The road to ruin: the formation of disease‐associated oral biofilms

Oral Diseases (2010) 16 , 729–739 The colonization of oral surfaces by micro‐organisms occurs in a characteristic sequence of stages, each of which is potentially amenable to external intervention. The process begins with the adhesion of bacteria to host receptors on epithelial cells or in the salivary pellicle covering tooth surfaces. Interbacterial cell–cell binding interactions facilitate the attachment of new species and increase the diversity of the adherent microbial population. Microbial growth in oral biofilms is influenced by the exchange of chemical signals, metabolites and toxic products between neighbouring cells. Bacterial cells on tooth surfaces (dental plaque) produce extracellular polymers such as complex carbohydrates and nucleic acids. These large molecules form a protective matrix that contributes to the development of dental caries and, possibly, to periodontitis. The identification of key microbial factors underlying each step in the formation of oral biofilms will provide new opportunities for preventative or therapeutic measures aimed at controlling oral infectious diseases.     

Surgical treatment of "difficult" gastric ulcers]

In surgical treatment of "difficult" ulcers of the stomach including ulcers of the proximal part of the stomach, giant ulcers (more than 3 cm in diameter) and multiple ulcers it is expedient to use resection of the stomach with the formation of functionally active anastomosis. The choice of the operative method is determined by specific features of the ulcerous process, morphofunctional state of proximal parts of the gastrointestinal tract which determines the individual character of the operative intervention. The use of such operative interventions has reduced the postoperative lethality to 0.9%. Complex examinations have established excellent and good results (by the Visick scale) at remote terms after operation in 95.2% of the patients.     

Young Malaysian children with lower respiratory tract infections show low incidence of chlamydial infection

Objective: The incidence of Chlamydia pneumoniae and Chlamydia trachomatis infection was studied among infants and young children admitted to hospital for the management of lower respiratory tract infections, over a 12 month period.
Methodology: Respiratory secretions were examined for chlamydiae by cell culture, enzyme-linked immunosorbent assay and polymerase chain reaction-enzyme immunoassay. Sera were tested by micro-immunofluorescence for chlamydial IgG, IgM and IgA. Other bacterial and viral pathogens were also looked for by standard cultural and serological methods.
Results: Of 87 patients aged 2 months-3 years, an aetiologic diagnosis was made in 41 (47.1%). C. pneumoniae and C. trachomatis were each detected in 1 (1.2%) of the patients. Among common bacterial pathogens, Haemophilus influenzae (13.8%) and Streptococcus pneumoniae (8.1%) were the most frequently identified. Respiratory viruses and elevated Mycoplasma pneumoniae antibodies were found in 10.3% and 9.1% of patients, respectively.
Conclusion: Chlamydiae are infrequent causes of community-acquired acute lower respiratory tract infections in infants and very young children in Malaysia.     

Sphincter-valve gastroduodenal anastomosis in surgery of stomach ulcer

A method of gastroduodenoanastomosis has been developed which allows exclusion or considerable reduction of the pathological effect of the duodenogastric reflux upon the gastric stump mucosa after distal resection of the stomach in patients with gastric ulcer. Complex examinations of the patients after operations have shown that the developed by the authors sphincter-valvular gastroduodenoanastomosis facilitates the rhythmic-portion evacuation of the gastric contents and prevents the reflux of the duodenal contents into the gastric stump.     

Surgical treatment of gastric and duodenal ulcer disease with chronic duodenal obstruction

One hundred and twenty-nine surgeries were performed from 1990 to 2001 for gastric (50) or duodenal (79) ulcers with chronic duodenal obstruction. Resection of 1/2 of the stomach by Bilrot-I was performed in 118 patients, pylorus-saving resection with creation of areflux valve in duodenal bulb--in 5, selective proximal vagotomy with duodenoplasty--in 6 patients. In early postoperative period complications were seen in 10 (10.9%) patients, postoperative lethality was 0.8% (one patient died). There was no insufficiency of anastomotic sutures. Postoperative stay was 11.3 +/- 1.5 days. In remote period after surgery symptoms of chronic pancreatitis was in 2.3% patients, but there were no symptoms of duodenostasis. Roentgenological symptoms of compensated duodenal obstruction were seen in 2 patients operative on for decompensated duodenostasis. These patients had no complaints.