The number of the applications for medical care of the adult population caused by pulmonary diseases are reported. The dependence of morbidity from air, water and soil conditions as well as work conditions at big industrial enterprises was demonstrated. The possibilities of phthysiological service in hospitals for patients with pulmonary diseases and its dynamic control are presented. The structure of the main phthisiopulmonological service is described. The role of primary prophylaxis of pulmonary diseases and the necessity of state preventive program are emphasized.

The predicted values system for flow—volume loop parameters in normal children and adolescents 6 to 18 years old, girls and boys, was worked out. The system complements the analogous one for adults that was published formerly by Klement R.F. et al. The system is based on regression equations describing the overall means of data given by various authors and from the own study of 188 healthy children. The table of decrease ranges of forced expiratory flow indices was calculated on the basis of average residual standard deviation and the reproducibility of the data.

The character and connection between changes of peroxide lipid oxidation and immune profile were studied in 325 patients with acute pneumonia in different courses of the disease. It was found that inflammatory process in pulmonary tissue was accompanied with expressed intensification of peroxide lipid oxidation processes, with the decrease of the antiperoxide protection level, and immunodeficiency state formation. The most expressed secondary immunodeficiency corresponded to the highest peroxide lipid oxidation level and the considerable decrease of antiperoxide protection. The author presumed that peroxide lipid oxidation processes and connected changes of peroxide protection lead to universal membrane pathology during the abundance of the primary factor and the lack of the latter are the most common mechanisms of the inflammation in the lung tissue. The authors suppose that the study of the peroxide lipid oxidation character in connection with changes of other organs and systems allows to outlying the essence of pathological process in the pulmonary tissue, to estimate mechanisms of reparation (the sanogenesis) of the morphological structure and the function of the lung, and to elaborate measures for correction of the revealed dysfunction.

75 conventional healthy persons and 91 males with CB aged from 20 to 49 years were examined. The patients were divided into groups in relations to the disease duration and the bronchitis entity. The cholesterolesterase activity of blood monocytes was determined by the method of Brecher P. et al., and the content of common cholesterine, triglicerides, cholesterine of high dencity lipoproteids was evaluated with autoanalyser AA-P of “Technicon”. The study revealed that in patients with CB with the increase of the disease duration the activity of cholesterolesterase of blood monocytes was diminished significantly in comparison with the control group. In that time the clinico-morphological entity of CB did not influenced essentially on the ehzyme activity change. In patients with the high clinicolaboratorial activity of the disease the activity of cholesterolesterase was increased significantly during the sharp decrease of the common cholesterol level while the enzyme activity and common cholesterol concentration were diminished in subjects with the similar clinics though without the laboratorial changes.

The pharmacokinetics of the β-adrenomimetic saltos (salbutamol derivate) was studied in 7 adult volunteers given a single 12 mg dose of the drug. Maximum serum concentration С_mах after administration of the dose was 5.67±0.84 ng/ml (mean ± S.E.M) and the time to reach С_mах (T_max) was 4.17±1.17 h. Saltos treatment resulted in significant enhancement in half-life elimination and MRT of salbutamol to 16.6 and 26.6 h respectively. The conclusion is made that enhanced starting dose is recommended for the rapid achievment of the therapeutic drug level.

50 patients with various forms of bronchial asthma with moderate severity were investigated. The efficiency of Pulmicort—turbuhaler (PT) was evaluated in the patients by means ofthe clinical state dynamics, of the respiration function, of estimation of the need of aerosol simathomimetics and glucocorticoids in tablets. The treatment period was one month. The results showed the high efficacy of PT in bronchial asthma patients treatment. The severity and the frequency of asthma attacks and the need of sympathomimetics and glucocorticoids were decreased. After treatment with PT, the FEV₁ increase was 18%. The expiratory flow increased by 20%, 17%, and 15% at MEF₇₅, MEF₅₀, and MEF₂₅ levels respectively. During the aprobation of PT, there was satisfactory patience of the drug without side effects at the therapeutic dosage in 400—800 mkg/day.

