The article demonstrates results of treatment of 32 patients with chronic fibrous-and-cavernous BK-positive lung tuberculosis with the lung tissue destruction. The treatment course lasted for 3 months and involved 4 or 5 antituberculosis drugs including ofloxacine. All the patients received the domestic immune modulating drug Likopid as a pathogenic therapy. A psychological correction was used according to the "Phthisa-school" educating programme. The combined therapy of the chronic lung tuberculosis patients using ofloxacine, Likopid and psychological correction was quite effective. BK contamination decreased including highly viable Micobacteria; a volume of the lung tissue destruction reduced. Our experience can be recommended for treatment of chronic lung tuberculosis patients with plentiful contamination by drug-resistant Micobacteria. 

To evaluate respiratory mechanics parameters 78 lung tuberculosis patients were examined. Patients with acute infiltrative tuberculosis predominated. The study design included the flow — volume loop, the bodyplethysmography, the static and dynamic compliance. Ventilation disorders were absent in 25 (32.1%) patients, the insulated obstruction was in 25 (32.1%) patients, the insulated restriction was in 4 (5.1%) patients and combined obstructive and restrictive disorders were in 24 (30.2%) patients. Lung function disturbances were registered in local (50%) and diffuse (62 to 71%) tuberculosis forms as well. A severity of the ventilation disorders depended on a spread, duration and a form of the lung tuberculosis. Changes in the static and dynamic lung compliance were different and due to pleural-and-pulmonary adhesions at the upper segments of the lungs, severity of the ventilation disorders and a spread of the pathological process.

When distinct clinical and radiological signs of lung tissue destruction are absent, radioimmune detection of serum ferritin level becomes an additional criterion to assess destruction in lung tuberculosis.
A permanent hyperferritinemia exceeding the normal level in 2-3 times or more with a tendency of beta2-globulin concentration to decrease appears to be a sign of the continuing lung tissue destruction and indicates a necessity of further specific anti-tuberculosis therapy, a course and a prognosis of the disease.

The purpose of the study was to evaluate a functional status of oxygen delivery system in various seasons in chronic bronchitis patients. The ergospirometry method was used to detect some parameters of work capacity, heamodynamics, ventilation and gas exchange under the maximal muscle activity in 93 patients and 40 healthy persons. Seasonal differences in cardiorespiratory maintenance of the maximal metabolic intensity and in a respiratory system’s reaction to the muscle activity were found in patients with chronic bronchitis.

The article shows results of prolonged (up to 19 years) surveillance of 62 children with post-infectious the functional status of the pulmonary ventilation, perfusion and cardiac morphofunctional status were used dynamically. In most adolescents the development of the cor pulmonale was accompanied by the absence of the pulmonary injury progressing, a steadiness of obstructive disorders and a significant reduction in pulmonary perfusion, and a progress of morphofunctional right heart disturbances.

We detected albumin (A), lactoferrin (LF), ferritin (F), C-reactive protein (CRP), fibrinogen degradation products (FDP), serum α-, β- and g-globulins, non-specific tissue esterase (NTE), total and placental alkaline phosphatase (TAP and PAP) dynamically in the bronchial secretion (sputum and bronchial aspirates) of 268 patients with bronchopulmonary pathology (pneumonia, chronic non-specific lung diseases, lung abscess, tuberculosis, lung tumours, pleural empyema) using immunochemical methods with rabbit anti-sera and corresponding reagents.
A strong correlations between a width of the antigen spectrum and endoscopic, clinical-and-radiological, cytological or bacteriological evidences of endobronchitis seventy were found. The appearance of NTE and PAF thermoresistent forms demonstrates a high risk for malignance development or tumor occurrence.

The study was performed during a treatment of 50 chronic bronchitis patients including those with exacerbation of the disease, and 20 pneumonia patients. Oxidant status was assessed using the total oxidant activity parameters and lipid hydroperoxides and malonyldialdehyde serum levels; antioxidant status was evaluated using the total antioxidant activity and superoxide dismutase and catalase activities parameters in erythrocytes. The patients with exacerbation of the chronic bronchitis had a severe oxidative stress provided by a significant hyperproduction of free-radical metabolites against the background of a decreased activity of intracellular antioxidant enzymes. The severity of the oxidative stress improved under the therapy, basically due to reducing in free radical production and the absence of a considerable change in antioxidant enzymes' activity. Patients with stable chronic bronchitis have still kept the oxidative imbalance. The pneumonia patients have the similar oxidative stress mostly at the top of the clinical signs, which was characterized by the initiation of the free-radical oxidation on the permanent activity of intracellular antioxidant enzymes.

