• The Journal of Internal Korean Medicine
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• v.29 no.1
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• pp.117-129
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• 2008

Background & Objective : Naeso-san(NSS) has been used for the treatment of functional dyspepsia, regarded as a gastric dysmotility disease. A main cause of gastric dysmotility is antral dilatation or antroduodenal uncoordination. Therefore, we investigated the effect of NSS on gastric motility and its mechanism of action, as well as the morphologic changes in antral dilatated rats. Methods : Antral dilatated rats were induced by wrapping a nonabsorbable rubber ring(D:6mm, W:4mm, T:1mm) around the 1st portion of the duodenum for 8 weeks. Then morphologic changes were investigated and compared with normal intact rats before and after 8 weeks. Gastric emptying was measured by administration of normal saline(NS) or NSS in normal intact and antral dilatated rats. In another series of experiments to evaluate the mechanism of NSS under delayed conditions, normal intact rats were treated with atropine sulfate(1mg/kg, s.c.), quinpirole HCl(0.3mg/kg, i.p.), $NAME(N^{G}-nitro-L-arginine$ methyl ester, 75mg/kg, s.c.) and cisplatin(10mg/kg, i.p.), respectively. The myoelectrical activity of the gastric smooth muscle was recorded in normal intact and antral dilatated rats. The contractile waves were measured for 30 minutes before and after administration of each solution(NS, NSS). Results : Body weight gain of antral dilatated rats was significantly lower than that of the controls. Futhermore, we found the thickness of the mucosal and muscular layers and surface area of the stomach increased significantly compared with controls. NSS 278㎎/㎏ improved gastric emptying more than normal saline or NSS 93mg/kg in normal intact(p=0.026) and antral dilatated rats(p=0.03). NSS enhanced gastric emptying significantly in the NAME treated group(p=0.002). NSS 278mg/kg increased the significant postprandial dominant power than that of NS in normal intact rats, whereas there was no statistical significance in antral dilatated rats. Conclusions : NSS stimulates gastric motility through the cholinergic pathway. We expect that pathologic model with antral dilatation can be used as an exprimental tool which is similar to dyspepsia and NSS would be effective especially in dysmotility-like functional dyspepsia with antral dilatation or impaired reservoir functions such as gastric adaptive relaxation.

• The Journal of Internal Korean Medicine
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• v.31 no.4
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• pp.857-869
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• 2010

Objectives : The aim of this study was to evaluate whether rats with non-obstructive antral dilation could be a useful tool resembling functional dyspeptic patients. We also investigated the effect of Bojoongikki-tang (BJ), and Youngkaechulgam-tang (YK) in antral dilated rats. Methods : Non-obstructive antral dilation was performed by first wrapping a non-absorbable rubber ring (D:6mm, W:4mm, T:1mm) around the 1st portion of the duodenum causing pyloric obstruction (PO). After 12 weeks, except for some PO group rats used for the control, the rubber ring was removed by performing another operation. The antral dilated rats (AD) were then divided into three groups, a non-treatment group (AD-NT), and two herbal medicine groups each given an extract solution containing 125 mg/kg of Youngkaechulgam-tang (AD-YK) or Bojoongikki-tang (AD-BJ) for 4 weeks. Then gastric contractility was evaluated by bowel sound measurement, and afterwards the changes of the weight, and morphologic changes of the stomach were evaluated for each group including the normal intact group (NI). Results : Loss of weight and enlargement of the stomach surface area was seen in the PO group. Decrease of gastric motility index was observed in the AD-NT group, while the increased surface area of the stomach was not significantly different from the PO group. Youngkaechulgam-tang seemed to increase gastric contraction, whereas Bojoongikki-tang showed no effect. Weight gain of rats was observed in both the AD-YK and AD-BJ groups, but there seemed to be no change of the dilated stomach surface area. Conclusions : The non-obstructive antral dilated rat seems to be an experimental pathologic model that reflects the gastric dysmotility similar to functional dyspeptic patients with antral dilation. Therefore patients with dysmotility-like dyspepsia with antral function disorders should be treated efficiently. As Youngkaechulgam-tang is shown to increase both gastric contraction and weight in antral dilated rats, it may be used for treating functional dyspepsia. However, Bojoongikki-tang should be used with caution in patients with gastric dysmotility.

