The correlation between the bronchial asthma development specificity and the disease internal structure features is considered. The study was performed in cooperation with the department for boundary psychological pathology and psychosomatic disorders of the Research Institute for Clinical Psychiatry of the NTsPZ Research Center of the Russian Academy of Medical Sciences.
49 women and 29 men aged from 21 to 65 were examined. All the patients had a verified diagnosis of the bronchial asthma. The disease duration was at least 1 year. The questionnaire contained a wide range of questions covering the peculiarities of a patient perception of his state, his attitude to the social significance of the disease consequences, changes in interpersonal relations resulting from a pathological process and others. The factor analysis of the poll was fulfilled. Five independent factors were distinguished. It is possible to interpret them as the main types (variants) of the disease internal structure. These factors were named as follows: hypernosognosia, ego-distennity, “ possibility of concealment” , “attribution of responsibility” and “shame” . The specific features of bronchial asthma course is classified in three groups with due consideration to the disease internal structure. The first group includes symptoms of the disease corresponding to the impossibility of a self-control of an acute bronchial asthma course. The second groups includes persisting symptoms of the bronchial asthma. These symptoms show not the degree of the disease severity but progradientness of the somatic suffering. The third group combines the repelling (evident to everybody) disease indications. The integral assessment of the bronchial asthma seventy excluding the index of the peak full expiration rate, does not evident of the correiation with the disease internal structure. It is possible to use the given differentiation of the bronc'niai asthma parameters for the forecast of the disease internal structure dynamics. Consequently psychotherapy is possible at a well-time in order to correct the patient’s behavior and the disease perception and to optimize the cooperation between the physician and a patient.

Patients’ unawareness of their pathology is a serious obstacle on the way of the disease successful overcome. In 1992 the development and introduction of special educational programs for patients was started within the framework of the National Program for conquering the bronchial asthma. In particular Asthma-Schools have been created.
When determining the efficiency of a bronchial asthma treatment the result has to be assessed from various points of view including a patient’s Life Quality.
In order to determine the Life Quality the SF-36 general questionnaire was chosen. Survey was carried out in three Moscow municipal clinical hospitals and in one clinical diagnostic center. Three groups of respondents including 177 patients were surveyed.
A significant decrease in the Life Quality was revealed for the patients suffering from bronchial asthma in contrast to the almost healthy people. It was shown that the Asthma-Schools promoted the patients’ Life Quality improvement. First and foremost these schools contributed to their social adaptation together with strengthening the psychological and emotion realm and increasing the vitality.

The piace of psychotherapy in the rehabilitation system for bronchial asthma patients is described. The article consists of two parts. Part I is focused on the asthma’s psychological factors including the description of the Asthmatic Club. Specific group dynamics is given as a three-phase process.

A place of psychotherapy in the rehabilitation system for bronchial asthma patients is described. The article consists of two parts. Part II presents a psychotherapy model. Psychotherapy of alexithymia and psychotherapy of the asthma’s secondary psychological symptoms are considered.

The NADPHN-diaphorase activity of the bronchial epithelium and bronchus mobility were studied for the healthy rats and the rats sick with parasitogenic pneumonia. The both groups took acetylcholine inhalation. It was found out that the ferment activity grew for the both groups. However the bronchus mobile response differed. The relaxation was observed for the healthy rats and the constriction — for the sick ones. Preliminary atropine injection blocks these effects up.

The NADPHN-diaphorase activity was studied for the epithelium and bronchial mast cells under aeafferentation caused by rats’ vagus cutting, it was determined that the deaffereniation results in the increase of the number of the mast cells together with their degranulation inhibition. This process also reduces the NADPHN-diaphorase activity and causes bronchus relaxation and distrophy. The results have given evidence of the vagus nerve coordinative role in the control of the nitrinergetic and mastcellular mechanisms regulating bronchus mobility.

Lung cancer is 4.5—7 times more frequent among the people sick with tuberculosis in contrast to the main population. A clinical morphological examination was performed for the specimen from 344 patients with a peripheral lung cancer and from 70 patients suffering from focal pulmonary tuberculosis. The examination confirmed the tuberculosis significance as a background disease for a lung cancer development. Fibrosis foci of tuberculosis origin have been determined on tumors in 73 percent of the “cancer in cicatrix” cases, in post-tuberculosis foci the specific weight of hard degrading collagens IV,V and collagen of the type III grew. The latter collagen can be found in an embryonal lung. The importance of tuberculosis for the lung cancer development is confirmed by a relatively frequent detection of precancerous changes in the iung epithelium for the patients suffering from the post primary pulmonary tuberculosis (23 percent). There was obtained new data on the production of the insuiin type growth factor 2 and protein of types 2 and 4 by the tuberculosis granuloma’s cells. These parameters were derived with the use of the ¡mmunohistochemical method. The described growth factor is a strong mitogen able to paracryinically stimulate the lung epithelium proliferation. In its turn this provokes a lung pre-cancer and cancer development. A correlation between the tuberculosis and the lung cancer due to chronic inflammation decompensation, reparative regeneration and sclerosis is discussed. The expediency of a surgical treatment for the patients with chronic focal tuberculosis is considered.

