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世界核心医学期刊文摘（胃肠病学分册） 2006年第1期2卷 21-21页

作者： dinning p.g. Bampton p.A. Kennedy M.L. I.J. Cook 尹勇 Department of gastroenterology St. George Hospital Kogarah NSW 2217 Australia Dr.

pURpOSE: Both motor and sensory dysfunction have been implicated in the pathogenesis of obstructed defecation. We have found that despite preservation of a defecatory urge, patients with obstructed defecation have lost the normal predefecatory augmentation in frequency and amplitude of colonic prop.g.ting pressure waves. This observation might be explainable by either altered rectal sensory thresholds or by dysfunction in the colonic motor apparatus. By measuring rectal sensory thresholds and proximal colonic motor responses to rectal mechanical and chemical stimuli, we tested the hypotheses that central perception of rectal stimuli is enhanced and that the proximal colonic motor response to rectal stimulation is attenuated. METHODS: In seven patients with obstructed defecation and ten healthy volunteers we measured proximal colonic motor responses and sensory thresholds in response to both rectal balloon distention and rectal instillation of chenodeoxycholic acid. RESULTS: In controls, but not in patients, rectal mechanical distention significantly reduced and chemical stimulation significantly increased the frequency of proximal colonic prop.g.ting sequences (p = 0.01). There was no significant difference in rectal sensory thresholds between patients and controls. prior instillation of chenodeoxycholic acid significantly reduced (p ge volume to comparable degree in both patients and controls. CONCLUSIONS: In obstructed defecation, 1) the normal rectocolonic pathways mediating stimulation- induced proximal colonic prop.g.ting pressure waves are nonfunctioning, and. 2) central perception of these rectal stimuli is normal.

关键词：化学性刺激近端结肠排粪感受阈鹅脱氧胆酸传输频率功能障碍传动装置发病机制波频率

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以异常结肠动力模式解释排便梗阻患者的便秘

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世界核心医学期刊文摘（胃肠病学分册） 2005年第1期1卷 32-32页

作者： dinning p.g. Bampton p.A. Andre J. I.J. Cook 赵天智 Department of gastroenterology The St. George HospitalUniversity of New SouthWales Kogarah NSW Australia

Background & Aims: The pathophysiology of constipation in the syndrome of obstructed defecation is unknown. Using 24-hour pancolonic manometric recordings of the unprepared colon to record basal pressures and spontaneous defecation episodes,we tested the hypothesis that the frequency, timing, or spatial distribution of prop.g.ting colonic pressure waves is abnormal in patients with obstructed defecation. Methods: In 11 patients with obstructed defecation and 16 healthy controls,pressures were recorded using a nasocolonic catheter that was positioned such that 16 recording sites spanned the unprepared colon at 7.5cm intervals. Results: The overall frequency of prop.g.ting sequences (pS) in the colon did not differ between patients and controls. When compared with controls, patients had a significant increase in the frequency of retrograde and antegrade pS (pgnificant reduction in the amplitude of prop.g.ting pressure waves throughout the entire colon (p patients and 9 of 16 controls. In the 15 minutes before defecation,controls showed a highly significant increase in frequency (p= 0.001) and amplitude (p = 0.01) of pS. In contrast, patients did not demonstrate this or the typical spatiotemporal organization of pS normally observed before expulsion of ***: patients with obstructed defecation lack the normal predefecatory augmentation in frequency and amplitude of prop.g.ting pressure waves and lack the normal stereotypic spatiotemporal patterning of colonic pressure waves that would normally culminate in effective expulsion of stool.

关键词：结肠动力压力波记录点病理生理学空间时间全结肠空间分布

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paediatric and adult colonic manometry: A tool to help unravel the pathophysiology of constipation

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World Journal of gastroenterology 2010年第41期16卷 5162-5172页

作者： philip.g.dinning Marc A Benninga Bridget R Southwell S Mark Scott Department of gastroenterology St George Hospital University of New South Wales Kogarah Sydney 2217 Australia Department of pediatric gastroenterology and Nutrition Emma Children's Hospital/AMC Amsterdam 1105 AZ The Netherlands Murdoch Childrens Research Institute Royal Children's Hospital Parkville Melbourne 3052 Australia Department of paediatrics University of Melbourne Melbourne 3052 Australia Queen Mary University London Barts and the London School of Medicine and Dentistry London E11BB United Kingdom

