The present article displays results of lung function (LF) and purine metabolism (PM) investigation in 80 non-atopic bronchial asthma (BA) patients (46 males and 34 females). Lung function parameters were studied using "Spirograph" and "Pneumoscop" devices. The calculation of LF parameters was made according to N.N.Kanayev’s method. Urine acid (UA) amount in blood serum and in daily urine volume was determined by Zeifert-Muller's unified method.
Studying the LF and PM parameters and their correlation allowed to elucidate that PM disturbances correlate inversely with lung vital capacity (VC) and forced expiratory volume for one second (FEV₁) and directly — with bronchial asthma course. Modified therapy, including low—purine—contained diet No. 6 and "Bronchodyl" phyto-blend, promotes faster normalization of LF and PM parameters compared with basic therapy. The expediency of using the correlation between UA blood serum content and LF parameters for appreciation of treatment efficacy was revealed.
Thus, differentiated approach to the investigation of functional tie between LF and PM parameters enables to evaluate metabolic processes in BA patients.

The work analyses 63 cases of acute purulent destructive lung diseases (APDLD) which had been observed in 1994-1998. It was elucidated that APDLD acquire abscess-forming pneumonia (AFP) features under conditions of modern antibiotic therapy: in contradistinction to acute lung abscess there is no stage development, destructive cavities are "dry" in 4/5 of cases, capsule (or pyogenic membrane) is not appeared by X-ray examination; recovery comes in 81.0% of cases. Males with poor social status are at a high risk for AFP development. Painful breathing, anemia of combined origin, lymphocytopenia, monocytopenia, hypoalbuminemia and hypergammaglobulinemia are also high-risk factors for AFP. Significant mononuclear infiltration is found histologically that is a sign of probable focal activation of cell-mediated immunity.

The involvement of nitric oxide in the formation of bronchial hyperresponsiveness and pulmonary hypertension in bronchial asthma was studied. Shifts of nitric oxide were assessed by measuring nitric anion content in saliva using Griess reaction in 67 patients with non-atopic bronchial asthma. We assessed a pulmonary hypertension level and a condition of left and right ventricles by echocardiography.
It was shown that nitrite level in saliva depends on severity of airway limitation. Significant increase in nitrite content was revealed in mild bronchial asthma patients, especially during exacerbation. However, nitrite level in patients with status asthmaticus was significantly decreased. Based on data obtained we have suggested that changes in saliva nitric oxide reflect adaptive capacities of upper and lower airways and cardiovascular system in asthmatic patients with pulmonary hypertension. Nitric oxide produced in upper respiratory tract and oral cavity and self-inhaled thought to provide remarkable improvement in asthma and pulmonary hypertension course.
The investigation findings allow us to conclude that measurement of nitrite saliva level in bronchial asthma patients could be used for diagnostic purpose and its results could constitute an alternative approach to antiasthmatic and hypotensive treatment.

Scientific and practical examination of diagnostic errors and statistical analysis of autopsies in lung pathology were carried out in Zheleznogorsk town situated in the neighbourhood of mining-and-chemical plant (radioactive industry). Protocols of 1259 postmortem examinations, which had been performed in 1990-1997, were studied. Lung pathology as the leading disease was found in 158 cases, that was 12.5% of all autopsies. Lung diseases as complications of other pathologies were revealed in 511 cases. Differences of diagnostics of leading diseases were in 29.7% and those of complications - in 44.4%. Hypodiagnostics of lung diseases was in the first place among other kinds of pathologies and it constituted 11.76%. Among diagnostic errors subjective reasons predominated both in hypodiagnostics and in hyperdiagnostics of lung diseases that took 77.3% and 86.7% respectively.

Impulse oscillometry is one of the latest modifications of forced oscillation method. The impedance components such as resistance (R) and reactance (X) are measured simultaneously in the most diagnostically important frequency range from 5 to 35 Hz. It allows to estimate the relative contributions of R, capacitive X and inertial X separately. Measurements were performed in 14 healthy subjects, 14 patients with obstructive ventilatory disorders and 8 with restrictive ones. It was obtained that R, X and resonant frequency were within normal range in healthy subjects and were changed differently in patients with ventilatory disorders. In patients with obstructive disorders R at 5 Hz was significantly enlarged and differed from R at 35 Hz. X was clearly negative, capacitive X predominated and resonant frequency was considerably shifted to the right. In patients with restrictive disorders R and resonant frequency were close to those of healthy persons, inertial X predominated over reactance one. Such differences could be very useful in difficult diagnostic cases.

Thirty three patients with chronic obstructive bronchitis were treated with new beta-2-agonists: Saltos, Salben and M-cholinolytic Troventol under extreme conditions of Taimyr Autonomous District. Fine clinical efficiency was marked for Saltos, Salben and Troventol in management of moderate chronic obstructive bronchitis. The drugs tested possess a significant bronchodilating activity throughout the bronchial tree, assist the microelement imbalance correction. This fact expands the possibilities of pathogenic therapy of chronic obstructive bronchitis in Norilsk region.

Twenty patients (12 females and 8 males) suffering from stable moderate non-atopic bronchial asthma and receiving Ingakort in the supporting dose 1000 to 1500 meg daily (in average 1150 meg daily) during 6 to 8 months, were moved up to 4-week treatment with 600 to 800 meg daily of dry powders of Beclomethazoneeasyhaler (660 meg daily in average) and 500 meg daily of Flixotide-diskus sequentially. Dynamics of clinical symptoms in marks, need for beta-2-agonists, pulmonary function parameters, airways obstruction reversibility tested by response to Salbutamol and local adverse events were investigated.
The reliable regression of asthma clinical symptoms was revealed in 2 weeks of treatment with dry powders of Beclomethazone and Flixotide and that of need for beta-2-agonists was obtained in 4 weeks. This effect was greater against the treatment with Flixotide-diskus background. The large bronchi’s passability was improved but FEV_1, FEF₅₀ and FEF₂₅ changes were not significant. No local adverse events were revealed.
The results obtained confirm the comparability of the doses mentioned above of Ingakort, Beclomethazone and Flixotide, high efficacy and safety of their powdered forms as well.

