1. Experimentally induced gastric ulcer in the rat MUDr. Michal Jurajda

2. Objective n To study the influence of H2-receptor antagonist on the development of the peptic ulcers of the stomach in the rats.The peptic ulcers will be induced experimentally by NSAID (cyclo- oxygenase inhibitor).

3. Physiology n Motor functions of the stomach n Gastric secretion

4. Physiology n Motor functions of the stomach –storage: reduction of the tone in the muscular wall –mixing and propulsion: constrictor ring leading to the retropulsion –emptying

5. Physiology n Secretions –parietal cells - HCl, intrinsic factor –chief cells – enzymes (pepsinogen, gastric lipase) –surface cells - mucous, sodium bicarbonate

10. Mucous neck cell Parietal cell Chief cell

11. Gastric mucosa surface cells neck cells parietal and chief cells

12. Hydrochloric acid secretion

13. Regulation of HCl secretion

15. Pathology n Gastritis –Acute - stress (Cushing’s ulcer), infection, radiation, corrosives –Chronic A type – autoimmune destruction of the parietal cells, B type – inflammation of the antral mucosa caused by H. pylori

16. Gastritis - acute

17. Chronic gastritis A

18. Chronic gastritis B

19. Helicobacter pylori

20. Peptic ulcer n Mucosal defect reaching deeper than muscularis mucosae layer, localized in areas exposed to acid-pepsin secretions.

21. Pathological anatomy

23. RTG with barium contrast Gastric ulcer

24. Duodenal peptic ulcer

25. Complications of peptic ulcer n Bleeding n Perforation n Penetration n Pyloric channel narrowing

26. Peptic ulcer ulcer

27. Bleeding

28. Perforation and penetration

29. Perforation – free intraperitoneal air

30. Ulcerogenic factors n NSAID n Stress n Chronic gastritis type B n A habitual increase of oxyntic glands secretion (increased number, increased sensitivity to k histamine or gastrin. n Zollinger-Ellison syndrom

31. Pharmacotherapy

33. H2 receptor antagonists n block histamine receptors 2 type udecrease HCl secretion in the gastric glands

34. Cyclooxygenase inhibitors n decrease synthesis of prostaglandins uanti-inflammatory effect uanalgetic effect uanti-trombotic effect uThe adverse side effect - the gastric ulcer