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PubMedDate not supplied

Semi-invasive laser-Doppler flowmetry technique. New application for recordings of hemodynamics in combination with manometry of human small intestine.

A small-bowel manometry tube was supplied with two single-fiber microprobes, which recorded blood flow in the proximal small intestine by the laser-Doppler flowmetry (LDF) technique. In all experiments, saline was infused intravenously as control during the first migrating motor complex (MMC) cycle, and a drug or another saline control given intravenously during the second MMC cycle. Recordings were performed during phase 1 of MMC, i.e. when motor pattern showed quiescence. Adrenaline increased blood perfusion values by 140% in proximal duodenum and 95% in distal duodenum. The alpha 2-adrenoceptor agonist clonidine decreased the corresponding values by 34 and 25%, respectively, while oxymetazoline decreased perfusion by 33 and 44% at the same levels. The beta-adrenoceptor agonist isoprenaline increased blood perfusion values by 172% in the proximal duodenum and 194% in the distal duodenum, whereas the antagonist propranolol decreased the corresponding values by 45 and 52%, respectively. In a separate group of subjects, propranolol was given after adrenaline. The increase in blood perfusion regularly seen after adrenaline was blocked after propranolol administration. In conclusion, our findings validate semi-invasive LDF technique for studies of hemodynamics in human small intestine under basal motor conditions and in drug-induced blood flow changes.

Adrenergic alpha-Agonists↗
PubMed1997

Surgical laparoscopy with intraoperative manometry in the treatment of esophageal achalasia.

The aim of this study was to describe and evaluate the laparoscopic treatment of esophageal achalasia in nine patients over a 35-month period. Five trocars were used to perform a Heller's myotomy to completely eliminate the cardial high-pressure zone, under manometric control. Intraoperative manometry also was used to calibrate a pick degrees 360 Rossetti's antireflux wrap. A complete regression of symptoms was observed postoperatively in seven of nine patients (77.8%); in two patients (22.2%) a moderate dysphagia persisted, but it disappeared 3 and 6 months, respectively. Only one intraoperative complication (esophageal perforation, recognized and laparoscopically repaired) occurred. At the present follow-up of 18 +/- 5.34 months (range 6-35), no dysphagia or symptoms related to reflux have been observed. Laparoscopic treatment of esophageal achalasia is considered a safe and effective procedure, and the results of this procedure are comparable with those of the open technique. Advantages common to other laparoscopic techniques are emphasized.

Adolescent↗
PubMed1997

The chronic anal fissure treatment by internal partial lateral sphincterotomy and following anal manometry.

Anal fissure remains one of the most common proctologic problems. A number of reports have advocated the use of partial internal sphincterotomy as a treatment of chronic anal fissure. Our study shows the results of a retrospective analysis of our patients who underwent lateral internal sphincterotomy for the treatment of chronic anal fissure. To determine long time results we examined random sample of 75 operated patients. Apart from taking careful history and patient's assessment of the operation effect, the patients were investigated "per rectum", and even possibly rectoscopically. To asscertain suitability and also security of properly done internal sphincterotomy, we performed anorectal manometric examinations in 53 patients controlled. To conclude our results, we can state that in 9 (12%) patients controlled some subjective complaints or certain pathologic findings connected with anal fissure or sphincterotomy were found. None of the people from the set of ours suffered from any complaints, which can be taken as stool incontinency. In no patients any change in pressure measured by anorectal manometry indicating incontinency was proved.

Anal Canal↗
PubMed1997

[The usefulness of manometry in the determination of the morphology of the anal canal].

The appearance of the new lecture systems for the manometry studies by computer, like the Polygram by Synectics (vector volume), offer the possibility to see the circumferential pressure forces, that even in rest conditions as in voluntary contraction, they keep coaptation of the anal canal, and this will act as a continent closure system in the most distal part of the G.I. tract. The study is with the normal parameters obtained in 14 individuals, considered as normal, getting the mean +/- sd pressure of the anal canal convey in mm Hg, from de anal canal profile in rest as in voluntary contraction, and the maximum variability that could exist between the six profile waves, that are obtained in the same individual to develop an image of the anal canal. This valves will allow the author's to get to the bottom of fecal incontinence derivative from anorectal malformations, defining the pressure valves of muscular hypoplasia or surgical outcomes of the malformations.

Adolescent↗
PubMed1997

Sphincter of Oddi manometry in various biliary diseases: a report in 20 Thai patients.

