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138 patients with chronic papillooditis were investigated, 15 of them in a stage of decompensation. In 83.3% of the cases, the diagnosis was not clinically determined (including 68 of 92 endoscoped before their hospitalization--82.9%). 34 patients were diagnosed as having chronic gastroduodenitis, 15--ulcer, 42--chronic cholecystitis, 11--chronic pancreatitis, 4--cholangitis, 9--postcholecystectomic status. All these diseases developed simultaneously with the papillitis. In a second endoscopic check-up with an examination of papilla Vateri, the patients were in all the cases diagnosed without difficulties and the diagnose was confirmed by biopsy. In 21 patients there was confirmed primary papillooditis and in 127--accompanying disorders: chr. gastroduodenitis--29, chr. atrophic gastritis--18, ulcer--15, chr. cholecystitis--42, postcholecystectomic status--9, choledocholithiasis--14, chr. pancreatitis--11. Most often misdiagnosis occurs if: 1) during the routine endoscopic investigation the endoscopist does not examine papilla of Vater; 2) chr. papillitis exists simultaneously with one of the already mentioned diseases that are easier of approach for diagnostics and explanation of the disorders; 3) the clinical picture of papillitis cannot be differentiated from the one of the basic or accompanying disease; 4) the bile drainage is not prevented; 5) the result of the venous biligraphy does not lead to the diagnosis and ERCP is carried out only in a case of a clinical suspicion.

Amyloidosis is characterized by organic dysfunction as a result of deposition of amyloid substance in the walls of the small blood vessels and extracellularly in different organs. The involvement of the kidneys in systemic amyloidoses AL and AA has irreversible evolution to renal failure. The object of the study was to determine the prevalence of the secondary (reactive) systemic amyloidosis AA in combination with primary glomerulonephritis (PGN) and lupus nephropathy (SLE) and to create diagnostic approach for its early detection. The prevalence of amyloidosis among the renal biopsies in the Department of Nephrology by the Chair of Internal Diseases for the period 1981-1988, retrospectively, is 4% (in 11 out of 268 biopsies). For the period 1989-1996, prospectively, by directed quest, amyloid was found in 35 out of 269 renal biopsies (11%). For differentiation of AA preliminary treatment of the histologic material with KMnO4 was used. In 20 cases amyloidosis appeared as independent finding in the renal tissue, while in 15 it was combined with histologic picture of immune nephropathies: in 11 with primary glomerulonephritis (7% out of 155 PGN) and in 4 with systemic lupus erythematodes (11% out of 31 SLE). The combination of PGN with AA was almost always associated with chronic infections. It was most often observed in diffuse membranous GN or FSGSH. Our studies demonstrate increased prevalence of amyloidosis among the renal biopsies during the last years, which could be due to directed quest, but it could be a real fact, too. We suggest staining for amyloid in all renal biopsies, as well as its directed quest in mucosae of the gastro-intestinal tract and by aspiration of the abdominal subcutaneous fatty tissue in the patients with primary GN or systemic diseases.

Among the pathogenetic mechanisms for the occurrence of gastroesophageal reflux disease, Helicobacter pylori infection is indicated. The conclusions are absolutely opposite. The object of our work was to assume ex juvantibus to what extent the eradication of the Helicobacter pylori infection would accelerate the healing of patients with reflux oesophagitis and would reduce the number of relapses. To investigation were submitted 42 patients with reflux oesophagitis with confirmed Helicobacter pylori infection, classified according to Savary-Miller. A group of 22 patients was treated 10 days with triple drug combination of omeprazole, amoxillin and metronidazol with the purpose of eradication of the infection, after which they continued with ranitidin up to 30 days, and a second group of 20 patients treated only with ranitidine for 30 days. The subjective complaints, endoscopic finding and present infection were followed up. A considerably higher number of recovered patients after eradication of the Helicobacter infection was established and the number of relapses for the six-month period of observation was considerably reduced.