The therapeutic effectivity of Berodual in 77 children with bronchial asthma was studied. The high effectivity of the drug in the decline of asthma attacks and in the disease remission achievement was revealed. Under the Berodual influence, regression of bronchial asthma is accompanied by reparation of the bronchial pass, by the increase of the cAMP concentration, by the decrease of the cGMP level, and by the increase of active adenilatcyclase in leukocytes.

56 patients with bronchial asthma (BA) were examined to evaluate features of the influence of trombocytes on active form oxygen generation (AFOG), peroxide oxidation of lipids (POL), and the antiperoxide activity of blood serum. AFOG and the serum peroxide activity were determined with the luminol dependent hemiluminescent (HL) method. The effect of trombocytes on AFOG was evaluated with comparison of delta-hemiluminescence (HL) under the influence o f serum with the trombocytes poverty (STP) and the one with the trombocytes excess (STE). The effect of trombocytes on HL of serum was determined with comparison of delta-HL of STP and STE under the H₂O₂ influence. The effect of trombocytes on POL was evaluated with comparison of the malon aldehyd content in STP and in STE. In comparison with healthy donors there was the decrease o f the inhibiting influence of trombocytes on AFOG (at 1.6 times), POL (at 1.2 times), and serum HL (at 1.5 times) in patients with the exacerbation phase of the disease. During the remission phase, the trombocytes inhibiting influence on AFOG, POL, and serum HL increased. The direct proportion was found between the decrease of the inhibited influence of trombocytes on AFOG, POL and serum HL and the severity of exacerbation. The great decrease of the inhibited influence of trombocytes on AFOG, POL, and serum HL was found in patients with steroid dependent and aspirin-induced asthma in comparison with those with nonsteriod dependent and atopic asthma. Thus, the obtained data testify about the inclusion of trombocytes into the pathogenesis of BA by means of the decrease of their function of inhibition of free radical processes.

The characteristics of erytrocyte insulin receptors (the number and affinity) by means of evaluation of the 125-I-insulin specific binding and level of immunoreactive insulin were studied during bronchial asthma (BA). Besides of the erytrocyte membrane, the glucose transport as a final effector mechanism was evaluated.

It was revealed that the level of the 125-I-insulin specific binding was higher during atopic BA (ABA) and was lower during infectional BA (IBA) than those in healthy subjects. During BA, the number of insulin receptors was decreased but their affinity was increased, especially during ABA.

ABA is characterized by the inverse paradoxal effector exflux of glucose from the erytrocyte instead of the influx of one revealed in healthy subjects. No any effects were shown in IBA patients.

The fat acid content of the expirate in 49 patients with acute pneumonia and in 43 ones with lingering forms of the disease were examined. It was found that the stearin-olein ratio was higher significantly in hospitilized patients with acute pneumonia than with lingering one.

After 15 days of treatment in patients with lingering pneumonia this parameter was significantly lower than in ones with signs of the clinical relief. The significant increase of the percent content of linolenic acid C_18:2 was found during the lingering form of the disease in comparison with the clinical recovery.

Thus, the significant dynamics of percent parameters of the fat acid content in the expired air condensate was revealed, that allows to determine the state of lipid structures of lungs during the various forms of the pneumonia course.

During experimental craniocerebral trauma, the hemorrhagic character of neurogenic pulmonary edema forces the impairments of lungs that is important in process of pathogenetical interpretation.

Systemic and regional extracorporal immunocorrection was used in complex treatment of 36 patients with acute lung suppuration. The method consisted of blood perfusion operation — leukocytapheresis with splenoplasmoperfusion with following fiberscope importation of cryopreserved autologic leukocytes into the pulmonary destruction focuses. Lung-pleural suppuration with the tendency to chronization of the process and with the drainaged focus, the tendency to intrapulmonary infection generalization are the indication for this procedure. Blood perfusion operation may be performed after the onset of the catabolic phase of lung suppuration only.

