The appreciation of one-year-term N -acetylcysteine oral use in treatment of Chernobyl accident liquidators with different forms of chronic bronchitis is given in this article. We have obtained results confirming the high mucolytic and antioxydant activity of this drug. Its property of improving the removal Chernobyl dust particles from airways is shown. The safety of this drug for oral use and the necessarity of its long-term prescribtion in dose 600 mg daily to patients with progressive bronchial and pulmonary diseases associated with gastrointestinal pathology are proved.

The problem of “ rebreathing” hindering effective removal of carbon dyoxide appears during non-invasive ventilation in patients with chronic hypercapnic respiratory faillure. The aim of our investigation was to com pare two types of m ask-valve system s — “Respironics nasal mask” with the “Whisper-Swivel” valve and “ADAM circuit” internasal mask. Parameters of respiratory pattern, compliance and removal of carbon dyoxide were examined. 12 patients with stable hypercapnic chronic respiratory failure underwent non-invasive ventilation courses using two types of mask/valve system s at various regimens IPAP/EPAP with evaluation of arterial blood gases, tidal volume, “ rebreathing” volume and carbon dyoxide volume into the circuit behind the valve. Also side effects and comfort for patients were evaluated. It was shown that in spite of significant decrease in PaC0₂ during the non-invasive ventilation (p=0.002 for RNM mask and p<0.001 for ADAM mask) usage of ADAM mask provided stastistically significant lower level of “ rebreathing” (p<0.001) and of absolute amount of carbon dyoxide (in millilitres) into the circuit behind the valve (p=0.004). Compliance was better with ADAM m ask which was estimated by the most patients as more comfortable mask. Thus, usage of the ADAM m ask can improve the removal CO₂ and ensure better co-operation between patient and doctor during non-invasive ventilation in patients with stable hypercapnic chronic respiratory failure.

We have constructed a sandwich immunoassay for detection of glycolyl-sialylated glycoprotein (mucin) antigen 3EG5 using a monoclonal antibody 3E 1.2 and affinity-purified polyclonal antibody G5 reactive against total mucin antigen family. Increased levels of mucin antigens may reflect the proliferation of Type 2 pneumocytes in chronic pneumonitis.
Using this assay, we have quantified a serum mucin in patients with interstitial lung diseases (ILD): idiopathic pulmonary fibro sis (IPF) and hypersensitivity pneumonitis (HP); bronchial asthma (BA); chronic obstructive pulmonary disease (COPD); other pulmonary diseases and healthy control subjects (hospital personnel). An arbitrary cut-off 75 U nits/m l (U /m l) was set as m ean+2SD (n=52) of healthy subjects. The serum level o f 3EG5 in patients with ILD was prominently greater (225,9 ± 112,1 U /m l, range: 108 — 595 U /m l; n=28) than in patients with BA (68 ,9 ±3 ,3 U /m l; л=40), COPD (59,5±30,8U /m l; л = 1 8), pneumonia (4 8 ,9 ± 3 1 ,1 U /m l; /7=20). The elevated serum mucin 3EG5 was detected in all studied forms of ILD. The degree of serum mucin elevation correlated with severity of clinical symptoms: dispnea score (r=0,73; p< 0,001), radiographic profusion score (r=0,43; p-0,020), degree of restrictive changes in pulmonary function tests (TLC: r= -0,46; p= 0,015; FVC: r= -0,46; p < 0,05; DLCO: r= -0,64 ; p < 0,001) and neutrophyle count in bronchoalveolar lavage fluid (/=0,87; p< 0 ,0 0 1 ) (for IPF).
We conclude that determination of serum mucin 3EG5 may contribute to diagnosing of ILD and m ay reflect activity and severity of these diseases.

Cough is one of the most common signs in internal practice. However, cough evaluation is subjective and sometimes it does not reflect the virtual intensity of this symptom. The origin device which has been constracted in Russia and called "Tussograph IK T-1” is used in Pulmonology Institute of Ministery of Health of Russia for cough monitoring. Record of cough by tussograph is called tussography. It is registration of contractions of those muscles which participate in coughing. At the same time the couhg impulses’ sounds are being recorded too. Tussographic parameters give information about cough frequency and intencity and about cough distribution at time. Use of tussography is important for cough expertise, appreciation of anti-coughing therapy and for scientific purposes.

