[Use of polymerase chain reaction in clinical diagnostic laboratories in viral hepatitis B and C]. / Ispol'zovanie tsepnoi polimeraznoi reaktsii pri virusnykh gepatitakh B i C v praktike kliniko-diagnosticheskikh laboratorii.

HBV and HCV markers were detected in the blood serum of patients with acute and chronic hepatitis B (HCV), chronic hepatis C (HCV), and acute nonA, non-B, non-C hepatitis by enzyme immunoassay and the polymerase chain reaction (PCR) in order to assess the clinical value of PCR for the diagnosis of HBV and HCV and monitor the antiviral roferon A therapy in patients with HCV. HBV DNA was detected by the PCR in 100% of acute HBV patients and in 65.7% of chronic HBV patients. In chronic HCV, the PCR detected HCV RNA in 71% of cases. After roferon A therapy, HCV RNA was no longer detected in 43.2% of PCR-positive patients. PCR is recommended for the diagnosis of acute and chronic HCV, selecting the patient groups, and assessing the efficacy of specific therapy.

[An epidemiological evaluation of the incidence of detecting markers of hepatitis B and C viral infection in the blood of the medical personnel of a large general hospital]. / Epidemiologicheskaia otsenka chastoty vyiavleniia markerov infitsirovaniia virusami gepatitov B i C v krovi meditsinskogo personala krupnogo mnogoprofil'nogo lechebnogo uchrezhdeniia.

Virus hepatitis B and C are widespread human diseases of viral etiology, characterized by a common mechanism of the transmission of their etiological agents. The study of the routes of transmission of these infections in hospitals and the epidemiological characterization of the occurrence of the markers of hepatitis B and C among the medical personnel working in therapeutic and prophylactic institutions (TPI) are highly important problems. The data obtained in our investigations make it possible to determine the irregular character of the detection rate of the markers of virus infection among the medical personnel in different departments of a large hospital and to give explanation for such irregularity. A high morbidity rate in virus hepatitis B and C among the medical personnel continues to be one of serious problem facing TPI, and the improvement of the methods of their prevention is still a highly important task of hospital epidemiology.

[The therapeutic efficacy of interferon-alfa-2a (Roferon-A) in chronic hepatitis C]. / Terapevticheskaia éffektivnost' interferona-al'fa-2a (roferona-A) pri khronicheskikh gepatitakh C.

THE AIM OF THE STUDY: Evaluation of 6-month treatment with roferon-A of patients with chronic hepatitis C (CHC) and comparison of the treatment regimens. MATERIAL AND METHODS: 79 CHC patients received roferon-A for 3 months in a dose 6,000,000 IU 3 time a week. In case of the response to treatment was continued for the next 3 months (3,000,000 IU 3 times a week). Clinical-laboratory findings, results, of EIA and liver biopsy histology were examined. RESULTS: Primary remission was achieved in 71.8% of cases. 36.9% of patients developed recurrences including 14.1% recurrence arising in the course of therapy. Stable remission was obtained in 32.4% of patients. 28.2% patients were non-responders. Side effects were mild, discontinuation of the treatment was necessary only in 7% of cases. CONCLUSION: Roferon-A administration in a dose 6,000,000 IU for 24 weeks is optimal both as related to cost and efficacy of the treatment.

[The vaccination of medical personnel as the most important link in the prevention of viral hepatitis B]. / Vaktsinatsiia meditsinskogo personala kak vazhneishee zveno profilaktiki virusnogo gepatita B.

The epidemiological importance of prophylaxis of virus hepatitis B among medical personnel of therapeutic-preventive establishments is caused by often revealing of infecting markers in various groups of the population and patients and the chronization of infectious process, the peculiarities of complications, the outcomes of hepatitis and the character of ways of transfer of the virus. The authors have established non-uniformity of the frequency of revealing of infecting markers by virus hepatitis B in blood of medical personnel of various department of the hospital, have described results of immunological efficiency of the domestic vaccine hepatitis B, produced by firm "Kombitech Ltd." (Russia).

[Russian recombinant vaccine against hepatitis B (results of controlled trials)]. / Otechestvennaia rekombinantnaia vaktsina protiv gepatita B (rezul'taty kontroliruemykh ispytanii).

Two yeast recombinant vaccines were compared: the Russian hepatitis B Combiotech vaccine in a dose of 20 mg and the Recombivax-HB vaccine in a dose of 10 mg manufactured in the USA (Merk, Sharp and Dohme Ltd.). Both agents were found safe and low reactogenic. After a course of 3 vaccinations with the Russian vaccine 92.5 to 97.5% subjects vaccinated after the 0-1-2 months and 0-1-6 months protocols had high levels of specific antibodies. In the group vaccinated with the American vaccine, antibodies to HBsAg were found in the sera of 95 to 100% subjects. These results demonstrate high immunological activity of both Russian and American vaccines.

