PURPOSE: To evaluate the efficacy of a modified small bowel follow-through (SBFT) and to optimize this technique. MATERIALS AND METHODS: Ninety-nine subjects without small bowel pathology underwent modified SBFT using oral administration of methylcellulose after taking 100ml of 120% or 100, 150, or 200ml of 70% barium. Thirty-three and 39 normal subjects undergoing enteroclysis or conventional SBFT, respectively, were also evaluated for comparison of image qualities and transit time. RESULTS: Enteroclysis was the most successful ofthree types of small bowel examination for obtaining the best quality of bowel transradiency and distension. Modified SBFT was, however much superior to the conventional series for obtaining good bowel transradiency and rapid transity time (mean, 37-49 minutes). The use of 150ml of 70% barium was better than the other three modified techniques in achieving good bowel transradiency, rapid transit time, and less flocculation. CONCLUSION: Our modified SBFT is a simple and safe method for easily improving bowel transradiency and transit time.
Administration, Oral ; Barium ; Flocculation ; Methylcellulose* ; Pathology

Perforation with extravasation of barium is a rare complication of contrast enema examination of the large bowel with a high associated mortality rate. The experience of performing a re-laparotomy in a patient previously exposed to barium peritonitis is even less common. We describe an elderly male patient with a Hartmann's procedure performed a year previously, presenting with peritonitis following barium enema evaluation of the proximal colon via an end descending colon stoma. Emergency laparotomy, segmental bowel resection and liberal peritoneal toilet resulted in a satisfactory outcome. The patient had a subsequent successful reversal of his Hartmann's procedure nine months later despite the presence of dense barium induced adhesions. This potentially preventable iatrogenic complication is discussed in this report, which is supplemented by a brief review of the English literature.
Barium Sulfate/administration & dosage ; Barium Sulfate/*adverse effects ; Colon ; Colostomy ; Enema/*adverse effects ; *Iatrogenic Disease ; Peritonitis/*chemically induced

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.
Administration, Oral ; Barium ; Consensus ; Erythromycin* ; Gastric Emptying ; Head ; Humans ; Ileum ; Jejunum ; Meals ; Methylcellulose ; Phenobarbital

OBJECTIVE: This preliminarily study was designed to determine and to compare the efficacy of two commercially available barium-based fecal tagging agents for CT colonography (CTC) (high-density [40% w/v] and low-density [4.6% w/v] barium suspensions) in a population in Korea. MATERIALS AND METHODS: In a population with an identified with an average-risk for colorectal cancer, 15 adults were administered three doses of 20 ml 40% w/v barium for fecal tagging (group I) and 15 adults were administered three doses of 200 ml 4.6% w/v barium (group II) for fecal tagging. Excluding five patients in group I and one patient in group II that left the study, ten patients in group I and 14 patients in group II were finally included in the analysis. Two experienced readers evaluated the CTC images in consensus regarding the degree of tagging of stool pieces 6 mm or larger. Stool pieces were confirmed with the use of standardized CTC criteria or the absence of matched lesions as seen on colonoscopy. The rates of complete fecal tagging were analyzed on a per-lesion and a per-segment basis and were compared between the patients in the two groups. RESULTS: Per-lesion rates of complete fecal tagging were 52% (22 of 42; 95% CI, 37.7-66.6%) in group I and 78% (28 of 36; 95% CI, 61.7-88.5%) in group II. The difference between the two groups did not reach statistical significance (p = 0.285). The per-segment rates of complete tagging were 33% (6 of 18; 95% CI, 16.1%-56.4%) in group I and 60% (9 of 15; 95% CI, 35.7%-80.3%) in group II; again, the difference between the two groups did not reach statistical significance (p = 0.171). CONCLUSION: Barium-based fecal tagging using both the 40% w/v and the 4.6% w/v barium suspensions showed moderate tagging efficacy. The preliminary comparison did not demonstrate a statistically significant difference in the tagging efficacy between the use of the two tagging agents, despite the tendency toward better tagging with the use of the 4.6% w/v barium suspension.
Administration, Oral ; Adult ; Barium/administration & dosage/*diagnostic use ; Colon/radiography ; *Colonography, Computed Tomographic/methods ; Colonoscopy ; Colorectal Neoplasms/diagnosis/radiography ; Contrast Media/*administration & dosage ; *Feces ; Female ; Humans ; Male ; Middle Aged ; Suspensions

