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PULMONOLOGIYA

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No 1 (1993)
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https://doi.org/10.18093/0869-0189-1993-0-1

EDITORIAL COLUMN

EDITORIAL

ORIGINAL STUDIES

10-14 223
Abstract

Features of clinical and functional relations of fungal superinfection were studied in patients with the bronchial obstructive syndome (BOS) of following nature: fibrosing alveolitis, bronchial asthma and chronic obstructive bronchitis. Moreover, the comparison of the effictivity of different methods of antifungal therapy was carried out.

345 patients with BOS were investigated. The essential worsening of the basal disease cource was determined in addiction of fungal infection, that is most expressed in functional parameters of respiration.

Results of cultural sputum investigation are the most reliable diagnostic critherion of fungal superinfection, while using clinical parameters it is possible only to assume the superinfection.

The maximal efficiency of antifungal therapy with antifunctional chemicals in accompany with plasmaferesis was determined. Isolated immunostimulation in its turn leads to fungal invasion mutation in patients with BOS.

14-16 228
Abstract

In most cases, dyspnea pathogenesis remains studied insufficiently. Comparison was carried out of the expression extent of dyspnea, of the common respiration work (CRW), and bethaendorphine concentration in blood in 25 patients with infectional-allergic asthma, chronic obstructive, bronchitis, and pulmonary hyperinflation. Dyspnea was classified on Dembo scale. During the first degree of dyspnea, CRW was 0.85e.069 kgM/min, betha-endorphine concentration acheved ll.e2.26 pmoll/1, that exeeded. 28e.045 and 4.45e.81 of normals respectively. During the second degree of dyspnea, CRW was 1.24e.089, and betha-endorphine concentration was 15.1e3.49, and during the third one, it was 2.68e.81 kgM/min and 19.1e2.46 pmoll/1 respectively. It was speculated that the betha-endorphine concentration increase in blood influences on the level of increased load perception and on dyspnea sence formation.

16-23 117
Abstract

9 patients, 7 male and 2 female, aged from 20 to 65 years with nocturnal asthma (NA) were submitted to standart polysomnography in computerized sleep laboratory. Results of the study revealed that in patient group with Na in comparison with controls bronchoconstriction was more greater expressed. The sleep study showed the efficiency decrease of sleep with increased number of interventing wakefulness and drowsiness. Either the decrease or the absence of slow-wave sleep in some patients was observed. Alfa-delta intrusion and paroxismal activity were revealed with EEG. Patient respiration with NA was characterized by the presence of intermitting pereiods of hypoand hyperventilation. During REM and NR EM sleep, asthmatic attacks appeared. Obstructive apnea and hypopnea were often revealed in investigated patients. During the mentioned events, desaturation was not severe usually.

23-27 146
Abstract

As the lipid formation, lipid drops, osmiumphil platyfied corpuscles, grating structures of surfactant, cholesterine crystals, and lipofuscine granules were identified in alveolar and interstitial macrophages by electronic microscopy methods.

In process of pneumoconiosis, macrophages take part actively in the lipid exchange of lung and organism in general. During the entrance of actually unsoluble dust particles to respiratory organs, alveolar macrophages in the most extent provide elimination of superfluous lipids by means of airways.

27-30 178
Abstract

Abilities of bronchiscopic laser surgery were investigated in 170 patients with various pathological formations of trachea and bronchi. The saser endoscopic surgery was characterized as an effective method for radical and palliative treatments of benign and malignant tumors, scar stenosis of trahcea and bronchi, broncholytias, and some others. The increase of the laser intervention efficiency was assisted by the simultaneous usage of some additional methods such as electroexcision of tumors, endoprosthesis, and many others.

30-35 112
Abstract

As a result of executed studies of the functional activity of the adenylate cyclase system (ACS) of periferal lymphocites and the immunological status condition in patients with various cources of pneumonia, the stagiality of changes of basal intracellular c-AMP levels (pmoll/106 cells), the beta-2-adrenoreception activity, and lymphocitarial response to concavaline A was revealed.

