Dorsal motor nucleus of the vagus: a site for evoking simultaneous changes in crural diaphragm activity, lower esophageal sphincter pressure, and fundus tone

2008 ◽  
Vol 294 (1) ◽  
pp. R121-R131 ◽  
Author(s):  
Mark Niedringhaus ◽  
Patrick G. Jackson ◽  
Stephen R. T. Evans ◽  
Joseph G. Verbalis ◽  
Richard A. Gillis ◽  
...  
Keyword(s):  
Smooth Muscle ◽  
Lower Esophageal Sphincter ◽  
Lower Esophageal Sphincter Pressure ◽  
Motor Nucleus ◽  
Sphincter Pressure ◽  
Vagus Nerves ◽  
Dorsal Motor Nucleus ◽  
Esophageal Sphincter ◽  
Crural Diaphragm ◽  
Stimulation Of

The sphincter mechanism at the esophagogastric junction includes smooth muscle of the lower esophagus and skeletal muscle of the crural diaphragm (CD). Smooth muscle is known to be under the control of the dorsal motor nucleus of the vagus (DMV), while central nervous system (CNS) control of the CD is unknown. The main purposes of our study were to determine the CNS site that controls the CD and whether simultaneous changes in lower esophageal sphincter (LES) pressure and CD activity occur when this site is activated. Experiments were performed on anesthetized male ferrets whose LES pressure, CD activity, and fundus tone were monitored. To activate DMV neurons, l-glutamate was microinjected unilaterally into the DMV at three areas: intermediate, rostral, and caudal. Stimulation of the intermediate DMV decreased CD activity (−4.8 ± 0.1 bursts/min and −0.3 ± 0.01 mV) and LES pressure (−13.2 ± 2.0 mmHg; n = 9). Stimulation of this brain site also produced an increase in fundus tone. Stimulation of the rostral DMV elicited increases in the activity of all three target organs ( n = 5). Stimulation of the caudal DMV had no effect on the CD but did decrease both LES pressure and fundus tone ( n = 5). All changes in LES pressure, fundus tone, and some DMV-induced changes in CD activity (i.e., bursts/min) were prevented by ipsilateral vagotomy. Our data indicate that simultaneous changes in activity of esophagogastric sphincters and fundus tone occur from rostral and intermediate areas of the DMV and that these changes are largely mediated by efferent vagus nerves.

Control of lower esophageal sphincter pressure by two sites in dorsal motor nucleus of the vagus

1990 ◽  
Vol 259 (6) ◽  
pp. G899-G906 ◽  
Author(s):  
C. D. Rossiter ◽  
W. P. Norman ◽  
M. Jain ◽  
P. J. Hornby ◽  
S. Benjamin ◽  
...  
Keyword(s):  
Glutamic Acid ◽  
Lower Esophageal Sphincter ◽  
Lower Esophageal Sphincter Pressure ◽  
Motor Nucleus ◽  
Sphincter Pressure ◽  
Intragastric Pressure ◽  
Dorsal Motor Nucleus ◽  
Efferent Neurons ◽  
Esophageal Sphincter ◽  
Pyloric Motility

Our purpose was to determine the central vagal sites for regulating changes in lower esophageal sphincter (LES) pressure in the cat. Injection of the retrograde tracer, horseradish peroxidase, into the LES resulted in labeling of cells in the dorsal motor nucleus of the vagus (DMV), with the largest number of cells appearing in two areas, one area rostral to obex (1.5-4.0 mm) and one area caudal to obex (-0.5 to -1.5 mm). In alpha-chloralose-anesthetized cats, L-glutamic acid was microinjected into these areas and LES pressure, intragastric pressure, and stomach motility were monitored. Microinjection of L-glutamic acid into the rostral area resulted in significant increases in LES pressure (18.6 +/- 4.9 mmHg; P less than 0.05), pyloric motility (baseline minute motility increased from 5.7 +/- 2.2 to 14.5 +/- 3.9 postinjection; P less than 0.05) and stomach pressure (baseline of 16.9 +/- 2.3 mmHg increased to 23.8 +/- 3.7 mmHg postinjection; P less than 0.05). Microinjection of L-glutamic acid into the caudal area resulted in significant decreases in LES pressure (-14.3 +/- 5.8 mmHg; P less than 0.05) and intragastric pressure (-7.5 +/- 2.2 mmHg; P less than 0.05) with no significant changes in pyloric motility. Ipsilateral vagotomy abolished both sets of responses. These data indicate that excitatory and inhibitory control of LES and intragastric pressure are mediated by vagal efferent neurons located in two distinct sites in the DMV.

Effects of hindbrain stimulation on lower esophageal sphincter pressure in the cat

1984 ◽  
Vol 247 (1) ◽  
pp. G70-G78 ◽  
Author(s):  
F. C. Barone ◽  
D. M. Lombardi ◽  
H. S. Ormsbee
Keyword(s):  
Lower Esophageal Sphincter ◽  
Nucleus Ambiguus ◽  
Motor Nucleus ◽  
Sphincter Pressure ◽  
Similar Frequency ◽  
Stimulation Parameters ◽  
Gastrointestinal Motor ◽  
Esophageal Sphincter ◽  
Upper Gastrointestinal ◽  
Stimulation Of

