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  • 1
    Electronic Resource
    Electronic Resource
    Springer
    Pediatric surgery international 5 (1990), S. 106-109 
    ISSN: 1437-9813
    Keywords: Lower esophageal sphincter ; Gastroesophageal junction ; Esophageal manometry ; Experimental study
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract An important controversy exists concerning the adaptive capacity of the lower esophageal sphincter (LES) in response to increases in intragastric pressure. This capacity would characterize the LES as a dynamic element in preventing gastroesophageal reflux (GER). This physiological property was studied in 15 male cats using an experimental model in which the gastroesophageal antireflux barrier was generated eyclusively by the intrinsic tone of the LES. Under these conditions, the intragastric pressure (GP) and sphincter pressure (LESP) were measured by electromanometric procedures. When the gastric lumen was perfused with known volumes (25, 50, 75, 100, 125, 150 ml) of saline solution, increases in GP and LESP were observed. Both pressures increased slowly as the gastric volume rose, and when both values were equal, GER appeared. Studying the physiological properties of the LES by direct methods in this model, we conclude that (a) there is segmental pressure response of the LES when faced with direct opening stimulation such as an increase in GP; and (b) the increase in LES resting tone has a linear relation with the increase in GP.
    Type of Medium: Electronic Resource
    Library Location Call Number Volume/Issue/Year Availability
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  • 2
    Electronic Resource
    Electronic Resource
    Springer
    Pediatric surgery international 1 (1986), S. 172-176 
    ISSN: 1437-9813
    Keywords: Lower esophageal sphincter ; Esophageal manometry ; Gastroesophageal junction LES competence
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The high pressure zone (HPZ) is a result of a series of combative forces that converge in the gastroesophageal junction and contribute to generate the pressure barrier. Recognized factors in this function are the positive intra-abdominal pressure transmitted to the lower esophagus, thoracic suction, the diaphragmatic hiatus, the intrinsic lower esophageal sphincter, and the effect of gastric fundus acting on the distal esophagus through the His angle. The exclusive and quantitative role of the His angle is evaluated with the help of two experimental models (in vivo and in vitro) in the dog. By manometric procedures the gastric pressure at which the sphincter opens (OP) is studied under overloaded conditions, both in the living animal and in a gastroesophageal specimen, varying the His angle from 90° to 0°. In the “in vivo” model the pressure of the barrier with a His angle of 90° was 7.33 ± 3.4 mm Hg and the OP of 8.66 +- 4.1 mm Hg, while with the His angle at 0° the pressure of this barrier was 10.66 +- 2.9 mm Hg and the OP 16 +- 6.9 mm Hg (p 〈 0.05). In the “in vitro” model the His angle at 0° multiplied the OP two or three times. We conclude that the His angle at 0° allows transmission of the fundic pressure extrinsically to the sphincter, giving way to a higher OP, and increasing the degree of competence.
    Type of Medium: Electronic Resource
    Library Location Call Number Volume/Issue/Year Availability
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