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Upper Oesophageal Sphincter (upper + oesophageal_sphincter)

Distribution by Scientific Domains

Medical Sciences	75%

Selected Abstracts

Modulation of oesophago-UOS contractile reflex: effect of proximal and distal esophageal distention and swallowing

NEUROGASTROENTEROLOGY & MOTILITY, Issue 3 2003
M. Aslam
Abstract Upper oesophageal sphincter (UOS) tone is influenced by intraoesophageal pressure events. Our aim was to test the hypothesis that UOS tone is responsive to simultaneous inhibitory and stimulatory signals originating from the oesophagus and compare effect of proximal and distal oesophageal air distention on oesophageal balloon-stimulated UOS contraction. We studied 16 healthy volunteers, ages 19,80 years in two stages. We induced UOS contraction by distending various size balloons intraoesophageally and studied response of contracted UOS to oesophageal air distentions and swallowing. Intraoesophageal injections of 60-ml room air resulted in UOS pressure augmentation (31%), relaxation (64%) and no effect in the remaining 5% of instances. The majority of air injections into the oesophageal segment proximal to the distended balloon were followed by relaxation of the contracted UOS, whereas, the majority of oesophageal air distentions distal to the balloon resulted in augmentation of UOS contraction (P < 0.01). Swallowing resulted in complete relaxation of the UOS. In conclusion, UOS contractile response to oesophageal balloon distention is overridden by further augmentation or relaxation as a result of oesophageal air distention and swallowing. Contractile and inhibitory responses of the contracted UOS to generalized oesophageal distention is region-specific. [source]

Medullary motor neurones associated with drinking behaviour of Japanese eels

JOURNAL OF FISH BIOLOGY, Issue 1 2003
T. Mukuda
A fluorescent dye, Evans blue (EB), was injected into the following seven drinking-associated muscles of the Japanese eel Anguilla japonica: the sternohyoid, third branchial, fourth branchial, opercular, pharyngeal, upper oesophageal sphincter and oesophageal body muscles. The sternohyoid muscle promotes ,ingestion', and the remaining muscles contribute to ,swallowing'. All neurones stained by EB were located ipsilaterally in the caudal medulla oblongata (MO) of the Japanese eel. Neurones projecting into the sternohyoid muscle were identified as those in the spino-occipital motor nucleus (NSO), and neurones projecting into the remaining muscles as those in the glossopharyngeal,vagal motor complex (GVC). Within the GVC, the neuronal arrangement was topological, and hence, ,swallowing' will be completed if the GVC neurones ,fire' progressively from rostral to caudal. These neurones in the NSO and GVC may use acetylcholine (ACh) as a neurotransmitter, as the EB-positive neurones in both nuclei were immunoreactive against anticholine acetyltransferase (anti-ChAT) antibody. Besides the MO, some somata in a ganglion of the vagal nerve were also stained by EB injected into the pharyngeal, the upper oesophageal sphincter and the oesophageal body muscles. The localization and the shape of the somata suggest that they are sensory neurones. These sensory neurones were not ChAT-immunoreactive. Combining these results, based on a model for ,swallowing' in mammals, a plausible model for central organization of ,drinking' in the Japanese eel is proposed, which suggests that ,drinking' in the fishes is regulated by the neuronal circuit for ,swallowing' in mammals. [source]

Review article: the gastrointestinal complications of myositis

ALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 3 2010
E. C. EBERT
Aliment Pharmacol Ther,31, 359,365 Summary Background, The inflammatory myopathies are a group of acquired diseases characterized by a proximal myopathy caused by an inflammatory infiltrate of the skeletal muscle. The three major diseases are dermatomyositis, polymyositis and inclusion body myositis. Aims, To review the gastrointestinal manifestations of myositis. Methods, Over 110 articles in the English literature were reviewed. Results, Dysphagia to solids and liquids occurs in patients with myositis. The pharyngo-oesophageal muscle tone is lost and therefore patients develop nasal speech, hoarseness, nasal regurgitation and aspiration pneumonia. There is tongue weakness, flaccid vocal cords, poor palatal motion and pooling of secretions in the distended hypopharynx. Proximal oesophageal skeletal muscle dysfunction is demonstrated by manometry with low amplitude/absent pharyngeal contractions and decreased upper oesophageal sphincter pressures. Patients exhibit markedly elevated creatine kinase and lactate dehydrogenase levels consistent with muscle injury. Myositis can be associated with inflammatory bowel disease, coeliac disease and interferon treatment of hepatitis C. Corticosteroids and other immunosuppressive drugs comprise the mainstay of treatment. Inclusion body myositis responds poorly to these agents and therefore a myotomy is usually indicated. Conclusion, Myositis mainly involves the skeletal muscles in the upper oesophagus with dysphagia, along with proximal muscle weakness. [source]

Effect of hiatal hernia on proximal oesophageal acid clearance in gastro-oesophageal reflux disease patients

ALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 6 2006
S. EMERENZIANI
Summary Background Proximal acid reflux is common in gastro-oesophageal reflux disease and is a determinant of symptoms. Patients with hiatal hernia complain of more symptoms than those without and are less responsive to proton-pump inhibitors. Aim To evaluate the role of hiatal hernia on spatiotemporal characteristics of acid reflux. Methods Thirty seven consecutive gastro-oesophageal reflux disease patients underwent endoscopy, videofluoroscopy, manometry and multichannel 24-h pH test. Data were compared with those of 15 asymptomatic controls. Multivariate linear regression was used for statistical analysis. Results At videofluoroscopy, hiatal hernia was found in 16 of 37 patients. The mean size of hiatal hernia was 3.4 cm. Patients showed significantly prolonged acid clearance time, both at proximal and distal oesophagus, compared with controls. Hiatal hernia patients showed a significantly delayed acid clearance, along the oesophageal body, compared with non-hiatal hernia patients. The prolonged acid exposure was maintained during upright and supine position. The presence of hiatal hernia significantly predicted acid clearance delay in the distal and proximal oesophagus [at 10 cm below upper oesophageal sphincter: , + 2.5 min (95% confidence interval: 0.4,4.5); P < 0.02]. Conclusions The presence of hiatal hernia is a strong predictor of more prolonged proximal oesophageal acid exposure and clearance. Hiatal hernia is likely to play a role in the pathophysiology of gastro-oesophageal reflux disease symptoms, and should be taken into greater consideration in the treatment strategies of the disease. [source]