Oddi括约肌运动调节与功能障碍的诊断和治疗

Odd i括约肌(SO)是位于胆管、胰管和十二指肠结合部位的神经肌肉复合体,是胆汁和胰液的最终流出道。SO由胆总管括约肌、胰管括约肌、壶腹部括约肌和纵肌束组成。测压结果表明SO的运动是一个动态的周期性变化过程,存在一种主动收缩波称为蠕动波,起源于胆总管下端,收缩时将胆汁排入十二指肠,舒张时胆汁流入括约肌管内。1 O dd i括约肌的运动调节1.1神经调节SO中有α、β肾上腺素能和胆碱能受体。α受体和胆碱能受体介导SO收缩,β受体介导SO舒张。支配SO括约肌的胆碱能和肾上腺素能神经将中枢神经系统与存在于SO肌层间的以及其表面的肠…     

Oddi括约肌同步测压与肌电记录的新方法

目的设计一种新的适用于壁内型Oddi括约肌（SO）同步测压与肌电记录的黏膜接触电极。方法分别将家兔和犬麻醉后，打开十二指肠大乳头对侧的十二指肠对系膜缘，同时使用浆膜钩状电极和黏膜接触电极记录家兔SO的肌电活动，比较二者记录的肌电波；用自制黏膜接触电极进一步检测犬SO的肌电活动，比较SO肌电活动和压力波之间的相关性。结果黏膜接触电极和浆膜钩状电极记录到的家兔SO肌电活动的波形较为一致。黏膜接触电极准确记录到犬SO的快波和慢波，SO的肌电活动与压力波之间具有一一对应的关系。结论黏膜接触电极能够同步记录壁内型SO的肌电和压力，SO的快波是SO周期性收缩的电生理基础。     

电刺激耳穴对兔奥狄氏括约肌电活动作用及机制研究

用针型电极插入健康家兔奥狄氏括约肌(SO)记录电活动。以兔耳廓血管标志选择刺激区测出真低电阻点作为刺激点。术后,动物稳定半小时,记录对照组SO电活动10分钟。第一组14只作迷走神经切断。第二组15只给阿托品以阻断受体。记录对照组SO电活动后,刺激耳穴10分,再记SO电活动;作迷切后记SO电活动10分。静脉注射阿托品观察SO电活动改变在阿托品背景下,刺激耳穴的效应。     

正常儿童肛门外括约肌肌电图研究

笔者采用表面电极对216名正常儿童作了肛门外括约肌肌电图,连续观察了(肛门外括约肌在静止、刺激和自主收缩状态的)肌电活动。用针刺肛周皮肤和自主收缩时,观察肌电活动的波幅和频率变化,发现随着年龄的增加,肌电活动逐渐增强,肛门右侧波幅高于后侧。肌电图观察结果表明:肛门外括约肌的发育程度在控制排便过程中起重要作用。     

人体奥狄氏括约肌肌电记录

12名志愿者(女11人,男1人)10人确诊为胆囊结石、2人为胆囊结石合并胆总管结石,在持续硬脊膜外麻醉下进行无菌手术。自制电极引导奥狄氏括约肌(SO)肌电信号,同步记录十二指肠肌电活动。(肌电信号一路引入Narcatrace-40四导生理仪(U、S、A)笔描,信号进入通用耦联单元,功能选择FMC、放大倍数100倍,高频滤波30或100Hz,时间常数0.3秒,定标电压1mv=10mm、纸速5mm/sec。实验表明人体SO     

