간행물

Journal of Neurogastroenterology and Motility update

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

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수록범위 : 1권1호(1994)~27권3호(2021) |수록논문 수 : 1,352
Journal of Neurogastroenterology and Motility
27권3호(2021년 07월) 수록논문
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KCI등재 SCI SCOPUS

4Roles of Sex Hormones and Gender in the Gut Microbiota

저자 : Kichul Yoon , Nayoung Kim

발행기관 : 대한소화기기능성질환·운동학회(구 대한소화관운동학회) 간행물 : Journal of Neurogastroenterology and Motility 27권 3호 발행 연도 : 2021 페이지 : pp. 314-325 (12 pages)

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The distribution of gut microbiota varies according to age (childhood, puberty, pregnancy, menopause, and old age) and sex. Gut microbiota are known to contribute to gastrointestinal (GI) diseases such as irritable bowel syndrome, inflammatory bowel disease, and colon cancer; however, the exact etiology remains elusive. Recently, sex and gender differences in GI diseases and their relation to gut microbiota has been suggested. Furthermore, the metabolism of estrogen and androgen was reported to be related to the gut microbiome. As gut microbiome is involved in the excretion and circulation process of sex hormones, the concept of “microgenderome” indicating the role of sex hormone on the gut microbiota has been suggested. However, further research is needed for this concept to be universally accepted. In this review, we summarize sex- and gender-differences in gut microbiota and the interplay of microbiota and GI diseases, focusing on sex hormones. We also describe the metabolic role of the microbiota in this regard. Finally, current subjects, such as medication including probiotics, are briefly discussed.
(J Neurogastroenterol Motil 2021;27:314-325)

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Functional dyspepsia (FD) is considered to be a heterogeneous disorder with different pathophysiological mechanisms or pathogenetic factors. In addition to traditional mechanisms, novel concepts regarding pathophysiologic mechanisms of FD have been proposed. Candidates of therapeutic agents based on novel concepts have also been suggested. FD is a symptom complex and currently diagnosed by symptom-based Rome criteria. In the Rome criteria, symptom-based subtypes of FD including postprandial distress syndrome and epigastric pain syndrome are recommended to be used, based on the assumption that each subtype is more homogenous in terms of underlying pathophysiologic mechanisms than FD as a whole. In this review, the usefulness of symptom-based subtypes of FD for predicting underlying pathophysiologic mechanisms and choosing appropriate therapeutic agents was evaluated. Although several classic pathophysiologic mechanisms are suggested to be associated with individual dyspeptic symptoms, symptom-based subtypes of FD are not specific for a certain pathogenetic factor or pathophysiologic mechanism, and may be frequently associated with multiple pathophysiologic abnormalities. Novel concepts on the pathophysiology of FD show complex interactions between pathophysiologic mechanisms and pathogenetic factors, and prediction of underlying mechanisms of individual patients simply by the symptom pattern or symptom-based subtypes may not be accurate in a considerable proportion of cases. Therefore, subtyping by the Rome criteria appears to have limited value to guide therapeutic strategy, suggesting that the addition of objective parameters or subclassification reflecting physiologic or pathologic tests may be necessary for the targeted therapeutic approaches, particularly when therapeutic agents targeting novel mechanisms are available.
(J Neurogastroenterol Motil 2021;27:326-336)

KCI등재 SCI SCOPUS

6Emergence of Celiac Disease and Gluten-related Disorders in Asia

저자 : Srikant Mohta , Mahendra S Rajput , Vineet Ahuja , Govind K Makharia

발행기관 : 대한소화기기능성질환·운동학회(구 대한소화관운동학회) 간행물 : Journal of Neurogastroenterology and Motility 27권 3호 발행 연도 : 2021 페이지 : pp. 337-346 (10 pages)

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Celiac disease (CeD) is a systemic, immune-mediated enteropathy, which is triggered by gluten protein in genetically susceptible individuals. CeD, once thought to be an uncommon disease, is now recognized to affect approximately 40-60 million people globally. While CeD is now well reported from a few Asian countries such as India, China, Pakistan, and Middle Eastern countries; it is still believed to be uncommon in the rest of Asia. Gluten-related diseases other than CeD, like non-celiac gluten sensitivity (NCGS) are also emerging globally. CeD and NCGS may present with either intestinal or extra-intestinal symptoms, and a proportion of them have overlapping symptoms with irritable bowel syndrome. Hence, many of them are misdiagnosed as having irritable bowel syndrome in clinical practice. In this review, we discuss the emergence of CeD and other gluten-related disorders, both globally and in Asia, the overlapping manifestations between gluten-related disorders and irritable bowel syndrome, and the challenges associated with diagnosis and management of CeD in Asia.
(J Neurogastroenterol Motil 2021;27:337-346)

