[Dissolution of uric acid stones in the ureter].

INTRODUCTION: Uric acid stones (UA), consisting of uric acid/uric acid dihydrate, occur in 6.1-15.1% of all cases of urolithiasis in industrialized countries. At the same time, the frequency of these stones is directly dependent on age. Thus, the incidence of UA reaches 40% in men over 80 years of age and 27.3% in women over 90 years of age. UA are the only stones that are amenable to dissolution therapy with the use of citrate salts that alkalinize urine pH. A number of authors and European Association of Urology guidelines consider stone dissolution as a first-line therapy in the treatment of patients with UA, both as monotherapy and in combination with surgical procedures. MATERIALS AND METHODS: The results of conservative treatment of 86 patients aged 28 to 78 years with radiolucent ureteral stones ranging in size from 3 to 25 mm and a density of 133 to 728 HU, who underwent 89 courses of stone dissolution therapy from 2011 to 2018, are presented in the article. They had no obstruction or were prestented. There were 52 men (n=55 courses) and 34 women (n=34 courses). RESULTS: In 78 out of 89 clinical cases (87.6%), stone-free status was obtained within 14 to 181 days. Most often the duration of therapy was 30 days. In 11 (12.4%) cases the treatment was considered ineffective. However, only in 4 (4.5%) patients the stone size did not change, while in 7 (7.9%) cases it decreased. The results of the study suggest the high efficiency of citrate therapy in patients with ureteral stones in case of unobstructed urine outflow (including those with stents), which is comparable to surgical treatment.

[Assessing the impact of pandemic on the resilience of older adults in Tomsk region.]

The article presents pioneer results of assessing the impact of the pandemic on the resilience of the older adults of the Tomsk region. We assessed the resilience of older adults and its predictors basing upon the survey of 400 respondents aged 55-92 using the Connor-Davidson resilience scale (CD-RISC-25). The results reveal statistically significant relationship between the resilience, material well-being and emotional state of elderly respondents in the context of the coronavirus pandemic. The results of the study complement the existing approaches to assessing and measuring the parameters of the quality of life of the older adults, and can be used to design tools for strengthening the resilience in line with the concept of active ageing.

[Role of drinking and dietary factors in effective dissolution therapy and recurrence prevention of uric acid kidney stones].

The use of alkaline mineral waters leads to alkalization of urine and an increase in level of urinary citrate, which represent important factor inhibiting the formation of urinary stones. Combination of alkaline mineral waters with citrates facilitates the achievement of target urine pH level not only during dissolution therapy, but also during recurrence prevention. Alkalization of urine and reducing of the influence of alimentary factor dont preclude drug therapy. Patients should be counselled about complex strategies aimed to modifiable risk factors for urinary stone disease.

[Urate urolithiasis: pathogenesis and possibilities of conservative therapy].

Urolithiasis is a widespread chronic disease; its prevalence has been steadily increasing over the past 50 years. Urolithiasis accounts for a large proportion urologic diseases, exceeded only by urinary tract infections and diseases of the prostate. Urate urolithiasis refers to a type of urolithiasis, characterized by the formation of kidney stones consisting of uric acid or its salts. In populations of industrialized countries, uric acid is the second or third most frequently occurring stone-forming substance. The article summarizes the data on the global prevalence of both urolithiasis as a whole and urate urolithiasis in particular. The authors provide a detailed overview of the formation of the current concept of the urate urolithiasis pathogenesis and the management of the disease. The main focus is placed on the possibilities and the role of litholytic (stone-dissolving) therapy for urate urolithiasis and the mechanisms of the action of citrate preparations.

Distribution of Polychaeta Communities in the West Spitsbergen Area in Winter (December 2015).

Using the materials collected in 2015, modern data have been obtained on the polychaete species composition and quantitative distribution in the West Spitsbergen area in winter. Polychaete species complexes corresponding to different habitat conditions have been identified in the outer and inner parts of the bays. The distribution of the Polychaeta communities proved to be dependent on the bottom sediment composition, depth, and specific hydrological regime.

Polychaeta of the Kara and Pechora seas: Data of the 2012 trawl survey.

The species composition of the polychaetes derived from ichthyological and Sigsbee trawls in the Pechora and Kara seas in 2012 was studied and compared with the grab survey data of 1993-1995. The distribution of the large sabellidae, nektobenthic, and bathypelagic species that are poorly caught by a grab has been determined for the first time. Changes that were observed in the biogeographical polychaete structure in the Kara Sea (a higher proportion of the boreal species and a lower proportion of the Arctic species) may reflect a response of zoobenthos to the Arctic warming in the late 20th and early 21st centuries.

[Modern conservative (citrate) therapy for urate calculi in the ureters].

