[Knee pain: choosing the right imaging]. / Gonalgies: quelle imagerie?

Gonalgia is a frequent reason for consultation of a primary care physician. The road leading to diagnosis is mainly clinical. A detailed medical history and physical examination are capital for establishing diagnostic hypotheses and choosing the most appropriate imaging test. Initially, a simple X-ray of the knee joint is the most common exam, even though it is not always needed, especially after a minor trauma. MRI and CT-scan allow a more detailed examination of the structures; however, they should only be ordered to answer a specific question. Most of the time, echography is reserved to extra-articular pathologies and for guiding an articular tap.

Endovascular treatment of infected aortic aneurysms.

OBJECTIVE: To report on the short- and long-term outcomes of patients with primary infected aortic aneurysm (IAA) treated by stent graft (SG) in two centers. MATERIAL AND METHOD: Over a period of 15 years, 32 patients with IAA underwent endovascular treatment. None had undergone previous aortic surgery. The causal relationship was gastrointestinal infection in 9 patients (28%), endovascular diagnostic/therapeutic procedures/resuscitation in 6 (19%), wound infection after previous surgeries in 5 (16%), urinary infection in 4 (13%), urology or gastroenterology procedures in 3 (9%), pancreatitis in 2 (6%), endocarditis in 1 (3%) and phlebitis in 1 (3%) patient. We implanted 11 bifurcated, 10 tubular thoracic, 4 aorto-uni-iliac, 4 tubular abdominal and 1 iliac SG. Two other surgeries were hybrid procedures. RESULTS: The etiological agent was identified in 28 (88%) patients. Twenty-six (81%) patients survived the 30-day postoperative period. Sixteen (50%) survived to 1-year follow-up and 13 (40.6%) survived to 3-year follow-up. Three patients have survived for less than 1 year and a further 3 for less than 3 years, so far. Among patients with aneurysms situated in central parts of the thoracic and infrarenal aorta there was a better death/survival ratio than among patients with a proximal or distal aneurysm location. CONCLUSION: The implantation of a SG may be an alternative to open surgery in selected groups of patients with primary IAA. Aneurysms of the central part of the thoracic or abdominal aorta have a more favorable prognosis with endovascular treatment.

[Changes in the true and false visceral segment lumen sizes following endovascular treatment of type B aortic dissections]. / Zmeny velikosti pravého a falesného lumen ve viscerálním segmentu po endovaskulární lécbe disekcí aorty typu B.

INTRODUCTION: The aim of the study was to assess technical success rates of endovascular procedures in acute and chronic type B aortic dissections and changes in the right (PL) and false (FL) lumen diameters in the visceral segment region during short-term and long-term follow up study periods. METHODS: From 2004 to 2009, the authors performed a prospective study, which included a total of 33 patients with acute and subacute (n = 16; 48.5%) or chronic (n = 17; 51.5%) type B dissections of the descending aorta, with dissections spreading as far as the visceral or infrarenal regions. The patients underwent successful implantations of stent grafts (SG) into the descending aorta. The study group included 7 female and 26 male subjects, at the time of the procedure, their mean age was 59 years, (34-70, the median of 56 y.o.a.). The mean follow up time was 39.3 months (8-68, the median of 41 months). During the study period, one of the patients exited due to another internal disorder, three subjects were converted to open replacements for progressing dilatation of the total diameter in the visceral or subrenal region. The true (PL) and false (FL) lumen diameters were measured at four levels: above the origin of truncus coeliacus (L 1), between the origin of truncus coeliacus and the origin of a. mesenterica superior (L 2), between the origin of a. mesenterica superior and the origin of aa. renales (L 3) and just distal to the origin of aa. renales (L 4). The measurements were performed 1 and 6 months after SG implantations and at the end of the study period. RESULTS: The primary entry was successfully sealed in all the study subjects. Significant widening of the true lumen in the region sealed by the stentgraft was recorded in all the subjects, however, the false lumen did not completely disappear in 3 (9%) patients. The false lumen was completely filled with thrombus down to the celiac trunk level (L 1) within one month in 7 (21.2%) patients, within 6 months in 14 (42.4%) subjects and by the end of the study period in 19 (58.6%) patients. The true lumen continued to enlarge at all the measured levels. The most significant enlargement was recorded at L 1 during the first postoperative month (the mean change of 5.9 mm). Furthermore, narrowing of the originally patent false lumen was observed as well, with the most significant change at L1 level during the first postoperative month (the mean change of 6.5 mm). At six months and during the whole follow up study period, further increases in the right lumen diameter and in the total aortic diameter were recorded at all the measured levels. At the same time, the false lumen diameters at all the measured levels continued to narrow, if patent at all. CONCLUSION: False lumen thrombosis along the extent of SG was recorded in 30 (91%) patients, SG filled the lumen completely and the false lumen disappeared. The true lumen expanded at all the measured visceral segment levels. The change was most significant during the first postimplantation month, and the true lumen expansions and the false lumen narrowing proceeded over the whole follow up study period, however, the progression was slower. The visceral segment true and false lumen changes will be monitored further.

