• The Korea Journal of Herbology
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• v.36 no.3
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• pp.1-8
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• 2021

Objective : Reflux esophagitis (RE), one of gastroesophageal reflux disease (GERD), is a disease that causes inflammation due to reflux of stomach contents such as stomach acid and pepsin due to the unstable gastroesophageal sphincter, and is currently increasing worldwide. The currently used treatment for reflux esophagitis has various side effects. Therefore, in this study the effect of Toosendan Fructus extract on chronic acid reflux esophagitis in rats was evaluated in order to find a new treatment material for reflux treatment. Methods : After inducing reflux esophagitis through surgery, the group was separated and the drug was administered for 2 weeks; Normal rats (Normal, n=8), chronic acid reflux esophagitis rats (Control, n=8), Toosendan Fructus 200 mg/kg body weight/day-treated chronic acid reflux esophagitis rats (TF, n=8). After, we were taken esophageal tissue and esophageal mucosa damage was identified, and analyzed the expression of NADPH oxidase, AP-1/MAPK-related proteins, and tight junction proteins by western blot in esophageal tissue. Results : Toosendan Fructus administration significantly protected the esophageal mucosal damage of reflux esophagitis. Also, Toosendan Fructus significantly reduced the expression of NADPH oxidases (NOX2 and p22^phox) and AP-1/MAPK-related proteins (c-Fos, c-Jun, p-p38, p-ERK, and p-JNK). In addition, it significantly increased the expression of tight junction proteins (Occludin, Claudin-3, and Claudin-4). Conclusions : These results suggest that Toosendan Fructus reduced damage to the esophageal mucosa by protecting the esophageal mucosa by upregulating tight junctions proteins as well as inhibiting the AP-1/MAPK pathway through reducing NADPH oxidases expression.

• Journal of Chest Surgery
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• v.17 no.4
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• pp.792-795
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• 1984

The modified Hellers myotomy for esophageal achalasia is known as the best procedure. A properly performed transthoracic esophagomyotomy is essential to prevent complications. But it has some problems such as persistent achalasia due to inadequate myotomy, recurrence due to the healing of myotomy and reflux esophagitis due to destruction of the lower esophageal sphincter. The methods of the reoperation after esophagomyotomy for achalasia of the esophagus consist of 1 ] for persistent achalasia due to inadequate myotomy, additional myotomy feasible. 2] for esophageal reflux, a long-limb jejunal gastric drainage after vagotomy and hemigastrectomy, jejunal after conservative resection for stricture. We experienced 3 cases of reoperation after esophagomyotomy for achalasia of the esophagus. The 1st and 3rd case belongs to 30 cases which were undertaken the primary operation at the National Medical Center from 1961 to 1984. The 2nd case was undertaken the primary operation at other hospital. The 1st and 3rd case were reoperated because of persistent achalasia due to inadequate myotomy and 2rid case was caused by stricture due to reflux esophagitis. The methods of the reoperation were additional myotomy in 1st case, esophagogastrectomy and lower thoracic esophagogastrostomy in 2nd case, and esophagogastrectomy and mid-thoracic esophagogastrostomy in 3rd case. All three cases were complicated with postoperative reflux esophagitis.

• Journal of Chest Surgery
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• v.34 no.10
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• pp.763-768
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• 2001

Background: The high pressure zone(HPZ) at the gastroesophageal junction is an important barrier for prevention of gastroesophageal reflux. Smooth muscle layers in the lower esophageal sphincter mainly contributes to HPZ at the throacoabdominal junction. The purpose of this study was to investigate the manometric characteristics of the thora-coabdominal junction in patients after surgical removal of the lower esophageal sphincter. Material and Method: Twenty two patients with prior esophagogastrectomy(10 Ivor-Lewis method and 12 left thoracotomy) and 30 normal adults(control group) were studied manometrically. Result: Esophageal manometry showed a HPZ and pressure inversion points distal to the anastomosis in 12 of 22 patients(2 of 10 patients with Ivor-Lewis method and 10 of 12 patients with left thoracotomy) and a HPZ in 30 of 30 normal adults. The location of HPZ front nostril was not significant different between the two groups(42.5$\pm$0.9cm in patients and 43.9$\pm$2.1cm in the control), while the length of HPZ was shorter in patients than in the control(2.13$\pm$0.6cm vs 2.83$\pm$0.59cm). By SPT and RPT, pressures of HPZ at rest were lower in patients(13.78$\pm$1.63mmHg, 28.58$\pm$6.06mmHg) than in control(20.3$\pm$4.95mmHg, 42.80$\pm$15.91mmHg). The HPZ relaxed partially in response to deglutition(84.4% in patient, 90.5% in control group) and contracted in response to increased intra- abdominal pressure induced by leg lifts(HPZ/ Intra-abdominal pressure= 1.81$\pm$0.23 in patient, 2.13$\pm$ 0.58 in control group).

