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An ultrasonic investigation of the kidneys in patients with renal forms of acute renal failure (32 and 24 with ethylene glycol poisoning and leptospirosis, respectively) recorded in the oligo-anuric phase a specific ultrasonic picture of renal lesion demonstrable as long as full recovery of impaired functions. The picture was characterized by enlargement of the kidneys with good differentiation of the pyramids in enhanced parenchymal echogenicity. Ethylene glycol poisoning is characterized by limited renal mobility and an echo negative halo around them. These signs may appear helpful in the diagnosis of renal forms of acute renal failure.

Altogether 64 young patients with nonconjugated hyperbilirubinemia (NH) underwent clinico-morphological correlations to establish the nosological essence of pigment metabolism disorders revealed. 32 patients showed up the signs of chronic nonspecific hepatitis, including 7 patients with the signs of chronic aggressive hepatitis. The remainder 15 patients were found to have other inflammatory processes in the liver. Only 10 persons examined (15.6%) were diagnosed to have functional hyperbilirubinemia and 7 (10.9%) to have latent hemolytic anemia. The conclusion is made about the necessity of a comprehensive examination of young persons with NH. The morphological examination of the liver is a must to early verify the pathological process manifested by the impairment of pigment metabolism.

The results of the catamnestic study of case reports and records of postmortem examination of 102 patients with bronchial asthma (BA) aged 47 to 88 years who died at a general hospital during 1976-1988 indicate that in the overwhelming majority of cases, there took place death "with asthma" rather than death "from asthma". At the same time the dominant pathology was coronary heart disease (acute coronary failure, myocardial infarction, progressive heart failure associated with atherosclerotic and postinfarction cardiosclerosis). Emphasis is laid on the fact that according to the autopsy data, the rate of the recognized stenosing atherosclerosis of the coronary arteries considerably exceeded the number of cases of coronary heart disease documented clinically (typical angina pectoris of effort, significant macrofocal myocardial infarction). The characteristic features of the group under observation included an unexpectedly frequent combination of BA and malignant neoplasms (24 cases), including lung cancer in 13 of these cases.

Based on the clinical observations and post mortem examinations the data are provided on the development, diagnosis and treatment of secondary pneumonias in bronchogenic pulmonary carcinoma. The authors describe the local immunological disorders in patients suffering from pneumonia: the morphologic changes, alterations in the content of lysozyme and protein, acid phosphatase activity, and in the NBT-test for neutrophils of the bronchoalveolar lavage fluid. Demonstrate the clinical efficacy of endobronchial administration of the incubated leukocyte and platelet mass stimulated with tactivin.

Using a method of circadian ECG monitoring, the authors detected a peculiar phenomenon of frequent arrhythmic action of sympathomimetic inhalants in patients with bronchial asthma, mainly during remission. Possible interpretation of the results obtained was as follows: reduction during remission of functional beta block including heart block determining "cardioprotective" action in sympathomimetic inhalations; depletion of reserves of myocardial sympathetic mediators at the height of exacerbation of bronchial asthma; peculiarities of absorption of sympathomimetic inhalants with relation to a stage of disease. The authors discussed the potentialities and limitations of the use of sympathomimetic inhalants during exacerbation and remission of bronchial asthma with relation to patients' age and concomitant coronary heart disease.

The use of various doses of metoprolol (spesicor, Leiras, Finland), a selective beta 1-adrenoblocker, in patients with CHD combined with clinical or instrumentally detectable symptoms of bronchial asthma or stage I-II essential hypertension with angina pectoris of I-II functional classes, has shown that metoprolol cardioselective blockade is a relative phenomenon which has definite correlation with a dose, duration of therapy, and the initial status of the bronchopulmonary system. An antianginal effect was observed in 68.5% of patients, an antihypertensive effect--in 71.3%, side-effects--in 6.4%.

The data are presented on the incidence and the course of coronary heart disease (CHD) in senior group patients with concomitant bronchial asthma (BA). The clinical symptomatology in the given case differs in some respects from the classical concepts of the conventional course of the disease under consideration. The patients with concomitant BA show, in a considerable number of cases, (21.9 percent), an asymptomatic course of CHD. Among the patients with the angina pectoris syndrome, the proportion of the patients with functional class I angina pectoris is relatively low. Among such patients, there predominate subjects with a brief history of CHD (lasting less than 5 years). The incidence of the arrhythmic patterns of CHD (paroxysmal or constant atrial fibrillation, stable ventricular premature heart beat of high brades) is not great either. The clinical interrelations between CHD and BA when combined are characterized, as a rule, by the fact that exacerbation of one of the diseases is accompanied by regression of the symptoms of the concomitant pathology that withdraws as if to the background. The data obtained appear to suggest that the given group of the patients require a goal-oriented instrumental examination (exercise tests, ECG-monitoring, etc.) followed by administration of adequate coordinated drug treatment.

