25 patients with CF and 20 with others of COPD were examinated. Ciliary beat was measured by a lifetime TV microscopy of bioptates of respiratory mucous. Material was obtained with the help of brush biopsy during fiberoptic bronchoscopy. The image of ciliary beat from a light microscope was recorded on the hard disk of the personal computer. The specially created program estimated ciliary beat frequency (CBF) and amplitude of ciliary beating. CBF into bronchi of the CF patients have made at impact phase – 6.3+0.33 Hz, raising phase – 5.7+0.36 Hz; in the patients with COPD: 6.5+0.32 Hz and 6.2+0.33 Hz accordingly. The precise tendency to a drop of CBF and amplitude of ciliary beating in the patients with CF on a comparison with the patients with COPD and literary datas was marked. Also, the drop of indexes of beating in the patients with Ps.aeruginosae mucoid were marked.

This article demonstrates high clinical efficacy of long-term treatment of bronchial obstructive syndrome in cystic fibrosis (CF) patients with N-acetylcysteine (Fluimucil, Zambon Group). Lung function parameters, oxygen saturation, sputum viscosity, biochemical parameters of inflammation activity in sputum (elastase, sialic acid and α 1 -antitripsin concentrations) were evaluated. Oral Fliumucil was combined with inhaled N-acetyl-Lcysteine. The therapy resulted in reduction of the sputum viscosity, recovering of the mucociliary clearance, improvement in the lung function, antiinflammatory and antioxidative effects of Fliumucil. This allows to recommend the drug for the long-term basic therapy of bronchoobstructive syndrome in CF patients.

Extractive substances obtained from the bark of aspen (Populus tremula L.) with the use of petroleum ether (lipids I) and diethyl ether (lipids II) have exhibited high antibacterial activity with respect to Streptococcus pneumoniae and Haemophilus influenzae, causing 100% cell destruction. The minimum inhibiting concentration for S. pneumoniae has been found to be 0.5 - 50 mg/ml for lipids I and 0.0005 - 0.5 mg/ ml for lipids II, depending on the strain of bacteria. The antibacterial activity of rhytidome extracts is somewhat higher than that of phloem extracts. To suppress the growth of H. influenzae, more concentrated solutions of these extracts from 30 to 50 mg/ml are needed. Staphylococcus aureus was resistent in lipids. The action of temperature, mineral acids and alkali on lipids, as well as prolonged storage of strains in a refrigerator decreases the antibacterial activity of extracts under study.

The microbiological and virological examination of 87 acute bronchitis patients (36 patients with the prolonged course and 31 patients with the relapsing course of the disease) was carried out. All forms of bronchitis were characterized by a high degree of infection with respiratory viruses and pneumococci. Haemophilus influenzae (type b) infection was registered rather rarely and only in combination with pneumococcal one. The highest characteristics of viro-bacterial associations were found in patients with acute bronchitis and with prolonged form of acute bronchitis, viral associations--with the prolonged and relapsing forms of the course of acute bronchitis in the presence of the bronchoobstructive syndrome.

Chronic obliterating bronchiolitis in children is characterized by the presence of chronic multifactor inflammatory infectious process with Streptococcus pneumoniae and Haemophilus influenzae being the leading causative agents. The inflammatory process is induced and maintained by S. pneumoniae and H. influenzae or by the association of these two pathogens, but the severity of the clinical course of obliterating bronchiolitis is determined by H. influenzae, which is confirmed by its high detection rate at the phase of exacerbation in patients with pronounced bronchial obstruction.

AIM:Assessment of the efficacy of dry high-dispersive aerosol of sodium chloride--the main acting factor of haloaerosol therapy--on defense system of the respiratory tract. MATERIAL AND METHODS:188 patients with respiratory disease and at risk of pulmonary pathology received course of haloaerosol therapy. 49 matched patients were given placebo. The effect of the treatment was assessed by clinicoendoscopic picture, cytomorphological and bacteriological characteristics of the bronchoalveolar lavage, contamination activity of the microflora, activity of local humoral immunity in pharyngeal brush-biopsies and saliva, rheological indices of the sputum. RESULTS:Dry aerosol of sodium chloride demonstrated antiinflammatory activity in the respiratory tract, mucoregulating action. It enhances drainage of the bronchi, activates alveolar macrophages, improves biocenosis and local humoral immunity. CONCLUSION:Haloaerosol therapy has positive effect on the defense system, improves function of the respiratory tracts.

AIM:To study clinical effectiveness and safety of a new mucolytic drug pulmozim (Switzerland) adjuvant to basic therapy in mucoviscidosis patients of different age in Russia. MATERIAL AND METHODS:15 patients with mucoviscidosis aged 5-36 years, functional lung capacity and FEV-1 at least 40% received pulmozim for 30 days. The drug was given in a single daily dose 2.5 mg in inhalations. The study included three stages: initial 14 days--discontinuation of all mucolytic drugs, 30-day course of pulmozim, 14-day follow-up without pulmozim and other mucolytics. RESULTS:Pulmozim in the above regimen was effective in patients with mixed and moderate mucoviscidosis. The drug facilitates respiration, improves sputum rheology, normalizes general condition of the patient, is simple for use, has good organoleptic properties. CONCLUSION:Pulmozim is an effective mucolytic drug in combined treatment of mucoviscidosis.