The results of conservative citrate therapy of 35 patients with urate calculi in ureter are presented. Due to the violation of the passage of urine in the upper urinary tract, the vast majority of patients (31 (88%)) underwent ureteral stenting to restore adequate flow of urine before treatment. In four patients, drainage of the upper urinary tract was not required. Citrate therapy allowed to achieve complete dissolution of calculi within 2 months in 25 (72%) patients. Another 14% of patients were able to reduce the size of the calculi, and in combination with contact ureterolithotripsy achieve complete discharge of calculi. Only in 14% of patients with urate calculi in ureter litholysis was ineffective. The used treatment option allows to avoid surgery in a large number of patients with urate lithiasis.

[Dynamics of benthic communities in the central trench of the Barents Sea].

Based on the data collected in five marine expeditions of the Murmansk Marine Biological Institute from 2002 through 2007, the spatial and temporary variability of benthic communities in the Central Depression of the Barents Sea (licensed plot of the Shtokmanovskoe condensed gas deposit) has been analyzed. The range of quantitative characteristics and the variability of species composition of deep-water zoobenthos have been determined. The influence of an insignificant change in the collecting method on the obtained results has been examined.

CD45RO+ T-cells immunoregulate spontaneous in vitro immunoglobulin production by normal and chronic lymphocytic leukaemia B-cells.

Immunophenotypic changes in the T-cell compartment in B-CLL are well recognised, although the functional significance is less well established. In this study we examined the immunoregulatory capacity of CD45RO+ T-cells to modulate in vitro IgG and IgM production by B-CLL cells in comparison to normal PB B-cells. Removal of CD45RO+ T-cells from normal PB lymphocyte cultures was associated with a 2.3-fold reduction in IgM production and a 7.9-fold reduction in IgG production. Activation of the T-cell component by alpha CD3 stimulation enhanced IgG and IgM production by factors of 1.85 and 3.4 respectively. Removal of CD45RO+ T-cells from alpha CD3-stimulated cultures reduced IgG production 3.7-fold, whereas no significant change in IgM production occurred. Supplementing T- and NK-depleted B-cell fractions with purified autologous CD45RO+ T-cells produced a positive correlation between Ig concentration and the CD45RO:CD19 ratio for IgG production but not for IgM. Collectively, these results suggest that: 1) 'resting' CD45RO+ ('primed' or memory) T-cells drive mainly the IgG response; 2) activation of these T-cells enhances this response; 3) activated CD45RO+ T-cells derived from the recent transformation of the CD45RA+ ('virgin' or naive) population drives mainly the IgM response. In B-CLL cultures however, the pattern of Ig production in response to alpha CD3 stimulation is more typical of regulation by CD45RO+ T-cells derived from the recent activation of virgin CD45RA+ T-cells. We believe this challenges the view that T-cells in B-CLL are largely memory cells.

Immunophenotypic and DNA genotypic analysis of T-cell and NK-cell subpopulations in patients with B-cell chronic lymphocytic leukaemia (B-CLL).

Absolute numbers and distributions of peripheral blood T-cells and NK cells were immunophenotypically determined in 21 patients with B-CLL and compared with those obtained from a series of 13 elderly normal controls with an age range of 60-87 years. For absolute CD3+, CD4+ and CD8+ T-cell, and CD16+ NK subpopulation numbers, there were no consistent differences between the normal and B-CLL groups although some individual patient variation was seen. Immunophenotypic analyses did however reveal that CD3+ T-cells in almost half (10/21) of the B-CLL patients were Ia+ (defined as > 20% positive cells), compared to 0/13 of the elderly control group (p < 0.001), and that the proportions of CD4+ and CD8+ cells expressing membrane CD45RO were significantly increased compared to the control group. Subdivision of the B-CLL cases into those with low (< 20%) and high (> 20%) proportions of CD3+ T-cells co-expressing Ia further showed that CD45RO expression by CD4+ fractions was particularly prominent in the Ia+ subgroup, and that the relative increase of CD4+CD45RO+ cells was primarily a consequence of decreased absolute numbers of CD4+CD45RA+ lymphocytes. This study also examined extracted DNA from enriched CD3+ T-cell fractions (obtained by immunomagnetic bead selection in 9 of the B-CLL cases) by PCR analysis with two primers for the T-cell gamma gene locus. With the V gamma C (consensus) primer, 8/9 cases were polyclonal and the remaining case was oligoclonal. For comparison, 7/9 CD3+ fractions were oligoclonal with the V gamma 9 primer with the other two cases being polyclonal. No monoclonal CD3+ components were found. It is suggested that the observed increased Ia expression by CD3+ cells and the predominance of CD4+ cells expressing membrane CD45RO in patients with B-CLL may be of potential relevance to understanding the pathogenesis and patterns of disease progression.

[The clinical significance of the expression of the multiple-drug resistance protein P-glycoprotein in chronic myeloleukemia]. / Klinicheskoe znachenie ékspressii belka mnozhestvennoi lekarstvennoi ustoichivosti P-glikoproteina pri khronicheskom mieloleikoze.

