[The state and role of esophagus, stomach, intestinal microbiota in patients with ulcer disease, chronic gastritis, esophagitis.]

The microflora of 64 biopsies taken during fibrogastroduodenoscopy of the mucous membrane of the esophagus, stomach and duodenum in healthy volunteers and 1120 samples obtained from the same parts of the digestive tract in patients with esophagitis, chronic gastritis and peptic ulcer disease were studied. The patients ranged in age from 18 to 62 years. Traditional bacteriological method was used to isolate and identify microorganisms. Staphylococcus spp., Streptococcus spp., Lactobacillus spp., Bacteroides spp., Stomatococcus spp., Enterobacteriaceae, Corynebacterium spp., Micrococcus spp., Neisseria spp., Veilonella spp. were isolated from biopsies of healthy respondents in an average amount from 3.2 to 4.68 lg CFU/g. H.pylori was found in 60% (5.66 lg CFU/g) in the esophagus, in 33.3% of cases (5.12 lg CFU/g) from the fundal part of the stomach, in 44.4% (5.25 lg CFU/g) from the antral part of the stomach, in 5.5% (4.2 lg CFU/g) in the duodenal mucosa. In samples obtained from the inflamed and eroded mucous membrane of the esophagus, stomach and duodenum, opportunistic bacteria of the genera Klebsiella, Enterobacter, Proteus, Pseudomonas, Peptococcus, Actinomyces, yeast fungi of the genus Candida etc. were detected in an amount exceeding 4 lg CFU/g. H. pylori isolated in 6.3-16.7% of patients (4.25-4.6 lg CFU/g) and did not dominate in relation to other microorganisms, and in most cases had a low frequency of its occurrence. In patients with the recurrence of peptic ulcer disease, exacerbation of chronic gastritis and esophagitis, dysbiosis was developed, characterized by an increase in the species and quantitative composition of opportunistic microflora, an increase in its enzymatic and cytotoxic activity, which can contribute to the maintenance of inflammatory and necrotic processes and inhibit the elimination of the pathological process.

[THE ROLE OF HELICOBACTER PYLORI IN NORMOMICROBIOCENOSIS AND DYSBACTERIOSIS OF MUCOSAL MICROFLORA OF OESOPHAGOGASTRODUODENAL ZONE IN THE CASES OF PEPTIC ULCER, CHRONIC GASTRITIS AND OESOPHAGITIS].

AIM: Determine the qualitative and quantitative composition of the mucosal microflora of oesophagogastroduodenal zone to determine the location of Helicobocter pylori and its place in normomicrobiocenosis and dysbacteriosis in cases of peptic ulcer, chronic gastritis and oesophagitis. MATERIALS AND METHODS: Clinical and microbiological studies were conducted in 30 healthy individuals-volunteers, 130 patients with peptic ulcer, 36--chronic gastritis and 24--chronic esophagitis. RESULTS OF THE STUDY: Helicobacter pylori in 33% of cases included in normomicrobiocenosis of mucosal microflora oesophagogastroduodenal zone, which consists of 12 genera of microorganisms and carries out all protection functions. The recurrence of peptic ulcer disease, exacerbation of chronic active gastritis and oesophagitis are accompanied by a dysbacteriosis of mucosal microflora with overgrowth of typical and atypical microorganisms for normal biotope with reduced occurrenceof Helicobocter pylori. CONCLUSION: Helicobacter pylori in the biocenosis of mucosal microflora of oesophagogastroduodenal zone is not an infection, has no independent significance in the development of peptic ulcer, chronic gastritis and esophagitis, does not require eradication.

[NEW ASPECTS OF TRANSENDOSCOPIC TREATMENT OF PEPTIC ULCER ASSOCIATED WITH DYSBACTERIOSIS OF GASTRODUODENAL ZONE].

AIM: Find out the condition of mucosal microflora in gastroduodenal ulcer patients in different phases of its recurrence, to determine changes in the value of dysbiotic changes in ulcerogenesis, develop and confirm new transendoscopic treatment of gastroduodenal ulcers. MATERIALS AND METHODS: The study included 134 patients and 10 healthy volunteers RESULTS: At relapse of peptic ulcer and distant from the ulcer areas of the mucosa were allocated to 28 genera and species of microorganisms with a wide range of enzymatic activity and cytotoxicity, that corresponds to the 2-3 degree dysbacteriosis and shows microbiological parameters infected wound which required sanation. CONCLUSION: Application for transendoscopic sanation of gastroduodenal ulcers of new compounds iodine-lysozyme, dimexide-iodine-lysozyme and chitosan with bactericidal and sorption effects, can significantly reduce the time of ulcer healing and restore normobiocenosis of mucosal microflora of the gastroduodenal zone.

[Treatment of disbacteriosis of gastroduodenal mucous microflora in mucosa inflammation, ulcer and erosion].

