Recovery of Hafnia alvei from diseased brown trout, Salmo trutta L., and healthy noble crayfish, Astacus astacus (L.), in Bulgaria.

Hafnia alvei was isolated in Bulgaria from healthy noble crayfish, Astacus astacus (L.), and then from farmed diseased brown trout, Salmo trutta L., with signs of haemorrhagic septicaemia. The isolates were identified initially with conventional phenotyping and commercial Merlin Micronaut and API 20E rapid identification systems, followed by sequencing of the 16S rRNA gene. Hafnia alvei Bt1, Bt2 and Aa4 were of low virulence to rainbow trout and brown trout, although cytotoxicity was demonstrated by Bt1 and Bt2, but not by Aa4.

The role of gastroesophageal reflux disease questionnaire in the Republic of Macedonia.

THE AIM OF THE STUDY: Gastroesophageal reflux disease is a common disease with a multifactorial pathogenesis. Our aim was to analyse the role of the Gastroesophageal Disease Questionnaire in diagnosing reflux disease in the population of the Republic of Macedonia. METHODS: The questionnaire on the severity of the symptoms related to GERD was used. An evaluation of the distal portion of the oesophagus was carried out in all patients with positive questionnaire results. All mucosal injury was classified by the Los Angeles criteria (LA). RESULTS: 642 patients were included. 58.73% females, with an average age of 37.5±8.2. Females had a higher BMI than males 26.8±4.1 vs. 24.9±3.8 p<0.001. Of the total number of examinees (642 patients), in those with erosive reflux disease and also in those with nonerosive reflux disease, as shown respectively in endoscopy, the sensitivity of the RDQ was 100%, and the specifity was 0%. The100 sensitivity means that the questionnaire verified/diagnosed patients with erosive reflux disease with 100% certainty. CONCLUSIONS: RESULTS were found in some studies comparing the positive Reflux Disease Questionnaire and the level of erosive esophagitis (LA classification). This study provides evidence that the RDQ represents a viable instrument for assessing symptom severity and response to treatment in clinical trials of patients with GERD, but in patients with a high score, endoscopic evaluation should not be excluded.

Obstructive jaundice caused by pancreatic head malignancies are there predictive factors for successful endoscopic biliary stenting?

Endoscopic retrograde cholangiopancreatography provides precise imaging of malignant biliopancreatic strictures and allows palliative treatment with endoscopic stenting. Initial successful biliary stenting can be achieved in about 69-100% of patients with pancreatic head malignancies. Preliminary data from our Clinic reported a much lower success rate of endoscopic biliary stenting in obstructive jaundice caused by pancreatic head malignancies. These findings may be because patients are referred at more advanced stages, which could contribute to the lower success rate of biliary stenting. We aimed to determine the success rate of endoscopic biliary stenting prospectively in 50 patients with pancreatic head malignancies and to asses if clinical, laboratory and ultrasound findings can be predictive of success and safety in biliary stenting. Initial successful biliary stenting was achieved in 70% of our patients. No major complications (perforation, severe pancreatitis, massive bleeding, death) were noted. We were able to identify factors predictive of a lower success rate which were associated with a more advanced disease and a longer delay before treatment. Based on our results, we conclude that ERCP should be offered without delay as a primary treatment option for all patients with unresectable pancreatic head malignancy and as a possible treatment option in patients with resectable malignancy who are poor candidates for surgery.

[Topografic anatomy of human liver in the early fetal period].

This investigation was aimed at the evaluation of holotopy, skeletotopy and sintopy of human liver in early fetal period. In 60 human fetuses aged 16-24 weeks, a quantitative characteristic of liver topography was obtained using a modification of N.I. Pirogov method and multiplane histitopograms with the application of multidimensional coordinate system. Fetal liver sintopy was described in sections performed in different planes and its peculiarities in the period studied was emphasized. As the standard sections to be used for the ultrasonographic and magnetic resonance diagnostics of fetal liver, authors recommend the horizontal sections, made at the level of IX-XII thoracic vertebrae.

[Results of a prospective randomized investigation [Russia (St.Petersburg)/WHO] to evaluate the significance of self-examination for the early detection of breast cancer]. / Rezul'taty prospektivnogo randomizirovannogo isledovaniia [Rossiia (Sankt-Peterburg)/VOZ] znacheniia samoobsledovaniia v rannem vyiavlenii raka molochnoi zhelezy.

