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Effects and mechanisms of electroacupuncture at PC6 on frequency of transient lower esophageal sphincter relaxation in cats 被引量:15
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作者 Chi Wang De-Feng Zhou Xiao-Wei Shuai Jian-Xiang Liu Peng-Yan Xie 《World Journal of Gastroenterology》 SCIE CAS CSCD 2007年第36期4873-4880,共8页
AIM: To investigate the effects of electroacupuncture (EA) at neiguan (PC6) on gastric distention-induced transient lower esophageal sphincter relaxations (TLESRs) and discuss the mechanisms of this treatment. METHODS... AIM: To investigate the effects of electroacupuncture (EA) at neiguan (PC6) on gastric distention-induced transient lower esophageal sphincter relaxations (TLESRs) and discuss the mechanisms of this treatment. METHODS: ProtocolⅠ: Twelve healthy cats underwent gastric distention for 60 min on the first day. Electrical acupoint stimulation was applied at the neiguan or a sham point on the hip in randomized order before gastric distention, on the third day and fifth day. Those cats that underwent EA at neiguan on the fifth day were named "Neiguan Group" and the cats that underwent EA at a sham acupoint on the fifth day were named "Sham Group" (control group). During the experiment the frequency of TLESRs and lower esophageal sphincter (LES) pressure were observed by a perfused sleeve assembly. Plasma levels of gastrin (GAS) and motilin (MTL) were determined by radioimmunoassay. Nitrite/nitrate concentration in plasma and tissues were measured by Griess reagent. The nuclei in the brain stem were observed by immunohistochemistry method of c-Fos and NADPH-d dyeing. Protocol Ⅱ: Thirty six healthy cats were divided into 6 groups randomly. We gave saline (2 mL iv. control group), phaclofen (5 mg/kg iv. GABA-B antagonist), cholecystokinin octapeptide (CCK-8) (1 μg/kg per hour iv.), L-Arginine (200 mg/kg iv.), naloxone (2.5 μmol/kg iv.) and tacrine (5.6 mg/kg ip. cholinesterase inhibitor) respectively before EA at Neiguan and gastric distention. And the frequencies of TLESRs in experimental groups were compared with the control group.RESULTS: ProtocolⅠ: Not only the frequency of gastric distention-induced TLESR in 60 min but also the rate of common cavity during TLESRs were significantlydecreased by EA at neiguan compared to that of sham acupoint stimulation. C-Fos immunoreactivity and NOS reactivity in the solitarius (NTS) and dorsal motor nucleus of the vagus (DMV) were significantly decreased by EA at neiguan compared to that of the sham group. However, the positive nuclei of C-Fos and NOS in reticular formation of the medulla (RFM) were increased by EA at neiguan. Protocol Ⅱ: The inhibited effect of EA at neiguan on TLESR’s frequency was completely restored by pretreatment with CCK (23.5/h vs 4.5/h, P < 0.05), L-arginine (17.5/h vs 4.5/h, P < 0.05) and naloxone(12/h vs 4.5/h, P < 0.05). On the contrary, phaclofen (6/h vs 4.5/h, P > 0.05) and tacrine (9.5/h vs 4.5/h, P > 0.05) did not influence it. CONCLUSION: Electric acupoint stimulation at Neiguan significantly inhibits the frequency of TLESR and the rate of common cavity during TLESR in cats. This effect appears to act on the brain stem, and may be mediated through nitric oxide (NO), CCK-A receptor and mu-opioid receptors. But the GABAB receptor and acetylcholine may not be involved in it. 展开更多
关键词 ELECTROACUPUNCTURE Transient lower esophageal sphincter relaxation C-FOS Nitric oxide CAT
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Neuro-regulation of lower esophageal sphincter function as treatment for gastroesophageal reflux disease 被引量:6
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作者 Anupender Singh Sidhu George Triadafilopoulos 《World Journal of Gastroenterology》 SCIE CAS CSCD 2008年第7期985-990,共6页
The junction between the esophagus and the stomach is a specialized region, composed of lower esophageal sphincter (LES) and its adjacent anatomical structures, the gastric sling and crural diaphragm. Together these s... The junction between the esophagus and the stomach is a specialized region, composed of lower esophageal sphincter (LES) and its adjacent anatomical structures, the gastric sling and crural diaphragm. Together these structures work in a coordinated manner to allow ingested food into the stomach while preventing reflux of gastric contents across the esophago-gastric junction (EGJ) into the esophagus. The same zone also permits retrograde passage of air and gastric contents into esophagus during belching and vomiting. The precise coordination required to execute such a complicated task is achieved by a finely-regulated high-pressure zone. This zone keeps the junction between esophagus and stomach continuously closed, but is still able to relax briefly via input from inhibitory neurons that are responsible for its innervation. Alterations of the structure and function of the EGJ and the LES may predispose to gastroesophageal reflux disease (GERD). 展开更多
关键词 Gastroesophageal reflux disease lower esophageal sphincter Esophago-gastric junction
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Investigation of cholecystokinin receptors in the human lower esophageal sphincter 被引量:3
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作者 Jun-Feng Liu Jian Zhang +1 位作者 Xin-Bo Liu Paul A Drew 《World Journal of Gastroenterology》 SCIE CAS 2014年第21期6554-6559,共6页
AIM: To compare the binding of cholecystokinin (CCK)-8 to CCK receptors in sling and clasp fibers of the human lower esophageal sphincter.