AIM: To propose pharmacotherapy of disbacteriosis of gastroduodenal mucous microflora in gastroduodenal inflammation, erosion and ulcer. MATERIAL AND METHODS: The study enrolled 30 healthy volunteers, 130 ulcer patients and 36 patients with chronic gastritis (27% of the latter had chronic duodenitis). In addition to general clinical examination, fibrogastroduodenoscopy, we made histological and microbiological examinations of biopsy specimens of the mucosa from different parts of the stomach and duodenum, determined sensitivity of the microflora to antibacterial drugs. RESULTS: We found that recurrent ulcer, chronic gastritis and duodenitis are accompanied with overgrowth of pathogenic microflora in gastric and duodenal mucosa. CONCLUSION: We developed an effective method of the treatment of gastroduodenal mucosa microflora disbacteriosis in gastroduodenal inflammation, erosion and ulcer including antibacterial, antifungal drugs and probiotics.

[Helicobacter pylori as a part of microbiocenosis of mucosal microflora esophago-gastroduodenal zone in the norm and pathology].

UNLABELLED: AIM; Revealing the level and significance of Helicobacter pylori (H. pylori) in the normobiocenosis and disbacteriosis of mucosal microflora in the osophagogastroduodenal zone. MATERIAL AND METHODS: Qualitative and quantitative composition of the mucosal microflora was defined in biopsy specimens from different parts of oesophagus, stomach and duodenum in addition to clinical and histological examination in 50 healthy volunteers, 106 ulcer duodenum patients, 24 patients with gastric ulcer, 36 with chronic gastritis and 24 with chronic oesophagitis. RESULTS: H. pyloril is involved into normomicrobiocenosis of the mocosal microbiota and take part of main defensive function of gastroduodenal tract. Excerbation of peptic ulcer, chronic gastritis and oesophagitis is accompanied with the reduction H. pylori in most cases, though the scar formation occurs both with and without presence of H. pylori. CONCLUSION: The colonization of the oesophagogastroduodenal zone by H. pylori has no infection process and play the independent role in the development of the ulcer disease, gastritis and oesophagitis and does not require the eradication.

[Dysbacteriosis of mucosal microflora of the gastroduodenal zone in inflammatory and ulcer lesions: diagnosis and classification].

AIM: To study mucous (parietal) gastroduodenal microflora in healthy persons, patients with ulcer and chronic gastritis, to develop diagnostic criteria and classification of gastroduodenal dysbacteriosis. MATERIAL AND METHODS: Biopsy specimens were obtained from gastroduodenal mucosa of 134 patients with ulcer, 36--with chronic gastritis and 28 healthy subjects. The mucous microflora agents were isolated microbiologically from biopsy specimens obtained from different compartments of the stomach and duodenum. The spectrum of their enzymatic activity and cytotoxic properties were determined. RESULTS: Gastroduodenal mucous microflora of healthy subjects was represented with 1-2, less often with 3-4 cultures of 12 species, enzymatic activity spectrum of microorganisms was small, cytotoxicity was absent. In ulcer recurrence and exacerbation of chronic gastritis gastroduodenal zone showed dysbacteriosis characterized by overgrowth of mucous microflora (up to 22 species of microorganisms) with a wide spectrum of enzymatic activity and cytotoxic properties. The criteria of dysbacteriosis diagnosis and classification are proposed. CONCLUSION: The role of gastroduodenal mucous microflora in ulcer and gastritis course is specified. New approaches to effective treatment of gastroduodenal diseases may be developed with consideration of dysbacteriosis.

[Ulcer recurrence and gastroduodenal dysbacteriosis]. / Retsidiv iazvennoi bolezni i disbakterioz gastroduodenal'noi zony

The studies that were conducted for 82 patients with ulcer established that 22 genera of microorganisms including H. pylori in a combination from 2 up to 8 various microbial cultures can be secured from the biopsy of the mucous coat of the pre-ulcer zone at the acute phase of recurrence. They have high enzymatic and cytotoxic activity. This draws together microbiological characteristics of the ulcer defect with parameters of the infected wound and corresponds to dysbacteriosis of the third degree. The data obtained form the basis for considering that the exacerbation of ulcer is accompanied by expressed dysbiotic shifts depending on the recurrence phase. It is necessary for taking this into account in the development of methods of adequate therapy for the disease aimed at the suppression of the excess growth of mucous microflora and restoration of normal microbiocenosis in the gastroduodenal zone.

[Microflora of the gastroduodenal zone and morphological characteristics of phases of recurrent peptic ulcer]. / Mikroflora gastroduodenal'noi zony i morfologicheskaia kharakteristika faz retsidiva iazvennoi bolezni.

The studies conducted for 126 patients with stomach and duodenal ulcers revealed that at the acute state of recurrent ulcer activation of the microflora displaying pathogenetic signs and corresponding to the third or fourth degree of dysbacteriosis takes place in the ulcerous defect zone along with microcirculatory disorders, necrotic inflammatory processes and reduction of the lysozyme content in tissues. This allows comparing ulcers of the gastroduodenal zone to an infected wound. At the sub-acute phase of recurrent ulcer (next one or two weeks) microbiological changes in the per-ulcer zone reduce to dysbacteriosis of the second or third degree as inflammatory and necrotic processes cease, an at the phase of cicatrisation and epithelization they are similar to normal biocenosis.

