The effect of high- vs low-density barium preparations on the quantitative features of swallowing.

We compared the effect of high-density and low-density barium preparations on the quantitative features of swallowing. The two barium preparations differed primarily in density but also differed somewhat in viscosity. Concurrent videofluoroscopic and manometric studies were done in nine healthy control subjects.

Opening mechanisms of the human upper esophageal sphincter.

Our goals in this study were to evaluate the mechanisms operative in swallow-associated opening of the upper esophageal sphincter (UES) and to determine the dynamics of fluid flow across the sphincter. For this purpose, we obtained concurrent videofluorographic and manometric studies of 2- to 30-ml barium swallows in 15 normal subjects. We found that the resting UES high-pressure zone corresponded closely with the location of the cricopharyngeus.

Timing of videofluoroscopic, manometric events, and bolus transit during the oral and pharyngeal phases of swallowing.

The aims of this study were to evaluate and quantify the timing of events associated with the oral and pharyngeal phases of liquid swallows. For this purpose, we recorded 0-20 ml barium swallows in three groups of volunteers using videoradiographic, electromyographic, and manometric methods. The study findings indicated that a leading complex of tongue tip and tongue base movement as well as onset of superior hyoid movement and mylohyoid myoelectric activity occurred in a tight temporal relationship at the inception of swallowing.

Effect of isosorbide dinitrate and atropine on the lower esophageal sphincter pressure in Chagasic patients.

The effect of isosorbide dinitrate (5 mg, sublingually) and of atropine (12 micrograms/kg i.v.) on the lower esophageal sphincter pressure of chagasic patients with esophageal involvement and of control subjects was studied by the manometric method.

[Effect of isosorbide dinitrate on the lower esophageal sphincter pressure in patients with Chagas' disease].

The effect of 5 mg of sublingual isosorbide dinitrate on the lower esophageal sphincter pressure of 28 chagasic patients with esophageal involvement, was studied by continuous perfusion manometry. The pressure was measured at 5 minute intervals for 60 minutes after drug administration. Isosorbide dinitrate reduced sphincter pressure from 5 to 60 minutes (p less than 0.

Cholinergic innervation of the lower esophageal sphincter in Chagas' disease.

1. The effect of 12 micrograms/kg iv atropine on the lower esophageal sphincter (LES) pressure was studied by continuous perfusion manometry in 14 Chagasic patients, 9 controls, and 3 patients with achalasia, and the effect of 3 ml iv saline was studied in 7 Chagasic patients. 2.

Gallbladder motor function in chagasic patients with megacolon and/or megaesophagus.

Gallbladder motor function was evaluated in 21 Chagasic patients with megacolon and/or megaesophagus and the results were compared with those obtained in 19 control subjects. Gallbladder contraction was evaluated by the radiologic method after the application of two different stimuli: an exogenous one consisting of intravenous injection of cholecystokinin octapeptide at the dose of 30 ng/kg over a period of 1 min, radiologic evaluation was performed before and 5, 10, 15 and 20 min after the stimulus; an endogenous one produced by standardised intraduodenal instillation of a lipid emulsion, radiologic evaluation was performed before and 3, 5, 10, 15, 20, 25 and 30 min after the beginning of intraduodenal infusion. The gallbladder of the Chagasic patients was found to be hypersensitive to both stimuli, since it contracted in a statistically more intense manner, with contraction starting earlier and lasting longer than among the controls.

Effect of CCK-OP and intraduodenal administration of essential amino acids on intraluminal pressures of sigmoid and rectum in patients with Chagasic megacolon.

The motility of the sigmoid colon and rectum was studied by manometry in patients with Chagasic megacolon and in control individuals using two different experimental procedures: (1) intravenous infusion of saline, followed by intravenous infusion of cholecystokinin octapeptide (OP-CCK) at the dose of 20 ng/kg/hr; and (2) intraduodenal instillation of saline followed by a solution of essential amino acids at a flow of 10 ml/min. CCK-OP induced an increase in motility index in the sigmoid colon (P less than 0.05) and rectum (P less than 0.

Effect of nifedipine on the lower esophageal sphincter pressure in chagasic patients.

The effect of 10 mg of sublingual nifedipine on the lower esophageal sphincter pressure (LESP) was studied by continuous perfusion manometry in 15 Chagasic patients and 9 controls. Resting LESP was lower in Chagasic patients (13.51 +/- 2.

[Incidence of diverticular disease of the large bowel in non-chagasic and chagasic individuals with and without megacolon].

To study the frequency of association between two common colonic disease in our midst, chagasic megacolon and diverticular disease, we reviewed the barium enemas of 243 patients aged more than 35 years. Diverticula were detected in 22 (21.6%) of the 102 non-chagasic individuals, in 10 (35.

Dysphagia lusoria and segmental aperistalsis in the upper third of the esophagus.

