• Title/Summary/Keyword: esophageal sphincter

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Esophageal manometry in the patients with foreign body sensation on the pharyngo-esopgageal region (인두 및 상부식도부 이물감 환자의 식도내)

  • 한승세
    • Journal of Chest Surgery
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    • v.17 no.2
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    • pp.280-285
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    • 1984
  • Although it is suspected that the foreign body sensation on the pharyngoesophageal region is caused by motility disturbance of upper esophageal sphincter, its pathophysiology is not yet clear. Esophageal manometry has become an important diagnostic tool in the evaluation of esophageal motor disorders such as dysfunction of upper esophageal sphincter. Intraluminal esophageal pressures were measured by perfusion manometry in fifteen patients with foreign body sensation on the pharyngoesophageal region and in twenty six controls. In upper esophageal sphincter, mean value of resting pressure of the patients by rapid pull-through technique was 45,9\ulcorner 15.6mmHg and 80.9\ulcorner9.7mmHg in the controls. The difference between the two groups was statistically significant. The distance from nostril to sphincter, length of sphincter, and resting pressure by station pull-through technique were not significantly different. The amplitude of esophageal peristalsis in the patients was reduced significantly at the level of the upper, mid and lower esophagus. The wave duration of the patients was reduced significantly at the level the upper and mid esophagus. The speed showed no difference between two groups. Length and resting pressure of lower esophageal sphincter revealed almost same values in two groups.

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Botulinum Toxin Injection for Postlaryngectomy esophageal speech failure and Achalasia (보툴리눔독소를 이용한 후두전적출술후 식도발성장애 및 식도이완불능증의 치료)

  • 최홍식;문형진;한재욱;서진원;김광문
    • Korean Journal of Bronchoesophagology
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    • v.3 no.2
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    • pp.302-306
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    • 1997
  • Persistent pharygoesophageal spasm has been demonstrated to be responsible for poor speech rehabilitation after laryngectomy Management of these patients has included bougienage and pharyngeal neurectomy. Achalasia is a disorder of swallowing in which the lower esophageal sphincter fails to relax. Botulinum toxin injection of the upper esophageal sphincter or lower esophageal sphincter has been successfully used diagnostically and therapeutically for esophageal speech failure or achalasia. So, we report the use of botulinum toxin, a paralytic agent, for the treatment of these conditions.

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Experimental Study for Effect of Banhasasim-tang on Mice with Reflux Esophagitis (역류성 식도염 유발 생쥐의 반하사심탕(半夏瀉心湯)투여 효과에 대한 실험 연구)

  • Jang, Myeong-Woong;Lim, Seong-Woo
    • The Journal of Internal Korean Medicine
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    • v.34 no.4
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    • pp.362-374
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    • 2013
  • Objectives : This study was carried out to investigate the inhibitory effect of Banhasasim-tang on early reflux esophagitis by control of gastric peristalsis and the lower esophageal sphincter in mice. Methods : Experimental mice were classified into three groups. The normal group were mice with no inflammation. The control group were mice with gastroesophageal reflux elicited by alcohol. The sample group were mice administered Banhasasim-tang after gastroesophageal reflux elicitation. We observed morphological change and production of ghrelin, substance P, and inducible nitric oxide synthase (iNOS) in gastroesophageal junction mucosa. In addition, we examined change of epithelial junction in esophageal mucosa and change of lower esophageal sphincter distribution. Results : The migration of inflammation-related cells in lamina propria of gastroesophageal junction decreased more in the sample group than in the control group. The positive reaction of ghrelin, substance P, and iNOS significantly decreased more in the sample group than in the control group (p<0.05). Injury of the epithelial junction in the esophageal mucosa and outer oblique layer in the lower esophageal sphincter were significantly mitigated by Banhasasim-tang administration in the sample group (p<0.05). Conclusions : According to the above results, it is supposed that Banhasasim-tang inhibits early reflux esophagitis by controlling not only gastric peristalsis and acid secretion through ghrelin, and substance P but also the lower esophageal sphincter through iNOS.

