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1.
Neurourol Urodyn ; 41(2): 592-600, 2022 02.
Artículo en Inglés | MEDLINE | ID: mdl-35094431

RESUMEN

AIMS: To measure the force applied along the anterior and posterior vaginal walls in a cohort of 46 patients measured by a fiber-optic pressure sensor and determine if this correlates with vaginal parity and pelvic organ prolapse (POP). METHODS: An intravaginal fiber-optic sensor measured pressure at nine locations along the anterior and posterior vaginal walls during a maximal voluntary pelvic floor muscle contraction (MVC). An automated probe dilation cycle measured the tissue resistance incorporating the vagina and surrounding anatomy. MVC and resting tissue resistance (RTR) were assessed between subjects grouped by the number of vaginal births and prolapse stage. RESULTS: A previous vaginal birth was associated with a significant threefold decrease in the overall anterior pressure measurement during MVC. Decreased anterior pressure measurements were observed at Sensors 1 and 3 (distal vagina) and, posteriorly at Sensors 4-6 (midvagina). Women with Stage 2 posterior prolapse exhibited a decreased MVC pressure in the midvagina than those with Stage 0/1. In this pilot study, there was no difference in the vaginal wall RTR according to previous vaginal birth or stage of prolapse. CONCLUSION: This pilot study found that a decrease in vaginal pressure measured during MVC is associated with vaginal birth and with posterior POP. Greater sample size is required to assess the role of resting tissue pressure measurement.


Asunto(s)
Diafragma Pélvico , Prolapso de Órgano Pélvico , Femenino , Humanos , Contracción Muscular/fisiología , Diafragma Pélvico/fisiología , Proyectos Piloto , Embarazo , Vagina
2.
Am J Physiol Gastrointest Liver Physiol ; 318(1): G99-G108, 2020 01 01.
Artículo en Inglés | MEDLINE | ID: mdl-31709829

RESUMEN

Cyclical propagating waves of muscle contraction have been recorded in isolated small intestine or colon, referred to here as motor complexes (MCs). Small intestinal and colonic MCs are neurogenic, occur at similar frequencies, and propagate orally or aborally. Whether they can be coordinated between the different gut regions is unclear. Motor behavior of whole length mouse intestines, from duodenum to terminal rectum, was recorded by intraluminal multisensor catheter. Small intestinal MCs were recorded in 27/30 preparations, and colonic MCs were recorded in all preparations (n = 30) with similar frequencies (0.54 ± 0.03 and 0.58 ± 0.02 counts/min, respectively). MCs propagated across the ileo-colonic junction in 10/30 preparations, forming "full intestine" MCs. The cholinesterase inhibitor physostigmine increased the probability of a full intestine MC but had no significant effect on frequency, speed, or direction. Nitric oxide synthesis blockade by Nω-nitro-l-arginine, after physostigmine, increased MC frequency in small intestine only. Hyoscine-resistant MCs were recorded in the colon but not small intestine (n = 5). All MCs were abolished by hexamethonium (n = 18) or tetrodotoxin (n = 2). The enteric neural mechanism required for motor complexes is present along the full length of both the small and large intestine. In some cases, colonic MCs can be initiated in the distal colon and propagate through the ileo-colonic junction, all the way to duodenum. In conclusion, the ileo-colonic junction provides functional neural continuity for propagating motor activity that originates in the small or large intestine.NEW & NOTEWORTHY Intraluminal manometric recordings revealed motor complexes can propagate antegradely or retrogradely across the ileo-colonic junction, spanning the entire small and large intestines. The fundamental enteric neural mechanism(s) underlying cyclic motor complexes exists throughout the length of the small and large intestine.


