检索结果-南通市图书馆

Proximal and distal esophageal sensitivity is decreased in patients with Barrett’s esophagus

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

World Journal of Gastroenterology 2011年第4期17卷 514-521页

作者： Anne L Kraru Sφren S Olesen Peter Funch-Jensen Hans Gregersen asbjφrn m drewes mech-Sense Department of Gastroenterology Aalborg Hospital Aarhus University Hospital Department of Surgery L Aarhus University Hospital

AIm: To investigate sensations to multimodal pain stimulation in the metaplastic and normal parts of the esophagus in patients with Barrett’s esophagus (BE). mETHODS: Fifteen patients with BE and 15 age-matched healthy volunteers were subjected to mechanical, thermal and electrical pain stimuli of the esophagus. Both the metaplastic part and the normal part (4 and 14 cm, respectively, above the esophago-gastric junction) were examined. At sensory thresholds the stimulation intensity, referred pain areas, and evoked brain potentials were recorded. RESULTS: Patients were hyposensitive to heat stimulation both in the metaplastic part [median stimulation time to reach the pain detection threshold: 15 (12-34) s vs 14 (6-23) s in controls; F = 4.5, P = 0.04] and the normal part of the esophagus [median 17 (6-32) s vs 13 (8-20) s in controls; F = 6.2, P = 0.02]. Furthermore, patients were hyposensitive in the metaplastic part of the esophagus to mechanical distension [median volume at moderate pain: 50 (20-50) mL vs 33 (13-50) mL in controls; F = 5.7, P = 0.02]. No indication of central nervous system abnormalities was present, as responses were comparable between groups to electrical pain stimuli in the metaplastic part [median current evoking moderate pain: 13 (6-26) mA vs 12 (9-24) mA in controls; F = 0.1, P = 0.7], and in the normal part of the esophagus [median current evoking moderate pain: 9 (6-16) mA, vs 11 (5-11) mA in controls; F = 3.4, P = 0.07]. Furthermore, no differences were seen for the referred pain areas (P-values all > 0.3) or latencies and amplitudes for the evoked brain potentials (P-values all > 0.1). CONCLUSION: Patients with BE are hyposensitive both in the metaplastic and normal part of esophagus likely as a result of abnormalities affecting peripheral nerve pathways.

关键词： Barrett’s esophagus Heat multimodal Pain Sensitivity

Is the pain in chronic pancreatitis of neuropathic origin? Support from EEG studies during experimental pain

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

World Journal of Gastroenterology 2008年第25期14卷 4020-4027页

作者： asbjФrn m drewes maciej Gratkowski Saber AK Sami Georg Dimcevski Peter Funch-Jensen Lars Arendt-Nielsen Department of Gastroenterology Aalborg University Hospital Center for Sensory-motor Interactions (SmI) Department of Health Science and Technology Aalborg University Department of Gastroenterology Haukeland University Hospital Department of Surgical Gastroenterology L Aarhus University Hospital

AIm: To prove the hypothesis that patients with chronic pancreatitis would show increased theta activity during painful visceral stimulation. mETHODS: Eight patients and 12 healthy controls underwent an experiment where the esophagus was electrically stimulated at the pain threshold using a nasal endoscope. The electroencephalogram (EEG) was recorded from 64 surface electrodes and "topographic matching pursuit" was used to extract the EEG information in the early brain activation after stimulation. RESULTS: A major difference between controls and patients were seen in delta and theta bands, whereas there were only minor differences in other frequency bands. In the theta band, the patients showed higher activity than controls persisting throughout the 450 ms of analysis with synchronous brain activation betweenthe channels. The main theta components oscillated with 4.4 Hz in the patients and 5.5 Hz in the controls. The energy in the delta (0.5-3.5 Hz) band was higher in the controls, whereas the patients only showed scattered activity in this band. CONCLUSION: The differences in the theta band indicate that neuropathic pain mechanisms are involved in chronic pancreatitis. This has important implications for the understanding and treatment of pain in these patients, which should be directed against drugs with effects on neuropathic pain disorders.

关键词： Chronic Pancreatitis Neuropathic pain Esophagus Thalamocortical system Electroence-phalography

Three-dimensional surface model analysis in the gastrointestinal tract

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

World Journal of Gastroenterology 2006年第18期12卷 2870-2875页

作者： Donghua Liao Jens B Frφk r Jian Yang Jingbo Zhao asbjφrn m drewes Odd H Gilja Hans Gregersen Center of Excellence in Visceral Biomechanics and Pain Aalborg Hospital and Institute of Health Technology Aalborg University Denmark National Center of Ultrasound in Gastroenterology Bergen University and Haukeland Hospital Bergen Norway

