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Objectives : Esophageal manometry and radionuclide esophageal transit study (RETS) are important tests for the esophageal motor function. So far, there are little available report concerning the correlation between two methods. In the present study, we have compared the results of esophageal manometry and RETS. Methods : Total 66 human subjects were employed in this study including 20 normals, 24 nonspecific esophageal motility disorders, 9 achalasia, 6 diffuse esophageal spasm, 3 hypertensive LES, 2 nutcracker and 2 scleroderma. In each subject, esophageal manomertic study was performed with low compliance pneumohydraulic capillary infusion system. Within 2 days of manometric study, each subject was studied for radionuclide esophageal transit using liquid containine 0.5 μci of Tc-99m tin colloid in supine position. Manometric parameters includes amplitude (A), duration (D) of the distal esophageal contraction, velocity (V) and prevalence of peristalsis (P), The number of abnormal contractions (ACT) and lower esophageal sphincter pressure (LESP) were also included in the parameters. Esophageal pressure (LESP) were also included in the parameters. Esophageal transit time (ETT) was defined as the time taken to reach 10% of the peak activity from the entry of the radionuclide. Results : In normal subjects, the mean ETT was 8.5±6.5 seconds (M±SD) and the mean manometry parameters including A, D, P, V, ACT and LESP were 86.3±37.2 mmHg, 98.2%, 3.4±0.9 cm/sec, 0.1±0.2 and 29.5±4.5 mmHg, respectively. In patients with various esophageal motility disorders ETT was delayed in variable degree from less than 15 seconds to more than 300 seconds. In order to find possible correlation between the ETT delay and manometry parameters, each parameter was compared in relation to ETT by regression analysis. We found an intimate relationship between ETT versus amplitude (r=-0.56, p$lt;0.001), prevalence of perisalsis (r = -0.63, p$lt;0.0001), velocity (r =-0.46, p$lt;0.0015), and number of abnormal contractions (r=0.47, p$lt;0.0011). However, neither duration of esophageal contraction nor LESP related to the ETT delay. Conclusions : Among the esophageal manometry parameters, A, V, P, ACT are related with esophageal transit. However, changes in LESP and duration of contraction are less important to estimate the esophageal transit.
Cytomegalovirus (CMV) infections are a major cause of morbidity and mortality among immunocompromised patients, especially organ transplant recipients and those suffering from the acquired immunodeficiency syndrome (AIDS). The CMV has been associated with gastric and enteric ulcerations, but infrequently with esophageal infection. CMV induced esophagitis has not previously been reported in Korea. Recently we have experienced one case of CMV induced esophagitis. A 47 year old man was admitted because of prolonged fever and massive hematemesis. He was undergone kidney transplantation 6 month ago and received immunosuppressive agents. Endoscopic examination revealed diffuse honey-comb like erosions and ulcerative lesions in lower esophagus and endoscopic biopsy specimens demonstrated innumerable typical CMV with light microscopy, electron microscopy and in situ hybridization. Esophageal lesions improved after gancyclovir therapy, but he was died due to DIC and systemic bleeding tendency.
A clean colon is one of the most important steps for the successful colonoscopic examination. So, the author evaluated the efficacy of four cleansing regimens (Regimen 1; magnesium citrate 250 cc, 97 patients, Regimen II; magnesium citrate 250 cc and bisacodyl 10 mg, 90 patients, Regimen III; castor oil 50 cc, 76 patients, Regimen IV; castor oil 100 cc, 348 patients) for detection of more effective colon cleansing method. This study was designed to compare effectiveness and patients acceptances of 4 colonoscopy cleansing regimens and to assess water and electrolyte blance before and after colon cleansing. The results were as follows: 1) The order of effective colon cleansing rate of the regimens was as follows, regimen IV 98.8%, regimen III 80.2%, regimen II 60.0%, and regimen I 54.5%. 2) Effective cleasing rate was related to bowel habit. 3) Common patient complaints by laxatives were nausea and vomiting, and patient complaints occurred significantly more often with castor oil than magnesium citrate. 4) After laxative application, serum sodium, chloride, and osmolarity concentrations statistically significantly decreased, but were not of clinical significance.