[Immunological aspects in the treatment of malignant melanoma].
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Sequential events during lymphocyte emigration from high endothelial venuses (HEV) were studied by scanning and transmission electron microscopy combined with regional perfusion techniques. The results indicate that blood lymphocytes selectively adhere to HEV surfaces through microvilli which attach to shallow pits on the luminal surfaces of high endothelial cells. These intercellular contact points resist hydrodynamic and osmotic shearing forces, but can be disrupted by treatments which remove endothelial glycocalyx, hydrolyse lymphocyte surface glycoproteins, or chelate divalent cations. After this initial attachment phase, lymphocytes enter apical clefts between endothelial cells where they assume a motile configuration characterized by loss of microvilli and formation of irregular surface folds. Intramural lymphocytes adhere to adjacent endothelial cells through macular and villous contacts. Fibrillar electron-dense material traverses the 15-20 nm gap at these points of adhesion. Microtubules and microfilaments are also seen around areas of cytoplasmic constriction in these motile lymphocytes. The migrating lymphocytes show cytoplasmic polarity which is oriented in the direction of movement as they pass through extracellular spaces in the venular wall and cross successive laminations in the perivascular sheath to enter the node. Since these lymphocytes enter channels between endothelial cells which are stained by intralymphatic injections with horseradish peroxidase, it is suggested that their entry into the node depends upon migration along a chemotactic gradient.
Clinical examination of 34 patients showed that lymphotropic administration of antibiotics creates concentrations in organs and tissues involved in the inflammatory process in acute cholecystitis which are 1.63-14.95 times higher than those produced by intramuscular injection. Study of the course of the clinical picture of the disease in 122 patients with acute destructive cholecystitis revealed the high efficacy of this method of antibiotic therapy: the laboratory indices of the inflammation became normal within a shorter period of time, the inflammatory process in the gallbladder was arrested more rapidly, the number of postoperative complications fell 2.6 times, and the terms of hospital-stay of the patients reduced by 1.3 times. Lymphotropic antibiotic therapy is more pathogenetic in the management of acute destructive cholecystitis.
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This study compares the effectiveness of various routes of administration of Bacillus Calmette-Guerin (BCG) utilizing the New Zealand white (NZW) rabbit V2 carcinoma model. The routes compared were intratumor, intravenous, scarification, subcutaneous, and intralymphatic. Primary tumor regression, disease-free interval, and survival were measured. The disease-free interval and survival for the intralymphatic group were significantly longer (p less than 0.05) than all groups except the scarification group. That group had a prolonged survival as compared with all groups except the intralymphatic group. The intralymphatic route of administration was the most effective method in causing local tumor regression and curtailing metastasis. This study clearly demonstrates that the intralymphatic route requires further mechanistic studies and clinical investigation as a means for delivering biological response modifiers.
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It was shown that intralymphatic+ inguinal administration of gentamicin provided its high concentrations in central lymph, blood and ++para-aortic lymph nodes and increased the antibiotic levels in the abdominal organs 2.33 to 6.66 times as compared with its intramuscular administration while lymphotropic retroperitoneal administration of gentamicin provided more prolonged maintenance of the antibiotic therapeutic concentrations in lymph of the thoracic lymphatic duct, central blood, ++para-aortic lymph nodes and the abdominal organs in comparison to its intramuscular administration. Intralymphatic+ inguinal administration of drugs providing the highest concentrations in all the organs of the abdominal cavity and the ways of the infection penetration is useful in therapy of severe inflammatory diseases of the abdominal organs inclined to generalization and lymphotropic retroperitoneal administration of drugs is useful in therapy of less severe purulent inflammatory processes in the abdominal cavity.
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Lesions histologically similar to those of natural caseous lymphadenitis developed in sheep popliteal lymph nodes following injection of viable Corynebacterium ovis cells into afferent lymphatic ducts. Histopathological examination of affected lymph nodes suggested that exotoxin might be involved in the establishment, progressive development and persistence of caseous lymphadenitis lesions through localised cytotoxicity.
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