Changes in gastric myoelectrical activity in hypertrophic pyloric stenosis and after surgical correction.

The changes of gastric myoelectrical activity were investigated in 20 infants by cutaneous electrogastrography (EGG) before and after the surgical correction of infantile hypertrophic pyloric stenosis (IHPS). The dominance of 2-4 cycles per minute (CPM) "slow waves" is typical of the healthy gastric function. The shift of the dominant frequencies towards the slower frequency (0-2 CPM) is defined as bradygastria, whereas a shift towards the more frequent waves (4-10 CPM) is called tachygastria. Unlike with healthy infants, the electrogastrogram showed pathologic patterns in 85% (18 out of 20) of IHPS patients. In all except two of these infants with pathologic electrical patterns, the frequency of the waves significantly shifted towards tachygastria. The effect of feeding on the gastric myoelectrical activity could only be studied in limited (9/20) cases because of recurring vomiting during the preoperative period. In IHPS infants, a significant increase in the bradygastria group was observed in the postprandial period compared with healthy infants. Three to 5 days after surgical repair (pyloromyotomy) and the reintroduction of feeding in gradually increasing amounts, the gastric myoelectrical activity showed physiologic patterns again, showing that the pyloric function was back to normal. Cutaneous EGG is a useful, noninvasive method to obtain indirect information about the motor function of the stomach and might be further applicable to pediatric gastric motility disorders.

Detection of mtDNA deletion in Pearson syndrome by two independent PCR assays from Guthrie card.

Pearson syndrome is a multisystem juvenile condition associated with deletions in the mitochondrial genome. The most common 4977 bp deletion of mitochondrial DNA (mtDNA) can mainly be detected in the patients' peripheral blood. Here we report a child with a clinically unclarified diagnosis where molecular genetic results proved Pearson syndrome from stored dried blood sample 6 months after the patient's death. PCR amplification around the breakpoint of the most common mtDNA deletion could detect the presence of mutated mtDNA. Another polymerase chain reaction (PCR) assay indicated the low level of wild type mtDNA in patients' blood. We believe that this case shows the importance of storing Guthrie card and the availability of detection of Pearson syndrome from dried blood sample.

Acremonium kiliense in oesophagus stenosis.

The aetiological significance of Acremonium kiliense is demonstrated for the first time in a human gastrointestinal infection. The mycotic oesophagitis with gastro-oesophageal reflux is described. The situation was treated effectively with itraconazole and anti-reflux surgery.

[Barrett esophagus in children]. / Barret-oesophagus gyermekekben.

The case of a 6.5 years old boy, hospitalised because of recurrent vomiting, epigastrial, periumbilical abdominal pain, is reported. The contrast--medium swallow--x-ray examination showed no alteration, while during repeated continuous 24 hours pH monitoring of the distal esophagus, the pH values permanently were wound to remain under 4. By esophagoscopy, only moderate inflammatory signs could be detected. The long-lasting complaints and the results of pH monitoring indicated serial biopsy from the esophagus-wall. The histological finding showed gastric mucosa 2 cm above the lower esophageal sphincter, i.e. a Barrett syndrome. Upon the treatment administered according to the diagnosis, the complaints of the child considerably improved.

The role of degradation of fetal haemoglobin in the energy supply of very low body weight pre-term babies.

Low body weight premature babies born before the 32nd gestational week were studied to analyse the postnatal fall in plasma haemoglobin and in quantitative changes in amino acid levels. Red blood cells of premature low body weight infants were found to disintegrate more rapidly than those of mature newborns. Thin-layer ion-exchange chromatographic studies showed that amino acids originating from the degrading haemoglobin-F lead to rise in plasma amino acids. These amino acids might play a role as substrates for gluconeogenesis in the energy supply of low body weight premature babies during the special fasting state just after birth.

Phytohaemagglutinin-induced leukocyte migration inhibition and phytohaemagglutinin skin test for screening the cell-mediated immune response in children.

Phytohaemagglutinin-induced leukocyte migration inhibition was studied in 72 children and compared with phytohaemagglutinin skin testing. The methods were used for screening the cell-mediated immune response. The in vitro method, which requires only 10-15% of the number of migrating cells as compared with other migration techniques, proved to be more sensitive, but gave some false-positive results when compared with other immunological parameters. Nevertheless, application of the microdroplet leukocyte migration is advantageous, used either simultaneously with the skin test, or as a single screening method in prematures, mature newborns and young infants, where application and/or evaluation of the skin tests is difficult.