Bronchial challenge is a powerful measure for C O P D differential diagnostics, treatment quality estimation, and action efficacy of various medications. Recently, many estimation ways are proposed and standardised for each bronchial challenge technique. The standard advances strict demand s to the choice of estimation criterias and methodically defined protocol fulfilment. That provides the comparability of test results. However, the current standard restricts the method ability by evidence of bronchial hyperreactivity in patients.
Two year experience of routine evaluation of bronchial hyperreactivity in called for military service and exploration experience of new drugs were the basis of proposed ways to estimation of bronchial challenge results. The new ways allow to extend diagnostic abilities of the method by means of information about current impairment pathogenesis and to open wider the action mechanism of antiasthmatic medications.
The short description of the currently acted standard of nonspecific bronchial challenge method with dosed aerosoles is presented in the article. New estimation parameters are proposed, analysed, and grounded. Advances of new method modifications are illustrated. Practical advices for use are given. The authors hope, that the article will be helpful for physician s and scientists dealt with bronchial hyperreactivity problem and new drug testing.

An experience of organising a speciality named “Engineering in medicobiological practice” on the basis of the Medical faculty in the Tula State Technical University was described in that article. The author proves scientifically the necessity of that speciality, expounds the fundamental principles of education standards, formulates the practical measures and shows the special training possibilities using pulmonology as an example.

Flow—volume curve parameters were studied in the group of 61 healthy children, aged 11 + 2.8 yrs, before and after fenoterol inhalation of 0.2 mg. The difference between initial and postfenoterol values was expressed in % predicted. All parameters significantly increased after inhalation. Airway broncholytic response was calculated as parameter changes in the range of M ± 1 .96 σ. These normal ranges are recommended as a criteria for individual evaluation of inhalation broncholytic test with fenoterol in children and adolescents.

Facts about psychodiagnostic testing use in complex examination in patients with chronic bronchitis were reported in this article. The presence was proven of clear dependence between somatic and psychic state of the patients, the progressive personality anxiety increase coupling with development of clinical and physical breath insufficiency syndrome signs. It was shown, that persons with great level of personality anxiety percept more expressive dyspnea and demonstrate significantly decreased exercise tolerance in comparison with those with low and moderate levels of personality anxiety.

The dynamics of airway resistance at the first stage of forced expiration was studied by modified method of bodyplethysmography in 16 males, aged 5 5 ± 1 .4 yrs, with chronic obstructive bronchitis (COB), 19 patients (5 males and 14 females, aged 38±3.1 yrs) with idiopathic fibrosing alveolitis (IFA), and 12 healthy subjects (7 males and 5 females, aged 3 8 ±3 .1 yrs). Instant R_aw values and fitted values of P_a were estimated, then the “ R_aw -P_a ” curve was plotted. The experimental points were approximated linearly, and the equation of R_aw dynamics at the first stage of forced expiration was calculated: R_aw = R_aw (P_a = 0)+b^.P_a , where b is an extent of the approximation line decline. R_aw at P_a= 0 was closer to its quite breath values in healthy persons. It was decreased in patients with COB and was increased in patients with IFA. The “ b ” parameter was increased in COB patients in comparison with healthy persons and was stable in IFA patients.
Therefore, these features of the parameters allow to consider them to be a useful index of airway deformation for differential diagnostics in “flow —volume ” testing.

More than 3000 respiratory function testings were analysed in patients with bronchial asthma (BA) and chronic bronchitis (CB ), who were medicated during 4—11 months with inhalational glucocorticosteroids (IGCS) of high and low doses, with theophilline, β₂-adrenomimetics of prolonged action. The patients were supervised during 5—22 months after abolition of the medicine. The efficiency of the drugs was analysed in 67 patient with most complete data on FEV₁ dynamics with its next estimation in the period of drug abolishment.

The difference between the velocity and degree of FEV₁ decrease after abolition of the medication was found, and that decrease depended not only on the dose of IGCS but on FEV₁ initial values. FEV₁ decreased faster and greater in patients medicated with high doses of IGCS and in ones withinitial FEV₁ greater than 30% pred. (p<0,05). Patients with BA were more sensible to the therapy. The same differences in FEV₁  dynamics were found in patients medicated with β₂-agonists and theophilline. The former treatment does not yields on its efficacy to IGCS treatment, especially in young patients with BA, and does not depended on the disease stage. It is necessary, however, to keep treatment constant taking into account the sharp FEV₁ decrease in patients with BA and СВ after β₂-agonist abolition. The theophilline treatment ought to be began at any stage of the disease, especially in young patients, and carried out continuously to eliminate possible worsening of the bronchial pass after medication abolition.

