Three-dimensional imaging of the stomach: role of pylorus in the emptying of liquids

1987 ◽  
Vol 253 (1) ◽  
pp. G79-G85 ◽  
Author(s):  
D. Kumar ◽  
E. L. Ritman ◽  
J. R. Malagelada

Using the dynamic spatial reconstructor and manometry, we measured gastric emptying, pyloric size, and antral contractile activity in three anesthetized dogs in the prone position. Our objective is to evaluate the effect of intestinal perfusion of equicaloric, neutral, and isosmolar nutrients (Maltose 32.5 mg/ml, casein hydrolysate 32.5 mg/ml, and oleic acid 15.5 mg/ml) at a constant rate of 10 ml/min in the proximal jejunum on the dynamics of the antropyloric region. Isotonic saline perfusion was used as a control solution. Test meal in the stomach was 600 ml of isotonic Gastrograffin. Antral phasic pressure activity was recorded using an antroduodenal six-channel (ports 5 mm apart) perfused probe(2 mm OD). Gastric emptying in response to intestinal perfusion of fat was significantly slower (P less than 0.02) in comparison to other nutrients or isotonic saline. There was no significant difference in the maximum or minimum pyloric diameter in response to the four intestinal perfusates. However, the pylorus was closed for a significantly longer duration (P less than 0.05) during the perfusion of fat in the upper intestine. Antral contractions were related to pyloric opening in an “antral contraction followed by pyloric opening” sequence. This study suggests that the presence of fat in the upper intestine delays gastric emptying and that this effect is regulated in part by increased resistance to flow offered by the pylorus.

1993 ◽  
Vol 264 (6) ◽  
pp. G1077-G1081
Author(s):  
D. Kumar ◽  
E. L. Ritman ◽  
J. R. Malagelada

We measured antral volumes and propulsion-retropulsion for individual peristaltic cycles using the dynamic spatial reconstructor in three female mongrel dogs. Our aim was to quantify the effect of intestinal perfusion of equicaloric, isotonic, and isomolar nutrients (maltose, 32.5 mg/100 ml; casein hydrolysate, 32.5 mg/100 ml; and oleic acid 15.5 mg/100 ml) at a rate of 10 ml/min in the upper small intestine on total antral volume and the propulsion-retropulsion function of the "antral pump." Isotonic saline was used as a control solution. Isotonic gastrografin (600 ml) was instilled intragastrically as a meal. A 6-channel perfused manometric assembly was used to record antral phasic pressure activity. Antral volume was significantly lower (P < 0.05) in response to fat perfusion compared with other nutrients or isotonic saline. The propulsion-retropulsion ratio was also significantly reduced (P < 0.05) in response to fat perfusion in the upper small intestine. Our study, therefore, indicates that the fraction of a liquid meal delivered to the antrum is determined, at least in part, by the upper small intestinal nutrients and also that the presence of fat in the small intestine alters the propulsion-retropulsion function of the antrum.


2000 ◽  
Vol 278 (4) ◽  
pp. G604-G616 ◽  
Author(s):  
K. Indireshkumar ◽  
James G. Brasseur ◽  
Henryk Faas ◽  
Geoffrey S. Hebbard ◽  
Patrik Kunz ◽  
...  

The relative contributions to gastric emptying from common cavity antroduodenal pressure difference (“pressure pump”) vs. propagating high-pressure waves in the distal antrum (“peristaltic pump”) were analyzed in humans by high-resolution manometry concurrently with time-resolved three-dimensional magnetic resonance imaging during intraduodenal nutrient infusion at 2 kcal/min. Gastric volume, space-time pressure, and contraction wave histories in the antropyloroduodenal region were measured in seven healthy subjects. The subjects fell into two distinct groups with an order of magnitude difference in levels of antral pressure activity. However, there was no significant difference in average rate of gastric emptying between the two groups. Antral pressure history was separated into “propagating high-pressure events” (HPE), “nonpropagating HPEs,” and “quiescent periods.” Quiescent periods dominated, and average pressure during quiescent periods remained unchanged with decreasing gastric volume, suggesting that common cavity pressure levels were maintained by increasing wall muscle tone with decreasing volume. When propagating HPEs moved to within 2–3 cm of the pylorus, pyloric resistance was found statistically to increase with decreasing distance between peristaltic waves and the pylorus. We conclude that transpyloric flow tends to be blocked when antral contraction waves are within a “zone of influence” proximal to the pylorus, suggesting physiological coordination between pyloric and antral contractile activity. We further conclude that gastric emptying of nutrient liquids is primarily through the “pressure pump” mechanism controlled by pyloric opening during periods of relative quiescence in antral contractile wave activity.


