[The surgical risk factors in patients with nonmalignant space-occupying lesions of the liver and the importance of immunological studies in assessing their extent]. / Faktory khirurgicheskogo riska u bol'nykh s nezlokachestvennymi ob''emnymi obrazovaniiami pecheni i znachenie immunologicheskikh issledovanii v otsenke ego stepeni.

Results of surgical treatment of benign new growths of the liver (BVML) depend not only on timely diagnosis of local growth but on precise analysis of surgical risk factors (SR) as well as accurate definition of its significance. The proposed classification helps to evaluate factors of SR in these patients. Results of the investigation showed that in majority of patients (94.7%) with BVML without complications immune system was were not suppressed. The fact may be considered as a favourable sign, demonstrating potential immunologic safety of patients in definite period of BVML development. Patients with lowered parameters of immunologic status made up a group of a high risk to develop inflammatory and septic complications in postoperative period. Definite correlation between the extent of immunodeficiency and frequency of postoperative complications has established the necessity of action to prevent the provocation of immunological status disturbances.

[Immunological indices of "drainage" blood used for compensation of blood loss]. / Immunologicheskie pokazateli "drenazhnoi" krovi, ispolzuemoi dlia vospolneniia krovopoteri.

The authors discuss experience in compensation for blood loss in patients with ischemic heart disease after aortocoronary shunting using drainage blood without or with donor blood (80 persons) and donor blood alone (60 persons). Mild changes of immunity cell factors were revealed and no differences in the concentration of class A, M, and G immunoglobulins and phagocytosis as compared to the indices recorded before the operation and 24 hours after it. Analysis of postoperative infectious-inflammatory complications showed their incidence to be less in patients who received drainage blood without or donor blood (23%) than in those given transfusion of only donor blood (55%). The results of the study allow drainage blood to be recommended for reinfusion.

[Microsurgical allotransplantation of fetal bone on a vascular peduncle: immunological aspects]. / Mikrokhirurgicheskaia allotransplantatsiia plodnoi kosti na sosudistoi nozhke: immunologicheskie aspekty.

The authors studied the immunological profile of three patients after transplantation of bone allobrephotransplants with their microsurgical revascularization in the recipient zone. A reaction of rejection of the transplanted brephobone did not occur in any of the three cases. In transplantation of a complex brephobone the soft tissues overlying it, rejection of the soft tissues was encountered but there were no signs of bone rejection. The data of immunological monitoring correlate with the results of the clinicolaboratory and histological studies.

[The immunological indices of patients with echinococcosis undergoing preoperative hemoexfusions]. / Immunologicheskie pokazateli u bol'nykh s ékhinokokkozom pri provedenii predoperatsionnykh gemoéksfuzii.

The immunologic parameters were studied in 38 patients with hydatid disease of the liver and abdomen before and after a single hemoexfusion (HE) in a volume of 400 ml. Among the patients who were examined there were those with uncomplicated hydatid disease of the liver (group I, second clinical stage, 25 persons), patients with suppuration of hydatid cysts (group 11, 10 persons), and two patients with multiple hydatid cysts complicated by their suppuration and calcification with involvement of large areas of the liver. Comparative analysis of immunological parameters in patients before and in the first 24 hours after HE showed a difference between the groups of patients and the controls. The parameters were restored to their initial values in patients of both groups 3-5 days after HE. The results of the study allow the conclusion that in screening patients with hydatid disease of the liver and abdominal cavity for preoperative HE a strict individual approach is necessary with the patient's general condition, the clinical form of the disease, and complications on the part of the cysts being taken into account.

[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.

[Early postoperative rejection crises after transplantation of the kidney from the living related donors]. / Rannie posleoperatsionnye krizy ottorzheniia pri peresadke pochki ot zhivogo rodstvennogo donora.

The frequency of the development of rejection crises in the early postoperative period in 32 recipients of allogeneic kidneys from alive related donors was analysed depending on the histocompatibility according to the antigens of the HLA-AB system and the nature of the immunosuppressant therapy. The results of the analysis showed that the frequency of rejection crises was 100% when the donor and recipient were compatible in 1-2 antigens, and 40% in compatibility according to 3-4 antigens. The incidence of rejection crises was 71.4% among patients who received the standard immunosuppressant therapy (corticosteroids + azathioprine) and 36% among those given also sandimmune. Analysis of the frequency of rejection crises according to the ABO blood group system to which the donor-recipient pair occurred, showed that rejection crises occurred most frequently among patients with A (II) blood group.

[Characteristics of immunologic homeostasis in the late period after reconstructive operations on the heart valves]. / Osobennosti immunnogo gomeostaza v otdalennom periode posle rekonstruktivnykh operatsii na klapanakh serdtsa.

The immune status, i.e. T and B lymphocytes and their populations, was assessed after heart valve replacement or reconstruction in 70 patients with acquired heart defects. In 30%, the immune status was found to be normal which corresponded to inactive rheumatic process in these patients; 40% showed activated immunity manifested by increased T-active, T-total, T-helper, and T-suppressor numbers compared to the first group, which corresponded to activation of a rheumatic process in these patients. The rest 30% patients showed suppressed immunity, i.e. diminished subpopulations of T lymphocytes and B lymphocytes. These changes were detected in patients with circulatory insufficiency and progressive septic endocarditis. This allows for a conclusion that determination of the status of immunity and its correction are essential for cardiac surgery patients.

[Immunological indicators as the criteria of prognosis and treatment of infectious complications in patients operated on for chronic nonspecific diseases of the lungs and pleura]. / Immunologicheskie pokazateli kak kriterii prognoza i lecheniia infektsionnykh oslozhnenii u bol'nykh, operirovannykh po povodu khronicheskikh nespetsificheskikh zabolevanii legkikh i plevry.

A correlation of clinical specific features of the postoperative period and dynamics of immunological indices in patients operated upon for chronic nonspecific diseases of lungs and pleura was established. Pyo-inflammatory complications were three times more often in decreased amount of T-lymphocytes after operation. HBO-therapy has an immunostimulating effect in the form of increased total and active T rosette-forming lymphocytes, causes more rapid elimination of purulent intoxication, purification of the pleural cavity from the purulent discharge and makes the period of treatment at the hospital shorter.

[Acid hydrolase activity of the blood in immunodepression]. / Issledovanie aktivnosti kislykh gidrolaz syvorotki krovi pri immunodepressii.

Immunosuppressants reduce the activity of acid RNase and acid phosphatase in the blood serum of mice and patients with kidney allografts. In reversible graft rejection crises, the activity of both enzymes ascends in the period preceding the crisis or at its height. However, following intensive immunosuppressive therapy it drops again. In irreversible crises, the activity of acid hydrolases goes on ascending in spite of immunosuppression intensification. The time course of the activity of these enzymes correlates with changes in "active" and "total" T-rosette-forming cells.