The activity decrease of ACS at the beginning of pneumonia was correlated with the diminishing of such parameters as E-ROC, Ea-ROC, EAC-ROC, C3 complement fraction and with changes of levels of IgA, M, G, that is more expressed in patients with severe forms of the disease.

The tendency to the activity repairment of ACS after 7—10 days of hospital treatment was noted in patients with uncomplecated entities of pneumonia accompanied by immunological status normalization. The tendency to the adenylate cyclase activity repairment was noted also in patients cured with hyperimmune antistaphylococcus serum, that was not signed in patients with the complicated disease cured with traditional treatment only.

Afetr 21 days, in the group of patients with uncomplicated pneumonia cured with sustitutional immunological correction, the ACS activity coincided with immunological and clinical normalization of parameters. Firmy impairments of immunological parameters and the severity of clinical manifestation of the disease were accompanied by tyhe absence of similar c-AMP dynamics in patients with complicated pneumonia entities not cured with immunocorrection methods.

The dynamics of the lymphocite ASC activity of patients with various pneumonia forms demonstrates the process of clinical immunological changes and points to the positive influence of the proper usage of immunocorrection treatment on molecular mechanisms of immunity regulation during the mentioned disease.

35-49 151
Abstract

Steroid drugs are used in treatments of patients with bronchial asthma (BA) more than 40 years. The present study was devoted to mechanisms of corticoid dependance (CD) formation during BA. The betha-adrenergic and glucocorticoid reception status estimated by the level of stimulated with adrenaline c-AMP and by the glucocorticoid receptor number with the dissociation constant respectively were studied. The reception was investigated with the model system of periferal blood lymphocytes. Moreover, the fuctional status of adrenals estimated by basal concentration of serum cortisol sampled on an empty stomach was observed. Basing on the estimation of the resuts and on literature data the conclusion is made about two entities of CD in patients with BA named as primar and secondar CD. The primar CD is defined by the state degree of beta-adrenergic reception desencitization. The secondar one is characterized by adrelan and glucocorticoid reception insufficiency. Steroid therapy of BA patients with depressing doses induced and aggravated CD and corticoresistivity.

49-53 106
Abstract

At 97 patients with COPD (chronic bronchitis and bronchial asthma) the transoesofageal atrial pacing was made with determining the elecrophysiological index, and the influence of nicardipin and salbutamol was investigated,. It was found, that in 40 % of investigated patients silent myocardial ischemia was revealed, and in 31 % of ones some impairments of the cardiac rhythm were provocated with including ventricular and supraventricular extrasystolia, paroxismal supra ventricular tachicardia, atrium fibrillation, and the WPW syndrome. In 53 % of cases arhythmias appeared with myocardial ischemia simultaneously. Nicardipin promoted the conduction delay through the atrio-ventricular node and prevented silent myocardial ischemia and had the antiarrhythmic effect. On the contrary, after salbutamol administration the conductance speed of impulses increased, the frequency of silent myocardial ischemia appearance and rhythm impairments increased. The obtained results allow to recomend the transoesofageal pacing of left atrium in patients with COPD for the diagnosis of silent myocardial ischemia and arrhythmias for following correction of treatment.

53-56 131
Abstract

The significant decrease of Na+K+-ATPase and Ca2+-ATPase activity was found at saponin-permeabilized erythrocytes in patients with with bronchial asthma. These changes were most expressed in infection-dependent variant or the disease, in which activities of both enzymes were different from normal by 40—60 %. The reduction of transport ATPase activities was also observed in erythrocytes of steroid-dependent patients. Parenteral administration of calcitrine in these patients caused the increase of activities of both enzymes.

