[Photoacoustic spectroscopy evaluation of the impact of smoking on the composition of exhaled air in patients with bronchopulmonary diseases]. / Otsenka vliyaniya kureniya na sostav vydykhaemogo vozdukha patsientov s bronkholegochnymi zabolevaniyami s primeneniem optiko-akusticheskii spektroskopii.

AIM: To investigate the impact of smoking on the air exhaled by patients with chronic obstructive pulmonary disease (COPD) and asthmatics, by applying photoacoustic spectroscopy. SUBJECTS AND METHODS: The exhaled air absorption spectra (EAAS) were analyzed in healthy volunteers and patients with COPD and asthmatics, by applying an ILPA-1 CO2 laser photoacoustic gas analyzer. The procedure based on the calculation of an integrated estimate (IE) of the state of the object was used to assess the findings. RESULTS: Comparison of the IE of EAAS in COPD patients and non-smoking healthy individuals showed that spectra of the compounds, the formation of which was associated with smoking, were recorded in the range of wavelengths corresponding to the 10R branch of CO2 laser generation. This also provided evidence indicating that the exhaled air of asthmatics differed from that of both smoking and non-smoking healthy individuals. The calculations yielded the threshold values of EAAS IE in the range of wavelengths corresponding to the 10P branche of CO2 laser generation, which made it possible to distinguish non-smoking healthy individuals from asthmatics and COPD patients in 94 and 89% of cases, respectively. CONCLUSION: The investigation has confirmed that smoking substantially impacts the composition of the air exhaled by healthy individuals. It has been shown that the use of reference groups formed from non-smoking healthy individuals can improve the accuracy of photoacoustic spectroscopy in detecting COPD and asthma. A further development in this direction will open up new prospects for a new method to diagnose COPD and asthma.

[Morphometric characteristics of the bronchial tree in smokers with and without chronic obstructive pulmonary disease].

AIM: To reveal the tissue, cellular, and molecular predictors leading to the development of chronic obstructive pulmonary disease (COPD) in smokers on the basis of a morphometric analysis of bronchial biopsy specimens. MATERIALS AND METHODS: A cross-sectional study was conducted in 115 smokers aged 40 to 60 years (58.3±3.24 years) with a male predominance of 90.9%. Morphological examination of bronchial biopsy specimens was first made in the smoking patients with and without COPD. RESULTS: The smokers with COPD versus those without this condition were found to have a statistically significant increase in a number of indicators: the specific volume (SV) of the surface epithelium (p=0.017), SV of basal epitheliocytes (p=0.008), the height of the epithelium (p=0.001), and the thickness of the basal membrane (p=0.006) due to impaired regeneration processes in the bronchial epithelium and to fibrosis of the lamina propria of the bronchi with a concurrent increase in the total number of fibroblasts. The group of smokers with COPD, unlike the comparison group, showed signs of vascular remodeling and microcirculatory disorders as the increased connective tissue volumetric density of the lamina propria of the bronchi with predominant perivascular localization. This was followed by reductions in the relative volume of capillaries (p=0.016), in the SV of micropinocytic vesicles (p=0.005), and the size of Weibel-Palade bodies (p=0.004) in the endotheliocytes. In the COPD patients, the total density of cell infiltrate per mm2 of the lamina propria of the bronchi was statistically significantly (p<0.001) greater than that in the comparison group at the expense of neutrophils, lowly and moderately granulated basophils, macrophages, plasma cells with a simultaneous rise in their interepithelial forms. CONCLUSION: Compensatory structural changes without signs of bronchial wall remodeling were recorded in the smokers without signs of bronchial disease. The smokers with the examined nosological entity were observed to have morphological signs of hemodynamic disorders, as well as perivascular fibrosis, atrophy, and squamous cell metaplasia of the bronchial epithelial lining.

[Haemophilus infection in nonspecific inflammatory lung diseases]. / Gemofil'naia infektsiia pri nespetsificheskikh vospalitel'nykh zabolevaniiakh legkikh.

Hemophilic infection incidence rate, characteristics and criteria of early detection were studied in 393 patients with nonspecific pulmonary diseases. H. influenzae represented the prevalent pathogenic agent in 17% of the cases: in 11% of acute pneumonias (276 patients) and 30% of chronic bronchitis exacerbations (117 patients). Hemophilic pneumonias were a more frequent finding in patients over 40 years of age, proved secondary, manifested usually interstitial inflammation of the lung tissue, were prone to interlobitis complication and protracted course. Purulent endobronchial inflammation used to be a typical sign of hemophilic aggravation of chronic bronchitis.

[Etiologic structure of exacerbations in chronic bronchitis]. / Etiologicheskaia struktura obostrenii khronicheskogo bronkhita.

The etiological appearance of exacerbations of chronic bronchitis was investigated in 117 patients. A combined study was aimed at the detection of viral, mycoplasmal, fungal and bacterial endobronchial infections. The etiological role of the latter was verified by a pathogen isolated from the sputum. Exacerbation of chronic bronchitis was determined by bacterial (79%) and/or viral (55%) infections, mostly by pneumococcal infection (45%), H. influenzae (30%), and influenza (31%). The role of pyogenic cocci was minimal (2%). Exacerbation of chronic purulent endobronchitis was more frequently caused by H. influenzae than in catarrhal bronchitis. In 9% of the patients the infectious etiology of an inflammatory bronchial process could not be established.

[Antibiotic sensitivity of pneumococci isolated in chronic bronchitis and bronchial asthma]. / Chuvstvitel'nost' k antibiotikam pnevmokokka, vydelennogo pri khronicheskom bronkhite i bronkhial'noi astme.

Antibiotic sensitivity of 218 pneumococcal strains isolated from sputum of 140 patients with chronic bronchitis and 78 patients with infectious and allergic bronchial asthma in Tomsk at the period from September 1981 to March 1984 was studied by the agar diffusion method with the use of standard sensitivity disks. A significant number of the isolates were resistant or little sensitive to tetracycline (54 per cent) and monomycin (42 per cent). It should be noted that 5.5 per cent of the pneumococcal strains were resistant or little sensitive to benzylpenicillin. The decreased sensitivity of the pneumococcal strains to many of the widely used antibiotics and especially occurrence of benzylpenicillin resistant strains require determination of the sensitivity of the pneumococcal strains isolated from each patient with aggravation of chronic bronchitis and infectious and allergic bronchial asthma.

[Criteria and methods of etiological diagnosis of acute and chronic inflammatory processes in the lungs]. / Kriterii i metody etiologicheskoi diagnostiki ostrykh i khronicheskikh vospalitel'nykh protsessov v legkikh.

The clinical, bacteriological, cytological, serological and allergological data were analyzed in 376 patients with acute pneumonia and chronic bronchitis to study the diagnostic importance of the microorganisms isolated from the sputum. The informativeness of the methods was estimated by correlation of the appropriate data with the data of the final verified diagnosis of the inflammatory process in the lungs. Bacterioscopy of the sputum smear stained according to Gram, bioassay on mice, determination of bacterial concentration per ml sputum, allergic tests with bacterial allergens were found to be the most reliable methods as regards the etiological diagnosis of acute pneumonias. It should be mentioned that bacterioscopy is an early criterion of the disease etiology. Criteria of the etiological significance of bacteria which cause exacerbation of chronic bronchitis encompass the measurement of bacterial concentration per ml sputum, indirect immunofluorescence with autostrains of the isolated bacteria and the bioassay. Early criteria include the first two methods.