2.110 MMC与胆道运动相互关系的实验研究

目的观察MMC变化对GB、SO运动的影响,探讨MMC与胆道运动的相互关系及二者之间的相互调节作用.进一步阐明MMC的发生机制.探讨胆道运动障碍的病理生理基础 ,并期望能为胆石症的防治提供理论依据.方法 1.分组选取健康成年豚鼠60只,体重450～600g,随机分为4组(1 )对照组(A组),n=15,胃内注入生理盐水(0.15mg/100g);(2)盐酸组(B组),n=15,胃内注入pH=1.5的盐酸(0.15mg/100g);(3)普卡比利组(C组),n=15,胃内注入普卡比利(0.01m g/100g);(4)地巴唑组(D组),n=15,胃内注入地巴唑(0.6mg/100g).2.方法于胃窦、距幽门5cm、10cm的十二指肠壁、GB壁、SO 5处,缝置银丝电极,电极末端通过屏蔽线接八导生理记录仪.实验记录生理状态下肌电活动4h.4h后,于MMC Ⅲ相结束后10min,通过胃管分别给A、B、C、D 4组动物灌入相应药物,之后再记录4h.结果 1.动物空腹状态下胃MMC 84个,十二指肠MMC各102年,SO周期性活动 102个,GB发生成族高振幅峰电活动81组.102次十二指肠MMC中,89次为推进性蠕动(87.25 %).2. A组动物给药后,各项指标无明显改变(P＞0.05);B组动物给药后,周期性运动消失;C组动物给药后,周期性运动变为持续性运动,胃、GB最大频率无显著性变化(P ＞0.05),十二指肠、SO处最大频率明显高于给药前(P＜0.05),各处最大振幅均显著高于给药前(P＜0.05);D组动物给药后,各处仍呈周期性活动,总时限延长(P ＜0.05),最大活动期频率、最大振幅明显低于给药前(P＜0.05),最大活动期时限无改变(P＞0.05).结论胃肠MMC与GB、SO运动各期时限、运动强度存在直线相关性,说明胃肠 MMC和胆道运动之间存在协调一致的关系.     

电针穴位及电刺激尾状核头部对髓一开颌反射的影响

本实验选用家兔14支,体重2公斤左右,性别不论。在完全清醒、活动受到部份限制的情况下,电刺激牙髓记录下颌二腹肌前腹的肌电活动,作为开颌反射痛反应的客观指标。从实验观察可见,电刺激牙髓诱发的二腹肌肌电活动的样式有双相和多相两类。其潜伏期约5     

刺激家兔面神经核腹内侧区对颏舌肌肌电活动的抑制效应

本研究在 2 6只氨基甲酸乙酯麻醉、断双侧迷走神经的健康成年家兔上观察了电、化学刺激面神经核腹内侧区 (vMNF)对颏舌肌肌电活动的影响。结果如下 :(1)长串电脉冲刺激vMNF导致颏舌肌肌电活动明显被抑制 ;(2 )在vMNF内微量注射谷氨酸钠 ,颏舌肌肌电活动出现明显的抑制效应 ;(3)单脉冲电刺激vMNF引起颏舌肌抑制反应的潜伏期为 (2 0 6± 0 4)ms。结果表明 :vMNF的兴奋能降低颏舌肌的肌电活动 ,从而提示其具有增强上呼吸道阻力的作用。     

胃动素、熊去氧胆酸对大鼠胃肠消化间期移行性复合运动的调节

目的　在大鼠清醒、空腹、自由活动的生理状态下 ,分别观察胃动素和熊去氧胆酸等药物对大鼠MMC的影响 ,初步探讨它们在小肠MMC的产生和调节中的作用。方法　 2 4只SD大鼠 ,雌雄不拘 ,6～ 8周龄 ,体重 2 0 0～ 2 5 0克。实验前 1周禁食 16小时后 ,开腹将内包银丝的电机线埋置于胃窦、十二指肠、空肠浆肌层 ,电机线通过皮下隧道由大鼠颈背部引出并固定。术后 7天禁食 16小时后 ,在大鼠清醒、空腹、自由活动的情况下 ,将电机线体外端与多导生理记录仪连接 ,记录胃肠肌电活动。分别给予胃动素静脉注射和熊去氧胆酸灌胃 ,给药前先记录一小时…     

溴甲烷中毒家兔脑电地形图变化研究

探讨溴甲烷对中枢神经系统电生理学的影响。健康成年家兔24只,采用呼吸道吸入法制成急性溴甲烷中毒模型。观察中毒后家兔脑电地形图的变化,与正常对照组相比较,染毒兔的脑电活动明显抑制,脑波慢化且呈弥漫性。脑电地形图表现为δ.θ段功率值明显增高(P<0.01),而反应大脑皮层兴奋过程的β频段功率值则明显降低(P>0.05),α频段染毒前后功率值无明显变化(P<0.05)。结论:溴甲烷对中枢神经系统具有一定的毒性作用。可明显抑制大脑皮层的生物电活动,从而影响脑的高级功能。     

