The important role of pneumococcus and its infection in etyology and pathogenesis of pulmonary diseases is coupled with its wide dissemination, with its great tropism to cells of the respiratory mucus lamina, with the presence of great number of various pathogenic factors, with its variability and adaptability, that is the reason of the pneumococcus specy survival.

Pneumococcal persistention in the bronchial tree in patients with chronic bronchitis, the stability of its concentration, and the high level of the pneumococcal immunity in exacerbation phase as well as in clinic remission in coupling with other data of laboratory methods allow to conclude about the feature of the pneumococcus infection currence.

The single intratracheal bleomycin instillation was used to produce a model for the development of pulmonary fibrosis in rats. The study of bronchoalveolar lavage fluid (BALF) was performed at 1, 3, 7, 14, 30 days after bleomycin administration. An addition of BALF from bleomycin-treated rats to the incubation mixture considerably supressed the reproduction of Staphylococcus aureus and enhanced self antiadhesive properties. The minimal adhesion (as well as the maximal bacteriostatic effect) was observed at 3th day post bleomycin. The index of adhesion remained lower than in untreated rats for 30 days. The percentage of neutrophyls and lymphocytes in BALF significantly increased post bleomycin. The increase of IL-2, IL-2, and natural killer activities and high levels of elastase and collagenase were found after bleomycin instillation. It was supposed that the high antimicrobial activity of BALF may be conditioned by defensive bacteriocidic functions of stimulated neutriphyls and macrophages and the high activity of natural killer cells. Aseptic conditions may play an important role in the inflammation transforming to pulmonary fibrosis.

The model of bloemycin-induced pulmonary fibrosis was produced in rats to evaluate the effect of tracheal mucous membrane peptides (TMMP) used for prevention of massive proliferation in the interstitial connective tissue in lungs. The application of TMMP reduced the negative consequences of bleomycin administration. The mortality was decreased by three times. The body weight was increased at 52 % of the initial value. Hypertrophy of the right heart ventricle developed in a smaller degree in comparison with untreated rats. The content of the connective tissue in alveolar walls was diminished. It was loose of the connective tissue with non numerous collagen fibers. Ultrastructural studies of bronchoalveolar lavage cells showed great differences of alveolar magrophage populations in two groups of rats — untreated and treated with TMMP. The possible role of alveolar macrophages in the observed effect of TMMP for modulation of fibroplastic process in lungs is discussed.

The variance of facts testifying about nongase exchangable functions of lungs (NGEFL) points to the nessessity of thier systematization. The scheme taking in consideration functions of the lung endogenous filter that controls in general the level of urgent and high active compounds of blood, the exogenous obstacle protecting from harmfull influences of environments (pollutants, bacterial and virual agents, e. s.), lung surfactant and the conditioning lung function was present. That functions are connected with the gase exchange, the hemodynamics of small circle of blood circulation, and the excretional lung function.

Considerable impairments of the endogenous filter and lung surfactant were observed during extremal situations (the schock lung, pulmonary oedema), the less expressed ones were observed during obstructive pulmonary diseases (bronchial asthma, chronic • obstructive bronchitis).

Inflammational and destructive processes located in the airways (chronic nonobstructive bronchitis, bronchoectasia, cystic fybrosis et al.) with hypersecretion are followed by most expressed impairments of the exogenous obstacle.

The opinion concerning the nessessity of the detail study of some NGEFL features and perspectives of new metabolic choises in pulmonary patients treatment was expressed.

Lightand electron microscopic data revealed in lobar and monolateral emphysema characterize the morphologic substratum of the functionally defected pulmonary tissue. The maldevelopment of the alveolar capillary bed, the defects in the structure of the connective tissue, bronchial hypoand dysplasia allow to support the opinion of the congenital nature of these kinds of emphysema.

Developed blood immunodeficiencies and activation of immunological processes in BAL-fluid were revaled in 28 patients with Histiocytosis-X during immunological examination. The activity of elastase and collagenase in BAL correlated with the intensity of the destructive process in the pulmonary tissue in patients with Histiocytosis-X. Corticosteroid treatment made it possible to control immunity disorders, but, however, there weren’t the satisfactory effect on the destructive process in the tissue in these patients.

Based on data obtained during the echodopplercardiographic study in 40 patients with COPD and in 15 healthy subjects the conclusion about the possibility of the mechanical disturbance of left ventricle (LV) function in patients with the hypertrophied right ventricle dilated (RV) by the ventricular interaction factor appearance conditioned with the paradox diastolic displacement of IVP into the LV cavity with the unnormal geometry changing was processed in the article. The usage of drugs depressing the preload on right sections of heart and repairing the normal diastolic function of LV is supposed to be available for correction of that disorders.

The article is devoted to the problem of organization of the centre for diagnostics and treatment of cystic fibrosis. The centre in St.-Petersburg was described as model; purposes and tasks of its work were formulated. Results of long-duration supervision for 32 patients suffering from cystic fibrosis were submitted.

It was shown, that the best results are achieved in patients being inhabitants of St.-Petersburg and having been under constant dispensary supervision, using modern outlines of treatment, and precisely following the modern recommendations of ambulatorial treatment. In that patients it was managed to reduce the number of hospitalizations to 1 times during the 1 and 1.5 years.

