• Title/Summary/Keyword: Motility disorder

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A Study of Esophageal Acidity and Motility Change after a Gastrectomy for Stomach Cancer (위암 환자의 위절제술 후 식도산도의 변화와 운동장애)

  • Kim Seon-woo;Lee Sang-Ho
    • Journal of Gastric Cancer
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    • v.4 no.4
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    • pp.225-229
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    • 2004
  • Purpose: Some patients develop gastroesophageal reflux disease (GERD) after a gastrectomy for stomach cancer. Therefore, we conducted this research to gain an understanding of esophageal acidity and motility change. Materials and Methods: From July 2002 to March 2004, the cases of 15 randomized patients with stomach cancer who underwent a radical subtotal gastrectomy (RSG) with Billroth I(B-I) reconstruction (n=12) or a radical total gastrectomy (RTG) with Roux-en-Y (R-Y) gastroenterostomy (n=3) were analyzed. We investigated the clinical values of the ambulatory 24-hour pH monitoring and esophageal manometry in these patients, just before discharge from the hospital after an operation. Results: GERD was present in three patients ($20\%$). Compared with two reconstructive procedures, 3 of the 12 patients in the RSG with B-I group had GERD; however, none of RTG with R-Y group had GERD. Compared with pathologic stage, 2 of 9 patients in stage I, 1 of 2 patients in stage II, none of 3 patients in stage III, and none of 1 patient in stage IV had GERD. Esophageal manometry was performed in 10 patients. Nonspecific esophageal motility disorder (NEMD) was present in 7 patients. Conclusion: Some patients had GERD as a complication following a gastrectomy for stomach cancer. We suspect that the postoperative esophageal symptom is due to not only bile reflux but also gastroesophageal acid reflux. Therefore, careful observation is recommended for the detection of GERD.

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Clinical Evaluation of Radionuclide Esophageal Transit Studies using Liquid and Solid Foods (유동식 및 고형식을 이용한 동위원소 식도통과검사의 임상적 의의에 대한 연구)

  • Choe, Jae-Gol;Lee, Min-Jae;Song, Chi-Wook;Hyun, Jin-Hai;Suh, Won-Hyuck
    • The Korean Journal of Nuclear Medicine
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    • v.29 no.1
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    • pp.61-72
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    • 1995
  • The author performed radionuclide esophageal transit studies(RETS) with liquid and solid boluses using the same day protocol in 90 normal controls and 164 patients with various primary esophageal motility disorders who were diagnosed by manometric criteria and clinical courses. The authors calculated mean esophageal transit time(MTT) and mean residual retention(MRR) in each of the liquid and solid studies, and classified time-activity curve(TAC) patterns. The normal criteria of RETS with liquid bolus were MTT<24 sec, MRR<9%, and the TAC pattern that showed rapid declining slope and flat low residual(Type 1). The normal criteria of RETS with solid bolus were MTT<35 sec, MRR<9% and TAC of type 1. With these normal criteria, the sensitivity and the specificity of the liquid study were 62.2 % and 97.8%, respectively. The sensitivity increased to 75.4% with the solid study. The author also found that the RETS was highly reproducible. The achalasia typically showed no effective emptying of both liquid and solid boluses during the whole study period, and was well differentiated by its extremely long transit time and high retention from the other motility disorders. The diffuse esophageal spasm (DES) and nonspecific esophageal motility disorder(NEMD) showed intermediate delay in transit time and increased retention. In the groups of hypertensive lower esophageal sphincter(LES), hypotensive LES and nutcracker, there noted no significant difference with the normal control group in terms of MTT and MRR. The DES and NEMD could be more easily identified by solid studies that showed more marked delay in MTT and increased MRR as compared with the liquid study. In conclusion, esophageal scintigraphy is a safe, noninvasive and physiologic method for the evaluation of esophageal emptying.

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The Role of Interstitial Cells of Cajal in Congenital Megacolons and Idiopathic Megacolons (선천성 거대결장 및 특발성 거대결장에서 카할 세포의 역할)

