Reversal of Asynchrony Between Circular and Longitudinal Muscle Contraction in Nutcracker Esophagus by Atropine  Hariprasad Korsapati, Valmik Bhargava, Ravinder K. Mittal  Gastroenterology  Volume 135, Issue 3, Pages 796-802 (September 2008) DOI: 10.1053/j.gastro.2008.05.082 Copyright © 2008 AGA Institute Terms and Conditions

Figure 1 Mean contraction amplitude and duration under 2 study (control [ctrl] and edrophonium [edr]) conditions in normal subjects and under 3 study conditions (control, 5 μg/kg atropine dose [atr5], and 10 μg/kg atropine dose [atro10]) in the NCE patients. Note that edrophonium caused a significant increase in the contraction amplitude and duration in the normal subjects. In the NCE patients, atropine significantly decreased the contraction amplitude and the contraction duration. Gastroenterology 2008 135, 796-802DOI: (10.1053/j.gastro.2008.05.082) Copyright © 2008 AGA Institute Terms and Conditions

Figure 2 B-mode images showing baseline thickness in control (ctrl) and after edrophonium (edr) administration in normal subjects and in NCE patients during control, after 5 μg/kg of atropine (atr5), and 10 μg/kg of atropine (atr10). Gastroenterology 2008 135, 796-802DOI: (10.1053/j.gastro.2008.05.082) Copyright © 2008 AGA Institute Terms and Conditions

Figure 3 Mean data of the baseline muscle thickness, contraction amplitude, and duration under 2 study conditions in normal subjects (control and edrophonium) and under 3 conditions in the NCE patients (control, 5 μg/kg of atropine [atr5], and 10 μg/kg of atropine [atro10]). ctrl, control; edr, edrophonium. Gastroenterology 2008 135, 796-802DOI: (10.1053/j.gastro.2008.05.082) Copyright © 2008 AGA Institute Terms and Conditions

Figure 4 Time lag between peak LM and CM contractions during baseline study, after administration of edrophonium in normal subjects, and during control, after 5 μg/kg of atropine (atro5), and after 10 μg/kg of atropine (atro10) is shown. Actual data points for the 10 normal subjects were also shown. ctrl, control; edr, edrophonium. Gastroenterology 2008 135, 796-802DOI: (10.1053/j.gastro.2008.05.082) Copyright © 2008 AGA Institute Terms and Conditions

Figure 5 Graph illustrates the frequency with which muscle layer (LM or CM) peaks first during the control (ctrl) period and after administrations of edrophonium (edr) in normal subjects. Similar data are shown in NCE patients after 5 μg/kg (atr5) and 10 μg/kg (atro10) of atropine. ▫, CM first; ▪, LM first. Gastroenterology 2008 135, 796-802DOI: (10.1053/j.gastro.2008.05.082) Copyright © 2008 AGA Institute Terms and Conditions

Figure 6 (A) M-mode US images and time-aligned pressure and muscle thickness in a normal subject in control and after edrophonium administration. (B) Same data in a NCE patient in the baseline state, and after 5 μg/kg (atr5) and after 10 μg/kg of atropine (see text for details). Gastroenterology 2008 135, 796-802DOI: (10.1053/j.gastro.2008.05.082) Copyright © 2008 AGA Institute Terms and Conditions

Figure 7 Synchrony and asynchrony of contractions of the 2 muscle layers in normal and NCE patients. Gastroenterology 2008 135, 796-802DOI: (10.1053/j.gastro.2008.05.082) Copyright © 2008 AGA Institute Terms and Conditions