ABSTRACT
Past measurement of gastric emptying of solid food in man has depended on external counting of surface-absorbed isotopes without verification that isotopic labels remain attached to solid food in the stomach. In this study chicken liver was isotopically labeled with 99mTc incorporated uniformly and intracellularly throughout the liver substance. In vitro studies showed less than 10% loss of 99mTc from liver incubated with pepsin HC1. By contrast, up to 90% of 51Cr absorbed to scrambled eggs became detached under similar conditions. In feeding experiments less than 10% of 99mTc was liberated from fed 99mTc liver, while significantly more 51Cr became detached from egg under identical intragastric conditions. We conclude that 99mTc-tagged chicken liver is an adequate marker of the rate of emptying of solid food and appears to be more reliable than 51Cr-labeled scrambled eggs from which 51Cr dissociates in the stomach.
Subject(s)
Food , Isotope Labeling , Liver/metabolism , Radionuclide Imaging , Stomach/physiology , Technetium , Animals , Chickens , Chromium Radioisotopes , Eggs , Gastrointestinal Motility , Humans , Pepsin A/pharmacology , Technology, RadiologicABSTRACT
Suture granulomas can occur after gastric surgery with nonabsorbable suture material. They are usually an asymptomatic, incidental finding on post-surgical x-ray studies, but have to be recognized because their radiological appearance may mimic gastric neoplasms and therefore may lead to unnecessary reoperations. Four cases of suture granulomas are presented, their diagnostic criteria outlined, and a plea is made for the use of a new completely absorbable suture material which could eliminate the occurrence of suture granulomas as well as the other known complications related to nonabsorable sutures, such as suture-line ulcers, abscesses, and adhesions.
Subject(s)
Granuloma/diagnostic imaging , Postoperative Complications/diagnostic imaging , Stomach Diseases/diagnostic imaging , Aged , Diagnosis, Differential , Foreign-Body Reaction/diagnostic imaging , Gastrectomy/adverse effects , Granuloma/prevention & control , Humans , Male , Middle Aged , Peptic Ulcer/surgery , Postoperative Complications/prevention & control , Radiography , Stomach Diseases/prevention & control , Suture Techniques , Sutures/adverse effectsABSTRACT
Older work in man with meals of carbohydrates in water has indicated that such meals slow gastric emptying in proportion to their osomolarities. Nevertheless, different carbohydrates have been found to have differing efficacies per milliosmole. One possibility which would explain such discrepancies among carbohydrates is that hyperglycemia induced by carbohydrate absorption itself contributes to the slowing of gastric emptying. To test this possibility, normal subjects were made acutely hyperglycemic with intravenous loads of glucose during the ingestion of various liquid test meals, and rates of gastric emptying of these meals were compared in the same subjects during periods of induced hyperglycemia with rates of gastric emptying under euglycemia conditions. Induced hyperglycemia significantly slowed the rate of emptying of meals containing fat + protein, or protein, but did not significantly alter emptying of meals containing only NaCl. It is concluded that hyperglycemia does exert some effect on gastric emptying, but that these effects of hyperglycemia are variably expressed, depending on the presence of other factors which themselves slow gastric emptying.
