scholarly journals Temporal and spectral properties of esophageal mucosal blood perfusion: a comparison between normal subjects and nutcracker esophagus patients

2016 ◽  
Vol 29 (2) ◽  
pp. e12917 ◽  
Author(s):  
A. Zifan ◽  
Y. Jiang ◽  
R. K. Mittal
Keyword(s):  
Spectral Properties ◽  
Blood Perfusion ◽  
Normal Subjects ◽  
Nutcracker Esophagus

scholarly journals Low esophageal mucosal blood flow in patients with nutcracker esophagus

2016 ◽  
Vol 310 (6) ◽  
pp. G410-G416 ◽  
Author(s):  
Yanfen Jiang ◽  
Ravinder K. Mittal
Keyword(s):  
Chest Pain ◽  
Visceral Pain ◽  
Blood Perfusion ◽  
Mucosal Blood Flow ◽  
Normal Subjects ◽  
Esophageal Wall ◽  
Spontaneous Pain ◽  
Noncardiac Chest Pain ◽  
Nutcracker Esophagus ◽  
Tissue Ischemia

Nutcracker esophagus (NE) is characterized by high-amplitude peristaltic esophageal contractions, and these patients often present with symptoms of “angina-like” or noncardiac chest pain. Tissue ischemia is a known cause of visceral pain, and the goal of our present study was to determine whether esophageal wall blood perfusion (EWBP) is reduced in patients with NE. Fourteen normal subjects (mean age 51 yr, 11 men) and 12 patients (mean age 53 yr, 9 men) with NE and noncardiac chest pain were investigated. The EWBP was measured continuously using a custom-designed laser Doppler probe tethered to a Bravo capsule, which anchored it to the esophageal wall. The baseline EWBP in normal subjects was 651 ± 27 perfusion units. In patients with NE, the baseline EWBP was significantly lower than in the normal subjects (451 ± 32 perfusion units). The EWBP decreased after injection of edrophonium (which increases muscle contractions) and increased following sublingual nitroglycerin administration (which relaxes muscle) in normal subjects, as well as in NE patients. Spontaneous pain events during the recording period were often associated with drops in the EWBP. We propose that low EWBP leads to hypoxia of the esophageal tissue, which may be a mechanism of esophageal pain in patients with NE.

Cholinergic stimulation induces asynchrony between the circular and longitudinal muscle contraction during esophageal peristalsis

2008 ◽  
Vol 294 (3) ◽  
pp. G694-G698 ◽  
Author(s):  
Hariprasad Korsapati ◽  
Arash Babaei ◽  
Valmik Bhargava ◽  
Ravinder K. Mittal
Keyword(s):  
Longitudinal Muscle ◽  
Acetylcholinesterase Inhibitor ◽  
Time Lag ◽  
Control Period ◽  
Temporal Correlation ◽  
Normal Subjects ◽  
Esophageal Peristalsis ◽  
Nutcracker Esophagus ◽  
The Mean ◽  
Mean Time

In healthy subjects, a close temporal correlation exists between contractions of the circular muscle (CM) and longitudinal muscle (LM) layers of the esophagus. Patients with nutcracker esophagus show disassociation between the peak of contractions of the CM and LM layers and the peak of contraction 1–3 s apart (Jung HY, Puckett JL, Bhalla V, Rojas-Feria M, Bhargava V, Liu J, Mittal RK. Gastroenterology 128: 1179–1186, 2005). The purpose of the present study was to evaluate the effect of acetylcholinesterase inhibitor (edrophonium) and acetylcholine receptor antagonist (atropine) on human esophageal peristalsis in normal subjects. High-frequency intraluminal ultrasound imaging and manometry were performed simultaneously during swallow-induced peristalsis in ten normal subjects. Standardized 5-ml water swallows were recorded 2 cm above the lower esophageal sphincter under three study conditions: control, edrophonium (80 μg/kg iv), and atropine (10 μg/kg iv). A close temporal correlation exists between the peak pressure and peak wall thickness during the control period. The mean time lag between the peak LM and peak CM contraction was 0.03 s. After edrophonium administration, the mean contraction amplitude increased from 101 ± 9 mmHg to 150 ± 20 mmHg ( P < 0.05) and mean peak muscle thickness increased from 3.0 ± 0.2 mm to 3.6 ± 0.3 mm ( P < 0.01), and duration of both CM and LM contractions were also increased. Furthermore, the mean time difference between the peak LM and CM was increased to 1.1 s, (ranging 0.2 to 3.4 s) ( P < 0.0001). We conclude that cholinomimetic agent induces discoordination between the two muscle layers of the esophagus.

