摘要:

SUMMARYThe presence of ammonium in gastric contents was described in 1852; urease activity in the stomach was identified 70 years later. The discovery of gastric urease resulted in intense research activity to discover its origin, function, and relation to the gastric levels of ammonium and urea. Interest in urease waned in the 1960s as most pertinent questions appeared to have been addressed and there was strong evidence that gastric urease was not a property of the stomach but was of microbial origin. Identification ofHelicobacter pylorias the source of urease in the stomach in the last decade has resulted in a rebirth of interest in gastric urease and its products.1–15There is little actual evidence to support a role for toxicity of ammonia in relation toH. pyloriand the bulk of the evidence suggests that the products of urease activity are not toxic and may even be beneficial. The purpose of this review is to examine the older literature and to examine‐ new findings in the perspective of what is already known and to suggest areas remaining to be examined. We ask, ‘What is old, what is new, and what needs to be

ISSN:0269-2813    

DOI:10.1111/j.1365-2036.1992.tb00730.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

SUMMARYIn parallel studies, the effects of 5‐aminosalicylic acid (5‐ASA) and acetyl‐5‐aminosalicylic acid (acetyl‐5‐ASA) on peroxidation of red‐cell membrane lipids and production of prostaglandins by peripheral blood mononuclear cells were assessed. 5‐ASA at concentrations of 10‐5, 10‐4and 10‐3msignificantly inhibited erythrocyte lipid peroxidation, measured as malondialdehyde production, by 20%, 56% and 63%, respectively, (P<0.05,P<0.002,P<0.001, respectively) while acetyl‐ 5‐ASA had no effect. 10‐5and 10‐4m5‐ASA significantly increased production by stimulated peripheral blood mononuclear cells of PGE2(by 31% and 30%,P<0.01,P<0.05, respectively) and PGF2α(by 30% and 25%,P<0.05,P<0.01, respectively). 10‐4M 5‐ASA also significantly stimulated prostacyclin production measured as 6KF1αby 10% (P<0.05). At 10‐3M 5‐ASA there were significant falls in 6KF1α(by 37%) PGE2(by 45%) and PGF2α(by 47%) (P<0.01,P<0.001,P<0.001, respectively) although this was accompanied by a decrease in cell viability. Acetyl‐5‐ASA had little effect upon prostaglandin production. 5‐ASA scavenges free radicals and stimul

ISSN:0269-2813    

DOI:10.1111/j.1365-2036.1992.tb00731.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

SUMMARYPaired studies were carried out on 12 healthy male subjects to compare the effect of intravenous doses of the 5‐HT1‐like agonist sumatriptan (GR43175; 3 mg), 10 mg metoclopramide and saline control on the rate of gastric emptying of a radiolabelled liquid test‐meal. Intravenous administration of metoclopramide accelerated gastric emptying by decreasing the lag period, while intravenous administration of sumatriptan delayed gastric emptying by increasing the lag period. The observation that sumatriptan causes a delay in gastric emptying in normal healthy volunteers, but relieves nausea and vomiting during migraine attacks, suggests that sumatriptan may be acting via a central mechanism to relieve symptoms of nausea and vomiting associated with mig

ISSN:0269-2813    

DOI:10.1111/j.1365-2036.1992.tb00732.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

SUMMARYForty‐seven healthy male subjects were studied twice using a randomized, placebo‐controlled design. Each subject took an 8‐day course of two of the following four regimens; 300 mg ranitidine, 800 mg cimetidine, 40 mg famotidine or placebo (identical either to 300 mg ranitidine or 800 mg cimetidine). The systemic bioavailability of ethanol (integrated 6‐h plasma ethanol concentration, peak plasma ethanol concentration, and the time to peak plasma ethanol concentration) was measured after the oral ingestion of 0.8 g of ethanol per kg body weight, given one hour after an evening meal on Day 8 of each regimen.There was no significant difference of integrated 6‐h plasma ethanol concentration, peak ethanol concentration, or time to reach peak ethanol concentration after dosing with either ranitidine, cimetidine or famotidine o

ISSN:0269-2813    

DOI:10.1111/j.1365-2036.1992.tb00733.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

SUMMARYWe have investigated colonic drug absorption in man by the caecal instillation of a multi‐component solution of atenolol, cimetidine, frusemide, hydrochlorothiazide and salicylic acid. We found that salicylic acid absorption from this solution was delayed but complete whereas the absorption of atenolol, cimetidine, frusemide and hydrochlorothiazide was four‐ to five‐fold lower than expected from oral bioavailability st

ISSN:0269-2813    

DOI:10.1111/j.1365-2036.1992.tb00734.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