Experimental Studies on Pharmacological Action of the Banhahubagtang, A Combined Preparation of Oriental Medicine (반하후박탕(半夏厚朴湯)의 실험약리학적(實驗藥理學的) 연구(硏究))

  • Lee, Bum-Koo;Cho, Tae-Soon
    • Korean Journal of Pharmacognosy
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    • v.18 no.1
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    • pp.14-25
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    • 1987
  • The effects of the water extract of 'Banhahubagtang', the combined herbal medicine, on the low esophageal sphincter, stomach, small intestine and CNS were investigated, and the results were as follows: The hexobarbital induced sleeping time was prolonged in female mice. The convulsion induced by electric shock was suppressed and analgesic action was recognized in mice. The extract inhibited intestinal propulsion of barium sulfate in mice. The extract inhibited free acid secretion and showed remarkable suppression of gastric ulcer in rats. Relaxation induced by isoproterenol and norepinephrine in low esophageal sphincter(L.E.S.) of rabbit was potentiated by addition of the extract. In conclusion, the Banhahubagtang exhibited anticonvulsive, sedative and L.E.S. inhibitory activities. These experimental results might indicate to be coincided with the indications for neuro-esophago-stenosis, esophagitis, esophagia, gastralgia, and neurosis which are well referred to the literature of oriental medicine.

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ESOPHAGEAL DYSMOTILITY IN PATIENTS WITH GLOBUS SENSATION (인두 이물감 환자의 식도 운동성 장애)

  • Lee, Heung-Man;Oh, Seung-Cheol;Lee, U-Seob;Kim, Kyung-Hyun;Choi, Geon;Bak, Young-Tae
    • Korean Journal of Bronchoesophagology
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    • v.2 no.2
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    • pp.232-237
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    • 1996
  • Burning and lump sensation in the throat is a common disorder in middle aged woman. It is generally considered to be a neurotic origin but its pathophysiology is still remained unknown. The purpose of this study was to evaluate the prevalence of the Pharyngoesophageal structural lesions and the esophageal motility disorders among the patients with globus pharyngeus and to elucidate whether any specific manometric abnormality might have any causative role in the pathogenesis of the globus sensation, and we also wanted to know whether such tests were necessary in evaluating those patients. Structural lesions were demonstrated in 21 cases(17.5 %) among 120 patients. But among 44 controls, there were also Two cases(4.5 %) of structural lesions, and there was less significantly difference in the prevalence of the structural lesions between the patients and controls(p=0.0625) Manometric abnormalities over the lower esophageal sphincter and the lower esophageal body were demonstrated in 28 cases (23.3 %) of the patients, while only one case (2.3 %) of the controls revealed such abnormality ( p=0.0037). Various manometric parameters of the upper esophageal sphincter and pharynx showed no difference between the patients and controls except the upper esophageal sphincter pressure at lateral sides which was lower in patients than in controls (p=0.0034). Globus sensation is a kind of symptom of esophageal dysmotility, and esophageal manometry is necessary to detect such abnormality in patients with globus sensation, Careful physical examination is also necessary to detect structural lesions in the pharynx and esophagus.

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Esophageal Pressure Monitoring in Normal Korean Adults (정상 한국성인의 식도내압 측정)

  • 정황규
    • Journal of Chest Surgery
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    • v.13 no.4
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    • pp.462-469
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    • 1980
  • Here, I and wer report the results of our studying about; 1. The length of esophagus and sphincters; 2. Resting pressure of upper sphincter, upper esophagus, mid-esophagus, lower esophagus and lower sphincter; 3. Pressure changes in swallowing at these points of esophagus; 4. Resting and swallowing pressure curves in these points in 50 normal Korean adults. In addition to these we wbserved pressure inversion point, slow and fast components of phasic pressure which are originating from respiration and heart beat. And we studied transportation time and speed of peristalsis. The speed of peristalsis is faster in the lower esophagus than in the upper. I can probalby be proud in the results of these study because these will become a standard criteria in the further evaluation of esophageal functional disturbances in such lesions as; Achalasia, Hiatal hernia, Esophageal canceer, Scleroderma, diverticula.