OBJECTIVE: The purpose of this study was to establish a minimally invasive and reproducible protocol for estimating the gastrointestinal (GI) transit time in mice using barium and radiopaque markers. MATERIALS AND METHODS: Twenty 5- to 6-week-old Balb/C female mice weighing 19-21 g were used. The animals were divided into three groups: two groups that received loperamide and a control group. The control group (n = 10) animals were administered physiological saline (1.5 mL/kg) orally. The loperamide group I (n = 10) and group II (n = 10) animals were administered 5 mg/kg and 10 mg/kg loperamide orally, respectively. Thirty minutes after receiving the saline or loperamide, the mice was administered 80 microL of barium solution and six iron balls (0.5 mm) via the mouth and the upper esophagus by gavage, respectively. Afterwards, the mice were continuously monitored with fluoroscopic imaging in order to evaluate the swallowing of the barium solution and markers. Serial fluoroscopic images were obtained at 5- or 10-min intervals until all markers had been excreted from the anal canal. For analysis, the GI transit times were subdivided into intestinal transit times (ITTs) and colon transit times (CTTs). RESULTS: The mean ITT was significantly longer in the loperamide groups than in the control group (p < 0.05). The mean ITT in loperamide group II (174.5 +/- 32.3) was significantly longer than in loperamide group I (133.2 +/- 24.2 minute) (p < 0.05). The mean CTT was significantly longer in loperamide group II than in the control group (p < 0.05). Also, no animal succumbed to death after the experimental procedure. CONCLUSION: The protocol for our study using radiopaque markers and barium is reproducible and minimally invasive in determining the GI transit time of the mouse model.
Analysis of Variance ; Animals ; Barium Sulfate/pharmacology ; Contrast Media/administration & dosage ; Female ; Fluoroscopy ; Gastrointestinal Transit/*physiology ; Iron ; Loperamide/administration & dosage ; Mice ; Mice, Inbred BALB C ; Microscopy, Electron, Scanning ; Prostheses and Implants ; Reproducibility of Results ; Sodium Chloride/administration & dosage ; Surface Properties

INTRODUCTIONFew reports have documented allergic hypersensitivity reactions after barium gastrointestinal studies. Of these, the barium suspension, its additives or intravenous glucagon given for bowel relaxation has been implicated as possible allergens. We report a patient with delayed hypersensitivity reaction after barium enema and discuss the reasons supporting glucagon as the possible allergen.

CLINICAL PICTUREA 74-year-old Chinese woman presented with pruritic rashes, 1 day after a barium enema. Intravenous glucagon (GlucaGen, Novo Nordisk, Denmark) was administered during the barium enema. Physical examination revealed palpable purpuric rashes on the legs with erythematous papules and plaques on the arms and trunk. Skin biopsy demonstrated superficial perivascular infiltrates of lymphocytes and eosinophils, consistent with a drug eruption.

TREATMENT AND OUTCOMEThe rashes resolved with antihistamines and topical corticosteroids.

CONCLUSIONThis report highlights the potential of glucagon to cause hypersensitivity reactions. Awareness of this entity is important for the prevention and recognition of complications during barium gastrointestinal studies.

Adrenal Cortex Hormones ; therapeutic use ; Aged ; Barium Compounds ; Drug Hypersensitivity ; etiology ; Enema ; Female ; Glucagon ; administration & dosage ; adverse effects ; Histamine H1 Antagonists ; therapeutic use ; Humans ; Hypersensitivity, Delayed ; etiology ; Injections, Intravenous ; Parasympatholytics ; administration & dosage ; adverse effects ; Time Factors

OBJECTIVETo study the effects of resvaratrol derivatives on spontaneous HR and CF of isolated guinea pig atrium.

METHODThe dose-effect curve of resvaratrol was observed. The possible mechanism of potassium channels responsible for changes of CF and HR after administering with resvaratrol was measured.

RESULTResvaratrol reduced the spontaneous HR and weakened the CF in a dose-dependent manner ranging from 10(-6) to 3 x 10(-4) mol x L(-1) (P < 0.05). As compared with Res group, the effects were partly blocked by Gli (P < 0.05) and TEA (P < 0.01), but not blocked by 4-AP, BaCl2, Atropine.

CONCLUSIONResvaratrol can induce negative chronotropic action and negative (inotropic action. The mechanism(s) may relate to the opening of K(ATP) and Kc(Ca).

Animals ; Barium Compounds ; pharmacology ; Cardiotonic Agents ; administration & dosage ; isolation & purification ; pharmacology ; Chlorides ; pharmacology ; Dose-Response Relationship, Drug ; Female ; Glyburide ; pharmacology ; Guinea Pigs ; Heart Rate ; drug effects ; In Vitro Techniques ; KATP Channels ; antagonists & inhibitors ; Male ; Myocardial Contraction ; drug effects ; Plants, Medicinal ; chemistry ; Potassium Channel Blockers ; pharmacology ; Potassium Channels, Calcium-Activated ; antagonists & inhibitors ; Potassium Channels, Inwardly Rectifying ; antagonists & inhibitors ; Stilbenes ; administration & dosage ; isolation & purification ; pharmacology ; Tetraethylammonium ; pharmacology