Some quantitative and qualitative changes, occurring in the tuberculous endemic during the last years are being analyzed. The analysis of the indices for the dynamics of the tuberculous endemic during the last years in our country reveals that the control of tuberculosis should take in consideration the following facts: 1) the increase of the morbidity will continue; 2) the increase of the morbidity disease is on behalf of the pulmonary tuberculosis. The causes in our country, which play role in the increase of the morbidity, are clarified. To detailed consideration are submitted the diagnostic problems, which are posed by the mycobacterioses in general and by the mycobacterioses and tuberculosis in HIV infection and AIDS.

The European Association for the Study of the Liver (EASL) International Consensus on Hepatitis C made by 72 experts in hepatology, epidemiology and virology at the EASL Consensus Conference, Paris, February, 1999 and confirmed by the 34th EASL Annual Meeting, Naples, 8-12 april 1999, is widely reviewed. Some newest and more effective strategies for treatment of the chronic viral hepatitis C were discussed during the Naples EASL meeting. Higher doses interferons (interferon-alpha or consensus interferon) plus ribavirin (or combination ribavirin and amantadine) for a longer period--12 months, improved efficacy of the treatment of chronic hepatitis C. An ultrarapid HCV clearance by daily hgh-dose interferon-alpha induction therapy in the start of the management plus ribavirin was achieved and discussed in naive patients and in nonresponders to standard therapy. A gene therapy by an effective genetic vaccine against HCV infection was widely discussed, too. Hepatitis C is an enormous present and future health burden to the world. Not until 2010, the most of therapeutic problems in patients with chronic persisted HCV infection would be resolved.

For a period of 7 years the dental status of 160 patients has been investigated and followed. These patients have been treated with calcium channel blockers and selected in age between 22 and 50 years. Their diagnoses are: m. hypertonicus I-II stage--106, WPW-syndrome--10, stenocardia--18, atrial extrasystolia--26. Duration of treatment--from 1 to 7 years (corinfar, nifedipin, adalat--tabl. 40 mg, taken peroral or chewed, respectively suck; isoptin, verapamil--tabl. 40 mg, diltiazem--tabl. 30 mg, taken peroral. A control group of 60 clinically well people at age from 20 to 48 years was investigated. Under continuous treatment with calcium antagonist (> 1 year) the examined patients are found to have considerable decalcination of the dental enamel and caries more frequent (87.5%) compared to the group of clinically healthy people (65%), also increased number of caries in the same patient in comparison to his dental status before starting the therapy in 108 of 160 (67.5%). The differences in the results are statistically significant (p < 0.001). The number of the discovered caries in patients treated with calcium channel blockers and in the studied groups is also large (4 to 2 on average, i.e. two times more). The results allow to recommend a continuous stomatological control for patients treated with calcium antagonists.

As the main target of influenza viral aggression, the respiratory tract is subject to easier bacterial infection superimposition. The researchers from Les Laboratoires Servier--France, managed to isolate a substance--fusafungine--from the microspore of the fungus Fusarium lateritium, which demonstrates unique anti-inflammatory and antibiotic action, and is the active ingredient of Bioparox Spray, an inhalant. The principal indications of Bioparox Spray for treatment of respiratory tract infections fall within the range from the sinuses to the finest alveolar duct, namely: rhinitis, sinusitis, tonsillitis, pharyngitis, laryngitis, tracheitis and bronchitis. In terms of technology Bioparox is unique due to the fact that 90% of the aerosol particles are less than one micron large, while generally the particles needed for penetration through the alveolar duct should be less than three microns. Due to such micronization, after inhalation Bioparox Spray reaches from the sinuses to the finest bronchial branches. Bioparox Spray possesses sound and broad antibiotic spectrum of action on the most common causative agents of respiratory infections, and more over, it acts upon Candida albicans, unlike the remaining broad-spectrum antibiotics. Bioparox Spray also has an independent anti-inflammatory effect by blocking the inflammation mediators: Bioparox Spray inhibits the synthesis of free radicals and the action of IL1 and TNF as pro-inflammatory factors, and it potentiates the action of IL2 and interferon-gamma which are anti-inflammatory factors. By its dual antibiotic and anti-inflammatory action Bioparox Spray is an excellent alternative to the conventional antibiotic therapy.