关键词 Cholecystokinins Cholecystokinins-A receptor Cholecystokinins-B receptor Radioligand binding lower esophageal sphincter Sling fibers Clasp fibers
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In vitro effect of pantoprazole on lower esophageal sphincter tone in rats 被引量:3
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作者 Mustafa Duman Mahmut zer +5 位作者 Enver Rean Yeliz Demirci Ali E Atιcι Tahsin Dalgι Erdal B Bostancι Ece Gen 《World Journal of Gastroenterology》 SCIE CAS CSCD 2011年第46期5105-5109,共5页
AIM:To investigate the in vitro effects of pantoprazole on rat lower esophageal sphincter(LES)tone.METHODS:Rats weighing 250-300 g,provided by the Yeditepe University Experimental Research Center(Yü-DETAM),were u... AIM:To investigate the in vitro effects of pantoprazole on rat lower esophageal sphincter(LES)tone.METHODS:Rats weighing 250-300 g,provided by the Yeditepe University Experimental Research Center(Yü-DETAM),were used throughout the study.They were anesthetized before decapitation.LES tissues whose mucosal lining were removed were placed in a stan-dard 30-mL organ bath with a modif ied Krebs solution and continuously aerated with 95% oxygen-5% carbon dioxide gas mixture and kept at room temperature.The tissues were allowed to stabilize for 60 min.Sub-sequently,the contractile response to 10-6 mol/L carba-chol was obtained.Different concentrations of freshly prepared pantoprazole were added directly to the tis-sue bath to generate cumulative concentrations of 5×10-6 mol/L,5×10-5 mol/L,and 1.5×10-4 mol/L.Activi-ties were recorded on an online computer via a 4-channeltransducer data acquisition system using the software BSL PRO v 3.7,which also analyzed the data.RESULTS:Pantoprazole at 5×10-6 mol/L caused a small,but statistically insignif icant,relaxation in the car-bachol-contracted LES(2.23% vs 3.95%).The 5×10-5 mol/L concentration,however,caused a signif icant relax-ation of 10.47% compared with the control.1.5×10-4 mol/L concentration of pantoprazol caused a 19.89% relaxation in the carbachol contracted LES(P<0.001).CONCLUSION:This is the fi rst study to demonstrate that pantoprazole has a relaxing effect in isolated LESs.These results might have signif icant clinical implications for the subset of patients using proton pump inhibitors who do not receive full symptomatic alleviation from gastroesophageal reflux disease. 展开更多
关键词 PANTOPRAZOLE lower esophageal sphincter Gastroesophageal reflux disease
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Factors influencing lower esophageal sphincter relaxation after deglutition 被引量:1
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作者 Lita Tibbling Per Gezelius Thomas Franzén 《World Journal of Gastroenterology》 SCIE CAS CSCD 2011年第23期2844-2847,共4页
AIM:To study the relationship between upper esophageal sphincter (UES) relaxation,peristaltic pressure and lower esophageal sphincter (LES) relaxation following deglutition in non-dysphagic subjects.METHODS:Ten non-dy... AIM:To study the relationship between upper esophageal sphincter (UES) relaxation,peristaltic pressure and lower esophageal sphincter (LES) relaxation following deglutition in non-dysphagic subjects.METHODS:Ten non-dysphagic adult subjects had a high-resolution manometry probe passed transnasally and positioned to cover the UES,the esophageal body and the LES.Ten water swallows in each subject were analyzed for time lag between UES relaxation and LES relaxation,LES pressure at time of UES relaxation,duration of LES relaxation,the distance between the transition level (TL) and the LES,time in seconds that the peristaltic wave was before (negative value) or after the TL when the LES became relaxed,and the maximal peristaltic pressure in the body of the esophagus.RESULTS:Relaxation of the LES occurred on average 3.5 s after the bolus had passed the UES and in most cases when the peristaltic wave front had reached the TL.The LES remained relaxed until the peristaltic wave faded away above the LES.CONCLUSION:LES relaxation seemed to be caused by the peristaltic wave pushing the bolus from behind against the LES gate. 展开更多
关键词 DEGLUTITION lower esophageal sphincter PERISTALSIS RELAXATION Upper esophageal sphincter
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Lower esophageal sphincter relaxation is impaired in older patients with dysphagia
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作者 Laura K Besanko Carly M Burgstad +4 位作者 Reme Mountifi eld Jane M Andrews Richard Heddle Helen Checklin Robert JL Fraser 《World Journal of Gastroenterology》 SCIE CAS CSCD 2011年第10期1326-1331,共6页