This is the first report of sphincter of Oddi manometry study in 20 Thai patients with various biliary diseases. The yield of abnormal SOM in 3 of 17 in our study was low and was comparable to other reports. The successful rate of 85 per cent and complication rate were acceptable. Careful clinical assessment is mandatory before SOM study in order to gain the best benefit and minimize the risk of SOM.

Adult↗
PubMed1998

Manometry and 24-hour ambulatory pH monitoring at two levels of the esophagus in patients with and without esophagitis.

OBJECTIVE: To define the relationship between esophageal dysmotility and severity of gastroesophageal reflux (GER) at the distal and proximal levels. METHODS: Two-level, 24-hour ambulatory pH monitoring and manometry of the esophagus were performed in 40 patients with abnormal distal acid exposure and in 20 healthy controls. Twenty patients with normal endoscopy or endoscopic evidence of grade I esophagitis were assigned to group 1 and 20 with grade II-III esophagitis were assigned to group 2. We used a dual-site pH probe with antimony electrodes spaced 15 cm apart. RESULTS: Patients had greater acid exposure than controls at both levels. The percentage of distal reflux episodes reaching proximal esophagus was significantly greater in group 1 than in the control group. The most marked reductions in the percentage of time of the pH remaining under 4 were detected in the patients with the most severe distal acid reflux and esophagitis (group 2). The mean lower esophageal sphincter pressure was significantly lower in group 2 than in group 1. The percentage of tertiary waves or nonperistaltic contractions was significantly higher in group 2 than in group 1 and the control group. Patients with milder distal reflux had significantly lower distal and middle esophageal wave amplitudes than controls. There were no significant differences between controls and patients with severe esophagitis in terms of the esophageal peristaltic wave amplitude in the middle third of the esophagus. CONCLUSIONS: No correlation was observed between episodes of distal reflux and proximal reflux in GER patients. Esophageal motor activity appears to be an important determinant of the severity and extension of GER in the proximal esophagus.

Adolescent↗
PubMed1976

[The lower esophageal sphincter and manometry methods].

For measuring the closing strength in the lower esophageal sphincter an adequate method of manometrie is necessary. A pressure measuring device is placed into the esophageal occlusion segment and is filled with water under a variably fixed pressure. Thus a radial force tries to open the closed sphincter. The opening pressure can be equated to the closing pressure. Moreover the activity of sphincteric musculature influenced by drugs can be investigated under a constant radial pressure.

Animals↗
PubMed1997

[Anorectal manometry--the first impressions of its use in pediatric surgical practice in the diagnosis and treatment of chronic obstipation].

The first impressions from anorectal manometry application in the diagnosis, differential diagnosis and treatment of chronic constipation in children is discussed. In the pediatric surgeon's practice the method may be used as a screening examination, contributing to identify the underlying organic causes of the constipation syndrome. What is more, manometric examination has an essential practical bearing on the clinical therapeutic approach to various forms of habitual chronic constipation.

Anal Canal↗
PubMed1998

[The use of anorectal manometry in the postoperative assessment of continence in congenital anorectal malformations in childhood].

Objective continence evaluation in children operated for anorectal malformation gives rise to complex sociomedical and ethical problems. Its adequate solution requires the use of high-precision methods for continence capacity assessment. Anorectal manometry is one of them--it enables the adoption of clearcut criteria in estimating the effect of operation, indications for reoperation and the patient's early- and long-term prognosis. The electromanometric examination, included in the comprehensive diagnostic and therapeutic protocol, still remains a procedure indispensable in evaluating the outcome of surgery in congenital anorectal malformations.

Anal Canal↗
PubMed1993

[Value of abdominal rectopexy in obstructive disorders of defecation. A prospective study using a defecation index, manometry and radiology].

