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Histamine concentrations in the gastric mucosa, gastric vein blood, and gastric contents were measured after instillation of 300 ml of 40%, 20% and 12.5%, vol/vol, ethanol intragastrically for 30 min in anesthetized dogs. The mean histamine concentration in the gastric mucosa, gastric vein blood, and gastric contents in dogs treated with 40% ethanol was significantly higher than in dogs treated with sodium chloride (NaCl). Serial studies of the gastric vein blood of the ethanol-treated dogs showed significant elevation of histamine concentrations for 2 hr after instillation of 40% ethanol, but less increases at 20 and 30 min after instillation of 12.5% and 20%, respectively. No change was observed after administration of 50% glucose and 25% mannitol. Morphologically, the gastric mucosa of the ethanol-treated dogs was edematous, congested and hemorrhagic. The severity of these changes increased with the concentration used. The mucosa of the dogs treated with sodium chloride, glucose, or mannitol was normal. The factors that may underlie the increase in histamine concentrations in the gastric vein blood and the possible relation of such an increase to the morphologic alterations are discussed.

Spontaneous hyponatremia in cirrhosis with ascites is generally considered to be due to an impaired renal ability to excrete free water, to be a contraindication of diuretics, and to be a bad prognostic sign. These concepts are reviewed in this paper. 55 cirrhotics with ascites were divided into three groups. Group I consisted of 13 patients with hyponatremia and very low free-water clearance ( $$C_{H_2 O} $$ , 0.07±0.26 ml/min). These patients also had poor renal function: low inulin clearance (CINU, 40.6±25.9 ml/min) and paraamino-hippurate clearance (CPAH, 383±275 ml/min). Group II consisted of 8 patients who also had hyponatremia. $$C_{H_2 O} $$ , CINU, and CPAH in these patients were fairly high: 5.85±1.53 ml/min, 85.7±26.2 ml/min, and 651±294 ml/min. These values are similar to those of the 34 patients without hyponatremia who make up Group III: (6.37±4.27 ml/min, 94.7±33.1 ml/min, and 598±199 ml/min). Hyponatremia in Group I could be related to the impaired free-water clearance. The mechanism of hyponatremia in Group II patients is not clear. Patients with hyponatremia and low CINU and CPAH had a negative response to diuretics and a poor prognosis. Patients with hyponatremia but with relatively good renal function had a good prognosis, similar to Group III patients. They responded to diuretics with no worsening of their hyponatremia.

Changes in the fine structure of the gastric mucosa following exposure to graded concentrations of ethanol were studied in dogs. 300 ml of 12.5, 20, and 40%, vol/vol, were instilled intragastrically for 30 min. Mucosa from the midbody and midantrum along the greater curvature was examined by light and electron microscopy. Ethanol produced a gradation of changes in the surface epithelial cells and in the lamina propria without affecting the parietal cells and chief cells. 12.5% ethanol produced widened and irregular intercellular spaces while 20 and 40% disrupted the apical cell membrane with concomitant exudation of mucin into the gastric lumen. These changes were more severe after 40% ethanol. The tight junction between cells remained intact following exposure to the lower concentrations of ethanol, but focal separation of cell junctions was observed in severely damaged areas. Quantitation of protein, sodium, and potassium concentrations in the gastric contents revealed marked increases following exposure to ethanol which correlated with the concentration. These studies provide additional morphological data on the relationship between structural changes and functional abnormalities induced by agents which break the gastric mucosal barrier.

Abstract: Clinical and experimental observations have shown that in the absence of the exocrine pancreas, substantial amounts of medium-chain triglycerides (MCT) can be absorbed.The present work investigates the mechanisms of MCT digestion and absorption from the gut of rats with surgically induced atrophy of the exocrine pancreas. It is shown that both the upper jejunum and cecum of these rats digest and absorb significant amounts of MCT, but by different mechanisms.In the jejunum, the triglyceride is not hydrolyzed in the lumen and is diffused intact into the epithelial cell. In the cell, MCT are partly hydrolyzed by an intestinal lipase and are transferred to the portal blood partly as intact triglyceride and partly as free fatty acids.In the cecum, MCT are hydrolyzed in the lumen. The liberated free fatty acids undergo rapid diffusion to the mucosa and portal plasma.

1. Absorption of G14-labelecd octanoic acid (RAO) and glyceryl trioctanoate (RATO) from the isolated rat cecum were estimated by continuous monitoring of the expired C14O2 for 1 hr.

The effect of ethanol on the mucosa of the Heidenhain pouch in dogs was studied by instilling ethanol in concentrations of 10, 20 and 40% using changes in ionic fluxes of an acid solution and mucosal alterations to measure the effects of ethanol. The instillation of 20 or 40% ethanol resulted in increased insorption of H+ and increased exorption of Na+ into the pouch lumen. Following the administration of 20 and 40% ethanol, the mucous layer and mucin content of the lining epithelial cells decreased markedly. Hourly bathing with the acid test solution aggravated the injury and induced bleeding, but hourly instillation of a buffer solution minimized the damage. Ionic fluxes returned to pre-ethanol levels 2 hr after 20% ethanol and 3–4 hr after 40% ethanol. Partial restoration of mucosal damage occurred in 4–6 hr and was complete in 24 hr.