The biomechanical changes during functional loading and unloading of the human gastrointestinal （GI） tract are not fully understood. GI function is usually studled by introducing probes in the GI lumen. Computer modeling offers a promising alternative approach in this regard, with the additional ability to predict regional stresses and strains in inaccessible locations. The tension and stress distributions in the GI tract are related to distensibility （tension-strain relationship） and smooth muscle tone. lore knowledge on the tension and stress on the GI tract are needed to improve diagnosis of patients with gastrointestinal disorders. A modeling framework that can be used to integrate the physiological, anatomical and medical knowledge of the GI system has recently been developed. The 3-D anatomical model was constructed from digital images using ultrasonography, computer tomography （CT） or magnetic resonance imaging （IRI）. Different mathematical algorithms were developed for surface analysis based on thin-walled structure and the finite element method was applied for the mucosa-folded three layered esophageal model analysis. The tools may be useful for studying the geometry and biomechanical properties of these organs in health and disease. These studies will serve to test the structurefunction hypothesis of geometrically complex organs.

关键词： GI tract Surface Tension Stress Three-dimensional

Quantities of comorbidities affects physical, but not mental health related quality of life in type 1 diabetes with confirmed polyneuropathy

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

World Journal of Diabetes 2019年第2期10卷 87-95页

作者： Anne-marie L Wegeberg Theresa meldgaard Sofie Hyldahl Poul Erik Jakobsen asbjφrn m drewes Birgitte Brock Christina Brock mech-Sense Department of Gastroenterology and HepatologyAalborg University Hospital and Clinical InstituteAalborg UniversityAalborg 9000Denmark Steno Diabetes Center North Judland Region NordjyllandAalborg 9000Denmark Steno Diabetes Center Copenhagen Region HovedstadenGentofte 2820Denmark

BACKGROUND A large number of adults with long-term type 1 diabetes are affected by symmetrical peripheral *** complications increase socioeconomic expenses and diminish the individual quality of *** 36-Item Short Form Health Survey(SF-36)is a generic patient reported questionnaire,measuring mental and physical health related quality of *** hypothesized that diabetic neuropathy would decrease physical and mental quality of life measured with SF-36,and that clinical appearance may be associated with the *** To investigate if diabetic neuropathy would decrease physical and mental quality of life measured with SF-36,and if clinical appearance may be associated with the *** Forty-eight adults[age 50±9 years,10 females,disease duration 32(14-51)years]with verified diabetic symmetrical peripheral neuropathy and 21 healthy participants(age 51±6 years,6 females)underwent standardised nerve conduction testing and completed the SF-36 ***,disease duration,number of comorbidities,both diabetes related and nondiabetes related,vibration perception threshold,number of hypoglycaemic events,HbA1c and administration way of insulin was *** In comparison to healthy subjects,patients’mental composite score was not significantly diminished(51.9±8.9 vs 53.1±5.5,P=0.558),while the physical composite score was(46.3±11.7 vs 54.6±3.3,P=0.002).As expected,the overall physical health related symptoms in patients were associated to total number of comorbidities(Pmorbidities relation to diabetes(P=0.0002)and HbA1c(P=0.005)as well as comorbidities not related to diabetes(P=0.0006).CONCLUSION The finding of this study emphasises the importance of focusing on quality of life in adults with diabetes and especially in those with multiple comorbidities as well as the possibility of HbA1c as a biomarker for severe complication.

关键词： Quality of life 36-Item Short Form Health Survey(SF-36) Diabetes mellitus,Type 1 Diabetic neuropathies Comorbidity

Brain changes in diabetes mellitus patients withgastrointestinal symptoms

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

World Journal of Diabetes 2016年第2期7卷 14-26页

作者： Anne m drewes Eirik Søfteland Georg Dimcevski Adam D Farmer Christina Brock Jens B Frøkjær Klaus Krogh asbjørn m drewes Department of medicine Haukeland University Hospital5021 BergenNorway Centre for Digestive Diseases Blizard Institute of Cell and Molecular ScienceWingate Institute of NeurogastroenterologyBarts and the London School of Medicine and DentistryQueen Mary University of LondonLondon E1 2AJUnited Kingdom Department of Gastroenterology University Hospitals of North MidlandsStoke on TrentStraffordshire ST4 6QGUnited Kingdom mech-Sense Department of Gastroenterology and Hepatology and Clinical InstituteAalborg University Hospital9100 AalborgDenmark Department of Radiology Aalborg University Hospital9100 AalborgDenmark Neurogastroenterology Unit Department of Hepatology and GastroenterologyAarhus University Hospital8000 AarhusDenmark