  • Yoo, Soo-Young;Koh, Yong-Taek;Han, Ai-Ri;Jung, Soon-Hee;Eom, Min-Seob;Kim, Il-Ho
    • Advances in pediatric surgery
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    • v.8 no.2
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    • pp.113-118
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    • 2002
  • The etiology of several motility disorders, including persistent megacolon after definitive surgery for Hirschsprung's disease, meconium ileus which is not associated with cystic fibrosis and idiopathic megacolon, is still unclear. Interstitial cells of Cajal (ICC) are thought to modulate gut motility as gastrointestinal pace maker cells. The aim of this study was to evaluate the role of ICC in the bowel walls of the patients (n=15) who had variable motility disorders. The ICC were identified by immunohistochemical staining using an anti-C-Kit antibody and the results were compared with control specimens (n=2). The control group (G1) showed evenly distributed ICC in their bowel walls. The second group (G2, n=5) who had normal bowel movements after Duhamel procedures and the third group (G3, n=4) who had persistent megacolon after Duhamel procedures showed absent or scarcely distributed ICC in their aganglionic bowels. The ICC were immunohistochemical staining using an anti-C-Kit antibody and the results were compared with control specimens (n=2). The control group (G1) showed evenly distributed ICC in their bowel walls. The second group (G2, n=5) who had normal bowel movements after Duhamel procedures and the third group (G3, n=4) who had persistent megacolon after Duhamel procedures showed absent or scarcely distributed ICC in their aganglionic bowels. Whereas ICC were evenly distributed in the ganglionic bowels of G2, they were not seen or scarecely distributed in the ganglionic bowels of G3. Two patients (G4) who suffered from idiopathic megacolon showed absence or decrease of ICC in spite of presence of ganglion cells in their colons. Four neonates (G5) who underwent ileostomy because of meconium obstruction showed absent or markedly decreased ICC in the the colon at the time of ileostomy and the distribution of ICC was changed to a normal pattern at the time of ileostomy closure between 39-104 days of age and their bowel motility were restored after that. The results suggest that lack of ICC caused reduce motility in the ganglionic colons and it may be responsible for the development of various motility disorders. Delayed maturity of ICC may also playa role in the meconium obstruction of neinates.

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Psychological Factors Affecting Gastrointestinal Disorders : Functional GI Disorders (위장관장애에 영향을 미치는 심리적 요인)

  • Song, Ji-Young
    • Korean Journal of Psychosomatic Medicine
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    • v.6 no.2
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    • pp.210-220
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    • 1998
  • The relationships between emotion, stress and gastro-intestinal dysfunction were briefly reviewed. Until now, several kinds of theories on about pathophysiology, such as motility dysfunction, changes of pain perception on the lumen, dysregulations on the central nervous system associated with psychosocial factors were reported. However, none of those factors could'nt give any clues for the causes of the functional bowel disorders. For understanding the meaning of the symptoms and for the treatment approach, clinicians should give attention to the comprehensive point of view, i.e., not only biological but also psychological aspects of the patients with non-organic bowel dysfunctions. Giving warm and kind explanations to the patient about symptom formation and progression and understanding the patient's illness behaviors, and good and strong doctor-patient relationship is essentials for the treatment.

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A Case of Woman with Histrionic Personality who Suffered from Chronic Gastrointestinal Dysfunction (만성 위장장애를 호소하는 히스테리성 성격의 여자)

  • Song, Ji-Young
    • Korean Journal of Psychosomatic Medicine
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    • v.1 no.1
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    • pp.101-108
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    • 1993
  • A case of a 38 year-old woman with histrionic personality who had chronic epigastric pain, dyspepsia and alternating bowel habit for more than 10 years was presented in detail on its course of two times of admission and follow-up. The diagnosis was thought as psychophy-siological disorder or gastrointestinal motility disorder of undefined etiology rather than hypo-chondriasis or Briquet's syndrome. She was characterized by sustained illness behavior and combined several physical illnesses. i.e. tuberculosis. anemia and hepatic stone. These physical diseases led to a blurring of psychological and physical boundaries regarding symptom formation. The points on consultation from medical part to psychiatric department were discussed and the supposed causal mechanisms in non-organic functional gastrointestinal disturbances were also reviewed. Physical and psychological modalities for the treatment and the abnormal illness behavior were mainly emphasized in this case.

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Roles of RasW in Cell Morphology, Migration, and Development in Dictyostelium

  • Nara Han;Taeck Joong Jeon
    • Journal of Integrative Natural Science
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    • v.16 no.2
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    • pp.69-74
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    • 2023
  • In Dictyostelium , there are 15 Ras subfamilies, including 11 Ras, 3 Rap, 1 Rheb. The Ras proteins are involved in regulating various cell processes as switch proteins. The functions of many Ras proteins have been identified, but some of Ras proteins have not yet been identified. Here, we focused on identifying the roles of RasW among them. To investigate the functions of RasW in cell morphology, cell migration, and development in Dictyostelium , we compared the phenotypes of wild-type cells and rasW null cells. rasW null cells showed a larger, more spread-out morphology and reduced cell motility compared to wild-type cells. There was no significant difference between wild-type cells and rasW null cells during multicellular developmental process. These results suggest that RasW is involved in regulating cell morphology and cell migration in Dictyostelium.

Time is Gut. Approaching Intestinal Leiomyositis: Case Presentation and Literature Review

  • Michail Aftzoglou;Christina Heinrich;Till Sebastian Clauditz;Thomas Menter;Deborah Dorth;Konrad Reinshagen;Ingo Konigs
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.27 no.4
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    • pp.197-205
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    • 2024
  • T-lymphocytic intestinal leiomyositis is a rare cause of "pediatric intestinal pseudo-obstructions." Diagnosis may be difficult and requires full-thickness bowel biopsies during laparotomy or laparoscopy with possible enterostomy. Currently, immunosuppressive therapy is the only available treatment. A delay in diagnosis and therapy may negatively affect the prognosis because of ongoing fibrotic alterations; therefore, early diagnosis and consequent treatment are crucial. This review summarizes the available information on the nosology, diagnostic steps, and treatment modalities. Here, we report the youngest case of enteric leiomyositis reported in the last two decades and analyze its management by reviewing previous cases.