A prospective clinical, manometric, electromyographic and radiological study was conducted to judge the degree of success achieved with anterior-posterior rectopexy in 18 female patients suffering from obstructed defecation and varying degrees of incontinence. Prior to being operated on, 6 of the patients showed symptoms of intussusception, 4 an internal prolapse of the anterior rectum wall, and 5 a rectocele at least 2 cm in size; all of them had significant perianal descent. The main aim of this study was more precise definition of the pre- and postoperative bowel evacuation using a defecation index. This study shows that obstructed defecation is significantly associated with a lasting feeling of needing to defecate after evacuation, a sensation of incomplete evacuation, perianal pain and necessity for manual support during defecation. The patients had a mean age of 62 (range, 38-78) years. All underwent anterior-posterior rectopexy (Ivalon or Vicryl) with posterior pelvic repair of the puborectalis muscle. In 2 patients rectopexy was combined with sigmoidectomy, in 11 cases, with left hemicolectomy, and in 2, with subtotal colectomy. The median follow-up was 40.8 months (range, 6-66 months). Postoperatively anorectal manometry showed a significant increase in the resting anal pressure and the maximum voluntary pressure (P = 0.05). Continence was improved in 10 patients (55%), 7 (39%) of whom regained normal continence. No significant change in pelvic descent or anorectal angle was observed. Only 8 patients reported a complete evacuation of the rectum postoperatively.

Adult↗
PubMed1977

An exploration method of the Eustachian tube for intact and perforated drums: tubal-impedance-manometry.

The author describes an exploratory method of the Eustachian tube: tubal-impedance-manometry. This method comprises two types of techniques, the one applicable to patients whose eardrum is intact, the other to cases of tympanic perforation. The instrumentation and the examination techniques are described. The discussion allows the results to be incorporated into a clinical perspective: T.I.M. with closed eardrums will deal principally with localizing an eventual tubal problem. On the other hand, T.I.M. with open eardrums will be more specifically viewed as a pre-surgical examination (tympanoplasty).

Acoustic Impedance Tests↗
PubMed1996

An evaluation of an ambulatory manometry system in assessment of antroduodenal motor activity.

While abnormalities in antroduodenal motor function have been documented in both organic and "functional" disorders, controversy surrounds the ideal manometric technique. We sought, therefore, to evaluate a digital solid-state ambulatory system. Sixteen normal volunteers underwent 24-hr recordings of antroduodenal motility. Following catheter placement, a standardized meal was ingested in the laboratory; thereafter, subjects were ambulatory and assumed normal diet and activities. The system was well tolerated; subjects reported that it did not affect their usual activities. Migrating motor complex (MMC) activity was identified in each subject (mean frequency: 4.1 MMCs/24 hr, range 1-8); on average 1.9 (range 0-4, frequency 0.1/hr) occurred while awake and 2.1 (range 0-5, 0.3/hr, P < 0.05 vs awake) during sleep. The fed response was evaluated by calculating a motility index (MI) at 30-min intervals from 30 min before to 120 min following meal ingestion. Postprandially, MI was maximal during the first 30 min following meal ingestion: MI (mean +/- SD) 30 min before vs 30 min after meal in the antrum: 4.16 +/- 1.42 vs 5.33 +/- 0.72 (P < 0.05), duodenum: 4.04 +/- 0.80 vs 4.57 +/- 0.47 (P < 0.05), respectively. None of the other postprandial intervals were significantly different from baseline. There was no significant difference in MI between the standard and ad libitum meals. Retrograde catheter migration (mean 5.6, range 1-10 cm) occurred in relation to all meals: as a consequence, antral recordings were lost following 60% of all meals, thereby limiting meaningful analysis of the antral fed response. We conclude, firstly, that while an ambulatory antroduodenal manometry system is well tolerated and reliably records duodenal motility, postprandial catheter migration limits antral recordings, and, secondly, that a motility index calculated during the first 30 min following an ad libitum meal accurately reflects the fed motor response.

Adult↗
PubMed2001

Outpatient hand held manometry: comparison of techniques.

OBJECTIVE: Anorectal manometry is an established important investigation in a number of disorders. The specialist ano-rectal laboratory is not always available, and a hand held manometer may be a useful tool in the outpatient setting to avoid an unnecessary visit to the anorectal physiology laboratory. Our aims were to determine whether the hand held manometer was as reliable as the standard system used in the anorectal laboratory, and to correctly compare the results from these two different techniques. PATIENTS AND METHODS: 24 patients visiting the Anorectal physiology laboratory were studies. Resting pressure, squeeze and cough pressures were recorded using the single channel hand held solid pressure transducer and with the dual channel pressure transducer MRP2 recorder. The first measurement by each method is used to illustrate the comparison of methods, the second measurement being used to study repeatability. RESULTS: The two methods correlate well for resting and squeeze pressures (Spearman coefficient with P < 0.01 for both) The level of agreement between the two methods was good for resting pressure recordings with a mean difference of 15 cm H2O. The same cannot be said for squeeze and cough pressures. Repeatability of both methods was good with mean differences on repeated recordings near zero. CONCLUSIONS: The hand held manometer is as repeatable as the laboratory but as some discrepancy occurs between the two methods they are not interchangeable. Thus the hand held manometer used alone in the outpatients Department is a useful screening and research tool.

