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  1. Article ; Online: Utility of Diagnostic Studies for Upper Gastrointestinal Symptoms in Children with Orthostatic Intolerance.

    Zhang, Lana N / Moak, Jeffrey P / Desbiens, John / Hanumanthaiah, Sridhar / Fabian, Robin R / Clarke, Lindsay / Sahay, Rashmi D / Darbari, Anil

    The Journal of pediatrics

    2018  Volume 205, Page(s) 138–144

    Abstract: Objective: To assess the utility of gastrointestinal (GI) diagnostic studies in the evaluation of patients with orthostatic intolerance.: Study design: Medical records of 103 consecutive children/young adults with orthostatic intolerance and ... ...

    Abstract Objective: To assess the utility of gastrointestinal (GI) diagnostic studies in the evaluation of patients with orthostatic intolerance.
    Study design: Medical records of 103 consecutive children/young adults with orthostatic intolerance and gastrointestinal symptoms were reviewed. All patients had undergone antroduodenal manometry in conjunction with the tilt table test, autonomic testing, and upper gastrointestinal endoscopy (EGD). A gastric emptying study (GES) was performed in 81 patients.
    Results: The median age of the cohort was 17 years (IQR, 15-19) with a female predominance (females:males, 3:1). As expected, the tilt table test was abnormal in all patients. Antroduodenal manometry was abnormal in 83 of 103 patients (81%), showing neurogenic intestinal dysmotility in 50%, rumination in 20%, and visceral hyperalgesia in 10%. The GES results were abnormal in 23 of 81 patients (28.4%), mostly (21 of 23) with delayed GES. None of the tilt table test or autonomic results were predictive of abnormal antroduodenal manometry or GES. Analysis of EGD biopsy samples revealed nonspecific esophagitis and/or gastritis in 16 of 103 patients (15%).
    Conclusions: Antroduodenal manometry with the tilt table test were the most insightful investigations in adolescents and young adults with orthostatic intolerance and gastrointestinal symptoms. GES and EGD provided limited information. Gastrointestinal symptoms were related more to functional rather than mucosal or organic etiologies, suggesting a limited role of endoscopy alone in evaluating patients with orthostatic intolerance presenting with gastrointestinal symptoms.
    MeSH term(s) Adolescent ; Biopsy ; Endoscopy, Digestive System/statistics & numerical data ; Female ; Gastrointestinal Diseases/diagnosis ; Gastrointestinal Diseases/physiopathology ; Gastrointestinal Motility/physiology ; Humans ; Male ; Manometry ; Orthostatic Intolerance/diagnosis ; Orthostatic Intolerance/physiopathology ; Retrospective Studies ; Tilt-Table Test/statistics & numerical data ; Young Adult
    Language English
    Publishing date 2018-10-24
    Publishing country United States
    Document type Journal Article
    ZDB-ID 3102-1
    ISSN 1097-6833 ; 0022-3476
    ISSN (online) 1097-6833
    ISSN 0022-3476
    DOI 10.1016/j.jpeds.2018.09.048
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Chemoreception regulates chemical access to mouse vomeronasal organ: role of solitary chemosensory cells.

    Ogura, Tatsuya / Krosnowski, Kurt / Zhang, Lana / Bekkerman, Mikhael / Lin, Weihong

    PloS one

    2010  Volume 5, Issue 7, Page(s) e11924

    Abstract: Controlling stimulus access to sensory organs allows animals to optimize sensory reception and prevent damage. The vomeronasal organ (VNO) detects pheromones and other semiochemicals to regulate innate social and sexual behaviors. This semiochemical ... ...

    Abstract Controlling stimulus access to sensory organs allows animals to optimize sensory reception and prevent damage. The vomeronasal organ (VNO) detects pheromones and other semiochemicals to regulate innate social and sexual behaviors. This semiochemical detection generally requires the VNO to draw in chemical fluids, such as bodily secretions, which are complex in composition and can be contaminated. Little is known about whether and how chemical constituents are monitored to regulate the fluid access to the VNO. Using transgenic mice and immunolabeling, we found that solitary chemosensory cells (SCCs) reside densely at the entrance duct of the VNO. In this region, most of the intraepithelial trigeminal fibers innervate the SCCs, indicating that SCCs relay sensory information onto the trigeminal fibers. These SCCs express transient receptor potential channel M5 (TRPM5) and the phospholipase C (PLC) beta2 signaling pathway. Additionally, the SCCs express choline acetyltransferase (ChAT) and vesicular acetylcholine transporter (VAChT) for synthesizing and packaging acetylcholine, a potential transmitter. In intracellular Ca2+ imaging, the SCCs responded to various chemical stimuli including high concentrations of odorants and bitter compounds. The responses were suppressed significantly by a PLC inhibitor, suggesting involvement of the PLC pathway. Further, we developed a quantitative dye assay to show that the amount of stimulus fluid that entered the VNOs of behaving mice is inversely correlated to the concentration of odorous and bitter substances in the fluid. Genetic knockout and pharmacological inhibition of TRPM5 resulted in larger amounts of bitter compounds entering the VNOs. Our data uncovered that chemoreception of fluid constituents regulates chemical access to the VNO and plays an important role in limiting the access of non-specific irritating and harmful substances. Our results also provide new insight into the emerging role of SCCs in chemoreception and regulation of physiological actions.
    MeSH term(s) Animals ; Cells, Cultured ; Chemoreceptor Cells/metabolism ; Chemoreceptor Cells/physiology ; Choline O-Acetyltransferase/metabolism ; Immunohistochemistry ; Mice ; Mice, Inbred C57BL ; Mice, Knockout ; Mice, Transgenic ; Phospholipase C beta/genetics ; Phospholipase C beta/metabolism ; TRPM Cation Channels/genetics ; TRPM Cation Channels/metabolism ; Vomeronasal Organ/cytology ; Vomeronasal Organ/metabolism
    Chemical Substances TRPM Cation Channels ; Trpm5 protein, mouse ; Choline O-Acetyltransferase (EC 2.3.1.6) ; Phospholipase C beta (EC 3.1.4.11) ; Plcb2 protein, mouse (EC 3.1.4.11)
    Language English
    Publishing date 2010-07-30
    Publishing country United States
    Document type Journal Article ; Research Support, American Recovery and Reinvestment Act ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
    ISSN 1932-6203
    ISSN (online) 1932-6203
    DOI 10.1371/journal.pone.0011924
    Database MEDical Literature Analysis and Retrieval System OnLINE

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