An aperistaltic zone located in the upper third of the esophagus was present in a young woman with dysphagia, who had undergone surgical treatment for dysphagia lusoria 3 months before. The segmental absence of contraction in the upper third of the esophagus was the most probable cause for the persistence of dysphagia, and could have resulted from damage related to compression or to surgical intervention in the area.

Esophageal dysfunction in patients with progressive systemic sclerosis and mixed connective tissue diseases.

Esophageal motility was studied in 37 patients with progressive systemic sclerosis (PSS), 12 patients with mixed connective tissue disease (MCTD) and 40 controls by the manometry method, using an open tube and continuous perfusion, and by radiological examination. Radiology was normal in 17 patients with PSS and five patients with MCTD, and abnormal in 15 patients with PSS and three with MCTD. The most frequent abnormality was slow transit time of barium.

Plasma gastrin and gastric acid responses to insulin hypoglycemia in Chagas' disease.

Plasma gastrin and gastric acid responses to intravenous injection of insulin (0.2 IU/kg) were measured in 8 patients with Chagas' disease, which is known to be associated with extensive reduction of the intramural neurons of the digestive tract, and in 6 control subjects. All subjects developed hunger, sweating and tachycardia, and exhibited less than 50 mg/dl venous blood glucose.

Gastric accommodation to distension and early gastric emptying in diabetics with neuropathy.

Gastric accommodation to distension and gastric emptying were assessed in diabetics with neuropathy and in control subjects. Gastric accommodation was measured by recording intragastric pressures during the air insufflation of the stomach and gastric emptying was measured by the double sample test meal after intragastric instillation of 500 ml of saline into the empty stomach. Maximal intragastric pressures during air insufflation were significantly higher in diabetics (N = 6) than in control subjects (N = 15), 16.

[Pharyngo-esophageal time in Chagas esophageal disease].

The pharyngoesophageal time, the time interval between the peak pharyngeal pressure and the peak esophageal pressure ten centimeters apart, after wet deglutitions, was measured in 50 controls and 37 chagasic patients. The time was 2.90 +/- 0.

Fasting and food-stimulated plasma gastrin levels in chronic Chagas' disease.

Chagas' disease is known to be associated with extensive lesions of the intramural neurons of the digestive tract. In order to evaluate the contribution of the intramural plexuses to the control of plasma gastrin levels in man, we performed the following measurements: (a) fasting plasma gastrin in 18 chagasic patients and 16 control subjects; (b) integrated gastrin response to food in 9 chagasic patients and 10 controls, (c) basal acid secretion and gastric acid responses to graded doses of pentagastrin in 14 chagasic and 13 controls. Fasting plasma gastrin levels and integrated gastrin response were significantly higher in chagasics than in controls.

Segmental absence of contraction in the upper third of the esophagus.

In a manometric study of esophageal motility, segmental absence of contraction was encountered in the upper third of the esophagus in five patients, although only two of them had complained about dysphagia. If the manometric patterns were identical in the patients with and without dysphagia, it is difficult to explain this symptom in all the cases.

Abnormalities of interdigestive motility of the small intestine in patients with Chagas' disease.

The fasting motor activity of the upper small intestine was studied in 36 patients with chronic Chagas' disease, which is known to be associated with extensive lesions of the myenteric plexuses, and the results compared with those obtained in 15 control subjects. The migrating motor complex (MMC) was detected as frequently in the Chagas' disease group as in the control group, and the frequency of contractions during the activity front was virtually the same in the two groups. In the Chagas' group the propagation of the activity fronts was slower, their duration was longer in the jejunum, but not in the duodenum, and the calculated length was shorter than normal.

Effect of pentagastrin on the motor activity of the dilated and nondilated sigmoid and rectum in Chagas' disease.

In order to evaluate the effect of pentagastrin on the motor activity of the sigmoid and rectum in patients with Chagas' disease, manometric studies were performed on 22 chagasic patients, 11 without and 11 with megacolon, and 11 control subjects. Pentagastrin had a stimulating effect on the sigmoid and rectum in control subjects as well as in chagasic patients without megacolon. In chagasic patients with megacolon, pentagastrin had no effect on sigmoid or rectum motility, probably as a result of the intrinsic denervation known to occur in this disease.

[The lower esophageal sphincter in patients with Chagas' disease with peristalsis and aperistalsis].

The opening of the lower esophageal sphincter (LES) were studied by intraluminal manometry in 23 control subjects, 10 chagasic patients with peristalsis in esophagus and 15 chagasic patients with aperistalsis in esophagus. The opening of the LES were 2,1 +/- 0,7 seconds after wet deglutitions in controls, 3,2 +/- 1,2 seconds in chagasic with peristalsis and 3,5 +/- 1,7 seconds in chagasic with aperistalsis. The duration of relaxation were 7,9 +/- 1,5 seconds in controls, 5,2 +/- 1,0 seconds in chagasic wih peristalsis and 5,9 +/- 1,3 seconds in chagasic with aperistalsis.