[Prevention of type II endoleak using postoperative coiling of the abdominal aortic aneurysm sac during stent graft implantation]. / Prevence endoleaku II. typu pomocí peroperacního coilingu vaku aneuryzmatu abdominální aorty behem implantace stentgraftu.

AIM: A prospective randomized study assessing the success rates of type II endoleak (EL) prevention, using postoperative coiling of the abdominal aortic aneurysm (AAA) sac during stent graft (SG) implantation. MATERIAL AND METHODS: From January 2008 to July 2009, 86 patients were operated for AAA using endovascular methods with bifurcation SG. The subjects were prospectively randomized into two subgroups. Group A subjects (42 subjects; 48.8%) had various numbers of coils introduced into the sac, close to the SG body. Group B (44 subjects; 51.2%) included patients without coils. Preoperative CT angiograhy (CT AG) was used to assess patency and the number of lumbal arteries (AL), a.mesenterica inferior (AMI), a. sacralis mediana (ASM) and aa. renales accessoriae (ARA), the AAA sac and the lumen size. At the end of the studied period, existence of type II EL and the AAA sac size was assessed using sonography and /or CT AG. RESULTS: Prior to the procedure, there were only minor differences in the number of source type II EL arteries (AL 3.8 vs. 3.5; AMI 0.78 vs. 0.55; ASM 0.26 vs. 0.3; ARA 0.095 vs. 0.05), preoperative AAA sac size (68.6 vs. 67.0 mm) and the lumen size (47.6 vs. 40.0 mm), the AAA sac size at the end of the studied period (63.9 vs. 62.1 mm) and its mean size change (-4.7 vs. -4.9 mm), between the Group A and B, respectively . Postoperatively, the type II EL was detected in 6 subjects in Group A (14.3%), and in 9 subjects in Group B (20.5%). At the study endpoint, the type II EL was identified in 4 subjects in Group A (9.5%), in 8 subjects in Group B (18.2%). CONCLUSION: Peroperative introduction of coils into the AAA sac is one of the options for type II EL prevention. It facilitates successful regression and disappearance of type II EL.

Nuclear factor-κB - importance, induction of inflammation, and effects of pharmacological modulators in Crohn's disease.

Crohn's disease (CD) is a chronic inflammatory disease of unknown etiology that covers the entire digestive tract and occurs with periods of remission and clinical exacerbation. CD is most common in North America and Europe, but its incidence is rising rapidly in Asian countries. The pathogenesis of CD is unclear, while genetic predisposition, immune imbalance, and host-intestinal microbiota interactions are taken into account. Incorrect activation of κB nuclear factor (NF-κB) signaling pathways is associated with CD initiation and progression. NF-κB leads to excessive production of pro-inflammatory cytokines that cause a chronic inflammatory process of the intestines. It is currently believed that the NF-κB pathway plays a key role in the pathogenesis of CD, hence current treatments aim to block this pathway. Studies have shown that activation of NF-κB is reduced by treatment with, among others, mesalazine and glucocorticoids. This review presents epidemiology and pathogenesis of CD, the participation of NF-κB in this disease, as well as modern methods of treatment aimed at inhibiting NF-κB activation.

