[The 14th Congress of the International Association of Gynecologists and Obstetritricians (Montreal, Canada, 1994)-].
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Biomedical subjects
Publications and source records attributed to V A Anan'ev.
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The results of the controlled field trial of lyophilized erythrocytic immunoglobulin diagnosticum for the detection of hepatitis A virus antigen in the urine and feces of patients are presented. This diagnosticum was used for the study of urine and fecal samples from 225 patients (of these, 176 had hepatitis A) and 54 healthy persons in the passive hemagglutination (PHA) test. Their blood sera were studied in the PHA test (to detect HBsAg) and the radioimmunoassay (to detect anti-HAV IgM). The immunoglobulin diagnosticum under study was found to be nonspecific and faintly sensitive and, therefore, unsuitable for use in medical practice.
Assay of group-specific blood substances (GSBS) A and B was conducted in 21 series of an albumin preparation produced from donors' blood serum, in 11 series of placental and in 5 series of "Postab" albumin. GSBS content was estimated by a comparative use of poly- and monoclonal antibodies prepared in this country. More than 80% of the preparations from donors' blood serum did not contain GSBS A and B. In the preparations obtained from placental and postabortion blood the mean levels of GSBS significantly fluctuated, and with the use of poly- and monoclonal antibodies in comprised 8.3-9.1 micrograms/ml GSBS A and 16.7-42.8 micrograms/ml GSBS B, respectively. Administration to recipients of albumin preparations contaminated with GSBS may produce an immunomodulating side effect.
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As a result of examining 276 patients with duodenal ulcer the leading psychopathogenic variants of the disease were established. Inclusion of psychotherapy into multimodality treatment of patients with duodenal ulcer led to the reduction of anxious-depressive disturbances, accelerated the cessation of the painful and dyspeptic syndromes, lowered the ergotropic activity of the neurohormonal systems. Normalization of adrenalin excretion served as an indicator of favourable prognosis. Psychotherapy turned out less effective in patients with hypochondriac fixations and affective rigidity.
The work presents materials on the study of subunit plasma vaccine against hepatitis B (HB), developed in the USSR, in a controlled epidemiological trial. The study showed low reactogenicity and complete safety of the preparation, the level of anti-HBsAg antibodies in persons, formerly found to have no such antibodies, being 88% after three injections of the vaccine. To determine the prophylactic effectiveness of the vaccine, the test and control groups, each consisting of 500 children, were formed from children aged 1-3 years, i.e. belonging to the age group most frequently affected by HB, by the method of random choice. During 18 months from the time of immunization no cases of HB were registered among the vaccinees, while in the control group 5 cases of HB were registered (8.9 per 1000). These results indicate that the plasma vaccine against HB, newly developed in the USSR, is faintly reactogenic, safe and shows sufficiently high antigenic activity and protective potency correlating with this activity.
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In this article the state of morbidity in hepatitis A and B in the USSR as a whole and in individual republics is analyzed, the causes of the preservation of high morbidity levels in some regions of the USSR are shown, the specific epidemiological features of fecal-oral hepatitis non A, non B in the republics of Central Asia are pointed out and the ways for improving separately the prophylaxis of hepatitis A and hepatitis B are considered.
In regions with a low endemic incidence of hepatitis B familial foci of those with a history of viral hepatitis B and HBsAg carriers are less actual objects of epidemiological surveillance than foci of group diseases, chronic carrier state of HBsAg.
Altogether 276 male patients with duodenal ulcer (DU), 45 with the preulcerative condition (PUC) and 70 with gastroduodenitis were examined. Anxiety-depressive disorders were most frequently revealed in all the groups. The frequency of hypochondriac fixation in DU increased. The neurohormonal "basis" of affective rigidity is formed during PUC. Specific variants of neurohormonal rearrangement in the transformation of PUC into DU were revealed in depressive, anxiety and hysterical manifestations.
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The study has revealed that the concentration of HBsAg preparations is simple and easily performed with the use of polyacrylamide, but not dextran gels. Rheophoresis has been shown to be a more sensitive method of indication than countercurrent immunoelectrophoresis. Rheophoresis has been proposed for introduction into medical practice at rural health institutions.
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The introduction of prophylactics of hepatitis B in surgical departments results in 2 times lower growth of HBsAg carriers among medical men. The main prophylactic measures consist in an analysis of the donor blood and HBsAg examination of surgical patients, treatment of HBsAg carriers as acutely contagious persons, centralized sterilization of medical instruments and individual protection of the personnel.
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Fourteen hybridoma clones have been isolated producing the monoclonal antibodies to the surface antigen of the hepatitis B virus (HBsAg). Monoclonal antibodies have been shown to react in high titres with HBsAg in the reactions of PHA, PH and ELISA. The specificity of monoclonal antibodies to two antigenic determinants has been found by the competitive solid phase ELISA technique. Monoclonal antibodies from nine clones react with one determinant while monoclonal antibodies from the rest five clones react with the other nonoverlapping determinant.