SUMMARYThis study investigated the influence of ranitidine on mucosal injury and gastric bleeding in 20 normal volunteers taking 600 mg aspirin q.d.s. This study was a double‐blind placebo controlled crossover study comparing ranitidine, as 150 mg b.d., 300 mg q.d.s. and 600 mg b.d. with placebo. Gastric mucosal injury was assessed at unsedated endoscopy by counting haemorrhagic and non‐haemorrhagic erosions; bleeding was measured in gastric washings. Aspirin alone increased mucosal injury from 0 to 11.4 erosions (mean,P<0.01) and bleeding from 1.77 to 9.11 μl blood/10 min (meanP<0.001). Ranitidine prophylaxis reduced bleeding to 5.34, 3.18 and 3.47 μl/10 min with 150 mg b.d., 300 mg q.d.s. and 600 mg b.d. respectively (overall effect of ranitidineP<0.001) and also reduced haemorrhagic erosions though it had no effect on the total number of erosions. Ranitidine is effective at reducing aspirininduced gastric bleeding and whilst not reducing aspirin‐induced gastric erosions, it does reduce the number that appear haemorrhagic. Ranitidine may have a role in the prophylaxis of aspirin‐induced gastric

ISSN:0269-2813    

DOI:10.1111/j.1365-2036.1992.tb00735.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

SUMMARYForty‐five patients taking long‐term indomethacin and with endoscopic erosions or superficial ulcers in the oesophagus, stomach or duodenal bulb were randomized in a double‐blind study to continue with standard indomethacin or receive a ‘delayed‐release’ formulation. This consisted of microgranules of indomethacin coated with an acrylic resin, Eudragit L, which releases drug in the small intestine. Endoscopy was repeated after 8 weeks and biopsies taken on both occasions. Changes in endoscopic lesions and histological appearances were similar in both groups, although mucosal erythema was less in those given Eudragit L indomethacin. Systemic, rather than topical, effects of indomethacin may therefore be responsible for persistence of gastro‐duodenal mucosal lesions in these patients. There is reason to question the clinical practice of using expensive, delayed‐relea

ISSN:0269-2813    

DOI:10.1111/j.1365-2036.1992.tb00736.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

SUMMARYWe have used a postal questionnaire to obtain data on the practice of maintenance therapy for peptic ulcer disease by members of the British Society of Gastroenterology. Completed questionnaires were returned by 434 members. Ninety‐six per cent used maintenance therapy for patients with duodenal ulcer and 81 % for gastric ulcer. Maintenance therapy was considered to be safe (duodenal ulcer 91%; gastric ulcer 78%), acceptable to patients (duodenal ulcer gastric ulcer 89%; gastric ulcer 80%) and to reduce the incidence of ulcer complications (duodenal ulcer 81 %; gastric ulcer 68 %). There was consensus that increasing age of patient, current use of non‐steroidal anti‐inflammatory drugs, previous ulcer complications, and ulcer relapse after surgery were relatively strong indications for maintenance therapy. However, the proportion of patients who received maintenance therapy varied widely amongst respondents (from50%). There was no agreement on the optimal duration of therapy, nor on management of patients who relapsed during maintenance therapy. It appears that the criteria for use of maintenance therapy need to be better defined, and that established knowledge about the practice of maintenance therapy should be better disseminated and acted

ISSN:0269-2813    

DOI:10.1111/j.1365-2036.1992.tb00737.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

SUMMARYThe aim of this study was to determine whether patients' tolerance of upper gastrointestinal endoscopy is related to the dose of lignocaine spray used for oropharyngeal anaesthesia and to measure plasma concentrations at these doses. Sixty consecutive patients undergoing routine upper gastrointestinal endoscopy with sedation were randomized to receive lignocaine spray 50 mg (Group A), 100 mg (Group B) or 200 mg (Group C). Patient, endoscopist and endoscopy nurse were unaware of the variation in dose used. Each patient's tolerance of the intubation and of the remainder of the gastroscopy was assessed independently by the patient, endoscopy nurse, and endoscopist using a visual analogue scale. Plasma lignocaine concentration was measured at 20, 40, 60 and 80 min after administration of the spray. Fifty (83 %) patients were unable to recall either the intubation, or the procedure. On the endoscopy nurse's assessment, the patients in Group B tolerated the intubation better than those in Group A, and Groups B and C tolerated the remainder of the gastroscopy better than those in Group A. On the endoscopist's assessment, Groups B and C tolerated the remainder of the gastroscopy better than Group A. There were fewer gags per min in Groups B and C compared to Group A. Mean plasma Lignocaine concentrations showed a dose—dependent absorption of the spray, but none exceeded the potentially toxic level of 5 mg/

ISSN:0269-2813    

DOI:10.1111/j.1365-2036.1992.tb00738.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

SUMMARYIt is not known whether hypoxia, associated with upper gastrointestinal endoscopic procedures when midazolam sedation is used without narcotics, persists into the post‐procedure recovery period. Thirty consecutive patients aged over 60 years, undergoing ERCP using midazolam sedation alone, were monitored clinically and by pulse oximetry before, during and for 2 hours after the procedure. They were randomized prospectively to receive either 0.5 mg flumazenil or normal saline on extubation. Results show that patients were most hypoxic in the first 30 minutes after the procedure and that mean oxygen saturation had not returned to pre‐sedation values by 2 hours. Treatment with flumazenil increased alertness 2 minutes after the procedure, and was associated with a significantly higher arterial oxygen saturation at 15 minu

ISSN:0269-2813    

DOI:10.1111/j.1365-2036.1992.tb00739.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY