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A New and Different Explanation of Traction Procedure's Gastric Emptying Ability

Posted by screeb , 18 January 2011 · 352 views

Abstract -- delayed gastric emptying is called gastroparesis (associated with Irritable Bowel Syndrome -constipation). The following procedure was developed to produce gastric emptying. Drinking coffee is a pre-requisite for the anti-gastro paretic effects of the procedure. Smoking or taking a smoking cessation pill (bupropion) is also a pre-requisite. The procedure, in a nutshell, is this: for one hour after taking coffee and rocking on one’s side, gastric emptying of coffee is induced (and palpable). The above steps are necessary for the cervical traction device (TD) to function. During application of TD, one lies on one’s side while performing neck pulls. The following analysis of the inputs of the procedure uses known research about how the steps of the procedure work.
There are differences in Ghrelin in patients with irritable bowel syndrome (c-constipation predominant) and controls. After an overnight fast, biopsies were taken from mucosa and duodenum. The density of ghrelin-immunoreactive cells in the mucosa was significantly lower in IBS-c, than in healthy controls. Delayed gastric emptying was observed in patients with abnormally low ghrelin levels.
A 20-min exercise swimming regimen increased the secretion of leptin. Leptin, the adipose-derived hormonal signal of body energy stores, acts via the leptin receptor on neurons in the lateral hypothalamic area (LHA). LHA leptin neurons densely innervate the LHA where they directly synapse with OX (orexin expressing cells). Systemic nicotine treatment induces Fos expression (a marker of neuronal activity) in the LHA, with orexin neurons being particularly responsive.
For a few years before the discovery that exercise could replace a male sexual response, the sexual response was used for 20 min instead of rocking. It was reported that in male rats, Fos immunoreactivity (ir) in OX neurons increased markedly during copulation. One locus for the prosexual effects of OX may be the ventral tegmental area (VTA) dopamine neurons, (synthesized in the tyrosine hydroxylase biosynthetic pathway). Triple immunolabeling in anterior VTA showed that Fos-ir in tyrosine hydroxylase-positive neurons apposed (causing asymmetric amplification) to OX fibers increases during copulation.
In the LHA, c-Fos expression increased by 226% at 10 and 30 mg/kg of caffeine. These results indicate that systemically administered caffeine preferentially activates OX over non-OX neurons in the same field, and this activation is most pronounced where orexin neurons are most concentrated. OXA, also described as orexin receptor type-1, is highly expressed in the dorsal motor nucleus of vagus (DMV). It was suggested that central OXA changes GI motor pattern form interdigestive to postprandial via the vagal cholinergic pathways.
The effect of GABA in the area of the medial subnucleus of the NTS on gastric motility was studied. Intra-NTS GABAergic signaling is between the vagal afferent nerve terminals and inhibitory projection neurons in the NTS that comprise the functionally relevant efferent arm of the vagovagal circuit, (the level of activity in the DMVX (dorsal motor nucleus of the vagus). The deactivation of DMV is caused by increased glutamate release at the NTS DMV (dorsal motor nucleus of the vagus) GABAergic synapses (inhibitory to DMV), leaving the vagal output controlling the stomach in an idle state, sufficient to perform interdigestive tasks.
The cervical traction device puts pressure on the sub-occipital muscles, which cause the muscles’ stretch receptors (myofibrils) to project to and activate the ImN (Intermedius nucleus of the medulla). The ImN acts to integrate information from the head and neck and relays this information on to the NTS (nucleus tractus solitarius) where suitable autonomic responses can be generated. Some intracellular recordings in NTS neurons following stimulation of the InM had both GABAergic (inhibitory) and glutamatergic (excitatory) components.
The ImN receives input from the neck muscle proprioceptors. Vesicular glutamate transporter 1 (VGluT1) is predominantly expressed in peripheral neurons and has restricted expression within the brainstem and spinal cord. Extending from the dorsal column nuclei, a band of terminals can be seen coursing towards the ImN, following the pattern of terminals observed when tracing from the upper cervical DRG (dorsal root ganglion). It is therefore likely that the VGluT1 terminals observed within the InM are the endings of primary afferents coursing from the upper cervical region. The presence of VGluT1 in primary afferent terminals is also indicative of the nature of the fiber, as VGluT1 is preferentially found within the thicker proprio- and mechano-ceptive afferents.
Glutamatergic markers and nNOS were both found in similar subregions of the NTS and in vagal afferents. Nitric oxide inhibits excitatory vagal afferent input to NTS neurons. Selective chemical (NOS) removal of vagal afferent inputs, was demonstrated to allow the inhibition of GABAergic synaptic transmission (dis-inhibition) to gastric related DMV neurons, causing post prandial GI motor patterns in the stomach and duodenum.


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