Spectral Properties and Quantitative Evaluation of Hypernasality in Vowels

1996 ◽  
Vol 33 (1) ◽  
pp. 43-50 ◽  
Author(s):  
Ryuta Kataoka ◽  
Ken-Ichi Michi ◽  
Kaoru Okabe ◽  
Tanetoshi Miura ◽  
Hiroshi Yoshida
Keyword(s):  
Spectral Properties ◽  
Power Level ◽  
Power Spectra ◽  
Normal Subjects ◽  
Acoustic Power ◽  
Preliminary Study ◽  
A New Technique ◽  
Second Formant ◽  
The One ◽  
Nasal Resonance

A new technique for evaluating hypernasality using an acoustic approach is presented. In a preliminary study using this technique, nasal resonance was assessed in 17 normal subjects and 16 subjects judged to be hypernasal. Analyses of the one-third-octave power spectra revealed an increase in power level between the first and second formant, and a reduction in the power level in second and third formant regions among utterances judged to be hypernasal. Factor analysis of the perceptual ratings revealed that the consensus perception of hypernasality accounted for 71% of the total variance. An additional 8% was accounted for by individual differences. Multiple regression analysis revealed a high correlation between the consensus perception of hypernasality and the variance in two acoustic-power levels, these being the power level between the first and second formant and the power level of the second and third formant regions.

371 Low Esophageal Wall Blood Perfusion & Hypoxia in Esophageal Mucosa in Patients With Nutcracker Esophagus

2015 ◽  
Vol 148 (4) ◽  
pp. S-75-S-76 ◽  
Author(s):  
Ravinder K. Mittal ◽  
Martina Buck ◽  
Melissa M. Ledgerwood ◽  
Yanfen Jiang
Keyword(s):  
Blood Perfusion ◽  
Esophageal Wall ◽  
Esophageal Mucosa ◽  
Nutcracker Esophagus

Relationship between esophageal muscle thickness and intraluminal pressure in patients with esophageal spasm

2002 ◽  
Vol 282 (6) ◽  
pp. G1016-G1023 ◽  
Author(s):  
Nonko Pehlivanov ◽  
Jianmin Liu ◽  
Ghassan S. Kassab ◽  
Cheryl Beaumont ◽  
Ravinder K. Mittal
Keyword(s):  
Ultrasound Imaging ◽  
Muscle Thickness ◽  
Normal Subjects ◽  
High Amplitude ◽  
Intraluminal Pressure ◽  
Diffuse Esophageal Spasm ◽  
Nutcracker Esophagus ◽  
Contraction Amplitude ◽  
Esophageal Spasm ◽  
Esophageal Muscle

We previously showed, in normal subjects, a positive correlation between the esophageal contraction amplitude and peak muscle thickness. The goal of this study was to determine the relationship between esophageal muscle thickness and contraction amplitude in patients with high-amplitude peristaltic and simultaneous contractions. Eleven patients with high-amplitude peristaltic contractions, 8 with diffuse esophageal spasm (DES), 7 with nonspecific (NS) motor disorder of the esophagus, and 10 normal subjects were studied using simultaneous pressure and ultrasound imaging. Pressure was recorded by manometry and ultrasound imaging with a high-frequency ultrasound probe catheter. Recordings were performed in the lower esophageal sphincter (LES) and at 2, 4, 6, 8, and 10 cm above the LES during resting state and swallow-induced contractions. Baseline esophageal muscle was thicker in the distal, compared with the proximal esophagus both in normal subjects and patient groups. Patients with DES and nutcracker esophagus (NC) have a higher baseline muscle thickness compared with normal and NS patients. Correlation between the peak pressure and the peak muscle thickness was weaker in patients with NC and DES compared with normal subjects and patients with NS. Whereas normal subjects have good correlation between delta (difference between peak and baseline) muscle thickness and peak pressures, this relationship was absent in patients with NC and DES. Increase in contraction amplitude in patients with NC and DES was associated with an increase in baseline thickness of esophageal muscularis propria. Increase in baseline thickness was specific to patients with spastic motor disorders and was not seen in patients with NS.

