scholarly journals Esophageal High Pressure Zones: Effect of Perisophageal Structures on Esophageal Manometric Recording

1994 ◽  
Vol 8 (4) ◽  
pp. 239-245
Author(s):  
G Bédard ◽  
A Pellicano ◽  
R Ste-Marie
Keyword(s):  
High Pressure ◽  
Lower Esophageal Sphincter ◽  
Radiopaque Marker ◽  
X Ray ◽  
Group A ◽  
Chest X Ray ◽  
Esophageal Sphincter ◽  
Group 2 ◽  
High Pressure Zone ◽  
Group 1

During the course of esophageal motility studies, short zones of elevated esophageal baseline pressure are occasionally noticed. The aim of this study is to determine their frequency and their cause. Among 77 consecutive esophageal manometries (group 1), 17 cases (22%) of ‘esophageal high pressure zones’ (EHPZs) were recorded. Thirty-three additional patients (group 2) were evaluated and 18 other cases of EHPZ were found; in the latter group, a miniature sound microphone was positioned on a carotid artery. When a high pressure zone was identified, the manometric catheter was immobilized; the patient underwent a chest x-ray, with the radiopaque marker imbedded in the catheter used to locate the thoracic structures adjacent to EHPZs. In both groups, indentations (pressure spikes) over the high pressure zones occurred synchronously with the patients’ radial or carotid pulse. Results suggest that EHPZs are caused by the compression and pulsations of vascular or cardiac periesophageal structures; the aortic arch is responsible for the manometric EHPZ when it is found between 10 and 14 cm above the lower esophageal sphincter whereas the left auricle is the cause of the EHPZ if it is located between 4 and 7 cm above the lower esophageal sphincter.

scholarly journals Carnitine for Body Composition in Hemodialysis Patients

2020 ◽  
pp. 5-8
Author(s):  
Hideki Kakutani ◽  
Yoshikane Kato ◽  
Tomomi Fujikawa ◽  
Takafumi Kawata ◽  
Masami Yamamoto ◽  
...  
Keyword(s):  
Body Composition ◽  
Pilot Study ◽  
Statistical Significance ◽  
Hemodialysis Patients ◽  
The Body ◽  
X Ray ◽  
Chest X Ray ◽  
Group 2 ◽  
Fat Volume ◽  
Group 1

Background: Authors and colleagues have continued clinical research for hemodialysis patients. Currently, a pilot study presents intervention of carnitine for changes of the body composition. Subjects and Methods: Subjects were six patients on hemodialysis with intervention of carnitine (group 1). Average data were 74.3 years, 65.4 kg, 22.6 in BMI. As levocarnitine, L-Cartin FF injection 1000 mg was administered three times a week for six months. Group 2 has six control patients for age-, sex-, body weight, BMI-matched (group 2). Body composition of muscle and fat tissues were measured by InBody 770 on 0 and 6 months. Results: In group 1, muscle volume and skeletal muscle showed increasing tendency without statistical significance. In contrast, there were significant decreases of body fat volume (22.3 kg vs 20.5 kg, 39.0% vs 35.8%) (p<0.05). No significant differences were found in hemoglobin, total protein, albumin and Cardio-Thoracic Ratio (CTR) of chest X-ray. Group 2 showed no significant changes. Discussion and Conclusion: Hemodialysis patients often have muscular reduction. Previous reports showed improved lean body mass by carnitine administration, which may support our result. These results from current pilot study would be expected to become useful reference data in the pathophysiological investigation in patients on hemodialysis.

scholarly journals Normal Chest X-Ray in Patients with Pulmonary Embolism May Involve Increased Risk of Massive Pulmonary Embolism

2022 ◽  
Vol 4 (1) ◽  
pp. 1-4
Author(s):  
Hatice Kilic ◽  
Habibe Hezer ◽  
Berker Ozturk ◽  
Muhammed Sait Besler ◽  
Huseyin Cetin ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Clinical Severity ◽  
Systolic Pulmonary Artery Pressure ◽  
Pathological Findings ◽  
X Ray ◽  
Increased Risk ◽  
Normal Chest ◽  
Chest X Ray ◽  
Group 2 ◽  
Group 1

