Search

The causes of lethal outcomes (n = 60) and postoperative complications which occurred in 26.1% of 610 patients operated on for lung cancer were investigated with due consideration for the regularities of thermodynamics of nonequilibrium processes and theory of disasters. A total systems pathological inflammatory reaction, which augments the injury by many times and develops as a result of inadequate anesthesiological protection, underlies the development of the most unfavorable variant of response to surgery leading to life-threatening complications, such as pneumonia, thromboembolism, or ulcerative hemorrhages.

Molecular, biological, and immunological studies on the recently identified human herpesvirus-6 (HHV-6) suggest that the virus is involved in the etiology of at least several lymphoproliferative diseases. Furthermore, HHV-6 may be an important cofactor in the pathogenesis of several other diseases, including cervical carcinoma, oral carcinoma, multiple sclerosis, and HIV infection. Analyzing the data available in the literature shows it necessary to conduct systematic investigations and to emphasize the importance of the problem for national public health.

The authors provide x-ray and postmortem examination data on pulmonary lesions in 36 patients with acute leukemia. Morphological lesions revealed in 80% of the examinees were as follows: hemorrhage, leukemic pneumonitis, secondary pneumonia (64%, 25% and 17% of case, respectively). The risk factors comprise severe and long-term thrombocytopenia, leukocytosis, long-term post-cytostatic agranulocytosis. It is stated that frequent pulmonary involvement in acute leukemia and the absence of specific clinicoroentgenological picture of pneumopathy often result in misdiagnosis. Wider use of fibrobronchoscopy with bronchoalveolar lavage examination and transbronchial pulmonary biopsy is recommended to advance the diagnosis and treatment of pulmonary lesions in acute leukemia.

The difficulties in performing the clinico-anatomical analysis of fatal outcomes and establishing the direct causes of death are discussed. It is suggested the automatic monitoring of basic physiologic indices with an obligatory magnetic registration of heart rate respiratory movements and encephalogram should be introduced into the practice of the surgical departments and departments of intensive therapy. This system should be implemented when the operation started, when the patient is in the critical condition, terminal state and resuscitation.

The pattern of immediate causes of death and types of terminal states (mechanisms of death) has been examined on the basis of thanatological analysis of 190 deaths occurred after operations on the heart (valve prosthesis) and lung (pneumonectomy). The differences in the thanatological profile of the respective surgical units are shown. Ways for reducing postoperative death in cardiopulmonary surgery are discussed.

Neuronal responses of area 7 of the parietal associative cortex (PAC) to paired stimulation of the nLD and nLP thalamic nuclei were investigated by extra- and intracellular recording methods. It was found out that testing stimulation of the associative nuclei resulted in inhibition, facilitation or absence of clear neuronal responses. Inhibition was observed more often then other types of reactions. The intracellular recording has shown that inhibition of responses to testing stimuli developed during the initial phase of IPSP, while in the repolarization phase a facilitation was possible. The reversion of a Cl- -dependent component of IPSP did not lead to inhibition of responses to the testing stimulation in that period. It is suggested that inhibition of responses to the testing stimulus occurs in the presence of inward Cl- -dependent current, while facilitation of responses may be a result of activation of the late EPSPs.

The study of the effect of sodium mefenaminate on radiation resistance of rats yielded positive results. Clinical investigations showed mefenamic acid to decrease the activity of cathepsin D-like protease in colonic cancer tissue. The acid failed to affect the proteolytic activity of the normal mucosa. It revealed an immunomodulating activity and influenced the hemostatic system which usually manifested itself in amelioration of hypercoagulation.

The problem of hyperglycemia in patients treated in posttraumatic or postoperative period with concentrated glucose solutions is discussed. It has been shown that hyperglycemias in terminal patients is commonly due to deteriorated glucose assimilation. The data of postmortem serum biochemical analysis are of great importance in the investigation of the nature of hyperglycemia.

Immunization of BALB/c mice with natural purified HIV antigen, fusion of spleen cells with myeloma cells and subsequent selection of hybrid clones using recombinant gag antigen of HIV gave hybridomas producing monoclonal antibodies (MCA) to HIV. The immune blotting method demonstrated that 3 clones interacted with protein p24 and 4 clones with protein p17 of HIV. Competitive EIA led to a conclusion that the resulting MCA detected at least 3 antigenic determinants in proteins, products of gag gene of HIV. The potentials of using these MCA for the detection of viral antigen in HIV-infected continuous cell lines were demonstrated.

