• The Journal of Internal Korean Medicine
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• v.28 no.4
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• pp.769-778
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• 2007

Background & Object : Postprandial epigastric fullness is one of common symptoms in functional dyspepsia, but its pathophysiological mechanism has still been unknown. In this study, its association between postprandial epigastric fullness and pyloric valve disturbance was studied through analysis of bowel sounds and electrogastrography. Methods : Bowel sounds and electrogastrography were recorded together for fasting 15 min and postprandial 40 min. Parameters of bowel soundincluding motility index, sound to sound interval, standard deviation of sound to sound interval, sounds per minute, % of bowel sound, sound length, intensity, dominant frequency of sounds, and postprandial / fasting ratio of dominant frequency of sounds were analyzed with a specialized program. By electrogastrography, regularity of slow waves and power ratio were obtained. Results : Significances of bowel sounds appeared in motility index (p=0.046), dominant frequency of fasting (p=0.048), postprandial (p=0.003), and the ratio of postprandial/fasting (p=0.000); those of EGG parameters were shown in postprandial regularity of slow waves (p=0.006) and power ratio (p=0.011). Conclusion : Pyloric valve disturbance was a cause of postprandial epigastric fullness in patients with functional dyspepsia. Analysis of bowel sound might be useful in diagnosing its existence.

• The Journal of Internal Korean Medicine
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• v.36 no.3
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• pp.276-283
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• 2015

Objectives: The purpose of this study is to report bowel sound patterns recorded in 3 diseases associated with structural deformity of the pylorus-duodenum. Methods: : Bowel sound recording is a useful non-invasive tool for the evaluation of gastrointestinal motility. However, the difficulty in manual attachment of the electronic stethoscope on the abdominal wall and noise production against bowel sound signals have prohibited its widespread use. Therefore, I developed a new apparatus that eliminates the noise; it contains a sound absorbing device and a holder for the head of stethoscope. Using the new bowel sound recording system, bowel sounds of the patients were recorded repeatedly. The endoscopic and abdominal computed tomography findings were obtained from other hospitals' medical record, and all patients were confirmed to have structural deformity in the pylorus-duodenum. The records of each patient were compared and assessed. Results: : Patients had either duodenal ulcer scar, pyloric stricture, or far advanced malignant stomach cancer, as diagnosed by the gastroscopy. Their dominant frequency of bowel sound obtained from the new system was checked more than 2 times at regular intervals. All 8 recordings in the 2 patients with duodenal ulcer scar (5 times) or pyloric stricture (3 times) showed a decrease in postprandial than fasting dominant frequency. One patient with stomach cancer showed no significant change between postprandial and fasting states at 2 recordings. Conclusions: The analysis of dominant frequency in bowel sounds can indicate the existence of pyloric obstruction that could delay gastric emptying.

• The Journal of Internal Korean Medicine
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• v.35 no.4
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• pp.439-447
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• 2014

Objectives: The aim of this study was to investigate whether 1) variation of bowel sounds recorded stably through an electronic stethoscope in a sound insulation box can be related with that of gastric contraction and 2) if they are thus useful tool in the measurement of the gastric contractility in awake rats or not. Methods: Electrical potentials of both electronic stethoscope of bowel sound and force transducer were recorded simultaneously and continuously in the sound insulation box for the starting 30 min of basal state, and then 30 min of 0.2 ml normal saline administration, finally 30 min of 0.2 ml mosapride citrate solution (100 mg/Kg) in rats. Each motility index of normal saline or mosapride citrate treatment was presented with ratio against the basal state by using integrated electrical potentials. Results: A pattern of significance of gastric contractility between bowel sound and force transducer was showed analogously. Conclusions: The amplitude of bowel sounds recorded by the electronic stethoscope related with the intensity of gastric contractions. This confirms that a sound insulation box and electronic stethoscope are useful tools in the measurement of the gastric contractility of awake rats.