Purpose: Chest radiography is normal in approximately 20-40% of acute pulmonary embolism (PE) patients without cardiopulmonary disease. The aim of this study was to determine whether there is any difference between the patients with normal chest X-ray and those with pathological findings in terms of clinical severity and prognosis. Methods: 178 of PE patients were included in the study. 110 patients had no parenchymal pathology, whereas group 1 (n = 110); group 2 (n = 68) had various pathological parenchymal findings in 68 patients. Clinical and radiological parameters were compared between these groups. Following the diagnosis of PE, the cases were recorded in the fifth year. Results: In 178 participants; those with normal chest X-ray (group 1), with parenchymal pathological findings on the chest X-ray (group 2); echocardiographic systolic pulmonary artery pressure (sPAP) (p = 0.68), gender (p = 0.9) and thrombus type (p = 0.41) were similar. The patients in group 1 were not different in terms of central thrombus detected in computed tomography pulmonary angiogram compared to the patients in group 2; however, the chest radiograph of the patients in group 1 had no parenchymal pathology. Central thrombus group 1, group 2, respectively; 97 (89.0%), 53 (77.9%), p = 0.07. There was no significant difference between the two groups in terms of mortality which was followed up in fifth year (p > 0.05). Conclusions: Normal chest X-ray in PE can determine mortality and may involve increased risk of massive PE.

scholarly journals Comparison of Different Diagnostic Method for Mycobacteria Tuberculosis in Suspected Patients

1970 ◽  
Vol 7 (2) ◽  
pp. 84-88
Author(s):  
AR Khagi ◽  
S Singh ◽  
S Subba ◽  
A Bajracharya ◽  
R Tuladhar ◽  
...  
Keyword(s):  
Comparative Study ◽  
Sputum Smear ◽  
Study Group ◽  
Bacterial Cells ◽  
X Ray ◽  
Smear Examination ◽  
Group A ◽  
Chest X Ray ◽  
Group B ◽  
Sputum Smear Examination

Background: Microbial examination of smear of AFB by Z-N stain is currently the most rapid method for the detection of M. tuberculosis but its sensitivity is low i.e. required at least 10,000 bacterial cells per ml of sputum and also none specific, but auramine staining method has higher sensitivity than that of the Z-N stain but there are chances of false positive. Objective of this study was to find the correlation between chest X-ray, direct sputum smear examination by Ziehl-Neelsen stain, Auramine fluorochrome stain and sputum culture for M. tuberculosis. Methods: During that study period 250 x 3 samples were taken three each from 250 patients and divided into two groups A and B by performing Auramine fluorochrome stain in all samples . In group A, there were 150 fluorochrome stain positive samples. One each from 150 patient for comparative study of direct sputum smear examination by Ziehl-Neelsen stain, , culture on LJ medium and chest X-ray. Similarly in group B, next 100 fluorochrome stain negative specimens one each from 100 patients were taken for the comparative study of direct sputum smear examination by Ziehl-Neelsen stain, culture and chest X-ray. Results: In the study group A (n=150) all the specimens were positive in Auramine fluorochrome stain and all of them show positive in X-ray but only 134 showed positive in Ziehl-Neelsen stain and 136 showed positive in culture. In the study group B (n=100), all the specimens were negative in Auramine fluorochrome stain and all of them show negative in Ziehl-Neelsen stain but 14 of them were positive in culture and 24 were positive in chest X-ray. Conclusions: The diagnosis of PTB could be made by Auramine fluorochrome microscopy and culture. Key words: auramine fluorochrome stain; culture; mycobacterium tuberculosis; x-ray; ziehl-neelsen. DOI: 10.3126/jnhrc.v7i2.3012 Journal of Nepal Health Research Council Vol.7(2) Apr 2009 84-88

scholarly journals Low Dose X-Ray Sources and High Quantum Efficiency Sensors: The Next Challenge in Dental Digital Imaging?

2014 ◽  
Vol 2014 ◽  
pp. 1-7
Author(s):  
Arnav R. Mistry ◽  
Daniel Uzbelger Feldman ◽  
Jie Yang ◽  
Eric Ryterski
Keyword(s):  
Low Dose ◽  
Image Resolution ◽  
X Ray ◽  
Imaging Technologies ◽  
Group 4 ◽  
X Ray Imaging ◽  
Group 3 ◽  
Group 5 ◽  
Group 2 ◽  
Group 1

