DIAGNOSTIC AND TACTICAL IMPORTANCE OF STUDYING SHORT CHAIN FATTY ACIDS IN DIFFERENT BIOLOGICAL SUBSTRATES TOOK PLACE IN PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE, LUNG CANCER AND COMMUNITY-ACQUIRED PNEUMONIA DEVELOPED AFTER ANTICANCER THERAPY.

The main aim of the study is to examine microbiocenosis of lower respiratory tract and intestine in patients with chronic obstructive pulmonary disease (COPD), lung cancer (LC), lung cancer with community-acquired pneumonia (CAP) and to determine their role in the etiological diagnosis of lower respiratory tract infections (LRTi), including those that develop during cancer chemotherapy (CC), to discuss the possibility of optimizing the treatment tactics. MATERIALS AND METHODS: To solve this task were examined 147 patients and 30 healthy individuals were divided into 4 groups, according to nosology. The number of patients in the COPD group was 38 people, m / f-35/3, median age 63 (57; 69) years, in the LC group -60 people, m / f - 56/4, with a median age of 65 (58; 71) year; LC groupwith CAP -21 persons m / f - 17/4, with a median age of 73(69; 75) years, in the LC group with CAP developed in the period up to 30 days after the end of chemotherapy (LC with CAP / CC) -28 persons m / f - 22/6, with a median age of 70 (67; 73) years, the norm group -30 healthy persons m / f- 26/4, median age 48(40,691 years. The spectrum of short-chain fatty acids (SCFA) sputum (in bronchoalveolar lavage standards group) and test groups of feces were studied by gas-liquid chromatographic analysis (GLC analysis). Results of the study. In the norm group: total absolute content of SCFA (X) in sputum was 0.032 mg / g, the relative content of acetic acid (pC2) 0906 u, propionic acid (pC3) 0.085 u, butyric acid (pC4) 0.009 u, anaerobic index (Al) -0.104 units. According to the analysis the total absolute content of SCFA in the sputum may be expressed as follows: ∑ SCPA (C2-C4) norm (0,032) <∑ SCFA (C2-C4) COPD (0,201) <∑ SCFA (C2-C4) RL (0,463) < ∑ SCFA (C2-C4) LC with CAP (0.510) < RCMP ∑ (C2-C4) LC with CAP / CC (0.612) (mg / g), the differences are statistically significant when compared with the norm. The findings of the relative content of C2-C4 show a statistically significant increase of the relative content of propionic and butyric acids: PC3 (0,085) pC4 (0.009) norm pC2 (0.846) COPD> pC2 (0.792) LC> pC2 (0.765) LC with CAP> pC2 (0.719) LC with CAP / CC (u) in patients of all study groups compared to the norm, and between groups. And the more pronounced changes in the content of SCFA in the sputum are ascertained in lung cancer with CAP during chemotherapy. *The values of Al in the studied groups are displaced to more negative values: Al (- 0.104) rate> Al (- 0.190) COPD> Al (- 0.257) RL> Al (- 0.307) LC with CAP> Al (- 0.391) LC with CAP / CC (sing.) compared with the norm and between groups. The findings of SCPA in feces in the group norm: ~1 SCFA 10.51 mg / g, 0.634 units pC2, pC3 0,189 units, 0,176 units pC4, -0.576 Al units. The total absolute content of SCFA in feces can be expressed as follows: ∑ SCFA (C2-C4) LC (4,11) <∑ SCFA (C2-C4) COPD (4,81) <∑ SCFA (C2-C4) norm (10 51) (mg / g), the differences were statistically significant when compared with the norm; depending on the chemotherapy, preceding the development of the CAP: ∑ SCFA (C2-C4) norm (10,51)> ∑ SCFA (C2-C4) LC with CAP / che- motherapy (5,54)> ∑ SCFA (C2-C4) LC CAP (4,96)> ∑ SCFA (C2-C4) LC (4.11) (mg / g). Results of the study of the relative content of C4-C2 also demonstrate a statistically significant increase of the relative content of propionic and butyric acids: pC3 (0.189), pC4 (0.176) norm pC2 (0.590) COPD> pC2 (0,560) LC> pC2 (0.529) LC with CAP> pC2 (0.503) LC with CAP! chemotherapy (u) in patients of all study groups in comparison with the norm. And the more pronounced changes in the content of SCFA in feces are ascertained at LC with CAP during chemotherapy. The values of Al intestinal ecological community of all groups are displaced to more negative values when compared with the norm: Al (- 0.576) norm> Al (- 0.695) COPD> Al (- 0.786) LC> Al ('0.890) LC with CAP> Al (- 0.988) LC with CAP / chemotherapy (u), with the most significant changes were observedin the group of LC with CAP during chemotherapy. Conclusion, Increased absolute SCFA concentration in patients with CQPD, lung cancer, lung cancer with CAP, LC with CAP! CC in comparison with the norm indicates increased number and activity of anaerobic flora, the most significant changes observed in patients with lung cancer with CAP, developed in the period up to 30 days after the end of chemotherapy. The unidirectional changes in SCFA parameters in the sputum and stool demonstrate the dependence of microorganism biocenosis. The resulting information can be used in the etiological diagnosis of LRTI, as well as the development of therapeutic and preventive measures flAw Af infprtiniis rnmnlications and treatment of these patients.

