The authors have analysed results of a complex radial examination of 1192 patients with various interstitial lung diseases. Based on the results obtained, an algorithm for diffuse and disseminated lung pathology differential diagnostics was created. It is constructed on a radiological and morphological basic. A level of lung structure injury, a character of tissue reactions and a presence of granuloma shadows are the main criteria for evaluation of macrostructure in this differential diagnostic programme.
The importance of X-ray computed tomography and especially high resoluted X-ray CT is emphasized which is becoming the primary radial diagnostic method in pulmonology.
Morphological and functional investigations, especially lung scintigraphy with technetium and gallium-67 citrate specify a degree of microcirculation change and intrathoracic lymphatic nodes activity.

The software-hardware equipment for computed prophylactic chest radiography units has been specified. After its testing in some Moscow hospitals it becomes possible to make conclusions about efficiency of its using and opportunities for further development.

The dual-energy computed tomography was performed for scanning of 95 peripheral pulmonary nodules up to 3 cm in a diameter without any visible petrification and cavities. The purpose of the study was a quantitative evaluation of diffusely located calcium contents. All the patients were divided into 3 groups. The first group included patients with nodules which did not change their density or changed it by ±10 HU. The patients whose nodules’ density grew by 10—25 HU were included in the 2-nd group. The third group was formed by patients whose nodules’ density increased more than by 25 HU. The measurements were carried out before the morphological data reception. Among 40 patients of the 1st group malignant neoplasm was revealed in 37 persons and benign tumor was in 3 persons. Among 21 patients of the 2-nd group 13 persons had malignant neoplasm and 8 of them had benign nodules. All the patients of the 3-rd group had benign lung formations. These data allow the given technique to be recommended for selection of patients who need morphological verification of pulmonary nodules origin.

Organization principles of examination of patients with pulmonary diseases are considered. The structure of re-examination center in case of digital prophylactic X-ray chest units application is offered.

We performed chest resonance magnetic tomography in 37 patients. The "Vectra" resonance magnetic tomograph was used in this study. It is constructed by the “General E lectric” firm and has a super-conducting magnet with the field tension of 0.5 Tl and synchronization with electrocardiogram. Among chest structures a mediastinum was well defined in tomograms, namely trachea, main bronchi, heart, large vessels, oesophagus, thymus. A lung parenchyma did not represent in details in tomograms; among lung elements only vessels up to 4—5 order were imaged. Concerning pathology, aortic aneurysm, additional formations and enlarged lymphatic nodes of mediastinum and lungs roots were revealed. Some lung pathology was also represented but the problem of diagnostics and differentiation of various lung pathological processes using resonance magnetic tomography requires further studies and more precise definition.

A retrospective analysis of clinical and laboratory parameters and radiological data was performed in 60 patients with nosocomial pneumonia. A dynamic investigation of clinical-and-laboratory parameters and radiological data was carried out in all the cases. Typically, radiographic examination was performed at the time when the first  clinical and laboratory features of pulmonary inflammatory process appeared. Fever and breathlessness prevailedin clinical picture, lungs’ auscultation revealed breathing weakening and fine crackles. Most patients demonstrated infiltration in lungs found by X-ray examination. In 10 cases reliable radiological sings of pneumonia were absent. During autopsy the diagnosis of pneumonia was confirmed in all the patients with X-ray negative nosocomial pneumonia. So, the absence of radiological features of pneumonia does not evidence its absence in a patient. The possible causes of nosocomial pneumonia X-ray negativity could be an atypical course of pneumonia in patients with neutropenia; the intrinsic diagnostics of nosocomial pneumonia on a background of chronic obstructive pulmonary diseases as well as in elderly people; insufficient sensitivity of traditional radiography for detection of this kind of pathology.

An intravascular ultrasonic examination of 105 lung segments was performed in 1995— 1998 in 29 patients with congenital cardiac defects or primary pulmonary hypertension aged of 9 months to 35 years. Linear dimensions of vascular structures and thickness indices of medium and internal vascular membranes were detected.
Initially the intravascular ultrasonic examination and histological investigation were carried out in anatomical preparations of 6 died patients. The identity of ultrasonic and histological structures of pulmonary arterial wall was revealed. The linear dimensions and the thickness indices of medium and internal vascular membranes have not differed reliably being measured by both of methods (p>0.05).
Then 23 patients with congenital cardiac defects and primary pulmonary hypertension were examined. Four patients with congenital cardiac defects without pulmonary hypertension were included into the first subgroup; they demonstrated the normal structure of pulmonary arterial walls and the normal thickness indices of the medium and internal vascular membranes (6.5±0.2% and 9.3±1.7%). 8 patients with pulmonary hypertension who could be operated according to clinical or haemodynamic data formed the second subgroup; they had the enlarged vascular wall thickness due to medium vascular membrane hypertrophy. The thickness index of the pulmonary •arterial medium membrane was increased up to 20.9±2.8%. Eight patients had both congenital cardiac defects and primary pulmonary hypertension and were recognized inoperable; three patients with primary pulmonary hypertension had a thinning of the pulmonary arterial medium membrane, hyperplasia of the internal vascular membrane and a thickening of the vascular wall; they formed the third subgroup. The thickness index of the internal vascular membrane was increased up to 24.8±3.5% whereas the thickness index of the medium vascular membrane was not very large.
The study performed evidences the sufficient informative level of the intravascular ultrasonic examination method and the possibility of their using for an evaluation of pulmonary vessels condition in pulmonary hypertension patients.