• The Journal of Internal Korean Medicine
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• v.26 no.4
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• pp.785-794
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• 2005

Little is known concerning the pathophysiology and symptomatology of gastric dysmotility of patients who have sought treatment in eastern traditional medicine. The aim of this study was to investigate gastric electrical activity and clinical characteristics between gastroparesis and non-gastroparetic functional dyspepsia(FD) and assess the necessity to distinguish them for eastern traditional medical treatment. 60 patients were surveyed by questionnaire. Gastric electrical activity was recorded and analyzed using electrogas-trography. Patients were divided into gastroparesis and non-gastroparetic FD by 1.0 of power ratio. Healthy persons were used as reference. Postprandial normogastria of gastroparesis decreased and that of non-gastroparetic functional dyspepsia increased compared before and after meals. Suggested causes of onset were the meat diets that most patients were on in the gastroparesis group, and that drugs that patients in the non-gastroparetic FD group were taking. Distribution of main symptom was equally regular in patients with gastroparesis, but patients with non-gastroparetic FD showed mainly upper abdominal pain and fullness. Values for the gastroparesis group were double those for the non-gastroparesis FD group in frequency of upper GI endosopic examination. Results suggest that effective application of eastern traditional medical treatment requires that first a clear distinction be made in state of gastric dysmotility and clinical characteristics of gastroparesis and non-gastroparesis FD when treating dyspepsia.

• The Journal of Internal Korean Medicine
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• v.25 no.2
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• pp.344-351
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• 2004

Systemic sclerosis Sine scleroderma(ssSSc) is an uncommon subtype of Systemic sclerosis(SSc), which is believed to attack internal organs without causing changes in the skin. Electrogastrography has been known to be a simple, non-invasive, and effective method in assessing gastric motility. In this new study, a case of Systemic sclerosis Sine Scleroderma exhibiting gastric symptoms was observed. For this, we applied herbal medicine. manual acupucture, electro-acupucture, and lumbar skin wanning. After applying these therapies, both systemic and dyspeptic symptoms of the patient improved. Electrogastrography suggests a relation between gastric myoelectrical activity and the patient's improvement in dyspeptic symptoms. Therefore, based on study of Oriental medical classics and recent medical articles, clinically emperical success in treating gastric dysmotility was seen in a patient with Systemic sclerosis Sine Scleroderma.

• 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.

• The Journal of Internal Korean Medicine
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• v.27 no.1
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• pp.276-287
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• 2006

Background & Objective : The herbal medicine Sojukgunbihwan granule has been used for the treatment of functional dyspepsia, generally categorized as a gastric dysmotility disease. However, its mechanisms are not yet well known. Therefore, the effects of Sojukgunbihwan granules on gastric motility in rats was investigated. Methods : The myoelectrical activity of the gastric smooth muscle was recorded by a bipolar electrode placed at the gastric antrum of rats. The contractile waves were measured for 30 minutes before and after intragastric administration of each solution(normal saline, Pyungwisan 40mg/kg, Sojukgunbihwan granules 60mg/kg) and expressed as the motility index. Gastric emptying was measured by the number of glass beads expelled from the stomach(containing one hundred 1mm glass beads) within an hour after glass beads and test drugs(normal saline, Pyungwisan 40mg/kg, Pyungwisan 120mg/kg, Sojukgunbihwan granules 60mg/kg, Sojukgunbihwan granules 180mg/kg) were administered. In another series of experiments to evaluate the mechanisms of Sojukgunbihwan granules under delayed conditions, the rats were treated with atropine sulfate(1 mg/kg, s.c.), cisplatin(10mg/kg, i.p.), and NAME($N^G$-nitro-L-arginine methyl ester, 75mg/kg, s.c.) respectively. Results : Intragastric administration of Sojukgunbihwan granules increased the myoelectrical activity significantly, gastric motility index rose 25%, and gastric emptying of glass beads was significantly enhanced over a period of 60minutes. Under the delayed gastric emptying induced by atropine sulfate, cisplatin, and NAME, Sojukgunbihwan granules aggravated gastric emptying in the atropine sulfate($5.71{\pm}3.45\;vs\;3.71{\pm}4.42$) and cisplatin($13.86{\pm}3.53\;vs\;5.14{\pm}5.05$, p<0.01) treated groups, but enhanced gastric emptying in the NAME treated group($5.00{\pm}3.21\;vs\;11.71{\pm}5.65$, p<0.05). Conclusions : Results suggest that Sojukgunbihwan granules stimulate gastric motility through cholinergic and 5-hydroxytryptamine 3 receptors. Results are indicative of Sojukgunbihwan as an especially effective remedy in dysmotility-like functional dyspepsia with impaired reservoir functions such as gastric adaptive relaxation.