• The Journal of Internal Korean Medicine
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• v.30 no.1
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• pp.173-180
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• 2009

Objectives : The aim of this study was to investigate the evaluation of gastrointestinal parasympathetic nerve activity by comparing between HRV and bowel sound parameters in patients with functional dyspepsia. Methods : 62 patients (male 22, female 40) were enrolled. HRV was measured in all patients. and TP (total power), LF (low frequency density: 0.04$\sim$0.15Hz), HF (high frequency density: 0.15$\sim$0.4Hz). and LF/HF ratio were analyzed. HF band is a reflection of parasympathetic activity. and the LF-to-HF ratio is considered a marker of sympathovagal balance. Bowel sounds were recorded at the day after, and postprandial %BS was used to indicate the gastric vagal activity after eating. HRV and bowel sound parameters were compared. and correlation between them was analyzed. Results : There was no difference in LF/HF ratio between patient group and healthy group of other report. According to values of %BS, each patient was classified into a normal (>6 %BS) or hypoactivity (<6 %BS) of gastric vagus nerve group. HF component of the hypoactivity group was not significantly higher than that of the normal group. There was no correlation between HRV and bowel sound parameters. Conclusions : Because no correlation was found between HRV and bowel sound parameters in patients with functional dyspepsia, we concluded that it is not proper to evaluate gastric vagus nerve activity by HRV measurement.

• The Journal of Internal Korean Medicine
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• v.31 no.2
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• pp.212-223
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• 2010

Objectives : The aims of this study were to evaluate whether gastric contractility could be measured by bowel sound of rats, and whether gastrointestinal side effect of any herbal restoratives would be related with their inhibition of gastric contraction. Methods : Streptozotocin (STZ)-induced diabetic rats were used as a gastric hypocontraction model. At the time of 6 weeks after induction of diabetes, 2mL of normal saline (NS) and 2mL of extract solution each containing 125mg/kg of Bojoongikki-tang (BJ), Sipjeondaebo-tang (SJ), Youngkaechulgam-tang (YG) were given to Normal (NR) and diabetic rats (DR), respectively. Bowel sound was recorded for 30 minute in fasting, and 120 minute of their administration. Gastric motility index was serially calculated with the ratio of accumulated potentials of post-administration/fasting state every 10 minutes. Results : Gastric contractility between NR and DR could be significantly distinguished by bowel sound auscultation. BJ had a decreasing effect, SJ had a bidirectional effect, and YG had an increasing effect on gastric contractility measured by bowel sound auscultation. Conclusions : BJ showed the possibility of inhibitory effects on gastric contraction. So, before administration, a gastric motility test should be recommended to prevent possible side effects in patients with gastric hypocontractility.

• Korean Journal of Adult Nursing
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• v.19 no.5
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• pp.127-137
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• 2007

Purpose: It was investigated if abdominal meridian massage has effects on constipation in institutionalized psychiatric patients taking antipsychotic drugs. Methods: According to the constipation screening tests, 22 patients were selected as subjects. One group pre and post repeated measurement design was used. Constipation was operationalized as perceived constipation, frequency of defecation, frequency of bowel sound, and number of medicine taken to relieve constipation. Abdominal meridian massage was given for two weeks, 10-15 minutes each time and 10 times in total. Results: Perceived constipation, frequency of bowel sound, and number of medicine taken were significantly improved after massage. Except for number of medicine taken, the effects on perceived constipation and frequency of bowel sound were found to be persistent 2 weeks after massage. Conclusion: Based upon these results, abdominal meridian massage was recommended as independent nursing intervention for the relief of constipation in psychiatric patients who taking anti-psychotic drugs. Further studies to investigate the maximal duration time of effects and whether the effects of intermittent application of this method is more beneficial than the continuous application of this method are necessary.

• The Journal of Internal Korean Medicine
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• v.29 no.2
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• pp.401-412
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• 2008

Objectives : The aim of this study was to investigate the characteristics of Ryodoraku and association of Ryodoraku with gastric dysmotility in functional dyspepsia(FD). Methods : Subjects were 154 patients with FD and 18 patients with asthma. We calculated the average Ryodoraku score(RS, ${\mu}A$) and each variation from physiologic range of 12 Ryodoraku points, and investigated the incidence when left and right points were simultaneously below(bilateral deficiency) or above(bilateral excess) physiologic range. Postprandial regularity of normal slow waves, power ratio, and postprandial % of bowel sound were obtained by electrogastrography and enterotachography, and were used as gastric dysmotility index. Results : 1. Bilateral excess of H4, H5, F1, and F4 and bilateral deficiency of H4, H5, and H6 were characteristic in FD compared with asthma patients. 2. Incidence of gastric dysmotility in bilateral deficiency of H4, H5, and H6 was 100%, and was higher than in total FD patients(88.3%). 3. There was a positive correlation between the variation of H6 and % postprandial bowel sound. 4. Deficient tendency of H4, H5, and H6 was more evident when RS was above $40{\mu}A$ in FD. Conclusions : These findings suggest that gastric dysmotility in FD can be diagnosed when a pattern of H4, H5, H6 bilateral deficiency and F1, F4 bilateral excess is shown at the same time. We think this phenomenon is related to low activity of the vagus nerve rather than meridian pathway with result based on positive correlation between variation of H6 and postprandial % of bowel sound.