2009 ◽  
Vol 297 (6) ◽  
pp. G1274-G1280 ◽  
Author(s):  
Julie E. Stevens ◽  
Selena Doran ◽  
Antonietta Russo ◽  
Deirdre O'Donovan ◽  
Christine Feinle-Bisset ◽  
...  

Gastric emptying (GE) of glucose is regulated closely, not only as a result of inhibitory feedback arising from the small intestine, but also because of the resulting hyperglycemia. Fructose is used widely in the diabetic diet and is known to empty from the stomach slightly faster than glucose but substantially slower than water. The aims of this study were to determine whether intravenous (iv) fructose affects GE and antropyloroduodenal motility and how any effects compare to those induced by iv glucose. Six healthy males (age: 26.7 ± 3.8 yr) underwent concurrent measurements of GE of a solid meal (100 g ground beef labeled with 20 MBq99mTc-sulfur colloid) and antropyloroduodenal motility on three separate days in randomized order during iv infusion of either fructose (0.5 g/kg), glucose (0.5 g/kg), or isotonic saline for 20 min. GE (scintigraphy), antropyloroduodenal motility (manometry), and blood glucose (glucometer) were measured for 120 min. There was a rise in blood glucose ( P < 0.001) after iv glucose (peak 16.4 ± 0.6 mmol/l) but not after fructose or saline. Intravenous glucose and fructose both slowed GE substantially ( P < 0.005 for both), without any significant difference between them. Between t = 0 and 30 min, the number of antral pressure waves was less after both glucose and fructose ( P < 0.002 for both) than saline, and there were more isolated pyloric pressure waves during iv glucose ( P = 0.003) compared with fructose and saline ( P = NS for both) infusions. In conclusion, iv fructose slows GE and modulates gastric motility in healthy subjects, and the magnitude of slowing of GE is comparable to that induced by iv glucose.


2020 ◽  
Vol 10 (2) ◽  
pp. 133-148
Author(s):  
Ankaj Kaundal ◽  
Pravin Kumar ◽  
Rajendra Awasthi ◽  
Giriraj T. Kulkarni

Aim: The study was aimed to develop mucoadhesive buccal tablets using Aster ericoides leaves mucilage. Background : Mucilages are naturally occurring high-molecular-weight polyuronides, which have been extensively studied for their application in different pharmaceutical dosage forms. Objective: The objective of the present research was to establish the mucilage isolated from the leaves of Aster ericoides as an excipient for the formulation of the mucoadhesive buccal tablet. Method: The mucilage was isolated from the leaves of Aster ericoides by maceration, precipitated with acetone and characterized. Tablets were prepared using wet granulation technique and evaluated for various official tests. Results: The mucilage was found to be non-toxic on A-431 and Vero cell lines. It was insoluble but swellable in cold and hot water. The results indicate that mucilage can form a three-dimensional network. The pH of the mucilage (6.82 ± 0.13) indicated that it might be non-irritant to the buccal cavity. The mucilage was found to be free from microbes. The release of drug was by Fickian diffusion. The in vivo buccal tablet acceptance was 80%. No significant difference between the diastolic blood pressure of standard and Aster tablets treated volunteer group was recorded. Conclusion: The mucilage was found to be non-toxic on A-431 and Vero cell lines. It was insoluble but swellable in cold and hot water. The results indicate that mucilage can form a three-dimensional network. The pH of the mucilage (6.82 ± 0.13) indicated that it might be non-irritant to the buccal cavity. The mucilage was found to be free from microbes. The release of drug was by Fickian diffusion. The in vivo buccal tablet acceptance was 80%. No significant difference between the diastolic blood pressure of standard and Aster tablets treated volunteer group was recorded. Other: However, to prove the potency of the polymer, in vivo bioavailability studies in human volunteers are needed along with chronic toxicity studies in suitable animal models.


Author(s):  
Yuan-Wei Zhang ◽  
Xin Xiao ◽  
Wen-Cheng Gao ◽  
Yan Xiao ◽  
Su-Li Zhang ◽  
...  

