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 47,337 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

"Spontaneous" tertiary esophageal contractions occur in a high proportion of healthy subjects. This study was carried out to investigate whether such contractions can be elicited by acoustical stimuli, to determine the threshold intensity at which contractions occur, and to find out how many of a sequence of equiintense tones at such a threshold intensity evoke contractile responses. Esophageal pressures were recorded 5, 10, and 15 cm above the lower esophageal sphincter, and swallowing was recorded by an electromyogram of the mylo-hyoid muscles. The results are summarized as follows: (a) All of 22 subjects exposed to 1000 Hz tones of intensities between 70 and 125 dBA responded with teritary contractions; their mean threshold intensity was 86.8 dBA +/- 3.0 SEM. Intensities that were 5 to 20 dBA higher were necessary to evoke contractions also in response to a second tone of a given intensity. (b) In 36 to 40 subjects exposed to 40 1000 Hz, 90 dBA tones tertiary contractions occurred in response to 47.2% of stimuli presented. (c) On repetitive stimulation, there was a significant decrease in number and amplitude of esophageal responses with an increasing number of stimuli. It is concluded that the esophagus takes part in the response system of the healthy organism to environmental stimuli.
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PMID:Tertiary esophageal contractions evoked by acoustical stimuli. 44 27

Nineteen patients with symptoms of upper gastrointestinal disease were assessed by endoscopy. Transmucosal potential difference (PD) in the lower oesophagus was recorded and suction biopsy specimens were obtained from the site of measurement and examined by light microscopy after haematoxylin and eosin staining. In 10 patients with normal histology, mean PD was--14.4 mV (SEM +/- 0.4 mV), whereas in nine patients with histological changes of reflux mean was +9.4 mV (SEM +/- 3.0 mV). In this latter group, polarity of the PD was reversed in all but one case. Good correlation was found between these objective indices of lower oesophageal disease and the presence of symptoms such as dysphagia and heartburn. The visual appearance at endoscopy was less reliable. It is suggested that measurement of PD is a simple, rapid, and sensitive method of detecting the presence of oesophageal mucosal damage.
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PMID:Transmucosal potential difference; diagnostic value in gastro-oseophageal reflux. 65 70

During exercise in a hot environment, blood flow in the exercising muscles may be reduced in favour of the cutaneous circulation. The aim of our study was to examine whether an acute heat exposure (65-70 degrees C) in sauna conditions reduces the blood flow in forearm muscles during handgrip exercise in comparison to tests at thermoneutrality (25 degrees C). Nine healthy men performed dynamic handgrip exercise of the right hand by rhythmically squeezing a water-filled rubber tube at 13% (light), and at 34% (moderate) of maximal voluntary contraction. The left arm served as a control. The muscle blood flow was estimated as the difference in plethysmographic blood flow between the exercising and the control forearm. Skin blood flow was estimated by laser Doppler flowmetry in both forearms. Oesophageal temperature averaged 36.92 (SEM 0.08) degrees C at thermoneutrality, and 37.74 (SEM 0.07) degrees C (P less than 0.01) at the end of the heat stress. The corresponding values for heart rate were 58 (SEM 2) and 99 (SEM 5) beats.min-1 (P less than 0.01), respectively. At 25 degrees C, handgrip exercise increased blood flow in the exercising forearm above the control forearm by 6.0 (SEM 0.8) ml.100 ml-1.min-1 during light exercise, and by 17.9 (SEM 2.5) ml.100 ml-1.min-1 during moderate exercise. In the heat, the increases were significantly higher: 12.5 (SEM 2.2) ml.100 ml-1.min-1 at the light exercise level (P less than 0.01), and 32.2 (SEM 5.9) ml.100 ml-1.min-1 (P less than 0.05) at the moderate exercise level.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Effect of heat stress on muscle blood flow during dynamic handgrip exercise. 139 49

It has been demonstrated that motility disorders may be responsible for esophageal and colon diverticulosis. Recently anatomic alterations of both small bowel muscular layers and myenteric plexus have been described in patients with small bowel diverticulosis. Such pathological features could be responsible for motility disorders and small bowel diverticulosis formation. The aim of this work was to study the small bowel motility in patients with small bowel diverticulosis. Ten patients (mean age: 69.2 +/- 6 years mean +/- SEM) with more than 3 diverticula in the jejunum or the ileum (excepting duodenal diverticulum) were studied. After an overnight fast, a 4 lumen probe (side holes 10 cm apart) was used to record duodeno-jejunal motility for 4 hours. Esophageal manometry was also performed in 8 patients. The mean number of phase 3 of the migrating motor complex (mean +/- SEM) during 4 hours was significantly lower in patients with small bowel diverticulosis (0.15 +/- 0.05/hours; mean +/- SEM) than in 10 normal volunteers (0.52 +/- 0.07/hours; mean +/- SEM) (P less than 0.01); 5 patients had zero phase 3 during the 4 hours of recording; one patient displayed intestinal hypomotility associated with aberrant phase 3 like activity; 4 patients showed simultaneous minute-rhythm during more than 80 percent of the phase 2 of the migrating motor complex. Esophageal manometry was also disturbed in 6 patients (low amplitude contractions less than 30 cm H2O in the distal esophagus). Bacterial overgrowth was investigated in 8 patients by means of a glucose breath-test and was found in 6 cases. In conclusion, duodeno jejunal motility is altered in patients with small bowel diverticulosis.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Intestinal motility in patients with small bowel diverticulosis]. 190 Dec 89