The author discusses the structure of complications and the immediate causes of death in 129 individuals after surgical interventions on the lungs in 1948-1952 (45 persons) and in 1984-1989 (84 persons). The revealed growth of the incidence of thromboembolism of the pulmonary arteries as a complication and the immediate cause of death of patients who underwent operation for carcinoma is probably linked, on the one hand, with increased survival after the operation and, on the other, with the severity and injurious character of the extended operative interventions. Some differences and similarities were established in the character and incidence of postoperative complications and the immediate causes of death in lobectomy and pneumonectomy. It is shown that despite the extended character of the operations for lung carcinoma they proved to be nonradical in 11% of cases, while distant metastases which were unrecognized during life were discovered on autopsy in 20% of cases.

Postmortem clinical and anatomic lung examinations in patients dead of blood loss and the experiments on animals have shown that pathological changes underlying acute pulmonary failure are to a great extent due to disorders in pulmonary hemodynamics associated with the spasm in the arterial and venous vascular bed of the respiratory zone. Durable spasm of pulmonary veins promotes to hydrostatic pressure elevation and the onset of pulmonary edema even after blood loss replacement. Massive infusion-transfusion therapy performed in pulmonary hemodynamic disorders may aggravate pulmonary edema and lead to the onset of acute pulmonary failure.

Responses of the parietal association cortex neurons to stimulation of lateralis dorsalis (LD) and lateralis posterior (LP) thalamic nuclei were investigated. Primary IPSP were observed in 62.5% of cases after stimulation of LD and in 79.6% of cases after LP stimulation. Latent periods of EPSP and IPSP were longer in case of LD stimulation rather than after LP stimulation. EPSP amplitude to association nuclei stimulation increased and decreased gradually, while amplitude of IPSP increased quickly and decreased slowly. Amplitude of EPSP which has appeared during IPSP development was larger than in case of the resting potential. Amplitude and duration of EPSP of the certain neuron after stimulation of different nuclei were rather similar. It is supposed that with stimulation of different association nuclei the same cortical inhibitory interneurons are involved. IPSP duration is shorter as compared to inhibition of the background impulse activity. A supposition is advanced that such a difference in duration is determined primarily by properties of these neurons.

The results of clinical and anatomical studies of acute respiratory insufficiency in patients suffering from hypotensive reactions caused by blood loss, shock, fat and thromboembolism and by acute left ventricular insufficiency are discussed. The role of impaired pulmonary circulation due to general circulatory disturbances in the development of acute respiratory insufficiency and the role of this syndrome in the onset of bilateral polysegment pneumonia after trauma and surgery are demonstrated. Acute diffuse alveolitis, interstitial intraalveolar edema, with the formation of hyalin membranes, atelectasis and emphysema are the main morphological signs of acute respiratory insufficiency. Massive infusion-transfusion therapy may aggravate acute respiratory insufficiency.

Studies on the antagonists of interferon effect ("stimulon", "TAI", "blocker", "antiinterferon") formed under the influence of viruses and mitogens as well as those found in noninfected tissues deal largely with their blocking effect on the antiviral activity of interferon. Previously we had found an inhibitor of antiviral effect in preparations of human cadaverous and swine leukocyte interferons. This paper presents the results of studies on some physico-chemical properties of an inhibitor of the effect of swine leukocyte interferon and its antiproliferative activity. The inhibitor is resistant to the effect of nucleases and lyophilization, manifests limited heterospecificity towards interferons and cell cultures, has marked antiproliferative activity in different cell cultures including those of tumor origin.

The effect of human leukocyte interferon (HLI) on three human cell cultures of different origin was studied. HLI inhibited the mitotic activity (MA) of human ovary carcinoma cell culture and to a lower extent that of a diploid cell culture. At the same time HLI preparation exerted a nonspecific stimulating effect on MA of the primary human embryo cell culture. The optimal conditions for the determination of the antimitotic effect of interferon on cells of tumor origin include: a seed dose of 5 X 10(4) cells/ml, addition of interferon to the culture 24 hours after cell seeding; the maximum effect of interferon is observed at 24 hours after addition to the culture.

The effect of homological and heterological (mice, pigs) interferon on cell cycle kinetics of human lymphoma cell in cultures (lines Molt-4, P3HRj, Namalva, Raji) was studied by the cytofluorimetric method. Different cell populations demonstrated unequal sensitivity to the antiproliferative interferon action. In sensitive cell populations (lines Molt-4, P3HRJ) nonspecific changes were revealed in the cell cycle kinetics. The action of the homological and heterological interferon on the investigated tumour cells was nearly the same.

