonary and intrapleural supputation, differential diagnosis of chronic nonspecific pulmonary diseases and lung cancer. The excretory salivary lactoferrin provided sufficient information on the condition of adaptive mechanisms of local defense of the lungs in premorbid state in 420 workers of the gas-processing plant exposed to aggressive occupational pollutants.

[Several aspects of clinical signs and pathogenesis of pneumopathies in acute poisoning caused by sulfur-containing natural gas]. / Nekotorye aspekty kliniki i patogeneza pnevmopatii pri ostrykh otravleniiakh serovodorodsoderzhashchim prirodnym gazom.

The article summarizes and analyzes data on 32 cases of acute intoxication varying in severity and caused by inhalation of sulfur-containing natural gas of Astrakhan gas deposit (SCNGAGD). The data were obtained in experimental poisoning of 120 Wistar rats with the gas. Pneumopathies (toxic pulmonary edema, pneumonitis, asthmatic bronchitis, alveolitis) appeared to play the central role among other syndromes of the intoxication by SCNGAGD. Mechanisms of the pneumopathies were traced to morphologic disorders of blood-lung barrier, compromised functions of lung surfactant, disturbances in lipid peroxidation and anaerobic glycolysis.