• The Journal of Churna Manual Medicine for Spine and Nerves
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• v.15 no.2
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• pp.33-41
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• 2020

Objectives The purpose of this report was to study the circulation of meridian WiGi, YoungGi, from the viewpoint of manual medicine. Methods First, the Korean Medical approach analyzes documents about the circulation of meridian WiGi, YoungGi, and the biomechanical approach is to analyze documents about kinetic force and kinematic movement. The third inherent energy approach is to analyze documents about craniosacral rhythm and visceral motility. Finally, it is to study the correlation between the circulation of meridian WiGi, YoungGi, and the viewpoint of biomechanics force and movement, the inherent energy of manual medicine. Results Meridian WiGi is fast, powerful, and changeful. It circulates through the head and extremities in the daytime and visceral organs at night. The deviation pelvis and distorted thoracic cage create kinetic force and kinematic movement. Meridian YoungGi is very small and soft energy and circulates meridians and visceral organs permanently. Craniosacral rhythm and visceral motility radiate continuously from cranial and visceral organs to the whole body. Conclusions Circulation of meridian WiGi is closely related to the biomechanical approach. In addition, circulation of meridian YoungGi is closely related to the inherent energy approach.

• Biomolecules & Therapeutics
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• v.19 no.1
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• pp.84-89
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• 2011

The present study was undertaken to determine whether combined treatment with prokinetic trimebutine and mosapride has a synergic effect on gastrointestinal motility and visceral pain associated with gastrointestinal dysfunction. To develop effective gastroprokinetic agents with greater potencies than trimebutine or mosapride for the treatment of gastrointestinal tract disease, a mixture of trimebutine and mosapride was designed and prepared. In the present study, treatment with trimebutine alone showed a dose-dependent effect on propelling movements of normal small and large intestine in mice, whereas mosapride effected only small intestine motility. Co-administration of trimebutine with mosapride, a well-established prokinetic drug, produced a synergistic influence on normal small intestine motility, but demonstrated an unclear effect on large intestine motility, with a slight tendency to reduce the propelling time. In a stress model, the small and large intestine motilities were significantly decreased. The reduction of intestine motility was restored to a normal level and the restoring effect was more pronounced in the combined treatment with trimebutine plus mosapride than treatment with trimebutine or mosapride alone. Furthermore, treatment with trimebutine plus mosapride significantly decreased acute visceral pain which was not controlled by trimebutine or mosapride alone. These data suggest that combination therapy with trimebutine plus mosapride has a synergic effect on small and large intestine motility and visceral pain control in gastrointestinal disorders.

• Advances in pediatric surgery
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• v.8 no.1
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• pp.54-61
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• 2002

Hirschsprung's disease (HD) is usually diagnosed in the newborn period and early infancy. The common presentation of HD in newborns consists of a history of delayed passage of meconium within the first 48 hours of life. The differential diagnosis in newborns is one of the clinical challenges of this disorder. A number of medical conditions which cause functional obstruction of the intestines are easily excluded. Neonates with meconium ileus, meconium plug syndrome, distal ileal atresia and low imperforate anus often present in a manner similar to those with HD in the first few days of life. Abdominal radiographs may help to diagnose complete obstruction such as intestinal atresia. Microcolon on contrast enema can be shown in cases with total colonic aganglionosis, ileal atresia or meconium ileus. Suction rectal biopsy or frozen section biopsy at operation is essential for differential diagnosis in such cases. HD is also considered in any child who has a history of constipation regardless of age. Older children with functional constipation may have symptoms that resemble those of HD and contrast enema is usually diagnostic. However, children with other motility disorders generally referred to as chronic idiopathic intestinal pseudoobstruction present with very similar symptoms and radiographic findings. These disorders are classified according to their histologic characteristics.; visceral myopathy, visceral neuropathy, intestinal neuronal dysplasia (IND), hypoganglionosis, immature ganglia, internal sphincter achalasia. Therefore, the workup for motility disorders should include rectal biopsy not only to confirm the presence of ganglion cells but also evaluate the other pathologic conditions.

• Journal of Neurogastroenterology and Motility
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• v.24 no.4
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• pp.656-668
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• 2018

