[Detoxification lymphorrhea and lymphosorption in the combined treatment of patients with endogenous intoxication].
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Clinical and morphological features of urinary bladder transitional carcinoma pathomorphosis after regional endolymphic polychemotherapy were studied to estimate the criteria of treatment efficiency and prognosis. Quantitative assessment of chemosensitive and chemoresistant tumours is given. The degree of cataplasia, growth character, the amount of stroma, blood supply and intensity of mononuclear infiltration predetermine the stage of pathomorphosis, efficiency of bladder cancer treatment. Studies of stromal immunomorphology, features of blood supply, mechanisms of neoplastic angiogenesis provide better understanding of biological nature of tumours, improve prognosis and choice of treatment.
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Under study were results of clinical, immunological and bacteriological examinations of 130 patients with acute abscesses of the lungs. The complex treatment included antibacterial therapy taking into account the antibiotic sensitivity of the microflora, correction of disturbances of the protein and water-salt metabolism, desintoxication measures, immunotherapy and sanitation of purulent cavities and the tracheobronchial tree.
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Seven patients suffering from advanced metastatic tumours, unresponsive to standard therapies, were treated with 3 to 5 intra-lymphatic injections of interleukin-2 (IL-2) and IL-2-activated-peripheral blood lymphocytes (PBL). A partial (50-70%) regression was obtained in three of the patients, and complete regression in the other four. It thus seems that intra-lymphatic injections of IL-2 and PBL can be used for the treatment of certain solid tumours (e.g., hypernephroma, adenocarcinoma, seminoma, epidermoid carcinoma) without noticeable side effects. This method could advantageously replace intravenous IL-2 administration and warrants further investigation.
A case of vulva cancer responding to the recombinant human tumor necrosis factor (rHu-TNF: PT-050), which had been administered to double inguinal lymph nodes, is herein reported. A 60-year-old female underwent resection of a vulva cancer following a diagnosis of condyloma acuminatum. After surgery, however, exacerbation of a residual tumor, sited on the right of the vulva, and metastasis of the double inguinal lymph nodes were uncovered. For treatment, rHu-TNF was injected in the inguinal lymph nodes at a dose of 1 x 10(6)U per injection, 2 times a week. After 8 therapeutic sessions for 4 weeks, a marked response was observed not only in swelling of the lymph nodes, into which rHu-TNF had been injected, but also in the tumor of primary focus, which received no injections. On the 32 nd day after the final injection of rHu-TNF, the tumor of primary focus completely disappeared and the swelling of lymph nodes had diminished to 25% of the initial volume.
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A lymphographic technique via direct injection into superficial inguinal lymphnodes is described which has proved useful in infants.
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Ninety eight patients with cervical cancer were subjected to endolymphatic chemotherapy with multiple cytostatic drugs to affect metastatic lymph nodes. A comcentrated mixture of chemotherapeutic drugs (total amount about 20 ml) was injected into plantar lymph vessels, an interval being 10-14 days. The combinations and dosage of the drugs were as follows: thio-TEPA (100-150 mg) or cyclophosphamid (1000-2000 mg)+methotrexate (100 mg)+5-fluorouracil (1000-1500 mg). Subsequently, 76 patients underwent an extended extirpation of the uterus with adnexa, and their lymph-nodes were studied morphologically. It was found that the number of metastases into the lymphnodes was considerably less than it had been expected. Of 45 patients with the disease stage II metastases have been found only in 3 cases (7%). Of 24 patients with cancer stage III the lymphnodes were involved in 4 cases (16.6%). According to the literature data metastatic involvement of the lymphnodes is on an average encountered in 36% for stage II and in 51% - for stage III.
Experiments on rats demonstrated that endolymphatic administration of high doses of cyclophosphane and degranol produces prolonged but reversible decrease of relative content of T- and B-lymphocytes both in the regional and remote lymph nodes. In early periods after lymphatic infusion there was observed the predominant action of degranol on T-lymphocytes and that of cyclophosphane on B-lymphocytes. Differences in the character of changes in primary immune response magnitude after administration of the drugs are related probably to their diverse effects on different subpopulations of lymphocytes.