The influence of distal colon irritation on the changes of cystometry parameters to esophagus and colon distentions

ABSTRACT The co-occurrence of multiple pathologies in the pelvic viscera in the same patient, such as, irritable bowel syndrome and interstitial cystitis, indicates the complexity of viscero-visceral interactions and the necessity to study these interactions under multiple pathological conditions. In the present study, the effect of distal colon irritation (DCI) on the urinary bladder interaction with distal esophagus distention (DED), distal colon distention (DCD), and electrical stimulation of the abdominal branches of vagus nerve (abd-vagus) were investigated using cystometry parameters. The DCI significantly decreased the intercontraction time (ICT) by decreasing the storage time (ST); nonetheless, DED and Abd-vagus were still able to significantly decrease the ICT and ST following DCI. However, DCD had no effect on ICT following the DCI. The DCI, also, significantly decreased the Intravesical pressure amplitude (P-amplitude) by increasing the resting pressure (RP). Although DED has no effect on the P-amplitude, both in the intact and the irritated animals, the abd-vagus significantly increased the P-amplitude following DCI by increasing the maximum pressure (MP). In the contrary, 3mL DCD significantly increased the P-amplitude by increasing the MP and lost that effect following the DCI. Concerning the pressure threshold (PT), none of the stimuli had any significant changes in the intact animals. However, DCI significantly decreased the PT, also, the abd-vagus and 3mL DCD significantly decreased the PT. The results of this study indicate that chemical irritation of colon complicates the effects of mechanical irritation of esophagus and colon on urinary bladder function.

Blood vessels i ganglia in human esophagus migt explain the higher frequency of megaesophagus compared with megacooon / Vasos sanguíneos em gânglios no esôfago humano poderiam explicar a maior freqüência de megaesôfago comparado com megacolon

This study aimed to determine the existence of blood vessels within ganglia of the myenteric plexus of the human esophagus and colon. At necropsy, 15 stillborns, newborns and children up to two years of age, with no gastrointestinal disorders, were examined. Rings of the esophagus and colon were analyzed and then fixed in formalin and processed for paraffin. Histological sections were stained by hematoxylin-eosin, Giemsa and immunohistochemistry for the characterization of endothelial cells, using antibodies for anti-factor VIII and CD31. Blood vessels were identified within the ganglia of the myenteric plexus of the esophagus, and no blood vessels were found in any ganglia of the colon. It was concluded that the ganglia of the myenteric plexus of the esophagus are vascularized, while the ganglia of the colon are avascular. Vascularization within the esophageal ganglia could facilitate the entrance of infectious agents, as well as the development of inflammatory responses (ganglionitis) and denervation, as found in Chagas disease and idiopathic achalasia. This could explain the higher frequency of megaesophagus compared with megacolon.

Este estudo teve como objetivo avaliar se existem ou não vasos sanguíneos no interior de gânglios do plexo mientérico do esôfago e cólon humano. Foram examinados 15 casos de necrópsias de natimortos, recém-nascidos e crianças de até dois anos de idade, sem alterações gastrintestinais, que faleceram por doenças em outros órgãos. Foram analisados anéis do esôfago e cólon, fixados em formol e processados para inclusão em parafina. Cortes histológicos escalonados foram corados pelas técnicas de hematoxilina-eosina, Giemsa e imuno-histoquímica para caracterização das células endoteliais, utilizando-se os anticorpos anti-fator VIII e CD 31. Foram identificados vasos sanguíneos no interior de gânglios do plexo mientérico do esôfago em todos os casos e não foram vistos vasos sanguíneos em nenhum gânglio do cólon. Concluímos que os gânglios do plexo mientérico do esôfago são vascularizados e, os do cólon, avasculares. A vascularização no interior dos gânglios do esôfago pode facilitar a entrada de agentes infecciosos, bem como o desenvolvimento de respostas inflamatórias (ganglionite) e denervação, como encontrados na doença de Chagas e na acalásia idiopática. Isso pode explicar a frequência maior de megaesôfago comparado com megacólon.

The correlation of esophageal body length with measure of external body parameters / Correlación de la longitud del cuerpo esofágico con medida de parámetros corporales externos

There is disagreement as to whether there is a correlation between esophageal body length and that of various measurable external body parameters. This length has also been noted to vary in various disease states of the upper gastrointestinal tract and among various races. To our knowledge no such study has been published amongst an African population and Kenyans in particular. The purpose of this study was to determine how the length of the esophagus correlates with various external body parameters. This was a cross-sectional observational study at the endoscopy unit of Kenyatta National Hospital (KNH). All consenting patients undergoing upper gastrointestinal endoscopy (OGD) at KNH. 76 subjects undergoing flexible esophagoscopy were evaluated. 43 were male. The mean esophageal length was 22.2 cm (SD 2.63). Males had a longer esophagus than women. The esophageal length had a negative correlation with weight of individual and body mass index. There was a positive correlation between esophageal length versus height of the individual and the sternal length. Individual's height is the parameter that best correlates with the esophageal body length.

