서행성 만성 변비증 환자에서 위 배출능 평가

문윤재,박효진,이귀순,이상인,박인서,김기황 대한대장항문학회 1997 Annals of Coloproctolgy Vol.13 No.4

천추(天樞) 및 상거허(上巨虛)의 침자극(針刺棘)이 대장(大腸) 통과시간(通過時間)에 미치는 영향(影響)

김동웅,이상용,이창현,Kim Dong-Woung,Lee Sang-Yung,Lee Chang-Hyun 대한침구의학회 1998 대한침구의학회지 Vol.15 No.2

Amis:ST25(Chonchu) and ST37(Sanggoho) are usually used acupoints to management several disease which induced to abnormal intestinal motility as diarrhea, constipation. Colonic transit time by radio opaque marker is able to study easily and useful method for evaluation of colonic motility. The aim of this study was to assess the effect on colonic transit time by manual acupuncture or electroacupuncture stimulation of ST25, ST37 in normal adult. Method: Colonic transit time, including Rt colon, Lt colon, rectosigmoid colon was measured by radio opaque marker in 11 normal adults. Colon transit time was measured before stimulation and after stimulation on ST25, ST37 by manual acupuncture and electroacupuncture. Each person was treated manual acupuncture or electroacupuncture stimulation for 3 days before colonic transit time measurement with 1 week interval. Result: Colon transit time before stimulation was measured $10.60{\pm}12.11$, $3.92{\pm}7.72$, $3.27{\pm}6.37$, $3.41{\pm}5.57$ hours total colon, Rt colon, Lt colon, rectosigmoid colon, respectively. Colon transit time after manual acupuncture is measured $10.48{\pm}12.35$, $3.72{\pm}7.52$, $3.37{\pm}6.76$, $3.39{\pm}5.84$ hours total colon, Rt colon, Lt colon, rectosigmoid colon, respectively. Colon transit time after electroacupuncture stimulation is measured $10.30{\pm}13.21$, $3.92{\pm}8.02$, $3.07{\pm} $, $3.31{\pm}5.49$ hours total colon, Rt colon, Lt colon, rectosigmoid colon, respectively. Significant change was observed Lt colon transit time after electroacupuncture as compared before acupuncture(P<0.05). Conclusion: Theses results suggest that manual acupuncture and electroacupuncture of ST25, ST37 in normal adults does not change colonic transit time.

대장 통과 지연성 만성 특발성 변비에 대한 섬유소의 효과

정문기(Moon Gi Chun),송치욱(Chi Wook song),문정섭(Jeong Seop Moon),진윤태(Yoon Tae Jeen),엄순호(Soon Ho Um),김창덕(Chang Duck Kim),류호상(Ho Sang Ryu),현진해(Jin Hae Hyun) 대한소화기학회 1996 대한소화기학회지 Vol.28 No.4

N/A Background/Aims: Chronic idiopathic constipation has been thought to be related to decreased intake of dietary ttber, and high fiber diet was recommended as an initial therapy for consitipated patients. So we estimated the effects of dietary fiber(psyllium husk) on symptoms and colonic transit time in patients with slow transit constipation. Methods: We measured colonic transit time using radioopaque markers in 74 controls and 68 patients with chronic idiopathic constipation. After 4 week treatment of psy]lium husk(3.25g/pack, t.I.d.), we re-evaluated symptoms and colonic transit time in 37 patients with slow transit constipation. Results: In controls, mean bowel frequency was 5.1/week, total colonic transit time was 16.9 hours, and segmental colonic transits were 4.0 hours for right, 5.1 hours for left, and 7.8 hours for rectosigmoid colon. Among 68 patients with chronic idiopathic constipation, 37 patients had delayed total colonic transit time (mean-t 2SD). In these patients with slow transit constipation, mean bowel frequency was 2.0/week, total colonic transit time was 56.6 hours, and segmental colonic transits were 16.2 hours for right, 22.4 hours for left and 18.0 hours for rectosigmoid colon. After treatment, bowel frequency increased from 2.0/week to 4.3/week, and total colonic transit time decreased from 55.6 hours to 37.7 hours. Right, left, and rectosigmoid segmental colonic transit time also decreased from 16.2 to 9.8 hours, 22.4 to 15.0 hours and 18.0 to 12.5 hours, respectively. We found 3 patients with abdominal bloating and I patient with abdominal pain, but no patients had any serious complications. Conclusions: In patients with slow transit constipation, psyllium husk improved symptoms and colonic transit without serious side effect. (Korean J Gastroenterol 1996; 28:513 - 519)

여성에 있어서 연령 및 생리주기가 대장통과시간에 영향을 미치는가?

