Hyperglycemia Affects Gastric Electrical Rhythm and Nausea During Intraduodenal Triglyceride Infusion

Hyperglycemia slows gastric emptying andincreases the intensity of perception of gastricdistension during fasting and small intestinal nutrientstimulation. In order to examine the possibility thatabnormalities of gastric electrical rhythm may be associatedwith the effects of hyperglycemia, the gastricelectrical rhythm (cutaneous electrogastrogram) and theperception rating scores for upper gastrointestinal sensations (visual analog scale) were examined.Studies were performed during intraduodenal triglycerideinfusion in 10 healthy volunteers under euglycemic andhyperglycemic (15 mmol/liter) conditions. During fasting, hyperglycemia had no effect oneither gastric electrical rhythm or sensation.Intraduodenal triglyceride infusion was associated withan increase in bradygastria (<2.4 cpm) during botheuglycemia (33 9%) and hyperglycemia (36 ± 10%, P< 0.05 vs baseline for each). During intraduodenaltriglyceride infusion, tachygastria (>3.6 cpm) wasmore prevalent during hyperglycemia when compared toeuglycemia (25 ± 10% vs 1 ± 1%, P <0.05) and the perception rating scores for nausea andabdominal discomfort were greater during hyperglycemia(P < 0.05 for both). The intensity of nauseacorrelated with the proportion of time spent in tachygastria (r = 0.64, P < 0.01).These data are consistent with the concept thatpostprandial upper gastrointestinal symptoms in patientswith diabetes mellitus may be modulated by the bloodglucose concentration.     

Impaired Gastric Myoelectrical Activity in Patients with Chronic Renal Failure

Dysmotility and delayed emptying of the stomachhave been reported in patients with chronic renalfailure (CRF). The aim of this study was to investigatewhether gastric myoelectrical activity was impaired in patients with CRF using electrogastrography.The electrogastrogram (EGG) was recorded in 24symptomatic patients with CRF (15 with diabetes) and 12normal subjects. Two 30-min EGG recordings before and after a test meal were analyzed using spectralanalysis methods. It was found that patients with CRFshowed a significantly lower percentage of normal 2-4cpm slow waves in both fasting and fed states in comparison with healthy controls (in fastingstate: 88.9 ± 2.5% vs 67.4 ± 6.6%/63.27.0%, P < 0.01; in fed state: 89.6 ± 1.8% vs64.6 ± 6.2%/62.0 ± 8.3%, P < 0.01;controls vs diabetic patients/nondiabetic patients). Both patient groups showed a significantlyhigher prevalence of the abnormal EGG, which was definedas the percentage of 2-4 cpm slow waves lower than 70%(fasting state: 8% vs 60%/56%, P < 0.01/0.05; fed state: 0% vs 53%/56%, P < 0.005/0.002;controls vs diabetic patients/nondiabetic patients). Nosignificant difference was observed in the regularity ofthe gastric slow waves between the two patient groups. The healthy controls showed a significantincrease in the dominant power and frequency of the EGGafter the test meal. However, this increase was absentin the two patient groups. It was concluded that patients with chronic renal failure haveabnormal gastric myoelectrical activity, includingimpaired regularity of the gastric slow wave and afailed increase in the power of the EGG at 3 cpm.Electrogastrography is an attractive noninvasive method for thestudy of gastric motility in patients with severechronic renal failure.     

Inhibitory reflexive effect of rectal distension on postprandial gastric myoelectrical activity

The aim of the study was to determine the effects of low-volume rectal distension on gastric myoelectrical activity. The study was performed in 14 healthy volunteers in 2 randomized sessions. In the control session, a small balloon was inserted into the rectum 10 cm beyond the anal verge and inflated with 20 ml of air. Gastric myoelectrical activity was recorded for 30 minutes in the fasting state and 30 minutes after a meal; and then the balloon was deflated and removed, and another 30-min recording was followed. The study session was the same except that after the 30-min baseline recording the balloon was inflated to reach a volume with which the subject felt an urgency for defecation. Spectral analyses were performed to compute the dominant frequency, power, and regularity (2–4 cycles/minutes, cpm) of the gastric slow waves and the percentage of gastric dysrhythmia. Results: 1). In comparison with our previously published data, the placement of the rectal balloon with a volume of 20 ml air did not affect the regularity of the slow waves (84.2 ± 3.6% in fasting, 85.3 ± 4.3% in fed); In comparison with the control session, the rectal distension inducing an urgency for defecation (average volume of air: 72.5 ml) significantly reduced the regularity of gastric slow waves in the fed state (72.0 ± 5.7%, P < 0.03 vs baseline; P < 0.02, vs control session) but not in the fasting state (80.1 ± 4.5%, P = 0.1). This postprandial change was attributed to a significant increase in bradygastria (3.1 ± 1.0% vs 7.9 ± 2.6%, P < 0.04) and a marginal increase in tachygastria (7.4 ± 2.5% vs 15.8 ± 4.3%, P = 0.06). The normal postprandial increases in the dominant frequency and power of the gastric slow wave were abolished in both sessions. conclusions, rectal distension evoking an urgency for defecation impairs postprandial gastric slow waves with an increase in the percentage of both bradygastria and tachygastria.     