Hay desacuerdo en cuanto a si existe una correlación entre la longitud del cuerpo esofágico y la de varios parámetros corporales externos medibles. Esta longitud se ha observado que varía en diferentes estados de enfermedades del tracto gastrointestinal superior y entre distintas razas. Según la literatura consultada, ningún estudio de este tipo se ha publicado, en particular, entre una población de África y Kenia. El propósito de este estudio fue determinar cómo la longitud del esófago se correlaciona con diversos parámetros corporales externos. Se realizó un estudio observacional y transversal en la Unidad de Endoscopía del Hospital Nacional Kenyatta (KNH). Todos los pacientes sometidos consintieron a la la endoscopía digestiva alta (OGD) en KNH. Fueron evaluados76 pacientes sometidos a endoscopía flexible. (43 eran hombres). La longitud promedio del esófago fue de 22,2 cm (DE 2,63). Los hombres tuvieron un esófago más largo que las mujeres. La longitud del esófago tuvo una correlación negativa con el peso del individuo y su índice de masa corporal. Hubo una correlación positiva entre la longitud del esófago en comparación con la altura de la persona y la longitud esternal. La altura individual es el parámetro que mejor se correlaciona con la longitud del cuerpo esofágico.

Aspectos clínicos e radiográficos de caprino com megaesôfago / Clinical and radiographic analyses of a goat with megaesophagus

A seven month old female goat showed neck swelling, apathy, appetite and weight loss, restlessness, increased salivation, cough, and regurgitation episodes which occurred post feeding. The animal was evaluated through both clinical and radiographic examinations. Plain radiography was performed and contrasted X-ray was done using barium sulfate. For radiological examination, the lateral projection was used for analysis. The results showed a radiopaque content in the esophageal lumen dorsally positioned to heart with density and appearance similar to the rumen. A dilation of the esophagus was reported and a diagnosis of megaesophagus was made. In conclusion, contrast esophagography must be included in the diagnosis of megaesophagus in goats.

Esophageal anatomy of the llama (Lama glama) / Anatomía del esófago de la llama (Lama glama)

This study describes gross, microscopic and muscle fiber anatomy of the esophagus of the llama, Lama glama. The esophagus was studied grossly in twenty-five adult llamas and a subset of ten with normal esophageal physiology was used for the microanatomic studies. Esophageal length was 122 +/- 7 cm with two-thirds of the length in the neck and the remainder in the thorax, consistent with the long neck of the llama. Esophageal diameter increased steadily from 2.5 +/- 0.3 cm in the cranial cervical region to 3.9 +/- 0.8 cm in the caudal thoracic region. The mucosal epithelium was keratinized stratified squamous and there were abundant submucosal glands throughout the esophagus. The entire muscularis of the esophagus was striated muscle in two general layers but also with a somewhat random orientation of fibers. The tunica muscularis steadily increased in thickness from 3.43 +/- 0.30 mm in the cranial cervical region to 4.39 +/- 0.39 mm in the middle thoracic region. In the llama Type 2 muscle fibers predominated in the esophageal musculature, with the percentage of Type 1 fibers increasing from 1 percent cranially to 33 percent in the caudal thoracic region of the esophagus. This study of the normal llama esophagus enhances our knowledge of this species and provides the basis for future study of pathological conditions of the esophagus.

Este estudio describe la anatomía morfológica, microscópica, y tipo de fibra muscular del esófago de la llama, Lama glama. Estudiamos la anatomía morfológica del esófago, con fisiología normal, en 25 llamas adultas y, adicionalmente, en 10 de ellas la anatomía microscópica. La longitud del esófago fue 122 +/- 7 cm con dos tercios en el cuello y un tercio en el tórax. El diámetro del esófago aumentó de 2,5 +/- 0,3 cm en la región craneal del cuello y a 3,9 +/- 0,8 cm en la región caudal del tórax. El epitelio de la mucosa eera escamoso estratificado queratinizado y la submucosa contenía abundantes glándulas a lo largo de todo el esófago. La muscular entera del esófago se compuso de músculo esquelético en más o menos dos capas, pero con algunas fibras orientadas al azar. La muscular aumentó de 3,43 +/- 0,30 mm en la región craneal del cuello a 4,39 +/- 0,39 mm en la región media del tórax. Fibras musculares Tipo 2 predominaron en la muscular. El porcentaje de fibras Tipo 1 aumentó de 1 por ciento al inicio del esófago a 33 por ciento en la región caudal torácica. Este estudio del esófago normal de la llama ofrece más información sobre la anatomía de la llama y proporciona una base para futuros estudios de patologías esofágicas.