Investigations of the antiviral and antiproliferative activities of human alpha and beta interferons were carried out in homologous and heterologous cell cultures (EBTr and TR - human embryo trachea cells). Both interferons were shown to inhibit the cytopathic effect of vesicular stomatitis virus and incorporation of 3H-thymidine in homologous cells. In heterologous cells of bovine embryo trachea the antiviral and antiproliferative effect was observed only with human alpha interferon.

Morphological studies of the thymus and the spleen were made in 54 alcohol addicts and 53 cases of other death cause at the age from 25 to 65 yr. Alcoholism was found to induce the reduction in thymus size and the number of its lobes with a simultaneous decrease of lymphocyte content in them; in the lymphatic follicles of the spleen (in the presence of infectious processes) absence of bright multiplication centres and alkaline phosphatase activity in their mantle zone cells was noted. There appeared to be a statistically significant difference in the amount of the parenchyma in the thymus of alcoholics (p less than 0.017) compared to that of the control group 0.68 +/- 0.09 g and 1.33 +/- 0.21 g, respectively and this figure was almost 4-fold less, than the average age norms, 0.26 +/- 0.03 g; the quantitative content of the splenic pulp in alcoholics also had a statistically significant difference compared to the control group (P less than 0.001), 6.37 +/- 0.66 g vs. 12.59 +/- 0.98 g, respectively. The data obtained indicate the development of immunodeficiency states in alcoholism and basing on the changes occurring in the thymus and spleen they can be referred to a combined T- and B-cell form of immunodeficiency.

The action of homological and heterological (pig) leukocytic interferon on cell cycle kinetics of cultivated human tumour cells (lines HeLa, CaOv) and diploid strain was studied by flow cytofluorimetry. The cells of HeLa line and dFch strain demonstrated low sensitivity to interferon administration. The cells of interferon-sensitive line CaOv reacted by the change in cell cycle kinetics (arrest in G2/M). The action of heterological interferon on sensitive cells was similar to that of homological one.

A comparative study of homologous (human) and heterologous (porcine and bovine) leukocyte interferon preparations showed them to have antiviral and antiproliferative effects on CaOv tumor cells culture derived from human ovary carcinoma. These effects were lower in heterologous than in homologous interferon preparations.

The effect of the preparations of human leucocytic interferon (HLI) of various purity levels and of various concentrations was studied with respect to the natural killer activity of human leucocytes. It was shown that the process of purification and concentration of the preparation of HLI with the Kantel method entailed a disproportionally high loss of the activity stimulating the natural killer cells as compared to the antiviral activity.

The expression of the artificial gene for the human leukocyte interferon (IFN) synthesized by the chemo-enzymic method has been studied in Escherichia coli cells. The genetic constructions in which the IFN gene transcription is carried out from A2 and B promoters of T7 phage or from E. coli lacZ UV5 gene promoter have been obtained, based on pEMB101 plasmid. In addition, the level of interferon production, depending on the promoter used, has been studied. It has been shown that the tandemly located promoters increase efficiency of the IFN gene expression.

The transition of trauma disease to the premortal period represents a qualitative leap of changing pathogenesis into thanatogenesis. Practically it means the appearance of such a condition of the patient which requires urgent measures of treatment directed to the correction of life-threatening alterations of homeostasis. The determination of some pathological process in the clinical picture of trauma disease as a possible direct cause of death presupposes the following prognosis of the type of the terminal condition, mechanism of death with the resulting conclusions concerning organization of curative measures.

Interferon-inducing and antiviral effects of natural dsRNA preparations of phage phi 6 and yeast cells were studied in the culture of murine cells L-929 and on random bred albino mice. Both the preparations showed interferon inducing activity in the cell culture. However, for realization of their effect modification of the surface cell membrane by polycation exchange resin (DEAE-dextran) was required. The interferon-inducing activity of both of the natural dsRNA in the mice was high. The maximum interferon titers (1280-5120 units/ml) in blood serum were observed 4-6 hours after the inductor intraperitoneal administration. The interferon-inducing activity of the phage dsRNA was high in the cell culture and yeast dsRNA--in mice, respectively. Both the inductors had antiviral activity and protected 15 to 38.9 per cent of the experimental animals from the effect of 100 LD50 of the murine encephalomyocarditis virus and 10 LD50 of the influenza virus A/Aichi 2/68 (H3N2).