The relationship of gastric mucosal hemodynamics, energy metabolism, and acid to antral histological lesion incidence following hemorrhage and retransfusion was investigated in rats. Decrease of mucosal blood flow and of the index of mucosal oxygen saturation (ISO2) during hemorrhage were slightly greater in the corpus than in the antrum. ATP content and redox ratio in the corpus were decreased by shock; however, these hardly changed in the antrum. The index of tissue hemoglobin concentration (IHb) recovered to above the prehemorrhage value only in the antrum after retransfusion. Histological lesion incidence in the antral mucosa was more markedly increased by acid instillation and/or retransfusion than in the corpus. From these results, it was concluded that the decrease of blood flow is related as an underlying factor to induction of ischemic damage in the antral mucosa and that intraluminal acid and/or postischemic hyperemia play a causative role in the development of histologic lesions in the antral mucosa during shock and retransfusion in the rat stomach.
We attempted to investigate the fine mucosal patterns of inlet patches using a transparent‐tip‐hood‐fitted magnifying electronic endoscope (Olympus, GIF‐200Z). The prevalence of inlet patch was 10.1%, 26 out of 257 patients undergoing screening endoscopic examination using a GIF‐200Z. This rate was higher than that of previous reports in Japan, higher in the young group than in the aged group, and higher in males than in females. The mean inlet patch size, measured by the new method using a transparent hood, was 5.2 mm. Large inlet patches, above 8.1 mm, were found more frequently in males than in females. The number of inlet patches in one patient was one in 19 patients and two in seven. The inlet patches were oval and had a smooth margin in 23 (69.7%) cases, and irregular in 10 (30.3%). The oval patches with smooth margins were significantly larger than those with an irregular form. The fine mucosal pattern of inlet patches was mixed with B, BC and C type. Inlet patches with acid production were suggested to be fewer in number than expected, and patients with an inlet patch appear to have minimal, if any, complaints. A transparent‐tip‐hood‐fitted magnifying electronic endoscope was thought to facilitate accurate diagnosis of the inlet patch.
From these results, it is concluded that the protective effect of teprenone on blood flow was partly responsible for its inhibitory effect on the incidence of lesions in the rat stomach in this hypovolemic shock model, although the former effect might be not a direct effect on systemic vascular tone.
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