[Microflora metabolites of different habitats in bronchopulmonary diseases].

PURPOSE: To investigate the content and profile of metabolites of bronchopulmonary and intestinal microflora, especially such as short chain fatty acids (SCFA) in various biological substrates in patients with lung malignant tumors on the background of COPD. Estimate their diagnostic and tactical implication. MATERIALS AND METHODS: The study involved 98 patients with diseases of the bronchopulmonary system. According to the basic nosology patients were divided into two main groups: COPD (38 patients), and lung cancer in combination with COPD (hereinafter LC) (60 patients). The diagnosis was verified by modern methods of examination. Group of norm included 30 healthy individuals. Groups matched by gender and age. The microbiological examination of sputum and feces was conducted in the studied groups of patients. SCFA in sputum and feces of patients with COPD and LC were identified by GLC method. In healthy individuals the SCFA investigation was performed in bronchial washings, obtained during bronchoscopy in 20 people, the SCFA investigation in feces was performed in 30 people. RESULTS: Study of the content and profile of short-chain fatty acids (SCFA) in patients with COPD and lung cancer (LC) in various biosubstrates indicate on the obvious changes in microbiocenosis ofbioptate (bronchopulmonary and intes- tinal), characterized by the dominance of residual and facultative anaerobic microorganisms in the spectrum. Except that more pronounced changes are ascertained at LC. Also, changes of the SCFA parameters in the sputum may indicate on the alterations in the metabolism of epithelial cells of the lower respiratory tract (LRT). Unidirectional change the SCFA in sputum and feces can indicate on either translocation of microflora in the LRT out of the intestine, and on the possible systemic changes in themetabolism of epithelial tissue in the oncological process. The identification of SCFA by GLC method in various biological substrates can be used in examination of patients with lung cancer for diagnostic purposes (for objectification of microecological violations), as well as to evaluate the prognosis of the disease and its complications.

[Current aspects and prospects of the combined treatment of respiratory papillomatosis in children]. / Sovremennye aspekty i perspektivy kompleksnogo lecheniia respiratornogo papillomatoza u detei.

Treatment methods and outcomes have been analyzed for 313 children aged 9 months-14 years with respiratory papillomatosis (RP) admitted to ENT clinic in 1950-1995. Beginning from 1982 papillomas were removed by means of ultrasonic disintegration. A novel approach included extracorporeal detoxication and immunocorrection. 85% of patients responded to treatment with discrete plasmapheresis and T-activin. It is concluded that best treatment results were achieved in combination of conventional methods with advanced modalities such as extracorporeal detoxication and immunocorrection.

[Indicators of resistance to infection in children with respiratory papillomatosis]. / Pokazateli antiinfektsionnoi rezistentnosti u detei, bol'nykh respiratornym papillomatozom.

The study was made of microbiological and immunological aspects of antiinfectious resistance (AIR) in children with respiratory papillomatosis (RP). At admission to hospital RP patients exhibited dysbacteriosis of the upper respiratory tract and colon. Immunological and microbiological response to the infection recurrences was adequate. Interrelated immunological and microbiological indices in RP objectively reflect the course of the pathological process and may be used in objective assessment of the disease and choice of its treatment.

[The efficacy of entomopathogenic bacilli against ancylostomide larvae--Nippostrongylus braziliensis Travassons, 1914]. / Effektivnost' éntomopatogennykh batsill protiv lichinok ankilostomid--Nippostronylus braziliensis Travassons, 1914.