[The combination of secondary recurrent syphilis and HIV infection]. / O sochetanii vtorichnogo retsidivnogo sifilisa s VICh-infektsiei.

HIV infection in connection with other venereal diseases change greatly there clinic development. Authors discuss comprehensively the peculiarities of infectious process in case of syphilis connection with HIV-infection, and in particular face syphilid, which is met little in practice of venereologists. Syndrome of aggravating influence of HIV-infection on clinic syphilis development is noted. It usually more serious. In given example syphilis was diagnosed only two month later after patient had took medical advice.

[An atypical course of chlamydial infection]. / Atipichnoe techenie khlamidioznoi infektsii.

In Burdenko Main Military Clinical Hospital 113 patients with acute lung inflammations were examined. According to the data of serological tests with application of indirect immunofluorescent reaction an antibody titer (Chlamydia Pneumoniae) was disclosed in 9 patients (11% from the whole number of 82 patients). By the authors' opinion bizarre and severe course of Chlamydia Pneumoniae could take place, thus, it is necessary to conduct serological examinations not only during epidemic outbreaks of acute respiratory diseases or pneumonias, but also during single cases of steady and long-term febrile diseases or protracted pulmonary inflammations.

[The detectability of the hepatitis B surface antigen and antibodies to the hepatitis C virus in serviceman blood donors]. / Vyiavliaemost' poverkhnostnogo antigena virusa gepatita B i antitel k virusu gepatita C u voennosluzhashchikh-donorov krovi.

Blood tests on HBsAg and anti-HCV were conducted in two groups of donors. The first group: 13677 servicemen, average age--20, constant place of residence--different regions of Russia. The second group: 1810 men (70%) and women (30%), average age--37, Moscow residence. In comparison with 1991 a reduction of positive HBsAg test results was marked in 1992 (by 1.6%) and in 1993 (by 1.8%), including 1.6 and 1.8% for combat units, and 2.2 and 3.9% for military construction units. In the authors' opinion such improvement of epidemiological HBV situation in the Armed Forces was caused by the fact that in autumn 1991 and in 1992 the drafting for the basic military service to the Russian Army was abolished in the regions of Middle Asia, Moldavia and Trans-Caucasus. The difference in anti-HCV positive results reduction between the first group (1.7%) and the second group (2.5%) can be explained by age factor, and by the more strict control over the selection of donors in the first group.

[Detection of antibodies to hepatitis C virus in blood donors]. / Vyiavliaemost' antitel k virusu gepatita C u donorov krovi.

The study was aimed at assessment of prevalence of antibodies to hepatitis C virus (anti-HCV) among donors. Blood sera were tested for anti-HCV, alanine aminotransferase (ALT), and bilirubin in two groups of donors. Group 1 were men belonging to organized collective bodies, mean age 20 years, permanent residents of Russia and CIS countries (n = 6157), group 2 were donors of both sexes, mean age 37, 70% men and 30% women, residents of Moscow (n = 1810). Incidence of anti-HCV in group 1 was 1.4%, in group 2 2.5%. ALT levels were elevated vs. the norm by 2.2% in group 2 but in only 4 of these subjects anti-HCV were detected. Bilirubin level was increased in 0.28% of group 1 subjects and in 2.8% of group 2 ones, none of these examinees having anti-HCV. The share of anti-HCV carriers increases with age. Screening for ALT and bilirubin cannot be a substitute for donor blood testing for anti-HCV.

[Laboratory tests in the diagnosis of stomach cancer]. / Laboratornye testy v diagnostike raka zheludka.

Blood alpha-fetoprotein, carcinoembyronic antigen, CA-19-9, alkaline phosphatase, gamma-glutamyltranspeptidase, alanine aminotransferase, aspartate aminotransferase, sorbitol dehydrogenase, glutamate dehydrogenase, hemoglobin and red cell sedimentation rate were measured in patients with stages III and IV gastric carcinoma and patients with benign diseases of the stomach. Alanine aminotransferase, sorbitol dehydrogenase and glutamate dehydrogenase were found diagnostically not informative in gastric carcinoma stages III and IV. A complex of measurements of alpha-fetoprotein, alkaline phosphatase, gamma-glutamyl transpeptidase and aspartate aminotransferase detected gastric carcinoma metastases to the liver in 84.6% of cases as against 61.5% detected by measurements of alpha-fetoprotein alone. A complex of measurements of carcinoembryonic antigen, CA-19-9, alkaline phosphatase, gamma-glutamyl transpeptidase, aspartate aminotransferase helped differentiate between gastric carcinoma stages III and IV. A complex of measurements of carcinoembryonic antigen, CA-19-9, alkaline phosphatase, gamma-glutamyl transpeptidase, aspartate aminotransferase, hemoglobin, and red cell sedimentation rate improved the diagnostic sensitivity in detection of gastric carcinoma stages III and IV to 70.8 and 100%, respectively.