Reversal of gastric electrical dysrhythmias by cisapride in children with functional dyspepsia report of three cases

Summary Three children (ages 5, 7.6, and 8 years), with recurrent unexplained upper abdominal symptoms such as vomiting, epigastric pain, anorexia, early satiety and without structural or mucosal abnormalities of gastrointestinal tract, underwent electrogastrography (EGG)—recording of gastric electrical activity using cutaneous electrodes positioned on the epigastric region and connected to a recording polygraph. Frequency of EGG signals was analyzed by fast Fourier transform. Significant changes of fasting and fed gastric myoelectrical activity (tachygastria, bradygastria, flatline pattern) were recorded in the three patients; furthermore, gastric emptying (GE) of a solid-liquid mixed meal, measured by ultrasonography, was significantly prolonged in them. A follow-up study was carried out after an eight-week course with oral cisapride: in all patients symptoms improved, GE time normalized, and EGG analysis showed normal electrical rhythm. It is suggested that gastric dysrhythmias can play a pathogenetic role in patients with functional gastrointestinal symptoms and that symptomatic improvement is accompanied by normalization of gastric electrical rhythm.     

Effects of Octreotide and Erythromycin on Gastric Myoelectrical and Motor Activities in Patients with Gastroparesis

Simultaneous recordings of gastric manometry andmyoelectrical activity were made in 10 patients withgastroparesis. Intravenous erythromycin (100 mg) wasadministered in the fasting state for a period of 30 min. Subcutaneous injection of octreotide(100 g) was administered before one of the fouridentical test meals. It was found that octreotidesignificantly decreased the antral motility index(30-min fasting: 4.51 ± 1.04 vs 1.75 ±0.97, P < 0.02; 60-min fed: 5.16 ± 1.44 vs 3.4± 1.41, P < 0.05) and the dominant power ofthe EGG (fasting power: 35.19 ± 1.54 vs 30.84± 1.57 dB, P < 0.004; postprandial powerincrease: 5.52 ± 1.06 vs 0.27 ± 0.87, P< 0.001). Erythromycin significantly increased theantral motility index (3.16 ± 0.96 vs 9.5± 0.61, P < 0.001) and the dominant power ofthe EGG (28.86 ± 1.57 dB vs 33.55 ± 1.59dB, P < 0.005) in the fasting state. An improvement in theregularity of the gastric slow wave was also noted witherythromycin. It was concluded that: (1) the inhibitoryeffect of octreotide on postprandial gastric motility and myoelectrical activity suggests thatcaution should be exercised when octreotide is used inpatients with gastroparesis; and (2) the stimulatoryeffect of erythromycin on gastric myoelectrical activity may enhance gastric motility and gastricemptying in patients with gastroparesis.     