Effects of seven bioinsecticides, containing Bacillus thuringiensis and B. sphaericus toxins, against N. braziliensis larvae were studied in vitro. Bitoxibacillin, astur-3, astur-4, gomelin, lepidocide, dendrobacillin, thuringin and sphaerix were found highly effective larvicides. Protein endotoxin was the principal component responsible for the larvicidal effect, the spores were of no importance.

[A system for the clinico-immunological prognosis of infectious-inflammatory complications in planned surgery]. / Sistema kliniko-immunologicheskogo prognozirovaniia infektsionno-vospalitel'nykh oslozhnenii v planovoi khirurgii.

Postoperative infectious complications in planned surgery are a pressing problem. The preoperative condition of the patient and his immune system play an important role in their development. Fifty patients of the "risk" group were selected from the standpoint of classification of the etiological factors of secondary immunodeficiency states. Fifteen patients who had no symptoms classified as SIDS risk factors formed the control group. The immune status was examined before and on the third day after the operation in all patients of the main and control groups. Various infectious complications developed after the operation in 23 patients of the risk group. No such complications occurred in the control group. The preoperative immune status of the risk group patients differed significantly from that of the controls in 13 of 19 parameters. The patients of the main and control groups formed the instructing selection. An expert system of preoperative clinico-immunological prognostication of postoperative infectious-inflammatory complications was created on oasis of the methods of the theory of image recognition and instructing selection. The system was tested in a direct clinical experiment on 66 patients. The prognoses were correct in 89% of cases. It was thus proved that symptoms classified as SIDS risk factors influence the initial immunity status and the course of the postoperative period in planned surgery. An accurate, sensitive, and specific method for prognosticating postoperative infectious complications is suggested.

[Growth and spore germination factors of various strains of Bacillus sphaericus]. / Faktory rosta i prorastaniia spor razlichnykh shtammov Bacillus sphaericus.

The work was aimed at studying the requirements of sixteen Bacillus sphaericus strains with a different larvicidal activity in amino acids and some other compounds necessary for their growth and spore germination. Most of the strains were found to require arginine, glutamate, methionine, threonine, serine, glycine, alanine and lysine, but they did not assimilate phenylalanine and proline. Arginine, methionine and glutamate were shown to be the most effective inductors of spore germination. Specific differences were detected in the requirements of virulent and avirulent strains. Glucose repressed both spore germination and spore formation.

[Chemical mutagenesis and the use of indirect enzymatic criteria for the selection of virulent clones of Bacillus thuringiensis]. / Khimicheskii mutagenez i ispol'zovanie kosvennykh énzimaticheskikh kriteriev dlia otbora virulentnykh klonov kul'tury Bacillus thuringiensis.

The effect of the mutagene nitrosoguanidine (N-methyl-N'-nitro-N-nitrosoguanidine) on the growth of Bacillus thuringiensis subsp. galleriae st. 69/6 was being studied. It depends on the physiological state of the cells, dose of the mutagene, pH of the culture medium and exposition. Nitrosoguanidine was found to have the maximum mutagenic effect on the vegetative cells at pH 6.2 and on the spores at pH 5.6.

[Effect of mineral salts on exotoxin formation and productivity of a Bacillus thuringiensis culture]. / Vliianie mineral'nykh solei na ékzotoksinoobrazovanie i produktivnost' kul'tury Bacillus thuringiensis.

The effect of ten mineral salts on the productivity and toxin synthesis was studied in Bacillus thuringiensis IPM-1140. Exotoxin synthesis was stimulated by Zn2+, Mn2+ and NH4+ ions as well as by potassium phosphates. The direct correlation between the number of viable spores and the exotoxin accumulation was disordered at extreme salt concentrations. Optimal salt concentrations in the yeast-polysaccharide medium were found using the method of a fractional factor experiment, which made it possible to increase the productivity of the culture to 5 X 10(9) spores/ml and the yield of the exotoxin to 730 micrograms/ml. The thermoresistance and the entomopathogenic activity of crystals increased when B. thuringiensis IPM-1140 was grown in this medium.

[Possible means for increasing exotoxin synthesis by a Bacillus thuringiensis culture--the producer of bitoxibacillin]. / Vozmozhnye puti uvelicheniia sinteza ékzotoksina kul'turoi Bacillus thuringiensis--produtsentom bitoksibatsillina.