Abstract Background This present study is aimed to retrospectively assess the efficacy of three-dimensional (3D) printing assisted osteotomy guide plate in accurate osteotomy of adolescent cubitus varus deformity. Material and methods Twenty-five patients (15 males and 10 females) with the cubitus varus deformity from June 2014 to December 2017 were included in this study and were enrolled into the conventional group (n = 11) and 3D printing group (n = 14) according to the different surgical approaches. The operation time, intraoperative blood loss, osteotomy degrees, osteotomy end union time, and postoperative complications between the two groups were observed and recorded. Results Compared with the conventional group, the 3D printing group has the advantages of shorter operation time, less intraoperative blood loss, higher rate of excellent correction, and higher rate of the parents’ excellent satisfaction with appearance after deformity correction (P < 0.001, P < 0.001, P = 0.019, P = 0.023). Nevertheless, no significant difference was presented in postoperative carrying angle of the deformed side and total complication rate between the two groups (P = 0.626, P = 0.371). Conclusions The operation assisted by 3D printing osteotomy guide plate to correct the adolescent cubitus varus deformity is feasible and effective, which might be an optional approach to promote the accurate osteotomy and optimize the efficacy.


Author(s):  
Hang-Nga Mai ◽  
Du-Hyeong Lee

This study evaluated the effects of different matching methods on the accuracy of dentofacial integration in stereophotogrammetry and smartphone face-scanning systems. The integration was done (N = 30) with different matching areas (n = 10), including teeth image only (TO), perioral area without markers (PN) and with markers (PM). The positional accuracy of the integrated models was assessed by measuring the midline linear deviations and incisal line canting between the experimental groups and laser scanner-based reference standards. Kruskal–Wallis and Mann–Whitney U tests were used for statistical analyses (α = 0.05). The PM method exhibited the smallest linear deviations in both systems; while the highest deviations were found in the TO in stereophotogrammetry; and in PN in smartphone. For the incisal line canting; the canting degree was the lowest in the PM method; followed by that in the TO and the PN in both systems. Although stereophotogrammetry generally exhibited higher accuracy than the smartphone; the two systems demonstrated no significant difference when the perioral areas were used for matching. The use of perioral scans with markers enables accurate dentofacial image integration; however; cautions should be given on the accuracy of the perioral image obtained without the use of markers.


Micromachines ◽  
2020 ◽  
Vol 12 (1) ◽  
pp. 3
Author(s):  
Kyo-in Koo ◽  
Andreas Lenshof ◽  
Le Thi Huong ◽  
Thomas Laurell

In the field of engineered organ and drug development, three-dimensional network-structured tissue has been a long-sought goal. This paper presents a direct hydrogel extrusion process exposed to an ultrasound standing wave that aligns fibroblast cells to form a network structure. The frequency-shifted (2 MHz to 4 MHz) ultrasound actuation of a 400-micrometer square-shaped glass capillary that was continuously perfused by fibroblast cells suspended in sodium alginate generated a hydrogel string, with the fibroblasts aligned in single or quadruple streams. In the transition from the one-cell stream to the four-cell streams, the aligned fibroblast cells were continuously interconnected in the form of a branch and a junction. The ultrasound-exposed fibroblast cells displayed over 95% viability up to day 10 in culture medium without any significant difference from the unexposed fibroblast cells. This acoustofluidic method will be further applied to create a vascularized network by replacing fibroblast cells with human umbilical vein endothelial cells.


2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Annarita Perillo ◽  
Valeria Landoni ◽  
Alessia Farneti ◽  
Giuseppe Sanguineti

