[The complicated course of an acute inflammatory process: its early diagnosis and the treatment principles].
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Non-specific antitumor resistance levels have been measured by correlation-regression analysis on the basis of 33 parameters in rats with tumors and under the influence of Thio-TEPA treatment, endolymphatic administration included. The study established 16 highly-informative criteria and parameter a, an integral indicator for non-specific antitumor resistance evaluation, which describes the synthetic activity of peripheral blood lymphocytes.
The results of treatment of 25 patients with diffuse peritonitis whom the combined endolymphatic therapy was conducted in postoperative period, including the lymph irradiation with helium-neon laser and direct endolymphatic antibacterial therapy, are presented. Catheter was used introduced in peripheral lymph vessel on the dorsal surface of foot. The decrease of organism intoxication, more rapid than in control, was noted.
The results of the endolymphatic chemotherapy application in patients with metastatic cancer of stomach are presented. The low toxicity and high effectiveness were suggested. One-year survival was achieved in 42.2% of patients.
The experience with the use of endolymphatic therapy (ET) in 110 patients with purulent surgical infection (50--with acute sepsis, 60--with localized infection against the background of diabetes mellitus) has been summarized. In acute sepsis, ET was the basis for the other methods of detoxication, the effect of its isolated use was a short-term one. In local purulent inflammation against the background of diabetes mellitus, the use of ET is highly effective, it can be used in the preoperative preparation of the patients with necrotic lesion of the lower extremities for improvement of the results of operative treatment.
Immunological examination and endolymphatic treatment were performed in 44 patients with cancer of the kidney or urinary bladder. In the majority of patients lymphocytes of the peripheral blood demonstrated reduced expression of some differential antigens. Subpopulation of T-lymphocytes, expression of T-lymphocyte receptors got decreased in almost all the patients. Endolymphatic introduction of immunocorrective thymalin improved the patients' life quality, their immune status. However, the level and proportional expression of differential lymphocyte antigens following course polychemotherapy and immunocorrection in patients do not coincide with relevant parameters of healthy subjects. It is evident that further search for optimal treatment schemes is needed.
The results of treatment of diffuse forms of rectal cancer with the use of a preoperative course of endolymphatic polychemotherapy (fluorouracil and platidiam) and local SHF-hyperthermia are presented. The most pronounced effect of treatment was noted in patients with metastases to the regional lymph nodes. The method suggested is effective in treatment of all the types of adenocarcinoma. All the patients survived for 2 years.
In 59 patients with malignant skin melanoma, the effect of regional endolymphatic therapy on pathomorphosis of lymphogenic metastases and long-term results of treatment was studied. The essential morphologic changes at the sites of melanoma and higher indices of patients' survival in the group studied when compared to the control group have been noted.
The results of treatment of the patients with I-II stage skin melanoma (including 84 with I stage melanoma of skin of the extremities and trunk, 59--with metastases of melanoblastoma to the regional lymph nodes) who underwent endolymphatic chemotherapy in addition to the radical operation are presented. A statistically significant improval of the results was established when compared with those of the surgical treatment.
We studied the efficacy of the intra-lymph nodal injection of the activated carbon particle absorbed mitomycin C (MMC-CH40) for gastric cancer. Ninety-five patients with gastric cancer underwent gastrectomy with D1 or D2 lymph node dissection. Of these, 38 patients were treated with intra-lymph nodal injection of MMC-CH 40 (MMC-CH 40 group). The other 57 patients were classified into the control group. The survival of MMC-CH group was significantly higher than that of the control group using generalized Wilcoxon method. However, since the percentage of stage IV was higher in the control group than in MMC-CH 40 group, the survivals of subgroups of stage I-III were compared. Although the percentage of the early gastric cancer was higher in the control group of stage I-III (n = 35) than in the MMC-CH group of stage I-III (n = 38), the survival curves of MMC-CH group were higher than in the control group. The difference in survival between the two groups was significant at 8 months after surgery. These results indicate that this new therapy improves survival in patients with stage I-III gastric cancer.
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Effect of endolymphatic lymphotropic polychemotherapy on tumor and regional lymphatic nodi was studied in postoperative material of 30 patients with vulval carcinoma. Significant antiblastomatous effect was obtained, tumor impairment index ranging from 68.9 to 79.2%.
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In the gynecological department of Rostov Oncological Institute endolymphatic polychemotherapy with a preliminary determination of tumor sensitivity to chemotherapy was employed in 54 patients with cervical cancer, 3 of them in stage III and IV having contraindications to radiotherapy. A combination of chemical substances and the dosage of single administration were as follows: thio-TEPA--100--150 mg + methotrexate 75--100 mg; thio-TEPA--100--150 mg + 5-fluoruracil--1000 mg; cyclophosphane--2000 mg + methotrexate--75--100 mg; cyclophosphane--1600 mg + methotrexate--75--100 mg + 5-fluoruracil--750 mg. Lymphoinfusion was made in the lower extremity, and after 7--10 days it was repeated in the second one. Visual disappearance of the tumor was noted in 17 patients, lessening of the tumor size by two-thirds--in 16, a 1/2 decrease--in 20. Among 23 patients in stage III after the treatment parametrial infiltrations disappeared entirely in 11 cases and only in pelvic walls--in 12. In 40 cases an extensive extirpation of the uterus with adnexa was performed. In all cases degenerative changes in tumor tissues were observed, whereas in 7 cases no tumor cells were found.
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