Background/Aims MicroRNAs (miRNAs) were reported to be responsible for intestinal permeability in diarrhea-predominant irritable bowel syndrome (IBS-D) rats in our previous study. However, whether and how miRNAs regulate visceral hypersensitivity in IBS-D remains largely unknown. Methods We established the IBS-D rat model and evaluated it using the nociceptive visceral hypersensitivity test, myeloperoxidase activity assay, restraint stress-induced defecation, and electromyographic (EMG) activity. The distal colon was subjected to miRNA microarray analysis followed by isolation and culture of colonic epithelial cells (CECs). Bioinformatic analysis and further experiments, including dual luciferase assays, quantitative real-time polymerase chain reaction, western blot, and enzyme-linked immunosorbent assay, were used to detect the expression of miRNAs and how it regulates visceral hypersensitivity in IBS-D rats. Results The IBS-D rat model was successfully established. A total of 24 miRNAs were differentially expressed in the distal colon of IBS-D rats; 9 were upregulated and 15 were downregulated. Among them, the most significant upregulation was miR-200a, accompanied by downregulation of cannabinoid receptor 1 (CNR1) and serotonin transporter (SERT). MiR-200a mimic markedly inhibited the expression of CNR1/SERT. Bioinformatic analysis and luciferase assay confirmed that CNR1/SERT are direct targets of miR-200a. Rescue experiments that overexpressed CNR1/SERT significantly abolished the inhibitory effect of miR-200a on the IBS-D rats CECs. Conclusions This study suggests that miR-200a could induce visceral hyperalgesia by targeting the downregulation of CNR1 and SERT, aggravating or leading to the development and progression of IBS-D. MiR-200a may be a regulator of visceral hypersensitivity, which provides potential targets for the treatment of IBS-D.

• Journal of Neurogastroenterology and Motility
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• v.24 no.4
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• pp.643-655
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• 2018

Background/Aims Irritable bowel syndrome (IBS) is a common disease characterized by intestinal dysmotility, the mechanism of which remains elusive. We aim to determine whether the high-affinity choline transporter 1 (CHT1), a determinant of cholinergic signaling capacity, modulates intestinal motility associated with stress-induced IBS. Methods A rat IBS model was established using chronic water avoidance stress (WAS). Colonic pathological alterations were evaluated histologically and intestinal motility was assessed by intestinal transit time and fecal water content (FWC). Visceral sensitivity was determined by visceromotor response to colorectal distension. RT-PCR, western blotting, and immunostaining were performed to identify colonic CHT1 expression. Contractility of colonic muscle strips was measured using isometric transducers. enzyme-linked immunosorbent assay was used to measure acetylcholine (ACh). We examined the effects of MKC-231, a choline uptake enhancer, on colonic motility. Results After 10 days of WAS, intestinal transit time was decreased and fecal water content increased. Visceromotor response magnitude in WAS rats in response to colorectal distension was significantly enhanced. Protein and mRNA CHT1 levels in the colon were markedly elevated after WAS. The density of CHT1-positive intramuscular interstitial cells of Cajal and myenteric plexus neurons in WAS rats was higher than in controls. Ammonium pyrrolidine dithiocarbamate partly reversed CHT1 upregulation and alleviated colonic hypermotility in WAS rats. Pharmacological enhancement of CHT1 activity by MKC-231 enhanced colonic motility in control rats via upregulation of CHT1 and elevation of ACh production. Conclusion Upregulation of CHT1 in intramuscular interstitial cells of Cajal and myenteric plexus neurons is implicated in chronic stress-induced colonic hypermotility by modulation of ACh synthesis via nuclear factor-kappa B signaling.

• Nutrition Research and Practice
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• v.15 no.4
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• pp.411-430
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• 2021

Irritable bowel syndrome (IBS) is a frequently diagnosed gastrointestinal (GI) disorder characterized by recurrent abdominal pain, bloating, and changes in the stool form or frequency without any structural changes and overt inflammation. It is not a life-threatening condition but causes a considerable level of discomfort and distress. Among the many pathophysiologic factors, such as altered GI motility, visceral hypersensitivity, and low-grade mucosal inflammation, as well as other immunologic, psychologic, and genetic factors, gut microbiota imbalance (dysbiosis), which is frequently found in IBS, has been highlighted as an etiology of IBS. Dysbiosis may affect gut mucosal homeostasis, immune function, metabolic regulation, and even visceral motor function. As diet is shown to play a fundamental role in the gut microbiota profile, this review discusses the influence of diet on IBS occurring through the modulation of gut microbiota. Based on previous studies, it appears that dietary modulation of the gut microbiota may be effective for the alleviation of IBS symptoms and, also an effective IBS management strategy based on the underlying mechanism; especially because, IBS currently has no specific treatment owing to its uncertain etiology.

• Journal of Neurogastroenterology and Motility
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• v.24 no.4
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• pp.512-527
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• 2018

This review provides a comprehensive overview of brain imaging studies of the brain-gut interaction in functional gastrointestinal disorders (FGIDs). Functional neuroimaging studies during gut stimulation have shown enhanced brain responses in regions related to sensory processing of the homeostatic condition of the gut (homeostatic afferent) and responses to salience stimuli (salience network), as well as increased and decreased brain activity in the emotional response areas and reduced activation in areas associated with the top-down modulation of visceral afferent signals. Altered central regulation of the endocrine and autonomic nervous responses, the key mediators of the brain-gut axis, has been demonstrated. Studies using resting-state functional magnetic resonance imaging reported abnormal local and global connectivity in the areas related to pain processing and the default mode network (a physiological baseline of brain activity at rest associated with self-awareness and memory) in FGIDs. Structural imaging with brain morphometry and diffusion imaging demonstrated altered gray- and white-matter structures in areas that also showed changes in functional imaging studies, although this requires replication. Molecular imaging by magnetic resonance spectroscopy and positron emission tomography in FGIDs remains relatively sparse. Progress using analytical methods such as machine learning algorithms may shift neuroimaging studies from brain mapping to predicting clinical outcomes. Because several factors contribute to the pathophysiology of FGIDs and because its population is quite heterogeneous, a new model is needed in future studies to assess the importance of the factors and brain functions that are responsible for an optimal homeostatic state.

