SUMMARY A new method is described which allows simultaneous measurement of gastric emptying and duodenogastric reflux and avoids transpyloric intubation. After intragastric instillation of a liquid lipid meal in six healthy volunteers the fractional gastric emptying rate was 2.9±0.3 in the upright and 2.5±0 6 SEM x1T2/min in the supine position, respectively (p>0.5). The duodenogastric reflux rate (expressed as fraction of the intraduodenal amount of duodenal marker) was 0.30 (range 0.03-081) and 0.22 (0.01-0.55) x102/min, respectively (p>0.2). Atropine (40 ,g/kg) decreased the supine gastric emptying rate to 1.1 ±02 (p<005) and increased the supine duodenogastric reflux rate to 2.74 (0.04-9.80) x 102/min (p<005). Fasting duodenogastric reflux rate was similar in the supine and upright position, 0.49 (0.04-0.89) and 0.42 (0.06-0.97) x 102/min, respectively (p>0.5). Fractional gastric emptying rate was similar in 10 volunteers and 17 patients with type I gastric ulcer (21±04 vs 1.7±0.2 SEM x 10-2/min, p>0O2). Their duodenogastric reflux rates were also similar, 0-65 (0.01-5.24) vs 1.10 (0.01-10.83)x102/min (p>05). We conclude therefore that (1) gastric emptying and both fasting and postprandial duodenogastric reflux are independent of the posture; (2) fasting and postprandial reflux are of similar magnitude; (3) atropine shows gastric emptying and increases duodenogastric reflux; and (4)

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A 4-year-old girl presented with recurrent infections. Immunoglobulin deficiency (serum and secretory IgA, serum IgG3) neutropenia and neutrophil dysfunction (defective spontaneous migration and chemotaxis) were found. T-lymphocyte counts were normal and they responded to phytohaemagglutinin but were not stimulated by Concanavalin A, pokeweed mitogen and microbial antigens in vitro. Delayed cutaneous hypersensitivity testing to purified protein derivative and candidin was negative. Despite bacille Calmette-Guérm vaccination and candidiasis, near normal beta-2-micro-globulin and human leucocyte antigen (HLA) class I concentrations were detected on mononuclear cells and phytohaemagglutinin-induced lymphoblasts. HLA class II antigens (HLA-DP, -DQ, -DR) were not expressed. These observations indicated a bare lymphocyte syndrome (BLS) type II. This is the first time neutrophil dysfunction has been noted in association with BLS.