Extended clinical and allergological study was performed in 95 medical workers of various specialities using latex gloves in their work. A high frequency of latex hypersensitivity (41%) among the persons working 6–8 hours in a shift in latex gloves, atopic persons and medical workers with the longest work as well. Local (nettle-rash, contact dermatitis, eczema on the hand skin) and systemic (generalized nettle-rash, anaphylaxis) allergic diseases associated to latex were diagnosed in 29.5% of the persons.

An analysis of the diagnostic tests values used was conducted. The receipt of the latex allergen into the airways and occurrence of dermatorespiratory syndrome were proved.

Generally primary ciliar dyskinesia (PCD) is characterized by ultrastructural lesions of cilia. We performed electronic microscopic investigation of epithelium cilia in 99 patients in 1990–1999 years. PCD was found in 23 patients (13 males and 10 females). Ultrastructural lesions were provided more often by structure of internal and external denein ledges and radial spokes. A disorder of tubule’s disposition or losses of central tubule were noted extremely rarely. Information about frequency of ultrastructural ciliar lesions and their characterization will be useful for detection and differential diagnosis of primary and secondary disturbances.

The aim of this work was to study morphological peculiarities and expression of biomolecular tumor markers including IGF family members in lung carcinoma patients lived for long time at Semipalatinsk territories with radioactive contamination.

The investigation drew operated and biopsy materials of 27 lung cancer patients; among them 17 patients (the 1-st group) lived from their childhood to 1993 near the proving ground and experienced radiation for long time (the annual irradiation dose exceeded 0.1 ber). The comparative group involved 10 patients (the 2-nd group) lived at Kazakhstan territories with normal radiation level. There were 23 males and 4 females aged from 45 to 69 years among the patients. Metastases were found in 5 of 17 lung carcinomas occurred under radiation exposure and in 7 of 10 lung carcinoma patients from areas with normal radiation level. The tumors had various histological types according to the WHO characterization. We used paraffin embedded archive blorks from Semipalatinsk oncology center. The sections were stained by hemotoxyllin and eosin, alcian blue, and by the van Gieson staining.

To detect the tumor histogenesis we used electronic microscopy of paraffin blocks and semi-thin sections stained by methylene bine, azur II, fuxine.

We performed immunohistochemical examination using immune peroxidase method, mono- and polyclonal antibodies against chromogranin, IGFI, IGFII, IGFBP1-6.

The characteristic features of lung carcinomas in residents at the radioactive contaminated territories of Semipalatinsk region (Kazakhstan) were constant presence of dust particles in tumors of various histological types and from different sites.

Lung carcinomas at the Semipalatinsk region have histogenetic peculiarities and they can be characterized as neuroendocrine tumors, not only small cell type but also non-small cell type with neuroendocrine differentiation.

The investigated lung carcinomas have specific mechanisms for tumor growth regulation referred to IGF family with high activity of IGF II and IGFBP1, 2 compared to the 2-nd group.

Aim: To assess the state of cardiac and respiratory function in adult cystic fibrosis patients. 36 patients participated in the study. Lung function tests and Doppler echocardiography were performed to each patient. The majority of adult CF patients develop generalized obstructive pattern of lung function and hyperinflation. Significant decrease of VC and its part in TLC was noted. Assessment of exercise tolerance revealed significant decrease of hemoglobin oxygen saturation and heart rate increase. Right atrium and ventricle dilatation and an increase of systolic pressure in pulmonary artery were reported in 20% of patients, all of them had severe bronchial obstruction (FEV₁ <35% pred), in 28% of patients left ventricle dysfunction of both systolic and diastolic nature was registered.

Our finding suggest that generalized obstructive disorders, hyperinflation and reduction in diffusion capacity are characteristic for adult cystic fibrosis patients. Pulmonary hypertension and cor pulmonale develop in patients with severe obstructive disorders.

The study assess effects of inhaled nitric oxide on pulmonary haemodynamics, gas exchange and oxygen transport in patients with primary pulmonary hypertension (PPH) and evaluates factors predicting the response to inhaled nitric oxide.