A complex clinical and fluorographic examination of thoracic organs was carried out in 3287 coal miners using the procedure of fluoropneumopolygraphy which enables to increase the efficiency of a diagnosis of occupational lung diseases during prophylactic examinations of miners by 21.2%. Due to that the significance of fluorography for recognition of adaptive human body possibilities in underground working conditions and detection of patients with respiratory disadaptive disturbances depending on a work length was found to be higher.

Based on the assessment of radiological, computed tomographic, magnetic resonance, ultrasonic and other methods of radial diagnostics 3820 patients with various respiratory diseases were examined. Radiological syndromes of the diseases were classified. An algorithm was created for usage of the methods depending on clinical situation. A diagnostic logic is demonstrated on the example of the lung transparence disturbance syndrome.

Forty-nine patients with various pulmonary, pleural and mediastinal pathology were examined with ultrasound. The ultrasonic approach was chosen after radiological and computed tomographic results had been analyzed. Ultrasound is a highly effective method for determination of cystic changes, lung cancer spreading, differentiation of various pleural diseases, differential diagnostics of retrosternal goitre, thymomas and lymphomas. This method is an important part of radial diagnostics of respiratory diseases. Its data make an origin of pathology more precise.

An asthmatic status is one of the most severe complications of bronchial asthma. According to literary data, 10 to 15% of bronchial asthmatic patients’ admissions to hospitals are connected with asthmatic status appearance which causes the mortality of 7 to 16%. Due to the actuality of the problem of timely diagnostics and adequate treatment of asthmatic status seventy two histories of asthmatic patients were analyzed. Those patients were admitted to 4 hospitals of Saratov city in 1995— 1998.
The high frequency of asthmatic statuses hyper-diagnosed before hospitalization and late asthmatic statuses’ diagnosing in the hospitals were found. It was revealed that different hospitals have different approaches to intensive care for asthmatic status patients. When principles of asthmatic status treatment are not performed it leads to long-time intravenous perfusion therapy as well as to the patients’ staying in hospitals for longer period. We have paid attention for different assessment of equal clinical situations that evidences the absence of well-defined AC diagnostic criteria in a physician’s mind. It leads both to hypo- and hyper-diagnosing of this condition and, thus, sometimes to inadequate therapy.

A hundred and forty three patients with various kinds of tracheal and bronchial pathology were examined using computed tomography. X-ray computed tomography is a highly sensitive method of radial diagnostics of respiratory diseases. It allows detecting not only an organ’s injury, but also its spreading, a predominant direction of tumor’s growth and a condition of tissues surrounded. Data obtained by X-ray computed tomography permit to select a correct treatment way and to control its results.

Skialoglc opportunities of computerized tomography for diagnosing of pneumonia (46 patients) and pneumonic forms of lung tuberculosis (65 patients) have been analyzed in the article. The role of computerized tomography for determination of structural changes in lung parenchyma, bronchi and lung vessels in these diseases has been shown, that make it possible to differ both acute and prolonged forms of pneumonia from lung tuberculosis. The equipment of pulmonology service with computerized tomographic technique should be one of the conditions of improvement in the quality of clinical diagnostics of inflammatory pulmonary diseases.

The efficacy of inhaled corticisteroid — fluticasone propionate (Flixotide, Glaxo Wellcome), depending on dosage and combination with long-acting p2 -agonist (LABA), was evaluated in an open noncomparative study. Forty five children aged from 3.5 to 16 years with bronchial asthma, received monotherapy of fluticasone propionate given in low, moderate doses, and in combination with long-acting P2 -agonist salmeterol (Serevent, Glaxofc Wellcome). Clinical symptoms, spirography data, free urine and plasma cortisol levels, bone density measured with a method of peripheral oesteodensitometry were assessed after one month of treatment, and then after 4—6 months, 1 and 2.5 years. Treatment with fluticasone propionate was effective in all children. Combination of low dose of ICS and LABA demonstrated superior efficacy over monotherapy. We did not observe any signs of negative impact of the continuous administration of fliticasone propionate on adrenal function and bone density in the studied population of children.

Diagnostic criteria of peripheral lung cancer were determined in 98 patients during colour de-ciphering of black-white image on a television UAR-2 facility. It was found that in case of small peripheral lung cancer the adequacy of the colour de-ciphering exceeds that of linear tomography by 8—9 % regarding to sensitivity plus accuracy and by 15—20% regarding to specificity; it is close to data of computed tomography.
The procedure was developed for reading of colour images of normal chest organs (the control group consisted of 155 healthy persons).