[Long-term results of conservative treatment of pyo-destructive diseases of the lungs and parapneumonic empyema].

An analysis of results and treatment outcomes of 178 patients has been made. The patients were examined 1, 3, 6, 12, 24 months after discharge from hospital. The parameters characterizing residual cavities, pneumofibrosis, pleural fibrosis and changes in the bronchial tree were analyzed. Recovery was noted in 172 patients (96.63%). According to CT scan data positive dynamics in the reparative processes in the lungs and pleural cavity could be seen. No relapses of the purulent processes and development of lung cirrhosis were noted.

Local administration of interleukin-1beta for the treatment of lung abscesses induces neutrophil activation and changes in proinflammation cytokine production.

Interleukin-1 (IL-1) is a potent immunostimulatory molecule with broad range biological activity that limits its systemic application in humans. Alternatively, IL-1 can be applied locally, directly to the inflammatory site for stimulation of local defense mechanisms, without activating an acute phase response. IL-1beta preparations have been successfully used for local therapy of patients with purulent bacterial lung abscesses who were resistant to usual antibiotic treatment. IL-1beta was applied directly to the abscess cavity at a concentration of 10 ng/ml, once a day for 7 days. Before IL-1beta administration, local leukocyte functional activity was significantly reduced compared to the same activity in neutrophils isolated from the peripheral blood of the same patient. Local application of IL-1beta led to increases in adhesion, chemotaxis, oxygen radical production and phagocytosis of abscess fluid neutrophils. After local IL-1beta treatment, the concentration of IL-8 and TNF-alpha in the abscess fluids increased, while in nearly all patients levels of endogenous IL-1beta decreased. Immunocytochemical analysis showed that IL-1beta increased the numbers of cytokine-producing cells and induced proinflammatory cytokine production by neutrophilic granulocytes. According to the results obtained, the mechanism of the local immunostimulatory activity by IL-1beta is associated with the significant activation of neutrophilic granulocyte functions and changes in cytokine production at the inflammatory site. IL-1beta can be used as a highly effective immunotherapeutic drug when applied locally at adequate immunostimulatory dose levels.

[Local use of recombinant interleukin-1 beta in the complex treatment of patients with acute lung abscess]. / Mestnoe primenenie rekombinantnogo interleikina-1beta v kompleksnom lechenii bol'nykh s ostrymi abstsessami legkikh.

An analysis of results of examination and treatment of 59 patients with a prolonged duration of acute abscesses of the lungs has shown the influence of immune disorders on the dynamics of the development and outcome of pyo-destructive disease in the lung. The indications to local immunosubstituting therapy were determined. A new original method of administration and a scheme of prescription of the medicine Betaleukin are proposed. Clinical efficiency of the method proposed is shown. The local immunocorrection used in the complex treatment of patients with acute abscesses of the lungs allows to get recovery of 89% of the patients.

[Long-term transbronchial catheterization of the destructive cavities in the treatment of acute lung abscesses with disordered bronchial patency]. / Dlitel'naia transbronkhial'naia kateterizatsiia polostei destruktsii v lechenii ostrykh abstsessov legkikh s narushennoi bronkhial'noi prokhodimost'iu.

High curative efficiency of prolonged transbronchial catheterization of destruction cavities of the lung is shown on the basis of results of treatment of 80 patients. Possible risk factors and preventive measures in using this method are described.