[Campylobacter (Helicobacter) pylori in chronic erosive gastritis, duodenitis and gastroduodenitis]. / Campylobacter (Helicobacter) pylori pri khronichnite erozivni gastriti, duodeniti i gastroduodeniti.

The presence and degree of manifestation of Campylobacter (Helicobacter) pylori in gastroduodenal mucosa were studied in 100 patients (56 men, mean age 51.4 years, and 44 women, mean age 46.5 years) with endoscopically proved chronic erosive gastritis (52 patients), erosive duodenitis (36 patients) and erosive gastroduodenitis (12 patients). The examinations revealed the presence of Campylobacter (Helicobacter) pylori in mean 77% of the patients with erosive gastritis, duodenitis and gastroduodenitis. Campylobacter (Helicobacter) pylori was found most often in patients with chronic erosive duodenitis--83.3%, whereas in the patients with erosive gastritis it was found in 73.07%. In 83.33% of the patients with chronic erosive gastritis, duodenitis and gastroduodenitis the campylobacter infection was well manifested--(++) according to Le Bodie et al (1987). The results allow the conclusion that one of the important pathogenetic factors of erosive gastritis, duodenitis and gastroduodenitis is the Campylobacter (Helicobacter) pylori infection of gastroduodenal mucosa.

[Ziksorin in the treatment of unconjugated familial functional jaundice--the Gilbert-Meulengracht syndrome]. / ziksorin pri lechenieto na nekoniugiranata familna funktsionalna zhultenita--sindroma na Gilbert--Meulengracht.

Zixoryn (Flumezinolum) is a new enzyme inductor without the adverse effects of the other known substances with similar inductor activity (phenobarbitals, DDT derivates, etc.). It was applied to 12 patients with unconjugated nonhemolytic familial jaundice--Gilbert-Meulengracht's syndrome. The dose was 600 mg'6 capsules of 100 mg taken as a single dose) once in a week in the course of 2 months. This treatment led to a 50% reduction of the hyperbilirubinemia in all patients treated. In the patients with initial bilirubin level under 35 mmol/l Zixoryn led to normalization of the bilirubin level with a normal ratio between the conjugated and unconjugated fractions. The discontinuance of Zixoryn treatment led in the course of 20-25 days to a gradual rise of bilirubin to its previous pathologic level. No side effects were registered in the patients treated with Zixoryn. Zixoryn is a new effecient drug for treatment through enzyme induction of bilirubin transport and glucuronizing enzyme systems in the hepatocytes. It is especially useful, in patients with high unconjugated hyperbilirubinemia as well as in patients with deterioration of the disease with an increase of the bilirubin level--total and unconjugated.

[Campylobacter pylori in patients with chronic gastritis and gastric and duodenal peptic ulcer]. / Campylobacter pylori pri bolni s khronichni gastriti, iazvena bolest na stomakha i duodenuma.

The presence of Campylobacter pylori was studied in biopsy material from gastric mucosa taken by guided biopsy during fiber gastroduodenoscopy from 101 patients with chronic gastritis (n = 50), peptic gastric ulcer (n = 28), peptic duodenal ulcer (n = 7), gastric cancer (n = 10) and gastric polyposis (n = 6). Campylobacter pylori was found in various quantity--moderate (++) and considerable ( )--in 64% of the patients with chronic gastritis, in 85.7% of the patients with peptic gastric ulcer and in 100% of the patients with peptic duodenal ulcer as well as in half of the patients with gastric cancer and polyposis. The quantity of Campylobacter pylori correlated with the severity of the inflammatory process and the degree of atrophy of the gastric antral mucosa. A tendency toward seasonal incidence of Campylobacter pylori infection of gastric mucosa was established: 78.69% of the patients examined during spring time (April-May) and 60.0% of the patients examined during winter time (January-February) had Campylobacter pylori infection. This explains to a certain extent the seasonal exacerbations of the pathological process in chronic gastritis and peptic ulcer. The development of a well expressed chronic atrophic gastritis is in direct relation with the greater quantity of Campylobacter pylori in the gastric mucosa. The study reveals the pathogenetic relations between the presence and quantity of Campylobacter pylori and the development and evolution of chronic gastritis and peptic gastric and duodenal ulcer.

