Enhanced expression of Duffy antigen in the lungs during suppurative pneumonia.

Duffy antigen is a chemokine binding protein expressed on the surface of erythrocytes and postcapillary venular endothelial cells. It binds selective CXC and CC chemokines with high affinity. Although Duffy antigen is present in the normal pulmonary vascular bed, it is not known whether its expression is altered by innate inflammatory responses in the lungs. We studied Duffy antigen expression by immunohistochemistry in autopsy lung specimens from 16 cases of suppurative pneumonia, 11 cases of acute lung injury, and seven normal lungs. In lungs with suppurative pneumonia, Duffy antigen was expressed in higher numbers of pre- and postcapillary parenchymal vessels compared to normal specimens or specimens with acute lung injury (p<0.03 and p<0.02, respectively). Lungs with suppurative pneumonia also showed Duffy antigen expression on the alveolar septa, whereas this was a rare finding in normal specimens or in acute lung injury (p<0.02). Furthermore, Duffy antigen labeling of the alveolar septa localized to regions with airspace accumulation of neutrophil-rich exudates. In summary, Duffy antigen expression is increased in the vascular beds and alveolar septa of the lung parenchyma during suppurative pneumonia, suggesting that Duffy antigen may have a functional role in the lung parenchyma during inflammation.     

Characteristics of the agents of acute suppurative destruction of the lungs in children]

The authors carried out bacteriological studies of the blood, the pleural cavity puncture material, the discharge from the bronchi in bronchoscopy, and also of smears from the nasopharynx of 40 children with acute purulent destruction of the lungs. Staphylococci, often in association with various Gram-negative bacilli, chiefly of the Pseudomonas genus, and Enterobacteriaceae family, prevailed in the cultures of the pathological material. Pathogenic staphylococcus was found in the nasopharynx of patients in 65% of cases. Along with staphylococci in over half of the patients there were revealed Gram-negative bacteria, and yeast-like Candida fungi. In the majority of patients the microbes isolated from the pharynx and the lungs were identical. In these cases bacteriological examination of pharyngeal smears can serve as an auxiliary method of laboratory diagnosis. The isolated straphylococcus strains possessed the majority of the pathogenicity signs; in the great majority of cases they were resistant to the antibiotics the most widely used in the therapeutic practice; among them strains of phage types 80, 54, 75, 77, and 81 prevailed. Thus, at different periods of the disease various types of the microbes prevailed in the materials obtained from the patients. In acute purulent destruction of the lungs bacteriological examination should be carried in dynamics.     

Mathematical approach to modeling of the treatment of suppurative processes

Consideration of an inflammation focus as an "open system" provided analogy between microbiological processes in inflamed wounds and in systems of continuous cultivation of microorganisms. Mathematical modeling of such systems is widely used. Some of the methods for the mathematical modeling were applied to chemoprophylaxis and chemotherapy of postoperative wounds. In modeling continuous cultivation of microorganisms it is usually necessary to determine optimal conditions for the maximum yield of their biomass. In modeling of wound treatment the aim was to determine the process parameters providing the minimum biomass. The described simple models showed that there could be certain optimal flow rate of the washing fluid in the aspiration-washing procedure for wound treatment at which the drug was not completely washed out while the growth rate of the microbial population was minimal. Such mathematical models were shown valuable in optimizing the use of bactericidal and bacteriostatic antibiotics.     

Clinical effectiveness of carbenicillin in suppurative inflammatory processes of varying localization]

The study on sensitivity of clinical strains of the causative agents of purulent infections to carbenicillin showed that 34.6% of the staphylococcal strains, 48.1% of the E. coli strains and 40.3% of the Proteus strains were sensitive to the antibiotic. The strains of Ps. aeruginosa were characterized by moderate sensitivity to carbenicillin. The MTC for most of the isolates ranged within 25-128 microgram/ml. High therapeutic efficacy of carbenicillin in treatment of cases with purulent inflammatory processes of various localization was shown. Positive results were obtained in 82.5% of the adults and 76.2% of the premature infants treated with carbenicillin. A satisfactory therapeutic effect was observed in the cases with sepsis, diffuse purulent peritonitis and abscessing pneumonia treated with carbenicillin in combination with gentamicin.     