Characteristics of fasting and fed myoelectric activity in rat small intestine: evaluation by computer analysis

Evaluation of gastrointestinal myoelectric activity has been limited by the assessment techniques and the complexity of the recorded myoelectric signal. Commonly, myoelectric activity is evaluated as motor patterns, which only gives a semiquantitative measure of myoelectric events within the bowel wall. Using myoelectric recordings from the proximal small intestine in rats, a computerized system for acquisition, storage, display and calculation of characteristics for the myoelectric activity was developed. The software was tested in myoelectric recordings from nine rats in fasting and fed states. All migrating myoelectric complexes (MMCs) during fasting and fed myoelectric patterns were recognized in both digital and analog recordings. Reproduction of myoelectric recordings by the computerized system was indistinguishable from that of the analog system. Employing an appropriate cut-off trigger level and a high sampling frequency, spike potentials were recorded in the proximal jejunum with 0.4 (0.3–0.5) spikes 10 s^-1 during phase 1 of MMC, 19.5 (15.1–23.9) (P<0.001) during phase 2, and 103.8 (97.2–110.5) (P<0.001) during phase 3. In fasted state, MMCs were most frequent in the proximal jejunum whereas fewer were found in the duodenum and distal jejunum. To achieve stable values for MMC cycle length at least four MMCs had to be calculated. After feeding in phase 1, the myoelectric activity increased to 23.8 (13.6–33.9) spikes 10 s^-1 (P< 0.001), whereafter the spiking activity decreased over a period of 2 h until a fasting motor pattern was resumed. It is concluded that computerized technology enables evaluation not only of myoelectric patterns, but also of spiking activity per time unit, i.e. the intensity of myoelectric activity in the gut.     

Sequential changes in the expression of genes involved in lipid metabolism in adipose tissue and liver in response to fasting

The aim of this study was to provide a sequential analysis of the expression patterns of key genes involved in lipid metabolism in white adipose tissue (WAT) and liver and their relationship with blood parameters in response to fasting. Adult male rats were studied under different feeding conditions: feeding state, after 4, 8, or 24 h fasting, and after 3 h refeeding after 8 h fasting. Blood parameters and the expression of genes involved in lipogenesis and lipolysis in WAT and liver were analyzed. mRNA levels of genes involved in lipogenesis in liver (SREBP1c, FAS, and GPAT) had already decreased after 4 h fasting, as well as those of PPARgamma in WAT, whereas the decrease in SREBP1c, FAS, GPAT, and GLUT4 mRNA levels in WAT was observed after 8 h. Concerning lipolytic and fatty-acid-oxidation-related genes, liver PPARalpha, FGF21, CPT1, and PDK4 mRNA levels increased after 8 h fasting and those of ACOX1 after 24 h, and in WAT, ATGL, and CPT1 mRNA levels were greater after 24 h. Three hours refeeding increased the expression levels of PPARgamma in WAT, SREBP1c in both liver and WAT, and GPAT in liver, and decreased the expression levels of PPARalpha, CPT1, and PDK4 in liver. These results give new insight into the different adaptive time course response to fasting in the expression of genes involved in lipid metabolism, thus pointing out the very rapid response of lipogenic genes, particularly in liver, and the later response of lipolytic genes, particularly in WAT.     

Feedback of the magnesium ion on the parathyroid hormone: differences in the action of magnesium sulfate and pyrrolidone carboxylate

Fourty-five minutes after an intravenous injection of Mg SO4 (170 mg of element Mg), in 7 young and healthy men, a significant decrease in circulating 53-84 PTH has been observed. An injection of magnesium pyrrolidone carboxylate (170 mg of Mg) failed to induce changes in plasma levels of PTH. The urinary excretion of Mg was 2-fold higher after the injection of Mg SO4 than after the injection of magnesium pyrrolidone carboxylate. For both magnesium salts used, the time patterns of plasma magnesium concentrations were the same and red blood cells magnesium was not increased. These results suggest that, in our experimental conditions, the retention of magnesium was higher after magnesium pyrrolidone carboxylate than after Mg SO4 and that the drop in plasma PTH could partly explain the larger urinary excretion of magnesium after Mg SO4.     

