Focal gastric blood perfusion in relation with the endoscopic signs and liver function in cirrhotic patients.

Focal blood perfusion was measured, by means of a laser-Doppler technique, in the gastric upper body of 70 patients with liver cirrhosis and of 33 noncirrhotic controls. Perfusion was found to be lower in patients with pink mosaic-like pattern as compared to controls (p < 0.001). On the contrary, patients with red spots showed a marked increase of the focal gastric blood flow (p < 0.001). No different blood flow values were found between patients with red mosaic-like pattern and controls. Multiple regression showed that focal gastric blood flow perfusion was independently related to the Child score (p < 0.003), suggesting that gastric hemodynamic abnormalities can be favored by functional decompensation of cirrhosis, whereas there was no independent correlation with esophageal varices size, as assessed by their lumen occupancy percentage. Such observations may contribute to the understanding of the pathophysiology of gastric wall lesions in liver cirrhosis

Age affects glutathione content and glutathione-transferase activity in human gastric mucosa.

This study was undertaken to evaluate the influence of age on the content of glutathione, and its amino-acid precursor cysteine and on the activity of glutathione-S-transferase of gastric mucosa in man. We examined 44 gastric mucosal samples taken from the body and the antrum of the stomach of 22 healthy subjects, aged between 19 and 65 years. The results were examined in relationship to their distribution in the stomach, to the sex and to the age of the subjects. Glutathione and glutathione-S-transferase were higher in the gastric body than in the antrum, without differences between males and females. The activity of glutathione-S-transferase was directly related to glutathione content and both decreased with age. Cysteine was not influenced by any of the factors considered. These data indicate that the antioxidative and detoxifying capability of gastric mucosa decreases with age in man.

Effect of liver cirrhosis and age on the glutathione concentration in the plasma, erythrocytes, and gastric mucosa of man.

GSH and its related enzymes are one of the protective mechanisms vs. the oxidative damage, both in the circulation and in various tissues, including gastric mucosa. Patients with liver cirrhosis frequently suffer from a gastropathy caused by portal hypertension and they present low circulating levels of GSH. Aging processes cause an increase of gastric damage, of lipoperoxidative phenomenons, and a decrease of GSH in animals. The aim of this study was the evaluation, in humans, of the effect of both these factors, age and liver cirrhosis, on the global pool of GSH and on the antioxidant capability of the cells of gastric mucosa. Therefore, we evaluated the effect of liver cirrhosis and age on the circulating levels of GSH, both in the plasma and in the erythrocytes, and the GSH concentration and the activity of the total GSH-transferase (GSH-T) in gastric mucosa of healthy subjects and in patients affected by liver cirrhosis. Age, but not liver cirrhosis, induced a significant decrease of GSH and GSH-T activity in gastric mucosa; on the contrary, the plasma levels of GSH decreased in cirrhotics but not in elderly healthy subjects. In the erythrocytes, GSH was affected by both these factors (age and liver cirrhosis). These findings indicate that both in patients with liver disease and in elderly healthy subjects the GSH-related cellular defensive mechanisms are depressed and therefore susceptibility to oxidative damage may increase.

Chemical sclerosing cholangitis after injection of scolicidal solution.

Sclerosing cholangitis may be due to developmental immunological, infective, vascular or chemical factors (1). Hydatid cysts of the liver may communicate with the biliary tree. This is the reason why intracystic injection of scolicidal solution before surgery may cause spreading of the solution into the bile ducts. This complication has already been described in literature (2,3). We present a new well-documented case of sclerosing cholangitis after the injection of formaldehyde into a hydatid cyst of the liver to kill it, and give some suggestions how to avoid this complication.