Comparative assessment of different aspects of pathomorphosis of pulmonary tuberculosis in Belarus was made on the basis of 968 post-morten examinations and 186 lung resections in cases of fibrotic caseous tuberculosis for 1981–1985 and 1986–1994 periods. The following features of pathological anatomy of pulmonary tuberculosis in com temporary conditions were revealed: acute progressing course, prevalance of causeous necrotic components with supparation and mild granulematous inflammatory reactions, promt development of lung dissemination. There is general tendency for increasing of post-primary adcnogenic tuberculosis in old patients, dessiminated pulmonary tuberculosis and caseous pneumonia. Two forms of caseous pneumonia were yielded differentiating by experession of local immune cell reactions and reversibility of pathological process.

We investigated case hystories o f 1230 patients with pulmonary tuberculosis treated in phthisiatric hospital. 340 patients (27.7%) have had lung diseases of non-tuberculosis origin. Nonspecific inflammatory pulmonary diseases such as pneumonia, bronchitis and malignant lung tumors were revealed more often. The basic causes impending the proper diagnosis of bronchopulmonary diseases at out-patient and in patient stages were evaluated. Informative methods verifying lung diseases were determined and measures improving diffrential diagnosis of bronchopulmonary diseases were defined.

The impotence and results of different programs for treatment of acute necrotic-purulent lung destructions were studied. The bacteriological analysis of abscess’s punctures revealed nonsporeforming anaerobic organisms in 100% of all cases (54 patients). Diagnostic criteria determining clinical forms and courses of diseases w ere elaborated. The effective methods of bronchial drainage and substitution therapy were suggested for each form of lung destructions. In case of giant cavities (20 patients) organ-preserving operations were worked out instead of lung resections. Secondary bronchiectasis may precede lung purulent destructions and that fact must be taken into account when determining the volume of resection. The suggested methods of diagnosis and treatment of lung destructions allow to decrease the mortality (6.7%) and chronisation of diseases (3.8%).

The efficacy of different treatment programmes using enterosorbent Polifepan, α-Tokopherol, L-Thyroxine and their combinations for wide-spreading pulmonary tuberculosis was stidied in patients living in districts with radionuclear pointions. It was found that combined treatment with Polifepan and α-Tokopherol besides their antioxidative and antiaterogenic effects may normalise hormonal regulation by stimulation the basal secretion of thyroid hormons and testosteron and diminishing the stress reaction. The use of α-Tokopherol besides complimentary action lead to deacreasing of peroxide lipid oxidative products and atherogenic factors.

The increased radiation level after Chernobyl catastrophe changed the structure of morbidity in Belarus and also influenced on pathogenesis and clinical features of internal diseases. We compared the pecularities of pulmonary tuberculosis and chronic lung diseases in two groups: in patients having been exposured to irradiation (Chernobyl catastrophe liquidators and inhabitants in radionuclide polluted territories) and in non-exposured patients (inhabitants of Minsk and Minsk district).  For the first group in patients with pulmonary tuberculosis there was rise in disease severity with tendency to chronisation, more frequent complications such as bronchial tuberculosis and non-specific bronchitis, antituberculosis drug resistence, prolonged hospital stay and in some cases diseases progressed resulting in patients deaths. In patients with chronic pulmonary diseases after radiation exposure the exacerbations were 1.5 times greater comparing with second group. We considered that one of reasons for pathomorphosis of lung diseases may be functional alteration of monocytes and alveolar macrophages, in particular changes in production tumor necrosis factor (TNF). In first group of patients with pulmonary tuberculosis the spon taneous syntesis of  TNF was activated, but induced syntesis was reduced; there were also increased level of monoc ins and reduced level in bronchoalveolar lavage fluid (BALF). In patients with chronic lung diseases the a tivation of spontaneous synthesis of TNF and reduction of induced synthesis of  TNF were more significant. In patients with chronic lung diseases living in radionuclide polluted territories the decreased level of TNF in BALF was revealed. The disorders of TNF synthesis and it’s contents in biological fluids correlated with clinical course of diseases.

