Neural mechanisms controlling retrograde giant contraction during vomiting were studied in six conscious dogs with implanted strain gauge force transducers. The small intestine was divided into proximal (P), middle (M), and distal (D) segments. These segments were transplanted on intact mesenteric neurovascular pedicles. In three dogs, M and D segments were interchanged (group A). In three dogs, P and M segments were interchanged (group B). Before transplantation, apomorphine-induced vomiting caused retrograde giant contractions, starting from the M segment and rapidly migrating to the stomach. However, in group A, even after recovery of interdigestive migrating contractions migration, retrograde giant contractions during vomiting always originated in the distally interchanged M segment and jumped to the P segment without migration to the D segment. In group B, the retrograde giant contraction always originated in the proximally interchanged M segment and successively occurred in the distally interchanged P segment. We conclude that origination and migration of retrograde giant contractions are extrinsically controlled. These motor events during vomiting are thought to be a specific motor function that does not exist in the lower small intestine, and retrograde giant contraction during vomiting may originate in the mid-small intestine.
Background Foramen of Winslow hernia (FWH) is a rare but emergent condition caused by an increase in the foramen diameter, visceral mobility, and intra-abdominal pressure. To the best of our knowledge, this is the first study to report a case of FWH secondary to large uterine fibroids that was successfully treated with laparoscopic surgery. Case presentation A 52-year-old woman with large uterine fibroids was diagnosed with FWH. Because of the absence of signs of bowel ischemia and peritonitis, we performed an elective laparoscopic surgery through a 5-port system after bowel decompression using a long intestinal tube. Although foramen of Winslow closure was not performed, her postoperative course was uneventful. Conclusions Laparoscopic surgery for FWH is considered an extremely effective surgical treatment option because of its safety and efficacy in performing delicate procedures (such as adhesiolysis) with a good magnified field of view.
Diurnal motor activities of the upper, middle, and lower thirds of the thoracic esophagus, the lower esophageal sphincter, and the gastric body were recorded in six conscious dogs, using extraluminal force transducers. The motor activities of the thoracic esophagus and the lower esophageal sphincter were divided into three major motility patterns: feeding, digestive, and interdigestive. Each motility pattern was basically composed of repetitive bursts of contractions that were clearly classified into type I and II according to their contractile properties. Type I bursts were peristaltic contractions initiated at the upper thoracic esophagus and sequentially propagated distally to include the sphincter. Propagation velocity and duration of type I contractions were similar in all three motility patterns, and these contractions never were propagated into the stomach. Type II bursts were nonperistaltic simultaneous contractions of the thoracic esophagus and lower sphincter appearing synchronously with phase III of gastric interdigestive migrating contractions. Amplitude and duration of type II contractions were maximal at the sphincter, suggesting initiation at that site. In nonfeeding patterns, type I contractions would clear the esophagus of refluxed gastric contents, while type II contractions would prevent reflux.
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