[Microflora of the peri-ulcer zone in patients with ulcer disease and its sensitivity to antibacterial agents]. / Mikroflora periul'tseroznoi zony u bol'nykh iazvennoi bolezn'iu i ee chuvstvitel'nost' k antibakterial'nym preparatam.

The investigations carried out on 126 patients with ulcer disease has shown that from bioptates of periulcer mucosa it is possible to elicit 21 kinds of microorganisms including H. pylori, in quantity 2.8-5.76 lg KOE in 1 gr of bioptate in a combination from 2 to 6 various microbial cultures. They have hemocatheretic, lecithin, urease, gelatinous, DRNA, RNA, katalase activity and cytotoxic properties, what makes the microbiological characteristics of ulcer defect close to parameters of contaminated wound. The given circumstance allows to conclude that in treatment of ulcer relapse it is necessary to suppress the activity not only H. pylori, but also another high pathogenic microbial flora. The testing of various antibacterial medications to microorganisms of periulcer zone has shown, that Ampicillin had the greatest effect in a combination with Gentamicin or Ofloxacin.

[Trans-endoscopic treatment of recurrent gastroduodenal ulcers by a combination therapy with lysozyme, molecular iodine and poly-iodides]. / Transéndoscopicheskoe lechenie retsidiva gastroduodenal'nykh iazv kompleksnym coedineniem lizotsima s molekuliarnym iodom i piliiodidami.

Pathogenesis substantiation and clinical efficiency of transendoscopic treatment of the patients with gastroduodenal ulcers relapse by lysozyme compound with molecular iodine and polyiodides are presented in this paper. The relapse of peptic ulcer was accompanied by lysozyme decrease and helicobacter's sowing increase in stomach and duodenal mucosa, as well as activity mucosa flora increase, especially in periulcer's region. This fact has drown near ulcer's defect and infected wound. Significant microbicidal and sorptional effects to the revealed strains of microorganisms, mucous membrane barrier properties increase and shortening of the peptic ulcer's scarring time on 8 days were demonstrated after transendoscopic treatment of the peptic ulcer with iodine lysozyme 3-4 times.

[Properties and clinical application of quasi-liquid form of lysozyme]. / Svoistva i klinicheskoe primenenie kvazizhidkostnoi formy lizotsima.

The course of transendoscopic quasi-liquid form of lysozyme treatment of the relapse of peptic ulcer was microbiologically and clinically substantiated. A high antimicrobial and sorption activity of the quasi-liquid form of lysozyme with respect to the microflora isolated from the mucous membrane of the stomach and the duodenum was shown. The transendoscopic introduction of this form of lysozyme significantly reduces the time of the cicatrization of ulcers and the stay of patients in the hospital.

[The microflora of ulzerous zone mucosa in patients with duodenal ulcer]. / Mikroflora slizistoi obolochki ul'tseroznoi zony bol'nykh iazvennoi bolezn'iu dvenadtsatiperstnoi kishki.

Bacteriological study of the biopsies taken from gastric and duodenal mucosa of 10 healthy volunteers and 74 patients with duodenal ulcer, was carried out. In the gastroduodenal zone of healthy subjects microorganisms of 6 genera (Streptococcus, Candida, Staphylococcus, Bacillus, Helicobacter and Lactobacillus) were detected. H. pylori was isolated in 20% of cases only in biopsy specimens taken from the antral section of the stomach of healthy as monoculture or in combination with C. albicans. In patients with duodenal ulcer activation of opportunistic microflora was observed in the periulcerous zone. More often H. pylori occurred in associations with fungi of the genus Candida, streptococci, staphylococci, enterobacteria, Pseudomonas and other microorganisms (of more than 30 genera). Quantitatively the dominating microorganisms (3.8-5.7 lg CFU/g) were H. pylori, fungi of the genus Candida, bacteria of the genera Streptococcus, Peptostreptococcus, Bacteroides, Gemella, Prevotella, Veillonella, Peptococcus, Bacillus, different species of opportunistic enterobacteria, as well as bacteria of the genera Staphylococcus, Micrococcus, Corynebacterium, Neisseria, Pseudomonas, etc. Opportunistic bacteria detected in the ulcerous zone, as a rule, expressed hemolytic, lecithinase, RNAase, caseinolytic, catalase and urease activity. Sonicated filtrates of such cultures produced a cytotoxic effect on cells HEp-2. Ulcer is an infected wound that needs sanitation.

[Chronic gastritis from the aspect of a thrombohemorrhagic syndrome]. / Khronicheskii gastrit v aspekte trombogemorragicheskogo sindroma.

As many as 148 patients were examined to demonstrate that chronic gastritis (CG) runs its course in the presence of marked changes in microcirculation and hemostasis which go into the framework of the chronic recurrent thrombohemorrhagic syndrome. The manifestations of the latter one were more appreciable in a dramatic exacerbation of the disease, erosive gastritis, diffuse atrophy of the mucous membrane and secretory insufficiency of the stomach, and disease standing over 10 years. The disorders indicated are involved into the pathogenesis of CG and promote the development of morphofunctional alterations in the gastric mucosa.