Electrogastrography in healthy subjects

Electrogastrography (EGG) permits measurements of the gastric electrical activity. However, normal values of electrical activity are poorly defined. In addition, limited data are available on the effect of age and gender. Therefore, in 40 healthy subjects (age range: 19–90 years) normal values for several EGG parameters were assessed after an overnight fast for 1 hr in the fasting and fed state after ingestion of a standardized solid-liquid meal. The electrical signals were capture by a pair of surface electrodes sonographically placed on the skin overlying the gastric antrum. The dominant electrical frequency was predominantly in the defined normal frequency range between 2 and 4 cycles per minute (cpm) (P<0.001) and was higher in the postprandial than in the preprandial period (3.1 cpm vs 2.8 cpm,P=0.02). The instability of the electrical rhythm calculated by a dominant frequency instability coefficient (DFIC) was postprandially lower than in the fasting state (P=0.04). The electrical power (amplitude) increased postprandially (postprandial to fasting power ratio =2.4). To evaluate the influence of age and gender on normal values the subjects were divided into four groups (median age: male, 28 and 69 years; female, 25 and 67 years). The most parameters did not differ significantly between the groups. However, DFIC was different between the groups (P<0.05), with elderly women revealing lowest DFIC. In conclusion, normal values for several EGG parameters evaluated in this study should be included in the analysis of gastric electrical activity. The magnitude of electrical frequency and power are not influenced by age and gender, whereas the instability of the electrical frequency is influenced by these factors.     

Postprandial Improvement of Gastric Dysrhythmias in Patients with Type II Diabetes

Using the technique known as electrogastrography, we studied the postprandial response of gastric myoelectrial activity in subjects with type II diabetes. Seventy-one subjects with type II diabetes underwent 1 hr of fasting electrogastrography recording. HbA1c and fasting serum glucose levels were obtained. Subjects then underwent an additional 2 hr of electrogastrography recording in the post prandial state. Sixty of the 71 patients (85%) had gastric rhythm abnormalities in the fasting state. Forty-six of 71 subjects (65%) responded to the test meal by improving their electrogastrography tracings (responders) while 35% did not respond (nonresponders). The time spent in bradygastria during the fasting state by responders was 26.3 ± 12.8% vs 10.9 ± 8.5% for nonresponders (P < 0.0001). The percent tachygastria during the fasting state in responders was 19.8 ± 13.0%, which was less than nonresponders (38.3 ± 29.7%) (P < 0.001). Fasting plasma glucose and HbA1c could not be used to predict the gastric myoelectrical response to meal. In conclusion, gastric rhythm disturbances are common in type II diabetes; there was no correlation between HbA1c levels, age, duration of diabetes, or fasting serum glucose and gastric dysrhythmia in response to meal; two groups of subjects emerged: those who became less dysrhythmic in the post pradial state (responders) and those who did not (non-responders); and fasting bradygastria was associated with responders and fasting tachygastria was associated with nonresponders.     

Gastric Dysrhythmias and Delayed Gastric Emptying in Patients with Functional Dyspepsia

An association between dyspepsia, gastricmotility disorders, and myoelectrical abnormalities hasbeen noted. The objective of the present study was toinvestigate both antral myoelectrical activity and gastric emptying in patients with functionaldyspepsia (FD). Electrogastrography (EGG) was performedin 25 adult patients with FD, which had been evaluatedby score. After an overnight fast, for 1 hr in the pre- and postprandial state (370 kcalliquid-solid test meal) the following EGG parameterswere determined: dominant frequency [DF (cpm)], DF (%)in the normal range (2-4 cpm), bradygastria (<2 cpm), tachygastria (4-10 cpm), dominant frequencyinstability coefficient (DFIC), and postprandial tofasting power ratio (PR). The data were correlated toresults obtained in 20 age- and gender-matched controls. In addition, in 17 consecutive patients the EGGdata were compared to the gastric retention ofradionuclides after 60 min (liquid-solid phase labeledwith ^99mTc colloid). Patients with FDrevealed a preprandial increase in tachygastria compared to controls(P < 0.001). Of 17 FD, seven patients exhibiteddelayed gastric emptying (t60 retention >68%). Thesepatients showed significantly more pre- and postprandial tachygastrias than patients with normal gastricemptying (P < 0.05). The dyspeptic symptology and H.pylori status did not correlate with EGG andradioscintigraphy. Patients with FD frequently revealimpaired gastric emptying and increased tachygastria,which may have pathophysiological significance in someof these patients.     

Ontogeny of fasting small intestinal motor activity in the human infant.

A clearly defined progression of fasting small intestinal motor development is seen in the human infant from disorganised low amplitude motor activity before 31 weeks gestation through an intermediate phase of increasing motor organisation and amplitude to the development of a normal cyclical pattern of motor activity with clearly defined phase I, II, and III activity between 37 weeks gestation and term. With increasing maturity smooth muscle contractility [gastric antral pressure (5-30 mmHg), average duodenal pressure (2-12 mmHg)], propagation and slow wave frequency (10.5-12.5 cpm) all increased in a significant fashion (p less than 0.01). The stage of development of fasting motor activity in the small intestine of the preterm infant can now be readily predicted from the gestational age of the infant.     

原发性病理性十二指肠胃反流患者的胃电活动和胃排空研究

目的 通过分析原发性病理性十二指肠胃反流(DGR)患者胆汁反流程度与体表胃电节律变化以及胃排空运动之间的关系,探讨原发性病理性DGR致病因素.方法 收集2007年1月至2008年4月青岛市立医院门诊诊断为原发性病理性DGR患者58例(DGR组)和健康者21例(对照组)进行24 h胃内胆红素监测、胃镜、胃电图和胃排空检测,分析胃电参数及其与胃排空、胆汁反流和Hp之间的关系.结果 ①原发性病理性DGR患者的餐前及餐后胃电慢波主频率[(1.94±0.04) cpm比(2.93±0.07) cpm;(2.12±0.03) cpm比(3.35±0.05) cpm]、餐前及餐后正常胃电慢波百分比(74.46％±0.56％比85.55％±1.06％;63.97％±0.64％比86.13％±1.49％)、餐前/餐后功率比(PR)(1.68±0.02比2.75±0.09)均低于对照组(P＜0.05).原发性病理性DGR患者的餐前及餐后胃动过缓百分比(18.04％±0.36％比7.76％±0.78％;23.73％±0.91％比8.47％±0.55％)、餐前及餐后胃动过速百分比(8.93％±0.26％比5.75％±0.66％;13.02％±0.40％比7.66％±0.27％)均高于对照组(P＜0.05).②高反流组患者的餐前及餐后胃电慢波主频率[(1.68±0.07) cpm比(2.13±0.07) cpm;(2.18±0.09)cpm比(2.76±0.06)]、餐前及餐后正常胃电慢波百分比(69.71％±0.43％比80.35％±0.68％;56.36％±0.85％比72.34％±0.80％)、餐前/餐后功率比(PR)(1.47±0.04比2.02±0.04)均低于低反流组(P＜0.05).高反流组患者的餐前及餐后胃动过缓百分比(22.94％±0.68％比13.47％±0.61％;29.61％±1.14％比17.55％±0.51％)、餐前及餐后胃动过速百分比(9.94％±0.54％比7.02％±0.42％;17.04％±0.70％比10.71％±0.20％)均高于低反流组(P＜0.05);③Hp阳性组和Hp阴性组餐前、餐后各胃电参数差异均无统计学意义(P＞0.05);④DGR患者胃钡条排空者明显低于对照组(37.9％比90.5％,P＜0.05).DGR组胃排空延迟较对照组明显增多,两者比较差异,(60.3％比9.5％,P＜0.05).高反流组与低反流组比较胃排空延迟率差异无统计学意义(69.0％比51.7％,P＞0.05).结论 原发性病理性DGR患者存在胃电节律紊乱和胃运动功能障碍,这可能是病理性DGR的一个重要原因.     

Pathophysiological roles of ectopic tachygastria induced with antral electrical stimulation

AIM: To investigate the pathophysiological roles of tachygastria using antral electrical stimulation (AES). METHODS: The study was performed on 13 healthy female hound-type dogs chronically implanted with three pairs of serosal electrodes and a gastric cannula (n = 7). In the first experiment (n = 7), the antral motility was measured for three 30-min periods right after a solid meal. AES was performed during the second 30-min period at a tachygastric frequency. In the second experiment (n = 6), gastric slow waves and animal behavior were monitored in the fasting state at baseline and with various parameters of AES. RESULTS: (1) AES at tachygastric frequencies (7-14 cpm) significantly reduced the percentage of normal 4- to 6-cpm slow waves and induced tachygastria; (2) AES significantly and substantially inhibited the antral motility in the fed state; (3) AES in the fasting state energy dependently induced symptoms, and the symptom score was linearly correlated with the stimulation frequency, and (4) there was a significant negative correlation between percentage of tachygastria and index of antral motility. CONCLUSIONS: AES induces tachygastria and inhibits the antral motility. Tachygastria is correlated with antral motility.     

Clinical value of electrogastrography and the gastric emptying test

OBJECTIVE : To: (i) assess the clinical value of electrogastrography (EGG) and the gastric emptying test; and (ii) investigate the relationship between gastric myoelectrical activity and gastric emptying (GE). METHODS : One hundred and forty patients with functional dyspepsia (FD), 30 patients with non‐insulin‐dependent diabetes mellitus (NIDDM) and 20 healthy volunteers were studied. Gastric myoelectrical activity was recorded by using cutaneous EGG. The gastric emptying time was measured by using isotopic, radiopaque marker (Rom’s) and ultrasound methods. RESULTS : The dysrhythmia rates in patients with NIDDM were 70.0% (21/30) before meals and 66.7% (20/30) after meals, and the tachygastria rates of these patients were 36.7% before meals and 33.3% after meals. In NIDDM patients, the dominant frequency (DF) after meals (2.60 ± 0.30 cycles per minute; c.p.m.), the fed DF/fasting DF ratio (1.01 ± 0.11), the dominant power (DP) after meals (121.45 ± 67.00 V² c.p.m.) and the fed DP and fasting DP ratios (0.81 ± 0.07) were significantly lower than those in normal controls (P < 0.05 or P < 0.01). The DP after meals in patients with FD (210.60 ± 68.40 V² c.p.m.) was significantly lower than that in normal controls (P < 0.01). Delayed gastric emptying was more common in patients with FD and NIDDM. The rate of delayed gastric emptying in 121 cases with normal myoelectrical rhythm was 39.7% (48/121). In 69 cases with dysrhythmia, 45.9% (17/37) with bradygastria and 78.1% (25/32) with tachygastria had delayed gastric emptying. CONCLUSIONS : Electrogastrography and the gastric emptying test are feasible methods for evaluating gastric myoelectrical activity and gastric motility. The precise relationship between gastric myoelectrical activity and gastric motility has not been proven, but there is a close relationship between tachygastria and delayed gastric emptying.     

Electrogastrographic characteristics in patients of stomach cancer

Using a homemade electrogastrography (EGG) system, we studied the characteristics of myoelectrical rhythm in gastric cancer (GC) patients. Based on a short-term Fourier transform, recorded slow waves could be automatically analyzed to obtain the following parameters: dominant frequency/power, percent of normal rhythm (2.4–3.7 cpm), power ratio, etc. Fifty histologically confirmed GC patients (34 men, 16 women) were enrolled before surgical intervention to measure their fasting and postprandial EGG parameters for 30 min. The cancerous parameters of GC patients were then obtained postoperatively. In addition, 46 healthy subjects were enrolled for comparison. When compared to controls, GC patients had the following characteristics: absence of postprandial increase in dominant frequency (GC: 3.04 ± 0.47 vs 3.07 ± 0.44 cpm, NS; controls: 3.02 ± 0.31 vs 3.21 ± 0.25 cpm, P < 0.001), marked power response after meal (P < 0.05), and obvious power ratio (4.58 ± 7.38 vs 2.27 ± 2.05, P < 0.05). Multivariate analysis indicated that advanced GC was the factor responsible for the obvious dominant power enhancement after meal (P < 0.05). Other demographic, clinical, and cancerous factors did not influence EGG parameters. We conclude that apparent arrhythmia is not encountered in GC patients, although they mainly exhibit obvious postprandial power response. Advanced GC is likely responsible for this power enhancement on EGG recording.     

Impaired Postprandial Gastric Slow Waves in Patients with Functional Dyspepsia

The aim of this study was to investigate gastricmyoelectrical activity in patients with functionaldyspepsia. Thirteen healthy subjects and 14 patientswith functional dyspepsia participated in the study. The electrogastrogram (EGG) recording was madein each subject for 30 min in the fasting state and 120min after a standard test meal of 475 calories. Spectralanalysis methods were applied to derive quantitative EGG parameters. There was no difference in theEGG between the patients and controls in the fastingstate. However, abnormalities in the postprandial EGGwere found in the patients. The percentage of 2-4 cpmwaves was significantly lower (74.4 ± 4.0% vs85.7 ± 1.6%, P < 0.03) and the postprandialincrease in EGG dominant power was significantly less(–0.52 ± 0.92 dB vs 2.24 ± 0.88 dB,P < 0.03) in patients than in controls. It was alsofound that the percentage of postprandial 2-4 cpm wavescould be used to differentiate the patients withfunctional dyspepsia from the healthy controls with a specificity of 100% and a sensitivity of 43%. It was concluded that a subset of patients withfunctional dyspepsia have impaired gastric myoelectricalactivity in the fed state.     