The results showed that blood perfusion operations and following infusion of the autoleukocytes into the infection focuses lead to optimization of both systemic and regional immune reaction and to the more quick focus destruction healing.

Wc have studied the efficacy of monoclonal extracorporeal anti-IgE-plasmoimmunosoibtion (EPIA) in treatment of 16 atopic asthma patients. We used new immunosorbent with immobilized anti-IgE-antibodies. The first group (9 patients) was treated by EPIA, the second group (7 patients) was treated only by placebo procedures. The investigation was done by double blind method. After EPIA in first the group good clinical results were obtained in 8 patients, in the second group we have seen clinical improvement only for a short time. It was not possible to decrease the number o f broncholitics and corticosteroids in patients of the second group. We have seen specific changes of the IgE serum levels after EPIA, but not after placebo procedures. Thus, EPIA is effective extracorporeal method for treatment of atopic asthma patients with high serum levels of IgE and plural hypersensitivity.

The luminescence examination of bronchial biopsy specimens taken from 52 patients with primary chronic bronchitis and 8 healthy volunteers (control group) was carried out using lectin sets marked with FITC having the various carbohydrate specificity. Selective lectin markers from healthy bronchial wall epithelial cells were determined. It was shown that defense properties of the normal bronchial mucus membrane are associated with glycoconjugates of goblet cells because mucus glands do not contains sialomucins. During chronic bronchitis, redistribution of lectin receptors is manifested by the increased level of binding with bronchial mucus formation apparatus cells of lectin which is akin to fucomucin and by the decrease of the content of receptors to lectin reacting with sialic acids (the decreased level of sialomucins). During basement hyperplasia and squamous metaplasia of germinal epithelium, the cellular differentiation impairment is accompanied with intensive binding of concavalin-A that isn’t normal characteristics of basal epithelial cells. That may prove significantly when immunoglobulin secretory component synthesis is impaired and local immune pathological reactions are formed. The revealed disturbances of production and those of the glycoproteins content in the epithelial structure of the bronchial wall during chronic bronchitis enable to include mucoregulators into complex pathogenic therapy of that condition.

104 patients with suppurative pulmonary diseases (SPD) were examined to study the functional state of rens for correction of traditional therapy. 32 healthy subject were as a control group. Glomerular filtration was evaluated with the endogenous creatinine clearance; clearances of concentration, osmotic active substations, and osmotic free water were calculated. Central hemodynamics was evaluated. Gammascintiography was carried out to estimate renal microcirculation.

Acute SPD (ASPD) were presented by pulmonary abscess, abscessed pneumonia, pleural empiema and staphylococcic pulmonary destruction. Chronic ones (CSPD) were presented by bronchiectasia and chronic purulent bronchitis. During ASPD, the increase of renal excretion of titred acids and total excretion of hydroions were revealed; during CSPD, these changes were more moderate. The scintigraphic data showed the significant impairment of renal microcirculation.

The results of the study showed that in patients with severe SPD the revealed impairments directed to the tubulointerstitial nephropathy formation. Dystrophy of tubular epithelium, focal sclerosis and lymphohystiocytic infiltration of interstition were found. Use of intravessel laser radiation in complex with traditional therapy promoted the normalization of osmotic homeostasis and the increase of the clearance of midle molecular size peptides.

The morbidity and the prevalence o f pulmonary diseases (PD) were studied on the territory of 5 regional zones and in the Yakutsk city. The mortality is evaluated on the base of the classification of Ninth Register of diseases, traumas, and death causes passed in USSR in 1986.

The morbidity of PD was stable and equal in average 253.9 and 275.3 in 1988 and 1992 respectively. However, there are some differences between parameters in different zones. The morbidity was significantly higher in the Arctic zone of Yakutia than in the South. Moreover, the morbidity o f PD takes the first place among the other pathologies, and the mortality takes the forth one. That situation is explained by the insufficiency of treatment and rehabilitation al measures.