The postponed survival with profitable outcomes of bronchial asthma was studied in 3 patient groups which were divided with the medical service and patient training quality. It was found, that patient undertraining and low medical service quality are unprofitable prognostic factors during bronchial asthma (BA). The following are the most unprofitable: the form al character of the dynamic following up in patients; the wrong way of patient behavior during BA exacerbation; the absence of conscious approach in patients to treatment and exacerbation prevention of BA. The effect of the medical service and the patient training quality has a postponed character, that should be taken in conciseration during efficiency evaluation of training programs and changés of medical service organization for BA patients.

The asthma patient training is one of the most important goals for health service. The objective of this study was to create training program and investigate its efficacy in the asthma out-patient group. Data were collected from patients questionnaire, physical examination, analysis of case histories, and lung function tests. The patients were examined before and 1 year after intervention. 60 asthma patients were in the actual group and 29 patients in the control group. The program included 12 subjects, concerning of main principals of asthma self-management and self-control. The course was conducted 2 times a week during 1.5 months in the asthmatic groups. The number of the patients in the each group was 10–15 patients. The duration of the each session was 1–1.5 hours in the asthmatic groups. The main results of the program were significant improvement of knowledge about disease, decreasing of hospitalisation rate in 2.3 times, emergency visits in 2 times, exacerbation in 1.6 times. Significant improvement in MDI technique and adherence to maintenance drug therapy was showed. The number of patients, using peakflowmeters, spacers and individual nebulisers increased substantially. Thus, achieved results showed high efficacy of suggested program and necessity of wide application.

Functional activity of pulmonary surfactant was studied in patients with malignant tumors and nonspecific inflammatory process in the lung tissue. Minimal and maximal surface tension (ST), hysteresis form, and stability index (SI) of bronchial lavage fliud were estimated with Willihelmi’s surface balance. The static surface tension of expirated condensate was studied too. The study resuts showed the significant decrease of surface active property of bronchial alveolar lavage fluids during pneumonia (SI=0.58±0.04, p<0.001). During the examination in patients with cancer progression, differences in ST and SI parameters were noted. The extreme depression of surface active properties (SI = 0.41±0.03, p<0.001) was noted in patients with the III–IV stage of lung cancer with expressed tumor germinatings into lung tissue and with atelectasis, while in earler stages of cancer, these ST parameters did not differ from those ones in pneumonia (S1=0.62+0.06 and S1=0.58+0.04 respectively). That points on the nonspccifics of functional surfactant activity depression during the tumor progression. During the expirate study, the insufficient increase of static ST was noted in pneumonia and cancer patients in comparison with controls.

Interiiidividiial variability of the configuration of maximal expiratoiy flow–volume curves (MEFV curves) was investigated in 2009 men and 1910 women aged 20 to 70 years. Three configuration types of MEFV curves were separated by means of quality analysis of the curves: “linear”, “convex", and “concave” into the volume axis. Three forms were separated in the “convex” type: spherical, trapezideous and trapezideous with concavation in the last 14 of FVC. The “concave” curves differed on the bend degree (into the volume axis side): the bend in the last 1/4 of FVC, moderate concavation of the whole curve, and extreme concavation which is close to those in patients with impairments  fairways. “Convex” forms were found in 23% of examined normals, “linear” ones were found in 15% of normals, “concave” ones were found in 41% of normals. “Pathologic-bent” curves were found in 11% of nonnal subjects. Volumic (FVC, FEV₁), flow (PEF, MEF₅₀, MEF₇₅, MEF_25-75), and time (MTT and TFVC) parameters were respective to curve forms that are mentioned above. FVC, FEV₁, MEF₅₀, and MEF₇₅ were greater in cases of “convex” forms and were decreased parallelly to curve concavation increase. On the contrary, MTT and TFVC were greater in groups with “concave” fonns of curves and increased parallelly to the concavation increase. It was found, that “concave” curves are featureous for humans which are older than 40 years. Cases of the “pathological–bent” curve did not depend on smoking. The more often cases of the “concave” curve form in humans over 50 years old allow to explaine formation of various flow–volume curves with age changes in airways and pulmonary tissue. The “concave” flow–volume curve fonns obtained in 52% of the examined did not allow to discuss them simply as a qualitative diagnostic sign of pathology in mechanical properties of lungs.

The reliability of estimational criterias of normal limits of flow–volume parameters was analysed on results of examination in 3544 healthy persons. During the analysis, preliminary elaborated criterias of estimation of parameter normal limits were used. The limits were defined at the level of the parameter variance (M-1.64σ) in healthy persons while converting it into the percent of predicted values. It was found, that this criteria provides the satisfactory diagnostic reliability for FVC, FEV₁, MEF₂₅, and MEF_25-75. As to MEF₅₀ and MEF₇₅, this criteria use may lead to the maldiagnostics in subjects having “concave” flow–volume curves. Due to variability of MEF in the second FVC half, the further diapason widening of normal values is irrational. The way based on simultaneous estimation of FVC, FEV₁, PEF, MEF₂₅, MEF₅₀, MEF₇₅, and MEF_25-75 changes is more preferable.

The efficiency of chronic treatment with salmeterol was estimated in 11 patients with mild and moderate bronchial asthma in remission stage. Salmeterol was unhaled via a diskhaler (Glaxo Gmbh, Bad Oldesloe, Germany) in dose of 50 mkg/puff twice a day during 4 weeks.

