Changes In Peristalsis Research Articles

The Use of L-Menthol in Endoscopic Transpapillary Interventions. Prospective Randomized Dual-Center Study

Aim: to study the effect of L-menthol on duodenal peristalsis, the results of cannulation of the papilla, the effectiveness and safety of endoscopic retrograde transpapillary interventions (ERTI).Materials and methods. A prospective two-center randomized placebo-controlled trial was carried out from January to November 2022 in two centers. The study included 126 patients, 69 (54.8 %) men and 57 (45.2 %) women, mean age — 62.1 ± 1.8 years. The inclusion criteria were age 18–75 years, indications for ERTI, absence of previous endoscopic papillotomy, absence of allergy to menthol, consent to participate in the study. After randomization, the main group (“L”) included 70 patients, the control group — 56. Patients in group “L” were irrigated with 25 mL (160 mg) of L-menthol (Spectavium), patients in the control group — with 25 mL of saline solution. Peristaltic activity was studied before and three minutes after administration of the drug. The intensity of peristalsis was assessed according to a modified Hiki scale: 0 points — complete absence of peristalsis; 1 point — single peristaltic waves; 2 points — intense peristalsis, little amenable to straightening at maximum insufflation; 3 points — pronounced peristalsis.Results. Three minutes post-irrigation, the suppression of peristaltic waves was noted in the experimental group “L”: 0 points — 63 (90 %) patients, 1 point — 6 (8.6 %) patients, compared to the control, with no change in peristalsis (p < 0.05). Successful selective cannulation was achieved in 64 (91.4 %) patients of group “L” and in 41 (73.2 %) — of the control group (p < 0.05). Non-cannulation endoscopic papillotomy had to be used in 6 (8.5 %) cases in group “L” and in 14 (25 %) cases in the control group. In general, successful cannulation was achieved in 100 % of patients in group “L”, and in 94.5 % — in the control group (p < 0.05). The duration of the intervention was significantly reduced in group “L” — 40 ± 2.5 vs. 50.3 ± 3.6 min. Among the complications, only intraoperative bleeding was registered (2 (2.9 %) — group “L”, 5 (8.9 %) — the control group), which was eliminated endoscopically in all cases.Conclusion. The use of L-menthol during ERTI helps to achieve noticeable inhibition of peristalsis, promotes successful cannulation, reduces the intervention time, minimizes the risk of intraoperative complications. Thus, L-menthol has demonstrated its effectiveness and safety, which makes it possible to use it in the arsenal of combating enhanced peristalsis during ERTI.

先天性食道閉鎖症術後の食道運動機能 : 第1報 臨床的検討

先天性食道閉鎖症術後の食道運動機能 : 第1報 臨床的検討

Effects of peroral endoscopic myotomy on esophageal dynamics in patients with esophageal achalasia

To investigate the effects of peroral endoscopic myotomy(POEM) on esophageal dynamics in patients with esophageal achalasia. From September 2011 to November 2011, 20 cases with esophageal achalasia received POEM at the Endoscopic Center in the Zhongshan Hospital of Fudan University. Pre-operation esophageal dynamics of all the patients were evaluated by high resolution manometry(HRM) system and 3 days after operation the test was repeated. Lower esophagus sphincter resting pressure(LESP), 4-second integrated relaxation pressure(4sIRP), lower esophagus sphincter relax rate(LESRR), lower esophagus sphincter length(LESL), and esophageal manometry were analyzed. After POEM, LESP decreased from(29.1±17.0) mm Hg to(14.6±4.9) mm Hg, and decrease rate was 49.8%(P<0.01). However, the decreases in LESRR and LESL were not statistically significant(P>0.05). Esophageal peristaltic contraction was absent in all the 20 patients preoperatively. After POEM, changes in the esophageal contraction were seen in 7 patients, and peristalsis was noticed but was below normal level. There were no significant changes in peristalsis in the remaining 13 patients. POEM can significantly reduce LESP and 4sIRP in patients with achalasia, but can not affect the contraction of the esophagus.

First Prize: Pharmacologic Manipulation of the Porcine Ureter: Acute Impact of Topical Drugs on Ureteral Diameter and Peristaltic Activity

Intraluminal application of pharmacologic agents for acute ureteral dilation may facilitate difficult ureteroscopy. We characterized the in-vivo effects of intraluminal application of verapamil and theophylline on ureteral peristalsis and diameter in a porcine model. Twenty-four female domestic pigs (35-40 kg) were incorporated into the study. We deployed a giant magneto resistive (GMR) sensor and electromagnetic (EMG) electrodes laparoscopically onto the ureteral surface for simultaneous measurement of the mechanical and electrical signals of ureteral peristalsis, respectively. The ureteral-luminal diameter was measured at three levels by digital retrograde pyelography and standardized to a 10-mm laparoscope. The results were calculated as change in peristalsis and ureteral diameter from baseline during the first hour after drug injection. We tested two smooth-muscle relaxants, verapamil (2 mg/kg) and theophylline (70 mg/kg), with saline and dimethylsulfoxide (DMSO; solvent) as controls. Six pigs were studied for each of the four groups. Hydration, anesthesia, and intra-abdominal pressure were standardized. The serum concentrations of the drugs were measured to determine systemic absorption. During the first 10 minutes after intraluminal drug injection, theophylline caused a significant decrease in ureteral peristalsis (6.75 waves/10 minutes) compared with the control group (1.00/10 minutes; P = 0.02). This trend persisted for the next hour. However, there were no changes from baseline in ureteral width. Ureteral peristalsis and dilation remained similar after the saline and DMSO injections. Verapamil increased the diameter of the proximal ureter compared with the controls throughout the hour after drug injection. Fifteen minutes after the drug injection, the change in the ureteral diameter with verapamil was 1.38 mm (4.14F), while the control group showed a change of 0.27 mm (P = 0.03). At 1 hour, the width of the proximal ureter in the verapamil group had increased by 1.72 mm (5.16F), while the control group had changed by 0.55 mm (P = 0.03). There were no statistically significant changes in the widths of the mid or distal ureter. No ureteral dilation was observed in the other groups. In the porcine model, intraluminal application of pharmacologic agents produced independent effects on ureteral dilation and peristalsis. Theophylline inhibited ureteral peristalsis, and verapamil produced acute proximal-ureteral dilation. The ability to alter ureteral diameter or peristaltic activity acutely may facilitate ureteroscopy.