Abstract Purpose The purpose of this study is to evaluate inter- and intra-fraction organ motion as well as to quantify clinical target volume (CTV) to planning target volume (PTV) margins to be adopted in the stereotactic treatment of early stage glottic cancer. Methods and materials Stereotactic body radiotherapy (SBRT) to 36 Gy in 3 fractions was administered to 23 patients with early glottic cancer T1N0M0. Patients were irradiated with a volumetric intensity modulated arc technique delivered with 6 MV FFF energy. Each patient underwent a pre-treatment cone beam computed tomography (CBCT) to correct the setup based on the thyroid cartilage position. Imaging was repeated if displacement exceeded 2 mm in any direction. CBCT imaging was also performed after each treatment arc as well as at the end of the delivery. Swallowing was allowed only during the beam-off time between arcs. CBCT images were reviewed to evaluate inter- and intra-fraction organ motion. The relationships between selected treatment characteristics, both beam-on and delivery times as well as organ motion were investigated. Results For the population systematic (Ʃ) and random (σ) inter-fraction errors were 0.9, 1.3 and 0.6 mm and 1.1, 1.3 and 0.7 mm in the left-right (X), cranio-caudal (Y) and antero-posterior (Z) directions, respectively. From the analysis of CBCT images acquired after treatment, systematic (Ʃ) and random (σ) intra-fraction errors resulted 0.7, 1.6 and 0.7 mm and 1.0, 1.5 and 0.6 mm in the X, Y and Z directions, respectively. Margins calculated from the intra-fraction errors were 2.4, 5.1 and 2.2 mm in the X, Y and Z directions respectively. A statistically significant difference was found for the displacement in the Z direction between patients irradiated with > 2 arcs versus ≤ 2 arcs, (MW test, p = 0.038). When analyzing mean data from CBCT images for the whole treatment, a significant correlation was found between the time of delivery and the three dimensional displacement vector (r = 0.489, p = 0.055), the displacement in the Y direction (r = 0.553, p = 0.026) and the subsequent margins to be adopted (r = 0.626, p = 0.009). Finally, displacements and the subsequent margins to be adopted in Y direction were significantly greater for treatments with more than 2 arcs (MW test p = 0.037 and p = 0.019, respectively). Conclusions In the setting of controlled swallowing during treatment delivery, intra-fraction motion still needs to be taken into account when planning with estimated CTV to PTV margins of 3, 5 and 3 mm in the X, Y and Z directions, respectively. Selected treatments may require additional margins.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jae-Young Kim ◽  
Michael D. Han ◽  
Kug Jin Jeon ◽  
Jong-Ki Huh ◽  
Kwang-Ho Park

Abstract Background The purpose of this study was to investigate the differences in configuration and dimensions of the anterior loop of the inferior alveolar nerve (ALIAN) in patients with and without mandibular asymmetry. Method Preoperative computed tomography images of patients who had undergone orthognathic surgery from January 2016 to December 2018 at a single institution were analyzed. Subjects were classified into two groups as “Asymmetry group” and “Symmetry group”. The distance from the most anterior and most inferior points of the ALIAN (IANant and IANinf) to the vertical and horizontal reference planes were measured (dAnt and dInf). The distance from IANant and IANinf to the mental foramen were also calculated (dAnt_MF and dInf_MF). The length of the mandibular body and symphysis area were measured. All measurements were analyzed using 3D analysis software. Results There were 57 total eligible subjects. In the Asymmetry group, dAnt and dAnt_MF on the non-deviated side were significantly longer than the deviated side (p < 0.001). dInf_MF on the non-deviated side was also significantly longer than the deviated side (p = 0.001). Mandibular body length was significantly longer on the non-deviated side (p < 0.001). There was no significant difference in length in the symphysis area (p = 0.623). In the Symmetry group, there was no difference between the left and right sides for all variables. Conclusion In asymmetric patients, there is a difference tendency in the ALIAN between the deviated and non-deviated sides. In patients with mandibular asymmetry, this should be considered during surgery in the anterior mandible.


2021 ◽  
Vol 49 (6) ◽  
pp. 030006052110285
Author(s):  
Kai Xiao ◽  
Bo Xu ◽  
Lin Ding ◽  
Weiguang Yu ◽  
Lei Bao ◽  
...  

Objective To assess the outcomes of traditional three-dimensional (3D) printing technology (TPT) versus mirror 3D printing technology (MTT) in treating isolated acetabular fractures (IAFs). Methods Consecutive patients with an IAF treated by either TPT or MTT at our tertiary medical centre from 2012 to 2018 were retrospectively reviewed. Follow-up was performed 1, 3, 6, and 12 months postoperatively and annually thereafter. The primary outcome was the Harris hip score (HHS), and the secondary outcomes were major intraoperative variables and key orthopaedic complications. Results One hundred fourteen eligible patients (114 hips) with an IAF (TPT, n = 56; MTT, n = 58) were evaluated. The median follow-up was 25 months (range, 21–28 months). At the last follow-up, the mean HHS was 82.46 ±14.70 for TPT and 86.30 ± 13.26 for MTT with a statistically significant difference. Significant differences were also detected in the major intraoperative variables (operation time, intraoperative blood loss, number of fluoroscopic screenings, and anatomical reduction number) and the major orthopaedic complications (loosening, implant failure, and heterotopic ossification). Conclusion Compared with TPT, MTT tends to produce accurate IAF reduction and may result in better intraoperative variables and a lower rate of major orthopaedic complications.


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