Serum galectin 3, galectin 9 and galectin 3-binding proteins in patients with active and inactive inflammatory bowel disease.

Galectins are lectins involved in physiological processes such as cell proliferation, apoptosis and migration, immune responses, inflammation, signalling, and angiogenesis. This study assessed the serum levels of galectin-3 (Gal-3) and galectin-3 (Gal-9) and galectin 3 binding protein (Gal-3BP), and evaluated their associations with the clinical characteristics and levels of inflammatory markers in patients with inflammatory bowel disease (IBD). A total of 48 patients with ulcerative colitis (UC), 77 with Crohn's disease (CD), and 30 healthy volunteers participated in the study. Complete blood counts, C-reactive protein, fibrinogen, albumin, glucose, creatinine, Gal-3, Gal-9, and Gal-3BP were measured. The median Gal-3 and Gal-9 levels did not differ between patients and controls. The median level of Gal-3BP was significantly higher in patients with CD than in controls (8084.6 (5637.8 - 11494.4) ng/ml versus 5962.2 (5280.15 - 7247.92) ng/ml, P = 0.02). No significant differences in Gal-3, Gal-9, and Gal-3BP between active and inactive CD and UC subgroups were found. The median Gal-3BP was higher in subgroups with active CD than in controls (8175.9 (5736.4 - 12871.62) ng/ml versus 5962.2 (5280.15 - 7247.92) ng/ml, P = 0.004). Our results showed that serum Gal-3 and Gal-9 should not be considered biomarkers of IBD. Despite not being a specific marker for CD, serum Gal-3BP might be used as an adjuvant biomarker for disease activity. However, further studies using a larger cohort are required to confirm its clinical usefulness.

[Urgent endovascular management of the thoracic aorta dissection and subsequent lower extremity ischemia]. / Akutní endovaskulární rerení disekce hrudní aorty a následné ischemie dolních koncetin.

SITUATION: Insertion of tubular stentgrafts in the management of acute type B dissection of the thoracic aorta has recently become a popular alternative to open surgeries. The classical surgical procedure in complicated dissections is associated with mortality rates of up to 50% and prolonged intensive care hospitalization. However, endovascular procedures have been associated with significantly lower morbidity and mortality rates. There is insufficient experience with the stentgraft implantation outcome concerning both the septum dissection and the lumini. CASE REVIEW: A tubular stentgraft has been implanted to a forty-nine-year-old patient with acute, type B dissection. Immediate ischemic and neurological complications, requiring reoperation and prolonged intensive care, were recorded postoperatively. The causes and the management are discussed. CONCLUSION: Endovascular management of the type B dissection is a popular, more patient-saving and healthcare professionals-saving procedure, compared to classical open surgery. Pressure changes in the true and false aortic lumen may result in rapid reduction of the organ and limb perfusion flow. These complications should be expected and must be managed urgently. Such surgeries should be performed in clinical centres with appropriate facilities.

Comparison of sucralfate and ranitidine in gastroprotection against alcohol in humans.

This endoscopic study was designed to assess histologic and functional features of human gastric mucosal injury by 40 percent ethanol, and to compare the gastroprotective effects of sucralfate with those of ranitidine or sucralfate combined with ranitidine against ethanol damage. A group of 16 young subjects with normal gastric mucosa were divided into two groups (A and B). Group A was pretreated for four days with either sucralfate alone (1 g four times per day) or placebo (one tablet four times per day). Group B received sucralfate (1 g four times per day) plus ranitidine (150 mg three times per day) or placebo plus ranitidine in a double-blind, randomized study. On the fifth morning, two hours after the last treatment, 100 ml of 40 percent ethanol spray was applied via an endoscope onto gastric mucosa. In placebo-treated subjects, ethanol caused widespread endoscopic damage (score = 2.43) with histologic disruption of surface epithelium and deep necrotic lesions accompanied by a decrease of mucosal potential difference from -41.3 to -15.8 millivolts. Pretreatment with sucralfate significantly reduced endoscopic damage (score = 0.75). The surface epithelium was disrupted, but necrotic lesions were greatly reduced and potential difference decreased to -27.1 millivolts. Ranitidine alone or combined with sucralfate did not prevent ethanol-induced histologic or functional changes in the mucosa. Ethanol produces pronounced mucosal damage that can be almost completely prevented by sucralfate.