Indications for puncture or excision biopsy were significantly higher in the study group (7.5%) as compared with control (3.5%) (p < 0.01) in a randomized prospective controlled trial of a comprehensive breast cancer screening (123,748) carried out in the framework of a self-examination education program. In the self-examination group, detection rates were higher both for benign (1.1%) and malignant (0.85%) tumors than in control (0.5% and 0.69%, respectively) (p < 0.05). Early stage (T1NOMO, Tis) distribution difference in the study group and controls was insignificant--23 and 17.6%, respectively. Compliance with the program requirements including monthly or bimonthly self-examination was followed by higher 15-year survival rates (53.2%) in 70-75% as compared with controls(45.8%) (p = 0.05105): yet it did not affect mortality.

[Expression of the NS1 gene of tick-borne encephalitis virus in gram-negative bacteria from the mouse nasopharynx]. / Ekspressiia gena NS1 virusa kleshchevogo éntsefalita v gramotritsatel'nykh bakteriiakh--obitateliakh nosoglotki myshei.

Bacteria were isolated from the nasopharynx of BALB/c mice and electroporated with pUR290(NS1)2 containing two copies of tick-borne encephalitis virus (TBEV) strain Sofjin NS1 under the control of the lac promoter. The plasmid persisted in transformants for at least ten passages. The NS1 gene expression was detected in Gram-negative enterobacteria via immunoblotting with monoclonal antibodies against TBEV nonstructural glycoprotein NS1. Recombinant NS1 was detected in bacterial cells and in the culture medium. Intranasal immunization with recombinant bacteria activated production of antibodies against NS1 in serum of BALB/c mice. The humoral immune response to NS1 failed to protect immunized mice from a TBEV challenge.

[Involvement of the common shrew, Sorex araneus (Insectivora, Soricidae), in circulation of the tick-borne encephalitis virus in south-western Siberia]. / Uchastie obyknovennoi burozubki Sorex araneus (Insectivora, Sorcidae) v tsirkuliatsii virusa kleshchevogo entsefalita na iuge zapadnoi Sibiri.

We presented the data on the abundance of immature instars of the taiga tick Ixodes persulcatus Schuize on the common shrews Sorex araneus L. in natural foci of tick-borne encephalitis in the south of Western Siberia. Basing on the results of virological and serological studies we demonstrated a low effectiveness of this host species as a donor of disease agent strains, which are predominant in the territory under study, for ticks feeding on shrews. The analysis of samples taken from the young shrews in winter and spring using reverse RNA transcription with polymerase chain reaction and ELISA revealed occurRence of subvirion components of the tick-borne encephalitis (RNA and capsid protein E) ether in brain, liver or spleen in 90 percent of shrews (n = 42). Neither hemagglutination antigen nor infectious virus have been detected. We discussed a possible epizootic role of the maintenance of non-infectious tick-borne encephalitis virus in overwintering animals.

[A comparison of the immune response induced by DNA or by an inactivated vaccine against tick-borne encephalitis]. / Sravnenie immunnogo otveta, indutsirovannogo DNK ili inaktivirovannoi vaktsinoi protiv kleshchevogo éntsefalita.

BALB/c mice were immunized with recombinant plasmid DNA pSVK3-ENS1 and pcDNAI-NS3 containing, respectively, genes E-NS1 and NS3 of tick-borne encephalitis (TBE) virus. Antibodies to TBE virus proteins were detected in the blood sera of the immunized animals by the method of the enzyme immunoassay. Though the titers of virus-specific antibodies in the sera of mice immunized with protein vaccines exceeded those registered after immunization with DNA vaccines, essential protective immunity was observed after the use of both vaccines.

[Interim results of a prospective randomized study of self-examination for early detection of breast cancer (Russia/St.Petersburg/WHO)]. / Promezhutochnye rezul'taty prospektivnogo randomizirovannogo issledovaniia (Rossiia/Sankt-Peterburg/VOZ) znacheniia samoobsledovaniia v rannem vyiavlenii raka molochnoi zhelezy.

