Cholinergic stimulation induces asynchrony between the circular and longitudinal muscle contraction during esophageal peristalsis

2008 ◽  
Vol 294 (3) ◽  
pp. G694-G698 ◽  
Author(s):  
Hariprasad Korsapati ◽  
Arash Babaei ◽  
Valmik Bhargava ◽  
Ravinder K. Mittal
Keyword(s):  
Longitudinal Muscle ◽  
Acetylcholinesterase Inhibitor ◽  
Time Lag ◽  
Control Period ◽  
Temporal Correlation ◽  
Normal Subjects ◽  
Esophageal Peristalsis ◽  
Nutcracker Esophagus ◽  
The Mean ◽  
Mean Time

In healthy subjects, a close temporal correlation exists between contractions of the circular muscle (CM) and longitudinal muscle (LM) layers of the esophagus. Patients with nutcracker esophagus show disassociation between the peak of contractions of the CM and LM layers and the peak of contraction 1–3 s apart (Jung HY, Puckett JL, Bhalla V, Rojas-Feria M, Bhargava V, Liu J, Mittal RK. Gastroenterology 128: 1179–1186, 2005). The purpose of the present study was to evaluate the effect of acetylcholinesterase inhibitor (edrophonium) and acetylcholine receptor antagonist (atropine) on human esophageal peristalsis in normal subjects. High-frequency intraluminal ultrasound imaging and manometry were performed simultaneously during swallow-induced peristalsis in ten normal subjects. Standardized 5-ml water swallows were recorded 2 cm above the lower esophageal sphincter under three study conditions: control, edrophonium (80 μg/kg iv), and atropine (10 μg/kg iv). A close temporal correlation exists between the peak pressure and peak wall thickness during the control period. The mean time lag between the peak LM and peak CM contraction was 0.03 s. After edrophonium administration, the mean contraction amplitude increased from 101 ± 9 mmHg to 150 ± 20 mmHg ( P < 0.05) and mean peak muscle thickness increased from 3.0 ± 0.2 mm to 3.6 ± 0.3 mm ( P < 0.01), and duration of both CM and LM contractions were also increased. Furthermore, the mean time difference between the peak LM and CM was increased to 1.1 s, (ranging 0.2 to 3.4 s) ( P < 0.0001). We conclude that cholinomimetic agent induces discoordination between the two muscle layers of the esophagus.

Bladder contractions and micturition in fetal sheep: their relation to behavioral states

1989 ◽  
Vol 257 (6) ◽  
pp. R1526-R1532 ◽  
Author(s):  
M. E. Wlodek ◽  
G. D. Thorburn ◽  
R. Harding
Keyword(s):  
High Voltage ◽  
Low Voltage ◽  
Control Period ◽  
In Utero ◽  
Fetal Sheep ◽  
Electrocortical Activity ◽  
The Mean ◽  
Behavioral States ◽  
Mean Time ◽  
The Brain

Fetal bladder contractions, indicative of micturition (voiding), and behavioral states were monitored in unanesthetized fetal sheep in utero during the last third of gestation. Fetal voids began during low-voltage electrocortical activity (LV ECoG) at a greater frequency (91.4 +/- 1.0%) than expected (57.2%) and began during high-voltage electrocortical activity (HV ECoG) with a lower frequency (8.7 +/- 1.0%) than expected (42.8%). Fetal voids began significantly sooner after the onset of LV ECoG (5.84 +/- 0.13 min) than after the onset of HV ECoG (10.88 +/- 0.04 min). Electroocular and nuchal muscle activities were associated with 96.2 and 66.0% of the voids, respectively, but there was no significant association between fetal voiding and swallowing episodes. Abolition of spontaneous voiding, by urine drainage (24 h), caused no significant differences, relative to a 24-h control period, in the duration or number of episodes of LV or HV ECoG or percentage of time spent in these states. Also, induction of voiding by infusing saline into the bladder did not significantly alter the time to the next change of ECoG state. However, the mean time to the next void and the mean volume of saline infused into the bladder to induce voiding tended to be less during LV ECoG than HV ECoG, although not significantly less. Our data show that most spontaneous voids in the fetus begin during LV ECoG, suggesting that voiding is regulated by descending information from the brain. Furthermore, these experiments demonstrate that fetal bladder contractions and voiding, either spontaneous or induced, do not influence the normal cycling of fetal ECoG states.

