[Pathogenetic aspects of chronic inflammation]. / Patogeneticheskie aspekty khronicheskogo vospaleniia.

Chronic inflammation (CI) was studied immunologically and immunomorphologically on biopsy and surgical material: interstitial pulmonary diseases, chronic inflammatory processes of the uteri and ovaries, decubitus in the spinal cord damage, trophic ulcers of the limbs, osteomyelitis, chronic abscesses of soft tissues, coccygeal cysts and chronic paraproctitis. The following parameters determine the development of CI: persistence of the damaging agent, immunological insufficiency, mechanisms of autoimmunization, progression of CI according to the principle of vicious circle. CI looses its biological usefulness as a compensatory-adaptive reaction.

[Immunomorphologic characteristics of bedsores]. / Immunomorfologicheskaia kharakteristika prolezhnei.

Biopsies and blood of 36 patients with bedsores developing due to spinal cord trauma were studied. Pronounced alterations in the blood content of IgA, IgM, IgG, a significant increase in circulating immune complexes (CIC) content and a decrease of neutrophil leukocyte chemotactic activity were found. The authors conclude that an immune system dysfunction occurs in patients with bedsores as well as secondary immune deficiency and immunoglobulin and CIC deposition in the granulation tissue vessels. Development of chronic vasculitis, obliteration and reduction of vessels, hypoxia and metabolic disturbances in the wound edges, formation of deficient fibroblasts synthesizing collagen type III which does not facilitate skin epithelium maturation, all these changes result in a chronic course of the wound and almost complete lack of healing.

[Immunopathology and morphology of chronic inflammation]. / Immunopatologiia i morfologiia khronicheskogo vospaleniia.

Biopsies from 40 patients with chronic trophic ulcers of lower limbs or osteomyelitis were investigated. Combination of immunopathological processes in the form of immune deficiency, unbalance of T-lymphocyte subpopulations and immunoglobulins, increased levels of circulating immunocomplexes and T-active lymphocytes, high functional T-lymphocyte activity. Moreover, there is a decrease of both chemotaxis and spontaneous motility of neutrophil leukocytes and phagocytosis. The disturbance of cellular and humoral immunologic reactions and nonspecific resistance correlates with morphological features of ulcers: suppression of collagenogenesis, productive vasculitis, obliteration and reduction of vessels, plasmatization of granulation tissue. The causes and mechanisms of the changes observed resulting in the chronic inflammation which takes the form of vitium cordis are discussed.

[Combined detoxification and immunocorrective therapy in patients with peritonitis]. / Kompleksnaia detoksikatsionnaia i immunokorrigiruiushchaia terapiia u bolnykh s peritonitom.

The authors examined 48 patients with peritonitis (20 with the generalized and 28 with the localized form). The content of T-lymphocytes, theophylline-resistant and theophylline-sensitive T-lymphocytes, leukocyte chemotaxic activity, and the lymphocyte ATP content were studied. It was found that the state of the immune system in the early postoperative period allows the severity of the disease and its outcome to be prognosticated. A sharp decrease in the T-lymphocyte content and decrease of the amount of ATP in the lymphocytes in stable reduction of chemotaxic activity is an unfavorable prognostic sign. Introduction of indirect electrochemical oxidation with a sodium hypochlorite solution into the complex of intensive therapy produces, in addition to a marked detoxification effect, a stabilizing effect on metabolic processes in the lymphocytes and activates the cellular link of immunity. Combined immunocorrection with the agents tactivin and leukinferon possesses a high potential of an immunobiological effect and can be recommended for correction of severe secondary immunodeficiency in patients with generalized peritonitis.

[Patho- and morphogenesis of pyo-inflammatory diseases of the adnexa uteri]. / Pato- i morfogenez gnoinykh vospalitel'nykh zabolevanii pridatkov matki.

The uterine appendages in 87 females aged from 17 to 53 years were surgically removed because of inefficacy of conservative treatment for purulent inflammation. There were signs of chronic recurrent inflammation in the uterine tubes or in the tubes and ovaries as shown by the operative material studied light and electron microscopically, immunomorphologically. Immune mechanisms as well as structural changes (reduction, vasculitis) of the vascular bed and muscular layer (sclerosis) of the tubes played a role in the pathogenesis of chronic inflammation. The detection of the antibodies against Chlamydobacterials in 60% of the patients implies their role in pathogenesis of chronic inflammation of the uterine appendages.

[Mechanisms of immunosuppression in surgical pathology]. / Mekhanizmy immunosupressii pri khirurgicheskoi patologii.

The mechanisms of immunodeficiency in surgical pathology are described. They are consequences of stress, anesthesia, operation, endotoxinemia, blood loss. The duration of secondary immunodeficiency and prognosis depend on the degree of tissue traumatization, scope of operation, peculiarities of pathologic process and the state of host defence, its capacity for mobilization in extreme situation. Transient damages of the early postoperative "shock" period are most pronounced and form a "window" for immunodeficiency development and infections association in subsequent period. Hence it seems reasonable to conduct immunoprophylaxis in the preoperative period and immunocorrection after the operation this aiming at lower lethality in surgical pathology.

[Disorders of the immune status in patients with acute diffuse peritonitis]. / Narusheniia immunnogo statusa u bol'nykh ostrym razlitym peritonitom.