Asunto(s)
Colon/inervación , Sistema Nervioso Entérico/fisiología , Intestino Delgado/inervación , Complejo Mioeléctrico Migratorio , Peristaltismo , Animales , Antagonistas Colinérgicos/farmacología , Inhibidores de la Colinesterasa/farmacología , Sistema Nervioso Entérico/efectos de los fármacos , Femenino , Bloqueadores Ganglionares/farmacología , Técnicas In Vitro , Masculino , Ratones Endogámicos C57BL , Complejo Mioeléctrico Migratorio/efectos de los fármacos , Peristaltismo/efectos de los fármacos , Presión , Factores de Tiempo
3.
J Physiol ; 597(20): 5125-5140, 2019 10.
Artículo en Inglés | MEDLINE | ID: mdl-31444880

RESUMEN

KEY POINTS: Enteric neural circuits enable isolated preparations of guinea-pig distal colon to propel solid and fluid contents by a self-sustaining neuromechanical loop process. In addition there are at least three neural mechanisms which are not directly involved in propulsion: cyclic motor complexes, transient neural events and distal colon migrating motor complexes. In excised guinea-pig colon we simultaneously recorded high resolution manometry, video-imaging of colonic wall movements and electrophysiological recordings from smooth muscle, which enabled us to identify mechanisms that underlie the propulsion of colonic content. The results show that the intermittent propulsion during emptying of the multiple natural faecal pellets is due to the intermittent activation of cyclic motor complexes and this is facilitated by transient neural events. Loss or dysfunction of these activities is likely to underlie disordered gastrointestinal transit. ABSTRACT: It is well known that there are different patterns of electrical activity in smooth muscle cells along different regions of the gastrointestinal tract. These different patterns can be generated by myogenic and/or neurogenic mechanisms. However, what patterns of electrical activity underlie the propulsion of natural faecal content remains unknown, particularly along the large intestine, where large quantities of water are reabsorbed and semi-solid faeces form. In this study, we developed a novel approach which enables for the first time the simultaneous recording of high resolution intraluminal manometry, electrophysiology from the smooth muscle, and spatio-temporal video imaging of colonic wall movements. Using this approach we were able to reveal the nature of enteric neuromuscular transmission and patterns of motor activity responsible for the movement of content. Three distinct neurogenic patterns of electrical activity were recorded even in the absence of propulsive movement. These were the cyclic motor complexes (CMCs), the transient neural events (TNEs) and the slowly propagating distal colonic migrating motor complexes (DCMMCs). We present evidence that the initiation of pellet propulsion is due to a cyclic motor complex (CMC) occurring oral to the pellet. Furthermore, we discovered that the intermittent propulsion of natural faecal pellets is generated by intermittent activation of CMCs; and this propulsion is facilitated by hexamethonium-sensitive TNEs. However, TNEs were not required for propulsion. The findings reveal the patterns of electrical activity that underlie propulsion of natural colonic content and demonstrate that propulsion is generated by a complex interplay between distinct enteric neural circuits.


Asunto(s)
Colon/fisiología , Motilidad Gastrointestinal/fisiología , Contracción Muscular/fisiología , Músculo Liso/fisiología , Potenciales de Acción , Animales , Electromiografía , Femenino , Cobayas , Masculino , Actividad Motora , Complejo Mioeléctrico Migratorio
4.
Neurogastroenterol Motil ; 31(12): e13704, 2019 12.
Artículo en Inglés | MEDLINE | ID: mdl-31407459

RESUMEN

BACKGROUND: High-resolution colonic manometry is an emerging technique that has provided new insights into the pathophysiology of functional colorectal diseases. Prior studies have been limited by bulky, non-ambulatory acquisition systems, which have prevented mobilization during prolonged recordings. METHODS: A novel ambulatory acquisition system for fiber-optic high-resolution colonic manometry was developed. Benchtop validation against a standard non-ambulatory system was performed using standardized calibration metrics. Clinical feasibility studies were conducted in three patients undergoing right hemicolectomy. RESULTS: Pressure profiles obtained from benchtop testing were near-identical using the ambulatory and the non-ambulatory systems. Clinical studies successfully demonstrated ambulatory data capture with patients freely mobilizing postoperatively during continuous recordings of >60 hours. The occurrence (P = .56), amplitude (P = .65), velocity (P = .10), and extent (P = .12) of colonic motor patterns were similar to those obtained in non-ambulatory studies. CONCLUSIONS: A novel ambulatory system for high-resolution colonic manometry has been developed and validated. This technique will facilitate prolonged ambulatory recordings of colonic motor activity, assisting with investigations into the role of colonic motility in disease states.


Asunto(s)
Colon/fisiología , Tecnología de Fibra Óptica/instrumentación , Motilidad Gastrointestinal/fisiología , Manometría/instrumentación , Monitoreo Ambulatorio/instrumentación , Anciano , Anciano de 80 o más Años , Colectomía , Diseño de Equipo , Estudios de Factibilidad , Femenino , Humanos , Masculino , Manometría/métodos , Persona de Mediana Edad , Monitoreo Ambulatorio/métodos , Periodo Posoperatorio , Periodo Posprandial/fisiología
5.
Neurourol Urodyn ; 38(8): 2264-2272, 2019 11.
Artículo en Inglés | MEDLINE | ID: mdl-31385355

RESUMEN

AIMS: Pelvic floor disorders (PFDs) in women are a major public health concern. Current clinical methods for assessing PFDs are either subjective or confounded by interference from intra-abdominal pressure (IAP). This study introduces an intravaginal probe that can determine distributed vaginal pressure during voluntary exercises and measures the degree of vaginal tissue support independent of IAP fluctuations. METHODS: An intravaginal probe was fabricated with 18 independent fiber-optic pressure transducers positioned along its upper and lower blades. Continuous pressure measurement along the anterior and posterior vaginal walls during the automated expansion of the probe enabled the resistance of the tissue to be evaluated as a function of displacement, in a manner reflecting the elastic modulus of the tissue. After validation in a simulated vaginal phantom, in vivo measurements were conducted in the relaxed state and during a series of voluntary exercises to gauge the utility of the device in women. RESULTS: The probe reliably detected variations in the composition of sub-surface material in the vaginal phantom. During in-vivo measurements the probe detected distributed tissue elasticity in the absence of IAP change. In addition, the distribution of pressure along both anterior and posterior vaginal walls during cough, Valsalva and pelvic floor contraction was clearly resolved with a large variation observed between subjects. CONCLUSIONS: Our data highlight the potential for the probe to assess the integrity of the vagina wall and support structures as an integrated functional unit. Further in vivo trials are needed to correlate data with clinical findings to assist in the assessment of PFDs.


Asunto(s)
Examen Ginecologíco/instrumentación , Examen Ginecologíco/métodos , Vagina/patología , Adolescente , Adulto , Anciano , Tos/fisiopatología , Elasticidad , Ejercicio Físico , Femenino , Tecnología de Fibra Óptica , Humanos , Persona de Mediana Edad , Contracción Muscular , Diafragma Pélvico , Trastornos del Suelo Pélvico/diagnóstico , Trastornos del Suelo Pélvico/patología , Fantasmas de Imagen , Presión , Transductores , Maniobra de Valsalva , Adulto Joven
6.
J Biophotonics ; 12(10): e201900139, 2019 10.
Artículo en Inglés | MEDLINE | ID: mdl-31102344

RESUMEN

Continuous monitoring of intrapulse measurement of blood flow in humans is currently not achievable with clinically available instruments. In this paper, we demonstrate a method of measuring the instantaneous variations in flow during pulsatile blood flow with an optical flow sensor comprising a fiber Bragg grating sensor and illumination from a 565 nm Light-Emitting-Diode. The LED illumination heats the blood and fluctuations in temperature, due to variations in flow, are detected by the fiber sensor. A set of experiments at different flow rates (20 to 900 mL/min) are performed in a simulated cardiac circulation setup with pulsatile flow. Data are compared with an in-line time of flight ultrasound flow sensor. Our results show that the optical and ultrasonic signals correlate with Pearson coefficients ranging from -0.83 to -0.98, dependent on the pulsatile frequency. Average flow determined by ultrasound and the optical fiber sensor showed a parabolic relationship with R2 = 0.99. An abrupt step change in flow induced by occlusion and release of the circuit tubing demonstrated that the optical fiber and ultrasound sensor had similar response. The method described is capable of intrapulse blood flow measurement under pulsatile flow conditions, with potential applications in medicine where continuous blood flow sensing is desired.


