Reestenosis hipertófica de píloro tras piloromiotomía, ¿recurrencia verdadera o complicación posquirúrgica? / Recurrent Infantile hypertrophic pyloric stenosis after pyloromyotomy: progression of original disease or delayed surgical complication?

La recurrencia de estenosis hipertrófica de píloro es una entidad rara. Debe sospecharse ante la aparición de vómitos proyectivos tras un periodo postoperatorio sin incidencias por piloromiotomía previa. Suele obedecer a cirugía anterior insuficiente o a lesión duodenal intraoperatoria y habitualmente precisa nueva cirugía reparadora. Se presentan dos casos de reestenosis hipertrófica de píloro, y se discute la naturaleza de esta estidad (AU)

Recurrent Infantile hypertrophic pyloric stenosis is a rare condition. It must be suspected if new projectile vomiting reoccurs after an uneventful postoperative period. It is usually caused by incomplete previous surgery or accidental duodenal injury during Ramstedt’s procedure. In general a new pyloromyotomy is required. Two cases of hypertrophic pyloric restenosis are presented, and the nature of this condition is discussed (AU)

Effect of hydrocarbon chain and pH on structural and topographical characteristics of phospholipid monolayers.

Structural characteristics (structure, elasticity, topography, and film thickness) of dipalmitoyl phosphatidylcholine (DPPC) and dioleoyl phosphatidylcholine (DOPC) monolayers were determined at the air-water interface at 20 degrees C and pH values of 5, 7, and 9 by means of surface pressure (pi)-area (A) isotherms combined with Brewster angle microscopy (BAM) and atomic force microscopy (AFM). From the pi-A isotherms and the monolayer elasticity, we deduced that, during compression, DPPC monolayers present a structural polymorphism at the air-water interface, with the homogeneous liquid-expanded (LE) structure; the liquid-condensed structure (LC) showing film anisotropy and DPPC domains with heterogeneous structures; and, finally, a homogeneous structure when the close-packed film molecules were in the solid (S) structure at higher surface pressures. However, DOPC monolayers had a liquid-expanded (LE) structure under all experimental conditions, a consequence of weak molecular interactions because of the double bond of the hydrocarbon chain. DPPC and DOPC monolayer structures are practically the same at pH values of 5 and 7, but a more expanded structure in the monolayer with a lower elasticity was observed at pH 9. BAM and AFM images corroborate, at the microscopic and nanoscopic levels, respectively, the same structural polymorphism deduced from the pi-A isotherm for DPPC and the homogeneous structure for DOPC monolayers as a function of surface pressure and the aqueous-phase pH. The results also corroborate that the structural characteristics and topography of phospholipids (DPPC and DOPC) are highly dependent on the presence of a double bond in the hydrocarbon chain.

Orientational changes in dipalmitoyl phosphatidyl glycerol Langmuir monolayers.

Dipalmitoyl phosphatidyl glycerol (DPPG) as Langmuir monolayers at the air/water interface was investigated by means of surface pressure measurements in addition to Brewster angle microscopy (BAM) during film compression/expansion. A characteristic phase transition region appeared in the course of surface pressure-area (pi-A) isotherms for monolayers spread on alkaline water or buffer subphase, while on neutral or acidic water the plateau region was absent. This phase transition region was attributed to the ionization of DPPG monolayer. It has been postulated that the ionization of the phosphatidyl glycerol group leads to its increased solvation, which probably provokes both a change in the orientation of the polar group and its deeper penetration into bulk phase. Film compression along the transition region provokes the dehydration of polar groups and subsequent change of their conformation, thus causing the DPPG molecules to emerge up to the interface. Quantitative Brewster angle microscopy (BAM) measurements revealed that along the liquid-expanded to liquid-condensed phase transition the thickness of the ionized DPPG monolayer increases by 4.2 A as a result of the conformational changes of the ionized polar groups, which tend to emerge from the bulk subphase up to the surface.

Structural and topographical characteristics of dipalmitoyl phosphatidic acid in Langmuir monolayers.

Dipalmitoyl phosphatidic acid (DPPA) monolayers at the air-water interface were studied from surface pressure (Pi)-area (A) isotherms and at the microscopic level with Brewster angle microscopy (BAM) under different conditions of temperature, pH, and ionic strength. BAM images were recorded simultaneously with Pi-A isotherms during the monolayer compression-expansion cycles. DPPA monolayers show a structural polymorphism from the liquid-expanded (LE)-liquid-condensed (LC) transition region at lower surface pressures toward liquid-condensed and solid (S) structures at higher surface pressures. An increase in temperature, pH, or ionic strength provokes an expansion in the monolayer structure. The results obtained from the Pi-A measurements are confirmed by the monolayer topography and relative reflectivity. The measurements of relative reflectivity upon monolayer compression showed an increase in relative monolayer thickness of 1.25 and 3.3 times throughout the full monolayer compression from the liquid-expanded to the liquid-condensed and solid states, respectively.

In situ measurement of the displacement of protein films from the air/water interface by surfactant.

The displacement of spread protein films from the air/water interface by surfactant was followed using Brewster angle microscopy (BAM) and interfacial rheology. The displacement of beta-lactoglobulin and beta-casein by a nonionic surfactant was monitored as a function of both surface pressure and time. In both cases, protein displacement occurred over the same surface pressure range that had been observed previously by atomic force microscopy (AFM). In the case of the beta-lactoglobulin, surfactant domains grew large enough in the protein film to be visible in the BAM images. The shapes of the domains were very similar to those seen previously by AFM in the late stages of displacement. The results from both proteins confirm the results published previously while highlighting some implications for the application of the "orogenic" model of displacement for large protein films. The surface rheological data showed that the beta-lactoglobulin/surfactant mixed film retained much of its elasticity until the latter stages of displacement. This indicates that at least in the early stages of displacement, the mixed film was dominated by the behavior of the protein in the film.