Analysis of reproducibility, evaluation, and preference of the new iC100 rebound tonometer versus iCare PRO and Perkins portable applanation tonometry

2019 ◽  
Vol 30 (6) ◽  
pp. 1349-1355 ◽  
Author(s):  
Mercedes Molero-Senosiaín ◽  
Laura Morales-Fernández ◽  
Federico Saenz-Francés ◽  
Julian García-Feijoo ◽  
Jose María Martínez-de-la-Casa
Keyword(s):  
Intraocular Pressure ◽  
Visual Analogue Scale ◽  
Analogue Scale ◽  
Normal Subjects ◽  
Applanation Tonometry ◽  
Rebound Tonometer ◽  
The Mean ◽  
The Difference ◽  
The Comparative Study ◽  
Mean Time

Objectives: To analyze the reproducibility of the new iC100 rebound tonometer, to compare its results with the applanation tonometry and iCare PRO and to evaluate the preference between them. Materials and methods: For the study of reproducibility, 15 eyes of 15 healthy Caucasian subjects were included. Three measurements were taken each day in three separate sessions. For the comparative study, 150 eyes of 150 Caucasian subjects were included (75 normal subjects and 75 patients with glaucoma). Three consecutive measurements were collected with each tonometer, randomizing the order of use. The discomfort caused by each tonometer was evaluated using the visual analogue scale. Results: No statistically significant differences were detected between sessions. In the comparison between tonometers, the measurements with iC100 were statistically lower than those of Perkins (−1.35 ± 0.417, p = 0.004) and that iCare PRO (−1.41 ± 0.417, p = 0.002). The difference between PRO and Perkins was not statistically significant ( p = 0.990). The mean time of measurement (in seconds) with iC100 was significantly lower than with Perkins (6.74 ± 1.46 vs 15.53 ± 2.01, p < 0.001) and that PRO (6.74 ± 1.46 vs 11.53 ± 1.85, p < 0.001). Visual analogue scale score with iC100 was lower than Perkins (1.33 ± 0.99 vs 1.73 ± 1.10, p < 0.05). In total, 61.7% preferred iC100 against Perkins. Conclusion: The reproducibility of this instrument has been proven good. iC100 underestimates intraocular pressure compared to applanation tonometry at normal values and tends to overestimate it in high intraocular pressure values. Most of the subjects preferred iC100 tonometer.

Synchrony between circular and longitudinal muscle contractions during peristalsis in normal subjects

2006 ◽  
Vol 290 (3) ◽  
pp. G431-G438 ◽  
Author(s):  
Ravinder K. Mittal ◽  
Bikram Padda ◽  
Vikas Bhalla ◽  
Valmik Bhargava ◽  
Jianmin Liu
Keyword(s):  
Muscle Contraction ◽  
Pressure Wave ◽  
Longitudinal Muscle ◽  
Circular Muscle ◽  
Temporal Correlation ◽  
Normal Subjects ◽  
High Frequency Ultrasound ◽  
Cross Sectional ◽  
Circularity Index ◽  
Muscle Cross Sectional Area