Effect of orotic acid on reparative processes in the lungs following pneumonectomy]

The effect of orotic acid on pulmonary regeneration has been studied in mature rats after left-sided pneumonectomy. A complex morphometric analysis of the pulmonary parenchyma during the process of compensatory-hypertrophic rearrangement has been carried out; mitotic activity of cells in the interalveolar septae, peculiarities of DNA synthesis and those of enzymatic status in lymphocytes of the peripheral blood have been determined. As the investigations have demonstrated, the administration of orotic acid during the postoperative period contributes to a more complete regeneration of the lung volume, alveolar surface, results in formation of new alveoli, prevents the development of morphologic long-term decompensation following pneumonectomy. Activation of the alveolar cells proliferation and increased DNA synthesis are the main stimulating effects of orotic acid. Certain correlative connections are revealed between the course of pulmonary regenerative processes and the enzymic status of circulating lymphocytes.     

The ecological communality of obligate anaerobic and aerobic causative agents of suppurative processes

The composition of aerobic-anaerobic associations in peritonitis and mediastinitis has been found to correspond to the normal microflora of the biotope organ whose lesion leads to the development of the pathological process. As shown with the use of Jacquard's coefficient, in peritonitis the highest degree of ecological similarity is observed among bacteroids and enterobacteria (45.8%) and in mediastinitis and phlegmons, among bacteroids and staphylococci (45.0% and 45.4% respectively). The results of the study of symbiotic relationships among bacteria in the focus of inflammation may be used in the study of the pathogenesis of mixed infections.     

Role of Pseudomonas aeruginosa in the etiology of postoperative suppurative inflammatory complications in patients with chronic suppurative lung diseases

The study of P. aeruginosa strains isolated from patients and various objects of the environment in one of the clinics of Yerevan, carried out by the methods of serotyping, pyocin typing and phage typing, has allowed the authors to establish the circulation of hospital strains and their role in the appearance of post-operative suppurative inflammatory complications in patients with chronic suppurative diseases. The study has also allowed them to reveal the sources of infection which is spread by patients serving either as its reservoirs or as intermediate hosts.     

Radioautographic study of DNA synthesis in bronchoalveolar lavage macrophages during chronic inflammatory processes in the lungs

The cells obtained by broncho-alveolar lavage from patients with chronic pulmonary inflammations were investigated using light and electron microscopy and radioautography. Proliferative activity of lavage alveolar macrophages was studied by 3H-thymidine in vitro incorporation. The labelling index of alveolar macrophages was up to 0.2% in chronic bronchitis and 1.25-3.33% in chronic destructive inflammation. The enhancement of human alveolar macrophage proliferation in chronic pulmonary destructive inflammation is of great importance for the maintenance of the number of mononuclear phagocytes responsible for cellular protection of respiratory lung structures.     

Electron microscopic and radioautographic study of the wall of the large bronchi in chronic inflammatory processes in the lungs

Synthesis of DNA, RNA and protein in the structures of large bronchi in patients with chronic inflammatory processes was studied. It was shown, that nuclei of all cell types of the tegmental bronchial epithelium, capillary endotheliocytes and stromal cells actively included 3H-uridine. By the intensification of bronchial wall sclerosis index and hardness of label with 3H-uridine were reduced in epitheliocytes, endotheliocytes, pericytes, labrocytes, macrophages, but were increased in fibroblasts which also had a high level of 3H-proline inclusion. High index of label with 3H-thymidine was found in basal cells of epithelium and capillary endotheliocytes. In conditions of chronic inflammation of bronchial wall the greatest metabolic and proliferative activity was found in the capillary endotheliocytes and cells of a pericapillary zone. In sclerosis the proliferative activity of basal cells was changed, that predetermined the character of tegmental epithelium reorganization.