Phenylephrine (Phe) is frequently administered as an intravenous (IV) bolus to increase blood pressure, yet the acute time course and hemodynamic effects of bolus Phe in patients with myocardial disease have not been reported. Therefore 50 randomized IV bolus doses of Phe (50, 100, 150, or 200 micrograms) were given to 18 patients during anesthesia for elective coronary artery surgery. Esophageal Doppler techniques were used to continuously monitor cardiac output (CO); mean arterial pressure (MAP), CO, and calculated systemic vascular resistance (SVR) were recorded every 5 seconds for a total of 2 minutes. The hemodynamic changes (mean +/- SEM) for each of the four doses of Phe (50, 100, 150, 200 micrograms) were maximal at about 42 seconds after the drug was given. They consisted of an increase in MAP (11.6 +/- 2.1, 15.6 +/- 2.4, 14.7 +/- 2.4, 18.0 +/- 1.5 mm Hg); increase in SVR (766 +/- 190, 930 +/- 310, 950 +/- 344, 1732 +/- 824 dynes.sec.cm-5); and a decrease in CO (-.58 +/- .11, -.68 +/- .13, -.73 +/- .20, -.77 +/- .18 L.min-1). Hypertension, increased age, low preoperative ejection fraction, high baseline CO, and low baseline SVR significantly (P less than 0.05) decreased hemodynamic responses to Phe (see text). In conclusion, bolus IV Phe in patients with myocardial disease increases MAP and SVR and simultaneously decreases CO; these peak hemodynamic events occur approximately 42 seconds after Phe administration.
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PMID:Time course and hemodynamic effects of alpha-1-adrenergic bolus administration in anesthetized patients with myocardial disease. 254 37

1. We measured brain and colonic temperatures in adult pigeons (Columba livia) with or without oesophageal ligation, and with or without simultaneous eye covering at ambient temperatures between 24 degrees C and 45 degrees C. 2. Colonic and brain temperatures rose at the higher ambient temperatures; the temperature elevations were no different in pigeons with oesophageal ligation, compared to sham-operated controls. The presence of simultaneous eye covering also had no effect on colonic or brain temperatures. 3. Oesophageal inflation decreased from a rate of 2.8 +/- 1.4 per minute (mean +/- SEM) to zero, in anaesthetized pigeons when warmed from a colonic temperature of 40.5 degrees C to 43.8 degrees C. 4. In pigeons oesophageal inflation plays no significant part in body temperature regulation or in the maintenance of a lower brain than body temperature even in hot ambient conditions.
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PMID:The effects of ligation of the oesophagus on body and brain temperature in pigeons. 288 95

Oesophageal transit and gastric emptying of liquids and solids was measured in eight normal subjects with a single test meal containing In113 labelled water and an omelette labelled with Tc99m sulphur colloid. Each volunteer was studied, basally, whilst continuously smoking, and while chewing nicotine gum. Neither liquid, nor solid oesophageal transit were affected by smoking, or gum. Liquid gastric emptying occurred exponentially and clearance was not affected by smoking nor gum (mean basal t1/2 17.4 (2.7) (SEM) min, smoking t1/2 16.6 (7.4) min, gum t1/2 12.5 (2.9) min). Gastric emptying of solid had three components. An initial mean lag phase increased from 17.5 (2.7) min, to 27.5 (6.1) min (p less than 0.05) during smoking, but was not prolonged by nicotine gum (17.5 (1.1) min). A subsequent linear emptying phase was also slowed by smoking from a mean of 1.01 (0.15)% min to 0.80 (0.15)% min (p less than 0.05), but was not affected by nicotine gum, 1.06 (0.2)% min. A third complex phase of solid gastric emptying was not analysed. Smoking delays gastric emptying of solids, but not liquids; nicotine is not responsible for this effect. This observation may partly explain the adverse effect of smoking in patients with gastro-oesophageal reflux.
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PMID:Smoking delays gastric emptying of solids. 292 Sep 27

