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The datasets are also available as weekly exports. NL EN. UZ - pain clinic Open print view. Willis, G. Pasricha, Pankaj Jay. Willis, William D. Publisher: New York : Informa Healthcare, c Description: Xv, p. In humans, patients with irritable bowel syndrome showed symptoms of urinary bladder dysfunction, such as, an increase in urination frequency, as well as an increase in residual volume 4. Moreover, patients with interstitial cystitis showed higher incidence of irritable bowel syndrome and other systemic diseases compared to controls 5.
The complexity of the viscero-visceral interactions requires the study of these interactions under different pathological conditions. Most studies were designed to show the simple viscero-visceral interaction between viscera or the direct effect of a pathological condition of one viscera on the function of another; however, it is rare to find a study on how a pathological condition of one viscera can affect the viscero-visceral interaction of other viscera.
In the present study, the influence of distal colon chemical irritation on the interaction of urinary bladder with distal colon and distal esophagus distentions was investigated. Eighteen male Wistar rats g were used in the present study. Ten of these animals had distal colon irritation and the other eight animals remained intact. Animals were purchased and housed under standard conditions in the animal house at The Hashemite University.
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At the day of experiment, each rat was anesthetized with urethane 1. Urethane was obtained from Sigma St. Louis, Missouri, USA. The carotid artery and jugular vein at the left side were cannulated, in each animal, for blood pressure monitoring and anesthetic supplementation, respectively. An abdominal incision was made, in each animal, in order to expose the urinary bladder and ureters. A gauge needle was introduced into the dome of the urinary bladder and connected to a programmable pump AL; World Precision Instrument, Sarasota, FL.
Cystometry was done by bumping normal saline at a rate of 0. Intravesical pressure was monitored using a pressure monitor BP-1; World Precision Instrument, Sarasota, FL that was connected to the needle through a pressure transducer. The temperature and hydration of the urinary bladder were preserved throughout the experiment by surrounding the urinary bladder with cotton pallets that were soaked in a warm normal saline.
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The ureters were tied proximal to the urinary bladder, then ureters were cut and drained distal to it. The colon balloon was inserted about 10cm from the anus and was taped to the base of the tale to prevent movement. Colon balloon was connected to a 3mL syringe filled with normal saline. Distal colon distention was done manually by infusing the balloon with three increasing increments of normal saline 1mL, 2mL, and then 3mL.
Last increment 3mL produced greater-than or equal to 70mm Hg pressure, which is reported to be a noxious stimulus 8 , 9. Distal esophagus distention was done by balloon, similar to the distal colon balloon. The esophagus balloon was inserted about 7cm from the upper incisors, intra-orally, to the distal esophagus The balloon was connected to 1mL syringe.
Esophagus distention was done by infusing the balloon with 0. The abdominal branches of the vagus nerve were stimulated, at the level of the esophageal opening of the diaphragm, using digital stimulator PG A; Cygnus Technology, Inc. The stimulation was done indirectly through the esophageal wall using a bipolar electrode that was introduced orally down to the esophagus.
Each pulse intensity was set at 8mA with 2msec duration This stimulus produced compound action potentials, which were recorded from the vagus nerve in the cervical region Ten rats had distal colon chemical irritation. A cotton pallet was attached to the distal end of the catheter by fixing part of it to the distal end of the catheter tub, while leaving the remaining free part in direct contact with colon mucosa. This procedure insures the localization of the irritant within the distal colon.
At the beginning of each experiment, normal cystometry recordings were performed for 30 minutes. After that, cystometry recordings were done for another 30 minutes following the infusion of the irritant in the irritated animals. Then, cystometry recordings were done for 10 minutes with esophagus distention, followed by 10 minutes recordings without esophagus distention. In the same way, cystometry recordings for another 10 minutes were done with vagal nerve stimulation, followed by normal recordings for 10 minutes.
At the end, cystometry recordings were done for 30 minutes with distal colon distentions 10 minutes for each increment of distal colon distentions; 1mL, 2mL and 3mL. Cystometry was recorded for 10 more minutes following colon balloon deflation. The micturition cycle timing parameters, intercontraction time the whole micturition cycle time ICT ; the time of the voiding phase VT ; and the time of the storage phase ST , and the intravesical pressure parameters, resting pressure RP ; pressure threshold PT ; maximum pressure MP ; and pressure amplitude P-amplitude; the deference between MP and RP were measured, offline, for statistical analysis.
cars.cleantechnica.com/la-representacin-final.php All the parameters of the micturition cycles in ten minutes after each stimulus and the micturition cycles in the last ten minutes preceded the stimulus from each animal were considered for statistical analysis for each stimulus. The measurements of micturition cycles parameters preceded the stimulus were considered as control for the measurements following the stimulus.
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Statistical analysis was performed using two tailed, unpaired student t-test t. Distal colon irritation significantly increased the ICT. In addition, DCI significantly increased the ST, however, there was no significant changes to the VT following distal colon irritation. Compared to intact animals 3 , in the irritated animals, distal esophagus distention and electrical stimulation of the abdominal branches of the vagus nerve were still able to significantly decrease the ICT and ST of the micturition cycles without any significant effect on the VT.
On the other hand, following distal colon irritation, all three distention increments 1mL, 2mL, and 3mL of distal colon had no significant effect on the ICT, ST, or VT, and so, all significant effects of distal colon distention on these parameters in the intact animals under publication disappeared following distal colon irritation.
The effect of esophagus, vagal, and distal colon stimuli on the ICT are presented in Figure Vertical bars represent standard error of the mean. Abd-vagus, electrical stimulation of the abdominal branches of the vagus nerve; distal esophagus, distal esophagus distention; distal colon, distal colon distention; colon irritation, chemical irritation of distal colon.
In the irritated animals, irritation of distal colon significantly increased the RP, while significantly decreased the PT and P-amplitude. However, Irritation of distal colon had no significant effect on the MP. Following distal colon irritation, distal esophagus distention still had no significant effect on the intravesical pressure parameters.
Simultaneously, distal colon distention almost had no significant effect on the intravesical pressure parameters following distal colon irritation, except for a significant increase in the PT with 3mL distal colon distention. However, in the irritated animals, electrical stimulation of the vagus nerve significantly decreased the PT, though, significantly increased the MP and P-amplitude.
Vagal stimulation had no significant effect on the RP. The effect of esophagus, vagal, and distal colon stimuli on the P-amplitude are presented in Figure The results of this study shows how the changes of the urinary bladder function in response to mechanical stimuli from other viscera, either in the same region distal colon distention or in another region esophagus distention , can be affected by chemical irritation to the distal colon.
The chemical irritation of the distal colon significantly increased the urinary bladder frequency. The increase in bladder frequency was attributed by the significant decrease in the storage time of the micturition cycle, where the voiding time did not have any significant changes. Since the storage phase is mainly a spinally mediated reflex 13 , these results may indicate that the effect of distal colon irritation on the urinary bladder mainly occur at the spinal level.
The increase of bladder frequency in response to colon irritation could be explained by neuronal sensitization. Colon irritation is proved to sensitize neurons that receive convergent inputs from colon and urinary bladder both at the dorsal root ganglion 14 and lumbosacral spinal segments 15 , These results are consistent with other studies, where there was an increase of bladder activity in response to colon inflammation both in rats 2 and mice The neuronal sensitization can also explain the effect of distal colon irritation on intravesical pressure, where colon irritation significantly decreased the pressure amplitude by significantly increasing the resting pressure.
In addition, distal colon irritation significantly decreased the pressure threshold.
The effect of colon irritation on pressure threshold could be related to sensitization of the urinary bladder afferents as well. Ustinova et al. Also, the decrease in pressure threshold could be related to the sensitization of the spinal neurons receiving bladder inputs. It was shown that the volume of urinary bladder distention necessary to excite the lumbosacral neurons decreased significantly following colon inflammation in rats All these effects of colon irritation on the cystometry parameters reflect an increase of bladder activity.
All the same, distal colon irritation had an influence on the bladder responses to the distal colon distention and distal esophagus distention, as well as to electrical stimulation of the abdominal branches of vagus nerve. Following distal colon irritation, the distal esophagus distention and electrical stimulation of vagus nerve were still able to significantly increase the bladder frequency as it did in the intact animals.
This increase in the bladder urinary frequency is still attributed to the decrease in the storage time as well 3. These results indicate that colon irritation sensitized the neural circuitries controlling the effect of esophagus and vagal stimuli to bladder activity.