[Functional studies in the prediction of postoperative complications in the presence of lung diseases]. / Funktsional'nye issledovaniia v prognoze posleoperatsionnykh oslozhnenii pri zabolevaniiakh legkikh.

Data on the functional status of the cardiorespiratory system are required to identify patients at risk for postoperative complication in the presence of lung diseases. Very many factors influence the course of an operation and the postoperative period so there is no golden standard or the only parameter for predicting how the postoperative period runs. Patients with normal spirographic values (FEV1, more than 80%??) and without cardiovascular comorbidity are at a slight risk for postoperative complications. These patients do not need to be additionally examined. A less than one-month history of myocardial infarction, instable angina pectoris, decompensated heart failure, severe valvular disease are contraindications to planned surgery. The risk of cardiovascular events is high when the signs of myocardial ischemia occur with low exercise (less than 4 MET). Stress echocardiography, loading tests, and radioisotopic study are used as auxiliary techniques, FEV1, under 60%; ppo-FEV1, and ppo-DC, under 40%; VO2max, under 15 ml/kg/min are the values of a high risk for respiratory complications.

[Changes in respiratory mechanics in post-tuberculosis emphysema and pneumosclerosis]. / Izmeneniia mekhaniki dykhaniia pri posttuberkuleznykh émfizeme i pnevmoskleroze.

The mechanics of breathing was studied in 457 patients with pulmonary tuberculosis. The restrictive mechanism of lowering the ventilation reserves was essential in sclerotic changes in the lower lung. Obstructive changes increased with the extent of pneumosclerosis. X-ray emphysematous changes were confirmed by functional diagnostic findings. The elastic properties of the lung were of the greatest value. Functional diagnosis is important in making clear the clinical and X-ray symptoms of pneumosclerosis and emphysema.

[Obstructive ventilatory disorders in pulmonary tuberculosis]. / Obstruktivnye narusheniia ventiliatsii pri tuberkuleze legkikh.

The results of the clinico-roentgenologic and functional examination of 434 patients with different forms of pulmonary tuberculosis were subjected to analysis. The obstructive syndrome of ventilation disorders was detected in more than 60% of pulmonary tuberculosis patients. The prevalent significance in its pathogenesis was played by disorders of patency of fine bronchi and air distribution in the lungs. They were associated with extension and activity of the processes and their tendency to acquire a chronic form and with the action of nonspecific factors on the bronchi, which included smoking, work under dust-contaminated conditions, concurrent nonspecific pulmonary diseases, nonspecific changes of the principal bronchi revealed by bronchoscopy and structural nonspecific changes of the peripheral air ways detected by a morphologic study of the resected material. A bronchospastic component was responsible for the broncho-obstructive syndrome in 57% of the patients.

[Status of the bronchi in patients with pulmonary tuberculosis and different haptoglobin phenotype]. / Sostoianie bronkhov u Bol'nykh tuberkulezom legkikh s razlichnymi fenotypami gaptoglobina.

External respiration function test and bronchologic examination were conducted in 206 pulmonary tuberculosis patients with different haptoglobin (Hp) phenotypes. It was found that obstructive changes in peripheral portions of the bronchial tree were most common and marked among the revealed disorders of pulmonary ventilation function. These changes promote a decrease in the ventilation reserve to a great extent. As compared to Hp 2-1 carriers, specific endobronchitis and bronchial obstruction symptoms were significantly more frequent in patients with Hp 2-2. Bronchial obstruction symptoms alone were twice as frequent as in patients with Hp 1-1 than in Hp 2-1 carriers. The findings indicate that there is a close relationship between the status of the bronchi in pulmonary tuberculosis patients and the genetically determined Hp phenotype.

[A system of comprehensive screening for tuberculosis and other chronic diseases of the respiratory organs in a rural area]. / Sistema kompleksnogo skrininga tuberkuleza i drugikh khronicheskikh boleznei organov dykhaniia v usloviiakh sel'skoi mestnosti.

Pulmonary disease screening system, including fluorography, interview and external respiration function tests was used in 6 regions of this country. Out of 90,262 people examined, 23,360 persons were subjected to external respiration function test. As a result of the screening, the following conditions were detected: active tuberculosis in 0.02-0.8%, lung cancer in 0.02-0.3%, X-ray positive and X-ray negative chronic non-specific bronchopulmonary diseases in 0.12-3.7% and 7.7-15.2% of these cases, respectively.

[Disorders of the ventilatory mechanics in patients with respiratory sarcoidosis]. / Narusheniia mekhaniki ventiliatsii u bol'nykh sarkoidozom organov dykhaniia.

The state of the ventilation apparatus was studied in 158 patients with active sarcoidosis of the respiratory organs. The following methods were used: spirography, registration of the curve of the flow-volume of forced expiration, body plethysmography and esophageal intubation. Various disorders in the ventilation mechanics were detected. They included impairment of bronchial patency, impairment of air distribution in the lungs, changes in the elastic properties of the lung tissue, increased respiration work per 1 1 of ventilation, etc. Impairment of the small bronchi patency (in 66.5 per cent of the patients) and impairment of air distribution in the lungs were the most frequent and the most pronounced disorders in the respiration mechanics. They played a significant role in lowering of the lung ventilation capacity and increasing of energy supply for respiration.

[Functional changes after segmental and lobar resections of the lungs at remote periods of observation]. / Funktsional'nye izmeneniia posle segmentarnykh i dolevykh rezektsii legkikh v otdalennye sroki nabliudeniia

Clinico-roentgenological and functional studies were carried out in 78 patients 2--12 years following segmental (42 patients) and lobar (3) pneumonectomies for tuberculosis. An analysis of the data obtained indicated that partial pneumonectomies within the boundaries of 1-5 segments per se fail to produce significant disorders in the ventilatory and gas metabolism function of the lung. 2-12 years after the operation the patients show considerable ventilatory reserves. Significant respiratory disorders are observed only in patients with postoperative complications and pathological changes in the lung, pleura and bronchi conditioned by tuberculosis and non-specific lung pathology.