[Complex assessment of nicotine dependence using questionnaires and measurement of carbon oxide concentration in exhaled air]. / Kompleksnaia otsenka nikotinovoi zavisimosti s ispol'zovaniem oprosnikov i izmereniem kontsentratsii oksida ugleroda v vydykhaemom vozdukhe.

AIM: To study nicotine dependence (ND) basing on special questionnaires and measurement of CO concentrations in the exhaled air. MATERIAL AND METHODS: 350 smokers (318 males and 32 females) aged 20-57 years (mean age 37.1 +/- 7.3 years) were studied. ND was assessed by Fagerstrom test (FT), motivation to smoke and to quit tests, smoking history and exhaled CO measurement. In addition, respiratory complaints and ventilation parameters such as peak expiratory flow (PEF) and forced expiratory volume per 1 sec (FEV1) were measured. RESULTS: Mean daily cigarette number was 14.2 +/- 7.3; smoking duration 16.3 +/- 7.8 years and smokers index 170.9 +/- 87.8. Smoking women differed from smoking men in ND, PEF% and FEV1% decline as well as CO level. Exhaled CO was 21.1 +/- 9.5 ppm, on the average, corresponding to moderate dependence. ND and daily cigarette number produced a direct impact on the exhaled CO level. FT findings directly correlated with the number of daily cigarettes and CO level (mean 3.2 +/- 2.3). Among motivation to smoke factors was the demand to release tension. CONCLUSION: ND varies considerably among smokers by severity. Smoking men and women differ considerably by ND. Along with dependence tests, exhaled CO measurement provides objective verification of ND.

[Effect of altitude on blood oxygenation during sleep in patients with bronchial asthma]. / Wplyw wysokosci na utlenowanie krwi w czasie snu u chorych na astme oskrzelowa.

The aim of our study was to investigate the severity of overnight arterial blood desaturations in patients with asthma at the altitude of 3200 meters above sea level. 12 asthmatics and 12 healthy controls were investigated. Three overnight pulsoximetries were performed in all subjects, one at the lowland and on the 1st and 5th night at the altitude. Mean SaO2 at the lowland was significantly lower in asthmatics than in the controls (p < 0.01). After the ascent to high altitude severe fall in mean SaO2 was noted in both groups (from 94.3% to 85.8% in asthmatics and from 97.1% to 88.7% in controls) (p < 0.001 for both groups). After few days of acclimatization mean SaO2 rose to 88.8% in asthmatics and to 91.3% in controls, but was still significantly lower than at the lowland (p < 0.001 for both groups). At the altitude differences in mean SaO2 between two groups were not statistically significant. We conclude that severity of overnight desaturations at high altitude do not vary between asthmatics with impaired respiratory function and healthy subjects.

[The rehabilitation under alpine conditions of the participants in the cleanup of the accident at the Chernobyl Atomic Electric Power Station who are ill with chronic bronchitis]. / Reabilitatsiia v usloviiakh vysokogor'ia uchastnikov likvidatsii avarii na Chernobyl'skoi AES, bol'nykh khronicheskim bronkhitom.

24 patients exposed to low-dose radiation after the Chernobyl accident were examined before and after 24-day treatment of chronic bronchitis in the high-altitude rehabilitation center (3200 m above the sea level) in Tien Shan. Sanogenic alpine climate improved the patients' general condition, physical performance and lung ventilation, corrected compromised immunity. After high-altitude adaptation tracheobronchial inflammation alleviated, cytologic composition and surface activity of bronchoalveolar fluid returned to normal. Therefore, high-altitude treatment of Chernobyl accident victims with chronic bronchitis is effective and can be recommended for such patients.

[Periodic breathing during sleep at high altitudes in patients with bronchial asthma]. / Oddychanie okresowe w czasie snu w wysokich górach u chorych na astme oskrzelowa.

Earlier we found that asthmatic patients treated at a high altitude sanatorium (3.200 m) had numerous episodes of arterial blood desaturation during the night. To investigate if periodic breathing (PB) was responsible for those episode we studied 5 asthmatics (A) (mean age 34 yrs) and 3 healthy controls (C) (mean age 28 yrs) using MESAM 4, a simple, portable system recording breathing sounds, heart frequency, arterial blood saturation and body position. A and C subjects were first investigated at low altitude (760 m). There was no PB at 760 m in either group. At high altitude MESAM 4 recordings were performed on the 2nd and the 7th night after the ascent. On the 2nd night in the A group subjects the number of PB cycles averaged 37.2 (22-54) occupying 3.2% (2-5%) of estimated sleep time. The number of no-PB episodes was 52.4 (23-109). In the C group subjects the number of PB cycles was 83.6 (10-147) occupying 9% (1-14%) of estimated sleep time. The number of no-PB episodes averaged 45.6 (6-84). On the 7th night in A the number of PB cycles was 46.6 (15-69) occupying 4% (1-7%) of estimated sleep time. The number of no-PB was 54.8 (13-147). In C the number of PB cycles averaged 29.3 (12-59) occupying 3.3% (2-6%) of estimated sleep time. The number of no-PB was 20.3 (9-37). We conclude that majority of desaturations during sleep in asthmatics at altitude of 3.200 m was not related to PB; the mechanisms of these desaturations require more investigations.

