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Background: Candida sp are frequently isolated from the ascitic fluid of patients with perforated ulcers. The present study was performed to examine whether Candida infection may be involved in the process of ulcer perforation., Methods: Male Wistar rats were divided into a saline group (n = 15) and a Candida group (n = 17). Cysteamine-HCl (Sigma; 31 mg/100 g) was administered thrice on day 1 to both groups of animals. Candida albicans at a density of 10(8) in 0.5 mL of saline was administered 1 h before, and 12 h and 24 h after the first administration of cysteamine in the Candida group., Results: Perforated duodenal ulcers were observed in 94.1% of the rats in the Candida group, but only 26.7% of the rats in the saline group (P < 0.01). The area of the duodenal ulcers in the Candida group was 40.89 +/- 33.07 mm2, whereas that in the saline group was 16.53 +/- 20.4 mm2 (P < 0.05). The mortality rate was significantly higher in the Candida group than in the saline group. In the Candida group, colonization by C. albicans was recognized at the ulcer base, surrounded by marked granulocytic infiltration. The number of eosinophils infiltrating the ulcer base was also significantly greater in the Candida group than in the saline group. Immunohistochemical analysis revealed the expression of secretory aspartyl protease (SAP) in the region of the ulcer showing colonization by C. albicans in the Candida group., Conclusion: Candida albicans aggravates duodenal ulcer perforation in the experimental model of cysteamine-induced duodenal ulcer perforation. The present findings suggest that SAP and host-parasite relationships, including granulocyte-dependent mechanisms, may be involved in the aggravation of ulcer perforation by C. albicans.

On the basis of investigations designed to study the condition of intragastric proteolysis and membrane digestion in the small intestine in 148 patients it has been found out that peptic ulcer is accompanied by enhancement of digestive processes in the stomach and by decrease thereof in the small intestine. With the development of peptic ulcer complications digestive disorders get aggravated, which fact leads to various manifestations of the enteral syndrome. A conclusion has been reached that study into intragastric proteolysis and membrane digestion can be useful in the objective evaluation of the activity and degree of severity of the ulcerous process as well as in the functional assessment of results of the treatments administered.

It is often difficult to differentiate acute pancreatitis (A.P.) from some other acute abdominal diseases, when there is an elevated serum amylase. In contrast, the renal clearance of amylase, expressed as a percentage of creatinine clearance, can separate patients with A.P. from patients with acute colecistitis, common duct stone without pancreatitis, hyperamylasemia after biliary surgery, acute peptic ulcer and acute salivary diseases.

The amylase:creatinine clearance ratio in patients suffering from acute pancreatitis or acute duodenal perforation was higher than normal in both groups of patients. These findings cast doubt on the value of this parameter as a specific index of acute pancreatitis. The mechanism or mechanisms underlying the increased amylase excretion have not been determined. However, the markedly elevated urinary excretion of lysozyme observed in some patients suggests, by analogy, that diminished tubular reabsorption of amylase may contribute towards the elevated amylase:creatinine ratio.

Investigation of the state of intraventricular proteolysis and membraneous digestion in the small intestine in 148 patients revealed that ulcer disease is accompanied by potentiation of the digestive processes in the stomach and their reduction in the small intestine. With appearance of complications of ulcer disease, the disorders of digestion deteriorated. This resulted in different manifestations of the enteral syndrome. It is concluded that examination of the intraventricular proteolysis and membraneous digestion may be used for objective evaluation of the activity and grade of severity of the ulcer process as well as for functional evaluation of treatment results.