Asunto(s)
Monitoreo Fisiológico/instrumentación , Fibras Ópticas , Algoritmos , Velocidad del Flujo Sanguíneo , Humanos
7.
Neurogastroenterol Motil ; 31(2): e13488, 2019 02.
Artículo en Inglés | MEDLINE | ID: mdl-30294875

RESUMEN

BACKGROUND: High-resolution impedance manometry (HRIM) catheters are used for esophageal reflux and bolus transit studies. Usually, these catheters have electrodes spaced at 20 mm intervals that are used for measuring electrical impedance between the consecutive electrodes and pressure sensors with 10 mm separation. Electrical impedance is a distributed measurement between the electrodes, unlike the point measurement of pressure sensors. Thus, the electrode separations affect the overall spatiotemporal resolution of the measurement. METHODS: A 3D model of the gastrointestinal tract, in which bolus shape and size can be modified, was used to simulate the admittance signal response of an intraluminal impedance catheter with 10 and 20 mm electrode separation to study the distributed sensitivity in the lumen to gain insight on the impedance measurement. In addition, experiments on sections of rabbit proximal colon were conducted with two catheters with electrode separations of 10 and 20 mm to compare the experimental data with the simulated data. KEY RESULTS: Reducing electrode spacing from 20 to 10 mm increased sensitivity to diameter change by a factor of ten. Admittance and diameter correlated strongly during a myogenic contraction with a Pearson's Correlation Coefficient of 0.86 for the custom catheter, in comparison with 0.56 for the commercial HRIM catheter. CONCLUSIONS: Ten millimeter electrode separation has a better spatiotemporal resolution, and unlike 20 mm electrode separation is able to identify myogenic contractions. Based on the numerical and experimental data, closer electrode separation should be considered for improved spatial resolution.


Asunto(s)
Impedancia Eléctrica , Electrodos , Tránsito Gastrointestinal/fisiología , Manometría , Modelos Animales , Animales , Catéteres , Modelos Teóricos , Conejos
8.
Am J Physiol Gastrointest Liver Physiol ; 316(1): G32-G44, 2019 01 01.
Artículo en Inglés | MEDLINE | ID: mdl-30335474

RESUMEN

In the guinea pig distal colon, nonpropulsive neurally mediated motor patterns have been observed in different experimental conditions. Isolated segments of guinea pig distal colon were used to investigate these neural mechanisms by simultaneously recording wall motion, intraluminal pressure, and smooth muscle electrical activity in different conditions of constant distension and in response to pharmacological agents. Three distinct neurally dependent motor patterns were identified: transient neural events (TNEs), cyclic motor complexes (CMC), and distal colon migrating motor complexes (DCMMC). These could occur simultaneously and were distinguished by their electrophysiological, mechanical, and pharmacological features. TNEs occurred at irregular intervals of ~3s, with bursts of action potentials at 9 Hz. They propagated orally at 12 cm/s via assemblies of ascending cholinergic interneurons that activated final excitatory and inhibitory motor neurons, apparently without involvement of stretch-sensitive intrinsic primary afferent neurons. CMCs occurred during maintained distension and consisted of clusters of closely spaced TNEs, which fused to cause high-frequency action potential firing at 7 Hz lasting ~10 s. They generated periodic pressure peaks mediated by stretch-sensitive intrinsic primary afferent neurons and by cholinergic interneurons. DCMMCs were generated by ongoing activity in excitatory motor neurons without apparent involvement of stretch-sensitive neurons, cholinergic interneurons, or inhibitory motor neurons. In conclusion, we have identified three distinct motor patterns that can occur concurrently in the isolated guinea pig distal colon. The mechanisms underlying the generation of these neural patterns likely involve recruitment of different populations of enteric neurons with distinct temporal activation properties.


Asunto(s)
Colon/fisiología , Motilidad Gastrointestinal/fisiología , Músculo Liso/fisiología , Complejo Mioeléctrico Migratorio/fisiología , Potenciales de Acción/fisiología , Animales , Cobayas , Neuronas Motoras/fisiología , Plexo Mientérico/fisiología , Neurogénesis/fisiología
9.
Annu Int Conf IEEE Eng Med Biol Soc ; 2018: 4949-4952, 2018 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-30441453

RESUMEN

This paper presents preliminary results on the effect of contact pressure on bioimpedance measurements in an excised section of human colon tissue. The impedance measurements were performed with a small diameter probe suitable for in-vivo use, which is capable of measuring contact force. Force measurements are performed by fiber optic sensor which consisted of a Fiber Bragg Grating. The obtained results highlight the importance on limiting the applied pressure during bioimpedance measurements.