Electrogastrography in Patients with Chagas' Disease

Electrogastrograghy (EGG) was performed in 33 patients with Chagas' disease and in 15 healthy volunteers—control group. The EGG was performed in two different periods: in fasting and postprandial. The EGG was submitted to a continuous spectral analysis. The following parameters were evaluated: % dominant frequency in spectral bands: normogastria (2–4 cpm), bradygastria (1–2 cpm), tachygastria (4–10 cpm) and duod/resp (10–15 cpm). EGG was considered normal if normogastria > 65% in both EGG periods. The chagasic group showed % normogastria significantly lower (basal, P < 0.01), % bradygastria (basal, P = 0.01) and % tachygastria (basal and postprandial, P =.001) significantly higher than the control group. EGG was normal in 14/15 (93%) in control group × 16/33 (53%) in chagasic group (P < 0.05). It was concluded that: 1) the prevalence of gastric dysrhythmias was higher in chagasic patients than in comparison to a control group 2) gastric dysrhythmias may be considered one of the abnormalities presented in the chagasic gastropathy.     

Placental transfer of maternal rubella antibodies to full-term and preterm infants

Summary Premature infants are vulnerable to infections, partly because of the low transplacental transfer of maternal antibodies. The present study investigated the placental transfer of maternal rubella-specific antibodies to full-term and preterm infants. The study group consisted of 133 healthy, native Israeli mothers and their 159 newborns. Of these, 69 were full-term infants (gestational age >37 weeks) of 69 mothers, and 90 were preterm infants (gestational age <35 weeks) of 64 mothers. Antibody titers against rubella were measured in maternal and umbilical cord blood samples by hemagglutination inhibition and microneutralization techniques. There was no significant difference in the level of protection and in geometrical mean titers by hemagglutination between the full-term and preterm groups. Conversely, significant differences in geometric mean titers of neutralizing antibodies were found between full-term and preterm infants, e.g., 65.9 and 39.8, respectively (P<0.001). Very low birth weight preterm infants are at greater risk of rubella infection during the first year of life, due to the diminished transfer of neutralizing maternal antibodies. Therefore, earlier vaccination of this group may be beneficial.     

Gastric Myoelectrical Activity in Patients with Parkinson's Disease (Evidence of a Primary Gastric Abnormality)

Parkinson's disease patients may experiencevarious gastrointestinal symptoms; however, the exactpathophysiology of these symptoms is not fullyunderstood. Therefore, the aim of this study was toinvestigate the pattern of gastric myoelectrical activityin patients with Parkinson's disease. Eleven patientswith Parkinson's disease and 10 healthy subjectsparticipated in the study. Patients were stratified as receiving dopaminergic therapy (N= 5) and off therapy (N = 6). Gastricmyoelectrical activity was measured by means of surfaceelectrogastrography (EGG) for 30 min before and for 90 min after a standardized meal. The dominantfrequency, postprandial EGG power change, and thepercentage of normal 2-4 cycles/min (cpm) slow-waveactivity in the three groups were calculated andcompared. The mean postprandial EGG power increase in theuntreated patients was smaller than in the treatedpatients (–3.11 ± 1.01 and 1.17 ±1.96 dB; P = 0.072). Moreover, both of these values weresignificantly decreased when compared to the control group(untreated vs control: d–3.11 ± 1.01 vs8.01 ± 1.86 dB; P = 0.04 and treated vs control:1.17 ± 1.96 vs 8.01 ± 1.86 dB; P = 0.02).The percentage of normal 2-4 cpm slow waves in untreated patients wasnot different from the treated patients (82.6 ±6.6% vs 75.8 ± 13.6%, P = NS) or from the controlgroup (88.2 ± 5.4%, P = NS). The dominantfrequency after the meal was similar to that in thefasting state both in the untreated (3.3 ± 0.1 vs3.2 ± 0.2 cpm; P = NS) and treated patients (3.2± 0.1 vs 3.1 ± 0.1 cpm, P = NS), whereasthe dominant frequency significantly increasedpostprandially in the control group (2.88 ± 0.12vs 3.05 ± 0.16; P < 0.05). Abnormalities ingastric myoelectrical activity in untreated Parkinson'sdisease patients reflect direct involvement of thegastrointestinal tract by the primary disease process.EGG can be regarded as a useful diagnostic tool inevaluating gastrointestinal involvement inneurodegenerative diseases.     

