[Additive technologies for complete recovery of joint function in revision endoprosthesis surgery (experimental trial)]. / Additivnaia tekhnologiia v polnom vosstanovlenii funktsii sustava pri éndoprotezirovanii (éksperimental'noe issledovanie).

AIM: Experimental analysis of the strength properties of integration of muscle tissue, tendons and ligaments, bone tissue into titanium highly porous materials prepared by using of additive technologies. MATERIAL AND METHODS: The study included 9 mature rabbits of the Chinchilla breed. Both posterior paws and latissimus dorsi muscles (36 specimens) were used. Titanium models (Ti-6-Al-4-V, 'Rematitan', Germany) were made by additive technologies with preliminary prototyping, the prototypes had a highly porous mesh structure. RESULTS: It was developed experimental model of functional bone defect involving points of attachment of the muscle and ligaments. Strength of attachment of muscles to highly porous implants was 145 H vs. 31 H for standard models. Tensile strength for fixation to bone tissue was 84 H vs. 152 H in the main group. CONCLUSION: It was found integration of soft tissues and bones into highly porous titanium implants prepared with additive technologies. Fixation strength significantly exceeds that for standard models.

The detection of hepatitis c virus core antigen using afm chips with immobolized aptamers.

In the present study, the possibility of hepatitis C virus core antigen (HCVcoreAg) detection in buffer solution, using atomic force microscope chip (AFM-chip) with immobilized aptamers, has been demonstrated. The target protein was detected in 1mL of solution at concentrations from 10-10М to 10-13М. The registration of aptamer/antigen complexes on the chip surface was carried out by atomic force microscopy (AFM). The further mass-spectrometric (MS) identification of AFM-registered objects on the chip surface allowed reliable identification of HCVcoreAg target protein in the complexes. Aptamers, which were designed for therapeutic purposes, have been shown to be effective in HCVcoreAg detection as probe molecules.

[Atomic force microscopy detection of serological markers of viral hepatites B and C].

The aim of the study was to demonstrate the possibility of detection of serological markers, containing the hepatitis B surface antigen (HBsAg) and hepatitis C virus core-antigen (HCVcoreAg) in human serum, by use of a new atomic force microscopy (AFM)-based nanotechnological approach. In this study, the immobilization on AFM-chip of antibodies against the hepatitis B virus surface antigen (anti-HBsAg) as well as the antibodies against the hepatitis C virus core antigen (anti-HCVcoreAg) was performed. It was shown that such approach enables to detect: HBsAg, HCVcoreAg and the viral fragments containing these antigens in the serum. Comparative analysis of detection of HBsAg- and HCVcoreAg-containing particles by use of the AFM method vs. traditional methods (ELISA, PCR) has demonstrated the 75% coincidence of results between the AFM and the latter two methods.

[Treatment and outcome of chronic hepatitis B in children]. / Techenie i iskhody khronicheskogo gepatitia B u detei.

225 children at the age from 6 months to 15 years with chronic hepatitis type B (CHB) were under observation. In addition to clinical biochemical evaluation and morphological recording, there also was the serologic monitoring of the pathologic process condition by means of determination of hepatitis type B and other hepatitis viruses markers. The patients were observed during 1-10 years. It was found that almost all of the patients, with the exception of 3 children (1.3%), had no acute onset of the disease. According to the morphological study data, changes in the liver varied from minimal to apparent activity, up to the formation of hepatocirrhosis in single cases. The clinical presentation of CHB in children included mainly the enlargement and induration of the liver, enlargement of the spleen and anhepatic signs (capillaritis and telangiectasia). After 4 years from the onset of CHB stable and prolonged remission was formed in most of the patients (64.6%); in 35.4% of cases clinical biochemical activity of the disease remained for a longer period of time (5-10 years or longer). The gradual cessation of the disease activity correlates with seroconversion of HBeAg on anti-Hbe. Children with the continuous pathologic process in the liver have HBV DNA in their blood. The main outcome of CHB in children is a prolonged remission with permanent HBs-antigenemia in 89% of cases. The recovery was recorded in 9.68% of cases (disappearance of HbsAg and acquisition of anti-HBs). Hepatocirrhosis was formed in 3 children (1.32%).