Colonic motility subserves large bowel functions, including absorption, storage, propulsion and defaecation. Co-lonic motor dysfunction remains the leading hypothesis to explain symptom generation in chronic constipation, a heterogeneous condition which is extremely prevalent in the general population, and has huge socioeconomic impact and individual suffering. physiological testing plays a crucial role in patient management, as it is now accepted that symptom-based assessment, although im-portant, is unsatisfactory as the sole means of directing therapy. Colonic manometry provides a direct method for studying motor activities of the large bowel, and this review provides a contemporary understanding of how this technique has enhanced our knowledge of normalcolonic motor physiology, as well as helping to elucidate pathophysiological mechanisms underlying constipation. Methodological approaches, including available catheter types, placement technique and recording protocols, are covered, along with a detailed description of re-corded colonic motor activities. This review also criti-cally examines the role of colonic manometry in current clinical practice, and how manometric assessment may aid diagnosis, classification and guide therapeutic inter-vention in the constipated individual. Most importantly, this review considers both adult and paediatric patients. Limitations of the procedure and a look to the future are also addressed.

关键词： Colon Constipation Manometry paediatric Adult

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Factor analysis identifies subgroups of constipation

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World Journal of gastroenterology 2011年第11期17卷 1468-1474页

作者： philip.g.dinning Mike Jones Linda Hunt Sergio E Fuentealba Jamshid Kalanter Denis W King David Z Lubowski Nicholas J Talley Ian J Cook Department of gastroenterology St.George HospitalUniversity of New South WalesKogarahNSW 2217Australia Department of psychology Macquarie UniversityNSW 2109Australia gastroenterology Research Unit Nepean HospitalUniversity of SydneySydneyNSW 2050Australia Department of Colorecta Surgery St.George HospitalKogarahNSW 2217Australia gastroenterology and Hepatology Mayo ClinicJacksonvilleFL 32224United States

AIM:To determine whether distinct symptom groupings exist in a constipated population and whether such grouping might correlate with quantifiable pathophysiological measures of colonic ***:One hundred and ninety-one patients presenting to a gastroenterology clinic with constipation and 32 constipated patients responding to a newspaper advertisement completed a 53-item,wide-ranging selfreport *** hundred of these patients had colonic transit measured *** analysis determined whether constipation-related symptoms grouped into distinct aspects of *** analysis was used to determine whether indi-vidual patients naturally group into distinct ***:Cluster analysis yielded a 4 cluster solution with the presence or absence of pain and laxative unresponsiveness providing the main *** all clusters there was a considerable proportion of patients with demonstrable delayed colon transit,irritable bowel syndrome positive criteria and regular stool *** majority of patients with these characteristics also reported regular laxative ***:Factor analysis identified four constipation subgroups,based on severity and laxative unresponsiveness,in a constipated ***,clear stratification into clinically identifiable groups remains imprecise.

关键词： Factor analysis Constipation Symptoms Clusters Laxatives

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与鲨共舞！

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科技新时代（下半月） 2006年第7期 28-33页

作者： MARK dinning

本以为这会是一次轻松愉快的度假。这次到巴拿马首都拿骚的豪华旅行，是为了纪念《碧海追踪（Into the Blue）》DVD版的发行，正是这部电影让性感女星杰西卡·奥尔芭一夜成名。不过，当我坐在鲨鱼密布的大海上的小船边上，将穿着脚蹼的... 详细信息

本以为这会是一次轻松愉快的度假。这次到巴拿马首都拿骚的豪华旅行，是为了纪念《碧海追踪（Into the Blue）》DVD版的发行，正是这部电影让性感女星杰西卡·奥尔芭一夜成名。不过，当我坐在鲨鱼密布的大海上的小船边上，将穿着脚蹼的双脚伸出船舷时，身体却忍不住在小3号的潜水服中颤抖不止，脑子里不由自主地联想到了“印第安纳波利斯号”船员的悲惨遭遇——这艘美国战舰曾经运送过轰炸广岛的那枚核弹，但在其受到鱼雷攻击之后，全部1100名船员里只有316人幸免于难，而造成如此重大伤亡的并不是炸弹，大多数在5天之后获救的船员，都是从鲨鱼的口中幸存下来的。

关键词：印第安纳鱼雷攻击巴拿马 the DVD 潜水服船员鲨鱼船舷战舰

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