Asunto(s)
Impedancia Eléctrica , Tecnología de Fibra Óptica , Humanos , Fenómenos Mecánicos , Presión
10.
Am J Physiol Gastrointest Liver Physiol ; 312(5): G508-G515, 2017 May 01.
Artículo en Inglés | MEDLINE | ID: mdl-28336544

RESUMEN

Colonic cyclic motor patterns (CMPs) have been hypothesized to act as a brake to limit rectal filling. However, the spatiotemporal profile of CMPs, including anatomic origins and distributions, remains unclear. This study characterized colonic CMPs using high-resolution (HR) manometry (72 sensors, 1-cm resolution) and their relationship with proximal antegrade propagating events. Nine healthy volunteers were recruited. Recordings were performed over 4 h, with a 700-kcal meal given after 2 h. Propagating events were visually identified and analyzed by pattern, origin, amplitude, extent of propagation, velocity, and duration. Manometric data were normalized using anatomic landmarks identified on abdominal radiographs. These were mapped over a three-dimensional anatomic model. CMPs comprised a majority of detected propagating events. Most occurred postprandially and were retrograde propagating events (84.9 ± 26.0 retrograde vs. 14.3 ± 11.8 antegrade events/2 h, P = 0.004). The dominant sites of initiation for retrograde CMPs were in the rectosigmoid region, with patterns proximally propagating by a mean distance of 12.4 ± 0.3 cm. There were significant differences in the characteristics of CMPs depending on the direction of travel and site of initiation. Association analysis showed that proximal antegrade propagating events occurred independently of CMPs. This study accurately characterized CMPs with anatomic correlation. CMPs were unlikely to be triggered by proximal antegrade propagating events in our study context. However, the distal origin and prominence of retrograde CMPs could still act as a mechanism to limit rectal filling and support the theory of a "rectosigmoid brake."NEW & NOTEWORTHY Retrograde cyclic motor patterns (CMPs) are the dominant motor patterns in a healthy prepared human colon. The major sites of initiation are in the rectosigmoid region, with retrograde propagation, supporting the idea of a "rectosigmoid brake." A significant increase in the number of CMPs is seen after a meal. In our study context, the majority of CMPs occurred independent of proximal propagating events, suggesting that CMPs are primarily controlled by external innervation.


Asunto(s)
Relojes Biológicos/fisiología , Colon/anatomía & histología , Colon/fisiología , Motilidad Gastrointestinal/fisiología , Recto/anatomía & histología , Recto/fisiología , Adulto , Anciano , Femenino , Humanos , Aumento de la Imagen/métodos , Imagenología Tridimensional/métodos , Masculino , Manometría/métodos , Persona de Mediana Edad
11.
Int Wound J ; 14(6): 973-977, 2017 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-28296351

RESUMEN

Compression bandaging is a mainstay practice in the treatment of conditions such as chronic wounds and lymphoedema. However, the ability of practitioners to measure bandage application to a desired pressure profile is difficult because of sensor limitations. We have used a novel fibre-optic-based, high-resolution sub-bandage pressure monitor to measure adherence to a target pressure gradient during compression bandaging. Participants of various experience (n = 46) were asked to bandage a lower-leg manikin to a gradient of 40 (ankle) to 20 mmHg (proximal calf) in both a blinded trial and subsequently with sensor feedback. Mean pressures across all sensors for both the blind and sensor-guided trials approximated a target mean of 30 mmHg. However, the mean gradient achieved in the blinded trial showed an inverse pressure gradient to the target with a high-pressure region at the mid-calf (44 ± 19 mmHg). Correlation to the target gradient improved from R2 = 0·62 during the blind trial to 0·93 using sensor feedback, with a gradient that closely approximated the target. This demonstrates the use of high-resolution sub-bandage pressure sensing in improving the ability of practitioners to achieve a target pressure gradient in compression bandaging for clinical use and training.