• Journal of Haehwa Medicine
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• v.10 no.2
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• pp.91-96
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• 2002

We arrived at the following conclusions after we have studied esophagitis through the literatures of oriental and western medicine. 1. The western medical causes of acute esophagitis are corrosiveness chemical material, esophageal or gastric disease, trauma, blister stomatitis, filamentous fungus infection and uremia of chronic patient etc, and the oriental medical causes are qi and blood stagnation, blood stasis and stagnation, stagnant phlegm by coldness, heating, dyspepsia and food poisoning etc. 2. The western medical causes of chronic esophagitis are malfunction of lower esophageal sphincter, esophageal tom chink and hernia, increase of gastric pressure by overeating, fatness, pregnancy and ascites etc, and the oriental medical causes are asthenic cardiac qi, hepatic qi attacking stomach by seven kinds of depression, cold-damp stagnation and insufficiency of gastric qi by overeating, excessive drinking and sexual indulgence etc. 3. The main symptoms of acute esophagitis are severe chest pain, instantly vomiting, swallowing pain etc, and chronic esophagitis are occasionally light chest pain, heart bum, anorexia, dysphagia, dizziness, general body weakness etc. These symptoms are come under thoracic obstruction, acid regurgitation, vomiting and chest pain of oriental medicine. 4. The western medical diagnoses of acute and chronic esophagitis have used radiation test, esophageal endoscopy, esophageal pressure test and biopsy etc, and the oriental medical diagnoses have used syndrome differentiation by four examination of inspection, listening and smelling examination, inquiring, pulse-taking and palpitation. 5. The western medical treatments of acute esophagitis have regarded preservation stability of esophagus as a principle, and the oriental medical treatments mainly have used expelling pathogen of expelling cold and regulating qi, cooling and removing stasis, promoting blood circulation to remove blood stasis, eliminating phlegm and regulating qi. 6. The western medical treatments of chronic esophagitis have regarded decrease flowing backward of gastric juice as a purpose, and the oriental medical treatments mainly have used strengthening body resistance of replenishing and strengthening cardioqi, dispersing stagnated hepatoqi, expelling cold and dehygrosis, invigorating stomach and nourishing qi.

• Tuberculosis and Respiratory Diseases
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• v.65 no.4
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• pp.323-327
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• 2008

Systemic lupus erythematosus (SLE) is a multisystem disorder where the etiology is not clearly known. Symptomatic chronic interstitial pneumonitis is an uncommon manifestation, with a reported prevalence of 3~13%. Achalasia is rare disease that presents with failure in the relaxation of the esophagus sphincter. A 22-year-old woman was admitted to our hospital because of fever, cough and dyspnea. The patient had a history of pericardial effusion and Raynaud's phenomenon. The results of laboratory tests indicated the presence of lymphopenia and included positive antibody tests for antinuclear antibody and anti Sm antibody. A chest X-ray demonstrated the presence of peribronchial infiltration on both lung fields. A Chest CT image showed interlobar septal thickening, ground-glass opacity and a honeycomb appearance in both lung fields and esophageal dilatation with air fluid level. An esophagogram showed the presence of dilated esophagus ends that represented the non-relaxed lower esophageal sphincter. Manometry demonstrated incomplete sphincter relaxation. The case was diagnosed as systemic lupus erythematosus associated with interstitial pneumonia and achalasia.