Intensive effect of traditional Chinese medicines activating blood to resolve stasis on medicines dredging intestines--influence on peristalsis of small intestine in guinea pigs

To observe the changes of peristalsis of small intestine in guinea pigs after administration of traditional Chinese medicines activating blood to resolve stasis (Compound Danshen Decoction, CDSD) or/and medicines dredging intestines (Dachengqi Decoction, DCQD), and to explore the synergetic or intensive effect of CDSD on DCQD. By means of BL-420 Biological Experimental System, peristalsis of small intestine was recorded and analyzed following administration of DCQD, CDSD or Huoxue Chengqi Decoction (HXCQD, compound of CDSD and DCQD) respectively in different experimental periods. The amplitude and frequency of intestinal peristaltic wave obviously increased following administration of the three decoctions, but HXCQD appeared to be most dominantly. The effect of DCQD can be further enhanced by combining use of CDSD, suggesting that the traditional Chinese medicines activating blood to resolve stasis have an intensive effect on medicines dredging intestines.

GASTROINTESTINAL ULTRASONOGRAPHY OF THE DOG: A REVIEW OF 265 CASES (1996-1998)

The findings of ultrasonography of the gastrointestinal (GI) tract of 265 dogs with GI disorders were analysed retrospectively. The sonographic changes associated with various inflammatory and neoplastic conditions and mechanical obstruction of the GI system were recorded and discussed. Sonographic alterations of the pancreas and the tissues adjacent to the GI tract were also included in the study. Ultrasonographic alterations of the GI tract were classified into three main categories: thickening of the GI wall, changes in peristalsis and dilation of the lumen. Localised thickening of the GI wall with disruption of its structure was caused by both neoplastic diseases and by inflammatory disorders. However, diffuse thickening with retained wall structure was generally associated with inflammatory diseases. The criteria previously established for the ultrasonographic diagnosis of intestinal obstruction were successfully applied to a large number of GI disorders. Pancreatitis was most often associted with hyperchoic mesentery and hypoechoic pancreas mass, but similar alterations were encountered in some cases of gastric or duodenal ulceration. Except in cases of invaginations and intestinal obstructions, the observed ultrasonographic changes were not specific enough for a definitive diagnosis. Nevertheless, ultrasonography proved to be a valuable technique in the diagnostic process of GI disorders of the dog.

Effect of stimulation of the ventral surface of the medulla on associated functions of small intestinal vessels

The vascular bed of the small intestine, hemodynamically isolated, was perfused with the animal's own blood (37.5~ by means of a constant-delivery pump. To exclude any influence of the extravascular factor (changes in peristalsis) atropine (0.3 ml) was injected intravenously.The capillary hydrostatic pressure and the coefficient of capillary filtration were measured by the method described previously [i], based on the principle of Papperheimer and Soto-Rivera [8]. The preand postcapillary resistance and the total regional vascular resistance were calculated by the formulas in [4]. The perfusion and venous pressure in the region of investigation was measured by means of the mechanotron transducers of an electromanometer; the venous outlow was estimated from the change in the blood level in the extracorporeal reservoir. The hemodynamic parameters were recorded on the N-327/5 instrument.

Radiological observations of stomach changes accompanying the threat of an injection, and further data on the normal variation of peristaltic rate.

1. The interval between peristaltic contractions was recorded for 61 people during a single period of several minutes. These records are combined with a previous series of 17 cases, and the data for the whole of 78 cases are presented. The mean interval for this sample was found to be 20·5 sec. with a standard deviation of 2·59 sec. 2. Forty-six people were subjected to a threat of an injection lasting 1–2 min. during the observation and recording of peristalsis. In about 50 per cent. of these a change in peristalsis occurred during the period of threat. The change consisted either in a cessation of peristalsis for from 69 sec. to over 250 sec. (9 persons), or in the peristalsis becoming much shallower (14 persons). 3. These changes are compared to those that were previously observed to follow an unexpected gun-shot. The proportion of people showing any change is not different in the two groups, but the proportion in whom cessation of peristalsis occurred is greater following the gun-shot stimulus. The pe...

On the mechanism of action of morphine on intestinal peristalsis

Аt intravenous injection of 2 mg Morph, hydrochlor. (Merck) per kg body weight of rabbits, the author did not observe any change in peristalsis; 5-10 mg leads to delayed peristalsis; over 20 mg, on the contrary, always causes excitation of peristalsis.