[The psychosomatic correlations in bronchial asthma]. / Psikhosomaticheskie sootnosheniia pri bronkhial'noi astme.

Combination of somatic symptoms with neurotic manifestations and personality's disturbances in clinical picture of bronchial asthma was established during clinical and psychological observation of 89 patients with bronchial asthma. It was shown that increase of the number of frustrating situations (when psychical vulnerability was elevated), strengthening of both anxiety and emotional tension, as well as rigidity of negative emotions, hypochondriac and anxious-depressive tendencies composed the whole correlational system with alterations in functions of external respiration, changes in blood immunoglobulins levels just as with clinical indices of bronchial asthma. This system represented different levels of psychosomatic correlations' regulation. The complex psychophysiological factor of frustration and emotional tension was described, moreover the increase of its value was accompanied by strengthening of both psychical alterations and somatic disorders which were quite characteristic for prevalence of either trophotropic activation or ergotropic one when beta-adrenoceptors were blocked.

[Effect of glucocorticosteroid therapy on immunologic indicators in patients with sarcoidosis and idiopathic fibrosing alveolitis]. / Vliianie terapii gliukokortikosteroidami na immunologicheskie pokazateli bo'lnykh sarkoidozom i idiopaticheskim fibroziruiushchim a'lveolitom.

Immunological findings were recorded in 22 patients with active sarcoidosis and 12 patients with idiopathic fibrosing alveolitis. In addition, the patients' endopulmonary cytograms were considered. Immunological evidence involved the use of bronchoalveolar lavage, bronchoscopy, peripheral blood. Administration of corticosteroid therapy resulted in alveolitis attenuation both in sarcoidosis and fibrosing alveolitis. Common features of immune response of sarcoidosis and idiopathic fibrosing alveolitis patients to glucocorticosteroids whose action proceeds as multicomponent immunomodulating effect implying reconstruction of some links of the immune system while aggravating dysfunction of the others are stated.

[Disorders of immune reactivity in chronic bronchitis]. / Narusheniia immunnoi reaktivnosti pri khronicheskom bronkhite.

The cytologic and immunologic analysis of bronchoalveolar washing offs and of peripheral blood was made in 45 patients with chronic bronchitis. Of these, 27 patients suffered from catarrhal bronchitis without infection signs and 18 were affected with purulent bronchitis with superinfection. It has been shown that discovery of a considerable number of neutrophils in the bronchoalveolar washing offs promotes the establishment of the infectious etiology of chronic bronchitis. The immunologic analysis of the washing offs was found to be of great informative value in the study of the mechanism of the disease development. Pronounced dysfunction of the immune system and its manifestations common to catarrhal and purulent bronchitis were demonstrated. It is concluded that dystrophic processes predominate in the lungs of the patients with chronic purulent bronchitis whereas catarrhal bronchitis is marked by the high local immune reactivity in the lungs. The characteristic features revealed are regarded as criteria of the differential diagnosis between the given bronchitis patterns. It has been disclosed that impairment of the mechanisms of cellular immunity is one of the properties shared by both the disease patterns. The authors discuss the prospects of the use of the combined immunologic analysis of the bronchoalveolar washing offs and peripheral blood in patients with chronic bronchitis.

[Modern criteria of sarcoidosis activity and approaches to glucocorticoid therapy]. / Sovremennye kriterii aktivnosti sarkoidoza i podkhody k gliukokortikoidnoi terapii.

Altogether 190 sarcoidosis patients were investigated including cytology of bronchoalveolar rinses in 31 patients, lung scintigraphy with 67Ga in 48, determination of the blood angiotensin converting enzyme activity in 18, and daily calciuria in 100 patients; 50 patients had erythema nodosum which turned out to be one of the main clinical symptoms of sarcoidosis activity. Corticosteroid therapy in patients with erythema nodosum was performed only in the presence of pulmonary changes and/or changes of the other internal organs. Extrathoracic manifestations (liver, splenic, renal, cardiac, CNS lesions) observed in 34 patients, deteriorated prognosis. Prolonged corticosteroid therapy was necessitated in all the cases; 4 patients were operated upon (splenectomy, nephrectomy, implantation of an artificial pacemaker); 3 patients died suddenly or from uremia. Comparison of the results of instrumental and laboratory methods showed that an increase in the lymphocyte count in bronchoalveolar rinses (by greater than 28%), total T-lymphocytes and T-active cells, 67Ga accumulation in the lungs, raised blood angiotensin converting enzyme activity, and hypercalciuria over 300 mg/day could be used as criteria of alveolitis activity in sarcoidosis. Corticosteroid therapy should be performed in stage II patients with the above symptoms only.