Endoscopic and histological appearance of pancreatic metaplasia in the human gastric mucosa: a preliminary report on a recently recognized new type of gastric mucosal metaplasia.

Recently a new type of gastric mucosal metaplasia referred to as pancreatic metaplasia (pancreatic acinar metaplasia) has been recognized. The difference is characterized by the presence of epithelial cells with the cytoplasm strongly basophilic in the basal compartment, whereas in the middle and apical portions it is acidophilic and finely granular. In contrast to intramuscular heterotopic pancreas, foci of pancreatic metaplasia are located in the lamina propria of the gastric mucosa. They form lobules, small clusters, or may be single. The present series included 13 cases of pancreatic metaplasia found in gastroscopic specimens obtained from seven women and six men. We investigated the histological pattern and endoscopic changes. Based upon clinical data it was found that in five patients the gastric mucosa was defined as 'dichromatic'. It is possible that studies involving greater numbers of patients will permit closer correlation between the histological pattern of pancreatic metaplasia and the corresponding endoscopic changes.

Vehicle crashworthiness ratings in Australia.

The paper reviews the published vehicle safety ratings based on mass crash data from the United States, Sweden, and Great Britain. It then describes the development of vehicle crashworthiness ratings based on injury compensation claims and police accident reports from Victoria and New South Wales, the two most populous states in Australia. Crashworthiness was measured by a combination of injury severity (of injured drivers) and injury risk (of drivers involved in crashes). Injury severity was based on 22,600 drivers injured in crashes in the two states. Injury risk was based on 70,900 drivers in New South Wales involved in crashes after which a vehicle was towed away. Injury risk measured in this way was compared with the "relative injury risk" of particular model cars involved in two car crashes in Victoria (where essentially only casualty crashes are reported), which was based on the method developed by Folksam Insurance in Sweden from Evans' double-pair comparison method. The results include crashworthiness ratings for the makes and models crashing in Australia in sufficient numbers to measure their crash performance adequately. The ratings were normalised for the driver sex and speed limit at the crash location, the two factors found to be strongly related to injury risk and/or severity and to vary substantially across makes and models of Australian crash-involved cars. This allows differences in crashworthiness of individual models to be seen, uncontaminated by major crash exposure differences.

[In vivo and vitro study of prostaglandins E2 and I2 participation in protective function of antacids on gastric mucosa]. / Badania in vivo i in vitro nad udzialem prostaglandyny E2 i I2 w ochronnym dzialaniu alkaliów na blone sluzowa zoladka.

Antacids apart from neutralization of hydrochloric acid possess the gastro-protective properties. In this paper, performed in vivo and in vitro, we studied the effects of antacids (aluminium and magnesium hydroxides) on secretion of PGE2 and 6-keto-PGF1 alpha (a stable metabolite of PGI2) by the gastric mucosa and isolated gastric mucosal cells of rats. We studied protective effects of these drugs on the gastric mucosa and isolated cells as well. It was shown that antacids stimulate generation of PGE2 and PGI2 in the gastric mucosa and protect it against alcohol-induced damage. Indomethacin given prior to antacids in a dose (1 mg/kg) which did not cause any gastric mucosal changes but inhibited generation of both prostaglandins, abolished protective effects of antacids. In comparison with control, surface epithelial cells of the gastric mucosa isolated from the stomachs of rats which were treated with antacids earlier, secreted significantly more PGE2 and PGI2, and were less damaged after incubation with 8% alcohol. Indomethacin inhibited secretion of prostaglandins by isolated surface epithelial cells of the gastric mucosa and abolished protective effects of antacids on these cells. The study confirms both in vivo and in vitro the protective properties of antacids and shows that prostaglandins participate in their action.

