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대한소화기기능성질환·운동학회> Journal of Neurogastroenterology and Motility

Journal of Neurogastroenterology and Motility update

  • : 대한소화기기능성질환·운동학회
  • : 의약학분야  >  내과학
  • : KCI등재
  • : SCOPUS
  • : 연속간행물
  • : 계간
  • : 2093-0879
  • : 2093-0887
  • : 대한소화관운동학회지(~2009) → Journal of Neurogastroenterology and Motility(2010~)

수록정보
수록범위 : 1권1호(1994)~28권4호(2022) |수록논문 수 : 1,467
Journal of Neurogastroenterology and Motility
28권4호(2022년 10월) 수록논문
최근 권호 논문
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KCI등재 SCOPUS

저자 : Kee Wook Jung

발행기관 : 대한소화기기능성질환·운동학회 간행물 : Journal of Neurogastroenterology and Motility 28권 4호 발행 연도 : 2022 페이지 : pp. 509-511 (3 pages)

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KCI등재 SCOPUS

저자 : Yong Sung Kim , Suck Chei Choi

발행기관 : 대한소화기기능성질환·운동학회 간행물 : Journal of Neurogastroenterology and Motility 28권 4호 발행 연도 : 2022 페이지 : pp. 512-514 (3 pages)

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KCI등재 SCOPUS

저자 : Seon-young Park

발행기관 : 대한소화기기능성질환·운동학회 간행물 : Journal of Neurogastroenterology and Motility 28권 4호 발행 연도 : 2022 페이지 : pp. 515-516 (2 pages)

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KCI등재 SCOPUS

저자 : Zahid Hussain , Hyojin Park

발행기관 : 대한소화기기능성질환·운동학회 간행물 : Journal of Neurogastroenterology and Motility 28권 4호 발행 연도 : 2022 페이지 : pp. 517-530 (14 pages)

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Post-operative ileus (POI) is the transient cessation of coordinated gastrointestinal motility after abdominal surgical intervention. It decreases quality of life, prolongs length of hospital stay, and increases socioeconomic costs. The mechanism of POI is complex and multifactorial, and has been broadly categorized into neurogenic and inflammatory phase. Neurogenic phase mediated release of corticotropin-releasing factor (CRF) plays a central role in neuroinflammation, and affects both central autonomic response as well hypothalamic-pituitary-adrenal (HPA) axis. HPA-stress axis associated cortisol release adversely affects gut microbiota and permeability. Peripheral CRF (pCRF) is a key player in stress induced gastric emptying and colonic transit. It functions as a local effector and interacts with the CRF receptors on the mast cell to release chemical mediators of inflammation. Mast cells proteases disrupt epithelial barrier via protease activated receptor-2 (PAR-2). PAR-2 facilitates cytoskeleton contraction to reorient tight junction proteins such as occludin, claudins, junctional adhesion molecule, and zonula occludens-1 to open epithelial barrier junctions. Barrier opening affects the selectivity, and hence permeation of luminal antigens and solutes in the gastrointestinal tract. Translocation of luminal antigens perturbs mucosal immune system to further exacerbate inflammation. Stress induced dysbiosis and decrease in production of short chain fatty acids add to the inflammatory response and barrier disintegration. This review discusses potential mechanisms and factors involved in the pathophysiology of POI with special reference to inflammation and interlinked events such as epithelial barrier dysfunction and dysbiosis. Based on this review, we recommend CRF, mast cells, macrophages, and microbiota could be targeted concurrently for efficient POI management.
(J Neurogastroenterol Motil 2022;28:517-530)

KCI등재 SCOPUS

저자 : Sawangpong Jandee , Suriya Keeratichananont , Jan Tack , Tim Vanuytsel

발행기관 : 대한소화기기능성질환·운동학회 간행물 : Journal of Neurogastroenterology and Motility 28권 4호 발행 연도 : 2022 페이지 : pp. 531-539 (9 pages)

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Manometry, particularly high-resolution manometry is the preferred diagnostic tool used to evaluate esophageal motor function. This investigation is strongly indicated in the setting of dysphagia, but is also useful in gastroesophageal reflux disease (GERD), especially in case of failure of conventional treatment to exclude alternative diagnoses and prior to anti-reflux surgery. Moreover, ineffective esophagogastric junction barrier function and esophageal motor dysfunction are pathophysiological mechanisms in GERD and can be identified by manometry. The recent international guidelines have positioned high-resolution manometry as an important part of functional diagnostic work up in GERD in order to identify the GERD phenotype to guide specific treatment. The proposed manometric identification and measurement is based on the Chicago classification version 4.0 adding with new established metrics for GERD evaluation.
(J Neurogastroenterol Motil 2022;28:531-539)