Diabetes mellitus is a common disease and its prevalence is increasing worldwide. In various studies up to 30%-70% of patients present dysfunction and complications related to the gut. To date several clinical studies have demonstrated that autonomic nervous system neuropathy and generalized neuropathy of the central nervous system(CNS) may play a major role. This systematic review provides an overview of the neurodegenerative changes that occur as a consequence of diabetes with a focus on the CNS changes and gastrointestinal(GI) dysfunction. Animal models where diabetes was induced experimentally support that the disease induces changes in CNS. Recent investigations with electroencephalography and functional brain imaging in patients with diabetes confirm these structural and functional brain changes. Encephalographic studies demonstrated that altered insular processing of sensory stimuli seems to be a key player in symptom generation. In fact one study indicated that the more GI symptoms the patients experienced, the deeper the insular electrical source was located. The electroencephalography was often used in combination with quantitative sensory testingmainly showing hyposensitivity to stimulation of GI organs. Imaging studies on patients with diabetes and GI symptoms mainly showed microstructural changes,especially in brain areas involved in visceral sensory processing. As the electrophysiological and imaging changes were associated with GI and autonomic symptoms they may represent a future therapeutic target for treating diabetics either pharmacologically or with neuromodulation.

关键词： Diabetes mellitus Gastrointestinal Electroencephalogram magnetic resonance imaging Brain

Pharmacological pain management in chronic pancreatitis

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

World Journal of Gastroenterology 2013年第42期19卷 7292-7301页

作者： Sφren S Olesen Jacob Juel Carina Graversen Yuri Kolesnikov Oliver HG Wilder-Smith asbjφrn m drewes mechSense Department of Gastroenterology and HepatologyAalborg University Hospital9000 AalborgDenmark mech-Sense Department of RadiologyAalborg University Hospital9000 AalborgDenmark Department of Neurorehabilitation Engineering Bernstein Center for Computational NeuroscienceUniversity Medical Center G ttingenGeorg-August UniversityD-37077 GttingenGermany Pain Service Department of OncologyEast Tallinn Central Hospital19086 TallinnEstonia Pain and Nociception Neuroscience Research Group Department of AnaesthesiologyPain and Palliative CareRadboud University Nijmegen Medical Centre6525 NijmegenThe Netherlands Center for Sensory-motor Interaction Department of Health Science and TechnologyAalborg University9000 AalborgDenmark

Intense abdominal pain is a prominent feature of chronic pancreatitis and its treatment remains a major clinical *** studies of pancreatic nerves and experimental human pain research have provided evidence that pain processing is abnormal in these patients and in many cases resembles that seen in neuropathic and chronic pain *** important ultimate outcome of such aberrant pain processing is that once the disease has advanced and the pathophysiological processes are firmly established,the generation of pain can become self-perpetuating and independent of the initial peripheral nociceptive ***,the management of pain by traditional methods based on nociceptive deafferentation(e.g.,surgery and visceral nerve blockade)becomes difficult and often *** novel and improved understanding of pain aetiology requires a paradigm shift in pain management of chronic *** mechanism based pain treatments taking into account altered pain processing are likely to increasingly replace invasive therapies targeting the nociceptive source,which should be reserved for special and carefully selected *** this review,we offer an overview of the current available pharmacological options for pain management in chronic *** addition,future options for pain management are discussed with special emphasis on personalized pain medicine and multidisciplinarity.

关键词： Chronic pancreatitis Pain Treatment Pharmacology Analgesics Adjuvant analgesics

Small mammal community composition impacts bank vole (Clethrionomys glareolus) population dynamics and associated seroprevalence of Puumala orthohantavirus

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Integrative Zoology 2024年第1期19卷 52-65页

作者： Felicitas maria BUJNOCH Daniela REIL Stephan drewes Ulrike mROSENFELD Rainer G.ULRICH Jens JACOB Christian ImHOLT Julius Kühn-Institute Federal Research Centre for Cultivated PlantsInstitute for Epidemiology and Pathogen DiagnosticsRodent ResearchMünsterGermany University of münster Institute for Evolution and BiodiversityMünsterGermany Friedrich-Loeffler-Institut Federal Research Institute for Animal HealthInstitute of Novel and Emerging Infectious DiseasesGreifswald-Insel RiemsGermany

Rodents are important reservoirs for zoonotic pathogens that cause diseases in *** is hypoth-esized to be closely related to pathogen prevalence through multiple direct and indirect *** example,the presence of non-host species can reduce contact rates of the main reservoir host and thus reduce the risk of transmission(“dilution effect”).In addition,an overlap in ecological niches between two species could lead to increased interspecific competition,potentially limiting host densities and reducing density-dependent pathogen transmission *** this study,we investigated the relative impact of population-level regulation of direct and indirect drivers of the prevalence of Puumala orthohantavirus(PUUV)in bank voles(Clethrionomys glareolus)during years with high *** compiled data on small mammal community composition from four regions in Germany between 2010 and *** equation modeling revealed a strong seasonality in PUUV control mechanisms in bank *** abundance of shrews tended to have a negative relationship with host abundance,and host abundance positively influenced PUUV seroprevalence,while at the same time increasing the abundance of competing non-hosts like the wood mouse(Apodemus sylvaticus)and the yellow-neckedfield mouse(Apodemusflavicollis)were associated with reduced PUUV seroprevalence in the *** results indicate that for PUUV in bank voles,dilution is associated with increased interspecific *** pressures leading to the decline of Apodemus *** a specific habitat could lead to the amplification of mechanisms promoting PUUV transmission within the host populations.

关键词： bank vole biodiversity Puumala orthohantavirus small mammals

Upper gastrointestinal sensory-motor dysfunction in diabetes mellitus

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

World Journal of Gastroenterology 2006年第18期12卷 2846-2857页

作者： Jingbo Zhao Jens Brφndum Frφkjaer asbjφrn mohr drewes Niels Ejskjaer Center of Excellence in Visceral Biomechanics and Pain Aalborg Hospital Sφndre Skovvej 15 DK-9000 Aalborg Denmark & Center for Sensory-Motor Interactions Department of Health Science Aalborg University Fredrik Bajers Vej 7 D-3 DK-9220 Aalborg Denmark Department of medicine m (Diabetes & Endocrinology) Aarhus University Hospital Norrebrogade 44 DK 8000 Aarhus C Denmark

Gastrointestinal （GI） sensory-motor abnormalities are common in patients with diabetes mellitus and may involve any part of the GI tract. Abnormalities are frequently sub-clinical, and fortunately only rarely do severe and life-threatening problems occur. The pathogenesis of abnormal upper GI sensory-motor function in diabetes is incompletely understood and is most likely multi-factorial of origin. Diabetic autonomic neuropathy as well as acute suboptimal control of diabetes has been shown to impair GI motor and sensory function. morphological and biomechanical remodeling of the GI wall develops during the duration of diabetes, and may contribute to motor and sensory dysfunction. In this review sensory and motility disorders of the upper GI tract in diabetes is discussed; and the morphological changes and biomechanical remodeling related to the sensory-motor dysfunction is also addressed.

关键词： Diabetes Esophagus Stomach Intestine motility Pain Diabetic neuropathy Hyperglycemia Remodeling

Impaired contractility and remodeling of the upper gastrointestinal tract in diabetes mellitus type-1

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

World Journal of Gastroenterology 2007年第36期13卷 4881-4890页

作者： Jens BrΦndum FrΦkjΦr SΦren Due Andersen Niels EjskjΦr Peter Funch-Jensen asbjΦrn mohr drewes Hans Gregersen Center for Visceral Biomechanics and Pain Aalborg Hospital Aalborg Denmark Department of Radiology Aalborg Hospital Aalborg Denmark Department of Endocrinology m Aarhus University Hospital Aarhus Denmark Department of Surgical Gastroenterology L Aarhus University Hospital Aarhus Denmark Center for Sensory-motor Interaction Department of Health Science and Technology Aalborg University Denmark Center for Sensory-motor Interaction Department of Health Science and Technology Aalborg University Denmark National Center for Ultrasound in Gastro-enterology Haukeland University Hospital Bergen Norway

AIm: To investigate that both the neuronal function of the contractile system and structural apparatus of the gastrointestinal tract are affected in patients with longstanding diabetes and auto mic neuropathy. mETHODS: The evoked esophageal and duodenal contractile activity to standardized bag distension was assessed using a specialized ultrasound-based probe. Twelve type-1 diabetic patients with autonomic neuropathy and severe gastrointestinal symptoms and 12 healthy controls were studied. The geometry and biomechanical parameters (strain, tension/stress, and stiffness) were assessed. RESULTS: The diabetic patients had increased frequency of distension-induced contractions (6.0 ± 0.6 vs 3.3 ± 0.5, P mpaired coordination of the contractile activity in diabetic patients was demonstrated as imbalance between the time required to evoke the first contraction at the distension site and proximal to it (1.5 ± 0.6 vs 0.5 ± 0.1, P = 0.03). The esophageal wall and especially the mucosa-submucosa layer had increased thickness in the patients (P mpressive stretch was less in diabetics (P mferential deformation induced by the distensions were not affected in the patients (all P > 0.14). CONCLUSION: The impaired contractile activity with an imbalance in the distension-induced contractions likely reflects neuronal abnormalities due to autonomic neuropathy. However, structural changes and remodeling of the gastrointestinal tract are also evident and may add to the neuronal changes. This may contribute to the pathophysiology of diabetic gut dysfunction and impact on future management of diabetic patients with gastrointestinal symptoms.

关键词： Diabetes Autonomic Neuropathy Bio- mechanics Contractility Ultrasound Esophagus Duodenum Deformation Stress