• The Korean Journal of Nuclear Medicine
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• v.35 no.1
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• pp.1-11
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• 2001

Current scintigraphic tests of gastrointestinal motor function provides relevant pathophysiologic information, but their clinical utility is controversial. Many scintigraphic methods are developed to investigate gastrointestinal motility from oral cavity to colon. These are esophageal transit scintigraphy, oropharyngeal transit study, gastric emptying test, small bowel transit time measurement, colon transit study and gastroesopahgeal reflux scintigraphy. Scintigraphy of gastrointestinal tract is the most physiologic and noninvasive method to evaluate gastrointestinal motility disorders. Stomach emptying test is regarded as a gold standard in motility study. Gastrointestinal transit scintigraphy also has a certain role in assessment of drug effect to GI motility and changes alter therapy of motility disorders. Scintigraphy provides noninvasive and quantitative assessment of physiological transit throughout the gastrointestinal tract, and it is extremely useful for diagnosing gastrointestinal motor dysfunction. This article reviews the current procedures, indications, significance and guidelines for gastrointestinal motility measurements by scintigraphy.

• Journal of Life Science
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• v.26 no.11
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• pp.1253-1258
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• 2016

Although major advances have been achieved in our understanding and treatment of diseases in many areas of medicine, relatively few improvements have been made in the area of gastrointestinal (GI) motor function. The dried root of Codonopsis pilosula (Franch.) Nannf. (CP) has been used as a traditional folk medicine for improving poor GI function in East Asia, including China and Korea. In the present study, neither aqueous (CP-W) nor ethanolic (CP-E) extracts of CP showed significant toxicity, even at an oral dose of 5 g/kg to mice. The effects of CP-W and CP-E on GI motor function were investigated by measuring in vivo the gastric emptying rate (GER) and intestinal transit rate (ITR) in mice. In normal mice, the ITR was significantly increased by CP-W in a dose-dependent manner, whereas the GER was not significantly affected by any CP extracts. The ITR was significantly retarded in the mice with experimental GI motility dysfunction (i.e., peritoneal irritation by acetic acid) compared with that in normal mice. However, the retardation was significantly recovered by the pre-treatment of CP-W in a dose-dependent manner. The above results suggest that CP-W might be a potential prokinetic agent preventing or alleviating GI motility dysfunctions in human patients.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.22 no.6
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• pp.518-526
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• 2019

Purpose: Limited means exist to assess gastrointestinal activity in pediatric patients postoperatively. Recently, myoelectric gastrointestinal activity recorded by cutaneous patches has been shown in adult patients to be predictive of clinical return of gastrointestinal function postoperatively. The aim of this case series is to demonstrate the feasibility of this system in pediatric patients and to correlate myoelectric signals with return of bowel function clinically. Methods: Pediatric patients undergoing abdominal surgery were recruited to have wireless patches placed on the abdomen within two hours postoperatively. Myoelectric data were transmitted wirelessly to a mobile device with a user-interface and forwarded to a cloud server where processing algorithms identified episodes of motor activity, quantified their parameters and nominally assigned them to specific gastrointestinal organs based on their frequencies. Results: Three patients (ages 5 months, 4 year, 16 year) were recruited for this study. Multiple patches were placed on the older subjects, while the youngest had a single patch due to space limitations. Rhythmic signals of the stomach, small intestine, and colon could be identified in all three subjects. Patients showed gradual increase in myoelectric intestinal and colonic activity leading up to the first recorded bowel movement. Conclusion: Measuring myoelectric intestinal activity continuously using a wireless patch system is feasible in a wide age range of pediatric patients. The increase in activity over time correlated well with the patients' return of bowel function. More studies are planned to determine if this technology can predict return of bowel function or differentiate between physiologic ileus and pathologic conditions.