We examined 88 patients with chronic bronchitis to study the respiratory heat exchange. A progressive decrease in the conditioning abilities of the respiratory system with a reduction in the exhaled air temperature was revealed. While the airway obstruction progressing, the respiratory reserve for the maintenance of the respiratory heat exchange exhausted. A diagnostics of latent disorders of the lung conditioning function was developed.

Nowadays there is no a unique approach for evaluation of a role of lipid peroxidation (LP) and its regulation in chronic obstructive bronchitis (COB) complicated by the chronic cor pulmonale (CCP).
The aim of our trial was to investigate the LP, the antioxidant defence system (AODS) and the proteases — antiproteases system in patients with COB complicated by the CCP and also to determine opportunities for a pharmacological correction of their disorders.
Forty-eight patients aged 28 to 52 years (the average age was 43±1.7 years) suffering from COB complicated by the CCP were examined. Among them 36 persons received the antioxidant drug cytochrome С and 12 ones formed the comparative group. The controls were 14 healthy persons with the average age of 44±1.0 years. We studied initial parameters of LP-AODS in erythrocytes and blood plasma, hemodymanics parameters and their changes under the treatment.
The patients with COB complicated by the CCP were found to increase LP products level and lysosomal and proteolytic enzymes activity. The activity of antioxidant enzymes and proteases’ inhibitors were noted to reduce simultaneously. The vigour of these shifts depended on a respiratory failure severity and respiratory system's structural disorders. A combination of cytochrome С and enalapril in patients with COB complicated by the CCP decreased pulmonary hypertension, improved the central and peripheral haemodynamics, blood gas content and acid-and-alkaline blood condition more effective than a traditional therapy. Such the dynamics facilitates shortening the inpatient period and improves the course of the disease.

Gas exchange and basal metabolism were investigated in young insulin-dependent diabetic patients with ketoacidosis. Fourteen patients were enrolled in this study. The energy expenditure and fat and keton utilization increased, the respiratory exchange ratio VC0₂/V0₂ reduced in these patients. The hypoxemia was not revealed. The lung hyperinflation and a reduction of single breath carbon monoxide diffusing capacity transfer factor were also registered. A pathogenic role of these disturbances is discussed in the article.

An investigation of pulmonary artery pressure was performed in 70 chronic obstructive bronchitis patients based on echodopplercardiography and lung function testing results. Against the background of the acute test with 40 meg of ipratropium bromide the pulmonary artery pressure decreased by 3.8 mm Hg in average. When the data obtained analyzed with mathematic statistic methods the correlation was revealed between the decreasing the pulmonary artery pressure and lung function parameters. The pulmonary artery pressure was not decreased under (RV*100)/FRC>90% condition. Thus, the effect of ipratropium bromide to the pulmonary haemodynamics is limited by certain parameters of the lung function.

The aim of this study was to assess abilities to achieve the control of the disease and to improve the quality of life in moderate to severe bronchial asthma patients under the therapy with Seretid Multidisk. Twentyfour patients were examined, among them 12 were moderate and other 12 were severe asthmatics.
A dynamics of clinical symptoms, peakflowmetry and flow — volume loop parameters, forced expiratory volume values and daily need in β₂-agonists were evaluated during the 12-week therapy with Seretid-Multidisk 50/250 meg given in 1 dose twice a day to the 1^st group patients and in 2 doses twice a day to the 2^nd group patients. The hypothalamic, hypophysial and adrenal function (a morning serum cortifan level) and cardiac safety (an influence on the heart beat rate and arterial blood pressure) were also investigated. The quality of life was assessed using the general questionnaire SF36 and the special AQLQ.
The results demonstrated that the therapy with Seretid Multidisk led to a positive dynamics in PEF and FEV1 values as well as to a reduction in clinical symptoms and exacerbation rate and to improvement in the quality of life. The safety testing did not reveal any significant systemic and cardiac adverse events.
So, the optimal control to the asthma is possible in moderate asthmatic patients. This fact provides Seretid to be recommended as the first line therapy for patients with uncontrolled asthma course.