송영진,이상전,윤효영 충북대학교 의과대학 충북대학교 의학연구소 1995 忠北醫大學術誌 Vol.5 No.1

20대에서 60대까지의 병력상 장운동 장애가 없는 여성 43명(50세미만으로서 생기주기가 규칙적이고 검사기간동안 나포기에 있는 자 13명, 황체기에 있는자 15명, 50세이상으로서 폐경기이후인 자 15명)을 대상으로 방사선 비투과표지를 수회 투여하는 방법을 사용하여 대장 통과시간을 측정하여 다음과 같은 결과를 얻었다. 1) 우측결장 11.2 ±2.2시간, 좌측결장 9.5 ±1.1시간, 직장 및 에스상결장 10.7 ±1.9시간, 전 대장 31.3 ±2.8시간이었다. 2) 50세미만 군은 우측결장 10.9 ±1.2시간, 좌측결장 9.9 ±1.3시간, 직장에스상결장 및 직장 9.9 ±2.3시간, 전 대장 30.7 ±3.0시간이었고, 50세이상군은 우측결장 11.5 ±1.9이상, 좌측결장 8.8 ±0.8시간, 직장 및 에스상결장 12.1 ±2.0시간, 전 대장 32.4 ±2.4 시간으로 양군간에 유의한 차이가 있었다(p<0.05). 3) 난포기 여성군은 우측결장 11.1 ±7시간, 좌측결장 8.6 ±1.2시간, 직장 및 에스상결장 10.4 ±1.3시간, 전 대장 30.1 ±2.4 시간이었으며, 황체기 여성군은 우측결장 10.8 ±1.2시간, 좌측결장 11.0 ±2.1시간, 직장 및 에스상결장 9.5 ±0.8시간, 전 대장 31.3 ±4.2 시간으로 좌측결장에서는 황체기가 난포기보다 통과시간이 유의하게 길었으나(p<0.05), 전체 대장 통과시간에는 유의한 차이가 없어(p>0.05) 생리주기상의 시기에 따른 차이가 없었다(p>0.05). 이상의 결과로부터 노인화에따라 대장 통과시간이 길어짐을 알 수 있었으나 생리주기에 따른 대장통과시간의 차이는 발견할 수 없었다. 따라서, 여성에 있어서 노인화에 따른 변비는 대장통과시간의 지연과 관련이 있을지 모르나, 생기주기에 따른 변비증상의 발현은 대장통과시간의 지연과는 관련이 없음을 시사한다. 아울러 이는 황체기가 변비 증상의 심한 정도와 관련이 있을지 모르지만 그 변화 양상은 장 평활근에 대한 progesterone의 영향과는 연관이 없음을 시사하고 있다. To ellucidate the effect of age and the phase of a menstrual cycle in women on the segmental or/and total colonic transit time, mean colonic transit time was measured in 43 women(13 in the follicular phase, 15 in the luteal phase, and 15 of the postmenopause) between 3rd decade and 7 the decade. All had complained of no functional gastrointestinal symptoms, and premenopausal women have regular menstrual cycles. Multiple bolus techniques of radioopaque markers were used by taking twenty markers for three consecutive days, and then two abdominal films on the day 4th. and 7th. The results were as follows : 1) Mean transit time was 11.2 ±2.2 hours in right colon, 9.5 ±1.1 hours in left colon, 10.7 ±1.9 hours in rectun and sigmoid colon, and 31.3 ±2.8 hours in total colon. 2) Mean transit time under age 50 was 10.9 ±1.2 hours in right colon, 9.9 ±1.3 hours in left colon, 9.9 ±2.3 hours in rectum and sigmoid colon, and 30.7 ±3.0 hours in total colon, while over age 50 they were 11.5 ±1.9 hours in right colon, 8.8 ±0.8 hours in left colon, and 12.1 ±2.0 hours in rectum and sigmoid colon, and 32.4 ±2.4 hours in total colon, which showed statistically differences in rectum and sigmoid colon, and total colon(p<0.05). 3) Mean transit time of women in the follicular phase were right colon 11.1 ±7 hours, left colon 8.6 ±1.2 hours, rectum and sigmoid colon 10.4 ±1.3 hours, and total colon 30.1 ±2.4 hours, in the luteal phase were right colon 10.8 ±1.2 hours, left colon 11.0 ±2.1 hours, rectum and sigmoid colon 9.5 ±0.8 hours, and total colon 31.3 ±4.2 hours. Although transit hour in the left colon was longer in the luteal phase than in the follicular phase, no significant difference was found in the total colon transit time(p>0.05). These results showed mean colon transit time prolongs as women become older, but is not affected by the specific phase in a menstrual cycle.

