[Comparative assessment of the strength properties of the mucous membrane of the stomach in patients with peptic ulcer and the effect of quamatel on ulcer cicatrization in experiment].

The article reviews the research work of the authors on the strength properties of the mucous membrane of the stomach in patients with peptic ulcer and in experiment with quamatel application. Experiments were performed in laboratory animals and resected stomachs of patients with duodenal or stomach ulcer and complications requiring scheduled surgical treatment. The results of the research into the maximum tension (durability) of the stomach mucous membrane, antrum, and the periulcer area are described. For both localizations of the ulcer, the mucous membrane of the antrum was found to exhibit the least durability, while the highest durability was exhibited by the mucous membrane of the periulcer area. In the case of bulbar ulcer, the durability of the mucous membrane was shown to decrease with an increase in the number of aggravations. An inverse relationship between the strength properties and the intensity of hydrochloric acid production was observed.

Sucrose concentration in blood: a new method for assessment of gastric permeability in horses with gastric ulceration.

A urine sucrose test has recently been reported to be a reliable method of detecting gastric ulcers in horses; however, technical difficulties associated with urine collection have limited the practical value of the test. The objective of this pilot study was to determine whether gastric sucrose permeability, as evaluated by serum sucrose concentration, could be used to detect gastric mucosal injury in horses. Twelve adult horses with naturally acquired gastric ulceration were studied. After a 20-hour nonfeeding period, each horse was dosed with 250 g of sucrose via nasogastric intubation. Blood samples were collected at 0, 15, 30, 45, 60, and 90 minutes, and horses underwent gastroscopy 4 hours later. The severity of gastric ulceration in each horse was defined by means of a 4-point ulcer-scoring system, and the relationship with serum sucrose concentration was analyzed by means of a linear mixed-effects model. Serum sucrose concentration was measured by liquid chromatography operating in tandem with electrospray mass spectrometry. After nasogastric administration of table sugar, horses with moderate to severe gastric ulceration had significant increase in serum sucrose concentration at 30, 45, 60, and 90 minutes, relative to earlier times (P < .05). Peak sucrose concentration was observed at 45 minutes, and was correlated with ulcer severity (Spearman's rank correlation coefficient = 0.898, P < .05). These data indicate that determination of sucrose concentration in equine serum may be a useful test for identifying horses with endoscopically visible gastric ulceration and has potential use as a noninvasive method for screening and monitoring horses engaged in racing training and other performance-related disciplines.

Endoscopic assessment of mucosal hemodynamic changes in a canine model of gastric ulcer.

In studying the side effects of sclerosants injected into the gastric submucosa in dogs (N = 7), we noted that 3 ml of absolute ethanol induced a large gastric ulceration. We describe the time course of change in the ulcer size, and suggest that such ulceration can be used for the endoscopic assessment of factors important in ulcer genesis and healing. Endoscopic reflectance spectrophotometric measurement of indices of mucosal hemoglobin concentration (IHB) and oxygen saturation (ISO2) were performed in a separate group of dogs (N = 4) with ethanol-induced gastric ulceration. We found a significant difference (p less than 0.05) in IHB and ISO2 immediately before (97 +/- 8 and 37 +/- 3, respectively) and after (138 +/- 7 and 21 +/- 5, respectively) the ethanol injection. At 24 hours after the ethanol injection, the IHB at the lesion margin (141 +/- 14) was significantly higher (p less than 0.05) than that at the adjacent mucosa (101 +/- 4), whereas the ISO2 measurements were not significantly different in these two locations, 34 +/- 2 and 31 +/- 2, respectively. We conclude that (1) injection of 3 mol of absolute ethanol into the submucosa of the canine stomach provides an animal model of gastric ulceration in which the ulcer can be examined repeatedly with the aid of the endoscope; (2) in this ulcer model, ischemia with congestion (increases IHB, decreases ISO2) precedes the development of gross mucosal ulcerations; and (3) the margin of the established ulceration in this model exhibits hyperemia (increases IHB, normal ISO2) which mimics that of a healing gastric ulcer.