[Protective effect of alkalies on ethyl alcohol-damaged gastric mucosa]. / Wplyw ochronny leków alkalizujacych na uszkodzona alkoholem etylowym blone sluzowa zoladka.

A few recent reports suggest the protective effect of antacids against gastric mucosal injury. This study was aimed to examine the influence of some antacids on ethanol induced gastric mucosal damage in rats. We have found that Polish antacids (Alugastrin, Gelatum Aluminii Phosphorici, Gastrin) and calcium carbonate diminished gastric mucosal lesions produced by ethanol. Moreover, Alugastrin and Gelatum Aluminii Phosphorici decreased volume of gastric contents, and its pH, as well as lowered sodium, potassium and protein levels and decreased LDH activity in gastric contents. These findings indicate that antacids protect rat gastric mucosa against injury caused by ethanol. We have found also that aspirin given prior to Alugastrin abolished the protective ability of Alugastrin. This suggest that prostaglandins might be involved in antacid cytoprotection. Our studies indicate that antacids can be used prophilactically in the gastric mucosal injuries.

[A clinical trial on the effect of aluminum containing antacids on the course of duodenal ulcer healing and morphology of the gastric mucosa]. / Badania kliniczne nad wplywem glinowych leków alkalizujacych na przebieg gojenia wrzodu dwunastnicy i stan blony sluzowej zoladka.

We carried out the controlled, double-blind clinical study on the effect of antacids containing aluminium on the healing of duodenal ulcer (DU) and the morphology of gastric mucosa in 153 patients with duodenal ulcer disease. The patients were treated for 4 weeks with either dihydroxyaluminium-sodium carbonate (Alugastrin) or aluminium and magnesium hydroxides (Alumag) and for comparison with ranitidine or placebo. The clinical usefulness of antacids were assessed according to the following criteria: ulcer healing ratio, disappearance of ulcer pain, drug tolerance both subjective and objective (biochemical analyses) and drug effect on the gastric mucosa (endoscopy, histology and morphometry). The results were compared with results obtained from ranitidine treated patients. We have shown that both antacids speed up the DU healing similarly to ranitidine (71%, 75% and 79% respectively) and significantly better than placebo (47% of cases). All administered drugs diminished subjective symptoms of patients and were well tolerated. Dihydroxyaluminium-sodium carbonate and aluminium and magnesium hydroxides as well as ranitidine were without any trophic effects on the gastric mucosa. Thus, despite differences in the pharmacological action (antacids are gastroprotective drugs, ranitidine inhibits HCl secretion), antacids are similarly effective to ranitidine in the treatment of DU patients. However, ranitidine is more comfortable for the patients and better accepted in the long-term treatment.

[The effect of selected cytoprotective drugs on alcohol-induced injury of isolated gastric mucosa cells]. / Wplyw wybranych leków cytoprotekcyjnych na uszkodzone alkoholem izolowane komórki blony sluzowej zoladka.

There were performed experimental study on the effect of Al(OH)3, 16,16dmPGE2, indomethacin, verapamil and calcium ionophore A 23157 on alcohol-induced injury of isolated gastric mucosal cells of rat. In the first step a dose dependent alcohol injury of isolated gastric mucosal cells was shown. The most susceptible cells to alcohol damage were parietal cells. 16,16dmPGE2 and verapamil (calcium channel inhibitor), except Al(OH)3, were cytoprotective--they protected surface epithelial cells against alcohol. Indomethacin and calcium ionophore A 23157 (increases the calcium influx into the cell) aggravated the alcohol damage to gastric cells. The results show important role of prostaglandin and calcium ions in the mechanism of gastric mucosal cell damage and indicate the lack of direct influence of antacids on these cells in vitro, in conditions independent of microcirculation and neurohormonal factors.

