[Role of the abnormal tracheobroncheal tree in the efficiency of treatment of patients with pulmonary tuberculosis].

The efficiency of treatment has been studied in 100 patients with pulmonary tuberculosis caused by drug-resistant (DR) Mycobacterium tuberculosis (MBT) strains and complicated by bronchial diseases, treated at the units of the Clinic of Phthisiopulmonology, I. M. Sechenov Moscow Medical Academy, in 2004 to 2006. Several forms of specific and/or nonspecific bronchial diseases are shown to be detected in patients with drug resistance in MBT. Pulmonary tuberculosis caused by DR MBT strains and complicated by bronchial diseases is characterized by the lower interferon-producing capacity of bronchoalveolar lavage (BAL) cells and by more significant impairments in the mechanisms of local lung protection. Inclusion of the immunomodulator leukinferon into the combined therapy of patients with pulmonary tuberculosis complicated by bronchial diseases contributes to the elevation of BAL cell production of alpha and gamma-interferons, reduces the generation of active oxygen forms in the BAL phagocytes and brush biopsy specimens, and increases the levels of immunoglobulins in BAL. The local administration of leukinferon reduces the time of cure of specific and nonspecific bronchial diseases in patients with pulmonary tuberculosis who isolate DR MBT strains, thus promoting the enhanced efficiency of treatment in reducing the times of bacterial isolation and decay cavity closure and the length of hospital stay.

[Free radical processes in the phagocytes of the lung in the diagnosis of granulomatous diseases].

The functional activity of pulmonary phagocytes (alveolar macrophages and macrophages isolated from biopsy specimens) was studied in patients with active sarcoidosis and active tuberculosis, by examining the level of free radical processes in them by luminol-enhanced chemiluminescence (CL). The CL parameters of alveolar macrophages were found to significantly differ in their baseline and peak CL-induced levels and the time of emergence of the peak CL-induced level. The CL level of macrophages isolated from the biopsy specimens does not play a prominent role in the differential diagnosis between these groups of diseases. The time of emergence of the peak of CL-induced alveolar macrophages in response to Mycobacterium BCG strain stimulation is of the most informative value in the differential diagnosis of active tuberculosis and active sarcoidosis. A relationship was found between the clinical and laboratory manifestations and the parameters of free radical processes of pulmonary phagocytes in a granulomatous inflammatory process (in case of sarcoidosis). The CL alveolar macrophage parameters that characterize the activity of the process were related to the magnitude of patients' complaints, the levels of haptoglobin and neutrophils in blood samples. The CL parameters of macrophages isolated from the biopsy specimens correlated with the levels of haptoglobin and gamma-globulin.

[Characterization of protection mechanisms in patients with drug-resistant pulmonary tuberculosis].

Examining the performance of the local protective system has indicated that patients with drug-resistant pulmonary tuberculosis in the presence of the higher count of cytotoxic lymphocytes had the diminished activation of lymphoid elements of bronchoalveolar lavage (BAL) and decreased alveolar macrophageal production of active oxygen forms. However, there was a drastically increased formation of active oxygen forms in the BAL macrophagues during mycobacterial phagocytosis, which may result to their death. At the same time, the decreased production of gamma-interferon in the BAL cells was found in patients with drug-resistant tuberculosis (8.0 +/- 3.0 U/ml versus 10.7 +/- 2.0 U/ml). In such patients, the generation of alpha-interferon was 105.0 +/- 38.0 U/ml versus 187.0 +/- 72 U/ml in patients with tuberculosis caused by drug-resistant Mycobacterium tuberculosis. In patients with drug-resistant tuberculosis, the lower production of alpha- and gamma-interferons in the BAL cells leads to their decreased regulatory effect on the mechanisms of local defense of the lung. The drastically enhanced production of active oxygen forms, which has been ascertained in patients with drug-resistant tuberculosis, is able to result in the death of macrophages, the release of lysing enzymes into the tissues surrounding the lung; the higher count of T cytotoxic lymphocytes, the lower levels of cells in apoptosis, and mycobacterial resistance to antibacterial drugs deteriorate the course of pulmonary tuberculosis in this category of patients.

[Influence of chemicals on female reproduction]. / O vliianii khimicheskikh veshchestv na reproduktivnoe zdorov'e zhenshchin.

Studying female reproductive health in city with developed chemical industry, the authors revealed significant difference in character and incidence of disorders between the chemical workers and general population. Calculated dependence of some reproductive disorders on values of chemicals in the air helps to forecast the risk degree.

[Heavy metal content of the hair of children in industrial cities]. / Soderzhanie tiazhelykh metalov v volosakh detei v promyshlennom gorode.

Heavy metals are most common pollutants in large industrial cities. Differences were first shown in the distribution of concentrations of toxic and biogenic heavy metals in the hair of children. Zinc and copper had dispersion close to normal values, whereas lead, cadmium, and nickel had asymmetric dispersion. Scales were first developed for rating the levels of heavy metals in the children's hair in cities. A typology of microareas was also first developed by the level of metal pollution. The permanent stay of children in the highly polluted areas causes a high accumulation of lead in the hair and it is a risk factor of morphofunctional abnormalities and chronic diseases.