Cases of Swallow Syncope Induced by the Activation of Mechanorecepters in the Lower Esophagus

Swallowing is a rare cause of neurally mediated syncope. The mechanism of swallow syncope that contributes to hypotension, bradycardia, or to both is complex. A 59-year-old man had experienced a recurrent loss of consciousness during swallowing of carbonated beverages or sticky foods. Another 59-year-old man had complained of intermittent syncope just after eating foods. These two patients had no significant structural or functional abnormalities in the esophagus or heart. Both cases showed bradycardia when the lower esophagus was stretched by balloon inflation. The activation of mechanoreceptors in the lower esophagus can be regarded as an initiating factor of these cardioinhibitions. The patients were treated with permanent pacemaker implantation and instructed to change eating habits, respectively.

Morphometry of submucous and myenteric esophagic plexus of dogs experimentally reinfected with Trypanosoma cruzi

We carried out a morphometric study of the esophagus of cross-bred dogs experimentally infected or consecutively reinfected with Trypanosoma cruzi 147 and SC-1 strains, in order to verify denervation and/or neuronal hypertrophy in the intramural plexus. The animals were sacrificed in the chronic stage, 38 months after the initial infection. Neither nests of amastigotes, nor myositis or ganglionitis, were observed in all third inferior portions of esophageal rings analyzed. No nerve cell was identified in the submucous of this organ. There was no significant difference (p>0.05) between the number, maximum diameter, perimeter, or area and volume of the nerve cells of the myenteric plexus of infected and/or reinfected dogs and of the non-infected ones. In view of these results we may conclude that the 147 and SC-1 strains have little neurotropism and do not determine denervation and/or hypertrophy in the intramural esophageal plexuses in the animals studied, independent of the reinfections

Estudo quantitativo e qualitativo dos plexos de Auerbach e Meissner do esôfago de cäes inoculados com o Trypanosoma cruzi / A quantitative and qualitative study of the Auerbach and Meissner plexus in dogs inoculated with Trypanosoma cruzi

A quantitative and qualitative study was conducted on the Auerbach and Meissner plexuses of the esophagus of four chagasic dogs sacrificed during the acute phase of infection. Ganglionitis and periganglionitis of the Auerbach plexus ranged from mild to moderate and induced significant neuronal lesions, especially in two animals. The ganglions of the Meissner plexus were observed in small number which did not permit any analysis. Mild or moderate myositis was observed mainly in the lower third of the esophagus and was rarely associated with amastigote nests. Ganglion and neuron counts did not demonstrate denervation. Although the formation of megaesophagus was not induced in any dog, lesions of the Auerbach plexus and myocells of the esophagus were observed during the acute phase of chagasic infection. To our knowledge, this is the first systematic quantitative and qualitative study of the Auerbach and Meissner plexuses of the esophagus in experimental trypanosomiasis cruzi.

A quantitative study of the myenteric plexus of the distal end of the human esophagus

The density of ganlia and nerve cells in the myenteric plexus of the last distal (12 cem. of the human esophagus was determined in six esophagi from autops y material. The density of ganglia and nerve cells in cresyl violet stained stretch preparations of twelve esophageal segments, each 1 cm. in length, were compared. The highest values were recorded in segments 4,5 and 6 cm. above the cardiac incisura. The lowest densities of ganglia and nerve cells were found in segments 1,2 and 3 cm. above the cardiac incisura. The segments contained 659-3316 perikarya/cm2; ganglia contained 3-310 cells

Esophageal myenteric plexus: nerve cell morphology

The myenteric plexus of the last 12 cm. of the human esophaguys have been studied using silver impregnated stretch preparations. Only type 1 nerve cells (Dogiel's type 1) vere observed. They have a proeminent axon and numerous dendrites which may be short and thick or more longer and thin. The axons may be seen passing down to join the fiber tracts of the plexus or ending on other nerve cell in the same ganglion and possibly pasing down to attach to the muscle cells. The dendrites of one neurone have been seen intimatelyu mingled with that of another neurone. Many neurones have been seen associated to pericellular endidngs which were interpreted as endings of vagus nerve fibers. The functional significance of the findings is discussed