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Clinical and laboratory criteria for estimating the role of viruses and bacteria that determine bronchopulmonary diseases have been derived. The clinical importance of the detectable microflora, part of which permanently invade the nasopharynx (pneumococcus, adenoviruses) is under critical review. Pneumonias that may develop within the first days of acute respiratory viral infection are characterized by monoviral influenzal or RS-infection; later pneumonias are marked by viral infection with the predominance of adenoviruses. Attempt has been made to reveal the role of geno- and phenotypic factors (N-acetylation, lipid peroxidation, synthesis of alpha-interferon). The data obtained support an assumption about self-regulation of the child's immune system and the adaptation character of responses in mixed infections.

To study the etiological role of Streptococcus pneumoniae in bronchial inflammation, 49 children with acute bronchitis and 21 children with acute nasopharyngitis were examined. The given patients' groups manifested no significant differences in the microflora of the upper respiratory tract, serotype landscape of pneumococcus, the level and dynamics of the immunologic characteristics. The growth of the titer of pneumococcal antibodies in the saliva in the early times of the disease as well as the lack of its changes in blood serum suggest that interaction of pneumococcus with the host is restricted in the given case by the bronchial lumen.

Immunoglobulins and nonspecific defence factors (complement, properdin, lysozyme) were studied over time in 194 children suffering from diabetes mellitus. In 145 children, diabetes mellitus was associated with chronic tonsillitis. Resistance in 49 children was examined depending on the phase of diabetes mellitus. The data obtained indicate that diabetes mellitus is marked by imbalance of nonspecific defence factors and humoral immunity. These changes are obviously related to the disease gravity, phasic nature of the process, diabetes mellitus standing, and the presence of concomitant diseases. No parallelism was established between the level of nonspecific defence factors and specific immunity activity.

Overall 120 children with chronic liver diseases of HB-virus etiology were examined. In 78.3% of the patients, RIA was used to reveal anti-delta in blood serum, 33 children were diagnosed to have chronic persistent hepatitis, 44 chronic active hepatitis, and 43 liver cirrhosis. The patients with anti-delta manifested certain characteristic features. There prevailed children from epidemiologically unfavourable regions as regards virus hepatitis B. There also prevailed boys. In one-third of the patients with chronic liver diseases and anti-delta, acute hepatitis ran a biphasic course. According to the data obtained, super-addition of delta-infection aggravates the disease; the process becomes chronic more rapidly, exacerbations are more pronounced. 16 out of 23 children showed delta-antigen in liver biopsy specimens; in patients with active disease, the antigen was detected in the nucleus and cytoplasm at a time. As the activity decreases, the antigen becomes mostly detectable in the cytoplasm.

Overall 1580 children from the regions with unsafe radiation situation were examined comprehensively at different times after the accident. The data obtained were correlated to the results of examining 610 children of the control group. The basic group children manifested a higher incidence of diverse alterations on the part of many organs and systems, which was accompanied by an increase of free radical processes signs of destabilization of cellular membranes, activation of blood cell metabolism, suppression of the T cell component of immunity in the presence of vegetovascular dysfunction. A tendency was noted toward normalization of these alterations seen over time after the accident. No clear-cut dose-effect dependence was found.

The use of specific immunoglobulin in combination with conventional agents of pathogenetic and symptomatic therapy was over two times more potent in reducing the lethality due to herpetic encephalitis. The residual phenomena in the survivors were also less pronounced in those given specific immunoglobulin. A relationship has been discovered between the outcomes of herpetic encephalitis and the time since the treatment with specific immunoglobulin was instituted, the rate of coma development and its intensity at the moment of the therapy onset.

Overall 21 children suffering from active liver cirrhosis were examined for the dynamics of allergic symptoms and IgE before and after splenectomy. The IgE level was measured 2-4 weeks, 3-11 months and 1-5 years after splenectomy. All the children received glucocorticosteroid therapy followed by the administration of maintenance therapy. It has been shown that splenectomy as one of the pathogenetic forms of therapy of active liver cirrhosis produces a decrease in blood IgE and in the incidence of allergic manifestations in addition to the clinical effect and amelioration of liver function.

In different forms of chronic hepatitis B, autoantibodies reacting with the epithelium of the basal skin layer (EBSL) and with the epithelium of the cortical and medullary areas of the thymus can be detected by indirect immunofluorescence. The rate of demonstration and the level of these antibodies were established to depend directly on the activity of chronic hepatitis. The data obtained indicate that autoantibodies to EBSL are typical not only for the beginning of the autoimmune process but may also serve as an indicator of the activity of chronic autoimmune disease. The highest titers of the autoantibodies were demonstrated in aggressive hepatitis B associated with liver cirrhosis (in 100% of cases). The data obtained were compared to the liver biopsy findings. Therefore, demonstration of the high titers of autoantibodies can be used without liver biopsy for the diagnosis of liver cirrhosis in hepatitis B.