[Morphology of the gastric mucosa in patients with duodenal ulcer treated with bismuth-containing drugs]. / Stan morfologiczny blony sluzowej zoladka u chorych z wrzodem dwunastnicy leczonych preparatami bizmutowymi.

The aim of this study was the effect of antacids containing inorganic bismuth compounds on the morphology of the gastric mucosa and healing of the duodenal ulcer (DU) in patients with exacerbation of the ulcer disease. 169 patients were treated for four weeks with low-dose antacids (two drugs containing bismuth subnitrate--Gastrin and Wikalina, with buffering capacity below 200 mmol HCl per day) and for comparison with ranitidine, colloidal bismuth subcitrate and placebo. We evaluated the effect of these drugs on the morphology of gastric mucosa using endoscopic, histologic and morphometric methods, as well as healing of DU, ulcer symptoms and drug tolerance. Antacids and colloidal bismuth subcitrate decreased both the chronic active gastritis of praepyloric region and frequency of Helicobacter infection, however without the full eradication. Antacids, ranitidine and colloidal bismuth subcitrate did not affect the height of surface epithelium, thickness of foveolar and glandular mucosa as well as the number and size of parietal cells, thus they were without any trophic effects on the gastric mucosa. All mentioned drugs healed DU in 68-73% of patients and significantly better than placebo (46%). These drugs were well tolerated by patients, however antacids caused slight increase in pH of urine and transient hipermagnesemia. Because the etiopathogenese of ulcer disease is still unclear, its therapy is unsuccessful in many cases. We should stress that the treatment with antacids in some cases can be a good and safe alternative therapy in spite of many other currently used medications.

[Barrett's metaplasia]. / Metaplazja Barretta.

Reflux oesophagitis is a chronic disorder with one important complication--Barrett's esophagus, which is also called Barrett's metaplasia (BM). It is not known why only a part of the patients develops BM. In BM the normal squamous mucosa of the esophagus is replaced by columnar epithelium of intestinal type. BM is frequently diagnosed during endoscopical examination, particularly in man over 60 years of age with symptoms of heartburn. This type of epithelium is a recognized risk factor of the esophageal adenocarcinoma. The incidence of this carcinoma is increasing in the last years. Based on the literature, we review the current pathogenesis, rules of diagnosis, surveillance and treatment of BM as well as the problem of connections between BM and esophageal adenocarcinoma.

Effect of sucralfate on the normal human gastric mucosa. Endoscopic, histologic, and ultrastructural assessment.

Twelve healthy volunteers were given a single sucralfate tablet (1 gm) orally. For 60 min after ingestion they were examined endoscopically for the localization and disintegration of the tablet in the stomach, and biopsies were taken to determine the effect of sucralfate on the histology and ultrastructure of the normal gastric mucosa. After ingestion, the sucralfate tablet had disintegrated and firmly adhered to a relatively small mucosal area of the greater curvature covering 5 +/- 2 and 7 +/- 2 cm2 at 15 and 30 minutes, and 9 +/- 3 cm2 at 60 minutes after drug ingestion. Histologic and ultrastructural examination of the mucosa in direct contact with sucralfate revealed distinct changes in the surface epithelial cells: mucus release, vacuolization, and exfoliation of some of the cells. Endoscopy offers a unique opportunity for the study of gastroduodenal effects and disposition of orally administered drugs.

[The effect of pentagastrin on calcium ion concentration in gastric juice]. / Wplyw pentagastryny na stezenie wapnia w soku zoladkowym.