Effect of motilin on the opossum upper gastrointestinal tract and sphincter of Oddi

We studied the effect of motilin on myoelectric activity of the sphincter of Oddi (SO) and upper gastrointestinal tract in conscious opposums. In 17 animals, bipolar electrodes were implanted on the gastric antrum, SO, duodenum, and jejunum. Subsequent 8-h recordings reconfirmed our previous findings that SO spike burst rate changed with interdigestive cycles of the gastrointestinal migrating myoelectric complex (MMC), becoming maximal during passage of phase III activity through the duodenum. In eight animals, peak motilin levels were shown to occur concurrently with maximal SO spike burst rate and MMC phase III activity in the duodenum. Motilin infusion (0.3 and 0.9 micrograms X kg-1 X h-1), given for 30-60 min starting 10 min after duodenal phase III, elicited premature MMC activity that originated in the stomach. Maximal SO activity occurred coincident with passage of premature phase III activity through the duodenum. Pulse intravenous doses of motilin (25-1,600 ng/kg) generally caused an immediate increase in spike burst activity in the gastric antrum, duodenum, and SO that lasted 3-5 min and was often followed by a premature MMC, usually starting in the antrum and progressing through the duodenum and jejunum. Increases in SO spike burst rate also occurred concurrent with motilin-induced, premature duodenal phase III. Motilin given at 5-60% of the duodenal MMC cycle length elicited premature MMCs at 10-60% of the cycle, but no premature MMCs were elicited by any of the motilin doses at the 5% intervals.(ABSTRACT TRUNCATED AT 250 WORDS)     

Pharmacokinetics of ciprofloxacin after intravenous and increasing oral doses

The pharmacokinetics of ciprofloxacin were evaluated after increasing single oral doses of 100, 250, 500 and 1000 mg, and an intravenous dose of 100 mg given to each of 12 healthy volunteers (6 females and 6 males). Concentrations in serum and urine were determined by microbiological assay. The rise in peak serum concentrations and the values of the total area under the serum concentration curve were proportional to the increase in the oral doses. As the oral dose increased a slight increase was observed in the apparent time lag before absorption from 0.34 h after 100 mg to 0.53 h after 1000 mg. The serum half-life after the intravenous dose was 3.2 h. After the oral doses shorter apparent half-life values were observed. The intravenous dose showed an elimination phase distribution volume of 2.76 l/kg and total body clearance of 40.7 l/h. The total urinary excretion was 42.2±15.6% of the dose after the intravenous dose; the figure was lower after the oral doses. The bioavailability of the 100 mg oral dose was 83.7% as calculated from the value of the total area under the serum curve after the same oral and intravenous dose in all 12 subjects. Ciprofloxacin thus demonstrates normal linear pharmacokinetics, the rise in serum concentrations being proportional to the dose.     

Role of serotoninergic structures in coordination of electric activity in the gastroduodenal complex

Myoelectric activity in various portions of the stomach and duodenum in normal and after vagotomy and intravenous injection of serotonin adipinate was studied in acute experiments on cats. Vagotomy disturbed coordination of myoelectric activity in the stomach and duodenum. Intravenous injection of serotonin adipinate restored coordination and increased myoelectric activity in the stomach, particularly, in the pylorus. Under these conditions the pacemaker of myoelectric activity in the gastric corpus and autonomic regulation of the duodenum were preserved. Intravenous injection of serotonin adipinate most significantly changed myoelectric activity in the pylorus. Myoelectric activity in the cardia increased after vagotomy against the background of serotonin adipinate. Our findings suggest that serotoninergic structures maintain functional heterogeneity of digestive organs and coordinate their interrelationships.     

Clinical application of EEG topography in cerebral ischemia: Detection of functional reversibility and hemodynamics.

To detect the functional reversibility and hemodynamic process in cerebral ischemia, the EEG topography cased on % time and amplitude was applied. % time and amplitude were obtained by the wave-form recognition method/EEGs were recorded under the resting state and during drug-induced conditions in 18 patients with steno-occlusion of main cerebral artery. The type of ischemic attack was TIA in 2 patients, RIND in 4, minor stroke in 7 and major stroke in 5. Six of 11 patients showed the improvement of EEG under induced hypertension. Four of those 6 patients were operated on ECIC bypass surgery, and all of them showed the improvement of clinical and EEG findings postoperatively. Twelve patients showed the deterioration of EEG under induced hypotension. Eight of them were operated on ECIC bypass surgery, and none of them suffered from reattack of cerebral ischemia postoperatively. Those preoperative EEG changes were observed mainly on the EEG topography of % time. And, the analysis of the EEG topography of % time under drug-induced conditions was available to study the pathophysiology of cerebral ischemia for selecting the suitable treatment.     

