1. Chey,
W.D., Shapiro, B., Zawadski, A. and Goodman, K. (2001)
Gastric emptying characteristics of a novel 13C-octanoate-labeled
muffin meal.J. Clin. Gastroenterol 32:394-399.
The objective of this study was to determine the gastric
emptying characteristics of a novel, 350-kcal test meal
consisting of two muffins, using scintigraphy and the
13C-octanoate breath test. Twenty healthy
volunteers underwent three studies on separate days
within a 1-week period. On day 1, they received a 350-kcal
muffin test meal labeled simultaneously with 99mTc
sulfur colloid and 13C-octanoate. On day
2, reproducibility of the muffin meal, 13C-octanoate
breath test was assessed. On day 3, the effect of erythromycin
(200 mg intravenously) was determined. There was a strong
correlation between half-emptying time (T1/2) determined
by scintigraphy and the breath test (r=0.83). The mean
T1/2 (±SD) for replicate determinations
using the breath test was 209 ± 52 minutes, compared
with 196 ± 42 minutes on days 1 and 2, respectively
(not significant, p=0.28). Treatment with erythromycin
on day 3 produced a significant decrease in T1/2
(155 ± 49 minutes, p=0.002). The 350-kcal muffin meal
provides a convenient, nonscintigraphic way of measuring
solid-phase gastric emptying.
2. Gonlachanvit, S., Chey, W.D., Goodman,
K.J. and Parkman, H.P. (2001) Effect of meal size and
test duration on gastric emptying and gastric myoelectrical
activity as determined with simultaneous [13C]Octanoate
Breath Test and electrogastrography in normal subjects
using a muffin meal. Dig Dis Sci 46:2643-2650.
The purpose of the study was to determine
the effect of meal size on gastric emptying (GE) as
measured by the octanoate breath test (OBT) muffin meal,
to determine the effect of the duration of breath collections
on assessment of GE by OBT and to determine the effect
of meal size on gastric myoelectrical activity as measured
by electrogastrography (EGG). Fourteen normal subjects
underwent two modified [13C]OBTs using muffin
meals of 250 or 350 kcal mixed with 13C-octanoate.
T1/2 for GE was determined for both the entire
postprandial 6-hr breath collection and a truncated
initial 4-hr data set. EGG was recorded for 30 min prior
to the muffin meal and 4 hr postprandially. Using the
4-hr data, the T1/2 for the 350-kcal meal
was 244 ± 32 min compared to 165 ± 12 min (p<0.05)
for the 250-kcal meal. The ratio of postprandial to
fasting EGG power of the dominant frequency for the
350-kcal meal (1.9 ± 0.4) was higher than that for the
250-kcal meal (1.3 ± 0.6). T1/2 for the 350-kcal
meal using the 4- and 6-hr data was significantly correlated
with the 4-hr power ratio (r=0.68 and 0.67; p<0.05,
respectively), but poorly correlated for the 250-kcal
meal. In conclusions, GE and EGG are affected by meal
size.
3. Bromer, M.Q., Kantor, S.B., Wagner,
D.A., Knight, L.C., Maurer, A.H., and Parkman, H.P.
(2002) Simultaneous measurement of gastric emptying
with a simple muffin meal using [13C]octanoate
breath test and scintigraphy in normal subjects and
patients with dyspeptic symptoms. Dig Dis Sci. 47:1657-1663.
The objective of this study was to determine how the
[13C]octanoate breath test (OBT) using a
muffin meal correlates with gastric emptying scintigraphy
(GES) in normal subjects and patients with dyspeptic
symptoms. Ten normal subjects and 23 patients with dyspeptic
symptoms underwent simultaneous GES and [13C]OBT.
After an overnight fast, a muffin labeled with [99mTc]-sulfur
colloid and [13C]octanoate was ingested along
with water labeled with [111In] DTPA. Breath
samples and scintigraphic images were obtained at baseline
and at regular postprandial intervals over 6 hr. In
normal subjects, the calculated OBT T1/2
using the breath collections correlated with T1/2
for solids by GES (r=0.664, p=0.05) but did not correlate
with T1/2 for liquids (r=0.13, p=0.738).
In dyspeptic patients, the T1/2 for the OBT
correlated with solid-phase GES T1/2 (r=0.86;
p<0.001). Delayed gastric emptying (GE) of the muffin
meal was identified by scintigraphy in seven patients.
The sensitivity and specificity for the OBT identifying
delayed GE were 86% and 94%, respectively. In conclusion,
the OBT for GE, using an easily prepared muffin meal,
significantly correlates with GES for solids. This muffin-based
OBT is a sensitive and specific method to detect delayed
GE in dyspeptic patients.
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