SPECIFICS OF PRESCRIBING ANTIRETROVIRAL DRUGS IN THE TREATMENT OF HIV INFECTION.

HIV infection is one of the most acute problems of our time, characterized by slow development, prolonged course, and numerous clinical manifestations. Currently, there is a large number of drugs acting on different processes of human immunodeficiency virus replication, which constitute the group of highly active antiretroviral therapy (HAART). This article shows a theoretical review of modern HAART and analyzes the prescribed treatment regimens for patients with HIV infection. The study revealed two most common combinations: nucleoside reverse transcriptase inhibitors + protease inhibitors; nucleoside + non-nucleoside reverse transcriptase inhibitors.

Recombinant ß-Glucocerebrosidase specific immunoaffinity ligands selected from phage-displayed combinatorial scFv libraries.

Antibodies specific to ß-Glucocerebrosidase were selected from phage displayed naïve scFv libraries. Biopannings were performed against recombinant human protein ß-Glucocerebrosidase immobilized on polystyrene surface, specific phages were eluted with 50% ethylene glycol in citrate buffer (pH 6.0). Several specific binders were discovered and converted to full-size hIgG1 antibodies leading to highly stable binders with dissociation constants (Kd) in the range 10-40 nM. The antibodies were used further as ligands for affinity chromatography, where efficient and selective recovery of biologically active ß-Glucocerebrosidase from cultured media of Chinese hamster ovary cells was demonstrated. ß-Glucocerebrosidase was purified to nearly homogeneous state and had specific activity comparable to the commercially available preparations (40-44 U/mg protein). The obtained immunoaffinity sorbents have high capacity and can be easily regenerated.

Multiple-beam reflection interferometer formed in a single-mode fiber for applications in fiber lasers.

A new variant of all-fiber multiple-beam interferometer capable to perform narrow-band filtration of a reflected light, with characteristics similar to those for Fabry-Perot interferometer in a transmission, is presented. The interferometer design accompanied with parameters simulation is conducted, the experimental sample is fabricated and the study of its characteristics is undertaken. Experimental results conform the calculations. This variant of reflection interferometer can be used as one of laser cavity mirrors providing frequency selection of low-powered fiber lasers and laser diodes with short linear cavities. We assume, that this device makes it possible to obtain single-frequency operation with fast continuous tuning of a laser wavelength in a wide spectral range.

Effects of nanodispersed iron on the morphofunctional parameters of the blood system.

The effects of nanodispersed iron forms on the morphology and function of the blood system were studied. Maghemite and lepidocrocite caused a leukocytic shift towards segmented neutrophil forms, reduction of lymphocyte rigidity, and stimulated their compactization. In addition, the counts of small hyperchromatic erythrocytes with high rigidity increased in the blood flow. The results indicated that a single dose of nanodispersed iron-containing drugs improved the blood respiratory function and its microrheology.

[Cognitive functions, social functioning and self-esteem in young male patients with adolescence onset schizotypal disorder].

The results of psychological examination of 33 male patients with a diagnosis of schizotypal disorder (SD), mean age 22 years, with age at onset in adolescence and 20 healthy young men are presented. Cognitive performance in patients with SD did not differ from healthy people on all measures, with the exception of social adaptation. There was a trend towards the change of normative responses and, respectively, estimation of the results of psychological techniques. The data suggest that personality deficits play a more significant role in the social maladaptation of patients with SD than cognitive impairment.

[Use of atomic force microscopy for estimation of the morphometric indices of blood cells].

The possibility of using the atomic-force microscopy for the evaluation of the geometrical characteristics of blood cells has been shown. It has been found by comparing the hemocyte morphometric indices obtained at different modes of scanning that noncontact and semicontact methods are adequate for the estimation of the size and geometry of biological objects. The scanning of cells in the semicontact mode leads to the irreversible deformation of samples.

[The percutaneous endoscopic treatment of staghorn nephrolithiasis]. / Perkutannoe éndoskopicheskoe lechenie korallovidnogo nefrolitiaza.

Basing on the data obtained on percutaneous removal of stag-horn nephroliths in 81 patients (44 females and 37 males aged 10-65), the authors discuss the operative technique and surgical results. The patients were divided into 4 groups depending on the stone size, its position in the pelvicaliceal system, the presence and severity of calicectasis. Nephroliths sizes ranged from 3.5 to 10 cm. Better treatment results were obtained in those patients who had the main mass of the stone in renal pelvis and in those with pyelocalicectasis. After the treatment 72 patients (88.8%) were free of the stones. Common among complications were episodes of pyelonephritis after the intervention and displacement of the nephrostomy drainage. The authors gained primary experience which supports benefit of percutaneous surgery of stag-horn nephroliths.

