摘要:

AbstractOesophageal hyperalgesia was demonstrated in the non‐cardiac chest pain syndrome and suggests an altered perception of visceral stimuli in these patients. Data on oesophageal sensory function and its pharmacological manipulation, however, are fragmentary.Using a randomized, double‐blind, placebo‐controlled, cross‐over design, ten healthy male volunteers were manometrically examined for the effects of topical oesophageal anaesthesia with benzocaine 0.75% on (1) oesophageal perception of graded intra‐luminal balloon distension, (2) oesophageal compliance and primary motility, and (3) rectal perception of graded intraluminal balloon distension.It was demonstrated that topical benzocaine significantly increased oesophageal perception thresholds for intraluminal distension (P<0.03), irrespective of them being correlated to distension volume or distension pressure. The level of first sensation increased from 4.3 ml (SD 2.8) and 24.8 mmHg (SD 9.1) to 7.4 ml (SD 4.4) and 32.1 mmHg (SD 8.3), respectively; pain perception increased from 11.O ml (SD 4.5) and 30.9 mmHg (SD 8.9) to 14.5 ml (SO 5.1) and 38.3 mmHg (SD 10.2), respectively. In contrast, oesophageal compliance, primary oesophageal motility and rectal perception were not altered.It was concluded that topical anaesthesia decreases visceral sensitivity of the oesophagus to mechanical distension by action on intramural nervous afferents. It does not affect oesophageal motor function, nor does it exert systemic analgesi

ISSN:1350-1925    

DOI:10.1111/j.1365-2982.1994.tb00191.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

AbstractBackground: Two‐dimensional ultrasonography has shown a widened gastric antrum in patients with non‐ulcer dyspepsia (NUD) and erosive prepyloric changes (EPC).Methods: In this study, volumes of gastric antrum and gallbladder were estimated with three‐dimensional (30) ultrasonography before and after ingestion of 500 ml meat soup in 17 NUD with EPC patients and in 18 healthy subjects. A mechanical ultrasound scanner, coupled to a stepping motor, tilted the transducer through an angle of 51° or 88° while recording a total of 95 or 81 images, respectively. Volume estimation was performed digitally after interactive manual contour tracing and organ reconstruction in three dimensions.Results: Antral volumes were larger in NUD patients than in healthy controls (P = 0.001). Fasting gallbladder volumes were similar in the two groups. Postprandial antral filling was more pronounced in patients than in healthy subjects (P = 0.02). whereas gallbladder emptying was more pronounced in healthy subjects than in patients (P = 0.05). The soup induced dyspeptic symptoms in 15 NUD patients, but only had this effect in two healthy subjects (P<0.001).Conclusion: Patients with NUD and EPC are characterized by abnormal antral filling, reduced gallbladder emptying, and dyspeptic symptoms in response to ingestion of me

ISSN:1350-1925    

DOI:10.1111/j.1365-2982.1994.tb00192.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

AbstractInfants commonly regurgitate during some, but not all, gastro‐oesophageal reflux episodes. As several different mechanisms for reflux episodes have been identified, it was hypothesized that the mechanisms for regurgitant and non‐regurgitant reflux differ. To test whether regurgitant episodes are associated with, and perhaps propelled by, rectus abdominis contraction, ten infants, aged 9–30 weeks (median 16.5 weeks), with regurgitant reflux and no other cause for their regurgitation, were studied with concurrent distal oesophageal pH probe monitoring and surface electromyography of the rectus abdominis muscles. Reflux episodes with material emanating from the mouth (regurgitant reflux) were distinguished from those without visible regurgitation, and were characterized as being, or not being, temporally associated with rectus abdominis activity.During 80 h of monitoring of the ten infants, 279 reflux episodes were identified. Electromyographic activity was observed with 58% of 24 regurgitant reflux episodes compared to only 32% of 255 non‐regurgitant reflux episodes (Mantel Haenzel P = 0.006, common odds ratio = 4.1, 95% confidence interval = 1.5–11.3). Among the 95 reflux episodes that were positive for rectus abdominis activity (whether regurgitant or not), 25% of those in the first 42 min following feeding were regurgitant, whereas only 6% of those occurring beyond 42 min were regurgitant (Mantel Haenzel P = 0.03, common odds ratio = 4.48, 95% confidence interval = 1.14–17.6). It was concluded that rectus abdominis contraction is one of the propulsive mechanisms that contribute to regurgitant reflux. Further, rectus abdominis contraction is more likely to result in regurgitation in the early period after a meal, suggesting that intragastric volume is a factor which influences whether reflux will be

ISSN:1350-1925    

DOI:10.1111/j.1365-2982.1994.tb00193.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

