Alterations in secretion and fine structure of histamine stimulated stomach mucosa following administration of oestrogens

The observation that benign peptic ulceration is less common in females during the reproductive period and the suggestion that oestrogens have an inhibiting effect upon the activity of carbonic anhydrase led us to investigate volumetric and ionic (H+, K+, NA+, C1-.) changes in gastric secretion and also the fine structural changes in gastric oxyntic cells following administration of oestrogens. Fifteen male dogs after 24 hour fasting were anaesthetised with ketalamine hydrochloride and then subjected to a constant i.v. infusion of histamine phosphate, (approx. 14ug/Kg/hour). Twelve dogs underwent truncal vagotomy and ligation at the distal oesophagus. Gastric secretions were collected at 20 minute intervals via a tube introduced into the most dependant part of the stomach through a duodenotomy. The pylorus was ligated around the tube. Approximately 3 hours later, when three consecutive specimens were similar in volume, 4mgm/Kg Premarin (Eguine conjugated oestrogens) was injected i.v. into ten dogs. Further specimens were collected for three hours. Gastric mucosal biopsies were taken from three histamine stimulated dogs before and after injection of Premarin 4mgm/Kg. and were prepared for electron microscopy. The mean hourly volumes of secretion diminished at one, two and three hours after Premarin (ANOVA F 4.5; d.f. 3:33; p< 0.05) with an inhibition of 65.3 percent of the mean pre-Premarin value observed at the third hour. There was a significant rise in the mean pH one hour after Premarin in P<0.05, however, after this there was no significant variation. There was an apparent rise in the mean sodium concentration in the first two hours with a statistically significant rise at three hours after Premarin p<0.05. No significant changes were observed in the mean Potassium or Chloride concentration. The comparison of fine structure of 40 oxyntic cells, 20 before and 20 after Premarin injection, showed an apparent reduction in numbers of canaliculi, with lengthening of the canalicular microvilli. Except for the absence of demonstrable effects on Potassium and on cytoplasmic micro-vesicles these results are comparable with reported findings after inhibition of carbonic anhydrase by acetazolamide (AU)

Haemodynamic studies in eleven patients before and during peritoneoscopy - abstract

The peritoneoscopy was performed under general anaesthesia in 9 cases and under local anaesthesia in 2 patients. Dye dilution studies and measurements of arterial blood pressure and pulse rate were done at 4 stages: 1. with patient awake 2. with patient anaesthetized (did not apply in local anaesthesia) 3. immediately after peritoneal insufflation of nitrous oxide, and 4. during the peritoneoscopy. With peritoneal insufflation there was a fall in cardiac output, mainly due to a reduction in stroke volume. There was also an increase in the circulation time. Most patients reponded to these changes in venous return by an increase in systemic vascular resistance and pulse pressure, with variable changes in mean arterial pressure, stroke work decreased following peritoneal insufflation. This indicates that the fall in stroke volume caused no compensatory rise in mean arterial pressure. Most patients showed a reversal of these changes during the next 10 to 15 minutes while peritoneoscopy was in progress (AU)

Birth weight in Jamaican twins

The birth weights of infants delivered in 100 uncomplicated twin pregnancies in Jamaica are discussed in relationship to gestational age, maternal age, parity of the mother, infant's sex, zygosity and birth order (AU)

Effects of oestrogens on carbonic anhydrase activity in human and canine gastric mucosa. The role of carbonic anhydrase inhibitors in the treatment of peptic ulcer - abstract

Carbonic anhydrase which is present in abundance in the mammalian gastric mucosa is concerned with the production of hydrochloric acid. The aim of the present study was to determine whether oestrogens had any effects on the activity of this enzyme in the gastric mucosa of man and dogs. Biopsies were taken from the body of the stomach of 20 male duodenal ulcer patients, 10 of whom had a pre-operative course of diethylstilboestrol. Ten male dogs were used in the animal experiments. Immediately after a biopsy was taken from the anerior wall of the stomach, midway between the cardiac end and the pylorus, 40 mg of equine conjugated oestrogens were injected intravenously in the dogs. Thirty minutes later a second specimen was collected from a site adjacent to the first one. The homogenate obtained from the mucosal layer of each specimen was used for the estimation of its carbonic anhydrase activity by the colorimetric method of Philpot and Philpot. Reaction times were also noted for various dilutions of pure hyophilized carbonic anhydrase. On the basis of a two-tailed test using a 't' distribution it was found that there is a significant difference in the results before and after injection of equine conjugated oestrogens and between the stilboestrol treated patients and the controls. A mean inhibition of 43.5 percent was achieved in man and 21.2 percent in dogs. One patient who was 14 weeks pregnant had an inhibition of 63.4 percent compared with the controls. Truelove and other workers were convinced that ulcer patients experienced symtomatic relief when put on a course of stilboestrol. Similar results were reported in dogs. On the basis of the present work the oestrogens seem to be carbonic anhydrase inhibitors and hence can account for the regular occurrence of hypochlohydria during pregnancy and the lower incidence of peptic ulcer in women of the child-bearing age. Although acetazalamide has been found to reduce the severity of ulcer symptoms, this beneficial action was overshadowed by a concomitant production of persistent acidosis and tingling and numbness in the fingers. The use of carbonic anhydrase inhibitors for the treatment of peptic ulcer merits further investigations. An ideal drug would be a non-feminizing steroid with good peptic ulcer healing powers (AU)

A case of widespread endometriosis and review of the literature

An unusual case of endometriosis is reported and the literature briefly reviewed (AU)