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[A new treatment method for hydrochloric acid burns of the hand].

The progression of hydrofluoric acid corrosion on the hands, which cannot be arrested by other means and leads to crippling or amputation, can be stopped by one single or several repeated intra-arterial perfusions of 10 ml 20% calcium-gluconate solution in 40 ml normal saline over 4 hours as close to the defect as possible via the brachial artery or one of the forearm arteries. In 4 patients, with corrosion of a severity judged to be between first and third degree, spontaneous healing resulted after this treatment. Based on our experience we advise the use of intra-arterial perfusion and show its advantages over subcutaneous injections or intravenous infusion of calcium.

Adult

Integration of biochemical functions of different cells of rat gastric mucosa for hydrochloric acid secretion.

The regulation patterns of gastric acid secretion in rats were investigated. Pentagastrin and histamine stimulate gastric acid secretion, but the inhibitors of DNA-dependent synthesis of RNA and of proteins prevent only the pentagastrin action. It has been found that pentagastrin induces histidine decarboxylase in gastric mucosa, ensuring local accumulation of histamine. The latter activates adenylate cyclase and results in 3',5'-AMP accumulation in gastric tissues. The administration of pentagastrin, histamine or 3',5'-AMP enhances the activity of gastric carbonic anhydrase, the enzyme which takes part in HCl formation. The data suggest that these three compounds act sequentially (pentagastrin leads to histamine leads to3',5'-AMP) and the effect of the last one could be mediated through 3',5'-AMP dependent protein kinase. The experiments in vitro demonstrated that gastric carbonic anhydrase can be separated into two isoenzymes and thephosphorylation of one of them by the 3',5'-AMP dependent protein kinase sharply increases its activity. The findings raise the possibility that histamine and 3',5'-AMP, mediating gastrin action, form together with enzymes (histidine decarboxylase, adenylate cyclase, protein kinase, carbonic anhydrase) a caascade of amplifiers. Autoradiographic studies have shown that [3H]-pentagastrin is not bound by oxyntic cells but adheres preferentially to histamine-producing alpha-like endocrine cells and to the chief cells, while 3H-histamine adheres preferentially to oxyntic and to chief cells. Electron microscopy indicates that only pentagastrin (but not histamine) initiates in alpha-like endocrine cells ultrastructural changes characteristic for induction. Pentagastrin, histamine and 3',5'-AMP administration produces in oxyntic cells ultrastructural changes typical for the secretion processes. These results lead to assumption that pentagastrin (gastrin) induces histidine decarboxylase in alpha-like endocrine cells of gastric glands. Histamine which is secreted enhances adenylate cyclase activity in the neighbouring oxyntic cells where 3',5'-AMP dependent protein kinase activates carbonic anhydrase by means of phosphorylation. These different cells form, probably, a multicellular functional unit for gastric acid secretion.

Adenosine Triphosphatases

Inhibition of hydrochloric acid and pepsin secretion from gastric pouches by antral pouch acidification in sheep.

1. Secretion of acid and pepsin from separated pouches of the body of the abomasum was studied in sheep during perfusion of antral pouches with acid solutions. 2. Resting secretion of acid and pepsin was reduced by acidification of antral pouches to pH 2.7 or less. 3. Increases in the secretion of HCl and pepsin normally obtained on feeding were reduced or abolished by perfusion of antral pouches with solutions at pH 1.3--2.0. 4. Perfusion of antral pouches with acetylcholine at pH 2.5 failed to stimulate acid secretion as it did at a higher pH. 5. Pentagastrin stimulated acid and pepsin secretion during the inhibition of secretion produced by antral pouch acidification. 6. Increases in reticular motility occurred on antral pouch acidification with solutions of pH 1.1--1.3. 7. The contribution of antral pH in regulating abomasal acid secretion is discussed.

Abomasum

Hydrochloric acid and cyclic 3'.5'-adenosine monophosphate content of rodent gastric juice after halothane administration.

Pulmonary aspiration of gastric contents during general anesthesia has always been a serious problem. Morbidity and mortality depend on the volume and acidity of the aspirated material. The anesthetic agent itself might affect gastric acid secretion. The effect of halothane (5, 10 and 20 mg/kg intravenously) on HCl secretion and cAMP content of gastric juice in pyloric and cardiac ligated male Sprague-Dawley rats was investigated. Compared with the control group, halothane significantly increased both HCl secretion and cAMP content of gastric juice, but to a lesser degree at the higher doses (p less than 0.05).

Animals

Secretion of hydrochloric acid in Ghosh-Lai rat preparation following stimulation with histamine and pentagastrin and inhibition by gastrone and atropine.

In this study of 48 successfully operated rats, we evaluated the applicability of the Ghosh-Lai stomach preparation to the quantitation of the HCl output following stimulation with histamine and pentagastrin and inhibition with gastrone and atropine. The usefulness of this rat preparation was well demonstrated and good duplication of results was obtained with various doses of histamine and pentagastrin. In this rat preparation, the HCl output following an optimal pentagastrin dose of 6 mug/kg/30 min i.v. was almost twice higher than that after an optimal histamine dose - for this rat preparation - of 0.2 mg/kg/30 min i.v. The inhibitory effect of gastrone B on histamine-stimulated HCl output has been confirmed in this rat preparation and shown to extend also on the pentagastrin-stimulated HCl secretion. The comparison of the atropine and gastrone inhibition of the pentagastrin-stimulated HCl output in the Ghosh-Lai preparation indicates that the inhibitory effect of 40 mug gastrone i.v. is similar in rat to that of 0.4 mg atropine sulfate i.v. under these conditions.

Animals

[Histochemical study of carbonic anhydrase and HCO3(-)-stimulated adenosine triphosphatase in the rat stomach during hydrochloric acid secretion].

By means of histochemical methods it was established that carboanhydrase of the parietal cells of fundal glands and HCO-3 stimulated ATP-ase of the rat's gastric mucosa capillaries disposed next to the parietal cells were activated by food and histamine. The obtained data confirm the idea of the multicellular functional essembly sustaining HCL secretion (R. I. Salganik, 1974). Should gastrin induce the formation of histamine in endocrinous cells and the histamine activate carboanhydrase in parietal cells, our data confirm the supposition that HCO-3-ions stimulate ATP-ase sustaining the exchange between HCO-3-cells and C1- of blood to form HCl in the endothelial cells of blood capillaries adjacent to the parietal cells.

Adenosine Triphosphatases

Evaluation of cimetidine (tagamet). An antagonist of hydrochloric acid secretion.

Cimetidine, a potent H2-receptor antagonist, has been introduced for the treatment of various conditions associated with acid peptic digestion in the gastrointestinal tract. Preliminary results are encouraging. Adverse reactions do not appear to be substantial; however, the effect of long-term use has yet to be ascertained.

Drug Evaluation