Pressure-Cross-Sectional Area Relations and Elasticity in the Rabbit Oesophagus in vivo

Gregersen, Hans; Christensen, L.L.

doi:10.1159/000201333

Cited by 9 publications

(4 citation statements)

References 21 publications

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“…There was no saliva or food retention. The patient was previously dilated three times (8,9, and 11 mo before investigation), with transient (1-2 wk) effect. Patient 2 was a man aged 60 yr with a lower esophageal sphincter pressure 41 mmHg (55 cmH 2O) before dilation and incomplete relaxation of the sphincter upon swallowing.…”

Section: Methodsmentioning

confidence: 99%

The functional lumen imaging probe (FLIP) for evaluation of the esophagogastric junction

McMahon

Frøkjær²,

Kunwald³

et al. 2007

American Journal of Physiology-Gastrointestinal and Liver Physi

134

136

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P, Drewes AM, Gregersen H. The functional lumen imaging probe (FLIP) for evaluation of the esophagogastric junction. Am J Physiol Gastrointest Liver Physiol 292: G377-G384, 2007. First published August 31, 2006; doi:10.1152/ajpgi.00311.2006.-There is a need for new methods to study the dynamics of the esophagogastric junction (EGJ). The aims were to verify the efficacy and usefulness of a "functional lumen imaging probe" (FLIP) for the evaluation of the EGJ. Eight healthy volunteers (6 men), median age 26 (21-35) yr, and two achalasia patients underwent the FLIP procedure. The EGJ was located by manometry. The FLIP measured eight cross-sectional areas (CSAs) 4 mm apart together with the pressure inside a saline-filled cylindrical bag. The data showed the geometric profile of the EGJ reconstructed in a video animation of its dynamic activity. A plot of curve-fitted data for the smallest CSA vs. pressure after balloon distension indicated that the pressure increased from 18 cmH 2O at a CSA of 38 mm 2 to a pressure of 37 cmH2O at a CSA of 230 mm 2 for the healthy controls. In one achalasia patient (unsuccessfully treated with dilations), the CSA never rose above the minimal measurable value despite the pressure increasing to 50 cmH2O. In another achalasia patient (successfully treated with dilations), the pressure only reached 15 cmH2O despite opening to a CSA of 250 mm 2 . In conclusion, FLIP represents the first dynamic technique to profile the function and anatomy of the EGJ. The method can be used practically to evaluate difficult cases of EGJ dysfunction and may provide a role in evaluating patients before and after therapies for diseases affecting the EGJ such as achalasia and gastroesophageal reflux disease. esophagus; competence; distensibility; cross-sectional area; functional imaging THE LOWER ESOPHAGEAL SPHINCTER (LES) is not solely responsible for impeding the flow between the esophagus and the stomach. The crural diaphragm encircles ϳ2 cm of the esophagogastric junction (EGJ), and the sling or oblique fibers of the stomach also contribute to the mechanism (15, 21). Esophageal and gastric motility, pressures in the abdominal and thoracic cavities, and the exact location of the EGJ all play a role in defining its function. The anatomy and behavior of the EGJ also change with time and body posture (20). The EGJ is a very dynamic mechanical structure. A lot of knowledge about the anatomy of the EGJ has been assembled over the last 40 years, but much of our limited understanding of the behavior has been related to manometric studies. Intraluminal pressure recording is the current gold standard for determining the motility characteristics of the esophagus. Although manometry provides useful information on the location of the EGJ and on phasic motility within the lumens of the digestive tract, it may be more restrictive in what it can tell us about sphincteric regions and their dynamics.Two classic diseases involving the EGJ are gastroesophageal reflux disease (GERD) and achalasia. Achalasia is an esophageal ...

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Section: Methodsmentioning

confidence: 99%

The functional lumen imaging probe (FLIP) for evaluation of the esophagogastric junction

McMahon

Frøkjær²,

Kunwald³

et al. 2007

American Journal of Physiology-Gastrointestinal and Liver Physi

134

136

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“…Research on passive biomechanical properties for soft tissues with tube shape is mainly used in elongated and inflated tests in two dimensions (Petersen et al 1999, Gregersen andChristensen 1996). Few tests of torque have been used for this purpose, but the torque test is extremely necessary to understand such tissues as the gastrointestinal tract and blood vessels, which have nonlinear and anisotropic properties.…”

Section: Discussionmentioning

confidence: 99%

Torque properties of a rat oesophagus for physiological and diabetic conditions

Zeng¹,

Qiao²,

Yang³

et al. 2004

Physiol. Meas.

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In this paper the torque of an oesophagus is studied for physiological and diabetic conditions. Since the function of the oesophagus is mainly mechanical, this work is focused on providing quantitative measurement of the passive biomechanical properties of the oesophagus torque. The oesophagus was treated as a membrane when calculating the stress and strain. The torque versus twist-angle relation was approximated to be linear at a specified pressure and longitudinal stretch ratio. Thus, the shear modulus can be computed by the torque, twist angle and polar moment of inertia in this state. The shear modulus varies greatly with the changing inflation pressure and longitudinal stretch ratio. When the longitudinal stretch ratio or transmural pressure is constant, the shear modulus is increased after 28 days of diabetes.

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“…Significant research related to the Esophagiome has been published by many interdisciplinary groups; however, much of this mechanics‐ and modeling‐based research has not yet been integrated into the GI clinical sciences, where the greatest potential impact might be realized. The Esophagiome remains in its infancy in a community that is dominated by applied clinicians and biological scientists.…”

Section: The Physiome and The Esophagiomementioning

confidence: 99%

The Esophagiome: concept, status, and future perspectives

Gregersen

Liao

Brasseur

2016

Annals of the New York Academy of Sciences

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The term "Esophagiome" is meant to imply a holistic, multiscale treatment of esophageal function from cellular and muscle physiology to the mechanical responses that transport and mix fluid contents. The development and application of multiscale mathematical models of esophageal function are central to the Esophagiome concept. These model elements underlie the development of a "virtual esophagus" modeling framework to characterize and analyze function and disease by quantitatively contrasting normal and pathophysiological function. Functional models incorporate anatomical details with sensory-motor properties and functional responses, especially related to biomechanical functions, such as bolus transport and gastrointestinal fluid mixing. This brief review provides insight into Esophagiome research. Future advanced models can provide predictive evaluations of the therapeutic consequences of surgical and endoscopic treatments and will aim to facilitate clinical diagnostics and treatment.

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Pressure-Cross-Sectional Area Relations and Elasticity in the Rabbit Oesophagus in vivo

Cited by 9 publications

References 21 publications

The functional lumen imaging probe (FLIP) for evaluation of the esophagogastric junction

The functional lumen imaging probe (FLIP) for evaluation of the esophagogastric junction

Torque properties of a rat oesophagus for physiological and diabetic conditions

The Esophagiome: concept, status, and future perspectives

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