[A comprehensive approach to the analysis of cytoimmunological indices in patients with viral hepatitis A and B].
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Biomedical subjects
Publications and source records attributed to N E Monogarova.
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Anti-DNA antibody titers are elevated in the patients with purulent diseases of the lungs and antibodies to nDNA appear that are undetectable in normal subjects. These data correlate with the inflammatory process activity in the lungs, with the diameter of the decayed cavity, disease duration, and efficacy of therapy. Dynamic titration of antibodies to DNA (particularly nDNA) over the course of the disease appears to be an important prognostic test reflecting the stability of autoimmune impairments and the efficacy of the therapeutic scheme used in the treatment of patients with purulent diseases of the lungs.
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Case records have been analyzed for 92 patients with primary cancer of the liver. The discrepancies between the clinical and postmortem diagnosis reached 31%. It appeared that the exact diagnosis depended on valid evaluation of the disease history, clinical signs and findings at special examinations rather than on the number of investigations. Associated liver cirrhosis recorded in 24% of cases put another obstacle for a precise vital diagnosis. The study has furnished evidence for a judgment on the incidence of hepatic cancer, concomitant cirrhosis, possible etiologic factors, the state of clinical diagnosis and causes of death.
Follow-up of 114 patients with bronchiectasis has demonstrated that immunomodulation agents levamisole and splenin included in combined treatment augment their therapeutic effect and normalize the immune status of patients. This is manifested by normalization of the amount and functional activity to T-lymphocytes, the content of IgG, IgM and IgA and the autoimmune shifts. A favourable effect was encountered significantly more often than that in patient who were treated by the traditional methods without the use of the immunomodulation agents and in those who were given only levamisole and splenin together with anti-bacterial and hygienic therapy.
A study of the immunological status in 52 patients with acute and 20 patients with chronic abscesses of the lungs, 86 patients with viral hepatitis revealed disorders of the immunological reactivity of a quantitative character with monotypic immune response. In autoimmune disorders it is necessary to carry out immunocorrection. In chronic forms immunocorrection should be considered the main treatment method.
A study of 156 patients admitted to the clinic with the diagnosis of "fever of unclear genesis" indicates that the most frequent cause of this condition are pathological processes in the abdominal and retroperitoneal space, renal diseases, patients with bacterial endocarditis and connective tissue diseases. Detailed clinical analysis makes it possible mostly to establish a correct diagnosis at early terms of the disease.
The authors examined 68 patients with cholelithiasis complicated by mechanical jaundice. The clinical course of the disease, functional and morphological changes of the liver were elucidated. Different hepatic functions were involved: the protein-forming, pigmentary, enzymatic, etc. Morphological changes of the liver revealed severe dystrophic changes in the liver parenchyma including necrosis of some parts the liver. The employed complex of therapeutic measures allowed to carry out operative interventions in more favourable conditions that reduced the number of postoperative complications.
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Patients with acute lung abscesses and bronchiectatic diseases manifested deep changes in the immune responsiveness, which were largely of compensatory (elevation of IgA content to over 2 mg/ml), immunosuppressive (decrease of lymphocyte blast transformation with PHA down to 52.2 and 48.6%) or autoimmune (increase of spontaneous lymphocyte blast transformation up to 8%) character. In patients with acute lung abscesses, the indicators enumerated tended during treatment toward normalization which was not over in the majority of them by the discharge from hospital. In patients with bronchiectatic disease, that tendency was observable only after additional treatment with immunocorrective drugs (levamisole, splenin).
Ultrasonic histogramme was studied in 35 patients with chronic pancreatitis and 20 donors, taken in the area of the head and body of the pancreas, as were levels of immunoreactive trypsin--fasting and after standard food load,--and C-peptide in blood serum on an empty stomach. To increase informative value and specificity of ultrasonic and radioimmunologic investigations an index has been suggested, based on the findings from histogramme and radioimmunity analysis.
As many as 12 patients with pseudotumorous chronic pancreatitis have been examined. While studying the functional state of the pancreas a conclusion was reached about a decrease in the organ's exocrine activity, with the hormone output remaining unaffected. Particular features of the immunity status in the patients are outlined. It is recommended that dynamic ultrasonic investigation and computerized tomography to the abdominal cavity and retroperitoneal space, transcutaneous puncture biopsy of the pancreas, should be used for the differential diagnosis with carcinoma of the organ to be made possible.
The authors theoretically explain the elevation of blood plasma levels of soluble fibrin monomer complexes occurring in elevated trypsin concentrations in the blood. Examinations of 50 patients with chronic relapsing pancreatitis and of 20 donors demonstrated a marked correlation between the levels of immunoreactive trypsin and soluble fibrin-monomer complexes in the blood. The authors recommend measurements of blood soluble fibrin-monomer complexes for the diagnosis of exacerbations of chronic relapsing pancreatitis.
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