KCI등재 SCOPUS

저자 : Wenxi Jiang , Jiali Wu , Shefeng Zhu , Linying Xin , Chaohui Yu , Zhe Shen

발행기관 : 대한소화기기능성질환·운동학회 간행물 : Journal of Neurogastroenterology and Motility 28권 4호 발행 연도 : 2022 페이지 : pp. 540-548 (9 pages)

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Irritable bowel syndrome (IBS) is a functional gastrointestinal disorder that is characterized by abdominal pain and disordered bowel habits. The etiology of IBS is multifactorial, including abnormal gut-brain interactions, visceral hypersensitivity, altered colon motility, and psychological factors. Recent studies have shown that the intestinal microbiota and its metabolites short chain fatty acids (SCFAs) may be involved in the pathogenesis of IBS. SCFAs play an important role in the pathophysiology of IBS. We discuss the underlying mechanisms of action of SCFAs in intestinal inflammation and immunity, intestinal barrier integrity, motility, and the microbiota-gutbrain axis. Limited to previous studies, further studies are required to investigate the mechanisms of action of SCFAs in IBS and provide more precise therapeutic strategies for IBS.
(J Neurogastroenterol Motil 2022;28:540-548)

KCI등재 SCOPUS

저자 : Yang Won Min , Ali Rezaie , Mark Pimentel

발행기관 : 대한소화기기능성질환·운동학회 간행물 : Journal of Neurogastroenterology and Motility 28권 4호 발행 연도 : 2022 페이지 : pp. 549-561 (13 pages)

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Gut microbiota and their metabolites like bile acid (BA) have been investigated as causes of irritable bowel syndrome (IBS) symptoms. Primary BAs are synthesized and conjugated in the liver and released into the duodenum. BA biotransformation by gut microbiota begins in the intestine and results in production of a broad range of secondary BAs. Deconjugation is considered the gateway reaction for further modification and is mediated by bile salt hydrolase, which is widely expressed by the gut microbiota. However, gut bacteria that convert primary BAs to secondary BAs belong to a limited number of species, mainly Clostridiales. Like gut microbiota modify BA profile, BAs can shape gut microbiota via direct and indirect actions. BAs have prosecretory effects and regulates gut motility. BAs can also affect gut sensitivity. Because of the vital role of the gut microbiota and BAs in gut function, their bidirectional relationship may contribute to the pathophysiology of IBS. Individuals with IBS have been reported to have altered microbial profiles and modified BA profiles. A significant increase in fecal primary BA and a corresponding decrease in secondary BA have been observed in IBS with predominant diarrhea. In addition, primary BA was positively correlated with IBS symptoms. In IBS with predominant diarrhea, bacteria with reduced abundance mainly belonged to the genera in Ruminococcaceae and exhibited a negative correlation with primary BAs. Integrating the analysis of the gut microbiota and BAs could better understanding of IBS pathophysiology. The gap in this field needs to be further filled in the future.
(J Neurogastroenterol Motil 2022;28:549-561)

KCI등재 SCOPUS

저자 : Tetsuya Tatsuta , Hiroki Sato , Yusuke Fujiyoshi , Hirofumi Abe , Akio Shiwaku , Junya Shiota , Chiaki Sato , Masaki Ominami , Yoshitaka Hata , Hisashi Fukuda , Ryo Ogawa , Jun Nakamura , Yuichiro Ikebuchi

발행기관 : 대한소화기기능성질환·운동학회 간행물 : Journal of Neurogastroenterology and Motility 28권 4호 발행 연도 : 2022 페이지 : pp. 562-571 (10 pages)