57-61 158
Abstract

By means of the open randomized study design features of pharmacokinetics and pharmacodynamics of two sustained drug preparations of theophylline (TP) named as Theopec (T) (for double medication per day in 8°° and 20°° p.m.) and Euphylong (E) (for single medication in 20° p. m.) were investigated in 59 elderly patients with COPD (bronchial asthma, chronic obstructive bronchitis). After 9—10 days of treatment, the daily monithoring of TP concentration in blood serum revealed that the TP concentration at the background of both drugs administration was restricted by limits of the therapy during the whole period of medication. In the period from 2°° to 8°° p.m. the TP concentration was significantly greater in the E group than the one in the T group (p<C0.01). The parameter analysis of pharmacokinetics during the steady-state stage revealed that minimal TP concentrations were 6,75±0,46 mkg/ml in the E group and 6,88+0,4 mkg/ml in the T group, and maximal ones were 13,55+0,67 mkg/ml and 12,5+0,79 mkg/ml respectively. The time of the reachment of the maximal concentration 4,13+0,41 hours for the E group and 13,6+0,66 hours for the T one. During the night time, the TP concentration in blood serum after T medication was smaller, on average, on 14,7 % in comparison with the day time.

The parameters revealing the absorbtional velocity and intencity in the night (the average TP concentration in the time interval from 2°° to 6°° p. m. named as C2°° — 6°°, the square under the concentration curve in that time period, and the parameter (Cav) revealing the percent of C2°°—6°° exeed over the averaged daily concentration) were significantly greater in the E group (p<0.01). The T group demonstrated the smaller range of TP concentration fluctuation in blood serum in comparison with the averaged TP concentration. The revealed features of pharmacokinetics are illustrated by dynamics of parameters of the respiratory function in the morning and evening time. The subjects medicated with E performed significantly greater values of the peak expiratory flow in 8°° p.m. in comparison with T. That featuers of E in single dosage makes it more preferable for patients with “sleep” asthma.

62-65 317
Abstract

In 7 patients with mixed genesis bronchial asthma which demontrated the FEV1 decrease more than 20 percents after finishing the test with the exercise on the bicycle, the profilactic effect of single inhalation and course treatment of Berotec. Ditec, and Bichromate was studied.

In 30 minutes and 2 hours after single inhalation of Berotec, Ditec, and Bichromate, the FEV1 increase was revealed in 23 and 21.6 %, in 26 and 23.5 %, and in 5.8 and 6.3 % respectively. The ergometry in 2 hours after two inhalations of Ditec caused the FEV1 decrease in 7.4 % on average in 10 minutes after cancelling the exercise. Bronchial constriction was not determined in all the 7 patients. After two inhalations of Berotec the FEV1 decrease in 8.9 % on average in 8—10 minutes of recovery was observed. 4 patients indicated subjectively favorable protective action of Berotec. The protective action at the background of two Bichromate inhalations on bronchial constriction was revealed in 6 patients. The ergometry being executed in 12 hours after the preparation dose evening administration revealed the FEV1 maximal decrease in 7.8 % in 8—10 minutes after finishing the exercise after the 4-weeks course treatment of Ditec, at the background of the Bichromate treatment — in 6.6 %; at the Berotec one — in 10.8 %.

65-67 120
Abstract

The therapeutic effect of arubendol (terbutaline sulfate) was studied in patients with BA of atopic form primarily with moderate currence in degree of moderate exacerbation. The drug was administered in doses of 1—2 mg per day. In most patients (25 among of 30 ones) the positive therapeutic effect was obtained. The undesired side effects noted in 16 patients were not severe and weren't as the cause for ancelling the medication. The betha-2-agonist arubendol medication may be concidered as an effective therapy in patients BA of mild and moderate exacerbation phase.

67-72 137
Abstract

The investigation of human organism’s functions during the state of hypoxia seems to be of great interest in connection with modifying environmental factors due to specific human activity (aviation and space research, work at hihg altitude, etc.,). This work was aimed at the study of functional and structural peculiarities of the brain in conditions of experimentally induced circulatory hypoxia. The obtained data may serve as theoretical basis for the recommendation to use hypoxia (in its early stages) as a factor, mobilizing reserved possibilities of the brain during extremal conditions and some kinds of pathology, though the initial state of a person must be thoroughly taken into account.

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ISSN 0869-0189 (Print)
ISSN 2541-9617 (Online)