Asunto(s)
Vendajes de Compresión/estadística & datos numéricos , Tecnología de Fibra Óptica/instrumentación , Úlcera de la Pierna/terapia , Manometría/instrumentación , Presión , Úlcera Varicosa/terapia , Cicatrización de Heridas/fisiología , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Tecnología de Fibra Óptica/métodos , Humanos , Masculino , Manometría/métodos , Persona de Mediana Edad
12.
J Biomed Opt ; 21(12): 127008, 2016 12 01.
Artículo en Inglés | MEDLINE | ID: mdl-28008450

RESUMEN

Pelvic organ prolapse (POP) occurs when changes to the pelvic organ support structures cause descent or herniation of the pelvic organs into the vagina. Clinical evaluation of POP is a series of manual measurements known as the pelvic organ prolapse quantification (POP-Q) score. However, it fails to identify the mechanism causing POP and relies on the skills of the practitioner. We report on a modified vaginal speculum incorporating a double-helix fiber-Bragg grating structure for distributed pressure measurements along the length of the vagina and include preliminary data in an ovine model of prolapse. Vaginal pressure profiles were recorded at 10 Hz as the speculum was dilated incrementally up to 20 mm. At 10-mm dilation, nulliparous sheep showed higher mean pressures ( 102 ± 46 ?? mmHg ) than parous sheep ( 39 ± 23 ?? mmHg ) ( P = 0.02 ), attributable largely to the proximal (cervical) end of the vagina. In addition to overall pressure variations, we observed a difference in the distribution of pressure that related to POP-Q measurements adapted for the ovine anatomy, showing increased tissue laxity in the upper anterior vagina for parous ewes. We demonstrate the utility of the fiber-optic instrumented speculum for rapid distributed measurement of vaginal support.


Asunto(s)
Tecnología de Fibra Óptica/instrumentación , Tecnología de Fibra Óptica/métodos , Instrumentos Quirúrgicos , Vagina/diagnóstico por imagen , Animales , Fenómenos Biomecánicos , Femenino , Prolapso de Órgano Pélvico/diagnóstico por imagen , Presión , Ovinos
13.
J Biophotonics ; 9(3): 305-10, 2016 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-26616543

RESUMEN

A fibre optic motion sensor has been developed for monitoring the proximity and direction of motion of a ferrous bead travelling axial to the sensor. By integrating an array of these sensors into our previously developed fibre optic manometry catheters we demonstrate simultaneous detection of peristaltic muscular activity and the associated motion of ferrous beads through a colonic lumen. This allows the motion of solid content to be temporally and spatially related to pressure variations generated by peristaltic contractions without resorting to videoflouroscopy to track the motion of a radio opaque bolus. The composite catheter has been tested in an in-vitro animal preparation consisting of excised sections of rabbit colon. Cut-away image of the fibre optic motion sensor showing the location of the fibre Bragg gratings and the rare earth magnet.


Asunto(s)
Catéteres , Colon/fisiología , Motilidad Gastrointestinal , Microesferas , Fibras Ópticas , Animales , Hierro/química , Hierro/metabolismo , Conejos
14.
Am J Physiol Gastrointest Liver Physiol ; 308(1): G1-G11, 2015 Jan 01.
Artículo en Inglés | MEDLINE | ID: mdl-25394659

RESUMEN

Narrow muscle strips have been extensively used to study intestinal contractility. Larger specimens from laboratory animals have provided detailed understanding of mechanisms that underlie patterned intestinal motility. Despite progress in animal tissue, investigations of motor patterns in large, intact specimens of human gut ex vivo have been sparse. In this study, we tested whether neurally dependent motor patterns could be detected in isolated specimens of intact human ileum. Specimens (n = 14; 7-30 cm long) of terminal ileum were obtained with prior informed consent from patients undergoing colonic surgery for removal of carcinomas. Preparations were set up in an organ bath with an array of force transducers, a fiberoptic manometry catheter, and a video camera. Spontaneous and distension-evoked motor activity was recorded, and the effects of lidocaine, which inhibits neural activity, were studied. Myogenic contractions (ripples) occurred in all preparations (6.17 ± 0.36/min). They were of low amplitude and formed complex patterns by colliding and propagating in both directions along the specimen at anterograde velocities of 4.1 ± 0.3 mm/s and retrogradely at 4.9 ± 0.6 mm/s. In five specimens, larger amplitude clusters of contractions were seen (discrete clustered contractions), which propagated aborally at 1.05 ± 0.13 mm/s and orally at 1.07 ± 0.09 mm/s. These consisted of two to eight phasic contractions that aligned with ripples. These motor patterns were abolished by addition of lidocaine (0.3 mM). The ripples continued unchanged in the presence of this neural blocking agent. These results demonstrate that both myogenic and neurogenic motor patterns can be studied in isolated specimens of human small intestine.


