Vinciane Muls

A radionuclide study of regional gastric motility

SummaryThe aims of this research were to study some methodological aspects of radionuclide methods for assessing regional gastric motility and to determine the parameters that can be extracted along with their normal values or patterns. During the lag phase, the antral contraction curve showed three different patterns. At the beginning, the antral activity was too low to be analysed. Irregular variation of the count rate was then observed, followed by a more regular contraction. The application of Fourier transformation to the well-defined cyclical count rate variations revealed two areas with high amplitude values but with phase opposition. No peristaltic wave could be identified. After the lag phase, the antral curve showed cyclical variations of count rates with a frequency of about three cycles per minute. Slightly displaced curves but with a much lower amplitude were observed at different parts of the stomach. Several factors were found to influence the antral contraction curve, including the choice of region of interest and time since the last meal. Irregularities in the antral curve, both in terms of frequency and of amplitude, were not unusual in healthy subjects. These should be taken into account when interpreting antral contraction curves. The phase image showed a well-defined peristaltic contraction pattern. Three 360° cycles were usually observed throughout the stomach, suggesting that the time necessary for a peristaltic wave to sweep through from the upper part of the stomach to the antrum is about 1 min. Similar phase images were obtained in all subjects regardless of the amount of time since the meal containing the radioactive tracer, suggesting that gastric peristalsis can easily be assessed and interpreted. The amplitude image showed high amplitude in the antral area and in the greater curvature of the stomach. In the lesser curvature, the amplitude was much lower. Unlike the phase image, however, there was marked variability in the regional amplitude distribution. The value of the region amplitude distribution for evaluating regional gastric motility is therefore limited.

Impact of Infliximab and Cyclosporine on the Risk of Colectomy in Hospitalized Patients with Ulcerative Colitis Complicated by Cytomegalovirus-A Multicenter Retrospective Study.

Background: Cytomegalovirus (CMV) is frequently detected in patients with ulcerative colitis (UC). The impact of CMV infection on the outcome of UC exacerbation remains unclear. The benefit of combining antiviral with anti-inflammatory treatment has not been evaluated yet. The aim of this study was to compare the outcome of CMV-positive hospitalized patients with UC treated with antiviral therapy either alone or combined with salvage anti-inflammatory therapy (infliximab [IFX] or cyclosporine A [CsA]). Methods: This was a multicenter retrospective study of hospitalized CMV-positive patients with UC. The patients were classified into 2 groups: antiviral—if treated with antivirals alone; combined—if treated with both antiviral and anti-inflammatory therapy. The outcomes included the rate of colectomy in both arms during the course of hospitalization and after 3/12 months. Results: A total of 110 patients were included; 47 (42.7%) patients did not receive IFX nor CsA; 36 (32.7%) received IFX during hospitalization or within 1 month before hospitalization; 20 (18.1%) patients received CsA during hospitalization; 7 (6.4%) were exposed to both IFX and CsA. The rate of colectomy was 14.5% at 30 days, 20.0% at 3 months, and 34.8% at 12 months. Colectomy rates were similar across treatment groups. No clinical and demographic variables were independently associated with the risk of colectomy. Conclusions: IFX or cyclosporine therapy is not associated with additional risk for colectomy over antiviral therapy alone in hospitalized CMV-positive patients with UC.

Transanal endolaparoscopic circumferential mucosectomy for symptomatic benign rectal stenosis – a video vignette

Transanal operative endolaparoscopy has becoming popular since the introduction of Total Endoscopic Microsurgery (TEM) more than 30 years ago. Recently, an evolution of laparoscopy called TransAnal Minimally Invasive Surgery (TAMIS) has been described. n nIn this video, a 38-year-old man presented with a circumferential rectal stricture due to a rectal ulcer, underwent a transanal endolaparoscopy procedure. The patient was previously had three unsuccessful endoscopic dilatations. Preoperative work-up showed a complete circumferential benign stenosis at 2.5 cm from the anal margin. n nThis article is protected by copyright. All rights reserved.

Unusual extrahepatic abdominal uptake of Tc-99m colloid

Extrahepatosplenic intraabdominal Tc-99m colloid uptake has been described in rare pathological conditions. This phenomenon was observed in a large abdominal tumor which, on pathological examination, corresponded to a benign hepatic adenoma; to the authors knowledge, extrahepatic uptake has not yet been described in hepatic adenoma.