Training in breast self-examination (BSE) technique involved 57,712 women, aged 40-64, at 14 out of randomly selected out-patient hospitals in St. Petersburg (1985-1989). Another 64,759 women selected at another 14 out-patient hospitals were in control. All patients with detected tumor pathology of the breast were biopsied and treated at the Institute's Clinic. The study focused on breast cancer incidence, survival and mortality. More women in the BSE group sought medical advice for suspected pathology (4,300) than those in control (2,438; p < 0.05). There were 493 cases of breast cancer in the BSE group with 157 fatalities, 446 cases of breast cancer with 167 fatalities in the control group. There was no significant difference in tumor stage. Nine-year survival (after Kaplan-Meyer) from the time of tumor detection was 65% in the study group and 55% in control (log rank 0.774; p > 0.05). There has been no significant difference in death rates in both groups for the past ten years. The study is to continue until the year 2001.

[The effectiveness of adjuvant chemotherapy with anthracyclines (adriablastin, doxorubicin) for stage-IIb-IIIa breast cancer]. / Effektivnost' ad''iuvantnoi khimioterapii antratsiklinami (adriablastinom, doksorubitsinom) u bol'nykh rakom molochnoi zhelezy IIb-IIIa stadii.

The effectiveness of adjuvant treatment with anthracyclins (adriablastin, doxorubicin) and standard CMF regimens for breast tumors has been compared. The study included 349 patients with stage IIB-IIIA tumors (T1-2N2M0, T3N0-2M0) (mean age-46 years) during 1985-1990 follow-up-60.38 months. In the doxorubicin group, overall 5-year survival was 73 +/- 8%, in the CMF group-62 +/- 8%. Recurrence-free 5-year survival was 62 +/- 8 and 55 +/- 8%, respectively. The differences are not significant. A stage-related analysis established a significant difference in overall survival in patients with T1-2N2M0 tumors (c-sqare 9.92, p < 0.01). However, due to a small number of cases, the phenomenon requires further study. Although adriablastin treatment involved a significantly higher frequency of carciotoxic symptoms, complete alopecia and dyspeptic complication, a systemic administration of cardioxan and effective antiemetic drugs was lacking.

[Preparation and properties of monoclonal antibodies to tick-borne encephalitis viral nonstructural proteins]. / Poluchenie i svoistva monoklonal'nykh antitel k nestrukturnym belkam virusa kleshchevogo entsefalita.

Hybridomas secreting monoclonal antibodies (Mab) to tick-borne encephalitis (TBE) virus are obtained. Immunodiffusion showed that 3 Mabs to TBE protein NS3 belong to class IgM and the rest to IgG1. Mabs to TBE protein NS1 were tested in hemagglutination inhibition, complement fixation, neutralization, and protection tests. Only 1 hybridoma produced Mab specific for protein NS1 of TBE strain Sofyin, the rest reacted with the common antigenic determinants of nonstructural TBE complex.

[Time course of changes in tuberculosis epidemiological parameters in Iakutia over 12 years (1983-1994)]. / Dinamika osnovnykh épidemiologicheskikh pokazateleí tuberkuleza v Iakutii za 12 let (1983-1994gg).

In the past 12 years, there were 1.3- and 1.9-fold reductions in the total morbidity rates of tuberculosis and its spread, respectively. However, its morbidity among children showed 3-fold increases. The reduction rate of bacterial excretion became much slower in the past 4 years. Tuberculosis mortality rates tended to rise. At the moment of study, the basic tuberculosis epidemiological parameters were 1.3-1.5 times higher than those in the Russian Federation. At the same time there was a decrease in the efficiency of antituberculous work at all levels.

[Recurrence of pulmonary tuberculosis in adults in the areas of the Republic of Sakha (Iakutia)]. / Retsidivy tuberkuleza legkikh u vzroslykh v ulusakh Respubliki Sakha (Iakutia).

The dynamics in recurrences of pulmonary tuberculosis was analyzed in the areas of Yakutia. The social and clinical characteristics of patients with recurrences and their treatment outcomes are presented in the paper. Recurrences of pulmonary tuberculosis were found to occur more frequently in the areas having a poor epidemiological tuberculosis situation and among socially unprotected groups of the population. Under these conditions, recurrences may occur in 30 years or more after clinical cure of tuberculosis. To treat patients with recurrences in the area presents great difficulties.