Assesment of q-heterochromatin in patients with acute mountain sikness / En pacientes con el mal de montaña agudo

El presente estudio se ha diseñado para determinar marcadores genéticos del posible desarrollo del mal de montaña agudo (MMA), para lo cual se ha evaluado el número y distribución de las regiones cromosomiales específicas, nominalmente, las regiones de heterocromatina-Q (Q-HR) en 34 sujetos que desarrollaron MMA después de ascender a 3600 metros sobre el nivel del mar (Eastern Pamir). Los controles fueron 36 sujetos sin signos de MMA. El análisis de Q-HR se realizó utilizando la tinción de mostaza de propil quinacrina de las preparaciones cromosomales obtenidas de los cultivos de linfocitos. A diferencia de los controles, los sujetos con MMA mostraron ciertas diferencias en la distribución de características cuantitativas de la Variabilidad cromosomal Q-HR; el número total de Q-HR en sujetos con MMA fue de 2.15 +/- 0.19 en tanto que en los cointroles fue de 1.06 +/- 0.14 (P menor que 0,001). Estos datos sugieren el rol de la predisposición hereditaria en el desarrollo del mal de montaña agudo.

Inmunologic prognosis of acute mountain sikness / Pronóstico inmunológico del mal de montaña agudo

En las personas predipuestas al mal de montaña agudo se observan, un reducción de EHC-células formadoras de rosetas (E-RFC), células T salvadoras, la reducción de monocitos y capacidad de los neutrófilos para la adhesión, la inhibición de C3 - y receptores FC en la membrana, aumento de células O.

[The alpine climatotherapy of bronchial asthma patients]. / Vysokogornaia klimatoterapiia bol'nykh bronkhial'noi astmoi.

As many as 132 patients with bronchial asthma were examined for the clinical, functional and laboratory parameters before and during alpine climatotherapy at a height of 3200 m above the sea level (the Tyuya-Ashu pass, the northern Tien Shan). In addition to the improvement of the general status, the patients manifested amelioration of ventilation and decreased responsiveness of the bronchial tree by the end of alpine climatotherapy. Favourable alterations in the immune parameters together with appreciable stimulation of steroidogenesis in the adrenals were discovered. Investigation into surface activity of the exhaled air condensate revealed activation of the surfactant system. These data and endoscopy with bronchoalveolar lavage confirmed the reduction of the inflammatory lesions in the tracheobronchial tree. Therefore, alpine climatotherapy produces a favourable effect on the main mechanisms of the disease development and can be used on a wider basis for the treatment of patients suffering from bronchial asthma.

[Effect of high-altitude climate therapy on the adrenal cortex function in patients with bronchial asthma]. / Vliianie vysokogornoi klimatoterapii na funktsiiu kory nad- pochechnikov u bolnykh bronkhial'noi astmoi.

132 bronchial asthma patients living in Frunze (760 m above the sea level) and those on adaptation days 3-5 and 25-30 to the climate of North Tien Shan (3200 m above the sea level) underwent clinical and functional examination involving assessment of ACTH, cortisol and aldosterone levels. The patients showed clinical response and improvement of bronchial permeability associated with a pronounced growth of plasma cortisol levels starting on adaptation days 3-5. By adaptation days 25-30 cortisol levels were still on the increase while ACTH concentration tended to reduction.

[Changes in the surface activity of bronchoalveolar washings and their cellular composition in bronchial asthma]. / Izmeneniia poverkhnostnoi aktivnosti bronkhoal'veoliarnykh smyvov i ikh kletochnogo sostava u bol'nykh bronkhial'noi astmoi.

The superficial activity and cytological composition of bronchoalveolar washes off (BAW) were investigated in 55 patients with bronchial asthma. As compared to the control group the patients with bronchial asthma in remission demonstrated a moderate decrease in the superficial BAW activity which grew in the phase of exacerbation, a degree of variations of the superficial BAW activity depending on the expression of exacerbation. Correlation between a decrease in the superficial BAW activity and changes in an endopulmonary cytogram was found. On the 25th day of the treatment of the patients with bronchial asthma at the Tuya-Ashu mountain pass (Tien Shan, 3200 m above the sea level) under the conditions of mountain climate superficially active BAW properties and edopulmonary cytogram got back to normal.

[Acute hemodynamic effects of finoptin in patients with bronchial asthma complicated by pulmonary hypertension]. / Ostrye gemodinamicheskie éffekty finoptina u bol'nykh bronkhial'noi astmoi, oslozhnennoi legochnoi gipertenziei.

The effect of i. v. verapamil administration on some indices of the hemodynamics of the greater and lesser circulation was studied in 19 patients with bronchial asthma by a multiple approach using noninvasive methods (rheopulmonography, polycardiography, tetrapolar chest rheography). A decrease in the systemic as well as pulmonary arterial pressure and vascular resistance was revealed. The anti-hypertensive effect of verapamil on the lesser circulation was more pronounced and stable.

[Effect of obsidan on the cardiovascular system under conditions of high-altitude hypoxia]. / Vliianie obzidana na serdechno-sosudistuiu sistemu v usloviiakh vysokogornoi gipoksii.

The effect of beta-adrenergic block on the circulatory reactions of a human being induced by high altitude hypoxia was studied by multi-channel rheography and indirect determination of systolic pulmonary arterial pressure. In healthy people not subjected to a pharmacological effect, 25-day stay at an altitude of 3,200 m was marked by an increase in cerebral blood flow at the beginning of adaptation and the development of pulmonary hypertension the maximum signs of which were recorded during the first days in the mountains. Daily intake of 80 mg of obsidan begun 3 days before the ascent levelled out the adaptative increase in cerebral perfusion and intensified the marked character and stability of hypoxic pulmonary vasoconstriction. It is concluded that great care should be exercised in giving obsidan at high altitude to individuals with even latent forms of right ventricular pathology since under conditions of hypobaric hypoxia beta-adrenergic block increases the load suffered by the right ventricular myocardium.