AbstractThis paper presents a new and effective adaptive filtering method for the cancellation of electrocardiogram (ECG) artifacts in the electromyographic (EMG) signals obtained through intraoesophageal electrodes. This technique requires adjustable filter weights and two input signals. The primary input signal was the EMG signal containing the ECG artifact and the reference or the second input was the ECG signal measured simultaneously by two chest electrodes. The adaptive filter weights were initially set at zero and iteratively adjusted according to a least mean square algorithm proposed in this paper. The filter weights were adjusted in such a way that the output of the adaptive filter was a replica of the contaminating ECG signal, which was then subtracted from the EMG signal, yielding an ECG‐free EMG signal. The performance of the proposed method was investigated using computer simulations. It was found that ECG artifacts could be effectively cancelled while the EMG signal was not affected by adaptive filtering. Its applications showed that the proposed new algorithm had better performance than the conventional least mean square algorithm. The EMG signals were obtained in six healthy subjects, during swallows (oesophageal muscle EMG) and deep inspiration (crural diaphragm EMG). Our results demonstrated the effective cancellation of the ECG artifact in both swallow‐induced and inspiration‐related EMG signals. Spectral analysis of the EMG was performed on the ECG‐free EMG signal. The inspiration‐related EMG signal was found to have higher frequency components than the swallow‐

ISSN:1350-1925    

DOI:10.1111/j.1365-2982.1994.tb00194.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

AbstractThe present in vivo study was conducted to investigate contractile activity and epithelial electrolyte transport in an inflammatory state during experimental colitis in the rabbit. Intrarectal administration of trinitrobenzenesulphonic acid (TNBS) induced a colitis‐like inflammation in the distal colon. Under basal conditions, TNBS evoked irregular patterns of contractions in 40% of treated animals, but total contractility and transmural potential difference were not significantly altered by this treatment. Contractile activity and transmural potential difference were increased by luminal perfusion with phosphate buffered saline in control, but not in TNBS‐treated animals. It was concluded that the inflamed colon does not respond normally to luminal stimulation and that this may contribute to the pathophysiology of inflammatory bowel disease (I

ISSN:1350-1925    

DOI:10.1111/j.1365-2982.1994.tb00195.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

AbstractThe mechanical and secretory factors in the stomach that may be implicated in the production of symptoms are still poorly understood. To determine whether symptoms in response to postcibal gastric distention are associated with increased acid secretion, the relationship between symptoms, acid secretion and intragastric pressure in healthy subjects was investigated. Perception (by a 0–6 score questionnaire) and the gastric secretory response to a glucose test meal (by intragastric titration) was quantified either at low (2 mmHg) or at high (8 mmHg) intragastric pressure levels, maintained by feedback regulation of the air volume within a gastric bag using an electronic barostat. Low intragastric pressure produced a small gastric expansion (87 ± 26 ml; mean ± SE) that was largely unperceived (score 0.7 ± 0.5). High intragastric pressure did not increase acid secretion (15 ± 3 mEq h‐1vs 16 ± 3 mEq h‐1at low pressure), but produced symptomatic perception (score 2.5 ± 0.7) related to a marked gastric expansion (521 ± 92 ml; P<0.05 vs low pressure for both). It was concluded that postcibal gastric hypertension induces symptoms without affecting the gastric acid secretory response

ISSN:1350-1925    

DOI:10.1111/j.1365-2982.1994.tb00196.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

AbstractAccording to recent manometric studies the last part of phase III of the migrating motor complex (MMC) shows the features of a retroperistaltic pump in the proximal duodenum in most healthy humans. In the present study, individual contractions in phase II and phase III of the MMC were investigated in ten healthy subjects (four males, six females), focusing on the distal duodenum and the jejunum. Motility was recorded on two different days with eight‐channel catheters. On one day a standard antroduodenojejunal fasting recording was performed for 5 h, allowing detailed analysis of pressure waves in the proximal duodenum. On another day a two‐station measurement was performed in the proximal jejunum and the distal duodenum. The propagated pressure waves were analysed for late phase II (last 30 min) and for the first and the last part (I min) of phase III in the three intestinal segments. Antegrade peristalsis predominated at all levels in phase II and in the first part of phase III. In contrast, 84 ± 11% of all propagated contractions were retrograde in the last part of phase III in the proximal duodenum and 75 ± 16% in the distal duodenum. The proportions of retrograde contractions in early phase III and in late phase III differed significantly, from 11 ± 11% to 84 ± 11% and from 32 ± 16% to 75 ± 16% in the proximal and distal duodenum, respectively (P<0.01 and P<0.05). In the proximal jejunum such retroperistalsis was not observed, neither in the beginning nor at the end of phase III. In phase II the proportions of retrograde pressure waves were small (3–10%) in the three segments studied. The migration velocity of the pressure waves showed a gradient in this phase, with the lowest values in the jejunum.It is concluded that the last part of phase III shows the pressure pattern of a retroperistaltic pump through out the duodenum. In contrast, no distinct MMC‐related retroperistalsis was observed i

ISSN:1350-1925    

DOI:10.1111/j.1365-2982.1994.tb00197.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

ISSN:1350-1925    

DOI:10.1111/j.1365-2982.1994.tb00198.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

ISSN:1350-1925    

DOI:10.1111/j.1365-2982.1994.tb00199.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

Book reviewed in this article:Constipation, Kam MA, Lennard‐Jones JE, ed

ISSN:1350-1925    

DOI:10.1111/j.1365-2982.1994.tb00200.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY