Gastric ischemia

Gastric ischemia There have been several case reports of gastric ischemia after endoscopic injection therapy. Inadvertent intraarterial injection may result in either spasm or thrombosis, leading to subsequent tissue ischemia or necrosis, although the stomach has a rich vascular supply and the vascular reserve of the intramural... 

A 51-year-old woman with h5rpertension and liver cirrhosis manifested gastric ischemia after submucosal... 

Histamine H3 receptors are well distributed in peripheral tissues, although relatively less abundant than in the CNS. As for the cellular localization, peripheral H3 receptors are present in different cell types, like the neural, paracrine, endocrine, muscular and endothelial cells, where they subserve a predominant inhibitory role. However, the multiple location of H3 receptors in the same tissue may lead to opposite effects on the physiologic function, thus, their role can sometimes be quite difficult to understand. As regards a possible clinical application of H3 ligands, although many suggestions have been derived from the experimental animal data (e.g. gastric disorders, asthma, myocardial ischemia, hypertension and inflammation), to date, no clinical evidence is available for any therapeutic indication. 

T. Yoshikawa et al.. Effect of zinc-camosine chelate compound (Z-103), a novel antioxidant, on acute gastric mucosal injury induced by ischemia-reperfusion in rats. Free Radic. Res. Commun., 14 (1991)289-296. 

Brzozowski T, Konturek PC, Konturek SJ, et al. Role of prostaglandins generated by cyclooxygenase-1 and cyclooxygenase-2 in healing of ischemia-reperfusion-induced gastric lesions. Eur J Pharmacol 1996 385 47-61. 

On the other hand, gastric mucosal injury has also been associated with periods of ischemia in several different clinical settings, including trauma [166], ethanol exposure [167], acetic acid [168], NSAID [169], or ischemia-reperfusion [170]. When a tissue is subjected to ischemia, a sequence of chemical reactions is initiated which may ultimately lead to cellular dysfunction and necrosis [171]. 

As shown by Alarcon de la Lastra et al. [100] using a model of gastric injury induced by ischemia-reperfusion in rats, pretreatment with silymarin, the hepatoprotective principle of Silybum marianum L. prevented post-ischemic injury. These protective effects were specifically related to reduction of MPO activity as index of polymorphonuclear leukocyte infiltration after injury. These findings indicated that inhibitory effects of silymarin on neutrophil function seem to contribute significantly to its gastroprotective actions. 

Airway. Airway protection in stroke patients may require immediate intervention. An impaired level of consciousness combined with emesis can occur in patients with increased intracranial pressure (ICP) and posterior circulation stroke. Vertebrobasilar ischemia may affect medullary respiratory centers and cause apnea, or more commonly, paralysis of pharyngeal and tongue musculature leading to obstruction of the airway. The patient may require gastric suction and intubation to protect the airway from aspiration of gastric contents. An oral airway or nasal trumpet can be helpful if the patient has an upper airway obstruction. 

Does ischemia cause a breakdown of the gastric mucosal barrier ... 

Finally, I decided to combine ischemia with an attack on the barrier by including bile salts in the irrigation fluid. A few experiments gave equivocal results. I should have done more and better experiments, but by that time Barr had left, and I was tired of the project. I wrote up the results and submitted them for publication under the title Failure of Ischemia to Break the Dog s Gastric Mucosal Barrier. 

Figure 8-10. Aminopyrine clearances, net fluxes of and Na" in a dog s Heiden-hein pouch irrigated with 100 mN HCI, and simultaneous volume secretion by the pouch. At the left, the lines represent the mean results in three experiments done on different days when the pouch was stimulated by continuous intravenous infusion of a mixture of pentagastrin and bethanechol. The lines in the middle represent the results obtained in an experiment in which norepinephrine was infused without pentagastrin and bethanechol. The lines on the right represent the results of an experiment in which pentagastrin, bethanechol, and norepinephrine were infused together. (From Davenport HW, Barr LL. Failure of ischemia to break the dog s gastric mucosal barrier. Gastroenterology 65 6 9-624, 1973.)...

Davenport HW, Barr LL. Failure of ischemia to break the dog s gastric mucosal barrier. Gastroenterology 65 619-624,1973. This paper may hold the record for delay in publication received December 17, 1971 accepted April 3, 1973. The delay was caused by my withdrawing the MS in what Morton Grossman called childish resentment of a referee s comments. 

Ritchie WP Jr. Acute gastric mucosal damage induced by bile salts, acid, and ischemia. Gastroenterology 6 699-101, 1975. 

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