Vol 15, No 4 (2015)

The review addresses the development of cell technologies designed to stimulate injured nerve regeneration, including original and published results. The experimental use of dissociated cells derived from embryonic primordiums of different neural system organs and of mesenchymal stem cells to stimulate nerve regeneration is discussed. The need for further basic research of grafted cells fate and their effects on recipient’s nerve fiber growth is emphasized.

The wide use of highly active antiretroviral therapy (HAART) significantly alters the structure of secondary manifestations of HIV infection, including neurocognitive impairments and opportunistic infections resulting in brain lesions. Study objective: To characterize the radiological semiotics of brain lesions of HIV patients having different immunological conditions and HIV activities upon HAART. Material and methods: Study group comprised 70 HIV patients. HIV infection was confirmed with standard laboratory tests. All patients were tested for CD4 cell counts and viral loads and subjected to brain MRI. Subgroups were defined according to HAART regimens, immunosuppression levels, and opportunistic infection-caused brain lesions. The results were treated using statistical procedures available in MS Excel. Results: Most patients were found to have MRI-visualized brain lesions ponding to HIV-associated encephalopathy and secondary infectious brain lesions. The mean blood CD4 cell counts in these patients was 237 mL -1, and the prevalence of such opportunistic infections as toxoplasmosis and cryptococcosis was high. Subcortical and subependymal brain structures and basal ganglia were most involved in brain pathology. Among patients who did not receive HAART, brain lesions were found in 74% of cases, and the mean blood CD4 cell count and viral load were 245 mL 1 and 154 548 RNA copies per 1 mL, respectively. No HAART was associated with more severe brain lesions, including gliosis and demyelination. Conclusions: Structural changes in the brain visualized with MRI are frequent manifestations of opportunistic infections in HIV patients. The course, localization and severity of the changes depend on immunosuppression and viral load. Clinical and radiological comparisons of HIV patients suggest that MRI is indispensable for clinic-diagnostic examination of HIV patients.

It is impossible to carry out cochlear implantation for patients with bilateral deafness because of damage auditory nerve, congenital aplasia of cochlea or auditory nerve, obliteration of cochlea. For these patients it was developed auditory brainstem implant (ABI). It delivers sounds to brain by means stimulation of the cochlear nucleus. In Russia the first 3 operations auditory brainstem implantation in December 2014 owing cooperation of St. Petersburg’s Research Institute of ENT and speech, Polenov’s neurosurgical institute, neurosurgical clinic Fulda. Materials and methods: two adult patients with neurofibromatosis type 2 and 1 child (2 years old) with bilateral cochlea aplasia got the surgery of auditory brainstem implantation. Results: 6-9 electrodes were activated in patients. The thresholds at warble tones in the range 500-6000 Hz were 45-55 dB. Adult patients detected different surrounding sounds, differed words and sentences with variable duration and rhythmic structure after 8-10 days of sound processor activation. The progress in auditory perception was revealed during 5 months of ABI using and auditory training. The child demonstrated the development of listening and vocal activity. Conclusions: auditory brainstem implantation is possible method of auditory rehabilitation of deaf patients who have contradictions for cochlear implantation. The patients with ABI differ and identify words and sentences in close set, improve speech perception by lip-reading. It was observed the progress in auditory, preverbal and verbal vocal skills in child with congenital deafness after implantation. The quality of life of patients and their family members increased.

The northwest of the Russian Federationbecame involved in HIV epidemic earlier than other region did and is currently a leader in HIV prevalence, which, while being still high, shows some positive trends discussed in the present paper. Objective: To characterize the current state of HIV epidemic in the Northwest Federal Region (NWFR) of the Russian Federation and to delineate the main routes of HIV transmission and the factors that destabilize the epidemic situation. Materials and methods: HIV epidemiological surveillance data related to all of 11 administrative units of NWFR in the year 2014 are reviewed. Results: Most of HIV patients are residents of Saint-Petersburg and Leningrad Oblast. The main routes of HIV spread during the last 15 years are intravenous drug use, which recently has been matched by the sexual transmission, which is characteristic of the newly found cases. Increasing HIV prevalence among MSM raises much concern as evidencing HIV accumulation in this subpopulation. In some administrative units, injection drug use remains to be a destabilizing factor. The perinatal HIV spread tends to decrease and is now responsible to 3,7% on average, being the lowest in Saint-Petersburg (1,1%) and the highest in Komi Republic (6,6%). People living with HIV are becoming older, the peak of HIV prevalence having shifted to 35 years, and the proportion of HIV patients younger than 30 years having decreased. About 40% of HIV patients in NWFR received ART, which is higher than in Russia on average. To increase the number of HIV patients involved in HAART, additional funding and personnel are required. HIV epidemic in NWFR is stabilized at high levels of epidemiological parameters and ahigh number of people living with HIV.

3’-Azido-3’-desoxythymidine 5’-aminocarbonylphsphonate (6HP) was tested according to HP-1-2013 Protocol № 6, which is a controlled clinical trial of 6HP monotherapy for HIV with the objective to define the optimal dose and daily dosage of 6HP. HPLC with solid-phase extraction was adopted to determine the concentrations and minimal equilibrium concentrations of AZT,the active metabolite of 6HP, in blood plasma samples from five groups of HIV patients.The HPLC datawere found to conform to reliability criteria and to beusable for defining the optimal doses and regimens of 6HP administration.

Nudity as part and mirror of the world, in European culture becomes both a halo forbidden and primary object of culture at the time of «original sin» - awareness of their nakedness and nudity another. Nudity in the patient s body loses eye doctors gender and sexual definition, becoming the object of study.