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PubMedDate not supplied

Effect of visceral afferent activation on leg extension induced by sciatic afferent stimulation.

In cats under light chloralose and sodium pentobarbital anesthesia the effects of electrical stimulation of various visceral afferent nerves on leg extension induced by sciatic afferent stimulation were studied. Stimulation of the central end of the cervical vagus and stellate ganglion produced inhibition of induced leg extension while stimulation of the distal end of the thoracic vagus, coeliac ganglion, and splanchnic nerves produced facilitation. Decortication slightly reduced the inhibitory effect and greatly reduced the facilitatory effect. Additional decerebration greatly reduced the inhibitory effect and almost abolished the facilitatory effect. Spinal transection at C1 completely abolished the inhibitory and facilitatory effects on induced leg extension. These results suggest that visceral afferents facilitate sciatic induced leg extension principally through the cortex while they inhibit extension through the midbrain and hypothalamus.

Afferent Pathways↗
PubMed2005

A rare variation of the coeliac trunk.

The hepatic, splenic and Left gastric arteries are considered as the "main classic branches" of the coeliac trunk. During the routine dissections in the laboratory of the Anatomy Department in a 62-year-old male cadaver, a rare variation, a coeliacomesenteric trunk was observed. This trunk gave rise to the left gastric, the common hepatic, the splenic, the left gastro-epiploic, the right and left inferior phrenic arteries. The developmental and clinical significance of this anomalous vessel is discussed.

Arteries↗
PubMedDate not supplied

Surgical outcome of para-aortic lymph node dissection preserving neural tissue based on anatomical evaluations.

The anatomical distribution of the para-aortic lymph nodes was studied to establish an effective operative procedure that preserves neural tissue for patients with advanced gastric cancer. Para-aortic lesions were anatomically examined in 31 cadavers, and histologic preparations of 14 cadavers were used to evaluate the relationship between para-aortic lymph nodes and surrounding neural tissue. Surgical results were analyzed in patients with D3 gastrectomy based on anatomical findings (n = 33). Anatomically, the splanchnic nerves merged into the celiac ganglion, which consisted of either one ganglion (type I) or several ganglia (type II). The average number of lymph nodes were 17.4 in the area superior to the superior mesenteric artery (SMA) and 13.3 in the area inferior to the SMA. According to the number of metastatic lymph nodes (< or = 3, > or = 4), the median survival time was 14.7 and 9.7 months, respectively (P < 0.02). Patients either with or without metastatic lymph nodes behind the neural tissue had a median survival time of 14.7 and 9.7 months, respectively (P < 0.02). We conclude that para-aortic lymph node dissection preserving neural tissue is useful in patients with three or fewer para-aortic metastatic lymph nodes that are in front of the neural tissue.

Aorta, Abdominal↗
PubMed2006

Percutaneous-guided pain control: exploiting the neural basis of pain sensation.

The gastroenterologist deals frequently with painful conditions and suffering patients. Performing regular pain assessments and applying basic pain medicine principles will augment the care of patients in pain. Percutaneous-guided pain therapy techniques play a role in the multidisciplinary approach to pain medicine. Systemic opioid analgesia is the primary means of controlling cancer pain. However, 10% to 15% of cancer patients may need additional interventions to control pain. Sympathetic ganglion nerve blocks with neurolytic agents such as alcohol or phenol are reserved mostly for cancer pain. The efficacy and safety of these tools are validated by several decades of clinical application and published studies. Although the procedures are operator-dependent, in the hands of experienced clinicians, patients achieve sustained relief in the majority of cases. Although these techniques have been attempted in some benign conditions,such as chronic pancreatitis, with limited success, studies of newer imaging localization techniques such as endoscopic ultrasonography may expand future indications. Patients of the gastroenterologist who experience malignant abdominal pain may benefit from referral for percutaneous-guided pain control techniques.

Acute Disease↗
PubMed2005

ASGE guideline: complications of EUS.

This is one of a series of statements discussing the utilization of GI endoscopy in common clinical situations. The Standards of Practice Committee of the American Society for Gastrointestinal Endoscopy prepared this text. In preparing this guideline, a MEDLINE literature search was performed, and additional references were obtained from the bibliographies of the identified articles and from recommendations of experts. When little or no data exist from well-designed prospective trials, emphasis is given to results from large series and reports from recognized experts. Guidelines for appropriate utilization of endoscopy are based on a critical review of the available data and expert consensus. Further controlled clinical studies are needed to clarify aspects of this statement and revision needed to clarify aspects of this statement and revision may be necessary as new data appear. Clinical consideration may justify a course of action at variance to the recommendations.

Autonomic Nerve Block↗
PubMed2000

Pharmacological comparison of P2X receptors on rat coeliac, mouse coeliac and mouse pelvic ganglion neurons.