[Breast-preserving (conservative) therapy of breast cancer]. / Organosokhraniaiushchee (konservativnoe) lechenie raka molochnoi zhelezy.

Conservative surgery (sectoral or segmental + axillary dissection) was performed in 278 patients with breast cancer (T1-2N0M0) at the Institute Clinic in 1990-1995. Following thorough morphological examination. 148 patients (53.2%) were selected to form a clinical study group for an investigation of the role of postoperative radiotherapy in the conservative treatment of breast cancer. Two groups-irradiation of the remaining breast tissue and controls-were formed on the basis of randomized data. Follow-up continued 3-60 months (average duration-37.7 months). Local recurrence was detected in 3 out of 73 (4.2%) patients of group I. A similar relapse was detected in 6 out of 75 (8.0%) patients of group II. No significant difference in total survival rates in the two groups was observed (97.3 and 96.0%; p > 0.05).

[Postoperative hormone therapy of breast cancer (analysis of overall survival)]. / Posleoperatsionnaia gormonoterapiia raka molochnoi zhelezy (analiz obshchei vyzhivaemosti)

A third series of randomized evaluation of postoperative (adjuvant) hormone therapy (tamoxifen, sinestrol and orimeten) was carried out in breast cancer patients. The study group involved 1.332 reproductive and postmenopausal females with stage I-III tumors. The investigation established quite a range of 10-year survival evidence versus stage and reproductive status; however, no significant differences were recorded in either of the groups. Untoward side-effects were more frequent when treating with diethyl-stilbestrol (over 30%) than with tamoxifen (3.5%). No significant differences were registered in five-year total and recurrence-free survival in the treatment with orimeten or tamoxifen.

[Preliminary results of the Russia (St.Petersburg)/WHO program for the evaluation of the effectiveness of breast self-examination]. / Promezhutochnye rezul'taty programmy Rocciia (Sankt-Peterburg)/VOZ po otsenke éffektivnosti samoobsledovaniia molochnykh zhelez.

Although an absolute difference of 10% (65,4 vs. 54,9%) in 5- and 9-year survival in breast cancer patients was recorded between the self-examination and control groups a large-scale randomized population-controlled study of 122,471 females has failed to provide significant differences (Log-rank - 0,774, p > 0.05). No significant decrease in mortality was observed in the self-examination group as compared with the untrained controls. As a result of providing more information to the population on risk factors. twice as many of the trained females consulted oncologists. Also, the number of early detection of breast tumor (T1-2NOMO) in both groups was 1,5-2,5 times that recorded elsewhere. Since 3,55 per 1,000 patients with breast tumors per year, aged 50-59, died of cardio-vascular disease, i.e. 3,1 times the expected 1,16 per 1,000, more attention should be focused on timely diagnosis and treatment of concomitant cardio-vascular pathology.

Antibodies against tick-borne encephalitis virus (TBEV) non-structural and structural proteins in human sera and spinal fluid.

Western immunoblotting of the serum and spinal fluid of patients with tick-borne encephalitis (TBE) revealed the presence of antibodies against non-structural and internal virion proteins. Antibodies against different viral proteins have been shown to appear 8 days postinfection and to circulate for more than 2 months in case of acute TBE. Antibodies against structural glycoprotein E and non-structural glycoprotein NS1 do not prevail over antibodies against other kinds of viral proteins. The large viral non-structural proteins NS5 and NS3 and small hydrophobic proteins NS2A and NS4B can cause an effective immune response as well. There is no strong correlation between immune response spectrum and fever or meningitis forms of disease. However, sera of patients with chronic TBE contained IgM antibodies to virus-specific proteins more than 1 year later and IgG antibodies with very low titers (if any).

[A method for diagnosing allergy by studying eosinophil morphology]. / Spsob diagnostiki allergii s pomoshch'iu izucheniia morfologii éozinofilov.

A total of 107 children with various clinical manifestations of food allergy were examined to investigate the morphological changes of eosinophils under the effect of food allergens. Eosinophil "injury" caused by cow milk allergen was detected in 71.4%, that caused by hen egg white in 82.4%, and that under the effect of fish in 77.8% of the examinees, these data being useful as a laboratory test for the diagnosis of food sensitization. Correlation between the index of eosinophil injury and late reactions to cow milk, as well as increased reactivity to nonspecific stimuli were traced.