The combination of bronchial asthma and chronic bronchitis is inevitable in old astmatic patients. The tolerance for sympatomimetic bronchodilatators and small reversebility are the grounds for elaboration of optimal schemes of bronchodilatation therapy. The including of antycholinergic agents into medical programs allow to obtain improvement of bronchial conduction and decrease the use of sympatomimetics.

Complex of modem biochemical approaches in study of lung surfactant content, composition and cell metabolism is analysed in the article. On the basis of received experimental results the advisability of investigation of the condensate of respiratory air as a substance, conteined lung surfactant, is called in question.

In 69 patients with pulmonary sarcoidosis the following homeostatic indices were studied before and after treatment: parameters of immunological tests, peroxide lipid oxidation, enzyme antioxidant defence, hormonal profile. The considerable disorders of all chains in systemic immunity were revealed: attenuation of T-lymphocytes with their subpopulation discrepancy, decreasing levels of IgA, M, G and increasing level of fibronectin. Significant changes in bronchopulmonary lavage fluid were found: decrease of alveolar macrophages, increase in lymphocytes, neutrophils, fibronectin and secretory IgA. The intensification of peroxide lipid oxidation was accompained by reduced antioxidant defense and pronounced hormonal disbalans was also marked. The criteria for differential diagnosis of pulmonary sarcoidosis and tuberculosis were elaborated.

The presented study was aimed at evaluation of the origin, peculiarities of pathogenesis, diagnosic problems, treatment and prophylaxis of exipiratory prolapse of membranous wall of the trachea and bronchi. As a result of complex examinations of the patients suffering from exiratory invagination of tracheobronchial noncartilaginous wall, clinical, endoscopical and functional features of disease were systemized and diagnostic criteria revealing the pathology during mass examination of the population were elaborated. On the basis of the obtained data the clinical classification of tracheabronchial dyskinesia was improved and the degrees and forms of expiratory prolapse were singled out. For the first time it was shown that this disease may be accopained by significant ventilation disordres and tension of the vegetative and cardiovascular systems which promote the development of such complication as pulmonary emphysema, chronic bronchitis, bronchial asthma and cor pulmonale. There were grounded methodical approaches towards complex treatment and prophylaxis of this respiratory pathology.

The influence of lung surfactant on E-rosette formation by pulmonary lymphocytes, the activity of secreted interleukin-1 and complex influence of macrophages on fibroblast growth were studied in rats with developing pneumofibrosis was found to loose the ability to decrease E-rosette formation of pulmonary lymphocytes. Cultivation of pulmonary macrophages in the presence of lung surfactant induced an augmentation of the secretion of interleukin-1. Cultivation of skin-muscular fibroblasts in the medium, in which macrophages had been preliminarily incubated, was accompanied by a decrease of 3H-thymidin incorporation in DNA of fibroblasts. Addition of lung surfactant to the medium enhanced this effect. The suppressive effect of surfactant-macrophage system from the lung with developing fibroblasts was the most manifested as compared to control. The more expressive effect of the surfactant from fibrotic lung on fibroblast growth was found to be a prostaglfndin-dependent process.

The possibilities of low energetic transcutaneous laser exposure use during pneumonia treatment were studied in 71 patients. It was shown, that that laser use in therapy complex results in fastening clinical disease manifestation regression and lysis of pneumonia infiltration, in decreasing residual abnormalities in lungs. It was concluded about antiinflammatory action of laser transcutaneous radiation exposure. The latter is recommended for the practical use.

Calcium and magnesium concentrations in senim, erythrocytes, lymphocytes, expiratory condensate, and daily volume urine were evaluated in 23 patients with preasthma, 31 ones with bronchial asthma, and their 23 first degree relatives (parents and children) by atomic absorbal spectrophotometry (AAC–508, “Hitachi”, Japan) and selective ionometry (Microlyte. “Kone”, Finland). The magnesium deficit and calcium excess were found in all the examined in blood elements, and diary urinal magnesium excretion decrease was found while parathormone and calcitonine serum concentrations were stable. It was suggested, that cell electrolyte content failures are the initial defect on contrary to endobronchial homeostasis changes of bivalent cathions and may be found before clinical manifestation of bronchial asthma.