KCI등재 SCI SCOPUS

7Variations in Clinical Practice of Esophageal High-resolution Manometry: A Nationwide Survey

저자 : Eun Jeong Gong , Soo In Choi , Bong Eun Lee , Yang Won Min , Yu Kyung Cho , Kee Wook Jung , Ji Hyun Kim , Moo In Park

발행기관 : 대한소화기기능성질환·운동학회(구 대한소화관운동학회) 간행물 : Journal of Neurogastroenterology and Motility 27권 3호 발행 연도 : 2021 페이지 : pp. 347-353 (7 pages)

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Background/Aims
Esophageal high-resolution manometry (HRM) enables the comprehensive evaluation of the esophageal motor function. However, protocols are not uniform and clinical practices vary widely among institutions. This study aims to understand the current HRM practice in Korea.
Methods
The survey was sent via email through the Korean Society of Neurogastroenterology and Motility. The questions covered descriptive information, preparation, techniques, analysis, and reporting of esophageal HRM.
Results
The survey was completed in 32 (74.4%) out of 43 centers, including 24 tertiary and 8 secondary referral centers. Of the 32 centers, 25 (78.1%) performed HRM in a sitting position, while 7 centers (21.9%) reported performing HRM in a supine position. All the centers utilized single wet swallows as a standard, but the volume, frequency, and interval between swallows varied widely. Sixteen centers (50.0%) applied adjunctive tests, including multiple rapid swallows (n = 16) and rapid drink challenges (n = 9). Parameters assessed and documented in the report were similar. In addition to the assessment of the esophagogastric junction and esophageal body, 27 centers (84.8%) and 18 centers (56.3%) included measurements for the upper esophageal sphincter and the pharynx, respectively, in the HRM protocol.
Conclusions
We found a variation in the available HRM practice among centers, even though they broadly agreed in the data analysis. Efforts are needed to develop a standardized protocol for HRM measurement.
(J Neurogastroenterol Motil 2021;27:347-353)

KCI등재 SCI SCOPUS

8Normal Values of High-resolution Manometry Parameters With Provocative Maneuvers

저자 : Hui Su , Amanda J Krause , Melina Masihi , Jacqueline Prescott , Alex Decorrevont , Emma Germond , Dave Karasik , Wenjun Kou , John E Pandolfino , Dustin A Carlson

발행기관 : 대한소화기기능성질환·운동학회(구 대한소화관운동학회) 간행물 : Journal of Neurogastroenterology and Motility 27권 3호 발행 연도 : 2021 페이지 : pp. 354-362 (9 pages)

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Background/Aims
Incorporation of complementary and provocative test swallows to the high-resolution manometry (HRM) protocol offers potential to address limitations posed by HRM protocols that involve only a single swallow type. The aim of this study is to describe normal findings of a comprehensive HRM testing protocol performed on healthy asymptomatic volunteers.
Methods
Thirty healthy asymptomatic volunteers completed HRM with 5-mL liquid swallows in the supine position. They also completed 5-mL liquid swallows in the upright position, viscous swallows, solid test swallows, multiple rapid swallows, and a rapid drink challenge. HRM studies were analyzed via Chicago classification version 3.0.
Results
The median (5th-95th percentiles) for integrated relaxation pressure (IRP) on supine swallows was 11 (4-16) mmHg; IRP was lower than supine on upright liquid 9 (0-17) mmHg, viscous 6 (0-15) mmHg, solid 9 (1-19) mmHg, multiple rapid swallows 3 (0-12) mmHg, and rapid drink challenge 5 (-3-12) mmHg; P < 0.005. While an “elevated” IRP value was observed on 1 to 2 test maneuvers in 8/30 (27%) subjects, all 30 subjects had an IRP value < 12 mmHg on at least one of the test maneuvers.
Conclusions
Normal values and findings from a comprehensive HRM testing protocol are reported based on evaluation of 30 healthy asymptomatic volunteers. Isolated “abnormalities” of IRP and contractile parameters were observed in the majority (80%) of these asymptomatic subjects, while all subjects also had normal features observed. Thus, the definition of “normal” should be recalibrated to focus on the entirety of the study and not individual metrics.
(J Neurogastroenterol Motil 2021;27:354-362)