Journal Article↗
PubMed1998

[CLINICAL USEFULNESS OF pH-MEASUREMENT AND ESOPHAGEAL MANOMETRY]

Gastroesophageal reflux disease is the most frequent pathology of the esophagus. Heartburn and regurgitation are the typical symptoms, and tissue damage due to gastric acid reflux can be easily demonstrated with Endoscopy. However, there is an important group of patients without endoscopic signs of Esophagitis. In this particular case, the diagnosis presents a difficult problem.New methods have been developed for the diagnosis of reflux disease. Esophageal Manometry is a test that measures the intraluminal pressures of the esophageal sphincters, and the coordination of the contractile activity of the esophagus body, important features in the pathophysiology of this entity. Ambulatory monitoring of esopinageal pH is a reliable way to determine the amount of gastric acid reflux to the esophagus, but this test is far from being considered a gold standard.In this article, the theoretical aspects of both procedures are reviewed.

Journal Article↗
PubMed1966

Intraocular pressure changes during tonography. Studies of other pressure tests in rabbit and enucleated human eyes by closed electric manometry.

The intraocular pressure responses in living rabbit and enucleated human eyes during tonography, suction-cup and bulbar pressure tests were continuously recorded by closed electric manometry. The tonography tests in rabbits produced an initial rapid rise in pressure, followed by a slight decline during tonography and a sharp drop to a level lower than the initial pressure as soon as tonography was discontinued; recovery to the initial pressure level was gradual. Increasing the plunger weights made the responses more marked. Enucleated human eyes showed similar results except, of course, there was no recovery to the initial pressure level. Similar pressure responses were produced in the suction cup and bulbar pressure tests. Our data showed that the manometric curves in living rabbit and enucleated human eyes during compression are of the same type.

Animals↗
PubMed1987

Relationship of radionuclide liquid bolus transport and esophageal manometry.

Using simultaneous esophageal manometry and radionuclide transit studies, we compared liquid bolus transport with the various parameters of esophageal contractions. Study subjects included seven normal individuals, six patients with the "nutcracker esophagus" (mean distal peristaltic amplitude greater than 180 mm Hg), and three patients with spastic motility disorders. Manometric studies were performed when the subjects were in the basal state and after intravenous administration of edrophonium and atropine. Simultaneous radionuclide studies were done with subjects in the supine position by swallows of 250 mu Ci technetium Tc 99m sulfur colloid in 10 ml water. We found that normal liquid bolus transport (less than 15 seconds) is primarily dependent on the presence of a peristaltic wave front throughout the esophagus. Above a threshold pressure of 30 mm Hg, liquid transport was not affected by amplitude (33 to 500 mm Hg) or duration (3 to 15 seconds) of esophageal contractions. Repetitive wave forms also gave normal transit times as long as the wave front was peristaltic in onset. There was a significant inverse correlation (-0.65; P less than 0.001) between liquid transit time and peristaltic velocity. Prolonged radionuclide transport (30 to less than 50 seconds) was observed only with nonperistaltic contractions and very low amplitude (15 to 30 mm Hg) peristaltic waves.

Atropine↗
PubMed1979

Evaluation of the effect of domperidone on human oesophageal and gastroduodenal motility by intraluminal manometry.

Intraluminal manometry has been used in a series of five studies on healthy volunteers and patients, to examine the action of domperidone on lower oesophageal sphincter pressure (LOSP), on peristaltic contraction, amplitudes and on antral, pyloric and duodenal motility. Furthermore, the effect on gastric acid secretion, pH, secretory volume and serum gastrin levels was studied. It was found that domperidone increased LOSP significantly but was less effective in patients with symptomatic gastro-oesophageal reflux than in normal volunteers. The drug also increased the amplitude of oesophageal and duodenal peristalsis but had no effect on endogenous gastrin release or on gastric acid secretion. The results suggest that this drug may be useful in the treatment of gastro-oesophageal and gastroduodenal reflux. This potential benefit is enhanced by the absence of side effects even when given in high doses.

Adult↗