[MODERN APPROACHES TO THE TREATMENT OF ECTOPIC PREGNANCY].

The 128 patients were investigated for progressive and impaired tubal pregnancy (TP), the physiological course of pregnancy and the threat of miscarriage. When undisturbed TP and clear visualization of the fallopian tube and the fetal ovum it suggested conservative treatment with methotrexate. If an ectopic pregnancy during laparoscopy is recommended to perform organ preserving surgery, after which the frequency of occurrence of intrauterine pregnancy more than after extra corporeal impregnation. It confirmed the effectiveness of both laparoscopic and conservative treatment provided a correct assessment of the indications for each method.

[Equipping the bacteriological laboratories of a tuberculosis service as the most important element of assurance of the quality and safety of their work].

By taking into account the present requirements for the equipping of the laboratories, the authors have drawn up the minimum standard list of equipment, as well as a list of additional equipment for the specialized bacteriological laboratory of a tuberculosis-controlling institution, which performs microbiological studies for the diagnosis and control of chemotherapy for tuberculosis. The specifications and characteristics of the baric types of equipment used to fit out the laboratories under the present conditions are described. Equipping the laboratories in accordance with the draw-up lists is shown to ensure a qualitative, effective, and safe work. Recommendations on how to supply the laboratories with equipment, to make the optimal choice, and to use consumables for tests are given.

[Evaluation of the efficiency of activity of the liposomal form of isoniazid against different types of mycobacteria in vitro].

M. avium and three M. tuberculosis strains were used as an example to study the bacteriostatic activity of the liposomal form of isoniazid in the liquid nutrient medium by serial dilutions. Unlike isoniazid in solution, its liposomal form was found to suppress the multi plication of all study mycobacterial samples and diminishes their viability, but at different concentrations. The liposomes that did not contain the drug exerted an inhibitory effect only on the M. tuberculosis strains H37Rv and Erdman. It is suggested that the change in isoniazid sensitivity results from the effect of liposomal phospholipids on some mycobacterial enzymes. Electron microscopy indicated that the liposomal form of isoniazid is able to penetrate into the alveolar macrophageal cytoplasm of guinea pigs just 30 min after incubation.

[Use of dissolved ozone in the treatment of experimental tuberculosis in mice]. / Ispol'zovanie rastvorennogo ozona pri lechenii éksperimental'nogo tuberkuleza u myshei.

Sixty-eight BALB/c mice were infected with the intravenous injections of Mycobacterium tuberculosis (MBT), a clinical strain resistant to streptomycin, isoniazid, rifampicin, and kanamycin. The mice were divided into 5 groups: Groups 1 and 2 were control (intact and infected without being treated, respectively). Group 3 mice were treated with isoniazid; Group 4 received isoniazid in combination with intraperitoneal dissolved ozone (pO3); and Group 5 was given pO3. The animals began to die at month 4 of infection. By month 5, mice died all, except for intact and pO3-treated ones. On inoculation of MBT from the lung, there was a reduction in isoniazid resistance in the pO3-treated groups. The lesion was least when isoniazid was used in combination with pO3. The mechanism responsible for that pO3 lowers drug resistance in MBT and whether it is expedient to co-administer isoniazid and pO3 in undetected drug resistance in MBT are under discussion.

[Ways of enhancing the effectiveness of bacterioscopic diagnosis of tuberculosis in general health care facilities in case of pilot areas of Russia]. / Puti povysheniia éffektivnosti bakterioskopicheskoi diagnostiki tuberkuleza v uchrezhdeniiakh obshchei lechebnoi seti na primere pilotnykh territorii Rossii.

The experience of researchers of the Central Research Institute of Tuberculosis, Russian Academy of Medical Sciences, in the pilot areas of Russia has made it possible to perfect approaches to improving a bacteriological diagnosis of tuberculosis in general health care facilities. A decisive role in enhancing the effectiveness of detection of patients with tuberculosis by the Ziel-Nielsen test is played by the following factors: training of laboratory personnel; provision of laboratories with high-grade equipment and reagents; introduction of the methods and techniques unified and approved by the Ministry of Health of the Russian Federation; regular supervision of jurisdictional laboratories; outside control of the quality of studies. Proper organization of examination of patients, including an effectual selection of patients to be examined, the observance of the established frequency of their examination, and provision of the required quality of a taken sample greatly affect the efficiency of a microscopic diagnosis of bacillary patients. In addition, the centralization of performed microbiological tests for tuberculosis in the most trained, certified, and licensed large laboratories exercising a centralized control of the quality of microbiological studies is optimal.