KCI등재 SCI SCOPUS

9Upright Integrated Relaxation Pressure Predicts Symptom Outcome for Esophagogastric Junction Outflow Obstruction

저자 : Songfeng Chen , Mengya Liang , Niandi Tan , Mengyu Zhang , Yuqing Lin , Peixian Cao , Qianjun Zhuang , Yinglian Xiao

발행기관 : 대한소화기기능성질환·운동학회(구 대한소화관운동학회) 간행물 : Journal of Neurogastroenterology and Motility 27권 3호 발행 연도 : 2021 페이지 : pp. 363-369 (7 pages)

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Background/Aims
Esophagogastric junction outflow obstruction (EGJOO) is characterized by elevated integrated relaxation pressure (IRP) and preserved esophageal peristalsis. The clinical significance of EGJOO is uncertain. This study aim to describe the clinical characteristics of these patients and to find out potential parameters to predict patients' symptom outcome.
Methods
Consecutive patients who received high-resolution manometry examination in our hospital in 2013-2019 and met the diagnostic criteria of EGJOO were retrospectively included. Motility and reflux parameters as well as endoscopy and barium esophagogram results were studied and compared. Patients were also followed up to record their treatment methods and symptom outcomes.
Results
A total of 138 EGJOO (accounting for 5.2% of total patients taking high-resolution manometry examination in our hospital) patients were included. Only 2.9% of these patients had persistent dysphagia. A total of 81.8% of EGJOO patients had symptom resolution during follow-up. Patients with persistent dysphagia had significantly higher upright IRP (16.6 [10.3, 19.8] vs 7.8 [3.2, 11.5]; P = 0.026) than those without. Upright IRP can effectively distinguished patients with persistent dysphagia (area under curve: 0.826; P = 0.026) using optimal cut-off value of 9.05 mmHg.
Conclusion
EGJOO patients with persistent dysphagia and higher upright IRP (median > 9.05 mmHg) needs further evaluation and aggressive management.
(J Neurogastroenterol Motil 2021;27:363-369)

KCI등재 SCI SCOPUS

10Evaluations of Gastric Acid Pocket Using Novel Vertical 8-Channel pH Monitoring System and Effects of Acid Secretion Inhibitors

저자 : Shohei Sumi , Norihisa Ishimura , Hironobu Mikami , Eiko Okimoto , Yuji Tamagawa , Tsuyoshi Mishiro , Yoshikazu Kinoshita , Shunji Ishihara

발행기관 : 대한소화기기능성질환·운동학회(구 대한소화관운동학회) 간행물 : Journal of Neurogastroenterology and Motility 27권 3호 발행 연도 : 2021 페이지 : pp. 370-376 (7 pages)

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Background/Aims
The gastric acid pocket has an important role in gastroesophageal reflux disease development. In this study, we utilized a novel 8-channel pH monitoring system with sensor intervals of 1 cm on the vertical axis for evaluation of postprandial gastric acid pocket in healthy Japanese adults, as well as the effects of vonoprazan and rabeprazole.
Methods
Twelve healthy volunteers without Helicobacter pylori infection were enrolled. A catheter was inserted transnasally and positioned under X-ray guidance, then postprandial acid pocket formation was monitored over time in a sitting position. Thereafter, acid pocket changes were assessed following administration of vonoprazan (20 mg) or rabeprazole (20 mg).
Results
The gastric acid pocket was successfully measured by use of the present system in 10 cases, while failure occurred in 2 because of inappropriate catheter positioning. Observed acid pockets were visualized with a mean length of 2.2 ± 0.4 channels on the top layer of food contents approximately 20 minutes after finishing a meal. There were some variations for lasting time of the acid pocket. Complete elimination within 3 hours after administration of vonoprazan was noted in all cases. Likewise, following administration of rabeprazole, the acid pocket was eliminated in 7 cases, while acidity was reduced though the pocket remained observable in 3.
Conclusions
Gastric acid pocket observations were possible using our novel vertical 8-channel sensor catheter. The present findings showed that vonoprazan strongly suppressed acid secretion within a short period, suggesting its effectiveness for gastroesophageal reflux disease treatment.
(J Neurogastroenterol Motil 2021;27:370-376)

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