Objective(s). The major challenge encountered to decrease the milliamperes (mA) level in X-ray imaging systems is the quantum noise phenomena. This investigation evaluated dose exposure and image resolution of a low dose X-ray imaging (LDXI) prototype comprising a low mA X-ray source and a novel microlens-based sensor relative to current imaging technologies.Study Design. A LDXI in static (group 1) and dynamic (group 2) modes was compared to medical fluoroscopy (group 3), digital intraoral radiography (group 4), and CBCT scan (group 5) using a dental phantom.Results. The Mann-Whitney test showed no statistical significance(α=0.01)in dose exposure between groups 1 and 3 and 1 and 4 and timing exposure (seconds) between groups 1 and 5 and 2 and 3. Image resolution test showed group 1 > group 4 > group 2 > group 3 > group 5.Conclusions. The LDXI proved the concept for obtaining a high definition image resolution for static and dynamic radiography at lower or similar dose exposure and smaller pixel size, respectively, when compared to current imaging technologies. Lower mA at the X-ray source and high QE at the detector level principles with microlens could be applied to current imaging technologies to considerably reduce dose exposure without compromising image resolution in the near future.

scholarly journals PMMA Intraocular Lenses Changes after Treatment with Nd:Yag Laser: A Scanning Electron Microscopy and X-ray Spectrometry Study

2020 ◽  
Vol 10 (18) ◽  
pp. 6321
Author(s):  
Alessandro Meduri ◽  
Alice Antonella Severo ◽  
Antonio De Maria ◽  
Pietro Perroni ◽  
Giuseppe Acri ◽  
...  
Keyword(s):  
Nd:Yag Laser ◽  
Surface Group ◽  
Intraocular Lenses ◽  
X Ray ◽  
Wrinkled Surface ◽  
Group 3 ◽  
Group 2 ◽  
Normal Shape ◽  
Scanning Electron ◽  
Group 1

Neodymium:yttrium-aluminum-garnet (Nd:YAG) laser may cause intraocular lenses (IOLs) damages. Therefore, the effects of Nd:YAG laser on IOLs were evaluated. Twenty-four IOLs (copolymer of 2-hydroxyethylmethacrylate and 2-ethoxyethylmethacrylate) were used. For scanning electron microscope (SEM), twelve IOLs were divided into three groups: Group 1, controls; Group 2, IOLs treated with two laser spots (YC-1800 Nidek Nd:YAG laser set at 1.2 mJ); and Group 3, IOLs treated with six laser spots. All IOLs were critical point dried in CO2 and viewed in a Zeiss EVO LS10 SEM. For Energy Dispersive X-ray spectrometry (EDX), four IOLs of each group were examined with a Jeol JMC-6000 SEM. With SEM, Group 1 IOLs showed well-preserved size, shape and surface. Group 2 IOLs exhibited normal shape and margins, a peripheral furrow with irregular blebs, straight clefts and holes on the wrinkled surface. Group 3 IOLs were swollen and broken into two or three parts. With SEM and EDX, Group 1 and the undamaged surfaces of Groups 2 and 3 showed evident carbon and oxygen peaks, while, in the damaged areas, both atoms were significantly reduced. Nd:YAG laser induced evident changes in IOLs morphology and organic alterations in their chemistry: great care during posterior capsule opacification treatment is required.

Identification of longitudinal muscle activity in opossum lower esophageal sphincter

1991 ◽  
Vol 261 (6) ◽  
pp. G974-G980 ◽  
Author(s):  
S. S. Harrington ◽  
W. J. Dodds ◽  
R. K. Mittal
Keyword(s):  
Muscle Contraction ◽  
Lower Esophageal Sphincter ◽  
Strain Gauge ◽  
Longitudinal Muscle ◽  
Pressure Fluctuations ◽  
Circular Muscle ◽  
Pharmacological Agents ◽  
Esophageal Sphincter ◽  
High Pressure Zone ◽  
Contraction And Relaxation

The aim of this study was to characterize lower esophageal sphincter (LES) longitudinal muscle contraction during changes in LES pressure in opossums. LES pressure was used as a marker of LES circular muscle contraction. Longitudinal muscle contraction was measured by strain gauge transducers. For precise placement of the strain gauge on the LES, the high-pressure zone was identified using a manometric-laser illumination technique. Measurements were made during 1) spontaneous LES pressure fluctuations, 2) LES pressure changes induced by pharmacological agents, and 3) LES relaxation induced by vagal nerve stimulation. These studies show that 1) spontaneous LES pressure fluctuations correlated with spontaneous changes in LES longitudinal muscle contraction; 2) pharmacologically induced contraction and relaxation of LES pressure correlated with contraction and relaxation of LES longitudinal muscle, respectively; 3) a close temporal relationship existed between changes in LES longitudinal muscle contraction and LES pressure that occurred spontaneously or were induced pharmacologically; and 4) vagal stimulation caused LES longitudinal muscle contraction and LES pressure relaxation. We propose that LES longitudinal muscle may play a role in the modulation of intraluminal LES pressure.