[Primary malignant non-Hodgkin's lymphoma of the stomach]. / Purvichen malignen nekhodzkinov limfom na stomakha.

A case of a 69 years old male patient with primary malignant non-Hodgkin lymphoma is presented. The disease resembled clinically, roentgenologically and endoscopically gastric cancer. The diagnosis was proved by histologic examination which revealed lymphoblast sarcoma with significant malignancy. The etiopathogenesis, clinical, diagnostic, prognostic and therapeutic problems of malignant non-Hodgkin gastric lymphoma are discussed.

[Doxycycline esophagitis and esophageal ulcer]. / Doksitsiklinov ezofagit i ezofagealna iazva.

Four cases of acute doxycycline injury of the esophageal mucosa--acute catarrhal doxycycline esophagitis and acute doxycycline ulcer are presented. The pathogenesis, clinical course, endoscopic pattern, prophylaxis and treatment of these complications of doxycycline treatment are discussed in detail. The gastroesophageal and duodenogastric reflux, which are most often the result of functional failure of the lower esophageal sphincter, are pointed out as the basic pathogenetic mechanism of the esophageal mucosa injury in oral doxycycline treatment.

[The necessity for intragroup individualization of diet No. 5 in hepatobiliary diseases]. / Vurkhu neobkhodimostta ot vutregrupovo individualizirane na dieta No. 5 pri chernodrobno-zhluchnite zaboliavaniia.

The frequency of cholelithiasis in Bulgaria has increased 9 times for the last 15 years. At the same time 40.5% of the patients with cholelithiasis are obese--II-IV degree of obesity. This fact calls for individualization of diet No 5 which in this country is applied to patients with liver and biliary diseases. A variant diet No 5-x for patients with cholelithiasis and abnormal body mass is proposed. This diet keeps the protein and fat components of diet No 5 but reduces the carbohydrates quantity from 346 g to 195-200 g which leads to the reduction of the daily intake of calories from 2369-2450 to 1700. The individualization of diet No 5 and the introduction of diet No 5-x in patients with biliary diseases will ensure a greater prophylactic and therapeutic efficacy of the dietetic treatment of patients with cholelithiasis and other biliary diseases combined with various degree of obesity.

[Erosive gastritis and gastroduodenitis--clinical, diagnostic and therapeutic studies]. / Erozivni gastriti i gastroduodeniti--klinichni, diagnostichni i lechebni prouchvaniia.

Diagnostic, clinical and therapeutic studies were carried out, under clinical conditions, on 80 patients with endoscopically confirmed chronic erosive gastritis and gastroduodenitis. The subjects aged between 20 and 59 are most often affected, the males being 2 times more often affected. The histological study on the purposeful biopsy of the mucosa of the stomach and duodenum established, most frequently, the presence of chronic superficial gastritis and duodenitis, followed by initial chronic atrophic gastritis. The clinical symptoms were studied in details--pain (91.20%), dyspeptic syndrome (83.7%), hemorrhagic manifestations (hematemesis or melena)--23.7%. In 40% of the patients with erosive gastritis and gastroduodenitis, the disease was combined with duodenal ulcer and in 7.5%--with gastric ulcer. The etiological factors of importance are: food factors, dietetic errors, alcoholic consumption, drug effects (first of all derivatives of Rauwolfia serpentina, followed by the peroral broad spectrum antibiotics, etc), duodenogastric reflux and toxic effect of the bile acids on the antral mucosa. The endoscopic studies are of decisive importance for the diagnosis and determining the effect of the treatment. The treatment with a dietetic regimen, gastro-protective drugs (almagel, preparations of deglycyrrhized licorice--alcid V, vitamin A, spasmolytics) eliminated the erosive alterations in 75% of the patients after 3-week treatment.