• The Journal of Internal Korean Medicine
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• v.29 no.3
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• pp.621-628
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• 2008

Objectives : The aim of this study was to investigate changes of gastric vagal nerve activity and pyloric valve function after execution of combination treatments of both electroacupuncture at Zusanli(ST36) and manual acupuncture at other acupoints in patient with functional dyspepsia. Methods : Bowel sounds of 49 patients (18 male, 31 female) were recorded and their % of bowel sound (%BS) and ratio of dominant frequency (DF) were analyzed. Postprandial %BS was used to indicate the gastric vagal activity after eating. Ratio of postprandial/fasting dominant frequency was used to present the degree of pyloric valve function. According to values of %BS and DF ratio, each patient was classified into normal or abnormal (<6 %BS, hypoactivity: <1 DF ratio, dysfunction) group. For 2 weeks, patients received a treatment consisting of both electroacupuncture stimulation at Zusanli (ST36) and acupuncture at other meridian points. Variation of parameters shifting normal to abnormal or abnormal to normal was observed, and total cure rate was calculated. Results : Total cure rate of %BS was 16%, and that of DF was 37%. Patients who improved to normal value from abnormal or aggravated to abnormal level showed both significant difference in both vagal nerve hypoactivity and pyloric valve dysfunction, respectively. Conclusions : Analysis of bowel sound might be useful to evaluate both gastric vagal nerve activity and pyloric valve function. Combination effects of Zusanli (ST36) electroacupuncture and manual acupuncture of other acupoints showed a bidirectional effect in which their activity and function were in general improved. sometimes from aggravated to abnormal level.

• The Journal of Internal Korean Medicine
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• v.29 no.3
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• pp.666-674
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• 2008

Objectives : The aim of this study was to evaluate gastrointestinal parasympathetic nerve activation and pyloric valve function in patients with functional dyspepsia through analysis of bowel sounds and to investigate clinical characteristics associated with the parameters of bowel sounds. Method : We surveyed clinical characteristics of patients by using a questionnaire about functional dyspepsia. Bowel sounds were recorded for 15 minutes during fasting state and for 40 minutes during postprandial state. We then classified the patients into 3 groups by abnormal states of bowel sounds, specifically by the percentage of B.S. and dominenet frequency, and studied clinical characteristics in each group. Results : Among the 182 subjects, patients who had low activity of parasympathetic nerve were 25.8% and showed a tendency of female-dominant, family history and more frequent abdominal pain. Those who had pyloric valve disturbance were 24.1% and showed no tendency by sex distribution, family history and complained of indigestion sensation. Patients who had both disorders were 10.9%, and their clinical characteristics were non-specific. Conclusion : Analysis of bowel sounds may be useful in evaluating pathophysiological factors of functional dyspepsia.

• The Transactions of The Korean Institute of Electrical Engineers
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• v.60 no.4
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• pp.877-879
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• 2011

Bowel sounds (BS) are produced by the movement of the intestinal contents in the lumen of the gastro-intestinal tract during peristalsis and thus, it can be used clinically as useful indicators of bowel motility. We devised an estimation algorithm of bowel motility based on the regression modeling of the jitter and shimmer of BS signals measured by auscultation. Ten healthy males ($23.5\pm2.1$ years) were examined. Consequently, the correlation coefficient, coefficient of determination and standard error between the colon transit times (CTT) measured by a conventional radiograph and the values estimated by our algorithm were 0.98, 0.96 and 2.86, respectively. Also, through k-fold cross validation, the average value of the absolute differences between them was $5.0\pm2.5$ hours. This method could be used as a complementary tool for the non-invasive measurement of bowel motility.