Estimation of human susceptibility to the high-pressure nervous syndrome

1983 ◽  
Vol 54 (4) ◽  
pp. 1063-1070 ◽  
Author(s):  
J. C. Rostain ◽  
C. Lemaire ◽  
M. C. Gardette-Chauffour ◽  
J. Doucet ◽  
R. Naquet
Keyword(s):  
High Pressure ◽  
Individual Variability ◽  
Theta Activity ◽  
Large Individual ◽  
Psychometric Tests ◽  
Activity Increase ◽  
Eeg Changes ◽  
Group 2 ◽  
Group 1

Twenty-four professional divers were put through a series of electroencephalographic (EEG) and psychometric tests at the surface and at 180 m after a fast compression (15 min) in an attempt to determine their susceptibility to high-pressure nervous syndrome (HPNS). The subjects were classified according to the EEG changes between the surface and 180 m: group 0, less than 10% increase in theta-band activity in the anterior region of the scalp; group 1, between 10 and 100% increase in theta-activity; group 2, theta-activity increase above 100%. Eight subjects were selected to make a dive to 450 m to verify the quality of our classification (3 from group 0, 3 from group 1, 2 from group 2). The results showed that, for the psychometric tests, the large individual variability between the surface and 180 m does not allow us to prejudge the behavior of each subject at 450 m, but the classification established from absolute values is stable from the surface to 450 m. For the EEG activities, intensity of the modifications at 450 m can be predicted at group level by a 180-m dive, performed with fast compression and similar breathing mixtures.

scholarly journals Interpleural Administration of Bupivacaine after Cholecystectomy: A Comparison with Intercostal Nerve Block

1989 ◽  
Vol 17 (3) ◽  
pp. 269-274 ◽  
Author(s):  
D. W. Blake ◽  
G. Donnan ◽  
J. Novella
Keyword(s):  
Local Anaesthetic ◽  
Intercostal Nerve ◽  
Intercostal Nerve Block ◽  
Nerve Blocks ◽  
Pain Scores ◽  
Lower Pain ◽  
Chest X Ray ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Pethidine requirements and verbal pain scores were recorded in 36 patients after cholecystectomy via subcostal incision. All patients also received 20 ml 0.5% bupivacaine with adrenaline 1/200,000. Group 1 (12 patients) received unilateral intercostal nerve blocks. Interpleural catheters were inserted through the 8th intercostal space in the remaining patients; 12 received local anaesthetic via the catheter immediately after surgery (Group 2) and 12 were given local anaesthetic at three hours (Group 3). Small asymptomatic pneumothoraces were noted on chest X-ray in six of the 24 patients with interpleural catheters. Both types of local anaesthesia produced lower pain scores than pethidine alone (P < 0.05) with 25% of intercostal nerve blocks and 63% of interpleural catheters requiring no pethidine in the following three hours. The provision of catheter ‘top-ups’ between six and 18 hours after surgery also resulted in lower pain scores and a reduction in pethidine requirements (P < 0.05).

Variability in the muscle composition of rat esophagus and neural pathway of lower esophageal sphincter relaxation

2011 ◽  
Vol 301 (6) ◽  
pp. G1014-G1019 ◽  
Author(s):  
Yanfen Jiang ◽  
Valmik Bhargava ◽  
Harshal A. Lal ◽  
Ravinder K. Mittal
Keyword(s):  
Skeletal Muscle ◽  
Smooth Muscle ◽  
Vagus Nerve ◽  
Longitudinal Muscle ◽  
Muscle Layer ◽  
Axial Stretch ◽  
Longitudinal Muscle Layer ◽  
Esophageal Sphincter ◽  
Group 2 ◽  
Group 1

