Background

The aim of this study was to determine whether there was a correlation between peppermint oil and gastric emptying by using a novel noninvasive technique for measuring gastric emptying with a continuous real-time ¹³C breath test (BreathID system, Oridion, Israel).

Methods

Ten healthy male volunteers participated in this randomized, two-way crossover study. The subjects were randomly assigned to receive a test meal (200 kcal per 200 ml) containing 0.64 ml of peppermint oil or the test meal alone, after fasting overnight. A ¹³C-acetic acid breath test was continuously performed with the BreathID system, which monitors gastric emptying, for 4 h after the administration of the test meal. Using Oridion Research Software (β version), the time for emptying of 50% of the labeled meals (T 1/2), the analog to the scintigraphy lag time for 10% emptying of the labeled meal (T lag), the gastric emptying coefficient (GEC), and the regression-estimated constants (β and κ) were calculated. The parameters between two occasions were compared using the Wilcoxon signed-rank test.

Results

After peppermint oil intake, the T lag and β constant were significantly decreased. No significant differences in T 1/2, GEC, or κ were observed between the two occasions.

Conclusions

The decrease in the T lag and β constant suggests acceleration of gastric emptying during the early phase. This study showed that peppermint oil enhances gastric emptying, suggesting the potential use of peppermint oil in clinical settings for patients with functional gastrointestinal disorders.

The changes of gastric myoelectrical activity were investigated in 20 infants by cutaneous electrogastrography (EGG) before and after the surgical correction of infantile hypertrophic pyloric stenosis (IHPS). The dominance of 2–4 cycles per minute (CPM) “slow waves” is typical of the healthy gastric function. The shift of the dominant frequencies towards the slower frequency (0–2 CPM) is defined as bradygastria, whereas a shift towards the more frequent waves (4–10 CPM) is called tachygastria. Unlike with healthy infants, the electrogastrogram showed pathologic patterns in 85% (18 out of 20) of IHPS patients. In all except two of these infants with pathologic electrical patterns, the frequency of the waves significantly shifted towards tachygastria. The effect of feeding on the gastric myoelectrical activity could only be studied in limited (9/20) cases because of recurring vomiting during the preoperative period. In IHPS infants, a significant increase in the bradygastria group was observed in the postprandial period compared with healthy infants. Three to 5 days after surgical repair (pyloromyotomy) and the reintroduction of feeding in gradually increasing amounts, the gastric myoelectrical activity showed physiologic patterns again, showing that the pyloric function was back to normal. Cutaneous EGG is a useful, noninvasive method to obtain indirect information about the motor function of the stomach and might be further applicable to pediatric gastric motility disorders.

Summary

Plasma, being a protein medium, represents a certain kind of protective system for microbial survival. The freezing of plasma at −22° C at least cannot always prevent its contamination. The survival of microbes, particularly spore-forming microorganisms after a six months' storage sets a good example that the influence of low temperatures and changes in freezing process cannot be relied on. The survival of gram negative bacilli should not be underestimated even after the storage of six months. Human plasma is usually transfused within this period of time, nevertheless, it is necessary to follow the regulations saying that the plasma once defreezed should be transfused within 2 h. Thus there being lack of time, the microorganisms can be prevented from regeneration.

Zusammenfassung

Gut 25 verschiedene Operationsmethoden zum plastischen Ersatz der subfibularen Bänder werden in der Literatur der letzten 50 Jahre empfohlen. Nach einer Sammelstatistik von JÄGER und WIRTH über 417 Fälle war bei 88% ein gutes Ergebnis festgestellt worden. Auch in unseren, bevorzugt nach der Methode von WATSONJONES in Modifikation nach HOLZ durchgeführten Bandplastiken der vergangenen 3 Jahre wurde in jedem Falle die Bandstabilität des oberen Sprunggelenks wiederhergestellt. Die Beweglichkeit war allerdings bei der Hälfte noch um 10 Winkelgrade und mehr eingeschränkt.

Patients with cystic fibrosis (CF) have abnormal concentrations and composition of electrolytes and macromolecules in gastrointestinal secretions. Such alterations could change intestinal surface properties, such as surface hydrophobicity, and may influence the adhesion of macromolecules, bacteria, or microbial toxins to the intestinal surface. The objective of this study was to compare the surface hydrophobicity of the gastrointestinal tract in wild type and CF mice. We used axisymmetric drop shape analysis-contact diameter to determine surface hydrophobicity by measuring contact angles of sessile water droplets placed onto epithelial surfaces. In wild type mice, there were no differences in contact angles between the duodenum, upper jejunum, lower jejunum, and ileum. The contact angle of the gastric mucosa was lower than the rest of the gastrointestinal tract. Contact angles of the proximal colon and distal colon were both higher than that of the gastric mucosa and those of the small intestinal sections. In CF mice, contact angles along the gastrointestinal tract followed the same pattern as in wild type mice. However, contact angles in the ileum and proximal colon of CF mice were greater than those from wild type mice. This study of the murine intestine showed regional differences in surface hydrophobicity comparable to those observed in other mammalian species. In addition, we showed that the ileum and proximal colon of CF mice were more hydrophobic than the corresponding segments in wild type mice. These observations are of potential clinical relevance because patients with CF exhibit clinical manifestations of gastrointestinal disease primarily in the ileum and proximal colon.

Chapter 11 on cardiac arrhythmias considers current arrhythmias in the pediatric ICU in terms of diagnostic procedures, clinical significance, and treatment. In addition, an overview is given of the most common differential diagnoses of pediatric arrhythmias. Antiarrhythmics and various diagnostic tests complete the overview.