Cell resistance to pharmaceutical agents arises among other causes because of multiple drug resistance induced by P-glycoprotein (P-gp). The analysis of expression of P-gp and differentiation antigens of hemopoietic cells has been made on myeloid cells from 14 patients in CML chronic phase and 25 with CML acceleration and in blast crisis. Surface antigen expression was evaluated at flow cytofluorimetry (FACScan unit). Fluorescent dye rodomin (Rh123) helped examine P-gp functional activity. A close relationship is shown between P-gp expression and CD34 (r = 0.69. p = 0.0004), this giving evidence of these antigens expression on the same cells. In chronic phase P-gp is expressed on a few cells in some patients, its activity being low or absent. The appearance of UIC-2+ cells was unrelated to previous chemotherapy and brought no resistance to treatment. In terminal stage P-gp is expressed in 50% of cases. Functional tests identified the active protein in blast populations with a large number of UIC-2+ cells and in some patients with a small number of cells expressing P-gp. Therefore, comprehensive clinical investigations are needed of multiple drug resistance, though in half of the resistant patients in AML blast crisis P-gp+ cells were not identified suggesting the existence of other mechanisms responsible for resistance to treatment.

[A "primitive" variant of the blast crisis in chronic myeloleukemia]. / "Primitivnyi" variant blastnogo kriza khronicheskogo mieloleikoza.

While immunotyping blast cells from 45 patients with CML blast crisis, we detected 5 cases with immunologically primitive blast cells. The immunological phenotype of these cells corresponded to that of primitive stem cells which are characterized by expression of CD34 and HLA-DR antigens in the absence of other immunological markers. We suggest that blast cells from these patients may undergo differentiation similar to that of primitive stem cells that implies the existence of a new immunological variant of CML blast crisis, a primitive variant. Morphologically, blast cells in 3 cases could be classified as myeloid, in 2 cases precise identification was impossible. Cytochemically, this type of cells can be defined as mixed. The patients with CD34+ phenotype do not differ clinically or hematologically from those with CML blast crisis. Blast cells with membrane marker CD34 are likely to arise in any CML phase either as a component of overall leukemic population or predominant, single subclone.

Early steps of the P-glycoprotein expression in cell cultures studied with vital fluorochrome.

This study shows that flow cytometry analysis of the rate of fluorochrome Rh123 efflux may be used for detection of cells at initial steps of P-glycoprotein expression and of minor subpopulations of multidrug-resistant (MDR) variants in human cell lines. This method also evaluates the fraction of low-level MDR cells among peripheral blood leukocytes of patients with chronic myeloid leukemia. The alterations in Pgp function were revealed in rat hepatoma cells after short treatment with colchicine.

[ICO-166 monoclonal antibodies against the CD45RA antigen]. / Monoklonal'nye antitela ICO-166 protiv antigena CD45RA.

Monoclonal antibodies (MCA) ICO-166 against CD45RA antigen were generated and characterized. In the indirect IFA, MCA ICO-166 reacted with 54.1 +/- 1.9% lymphocytes of human peripheral blood and 15.2 +/- 2.3% monocytes but not with granulocytes or thrombocytes. The method of double labelling of cells demonstrated that MCA ICO-166 detected all B-lymphocytes, all NK-cells and 31% of mature T-lymphocytes but only 55% of CD8 suppressor cells and only 21% of CDA helper cells carried this antigen on the surface. Experiments were carried out to block binding of FITC-labeled MCA ALB11 against CD45RA antigen with human lymphocytes by pretreatment of cells with different concentrations of MCA ICO-166. Treatment of cells with MCA ALB11 blocked binding of MCA ALB11-FITC by 85% on the average. MCA ICO-166 blocked binding of MCA ALB11-FITC by 66% on the average. When different dilutions of MCA ICO-166 were used, the dose-dependent effect of blocking of MCA ALB11-FITC binding was observed. MCA ICO-166 immunoprecipitated a protein band of molecular weight 220 kDa from lysates of mononuclear cells of the human peripheral blood.

[Mechanisms of immunodeficiency in HIV infection and ways of overcoming it]. / Mekhanizmy immunodefitsita pri infektsii VICh i puti ego preodoleniia.

Though antibodies against HIV-1 appearing in the course of infection are successfully used for the diagnostic purposes, their accumulation on the earlier step leads to: firstly, to the rapid generation of the immunodeficiency by different mechanisms and secondly, to inefficiency of immunotherapy. One of the causes for immunodeficiency seems to be antibodies which are induced in the HIV-infected person by the HIV peptides homologous to the MHC class II molecules by their amino acid sequences. 73% of HIV-1 positive sera are shown to react with human B-lymphoma cells expressing surface class II molecule. The binding is caused by the antibodies preventing the murine monoclonal anti-HLA.DR Ab interaction with B-lymphoma. Three amino acid sequences are identified in both alpha- and beta-chain of the HLA.DR antigen, these sequences being homologous to HIV-1 gp120 or gp42 molecules for 50 to 70%. Using synthetic peptides it was shown that HIV-1-infected persons contain antibodies which cross-react to the homologous peptides of the HIV-1 and of the MHC class II. It is supposed that such antibodies shield the class II molecule on the surface of their own antigen-presenting cell which may lead to immunodeficiency caused by the anti-HIV-1 antibody.