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Dive into the research topics where James L. Puckett is active.

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Featured researches published by James L. Puckett.


The American Journal of Gastroenterology | 2007

Prevalence of Increased Esophageal Muscle Thickness in Patients With Esophageal Symptoms

Ibrahim Dogan; James L. Puckett; Bikram Padda; Ravinder K. Mittal

BACKGROUND:Patients with achalasia, diffuse esophageal spasm (DES), and nutcracker esophagus have a thicker muscularis propria than normal subjects. The goal of our study was to determine the prevalence of increased muscle thickness in a group of unselected patients referred to the esophageal function laboratory for evaluation of the symptoms.METHODS:We studied 40 normal subjects and 94 consecutive patients. Manometry and ultrasound images were recorded concurrently, using a special custom-built catheter. Esophageal muscle thickness and muscle cross-sectional area were measured at 2 and 10 cm above the lower esophageal sphincter (LES). Patients were assigned manometric diagnosis and determination was made if they had increased muscle thickness and muscle cross-sectional area.RESULTS:Nearly all patients with well-defined spastic motor disorders, i.e., achalasia, DES, and nutcracker esophagus, revealed (a) an increase in the muscle thickness/cross-sectional area, (b) increase in esophageal muscle thickness/cross-sectional area was also seen, albeit at a lower prevalence rate, in patients with less well-characterized manometric abnormalities, i.e., hypertensive LES, impaired LES relaxation, and ineffective esophageal motility, and (c) 24% of patients with esophageal symptoms but normal manometry were also found to have an increase in muscle thickness/cross-sectional area. Dysphagia was more likely, and heartburn less likely in patients with increased muscle thickness, but there were no differences in chest pain and regurgitation symptoms between the groups.CONCLUSION:We describe, for the first time, increased muscle thickness in patients with esophageal symptoms and normal manometry. We suggest that increased esophageal muscle thickness is likely to be an important marker of esophageal motor dysfunction.


The American Journal of Gastroenterology | 2003

Hypertrophy of the muscularis propria of the lower esophageal sphincter and the body of the esophagus in patients with primary motility disorders of the esophagus

Ravinder K. Mittal; Ghassan S. Kassab; James L. Puckett; Jianmin Liu

OBJECTIVES:Patients with diffuse esophageal spasm (DES) and nutcracker esophagus/high amplitude esophageal contraction (HAEC) have a thicker esophageal muscularis propria than do healthy subjects. The goals of this study were to determine the esophageal muscle cross-sectional area (MCSA), a measure of muscle mass, in patients with achalasia of the esophagus; and to compare it with that in patients with DES, patients with HAEC, and normal subjects.METHODS:Using a high-frequency ultrasound probe catheter, concurrent manometry and ultrasound images of the esophagus were recorded in four subject groups: normal volunteers, patients with HAEC, patients with DES, and patients with achalasia of the esophagus. Recordings were obtained from the lower esophageal sphincter (LES) and multiple sites in the esophagus 2, 4, 6, 8, and 10 cm above the LES.RESULTS:The LES and esophageal muscle thickness as well as esophageal MCSA were greater in all three patient groups than in the normal subject group. Muscle thickness and MCSA were observed to be greatest in patients with achalasia, which were greater than in patients with DES, which were greater than in those with HAEC, which in turn were greater than in normal subjects.CONCLUSIONS:We propose that an increase in the MCSA is an important feature of patients with primary motility disorders of the esophagus. The degree of increase in muscle mass may be an important determinant of the type and the severity of esophageal motor dysfunction.


Gastroenterology | 2001

Crural diaphragm inhibition during esophageal distension in cats correlates with contraction of esophageal longitudinal muscle

Jiammin Liu; James L. Puckett; Torahiko Takeda; Wayne Liu; Ravinder K. Mittal

between the two groups. From the histological point of view at cardia level, no differences have been documented between GERD + or in terms of cardial-type mucosa (78% vs. 81.7%), non active (28% vs. 31.7%) and active inflamatory changes (56% vs. 54.8%), and intestinal metaplasia (9% vs. 9.6%). Inflamatory changes, but not intestinal metaplasia, were statistically more frequently associated to HP infection (94% vs.79%,<O.O1).Conclusions:in our study 1.no statistically significant data are emerged correlating GERD either to infiamatory changes or intestinal metaplasia at cardia level. 2.inflamatory changes at cardia level are statistically correlated to Helicobacter pylori presence in stomach.


Gastroenterology | 2005

Sensory and motor function of the esophagus: Lessons from ultrasound imaging

Ravinder K. Mittal; Jianmin Liu; James L. Puckett; Vikas Bhalla; Valmik Bhargava; Neelish Tipnis; Ghassan S. Kassab


Gastroenterology | 2005

Asynchrony between the circular and the longitudinal muscle contraction in patients with nutcracker esophagus

Hwoon-Yong Jung; James L. Puckett; Vikas Bhalla; Maria Rojas-Feria; Valmik Bhargava; Jianmin Liu; Ravinder K. Mittal


American Journal of Physiology-gastrointestinal and Liver Physiology | 2004

Symptom Hypersensitivity to Acid Infusion is Associated with Hypersensitivity of Esophageal Contractility

Vikas Bhalla; Jianmin Liu; James L. Puckett; Ravinder K. Mittal


American Journal of Physiology-gastrointestinal and Liver Physiology | 2001

Relationship between esophageal muscle thickness and intraluminal pressure: an ultrasonographic study

Nonko Pehlivanov; Jianmin Liu; Ghassan S. Kassab; James L. Puckett; Ravinder K. Mittal


American Journal of Physiology-gastrointestinal and Liver Physiology | 2002

A novel ultrasound technique to study the biomechanics of the human esophagus in vivo

Torahiko Takeda; Ghassan S. Kassab; Jianmin Liu; James L. Puckett; Rishi R. Mittal; Ravinder K. Mittal


American Journal of Physiology-gastrointestinal and Liver Physiology | 2002

Measuring esophageal distension by high-frequency intraluminal ultrasound probe

Poong-Lyul Rhee; Jianmin Liu; James L. Puckett; Ravinder K. Mittal


American Journal of Physiology-gastrointestinal and Liver Physiology | 2005

Crural diaphragm inhibition during esophageal distension correlates with contraction of the esophageal longitudinal muscle in cats.

Jianmin Liu; James L. Puckett; Torahiko Takeda; Hwoon-Yong Jung; Ravinder K. Mittal

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Jianmin Liu

University of California

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Vikas Bhalla

University of California

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Bikram Padda

University of California

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