ISSN:0012-2823    

DOI:10.1159/000201214

出版商:S. Karger AG    

年代:1995

数据来源: Karger

ISSN:0012-2823    

DOI:10.1159/000201293

出版商:S. Karger AG    

年代:1995

数据来源: Karger

摘要:

Various defence mechanisms are found in the oesophagus which can be elicited by reflux damage. Premucosal defence includes bicarbonate ions and epidermal growth factor (EGF) secreted by salivary and oesophageal glands. The mucosa can respond by increasing epithelial cell turnover and upregulating EGF receptor and endocytosis. The intercellular barrier can be increased by the contents of membrane-coating granules. Local pH can be regulated by carbonic anhydrase. The whole viscus can exhibit peristalsis to effect a mechanical clearance of the refluxed gastric and duodenal material.

ISSN:0012-2823    

DOI:10.1159/000201294

出版商:S. Karger AG    

年代:1995

数据来源: Karger

摘要:

Oesophageal Langerhans’ cells (LC) are bone marrow-derived dendritic cells situated suprabasally in most stratified squamous epithelia, such as the epidermis and the epithelium of oesophageal mucosa. LC function as antigen-presenting cells. Associated with relatively numerous intra-epithelial lymphocytes present in the normal state in oesophageal mucosa, they play a major role in the immunologic defense system of the oesophagus. Structure and role of LC are summarized in this review. Moreover, the implications of LC in different pathologic oesophageal reactions are discusse

ISSN:0012-2823    

DOI:10.1159/000201295

出版商:S. Karger AG    

年代:1995

数据来源: Karger

摘要:

Treatment with omeprazole plus amoxicillin or clarithromycin resulted in encouraging Helicobacter pylori cure rates in pilot and controlled studies. The present prospective, randomized study was designed to compare the efficacy and safety of amoxicillin and clarithromycin as constituents of omeprazole-enhanced antibiotic therapy of H. pylori infection. Fifty patients with active duodenal ulcer disease and histologically and/or culturally confirmed H. pylori colonization of the gastric mucosa were treated with omeprazole (day 1-14: 40 mg twice daily, day 15-42: 20 mg once in the morning). The patients were randomly assigned to receive either amoxicillin (1 g twice daily; group I: n = 25) or clarithromycin (500 mg twice daily; group II: n = 25) during the first 2 weeks of treatment. The patients of group I and II had comparable demographic and clinical characteristics. One patient of group I was lost to follow-up. H pylori infection was cured in 87.5% of group I and 84.0% of group II (p = 1.00). All ulcers had healed after 6 weeks of omeprazole treatment. Pain relief occurred within the first day of treatment in the majority of patients of both groups (p = 0.89). Minor side effects were recorded in 6 patients of group I and in 4 patients of group II (25 vs. 16%; p = 0.50). In 1 female patient amoxicillin had to be withdrawn after 3 days because of nausea and emesis. In conclusion, 2 weeks of treatment with omeprazole plus amoxicillin or clarithromycin are highly and equally effective regimens to cure H. pylori infection in patients with duodenal ulcer disease.

ISSN:0012-2823    

DOI:10.1159/000201215

出版商:S. Karger AG    

年代:1995

数据来源: Karger

摘要:

Histology of the human esophageal mucosa reveals numerous submucosal mucous glands, scattered along the esophagus and especially accumulated below the upper and above the lower esophageal sphincters. Mucin remains a major organic component of human esophageal secretion, collected using our newly developed esophageal perfusion catheter. Esophageal mucin is accompanied by nonmucin proteins, epidermal growth factor (EGF) and prostaglandin E2 (PGE2). Bicarbonate is the major inorganic component of esophageal secretion in humans. Mucosal exposure to an HC1/pepsin solution, mimicking the natural gastroesophageal scenario, significantly changed the secretory profile of all esophageal secretion components. The rate of secretion of esophageal mucin, EGF and PGE2 under the impact of HC1/pepsin in patients with reflux esophagitis appeared to be significantly impaired, although the basal rate of esophageal PGE2 output remained higher than in controls. These data indicate that a significant impairment in esophageal components of the preepithelial mucosal barrier, paralleling the severity of mucosal inflammation, may have a detrimental impact on the protective potential of the esophageal mucosal barrier, facilitating the development of reflux esophagitis.