Postnatal development of disaccharidase activities in jejunal fluid of preterm neonates.

Because human fetuses of 26-30 weeks gestation are known to have low levels of intestinal mucosal lactase activity, it has been assumed that live born preterm neonates of comparable gestational age are also lactase deficient. We have previously shown that disaccharidase activities in jejunal fluid in infants are highly significantly correlated with enzyme activities in the adjacent mucosa. We have now measured disaccharidase activities cross-sectionally and longitudinally in the jejunal fluid of a group of very preterm neonates of 26-29 weeks gestation who were fed with pasteurised human milk. Lactase activity was within the normal range for older infants and children within the first week of life. Sucrase: lactase ratios fell significantly in the second and third weeks of life, strongly suggesting a further increase in lactase activity. This increase was independent of postconceptional age. Preterm neonates are not as lactase deficient as previously believed, and this has implications in the search for optimal feeding regimes.     

Atropine-induced gastric dysrhythmia is not normalized by electroacupuncture

Acupuncture has been shown to improve the regularity of gastric myoelectric activity. The aim of this study was to evaluate whether atropine-induced gastric dysrhythmia can be normalized by electroacupuncture. Fifteen healthy male volunteers were enrolled for this study. Each subject was studied for three sessions in a randomized sequence which included electroacupuncture on the Zusanli (St 36) points with or without premedication with atropine and a placebo stimulation on a nonacupoint. Cutaneous EGG was performed for 30 min at the baseline, 30 min during acupuncture, and for an additional 30 min after acupuncture. Serum gastrin, motilin, and human pancreatic polypeptide (hPP) levels were also measured. When applying 2 Hz of electrical stimulation on the Zusnali point, there was a significant increase in the percentage of normal frequency (2–4 cpm) during acupuncture (baseline versus acupuncture, 82.09 ± 12.37% versus 93.08 ± 8.17%, P < 0.01). There was a significant decrease in the percentage of bradygastria as well as tachygastria during 2 Hz of electrical stimulation on the Zusnali point. Using intravenous atropine immediately before electroacupuncture, the percentage of normal frequency during acupuncture and postacupuncture periods decreased significantly (baselines versus acupuncture and postacupuncture, 83.86 ± 13.79% versus 55.07 ± 29.44% and 56.76 ± 33.44%, P < 0.01). There was a significant decrease in serum PP after intravenous atropine. This observation indicated that atropine-induced gastric dysrhythmia might be mediated partly via the vagal pathway. However, atropine-induced gastric dysrhythmia is not normalized by electroacupuncture.     

Psychosocial distress is associated with abnormal gastric myoelectrical activity in patients with functional dyspepsia

OBJECTIVE: Functional dyspepsia (FD) is a heterogeneous and loosely defined clinical syndrome that is characterized by persistent or recurrent abdominal pain or discomfort centered in the upper abdomen without any identifiable structural or biochemical basis. Gastric myoelectrical activity in functional dyspepsia patients with gastric reddish streaks as a subgroup has not previously been investigated and the potential role of psychosocial distress in the genesis of gastric dysrhythmia in patients with FD is unclear. MATERIAL AND METHODS: Electrogastrography was performed in 45 patients with FD and 35 healthy controls for 30 min in the fasting state and 30 min postprandially. Psychological distress and the number and severity of stressful life events were measured using self-rating questionnaires. RESULTS: FD patients had a higher percentage of pre- and postprandial dysrhythmia, lower dominant frequency, and a higher instability coefficient as compared to healthy controls. In FD patients, severity of stressful life events was positively correlated with the percentage of tachygastria in the fasting state (r=0.43, p=0.005) and marginally positively correlated with the percentage of postprandial tachygastria (r=0.253, p=0.098) and instability coefficient of the dominant frequency (r=0.256, p=0.093). Total number of stressful life events was marginally positively correlated with fasting tachygastria (r=0.25, p=0.098) and instability coefficient of the postprandial dominant frequency (r=0.287, p=0.056). Interpersonal sensitivity was found to be negatively correlated with fasting dominant frequency in FD patients (r= - 0.311, p<0.05). CONCLUSIONS: FD patients with gastric reddish streaks have abnormal fasting and postprandial gastric myoelectrical activity. Perceived severity of stressful life events and interpersonal sensitivity are associated with disturbance of gastric myoelectrical activity.