The current understanding is that longitudinal muscle contraction begins before and outlasts circular muscle contraction during esophageal peristalsis in normal subjects. The goal of our study was to reassess the relationship between the contractility of two muscle layers using novel ways to look at the muscle contraction. We studied normal subjects using synchronized high-frequency ultrasound imaging and manometry. Swallow-induced peristalsis was recorded at 5 and 10 cm above the lower esophageal sphincter (LES). Ultrasound (US) images were analyzed for muscle cross-sectional area (CSA) and circularity index of the esophagus during various phases of esophageal contraction. A plot of the M mode US image, muscle CSA, and esophageal circularity index was developed to assess the temporal correlation between various parameters. The muscle CSA wave began before and lasted longer than the contraction pressure wave at both 5 and 10 cm above the LES. M mode US images revealed that the onset of muscle CSA wave was temporally aligned with the onset of lumen collapse. The peak muscle CSA occurred in close proximity with the peak pressure wave. The esophagus started to become more circular (decrease in circularity index) with the onset of the muscle CSA wave. The circularity index and muscle CSA returned to the baseline at approximately the same time. In conclusion, the onset of lumen collapse and return of circularity index of the esophagus are likely to be the true markers of the onset and end of circular muscle contraction. Circular and longitudinal muscle layers of the esophagus contract in a precise synchronous fashion during peristalsis in normal subjects.

Decay of inspiratory muscle pressure during expiration in anesthetized kyphoscoliosis patients

1992 ◽  
Vol 72 (2) ◽  
pp. 712-720 ◽  
Author(s):  
A. Baydur
Keyword(s):  
Flow Resistance ◽  
Relaxation Method ◽  
Normal Subjects ◽  
Respiratory Impedance ◽  
Elastic Recoil ◽  
Intrinsic Resistance ◽  
Inspiratory Muscles ◽  
The Mean ◽  
Work Done ◽  
Mean Time

The decay of pressure developed by the inspiratory muscles during expiration (PmusI) has not been studied in subjects with increased respiratory impedance such as in kyphoscoliosis. PmusI was compared in 11 anesthetized patients with kyphoscoliosis with that in 11 anesthetized normal subjects. PmusI was obtained according to the following equation: PmusI(t) = Ers.V(t) - K1V(t) - K2V2(t), where V is volume and V is airflow at any instant t during spontaneous expiration, Ers is the passive elastance, and K1V + K2V2 is the flow resistance (curvilinear in both groups because of the endotracheal tube and the intrinsic resistance in the kyphoscoliotics) of the total respiratory system. Ers was determined by the relaxation method and resistance from the ensuing V-V relationships during the ensuing relaxed expiration. Changes in impedance due to pliometric work done by the inspiratory muscles during relaxation were neglected. Subjects in both groups showed marked braking of expiratory flow by PmusI. The mean time for PmusI to decrease to 50 and 0% amounted to 17 and 8% less, respectively, in the kyphoscoliosis group. Average values for flow-resistive work in the control and kyphoscoliosis groups both amounted to approximately 40% of the elastic energy stored during inspiration. The remaining portion, used as negative work, amounted to approximately 60% in both groups. Expiratory braking in anesthetized kyphoscoliotic patients appears to be in proportion to their magnitude of elastic recoil and intrinsic flow resistance.

scholarly journals Blood ordering and transfusion practice in routine operation theatres of BPKIHS: a pilot study

2012 ◽  
Vol 10 (2) ◽  
pp. 137-138
Author(s):  
R K Chaudhary ◽  
R K Singh ◽  
K Pokharel ◽  
B Bhattarai
Keyword(s):  
Blood Loss ◽  
Service System ◽  
Elective Surgery ◽  
Time Lag ◽  
Transfusion Practice ◽  
Time Interval ◽  
Hospital Resources ◽  
The Mean ◽  
Mean Time ◽  
Larger Sample

Background: The practice of blood ordering before surgery is usually excessive. Hazards of over ordering include burden to blood banking, outdating of blood, unnecessary wastage of hospital resources, mental and physical stress to patient party. A study on blood ordering practice provides important feedback for improvement of blood ordering service system and developing Maximum Surgical Blood Ordering Schedule (MSBOS). Objectives: To find out the ratio between cross-matched and transfused blood units (C:T ratio) in routine operation theatres (OT) of BP Koirala Institute of Health Sciences (BPKIHS) and the time lag between blood demand and arrival in the OTs. Methods: Data of 94 patients undergoing elective surgery with potential need for blood transfusion over the period of one month were collected and analyzed prospectively. The variables noted include age, gender, body weight, blood group, hemoglobin level, diagnosis, type of surgery, maximum allowable blood loss, actual blood loss; number of blood units cross-matched and actually transfused. Results: Altogether, 161 blood units were cross matched and only 24 of them were transfused making the C:T ratio of 6.7:1. Fourteen out of 24 units were transfused only in gynecological & obstetrical patients. The mean time interval between the demand and the arrival of blood units was 10 ± 7.6 minutes. Conclusion: The overall C:T ratio in the routine OT of BPKIHS is comparatively high. Further study with larger sample size is needed for recommending MSBOS.DOI: http://dx.doi.org/10.3126/hren.v10i2.6583 Health Renaissance 2012; Vol 10 (No.2); 137-138 