Analysis of various parameters of the immune system and non-specific resistance in patients with acute generalized peritonitis (AGP) has indicated that in AGP there is immunodeficiency involving all the links of immune defense and non-specific resistance. The T-cell immunity, primarily T helpers, is afflicted in AGP to the greatest extent. A magnitude of decreases in T helper counts may be used as a prognostic indicator in AGP. The severity of immune defense abnormalities correlates with the duration and intensity of intoxication, there is a "paralysis" of this defense in the terminal stage of AGP.

[Chemotaxis of peripheral blood leukocytes in patients with diffuse purulent peritonitis]. / Khemotaksis leikotsitov perifericheskoi krovi u bol'nykh razlitym gnoinym peritonitom.

Leukocytic chemotaxis was evaluated in 43 patients with diffuse purulent peritonitis. It was found out that time course changes in chemotactic activity of leukocytes have a phasic pattern: it was reduced in an early postoperative period, there is a tendency to enhancement of cellular spontaneous and target migration 3-6 days after operation and onwards, maximal response to chemotactic stimulus on day 7-14 after operative intervention. Postoperative serum factors show a diverse influence on leukocytic chemotaxis. Correlation observed between chemotaxic activity and postoperative developments allows the author to propose an assessment of leukocytic chemotaxis in patients with diffuse purulent peritonitis on follow-up to diagnose early complications and to control immunocorrective therapy administered.

[Characteristics of the course of abscesses during effects on the system of phagocytosing mononuclear cells]. / Osobennosti techeniia abstsessov v usloviiakh vozdeistviia na sistemu fagotsitiruiushchikh mononuklearov.

In a series of experiments on 230 noninbred white rats the trend in the development of soft tissue abscess was investigated under stimulation and inhibition of phagocytizing mononuclear cells (PMC). The results suggest the stimulation to promote more reliable localization of the inflammation focus and encapsulation with connective tissue. The test for alpha-naphthyl esterase and quantitation of macrophages (absolute number) per infiltration area unit adjacent to the abscess suggest a direct correlation between the absolute number of macrophages and the width of the capsule. The data obtained confirm the assumptions on the role of macrophages in inflammation focus as a regulatory and controlling factor for cellular reactions. PMC system is shown to affect the process of abscess separation from adjacent tissues including formation of the capsule.

[Status of cellular immunity in diabetic microangiopathy detected by skin biopsy]. / Sostoianie kletochnogo immuniteta pri diabeticheskoi mikroangiopatii, vyiavlennoi s pomoshch'iu biopsii kozhi.

As compared with normal persons, in 46 patients with diabetes mellitus there was a significant decrease in spontaneous leukocyte migration, a reduction in the absolute count of T-, B- and O-lymphocytes, and a rise in the relative count of D-lymphocytes. The disorders of cell-mediated immunity are formed during the first five years of illness. They do not depend on the diabetes severity, distinctly growing on with the appearance and increase of the degree of diabetic microangiopathy diagnosed on morphological analysis of skin biopsy specimens.

[Action of low-frequency ultrasound on the peritoneum, peritoneal exudate cells and the course of experimental peritonitis]. / Deistvie nizkochastotnogo ul'trazvuka na briushinu, kletki peritoneal'nogo ékssudata i techenie éksperimental'nogo peritonita.

The authors studied the action of low-frequency ultrasound on rat and guinea-pig peritoneal exudate cells during aseptic peritonitis, on the intact peritoneum of these animals, and on experimental peritonitis in guinea-pigs. It was shown that ultrasound "hammers in" India ink solutions and antibacterial drugs into the peritoneum and in combination with antibiotics, it increases the guinea-pig survival rate in peritonitis. Ultrasound was not found to produce a direct bactericidal effect in vivo. Exposure of peritoneal exudate to ultrasound (1 s/cm2) demonstrated an increase in chemotaxis of neutrophil leukocytes to autologic serum and appreciable phagocytic activity. A longer exposure (up to 3-5 s/cm2 or 6-8 s/cm2) resulted in the partial damage to the peritoneum. Leukocytes, mesotheliocytes and subperitoneal striated muscles were found to be especially sensitive to ultrasound.

[Chemotaxis in normal and pathologic conditions]. / Khemotaksis v norme i patologii.

Under the influence of environmental chemical substances phagocytes are capable of directed migration towards chemoattractant concentration gradient (chemotaxis) and of increased speed of movement (chemokinesis). In the chain of events "triggered" by inflammation an important role is played by chemotaxis. The content of cell membrane enzymes, the level of cyclic nucleotides, mechanisms of ion transport, and ways of energy production change in response to the chemotaxic factor. Primary (congenital) and secondary (acquired) disorders of chemotaxis are distinguished. In detecting chemotaxis defects it is necessary to determine the capacity of cells for spontaneous migration in the absence of a chemical stimulation as well as the presence of serum inhibitors of chemotaxis. The study of cell receptor apparatus with the help of structurally defined chemotaxic factors as well as of the motor apparatus of the cell will give an insight into the concept of chemotaxis. At the same time, exerting an influence on chemotaxis simultaneously influences the inflammatory processes, therefore new approaches to treatment of inflammatory diseases may be developed by means of drugs modulating chemotaxis.