[Wide range of the use of natural lipases and esterases to inhibit Mycobacterium tuberculosis]. / O vozmozhnostiakh primeneniia prirodnykh lipaz i ésteraz dlia ingibirovaniia Mycobacterium tuberculosis.

Lipases and/or esterases (hereinafter referred to as esterases) isolated from the wax moth (Galleria mellonella) were found to have a bacteriological action on Mycobacterium tuberculosis (MBT) H37Rv. Different types of raw esterase preparations (REP) were incubated with MBT at 37 degrees C for 18 hours, the incubate was seeded on the Finn-II solid medium or intraperitoneally injected into guinea pigs in a single dose of 100,000,000 bacteria. There was no growth of MBT in the medium within 8 weeks, some variants of REP causing a destruction of the medium for 3-7 days. This "toxic" effect on the lipid-containing Finn-II medium could be lowered by the simplest techniques for purifying esterases. In the experimental guinea pigs, a tuberculous process substantially regressed: autopsy of control animals at interval of 3-6 weeks after inoculation with native MBT showed the typical picture of progressive generalized tuberculosis; at the same time a visible pathology was not noted in the animals contaminated with MBT incubated with esterases. At week 7, control guinea pigs died; the onset of a tuberculous process was observed in experimental guinea pigs at week 8. An attempt to reveal the therapeutical effect of REP on guinea pigs with tuberculosis in a direct experiment failed. At the same time, there was a low toxicity of REP (in the used doses) for guinea pigs and B10.A(4R) mice. Based on their own findings and some data available in the literature, the authors have arrived at the following provisory conclusions: the studied REPs contain mammalian lysosomal lipase-type enzymes that determine the bacteriostatic and, perhaps, bacteriolytic effect of REP shown on MBT in vitro; there is evidence for promises of continued detailed studies of natural esterases for searching new antituberculous agents. A program of investigations of the studied and other natural esterases has been developed by taking into account the authors' developments and know-how. The study may be regarded as part of global unselected screening of biological and other materials for detecting new promising sources of drugs.

[Dissolved ozone treatment-induced change in the resistance of multi-resistant mycobacterial strain to isoniazid and rifampicin]. / Izmenenie ustoichivosti k izoniazidu i rifampitsinu poliresistentnogo shtamma mikobakterii tuberkuleza posle obrabotki rastvorennym ozonom.

For 60 minutes, a mycobacterial (MBT) clinical strain resistant to streptomycin (S), rifampicin (R), isoniazid (I) was treated with dissolved ozone (PO3) at the concentration used for intravenous injection in the clinic. Then the strain was added to the Löwenstein-Jesen solid medium containing different concentrations of antituberculous agents. Following 3 weeks, drug sensitivity was determined by the number of grown colonies. Then MBT were retreated with PO3 in the same fashion, by repeating the cycle three times. At week 3, a growth of over 100 colonies was recorded in all control cultures. After each PO3 treatment of the strain, there was a reduction in its resistance to I and R. After triple treatment, MBT sensitivity to I completely recovered. In the R-containing media, there was also decrease in drug resistance, but the latter remained high (640 mu/ml). S resistance substantially lowered after the second PO3 treatment, but it restored after the third one. A mechanism responsible for lower MBT resistance to I and R under the action of "therapeutical" concentrations of PO3 is analyzed. The paper discusses whether MBT resistance can be changes at the phenotypic level rather that at the genetic one.

[Organizational and methodological approaches to improving the microbiological diagnosis of tuberculosis in Russia]. / Organizatsionno-metodicheskie podkhody k sovershenstvovaniiu mikrobiologicheskoi diagnostiki tuberkuleza v Rossii.

The practice of the researchers of the Central Research Institute of Tuberculosis in Russia's experimental areas yielded approaches to improving the microbiological diagnosis of tuberculosis in both specialized and general health care facilities. A decisive role in enhancing the efficiency of microbiological identification of patients with tuberculosis is played by the following factors: laboratory staff training, provision of laboratories with qualitative equipment and reagents, introduction of unified methods and those approved by the Ministry of Health of the Russian Federation, regular supervision of jurisdictional laboratories, and outside test quality control. The efficiency of microbiological diagnosis of bacillary patients primarily depends on the expediency of formation of groups of patients under study, the observance of the frequency of examinations, and the assurance of the quality of collected materials. With this, the centralization of microbiological tests for tuberculosis at the most trained, certified, and licensed large laboratories that exercise a centralized control over the quality of microbiological tests.

[Analyzing the drug resistance of Mycobacterium tuberculosis in Russia's experimental areas introducing the WHO tuberculosis control programme]. / Analiz lekarstvennoi ustoichivosti mikobakterii tuberkuleza v éksperimental'nykh regionakh Rossii, vnedriaiushchikh programmu VOZ po bor'be s tuberkulezom.

The authentic data on the drug resistance of Mycobacterium tuberculosis can be obtained only provided that standard laboratory procedures and the unified standardized method for determining the resistance are used along with a compulsory outside quality control over the performance of this test. The supervisory activities of the researchers of the Central Research Institute of Tuberculosis (CRIT), Russian Academy of Medical Sciences, made in some regions of Russia included standardization of methods and their implementation quality control allowed them to reveal and to correct main errors in drug resistance testing. In this connection, this made it to record the true level of M. tuberculosis resistance to essential antituberculous agents in the areas investigated by the researchers of CRIT. Analyzing the data on the drug resistance of M. tuberculosis in the above areas leads to the conclusion that 2000 was marked by rather high rates of primary drug resistance; nearly a fourth of all new and prior cases of pulmonary tuberculosis studied for its drug resistance were carriers of a M. tuberculosis resistant to at least one antituberculous agent.

[Clinical and experimental rationale of policatan administration in upper respiratory tract inflammation]. / Kliniko-éksperimental'noe obosnovanie primenenie polikatana pri vospalitel'nykh zabolevaniiakh verkhikh dykhatel'nykh putei.

Experimental and clinical trials of policatan in ENT inflammation have established that maximal antiinflammatory effect of the drug manifests in experimental serotonin, histamine and corragenin edema, less pronounced--in formaline-induced edema. The drug accelerated healing of infected burn ulcer in rabbit nose by 37%. This may be explained not only antiinflammatory effect of policatan, but also by stimulation of macrophage phagocytosis and bacteriostatic potential. Policatan proved effective in acute and chronic maxillary sinusitis, chronic frontal sinusitis and rhinitis, chronic hyperplastic maxilloethmoiditis. The drug reduced contamination with pathogenic and opportunistic microflora and reestablished saprophyte microflora.

Fabrication of plastic microfluid channels by imprinting methods.

Microfluidic devices have been fabricated on poly(methyl methacrylate) substrates by two independent imprinting techniques. First-generation devices were fabricated using a small-diameter wire to create an impression in plastics softened by low-temperature heating. The resulting devices are limited to only simple linear channel designs but are readily produced at low cost. Second-generation devices with more complex microchannel arrangements were fabricated by imprinting the plastic substrates using an inverse three-dimensional image of the device micromachined on a silicon wafer. This micromachined template may be used repeatedly to generate devices reproducibly. Fluorescent analtyes were used to demonstrate reproducible electrophoretic injections. An immunoassay was also performed in an imprinted device as a demonstration of future applications.

[Action of dissolved ozone on mycobacterium tuberculosis and alveolar macrophages in experimental tuberculosis]. / Vliianie rastvorennogo ozona na mikobakterii tuberkuleza i al'veoliarnye makrofagi pri eksperimental'nom tuberkuleze.

Sixty CBA mice were intravenously inoculated with the Mycobacterium tuberculosis (MBT) strains Erdman and 2255 (a polyresistant clinical strain) pretreated with dissolved ozone (experimental groups), a single therapeutical dose. of dissolved ozone being intravenously injected. By 1 month of inoculation, all control mice (MBT-inoculated and ozone-untreated) died and in their organs there were a great deal of MBT both outside and inside the macrophages. No pathogen in its typical form was not found in experimental mice, but there were many granular and L forms, the lung showing a large number of highly vacuolized (foamy) alveolar macrophages (AM). All experimental mice survived by month 5 and their organ examination showed that the pathogen was detectable only inside the macrophages, but they are chiefly unchanged (more elongated and badly stained with aniline dyes). Juvenile forms are prevalent among AM. It should be concluded that the action of dissolved ozone on AM and MBT is heterodirectional.

Flow immunoassay using solid-phase entrapment.

A flow injection immunoassay was performed using a column packed with reversed-phase sorbents to effect separation of the immunoreacted species by entrapping free analyte and allowing antibody-conjugated analyte to pass unretained. Fluorescein-labeled analyte was measured in a competitive assay for the anticonvulsant drug phenytoin. The simplicity of the assay was the greatest advantage of the technique, which allowed for measurement of phenytoin in a 2-min assay time. The reliable detection limit for the assay was 5 nmol L(-)(1) of phenytoin in serum. The columns were regenerated with periodic injections of ethanol solutions to remove the entrapped analyte and prepare the column for subsequent analyses.

[Sensitivity of bacteria of the genus Proteus to antibiotics]. / Chuvstvitel'nost' bakterii roda Proteus k antibiotikam.

Antibiotic susceptibility of 481 cultures of the bacteria belonging to the genus Proteus isolated within 1990-1994 from children with enterocolitis was studied. The study included 10 antibiotics. The efficacy of the antibiotic therapy in 388 children with the above disease was estimated. It was shown that the Proteus isolates were most frequently susceptible to kanamycin, gentamicin and carbenicillin. When used clinically in the treatment of children with Proteus enterocolitis, the antibiotics proved to be the most efficient agents.

[Neurogenic lesions of the lungs in severe craniocerebral trauma]. / Neirogennye porazheniia legkikh pri tiazheloi cherepno-mozgovoi travme.

The role of sympathicotonia in the development of neurogenic edema of the lungs in patients with the craniocerebral trauma (CCT) was confirmed experimentally. Morphological examinations of the lungs in 12 people who died from CCT have revealed the stage-wise character of the development of neurodystrophic alterations in the air-conducting and respiratory parts, up to the development of denervation.

Surface polarization in loach eggs and two-cell embryos: correlations between surface relief, endocytosis and cortex contractility.

The aim of this study was to examine the reorganization of the microfilamentous cortical layer (MC) accompanying ooplasmic segregation in loach eggs. Using scanning (SEM) and transmission electron microscopy (TEM), we found that the MC is thicker in folded areas. Prior to fertilization, surface microvilli are distributed more or less uniformly throughout the egg. A similar, more or less uniform, distribution of endocytotic events was observed in the eggs 5-15 min after insemination using fluorescence microscopy of Lucifer yellow CH uptake. During ooplasmic segregation, the surface is progressively polarized so that before the first cleavage onset (50-60 min after insemination) only the blastodisc surface is folded and undergoes endocytosis, whereas the vegetal surface is smooth and does not show internalization. In two-cell embryos, the blastomeric surface is also regionalized according to its relief and endocytosis. When surface tension was lowered by sucking most yolk granules out of the egg, we observed contractile responses only in the animal folded surface. These data suggest that a polar distribution of contractile structures is established in the loach egg undergoing ooplasmic segregation.

Gangliosides of sea urchin embryos. Their localization and participation in early development.

The influence of antibodies to gangliosides of sea urchin Strongylocentrotus intermedius eggs on early embryos of this species was studied. gamma-Globulins were isolated from rabbit anti-ganglioside serum by micropreparative electrophoresis. These gamma-globulins produced anomalies in the development of embryos permeabilized in Triton X-100. The anomalies were not observed when anti-ganglioside gamma-globulins were added to the incubation medium together with gangliosides or when the permeabilized embryos were incubated with gamma-globulins of normal rabbit serum. Pretreatment of S. intermedius embryos with serotonin, tryptamine or some other indole derivatives led to the disappearance of ganglioside determinants from the cell surface and sharply increased immunofluorescence within the cell. Such pretreatment of embryos increased the amount of cell-associated gangliosides more than threefold as compared to untreated embryos. Serotonin was shown to bind specifically to sea urchin gangliosides immobilized on octyl-Sepharose. These observations suggest that cell-surface gangliosides, after binding drugs, are internalized and that serotonin and its antagonists inhibit the transport of newly synthesized gangliosides to the cell-surface membrane.