Several studies from our laboratory show that axial stretch of the lower esophageal sphincter (LES) in an oral direction causes neurally mediated LES relaxation. Under physiological conditions, axial stretch of the LES is caused by longitudinal muscle contraction (LMC) of the esophagus. Because longitudinal muscle is composed of skeletal muscle in mice, vagal-induced LMC and LES relaxation are both blocked by pancuronium. We conducted studies in rats (thought to have skeletal muscle esophagus) to determine if vagus nerve-mediated LES relaxation is also blocked by pancuronium. LMC-mediated axial stretch on the LES was monitored using piezoelectric crystals. LES and esophageal pressures were monitored with a 2.5-Fr solid-state pressure transducer catheter. Following bilateral cervical vagotomy, the vagus nerve was stimulated electrically. LES, along with the esophagus, was harvested after in vivo experiments and immunostained for smooth muscle (smooth muscle α-actin) and skeletal muscle (fast myosin heavy chain). Vagus nerve-stimulated LES relaxation and esophageal LMC were reduced in a dose-dependent fashion and completely abolished by pancuronium (96 μg/kg) in six rats ( group 1). On the other hand, in seven rats, LES relaxation and LMC were only blocked completely by a combination of pancuronium ( group 2) and hexamethonium. Immunostaining revealed that the longitudinal muscle layer was composed of predominantly skeletal muscle in the group 1 rats. On the other hand, the longitudinal muscle layer of group 2 rats contained a significant amount of smooth muscle ( P < 0.05). Our study shows tight coupling between axial stretch on the LES and relaxation of the LES, which suggests a cause and effect relationship between the two. We propose that the vagus nerve fibers that cause LMC induce LES relaxation through the stretch-sensitive activation of inhibitory motor neurons.

The impact of pretreatment absolute lymphocyte count (pALC) and neutrophil-lymphocyte ratio (pNLR) on checkpoint inhibitors (CPIs) response rates in renal cell carcinoma (RCC) and bladder urothelial cancers (BC).

2020 ◽  
Vol 38 (5_suppl) ◽  
pp. 29-29
Author(s):  
Tonjeh Mary Stella Bah ◽  
David Sommerhalder ◽  
Philip A. Haddad
Keyword(s):  
Checkpoint Inhibitors ◽  
Medical Center ◽  
Response Rates ◽  
Neutrophil Lymphocyte Ratio ◽  
Essential Components ◽  
Group A ◽  
Group 2 ◽  
Group B ◽  
The Impact ◽  
Group 1

31 Background: CPIs have been established as essential components of cancer immunotherapy across multiple cancer types with proven clinical benefit, improved outcomes, and less toxicity. Studies in lung and head and neck cancers found that low ALC, a marker of immune exhaustion, was associated with poor response to CPIs and worse progression-free survival. We explored the effect of pALC and pNLR on CPI response rates in patients with RCC and BC. Methods: We retrospectively reviewed every RCC and BC patient that received CPIs at Overton Brooks VA Medical Center and LSUHSC-S between 2015 and 2019. Patients’ pALC and pNLR were calculated. The patients were divided according to pALC into 2 groups: Group A with pALC > 1000 and Group B with pALC < 1000. Similarly, using NLR’s established upper normal limit of 3, 2 groups were created: Group 1 with pNLR < 3 and Group 2 with pNLR > 3. Our primary outcome of interest was defined as the presence or absence of CPI response. Patients who attained stable disease, partial response, and complete response were categorized as responders. Those who progressed on CPIs were labeled as non-responders. The significance of the association between pALC and pNLR groups and the occurrence of any response was analyzed statistically. Results: Twenty patients (13 RCC, 7 BC) were treated with CPIs and had documented responses. Twelve patients had pALC > 1000 (Group A) whereas 8 patients had pALC < 1000 (Group B). Both groups were comparable with respect to age, sex, race, and types of CPIs. Group A had a significantly higher response rate (75% vs 25%, p = 0.027). As to pNLR, 10 patients had pNLR < 3 (Group 1) and another 10 patients had pNLR > 3 (Group 2). Patients with pNLR > 3 had worse response rates to CPIs compared to those with pNLR < 3 (30% vs 80%, p = 0.024). Conclusions: This is the first report from a real-world clinical setting to show a detrimental association between pALC < 1000 and pNLR > 3 and CPI response rates in a retrospective cohort of consecutive non-selected kidney and bladder cancer patients. This association and its clinical utility require further confirmation in a prospective larger cohort.

Sign in / Sign up

Export Citation Format

Share Document