[Cardinal problems of the regional bacteriological laboratories of tuberculosis facilities].

Restructuring the health care system and the epidemiological situation associated with tuberculosis result in an increased burden on the bacteriological laboratories (BLs) of tuberculosis facilities. At present, there are no statistical data that enable one to estimate the capacity of a laboratory service to assure the adequate quality and efficiency of bacteriological diagnosis. To assess the state of the headquarters BLs of tuberculosis facilities, the authors have worked out a questionnaire to glean necessary information on the activity of the laboratories to such an extent that suffices to reveal cardinal problems in the work of individual laboratories and the laboratory network as a whole. Out of the 48 questionnaires sent from the regional BLs, the data available from 22 laboratories that had fully answered all the questions were analyzed. The data obtained are referred to as of 2004, i.e. when the current antituberculous care projects were launched, which is of significance in organizing the monitoring of a laboratory service and in assessing the progress of the projects. The authors have identified the following cardinal problems: inadequate readiness of most laboratories to fully perform their incumbent functions; no coordination in providing data at the regional and federal levels; inefficient laboratory diagnosis that is associated with the disintegration of the curatorial institution, with neither reference relations no united external or internal quality control programs, with the lack of expertise and the undermanning of the laboratories, with the obsolete list of staff members and the obsolete standards for calculation of their loads, with the deterioration of a material and technical base, and with the unconformity of equipment to the state-of-the-art technologies. In order to solve the above problems, the authors offer a laboratory service monitoring system based on the proposed questionnaire, followed by the computerization of data collection and the compulsory supervision of regional laboratories by the officials of district and federal BLs.

[A procedure for calculating needs for antituberculous drugs].

OBJECTIVE: to develop a procedure for calculating needs for antituberculous drugs (ATD). MATERIALS AND METHODS: A unified E-form (UEF) was developed as an "Excel" file with the underlying invariable formulas and coefficients for the computer-based calculation of ATD needs in any subject of the Russian Federation. The needs were estimated using the average number of tablets (capsules, vials) of each ATD required per man/course, by taking into account the conventional chemotherapy regimens, the duration of chemoprophylaxis, antirecurrent courses, ATD test therapy, a treatment regimen for complications due to BCG vaccination. Information on the inventory of ATDs at the end of the previous year and their estimated deliveries from various sources was additionally considered. Data to be filled in the UEF were obtained from the reporting documents: 1) TB Form No. 2 "Information on patients registered for treatment" approved by Order No. 50 "On Consummation of Recording and Reporting Documents as to Tuberculosis Monitoring" issued by the Ministry of Health of the Russian Federation on February 13, 2002; 2) Form No. 030-4/y "Tuberculosis Patient Follow-Up Schedule"; and 3) Form No. 33 "Information on Patients with Tuberculosis" approved by Regulation No. 80 issued by the Russian Statistics Agency on November 11, 2005. The filled-in UEFs were obtained from 82 subjects of the Russian Federation. RESULTS: among all the contingents of antituberculosis dispensaries, who were given ATDs, the absolute majority was the persons receiving chemoprophylaxis. Only 18.3% received chemotherapy for active tuberculosis. Of them, 56.8 and 15.3% were treated in accordance with chemotherapy regimens 1 and 3, respectively. The regimes (2B and 4) using second-line agents were given least frequently (7.1 and 7.1%, respectively). Comparing the data from Form No. 33 and those obtained on filling in UEF showed with a fair degree of assurance that the treatment of patients with a chronic tuberculous process had been incompletely registered. Personified registration of patients with multidrug Mycobacterium tuberculosis resistance should be performed in order to have objective information on the scope of required medical aid and the real calculation of needs for second-line ATDs. For unified calculation of needs for ATDs for chemotherapy, it is necessary to introduce a standardized approach to its performance at different dispensaries. By taking into account that ATDs are purchased and dispensed free of change, one should have a responsible attitude to consuming drugs, determining indications for their usage, and filling the UEF. TB Form No. 2 "Information on patients registered for treatment" and Register No, 03-TB/y "Register of patients with tuberculosis" should be improved, by adding data on the number of patients receiving chemoprophylaxis, antirecurrent courses, test therapy, and treatment of complications due to BCG vaccination.

[Supervision of tuberculosis facilities]. / O kuratsii protivotuberkuleznykh uchrezhdenii.

The paper presents the current approaches to organizing and supervising tuberculosis at different levels. The present-day conditions for organizational and methodological measures are analyzed, the concept of supervision is defined and its principles and main elements are described.

The behaviour of mitochondria and cell integration during somatic hybridisation of sister blastomeres of the 2-cell mouse embryo.

The capacity of sister blastomeres of mouse embryos for induced fusion changed during the 2-cell stage. It was at low level (24%) at the early 2-cell stage, increased and reached 98.5% at the middle 2-cell stage and fell sharply to 31% at the late 2-cell stage. At the time corresponding to the G2/M-phase of the cell cycle the blastomeres fused in only 8% of cases. Vital staining of 2-cell embryos by rhodamine 123 showed that the mitochondria were dispersed throughout the cytoplasm with a ring-like (around the nucleus) or spot-like (over the metaphase plate) concentration in the centre of each blastomere. At the periphery of blastomeres the mitochondrial content was low. The behaviour of the mitochondria reflected the subsequent events of structural and functional integration of the sister blastomeres under induced fusion: a discernible boundary between partners during 30 min after electrofusion or 1 h after fusion with polyethylene glycol; movement of the two 'rings' to the centre of the blastomere fusion products (BFP) to form one large bright 'spot' over the common metaphase plate; mitochondria outlining the shape of the spindle and connection between sister blastomeres until completion of the first mitosis of BFP. The data obtained suggest that fusion of the blastomeres does not lead to extensive changes in the hybrid cytoplasm and integration of nuclear material is taking place only at metaphase stage. Cytogenetic examination of BFP at the 2-cell stage confirmed reconstruction of the tetraploid embryos and found that sister blastomeres of such embryos could asynchronously enter the next cleavage division similarly to normal diploid 2-cell embryos.

[Effect of neurotoxins on mediator release from the motor nerve endings of the Drosophila melanogaster larva]. / Vliianie neirotoksinov na osvobozhdenie mediatora iz dvigatel'nykh nervnykh okonchanii lichinki drozofily Drosophila melanogaster.

Spontaneous miniature junctional potentials and induced by motor nerve stimulation junctional potentials were recorded in muscle fibres of the third instar Drosophila larvae. Presynaptically active neurotoxins isolated from the snake venoms (beta-bungarotoxin 4.5 x 10(-7) M, notexin and notechis-II-51 X 10(-7) M, Crotoxin 9 x 10(-8) M, phospholipase from the venom of cobra 4 x 10(-6) M did not induce any changes in transmitter release during 60--120 min of contact with Drosophila preparation, although these concentrations exceed those used in frog or mice preparations. On the contrary, bee venom phospholipase (1.25 x 10(-7) M) turned out to be even more active than in frog or mice junctions. A similar sequence of three phases of the presynaptic blocking effect was found: initial decrease followed by a period of increase and finally -- depression of both spontaneous and evoked release. Bee venom phospholipase was ineffective in Ca2+-free solution but its irreversible binding to nerve endings took place evidently in spite of Ca lack.