Auditory Selective Attention in Cerebral-Palsied Individuals

1985 ◽  
Vol 16 (4) ◽  
pp. 260-266 ◽  
Author(s):  
Lee Ann Laraway
Keyword(s):  
Selective Attention ◽  
White Noise ◽  
Normal Subjects ◽  
Auditory Selective Attention ◽  
Normal Individuals ◽  
Significant Difference

The purpose of this study was to determine whether there is a statistically significant difference between the auditory selective attention abilities of normal and cerebral-palsied individuals. Twenty-three cerebral-palsied and 23 normal subjects between the ages of 5 and 21 were asked to repeat a series of 30 items consisting of from 2 to 4 digits in the presence of intermittent white noise. Results of the study indicate that cerebral-palsied individuals perform significantly poorer than normal individuals when the stimulus is accompanied by noise. Noise was not a significant factor in the performance of the normal subjects regardless of age.

The Effect of Stapedectomy on the Loudness of One’s Own Voice

1965 ◽  
Vol 8 (3) ◽  
pp. 223-234 ◽  
Author(s):  
William Melnick
Keyword(s):  
Middle Ear ◽  
Normal Subjects ◽  
Sound Energy ◽  
Loudness Function ◽  
Before And After ◽  
Increased Sensitivity

Five subjects with normal middle ear mechanisms, and otosclerotic patients, before and after stapedectomy, matched the loudness of their voices to the loudness of a 125-cps-sawtooth noise. The results showed loudness matching functions with gradual slopes, less than 1.00, for the normal subjects and the patients prior to stapedectomy. Post-surgically, the loudness function for the patients increased in steepness to considerably more than 1.00. These results are explained, most logically, in terms of increased sensitivity of the altered middle ear to sound energy generated by the listener’s own voice.

Delayed Auditory Feedback with Different Delay Times at Each Ear

1964 ◽  
Vol 7 (4) ◽  
pp. 369-371
Author(s):  
Samuel Fillenbaum
Keyword(s):  
Delay Interval ◽  
Auditory Feedback ◽  
Normal Subjects ◽  
Delayed Auditory Feedback ◽  
Delay Times

Binaurally asynchronous delayed auditory feedback (DAF) was compared with synchronous DAF in 80 normal subjects. Asynchronous DAF (0.10 sec difference) did not yield results different from those obtained under synchronous DAF with a 0.20 sec delay interval, an interval characteristically resulting in maximum disruptions in speech.

Object Transformations in the Play of Language-Impaired Children

1988 ◽  
Vol 53 (4) ◽  
pp. 459-466 ◽  
Author(s):  
Brenda Y. Terrell ◽  
Richard G. Schwartz
Keyword(s):  
Normal Subjects ◽  
Play Behavior ◽  
Chronological Age ◽  
Standard Group ◽  
Language Impaired ◽  
Normal Language ◽  
Mean Length Of Utterance ◽  
Impaired Children

The play behavior of 10 language-impaired children was observed. Their performances in play were compared to those of 10 normal-language children matched for chronological age as well as to those of 10 normal-language children matched for mean length of utterance. The children were observed as they played spontaneously with a standard group of toys and as they played with objects that required object transformations for successful play. The chronological age-matched normal subjects showed a trend toward performance of more object transformations in play than either the language-impaired or younger normal-language children. Additionally, although object transformations were observed in both segments, all children performed more object transformations with objects than with toys.

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