• The Journal of Korean Medicine
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• v.40 no.1
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• pp.99-113
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• 2019

Objectives: This study is designed to identify the responses of autonomic nervous system and gastrointestinal function which are induced by acupuncture at abdominal anterior cutaneous nerve. Methods: This study is one group before and after pilot study. Subjects were treated once, after having been fasting six hours. They had before tests, labeling points for acupuncture, acupuncture, and after tests in order. The points of acupuncture were motor points of rectus abdominis where the abdominal anterior cutaneous nerve came to the skin from abdominal wall. Before and after tests were consisted of three things: Digital Infrared Thermographic Imaging(D.I.T.I.), Heart Rate Variability(HRV), and Recording of bowel sounds. Results: There were significant differences on the skin temperature of upper body and the frequency of bowel sounds(p<0.001, p<0.001). The HRV parameters and volume of bowel sounds had no significant differences(p>0.05, p>0.05). Conclusion: Even though no significant differences in HRV parameters, the significant differences of skin temperature of upper body and frequency of bowel sounds could mean acupuncture at abdominal anterior cutaneous nerve could affect the autonomic nervous system and gastrointestinal function. However, this study had no group to compare with. Future randomized project should address this issue.

• 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.

• Annals of Clinical Neurophysiology
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• v.3 no.1
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• pp.43-46
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• 2001

Acute pandysautonomic neuropathy(APN) is an uncommon clinical entitiy involving vasomotor, sudomotor, pupilomotor, secretomotor and other autonomic systems. Both sympathetic or parasympathetic fibers are involved with relative preservation of somatic sensory and motor function. Although APN shares several clinical features with GBS, it is not clear whether APN is a subvariety of GBS. We report two young patients with APN. Patient 1 was a 18-year-old girl with recurrent fainting spells. Patient 2 was a 23-year-old man sufferring from unexplained nausea and vomiting. Both had a history of previous upper respiratory infection. They presented with gastroparesis, anhydrosis and orthostatic hypotension. Mild numbness and tingling sense was present, but motor power was intact. Neurologic examination showed bilateral tonic pupil, decreased pain and vibration sense, and absent tendon reflexes. Nerve conduction study indicated diffuse sensorimotor polyneuropathy. Nerve biopsy in patient 2 revealed axonal degeneration. After conservative management, gastrointestinal symptoms were improved in patient 2, however, patient 1 suffered from the symptoms lasting more than several months. These cases suggest that post-infectious dysautonomic symptoms in young patient may indicate the diagnosis of APN. Although the natural course is generally benign, accurate diagnosis and proper management may be mandatory for the better clinical outcome.

• Journal of Life Science
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• v.26 no.12
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• pp.1466-1469
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• 2016

A group of traditional folk medicines obtained from the fruits of Rutaceae plants, such as Ponciri Fructus Immaturus (PFI) from Poncirus trifoliata Raf., Aurantii Fructus Immaturus (AFI) and Aurantii Pericarpium (AP) from Citrus aurantium L., and Aurantii Nobilis Pericarpium (ANP) from Citrus unshiu Marc., has been widely used for improving poor gastrointestinal function in East Asia, including in China and Korea. In the present study, the effects of Rutaceae-fruit-derived folk medicines on gastrointestinal motor function were investigated and compared by measuring in vivo gastric emptying and intestinal transit in mice. Among the aqueous and ethanolic extracts of some Rutaceae-fruit-derived folk medicines, an ethanolic extract of AP (AP-E) significantly accelerated intestinal transit in a dose-dependent manner without affecting gastric emptying. Furthermore, the intestinal transit rate of AP-E was the highest among all extracts examined in this study, including aqueous extracts of PFI, AFI, and ANP, of which the activities of accelerating intestinal transit have been already reported.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.21 no.1
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• pp.20-27
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• 2018