Examination results in 95 children after bronchiolitis relief caused the obliteration development are presented in the article. The patients were divided into the following groups relatively to prevalence of obliteration: the group with Me Leod syndrome, the “lobar obliteration” group, and the “focal obliteration” group. The characteristics of every marked obliteration types was observed. The data of histology studies in pulmonary tissue were observed in 4 operated children.

The study aim was investigation of the efficacy of β₂-sympathomimetic Gen-Salbutamol inhalation in therapy with compressor pneumatic nebulizer “Pulmo-Aide” use in 24 patients with various entities of bronchial asthma. The medication was used in case of pocked inhaler unefficacy. The single dose of Gen-Salbutamol (2.5 mg) was inhaled 2—4 times per day. The most of the patients (22 of ones) demonstrated the positive effect. The side effects were found in 2 patients. The authors concluded about the high efficacy of β₂-sympathomimetics inhalations with “Pulmo-Aide” nebulizer use in patients with bronchial asthma exacerbation.

Respiratory distress syndrome was studied in 14 patients hospitalised with diagnosis of acute occupational nickel carbonyl intoxication. The severity of respiratory failure resulted from pulmonary parenchematous edema was found to be the major predictor of intoxication outcome. Steroid medication (prednison) in couple with curpentil is capable to improve quickly the clinical status and may well prevent the postponed pneumofibrosis in that patients.

Results of follow-up in 27 patients with Williams—Campbell’s syndrome was present in the article. It was shown, that disease defining anatomical defect leads in children to formation of chronic obstructive bronchopulmonary process with suppurative endobronchitis, diffuse located sacculative bronchiectasia, and pneumosclerosis. The clinical symptoms manifestate in 96.3% of patients during first three years after birth and are characterised by intermittent cases of pneumonia and bronchoobstructive syndrome.

During Williams—Campbell’s syndrome course, diffuse suppurative bronchitis or bronchial suppurative catarrh with chronic course, as well as great number of tracheobronchial tree abnormalities, are character for endoscopic view. The coupling of anamnestic data, clinical signs, and typical changes in bronchogramms and spirogramms allow to diagnose lighter Williams—Campbell’s syndrome. The disease prognosis is serious. It is defined directly by extent of bronchopulmonary process and depends on pulmonary hypertension and cor pulmonale developing.

Lipid peroxidation processes and antioxidant enzyme/nonenzyme system activity in alveolar macrophages in patients with preasthma and bronchial asthma were studied in comparison with disease phase. Hyperactivity of lipid peroxidation, lipid antioxidant ability suppression and expression of peroxide generation processes were found in the patients. During bronchial asthma remission, the content of lipid peroxidation products decreased, although not to normal values. A tendency to antioxidant macrophagal activity increase in comparison with asthma exacerbation patients was noted.

Postponed outcomes of bronchial asthma were studied in 55 patients by urgent method. During 5—10 years, continuous therapy with inhalation corticosteroids (CS) as well as in combination with oral ones was prescribed to 17 patients (group A). Ten patients were medicated with CS episodically (group B), and 28 patients weren’t medicated with CS (control group). Ten year survival without fatal outcome (death, hazardous to life state development, invalidisation due to bronchial asthma) was 76±10% in the A group, 23±10% in the B one, and 42±9% in the control one (p_A-B< 0.05 ; p_A-C < 0.05; p_B--C > 0.05). The most of cases of unfavourable bronchial asthma outcomes in the A group were noted during the first year of the CS therapy use. The obtained results allow to consider that a) prolonged continuous CS therapy enable to improve the postponed prognosis of bronchial asthma; b) defensive CS action develops gradually; c) irregular CS use does not improve the postponed prognosis of bronchial asthma; d) antiinflammation CS therapy absence is matched by high frequency of postponed unfavourable outcomes (up to 50%).

The method of biological control with the original technique of feedback with electroencephalogram was described. The result of EEG computing as an informational signal was used. The efficiency of the technique was proved with the significant decrease of the variance of the Shiposh’s vegetative ratio (the computed with the Lusher’s test parameter), with the decrease of the reactive anxiety, and positive changes of EEG.

The functional state of alveolar macrophages and their predecessors, mononuclear blood phagocytes, was dynamically studied in 71 patients with bronchial asthma during high-land climate therapy in 3200 m over the sea. In the same conditions, 12 subject without pathology evidence were examined as controls. The phagocytal cell activity, the state of cell receptor apparatus, oxygen dependent and oxygen independent metabolism, the content of serum and secretorial IgA were studied in that patients. The 25—30 days being in high-land conditions resulted in corrective influence on mononuclear phagocyte system besides of the expressed clinical effect, that had became fit to normal values in the most of parameters.