A method for recording the motor activity of the reticulum in cattle.
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The combination of vagotomy, of proximal and of total gastrectomy with antireflux-surgery can lead to a characteristic roentgenmorphology of the lower esophagus and the upper stomach. The fundoplication or hemifundoplication may have a tumorlike shape, may open up or may slide down. The knowledge of the preceding operation and of the symptoms allows a correct interpretation of the x-ray findings in most cases.
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The postoperative experiences of a high-performance pilot who underwent Nissen fundoplication for reflux esophagitis illustrate two important points concerning return to flying duties. Both the gas bloat syndrome and obstructive phenomena are potential sequelae to surgery. Both have obvious implications for flight personnel. A logical approach for flight medical officers is presented.
Benign giant retroperitoneal neurilemoma is a rare tumor which may cause gastrointestinal symptoms. An unusual case that recurred 12 years after initial excision is detailed here. Clinicians should, in selected cases, consider the possibility of a primary retroperitoneal tumor in the differential diagnosis of GI tract signs and symptoms, when primary gastrointestinal disease is not demonstrated. Primary retroperitoneal tumors are practically symptomless in early stages and are insidious in their growth patterns. Later stages of the tumors are capable of causing an array of digestive tract disturbances which may include ascites and GI blood loss. Computed axial tomographic studies have supplanted traditional diagnostic techniques, with angiography recommended in selective cases to define the blood supply. The pathology of neurilemoma and the spectrum of primary mesenchymal nonepithelial retroperitoneal tumors are presented.
The question was examined as to whether or not lower esophageal sphincter pressure (LESP) rises in response to increases in intragastric pressure. Pressure profiles of the lower esophageal sphincter (LES) were recorded with low compliance rapid pull-through manometry, in 9 healthy volunteers without hiatal hernia. Fundic pressure was increased by inflating the stomach with air. Air insufflation was stopped when gastric distension became painful (at 8.4 mm Hg +/- 0.7 SEM). No subject had nausea. Mean resting LESP was 24.6 mm Hg +/- 2.2 SEM. There was a negative linear relationship between fundic pressure and LESP: LESP decreased by 1.10 +/- 0.15 SEM per 1 mm Hg fundic pressure rise. On the average, the sum of fundic pressure and LESP remained constant. Thus, there is not only a lack of reflex contraction of LES in response to fundic pressure rise, but actually a weakening of the LES by fundic distension. This mechanism might facilitate belching following swallowing of air.
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The requirements which have to be satisfied to ensure adequate functioning of bacterial digestion in the fore-stomachs are reviewed. This is followed by a discussion of the various disturbances of fermentation in the rumen. The majority of disturbances of rumen fermentation are attributable to one or several deficiencies in the rations. This is particularly due to the fact that high-energy rations are required. In addition, an increasing number of substances are being added to the rations in order to affect fermentation in some way or another. Errors of mixing, substitutions and other human factors are liable to result in disturbances of fermentation, which may cause severe losses unless they are rapidly detected. Several instances have been reported in the literature.
Reflux disease in most cases shows a benign course, but it only responds slowly to medical treatment and tends to recurrences. Therefore, surgical treatment is far from being substituted by medical treatment. A preoperative assessment by esophageal function tests is indicated when the disease shows unusual features, e.g. hypomotility and retention in the tubular esophagus, no macroscopic sign of esophagitis at endoscopy and complications such as peptic stenosis and columnar lined esophagus.