Antral Web - A Rare Cause of Vomiting and Haematemesis in Childhood

The case of a 3 year-old girl with an antral diaphragm is reported. The patient presented with vomiting and haematemesis. In spite of extensive investigations the lesion causing the haematemesis remained undetected.     

SERUM {gamma}-GLUTAMYL-TRANSPEPTIDASE ISOFORMS IN ALCOHOLIC LIVER DISEASE

-Glutamyltranspeptidase (GT) appears in serum in multiple forms;their significance and clinical utility in hepatobiliary andpancreatic diseases are still a matter of controversy. Electrophoreticseparation of the multiple forms of GT on agarose gel was performedin 20 alcoholic patients (six with cirrhosis and 14 with fattyliver) and the results compared with those obtained in 50 healthyvolunteers, 43 patients affected with chronic hepatitis C, 36patients with posthepatitic cirrhosis and in 52 epileptic patientson long-term anti-epileptic medication. Multiple forms of GTwere separated into several bands (up to 11), labelled 0a, 0b,la, lb, 2a, 2b, 2c, 3a, 3b, 4a, 4b. In the alcoholic patientsnine fractions were detected, and the electrophoretic patternobserved was significantly different from that observed in healthyvolunteers and in patients with chronic hepatitis C or posthepatiticcirrhosis. No differences were observed in the electrophoreticpatterns in the alcohol abusers and epileptic patients. In alcoholicpatients significant differences were observed in the electrophoreticpatterns in relation to the degree of liver injury; the electrophoreticpatterns in patients with alcohol-related cirrhosis and posthepatiticcirrhosis differed significantly. The separation of multipleforms of GT has high sensitivity and good reproducibility. Itmay be proposed as a complementary test in the diagnosis ofalcoholic liver disease.     

24-Hour Heart Rate Variability in Patients with Vasovagal Syncope

Since alterations in the autonomic nervous system are thought to play a major role in the pathogenesis of vasovagal syncope, we characterized the chronic autonomic profile of 44 patients with syncope and 20 healthy subjects by means of heart rate variability using 24-hour Holter recordings (time- and frequency-domain indexes), and evaluated whether the different types of responses to tilting (vasodepressive versus cardioinhibitory) could be associated with different cardiac autonomic patterns. Twenty-three patients exhibited a positive response to tilting, which was vasodepressive in 11 patients and cardioinhibitory in 12 patients. All vasodepressive patients had a standard deviation of the averages of NN (SDANN) intervals in all 5-minute segments lower than 100 ms. Patients with vasodepressive syncope also had significantly lower values of RMSSD (the 24-hour square root of the mean of the sum of the squares of differences between adjacent normal RR intervals) than those with cardioinhibitory response, and lacked the day-night rhythm of the low frequency/high frequency ratio. However, only SDANN values correctly identified patients with vasodepressive response to tilting. We conclude that (1) the population of patients with vasovagal syncope is heterogeneous, (2) patients with vasodepressive syncope have a peculiar chronic autonomic profile as assessed by 24-hour heart rate variability analysis, and (3) the evaluation of the autonomic profile in 24-hour Holter recordings could be of value in the diagnosis of patients with syncope.     

CONSTANT ABSOLUTE ETHANOL INTAKE BY SARDINIAN ALCOHOL-PREFERRING RATS INDEPENDENT OF ETHANOL CONCENTRATIONS

The present study was designed to evaluate ethanol drinkingbehaviour in Sardinian alcohol-preferring (sP) and Sardinianalcohol-non-preferring (sNP) rats in the presence of differentethanol concentrations. Ethanol intake was tested under thetwo-bottle, free-choice regimen and continuous access schedule.Ethanol-naive sP and sNP rats were initially given ethanol solutionat the standard, constant concentration of 10% (v/v) for 8 consecutivedays (Phase 1). As expected, daily ethanol intake in sP ratsrose from 4 to {small tilde}l6g/kg; in contrast sNP rats consumed<10g/kg/day ethanol. Subsequently, an ascending series ofethanol concentrations, ranging from 3 to 60% (v/v), was presentedto sP and sNP rats over a 28-day period (Phase 2). At concentrationsvarying from 7 to 30%, sP rats consumed constant amounts ofabsolute ethanol per kg of body weight ({small tilde}6.0 g/kg/day).Daily ethanol intake in sNP rats remained constantly lower than1.0 g/kg, irrespective of the ethanol concentration. Data fromPhase 2 demonstrate the ability of sP rats to precisely adjustdaily ethanol intake and support the hypothesis that voluntaryethanol drinking in sP rats is sustained by specific pharmacologicaleffects of ethanol.     

Chronic Gastric Torsion in Infancy: A Revisited Diagnosis

Twenty out of 108 infants with vomiting, who underwent an upper gastrointestinal X-ray study during a period of 2 years, showed a peculiar shape and position of the stomach already described as chronic gastric torsion. We examined clinical, radiologic and laboratory findings of these 20 infants. Our results showed that chronic gastric torsion is frequently associated with gastroesophageal reflux and has a wide spectrum of symptoms, complications and nutritional abnormalities.