The effect of short-term lower esophageal distension on intragastric pressure (IGP) and the related neural pathways involved were investigated in urethane-anesthetized rats in which enteric nervous system connections were interrupted by ligations of the pylorus and the gastroesophageal junction while keeping the gastric vagus nerve trunks intact. Under these conditions, lower esophageal distension with a bolus of 0.2 to 0.5 ml saline in 0.1 ml step increments, raised the inside esophagus balloon pressure from 1.89 +/- 0.17 to 4.21 +/- 0.13 cm H2O and reduced IGP from -0.42 +/- 0.08 to -0.77 +/- 0.12 cm H2O, respectively. Bilateral cervical vagotomy partly blocked the gastric relaxation induced by 0.5 ml esophageal distension from -0.77 +/- 0.12 to -0.34 +/- 0.02 cm H2O; in contrast, a further bilateral splanchnectomy partly rebounded the effect of 0.5 ml esophageal distension from -0.34 +/- 0.02 to -0.46 +/- 0.05 cm H2O. These results suggest that the enteric nervous system may not play a prominent role in acute esophageal distension induced-gastric relaxation. However, more than 50% of this effect is central nervous system mediated (via the long vago-vagal reflex). The other 40% can be maintained without central and enteric nervous systems involvement, probably via a proposed gastric vagal afferent-esophageal collateral reflex.
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http://dx.doi.org/10.1016/s0165-1838(96)00126-9 | DOI Listing |
BMC Pediatr
January 2025
Liver Transplantation & Hepatopancreatobiliary Surgery Unit, Department of General Surgery, Istanbul Faculty of Medicine, Istanbul, Türkiye.
Background: Gastro-esophageal variceal hemorrhage (GEVH) is one of the major causes of life-threatening gastrointestinal bleeding in children. Medical, endoscopic, angiographic, and surgical interventions can be utilized in treatment. In this case report, we describe partial splenic artery embolization for refractory GEVH due to portal vein thrombosis.
View Article and Find Full Text PDFJ Neurogastroenterol Motil
January 2025
Kenneth C. Griffin Esophageal Center of Northwestern Medicine, Rockford, IL, USA.
Background/aims: Functional lumen imaging probe (FLIP) Panometry has demonstrated utility in the assessment of esophageal motility as a complement to existing methodologies like high-resolution manometry. However, as FLIP is typically performed with sedation during routine endoscopy, there is potential for impact of sedation agents on esophageal motility. We aim to examine the effects of conscious sedation with midazolam and fentanyl on FLIP Panometry metrics and classification.
View Article and Find Full Text PDFPharmaceuticals (Basel)
November 2024
Biomedical Research Centre, University Hospital Hradec Kralove, 500 05 Hradec Kralove, Czech Republic.
Tacrine is a centrally active non-competitive reversible acetylcholinesterase inhibitor. It also exerts antagonising activity against -methyl-D-aspartate receptors. Tacrine was approved for the treatment of Alzheimer's disease in 1993, but was withdrawn from clinical use in 2013 because of its hepatotoxicity and gastrointestinal side effects.
View Article and Find Full Text PDFBMC Pediatr
December 2024
Department of Pediatrics, Shaoxing People's Hospital (Shaoxing Hospital, Zhejiang University School of Medicine), Shaoxing312000, China.
Background: Eosinophilic Gastrointestinal Disorders beyond Eosinophilic Esophagitis (non-EoE EGIDs) are chronic rare inflammatory disorders characterized by eosinophilic infiltration of the gastrointestinal (GI) tract.
Case Presentation: We report the first pediatric case of eosinophilic duodenitis (one type of the non-EoE EGIDs) with concomitant pancreatic reaction that was misdiagnosed as acute pancreatitis (AP). A 13-year-old girl was admitted to our hospital for a week of abdominal distension, vomiting, and epigastric pain that worsened recently.
Neurogastroenterol Motil
February 2025
Division of Gastroenterology and Hepatology, Department of Medicine, Feinberg School of Medicine, Kenneth C. Griffin Esophageal Center, Northwestern Medicine, Northwestern University, Chicago, Illinois, USA.
Background: The functional lumen imaging probe (FLIP) has proven to be a versatile device for diagnosing esophageal motility disorders and estimating esophageal wall compliance, but there is a lack of viable software for quantitative assessment of FLIP measurements.
Methods: A Python-based web framework was developed for a unified assessment of FLIP measurements including clinical metrics such as esophagogastric junction (EGJ) distensibility index (DI), maximum EGJ opening diameter, mechanics-based metrics for estimating strength, and effectiveness of contractions, such as contraction power and displaced volume, and machine learning-based clustering and predictive algorithms such as the virtual disease landscape (VDL) and EGJ obstruction probability. The clinical and VDL probability metrics were then validated using FLIP data from 121 subjects constituting different categories of EGJ opening which were diagnosed by expert clinicians.
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