Halotherapy was used for rehabilitation in 25 patients with acute bronchitis of long-standing and recurrent types. The main therapeutic action was ensured by aerodispersed medium saturated with dry highly dispersed sodium chloride aerosol, the required mass concentration being maintained in the range of 1 to 5 mg/m3. Therapy efficacy was controlled through assessment of clinical, functional, immunological and microbiological findings. Metabolic activity values were taken into consideration as well. Positive dynamics of the function indices in the clinical picture resulted from elimination of pathogenic agents, control of slowly running inflammatory lesions and stimulation of some immune system factors. Favourable changes in metabolic activity were present: normalization of serotonin excretion, marked decrease of unbalance in lipid peroxidation-antioxidant system.

In 1980-1986 the sensitivity of 2,045 H. influenzae strains isolated from the bronchial contents of patients with inflammatory lung diseases were studied. This study revealed that 60-80% of H. influenzae cultures circulating in Leningrad were sensitive to tetracyclin, chloramphenicol and erythromycin. During the period of observation the tendency towards the decrease of the number of highly sensitive H. influenzae cultures and the increase of the number of strains resistant to all antibiotic preparations was followed. Most of H. influenzae strains isolated in Leningrad were sensitive to penicillin, oleandomycin and ampicillin. In 1983 the appearance of H. influenzae strains, multiresistant to antibiotics, was noted. In 1986 these strains constituted 4.5% of all isolated cultures.

During the microbiological examination of 314 tentatively healthy donors, residents of Leningrad, Streptococcus pneumoniae was detected in the rhinopharynx of 94 donors (29.9%) in amounts ranging from a few individual microbial cells to 10(6) microbial cells with the mean geometric concentration equal to 3.58 lg. Antipneumococcal antibodies were detected in the blood of 147 donors (46.8%). The occurrence of antipneumococcal antibodies was approximately 2.5 times higher than the average level of carriership, but in most cases the dynamics of immunological reactions changed in the same direction. Considerable monthly and annual fluctuations in the occurrence of pneumococcal carriership and antipneumococcal antibodies, as well as their correlation with the epidemic rises of acute respiratory diseases, influenza and other acute respiratory viral diseases, were established. These data indicate that pneumococcal infection plays a definite role in the epidemic rises of acute respiratory diseases.

The etiology of acute pneumonia (AP) was studied in 229 patients who had the disease simultaneously with influenza (106 patients), other viral and mycoplasmal infections (48 patients), and without concomitant acute viral infections (75 patients). The use of the quantitative microbiological method and the indirect immunofluorescence test with autostrains or Streptococcus pneumoniae strains of serotypes 2, 3, and 6, prevailing in Leningrad in patients with acute inflammatory diseases of the lungs, made it possible to find out the pneumococcal etiology of AP in 95% of patients irrespective of the presence of acute respiratory viral infections. The etiological role of opportunistic bacteria was revealed in 13 AP patients (5.7%); in 2 of them the causative agent of AP was Staphylococcus aureus and in 11, various species of Gram-negative enterobacteria. The latter were the cause of complications in 8 cases of pneumococcal pneumonia.

The comparison of the antigenic structure of the polysaccharide capsule in 342 pneumococcal strains isolated in Leningrad from the bronchial contents of patients with acute and chronic inflammatory pulmonary diseases indicated that during 1978-1980 a change in the composition of the prevailing groups of serotypes occurred every year. The comparison of the groups of prevailing pneumococcal serotypes isolated from children and adults has revealed no statistically significant differences in the specific prominence of different types, with the exception of serotype 15. Serotypes 6, 7 and 2 have been found to occur most frequently in acute pneumonia, and serotypes 23, 3, 9, 6, 15, 29 and 34 in chronic inflammatory pulmonary diseases. The preliminary data on the differences in the composition of the prevailing pneumococcal serotypes causing acute pneumonia in Leningrad and Kaunas have been obtained.

The simultaneous microbiological study of sputum and bronchial washings from 440 patients with acute and chronic inflammatory pulmonary diseases has revealed that pneumococci can be isolated most frequently from both these materials or sputum alone. The isolation of pneumococci by the inoculation of the pathological materials or sputum alone. The isolation of pneumococci by the inoculation of the pathological material into solid culture media is practically as effective as the inoculation of white mice with this material, but the former method accelerates the isolation of Str. pneumoniae and allows one to determine the content of these organisms in the initial material. The appearance and the size of pneumococcal colonies depend on the composition of the culture medium, the biological properties and the amount of Str. pneumoniae and other microorganisms in the material under study. The identification of the S-forms of pneumococci is based on their cultural and morphological properties and carried out by one test or by a complex of tests. 4 criteria allowing to determine the etiological importance of pneumococci isolated from patients are proposed.