PRIST was used to examine the time course of changes in the content of total blood IgE in 128 children aged 3 to 15 years suffering from chronic virus hepatitis and liver cirrhosis. A well-defined relationship was discovered between the above parameter and allergic background as well as the process activity in the liver, pointing to the capacity of that class immunoglobulins to reflect the intensity of not only allergic reactions but also of immunopathological processes lying at the basis of chronic active hepatic diseases.

Overall 69 girls with stage II and III juvenile hyperplasia of the thyroid without any clinical signs of pubertal abnormality were examined. Of these, 2/3 had the normal content of circulating thyroid and thyrotropic hormones in the blood serum. In prepubertal girls, the age-associated basal concentrations of gonadotropins and sexual steroid were discovered, whereas in puberty, there was a significant increase of the content of luteinizing hormone, prolactin, estradiol (a two-fold increase) and progesterone (a ten-fold increase) in the second phase of the menstrual cycle, which attested to its ovulatory nature. In 1/3 of the girls, subclinical hypothyrosis with a significant rise of the level of thyrotropic hormone associated with normal or lowered concentrations of triiodothyronine or thyroxine was diagnosed. In addition, the metabolic markers of the discoordination of the hypothalamo-hypophyseal-gonadal system were revealed: an increase of the content of luteinizing hormone and prolactin associated with the low levels of estradiol and progesterone.

The authors describe lesions of the upper alimentary tract in 91 children aged 4 to 15 years suffering from pyelonephritis. Intragastric pH-metry, endoscopy and histological examination of biopsy specimens from the gastric and duodenal mucosa were carried out, as a result of which gastroduodenal pathology was diagnosed in 3/4 of the patients. In 69.4% of the children, biopsy specimens of the mucous membrane of the antrum of the stomach showed Campylobacter pylori. Such combined pathology requires, in addition to the treatment of pyelonephritis correction of the diet, administration of agents that may contribute to the decrease of upper alimentary tract inflammation. If Campylobacter pylori are detected, the treatment eliminating those bacteria is to be administered.

The immune status was estimated comprehensively and indicators of the level I and II tests of T and B components of the immunity system were defined in 120 children with thymomegaly (group I), in 30 children with unenlarged thymus (group II), and in 40 practically healthy children with unestablished size of the thymus, with a favourable family and personal disease history, who had never fallen ill before the immunologic examination (group III). The children belonging to groups I and II were examined at the acute disease period, during convalescence and clinical wellbeing. It has been established that during the acute bronchopulmonary disease, the group I and II children manifested the same regularities of immune response to the action of an antigenic stimulus. However, at the period of the clinical wellbeing, the group II children showed a higher lymphocytosis, impairment of the ratio of the T lymphocyte subpopulations, an increase of the EAC--RFC count, and a decline of the level of serum thymic factor. It is assumed that in the group I children, the system of immunologic defence is of weak safety within the first 3 years of life.

++Semi-closed interview was used to examine some social and demographic characteristics in 201 families having children of the school age suffering from diabetes mellitus (a random sample). Among sick children of Moscow highly aggravated heredity as regards diabetes mellitus was established (44.28%). In the first year of life, the majority of diabetes mellitus children had unsatisfactory living conditions, the family income per capita was low. Today 16.4% of the children continue having unsatisfactory living conditions; in the majority of the families (62.7%), the income per capita does not exceed 100 roubles. Among parents of diabetes mellitus children, the main group is made up of white collars, engaged primarily in intellectual activity and having a high educational level. The latter circumstance makes it possible to perfect the methods of the control over diabetes mellitus children in the family itself, which is to be coupled with systematic sanitary and instructive work on the part of the public health bodies.

Investigation of the bioelectrical activity of the brain (EEG, echoEG) in 60 patients aged 8 to 20 years with a long relapse-free course of acute lymphoblastic leukemia (6-10 years) made it possible to distinguish 3 groups of patients in accordance with the changes seen on the EEG. A reverse relationship was noted between the characteristics of the leukemic process during disease diagnosis and neurophysiological disorders after intensive therapy including chemoradiation prophylaxis of neuroleukemia. It is recommended that the dose of radiation of the brain of children with acute lymphoblastic leukemia may be reduced, if there are no risk factors of the development of disease relapses.

The follow-up of 318 children with acute lymphoblastic leukemia given program therapy that included different treatments including chemo- and radioprevention of neuroleukemia demonstrated the high efficacy of the measures carried out, which reduced the incidence of neuroleukemia to 5.6%. No gross changes on the part of the neuropsychic status were revealed in the course of the follow-up of children who received the combined prophylaxis of neuroleukemia. The derangement of the CNS was recorded in 17 patients and ran its course in the form of leukemic meningitis and meningoencephalitis.