Localization by immunogold labelling of HIV-1 structural proteins on Lowicryl embedded HIV-1 infected cell ultrathin sections.

Using several HIV-1-specific antibodies and the immunogold labelling technique, we have detected and localized distinct viral proteins on ultrathin sections of HIV-1 infected cells embedded in the Lowicryl K4M resin. Monoclonal antibodies (MAbs) against p24, p17 and gp160/gp41 showed a preferential labelling on viral formations still attached to the cell membrane (budding process) or free in the extracellular space. The anti-p24 and the anti-p17 MAb yielded a gold labelling not only on mature but also on immature virions where the gold particles were associated with the ring-like electron-dense material. The three HIV-1-specific antibodies against p24, p17 and p55 yielded a cross-reaction with HIV-2 in agreement with the conservation of the internal antigenic determinants of both viruses. In all instances, there was no specific immunogold labelling over the cells, suggesting that once the virus structural proteins were synthesized, they were promptly utilized for virus assembly at the plasma membrane level.

[Telelithotripsy in the treatment of staghorn nephrolithiasis in children using the URAT-P lithotriptor]. / Distantsionnaia litotripsiia v lechenii korallovidnogo nefrolitiaza u detei litotriptorom "URAT-P".

The paper presents the results of telelithotripsy monotherapy for 34 staghorn stones in 32 nephrolithiasis children carried out at the RSFSR Research Institute of Urology, Moscow. Commonest manifestations of the disease were leukocyturia (87.5% of cases) and Proteus bacteriuria (31.8% of cases). Basing on roentgenological findings, the stones were classified into 3 groups: initial (K1), incomplete (K2) and complete (K3). All the children underwent treatment on Soviet lithotriptor "URAT-P" under a delicate regime using different techniques of disintegration which started from the periphery and advanced to the pelvic part of the calculus. No pretreatment drainage of the pelvicaliceal system was performed. The intended staged disintegration of the stones was achieved in 94.2% of cases at 2.4 sessions, on the average, and overall number of impulses 1973.1 per each stone. At discharge 76.4% of the children were free of the main mass of the stone dust. Acute pyelonephritis which appeared the most frequent postoperative complication developed in 7.8% of the patients one of which required open nephrostomy and one percutaneous puncture nephrostomy. Other cases were treated by specific antimicrobial therapy. Complete series of investigations in the postoperative period did not reveal any intra- or pararenal hematomas. Radioisotopic renography revealed improvement in renal function in 62% of cases in early postoperative follow-up. Thus, 93.8% of children with stag-horn stones were spared of traumatic operative intervention or invasive manipulations. This makes the method of telelithotripsy a valuable therapeutic tool in childhood staghorn nephrolithiasis.

[The immunoenzyme test system for detection of HIV-1 antigens based on using immune polyclonal anti-HIV serum and monoclonal antibodies against gene GAG HIV-1 proteins]. / Immunofermentnaia test-sistema dlia vyiavleniia antigenov VICh-1, osnovannaia na primenenii immunnoi poliklonal'noi anti-VICh syvorotki i monoklonal'nykh antitel k belkam gena GAG VICh-1.

The paper describes the enzyme immunoassay system for detection of human immunodeficiency virus antigens, which is based on the use of rabbit anti-HIV antibodies and monoclonal antibodies to HIV-1 gene proteins gag. The system may be useful in the examination of laboratory and clinical samples to reveal both free and conjugated antigens in the composition of immune complexes. The sensitivity of the assay system under development is 0.5 ng/ml at 100% specificity.

[The anesthesiological support for children in extracorporeal lithotripsy on the Urat-P apparatus]. / Anesteziologicheskoe obespechenie distantsionnoi litotripsii u detei na apparate Urat-P.