[Detection of the hepatitis B virus surface antigen with a biosensor]. / Detektsiia poverkhnostnogo antigena virusa gepatita B s pomoshch'iu opticheskogo biosensora.

A new method for detection of hepatitis B surface antigen (HBsAg) has been developed. It employees IAsys optical biosensor registration kinetics of HBsAg complexes with monoclonal antibodies. Detection of intermolecular interactions is accompanied by changes of the light refraction coefficient in the sensitive layer of the biosensor cuvette. The main advantage of this diagnostic technique consists in rapid registration of these interactions in real time, without any introduction of special labels into analysing molecules. The optical biosensor method was successfully employed for the detection of HBsAg in human blood serum. A comparative study of HBsAg detection by the optical biosensor and by immunoenzyme analysis demonstrated high specificity of HBsAg detection by this new method.

[The characteristics of the specific immune response in vaccinated children in an area of high endemicity for viral hepatitis B]. / Kharakteristika spetsificheskogo immunnogo otveta u vaktsinirovannykh detei v regione vysokoi éndemichnosti po virusnomu gepatitu B.

The effectiveness of vaccination against virus hepatitis B (VHB) in the arid region of the Aral, endemic with respect to VHB, was evaluated. The character of specific immune response in 101 immunized children and in 12 adults belonging to a high risk group with respect to VHB. The vaccination of children was shown to be highly effective (96%). The average concentration of anti-HBs antibodies in these children was 856--133 IU/L after completed vaccination and 733--238 IU/L after revaccination. The comparative analysis of antibody levels in children at different periods after complete vaccination indicated that the level of anti-HBs antibodies in recipients decreased with the increase of time elapsed after the moment of vaccination. The effectiveness of the immunization of adults was low, which was probably due to the specific features of immune response to vaccination characteristic of their age and, in one case (a female recipient), to the presence of HBsAg.

[The clinical picture, course and outcome of viral hepatitis A in children with chronic HBV infection]. / Klinika, techenie i iskhody virusnogo gepatita A u detei s khronicheskoi HBV-infektsiei.

The clinical picture, course and outcomes of hepatitis A developing as a superinfection in children with chronic hepatitis B virus (HBV) infection, hospitalized in connection with acute viral hepatitis, were determined on the basis of the dynamic clinico-laboratory investigation and identification of viral hepatitides A, B and delta by the method of enzyme immunoassay. In all children hepatitis B virus surface antigen (HBsAg), i.e. the serological sign of HBV infection, and anti-HAV IgG, the serological sign of hepatitis A virus (HAV) infection, were present in the blood. 11 out of 12 children had never before been examined for diseases of the liver. Only in one child chronic HBsAg carriership had been detected 14 months before this hospitalization. Considering the data of epidemiological history and clinical observations, as well as the results of serological survey, these children were found to have hepatitis A superimposed on chronic HBV infection. As revealed in the present investigation, in cases of HAV superinfection observed simultaneously with chronic hepatitis B viral hepatitis A was manifested by typical clinico-laboratory symptoms.

[Prevalence of hepatitis B in the focus of HIV infection]. / Rasprostranennost' virusnogo gepatita B v ochage infektsii, vyzvannoi virusom immunodefitsita cheloveka.