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Background/Aims
ManoScan and Sandhill high-resolution manometry (HRM) systems are used worldwide; however, the diagnosis of achalasia on the Starlet HRM system is not fully characterized. Furthermore, the impact of calcium channel blockers and nitrites in treating achalasia has not been investigated using HRM. Management of recurrent cases is a priority issue, although few studies have examined patient characteristics.
Methods
We conducted a multicenter, large-scale database analysis. First, the diagnosis of treatment-naive achalasia in each HRM system was investigated. Next, patient characteristics were compared between type I-III achalasia, and the impact of patient characteristics, including calcium channel blocker and nitrite use for integrated relaxation pressure (IRP) values, were analyzed. Finally, patient characteristics with recurrent achalasia were elucidated.
Results
The frequency of type I achalasia with Starlet was significantly higher than that with ManoScan and Sandhill HRM systems. In achalasia, multivariate analysis identified male sex, advanced age, long disease duration, obesity, type I achalasia, and sigmoid type as risk factors related to normal IRP values (< 26 mmHg). Calcium channel blockers and nitrites use had no significant impact on the IRP values, although achalasia symptoms were indicated to be alleviated. In recurrent cases, the IRP value was significantly lower, and advanced age, long disease duration, and sigmoid type were more common than in treatment-naive patients.
Conclusions
We should cautiously interpret the type of achalasia and IRP values in the Starlet HRM system. Symptoms of recurrent cases are related to disease progression rather than IRP values, which should be considered in decision making.
(J Neurogastroenterol Motil 2022;28:562-571)

KCI등재 SCOPUS

저자 : Jacob M Schauer , Wenjun Kou , Jacqueline E Prescott , Peter J Kahrilas , John E Pandolfino , Dustin A Carlson

발행기관 : 대한소화기기능성질환·운동학회 간행물 : Journal of Neurogastroenterology and Motility 28권 4호 발행 연도 : 2022 페이지 : pp. 572-579 (8 pages)

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Background/Aims
This study aimed to develop a diagnostic tool using machine learning to apply functional luminal imaging probe (FLIP) panometry data to determine the probability of esophagogastric junction (EGJ) obstruction as determined using the Chicago Classification version 4.0 (CCv4.0) and high-resolution manometry (HRM).
Methods
Five hundred and fifty-seven adult patients that completed FLIP and HRM (with a conclusive CCv4.0 assessment of EGJ outflow) and 35 asymptomatic volunteers (“controls”) were included. EGJ opening was evaluated with 16-cm FLIP performed during sedated endoscopy via EGJ-distensibility index and maximum EGJ diameter. HRM was classified according to the CCv4.0 as conclusive disorders of EGJ outflow or normal EGJ outflow (timed barium esophagram applied when required and available). The probability tool utilized Bayesian additive regression treesBART, which were evaluated using a leave-one-out approach and a holdout test set.
Results
Per HRM and CCv4.0, 243 patients had a conclusive disorder of EGJ outflow while 314 patients (and all 35 controls) had normal EGJ outflow. The model accuracy to predict EGJ obstruction (based on leave-one-out/holdout test set, respectively) was 89%/90%, with 87%/85% sensitivity, 92%/97% specificity, and an area under the receiver operating characteristic curve of 0.95/0.97. A free, opensource tool to calculate probability for EGJ obstruction using FLIP metrics is available at https://www.wklytics.com/nmgi/prob_flip. html.
Conclusions
Application of FLIP metrics utilizing a probabilistic approach incorporates the diagnostic confidence (or uncertainty) into the clinical interpretation of EGJ obstruction. This tool can provide clinical decision support during application of FLIP Panometry for evaluation of esophageal motility disorders.
(J Neurogastroenterol Motil 2022;28:572-579)

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Background/Aims
Lyon consensus differentiates acid exposure time (AET) as physiological, borderline, and pathological. Mean nocturnal baseline impedance (MNBI) and post-reflux swallow-induced peristaltic wave index (PSPWi) are believed to increase diagnostic yield of gastroesophageal reflux disease (GERD) and correlate with symptom outcome of proton pump inhibitor (PPI) treatment. We aim to explore the clinical characteristics and the correlation of pH-impedance parameters with PPI response in Chinese patients with different AET levels.
Methods
We retrospectively investigated 177 patients with typical reflux symptoms who received esophageal function tests. The demographics, GERD questionnaire scores, the proportion of esophagitis and PPI responders, and manometric and pH-impedance parameters were compared among patients with AET < 4%, 4-6%, and > 6%. In patients with AET ≥ 4%, manometric and pH-impedance parameters were compared between PPI responders and non-responders.
Results
Among 177 patients, 69 (39.0%) had AET 4-6%, and 53 (29.9%) had AET > 6%. The demographics, esophagogastric junction type, and occurrence of ineffective esophageal motility were similar between patients with AET 4-6% and > 6%, but different from AET < 4%. MNBI and PSPWi were different among different AET levels, but similar between PPI responders and non-responders in patients with AET ≥ 4%.
Conclusions
It is reasonable to set 4% as a threshold to define pathological AET in Chinese patients. MNBI and PSPWi could identify GERD patients, but may not correlate with PPI response of Chinese GERD patients.
(J Neurogastroenterol Motil 2022;28:580-588)

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