Distension during gastroesophageal reflux: effects of acid inhibition and correlation with symptoms

2007 ◽  
Vol 293 (2) ◽  
pp. G469-G474 ◽  
Author(s):  
Neelesh A. Tipnis ◽  
Poong-Lyul Rhee ◽  
Ravinder K. Mittal
Keyword(s):  
Chest Pain ◽  
Gastroesophageal Reflux ◽  
Ultrasound Imaging ◽  
Significant Role ◽  
Physiological Data ◽  
Ultrasound Images ◽  
Sectional Area ◽  
Cross Sectional ◽  
Esophageal Ph ◽  
The Mean

We studied spontaneous gastroesophageal reflux (GER)-induced esophageal distension using ultrasound imaging and its role in the genesis of esophageal symptoms before and during esomeprazole therapy. Ten controls and 10 GER disease (GERD) patients were studied by combined impedance, esophageal pH, manometry, and ultrasonography before and during esomeprazole therapy. Physiological data and symptoms were recorded for 2 h following a standardized meal. From ultrasound images, the esophageal cross-sectional area (CSA) at the peak of GER-induced distension was determined and compared between controls vs. patients, symptomatic vs. asymptomatic GER episodes, and before vs. during esomeprazole in GERD patients. The mean lumen CSA is greater in the patients than controls (271 ± 71 mm2 vs. 163 ± 56 mm2, P = 0.001) but not different among asymptomatic reflux episodes, and those associated with regurgitation (290 ± 110 mm2) or heartburn (271 ± 67 mm2). Eight chest pain episodes associated with reflux revealed a tendency toward larger mean esophageal distension (459 ± 40 mm2) compared with asymptomatic reflux (268 ± 70 mm2, P = 0.058). Following esomeprazole treatment, most GER episodes were nonacidic and asymptomatic except in two patients in whom cyclical reflux was associated with large esophageal distensions. Esomeprazole did not alter the lumen CSA during GER. Esophageal distension is greater in the GERD subjects compared with controls; however, it is unlikely that the GER-induced distension of the esophagus plays a significant role in the genesis of heartburn sensation. Esomeprazole therapy does not alter the GER-induced distension of the esophagus.

Postnatal ultrasound follow-up in neonates with prenatal hydronephrosis

Diagnosis ◽  
2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Elham Kebriyaei ◽  
Ali Davoodi ◽  
Seyed Alinaghi Kazemi ◽  
Zahra Bazargani
Keyword(s):  
Ultrasound Imaging ◽  
Maternal Education ◽  
Left Kidney ◽  
Ultrasound Images ◽  
Fetal Ultrasound ◽  
Renal Anomalies ◽  
Cross Sectional ◽  
Fetal Hydronephrosis ◽  
Kidney Involvement

Abstract Objectives Renal anomalies are the most common fetal abnormalities that occur during prenatal development, and are typically detected by observing hydronephrosis on fetal ultrasound imaging. Follow-up with post-natal ultrasound is important to detect clinically-important obstruction, because many of the pre-natal abnormalities resolve spontaneously. This study aimed to evaluate the postnatal hydronephrosis follow-up rate, and reasons for non follow-up in affected neonates. Methods In this cross-sectional study all neonates born during a period of one year at Ayatollah Mousavi Hospital with hydronephrosis on fetal ultrasound imaging were recruited. All mothers were also given face-to-face information about fetal hydronephrosis and its postnatal outcomes, and follow-up with at least a postnatal ultrasound was recommended from the fourth day of their neonates’ birth until the end of the fourth week. The neonates were subsequently observed for one month to determine the postnatal ultrasound follow-up rate and to reflect on diagnostic test results, reasons for failure to follow-up, as well as causes of hydronephrosis. Results In this study, 71 cases (1.2%) out of 5,952 neonates had fetal hydronephrosis on prenatal ultrasound images. The postnatal ultrasound imaging showed kidney involvement in 18 neonates (25%), particularly in the left kidney (61.1%). Seven neonates had no follow-up at one month (10%). No significant relationship was found between lack of follow-up and the neonates’ place of residence (p=0.42), maternal education (p=0.90), number of siblings (p=0.33), or gender (p=0.64). Conclusions Postnatal ultrasound follow-up rate in these neonates with a history of fetal hydronephrosis was incomplete even though parents had been provided with education and advice at their birth time. Accordingly, it is recommended to perform postnatal ultrasound once neonates are discharged from hospitals.