[A comparative assessment of gastric secretory function using a probe method and intragastric Ph-metry]. / Sravnitel'naia otsenka sekretornoi funktsii zheludka, izuchaemoi zondovym metodom i intragastral'noi Ph-metriei.

To compare informative value of probing and intragastric pH-metry, relevant examination was performed in 130 patients with chronic gastritis, 132 patients with noncomplicated peptic ulcer and 50 healthy subjects. pH values obtained with probing and intragastric pH-metry did not differ significantly in defects of gastric mucosa, superficial gastritis, peptic ulcer. In apparent atrophic gastritis intragastric pH-metry detected minimal secretion of H ions in all the patients, whereas probing failed to show it. Intragastric pH-metry is useful in recognizing duodenogastric reflux and decompensated acid stomach as shown by antral basal pH (below 2.0).

In vivo assessment of precursor induced prostaglandin release within the rat gastric lumen.

Gastroprotection associated with the intragastric administration of prostaglandin (PG) precursor fatty acids such as linoleic (LA), gamma-linolenic (GLA), and arachidonic acid (AA) has been reported to be mediated via their conversion to PGs. This report examines the relationship between gastroprotection and the extent/rate of PG-release in rats intragastrically administered PG biosynthetic precursors: LA, AA, dihomo-gamma-linolenic acid (DHGL) or oleic acid (OA, a nonprecursor fatty acid). At various times following intragastric administration of a fatty acid, gastric fluid was collected, extracted, chromatographed, and assayed for PGE1 or PGE2 by specific radioimmunoassay. AA and DHGL dose dependently elevated gastric PGE2 and PGE1 levels, respectively. Maximal PGE elevation, 200-400 ng/stomach, was over 400-fold above basal values, and observed within 5-10 minutes of administration. Conversely, OA and LA elicited only a minor (2-10 fold) stimulation of PGE release. In contrast to effects on PG release, all four fatty acids protected the gastric mucosa against macroscopic damage induced by ethanol. The apparent rank order of potency was AA greater than DHGL = LA greater than OA (the difference in potency between DHGL or LA and OA was not significant). Since LA and OA (a nonprecursor) only marginally elevated lumenal PGs relative to DHGL or AA, yet were equally efficacious in the gastroprotection assay, it is likely that other fatty acid-related mechanisms play an important role in protecting the stomach against ethanol-induced injury.

Current status of argon laser hemostasis of bleeding ulcers.

Endoscopic argon laser photocoagulation has been extensively studied in animals. Clinical pilot studies and randomized controlled trials have demonstrated that argon laser endoscopic hemostasis is both safe and efficient. Specific guidelines for successful endoscopic hemostasis have been determined. The limitations of the argon laser for emergency hemostasis are a strong absorption by blood, its expense and lack of portability, the inability to tamponade or to treat tangentially, and the vaporization potential. The Nd:YAG laser shares all these limitations except that it is less absorbed by blood. Because of these limitations, GI lasers are at present being used less for emergency hemostasis than for elective tumor ablation. Some new, non-laser, thermal devices which do not have these limitations have been developed. They are currently being evaluated in randomized trials. Perhaps because of these factors, the good results obtained with lasers for emergency hemostasis of bleeding ulcers have not been translated into clinical practice at most hospitals.

[Clinical assessment of pyloric sphincter function in different variants of denervation]. / Klinicheskaia otsenka funktsii privratnikovogo sfinktera pri razlichnykh variantakh ego denervatsii.

A comparative evaluation of the function of pylorus sphincters was made on the basis of clinical examination of 152 patients after operations performed by the methods of A. E. Zakharov (in 31 patients), A. A. Shalimov-Maki (in 31 patients) and by the author's method (in 90 patients). The variant of the author's operation where only the extraorganic nerve connections were preserved proved to be better in functional respect since no disturbance of the motor-evacuation function took place.