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The paper compares the characteristics of the informative value of tests determining the activity of adenosine deaminase (ADA) activity and the level of gamma-interferon (gamma-IFN) for the differential diagnosis of tuberculous pleurisy (n = 35) and non-tuberculous pleural effusion (n = 53). Both tests were ascertained to have the similar differentially diagnostic capacities with their threshold values of 35 U/l and 180 pg/ ml, respectively. At the same time, the sensitivity and specificity of the ADA test were 98.4% and these of the gamma-IFN test were 94.3 and 96.2%, respectively, with the positive and negative predictive value being 91.3 and 98.3% and 94.3 and 96.2%, respectively, and with the diagnostic value of 94.5% for the ADA test and 96.4% for the gamma-IFN test. There was a high unidirectionality of changes in both values: it was higher than the cut-off points in 94.1% of the patients with tuberculous pleurisy and below them in 88.7% of those with other pleural effusions.

In 20% of cases, tuberculous spondylitis running with a prevalence of the exudative-necrotic type of a local tissue reaction has an acute onset with febrile fever, severe pains, and progressive neurological disorders and clinically resembles acute hematogenous osteomyelitis of the spine. With a predominance of the productive type of a tissue reaction, tuberculous spondylitis resembles subacute hematogenous osteomyelitis of the spine. History data, laboratory parameters, and an X-ray follow-up are of great importance in its differential diagnosis.

A hundred and three patients with destructive pulmonary tuberculosis were examined. These patients had heterodirectional changes in the serum levels of alpha2-macroglobulin (MG) and its forms. The lowering of the level of the F-form of the inhibitor outstripped the decrease in the activity of total alpha2-MG and it was detectable in the lobar processes with moderate symptoms of intoxication and with the inoculation of adjacent segments. The preservation of the low total activity of the inhibitor and its forms during antituberculous therapy characterize a diminished process. The high content of the S form of alpha2-MG is a feature in patients showing positive changes before and 2 months after treatment whereas the changes in total alpha2-MG and its F form may vary. Whether it is expedient to study the fractional composition of alpha2-MG is determined by the heterodirectionality of changes in its S and F forms depending on the pattern of a process.

Adenosine deaminase (ADA) and 2-deoxyadenosine deaminase (2-deoxyADA) activities were measured in pleural exudation of different origin in 373 patients (124 of these with serous tuberculous pleurisy and 75 with specific empyema). High diagnostic value of ADA activity in the presence of threshold value higher than 35 Units/liter was established: the sensitivity of the test in the diagnosis of tuberculous pleurisy and empyema was 94.4 and 93.3% respectively, specificity 93.0 and 89.5%, respectively. Judging by the coefficient of 2-deoxyADA/ADA, total ADA activity is determined by the activity of ADA-2 isoenzyme, while in tuberculous empyema by ADA-1. Additional use of this coefficient, requiring measurement of 2-deoxyADA activity, does not improve the efficiency of the diagnostic process, including measurement of total ADA activity in pleural exudate.

The serum activity of the enzyme adenosine desaminase (ADA) was studied in patients with infiltrative tuberculosis in relation to IL-1 beta, TNF-alpha, IL-2 productions, the magnitude of a lymphocytic proliferative response to PPD and PGA. There was an association of high ADA levels with the severity of a tuberculous process, with the least IL-2 production together with drastically increased IL1 beta and significant disorders in the TNF-alpha system. Moderate ADA increases reflect the regularly enhanced activity of immunocompetent cells in response to an infectious agent. The findings indicate that a simple biochemical test may be used for rapid preliminary evaluation of the severity of disease and immune performance.

Examining the activity of serum adenosine deaminase in 112 patients with lymphadenopathy of various etiology revealed its increase (at the discriminant level equal or exceeding 20 U/l) in 86% of 50 patients with active tuberculous infection. The specificity of the parameter as a test for tuberculous peripheral lymph nodal lesion is 90.3%, the positive and negative prognostic significances are 83 and 89%, respectively, the diagnostic efficiency is 88.4%.

A complex study of hemodynamics and renal function in 30 patients with adenoma of the prostate during peridural anesthesia has been carried out. The functional renal reaction depends upon the scope of the sympathetic blocade in peridural anesthesia and bears an intimate relation to hemodynamic and neurohumoral effects of the developing blocade. All these changes are of a temporary character and regain values close to the initial ones by the time of the adaptation of the body to peridural anesthesia and stabilization of hemodynamics.