• Journal of Chest Surgery
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• 제17권2호
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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.

• 대한기관식도과학회지
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• 제3권2호
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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.

• 대한한방내과학회지
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• 제34권4호
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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.

• 대한기관식도과학회지
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• 제2권2호
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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.

• Journal of Chest Surgery
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• 제13권4호
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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.

• 약학회지
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• 제46권1호
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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.

• 대한한의학회지
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• 제39권2호
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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.

• Journal of Chest Surgery
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• 제27권8호
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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.

• Archives of Pharmacal Research
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• 제29권5호
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• pp.400-404
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• 2006

This study examined the effect of Gamma-Amino butyric acid (GABA) and selective GABA receptor related drugs on the electrically stimulated relaxation in the lower esophageal sphincter muscle (LES) of a cat. Tetrodotoxin $(10^{-6}\;M)$ suppressed the electrically stimulated (0.5-5 Hz) relaxation of the LES. However, guanethidine $(10^{-6}\;M)$ and atropine $(10^{-6}\;M)$ had no effect indicating that the relaxations were neurally mediated via the nonadrenergic and noncholinergic (NANC) pathways. NG-nitro-L-arginine methyl ester ($10^{-4}M$, L-NAME) also inhibited the relaxant response but did not completely abolish the electrically stimulated relaxation with 60% inhibition, which suggests the involvement of nitric oxide as an inhibitory transmitter. This study examined the role of GABA, an inhibitory neurotransmitter, on neurally mediated LES relaxation. GABA ($10^{-3}-10^{-5}M$, non selective receptor agonist), muscimol ($10^{-3}-10^{-5}M$, GABA-A agonist), and baclofen ($10^{-3}-10^{-5}M$, GABA-B agonist) had no significant effect on the electrically stimulated relaxation. Moreover, bicuculline ($10^{-5}M$, GABA-A antagonist) and phaclofen ($10^{-5}M$, GABA-B antagonist) had no inhibitory effect on the electrically stimulated relaxation. This suggests that GABA and the GABA receptor are not involved in the electrically stimulated NANC relaxation in the cat LES.

• Journal of Gastric Cancer
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• 제24권2호
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• pp.137-144
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• 2024

Purpose: Laparoscopic proximal gastrectomy (LPG) is a viable choice for treating proximal gastric lesions. However, the occurrence of severe reflux has limited its widespread adoption. To address this issue, the double flap technique (DFT), which incorporates artificial lower esophageal sphincteroplasty, has been developed to prevent reflux problems after proximal gastrectomy. In this study, we aimed to investigate the usefulness of this technique using high-resolution manometry (HRM), impedance pH monitoring, and esophagogastroduodenoscopy (EGD). Materials and Methods: The findings of pre- and postoperative 6-month HRM, pH monitoring, and EGD were compared for 9 patients who underwent LPG with DFT for various proximal gastric lesions at Incheon St. Mary's Hospital from January 2021 to December. Results: A total of 9 patients underwent proximal gastrectomy. Approximately half of the patients had Hill's grade under II preoperatively, whereas all patients had Hill's grades I and II in EGD findings. In the HRM test, there was no significant difference between distal contractile integral (1,412.46±1,168.51 vs. 852.66±495.62 mmHg·cm·s, P=0.087) and integrated relaxation pressure (12.54±8.97 vs. 8.33±11.30 mmHg, P=0.27). The average lower esophageal sphincter (LES) pressure was 29.19±14.51 mmHg preoperatively, which did not differ from 19.97±18.03 mmHg after the surgery (P=0.17). DeMeester score (7.02±6.36 vs. 21.92±36.17, P=0.21) and total acid exposure time (1.49±1.48 vs. 5.61±10.17, P=0.24) were slightly higher, but the differences were not statistically significant. Conclusions: There is no significant functional difference in HRM and impedance pH monitoring tests after DFT. DFT appears to be useful in preserving LES function following proximal gastrectomy.