• The Journal of Internal Korean Medicine
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• v.28 no.2
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• pp.209-216
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• 2007

Background & Objective : The herbal medicine JGT has been used for the treatment of functional dyspepsia, generally categorized as a gastric disease. However, its effect and mechanism are not yet well known. Therefore, the effects of JGT on gastric emptying in rats was investigated to know its effectiveness and mechanism. Methods : Gastric emptying effect was measured by the number of glass beads expelled from the stomach within an hour after glass beads and test drugs were administered. In another series of experiments to evaluate the mechanisms of JGT under delayed conditions, the rats were treated with atropine sulfate Results : Intragastric administration of JGT significantly increased gastric emptying of glass beads Under the gastric emptying delayed with atropine sulfate, JGT insignificantly increased gastric emptying of glass beads. Conclusions : These suggest that JGT has a significant effect to stimulate gastric emptying. Results are indicative of JGT as an especially effective remedy for dysmotility-like functional dyspepsia with impaired reservoir function such as gastric adaptive relaxation.

• The Journal of Internal Korean Medicine
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• v.27 no.2
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• pp.471-479
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• 2006

Backgrounds & Objectives: Banhasasimtang granule(BHSST) has been used for the treatment of functional dyspepsia regarded as one of the gastric dysmotility disease. but its mechanisms of action are not well known yet: So we investigated the effects of BHSST on gastric emptying and its mechanisms of action in rats. Methods: Gastric emptying was measured by glass beads(1mm in diameter) expelled from the stomach for 60 min after administration of normal saline(NS) or BHSST 31mg/kg or 93mg/kg in rats. And by the same method gastric emptying was measured after administration of NS or BHSST 93mg/kg in rats treated with atropine sulfate(1mg/kg, s.c.), quinpirol HCI(0.3mg/kg, i.p.), NAME(NG-nitro-L-arginine methyl ester, 75mg/kg, s.c.) or cisplatin(10mg/kg, i.p.) to make delayed gastric emptying. Results: BHSST 93mg/kg improved gastric emptying more than NS or BHSST 31mg/kg(p=0.016). Under the delayed gastric emptying, BHSST 93mg/kg improved gastric emptying in the group treated with NAME$(5.00{\pm}3.101\;vs\;9.00{\pm}3.51,\;p\;=0.046)$, but aggravated it With atropine sulfate$(5.71{\pm}3.45\;vs\;2.57{\pm}1.62,\;p\;=0.050)$ and cisplatin$(12.7{\pm}2.29\;vs\;8.57{\pm}5.06,\;p\;=0.072)$. Conclusions: BHSST improves the gastric emptying through cholinergic and 5-hydroxytryptamine 3 receptors. Especially it is effective to improve gastric emptying delayed by NAME. So we expect that it would be effective in functional dyspepsia with impaired reservoir functions such as gastric adaptive relaxation.