• Journal of Korea Association of Health Promotion
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• v.3 no.1
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• pp.46-54
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• 2005

The functional dyspepsia is a complex disease reaction that ocurs due to the presence of various factors and its pathophysiology has not been clearly verified until now. This disease is diagnosed after the organic diseases are ruled out. Therefore, the main treatments are limited down to compensating for revealed symptoms through exercising the supportive care. The international prevalence of the functional dyspepsia under the Rome I criterior is approximately 25%. For the cases of Koreans, there are very omnifarious symptoms in gastrointestinal disorders and the medical vocabularies which describe the diagnostic standard are not closely associated with the daily vocabularies, thus there would be a lot of restrictions to directly apply the Rome II criterior. However, the Korean Society of Gastrointestinal motility had decided to promote the use of the international standardized Rome II criterior in order for Korea to be comparable to the clinical studies from the other nations. There should be more extensive studies to differentiate the definitions of symptom descriptions from Korea to foreign countries. The extended researches concerning the pathophysiology are highly recommended which in return, would help enabling the reliable treatment techniques for this disease.

• Journal of Physiology & Pathology in Korean Medicine
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• v.21 no.2
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• pp.444-452
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• 2007

Acupuncture treatment cures disease by regulating the functional excessiveness or deficiency which occurs in the meridian and visceral organs, and by letting stagnated Qi and Blood flow through the whole body and then controlling Qi. Whether or not to have Qi feeling is the main factor needed to manifest the efficacy of acupuncture. So it needs the very stimulus to make Qi felt rather than the simple stimulus. In order to have Qi feeling, it needs to acupuncture a patient according to patient's thinness or fatness, constitution, richness or poverty and age. And also it needs to vary the way to acupuncture a patient according to meridian, kinds of pulse, degrees of disease, new or old diseases, seasons with a disease and local areas of disease. In order to ascertain that it is important for the quality and quantity of acupuncture stimulus and the state of feeling acupuncture to get the efficacy of acupuncture, the experiment was planned to confirm whether the form and Qi of subject has different result according to the stimulated duration and depth. On the basis of the report that acupuncture on derma, when using electroacupuncture at Zusanli(ST 36) which denotes small intestinal motility, is more efficient than full depth acupuncture, I got the following result, after I observed whether the stimulated duration and depth give different efficacy according to the sex and weights of rat in experiment. The increased effects of small intestinal motility by electroacupuncture on Zusanli(ST 36) appeared after stimulating full depth for thirty minutes without distinction of sex and weights. This significant change was observed only in the female experimental group when I distinguished the sex. The small interstinal motility in rats by electroacupuncture at zusanli(ST 36) decreased in the 10 minutes' stimulated group and 30 minutes' stimulated group by duration on the one hand, and derma-deep stimulated group and full depth stimulated group by the depth of stimulus on the other hand, as the weights increased. This result shows that the duration and depth of acupuncture depends on the differences of acupuncture points, sex of the experimental animals, ages, and, weights. And the further study on the experimental and clinical differences and sextual differences need to be continued on.

• The Journal of Internal Korean Medicine
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• v.41 no.5
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• pp.734-739
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• 2020

Objectives: The purpose of this study was to propose a diagnostic method for classifying patients with dyspepsia by symptom type. The correlation between symptom types and X-ray findings was studied in 62 patients with indigestion. Methods: In this study, the complaints and abdominal X-ray findings were collected for 62 patients who visited the outpatient Korean medicine clinic. The medical information related to dyspepsia was grouped for similar patients and classified by symptom type. Results: The patients with dyspepsia were classified into three types according to their medical symptoms: Distention type (N=43, 68.3%), Abdominal Pain type (N=16, 25.5%), and Constipation type (N=12, 19.0%). Intestinal fecal findings (80.6%) on x-rays were noted in most of the cases, followed by intestinal gas pattern findings (14.5%). Conclusion: Classifying patients with dyspepsia by symptom types is an appropriate diagnostic method due to the unclear pathophysiology of indigestion and the difficulty in applying a Korean medical dialectic. Irrespective of the symptom types, the large number of fecal material findings (80.6%) on x-rays means an effect on the interior environment of the body where intestinal feces accumulate easily and decreased gastrointestinal motility in patients with indigestion. This can be correlated with "food accumulation (食積)" as intestinal feces are tangible substances. In addition, gas in the intestine increases visceral sensitivity, causing abdominal distention or pain. The gas pattern findings (14.5%) on x-ray were observed in the "Distention type" and "Abdominal pain type," but not in the "Constipation type."