Effect of paracetamol on gastric mucosa.

The effect of paracetamol on the gastric mucosa was examined in seven healthy volunteers. The dose used (2 g instilled in 100 ml isotonic saline) was equivalent to about six tablets taken with water. Biopsy specimens were taken before and 10 and 60 minutes after instillation. The mean incidence of damaged surface cells in the control period was 1.7%. Ten minutes after instillation 3.5% of the surface cells were damaged. This increase was not significant. Light microscopy showed focal cell disruption and infiltration of red blood cells. Scanning electronmicroscopy showed minimal loss of normal cell apices. No erosions were seen on microscopy. Biopsy specimens taken 60 minutes after paracetamol showed similar changes. These findings differ appreciably from the extensive cell damage and microscopic erosions caused by therapeutic doses of 600 mg (two tablets) of aspirin. We conclude that large "analgesic" doses of paracetamol cause minimal ultrastructural changes in normal human gastric mucosa. The continued use of paracetamol in place of aspirin appears to be justified when there is a possibility of gastric mucosal injury.     

Fate of aflatoxins B1 and G1 residues during biscuit processing

Effect of biscuit processing on the destruction of aflatoxins B₁ and G₁ with and/or without some commonly leavening agents used namely sodium bicarbonate, ammonium bicarbonate and sodium bisulfite and sodium chloride. It was found that mixing step reduced the concentration of aflatoxins B₁ and G₁ by 80.7% and 82.7%, while the effect of baking step being 28.9% and 21.5%. The effect of mixing was found to be more pronounced than that baking step. The highest destruction effect on aflatoxin B1 was observed by adding a mixture composed of sodium and ammonium bicarbonate and sodium bisulfite followed by sodium chloride, sodium bisulfite, ammonium bicarbonate and/or sodium bicarbonate alone, where the reduction values of toxin after mixing were 93.4,91.9,91.7, 88.8 and 86.6% respectively, while the baking effect ranged 17.2 to 34.5% in the presence of different leaving agents added. Concerning aflatoxin G1; the highest destructive effect of toxin was adsorbed by adding a mixture of sodium and ammonium bicarbonate and sodium bisulfite followed by sodium bisulfite, sodium chloride, ammonium bicarbonate and/or sodium bicarbonate alone since the destruction values of such toxin after mixing were 96.2%, 92.8%, 92.6%, 89.0% and 87.7% respectively, while the baking effect ranged 20.9 to 34.5% in all leavening agents added.     

Effect of Several Drugs on Gastric Potential Difference in Man

Measurement of gastric mucosal potential difference was used to study the effect on the gastric mucosal barrier in six volunteer subjects of several drugs known to provoke ulcers. Potential differences were also recorded in nine patients with rheumatoid arthritis being treated with long-term aspirin and five patients on long-term prednisone. Unbuffered aspirin and ethanol “broke” the barrier as shown by a rapid fall in potential difference. The effects of aspirin were dose related, with 600 mg causing a greater reduction than 300 mg. The effects of aspirin and ethanol given together were additive and caused the greatest fall in potential difference. Sodium acetylsalicylate did not alter the normal potential difference. Indomethacin, phenylbutazone, and prednisone all failed to cause any change in potential difference. The patients on long-term aspirin and prednisone had readings within the normal range and responded the same as normal subjects to an acute challenge. These studies show that aspirin and ethanol will damage the gastric mucosal barrier but that indomethacin, phenylbutazone, and prednisone do not.     

A sodium bicarbonate-acid powered blow-gun syringe for remote injection of wildlife

An automatic blow-gun syringe which uses carbon dioxide gas as the injecting force is described. Upon striking the animal, carbon dioxide gas is released by the chemical combination of sodium bicarbonate (baking soda) and acid (vinegar), within the blow-gun syringe. The syringe has been used successfully with captive collared peccaries (Dicotyles tajacu). It has the advantages of longer stability, dependable gas expansion, reduction of drug loss, and consistent drug injection.     

