OBJECTIVES: Physical exercise has become popular in recent years. It has been known that exercise is related to the development of heartburn, belching, regurgitation and chest pain. However there are few data concerning the effect of exercise on esophageal motor function and gastroesophageal reflux. We evaluated the effect of exercise intensity on esophageal motor activity and gastroesophageal reflux. METHODS: We studied healthy volunteers (15 males, age: 28+/-5 years, BW: 68+/-10kg) using a 24 hours ambulatory esophageal pressure, pH catheter and portable digital data recorder (Microdigitrapper 4Mb, Synetics Medical, Sweden). Subjects exercised on a treadmill (Marquette Case 15 Electronic INC) at 50% and 70% maximal heart rate for 30 min. Subjects rested 2 hours before exercise (base line) and for 30 min between exercise sessions. RESULTS: 1) Exercise of 50% maximal heart rate reduced total contraction, contraction duration, percentage of simultaneous contraction and repetitive contraction, (P<0.05) but increased percentage of contractions above 20mmHg amplitude (P<0.05). 2) Exercise of 70% maximal heart rate decreased total contraction, esophageal amplitude, contraction duration and percentage of peristaltic contraction, (P<0.05) but increased percentage of simultaneous contraction (P<0.05). 3) Gastroesophageal reflux was not change on both 50% maximal heart rate and 70% maximal heart rate exercise. CONCLUSION: More propulsive esophageal motility are induced following exercise of 50% maximal heart rate, but not 70% maximal heart rate.
Catheters ; Chest Pain ; Eructation ; Exercise ; Gastroesophageal Reflux* ; Healthy Volunteers ; Heart Rate ; Heartburn ; Humans ; Hydrogen-Ion Concentration ; Male ; Motor Activity ; Running*

The routine of endoscopy in the evaluatien of gastrointestinal bleeding demonatratd that telangiectasia in the upper gastrointestinal tract may be responsible for the chronic recurrent bleeding. If the bleeding lesion within the reach of the endoscaiye, it is amenahle to endoscopic therapy, One of the several treatment modalities that has been employed is laser photocoagulation. We report a case of ef fective laser therapy in a 63-years old woman presented with a about 3 years history of recurrent upper gastrointestinal bleeding and persistent iron deficieney anemia in gaatic multiple telangeictasias. An upper gastrointestinal endoscopy demonstrated variable sized multiple bleeding telangectatic lesions in the entire stomach. Nd-YAG laser photocoagulation was appligd in 0.5 seconds pulse of 60-70W power(2300 joules and total 7 sessions). All legions in the stomach were treated. Local epinephrine injection prior to laser treatment was carried out in the telangiectatie lesions greater than 1 cm. Follow-up endoscopy 5 months after laser treatment demonstrated no telangiectatic lesions in the stomach and no episodes of upper gastrointestinal bleeding were noted and the other symptoms improved.
Anemia ; Endoscopy ; Endoscopy, Gastrointestinal ; Epinephrine ; Female ; Follow-Up Studies ; Hemorrhage ; Humans ; Iron ; Laser Therapy ; Lasers, Solid-State ; Light Coagulation* ; Middle Aged ; Stomach ; Telangiectasis* ; Upper Gastrointestinal Tract

The routine of endoscopy in the evaluatien of gastrointestinal bleeding demonatratd that telangiectasia in the upper gastrointestinal tract may be responsible for the chronic recurrent bleeding. If the bleeding lesion within the reach of the endoscaiye, it is amenahle to endoscopic therapy, One of the several treatment modalities that has been employed is laser photocoagulation. We report a case of ef fective laser therapy in a 63-years old woman presented with a about 3 years history of recurrent upper gastrointestinal bleeding and persistent iron deficieney anemia in gaatic multiple telangeictasias. An upper gastrointestinal endoscopy demonstrated variable sized multiple bleeding telangectatic lesions in the entire stomach. Nd-YAG laser photocoagulation was appligd in 0.5 seconds pulse of 60-70W power(2300 joules and total 7 sessions). All legions in the stomach were treated. Local epinephrine injection prior to laser treatment was carried out in the telangiectatie lesions greater than 1 cm. Follow-up endoscopy 5 months after laser treatment demonstrated no telangiectatic lesions in the stomach and no episodes of upper gastrointestinal bleeding were noted and the other symptoms improved.
Anemia ; Endoscopy ; Endoscopy, Gastrointestinal ; Epinephrine ; Female ; Follow-Up Studies ; Hemorrhage ; Humans ; Iron ; Laser Therapy ; Lasers, Solid-State ; Light Coagulation* ; Middle Aged ; Stomach ; Telangiectasis* ; Upper Gastrointestinal Tract