After regular treatment with salmeterol in patients with asthma, it was found significant increase in pulmonary function parameters (6.0% in FVC, 6.5% in FEV₁, 9.0% in FEF₂₅, 40.9% in sGaw, and 20.8% decrease in RV) and airways hystamin sensitivity decrease (the increase of PD₂₀ logarithmic value in 0.6 mg/ml, p<0.05). That corresponds to the PD₂₀ increase at 2.87 times in average. During the whole treatment period, the stable remission was noted in the patients.

During the prolonged use, salmeterol is high effective remedy for patients with mild and moderate bronchial asthma.

Reactive osygen species generation (ROSG) in alveolar macrophages and blood leukocytes was studied in 20 patients with sarcoidosis, 15 ones with idiopathic fibrosing alveolitis (IFA), and 20 healthy volunteers by the luminol dependent chemiluminescence method. The lipid peroxidation state was estimated relatively to malonic dialdehyd concentration. The antiperoxide activity of serum (SAA) was studied relatively to the lipid peroxidation stability to iniciation by hydroperoxide. Pulmonary bioptates from the patients were studied by electronic microscopy and the immunohystochemical method. During sarcoidosis exacerbation phase and early stages of IFA, the significant increase in ROSG was noted in blood leukocytes as well as in alveolar macrophages in comparison with controls (p<0.01, p<0.05 respectively). During the sarcoidosis remission period and the “honeycombal lungs” stage of IFA, ROSG parameters decreased down to the control level. Nosological features of IFA, that differ it from sarcoidosis, were based on the increasing o f lipid peroxidation parameters at the background of ROSG decrease. On the contrary, there were noted coupled parallel fluctuations of ROSG and lipid peroxidation processes in sarcoidosis. During IFA, alveolar macrophages were characterised by greater ROSG parameters, the monocytoid type of différenciation, and the high synthesis activity, that was shown during electron microscopy and immunohystochemistry. The ROSG enforcement conditioned the nessessity to include antioxidants into the sarcoidosis and IFA therapy.

The effect of sulfur products in the air on public health was studied in 1992 to 1993. The study was a part of common Finnish Russian investigation named as “IEVA”, there was not published information in Russia about atmosphere pullution effects on health of citizens exposed to chemical wase influence. Air concentrations of stinking wastes of sulfur products and sulfur dioxide in the industrial part of Svetogorsk were controlled by non-stop measuring devices. The special questionaire was proposed for examination in citizens. It contained the query of various information about health, the appearance of sympthoms (headache, eye and nose itching, cough, and dyspnea) during 1.5 years. The questionaires were given to 1100 citizens, and 990 of the questionaires were spread in Svetogorsk. The analysed answers were obtained in 430 persons in Svetogorsk (43%) and 85 persons in Losevo (77%). The greatest instant value of total concentrations of stinking sulfur products in Svetogorsk, as well 144 mkg/m, was 3 times greater than that in Losevo. Average values of hour mean concentrations of stinking sulfur products were 5 mkg/m³ in Svetogorsk (period of 06.01 to 24.06.1992) and 12 mkg/m in Losevo (period of 21.07 to 07.11.1992). The greatest hour mean concentration of sulfur dioxide and the greatest daily value were 540 mkg/m and 125 mkg/m³ respectively in Svetogorsk, and these ones were 123 mkg/m and 33 mkg/m respectively in Losevo. During the whole study period, the mean concentration of sulfur dioxide 16 mkg/m and 10 mkg/m in Svetogorsk and Losevo respectively.

Based on literature data, the effect of endothelial relaxation factor on hypoxical vasoconstriction, pulmonary circulation regulation, the pressure in pulmonary artery, and vasal resistance was discussed. New abilities of Corvaton in treatment of pulmonary hypertension and its effect on circulation were described.

The expression of NADPH-diaphorasae co-localizated with NO-sinthase in bronchial epithelium of human embryos in First and second half of gestation was studied thopochemically. The expression of NADPH-diaphorasae was decreased in embryos of first half of pregnancy and was increased in embryos of second half  of pregnancy in bronchi in the direction of 11 to 16 degrees. The result of increasing enzyme expression in embryos of the second half of pregnancy confirms the lung readiness to functioning.

Clinical anatomical analysis in 107 diphtheria cases with lethal outcomes was carried out in adults during 1991 to 1995. The airway injury is the most frequent complication of diphtheria cases in modern time. The inflammation character manifestâtes in its early progressing and spreading down to bronchioli. During diphtheria, the lung injury has a nonhomogenous character, that is caused by differet agents. Caused by diphtheria corin bacteries, the changes in airways are quite featurefull and allow to carry out morphologic diagnostics among different ethiological entities.

Experimental model of noninfectional granulomatosis in lungs was elaborated by the authors. The lung granulomatosis was induced by Sefadex A-25 aerosol inspiration in Wistar rats. It was characterised by the mature macrophagal granulomas appearance in couple with acute bronchitis and alveolitis. Granulomatous reaction in lungs was accompanied by extreme hyperplasia of lymphoid bronchial folliculi. The bronchial alveolai lavage cell count, especially neutrophil, lymphocyte, and polynuclear macrophage counts, increased during the experiment. Maximally manifestated changes of the mentioned parameters were noted after 7 days since Sefadex A-25 aerosol inhalation. Using the elaboreted model of noninfectional pulmonary granulomatosis, it was demonstrated that the model can be used to estimate the efficiency of antiinflammatory and immunomodulating pharmacological products, as well Budesonide, which are used in pulmonology.