방사성동위원소를 이용한 대장분절 통과시간의 정량적 연구

최석채(Suck Chei Choi),김제형(Jae Hyung Kim),황호근(Ho Geun Hwang),양세훈(Sei Hoon Yang),김진아(Jin Ah Kim),나용호(Yong Ho Nah),이춘호(Choon Ho Lee),김창근(Chang Guhn Kim) 대한소화기학회 1997 대한소화기학회지 Vol.29 No.1

N/A Background/Aims: Measurements of regional transit are highly relevant to an understanding of normal colonic function and of any derangements associated with disease. Currently available clinical tests of colonic transit, such as the radiopaque marker method, are useful in detecting delayed transit but may be less sensitive for rapid transit. Our aim was to develop a method whereby the transit of solid residue measvred unprepared human colon. Methods: We used a noninvasive method to label the solid phase of contents in the unprepared human colon. 'Indium-labeled Amberlite IR-120 beads(Siga Chemica] Co.) were placed in a gelIatin capsule which was then coated with methacrylate. When ingested by healthy controls, capsules released radiolabeled beads in the dista] ileum or proximal colon in 22 of 22 controls. Transit of 'Indium-pellets through the unprepared colon could be quantitated radioscintigraphically. Results: Emptying of the ascending colon was characterized by an initial lag period(112.50' 80.75 min, mean + S.D). Mean colonic transit times were measured using both the radiopaque markers and radioscintigraphy. The mean colonic transit times were 1212.50<413.98min (rnean < S.D) in radioscintigraphy, and 1014.40+631.67min(mean < S.D) in radiopaque marker. So there was a good correlation(r=0.7) between radioisotope method and radiopaque marker method. Radioactivity counts were distributed equally between ascending colon, transverse colon, descending colon, and rectosigmoid colon at the 12th hour. Geometric center analysis showed an initial progression of activity in the proximal colon and a linear progression distally. Conclusions: Colonic scintigraphy is a safe and quantitative method for evaluating the colonic transit of fecal material and may provide a usefu] tool for evaluating large intestinal physiology. In healtby adults, normal orol-cecal transit time is about 5 hours and normal colonic transit time is about 24 hours when using radioscintigraphic method.(Korean J Gastroenterol 1997; 29:1-8)

간경변 환자에서 대장통과시간에 관한 연구

김영훈 ( Kim Yeong Hun ),심성곤 ( Sim Seong Gon ),조경란 ( Jo Gyeong Lan ),김진배 ( Kim Jin Bae ),이오영 ( Lee O Yeong ),최호순 ( Choe Ho Sun ),함준수 ( Ham Jun Su ),이민호 ( Lee Min Ho ) 대한소화기학회 2003 대한소화기학회지 Vol.42 No.5

