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Reflux Hypersensitivity: A New Functional Esophageal Disorder
( Takahisa Yamasaki ),( Ronnie Fass ) 대한소화기기능성질환·운동학회(구 대한소화관운동학회) 2017 Journal of Neurogastroenterology and Motility (JNM Vol.23 No.4
Reflux hypersensitivity, recently introduced by Rome IV as a new functional esophageal disorder, is currently considered as the presence of typical heartburn symptoms in patients with normal upper endoscopy and esophageal biopsies, normal esophageal pH test and with evidence of a close correlation between patients’ heartburn and reflux events. Reflux hypersensitivity is very common and together with functional heartburn accounts for more than 90% of the heartburn patients who failed treatment with proton pump inhibitor twice daily. In addition, reflux hypersensitivity affects primarily young to middle aged women, commonly overlaps with another functional gastrointestinal disorders, and is often associated with some type of psychological comorbidity. Diagnosis is made by using endoscopy with esophageal biopsies, pH-impedance, and high-resolution esophageal manometry. Reflux hypersensitivity is primarily treated with esophageal neuromodulators, such as tricyclic anti-depressants and selective serotonin reuptake inhibitors among others. Surgical anti-reflux management may also play an important role in the treatment of reflux hypersensitivity. (J Neurogastroenterol Motil 2017;23:495-503)
Takahisa Shiraishi,Hiro Einishi,Shintaro Yasui,Hiroshi Funakubo,Tomohito Hasegawa,Minoru Kurosawa,Mutsuo Ishikawa,Hiroshi Uchida,Yukio Sakashita,김상수,송태권,도달현,김명호 한국물리학회 2013 THE JOURNAL OF THE KOREAN PHYSICAL SOCIETY Vol.62 No.7
(K0.88Na0.12)NbO3 (KNN) thick films with various thicknesses were prepared on Ni-based metal substrates by hydrothermal method. Although the deposition of KNN films was hardly observed directly on metal substrates until 12 h, the amount of KNN films deposited on both SrRuO3/LaNiO3- and SrRuO3-covered Ni based metal substrates increased to about 5 μm with increasing deposition time above 3 h. X-ray diffraction studies confirmed the formation of {100}c- and randomly-oriented KNN films on SrRuO3/LaNiO3- and SrRuO3-covered metal substrates, respectively. Ferroelecctric property studies revealed an improved remanent polarization and an improved piezoelectric response of {100}c-oriented KNN films over the randomly-oriented KNN films. In addition, the values for {100}c-oriented KNN films were similar to those of {100}c-oriented epitaxial KNN films prepared on (100)cSrRuO3//SrTiO3 substrates.
( Takahisa Yamasaki ),( Toshihiko Tomita ),( Sumire Mori ),( Mayu Takimoto ),( Akio Tamura ),( Ken Hara ),( Takashi Kondo ),( Tomoaki Kono ),( Katsuyuki Tozawa ),( Yoshio Ohda ),( Tadayuki Oshima ),( 대한소화기기능성질환·운동학회(구 대한소화관운동학회) 2018 Journal of Neurogastroenterology and Motility (JNM Vol.24 No.3
Background/Aims High-resolution esophageal manometry (HREM) is considered to be the gold standard for the diagnosis of achalasia. However, the Japan Esophageal Society recommends that esophagography is also accurate in either diagnosing or excluding the disorder. Accordingly, we compared the efficacy of esophagography and HREM in diagnosing achalasia patients with upper gastrointestinal symptoms. Methods HREM was performed in 126 patients with dysphagia. The final diagnosis of achalasia was done using HREM. Demographic data, symptoms, quality of life (QOL) were also obtained. We assessed the patients who were not able to be diagnosed by esophagography and compared the diagnostic values for esophagography with HREM-based achalasia diagnosis as the gold standard. Results A total of 48 cases of patients with achalasia, including 21 men and 27 women (mean age, 48.4 ± 19.6 years), were included in the study. Two patients were excluded. Of the remaining 46 patients, 36 (78.3%) patients were diagnosed as having achalasia by esophagography. The diagnostic sensitivity, specificity, and accuracy of esophagography were 78.3%, 88.0%, and 83.0%, respectively. Patients with type III achalasia had significantly lower physical QOL score than those with type I or II achalasia. Although the mental QOL score in patients with type III achalasia tended to decrease compared with that in patients with type I and II achalasia, the difference was not statistically significant. Conclusions Diagnosing esophageal achalasia by using esophagography alone has limited yield. Therefore, HREM should be used in patients with dysphagia and in whom achalasia cannot be diagnosed using EGD or esophagography. (J Neurogastroenterol Motil 2018;24:403-409)