Based on light and electronic microscopic examination of bronchial wall biopsy species the principal pathological features of chronic bronchitis and bronchial asthma were defined. Apart from typical catarrhal changes and the ciliary cell substitution for the goblet cells, the hyperplasia of the latter ones and hypersecretion they were as follows: an occurrence of immune inflammation signs with considerable cell infiltration of the bronchial wall by eosinophilic leukocytes and degranulated mast cells and concentration of active plasma cells. Moreover, there was significant sedimentation of structured fibrin with a character striation inside the bronchi.

Aiming to estimate smoking behavior and nicotine addiction in smokers with chronic obstructive pulmonary disease (COPD) compared with smokers not having COPD symptoms, 166 COPD patients were examined comprising 146 smokers (aged 20-55 yrs) and 115 smokers without COPD as a control group. They were experienced to the Fagerstrom test, a motivation to quit test, ventilation and exhaled carbon monoxide assessment. Nicotine dependence in the smoking COPD patients was different from that in the persons without COPD. It also differed in various COPD severity. The motivation to quit was maximal in COPD stage II. The exhaled carbon monoxide should be implemented to verify the nicotine dependence.

To investigate cold airway reactivity we observed 88 patients with chronic bronchitis. The cold airway hyperreactivity revealed by cold isocapnic hyperventilation was established to take place in one third of the patients and was represented by a set of clinical symptoms. The severity of subsequent bronchial constriction depended on an initial airway patency, a level of ventilation and the temperature fall during the cold provocation.

The respiratory function was studied in 157 patients with chronic pulmonary diseases who were inhabitants of the Extreme North settlements, exposed to outbreaks from Norilsk mining and smelting industry complex. We have found a reverse correlation between the patients’ flow-volume curve parameters and copper and nickel blood concentration. We have revealed some peculiarities of the respiratory function in patients with chronic obstructive bronchitis and bronchial asthma under the combined influence of extreme conditions of the North and severe environmental pollution in inhabited area of Taymir autonomous district.

Cytological and oxidant features of bronchial inflammation were investigated in 155 patients with severe obstructive pulmonary pathologies. The cytooxidative peculiarities of the bronchial inflammation found in the patients with different severe obstructive lung disorders can be applied as additional diagnostic markers. A differentiated approach to detection and treatment of severe bronchial asthma and severe chronic obstructive bronchitis considering the cytooxidative inflammatory features in bronchi allows control an exacerbation for the shortest period of time, optimizing the basic therapy, to reduce a cost of the treatment and to treat more patients need specialized pulmonologic care.

An algorithm of functional diagnosis is based on characteristic features of respiratory and cardiovascular changes in 1102 patients with combination of COPD and IHD observed for long time (4 to 20 yrs). The mean age of the patients was 66.0±6.4 yrs. Majority of them (881 persons, or 73.6%) were males. A regularity and a specificity of respiratory function changes revealed were provided by an analysis of more than 25,000 lung function test results. To examine the cardiovascular pathology monitoring of electrocardiogram, aerobic capacity of the patients using ergospirometry and haemodynamic parameters using ultrasound methods was done. Intricate persistent interrelated functional cardiorespiratory disorders were found which should be considered in the algorithm of the functional diagnosis proposed by the authors and including respiratory and haemodynamic parameters as well.

The study was designed to investigate a role of nitric oxide, α₁-acidic glycoprotein (AAGP), and tumor necrotic factor (TNF) for inflammatory response in bronchial asthma (BA) and chronic obstructive bronchitis (COB) with biochemical testing of induced sputum (IS). The study material was IS supernatant. The search of IS biochemical markers showed their different concentration in BA and COB patients dependent on the diseases stage and therapy. The IS biochemical analysis can be applied to monitor the inflammatory activity in the airways in BA and COB and the efficacy of the treatment as well.

The objective was to describe early symptoms of pulmonary tubeculosis (T) when the chest radiograph (CXR) is normal.
Seventy patients with culture-positive pulmonary T and normal CXR were selected from a review of 377 consecutive patients with smear- or culture-positive pulmonary T in Babol (Iran) in 1994-2000. Patients with abnormal CXR at the time of the diagnosis were excluded from the analysis.
Sixty-eight of the 70 patients (98%) were symptomatic at the time of the diagnosis with cough and sputum production being reported most commonly (97%). Two patients were examined due to contact tracing of a case of infectious pulmonary T, while other 68 patients were tested because of symptoms presence. Sixtyeight patients (97%) had cough longer that 1 month, sputum production was in 63 patients (90%), fever for more than 1 week was in 18 patients (25%), haemoptysis was in 28 patients (40%), weight loss was in 21 patients (30%), hoarseness was in 1 patient (1,4%), dyspnea was in 5 patients (7%). The sputum smears of 5 patients (7 % ) were positive. No-one of patients had underlying diseases. Fifty-six patients (80%) had positive Mantoux skin test. The incidence of culture-positive pulmonary T with a normal chest radiograph was less than 1% in the period from 1988 to 1989 and steadily increased to 10% in the period from 1996 to 1997.
The culture-positive pulmonary T with abnormal CXR is not uncommon and the incidence of such presentation is increasing. Patients with this presentation of T are typically symptomatic and/or are detected by contact tracing of infectious pulmonary T cases. The results suggest that patients presenting cough for more than 1 month, a fever longer than 1 week or documented weight loss after known exposure to infectious T should undergo sputum examination for a mycobacterium tuberculosis despite a normal CXR.