The colonic transit time in patients with liver cirrhosis has not been studied extensively in South Korea. Thus, the authors investigated the differences of colonic transit time between cirrhotic patients and normal controls with attention to factors that affect this change. Methods: Fifteen cirrhotic patients and 15 controls were included in this study. To exclude any organic diseases, colonoscopy was preceded. The colonic transit time was measured by taking plain abdominal films on the 4th and 7th days after ingestion of radiographic non-absorbable colon markers for 3 days. Results: The colonic transit time was 10.7±2.6 hours and 24.0±4.1 hours for cirrhotic patients and controls, respectively, indicating that the transit time in cirrhotic patients is much faster (p<0.05). The transit time for each segment of the colon was also measured. For the ascending colon, average transit time of the cirrhotic patients and controls were 5.60±1.93 and 6.88±1.77 hours respectively. For the descending colon, those were 2.80±1.04 and 10.80±2.59 hours (p<0.05), while those in the rectosigimoid portion were 2.32±0.81 and 4.96±1.19 hours, respectively. These results indicated that a significant difference is present in the descending colon. Additionally, the transit time is correlated with age and albumin level (B=0.760, p<0.05 and B=7.498, p<0.01, respectively). Conclusions: The colonic transit time of cirrhotic patients is faster than that of control, especially in the descending colon. (Korean J Gastroenterol 2003;42:394-399)

방사성동위원소를 이용한 대장분절 통과시간의 정량적 연구

최석채,김제형,황호근,양세훈,김진아,나용호,이춘호,김창근 大韓消化器病學會 1997 大韓消化器病學會誌 Vol.29 No.1

How to Interpret a Functional or Motility Test - Colon Transit Study

( Eun Ran Kim ),( Poong Lyul Rhee ) 대한소화기기능성질환·운동학회 (구 대한소화관운동학회) 2012 Journal of Neurogastroenterology and Motility (JNM Vol.18 No.1

Measurement of colon transit time is the most basic and primary tool in evaluating disorders of colonic motility. In particular, it is helpful in pathologic diagnosis and for planning management in patients with constipation. Several techniques for measuring colon transit time currently exist. The standard measurement of colon transit time has been performed using radioopaque marker test. The radioopaque marker test is the most widely used method; it is simple to perform as well as being cost effective. But, this technique produces radiation exposure. Radionuclide scintigraphy and wireless motility capsules are other techniques used to measure colon transit time. In radionuclide scintigraphy, the transit of radioisotope is viewed by gamma camera; this approach has an advantage in that it uses minimal radiation and it allows a physiological assessment of gastrointestinal transit. Wireless motility capsules have been validated most recently, but this technique is not useful in Korea. This review presents the techniques used to measure colon transit time and the interpretations provided in different colon transit studies. (J Neurogastroenterol Motil 2012;18:94-99)

만성 변비증 환자에서 대장 통과시간

임창인(Chang In Yim),나용호(Yong Ho Nah) 대한내과학회 1991 대한내과학회지 Vol.41 No.5

Twenty-three patient with chronic constipation under- went studies of total and segmental colonic transit of radio-opaque markers to determine the utility of this test in chronic constipation for further diagnostic and therapeutic plans. The subjects ingested 1 radio-opaque marker at 9:00 AM on each of 3 consecutive days while they were fully ambulatory, A plain abdomen was obtained on the 4th day. Repeated plain abdomen was obtained on the 7th day if the markers did not pass on the 4th day. The abdomen was divided into 3/areas of interest using bony landmarks: the right colon, the left colon and the rectosigmoid area. The markers are counted in each site on X-rays taken on the 4th day; these markers were multiplied by 1.2 The result were as follows: 1) Colonic transit studies showed 3 different groups: colonic inertia (n=9), outlet obstruction (n=6), and normal transit (n=8), 2) The mean trasit time in the total colon was 28.47± (24.27hr) (mean±SD) in chronic constipation and 10.57+12.80hr in the normal controls (p<0.01). 3) The mean transit time in the right colon was 8.04±9.72 hr in chronic constipation and 3.87±7.23 hr in the normal controls (p<0.01). Corresponding values in the left colon were 10.64±13.23hr and 3.31±5.01 hr (p<0.01) and, in the rectosigmiod, 9.91±14.54 hr and 3.27±5.56hr, respectively (p<0.01). 4) Colonic transit was delayed in chronic constipation about 3 times more than in the normal controls (p<0.01). 5) Colonic transit was delayed predominantly in the left colon. In summary a colonic transit study using radiopaque markers is a simple and useful test in the evaluation of chronic canstipation.