AIM: To characterize the effects of age on the mechanisms underlying the common condition of esophageal dysphagia in older patients, using detailed manometric analysis. METHODS: A retrospective case-control audit was ... AIM: To characterize the effects of age on the mechanisms underlying the common condition of esophageal dysphagia in older patients, using detailed manometric analysis. METHODS: A retrospective case-control audit was performed on 19 patients aged ≥ 80 years (mean age 85 ± 0.7 year) who underwent a manometric study for dysphagia (2004-2009). Data were compared with 19 younger dysphagic patients (32 ± 1.7 years). Detailed manometric analysis performed prospectively included basal lower esophageal sphincter pressure (BLESP), pre-swallow and nadir LESP, esophageal body pressures and peristaltic duration, during water swallows (5 mL) in right lateral (RL) and upright (UR) postures and with solids. Data are mean ± SE; a P-value < 0.05 was considered significant. RESULTS: Elderly dysphagic patients had higher BLESP than younger patients (23.4 ± 3.8 vs 14.9 ± 1.2 mmHg; P < 0.05). Pre-swallow LESP was elevated in the elderly in both postures (RL: 1 and 4 s P = 0.019 and P = 0.05; UR: P < 0.05 and P = 0.05) and solids (P < 0.01). In older patients, LES nadir pressure was higher with liquids (RL: 2.3 ± 0.6 mmHg vs 0.7 ± 0.6 mmHg, P < 0.05; UR: 3.5 ± 0.9 mmHg vs 1.6 ± 0.5 mmHg, P = 0.01) with shorter relaxation after solids (7.9 ± 1.5 s vs 9.7 ± 0.4 s, P = 0.05). No age-related differences were seen in esophageal body pressures or peristalsis duration. CONCLUSION: Basal LES pressure is elevated and swallow-induced relaxation impaired in elderly dysphagic patients. Its contribution to dysphagia and the effects of healthy ageing require further investigation. 展开更多
关键词 DYSPHAGIA ELDERLY esophageal Motility lower esophageal sphincter AGING
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The molecular pathogenesis of achalasia:a paired lower esophageal sphincter muscle and serum 4D label-free proteomic study
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作者 Songfeng Chen Xiangbin Xing +7 位作者 Xun Hou Qianjun Zhuang Niandi Tan Yi Cui Jinhui Wang Mengyu Zhang Shixian Hu Yinglian Xiao 《Gastroenterology Report》 SCIE CSCD 2023年第1期340-349,共10页
Background:Achalasia is a primary esophageal motility disorder with potential molecular pathogenesis remaining uncertain.This study aimed to identify the differentially expressed proteins and potential pathways among ... Background:Achalasia is a primary esophageal motility disorder with potential molecular pathogenesis remaining uncertain.This study aimed to identify the differentially expressed proteins and potential pathways among achalasia subtypes and controls to further reveal the molecular pathogenesis of achalasia.Methods:Paired lower esophageal sphincter(LES)muscle and serum samples from 24 achalasia patients were collected.We also collected 10 normal serum samples from healthy controls and 10 normal LES muscle samples from esophageal cancer patients.The 4D label-free proteomic analysis was performed to identify the potential proteins and pathways involved in achalasia.Results:Analysis of Similarities showed distinct proteomic patterns of serum and muscle samples between achalasia patients and controls(both P<0.05).Functional enrichment analysis suggested that these differentially expressed proteins were immunity-,infection-,inflammation-,and neurodegeneration-associated.The mfuzz analysis in LES specimens showed that proteins involved in the extracellular matrix–receptor interaction increased sequentially between the control group,type III,type II,and type I achalasia.Only 26 proteins altered in the same directions in serum and muscle samples.Conclusions:This first 4D label-free proteomic study of achalasia indicated that there were specific protein alterations in both the serum and muscle of achalasia,involving immunity,inflammation,infection,and neurodegeneration pathways.Distinct protein clusters between types I,II,and III revealed the potential molecular pathways associated with different disease stages.Analysis of proteins changed in both muscle and serum samples highlighted the importance of further studies on LES muscle and revealed potential autoantibodies. 展开更多
关键词 ACHALASIA PROTEOMICS SERUM lower esophageal sphincter
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Gastroesophageal reflux disease in children: What’s new right now? 被引量:1
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作者 Palittiya Sintusek Mohamed Mutalib Nikhil Thapar 《World Journal of Gastrointestinal Endoscopy》 2023年第3期84-102,共19页
