RESUMO
The aim of this study was to obtain detailed information regarding the three-dimensional structure of the gastro-oesophageal region, and, in particular, the fiber orientation of the different muscle layers of the junction. This was achieved by a study of an en bloc resection of the gastro-oesophageal junction (GOJ) harvested from a human cadaver. The excised tissue block was suspended in a cage to preserve anatomical relationships, fixed in formalin and embedded in wax. The tissue block was then processed by a custom-built extended-volume imaging system to obtain the microstructural information using a digital camera which acquires images at a resolution of 8.2 microm/pixel. The top surface of the tissue block was sequentially stained and imaged. At each step, the imaged surface was milled off at a depth of 50 microm. The processing of the tissue block resulted in 650 images covering a length of 32.25 mm of the GOJ. Structures, including the different muscle and fascial layers, were then traced out from the cross-sectional images using color thresholding. The traced regions were then aligned and assembled to provide a three-dimensional representation of the GOJ. The result is the detailed three-dimensional microstructural anatomy of the GOJ represented in a new way. The next stage will be to integrate key physiological events, including peristalsis and relaxation, into this model using mathematical modeling to allow accurate visual tools for training health professionals and patients.
Assuntos
Junção Esofagogástrica/ultraestrutura , Humanos , Imageamento Tridimensional , Masculino , Adulto JovemRESUMO
Between 60 and 70 million people in the United States are affected by gastrointestinal disorders. Many of these conditions are difficult to assess without surgical intervention and accurate noninvasive techniques to aid in clinical assessment are needed. Through the use of a superconducting quantum interference device (SQUID) gradiometer, the weak magnetic field generated as a result of muscular activity in the digestive system can be measured. However, the interpretation of these magnetic recordings remains a significant challenge. We have created an anatomically realistic biophysically based mathematical model of the human digestive system and using this model normal gastric electrical control activity (ECA) has been simulated. The external magnetic fields associated with this gastric ECA have also been computed and are shown to be in qualitative agreement with recordings taken from normal individuals. The model framework thus provides a rational basis from which to begin interpreting magnetic recordings from normal and diseased individuals.
Assuntos
Fenômenos Fisiológicos do Sistema Digestório , Campos Eletromagnéticos , Gastroenteropatias/diagnóstico , Modelos Anatômicos , Eletrofisiologia , Humanos , Valores de ReferênciaRESUMO
The aim of this study was to combine the anatomy and physiology of the human gastroesophageal junction (the junction between the esophagus and the stomach) into a unified computer model. A three-dimensional (3D) computer model of the gastroesophageal junction was created using cross-sectional images from a human cadaver. The governing equations of finite deformation elasticity were incorporated into the 3D model. The model was used to predict the intraluminal pressure values (pressure inside the junction) due to the muscle contraction of the gastroesophageal junction and the effects of the surrounding structures. The intraluminal pressure results obtained from the 3D model were consistent with experimental values available in the literature. The model was also used to examine the independent roles of each muscle layer (circular and longitudinal) of the gastroesophageal junction by contracting them separately. Results showed that the intraluminal pressure values predicted by the model were primarily due to the contraction of the circular muscle layer. If the circular muscle layer was quiescent, the contraction of the longitudinal muscle layer resulted in an expansion of the junction. In conclusion, the model provided reliable predictions of the intraluminal pressure values during the contraction of a normal gastroesophageal junction. The model also provided a framework to examine the role of each muscle layer during the contraction of the gastroesophageal junction.
Assuntos
Junção Esofagogástrica/anatomia & histologia , Fenômenos Biomecânicos , Cadáver , Simulação por Computador , Elasticidade , Junção Esofagogástrica/fisiopatologia , Esôfago/anatomia & histologia , Humanos , Imageamento Tridimensional , Imageamento por Ressonância Magnética/métodos , Modelos Anatômicos , Contração Muscular , Músculos/anatomia & histologia , Músculos/patologia , Pressão , Software , Tomografia Computadorizada por Raios XRESUMO
In this study the construction of an initial three-dimensional anatomically based mathematical model of the esophagus is presented. The aim of this model is to provide a framework with which to examine the functional behavior of the esophagus and the lower esophageal sphincter during swallowing. Anatomical data from the Visible Human Project was used to provide the outlines of the regions of interest. A C/sup 1/ continuous cubic Hermite finite element mesh was then created using an iterative finite element linear fitting process to an RMS error less than 1 mm. Muscular fiber information was embedded within the model using data from published literature. There is a current lack of detailed microstructural data on the gastroesophageal junction. We describe the specialist measurement rig that we propose to use to obtain the microstructural information in our experimental studies.