Regional gastrointestinal transit times in severe ulcerative colitis.

BACKGROUND: Gastrointestinal (GI) dysmotility may present secondary to inflammatory bowel disease. The main aim of this study was to investigate GI motility in ulcerative colitis (UC) patients during severe disease activity. METHODS: Twenty patients with severe UC were studied with a novel telemetric capsule system (3D-Transit) designed for minimally invasive, ambulatory assessment of total and regional GI transit times. Ten patients were available for follow-up during remission. Data were compared to those of 20 healthy subjects (HS). KEY RESULTS: Total GI transit time was significantly longer in patients with severe UC (median 44.5 h [range 9.9-102.7 h]) than in HS (median 27.6 h [range 9.6-56.4 h]) (p = 0.032). Additionally, during severe UC, transit time was prolonged through the proximal colon (p = 0.003) and there were strong trends toward longer than normal small intestinal transit time (HS: median 4.9 h [range 3.4-8.3 h] vs severe UC patients: median 5.9 h [range 3.9-11.9 h]; p = 0.053) and colorectal transit times (HS: median 18.2 h [range 1.5-43.7] vs severe UC patients: median 34.9 h [range 0.4-90.9 h]; p = 0.056). Our data further indicate that total GI and colorectal transit times may be prolonged in UC during early remission. CONCLUSIONS & INFERENCES: Total GI transit times are significantly prolonged during severe UC.

Pilot study trialling a new ambulatory method for the clinical assessment of regional gastrointestinal transit using multiple electromagnetic capsules.

BACKGROUND: Gastrointestinal (GI) motor disorders often involve several regions of the GI tract. Therefore, easy and safe assessment of whole gut and regional motility is valuable for more precise diagnosis. 3D-Transit is a novel method for ambulatory evaluation of total and regional gastrointestinal transit times (GITT) based on the anatomical localization of ingestible electromagnetic capsules. The main purpose of this study was to test the performance of the 3D-Transit system. METHODS: Twenty healthy volunteers each ingested three electromagnetic capsules over a period of two consecutive days. Standard radio-opaque markers (ROM) were also ingested to assess the agreement between total GITT obtained with both methods. KEY RESULTS: Investigations were well-tolerated and three capsules could be tracked simultaneously with minimal data loss (Capsule 1: median: 0.2% of time (range 0-25.3%). Region specific contraction patterns were identified and used for computation of total and regional GITT in all subjects. Inter-observer agreement was 100% for total GITT (median variation 0%) but less for regional GITT. Day-to-day and diurnal variations were significant for total and regional GITT. Total GITT assessed by 3D-Transit capsules were moderately well-correlated to those assessed with standard ROM (Spearman's rho = 0.7). CONCLUSIONS & INFERENCES: 3D-transit is a well-tolerated and minimal invasive ambulatory method for assessment of GI motility. By providing both total and regional transit times, the 3D-Transit system holds great promise for future clinical studies of GI function in health and disease.

Gastric and small intestinal dysfunction in spinal cord injury patients.

BACKGROUND: Many patients with spinal cord injury (SCI) suffer from constipation, abdominal pain, nausea, or bloating, and colonic transit times are prolonged in most. Gastric and small intestinal dysfunction could contribute to symptoms but remain to be described in detail. Also, it is obscure whether the level of SCI affects gastric and small intestinal function. AIM: To study orocecal transit time and gastric emptying (GE) in patients with SCI. METHODS: Nineteen patients with SCI (7 ♀, median age 54 years) and 15 healthy volunteers (9 ♀, median age 32 years) were included. All were referred because of neurogenic bowel problems. Eleven patients had low SCI (located at conus medullaris or cauda equina) affecting only the parasympathetic nerves to the left colon and eight had high SCI (above Th6) affecting parasympathetic and sympathetic innervation. Subjects ingested a small magnetic pill that subsequently was tracked by the Motility Tracking System - MTS-1 (Motilis, Lausanne, Switzerland). RESULTS: Orocecal transit time was longer than normal both in individuals with high lesions (P < 0.01) and in individuals with low lesions (P < 0.01). Individuals with high lesions had slower GE than those with conal/cauda equina lesions (P < 0.05). Basic contractile frequencies of the stomach and small intestine were unaffected by SCI. CONCLUSION: Surprisingly, upper gastrointestinal transit is prolonged in subjects with SCI suffering from bowel problems, not only in subjects with cervical or high thoracic lesions but also in subjects with conal/cauda equina lesions. We speculate that this is secondary to colonic dysfunction and constipation.

[Alteromonas putrefaciens. Taxonomy and cultivation (author's transl)]. / Alteromonas putrefaciens. Taxonomi og dyrkning.

The morphology and biochemical activity of pseudomonas/Alteromonas putrefaciens is described. Features indicating the uncertain taxonomic position of the organism are discussed, and it is pointed out why A. putrefaciens does not fit into neither Pseudomonas nor Alteromonas, but should be considered as a separate unit or group. Table I shows criteria which can be used for differentiation between A. putrefaciens and the genera pseudomonas, Alcaligenes and Alteromonas. Essential characteristics are it's ability to decarboxylate ornithine, it's production of a typical pink pigment and the production of H2S in suitable media. Methods for isolation and quantitation of the organism are generally based on the latter two characteristics.

[Comparison of Micro-ID, API 20 E and a conventional technique for the identification of Enterobacteriaceae]. / Sammenlignende undersøgelse af Micro-ID, API 20 E og konventionel teknik til identifikation af Enterobacteriaceae.

A new system, Micro-ID, for the identification of Enterobacteriaceae is described. 100 strains of Enterobacteriaceae (Table I) are identified by Micro-ID and the identifications are compared with the identifications performed by conventional techniques and by the API 20 E system. There is a total agreement between Micro-ID and conventional techniques on 96.5% and between API 20 E and conventional techniques on 90% (Tables II and III). The differences in the reactions between the systems are discussed and explained. It is concluded, that the Micro-ID and the API 20 E both are very suitable for the identification of Enterobacteriaceae.

[An evaluation of the PATHOTEC system for identification of Enterobacteriaceae (author's tranls)]. / En vurdering af Patho Tec systemet til identifikation af enterobacteriaceae

One hundred species of Enterobacteriaceae were examined according to the PathoTec Rapid I-D system, and the results were compared to the results obtained by conventional bacteriological methods. The results of the examinations are given in Tables II, III, and IV. It is concluded that 97% agreement between the results of biochemical reactions is excellent, whereas 81% agreement between the diagnoses is not quite satisfactory; but it can be improved to 90% fairly easily, which would be a satisfactory result.