Gastric cytoprotection 30 years after its discovery by André Robert: a personal perspective.

It is generally accepted that the development of gastric mucosal injury and protection is a consequence of an imbalance between the existing aggressive and defensive factors in the gastric mucosa. The excess secretion of gastric acid and increased production of pepsin have been considered as the main etiological factors in the development of peptic ulcer diseases in humans. André Robert and his coworkers (Kalamazoo, Michigan, USA) identified a new pathway for the gastric mucosal protection against the gastric mucosal damage injury (e.g. from HCl, NaOH, NaCl, ethanol, or thermal injury) by small doses of prostaglandins (1-5 µg/kg given ig or sc), without presence of any gastric acid secretory properties in rats. This phenomenon was termed "gastric cytoprotection" (1979). The results of this basic research offered a lot of new possibilities to test this hypothesis in different experimental models under different experimental conditions, in both human healthy subjects as well as in patients with various gastrointestinal disorders (acute and chronic gastrointestinal inflammatory conditions in the stomach and intestines, as well as GI precancerous states, i.e., oesophageal, stomach, pancreatic, liver and colon cancers). An international symposium on "gastric cytoprotection: 30 years after André Robert's concept" was organized at Split (Croatia) on September 13, 2009, at which invited experts from China, Croatia, Italy, Japan, Poland, and USA gave presentations and discussed the studies performed in the field of cytoprotection between 1979 and 2009. This paper provides a short critical summary of this meeting in the context of an "official historic background" of the events underlying the discovery of "gastric cytoprotection" which originated from the pioneering work of André Robert.

[The role of Orvosi Hetilap in the development of Hungarian gastroenterology. Part 2: 1905-1944]. / Az Orvosi Hetilap szerepe a magyar gasztroenterológia kialakulásában - II. rész, 1905-1944.

UNLABELLED: The editions of Orvosi Hetilap published between 1857 and 1905 covered most of the contemporary aspects of digestive diseases. Most of knowledge was transferred from German, French and English literature. AIM: Evaluation of the papers dealing with the diseases of the gastrointestinal tract published in Orvosi Hetilap between 1905 and 1944. METHOD: The author manually reviewed the journal volumes published between 1905 and 1944. The original articles, journal and book reviews were identified and classified according to their subject and origin. The rate of publications of the editorial periods (1857 and 1904 vs 1905 and 1944) was statistically compared with that of certain historical periods (World Wars I and II, the years following the Trianon treaty). RESULTS: Between 1905 and 1944, a total of 1101 original articles were published about the diseases of the gastrointestinal tract, constituting 10.3% of the total publications. The rate of publications was decreased during World Wars I and II and the years following the Trianon treaty. The most studied diseases were that of the stomach and duodenum (21%), while hepatologic studies accounted for 16.4%. The proportion of basic science studies (anatomy, pathology, physiology) decreased to 3%. Endoscopy was studied in only 1.4% of the publications, while gastrointestinal radiology, as a newcomer, achieved a figure of 3.2%. 1695 publications were reviewed from 112 journals, constituting a significant increase as compared to the previous period. 74.6% of the reviews were published in 15 core journals. 57.1% of the journals were German, 19.6% were English/American and 16.9% French, showing the persistence of the major German influence. The number of book reviews slightly decreased from 116 to 95. Peptic ulcers were the most studied disease of the period and several alternative treatments were tried, all of which are now obsolete. CONCLUSION: The rate of gastroenterologic publications in Orvosi Hetilap increased considerably in 1905-1944, as compared to the prior period. The main sources of knowledge remained the German literature. Diseases of the stomach and duodenum, including peptic ulcers, were studied in most detail. The development of endoscopy was overshadowed by the emergence of radiology.

[One hundred years before: "the man with a hammer"]. / Ily a cent ans: l'homme au marteau.

Fragmented presentation of the "Poudres de Cock" and their famous adventiste claim: "the man with a hammer".

Treatment of ruminal indigestion according to popular belief in Sweden.

For hundreds of years, the Swedish peasantry were able to cure diseases of animals by using various popular remedies. In this context, ruminal indigestion is a disease of special interest to veterinary history. Long before research had demonstrated the importance for rumination of the ruminal microflora and microfauna, the Swedish peasantry used to administer living ruminal microorganisms from a healthy cow or sheep to an animal suffering from ruminal indigestion. This was performed by giving the diseased animal a cud obtained from the healthy animal. According to some beliefs, the cud was a living being. Those cherishing this belief therefore thought it wise to take only part of the cud so as not to harm the involuntary donor. Another common treatment of ruminal indigestion was based on the thought that the cow had lost the ability to chew. The authors describe the frequent use of chewing of various substances as a remedy. In the available literature, some forty different remedies have been described either alone or used in combination with the above principles.

[Crude drugs for curing internal injury (NeiShang) caused by improper diet or fatigue in "NeiWaiShangBianHuoLun" and "PiWeiLun"].

In "NeiWaiShangBianHuoLun," written by LiGao in the 13th century, internal injury (NeiShang) caused by emotional strain, improper diet and overwork was compared against external injury (WaiShang) caused by exogenous pathogenic factors. A combination of Aurantii Fructus Immaturus and A tractylodis Rhizoma is used for treating the feeling of stuffiness and fullness in the gastric region (Pi) due to improper diet. For treatment of general debility and lassitude due to emotional strain, improper diet and overwork, BuzhongYiqiTang was invented, in which the combination of Ginseng and Astragali Radix is used to activate and reinforce the Qi-deficiency of PiWei (vital energy or digestive function). LiGao recommended the combination of Bupleuri Radix and Cimicifugae Rhizoma for treating loose tissues due to Qi-deficiency, and to assist drugs for replenishing Qi such as Ginseng and Astragali Radix. These uses of crude drugs for curing internal injury (NeiShang) may be useful for treating modern deficiency syndrome in weak children with atopic disposition and persons with postoperative complications.

Retrograde jejunogastric intussusception.

Jejunogastric intussusception is an infrequently reported complication of gastroenterostomy. Prognosis and treatment are functions of the anatomic type (Shackman's classification). Gastroscopy and sometimes roentgenograms are the major diagnostic tools. Surgical treatment is required in the acute types where incarceration or strangulation occurs, and in the chronic types when function or quality of life is impaired.