scholarly journals Atrophy patterns in isolated subscapularis lesions

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Gernot Seppel ◽  
Andreas Voss ◽  
Daniel J. H. Henderson ◽  
Simone Waldt ◽  
Bernhard Haller ◽  
...  
Keyword(s):  
Muscle Atrophy ◽  
Area Ratio ◽  
Cross Sectional Area ◽  
Control Group ◽  
Sectional Area ◽  
Cross Sectional ◽  
Subscapularis Muscle ◽  
Mri Scans ◽  
The Mean ◽  
The Cross

Abstract Background While supraspinatus atrophy can be described according to the system of Zanetti or Thomazeau there is still a lack of characterization of isolated subscapularis muscle atrophy. The aim of this study was to describe patterns of muscle atrophy following repair of isolated subscapularis (SSC) tendon. Methods Forty-nine control shoulder MRI scans, without rotator cuff pathology, atrophy or fatty infiltration, were prospectively evaluated and subscapularis diameters as well as cross sectional areas (complete and upper half) were assessed in a standardized oblique sagittal plane. Calculation of the ratio between the upper half of the cross sectional area (CSA) and the total CSA was performed. Eleven MRI scans of patients with subscapularis atrophy following isolated subscapularis tendon tears were analysed and cross sectional area ratio (upper half /total) determined. To guarantee reliable measurement of the CSA and its ratio, bony landmarks were also defined. All parameters were statistically compared for inter-rater reliability, reproducibility and capacity to quantify subscapularis atrophy. Results The mean age in the control group was 49.7 years (± 15.0). The mean cross sectional area (CSA) was 2367.0 mm2 (± 741.4) for the complete subscapularis muscle and 1048.2 mm2 (± 313.3) for the upper half, giving a mean ratio of 0.446 (± 0.046). In the subscapularis repair group the mean age was 56.7 years (± 9.3). With a mean cross sectional area of 1554.7 mm2 (± 419.9) for the complete and of 422.9 mm2 (± 173.6) for the upper half of the subscapularis muscle, giving a mean CSA ratio of 0.269 (± 0.065) which was seen to be significantly lower than that of the control group (p < 0.05). Conclusion Analysis of typical atrophy patterns of the subscapularis muscle demonstrates that the CSA ratio represents a reliable and reproducible assessment tool in quantifying subscapularis atrophy. We propose the classification of subscapularis atrophy as Stage I (mild atrophy) in case of reduction of the cross sectional area ratio < 0.4, Stage II (moderate atrophy) in case of < 0.35 and Stage III (severe atrophy) if < 0.3.

Mechanical load-dependent regulation of satellite cell and fiber size in rat soleus muscle

2006 ◽  
Vol 290 (4) ◽  
pp. C981-C989 ◽  
Author(s):  
X. D. Wang ◽  
F. Kawano ◽  
Y. Matsuoka ◽  
K. Fukunaga ◽  
M. Terada ◽  
...  
Keyword(s):  
Satellite Cell ◽  
Muscle Fiber ◽  
Satellite Cells ◽  
Central Region ◽  
Sarcomere Length ◽  
Sectional Area ◽  
Cross Sectional ◽  
Fiber Properties ◽  
Rat Soleus Muscle ◽  
The Mean

The effects of mechanical unloading and reloading on the properties of rat soleus muscle fibers were investigated in male Wistar Hannover rats. Satellite cells in the fibers of control rats were distributed evenly throughout the fiber length. After 16 days of hindlimb unloading, the number of satellite cells in the central, but not the proximal or distal, region of the fiber was decreased. The number of satellite cells in the central region gradually increased during the 16-day period of reloading. The mean sarcomere length in the central region of the fibers was passively shortened during unloading due to the plantarflexed position at the ankle joint: sarcomere length was maintained at <2.1 μm, which is a critical length for tension development. Myonuclear number and domain size, fiber cross-sectional area, and the total number of mitotically active and quiescent satellite cells of whole muscle fibers were lower than control fibers after 16 days of unloading. These values then returned to control values after 16 days of reloading. These results suggest that satellite cells play an important role in the regulation of muscle fiber properties. The data also indicate that the satellite cell-related regulation of muscle fiber properties is dependent on the level of mechanical loading, which, in turn, is influenced by the mean sarcomere length. However, it is still unclear why the region-specific responses, which were obvious in satellite cells, were not induced in myonuclear number and fiber cross-sectional area.