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Inflammatory Changes in Esophagus and Lower Esophageal Sphincter of HCI-elicited Esophagitis in Cats (HCl에 의한 식도염에서 식도와 하부괄약근의 점막과 근육세포의 인증변화)

  • 심상수;이승준;김창종;손의동;이무열;신용규
    • YAKHAK HOEJI
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    • v.46 no.1
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    • pp.58-62
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    • 2002
  • The underlying mechanism by which the reflux of gastric juice elicits oesophagitis remaind unclear. To investigate inflammatory response to HCI in tissue of esophagus and lower esophageal sphincter experimental esophagitis was elicited by perfusion of 0.1 N HCI in cats. There was no difference in phospholipase $A_2$ (PLA$_2$) activity of tissue between control and esophagitis. Myeloperoxidase activity in esophagitis was significantly greater than that of control. However histamine content in esophageal mucosa of esophagitis was significantly smaller than that of control. These finding suggest that inflammatory response to HCI in esophagitis is related to changes of myeloperoxidase activity and histamine rather than change of PLA$_2$ activity.

A Comparative Study of Sepiae Os, Arcae Concha, Ostreae Concha and Esomeprazole in a Mouse Model of Reflux Esophagitis (역류성 식도염 생쥐 모델에서 해표초, 와릉자, 모려와 Esomeprazole의 치료효과에 대한 비교 연구)

  • Song, Chang-Hun;Baek, Tae-Hyun
    • The Journal of Korean Medicine
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    • v.39 no.2
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    • pp.92-105
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    • 2018
  • Objectives: This aim of this study is to compare the reflux esophagitis improvement effects of Sepiae Os, Arcae Concha, Ostreae Concha, and Proton Pump Inhibitor(esomeprazole) through rat experiments. Methods: NO production inhibitory effect was measured by NO production amount and iNOS mRNA expression level in cell lines. iNOS, $TNF-{\alpha}$ and $p-I{\kappa}B$, and serotonin were compared using immunohistochemistry at the rat reflux esophagitis. Reflux esophagitis connection external form, lower esophageal sphincter, and gap were observed and an esophageal inflammatory indicator, IL-6 activity was also evaluated by immunohistochemistry. Results: NO production and iNOS mRNA expression was showed concentration dependent decrease in cell lines treated with Sepiae OS, Arcae Concha, and Ostreae Concha at the experiments of cell lines. In the suppression of iNOS and $p-I{\kappa}B$ at the rat reflux esophagitis, Sepiae Os treat group(SOT) and Ostreae Concha treat group(OCT) were more effective. In the increase of serotonin at the rat reflux esophagitis, ACT, MT and OCT were more effective. Damage of lower esophageal sphincter, and gap between esophageal keratin and mucosa were observed less at the SOT, ACT, OCT. In the suppression of IL-6 at the rat reflux esophagitis, SOT and OCT were more effective than GE and, SOT was more effective than MT significantly. Conclusions: The anti-inflammatory effect was the best in the SOT and lower esophageal sphincter muscle contraction was the best in the ACT at the rat reflux esophagitis. Sepiae OS was more effective than esomeprazole in the suppression of iNOS, $TNF-{\alpha}$, and IL-6.

Thoracoscopic Esophagomyotomy in Achalasia -Case Report- (흉강경을 이용한 식로근 절개술 -1례 보고-)

  • 백효채
    • Journal of Chest Surgery
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    • v.27 no.8
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    • pp.717-721
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    • 1994
  • Extramucosal esophagomyotomy by thoracotomy, first described by Heller in 1913 was the principal therapy for achalasia. Recently however, video-assisted thoracoscopic surgery has been implied in esophageal surgery, and we have experienced 23 year old male patient with dysphagia and was diagnosed as achalasia who underwent thoracoscopic esophagomyotomy. The esophagogram showed typical bird beak appearance and the lower esophageal sphincter pressure was increased to 35 mmHg. Thoracoscopic surgery was done twice due to incomplete myotomy in first operation and the patient was released of dysphagia in the second operation.

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