• The Journal of Internal Korean Medicine
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• v.28 no.2
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• pp.242-249
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• 2007

Backgrounds & Objectives : Yukgunjatanggranule (YGJT) ha been used for the treatment of functional dyspepsia, regarded as one of the gastric dysmotility diseases, but its mechanisms of cation are not yet well known, We investigated the effects of YGJT on gastric emptying and its mechanisms of action in rats. Methods : Gastric emptying was measured by glass beads (1mm in diameter) expelled from the stomach for 1 hour and 2 hours after administration ofnormal saline (NS) or YGJT 41.6mg/kg or 124.8mg/kg in rats. By the same method, gastric emptying was measured only for 2 hours after administration of NS of YGJT 124.8mg/kg in rats treated with atropine sulfate (1mg/kg, s.c), quinpirole HCl(0.3mg/kg, i.p.), NAME (NG-nitro-L-arginine methyl ester, 75mg/kg, s.c.) or cisplatin (10mg/kg, i.p.) to delay gastric emptying. Results : YGJT 124.8mg/kg improved gastric emptying more than NS or YGJT 41.6mg/kg (p=0.046). Under delayed gastric emptying, YGJT 124.8mg/kg improved gastric emptying in the group treated with cisplatin ($3.1{\pm}1.3$ vs. $6.6{\pm}3.1$, p=0.015), quinpirole HCl ($4.7{\pm}2.8$ vs. $5.5{\pm}5.6$, p=0.874) and NAME ($2.2{\pm}1.4$ vs. $4.7{\pm}6.0$, p=0.414), but aggravated it with atropine sulfate ($1.8{\pm}0.9$vs. $1.7{\pm}1.0$, p=0.957). Conclusions : YGJT improves gastric emptying through the cholinergic pathwas, and shows some effect against the toxicity of cisplatin. Therefore, we expect that it would be effective in relieving gastrointestinal symptoms in functional dyspepsia patients and cisplatin-treated patients.

• The Journal of Internal Korean Medicine
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• v.30 no.1
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• pp.107-118
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• 2009

Objectives : This study was aimed to investigated the effect of Yijin-tang on gastric motility and its mechanism of action in normal intact and partial pyloric obstructed rats. Methods : Gastric emptying was measured by the number of glass beads expelled from the stomach (containing one hundred of glass beads. ${\phi}1mm$) in 1 hour or 2 hours after glass beads and test drugs (normal saline. Yijin-tang 90mg/kg. Yijin-tang 270mg/kg) administration in normal intact and partial pyloric obstructed rats. In another series of experiments to evaluate the mechanism of Yijin-tang 270mg/kg under delayed conditions, normal intact rats were treated with atropine sulfate (1mg/kg,s.c.), cisplatin (10mg/kg,i.p.), quinpirole HCI (0.3mg/kg,i.p.) and NAME (NG-nitro-L-arginine methyl ester. 75mg/ kg,s.c.), respectively. Partial pyloric obstructed rats were modified by wrapping the nonabsorbable rubber ring (D :6mm, W:4mm, T: 1mm) around the 1st portion of the duodenum for 8 weeks. The myoelectrical activity of the gastric smooth muscle was recorded by a bipolar electrode placed at the abdominal surface in normal intact and partial pyloric obstructed rats. The gastric myoelectrical activity was measured for 30 minutes before and after orogastric administration of each solution (normal saline, Yijin-tang 270mg/kg) and expressed as dominant frequency, percent of normogastria and power ratio. Results : Yijin-tang improved gastric emptying more than normal saline in normal intact(p<0.001) and partial pyloric obstructed rats(p=0.002). Under the delayed gastric emptying induced by atropine sulfate, cisplatin, quinpirole HCI and NAME. Yijin-tang enhanced gastric emptying significantly in the cisplatin treated group(p<0.001). but didn't in other treated groups. Administration of Yijin-tang 270mg/kg has no significant effect on the myoelectrical activity of the gastric smooth muscle in both normal intact rats and partial pyloric obstructed rats. Conclusions : Yijin-tang seems to stimulate the gastric motility through suppressing the 5HT3 receptor and promoting the antroduodenal flow. We expect that Yijin-tang would be effective especially in dysmotility-like functional dyspepsia with partial pyloric obstruction or the side effects of cisplatin such as nausea, vomiting, abdominal discomfort, and delay of gastric emptying.