ISSN:0012-2823    

DOI:10.1159/000201297

出版商:S. Karger AG    

年代:1995

数据来源: Karger

摘要:

Smooth muscle cells isolated from the circular muscle layers of the guinea pig caecum were used to determine whether endothelin-1 (ET-1) can cause contraction by exerting a direct action on smooth muscle cells. In addition, the inhibitory effects of 8-(N, N-diethylamino)-octyl-3,4,5-trimethoxybenzoate hydrochloride (TMB-8), an inhibitor of intracellular Ca2+ release, verapamil, a Ca2+ channel blocker, and removal of extracellular Ca2+ on the ET-1-induced muscle contraction were examined. ET-1 elicited a contractile response of isolated smooth muscle cells in a dose-dependent manner (ED50: 2 nM). TMB-8, verapamil, and removal of extracellular Ca2+ significantly inhibited the contraction produced by ET-1. These results strongly suggest that ET-1 has a direct contractile effect on circular smooth muscle cells of the guinea pig caecum, and that this contraction depends on both intracellular and extracellular Ca2+.

ISSN:0012-2823    

DOI:10.1159/000201216

出版商:S. Karger AG    

年代:1995

数据来源: Karger

摘要:

The integrity of the esophageal mucosa depends upon an equilibrium between aggressive factors and protective mechanisms. Esophageal mucosal protective mechanisms operate at three overlapping levels: (1) preepithelial, (2) epithelial and (3) postepithelial. Since aggressive factors always operate on the luminal side of the esophagus, preepithelial defense remains as the first line in mucosal barrier protection. Salivary secretion quantitatively and qualitatively contributes to the protective potential of the preepithelial barrier. Salivary volume and its buffering capacity are elaborated by lowering intraluminal pH within the esophagus, and are key factors in restoration of physiologic pH within the esophagus. Salivary secretory response to esophageal mechanical (bolus) and chemical (intraluminal pH) stimuli, mediated by the esophagosalivary reflex pathway, is impaired in patients with reflux esophagitis.

ISSN:0012-2823    

DOI:10.1159/000201298

出版商:S. Karger AG    

年代:1995

数据来源: Karger

摘要:

The effect on intragastric pH of two different dose regimens of continuous intravenous infusion of omeprazole (4 or 8 mg/h after a bolus of 80 mg), and ranitidine (0.25 mg/kg/h after a bolus of 50 mg) was studied in 10 patients with duodenal ulcer disease in symptomatic remission. The pH was monitored over 24-hour periods during fasting in a cross-over, randomised design including a baseline period. With the high omeprazole dose it was possible to maintain a pH ≥ 4 in all patients but 1 and 6 of the patients also maintained a pH ≥6. The lower dose of omeprazole seemed to be somewhat less effective. Continuous infusion of ranitidine was as efficient as the higher omeprazole infusion although with a tendency to decreased pH levels towards the end of the 24-hour period. Thus, in order to obtain consistently high pH levels of 4-6 over a prolonged period a continuous infusion of omeprazole, an 80-mg bolus plus a continuous infusion of 8 mg/h seem to be nee

ISSN:0012-2823    

DOI:10.1159/000201217

出版商:S. Karger AG    

年代:1995

数据来源: Karger

摘要:

The functional role of the cholinergic nervous system in regulating gastrin release was investigated using enriched canine antral G cells. Gastrin content was 30.1 ± 2.9 pmol per well and basal gastrin release was 900 ± 27 fmol per well (n = 45). Carbachol (10-8 to 10-5M) dose-dependently stimulated gastrin release with a maximal stimulatory response achieved at a concentration of 10-5M (330% over basal). To characterize the muscarinic receptor which mediates gastrin release from antral G cells, we examined the effect of three muscarinic receptor antagonists on carbachol-stimulated gastrm release; atropine (nonselective muscarinic receptor antagonist), pirenzepine (M1 muscarinic receptor antagonist) and 4-DAMP (M3 muscarinic receptor antagonist). Atropine (10-9 to 10-6M), pirenzepine (10-8 to 10-5M) and 4-DAMP (10-9 to 10-6 M) had no effect on the basal gastrin release. However, carbachol (10-5 M)-stimulated gastrin release was effectively inhibited by atropine and 4-DAMP with Ki values of 0.48 and 0.66 nM, respectively. Pirenzepine at a high concentration (10-5M) also inhibited carbachol-stimulated gastrin release with a Ki value of 46.3 nM. These results suggest that the cholinergic nervous system directly stimulates gastrin release via M3 muscarinic receptors located on antral G cell

ISSN:0012-2823    

DOI:10.1159/000201218

出版商:S. Karger AG    

年代:1995

数据来源: Karger