[Ultrastructural analysis of the interaction of staphylococci with mono- and polynuclear phagocytes during nonphlogogenic and phlogogenic response].
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Biomedical subjects
Publications and source records attributed to V N Galankin.
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Peritoneum biopsies from patients with various stages of peritonitis were studied electron microscopically. As distinct from the widespread opinion of a significant phagocytic activity of neutrophil leucocytes in early peritonitis this activity was not found. The authors consider this as a cause of peritonitis progression and fatality of the disease in the absence of surgical treatment. Phagocytic activity is restored after the elimination of the causative factors, i.e. after the sanative operation.
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The necessity of distinguishing the compensatory reactions as a special class of phenomena discovered by the author among all protective and adaptive processes is substantiated. The signs distinguishing compensatory reactions from physiological types of adaptation are presented. The rule is established that reflects an inevitable change in the type of live substrate functioning after the physiological regimen is switched to the compensatory one: when structural and functional deficiency develops in a system the principle of its functioning shifts from the balanced form (the function is brought about by a small number of perfectly working elements) to an extensive one (the function is brought about by many elements, each of them working with errors).
On the basis of qualitative and quantitative indexes of the plasmatic-cellular system of neutrophilic leukocyte /NL/ a classification of granulocytic deficiencies /GD/ is developed, 4 forms of GD are distinguished: agranulocytosis, granulocytasthenia, myeloproliferative conditions and inflammatory leukocytosis. As a clinicomorphological criterium of GD a triad is suggested that includes a tissue necrosis, microbism and inflammatory infiltration. Functional failure typical for every form of GD has it sown features.
Due to its cell pool autoturnover, gram-negative intestinal microflora releasing the biologically active agent lipopolysaccharide may cause portal and systemic endotoxemias. Lipopolysaccharide may function in the activation of the polymorphonuclear leukocyte system and in complex antibacterial homeostatic processes, and, in some situations be the initiating factor in the development of various organ pathology, which is mediated by hyperactivated granulocytes.
Light optic and ultrastructural examinations of neutrophilic phagocytosis in patients with phlegmons in test system revealed morphological changes in the cells. The changes were proposed by the authors to be regarded as a criterion for assessing the antibacterial resistance of the body. Moreover, a unique approach was developed to the overall assessment of phagocytic indices, providing characterization of two neutrophilic performance types: balanced and extensive. When neutrophils begin to function extensively, this may be considered as a reflection of their relative functional inadequacy.
56 biopsies of the parietal peritoneum from 28 patients with diffuse purulent peritonitis treated with periodical irrigations of the abdominal cavity. The goal of the study was to determine histological criteria of the peritonitis course in order to establish the earliest time for hermetic closure of the abdominal cavity. It is found that the abdominal cavity irrigations--when the cause of the peritonitis is eliminated--improve the microcirculation, facilitate the development of the granulation tissue, result in the shift of cell reactions; in other words, the reparative-resorptive process dominate the destructive-inflammatory ones. The hermetic closure of the abdominal cavity can be performed without waiting for the complete morphological restoration of the peritoneum; the absence of the mesothelium and the presence of the necrotic foci may not be contraindications. It is sufficient to establish the lack of the progression of the disease (absence of the microcirculation disturbances, the cessation of the polynuclear migration beyond the vascular wall, the appearance of numerous macrophages and granulation tissue. The absence of the complications during 1.5 year allows one to suggest the complete morphological restoration of the peritoneum, after the hermetic closure of the cavity.
The author reviews current notions on the adaptation and disease as reflected in biological and medical literature and discusses the problem of the relationships between these states from a materialistic and dialectic, biological and medical theoretical and practical viewpoints. In the phylogenesis the disease is regarded as a mechanism for elimination of poorly resistant species and does not take root in the gene pool. In the ontogenesis the disease should be set against health, i.e., the adaptation status; the author rejects the concept of the adaptation as the essence of the disease.
Large amounts of lipopolysaccharides released in blood after death of Gram-negative bacteria are responsible for endotoxinemia and endotoxic shock. Endotoxin is eliminated from the body via different routes including the lungs. One of the mechanisms of lipopolysaccharides transport to the lungs, which respond with acute distress syndrome, is their transfer by polymorphonuclear leukocytes.
Phagocytic function of neutrophils is associated with activation of cell membranes. Neutrophil membranous activity is considered for patients with inflammatory and purulent diseases. It appeared not uniform and served the basis for division the neutrophils into three groups. Group I neutrophils are inactive, being not involved in phagocytosis, but bearing bactericidal potential; their membranes are stable. Group II neutrophils show moderate activity, phagocytizing and inactivating bacteria; phagocytosis proceeds without cell destruction. Group III neutrophils cause membranes hyperactivation with resultant dysfunction of phagocytes, phagocytosis involves both bacteria and surrounding protein substrates, immature phagosomes and vacuoles are produced, membranes are unstable. With aggravation of the inflammation and suppuration, the number of blood hyperactivated neutrophils increases.
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The proposed method is said to provide more precise and reliable information about phagocytic properties of PNL at the light-optical and electron-microscopic levels than do the other currently available and widely used techniques.
Phagocytic capacities of segmented and rod neutrophils were examined in in vitro studies of whole blood samples taken at weekly intervals from 32 patients with mild to severe phlegmons of odontogenic origin; 25 blood donors served as controls. The ability of neutrophils to take up and digest bacteria was found to be less marked the more severe the disease although the number of actively phagocytizing cells was increased. In some cases of purulent inflammation, though, the neutrophils showed a higher bactericidal potential as compared to the controls. During recovery, the phagocytic function of neutrophils improved, approaching (but never reaching) the normal level by the time of full clinical recovery. At the light-microscopic level, neutrophils from phlegmon-affected patients displayed cytoplasmic granulation and vacuolation of a degree that correlated with the severity of the disease.
Chronic non-specific pulmonary diseases are frequently followed by the development of inflammatory-degenerative and erosive-ulcerative processes in the mucous membrane of the stomach and duodenum. The literature date are presented on the frequency of combination of these conditions, the attempt is made to assess their link from the viewpoint of pathogenesis. Disturbances of respiratory lung function and hypoxia as well as non-respiratory metabolic functions of the pulmonary tissue are regarded as etiological factors of pathological processes in the gastro-duodenal area.
Peculiarities of interaction between the polynuclear leucocyte (PNL) system and bacterial agents are considered within the framework of four typical clinico-biological situations: interaction of a primarily genetically deficient PNL system with a bacterial agent; interaction of a secondarily affected by various diseases and traumas PNL system with a bacterial agent; interaction of an unaltered PNL system with a bacterial agent of an extreme intensity; interaction of an unaltered PNL system with an ordinary bacterial agent. In the first three situations characterized by a purulent inflammatory-infectious process, current methods of investigation detect some disturbances of PNL function reflecting their functional insufficiency. In the fourth situation the functional sufficiency (but not inactivity) of the PNL system determines the state of clinical health. Obviously, regardless of the functional insufficiency, whether absolute or relative, it results in an inflammatory-infectious process.
The problems concerning the wound healing by first intention and by second intention are discussed, on the instance of the wounds caused by a carbon dioxide laser. The authors claim that the cell system responsible for the resorption of necrotic tissues in the absence of purulent processes, i.e. absence of polynuclear leukocytes, is the system of mono- and multinuclear macrophages. The phase of leukocytic lysis of the necrotic tissues may be lacking during healing.