Lower esophageal sphincter (LES) pressure was measured in anesthetized cats during electrical stimulation of the dorsal motor nucleus of the vagus (DMV) and nucleus ambiguus (NA). Stimulation parameters were varied to determine maximal changes in LES pressure and upper gastrointestinal motor responses. LES pressure decreased significantly during DMV and NA stimulation. The LES preferentially was affected over other upper gastrointestinal locations. Bradycardia and increases in blood pressure occurred with stimulation of both nuclei. LES pressure changes could be demonstrated in the absence of other gastrointestinal responses by decreasing hindbrain stimulation parameters. Cervical vagotomy completely eliminated hindbrain stimulation-induced changes in LES pressure, upper gastrointestinal motor activity, and heart rate. Similar frequency-LES pressure response relationships were observed for DMV and NA stimulation, with maximum changes occurring at 25 Hz. Changes in LES pressure occurred at shorter stimulation pulses (0.05 vs. 0.5 ms) and at lower stimulating current strength (30 vs. 60 microA) during DMV as compared with NA stimulation. In addition, stimulation of areas adjacent to the DMV and NA also significantly altered LES pressure, indicating that a large portion of the cat hindbrain associated with the vagal motor nuclei is involved in LES pressure control.

Motilin agonist erythromycin increases human lower esophageal sphincter pressure by stimulation of cholinergic nerves

1994 ◽  
Vol 39 (2) ◽  
pp. 381-384 ◽  
Author(s):  
Stanislas Chaussade ◽  
Spyros Michopoulos ◽  
Phillipe Sogni ◽  
Jean Guerre ◽  
Daniel Couturier
Keyword(s):  
Lower Esophageal Sphincter ◽  
Lower Esophageal Sphincter Pressure ◽  
Sphincter Pressure ◽  
Cholinergic Nerves ◽  
Esophageal Sphincter ◽  
Stimulation Of

Somatostatin effects on lower esophageal sphincter function.

1979 ◽  
Vol 237 (1) ◽  
pp. E77
Author(s):  
D E Bybee ◽  
F C Brown ◽  
L P Georges ◽  
D O Castell ◽  
J E McGuigan
Keyword(s):  
Smooth Muscle ◽  
Lower Esophageal Sphincter ◽  
Lower Esophageal Sphincter Pressure ◽  
Immunoreactive Insulin ◽  
Sphincter Pressure ◽  
Significant Suppression ◽  
Abdominal Compression ◽  
Muscle Response ◽  
Sphincter Function ◽  
Esophageal Sphincter

The effect of somatostatin (GH-RIH) infusion (2 microgram/min) on lower esophageal sphincter pressure (LESP) responses to various stimuli was evaluated in adult male baboons. GH-RIH infusion did not affect basal LESP, but did cause a significant suppression of mean immunoreactive insulin (IRI) to 5.8% of basal values (P less than 0.05). Pentagastrin IV caused dose-related increases in LESP that were unaffected by GH-RIH. Abdominal compression caused a threefold rise in LESP (P less than 0.005) both without and with GH-RIH. However, atropine (20 microgram/kg iv bolus) completely blocked this cholinergic LES pressure response. Intragastric alkali as well as intragastric glycine caused significant increases in LESP (P less than 0.05). These LESP responses to alkali and to glycine were totally abolished by GH-RIH. In conclusion, GH-RIH infusion in the baboon does not affect basal LESP, LES smooth muscle response to exogenous stimulation, nor a cholinergically mediated LES response. GH-RIH does inhibit the response of LESP both to intragastric alkali and to glycine by the apparent suppression of a hormonally mediated mechanism.

Outcome of Pneumatic Balloon Dilatation in Achalasia Cardia

2021 ◽  
Vol 10 (1) ◽  
pp. 8-13
Author(s):  
Shankar Baral ◽  
Bidhan NIdhi Paudel ◽  
Ajit Khanal ◽  
Jiwan Thapa ◽  
Bhuwneshwer Yadhav ◽  
...  
Keyword(s):  
Observational Study ◽  
Lower Esophageal Sphincter ◽  
Poor Response ◽  
Lower Esophageal Sphincter Pressure ◽  
Pneumatic Dilatation ◽  
Response To Treatment ◽  
Sphincter Pressure ◽  
Achalasia Cardia ◽  
Type Iii ◽  
Esophageal Sphincter

Background: Achalasia Cardia is a rare esophageal motility disorder. Among various treatment options, Pneumatic Dilatation (PD) is the most widely used and cost effective modality till date. This is the first observational study aiming to evaluate the short term response and complications of PD for Achalasia Cardia in Nepal. Methods: This prospective observational study was conducted between 28th Jan 2020 to 27th Jan 2021. It included 39 patients with Achalasia Cardia diagnosed by clinical presentation, esophagoscopy, barium esophagogram and high resolution manometry. Two patients of Type III achalasia were excluded from study. Thirty seven patients underwent pneumatic dilatation with 30 mm Rigiflex balloon (Boston Scientific, USA) for a duration of 1 minute. Response was assessed by Eckardts score at 3 and 6 months. Result: Among 39 cases (mean age= 39.03±15.017 years, 59% men), commonest was Type II Achalasia (71.8%) followed by Type I (23.1%) and Type III (5.1%). Dysphagia was present in all patients (100%), followed by weight loss (84.6%), regurgitation (79.5%) and chest pain (35.9%). Mean basal Eckardts score and Lower Esophageal Sphincter pressure of the study population was 7.81±1.24 and 24.40±6.83 respectively. Response to pneumatic dilatation was 89.2%. Eckardts score changed significantly from7.81±1.24 to 1.03±1.82 at 6 months (p<0.001). None of the patients had major complications. Younger age (23±6.377 years) had poor response to treatment, while predilatation Lower Esophageal Sphincter pressure, gender and type of achalasia did not affect the treatment outcome. Conclusion: PD is safe and effective treatment modality for Achalasia. Younger patients have poor response to treatment with Pneumatic Dilatation.  

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