Characteristics of P2X receptors on neurons of the rat coeliac, mouse coeliac and mouse pelvic ganglia have been studied using the whole cell voltage-clamp technique. Fast application of ATP (100 microM) on to isolated neurons voltage clamped at -70 mV induced a slowly desensitising inward current in 96% of the cells tested. Concentration-response curves for ATP yielded EC50 values of 86 microM, 64 microM and 123 microM, for rat coeliac, mouse coeliac and mouse pelvic ganglion neurons, respectively, while alpha,beta-methylene ATP was inactive. The response to ATP was antagonised by suramin, Cibacron blue and pyridoxalphosphate-6-azophenyl-2',4'-disulphonic acid (PPADS). The potency of ATP was increased by extracellular acidification and by co-application of micromolar concentrations of Zn2+, while raising pH decreased it. On rat coeliac ganglion neurons, the EC50 values for ATP were 35 microM and 253 microM at pH 6.8 and 8.0, respectively. On mouse coeliac and pelvic ganglion neurons, altering the pH produced comparable changes. In conclusion, our results indicate that, in contrast to the guinea-pig coeliac ganglion, the characteristics of the P2X receptors present on rat coeliac, mouse coeliac and mouse pelvic ganglia are all identical to those present on rat pelvic ganglion, i.e. they are homomeric P2X2 receptors, or heteromultimers with P2X2 being the dominant subunit.

Adenosine Triphosphate↗
PubMed2001

Effect of L-carnosine on the hyperglycemia caused by intracranial injection of 2-deoxy-D-glucose in rats.

Effects of a chicken essence and one of its components, L-carnosine, on the hyperglycemia caused by intracranial injection of 2-deoxy-D-glucose (2DG-hyperglycemia) in unanesthetized rats were examined. The chicken essence inhibited the 2DG-hyperglycemia. Central or peripheral administration of specific doses of L-carnosine reduced the 2DG-hyperglycemia. L-carnosine inhibited neural activities of sympathetic efferent nerves innervating the adrenal gland and liver and facilitated the activity of vagal celiac nerve innervating the pancreas in urethane anesthetized rats. Specific doses of histamine also suppressed the 2DG-hyperglycemia, and thioperamide eliminated the inhibiting actions of both histamine and L-carnosine on the 2DG-hyperglycemia. Considering mammalian muscles contain L-carnosine, these facts suggest a possibility that L-carnosine might be an endogenous control factor of the blood glucose level through autonomic nerves via H3-receptor.

Adrenal Glands↗
PubMed1994

Median arcuate ligament compression syndrome in monozygotic twins.

Twin 27-year-old women had symptomatic mesenteric ischemia caused by median arcuate ligament compression. Arteriography demonstrated severe celiac artery stenosis in one twin, celiac artery occlusion in the other, and proximal superior mesenteric artery narrowing with retrograde filling from a meandering mesenteric artery in both. Division of the ligament and direct celiac artery revascularization completely relieved symptoms in both patients. Median arcuate ligament compression of the celiac and superior mesenteric arteries can result in mesenteric ischemia. Documentation of this unusual syndrome in monozygotic twins suggests that the responsible anatomic relationships are congenital.

Adult↗
PubMed1987

[Hemodynamic changes caused by laparotomy during aorto-iliac surgery].

A haemodynamic study was carried out on 53 patients undergoing elective surgery of the abdominal aorta in order to assess the haemodynamic changes consequent to abdominal manipulations prior to aortic clamping. Surgery was carried out under general anaesthesia and ventilation was controlled. The following parameters were monitored: mean arterial pressure (Pa), cardiac index (CI), systolic index (SI), systemic vascular resistances (Rsa), pulmonary vascular resistances (Rpa), heart rate (fC). Cutaneous circulation was monitored using a photoplethysmographic transducer. The following haemodynamic pattern was seen as the peritoneal cavity was opened and traction on the mesentery was applied: CI +40.7%; fC +28.61%; SI +9.85%; Rsa -39.16%; Rpa -28.43%; Pa -15.7%. The recording of the facial cutaneous photoplethysmographic wave showed an increase of 50%. In some extreme cases, a state of cardiovascular collapse with marked cutaneous erythema strongly resembling anaphylactic shock ensued. The physiopathology of these cardiovascular reactions is unclear, but the haemodynamic pattern as well as the cutaneous vasodilation suggest a stimulation of both vagal and sympathetic nervous systems and the release of vasoactive substances into the general circulation.

Adult↗
PubMed2003

Acid challenge delays gastric pressure adaptation, blocks gastric emptying and stimulates gastric fluid secretion in the rat.

Functional dyspepsia can be associated with impaired gastric relaxation in response to food intake and delayed gastric emptying. In this study, we investigated whether luminal hydrochloric acid (HCl) may reproduce these motor alterations in phenobarbital-anaesthetized rats via activation of extrinsic neural pathways. Intragastric pressure (IGP) changes induced by a 2-mL fluid bolus were recorded with an oesophageal catheter, and gastric emptying was determined via the fluid volume recovered from the stomach 30-min post-bolus. Experiments involving acute nerve transections or pharmacological blockade of nitric oxide synthesis revealed that the initial increase of IGP after a 0.35 mol L(-1) HCl bolus is dampened by duodenogastric and gastrogastric relaxation reflexes depending on vagal and splanchnic pathways as well as nitric oxide. Compared with saline, HCl (0.15-0.5 mol L(-1)) delayed the subsequent decrease (adaptation) of IGP, inhibited gastric emptying and stimulated gastric fluid secretion as seen in stomachs with ligated pylorus. The acid-evoked delay in IGP adaptation and inhibition of gastric emptying involved duodenogastric and duodenopyloric extrinsic nerve reflexes, whereas the gastric fluid secretion was independent of the extrinsic innervation. It is proposed that the gastropyloric motor changes induced by luminal acid challenge have a bearing on the motor disturbances underlying functional dyspepsia.

Animals↗