Primary cilia in energy balance signaling and metabolic disorder

  • Lee, Hankyu;Song, Jieun;Jung, Joo Hyun;Ko, Hyuk Wan
    • BMB Reports
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    • v.48 no.12
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    • pp.647-654
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    • 2015
  • Energy homeostasis in our body system is maintained by balancing the intake and expenditure of energy. Excessive accumulation of fat by disrupting the balance system causes overweight and obesity, which are increasingly becoming global health concerns. Understanding the pathogenesis of obesity focused on studying the genes related to familial types of obesity. Recently, a rare human genetic disorder, ciliopathy, links the role for genes regulating structure and function of a cellular organelle, the primary cilium, to metabolic disorder, obesity and type II diabetes. Primary cilia are microtubule based hair-like membranous structures, lacking motility and functions such as sensing the environmental cues, and transducing extracellular signals within the cells. Interestingly, the subclass of ciliopathies, such as Bardet-Biedle and Alström syndrome, manifest obesity and type II diabetes in human and mouse model systems. Moreover, studies on genetic mouse model system indicate that more ciliary genes affect energy homeostasis through multiple regulatory steps such as central and peripheral actions of leptin and insulin. In this review, we discuss the latest findings in primary cilia and metabolic disorders, and propose the possible interaction between primary cilia and the leptin and insulin signal pathways which might enhance our understanding of the unambiguous link of a cell's antenna to obesity and type II diabetes.

Studies on the Efficacy of Combined Preparations of Crude Drug(XXXIX). -Effect of Hyangsayangwee-Tang on the Stomach and Intestinal Disorder- (생약복합제제(生藥複合製劑)의 약효연구(藥效硏究) 제39보(第39報) -향사양위탕(香沙養胃湯)이 소화기계(消化器系)에 대한 작용-)

  • Hong, Nam-Doo;Chang, In-Kyu;Kim, Nam-Jae;Lee, In-Sun
    • Korean Journal of Pharmacognosy
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    • v.20 no.3
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    • pp.188-195
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    • 1989
  • Hyangsayangwee-Tang, a combined preparation of crude drugs, which has been used for stomach and intestinal disorder, was examined for anti-spasmodic, anti-ulcerative and anti-emetive effects. Spontaneous motility of isolated ileum was strongly suppressed and inhibitory effects against contraction of isolated ileum induced by acetylcholine and barium chloride were shown in mice. And, contraction of isolated guinea-pig ileum by histamine was inhibited. In rats fundus preparations, Hyangsayangwee-Tang elicited strong relaxation and had antagonist effects against the spasm induced by acetylcholine and barium chloride. A significant inhibitory effect on the intestinal propulsion of barium sulfate in mice was shown. In pylorus-ligated rats, Hyangsangwee-Tang inhibited gastric secretion and showed a strong anti-peptic activity. Protective effects against gastric ulceration induced by pyloric ligation, water-immersion stress, histamine and aspirin were significantly recognized in mice and rats. Hyangsayangwee-Tang decreased cupric sulfate-induced vomitting in frogs.

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Severe Traumatic Intraocular Injuries Related to Blowout Fractures (안와파열골절 환자에서 중증 외상성 안구내 손상 발생과 연관인자 분석)

  • Shin, Jae Hoon;Lee, Mi Jin;Park, Seong Soo;Jeong, Won Joon;You, Yeon Ho
    • Journal of Trauma and Injury
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    • v.22 no.1
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    • pp.97-102
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    • 2009
  • Purpose: Blunt trauma can cause a wide range of ocular injuries. This study was performed to describe the prevalence of severe intraocular injuries (SIOI) and their correlation with the severity of blunt orbital trauma. Methods: We retrospectively analyzed 117 eyes of 107 patients with orbital wall fractures who visited the emergency room at Konyang University Hospital from July 2006 to June 2008. Clinical features such as age, sex, causes of injury, revised trauma score (RTS), type of orbital wall fractures were recorded. The patients were divided into two groups: blowout fracture with severe intraocular injuries (SIOI) and blowout fracture without SIOI. We compared the clinical and the injury-related characteristics between two groups and analyzed the SIOS-related factors. Results: Among the 107 patients (117 eyes) with blowout fractures, 29 (27.1%) patients with 32 eyes (25.6%) had complicated severe intraocular injuries. Retrobulbar hemorrhage (14.5%), hyphema (13.7%), traumatic optic nerve injury (4.3%), and sustained loss of visual acuity (4.3%) were the most common SIOI disorders. A logistic regression analysis revealed that loss of visual acuity (odds ratio = 4.75) and eyeball motility disorder (odds ratio=7.61) were significantly associated with SIOS. Conclusion: We suggest that blowout fracture patients with loss of visual acuity or eyeball motility disorder are mostly likely to have severe intraocular injuries, so they need an ophthalmologic evaluation immediately.