MOTILITY AND TRANSIT ACROSS THE ILEOCOLONIC JUNCTION

过去五年的工作得到了这笔赠款的支持，我们得出结论， 回结肠括约肌（ICS），至少在狗和人身上， 控制运动和运输的几种元素之一， 回结肠连接处（ICJ）。 机械因素，特别是 末端回肠在近端结肠上的成角也有贡献; 但主要的控制机制存在于综合的，有时 回肠末端、ICS和近端结肠之间独特的运动模式。 的 在国际法院控制交通方面很重要的特殊运动项目， 目前的方案已经确定了几个问题并确定了其特点。 这些包括a）从终末转移的频繁回肠阶段性爆发， 回肠进入ICS;事实上，这些迁移性阶段性收缩构成了 大多数在ICS处的阻力，B）回肠蠕动波（“PPC”），这些 是开始于回肠的强有力的传播性收缩， ICS然后涉及可变长度结肠，c）接受性松弛 在蠕动波之前，d）独特的回结肠 运动在餐后后期，当食物残渣达到 区 过去五年的工作还产生了一些强有力的新成果， 方法，现已验证到广泛应用的地步。 这些 包括：a）双相（液体/固体）或双部位（胃-小肠， 节段性大肠）运输研究，通过该研究， B）将机电恒压器应用于 人和狗的结肠 因此，本提案将针对 具体目标： 1. 为了明确结肠壁的紧张性变化在结肠癌中的作用， 国际法院过境管制;探讨语气 修改. 2. 为了在国际法院确定专门的运动模式， 残留物到达该地区;以确定这些电机的影响 过境模式;探索这些motilities的控制。 3. 为了进一步确定回结肠运动障碍的作用， 在人类疾病中传播。 位于两段肠道之间， 回结肠交界处在生态学上是独特的， 通过优化小肠中膳食残留物的保留来实现体内平衡 直到消化基本完成 相反，为了防止 细菌过度生长、结肠回肠反流的有害影响被最小化。 ICJ是肠道中最后一个需要详细研究的重要区域，它 已被证明是直接临床疾病的病理生理学来源。 本案无关 这些都需要进一步调查。

The past five years' work supported by this grant have led us to conclude that the ileocolonic sphincter (ICS), at least in the dog and man, is only one of several elements that control motility and transit at the ileocolonic junction (ICJ). Mechanical factors, specifically the angulation of the terminal ileum upon the proximal colon, also contributes; but the major controlling mechanisms reside in the integrated and sometimes unique, motor patterns among distal ileum, ICS and proximal colon. Of the special motor events that are important in controlling transit at the ICJ, several have been identified and characterized by the current program. These include a) frequent ileal phasic bursts that migrate from terminal ileum into the ICS; indeed, these migrating phasic contractions constitute most the resistance at the ICS, b) ileal peristaltic waves ("PPC's"), these are powerful propagated contractions that begin in the ileum, pass through the ICS and then involve variable lengths of colon, c) receptive relaxation of the proximal colon, ahead of the peristaltic wave, d) unique ileocolonic motility in the late postprandial period, when food residue reaches the area. The past five years work has also yielded several powerful new methodologies, now validated to the point of broad application. These include, a) dual phase (liquid/solid) or dual site (gastric-small bowel and segmental large bowel) transit studies by which the unprepared colon can be studied noninvasively, b) application of the electromechanical barostat to the human and dog colons. Accordingly, this proposal will address the following Specific Aims: 1. To define the role of tonic changes in the wall of the colon in the control of transit at the ICJ; to explore mechanisms whereby tone is modified. 2. To define the patterns of specialized motility at the ICJ when food residue reaches the region; to determine the effects of these motor patterns on transit; to explore the control of these motilities. 3. To further establish the role of disordered ileocolonic motility and transit in human disease. Located between two segments of gut that are physiologically and ecologically distinct, the ileocolonic junction contributes importantly to homeostasis by optimizing retention of meal residues in the small bowel till digestion is largely complete. Conversely, to guard against the deleterious effects of bacterial overgrowth, coloileal reflux is minimized. The ICJ is the last important region of the gut to be studied in detail; it has proven to be the source of pathophysiologies of direct clinical relevance. These need to be further investigated.