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It is well known that alimentary tract of the PSS patients is disordered in motor activity and many reports review the dysfunction in esophageal motility, although few focus on that of duodenum. In this study, duodenal motility was examined in 27 PSS patients and compared with that of 19 normal subjects, in the view points of interdigestive migrating motor complex (IMMC) and secretin-induced IMMC-like motor complex (SI-IMMC).Duodenal manometric recordings were obtained by an infused catheter method, using an Arndorfer's system. A polyvinyl sensor catheter was inserted to a part of jejunum through nasal canal. After the appearance of spontaneous IMMCs, secretin of 2U/kg was administered intravenously.PSS patients showed less IMMCs than the normal group, but there was no difference in the reaction to secretin administration. The component values of contractions of IMMC were compared between the two groups. The values of amplitude, frequency and conduction velocity were significantly reduced in the PSS group. SI-IMMCs also had the same tendency but the values had no significant differences between the groups. The PSS patients with the history less than ten years had amplitudes of IMMCs which tended to reduce by degrees with years, and the cases with esophageal complaints or abnormal x-ray changes in esophagus or duodenum showed significantly lower amplitudes.It is concluded that duodenal motility is significantly reduced in the PSS patients and it correlated with their courses or clinical findings. Alterations in the characteristics of IMMCs and the reaction to secretin administration similar to the normal group suggest that the motor disorders of duodenum in the PSS patient may be due to the changes in the duodenal wall and its smooth muscle layer.
- 財団法人 日本消化器病学会の論文
財団法人 日本消化器病学会 | 論文
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