Asunto(s)
Sistema Nervioso Entérico/fisiología , Motilidad Gastrointestinal , Íleon/inervación , Contracción Muscular , Músculo Liso/inervación , Anciano , Anciano de 80 o más Años , Anestésicos Locales/farmacología , Catéteres , Sistema Nervioso Entérico/efectos de los fármacos , Femenino , Tecnología de Fibra Óptica , Motilidad Gastrointestinal/efectos de los fármacos , Humanos , Técnicas In Vitro , Lidocaína/farmacología , Masculino , Manometría/instrumentación , Persona de Mediana Edad , Contracción Muscular/efectos de los fármacos , Músculo Liso/efectos de los fármacos , Presión , Factores de Tiempo , Transductores de Presión , Grabación en Video
15.
Front Neurosci ; 8: 75, 2014.
Artículo en Inglés | MEDLINE | ID: mdl-24795551

RESUMEN

Propulsive contractions of circular muscle are largely responsible for the movements of content along the digestive tract. Mechanical and electrophysiological recordings of isolated colonic circular muscle have demonstrated that localized distension activates ascending and descending interneuronal pathways, evoking contraction orally and relaxation anally. These polarized enteric reflex pathways can theoretically be sequentially activated by the mechanical stimulation of the advancing contents. Here, we test the hypothesis that initiation and propagation of peristaltic contractions involves a neuromechanical loop; that is an initial gut distension activates local and oral reflex contraction and anal reflex relaxation, the subsequent movement of content then acts as new mechanical stimulus triggering sequentially reflex contractions/relaxations at each point of the gut resulting in a propulsive peristaltic contraction. In fluid filled isolated rabbit distal colon, we combined spatiotemporal mapping of gut diameter and intraluminal pressure with a new analytical method, allowing us to identify when and where active (neurally-driven) contraction or relaxation occurs. Our data indicate that gut dilation is associated with propagating peristaltic contractions, and that the associated level of dilation is greater than that preceding non-propagating contractions (2.7 ± 1.4 mm vs. 1.6 ± 1.2 mm; P < 0.0001). These propagating contractions lead to the formation of boluses that are propelled by oral active neurally driven contractions. The propelled boluses also activate neurally driven anal relaxations, in a diameter dependent manner. These data support the hypothesis that neural peristalsis is the consequence of the activation of a functional loop involving mechanical dilation which activates polarized enteric circuits. These produce propulsion of the bolus which activates further anally, polarized enteric circuits by distension, thus closing the neuromechanical loop.

16.
Front Syst Neurosci ; 7: 7, 2013.
Artículo en Inglés | MEDLINE | ID: mdl-23596400

RESUMEN

Excitatory and inhibitory enteric neural input to intestinal muscle acting on ongoing myogenic activity determines the rich repertoire of motor patterns involved in digestive function. The enteric neural activity cannot yet be established during movement of intact intestine in vivo or in vitro. We propose the hypothesis that is possible to deduce indirectly, but reliably, the state of activation of the enteric neural input to the muscle from measurements of the mechanical state of the intestinal muscle. The fundamental biomechanical model on which our hypothesis is based is the "three-element model" proposed by Hill. Our strategy is based on simultaneous video recording of changes in diameters and intraluminal pressure with a fiber-optic manometry in isolated segments of rabbit colon. We created a composite spatiotemporal map (DPMap) from diameter (DMap) and pressure changes (PMaps). In this composite map rhythmic myogenic motor patterns can readily be distinguished from the distension induced neural peristaltic contractions. Plotting the diameter changes against corresponding pressure changes at each location of the segment, generates "orbits" that represent the state of the muscle according to its ability to contract or relax actively or undergoing passive changes. With a software developed in MatLab, we identified twelve possible discrete mechanical states and plotted them showing where the intestine actively contracted and relaxed isometrically, auxotonically or isotonically, as well as where passive changes occurred or was quiescent. Clustering all discrete active contractions and relaxations states generated for the first time a spatio-temporal map of where enteric excitatory and inhibitory neural input to the muscle occurs during physiological movements. Recording internal diameter by an impedance probe proved equivalent to measuring external diameter, making possible to further develop similar strategy in vivo and humans.