Close arterial infusion of calcitonin gene-related peptide into the rat stomach inhibits aspirin- and ethanol-induced hemorrhagic damage

Afferent neuron-mediated gastric mucosal protection has been suggested to result from the local release of vasodilator peptides such as calcitonin gene-related peptide (CGRP) from afferent nerve endings within the stomach. The present study, therefore, examined whether rat alpha-CGRP, administered via different routes, is able to protect against mucosal injury induced by gastric perfusion with 25% ethanol or acidified aspirin (25 mM, pH 1.5) in urethane-anesthetized rats. Close arterial infusion of CGRP (15 pmol/min) to the stomach, via a catheter placed in the abdominal aorta proximal to the celiac artery, significantly reduced gross mucosal damage caused by ethanol and aspirin whereas mean arterial blood pressure (BP) was not altered. Intravenous infusion of CGRP (50 pmol/min) did not affect aspirin-induced mucosal injury but significantly enhanced ethanol-induced lesion formation. Intravenous CGRP (50 pmol/min) also lowered BP and increased the gastric clearance of [14C]aminopyrine, an indirect measure of gastric mucosal blood flow while basal gastric output of acid and bicarbonate was not altered. Intragastric administration of CGRP (260 nM) significantly inhibited aspirin-induced mucosal damage but did not influence damage in response to ethanol. BP, gastric clearance of [14C]aminopyrine, and gastric output of acid and bicarbonate remained unaltered by intragastric CGRP. These data indicate that only close arterial administration of CGRP to the rat stomach, at doses devoid of a systemic hypotensive effect, is able to protect against both ethanol- and aspirin-induced mucosal damage. As this route of administration closely resembles local release of the peptide in the stomach, CGRP may be considered as a candidate mediator of afferent nerve-induced gastric mucosal protection.     

Hyperosmotic instillation of rat stomach.

Instillation of equally hyperosmotic solutions (1000 m0sm/kg) of NaCl, KCl, MgCl₂, or dextrose depressed the electrical potential difference and the spontaneous acid secretion of rat stomachs. Luminal osmolality declined only slightly after hyperosmotic dextrose instillation, but loss of luminal chloride followed hyperosmotic salt instillation. Comparable losses of luminal sodium or potassium were observed. These changes result from a hyperosmotic alteration of ion transport through the gastric mucosa.     

Aspirin and indomethacin: Effect on instillation/abortion time of mid-trimester hypertonic saline induced abortion

Two acidic non steroid anti-inflammatory drugs, aspirin (acetylsalicyclic acid) and indomethacin were administered to patients undergoing mid-trimester saline induced abortion, to test their analgesic properties and to observe their effect on the instillation/abortion time interval. Both drugs when administered to patients undergoing mid-trimester saline abortion prolong significantly the instillation/abortion interval. These observations on human mid-trimester saline induced abortion treated with aspirin and indomethacin correspond with experimental data recently published relative to the antiprostaglandin activity of acidic non steroid drugs. The analgesic properties of both aspirin and indomethacin are difficult to assess accurately because of the highly emotional state of the patients studied; indomethacin, however, appears to be more effective for the prodromal abortion type of pain experienced by the patient but is still inadequate for sedation for the pain resulting from strong uterine contractions.     

Inhibition of hepatic gluconeogenesis by dichloroacetate

Gluconeogenesis from lactate by isolated hepatocytes suspended in a low bicarbonate medium is effectively inhibited by the hypoglycemic agent dichloroacetate. With this medium dichloroacetate suppresses the accumulation of the components of the malateaspartate shuttle, limits mitochondrial utilization of cytoplasmic reducing equivalents, and makes the availability of pyruvate and/or oxaloacetate limiting for gluconeogenesis. Much less inhibition is observed with hepatocytes suspended in a medium (Krebs?Henseleit saline) containing physiological concentrations of bicarbonate. No inhibition is observed with Krebs-Henseleit saline supplemented with lysine as a source of amino groups for the malate-aspartate shuttle. Thus, dichloroacetate inhibition of gluconeogenesis is observed only when hepatocytes are incubated in a medium deficient in bicarbonate and amino acids. This means that the action of dichloroacetate as a hypoglycemi agent is best explained by stimulation of peripheral tissue utilization of glucose and potential precursors for hepati gluconeogenesis rather than by direct inhibition of hepatic gluconeogenesis.     