Instant 99mTc-Labelled Glucoheptonate Kit for Kidney Imaging

1983 ◽  
Vol 22 (05) ◽  
pp. 246-250 ◽  
Author(s):  
M. Al-Hilli ◽  
H. M. A. Karim ◽  
M. H. S. Al-Hissoni ◽  
M. N. Jassim ◽  
N. H. Agha
Keyword(s):  
Sodium Hydroxide Solution ◽  
Normal Subjects ◽  
Organ Distribution ◽  
Stable Complex ◽  
Scintillation Camera ◽  
Ph Adjustment ◽  
The Mean ◽  
The Stability ◽  
Kidney Imaging ◽  
Mean Concentration

Gelchromatography column scanning has been used to study the fractions of reduced hydrolyzed 99mTc, 99mTc-pertechnetate and 99mTc-chelate in a 99mTc-glucoheptonate (GH) preparation. A stable high labelling yield of 99mTc-GH complex in the radiopharmaceutical has been obtained with a concentration of 40-50 mg of glucoheptonic acid-calcium salt and not less than 0.45 mg of SnCl2 2 H2O at an optimal pH between 6.5 and 7.0. The stability of the complex has been found significantly affected when sodium hydroxide solution was used for the pH adjustment. However, an alternative procedure for final pH adjustment of the preparation has been investigated providing a stable complex for the usual period of time prior to the injection. The organ distribution and the blood clearance data of 99mTc-GH in rabbits were relatively similar to those reported earlier. The mean concentration of the radiopharmaceutical in both kidneys has been studied in normal subjects for one hour with a scintillation camera and the results were satisfactory.

Predicting Daily Maintenance Dose of Fluindione, an Oral Anticoagulant Drug

1996 ◽  
Vol 75 (05) ◽  
pp. 731-733 ◽  
Author(s):  
V Cazaux ◽  
B Gauthier ◽  
A Elias ◽  
D Lefebvre ◽  
J Tredez ◽  
...  
Keyword(s):  
Effective Dose ◽  
Maintenance Dose ◽  
Successive Approximations ◽  
Hemorrhagic Complication ◽  
Simple Method ◽  
Individual Variations ◽  
Anticoagulant Drug ◽  
The Mean ◽  
Mean Time ◽  
Daily Maintenance Dose

SummaryDue to large inter-individual variations, the dose of vitamin K antagonist required to target the desired hypocoagulability is hardly predictible for a given patient, and the time needed to reach therapeutic equilibrium may be excessively long. This work reports on a simple method for predicting the daily maintenance dose of fluindione after the third intake. In a first step, 37 patients were delivered 20 mg of fluindione once a day, at 6 p.m. for 3 consecutive days. On the morning of the 4th day an INR was performed. During the following days the dose was adjusted to target an INR between 2 and 3. There was a good correlation (r = 0.83, p<0.001) between the INR performed on the morning of day 4 and the daily maintenance dose determined later by successive approximations. This allowed us to write a decisional algorithm to predict the effective maintenance dose of fluindione from the INR performed on day 4. The usefulness and the safety of this approach was tested in a second prospective study on 46 patients receiving fluindione according to the same initial scheme. The predicted dose was compared to the effective dose soon after having reached the equilibrium, then 30 and 90 days after. To within 5 mg (one quarter of a tablet), the predicted dose was the effective dose in 98%, 86% and 81% of the patients at the 3 times respectively. The mean time needed to reach the therapeutic equilibrium was reduced from 13 days in the first study to 6 days in the second study. No hemorrhagic complication occurred. Thus the strategy formerly developed to predict the daily maintenance dose of warfarin from the prothrombin time ratio or the thrombotest performed 3 days after starting the treatment may also be applied to fluindione and the INR measurement.