The Urat-P lithotriptor made in this country was employed for remote lithotripsy (RLT) in 94 children with urolithiasis. Altogether 132 sessions were conducted. In 120 cases the concrement disintegration progressed in a sparing regimen (impulse duration 0.3-0.4 ms, shock wave energy 5-8 J). In the rest 12 cases there were additional hard impulses (0.5-0.6 ms, the energy 10-12 J). Anesthesiological and transfusiological problems are considered. It is shown that choice of anesthesiological defense is based on the clinical form of the disease, the concrement size, the child's age. Intubation anesthesia with artificial pulmonary ventilation is indicated for young children (under 5). Intravenous balanced anesthesia under normal respiration accompanies RLT in large coral calculi treated in senior children (6-14 years of age). Single stones (up to 1.5 sm) in them are managed under local infiltration anesthesia. It is stated that a valid choice of anesthesia and transfusion therapy warrants favourable conditions for RLT sessions, adverse effects of the impulses on the renal parenchyma and adjacent tissues lessen facilitating the fragments elimination and reducing the number of complications in the postoperative period.

[The endoscopic transurethral treatment of ureterocele]. / Endoskopicheskoe transuretral'noe lechenie ureterotsele.

The authors describe results of transurethral endoscopic treatment of ureterocele in 61 patients, two techniques of a relevant operative intervention, indications, complications of an early (pyelonephritis) and late (vesicoureteral reflux) postoperative period, measures of their prevention. Advancing impairment of the urine outflow via the upper urinary tracts on ureterocele side necessitates earlier surgery (transurethral dissection or resection of ureterocele). Good 4-year follow-up results (normal function of the kidney, absence of pyelonephritis attacks and vesicoureteral reflux) suggest endoscopic transurethral treatment of ureterocele to be a method of choice the failure of which implies open surgical intervention.

[The detection of antibodies to HIV protein p24 in human blood sera by the method of lanthanide immunofluorescent analysis]. / Vyiavlenie antitel k belku p24 VICh v syvorotkakh krovi cheloveka metodom lantanidnogo immunofliuorestsentnogo analiza.

A competitive time-resolved fluoroimmunoassay (TR-FIA) system for the detection of antibodies to protein p24 of HIV was developed on the basis of monoclonal antibodies. The advantages of this test system over analogous enzyme immunoassay system and commercial test system "Antigen" (USSR) were demonstrated. The newly developed test system of TR-FIA was used for examination of sera from HIV-infected persons.

[The properties of monoclonal antibodies to HIV gag gene proteins]. / Svoistva monoklonal'nykh antitel k belkam gena gag VICh.

Immunization of BALB/c mice with natural purified HIV antigen, fusion of spleen cells with myeloma cells and subsequent selection of hybrid clones using recombinant gag antigen of HIV gave hybridomas producing monoclonal antibodies (MCA) to HIV. The immune blotting method demonstrated that 3 clones interacted with protein p24 and 4 clones with protein p17 of HIV. Competitive EIA led to a conclusion that the resulting MCA detected at least 3 antigenic determinants in proteins, products of gag gene of HIV. The potentials of using these MCA for the detection of viral antigen in HIV-infected continuous cell lines were demonstrated.

[Anti-idiotypic antibodies to the herpes simplex type-1 virus neutralize the virus' infectious activity]. / Antiidiotipicheskie antitela k virusu prostogo gerpesa tipa 1 neitralizuiut infektsionnuiu aktivnost' virusa.

Immunochemical study of blood sera from mice immunized with rabbit immunoglobulins (AT1) to herpes simplex virus type I (HSV-I) detected antiidiotypic antibodies AT2 in five of them (antiID). The affinity-purified antiID were shown to induce in syngeneic mice production of antibody (AT3) interacting with HSV-I antigen. In vitro, antiID (AT3) were shown to neutralize the virus activity. Analysis of the results suggests that the antiID imitate the antigenic properties of HSV-I and can induce specific immune response.

[The prevention and treatment of complications from extracorporeal lithotripsy]. / Profilaktika i lechenie oslozhnenii distantsionnoi litotripsii.

Since October 1987, remote lithotripsy (RL) has been performed at the Research Institute of Urology, RSFSR Ministry of Health, over 3 years. "Specific" complications associated with RL made with a Urat-P lithotriptor are common in the immediate period following the procedure. The paper describes the analysis and outlines complications, causes of their occurrence, and prophylactic measures. A total of 2,300 lithotripsies conducted in 1988-1990 were analyzed. The incidence of the complications was 2.4%, which is similar to the values observed with foreign lithotriptors. The occurrence of acute pyelonephritis caused by RL is likely to increase when there is a baseline active inflammatory process in the urinary tract. The paper proposes a procedure for selecting patients in RL, antibacterial preoperative therapy, methods for lithoclasty with the use of the national lithotriptor. Involving two lithotripsy regimens. The authors find it necessary to drain the urinary tract within the first days of the appearance of signs of acute pyelonephritis by renal catheterization or paracentetic nephrostomy.