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At least 577 records · Page 32Linked to original sources
PubMed2001

Ambulatory 24-h colonic manometry in healthy humans.

Our aim was to investigate motor activity of the healthy, relatively unprepared colon in the ambulatory state. Twenty-five age- and gender-matched adults had a six-sensor solid-state probe inserted into the proximal transverse colon without sedation. Subjects ambulated freely and ate standard meals. In 528 h of recording, we found a lower (P < 0.05) area under the curve during the night. Waking induced a threefold increase in motility, whereas meals induced a twofold increase. Women showed less activity (P < 0.05) in the transverse/descending colon than men. The transverse/descending colon showed more (P < 0.05) activity than the rectosigmoid colon. Seven patterns were recognized; predominantly, they were simultaneous, propagated, or periodic bursts of 3-cycles/min (cpm) waves. A specialized propagating pressure wave with a high amplitude (>105 mmHg) and a prolonged duration (>14 s) occurred in all subjects (mean 10/day), mostly after waking, after meals, or with defecation. A 3-cpm motor activity was seen in the rectosigmoid region predominantly at night. The colon exhibits a wide spectrum of pressure activity around the clock, with gender and regional differences and circadian rhythm. This comprehensive study provides qualitative and quantitative normative data for colonic manometry.

Aged↗
PubMed1975

Influence of perfusion rate and compliance on esophageal manometry.

The accuracy of esophageal manometry using the conventional perfused three-lumen catheter depends on the proper choice of the perfusion rate. Previous investigators have used a wide range of perfusion rates without considering the compliance of the transducer-catheter assembly as a variable in the selection of the perfusion rate for the hydraulic systems. We present a relationship relating the perfusion rate and the compliance which specifies the minimum adequate perfusion rate for a given transducer-catheter assembly. This approach explains apparent discrepancies in the literature regarding the proper rate of perfusion for accurate measurement of esophageal contractions. Esophageal motility tests with 10 subjects confirmed the accuracy of manometric tests at the prescribed perfusion rate (1.25 ml/min) since they compared well with intraluminal pressures measured directly with a Honeywell intraesophageal transducer. The effect of perfusion rate on the apmlitude of esophageal contraction was also investigated and it is shown that high perfusion rates result in increased amplitudes of contraction. Furthermore, at large perfusion rates a large volume of liquid builds up in the esophagus. This fluid accumulation could possibly be responsible for the increased amplitudes of contraction.

Adult↗
PubMed1982

Oxygen consumption measured with microcomputer-assisted Warburg manometry.

We have developed and tested an automated system that measures in vitro oxygen consumption by Warburg manometry in as many as 16 units that are under the simultaneous control of a microcomputer which requires attention at the beginning of the study only. The all-glass Submarine Volumometers used are readily adapted to automation using a microcomputer that interacts with an infrared photodetector sensitive to manometric changes in the reaction vessel and a stepper motor that can advance the calibrated micrometer in response to these changes. The microcomputer interacts with the user at the start of the study during data entry and subsequently determines volume changes related to oxygen consumption, calculates respiration rates, and prints or graphs the results without further user interaction. We compared this automated system with manual methods by measuring the oxygen consumption of lung tissue slices and by determining the ability of the system to match known volumes entered manually. We found that the results obtained using the automated system were not significantly different from known manual methods (P less than 0.05).

Animals↗
PubMed2000

Topographic esophageal manometry: an emerging clinical and investigative approach.

Topographic esophageal manometry utilizes an increased number of pressure sensors and three-dimensional displays to fully reveal the pressure continuum representing peristalsis. The techniques demonstrate that peristalsis is comprised of a chain of pressure segments, beginning at the upper esophageal sphincter and continuing through lower sphincter aftercontraction. Topographic methods have already proven useful in both research and clinical settings. Description of the techniques, the topographic representation of normal and abnormal esophageal motility, and advantages of topography over conventional manometric methods are discussed in this review.

Esophageal Motility Disorders↗
PubMedDate not supplied

Ambulatory esophageal manometry in the evaluation of unexplained chest pain.

Ambulatory esophageal manometry is a relatively new technology, widely accepted as a research tool in the study of esophageal motility disorders. Its role as a clinical tool has been more controversial. This paper reviews current opinions regarding the use of this diagnostic tool, and attempts to summarize the advantages and shortcomings of this technology as it has been employed in the evaluation of unexplained chest pain.