A COMPARISON OF TWO METHODS FOR MEASUREMENT OF ALDOSTERONE SECRETION RATE IN MAN

1966 ◽  
Vol 53 (2) ◽  
pp. 177-188 ◽  
Author(s):  
P. Lund-Johansen ◽  
T. Thorsen ◽  
K. F. Støa
Keyword(s):  
Urinary Excretion ◽  
Normal Subjects ◽  
Secretion Rate ◽  
Aldosterone Secretion ◽  
Simple Method ◽  
Mean Values ◽  
Pathological Conditions ◽  
Significant Difference ◽  
Derivative Method ◽  
The Mean

ABSTRACT A comparison has been made between (A), a relatively simple method for the measurement of aldosterone secretion rate, based on paper chromatography and direct densitometry of the aldosterone spot and (B) a more elaborate isotope derivative method. The mean secretion rate in 9 normal subjects was 112 ± 26 μg per 24 hours (method A) and 135 ± 35 μg per 24 hours (method B). The »secretion rate« in one adrenalectomized subject after the intravenous injection of 250 μg of aldosterone was 230 μg per 24 hours (method A) and 294 μg per 24 hours (method B). There was no significant difference in the mean values, and correlation between the two methods was good (r = 0.80). It is concluded that the densitometric method is suitable for clinical purposes as well as research, being more rapid and less expensive than the isotope derivative method. Method A also measures the urinary excretion of the aldosterone 3-oxo-conjugate, which is of interest in many pathological conditions. The densitometric method is obviously the less sensitive and a prerequisite for its use is an aldosterone secretion of 20—30 μg per 24 hours. Lower values are, however, rare in adults.

EARLY VARIATIONS OF PLASMA CORTISOL AFTER PULSE INTRAVENOUS INJECTION OF DIBUTYRYL CYCLIC ADENOSINE 3′,5′-MONOPHOSPHATE IN NORMAL SUBJECTS

1973 ◽  
Vol 72 (4) ◽  
pp. 753-761 ◽  
Author(s):  
Alberto Angeli ◽  
Giuseppe Boccuzzi ◽  
Roberto Frajria ◽  
Daniela Bisbocci ◽  
Franco Ceresa
Keyword(s):  
Intravenous Injection ◽  
Plasma Cortisol ◽  
Time Course ◽  
Healthy Adult ◽  
Normal Subjects ◽  
Adult Women ◽  
Healthy Women ◽  
Adrenal Steroidogenesis ◽  
The Mean ◽  
Zero Time

ABSTRACT 10 mg/kg of dibutyryl cyclic adenosine 3′,5′-monophosphate (Db-cAMP) was iv pulse injected into twelve healthy adult women. The plasma cortisol levels were determined as 11-OHCS at zero time and then at 2.5, 5, 7.5, 10, 15, 30, 60 and 180 min after the injection. The data were compared with those obtained at the corresponding times in two groups of eleven and seventeen healthy women after the injection of 250 ng and 250 μg of synthetic β-1-24 corticotrophin performed in the same manner as the injection of the nucleotide. The mean increments in plasma cortisol were significantly lower after Db-cAMP than after ACTH. Differences were noted by analyzing the time course of the responses. In the case of stimulation with Db-cAMP the 11-OHCS levels rose progressively to a maximum at 15–30 min. By contrast, a peak of plasma cortisol was evident in most cases within a few min after the injection of ACTH; after a fall, a later rise was then observed starting from 15 min. The differences in the plasma 11-OHCS responses after the two stimuli may also be of interest clinically for the investigation of some aspects of adrenal steroidogenesis.

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