Purpose: Minimal change esophagitis (MCE) is a reflux disease without mucosal breaks, known to be partially associated with abnormal gastric motor function. Electrogastrography (EGG) is commonly applied to assess gastric motor function in a noninvasive fashion. We aimed to determine the relationship between MCE and gastric myoelectrical activity (GME) recorded on EGG in children. Methods: We retrospectively assessed the records of 157 children without underlying disease who underwent both EGG and upper gastrointestinal endoscopy at Gachon University Gil Medical Center between January 2010 and June 2015. The children were stratified according to the appearance of the esophagus (normal vs. MCE). Between-group differences in EGG parameters and their correlation with each MCE finding were statistically analyzed. Results: Only the power ratio, one of the EGG parameters analyzed, differed significantly between the two groups (MCE, $1.68{\pm}3.37$ vs. normal, $0.76{\pm}1.06$; p<0.05), whereas the other parameters, such as dominant frequency, dominant power, and the ratio of abnormal rhythm, showed no differences. Among children with MCE, significant correlations were noted between erythema and power ratio (p<0.05), friability and postprandial dominant frequency (p<0.05), and edema and/or accentuation of mucosal folds and pre-prandial frequency (p<0.05). Helicobacter pylori infection correlated with postprandial arrhythmia (MCE, $33.59{\pm}15.52$ vs. normal, $28.10{\pm}17.23$; p<0.05). EGG parameters did not differ between children with normal esophagus and those with biopsy-proven chronic esophagitis. Conclusion: In children with MCE, gastric dysmotility may affect the development of MCE, manifesting as EGG abnormalities. H. pylori infection may also affect GME. However, larger prospective investigations are needed to confirm these findings.

• Journal of Life Science
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• v.24 no.3
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• pp.260-265
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• 2014

Dried Citrus unshiu peels (Aurantii Nobilis Pericarpium; ANP) are used as a traditional folk medicine for the treatment of gastrointestinal (GI) motility disorders in East Asia, including Korea. In the present study, an ethanolic extract of ANP (ANP-E) exhibited no significant toxicity in mice, even at an oral dose of 5 g/kg. The effects of ANP-E on GI motor function were investigated by measuring the intestinal transit rate (ITR) of Evans blue in normal mice and mice with experimental GI motility dysfunction (i.e., peritoneal irritation by acetic acid; PIA). In normal mice, ANP-E significantly increased the ITR in a dose-dependent manner. The ITR in the PIA mice was significantly retarded compared to that in the normal mice. However, ANP-E significantly inhibited this retardation in a dose-dependent manner. Furthermore, in all the models, the potency of ANP-E appeared to be same or higher than that of cisapride, which was used predominantly for the treatment of various GI motility disorders in humans in the 1900s but was removed from the market in 2000 due to fatal side effects. The results suggest that ANP-E has potential as a new prokinetic agent that could be used as a substitute for cisapride.

• Journal of Neurogastroenterology and Motility
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• v.24 no.4
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• pp.669-675
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• 2018

Background/Aims Functional dyspepsia (FD) and irritable bowel syndrome (IBS) are common gastrointestinal (GI) disorders and these patients frequently overlap. Trimebutine has been known to be effective in controlling FD co-existing diarrhea-dominant IBS, however its effect on overlap syndrome (OS) patients has not been reported. Therefore, we investigated the effect of trimebutine on the model of OS in guinea pigs. Methods Male guinea pigs were used to evaluate the effects of trimebutine in corticotropin-releasing factor (CRF) induced OS model. Different doses (3, 10, and 30 mg/kg) of trimebutine were administered orally and incubated for 1 hour. The next treatment of $10{\mu}g/kg$ of CRF was intraperitoneally injected and stabilized for 30 minutes. Subsequently, intragastric 3 mL charcoal mix was administered, incubated for 10 minutes and the upper GI transit analyzed. Colonic transits were assessed after the same order and concentrations of trimebutine and CRF treatment by fecal pellet output assay. Results Different concentrations (1, 3, and $10{\mu}g/kg$) of rat/human CRF peptides was tested to establish the OS model in guinea pigs. CRF $10{\mu}g/kg$ was the most effective dose in the experimental OS model of guinea pigs. Trimebutine (3, 10, and 30 mg/kg) treatment significantly reversed the upper and lower GI transit of CRF induced OS model. Trimebutine significantly increased upper GI transit while it reduced fecal pellet output in the CRF induced OS model. Conclusions Trimebutine has been demonstrated to be effective on both upper and lower GI motor function in peripheral CRF induced OS model. Therefore, trimebutine might be an effective drug for the treatment of OS between FD and IBS patients.