[The efficacy of specific plasma in the therapy of newborn infants with a Pseudomonas aeruginosa surgical infection]. / Effektivnost' spetsificheskoi plazmy v terapii novorozhdennykh s sinegnoinoi khirurgicheskoi infektsiei.

141 newborn with purulent surgical infection were under observation. In 73 the inflammatory process was not induced by Pseudomonas aeruginosa in 68 the infection was caused by the blue pus bacillus. Bacteriological and immunological examination was conducted, including that with the use of enzyme immunoassay, to monitor the optical density of anti-pyocyanea antibodies during the course of the disease. It was found that the serum of a healthy newborn baby contains antibodies to Pseudomonas pyocyanea and did no differ from that of healthy older children in the level of anti-pyocyanea antibodies. The increase of the level of anti-pyocyanea antibodies in response to infection with Pseudomonas pyocyanea is twice less in newborns than older children with this infection. The use of specific plasma is much more effective than the administration of nonhyperimmune plasma. The efficacy of treatment with anti-pyocyanea plasma is determined by the level of anti-pyocyanea antibodies produced in the patient as a result of plasmatherapy rather than the volume of the dose given for the course.

[Endolymphatic therapy of children with chronic osteomyelitis of the long tubular bones]. / Endolimfaticheskaia terapiia khronicheskogo osteomielita dlinnykh trubchatykh kostei u detei.

A study was made of the clinical efficacy and immune status in 40 children with chronic osteomyelitis of long tubular bones. Of these, 13 patients received antibiotics endolymphatically and 27 patients were given conventional antibiotic therapy (intramuscularly, intravenously). In view of the predominance of the staphylococcal flora, endolymphatic therapy included the use of gentamycin and lincomycin, the treatment course lasted up to 10 days. Endolymphatic antibacterial therapy has been demonstrated to produce a beneficial clinical effect there was a decrease in fever duration, the amount of postoperative complications, and the duration of inpatient treatment. After endolymphatic therapy the patients' blood manifested a more remarkable, as compared to the control group, rise of the absolute count of T lymphocytes, "active" population of T lymphocytes, together with an increase of the functional activity of lymphocytes in blast transformation, and a reduction, to an equal degree, of the neutrophil and monocyte counts, attesting to a decline of antigenic load of phagocytes. In patients who received antibiotics endolymphatically, the general blood analysis showed a decrease of neutrophilia and marked lymphocytosis. All this mirrored the intensity of immunity activation.

[Immunologic correction in the treatment of chronic hematogenic osteomyelitis of long tubular bones in children]. / Immunokorrektsiia v terapii khronicheskogo gematogennogo osteomielita dlinnykh trubchatykh kostei u detei.

Children suffering from chronic osteomyelitis of long tubular bones were compared for the action of the immunomodulating drug tactivin injected subcutaneously and endolymphatically. The study was carried out in 57 patients staying in hospital. The patients were distributed into the following groups: 18 patients entered a group where tactivin was injected subcutaneously, 9 patients made up a group where the drug was administered endolymphatically, and a reference group included 30 patients treated by conventional methods. On admission the patients demonstrated secondary immunodeficiency characterized by the lowering of the absolute and relative T lymphocyte count, a decrease of functional activity in blast transformation of lymphocytes, and dysimmunoglobulinemia. The use of immunomodulation with tactivin whatever the route of administration promoted a more uneventful course of the postoperative period, a decrease of suppurations of the postoperative wounds, reduction of the patient's hospital stay, a decrease in the dose of antibacterial drugs required for continuous treatment, and enhancement of the efficacy of antibacterial therapy. The use of tactivin endolymphatically brings about rapid normalization of the count of T, T active and B lymphocytes, an increase of the indicated parameters to the lower limit of normal on subcutaneous injection. As for the reference group, these parameters continue a progressive lowering.

[Immunologic disorders in children with developmental thoracic defects]. / Immunologicheskie narusheniia u detei s defektami razvitiia grudnoi kletki.

As the result of immunological examination of 21 children with developmental defects of the chest and analysis of the course of the postoperative period in 136 children, among which 36 had hereditary syndromes of systemic connective-tissue dyshistogenesis, it was found that suppurative complications of thoracoplasty, which are encountered in 15% of children with isolated developmental chest defects and in 33.3% of those with the above mentioned syndromes, were caused to a great measure by disorders of the immune status. The most serious immunological deviations were encountered in the Marfan syndrome due to impaired phagocytic activity of neutrophils and monocytes, decreased number of T, T active, and B lymphocytes, and diminished function of T helpers. In unclassified complexes of developmental defects with Marfaneic ++ phenotypes, the immunological disorders were similar, but less deep. In the Ehlers-Danlos syndrome, a decrease of the number of immunocompetent cells, function of T helpers, and neutrophils was mainly revealed. In isolated forms of funnel chest the function of monocytes and the number of immunoglobulins are mainly decreased.

The effect of using T-activin in the therapy of the newborn with suppurative surgical infection.

A total of 156 newborn infants with suppurative surgical infection (SSI) were observed; 73 of them had sepsis and 83 a severe localized process. In 47 patients with sepsis and 34 with localized infection, T-activin was included in complex therapy while the other infants formed the control group. It has been established that T-activin leads to an increase in the quantity of the active population of T-lymphocytes in the peripheral blood and to enhanced functional activity of T-lymphocytes in the newborn with SSI independent of generalization of the process. Bactericidal activity of circulating phagocytes is improved. The clinical course of SSI is less severe with more pronounced positive changes in the symptoms, hospital stay of the children is shortened, lethality is reduced. The effect of T-activin on the dynamic of the indices of the immune state is more marked in a septic process.

[Changes in the blood immunological indices of newborn infants as affected by T-activin in vitro]. / Izmenenie nekotorykh immunologicheskikh pokazatelei krovi u novorozhdennykh detei pod deistviem T-aktivina in vitro.

T-activin, introduced into the culture of mononuclear cells obtained from the blood of healthy newborn infants, does not induce any essential changes in the levels of E-, Ea- and EAC-rosette-forming cells. An overwhelming majority of healthy infants has shown a decrease in the functional activity of lymphocytes in the blast transformation test in response to the optimal dose of ConA and an increase in their functional activity in response to the suboptimal dose of this mitogen. After stimulation with phytohemagglutinin, both the increase of the stimulation index and its decrease have been observed in an equal number of cases. The introduction of the preparation into the culture of mononuclear blood cells isolated from newborn infants with sepsis leads to a considerable increase in the detection rate of Ea-rosette-forming cells with a tendency to an increase in that of E- and EAC-rosette-forming cells. The final values of the stimulation indexes, no matter what the mitogens used, are in conformity with the values characteristic of the normal parameters for healthy newborns, due to a specific pattern of changes in the T-lymphocyte functional activity in the blast-transformation test.