scholarly journals The influence of muscle pennation angle and cross-sectional area on contact forces in the ankle joint

2016 ◽  
Vol 52 (1) ◽  
pp. 12-23 ◽  
Author(s):  
Ran S Sopher ◽  
Andrew A Amis ◽  
D Ceri Davies ◽  
Jonathan RT Jeffers
Keyword(s):  
Pennation Angle ◽  
Muscle Architecture ◽  
Cross Sectional Area ◽  
Contact Forces ◽  
Sectional Area ◽  
Muscle Forces ◽  
Cross Sectional ◽  
Contact Loads ◽  
The Mean ◽  
And Function

Data about a muscle’s fibre pennation angle and physiological cross-sectional area are used in musculoskeletal modelling to estimate muscle forces, which are used to calculate joint contact forces. For the leg, muscle architecture data are derived from studies that measured pennation angle at the muscle surface, but not deep within it. Musculoskeletal models developed to estimate joint contact loads have usually been based on the mean values of pennation angle and physiological cross-sectional area. Therefore, the first aim of this study was to investigate differences between superficial and deep pennation angles within each muscle acting over the ankle and predict how differences may influence muscle forces calculated in musculoskeletal modelling. The second aim was to investigate how inter-subject variability in physiological cross-sectional area and pennation angle affects calculated ankle contact forces. Eight cadaveric legs were dissected to excise the muscles acting over the ankle. The mean surface and deep pennation angles, fibre length and physiological cross-sectional area were measured. Cluster analysis was applied to group the muscles according to their architectural characteristics. A previously validated OpenSim model was used to estimate ankle muscle forces and contact loads using architecture data from all eight limbs. The mean surface pennation angle for soleus was significantly greater (54%) than the mean deep pennation angle. Cluster analysis revealed three groups of muscles with similar architecture and function: deep plantarflexors and peroneals, superficial plantarflexors and dorsiflexors. Peak ankle contact force was predicted to occur before toe-off, with magnitude greater than five times bodyweight. Inter-specimen variability in contact force was smallest at peak force. These findings will help improve the development of experimental and computational musculoskeletal models by providing data to estimate force based on both surface and deep pennation angles. Inter-subject variability in muscle architecture affected ankle muscle and contact loads only slightly. The link between muscle architecture and function contributes to the understanding of the relationship between muscle structure and function.

A computed method for noninvasive MRI assessment of pulmonary arterial hypertension

2004 ◽  
Vol 96 (2) ◽  
pp. 463-468 ◽  
Author(s):  
Eric Laffon ◽  
Christophe Vallet ◽  
Virginie Bernard ◽  
Michel Montaudon ◽  
Dominique Ducassou ◽  
...  
Keyword(s):  
Arterial Pressure ◽  
Pulmonary Arterial Pressure ◽  
Cross Sectional Area ◽  
Physical Parameters ◽  
Sectional Area ◽  
Biophysical Parameters ◽  
Cross Sectional ◽  
Mean Pulmonary Arterial Pressure ◽  
Pulmonary Arterial ◽  
The Mean

The present method enables the noninvasive assessment of mean pulmonary arterial pressure from magnetic resonance phase mapping by computing both physical and biophysical parameters. The physical parameters include the mean blood flow velocity over the cross-sectional area of the main pulmonary artery (MPA) at the systolic peak and the maximal systolic MPA cross-sectional area value, whereas the biophysical parameters are related to each patient, such as height, weight, and heart rate. These parameters have been measured in a series of 31 patients undergoing right-side heart catheterization, and the computed mean pulmonary arterial pressure value (PpaComp) has been compared with the mean pressure value obtained from catheterization (PpaCat) in each patient. A significant correlation was found that did not differ from the identity line PpaComp = PpaCat ( r = 0.92). The mean and maximal absolute differences between PpaComp and PpaCat were 5.4 and 11.9 mmHg, respectively. The method was also applied to compute the MPA systolic and diastolic pressures in the same patient series. We conclude that this computed method, which combines physical (whoever the patient) and biophysical parameters (related to each patient), improves the accuracy of MRI to noninvasively estimate pulmonary arterial pressures.