Gastric mucosal integrity: gastric mucosal blood flow and microcirculation. An overview

The stomach is in a state of continuous exposure to potentially hazardous agents. Hydrochloric acid together with pepsin constitutes a major and serious threat to the gastric mucosa. Reflux of alkaline duodenal contents containing bile and pancreatic enzymes are additional important injurious factors of endogenous origin. Alcohol, cigarette smoking, drugs and particularly aspirin and aspirin-like drugs, and steroids are among exogenous mucosal irritants that can inflict mucosal injury. The ability of the stomach to defend itself against these noxious agents has been ascribed to a number of factors constituting the gastric mucosal defense. These include mucus and bicarbonate secreted by surface epithelial cells, prostaglandins, sulfhydryl compounds and gastric mucosal blood flow. The latter is considered by several researchers to be of paramount importance in maintaining gastric mucosal integrity. The aim of this paper is to review the experimental and clinical data dealing with the role of mucosal blood flow and in particular the microcirculation in both damage and protection of the gastric mucosa.     

Diuresis or urinary alkalinisation for salicylate poisoning?

Forty-four adults with aspirin poisoning were treated with oral fluids only, standard forced alkaline diuresis, forced diuresis alone, or sodium bicarbonate (alkali) alone. Alkali alone was at least as effective and possibly more effective than forced alkaline diuresis in enhancing salicylate removal. Unlike the diuresis regimens it did not cause fluid retention or biochemical disturbances. The renal excretion of salicylate depends much more on urine pH than flow rate, and forced diuresis alone had little useful effect. In overdosage aspirin causes sodium and fluid retention and may impair renal function. Attempts to force a diuresis are potentially hazardous and the spurious fall in plasma salicylate concentration caused by haemodilution gives a false impression of efficacy. Further studies are required to determine the optimum treatment for salicylate poisoning.     

Potential, Current, and Ionic Fluxes across the Isolated Retinal Pigment Epithelium and Choroid

A flux chamber was utilized for in vitro studies of a membrane formed by the retinal pigment epithelium and choroid of the eye of the toad (Bufo arenarum and Bufo marinus). A transmembrane potential of 20 to 30 mv was found, the pigment epithelium surface positive with respect to the choroidal surface. Unidirectional fluxes of chloride, sodium, potassium, and calcium were determined in the absence of an electrochemical potential difference. A net transfer of chloride from pigment epithelium to choroid accounted for a major fraction of the mean short-circuit current. A small net flux of sodium from choroid to pigment epithelium was detected in Bufo marinus. In both species of toads, however, about one-third of the mean short-circuit current remained unaccounted for. Manometric determinations of bicarbonate suggested an uptake of this ion at the epithelial surface of the membrane but did not provide evidence of a relationship between this process and the short-circuit current.     

Haloalkaliphilic sulfur-oxidizing bacteria in soda lakes

The existence of chemolithoautotrophic sulfur-oxidizing bacteria (SOB) capable of growth in an extremely alkaline and saline environment has not been recognized until recently. Extensive studies of saline, alkaline (soda) lakes located in Central Asia, Africa and North America have now revealed the presence, at relatively high numbers, of a new branch of obligately autotrophic SOB in these doubly extreme environments. Overall more than 100 strains were isolated in pure culture. All of them have the potential to grow optimally at around pH 10 in media strongly buffered with sodium carbonate/bicarbonate and cannot grow at pH<7.5 and Na(+) concentration <0.2 M. The majority of the isolates fell into two distinct groups with differing phylogeny and physiology, that have been described as two new genera in the Gammaproteobacteria; Thioalkalimicrobium and Thioalkalivibrio. The third genus, Thioalkalispira, contains a single obligate microaerophilic species T. microaerophila. The Thioalkalimicrobium group represents a typical opportunistic strategy, including highly specialized, relatively fast-growing and low salt-tolerant bacteria, dominating in hyposaline steppe soda lakes of Central Asia. The genus Thioalkalivibrio includes mostly slowly growing species better adapted to life in hypersaline conditions and with a more versatile metabolism. It includes denitrifying, thiocyanate-utilizing and facultatively alkaliphilic species.     

The effect of analgesic drugs on the instillation/abortion time of hypertonic saline induced mid-trimester abortion

Three drugs, a non-steroid anti-inflammatory drug sodium salicylate, an analgesic propoxyphene hydrochloride and an antipyretic-analgesic acetaminophen were administered orally to patients undergoing mid-trimester hypertonic saline induced abortion to determine analgesic potency and the effect on the instillation/abortion time interval (I/ATI). Sodium salicylate (structurally related to acetylsalicylic acid, aspirin) and propoxyphene hydrochloride did not prolong the I/ATI. Acetaminophen, reportedly free of anti-inflammatory activity, prolonged the I/ATI. Clinically, acetaminophen and propoxyphene appeared to provide better analgesia than sodium salicylate. The hypothesized relationship of the three drugs to suppression of prostaglandin biosynthesis is presented.     

Phagocytosis of cells in the gastric surface epithelium of the rat

Summary Gastric surface epithelial cells (SEC) from fed rats, from rats fasted for 16 h and from mucosae exposed in an ex-vivo chamber to 16 mM aspirin for 5 min were examined by transmission electron microscopy. SEC have the capability to phagocytose adjacent epithelial cells and parietal cells. Phagocytosis is rare in mucosae from fasted animals but common in fed animals or after brief exposure to aspirin. Phagocytic capabilities are not restricted to the progenitor zone but exist throughout the surface epithelium. Phagocytosis may provide a mechanism for the removal of damaged or senescent cells from the surface epithelium.Suported by the Medical Research Council of Canada     

Inhibition of pentagastrin-stimulated gastric acid secretion by intraileal administration of bile and elevation of plasma concentrations of gut glucagon-like immunoreactivity in anesthetized dogs

The effects of intraileal administration of bile on gastric acid secretion stimulated by a submaximal dose of intravenous pentagastrin infusion and on plasma concentrations of gut glucagon-like immunoreactivity (gut GLI) were studied in anesthetized dogs. Gastric acid secretion was measured for a 2-h period at 15-min intervals before and after intraluminal instillation of test solutions. 100 ml of canine bladder bile diluted to 10% in saline evoked a significant inhibition (20%) of gastric acid secretion. The inhibition of gastric acid secretion was accompanied by an elevation of plasma concentration of gut GLI, whereas saline instillation (in controls) caused no responses. Although the inhibition of gastric acid secretion and the elevation of plasma gut GLI are parallel phenomena, gut GLI can be reasonably postulated as one of the candidate mediators of bile-induced inhibition of gastric acid secretion, since its structurally related peptides, pancreatic glucagon, glicentin and oxyntomodulin have been reported as inhibitors of gastric acid secretion.     

Bacterial counts in canine duodenal fluid after exposure to saline, sodium bicarbonate and hypertonic dextrose solutions used to maintain patency of chronically implanted catheters

Flushing of intestinal vascular access ports (VAPs) is commonly performed to prevent the problems of blockage and infection, and in this study four different flushing solutions were compared. The growth of bacteria from canine duodenal contents was compared in: 0.9% saline, 50% dextrose, 8.4% sodium bicarbonate (NaHCO3) and 0.01 M phosphate buffered saline (PBS). Duodenal contents from three laboratory beagles were serially diluted in these four solutions, spread plated onto agar at 24 h periods for 7 days and bacterial counts were performed. Immediately after the duodenal juices were added, no significant differences could be seen in bacterial counts with any of the solutions. Over the 7 day period, bacterial numbers greatly increased in saline and phosphate buffered saline, but greatly decreased in dextrose and sodium bicarbonate solutions. Dextrose and sodium bicarbonate appeared to be the most promising flushing solutions tested to minimize infections of associated intestinal VAPs.     

Metabolic effects of bicarbonate in the treatment of diabetic ketoacidosis.

The effect of intravenous bicarbonate on the changes in intermediary metabolites during the initial treatment of diabetic ketoacidosis was examined in 16 patients. The results were compared with the changes seen in 16 patients receiving intravenous saline. Infusion of 150 mmol (mEq) bicarbonate significantly delayed the fall in blood lactate, lactate:pyruvate ratio, and total ketone bodies observed in the saline treated group. No difference in the rate of fall of blood glucose concentration was found. There is no metabolic indication for the use of intravenous bicarbonate in the treatment of diabetic ketoacidosis.     

Hypertonic sodium bicarbonate partially reverses QRS prolongation due to flecainide in rats

Hypertonic (1M) sodium bicarbonate can partially reverse the cardiac toxicity of some Class IA antiarrhythmic agents, presumably by antagonizing sodium channel inhibition. We studied the effects of 1M sodium bicarbonate on toxicity due to the Class IC drug flecainide. Anesthetized rats received i.v. loading and maintenance doses of flecainide to produce QRS prolongation of 76% that was stable over the 60 min study period. 20 min after the start of the maintenance infusion, groups of 8 rats received an i.v. infusion of 1M sodium bicarbonate (6 meq/kg) or an equal volume of 0.9% saline. QRS prolongation was reduced by 1M sodium bicarbonate but not only 0.9% saline (% change -12.2 +/- 10.0 v. +3.0 +/- 2.7, p = 0.001). Expressed as a percent of the flecainide-induced QRS prolongation, bicarbonate reduced this prolongation by 26.5%. The improvement in QRS duration persisted until sacrifice 30 min later. Compared to controls, the bicarbonate group had a significantly higher blood pH (7.55 +/- 0.06 v. 7.44 +/- 0.05) and serum sodium concentration (149 +/- 5 v. 137 +/- 2 meq/l). Serum flecainide concentrations were similar. These data suggest that 1M sodium bicarbonate can partially reverse flecainide-induced conduction delay in rats. This effect may be due to changes in the extracellular pH and sodium concentration. 1M sodium bicarbonate may be useful in assessing the role of sodium channel inhibition in mediating the toxicity of flecainide or other Class IC drugs.     

Disruption of the Cox-1 gene slows repair of microscopic lesions in the mouse gastric epithelium

Cyclooxygenase-1 (Cox-1) contributes to gastric defense of healthy tissue, but the role in the protection of the gastric epithelium after minor, acute damage has been difficult to study in vivo. Using 710-nm two-photon light absorption to create microscopic gastric damage in anesthetized mice with the gastric mucosal surface surgically exposed and perfused on the microscope stage, the acute response of surface cells to injury could be monitored using in vivo microscopy within seconds after injury. Using exogenous (Cl-NERF) and endogenous fluorophores, extracellular pH and cell death were monitored in real time during the entire damage and repair cycle. Two-photon damage was initiated by scanning approximately 200 microm(2) of gastric surface cells with high laser intensity, causing rapid bleaching of NAD(P)H fluorescence in optically targeted cells. In both Cox-1(+/-) and Cox-1(-/-) mice, a similar initial damage area expanded to include bystander epithelial cells over the next 2-5 min, with larger maximal damage noted in Cox-1(-/-) mice. The maximal damage size seen in Cox-1(-/-) mice could be reduced by exogenous dimethyl-PGE(2). All damaged cells exfoliated, and the underlying epithelium was coincidently repaired over a time interval that was briefer in Cox-1(+/-) (12 +/- 2 min, n = 12) than in Cox-1(-/-) (24 +/- 4 min, n = 14) mice. Directly after damage, pH increased transiently in the juxtamucosal layer (maximal at 3-6 min). A smaller peak pH change was noted in Cox-1(-/-) mice (DeltapH = 0.3 +/- 0.04) than in Cox-1(+/-) mice (DeltapH = 0.6 +/- 0.2). Recovery to normal surface pH took longer in Cox-1(-/-) mice (27 +/- 5 min) than in Cox-1(+/-) mice (12 +/- 1 min). In conclusion, constitutive loss of Cox-1 leaves the gastric mucosa more prone to damage and slowed repair of microlesions.