The immunoreactivity was studied in children with cystic fibrosis (CF) and in patients of CF older than 14 years old during exacerbation periods of the disease and after treatment in clinic. Parameters of the humoral and T-cellular immunity, the fagocytic activity of blood monocytes and neutrophyls in carriers of the allele ∆F508 (homozygotes and compound heterozygotes) and in patients with other CF gen mutations were compared.

The carriers of AF508 mutations had the high levels of immunoglobulins A, G, M and of circulating immune complexes (CIC) considerably more often than the ones with other CF gen mutations, that was caused by more frequent colonization of bronchial Ps. aeruginosa and S. aureus. After treatment in majority of homozygotes ∆/∆F508) high levels of IgG and CIC (63 %), the reduction of the fagocytic activity of monocytes (75 %) and FGA-induced blasttransformation (81 %) were remained. In this period, 63 % of patients with CF older than 14 without F508 mutation had the decrease of the number of OKT3⁺ ymphocytes and 89 % of them showed the weak response on FGA-induction, that can be connected with the more frequent infectioning of these patients by Ps. aeruginosa and S. aureus in comparison with children without ∆F508 allele.

The study of the halotherapy efficiency in 100 paients with bronchial asthma and in persons with conditions of preasthma with the use of clinical, roengenological, functional and laboratory methods of research has allowed to reveal five clinical types of reaction on halotherapy and to develop the prescription for its application.

The results of the study have allowed to generalize that halotherapy promotes the improvement of the bronchial conductivity, reduction of the activity of the inflamation process in the airways, normalization of the function of the humoral and cellular immunity and activation of protective abilities of organism.

In order to evaluate the lung response to the nickel aerosol exposure 47 potroom workers (43 males, 4 females aged 31 to 56 years) were submitted to a clinical examination. The mean time of the exposure achieved 18.5+2.1 years. The examination consisted of chest roentgenoscopy, bronchoscopy, and cellular immunological and biochemical studies of bronchoalveolar lavage fluid (BALF) and blood. Spirometric parameters and the carbon monoxide diffusing capacity (DLco) were measured. Two classical types of alveolitis were met: the neutrophilic (5 patients) and lymphocytic (11 patients) type. The following features of the pulmonary sailent response to the nickel exposure were observed: 1) The number increase of neutrophils or lymphocytes in BALF; 2) The increased elastase and collagenase activity in BALF; 3) The increased phagocytic activity of monocytes in periferal blood and of alveolar macrophags in BALF; 4) The decrease of DLco (steady-state test). Application of transbronchial biopsy and provocation tests in workers of nickel industry having a high risk of occupational alveolitis can represent a great hint to early specific diagnostics.

There were discovered 7 cases of diffuse lung diseases (DLD) (5 — pneumoconiosis, 2 — fibrosing alveolitis) among 60 workers (welding and metal-polishing workers) with chronic non-specific lung diseases (CNLD). Five cases of pneumoconiosis were also found among 16 welding workers who worked indoors. Other 11 welding workers and 9 of 15 patients with chronic bronchitis without roentgenographic signs of DLD had similar changes in bronchoalveolar lavage fluid in comparison with patients having DLD changes. It was recomended to consider the large number of lymphocytes in lavage fluid as an evidence of the risk of the DLD development. The large number of neutrophyls, eosinophyls, T-4⁺ cells, the fagocytic activity of alveolar macrophages, and the activity of natural killers in lavage fluid could testify about the onset of DLD.

General view points on bronchial asthma features are presented in the article. Genetic and occupational factors of ethyology and various mechanisms of bronchial asthma pathogenesis in cellular and system levels are discussed. Various views of the character of the cellular and subcellular level impairment of mucus lamina epythelium and the character of endocrinal changings during that pathology were speculated. The author offers the scheme of therapy on the nondrug basis with the usage of psychocorrection and oriental treatment accounting the individual features of the patient.

The authors describes the results of cytogenetic assay which included the count of chromosomal aberrations and sister chromatid exchanges (SCE) in peripheral blood lymphocytes of 65 patients with bronchial asthma. The significant elevation of chromosomal aberration levels and SCE frequencies in patients was revealed as compared to healthy individuals. The rate of cytogenetic alterations was established with depend ance on clinical and pathogenic types of the disease. It was shown that the therapy with oral corticosteroids does not cause any significant genotoxic effect in the examined patients. Possible mechanisms for chromosomal damages in cells of asthmatic patients are discussed.

Immunological and biochemical parameters such as: Interleukin 1 and 2 (IL-1, IL-2), prostaglandin E and F2alfa levels, subpopulations of T-lymphocytes, the activity of elastase and collagenase were studied in patients with cryptogenic fibrosing alveolitis and pulmonary sarcoidosis.

It was found that the immunoreactivity of the patients is characterized by high levels of the IL-1 and IL-2 activity and the T-lymphocyte subpopulation disbalance. High levels of elastase and collagenase in bronchoalveolar fluid in these patients were detected.

Data of 12 patients with blocked pulmonary abscess cured in the reserch institute of pulmonology in the period from 1988 to 1992 were presented. Difficulties of the differential diagnostics of blocked pulmonary abscess and some features of its clinical roentgenological abd bronchological currence and of data of the morphological and hystological currence and of data of morphological and hystological studies were observed. The role of transbronchial punction resulting in some cases in the abscess cavity drainage and in the patient relief was emphasized.