PubMed Health⌕ Search

Biomedical subjects

C O Russell

Publications and source records attributed to C O Russell.

13 recordsLinked to original sources
PubMed1992

Oesophageal propulsive force and its relation to manometric pressure.

A fixed volume capsule incorporating a force transducer and a side hole for manometric measurements was constructed and calibrated. Simultaneous measurements of the propulsive (aboral) force and the manometric pressure (intraluminal pressure) were made at 5, 10, and 15 cm above the lower oesophageal sphincter and in response to dry and wet (5, 10, and 15 ml) swallows. The propulsive force and manometric pressure waves had a simultaneous onset and were of similar duration. Peak values of propulsive force for wet swallows increased significantly as measurements were made progressively more distally within the oesophagus and were greatest in the distal oesophagus. The association between manometric pressure and propulsive force is not strong (r = 0.61) suggesting that intraluminal pressure is a poor predictor of propulsive force and hence an unreliable measure of oesophageal 'function'.

Adult↗
PubMed1991

Achalasia of the oesophagus: results of treatment.

Achalasia of the oesophagus is an uncommon neuromuscular disorder characterized by symptoms of dysphagia and regurgitation of undigested food. The results of treatment of 43 patients with achalasia over 10 years are presented. Clinical data on presenting complaints and duration, and all subsequent treatments, were recorded. Patients were contacted to assess their current symptomatic status.

Adolescent↗
PubMed1987

Pharyngeal pump and esophageal transit.

In deglutition the pharynx appears to act as a pump to "inject" boluses into the esophagus. A new method for measuring the velocity profile of the leading edge of a radionuclide bolus has been developed and applied to boluses of different viscosity--water and treacle--in nine normal volunteers. The results show that the more viscous bolus (treacle) acquires a slower initial "injection" velocity (152 mm/sec vs 236 mm/sec) that only propels it over the proximal half of the esophagus. Peristaltic action must drive the bolus over the distal half. With water boluses, however, the higher initial velocity is sufficient to propel a part of the bolus at least to the gastroesophageal junction leaving minimal "work" to be performed by esophageal peristalsis. This confirms the important role of the pharyngeal pump in deglutition. The pump may be the major mechanism for ingestion of nonviscous liquids (water), peristalsis merely being required to "sweep up" what remains in the esophagus.

Deglutition↗
PubMed1987

Oesophageal manometry: how well does it predict oesophageal function.

The variability in manometric measurements of oesophageal peristalsis was assessed in 10 volunteers. The amplitude, velocity and duration of the peristaltic waves resulting from 10 separate 10 ml boluses of water were measured at fixed distances above the lower oesophageal sphincter (LOS). After a 10 minute rest period with the manometry catheter still in situ peristaltic values in response to a second group of 10 10 ml boluses were measured. The measurement of peristaltic amplitude at a fixed distance above the LOS showed wide interindividual variation--for example, at 8 cm above the LOS the variation between individuals was marked (p less than 0.001). At the same site, however, there was only a small intra individual variation noted with time (p greater than 0.25). Similar differences were noted at 16 and 4 cm above the LOS. For the first group of swallows, while the interindividual variation remained high (p less than 0.025), the measurement variation from site to site was of lesser magnitude (p greater than 0.1). Similar findings were noted for interindividual variation and site to site variation at the second group of swallows. The values for velocity showed a similar pattern of variation. From this study we conclude that manometric measurements can be used as a valid method for assessing the effects of drugs on peristalsis in individuals provided all measurements are made at the exact same level in the oesophagus and 'normal' subjects with a large inherent variation are excluded. Any studies comparing peristaltic values in different population groups - for example, normal v reflux patients, may not detect any significant difference even with large sample numbers. Any differences detected may be of no clinical importance because of the large normal variation.

Adult↗
PubMed1986

Barrett's oesophagus and adenocarcinoma--a case report.

Since Barrett's original description of the columnar lined lower oesophagus in 1950, this condition has been linked with over 140 cases of adenocarcinoma in the English literature. To date the youngest reported cases are a 23 year old male and a 25 year old male. This report concerns what is believed to be the youngest reported case of adenocarcinoma in a Barrett's oesophagus.

Adenocarcinoma↗
PubMed1983

Relationship among esophageal dysfunction, diabetic gastroenteropathy, and peripheral neuropathy.

Esophageal motor function was tested in 12 patients with a clinical diagnosis of diabetic gastroenteropathy by radionuclide transit (RT) studies. Other insulin-dependent diabetics with and without symptoms of peripheral neuropathy but with no symptoms of gastrointestinal disease were similarly studied. Eleven of the 12 patients with gastroenteropathy were found to have abnormal esophageal function, even though only five had esophageal symptoms. Half the diabetics with peripheral neuropathy symptoms, and a quarter of those with no symptoms had abnormal esophageal transit studies. No abnormalities were found in a group of asymptomatic volunteers studied in a similar manner. We conclude that esophageal dysfunction, often subclinical, is present in nearly all patients with suspected diabetic gastroenteropathy. Esophageal dysfunction correlates less well with peripheral neuropathy. This study implies that if a diabetic, presenting with diarrhea or nausea and vomiting, has normal esophageal transit, then a cause for these symptoms, other than diabetic gastroenteropathy, may exist.

Adult↗
PubMed1981

Does surgery correct esophageal motor dysfunction in gastroesophageal reflux.

The high incidence of dysphagia in patients with symptomatic gastroesophageal reflux (GER) but no evidence of peptic stricture suggests esophageal motor dysfunction. Conventional methods for detecting dysfunction (radiologic and manometric examinations) often fail to detect abnormality in these patients. Radionuclide transit (RT), a new method for detecting esophageal motor dysfunction, was used to prospectively assess function in 29 patients with symptomatic GER uncomplicated by stricture before and three months after antireflux surgery (HILL). The preoperative incidence of dysphagia and esophageal dysfunction was 73% and 52%, respectively. During operation (Hill repair), intraoperative measurement of the lower esophageal sphincter pressure was performed and the LESP raised to levels between 45 and 55 mmHg. The preoperative lower esophageal sphincter pressure was raised from a mean of 8.6 mmHg, to mean of 18.5 mmHg after operation. No patient has free reflux after operation. Postoperative studies on 20 patients demonstrated persistence of all preoperative esophageal dysfunction despite loss of dysphagia. RT has demonstrated a disorder of esophageal motor function in 52% of patients with symptomatic GER that may be responsible for impaired esophageal clearance. This abnormality is not contraindication to surgery. The results indicate that construction of an effective barrier to reflex corrects symptoms of reflux, even in the presence of impaired esophageal transit. Radionuclide transit is a safe noninvasive test for assessment of esophageal function.

Deglutition Disorders↗
PubMed1981

Radionuclide transit: a sensitive screening test for esophageal dysfunction.

The purpose of this study was to extend existing nuclear medicine techniques for the diagnosis of esophageal motor disorders. A standard homogeneous bolus of 99mtechnetium sulfur colloid in water was swallowed in the supine position under the collimator of a gamma camera linked to a microprocessor. Bolus transit was recorded at 0.4-s intervals, and the movie obtained was used to analyze transit in an objective manner. Ten normal volunteers and 30 subjects with dysphagia not related to mechanical obstruction were studied with this technique. Radionuclide transit studies detected a higher incidence of esophageal motor abnormality than manometry or radiology in the dysphagia group. In addition a definitive description of the functional problem was possible in most cases. Radionuclide transit is a safe noninvasive test and suitable as a screening test for esophageal motor disorders.

Adult↗