• 대한핵의학회지
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• 제35권1호
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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.

• 생명과학회지
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• 제26권11호
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• pp.1253-1258
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• 2016

만삼(Codonopsis pilosula)의 뿌리를 말린 한약재인 당삼은 오래 전부터 우리나라와 중국 등지에서 위장관 기능항진에 전통적으로 쓰여 왔다. 본 연구에서는 당삼의 열수 및 에탄올 추출물을 제조하여 실험하였는데, 우선 마우스 단회 투여 경구 독성 시험 결과, 두 추출물 모두 5 g/kg의 고용량 투여 시에도 급성 독성을 나타내지 않았다. 당삼 추출물이 위장관 운동 기능에 미치는 영향을 검정하기 위해, 마우스에서 in vivo 위 배출 속도 및 위장관 이송률을 측정하는 실험을 수행하였다. 두 추출물 모두 마우스의 위 배출 속도에는 유의적인 영향을 주지 못한데 반해, 당삼 열수 추출물은 정상 및 실험적 위장관 운동 저해 마우스에서 모두 위장관 이송률을 유의적으로 증가시켰으며, 용량 의존적 증가 양상을 보였다. 이상과 같이, 본 연구에서는 당삼 열수 추출물이 정상 및 위장관 운동 기능 저해 상황의 마우스에서 모두 위장관 이송률을 증가시켰음을 최초로 보고하였으며, 이는 당삼 열수 추출물이 잠재적으로 인간의 위장관 운동 기능 저해 상황을 개선하는 신약 또는 건강 보조제로 개발될 수 있는 후보 물질임을 시사한다.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제22권6호
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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.

• 대한한의학회지
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• 제40권1호
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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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• 제15권4호
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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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• 제3권1호
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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.

• 생명과학회지
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• 제26권12호
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• pp.1466-1469
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• 2016

운향과(Rutaceae) 식물의 과실을 소재로 하는 일군의 한약재들은 위장관 운동 기능 항진을 목적으로 우리나라와 중국 등지에서 오래 전부터 널리 사용되어 왔으며, 대표적인 약재로 각각 탱자나무 및 광귤나무의 미성숙 과실인 지실 및 지각, 각각 광귤나무 및 귤나무의 성숙 과피인 등피 및 진피 등이 있다. 본 연구에서는, 이러한 운향과 과실 유래 한약재들이 위장관 운동 기능에 미치는 영향을 검정하고 이 약재들 간의 효능을 비교하기 위해, 이들 한약재의 열수 및 에탄올 추출물을 제조하여 마우스에 경구 투여한 후 위 배출 속도 및 장 이송률을 측정하는 실험을 수행하였다. 본 연구는, 공통 성분을 다수 함유하는 운향과 과실 유래 한약재들 간의 위장관 운동 기능개선 효과를 in vivo 동물 실험을 통해 직접 비교한 최초의 연구 자료로서 의미를 가진다. 특히, 등피 에탄올 추출물 투여 시 위 배출 속도에는 유의적인 변화 없이 장 이송률의 유의적 및 용량 의존적 증가 양상을 보였으며, 이전 연구들을 통해 장 이송률 증가 효능이 보고된 바 있는 지실, 지각, 진피 열수 추출물 투여군들과 비교했을 때에도 수치 상으로 등피 에탄올 추출물의 장 이송률이 가장 높았다.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제21권1호
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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.

• 생명과학회지
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• 제24권3호
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• pp.260-265
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• 2014

귤나무(Citrus unshiu)의 과피를 말린 한약재인 진피(Aurantii Nobilis Pericarpium; ANP)는 오래 전부터 대한민국을 비롯한 동아시아에서 위장관 운동 관련 질환의 치료에 전통적으로 쓰여 왔다. 본 연구에서는 진피 주정 추출물(ANP-E)을 제조하여 실험하였는데, 우선 ANP-E는 5 g/kg의 고용량을 mouse에 경구 투여하였을 때에도 급성독성을 나타내지 않았다. ANP-E가 위장관 운동 기능에 미치는 영향을 파악하고 이를 cisapride의 효과와 비교하기 위하여, mouse를 대상으로 위장관 이송률을 측정하는 실험을 수행하였다. Cisapride는 20세기 말까지 다양한 위장관 운동 저해 상황에서 임상적으로 광범위하게 적용되었던 최고의 위장관 운동 촉진제였으나, 치명적인 부작용으로 인하여 2000년 이후 시장에서 철수된 약물이다. 실험 결과, ANP-E는 정상 및 위장관 운동 저해 상황에서 모두 용량 의존적으로 위장관 운동을 촉진시키는 것으로 나타났다. ANP-E의 위장관 운동 촉진 효과를 cisapride와 비교해 보면, 정상 mouse에서는 cisapride와 거의 대등한 위장관 이송률 수치를 나타내었으며, 특히 위장관 운동 저해 상황에서는 cisapride보다 약효 및 안전성 측면에서 모두 비교 우위를 점하는 강력한 위장관 운동 기능개선 효과를 보였다. 이상과 같은 결과들은, ANP-E가 인간의 위장관 운동 기능 저해 상황을 개선할 수 있는 새롭고 강력한 신약 후보 물질이자, 아직 시장에 출현하지 않고 있는 cisapride의 대체 의약품으로서 개발 가능함을 시사하고 있다.

• Journal of Neurogastroenterology and Motility
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• 제24권4호
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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.