Ten patients with PPH (8 females, 2 males) were observed.

Oxygenation and haemodynamic variables were measures and calculated at room air and then 15 min after each sequential addition of 10, 20 and 40 ppm nitric oxide to the gas mixture. Patients were considered responders if the mean pulmonary artery pressure or pulmonary vascular resistance decreased by 20%. An electrochemical gas sensor device PrinterNOx provided continuous analysis of nitric oxide and oxidative nitric oxide products.

There was a dose-dependent improvement in haemodynamic variables that was maximal at 40 ppm nitric oxide (mean pulmonary artery pressure decreased from 67±7 to 56±5 mm Hg, pulmonary vascular resistance index decreased from 1335±302 to 790±102 dyne sec/cm^-5, and cardiac index increased from 2.3 to 2.7 L/min/m², all p<0.05). There was a significant improvement in oxygen transport at 20 and 40 ppm nitric oxide (DO₂ improved from 684±108 to 791±110 and 835±98, respectively, p<0.05). Five patients (50%) responded to NO. The responders differed from non-responders in such factors as distance during 6-minute walking test, p_a0₂ and p_aC0₂ (all p≤0.01).

Our data show an improvement in pulmonary haemodynamics and oxygen transport in patients with primary pulmonary hypertension.

The article contains data of clinical monitoring of 106 patients with drug-resistant tuberculosis. The great attention was paid to various microbiological methods of Micobacterium tuberculosis drug sensitivity investigation including sputum investigation with the method of absolute concentrations and the BACTEC-46 ТВ system.

An important role of timely correction of the therapy using the express-method of detection Mycobacterium’s sensitivity to anti-tuberculosis drugs to arise the chemotherapy efficacy for drug-resistant lung tuberculosis was highlighted.

Studying of efficiency of various anti-tuberculosis drug combinations in drug-resistant lung tuberculosis patients is of great importance for concrete Micobacteria drug resistance. The necessity was shown to add two reserve drugs at least to the chemotherapeutic scheme for patients with the resistance to isoniasid and rifampicine and 5 reserve drugs at least for patients with multidrug resistance.

Recommendations were given to treat different groups of patients with drug resistant lung tuberculosis.

Combined chemotherapy and laser therapy were used together with a rehabilitation complex in 159 patients of the basic group. After 3-month treatment Mycobacterium tuberculosis stopped to be isolated in 80.1% of the patients and decay cavities vanished in 65.7%. The control group involved 87 patients, and the corresponding parameters for them were 56.2% and 40.3%. After 6-month complex therapy 94.8% of the basic group patients ceased to excrete Mycobacterium tuberculosis and decay cavities disappeared in 85.1%. The control group received a standard chemotherapy showed 68.5% and 40.3% accordingly. Lung function became normal in 64.0% of the patients treated with the rehabilitation complex and ventilation disorders became moderate in 30.2%. The control group demonstrated 40.2% and 21.7% correspondingly.

DOTS strategy includes several important points, primarily, detection of tuberculosis patients and a strong monitoring of treatment efficacy.

Specialists on lung tuberculosis from Tomsk have 5-year experience in work with DOTS programme. They observed 675 patients asked medical care in tuberculosis settings of Tomsk region from the March 1995 to November 1996. The patients ere divided into the group A and B. The group A received anti-tuberculosis therapy adopted in Russia. The group В was given directly observed treatment short course (DOTS) according to WHO standard. It included the intensive phase (2 months for new diagnosed cases and 3 months for repeated therapy course) and the continued phase of 2–4 (new diagnosed cases) to 5 months (repeated course) length. Typical WHO modes were used the first line drugs, such as isoniasid, rifampicin, pyrasinamid, etambutol, streptomycin. The therapy delayed results were assessed with criteria accepted by WHO and in Russia as well. Seventy one per cent of the patients recovered: 69% from the group A and 74% from the group B. The treatment failures were registered in 15 (4.2%) patients of the group A and 18 (5.6%) of the group B. Residual lesions of respiratory system were less severe in the group A patients just at the early period; there was no significant difference between the groups by the 30-th month of the observation. Meantime the cost-effectiveness of WHO standard treatment is 1.9 times less than that of Russian traditional schemes. Generally, a positive tendency in lung tuberculosis patients’ treatment and observation effectiveness has been noted in the Tomsk region for the last 5 years due to the DOTS strategy, so that it takes a positive role for tuberculosis patients’ cure.