The exact incidence of esophagitis in gastroesophageal reflux disease (GERD) remains poorly understood in Korea. To determine incidence of esophagitis in GERD, from August 1988 to July 1993, endoscopy, esophageal manometry with Bernstein test, and ambulatory 24 hour esophageal pH monitoring were carried out in a group of 349 patients with symptoms of heartburn or noncardiac chest pain. Based on these studies, 151(40%) patients had some degree of GERD and pstients were categorized as having: pathologic reflux, 98 patients; symptomatic reflux, 42 patients; and sensitive mucosal reflux, 11 patients. Among 151 patients with GERD, 27 patients(18%) had some degree of esophagitis. In conclusion, 40% of patients with symptoms suggestive of GERD have GERD. GERD is divided into subgroups; pathologic reflux, symptomatic reflux, and mucosal sensitive reflux. Less than 20% of GERD have esophagitis or esophageal mucosal injury and these low incidence of mucosal injury in Korean may be due to increased esophageal mucosal resistance.
Chest Pain ; Endoscopy ; Esophageal pH Monitoring ; Esophagitis* ; Esophagitis, Peptic ; Gastroesophageal Reflux* ; Heartburn ; Humans ; Incidence* ; Korea ; Manometry

Cerebrospinal disease or injuries frequently result in defecatory difficulty. Management of these patients requires an understanding of the alterations in the mechanisms regulating colorectal function in the cerebrospinal disease. Rectal sensation is usually impaired in cerebrospinal disease and this is one of the pathogenic mechanisms of defecatory difficulty Aim : This study was carried out to evaluate a biofeedback treatment in the patients with impaired rectal sensation after cerebrospinal disease. Subjects : Thirteen patients (5F, 8M, mean age 36 years, range 14~56) with impaired rectal sensation and constipation over 6 months duration developed after brain or spine operation were studied. These included 7 traumatic head injury (5: temporoparietal epidural hematoma, 2: frontal lobe epidural hematoma) and 6 HNP (3: L4~5, 3: L5 ~S1) operation. METHODS: These patients were evaluated by questionnaire, office examination, colon transit studied, anorectal manometry including rectal sensation, balloon expulsion studies, and defecography. All patients underwent biofeedback treatment twice a week for 2 or 3 months. Results : Six brain hematoma and two HNP patients had impaired rectal sensation with anismus and the remaining 5 had only impaired rectal sensation. One brain hematoma (temporoparietal) had anosmia. All patients had normal anal basal pressure, squeeze pressure, rectal compliance, and intact rectoanal inhibitory reflex. Colonic transit time was delayed, but the delay was accounted for by prolonged rectal transit time. The mean volume at which anal relaxation first occurred were 12 ml (range 5~15 ml). The mean threshold volume at which these patients experienced rectal sensation were 90 ml (range 60~130 ml). Biofeedback conditioning in these 13 patients led to normal sensory threshold (mean 20m1, range 10~30 ml) in all patients. Biofeedback also provided spontaneous good passage of stool. Conclusion : Biofeedback treatment appears to be effective in impaired rectal sensation after cerebrospinal operation. Also central neural mechanism may be involved in the pathogenesis of anismus.
Biofeedback, Psychology ; Brain ; Colon ; Compliance ; Constipation ; Craniocerebral Trauma ; Defecography ; Frontal Lobe ; Hematoma ; Humans ; Manometry ; Olfaction Disorders ; Surveys and Questionnaires ; Reflex ; Relaxation ; Sensation* ; Sensory Thresholds ; Spine

BACKGROUND/AIMS: Esophageal squamous papillorma is a rare benign lesion. This lesion is generally asymptomatic and solitary. Resent studies reveal the presence of human papil- lomavirus in certain cases of esophageal squamous papilloma, and human papillomavirus appears to be pathogenetically related to the esophageal squamous papilloma. The aim of this study was to evaluate the presence of human papillomavirus in esoplmgeal spuamous papilloma. METHODS: In situ hybridizations and direct in situ polymerase chain reactions for human papillomavirus type 6/11 were performed on 16 paraffin embedded tissues with esophageal squamous papilloma. RESULTS: Human papillomavirus type 6/11 was detected in 1 of 16 esophageal squamous papillomas on direct in situ polymerase chain reaction. All lesions were solitary, and 12 of 16 cases were located in distal one-third of the esophagus. Age range was 23-71 years (mean, 41 years). CONCLUSION: These results indicate that causal relation between human papillomavirus type 6/11 and esophageal squamous papilloma is inconspicuous.
Esophagus* ; Humans* ; In Situ Hybridization ; Papilloma* ; Paraffin ; Polymerase Chain Reaction

PURPOSE: Constipation in children usually is due to poor bowel habit. Ignoring the urge to have a bowel movements initiates a viscious cycle of constipation. After a period of time children may stop feeling the urge, leading to fecal impaction. This leads to loss of anorectal reflex. What is the outcome of the children with long-standing poor bowel habit? METHODS: Forty-two patients with obstructed defecation (non-relaxing puborectalis syndrome) diagnosed by defecogram and anorectal manometry were investigated with rectal sensation and elasticity studies (threshold of sense: TS, defecation sensation volume: DS, maximal tolerable volume: MTV, rectal compliance: RC), and colon transit time (CTT). All detailed questionnaires on the subject were completed. Eighteen patients (11F: 7M, mean age 39 years, range 16~75) with history of poor bowel habits since childhood were compared with 24 (16F: 8M, mean age 40 years, range 16~31) with no history of poor bowel habit. RESULTS: Studies of colonic transit time demonstrated no significant difference in the right and left colon between two groups, but the rectosigmoid transit time in the poor bowel habits group was more increased than in the normal bowel habit group (P<0.05). The rectal wall compliance was increased in the poor bowel habit group as compared to the normal bowel habits group (P<0.01). Maximal tolerable volume and defecation sensation volume were greater in the poor bowel habits group than in the control group (P<0.01), but there was no significant difference in the threshold of sense between two groups. CONCLUSIONS: Prolonged poor bowel habit in childhood period leads to loss of rectal sensation, and provide an explanation for one of the pathophysiologic mechanism of non-relaxing puborectalis syndrome.
Child ; Colon ; Compliance ; Constipation ; Defecation ; Elasticity ; Fecal Impaction ; Humans ; Manometry ; Surveys and Questionnaires ; Reflex ; Sensation