The effect of temperature on food emulsifiers at fluid-fluid interfaces.

Heat-induced interfacial aggregation of a whey protein isolate (WPI) with a high content of beta-lactoglobulin (>92%), previously adsorbed at the oil-water interface, was studied by means of interfacial dynamic characteristics performed in an automatic drop tensiometer. Protein concentration in aqueous bulk phase ranging between 1x10(-1) and 1x10(-5) % wt/wt was studied as a variable. The experiments were carried out at temperatures ranging from 20-80 degrees C with different thermal regimes. During the heating period, competition exists between the effect of temperature on the film fluidity and the increase in mechanical properties associated with the interfacial gelation process. Interfacial crystallisation of food polar lipids (monopalmitin, monoolein, and monolaurin) previously adsorbed at the oil-water interface, was studied by interfacial dynamic characteristics (interfacial tension and surface dilational properties). The temperature, ranging between 40 and 2 degrees C, and the lipid concentration in aqueous oil phase, ranging between 1x10(-2) and 1x10(-4) % wt/wt, were studied as variables. Significant changes in interfacial dynamic characteristics associated with interfacial lipid crystallisation were observed as a function of lipid concentration in the bulk phase. Interfacial crystallisation of food polar lipids (monopalmitin, monoolein, and monolaurin) at the air-water interface, was studied by pi-A isotherms performed in a Langmuir trough coupled with Brewster angle microscopy (BAM). A condensation in monoglyceride monolayers towards lower molecular area was observed as the temperature decreased. This effect was attributed to lipid crystallisation at lower temperatures. BAM images corroborated the effect of temperature on the monolayer structure, as a function of the monoglyceride type.

Protein-lipid interactions at the oil-water interface.

The distribution of proteins and lipids in food emulsions and foams is determined by competitive and cooperative adsorption between the two types of emulsifiers at the fluid-fluid interfaces, and by the nature of protein-lipid interactions, both at the interface and in the bulk phase. The existence of protein-lipid interactions can have a pronounced impact on the surface rheological properties of these systems. Therefore, these results are of practical importance for food emulsion formulation, texture, and stability. In this study, the existence of protein-lipid interactions at the interface was determined by surface dynamic properties (interfacial tension and surface dilational modulus). Systematic experimental data on surface dynamic properties, as a function of time and at long-term adsorption, for protein (whey protein isolate (WPI)), lipids (monoglycerides), and protein-lipid mixed films at the oil-water interface were measured in an automated drop tensiometer. The dynamic behaviour of protein+lipid mixed films depends on the adsorption time, the lipid and the protein/lipid ratio in a rather complicated manner. The protein determined the interfacial characteristics of the mixed film as the protein at WPI>/=10(-2)% wt/wt saturated the film, no matter what the concentration of the lipid. However, there exists a competitive or cooperative adsorption of the emulsifier (WPI and monoglycerides), as the concentration of protein in the bulk phase is far lower than that for interfacial saturation.

Analysis of beta-casein-monopalmitin mixed films at the air-water interface.

The surface pressure (pi)-area (A) isotherms and Brewster angle microscopy (BAM) images of monopalmitin and beta-casein mixed films spread on buffered water at pHs 5 and 7 and at 20 degrees C were determined as a function of the mass fraction of monopalmitin in the mixture (X). The structural characteristics and morphology of monopalmitin-beta-casein mixed films are dependent on surface pressure, pH, and monolayer composition. The prevalence of monopalmitin in the interface increases with the amount of monopalmitin in the mixture and at higher pi. At the monopalmitin monolayer collapse the mixed film is practically dominated by the presence of monopalmitin. However, some degree of interactions exist between monopalmitin and beta-casein in the mixed film, and these interactions are more pronounced as the monolayer is compressed at the highest surface pressures.

Dynamic interfacial rheology as a tool for the characterization of whey protein isolates gelation at the oil-water interface.

Heat-induced interfacial aggregation of a whey protein isolate (WPI), previously adsorbed at the oil-water interface, was studied by interfacial dynamic characteristics coupled with microscopic observation and image analysis of the drop after heat treatment. The experiments were carried out at temperatures ranging from 20 to 80 degrees C with different thermal regimes. During the heating period, competition exists between the effect of temperature on the film fluidity and the increase in mechanical properties associated with the interfacial gelation process. During the isothermal treatment, the surface dilational modulus, E, increases, and the phase angle, delta, decreases with time to a plateau value. The frequency dependence of E and delta is characteristic of viscoelastic films with increasing delta and decreasing E at lower frequencies. The effects of heat treatment depend on the conditions at which the gelation process takes place. Microscopic observation of gelled films gives complementary information on the effect of heat treatment on WPI adsorbed films.

Adsorption of whey protein isolate at the oil-water interface as a function of processing conditions: a rheokinetic study.

In this paper we present surface dynamic properties (interfacial tension and surface dilational properties) of a whey protein isolate with a high content of beta-lactoglobulin (WPI) adsorbed on the oil-water interface as a function of adsorption time. The experiments were performed at constant temperature (20 degrees C), pH (5), and ionic strength (0.05 M). The surface rheological parameters and the interfacial tension were measured as a function of WPI concentration (ranging from 1 x 10(-)(1) to 1 x 10(-)(5)% w/w) and different processing factors (effect of convection and heat treatment). We found that the interfacial pressure, pi, and surface dilational modulus, E, increase and the phase angle, phi, decreases with time, theta, which should be associated with WPI adsorption. These phenomena have been related to diffusion of the protein toward the interface (at short adsorption time) and to the protein unfolding and/or protein-protein interactions (at long-term adsorption) as a function of protein concentration in solution and processing conditions.