scholarly journals Patients with Achilles Tendon Rupture Have a Degenerated Contralateral Achilles Tendon: An Elastography Study

2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Qianru Li ◽  
Qi Zhang ◽  
Yehua Cai ◽  
Yinghui Hua
Keyword(s):  
Achilles Tendon ◽  
Axial Strain ◽  
Achilles Tendon Rupture ◽  
Cross Sectional Area ◽  
Control Group ◽  
Computer Assisted ◽  
Study Group ◽  
Sectional Area ◽  
Cross Sectional ◽  
The Mean

Purpose. To evaluate differences of Achilles tendon (AT) hardness and morphology between asymptomatic tendons in patients with acute AT ruptures on the contralateral side and asymptomatic tendons in healthy people by using computer-assisted quantification on axial-strain sonoelastography (ASE). Methods. The study consisted of 33 asymptomatic tendons in 33 patients (study group) and 34 tendons in 19 healthy volunteers (control group). All the tendons were examined by both ASE and conventional ultrasound. Computer-assisted quantification on ASE was applied to extract hardness variables, including the mean (Hmean), 20th percentile (H20), median (H50) and skewness (Hsk) of the hardness within tendon, and the ratio of the mean hardness within tendon to that outside tendon (Hratio) and three morphological variables: the thickness (THK), cross-sectional area, and eccentricity (ECC) of tendons. Results. The Hmean, Hsk, H20, H50, and Hratio in the proximal third of the tendon body in study group were significantly smaller than those in control group (Hmean: 0.43±0.09 vs 0.50±0.07, p=0.001; Hsk: -0.53±0.51 vs -1.09±0.51, p<0.001; H20: 0.31±0.10 vs 0.40±0.10, p=0.001; H50: 0.45±0.10 vs 0.53±0.08, p<0.001; Hratio: 1.01±0.25 vs 1.20±0.23, p=0.003). The THK and cross-sectional area of tendons in the study group were larger than those in the control group (p<0.05). Conclusions. As a quantitative objective method, the computer-assisted ASE reveals that the asymptomatic ATs contralateral to acute rupture are softer than those of healthy control group at the proximal third and the asymptomatic tendons in people with rupture history are thicker, larger, and rounder than those of normal volunteers especially at the middle and distal thirds of AT body.

scholarly journals INDIRECT DECOMPRESSION BY LATERAL FUSION: ANALYSIS OF SAGITAL ALIGNMENT

2021 ◽  
Vol 20 (1) ◽  
pp. 50-54
Author(s):  
Thyago Guirelle Silva ◽  
Rodrigo Augusto do Amaral ◽  
Raphael Rezende Pratali ◽  
Luiz Pimenta
Keyword(s):  
Magnetic Resonance ◽  
Pelvic Incidence ◽  
Magnetic Resonance Images ◽  
Cross Sectional Area ◽  
Disc Height ◽  
Lower Limbs ◽  
Sectional Area ◽  
Cross Sectional ◽  
Indirect Decompression ◽  
The Mean