The success rate of noninvasive positive pressure ventilation (NIPPV) in acute exacerbation of chronic obstructive pulmonary disease (COPD) is about 7 0— 80 %. The aim of our study was to determine factors predicting successful outcome of NIPPV.
Methods. We analysed 38 patients with acute exacerbation of COPD treated with NIPPV. Noninvasive respiratory support was applied by means of BiPAPS/T-D pventilatory device via nasal or facial masks. All patients were divided in two groups according outcome of NIPPV — need for ET intubation and survival. Pulmonary and nonpulmonary parameters were compared in these groups.
Results. NIPPV was successful in 29 patients (76,3% ) and nonsuccessful in 9 patients (23,7% ). Unsuccessfully treated patients were more acidotic on admission (pH: 7,22±0,06. vs 7,2 8± 0,05 ; p = 0,0 1), had greater index of rapid shallow breathing (RR/Vt: 154±52 vs 107±36; p=0 ,0 0 4 ),had more greater length of acute decom pensation before administration o f NIPPV (2,9±1,3 vs 2,1 ±0,7 days; p < 0,05), m ore often had pneumonia as precipitating fa c to r (44,4 vs 6,9% , p=0,05). Outcome was also related to the severity of clinical status assessed by Simplified Acute Physiological Score (SAPS points: 15,2±2,3 vs 10,8±2,8 ; p= 0,001), reduced level of conciousness (1 ,7± 1,3 vs 0,6±0,6 points; p = 0,002), reduced level of com pliance (2,4±1,1 vs 3,7±0,9 points; p= 0,0 01), poor nutritional status (Body M ass Index: 18,0±2,7 vs 20,7±2,6 k g /m 2 ; p < 0,05).
Conclusion. Our findings suggest that outcome of NIPPV may be predicted by the level of acidosis, cause of acute respiratory failure, severity of clinical status, level of conciousness, compliance and nutritional status.

The aim of study was to describe clinical and functional characteristics of adult patients with cystic fibrosis, who underwent hospital and outpatient treatment in 1994— 1997. Seven subjects (2 males and 5 fem ales, aged 24.0±1.9 years) participated in the study. The diagnosis of cystic fibrosis was confirmed by positive sweat test in all the patients, 6 of them were heterozygous for DF 508 mutation (the most common disease-causing mutation in Russia). All of them underwent regular treatment in accordance with internertional guidlines. Body mass index (BM I) and lung function were evaluated during 1994— 1997. The evaluation of Schwachman score demonstrated mild to moderate clinical state of the patients in 1997 (the mean value was 57.4±1.5). There was a trend toward lower BMI in 1997 (17.5±1.2 kg/m at 1994 versus 17.2±1.4 k g /m² at 1997). The differences in lung function during 1994— 1997 years were not significant. The retrospective analysis of lung function and BMI in 1994 did not reveal any statistically significant changes the result, that could be attributed to regular treatment during 1994— 1997 years.

The high frequency of various gastrointestinal tract pathology associated with Helicobacter (98% of observations) and Campylobacter (100% of observations) has been revealed in patients with atopic syndrome. The clinical characteristic feature is frequent a symptomatic course of gastrointestinal diseases. Viral-and-bacterial intestinal dysbiosis is primarily found in patients with diffuse form of atopic dermatitis and it is revealed in 71.4% o f cases. Allergic inflammation of mucous membrane in both respiratory and alimentary tracts has such features as predominant catarrhal changes, intensive eosinophyl degranulation and increase of mastocytes’ count. The viral dysbiosis intensity which is revealed in 83.3% of patients is connected with the severity of atopic syndrome. Detailed inquiry and full investidation of gastrointestinal tract are neceassary for early diagnosis and adequate therapy of patients with atopic syndrome.

The high percentage of gastroesophageal regurgitation disease associated with other different diseases of alimentary tract is noted in patients with broncial asthma. The gastroesophageal reflux which is estimated as broncial asthmatic ‘trigger’ , especially at night, is the most interesting. Diurnal monitoring of esophageal pH in some occasions has shown time -dependent connection of clinical asthmatic attack and pathological gastroeaophageal reflux.Somnological data have confirmed the role of gastroesophageal regurgitation disease, obstructive sleep-apnea syndrome and disorder of sleeping structure in the origin of nighttime bronchial asthmatic attacks.

The diagnosis of chronic obstructive pulmonary diseases today is based on data of complex examination of patients including fiberoptic bronchoscopy and bronchoalveolar lavage.
The bronchoalveolar washouts from 24 asthmatic patients (BA) and 10 chronic obstructive bronchitic patients (COB) were investigated. Following parameters were studied: bronchoalveolar washouts cytology, SlgA level, secretory lysozyme activity.
The obtained results showed that increased number of alveolar m acrophages, eosinophyles, lymphocytes, plasmocytes and mucosal cells were distinctive features of atopic BA. SlgA level and lysozyme activity were twice lower than in COB.
High percentage of neutrophyles, bronchial epithelial cells with dystrophya features, metaplastic squamous epithelial cells and microflora were typical for infection dependent BA. Cell set in infection-dependent BA had the ^ considerable similarity with one in COB. Parameters of secretory lysozyme activity and SlgA level were significantly lower than in COB.
Cytological structure of bronchoalveolar washouts in mixed BA had both atopic (macrophages and lymphocytes predominance, low neutrophyles number, presence of eosinophyles) and infection-dependent asthmatic features (major count of ciliated epithelial cells with dystrophic changes, presence of metaplastic squamous epithelial cells)
Thus, bronchoalveolar washouts investigation allows to appreciate the inflammatory character in BA and COB and, probably, to identify the BA form .

The mathematic analysis of cardiac rythm by the method of academic R .M .Baevsky was conducted in bronchial asthma patients in order to study the influence of long-term glucocorticoid course and its combination with magnium on homeostasis of autonomic nervous system . The cardiac rythm was analyzed before treatment, in acute test, in 7 days and at the end of remedial course. It was found out the predomination of sympathetic part with decreasing adaptive possibilities in steroid -dependent asthma patients. The administration of corticosteroid short-term courses in combination with magniumis optimum. The appreciation of treatment requires to take into account drug’s influence on hum an regulative system .

The cortisol blood level and its change after taking dexamethasone (D) was studied in comparison with the main melatonin metabolite — 6-sulfatoxymelatonin (6-SO M T) urine level in 16 aspirin-induced asthmatic patients (ABA), 19 non-aspirin-induced asthmatic patients (NABA) and 16 normal subjects. It was found that after receiving dexamethasone cortisols synthesis was sharply inhibited in aspirin-induced asthmatics who had low 6-S O M T urine excretion level. The absence of correlation between cortisol plasma level before and after taking dexamethasone can reflect the epiphysis- controlled regulation disorder in the central links of hypothalamic-pituitary-adrenal system that can promote the development of the secondary glucocorticoids adrenal failure in chronic stress.

32 patients with different clinical and radiological acute pneumonia variants and severe onset, which were divided in two groups by blind method, were examined. Thyotriozalin’s clinical efficacy and its influence to inhibitory blood potential in acute pneumonia were investigated. It was revealed that the inhibitory blood potential increased in taking thyotriozalin patients which associated with clinical improvement and more rapid recovering.

The possibility of correction of X -ray-induced rat lungs pathology was investigated after a single intratracheal administration of phosphatidylcholine-cholesterol liposomes in dose 40 mg per kg of body weight. The rig h t rat lung was irradiated in dose 12 or 14 Gr once. The lung tissue underwent histological and electron -microscopic examination using morphometric methods in 7 and 13 weeks after irradiation. The decrease of intensity and extension of radial alveolitis was revealed. Ultrastructure alteration of some alveolocapillary barrier elements in treated animals was lower than in untreated ones. Intratracheal liposome administration can be used in complex therapy for the reduction of the severity of radio-induced lung injury.