• Journal of Chest Surgery
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• v.31 no.3
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• pp.329-335
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• 1998

A 55-year-old male was admitted to our hospital complaining of chest discomfort, dysphagia and severe pain on swallowing. Esophageal manometry showed that there was no relaxation of lower esophageal sphincter to swallowing. There was double barrelled esophagus or mucosal stripe appearance on esophagogram. Endoscopy revealed an appearance as if an esophago-tracheal fistula had been made at the level of the upper thoracic esophagus. Also, two slit-like mucosal tears was seen on the lower esophagus. There after, fasting and total parenteral nutrition for several weeks failed to bring about any changes in his symptoms. So, as treatment, primary closure of the upper opening of the false lummen was performed under general anesthesia. Soon after the surgical procedure, the patient's symptoms were improved except for mild dysphagia. He was discharged after oral intake had been juduciously commenced with fluids and soft diet subsequently. During follow-up in out-patient department, he had no specific symptoms including fever or dysphagia and massive dissection of the esophagus was improved on esophagogram. We report the experience of a case of spontaneous submucosal dissection of the esophagus which required conservative and surgical management

• Korean Journal of Bronchoesophagology
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• v.2 no.1
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• pp.19-28
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• 1996

이상에서 고찰한 위식도역류의 병태를 간략히 요약하면 다음과 같다. 위액에는 염산, 펩신, 담즙산과 췌효소등을 포함하고 있어 역류된 위액은 상부 기관식도관에 자극을 주거나 손상을 줄 수 있으며 개개인의 점막 상피의 저항도와 적절한 타액의 분비는 위액에 의한 손상의 정도를 결정하는 중요한 요소로 알려져 있다. 위식도역류로 인한 많은 증상이나 소견은 두가지의 기전으로 나타나서 첫째, 역류된 위액이 직접 조직에 영향을 주거나 둘째, 간접적으로 식도 하부에 분포된 미주신경에 의한 연관자극에 의해 일어나는데 위식도역류의 증상 중 두부, 경부, 심장 및 폐장의 증상은 이들 장기에 미주신경의 일부가 같이 분포하여 일어나는 간접적인 기전이다. 하부식도괄약근(lower esophageal sphincter)의 기능은 역류를 막는 가장 중요한 요소로 알려져 있어 간헐적으로 하부식도 괄약근의 압력이 떨어지면 역류가 일어나게 된다. 정상적인 식도의 연동운동은 식도에 역류된 위내용물을 위로 제거되는데 중요하며 위식도역류 환자에서 흔히 연동운동이 저하되거나 비정상적인 연동운동을 관찰할 수 있다. 또한 위내용물이 소장으로 비워지는 시간이 연장되어 위내용물이 위내에 축적되는 것도 위식도역류의 원인의 하나로 생각된다. 이러한 위식도역류의 병태를 연구하는 것은 이 질환의 이해에 도움을 줄 것으로 생각된다.

• Proceedings of the KOR-BRONCHOESO Conference
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• 1977.06a
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• pp.9.3-9
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• 1977

Achalasia is the disease of nonorganic obstruction of the cardia associated with dilatation of the esophagus, and of unknown etiology characterized by failure of relaxation of the inferior esophageal sphincter and lack of normal peristalsis in the body of the esophagus. This disorder is primarily one of neuromuscular dysfunction, most probably due to a central nervous system lesion with consequent nerve, ganglion and muscle degeneration. The characteristic symptoms are dysphagia, regurgitation and epigastric pain etc. We have experienced a case of Achalasia in 43 aged female with good results by daily mercury bougienage.

• Journal of Veterinary Clinics
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• v.38 no.6
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• pp.290-294
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• 2021

An 8-year-old neutralized male Dachshund was presented with severe vomiting, anorexia, and weight loss for two weeks. The patient had to feed in a standing position due to problem of vomiting immediately after meal. Serum chemistry and CBC results were all within reference limits. CT imaging revealed a mass distributed widely in the caudal part of the esophagus including the sphincter and the gastric cardia. Complete surgical removal was difficult because of adhesion to the caudal vena cava. A partial surgical excision and gastropexy with MIC-key feeding tube were performed under the owner's permission. Histologically, the mass was interpreted as leiomyoma. This patient is doing well at present time, six years after the tube installation in 2015.

• CELLMED
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• v.13 no.4
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• pp.15.1-15.6
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• 2023

Objective: A case report on improving the symptoms of patients with reflux esophagitis by Ortho-Cellular Nutrition Therapy (OCNT). Methods: A 61-year-old Korean male who has been taking proton-pump inhibitors in the hospital for a long time due to the symptoms of reflux esophagitis. Results: The practice of Ortho-Cellular Nutrition Therapy (OCNT) restored the patient's mucosal cells of the esophageal sphincter, which led to the judgment that he was cured of reflux esophagitis. Conclusion: Ortho-Cellular Nutrition Therapy (OCNT) can be effective in relieving the symptoms of patients with reflux esophagitis.