We assessed results of 7-year monitoring of lung function in 33 Chernobyl accident liquidators using spirography, bodyplethysmography, lung diffusion capacity test, BAL cytology, and lung tissue biopsy. Among them 20 patients were treated since 1993, 13 patients were not treated. All the treated patients initially showed normal lung function values, but now 9 of them have kept normal flow rate values (the 1nd group). Ten others developed bronchial obstruction (the 2st group). The untreated patients (the 3rd group) had airflow limitation starting the observation. The 2nd group patients reduced their FVC from 4.67±0.15 in 1993 to 3.52±0.16 L in 2000 and FEVt from 3.69±0.15 to 2.72±0.17 L (p<0.02). The average FEVt annual decline was 71.16±36.58 Ml for the 1st group and 127.8±44.51 mL for the 2nd group. Lung volume parameters were normal in all the groups and did not change significantly. A number of alveolar macrophages containing Chernobyl dust particles decreased reliably in the 1st group: from n 24.65±5.18% in 1993 to 6.0±2.42% in 2000 (p<0.05), but not reliably in the 2nd group (from 17.83±4.24% in 1993 to 3.33±2.16% in 2000). The 3rd group patients has greatly less amount of such macrophages in spite of the absence of the therapy. Focal pulmonary fibrosis was revealed in 5 patients of the 1st group (55.6%), 4 patients of the 2nd group (36.4%) and 2 patients of the 3rd group (15.4%, p<0.025) without any X-ray features of lung fibrosis.
Thus, 73% of persons had exposed to inhaled radionuclides developed lung function disorders which greatly and progressively impair. A number of laden alveolar macrophages reduces over time without any eliminating treatment. Initial elimination rate of radionuclides provides a severity of delayed bronchial obstruction. Bronchial obstruction occurs less frequently and severe under the eliminating therapy. Focal pulmonary fibrosis at the initial stage does not influence the respiratory functional status probably due to its small size.

The aim of the present study was to evaluate an efficacy and safety of 7-day outpatient therapy with Levofloxacin (500 mg once a day) in adults upward 18 years with community-acquired pneumonia or exacerbation of chronic bronchitis. The study involved 925 patients from 51 sites of Russian Federation: 442 patients with community-acquired pneumonia and 483 patients with exacerbation of chronic bronchitis. The clinical efficacy was assessed in 704 of them in 8-11 days after the finish of taking Levofloxacin. It was 97.5% in chronic bronchitis patients and 97.6% in pneumonia patients. The drug was well-tolerated. No-one patient was excluded from the study due to occurrence of serious adverse effects.

The aim of the study was to evaluate a dynamics of bronchial inflammation caused by smoking during the cessation period. The inflammation was assessed by lung function parameters (LFP), chronic bronchitis (CB) signs. An efficacy of anticholinergic drug and N-acetylcysteine to prevent the CB exacerbation in addition to nicotine replacement therapy was also checked. The study involved 32 smokers with CB (the smoking history was 24.7 pack-years) who were divided into 2 groups: 18 and 14 persons. The 1^st group patients were treated with nicotine replacement therapy (NRP), anticholinergic drug (Atrovent) and N-acetylcysteine (Fluimucil) in standard doses, the 2^nd group patients received the NRT only. LFP and CB symptoms (cough, sputum expectoration, shortness of breathing) were evaluated weekly during a month, then every month for 180 days. The 2^nd group patients demonstrated a significant decline of FEV₁ (7.2%), FVC (12.3%), MMEF_75/25 ( 8.7%) and an increase in CB symptoms to the 2^nd or 3^rd day of the treatment that became maximal to the 7^th day and continued for 2 to 3 weeks. The 1^st group patients did not have any considerable changes. Conclusion: Atrovent and Fluimucil permit to prevent or reduce the CB exacerbation under the smoking cessation and to enhance the therapy of the nicotine dependency.

The aim of this work was to enroot a local programme of detection, treatment and prevention of bronchial asthma (BA) in an industrial town with a poor epidemiological situation on BA.
Such the programme was enrooted in Lesnoy town of the Sverdlovsk region with 46 500 of adult residents and the BA mortality of 15 per 100 000 of adults. The programme included an epidemiological study, doctors' and patients' training; provision with the modern technique for diagnostics, treatment and prevention of BA and antiasthmatic medication, and pharmacoeconomic research as well.
The programme showed 5.45% of the BA spread in Lesnoy town. Among 537 BA patients involved the basic therapy was given for 9% before the programme’s inculcation and 64% at the beginning of the year 2002. The number of newly diagnosed BA patients increased in 4.3 times in 2000 compared with the previous 4 years in average. The primary disability of BA reduced in 2 times in 2001. The amount of emergency medical service calls dropped by 39%, a number of admissions to a hospital diminished by 21% compared with the average parameters in 1997-1999. The 1st year of using this programme resulted in decline of the mortality of BA to zero.
So, the successful employment of the programme for the detection, treatment and prevention of BA in an industrial town demonstrated its reasonability for regions with a poor epidemiological situation on BA.