[Changes in external respiration function in response to berotek and histamine in diabetic patients].

AIM: To study airways reactivity in patients with diabetes mellitus (DM). MATERIAL AND METHODS: Berotek and histamine tests were performed in 29 DM patients (type 1 DM - 20, type 2 DM - 9 patients) and 39 DM patients (12 and 27 patients, respectively). The age of the patients varied from 16 to 66 years. RESULTS: Positive berotek test was in 6 (20.7%) patients (delta FEV1 > 200). Of them 5 had type 1 DM. Positive histamine test was registered in 9 patients with type 2 DM (23.1%). This indicates bronchial hyperreactivity (BH). A qualitative analysis with Fisher's criterion detected correlation between BH and type of DM, BH and intake of sugar reducing tablets. Correlations between BH, body mass index, diabetes duration and late complications were not found. CONCLUSION: DM patients have predisposition to bronchial spasm. Positive bronchodilation test was mainly in type 1 DM, BH in response to histamine was obtained in type 2 DM. Different mechanisms of a bronchospasm in type 1 and 2 DM are demonstrated. Predisposition to bronchospasm may play an unfavourable role in the course of nonspecific pulmonary diseases in DM patients.

[Effective correction of lung hyperinflation in pneumonia using positive end-expiratory pressure]. / Effektivnaia korrektsiia giperinfliatsii legkikh pri pnevmonii s pomoshch'iu dykhaniia s polozhitel'nym davleniem v kontse vydokha.

AIM: Study of PEEP effects on breathing biomechanics in patients with pneumonia. MATERIALS AND METHODS: In 37 patients with pneumonia breathing biomechanics was studied using Masterlab (Jaeger). PEEP (3-10 cm H2O) was employed during 20 min. RESULTS: Sputum expectoration, expiration and inspiration were improved, lung hyperventilation observed in pneumonia reduced after PEEP. CONCLUSION: There is early expiration obstruction of the airways in pneumonia. PEEP removes this obstruction through control of lung hyperinflation. Thus, PEEP can be applied in the treatment of pneumonia.

[The effect of positive end-expiratory pressure on respiratory biomechanics in bronchial asthma]. / Vliianie polozhitel'nogo davleniia v kontse vykhoda na biomekhaniku dykhaniia pri bronkhial'noi astme.

The influence of PEEP breathing has been studied in 43 patients with exacerbation of bronchial asthma (BA) during 20 min in resistance of 5, 7 or 9 sm. Sputum expectoration and inspiration were found improved after PEEP breathing. Moreover, in some patients mild BA attacks relieved. Lung hyperinflation, bronchial obstruction reduced. A positive effect was observed in moderate asthma in PEEP breathing of 7 and 9 sm more frequently. This, PEEP breathing can be applied in the treatment of BA.

[Disorders of the protease-antiprotease system of a bronchial washout in patients with bronchiectasis and the means for their correction]. / Narusheniia sistemy proteazy--antiproteazy bronkhial'nogo smyva u bol'nykh bronkhoéktaticheskoi bolezn'iu i puti ikh korrektsii.

Patients with bronchiectatic disease show imbalance between the activity of proteolytic enzymes and their inhibitors contained by bronchial wash-out, manifesting in a reduction of the inhibitory potential and a rise of the activity of trypsin-like proteinases. After the standard basic treatment the protease-antiprotease system in bronchial wash-out shows a definite improvement. Endobronchial therapy with contrykal given in a dose of 20-30 thousand ATpE for 5-7 days does not ameliorate imbalance in the protease-antiprotease system in bronchiectatic disease patients as compared to the common basic therapy.

[Procoagulant and proteolytic activities of leukocytes in the foci of acute abscesses and gangrene of the lungs]. / Prokoaguliantnaia i proteoliticheskaia aktivnost' leikotsitov v ochage porazheniia u bol'nykh ostrymi abstsessami i gangrenoi legkikh.

Essential role in development of acute purulent destruction of the lungs in attributed to proteinases of polimorphonuclear leukocytes. Poor localization of the destruction focus seems to result from low procoagulant activity of pulmonary macrophages. If the activity of purulent and destructive process stands high the ability of phagocytes to synthesize and release proteinases is realized fully. epsilon-Aminocaproic acid prohibits phagocytic proteolytic activity from growing under the influence of stimulators. Correction of defective leukocytic proteolysis and mononuclear activity can be done with prodigiozan, streptokinase and epsilon-aminocaproic acid.

[The differential use of fibrinolysis activators and inhibitors in treating acute abscesses and gangrene of the lungs]. / Differentsirovannoe primenenie aktivatorov i ingibitorov fibrinoliza v lechenii ostrykh abstsessov i gangreny legkikh.

The authors examined 25 patients with acute abscesses and gangrene of the lungs to study the condition of the phagocyte system and its effect on processes of fibrin formation and destruction in the focus of inflammation. They found marked increase of the number of polymorphonuclear leucocytes and decrease of alveolar macrophages in lavage fluid of the diseased lung. The fibrinolytic, procoagulant, and oxygen-dependent metabolic activity of phagocytes was increased. With the degree of these changes and the clinical and endoscopic signs of the activity of the inflammatory process taken into account, the choice of the fibrinolysis activators and inhibitors for endobronchial administration can be differentiated and the results of treatment improved.

[Ventilation-perfusion ratios and pulmonary shunt]. / Ventiliatsionno-perfuzionnye otnosheniia i legochnyi shunt.

A group of 63 healthy subjects aged from 17 to 29 years were studied in a sitting posture. The following indices of pulmonary ventilation were revealed: Vd, phys/VT-30 +/- +/- 0.6%, AaDO2-10 +/- 0.9 mm Hg, aADCO2 (PA, CO2 = = Pet, CO2)-5.0 +/- 0.4 mm Hg, Qva/QT (air)-2.3 +/- 0.3% Qs/QT (O2)-1.8 +/- 0.2%. In general VA/Qc is normal being 0.86 +/- 0,03. No differences in VA/Qc are recorded in males and females. The anatomic shunt and perfusion of nonventilated alveoli play the leading role in the formation of QVa/QT in healthy persons.