Chest Pain↗
PubMed1981

Biliary manometry in dogs. Influence of selective electrostimulation of the right and left vagus nerves.

Acute biliary manometry was performed in 10 dogs during operation. The sphincter of Oddi was a high-pressure zone with phasic activity. No active contractions were observed either in the common bile duct or in the gallbladder. Electrostimulation of the right and left thoracic vagal branches increased bile flow, decreased the activity of the sphincter of Oddi and gallbladder pressure. Stimulation of the right vagus gave a more complex response as the initial inhibition of the activity of the sphincter of Oddi was followed by an increased motor activity. Intra-arterial cholecystokinin injection increased bile flow, inhibited the activity of the sphincter of Oddi, whereas gallbladder pressure remained unchanged.

Ampulla of Vater↗
PubMed1985

Effect of the artificially elevated common bile duct pressure on the motor activity and function of the papilla of Vater. A study by endoscopic manometry.

In 10 patients without disease of the pancreatico-biliary system, the common bile duct pressure was artificially elevated by endoscopic retrograde feeding with saline under manometric control. The motor activity of the papilla of Vater was recorded by endoscopic manometry using the hydraulic capillary perfusion system according to Arndorfer. Compared to the baseline motility, a mild pressure elevation (from 9.75 +/- 1.8 to 13.5 +/- 0.26 mm Hg) had no effect. After the following strong pressure elevation (to 32 +/- 0.9 mm Hg), however, the papillary residual pressure and the wave duration of the papillary contractions increased significantly (p less than 0.001) from 5.5 +/- 0.5 s and 6.3 +/- 0.16 mm Hg to 10.7 +/- 0.75 s and 8.6 +/- 0.64 mm Hg, whereas the papillary contraction frequency and amplitude were not affected. These data indicate several clinically important speculations.

Adult↗
PubMed1995

Influence of chest wall distortion and esophageal catheter position on esophageal manometry in preterm infants.

The purpose of this study was to determine the effect of chest wall distortion on esophageal manometry by measuring simultaneous esophageal pressure changes at two sites in preterm infants. Fourteen infants were studied (mean +/- SD; birth weight, 1340 +/- 260 g; age, 8.5 +/- 4 d). Esophageal pressure was measured through two water-filled catheters, one placed just above the cardia (Pes1) and the other at the level of the carina (Pes2). Chest wall distortion was measured by inductance plethysmography, and inspiratory and expiratory flow by pneumotachography. No significant differences were found between the peak to peak esophageal pressure changes measured through the lower and higher catheters during both airway occlusion (18.7 +/- 4.4 versus 18.3 +/- 2.6 cm H2O) and spontaneous breathing (9.4 +/- 1.8 versus 9.0 +/- 1.8 cm H2O), although half of the infants had significant chest wall distortion. Mean pulmonary compliance and resistance measures calculated from the two pressures for individual infants showed small differences consistent with the difference between Pes1 and Pes2. For the whole group of 14 infants, however, these differences were not significant. The pressure changes from the lower and higher measuring sites for each breath were analyzed using linear regression. The weighted average of the mean slopes of the 14 infants was significantly different from 1.0 (mean +/- SD: 0.92 +/- 0.10, range: 0.75-1.10; p < 0.05). In some of the infants, the slopes for different breaths were not consistent, but varied from breath to breath.(ABSTRACT TRUNCATED AT 250 WORDS)

Airway Resistance↗
PubMed1985

Simultaneous manometry and electromyography in the pharyngoesophageal segment.

Whether the occlusion between hypopharynx and esophagus is established by anatomical relations and tissue elasticity or by a functional resting tone of the muscle fibers is not quite clear. This study describes simultaneous electromyography (EMG) and electromanometry in the pharyngoesophageal segment to solve this problem and investigate the complex mechanism of deglutition. To register the EMG from the hypopharyngeal constrictor muscle and the upper esophageal sphincter (UES), two copper wire electrode pairs with hooked bare ends were used. These electrodes were introduced into the muscles through a rigid esophagoscope. It is demonstrated that at rest muscle activity is present in the UES. This activity disappears during the relaxation period. Simultaneous manometry and EMG is a valuable supplement to diagnostic procedures in dysphagia patients.

Deglutition↗
PubMed2000

Endoscopic treatment of the main pancreatic duct: correlations among morphology, manometry, and clinical follow-up.

