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1 diffuse esophageal spasm, nutcracker esophagus, hypertensive LES, nonspecific esophageal motility disorder, ineffective esophageal motility Esophageal motor function in nonachalasia motility disorders Motoyasu KUSANO, Masaki MAEDA, Yasuyuki SHIMOYAMA, Shikou KURIBAYASHI and Masatomo MORI' 1) Department of Medicine and Molecular Science, Gunma University Graduate School of Medicine

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10 9) Anderson KO, Dalton CB, Bradley LA, et al : Stress induces alteration of esophageal pressures in healthy volunteers and non-cardiac chest pain patients. Dig Dis Sci 1989; 34: ) Ward BW, Wu WC, Richter JE, et al : Long-term follow-up of symptomatic status of patients with non-cardiac chest pain : is diagnosis of esophageal etiology helpful? Am J Gastroenterol 1987: ) Okamura S, Oshimoto H, Sakamoto T, et al : Beta adrenoreceptor agonists for diffuse esophageal spasm. J Gastroenterol 2002; 37: ) Richter JE : Oesophageal motility disorders. The Lancet 2001;358: ) Ouyang A, Cohen S : Motility disorders of the esophagus. In : Bockus Gastroenterology, 5th ed, Haubrich W, Schafener F, Berk JE, eds, WB Saun ders, Philadelphia, 1995; ) Vantrappen G, Janssens J, Hellemans J, et al : Achalasia, diffuse esophageal spasm, and related motility disorders. Gastroenterology 1979 ; ) Clouse RE, Staiano A : Manometric patterns us ing esophageal body and lower sphincter charac teristics. Findings in 1013 patients. Dig Dis Sci 1992;37:289 5) Leite LP, Johnston BT, Barrett J, et al : Ineffec tive esophageal motility (IEM) : the primary finding in patients with non-specific esophageal motility disorder. Dig Dis Sci 1997; 42: ) Hirano I, Tatum PR, Shi G, et al : Manometric het erogeneity in patients with idiopathic achalasia. Gastroenterology 2001 ; 120: ) Behar J, Biancani : Pathogenesis of simultaneous esophageal contractions in patients with motility disorders. Gastroenterology 1993; 105: 111 8) Sifrim D, Janssens J, Vantrappen G : Failing de glutive inhibition in primary esophageal motility disorders. Gastroenterology 1994; 106: ) Achem SR, Kolts BE, Burton L : Segmental ver sus diffuse nutcracker esophagus : An intermit tent motility pattern. Am J Gastroenterol 1993 ; 88: ) Clouse RE, Lustman PJ : Psychiatric illness and contraction abnormalities of the esophagus. N Engl J Med 1983 ; 309: ) Valori RM : Nutcracker, neurosis, or sampling bias? Gut 1990; 31 : ) Achem SR, Koltz BE, Wears R, et al : Chest pain associated with the nutcracker esophagus : a pre liminary study of the role of gastroesophageal re flux. Am J Gastroenterol 1993 ; 88: ) Lacima G, Grande L, Pera M, et al : Utility of am bulatory 24-hour esophageal ph and motility monitoring in noncardiac chest pain. Report of 90 patients and review of the literature. Dig Dis Sci 2003;48: ) Pilhall M, Borjesson M, Rolny P, et al : Diagnosis of nutcracker esophagus, segmental or diffuse hy pertensive patterns, and clinical characteristics. Dig Dis Sci 2002: 47: ) MacKenzie J, Belch J, Land D, et al : Oesophageal ischaemia in motility disorders associated with

11 chest pain. The Lancet 1988; 2 : ) Balaban DH, Yamamoto Y, Liu J, et al : Sustained esophageal contraction : A marker of esophageal chest pain identified by intraluminal ultrasono graphy. Gastroenterology 1999; 116: ) Melzer E, Tiomny A. Coret A, et al : Nutcracker esophagus : severe muscular hypertrophy on en dosonography. Gastrointest Endosc 1995 ; ) Pehlivano V, Liu J, Kassab GS, et al : Relationship between esophageal muscle thickness and in traluminal pressure in patients with esophageal spasm. Am J Physiol (Gastrointest Liver Physiol) 2002: 282: G ) Achem AC, Achem SR, Stark ME, et al : Failure 26) Melzer E, Ron Y, Tiomni E, et al : Assessment of the esophageal wall by endoscopic ultrasonogra phy in patients with nutcracker esophagus. Gas trointest Endosc 1997: 46: ) Waterman DC, Dalton CB, Ott DJ, et al : Hyper tensive lower esophageal sphincter : what does it mean? J Clin Gastroenterol 1989; 11: ) Kahrilas PJ : Nutcracker esophagus : an idea whose time has gone? Am J Gastroenterol 1993; 88: ) Champion JK, Delise N, Hunt T : Myenteric plexus in spastic motility disorders. J Gastrointest Surg 2001;5: ) Clouse RE, Eckert TC : Gastrointestinal symp toms of patients with esophageal contraction ab normalities. Dig Dis Sci 1986; 31: ) Handa M, Mine K, Yamamoto H, et al : Esopha geal motility and psychiatric factors in functional dyspepsia patients with or without pain. Dig Dis Sci 1999; 44: ) Hsu JJ, O'Connor MK, Kang YW, et al : Nonspe cific motor disorder of the' esophagus : a real dis order or a manometric curiosity? ogy 1993;104: Gastroenterol 34) Kojima Y, Ikeda M, Nakamura T, et al : Nonspe cific esophageal motor disorder associated with thickened muscularis propria of the esophagus. Gastroenterology 1992; 103: ) Zalar AE, Olmos MA, Piskorz EL, et al : Esopha geal motility disorders in HIV patients. Dig Dis Sci 2003: 48: of esophageal peristalsis in older patients : asso ciation with esophageal acid exposure. Am J Gas troenterol 2003; 98: ) Ho SH, Chang CS, Wu CY, et al : Ineffective esophageal motility is a primary motility disorder in gastroesophageal 2002; 47: reflux disease. Dig Dis Sci 38) Fouad YM, Katz P0, Hatlebakk JG, et al : Ineffec tive esophageal motility : the most common motil ity abnormality in patients with GERD-associated respiratory symptoms. Am J Gastroenterol 1999; 94: ) Wu JC, Chan FK, Ching JY, et al : Effect of H. py lori eradication on esophageal acid exposure in duodenal ulcer patients without concomitant gas troesophageal reflux disease. Gastroenterology 2003; 124 (Suppll) : A-72

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