A 47-year-old man was diagnosed a Lofgren's syndrome and corticosteroid therapy was started. On the seventh month of the therapy a pleural effusion developed. Although no definite diagnosis was made, anti tuberculous therapy was started empirically. Three weeks later mycobacterium growth was detected on Lowenstein-Jensen culture. The patient recovered almost completely in 2 months of the anti-tuberculous therapy. In a well controlled sarcoidosis patient who presents pleural effusion, if other causes are excluded, it would be wise to start anti-tuberculous therapy since sarcoid pleural effusion is a rare form of the disease which accompanies advanced disease and since corticosteroid therapy renders patients susceptible to tuberculosis.

The study was aimed to define criteria for early-stage diagnosis of idiopathic pulmonary fibrosis (IPF) and detection of pulmonary fibrosis at its advanced stage based on high resolution computed tomography data. Results of CT examination of 36 patients with histologically verified IPF were showed. The presence, type, extension and spread of CT characteristic signs of IPF at its various stages were analyzed. The thickening of the interlobular walls and ground glass attenuation were noted in 100% of the patients with early stage of the disease, even thickening of large bronchi walls and dilation of vascular shadows were in 44%. The fibrous stage was presented with features of the lung tissue disorganization, such as focal increased density of the lung parenchyma (41%), linear and/or reticular opacities (70%), air-filled cysts 2 to 20 mm in a diameter (77%), bronchiolectasis (44%), traction bronchiectasis (26%). All the changes were diffuse with prevalent location at subpleural medium and lower lung fields.
Thus, HRCT features of early and advanced IPF allow radiological and morphological correlations to discover regularities and occurring pathological disorders in the lung interstitial tissue.

Thirty patients with low and moderate differentiated squamous-cell lung cancer were examined to investigate expression of cancer-associated proteins. The methods of polymerase chain reaction and immunohistochemistry were used. Epstein-Barr virus antigen and expression of mutant p53 protein were found in the tumor cells of the lung cancer patients. The obtained data of the character of molecular genetic disorders will entail early diagnosis, a choice of anti-tumor agents and their combination for an individual therapy of each patient.

Paraneoplastic (onconeural) antigens involve normal high-specific for the nervous system proteins which could be also expressed by tumor cells outside the nervous system. While entering the blood vessels paraneoplastic antigens initiate an autoimmune process resulted in production of autoantibodies which evoke paraneoplastic neurological syndrome occurrence. One of the paraneoplastic antigens — Ca²⁺-binding protein recoverin — can be expressed by some tumors' cells and induce autoimmune injury of the retina. We compared ELISA and immunoblotting methods to detect autoantibodies against recoverin in sera of lung cancer patients and demonstrated the ELISA to be non-specific whereas the immunoblotting is quite sensitive and specific for serial analysis of sera of lung cancer patients to detect the anti-recoverin autoantibodies.

The aim of this study was to evaluate safety and efficacy of salbutamol, fenoterol and ipratropium bromide in patients with bronchial asthma (BA) associated with ischaemic heart disease (IHD). One hundred and twenty five patients with exacerbation of moderate to severe BA entered the study. Sixty four of them were diagnosed associated IHD (angina pectoris of II to III functional class and postinfarct cardiosclerosis). All the patients were divided into 4 group, receiving fenoterol, salbutamol, ipratropium bromide and Berodual correspondingly as via dosing aerosol and nebulizer. The bronchodilating effect of the drugs was assessed using peakflowmeter. Moreover, oxygen saturation, arterial blood pressure were measured and 24-hour ECG Holter monitoring was performed. As a result, nebulized therapy with short-acting β₂-agonists gave a significant bronchodilating effect and did not cause considerable hemodynamic disorders and myocardial ischaemia. When using high doses of these drugs in patients with BA and associated IHD the efficacy/safety ratio decreased due to possible hemodynamic disturbances, hypoxemia and myocardial ischaemia induction. The alternative bronchodilator to control the bronchoobstructive syndrome in such patients is to be ipratropium bromide.