BACKGROUND AND AIM: During the course of chronic pancreatitis, the gradual increase in the main pancreatic duct pressure is the main pathophysiological factor responsible for pain, but up to now, the intra ductal pressure has never been measured during and after endoscopic stenting and correlated with clinical results. Pressure measurements of this kind could thus provide objective information about the useful duration of stenting period. METHODS: Main pancreatic duct pressure was measured by performing endoscopic manometry on 13 chronic pancreatitis symptomatic patients (10 men, 3 women, mean age: 45.1+/-7.9 yr); clinical follow-up was carried out for a period of 29.0+/-16.1 mo. Before treatment, the main anatomical alteration present was a localized stenosis of the main pancreatic duct, i.e., one with a diameter of less than 2 mm (chronic pancreatitis alone), 10 cases; chronic pancreatitis associated with pancreas divisum, 3 cases). Stenosis was treated by endoscopic stenting: 7 F stent (7 cases) and 12 F stent (6 cases). The pressure was measured simultaneously in the duodenum (zero level) and within the main pancreatic duct, using an electronic device, The pancreatico-duodenal gradient was taken to be the difference between the pressure in the main pancreatic duct and the duodenum. RESULTS: The endoscopic stenting induced a nonsignificant decrease in the intraductal pressure (p = 0.16). Among the 9 patients with a normal pressure at the end of the stenting and a successful anatomical outcome, 6 were painless during the follow-up period whereas 3 presented with recurrent pancreatic-type pain. The remaining 4 patients were symptom-free during the entire follow-up period, although the main pancreatic duct pressure was high at the end of the stenting and the stenosis was not completely cured. CONCLUSION: The intraductal pressure at the end of the stenting period was perfectly correlated with the anatomical result, whether or not it was successful, but was not an accurate predictor of a favorable clinical outcome in patients with a poor anatomical result.

Adult↗
PubMed1978

The measurement of resting and stimulated lower esophageal sphincter pressure using the rapid pull-through technique of esophageal manometry.

The value of the rapid pull-through technique of esophageal manometry for the measurement of lower esophageal sphincter pressure (LESP), in the diagnosis of symptomatic gastroesophageal reflux, has been investigated. The technique provides reproducible measurements of LESP in individual subjects during the period of a single recording study. It does not discriminate between normal subjects and patients with symptomatic gastroesophageal reflux in measurements of basal LESP or in measurements of the LESP response to abdominal compression and the cholinergic drugs bethanechol and metoclopramide. The findings of the study suggest that the rapid pull-through technique will not prove helpful in the diagnosis of symptomatic reflux.

Adult↗
PubMed1978

Mechanisms affecting lower oesophageal sphincter opening and oesophageal retention. A combined X-ray and manometry study.

Using simultaneous manometry and cineradiography, oesophageal evacuation was studied while contrast medium was infused via a catheter. The distal half of the oesophagus could be filled with contrast medium without triggering peristalsis. The hydrostatic pressure necessary to open the lower oesophageal sphincter (LES) was of approximately the same magnitude as the pressure gradient between oesophagus and LES. No significant relaxation of the LES could be observed at the initiation of swallowing. The LES may be looked upon not only as a sphincter preventing reflux but also as a gate which must be forced open by food.

Adult↗
PubMed1979

Clinical evaluation of different fluid-filled systems for oesophageal manometry.

In a clinical study of oesophageal manometry with fluid-filled catheters, both a non-perfused system and a perfused system with a syringe pump have been compared to a system with a low-compliance perfusion pump, which served as a reference. Significantly lower values of motility amplitudes, motility derivatives, and partly of LES pressures, and a time delay of up to 0.5 sec of the amplitude maximum were obtained with the non-perfused system and the system with a syringe pump in comparison to the low-compliance system. Since the oesophageal function can be erroneously evaluated by use of a non-perfused system or a perfused system with a syringe pump, such systems cannot be recommended for clinical use.

Adult↗
PubMed1980

Intraluminal oesophageal manometry. Influence of pressure probe diameter.

The influence of the pressure-probe diameter on the values of gastro-oesophageal sphincter pressure, pharyngo-oesophageal sphincter pressure, and peak peristaltic pressure in the oesophageal body was investigated in eight healthy subjects. A low-compliance perfused pressure-measuring unit was used for the recordings. Three different probes were made with external diameters of 1.5 mm, 3.5 mm, and 4.5 mm. Sphincter pressures were measured in the resting state, and peristaltic pressures were measured during wet swallows. The pressure in the sphincter regions was found to depend on the diameter of the probe, whereas the peak peristaltic pressure amplitudes were independent of the probes used. The need for standardization of manometry equipment is emphasized.