93 patients suffering from bronchial asthma and taking intal were examined. The phenomenon of decreasing the need in glucocorticosteroid hormones injected in vitro was studied. In order to estimate the tissue sensitivity to the giucocorticosteroid hormones the cortisole-absorption of lymphocytes (CAL) and erythrocytes (CAE) was determined together with its modification for preincubation with 0.2 ml of 5x10^-4 g/l intal solution. For two-week intai course the number of asphyxia and cough attacks reduced. We managed to reduce the dose of injected glucocorticosteroid hormones for 62.5 percent of patients. However the level of 11-OKS blood plasma did not changed. The CAL and CAE indices for patients suffering from bronchial asthma was authentically lower than those for healthy people. After preincubation of blood cells with intal solution the CAL increased for sick patients, but for healthy peopie this phenomenon was not observed. The maximum CAL and CAE increment was observed for patients suffering from bronchial asthma with the main infection-dependent disease, on the background of steroid therapy (mainly by inhalation) and for initially reduced CAL indices. On the contrary for the patients with the normal sensitivity to cortisole the preincubation of cells with intal did not significantly influenced on CAL. Thus the in vitro preincubation of blood cells with intal promotes the increase of blood cells sensitivity to cortisole. Bronchial asthma patients with lymphocyte and erythrocyte low sensitivity to cortisole should be given chromoglycate sodium preparations in order to decrease tissue cortisole resistance level.

The study was aimed at the analysis of a possibility of the lung hypertension correction for patients suffering from a severe bronchial asthma with due consideration to various treatment.
48 patients with bronchial asthma were examined. Four clinical groups were specified. The first group (14 patients) took angiotenzin-transforming enzyme inhibitor (iATE) — enalapril with an average dose of 20 mg/day.
The second group (14 patients) took enalapri in combination with the plasmapheresis. The third group (8 people) took plasmapheresis only. The fourths group (12 patients) was a control group. These patients took basic therapy preparations only. These preparations were used for treating patients of all clinical groups.
The basic therapy preparations were cholinolytics, methylxanthines, β-agonists and corticosteroids (by indication). The clinical parameters (number of asphyxia attacks and/or coughing, dyspnea, rales in lungs - cumulative indices), indices of the external respiration function and diastolic pressure in the lung artery were assessed weekly. The latter parameter was determined by the impulse Doppler echocardiography technique on the basis of the flow shape at the iung artery’s vaive. The 6-stage Ali-Sadec-Ali scale (1988) was used for the assessment of diastolic pressure in the iung artery.
Initially all the patients had high diastolic pressure in lung artery (31 ±2,1) Mercury and low FEV₁(49,4±5,1).
After the treatment a reliable diastolic pressure decrease together with the FEV₁ increase was marked for the patients of the first and second groups. The breathing insufficiency has decreased aiso. These first two parameters did not chang for the third and fourths groups however clinical indices authentically improved.
Taking into consideration the results of the fulfilled analysis it is possible to draw a conclusion that in order to reduce the diastolic pressure in lung artery when treating severe bronchial asthma complicated with the lung hypertension, it is possible to use the isolated enalapril treatment or its combination with the plasmapheresis.

Human bronchial smooth muscular cells isolated by the alkaline dissociation technique were studied. Morphometric indices of myocytes were specified, in addition the contents of both DNU in nuclei and totai cytoplasma protein were determined using scanning cytospectrophotometer. Subpopulations of small, mid and large leiomyocytes were also distinguished. It was shown that the mid volume of smooth muscular cells in large, mid and small bronchi differ reliably. With the bronchus diameter to decrease, the share of small myocytes increases and the subpopulation of large myocytes decreases in the structure of the muscular tissue population. Small myocytes are the most dynamic component of the cell’s muscular tissue population. Their prevalence is considered relevant to the high adaptation and functional ability of small bronchi.

The problems of the clinical and economic efficiency of the bronchial asthma treatment with salben, saltos and benacort are considered. It is shown that the Russian anti-asthmatic preparations are not inferior to the foreign analogs as for the therapy efficiency. Introduction of these preparations into a large-scale clinical practice can provide for a considerable economic and social effect.