Gastroesophageal reflux(GER)in children is very common and refers to the involuntary passage of gastric contents into the esophagus.This is often physiological and managed conservatively.In contrast,GER disease(GERD)i... Gastroesophageal reflux(GER)in children is very common and refers to the involuntary passage of gastric contents into the esophagus.This is often physiological and managed conservatively.In contrast,GER disease(GERD)is a less common pathologic process causing troublesome symptoms,which may need medical management.Apart from abnormal transient relaxations of the lower esophageal sphincter,other factors that play a role in the pathogenesis of GERD include defects in esophageal mucosal defense,impaired esophageal and gastric motility and clearance,as well as anatomical defects of the lower esophageal reflux barrier such as hiatal hernia.The clinical manifestations of GERD in young children are varied and nonspecific prompting the necessity for careful diagnostic evaluation.Management should be targeted to the underlying aetiopathogenesis and to limit complications of GERD.The following review focuses on up-to-date information regarding of the pathogenesis,diagnostic evaluation and management of GERD in children. 展开更多
关键词 Gastroesophageal reflux Gastroesophageal reflux disease CHILDREN INFANT Impedance study lower esophageal sphincter
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Effects of anti-hypertensive drugs on esophageal body contraction 被引量:5
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作者 Koichi Yoshida Kenji Furuta +7 位作者 Kyoichi Adachi Shunji Ohara Terumi Morita Takashi Tanimura Shuji Nakata Masaharu Miki Kenji Koshino Yoshikazu Kinoshita 《World Journal of Gastroenterology》 SCIE CAS CSCD 2010年第8期987-991,共5页
AIM:To clarify the effects of anti-hypertensive drugs on esophageal contraction and determine their possi-ble relationship with gastro-esophageal reflux disease.METHODS:Thirteen healthy male volunteers were enrolled. ... AIM:To clarify the effects of anti-hypertensive drugs on esophageal contraction and determine their possi-ble relationship with gastro-esophageal reflux disease.METHODS:Thirteen healthy male volunteers were enrolled. Esophageal body peristaltic contractions and lower esophageal sphincter (LES) pressure were measured using high resolution manometry. All subjects were randomly examined on four separate occasions following administrations of nifedipine,losartan,and atenolol,as well as without any drug administration.RESULTS:Peristaltic contractions by the esophageal body were separated into three segments by two troughs. The peak peristaltic pressures in the mid and lower segments of the esophageal body under atenolol administration were signifi cantly higher than those without medication in a supine position. On the other hand,peristaltic pressures under nifedipine administration were lower than those observed without drug ad-ministration. Losartan did not change esophageal body peristalsis. Atenolol elevated LES pressure and slowed peristaltic wave transition,while the effects of nifedip-ine were the opposite. CONCLUSION:Among the anti-hypertensive drugs tested,atenolol enhanced esophageal motor activity,which was in contrast to nifedipine. 展开更多
关键词 Anti-hypertensive drug High-resolution manometry lower esophageal sphincter esophageal body contraction Calcium-channel blocker β1 blocker
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Magnetic challenge against gastroesophageal reflux 被引量:3
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作者 Mauro Bortolotti 《World Journal of Gastroenterology》 SCIE CAS 2021年第48期8227-8241,共15页
Almost 15 years have passed since the first paper on the possibility of using magnets to prevent gastro-esophageal reflux(GER)was published and so it is time to assess the results obtained with the first magnetic devi... Almost 15 years have passed since the first paper on the possibility of using magnets to prevent gastro-esophageal reflux(GER)was published and so it is time to assess the results obtained with the first magnetic device available on the market,the Linx magnetic sphincter augmentation(MSA)and to consider what other options are forthcoming.MSA demonstrated an anti-reflux activity similar to that of Nissen fundoplication,considered the“gold standard”surgical treatment for GER disease,and caused less gas-bloating and a better ability to allow vomiting and belching.However,unlike Nissen fundoplication,this magnetic device is burdened by complications,which are roughly similar to those of the non-magnetic anti-reflux Angelchik prosthesis,that,after considerable use in the eighties,was shelved due to these complications.It is interesting to note that some of these complications show the same pathophysiological mechanism in both devices.The upcoming new magnetic devices should avoid these complications,as their anti-reflux magnetic mechanism is completely different.The experiments in animals regarding these new magnetic appliances were examined,remarking their advantages and drawbacks,but the way to apply them in surgical practice is long and difficult,although worthy,as they represent the future of magnetic surgery. 展开更多
