MD FRCSEd .
-
,
-. , .
His
. (Goubarov's valve) . .
, , C, . , C (clasp fibres) (sling fibres).
, 1.5 . 2 ,
, . , , , . 10
, ,
LOS basal tone
(myogenic tone) , ,
-adrenoceptor agonist (phenylephrine) -adrenoceptor agonist for
1, 2 and 3: isoprenaline, isoproterenol, dobutamine, terbutaline,
albuterol, CL 316243 Dopamine Angiotensin II Prostanoids (PGFalpha,
PGH2, TXB2, PGE1 and PGF1, arachidonic acid) Xanthines
(theophylline) Motilin Galanin Bombesin CCK-8 Pentagstrin IL-1 PAR
receptor agonists for PAR1 and PAR2: TFLLR-NH2, SFLLRN-NH2
SLIGKV-NH2 and SLIGRL-NH2 (Tian et al., 2004) (Allescher et al.,
1988) or (Tian et al., 2004) (Rattan et al., 2003) (Daniel et al.,
1979a) (Tottrup et al., 1990b) (Tomita et al., 1997) (Rattan and
Goyal, 1987) (Mukhopadhyay and Kunnemann, 1979) In vivo (Behar and
Biancani, 1977) (Zwick et al., 1976) (Cheng et al., 2005) (Huang,
2007)
phasic contractions
710 . , ,
2 . . ,
transient lower esophageal sphincter relaxation TLESR
, . ( ) , . TLESR . . .
TLESR
TLESR (nucleus solitarius)
( 9)
. . . , , . .
- Poiseuille: () ()
. () 1. : ( ) 2. : (TLESR) ( 40mmHg )
( ), (TLESR)
:
() . , . , . ( , His, ). (.) : a. , . , . (ph ) . ( )
Of all the attributes of sphincters, one can not help but marvel
at how much we depend on so little. The anal sphincter, the
external urethral sphincter, the pylorus, and the lower esophageal
sphincter (LES) are all quite small, but their dysfunction can be a
life-altering event