Various procedures were studied for obtaining Bacillus thuringiensis strains of serotype I which synthesized exotoxins. Mutant clones with elevated exotoxin synthesis could be selected by treating the cells with N-methyl-N-nitro-N-nitrosoguanidine. The frequency of (+) variant selection was from 17 to 12 X 10(-2). The clones of S and R types differed in the insecticide activity of the exotoxin. Its yield could be increased by optimizing the composition of growth media. The strain specificity of B. thuringiensis producing the exotoxin was assayed in terms of carbon and nitrogen requirements.

[Effect of temperature and aeration on Bacillus thuringiensis growth and sporulation]. / Vliianie temperatury i aératsii na rost i sporoobrazovanie Bacillus thuringiensis.

The growth of Bacillus thuringiensis was studied as a function of temperature and aeration. The vegetative growth, the yield of viable spores and their thermoresistance did not depend, for all practical purposes, on the rate of aeration within the range of 25 to 60 mg O2 per litre per minute. A rise of temperature from 20 to 35 degrees C doubled the titre of spores and increased their thermoresistance. When the temperature of cultivation was increased to 40 degrees C, the process of spore formation was inhibited.

[Membrane-active properties of a preparation from a bacterial culture broth possessing autoregulation action]. / Membranoaktivnye svoistva preparata iz kul'tural'noi zhidkosti bakterii, obladaiushchego autoreguliatornym deistviem.

The effect of a preparation obtained by butanol extraction of the culture fluid of B. cereus and Ps. carboxydoflava and previously termed an autoregulatory factor d1 on the respiration chain within intact bacterial cells and isolated membranes was investigated. In comparable concentrations this factor d1 inhibits the endogenous respiration of B. cereus and M. lysodeikticus as well as oxidase and dehydrogenase activities of isolated membranes from these bacteria and E. coli. The factor-induced decrease of the cell respiration rate is independent from disorders of the cell permeability osmotic barrier for respiration substrates. The factor d1 shows a higher effect at acidic pH values. It is concluded that the above preparation has membrane-active properties. It is also suggested that in the bacterial cell its target is the inner surface of the cytoplasmic membrane.

[Activity of intracellular enzymes in Bacillus thuringiensis prospores and sporangia]. / Aktivnost' vnutrikletochnykh fermentov v prosporakh i sporangiiakh Bacillus thuringiensis.

The activity of endocellular enzymes (alkaline phosphatase, protease, glucose dehydrogenase, aldolase, malate dehydrogenase, NADH dehydrogenase, NADH oxidase) was studied in isolated prospores and sporangia as well as in vegetative cells of Bacillus thuringiensis strains, one of which produced crystals and one did not. The activity of malate dehydrogenase and NADH dehydrogenase was high in prospores of the both strains at the fifth and sixth stages of spore formation. The strain which did not produce crystals differed from the parent strain by a higher aldolase activity at all of the growth stages and by an abrupt increase in the activity of hydrolytic enzymes in sporangia (in the cytoplasm of the parent cells).

[Effect of physicochemical factors on Bacillus thuringiensis sporulation]. / Vliianie nekotorykh fiziko-khimicheskikh faktorov na prorastanie spor Bacillus thuringiensis.

Spore germination was studied in Bacillus thuringiensis subsp. galleriae. Optimal temperature regimes were selected for spore activation and initiation. The formation of spores and the rate of their subsequent germination were shown to depend on the composition of growth media in which the organism was cultivated. The paper describes changes in the fine structure of spores at different stages of their germination.

[Resistance of resting cyst-like forms of Bacillus cereus to exposure to high temperature, ultraviolet rays and low-molecular alcohols]. / Ustoichivost' pokoiashchikhsia tsistopodobnykh form Bacillus cereus k vozdeistviiu vysokoi temperatury, ul'trafioletovykh luchei i nizkomolekuliarnykh spirtov.

The dormancy cyst-like forms of Bacillus cereus obtained under the action of an autoregulatory factor were shown to be more resistant to the action of such external factors of the medium as high temperatures, ultraviolet irradiation and low molecular weight alcohols comparing to the vegetative cells. Incubation at 80 degrees C for 15 min killed 98,5% vegetative cells and 86,5% of the dormancy refractile forms. U. V.--radiation treatment resulted in a loss of viability in 97% of the vegetative cells and in 75% of the refractile forms. Differences were also found in the resistance of the cyst-like forms and the vegetative cells to the action of ethanol, methanol and butanol. The resistance of the cyst-like forms of B. cereus to the action of the above damaging factors is consistent, in general, with the resistance of cysts, methylotrophic bacterial spores and other dormancy prokaryotic cells differing in the mode of their formation from endospores.