A study of patients with a stable course of bronchial asthma (BA) has confirmed the absence of a significant bronchodilating effect of nifedipine during an acute drug test (a single sublingual administration of the drug at a dose of 20 mg). Preliminary administration of nifedipine at a dose of 20 mg was noted to result in the prolongation of a bronchodilating effect of salbutamol inhaled at a dose of 200 micrograms, not influencing a degree of its expression. it has been assumed that prolonged use of nifedipine would result in reduced requirements of BA patients in inhalation sympathomimetics. This therapeutic trend especially holds promise for middle aged and aged BA patients with concomitant CHD, arterial hypertension. Reduced requirements in sympathomimetics in them would lead to the reduction of risk of iatrogenic exacerbations of cardiovascular diseases.

A case of isolated amyloidosis of the trachea in a woman aged 46 was described. The main clinical signs of the disease were dry cough, recurring hemoptysis and hoarseness of the voice. Endoscopy showed disseminated polypoid formations in the trachea. A histological study of mucosal biopsy from these formations revealed amyloid masses deposited in the submucosal layer. An additional study brought about no data on the generalized nature of amyloid dystrophy of any other organs. The use of computed tomography to determine the type of tracheal lesion in this localization of the process was shown to be promising.

A study was made of the therapeutic efficacy of calcium antagonists (CA) in the treatment of bronchial asthma. It has been shown that CA, particularly nifedipine and verapamil, do not exert, in the course of an acute drug test, any significant effect on bronchial patency. At the same time CA produce an appreciable preventive effect when administered to bronchial asthma patients with the syndrome of bronchial tree hyperreactivity--cold and post-exercise bronchospasm. Special attention is drawn to CA synergism with inhalation sympathomimetics, which lies in the increase of the duration of the bronchodilating action of the latter ones. The paper provides the data concerned with the effective use of CA in multimodality treatment of the patients with associated bronchial asthma and coronary heart disease.

The article concerns one of the present-day problems in the teaching of the allergic diseases of the lungs, namely allergic bronchopulmonary aspergillosis. Discusses the disease diagnosis and clinical course, diagnostic approaches, efficient drug therapy, and prognostic aspects. Based on an analysis of the authors' own data, the problem of the possibility of the systemic pathoimmune manifestations associated with skin, eye and kidney injuries that occur during allergic bronchopulmonary aspergillosis is discussed.

Clinical, bicycle ergometry and coronographic findings were compared in 161 patients with pains in the heart area. It was shown that patients with the involvement of the coronary arteries could be detected on the basis of anamnestic data and almost as frequently on the basis of the results of the bicycle ergometric test among persons with pains in the heart. In patients with a high probability of the involvement of the coronary arteries on the basis of anamnestic data a negative bicycle ergometric test was often false negative and in patients with a high probability of the absence of the involvement of the coronary arteries on the basis of anamnestic data the positive bicycle ergometric test was often false positive. The development of a typical angina attack during the bicycle ergometric test played the same role in the diagnosis of the involvement of the coronary arteries as a shift of the ST segment on ECG.

A study of bronchial permeability in 98 patients with acute pneumonia during clinico-roentgenological convalescence using a method of the analysis of the flow-volume loop diagram showed disorders of bronchial permeability in 73.46% of the patients, of them obvious disorders in 21.42% and latent ones in 52.04%. Hyperreactivity of the tracheobronchial tree to acetylcholine was established in 84.4% of the patients without signs of obvious obstruction and in some cases only to obsidan indicating the presence of disorders of vagotonic regulation without change in the functioning of beta-adrenoreceptors.

Rehabilitation of patients with bronchial asthma is a complicated problem which has been studied insufficiently. It includes a number of constituent elements: exclusion or restriction of contact with an allergen, specific sensitization, choice of rational maintenance therapy, health resort treatment, and so forth. The main purpose of rehabilitation treatment for bronchial asthma consists in the creation of the most favourable life and work conditions for patients.