The results of the immunological examination of 126 people working in the conditions of the constant influence of dioxines and related compounds are cited in the article. Cellular and serum-transferable immunity were assessed with the methods of enzymoimmunoassay and laser flow cytometry. It was determined that firstly the macrophage-neutrophil system is drawn in the process of the rendering harmless of the dioxines. However, all-resorptive action of dioxines brings to the exhaustion of the functional possibilities of the macrophage-neutrophil system and activization of the immunity system functionning on the dioxines neutralization.

The aim of the work performed was to develop a modern model of diagnosis and observation of sacroidosis patients. We examined 144 patients, and sarcoidosis was diagnosed in 109 of them. Each the third case of sarcoidosis was histologically verified. The phthysiatric facilities played the leading role in detecting sarcoidosis-like diseases and definition of the patients' contagiosity. The diagnosis of sarcoidosis and topic detection of injured organs require a complex examination in a modern diagnostic centre including various specialists' consultations. Such approach allows to assess a real spread of the disease, a rate of extrapuimonary lesions and efficacy of different therapeutic methods. The authors propose to create a national consensus on sarcoidosis.

Effect of Pulmozyme is studied in 28 children aged 8 to 16 with chronic lung diseases (14 children with congenital bronchi defects, 6 ones with the Kartagener's syndrome, 2 ones with hypogammaglobulinemia, 6 ones with chronic pneumonia). The drug was given in the dose of 2.5 mg once a day by inhalation. The treatment course was 10 days. Eight children received endobronchial Pulmozyme during bronchoscopic procedure. The sputum viscosity was tested with a rotary viscometer Reotest 2.1 (Germany) using a cone — flat working joint under the standard temperature of 20^°C.
The Pulmozyme therapy caused a positive clinical dynamics in all the children such as easier sputum expectoration due to reduction of its viscosity resulted in more effective bronchial drainage and improvement in the patients' general status. The study in vitro showed Pulmozyme to diminish the sputum viscosity and structuring from 10⁴ to 10³—10² mPa/s; the mucolytic effect of Pulmozyme kept for a day. The sputum viscosity in vitro was investigated before the drug inhalation, just after and in 4 and 8 hrs. The maximal viscosity decrease from 10⁴ to 10³—10² mPa/s was found 4 hrs after the inhalation followed by the viscosity growth up to the initial level 8 hrs after the inhalation. The adverse effect of Pulmozyme was noted in 1 patient (sore throat). The endobronchial delivery provided fast mucolytic effect and an improved expectoration after the bronchoscopic procedure.

To analyze spread and a pathogenic role of various risk factors (RF) influencing members of bronchial asthma (BA) patient’s family 19 sick persons and 23 their relatives were examined. Serum Ig A, G, M and E levels and the antioxidant activity (AA) of the blood were investigated. High levels of biological, environmental and psychosocial RF in the families examined have been shown. The BA patients unlike their descendants without BA had higher IgE level, more frequent breast-feeding, lower birthweight, lower income and bad microclimate in their families. Smoking, child viral infections, gastrointestinal diseases were observed in BA patients as often as in their descendants. Parents of the BA patients showed a prevalence of the environmental FR, a high IgE level and AA activation.

Impedance pneumography (IP) system for breathing pattern monitoring was developed. IP system was calibrated volumetrically using integrated pneumotachigraphy. We studied mean breathing pattern parameters in 39 healthy subjects, patients with mild (n=39), moderate (n=25) and severe (n=17) bronchial asthma (BA) in sitting posture during 10 min. interval. Mean breathing rate was significantly (p<0.05) higher in all BA groups (18.0±0.6, 18.0±0.6, 20.4±1.2 /min., M±m) than in controls (16,2±0,6 /min.). Patients with severe BA demonstrated significantly higher mean partial expiratory time (58.2±0.8%) and lower mean tidal volume (0.35±0.04 I) than healthy subjects (55.8±0.5% and 0.47±0.02 I, respectively). We concluded that developed noninvasive breathing pattern monitoring method is informative in patients with BA.

95.7% of sputum cultures from patients with tuberculosis combined with chronic obstructive pulmonary disease (COPD) yield non-specific mircoorganisms. Among them 28.8% fall on highly pathogenic microorganisms and mostly Str.pneumoniae. 66.6% of the patients with lung tuberculosis and COPD have multiple drug resistance of the Mycobacteria tuberculosis to combinations of isoniazid, rifampicin and other anti-tuberculosis drugs. The patients with lung tuberculosis and COPD demonstrate a considerable reduction in FEV₁ together with increase in pulmonary artery systolic pressure up to 34.1 ±3.0 mm Hg. The COPD patients bearing the Cw4 antigen and simultaneously not having the HLA-A2 antigen predispose to tuberculosis and are at risk for this disease.