17.
J Biophotonics ; 4(4): 244-51, 2011 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-20575106

RESUMEN

Diagnostic catheters based on fibre Bragg gratings (FBG's) are proving to be highly effective for measurement of the muscular activity associated with motility in the human gut. While the primary muscular contractions that generate peristalsis are circumferential in nature, it has long been known that there is also a component of longitudinal contractility present, acting in harmony with the circumferential component to improve the overall efficiency of material movement. We report the detection of longitudinal motion in mammalian intestine using an FBG technique that should be viable for similar detection in humans. The longitudinal sensors have been combined with our previously reported FBG pressure sensing elements to form a composite catheter that allows the relative phase between the two components to be detected. The catheter output has been validated using video mapping in an ex-vivo rabbit ileum preparation.


Asunto(s)
Catéteres , Tecnología de Fibra Óptica/métodos , Motilidad Gastrointestinal , Tracto Gastrointestinal/patología , Contracción Muscular , Animales , Tecnología de Fibra Óptica/instrumentación , Tracto Gastrointestinal/metabolismo , Masculino , Conejos , Sensibilidad y Especificidad , Factores de Tiempo
18.
Opt Express ; 17(25): 22423-31, 2009 Dec 07.
Artículo en Inglés | MEDLINE | ID: mdl-20052166

RESUMEN

The design of a fibre Bragg grating based manometry catheter for in-vivo diagnostics in the human colon is presented. The design is based on a device initially developed for use in the oesophagus, but in this instance, longer sensing lengths and increased flexibility were required to facilitate colonoscopic placement of the device and to allow access to the convoluted regions of this complex organ. The catheter design adopted allows the number of sensing regions to be increased to cover extended lengths of the colon whilst maintaining high flexibility and the close axial spacing necessary to accurately record pertinent features of peristalsis. Catheters with 72 sensing regions with an axial spacing of 1 cm have been assembled and used in-vivo to record peristaltic contractions in the human colon over a 24hr period. The close axial spacing of the pressure sensors has, for the first time, identified the complex nature of propagating sequences in both antegrade (towards the anus) and retrograde (away from the anus) directions in the colon. The potential to miss propagating sequences at wider sensor spacings is discussed and the resultant need for close axial spacing of sensors is proposed.


Asunto(s)
Cateterismo , Colon/fisiopatología , Estreñimiento/diagnóstico , Estreñimiento/fisiopatología , Tecnología de Fibra Óptica/instrumentación , Manometría/instrumentación , Transductores , Diseño Asistido por Computadora , Diseño de Equipo , Análisis de Falla de Equipo , Femenino , Humanos , Presión , Refractometría/instrumentación , Reproducibilidad de los Resultados , Sensibilidad y Especificidad
19.
Appl Opt ; 46(25): 6375-80, 2007 Sep 01.
Artículo en Inglés | MEDLINE | ID: mdl-17805377

RESUMEN

A technique for correction of optical surfaces has recently been reported. The technique involves oscillating an optical surface back and forth behind a multiaperture mask to deposit a spatially varying dielectric layer onto the optic to create the desired surface profile. Details are reported of a modified mask design that inherently smooths the deposited layer used for these corrections. Results are also reported with regard to a recent correction that resulted in a thickness uniformity of better than lambda/2000 rms over a working aperture of 37.5 mm.

20.
Appl Opt ; 46(15): 2863-9, 2007 May 20.
Artículo en Inglés | MEDLINE | ID: mdl-17514231

RESUMEN

The resolution of an angle-scanning technique for measuring transparent optical wafers is analyzed, and it is shown both theoretically and experimentally that subnanometer resolution can be readily achieved. Data are acquired simultaneously over the whole area of the wafer, producing two-dimensional thickness variation maps in as little as 10 s. Repeatabilities of 0.07 nm have been demonstrated, and wafers of up to 100 mm diameter have been measured, with 1 mm or better spatial resolution. A technique for compensating wafer and system aberrations is incorporated and analyzed.

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