ABSTRACT Objective: To verify the effectiveness of indirect decompression after lateral access fusion in patients with high pelvic incidence. Methods: A retrospective, non-comparative, non-randomized analysis of 22 patients with high pelvic incidence who underwent lateral access fusion, 11 of whom were male and 11 female, with a mean age of 63 years (52-74), was conducted. Magnetic resonance exams were performed within one year after surgery. The cross-sectional area of the thecal sac, anterior and posterior disc heights, and bilateral foramen heights, measured pre- and postoperatively in axial and sagittal magnetic resonance images, were analyzed. The sagittal alignment parameters were measured using simple radiographs. The clinical results were evaluated using the ODI and VAS (back and lower limbs) questionnaires. Results: In all cases, the technique was performed successfully without neural complications. The mean cross-sectional area increased from 126.5 mm preoperatively to 174.3 mm postoperatively. The mean anterior disc height increased from 9.4 mm preoperatively to 12.8 mm postoperatively, while the posterior disc height increased from 6.3 mm preoperatively to 8.1 mm postoperatively. The mean height of the right foramen increased from 157.3 mm in the preoperative period to 171.2 mm in the postoperative period and that of the left foramen increased from 139.3 mm in the preoperative to 158.9 mm in the postoperative. Conclusions: This technique is capable of correcting misalignment in spinal deformity, achieving fusion and promoting the decompression of neural elements. Level of evidence III; Retrospective study.

Intravascular Ultrasound: Potential Tool to Assess Coronary Anastomosis Quality

2003 ◽  
Vol 11 (2) ◽  
pp. 143-146
Author(s):  
Piergiorgio Tozzi ◽  
Antonio F Corno ◽  
Ludwig K von Segesser
Keyword(s):  
Coronary Artery ◽  
Intravascular Ultrasound ◽  
Left Internal Mammary Artery ◽  
Artery Bypass ◽  
Ultrasound Images ◽  
Cross Sectional ◽  
Flow Measurements ◽  
Off Pump ◽  
The Mean ◽  
Macroscopic Examination

Coronary angiography and Doppler flow measurements are most commonly used to assess the patency of anastomoses in the operating theater. Intravascular ultrasound might be another means of monitoring the surgical procedure during coronary artery bypass. Five sheep underwent off-pump bypass of the left anterior descending coronary artery using the left internal mammary artery. The running suture was evaluated by intraoperative fluoroscopy and a coronary intravascular ultrasound probe inserted into the target artery proximal to the anastomosis. Macroscopic examination of the anastomosis was performed to validate the angiographic and intravascular ultrasound images. The diameter, cross-sectional area, and compliance of each anastomosis were calculated in systole and diastole. All anastomoses were patent without signs of stenosis. In one case, intravascular ultrasound showed an intimal flap, which was confirmed by macroscopic examination. The mean major anastomotic diameter was 4.5 ± 0.5 mm on angiography and 4.0 ± 0.5 mm on intravascular ultrasound. From the ultrasound data, the mean cross-sectional anastomotic area was calculated as 6.21 ± 0.1 mm2 in systole and 5.49 ± 0.1 mm2 in diastole, and these data were used to calculate the cross-sectional anastomosis compliance. Coronary intravascular ultrasound can visualize intima-to-intima apposition and provide reliable calculations of anastomosis compliance.

The Vertical Mean Force and Moment of Submerged Bodies Under Waves

1971 ◽  
Vol 15 (03) ◽  
pp. 231-245 ◽  
Author(s):  
C. M. Lee ◽  
J. N. Newman
Keyword(s):  
Free Surface ◽  
Added Mass ◽  
Cross Sectional Area ◽  
The Body ◽  
Slender Body ◽  
Longitudinal Distribution ◽  
Vertical Force ◽  
Sectional Area ◽  
Cross Sectional ◽  
The Mean

A neutrally buoyant slender body of arbitrary sectional form, submerged beneath a free surface, is free to respond to an incident plane progressive wave system. The fluid is assumed inviscid, incompressible, homogeneous and infinitely deep. The first-order oscillatory motion of the body and the second-order time-average vertical force and pitching moment acting on the body are obtained in terms of Kochin's function. By use of slender-body theory for a deeply submerged body, the final expressions for the mean force and the moment are shown to depend on the longitudinal distribution of sectional area and added mass and on the amplitude and the frequency of the ambient surface waves. The magnitude of the mean force for various simple geometric cylinders is compared with that of a circular cylinder of equal cross-sectional area. The mean force on a nonaxisymmetric body is often approximated by replacing the section with circular profiles of equivalent cross-sectional area. A better scheme of approximation is presented, based on a simple way of estimating the two-dimensional added mass. It is expected that the effect of the cross-sectional geometry on mean vertical force and moment will be more significant when the body is very close to the free surface.

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