关键词 Gastro-esophageal reflux disease Magnetic sphincter augmentation device Nissen fundoplication Angelchik prosthesis lower esophageal sphincter DYSPHAGIA
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Botulinum Toxin A in the Treatment of Oropharyngeal or Esophageal Dysphagia
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作者 Caroline Beutner Katharina Bartsch +2 位作者 Harald Schworer Rainer Laskawi Saskia Rohrbach 《International Journal of Otolaryngology and Head & Neck Surgery》 2013年第6期253-258,共6页
Objectives: In this retrospective analysis, we explored the effect of botulinum toxin A (BTA) injection to treat oropharyngeal dysphagia or esophageal dysfunction caused by diseases of the upper (UES) and lower (LES) ... Objectives: In this retrospective analysis, we explored the effect of botulinum toxin A (BTA) injection to treat oropharyngeal dysphagia or esophageal dysfunction caused by diseases of the upper (UES) and lower (LES) esophageal sphincter. Methods: In total, 48 patients (17 patients with UES disorders, and 31 patients with LES dysfunction;mean age 64 years) were treated between 1996 and 2007 in our hospital. Comorbid diseases as well as maintenance medication were documented to evaluate the overall health status of our patients. The mean duration of symptoms, the number of pre-treatments and the specification of dysphagia were considered. Results: One month after injection, the response rates were 73.3% (UES group) and 76.6% (LES group). Most patients in the UES group received 30-40 units BTA (Botox?) whereas most patients in the LES group were treated with 100 units BTA. In cases of re-injection, 50% of patients in the UES group experienced an escalation of dosage (up to 75 units), whereas the other 50% received the same dosage. The dosages in the LES group were mostly kept constant. Conclusion: Comparing the two groups with esophageal dysfunction of fundamentally different etiologies (UES/LES), a discrepancy in the level of symptom relief, onset and a longer cessation of clinical benefit were observed in the LES group. In this analysis, we were able to show that injection of BTA is an effective and safe treatment for disorders of the UES and LES. 展开更多
关键词 Botulinum Toxin DYSPHAGIA Upper esophageal sphincter lower esophageal sphincter
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Current clinical approach to achalasia 被引量:20
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作者 Alexander J Eckardt Volker F Eckardt 《World Journal of Gastroenterology》 SCIE CAS CSCD 2009年第32期3969-3975,共7页
Idiopathic achalasia is a rare primary motility disorder of the esophagus. The classical features are incomplete relaxation of a frequently hypertensive lower esophageal sphincter (LES) and a lack of peristalsis in th... Idiopathic achalasia is a rare primary motility disorder of the esophagus. The classical features are incomplete relaxation of a frequently hypertensive lower esophageal sphincter (LES) and a lack of peristalsis in the tubular esophagus. These motor abnormalities lead to dysphagia, stasis, regurgitation, weight loss, or secondary respiratory complications. Although major strides have been made in understanding the pathogenesis of this rare disorder, including a probable autoimmune mediated destruction of inhibitory neurons in response to an unknown insult in genetically susceptible individuals, a definite trigger has not been identified. The diagnosis of achalasia is suggested by clinical features and conf irmed by further diagnostic tests, such as esophagogastroduodenoscopy (EGD), manometry or barium swallow. These studies are not only used to exclude pseudoachalasia, but also might help to categorize the disease by severity or clinical subtype. Recent advances in diagnostic methods, including high resolution manometry (HRM), might allow prediction of treatment responses. The primary treatments for achieving long-term symptom relief are surgery and endoscopic methods. Although limited high-quality data exist, it appears that laparoscopic Heller myotomy with partial fundoplication is superior to endoscopic methods in achieving long-term relief of symptoms in the majority of patients. However, the current clinical approach to achalasia will depend not only on patients' characteristics and clinical subtypes of the disease, but also on local expertise and patient preferences. 展开更多
关键词 ACHALASIA esophageal motility disorder DYSPHAGIA ESOPHAGUS lower esophageal sphincter Pneumatic dilation Botulinum toxin Heller myotomy
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