A new method of lung emphysema radiological diagnostics is reported. It is based on computed technologies. The computed X-ray lung densitometry was applied in lung emphysema patients with the aid of softwarehardware equipment "Dia-Vid" for evaluation of lung function local disturbances. The main features of local lung ventilatory disorders in lung emphysema patients were revealed which were rigid zones (RZ), or areas with increased lung transparency which are not changed during breathing in the identified zones. A close correlation was found between results of computed X-ray lung examination and pulmonary function parameters that reflects a bronchial passability and lungs’ filling with air. The opinion is spoken out that the method proposed could be widely used in clinical practice for pulmonary obstructive diseases diagnostics as long as its basic configuration is quite cheap and it significantly decreases radial burden to patients.

Pharmacoepidemiological analysis of mild community-acquired pneumonia management was performed in 800 patients who were divided into two groups: 418 patients younger 60 without concomitant pathologies (groupl) and 382 patients older 60 and/or having concomitant diseases (group 2). Monotherapy took place in 73% of all the patients. Twenty two antibiotics of 9 pharmacological classes were applied. Aminopenicillins, macrolides and quinolones were prescribed more often. Aminopenicillins, spiramycin and erythromycin were more effective in the 1st group (their effectiveness were 91.3%, 82.4% and 78.6% accordingly) compared with the 2nd group (80%, 74.1% and 41.2% respectively). Quinolones and co-amoxiclav were more effective in the 2nd group (81.4% and 84.6% versus 67.1% and 100% in the 1st group). The identical efficiency in the both groups was shown for azithromycin and midecamycin (100% and 84.6% correspondingly). The extremely low efficacy was found for gentamycin and co-trimoxazole (40.6% and 33% respectively); these drugs should not be used in community-acquired pneumonia management. The most reasonable antibiotics’ combinations were: ampicillin + co-trimoxazole (the effectiveness is 76%, which was lower than that of monotherapy with ampicillin) and ciprofloxacin + co-trimoxazole (75% of the efficacy). The best cost-effectiveness was revealed for ampicillin, amoxicillin, azithromycin and midecamycin. So, this analysis demonstrates the necessity of different approach to antibiotics administration taking into account various parameters including economic ones.

Growing number of bronchial asthma patients and progressive morbidity of diabetes make actual the investigation of their combined course. Structural and functional lung changes In bronchial asthma influence the frequency range of cough sounds and the diabetes joint reinforces them. Spectral tussography allows to expand our conception of bronchial asthma alone and bronchial asthma against the diabetes background clinical features. Based on the analysis of the tussographic data obtained, the prevalence of a low frequency range over medium and high ones and also the extension of cough duration were found; those changes were more significant in the case of the combined pathology. Repeated researches showed a lessening of the low frequency range portion and an insignificant reduction of cough duration. Thus, the spectral tussography method can be applied for an assessment of the treatment efficacy so that it makes an image of structural and functional changes in bronchopulmonary system due to the treatment.

This trial was aimed to a comparative evaluation of clinical efficiency of different approaches (step up and step down) to moderate bronchial asthma management in children.
This study was designed as a single-blinded randomized parallel-groups trial. It involved 50 children with moderate asthma aged from 6 to 15 years; they were divided into 2 groups. The 1st group patients received fluticazone propionate 200 meg daily for 12 weeks. Then they were transferred to the treatment with sodium cromoglicate in a dose of 20 mg daily (step down). The children included into the 2nd group received sodium cromoglicate as a starting therapy. The evaluation of the treatment efficacy was assessed in 4 weeks. When the initial treating course was declared to be successful the patients went on to receive the same drug for 20 weeks more (the 2A group). In a case of unsatisfactory effectiveness of the therapy with sodium cromoglicate the children were administrated fluticazone propionate for 12 weeks (step up) and then they were transferred to the cromoglicate therapy (the 2B group).
The trial protocol included an assessment of main asthmatic signs intensity, respiratory function parameters, severity of bronchoconstruction after exercise, a degree of metacholine-induced bronchial hyperresponsiveness and quality of the children’s life.
It was demonstrated that the step down approach is more preferable in moderate asthma children during basic anti-inflammatory therapy as far it facilitates to achieve the stable asthma condition in short time, to prevent successfully a bronchoconstruction after exercise and to reduce most significantly the bronchial hyperresponsiveness. All these conditions considerably improve the quality of the patients’ life. The replacement of fluticazone propionate to sodium cromoglicate in the children leads neither to worsening of asthma course nor to decreasing of expiratory flow value and does not cause a great reinforcement of bronchial hyperresponsiveness in overwhelming majority of patients as well.

The therapy by nebulized Berodual was applied for solution of severe bronchial asthma attacks in 42 bronchial asthma patients. The drug was well-tolerated by all the patients. Against the background of such therapy a number of asthma attacks was diminished in 100% of cases and those quite ceased in 7 patients from 42 ones. A need of beta-2-agonists inhalations was reduced almost in 3 times. Doses of corticosteroids were decreased in 15 patients from 38 ones. An analyze of peak flow rate, peak expiratory flow for one second and lung vital capacity values demonstrated their reliable growth. So, the therapy by nebulized Berodual is thought to be optimal from the point of efficacy and safety for intensive treatment of bronchial asthma patients who were admitted to a hospital because of bronchial asthma attacks arising.