Adult↗
PubMed1986

Results of sphincteroplasty in patients with spastic sphincter of Oddi. Predictive value of operative biliary manometry and provocation tests.

The predictive value of different preoperative provocation tests and operative biliary manometry was studied in a series of 22 patients undergoing sphincteroplasty for suspected spastic sphincter of Oddi (SPO). The result of the operation was good in 59%, 54%, and 71% of patients in groups with a positive codein test, a positive endoscopic retrograde cholangiopancreatography filling pain sign, and positive fentanyl test, respectively. Common bile duct pressure (CBDP) did not differ significantly between the SPO spasm group and control patients, but in the fentanyl test the CBDP elevation was significantly higher (p less than 0.01) than in controls (7.7 versus 3.3 mm Hg). It was concluded that the operative fentanyl test seems to be useful in predicting the response to surgery (sphincteroplasty) in patients with post-cholecystectomy biliary-type pain and suspected SPO spasm.

Adult↗
PubMed1986

Oesophageal reflux tests, manometry, endoscopy, biopsy, and radiology in healthy subjects.

The aim was to study the exposure time of acid during 24 h at two different oesophageal levels in 15 healthy subjects and its relation to other kinds of oesophageal findings. Five centimetres above the lower oesophageal sphincter the total reflux time was 0.2% (0-1.3%), and at the 15-cm level it was 0.1% (0-0.7%). A standardized compression test during manometry and radiologic examination showed that no subject had reflux. Hiatus hernia was provoked at the radiologic examination in four subjects, one of whom also had a widened hiatus. At endoscopy, one subject had a hiatus hernia and slightly granulated oesophageal mucosa. Biopsy specimens showed slight basal cell hyperplasia in one case. Bleeding in the dermal papillae or a few intraepithelial leukocytes were seen in eight cases, findings that might be due to endoscopic trauma. Without any history of gastrointestinal disorders, gastrooesophageal reflux was minimal under standardized conditions, although hiatus hernia and mild changes in biopsy specimens could be seen.

Adult↗
PubMed1986

Endoscopic manometry of the sphincter of Oddi and pancreatic duct in chronic pancreatitis.

Pancreatic duct pressure was studied by endoscopic manometry in 12 patients with chronic pancreatitis and in 9 patients with a normal pancreas (suspected biliary dyskinesia). To study the effect of increased intraduodenal concentration of pancreatic enzymes, the duct pressure was measured before and after intraduodenal enzyme infusion. The mean pancreatic duct pressure was 12 (range, 6-25) mm Hg and 18 (range, 6-38) mm Hg in the pancreatitis and 'control' groups, respectively. The occasional patient in each group who had a high duct pressure also had an elevated sphincter of Oddi pressure. A significant correlation between the two pressures was found in both groups of patients. During intraduodenal infusion of pancreatic enzymes a decrease of the pancreatic duct pressure occurred in only two patients. We conclude that an increased pancreatic duct pressure is not a frequent finding in chronic pancreatitis. An elevation of the duct pressure can also be found in patients without pancreatitis. The sphincter of Oddi pressure appears to be more important for the pancreatic duct pressure than the severity of the pancreatitis. Intraduodenal infusion of enzymes, as done in our study, had an inconsistent effect on the pancreatic duct pressure.

Adult↗
PubMed1987

Endoscopic sphincter of Oddi manometry in healthy volunteers.

This study evaluates the endoscopic manometric findings within the sphincter of Oddi (SO) in nine healthy volunteers premedicated with atropine 1 h before and with diazepam during the investigation. We measured the bile duct sphincter in seven persons and the pancreatic duct sphincter in two. A hydraulic capillary infusion system and a triple-lumen catheter were used. In all the SO was identified as a zone (median length, 8 mm) with elevated base-line pressure and superimposed phasic activity. Median values for amplitude was 102.9 mm Hg; base-line pressure, 10 mm Hg; wave duration, 4.8 sec; and frequency, 2.6/min. Most waves propagated antegrade or simultaneously, and in no individual were more than one third of the waves retrograde. When peak-to-peak intervals were analyzed in one volunteer with prolonged manometry, a basal mode of 6 sec or an even multiple of this value was disclosed, indicating that the SO is paced.

Adolescent↗