Enkephalins are short lived peptides which are rapidly cleaved by 2 membrane peptidases: an enkephalinase and a carboxypeptidase. Enkephalin-like immuno-reactivity has been demonstrated in the smooth muscle and in the myenteric plexus of the human lower esophageal sphincter (LES). Opioid receptors have been found in the gastrointestinal tract and recently an enkephalin analog has been shown to inhibit LES relaxation and modify the peristaltic progression of the esophageal contractions. Acetorphan is an enkephalinase inhibitor which prevents, at least to some extent, the hydrolysis of endogenous enkephalins. Thus, the present work was designed to study the effect of acetorphan on esophageal motility. Ten healthy volunteers (mean age: 23 years) were studied. On 2 separate days, each subject received in random order acetorphan (2.5 mg/kg intravenously at a constant rate in 20 min) or placebo. Esophageal manometry was performed with a Dentsleeve. Wet swallows (5 ml) were performed at 1 min intervals during 80 min and results were pooled in 10 min periods. Acetorphan inhibited significantly (p less than 0.02) LES relaxation 20 min after the beginning of the infusion and throughout the study. The maximal effect occurred 50 min after the beginning of acetorphan infusion and LES relaxation (m +/- SEM) was reduced from 92 +/- 2.6 to 79.5 +/- 2.9 p. 100 (p less than 0.01). Duration, amplitude, and velocity of esophageal contractions were not modified. Acetorphan an enkephalinase inhibitor, is able to reproduce the effect of IV exogenous enkephalins on LES relaxation in man. This result suggest that endogenous enkephalins might play a role in the normal control of the LES relaxation.
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PMID:Effects of an enkephalinase inhibitor on esophageal motility in man. 322 Feb 32

Esophageal pressure events during deglutition were evaluated in healthy adult animals (6 horses, 6 cattle, and 5 sheep), using a 3-side hole catheter assembly perfused with water by use of a hydraulic-capillary infusion system. The peak postdeglutition pressure, contraction time, and contraction length were determined for the cranial and caudal esophageal sphincter regions and for each functionally different region within the body of the esophagus. The percentage of deglutitions in which relaxation developed at the sphincter regions and the propagation speed (velocity at which pressure waves traversed the esophagus) for the regions within the body of the esophagus also were determined. Mean (+/- SEM) resting pressures within the cranial and caudal esophageal sphincter regions in the horse were 84.8 +/- 4.39 and 12.7 +/- 0.61 mm of Hg, respectively, with postdeglutition peaks of 208.0 +/- 4.78 and 100.0 +/- 1.06 mm of Hg, respectively. Peak postdeglutition pressure was 92.3 +/- 1.59 mm of Hg in the cranial two thirds of the esophageal body and 100.9 +/- 1.31 mm of Hg in the caudal third. Mean resting pressure of the cranial esophageal sphincter region in the cow was 82.0 +/- 7.81 mm of Hg, whereas that of the caudal esophageal sphincter region was 20.5 +/- 0.36 mm of Hg. The peak postdeglutition pressures for the cranial esophageal sphincter region, proximal portion of the esophageal body, caudal portion of the esophageal body, and caudal esophageal sphincter region in the bovine esophagus were 238.1 +/- 2.93, 105.4 +/- 1.97, 114.5 +/- 1.49, and 112.0 +/- 1.20 mm of Hg, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Esophageal manometry in horses, cows, and sheep during deglutition. 359 52

To reassess 24-hour esophageal monitoring and determine if shorter time periods might retain its diagnostic benefits, we studied 16 gastroesophageal reflux (GER) patients and eight controls. Esophageal pH monitoring was performed for 24 hours, with patients in an upright position during the day and supine when retiring. During the 24-hour pH monitoring period, the mean percentage time that pH was less than 4.0 in GER patients, 13.2% +/- 2.9% (SEM), was significantly higher than in normal subjects, 0.7% +/- 0.2% (SEM). Analysis of individual data indicated clear separation of GER patients from normal subjects when in the upright posture, but 25% of GER patients were within the range of the normal subjects when supine (overnight). Three-hour time periods after meals were analyzed. Postprandial pH monitoring, when compared with 24-hour pH monitoring, can identify GER with a 77% sensitivity and a 96% specificity. A 12-hour period (four hours after the dinner meal and eight hours supine) can identify GER with a 94% sensitivity and a 100% specificity. We conclude that (1) 24-hour pH monitoring of the esophagus may have a continuing role in research aspects of GER, (2) 12-hour pH monitoring is a highly accurate test that could be adapted to patients' work schedules or to outpatient telemetry, and (3) postprandial pH testing is a practical, less expensive, and accurate method of diagnosing GER that could be utilized by any gastroenterology diagnostic unit.
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PMID:The role of prolonged esophageal pH monitoring in the diagnosis of gastroesophageal reflux. 647 39


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