PURPOSE: The ulcerative colitis is a major chronic intestinal disease of unknown etiology affecting principally the rectum and left colon, and its incidence is markedly increasing in Korea. The main differential diagnosis of ulcerative colitis is an acute self-limited colitis. This study was performed to evaluate difference of cell kinetics between chronic ulcerative colitis and acute self-limited colitis. METHODS: The normal colon (n=25), acute self-limited colitis (n=25) and chronic ulcerative colitis (n=25) were investigated by using Ki-67 immunohistochemical staining for proliferation and TUNEL method for apoptosis. The Ki-67 labeling indices and TUNEL labeling indices were determined. RESULTS: The means of Ki-67 labeling indices in normal colon, acute self-limited colitis and chronic ulcerative colitis were 5.14 5.25%, 6.81 5.73%, 13.10 10.15%, respectively. And the means of TUNEL labeling indices in normal colon, acute self-limited colitis and chronic ulcerative colitis were 1.59 0.10%, 2.54 1.60%, 2.51 1.40%, respectively. CONCLUSIONS: The apoptosis is one of method of cell loss in both acute self-limited colitis and chronic ulcerative colitis. High proliferative activity of chronic ulcerative colitis may predispose to mutational events in colonic mucosa, therefore may be one of the increased cancer risk factors in chronic ulcerative colitis.
Apoptosis ; Cell Proliferation* ; Colitis* ; Colitis, Ulcerative ; Colon ; Diagnosis, Differential ; In Situ Nick-End Labeling ; Incidence ; Intestinal Diseases ; Kinetics ; Korea ; Mucous Membrane ; Rectum ; Risk Factors ; Ulcer*

No abstract available.
Gastric Emptying*

STUDY DESIGN: Posterior and posterolateral fusions were performed in rabbit lumbar spines. OBJECTIVES: To investigate the osteoinductive effect of polyphosphates. SUMMARY AND LITERATURE REVIEW: Inorganic polyphosphates are known to be rich in osteoblasts and involved in the mineralization process in bone metabolism. However, no study has been undertaken to investigate the osteoinductive effect of polyphosphates. MATERIALS AND METHODS: Forty adult New Zealand white rabbits underwent monolevel lumbar fusions, and were divided into two groups according to the fusion beds: twenty each between the laminae (posterior fusion group, PF group) and between the transverse processes (posterolateral fusion group, PLF group). In ten of twenty rabbits in the PF group, 0.8gm of autogenous iliac bone was grafted onto the right sides of the laminae, which were used as a control group (C1), with 0.4gm autogenous bone immersed in polyphosphate solution in the left sides as an experimental group (E1). In the other ten, 0.8gm of autogenous bone was grafted onto the right sides (C2) and 0.8gm of tricalcium phosphate porous blocks containing polyphosphate in the left sides (E2). The other twenty rabbits of the PLF group were similarly divided into C1, E1, C2 and E2 groups by grafting the same amount of materials between the transverse processes. The animals were sacrificed at the 16th postoperative week and the fusions evaluated grossly, radiologically and histologically. Statistical differences between the groups (C1 vs. E1, C2 vs. E2 and E1 vs. E2) in each of the PF and PLF groups were compared by chi-square tests. RESULTS: The fusions were finally determined by the gross finding using manual palpation. In the PF group, bony fusions were obtained in 90, 80, 90 and 70% of the C1, E1, C2 and E2 groups, respectively. In the PLF group, these were 80, 70, 60 and 0% of the C1, E1, C2 and E2 groups, respectively. Statistical analysis revealed differences only between C2 and E2 (p=0.005), and between E1 and E2 (p=0.002) of the PLF group. Histologically, beta-tricalcium phosphate particles containing polyphosphate were transformed into the osteoid in some areas of the PLF-E2 group, although only fibrous unions were obtained grossly. CONCLUSIONS: It is suggested that the polyphosphate may have an osteoinductive effect, even though the osteoinductive potency was very week in this fusion model of the rabbit lumbar spine. Therefore, further explorations, such as the threshold and optimal concentrations of polyphosphate in vivo and the best carrier material of polyphosphate, should be performed to obtain the optimal conditions for fusion.
Adult ; Animals ; Bone Regeneration ; Humans ; Metabolism ; Osteoblasts ; Palpation ; Polyphosphates ; Rabbits ; Spine* ; Transplants