[The use of tumor markers in the diagnosis and treatment monitoring of malignant tumors of the female genitalia]. / Ispol'zovanie opukholevykh markerov v diagnostike i monitoringe lecheniia zlokachestvennykh opukholei zhenskikh polovykh organov.

Levels of carcinoembryonic antigen (CEA), CA-19-9, CA-125, and mucin-like associated tumor antigen (MAA) were measured in the blood sera of 108 patients with uterine cervix and body, and ovarian carcinomas before treatment, and in those with ovarian carcinoma over the course of treatment to monitor its efficacy. The findings indicate that neither CEA nor MAA were diagnostically informative in malignant tumors of female genitals, and in uterine cervix cancer none of the tumor markers was diagnostically valuable. In neglected cases of uterine body cancer blood levels of CA-19-9 and CA-125 were elevated. In ovarian carcinoma CA-125 levels varied statistically significantly (p < 0.05) in various stages of the disease. CA-125 measurements are recommended for monitoring the treatment efficacy in patients with ovarian cancer.

[The use of the carbohydrate antigen CA-19-9, the carcinoembryonic antigen and alpha fetoprotein in the diagnosis of pancreatic cancer]. / Ispol'zovanie karbogidratnogo antigena CA-19-9, rakovo-émbrional'nogo antigena, al'fa-fetoproteina v diagnostike raka podzheludozhnoi zhelezy.

Enzyme immunoassay was used to study blood levels of CA-19-9, cancerous embryonal antigen, and alpha-fetoprotein in blood donors (n = 33), patients with chronic pancreatitis (n = 35), those with pancreatic carcinoma with metastases (n = 28), and without them (n = 21). A differential diagnosis was found to be made between healthy individuals and patients with chronic pancreatitis and those with pancreatic carcinoma via determination of the above tumour markers. The presence of hepatic metastases of pancreatic carcinoma may be suspected if the blood levels of the cancerous embryonal antigen and CA-19-9 are over 15 ng/ml and over 600 U/ml. The level of alpha-fetoprotein was higher only in 14.3% of pancreatic carcinoma patients with hepatic metastases. A comprehensive examination of the levels of all three tumor markers allows one to differentiate pancreatic carcinoma and chronic pancreatitis and to determine whether a patient with pancreatic carcinoma is operable.

[Tumor markers in the diagnosis and prognosis of breast cancer]. / Znachenie opukholevykh markerov v diagnostike i prognozirovanii techeniia raka molochnoi zhelezy.

Serum levels of markers--mucinoid associated antigen (MAA), carcinoembryonal antigen (CEA) and carbohydrate antigen (CA-19-9) were measured in 78 breast cancer patients using enzyme immunoassay. It was found that MAA was most reliable of the above markers in staging breast cancer. A combined study of the latter is advisable in determination of breast cancer dissemination, in the control over the disease course and prognosis.

[Helicobacter pylori infections in various groups of patients at a general hospital and in blood donors]. / Infitsirovannost' Helicobacter pylori razlichnykh grupp bol'nykh mnogoprofil'nogo statsionara i donorov krovi.

Incidence of Helicobacter pylori (HP) infection in inpatients of a general hospital and donors was evaluated immunologically: the serum was examined for IgG antibodies to HP using enzyme immunoassay. Of 354 examinees 89 had duodenal ulcer (DU), 101 were healthy donors. HP infection was found prevalent in all the groups of the inpatients. Cases of HP were more numerous in the gastroenterological department as compared to other departments (81.6% against 39.6%, respectively). Among patients of the gastroenterological department DU patients were most frequent HP carriers (93.2%), this being indicative of a close correlation between DU and HP revealed previously by other diagnostic methods. Rare occurrence of HP in normal subjects (6-11%) reported by many authors was not confirmed, as HP was detected in 33% of the donors. Age-related analysis points to early onset of HP infection (25-26% incidence in 18-20-year-olds), its peak in middle-aged and presenile patients (78-80% in 50-69-year-olds) and lower occurrence in senile patients (25% at the age over 70).

[Laboratory diagnosis of tumors of the pancreato-biliary area in patients with mechanical jaundice]. / O laboratornoi diagnostike opukholei pankreatobiliarnoi zony u bol'nykh s mekhanicheskoi zheltukhoi.

Blood investigation of tumor markers CA-19-9, carcinoembryonic antigen and alpha-fetoprotein was performed in patients with mechanical jaundice due to tumor involvement of the pancreatobiliary area and a nontumor process. It was concluded that the use of CA-19-9-marker and carcinoembryonic antigen provided a successful differential diagnosis between jaundice resultant from tumor and nontumor diseases. Alpha-fetoprotein turned to be of no informative value. Analysis of tumor markers contents in patients with pancreatobiliary tumors demonstrated the usefulness of them in the preoperative assessment of surgical intervention practicability.