Highly sensitive up-to-date research methods (enzyme immunoassay) for HbsAg and antibodies against HBsAg and HBcAg were employed to examine 565 adults and children living in the Kalmuck++ ASSR (Elista and adjacent regions), where in 1988-1989 cases of HIV-infection were recorded. Markers of HBV-infection were detected with a high enough frequency in the control group of children (15.2%). The prevalence of the infection in the adult population was at an intermediate level (38.9%). The high infectivity with HBV-infection was recorded among children who had been hospitalized before (for different diseases including chronic ones), among women who had undergone laboratory studies because of the diagnosis of HIV-infection in their children; among adult patients suffering from tuberculosis of morons from a closed boarding school. The highest frequency of HBV-infection marker demonstration was found in HIV-infected children (70%). The data obtained point to the necessity of vaccination against viral hepatitis B in risk groups (children and adults) and in the newborn as well as of raising the efficacy of preventing measures against infections transmitted via blood.

[Current etiological structure of acute viral hepatitis in children]. / Etiologicheskaia struktura ostrykh virusnykh gepatitov u detei na sovremennom étape.

The etiological structure of viral hepatitides (VH) was defined in 345 children admitted to the clinic during one year with a diagnosis of acute viral hepatitis. It was established on the basis of clinico-laboratory studies and identification of serological markers of viral hepatitides A, B and delta. It has been demonstrated that in the structure of viral hepatitides in children living in Moscow, VHA accounts for 83.1%, acute VHB for 11.1%, HBV and HDV coinfection for 2.6%, and VH non A non B for 1.7%. In children of the first year of life, acute hepatitis was etiologically related to HBV-infection or to HBV and HDV coinfection. In a negligible part of the patients, VHA was diagnosed in the presence of chronic HBV-infection (1.2%) or exacerbation of chronic hepatitis B (0.3%). These data should be taken into consideration in planning and carrying out diagnostic, treatment and prophylactic measures aimed at solving VH problem in childhood.

[Clinico-pathogenetic role of hormones of the pituitary-adrenal system and somatotropin in the development of immunosuppression in chronic hepatitis B and delta infection in children and the approach to its correction]. / Kliniko-patogeneticheskoe znachenie gormonov gipofizarno-nadpochech- nikovoi sistemy i somatotropina v razvitii immunodepresii pri khro- nicheskom gepatite B i del'ta u detei i podkhody k korrektsii.

The basal level of secretion of hypophyseal (ACTH, STH) and peripheral glucocorticoid (cortisol, corticosterone) hormones as related to the immune status (lymphocyte subpopulations, serum immunoglobulins, circulating immune complexes, macrophagal component) and specific marker profiles of viruses B and delta was measured in 142 children with different forms of chronic virus hepatitis B and delta (D). The patients with chronic persistent hepatitis was characterized by the "cortisol" type response of stressor adaptation hormones in parallel with the genetically determined weak immune response, demanding no correction. The patients with chronic active hepatitis B and D demonstrated the "central" type of hormonal response with a primary increase in the content of ACTH and CTH and a moderate rise of the cortisol level, which correlated with pronounced secondary immunodeficiency of the T cell and macrophagal components of immune response. In the patients with chronic virus hepatitis B and D, the hormonal profile, as liver cirrhosis develops, is characterized by an increase in corticosterone and blood somatotropin and by a relatively low cortisol content. This reflects depletion of the mechanisms of adaptation and correlates with deep insufficiency of all the three components of immune response. The use of human leukocytic interferon and T-activin exert a well-defined effect on hormonal adaptation of immune response, promotes completion of HB-virus infection replication and the onset of a stable remission.

[Significance of quantitative indicators of HBsAg in the pathogenesis and outcome of a malignant form of viral hepatitis B in children]. / Znachenie kolichestvennykh pokazatelei HBsAg v patogeneze virusnogo gepatita B u detei.

The paper is concerned with the time-course of changes in the HBsAg concentration in 31 patients with malignant hepatitis B. No relationship was discovered between the disease outcome and the HBsAg concentration. At the same time in lethal outcomes, the HBsAg concentration dropped significantly more swiftly as compared to that in convalescents. The disease outcome was established to be related to the characteristics such as pregnancy pathology, acute respiratory viral infection, intestinal infections, pyoinflammatory diseases as well as these diseases in combination.