[Effect of lomefloxacin on the functional activity of the phagocytic system]. / Vliianie lomefloksatsina na funktsional'nuiu aktivnost' kletok fagotsitarnoi sistemy.

The in vitro effect of lomefloxacin on the absorption activity of macrophages with respect to Mycobacterium tuberculosis and chemiluminescence of the phagocytizing cells was studied with the use of a wide range of the antibiotic concentrations. Lomefloxacin was shown to have no inhibitory effect on the phagocytic activity of the pulmonary macrophages and on the formation of active oxygen in the phagocytizing cells for the realization of the bactericidal action on M. tuberculosis.

[Body's responsiveness and postoperative course in patients with pulmonary tuberculosis]. / Reaktivnost' organizma i techenie posleoperatsionnogo perioda u bol'nykh tuberkulezom legkikh.

The purpose of the study was to reveal a package of criteria for the body's responsiveness in order to predict the course of a postoperative period in 25 patients with short-term pulmonary tuberculosis. The indices of the responsiveness were comparable with the specific features of a postoperative course. The study of the body's responsiveness prior to surgery and in the first days after it was found to be of value in the prediction of a postoperative course. The determination of the intensity of free radical processes may more accurately estimate the impact of surgical interventions on the body's responsiveness. The drastic rise in the activation of free radical oxidation after surgery suggests its unfavourable influence on immune mechanisms.

[Free-radical processes in the pulmonary macrophages of patients with pulmonary tuberculosis]. / Svobodnoradikal'nye protsessy v legochnykh makrofagakh bol'nykh tuberkulezom legkikh.

Free radical processes in the alveolar and interstitial macrophages were compared for patients with different forms of tuberculosis, chronic nonspecific pulmonary diseases and cancer of the lungs. Alveolar macrophages were found to have more active free radical processes than interstitial macrophages. Chronic transformation of pulmonary tuberculosis results in activation of free radical processes in pulmonary macrophages. Differences in the value of alveolar macrophages chemiluminescence maximum and time of its appearance may facilitate differential diagnosis between tuberculosis, chronic nonspecific pulmonary diseases and cancer of the lungs.

[Development of chronic cor pulmonale in restrictive and obstructive pulmonary dysfunctions]. / Razvitie khronicheskogo lëgochnogo serdtsa pri restriktivnom i obstruktivnom tipakh narusheniia funktsii lëgkikh.

A total of 2840 patients with pulmonary tuberculosis and bronchial asthma were studied. Antigens are shown to induce a systemic vascular response with elevated systolic pressure in the pulmonary artery, peripheral venous spasms. There is activation of the sympathoadrenal system and desensitization of beta-adrenoreceptors with lower levels of cyclic adenosine monophosphate (CAMP). There is a direct correlation between the CAMP levels and the cardiac output, between those and the pulmonary systolic pressure (PSP). This determines hyperkinetic hemodynamics in tuberculosis with the volume- and pressure-loaded heart. Paresis of pulmonary circulation, as well as hypokinetic hemodynamics occur as a result of an allergic immunological reaction in severe fibrocavernous processes in the area of tuberculosis. There is a direct correlation between the circulating immune complexes and CAMP. In bronchial asthma microcirculation is impaired due to antigenic exposures and elevated intrathoracic pressure. Pulmonary capillary reduction in restrictive processes results in higher levels of CAMP and right-to-left shunt, leading to hypoxemia. In obstructive pulmonary diseases, hypoxemia is caused by hypoventilation and impaired ventilation-perfusion ratios.

[Possibilities of intravenous use of helium-neon laser in the treatment of experimental tuberculosis of animals]. / Vozmozhnosti vnutrivennogo ispol'zovaniia gelii-neonovogo lazera pri lechenii éksperimental'nogo tuberkuleza zhivotnykh.

The study presents experimental finding of 40 mongrel dogs whose intravascular blood was irradiated with laser as a supplement to the multimodality treatment of respiratory tuberculosis. Earlier disappearance of intoxication symptoms and reduced terms of destruction cavity decrease and closure, as roentgenologically evidenced, was achieved. The influence of this treatment on certain lipid peroxidation parameters, hemocoagulation, immunity status and bacteriostatic blood activity were found. There were no side effects during treatment.

[Health-related efficacy of measures to protect reservoirs in the vicinity of a large territorial-industrial chemical industry complex]. / Gigienicheskaia éffektivnost' meropriiatii po okhrane vodoemov v raione krupnogo territorial'no-proizvodstvennogo kompleksa khimicheskoi promyshlennosti.

Investigation results made it possible to make a conclusion that implementation of the developed recommendations has stabilized the sanitary state of the water reservoir and lately has significantly improved it. The future ways to improve water reservoirs in the area of location of big chemical enterprises have been determined.

[Determination of the bactericidal strength of alveolar macrophages by using the NBT test]. / Opredelenie bakteritsidnoi sily al'veoliarnykh makrofagov s pomoshch'iu NST-testa.

The NBT test on alveolar macrophages can be used for the indirect evaluation of their bactericidal potency. This test has made it possible to show that the development of the tuberculous process in the lungs is characterized by the increasing intensity of the reduction of NBT by alveolar macrophages, which indirectly indicates their considerable bactericidal potency. But 3-4 weeks after infection macrophages, though capable of considerable bactericidal action, do not react to stimulation by Mycobacterium tuberculosis.