The Effects of Erythromycin in Small-Bowel Follow-through

PURPOSE: To evaluate the efficacy of erythromycin(EM), known to accelerate gastric emptying, in modified small-bowel follow-through(SBFT). MATERIALS AND METHODS: We evaluated 32 normal patients who underwent modified SBFT by oral administration of methylcellulose. In the EM injection group(n=20), 500 mg EM (3 mg/kg in pediatric patients) in 100 ml saline was infused intravenously over a 15-minute period prior to the administration of a barium meal, while in the control group(n=12), EM was not infused. Gastric emptying time(GET), small-bowel transit time(SBTT) for barium and methylcellulose, small-bowel transit(SBT) during the first 15 minutes, luminal diameter and quality of image were compared between the two groups. SBT was assigned 1, 2, 3, or 4 points, depending on the extent to which the barium head reached the proximal or distal jejunum, and the proximal or distal ileum during the initial 15-minute. Three radiologists reached a consensus as to image quality. RESULTS: Mean GET was significantly faster in the EM injection group (18.5 mins for 150 ml barium suspen-sion and 25.8 mins for 600 ml methylcellulose). The SBT score during the initial 15 minutes was significantly higher in the EM injection group (3.3 points) than in the control group (2.4 points), but mean SBTT was not sig-nificantly different between the two groups. Luminal diameter and image quality were also higher in the EM injection group. CONCLUSION: EM does not decrease SBTT but is highly effective for shortening gastric emptying time, helping to increase the range of fluoroscopic examination and improve image quality in modified small-bowel follow-through, especially in patients with delayed gastric emptying.

Effects of Exogenous Nitric Oxide on the Ischemic Damage of H9c2 Cardiac Myoblast Cells

BACKGROUND: Nitric oxide(NO) is known to have protective effects on an ischemic heart and to exert triggering effects on ischemic preconditioning. However, the effects of NO during the ischemic period have not been investigated. To investigate the role of exogenous nitric oxide in a model of ischemic heart cell death, we studied the effects of ischemic preconditioning and ischemia in a normal and an ischemic buffer. METHODS: Rat cardiac myoblast cells(H9c2) were cultured in a normal and an ischemic buffered medium. For the ischemic culture of heart cells, the cells were cultured in a dessicator with GasPak for 5 hrs. In ischemic preconditioning, the cells were pretreated with ischemic buffer for 5 min and then perfused with normal medium for 30 min. For the measurement of the cytotoxicity, a MTT(3-4-5dimethylthiazol-2-yl-2,5-diphenyl tetrazolium bromide) assay was performed. A DAPI(4',6-diamidino-2-phenylindole dihydrochloride) staining procedure and a flow cytometry analysis were performed to confirm apoptotic cell death by ischemia. RESULTS: Cell viability, as determined by using a MTT assay, showed that the preconditioned group treated with NO showed more cell death than with the not-preconditioned groups in both normal and ischemic buffers. But, In normal medium and not-preconditioned groups, NO showed protective effect according to the concentrations(100, 1000 microM) . No treatment with NO produced the different results. In normal medium, the protective effect of ischemic preconditioning was demonstrated, but no protective effect of ischemic preconditioning could be seen in the case of the ischemic buffer. The DAPI staining and flow cytometry analysis of heart cells showed characteristic apoptotic features. CONCLUSION: NO added in the ischemic phase had deterious effects on heart cells. Ischemic preconditioning was more harmful than ischemia alone. The toxicity of the cells was characteristic apoptosis.