Lipid metabolism in lymphocytes was compared to that in the blood serum and red blood cells. 50 children aged 7 to 15 years suffering from insulin-dependent diabetes mellitus (IDDM) in the phase of decompensation without ketosis were examined. The patients were treated at hospital. 12 healthy children of the same age made up the control group. The changes in the lipid composition of red blood cells were shown to follow "passively" the changes occurring in the lipid composition of the blood serum. On the contrary, the changes in the lipid composition of lymphocyte membranes in IDDM are of "active" nature and may be caused by the displacement of the metabolic changes in lipid to a new pathological level. The changes in the lipid composition of lymphocyte membranes, seen in the phase of IDDM decompensation are one of the main factors responsible for the lowering of lymphocyte function that determines the formation of immunodeficiency followed by the superaddition of infectious diseases.

A total of 102 children aged 5 to 14 years with virus hepatitis B were examined for the status of the mononuclear phagocytic system in accordance with the absolute monocyte count in the circulating blood, esterase and acid phosphatase activity in the monocytes, for function of organ macrophages of the liver and spleen using dynamic scintigraphy with TC-colloid and for macrophages of the skin by the "skin window" method. The rise of the absolute count and lowering of the functional and metabolic activity of blood monocytes were directly proportional to the gravity of virus hepatitis B. The changes persisted for a long time, namely up to 1.5 to 3 months since the disease onset. There was a progressive drop of the functional activity of Kupffer cells in the liver with a maximum decrease seen within 4 to 6 weeks since the disease onset, followed by returning to normal in cyclic disease and preservation of the changes in lingering and chronic virus hepatitis B. Spleen macrophages play an active compensatory role, maintaining normal "purifying" function of the mononuclear phagocytic system. That compensatory response tension appeared high in lingering and especially in chronic virus hepatitis and may serve as a criterion for process chronicity. The changes in the mononuclear phagocytic system observed in cyclic course of mild and medium-gravity virus hepatitis B may be regarded as normal adaptive reaction and do not require any drug correction. The latter one may only be indicated in patients with grave, lingering or chronic disease patterns associated with break down or depletion of the adaptive mechanisms of the system in question.

The authors provide the results of observing 150 patients with acute pneumonia verified on x-ray. Comprehensive serological studies enabled the legionellosis etiology of pneumonia to be established in 17.3% of cases in sporadic morbidity of children. The disease was marked by the peculiarity of the clinical manifestations, demanding nonstandard treatment approaches.

Eight children suffering from diabetes mellitus and epilepsia were followed up. Emphasis is laid on the necessity of measuring glycemia in diabetes mellitus patients during convulsive attacks as well as on the importance of early diagnosis of epilepsia to institute multimodality treatment.

The authors relate the data obtained during echographic examination of 863 children suffering from gastric pains. Proceeding from the clinical and laboratory data the early topical diagnosis of the causes of the painful syndrome was impeded. Use was made of ultrasonography of the gallbladder along with its function estimation, of the intra- and extrahepatic bile ducts as well as of the liver and pancreas. A study was made of correlations between the echographic signs of the microscopic and biochemical indicators of the bile and the status of the duodenal mucosa (according to esophagogastroduodenoscopy). The data obtained demonstrate great potentialities of echography in differential diagnosis of gastric pains in children.

The content of IgE, IgG, IgM and secretory IgA was measured in the stomatopharyngeal secretion (saliva) and in the intestinal secretion (coprofiltrates) of 58 patients aged 3 to 15 years suffering from chronic viral hepatitis and liver cirrhosis. It has been established that in addition to hyperimmunoglobulinemia, children with chronic viral diseases of the liver manifested elevated synthesis of immunoglobulins in the system of local immunity, including a high content of IgE in the alimentary secretions, thus pointing to enhanced antigenic stimulation occurring in this pathology.

A comprehensive study of the content of hormones (ACTH, STH and hydrocortisone) directly in the cells of endocrine organs (pituitary) and in the blood of the dead newborn was conducted for the first time, using immunocytochemistry and radioimmunoassays. Based on the findings obtained, the degree of maturity of adnenocorticotropic function of the pituitary was established as were adaptation reserve potentiatialities of endocrine functions in the newborn, bearing in mind the gestation age, the influence of the mother's infectious disease (chronic pyelonephritis, rheumatic fever, bronchopulmonary pathology), and the time of the child's life.

During measurements of the content of malonic dialdehyde and the total antioxidant activity in blood plasma and red blood cells as well as of their peroxide resistance in healthy neonates, it has been established that in boys and girls the majority of the study parameters did not differ within the first 6 days of life. At the same time in girls, catalase and peroxidase of red blood cells were activated and the total antioxidant activity of blood plasma was increased since the first days after the birth.