The authors performed an opened randomized study of therapeutic efficacy of various medications for bronchoobstructive syndrome (BOS) treatment in different aged children. Sixty nine children aged from 1.5 months to 8 years were observed; they were divided into 2 groups equal in age, demographic and functional parameters according to medications received. Each of the groups was divided into subgroups according to BOS severity. The medications efficacy was scored for the patients’ general status, dyspnoea, cough, wheezing, the lung auscultation and for visual and mathematical characteristics of bronchophonogram which are objective parameters.

The data obtained evidence that the inhaled nebulized therapy with the modern bronchodilating drugs, such as Berotec, Salgim, ipratropium bromide, Berodual is effective in most cases (more than 97%): clinical symptoms were solved, the patients’ general status and lung function parameters became normal confirmed by normal values of bronchophonography. The nebulized therapy with ipratropium bromide (Atrovent) was reliably shown to be optimal for BOS treatment in infants in term of tolerability, efficiency and safety.

We observed 31 children received fenspirid (Erespal) including 15 bronchial asthma children (the study group) and 16 children with chronic non-specific inflammatory bronchopulmonary diseases (the comparative group).

The bronchial asthmatic children showed increased H₁-receptors sensitivity for histamine accompanied by exceeded intracellular calcium ion concentration as a response to the histamine stimulation. They also showed an increase of ɑ₁-adrenoreceptors number. Meantime the intracellular calcium ion concentration arise less than it was in the children with chronic non-specific inflammatory bronchopulmonary diseases under the noradrenaline stimulation.

Against the background of treatment with fenspirid (Erespal) the H₁-histamine receptors sensitivity as well as calcium ions response to histamine and noradrenalin stimulations decreased in the bronchial asthma children and the similar events appeared in less degree after the histamine stimulation in children with chronic inflammatory bronchopulmonary diseases. Simultaneously clinical bronchial obstruction signs solved and lung function improved.

We performed a clinical-and-morphological analysis of 6 cases of malignant pleural mesotheliomas in 1990 to 1999 years. The diagnosis was made in operated material. It was shown that malignant pleural mesotheliomas constitute 0.6% of all lung carcinomas. Pathognomonic clinical signs of malignant pieural mesotheliomas were not found. Males suffer from this disease more frequent (5 cases) than females (1 case). The patients’ age varied between 44–67 years. The tumours had diffuse or papillary histological structures.

A study was performed to investigate an efficacy of drugs Imudon and IRS19 containing various locally acting bacterial lysates with of the most frequent pathogens of respiratory diseases in children with anti-infectious defence disorders. The drugs were used for immune rehabilitaion goal as a monotherapy for 14 days in 38 children suffering from chronic rhinosinusitis, chronic tonsillitis, reccurent bronchitis (IRS19) and 20 children older 10 years with chronic tonsillitis and pharyngitis (Imudon). Clinical and laboratory examination was conducted twice: before the therapy and in 3 months after the course finishing. A positive clinical and laboratory effect was found such as reduction in number and length of chronic upper airways infections exacerbations (in 2.5 times), decreasing in their severity providing by an activation of the local defence and in shortening or abolishing antibacterial therapy. We noted the normalization in neutrophil phagocytosis parameters and increased serum IgA concentration, rising in IgM concentration had been previously reduced. The data obtained allow to recommend this drugs to be applied as preventing and therapeutic agents in patients with recurrent and chronic respiratory infectious diseases to provide their immune rehabilitation.