Neurogastroenterology and motility : the official journal of the European Gastrointestinal Motility Society
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Neurogastroenterol. Motil. · Dec 2000
Abnormal cerebral processing of oesophageal stimuli in patients with noncardiac chest pain (NCCP).
In noncardiac chest pain (NCCP), altered visceral perception may result from abnormal cerebral processing of sensory input rather than abnormalities of afferent pathways. However, the interactions between symptoms, autonomic function and oesophageal stimuli are poorly studied. Oesophageal stimulation elicits reproducible cortical evoked potentials [CEP] and modulates heart rate variability via vagal pathways, as visible on power spectrum analysis of heart rate variability [PS-HRV]. ⋯ During EOS, heart rate decreased in NCCP from 68 vs. 62 beats min-1 (P < 0.003) but not in controls. In NCCP patients, EOS was perceived at lower intensities and was associated with a greater cardiovagal reflex response. EP responses associated with EOS were smaller in NCCP than in controls, suggesting that an increased perception of oesophageal stimuli results from an enhanced cerebral processing of visceral sensory input in NCCP, rather than from hyperalgesic responses in visceral afferent pathways.
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Neurogastroenterol. Motil. · Oct 2000
Human postprandial gastric emptying of indigestible solids can occur unrelated to antral phase III.
According to animal experiments, postprandial gastric emptying of indigestible solids is mainly related to the antral phase III activity of the migrating motor complex. Gastric emptying of indigestible solids in humans has not been directly correlated to pressure recordings. The aim of the present study was to investigate the postprandial emptying pattern of indigestible solids in humans and its relation to fed and fasted antral motility. ⋯ There was no difference between emptying of the 3 mm cubes with or without the presence of the tube. Contrary to common opinion, gastric emptying of indigestible solids after a meal can occur unrelated to the antral phase III, at least up to a particle size of 3 mm and perhaps even 7 mm. These findings are of great importance for the evaluation of gastric emptying of indigestible solids, including the pharmacodynamics of orally administered drugs.
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Neurogastroenterol. Motil. · Feb 1999
Fat delays emptying but increases forward and backward antral flow as assessed by flow-sensitive magnetic resonance imaging.
Flow has been assessed in the gastric antrum using a velocity-sensitive version of the high-speed magnetic resonance imaging technique, echo planar imaging (EPI). Eight healthy volunteers attended fasted on three separate days and consumed 800 mL of either a 5% glucose (0.2 kcal mL-1), 10% glucose (0.4 kcal mL-1) or an isotonic mixed nutrient meal, Fresubin (1 kcal mL-1, 27.2 g fat). Gastric volumes were obtained at 10-min intervals for 1 h. ⋯ AT 35 min flow activity was significantly greater after both the high-calorie meals relative to the 5% meal (total number of flow events: Fresubin = 6.6 +/- 1.7,[symbol: see text] 10% glucose = 9.9 +/- 2.2, [symbol: see text] 5% glucose = 2.5 +/- 0.9,[symbol: see text] P < 0.03,[symbol: see text] P < 0.007 vs 5% glucose, n = 8). Peak forward velocities for the initial phase of emptying tended to be greater for the rapidly emptying 5% meal (5.9 +/- 0.8 cm-1) compared with the Fresubin (3.3 +/- 0.6 cm-1, P < 0.069, n = 8) and the 10% glucose (2.9 +/- 1.0 cm-1, P < 0.068, n = 8) meals. In spite of delayed gastric emptying, high-calorie meals were associated with substantial to and fro movements which may be important for meal tritruration and fat emulsification.
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We wished to establish anorectal functions in patients with spinal cord lesions, related to the level of lesion and its completeness. We also wished to determine the value of neurophysiological tests for completeness of transsections in comparison with manometry and visceral sensory testing. In 32 patients (31.5 +/- 14.1 years, 25 males) with spinal trauma, completeness of transsection was assessed clinically. ⋯ These patients had lesions at all levels of the spinal column, ranging from cervical (C4,C6,C7) via thoratical (2 x T7,T8,T12) to lumbar segments. Anorectal function testing, and specifically visceral sensory testing may be superior to neurological assessment of 'completeness' of spinal cord lesions. It may be that visceral afferent pathways others than spinothalamic tract are involved in rectal perception that are less accessible to conventional neurophysiological diagnostic work-up.
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Neurogastroenterol. Motil. · Mar 1997
Use of echo planar imaging to demonstrate the effect of posture on the intragastric distribution and emptying of an oil/water meal.
Intragastric distribution of solids and liquids is far from uniform but until recently technical limitations have prevented detailed study. Echo planar imaging (EPI), which can provide high-quality images of intragastric contents, has been used in this study to assess the intragastric distribution of oil and water and gastric emptying in subjects lying on either their left or right side. Eight healthy volunteers underwent four gastric emptying studies after consuming either an aqueous meal (400 mL beef consomme soup + 100 mL water) or a fat/aqueous meal (400 mL soup + 100 mL olive oil) lying on either their left or right side. ⋯ Oil was clearly observed to layer above the water and fill the duodenal cap when subjects lay on their left and the fundus when they lay on their right side. EPI clearly demonstrates the intragastric layering of oil which causes posture to strongly influence gastric emptying. EPI is a tool with great potential to describe the intragastric events following ingestion of complex multiphase meals.