Caffeine, theophylline 및 adenosine 이 기니 픽 대장 통과 시간에 미치는 효과

문종태 ( Jong Tae Moon ),최은주 ( Eun Ju Choi ),김영균 ( Yung Gyun Kim ),김희선 ( Hee Sun Kim ),박효진 ( Hyo Jin Park ) 대한소화기기능성질환·운동학회 2006 Journal of Neurogastroenterology and Motility (JNM Vol.12 No.2

목적: Methylxanthine의 유도체인 caffeine, theophylline은 adenosine 수용체에 대한 대항제이고 PDE 억제제로서 cyclic nucleotide를 증가시켜 평활근의 이완을 유도한다. Adenosine 수용체는 장 근육세포의 이완 또는 수축을 유도한다. 이에 caffeine, theophylline 및 adenosine의 기니 픽 대장 통과 시간에 대한 영향을 알아보고자 하였다. 대상 및 방법 : 항문연으로부터 약 15 ㎝ 길이의 기니 픽 대장을 적출하여 근위부 10 ㎝을 사용하였다. 채취한 대장을 K-H 용액을 채운 욕조 양측단에 연결하고 기니 픽 대변 형태 및 굳기와 유사하게 만든 인공 배설물을 구측단에 넣은 후, 인공배설물이 항문측으로 이동하는 시간을 측정 후 평균값을 구하여 평균 대장 통과 시간으로 정하였다. 결과: caffeine 단독 사용시에는 10(-7) M와 10(-6) M농도에서 대장 통과 시간의 농도 의존적으로 통계적으로 유의한 지연을 보였으나 theophylline은 유의한 지연을 보이지 않았다. Adenosine은 10(-4) M와 10(-3) M농도에서 통계적으로 유의한 지연이 관찰되었다. Caffeine (10(-6) M) 단독 투여하는 경우와 caffeine (10(-6) M)과의 adenosine (10(-3) M)을 병용하는 경우를(199.1±33.5% vs 298.8±65.8%, p=0.036) 비교시 유의하게 대장 통과 시간의 지연을 보였다. 10(-6) M농도의 theophylline과 10(-6)~10(-3) M농도의 adenosine의 병용 투여군과 adenosine 단독 투여군을 비교했을 때 통계적으로 유의한 차이는 보이지 않았다. 그러나 10(-6) M농도의 caffeine과 10(-6)~10(-3) M농도의 adenosine의 병용 투여군과 adenosine 단독 투여군을 비교했을 때 adenosine 10(-3) M농도(adenosine 단독 투여시 1172.7±168.4%에서 caffeine 전처치시 298.8±65.8%, p=0.021)에서 유의한 차이를 보여 adenosine의 통과 시간 지연을 caffeine의 투여가 억제함을 알 수 있었다. 결론: Caffeine, adenosine은 기니 픽 대장 통과 시간을 지연시켰으며, caffeine은 비특이적 PDE 억제제로서 대장 통과 시간 지연을 일으킨다. Background/Aims: Caffeine and theophylline are adenosine receptor antagonists and they are also non-specific phosphodiesterase inhibitors. We aimed to estimate the effects of caffeine and theophylline on the colonic activity of guinea pigs, and we investigated whether caffeine or theophylline has an offsetting effect on adenosine. Methods: The colon (approximately 10 ㎝ from the guinea pig`s anus) was extracted; both ends of it were connected to a chamber that contained K-H solution. Artificial feces was inserted into the oral side of the lumen, and it was moved toward the anal side. We observed a total length of 8 ㎝ of the colon and recorded the time taken for the artificial feces to move each 2 ㎝. Results: Caffeine decelerated the transit with a dose dependant pattern, but theophylline had no significant effect on the transit time. Adenosine significantly increased the colonic transit time at only high concentrations. When caffeine (10(-6) M) was administered with adenosine (10(-3) M), the colonic transit time was significantly delayed compared with administering caffeine alone. When caffeine was administered with adenosine, the colonic transit time was significantly shortened compared with administering adenosine alone at 10(-3) M, and this didn` change after theophylline was added. Conclusions: Caffeine or adenosine inhibits colonic transit, but theophylline does not affect colonic motility. Caffeine offsets the inhibitory effect of adenosine. Caffeine probably delays colonic transit as an intrinsic PDE inhibitor. (Kor J Neurogastroenterol Motil 2006;12:117-121)