Calcium concentration in gastric juice is lower then other electrolytes. The mechanism of its transport remained unknown. The aim of the study was to evaluate influence of pentagastrin on calcium concentration in gastric juice in humans. Ten patients were examined (4 females and 6 males, mean age 46.8 range 33-67), four with duodenal ulcer, three with achalasia cardiae and three with Addison-Biermer anemia. Pentagastrin--PG (Cambridge Laboratories, Newcastle, United Kingdom) was injected subcutaneously after overnight fast in dose of 6 micrograms/kg of body weight. Nosogastric tube was located in body of the stomach near large curvature and connected to suction of--40 mmHg pressure. Gastric juice was collected during subsequent five 15 minutes periods (first fasted and four periods after stimulation with PG). Calcium concentration was measured in each sample by fluorescentic titration method with EGTA. Statistic analysis was performed with student "t" test. Mean fasted and stimulated calcium concentrations were 0.83; 0.44; 0.54; 0.37 and 0.95 mmol/l respectively. Ca2+ concentration range in fasted state from 0.21 to 1.75 mmol/l and from 0.07 to 0.27 mmol/l by maximal stimulation. Calcium concentration decreased immediately after stimulation (significance p = 0.0025). This strong effect persisted throughout the period of stimulation. Calcium output was 0.064; 0.029; 0.032; 0.018 and 0.17 mmol/15 min respectively. Two phases of decrease of the calcium output were observed: first, fast decrease immediately after pentagastrin injection and second, slower, between 30 and 45 minute after stimulation (p < 0.01 and 0.02 respectively). Calcium concentration in gastric juice decreases after stimulation with pentagastin (p = 0.0025). Calcium concentration was lower in Addison-Biermer anemia and higher in duodenal ulcer patients then in healthy control. We conclude that calcium ions are not actively secreted by gastric mucosa. Their presence in gastric juice is a result of leak from mucosal cells and remains opposite to their metabolic activity.

Prostaglandin protection of the human gastric mucosa against alcohol-induced injury. Endoscopic, histologic, and functional assessment.

UNLABELLED: We studied whether pretreatment with prostaglandin (16,16-dimethyl (dm) prostaglandin E2) may protect the human gastric mucosa against alcohol-induced injury. Healthy volunteers received (via an endoscope) intragastric pretreatment with either: A) placebo or B) 16,16 dm prostaglandin E2, 1 microgram/kg, and 15 min later 40 ml 60% alcohol was sprayed directly on gastric mucosa. STUDIES: endoscopic appearance of the gastric mucosa was evaluated and scored (scale 0-5) by two investigators, gastric mucosal potential difference (PD) was continuously recorded, and mucosal biopsies were obtained at 30 min after alcohol for histologic examination. Alcohol instillation in subjects pretreated with placebo (group A) produced within 30 min prominent endoscopic hemorrhagic lesions (grade 4.8 +/- 0.2). Histologic examination showed exfoliation of the surface epithelium, extensive edema of lamina propria, and deep hemorrhagic necrotic lesions in 86% +/- 10 of specimens. These morphologic changes coincided with a sudden drop in gastric PD of 42 mV. Prostaglandin pretreatment (group B) significantly reduced alcohol-induced endoscopically visible lesions (grade 3.1 +/- 0.2, P less than 0.01 vs group A). Histologically, prostaglandins reduced deep hemorrhagic erosions (4.5-fold reduction) and subepithelial hemorrhages, but did not prevent exfoliation of the surface epithelium and gastric PD drop. Thus, prostaglandin administration to human volunteers effectively reduced alcohol injury to the gastric mucosa.

[Studies on the effect of Krynica mineral water from the "Zuber" spring on alcohol-damaged gastric mucosa in rats]. / Badania nad wplywem krynickiej wody mineralnej ze zródla "Zuber" na uszkodzona alkoholem blone sluzowa zoladka szczurów.

The study was performed to investigate the protective effect of mineral water "Zuber", "Zuber" with "Jan" and an antacid on the alcohol induced gastric mucosal injury in rats. It was shown that Alugastrin, a hyperosmotic liquid antacid, protects rat gastric mucosa against alcohol. In opposite, a hyperosmotic and alkaline mineral water "Zuber" increases a vulnerability of the gastric mucosa and worsen the damaging effect of alcohol on it. Izoosmotic mixture of mineral waters "Zuber" and "Jan", similarly to a physiologic saline, do not protect rat gastric mucosa. The study show that mineral waters "Zuber" and "Zuber" with "Jan" have a short-lasting neutralizing effect on the gastric HCl and in opposite to antacids have not protective properties on gastric mucosa.