Pharmacokinetics of ciprofloxacin in healthy volunteers after oral and intravenous administration

The pharmacokinetics of ciprofloxacin was studied in three groups of healthy volunteers comprising a total of 16 males and 16 females (age 21–35 years; body weight 52–80 kg). Single oral doses of 50, 100, 250, 500 and 750 mg were given to fasting subjects. The 250 mg dose was repeated after a breakfast. Intravenous doses of 50, 100 and 200 mg were given by short infusion in a randomized cross-over sequence. Concentrations of the drug in serum and urine were determined by high-performance liquid chromatography and by a microbiological assay. Mean peak concentrations between 0.37±0.49 mg/l (100 mg dose) and 1.97±0.50 (750 mg dose) were measured 60–75 min after oral administration. Twelve hours after 750 mg ciprofloxacin, serum concentrations were 0.15±0.05 mg/l. Taking a breakfast reduced absorption by 15–20% compared to the fasting state, as judged by peak concentrations, AUC and renal excretion. After 200 mg i. v. (20 min infusion period), initial serum concentrations of 4.0±1.2 mg/l were observed which declined 12 h later to 0.070±0.025 mg/l. Mean cumulated recovery of ciprofloxacin from urine over 24 h varied between 25.5% and 33.6% of oral doses and between 53.2% and 57.4% of intravenous doses. Two of the three metabolites seen in the chromatograms were identified as M1 and M3 (oxo-ciprofloxacin). Cumulated renal excretion after an oral 250 mg dose was 1.2±0.4% of M1 and 5.5±1.6% of M3. Bioavailability of oral doses varied from 0.64±0.16 (100 mg) to 0.52±0.11 (500 mg). The AUC was linearly proportional to a single dose of up to 250 mg. Ciprofloxacin was rapidly absorbed and distributed. High distribution volumes were calculated (mean VD_area 186–217 1). The terminal half-life (t₁/2) was 3.1 to 5.4 h. Mean total body clearance was also high (600 to 693 ml/min · 70 kg)). Tolerance of ciprofloxacin was good for all oral doses and for intravenous administration up to 100 mg per dose. Intravenous infusion of 200 mg ciprofloxacin caused transient local irritation.     

Tramadol induces conditioned place preference in rats: interactions with morphine and buprenorphine

It is well established that under fasting conditions the expression of the orexigenic neuropeptide agouti-related peptide (AGRP) is up-regulated in the hypothalamic arcuate nucleus (ARC), while inconsistent data exist regarding fasting regulation of the anorexigenic neurohormone proopiomelanocortin (POMC). Inconsistencies might have methodological reasons, especially concerning neuromorphological and/or experimental (nutritional) specificity. We analyzed the expression of both neuropeptides in ARC neurons, using lasercapture microdissection (LMD) and real-time PCR in 12h fasted vs. fed Wistar rats as well as after a standardized glucose load, i.e., under clinically relevant conditions in terms of diagnosing glucose intolerance in the human. Under fasting conditions, clear up-regulation of AGRP was observed, with increasing magnitude in ARC single neurons (SNP) as compared to ARC cell layers (+125% vs. +23%, resp.), closely correlated to hypoinsulinemia and hypoleptinemia. Surprisingly, in the fasting state POMC was not found to be down-regulated, neither in ARC cell layers nor in ARC single neurons (+9% vs. +6%). However, glucose-refeeding under diagnostically relevant conditions led to strong neuronal up-regulation of POMC expression in ARC SNP (+128%), and AGRP down-regulation (-50%). In conclusion, experimentally, topographically, and analytically specific and standardized conditions confirmed AGRP in ARC neurons as being neuronally up- and down-regulated, resp., depending on the general nutritional state, while POMC was found to be (up-) regulated only after peripheral glucose load. Findings suggest that POMC in ARC neurons acts glucose-mediated as an "anti-orexigenic" neurohormone, specifically responding to hyperglycemia.