For the purpose of clarifying lower esophageal sphincter function, which is representaive of antireflux competence, 51 normal newborn and early infants and 28 newborn and infants with gastroesophageal reflux were examined by standardized manometric studies. Barium studies and 24-hour pH monitoring in the distal esophagus were also performed, and the following results were obtained.
1) In normal infants, there was no correlation between LES pressure and age, but LES length increased with age.
2) LES Pressure of GER infants (22.2±6.4cmH₂O) was lower than normal infants (37.6±8.8 cmH₂O). This indicated LES function was lower in GER infants.
3) In GER infants, LES pressure increased to within normal range with clinical improvement. The critical point of LES pressure was 27 cmH₂O.
4) In radiological studies in GER infants there was no correlation between the grade of Barium regurgitation and LES pressure, or between HIS angle, Fornix Index and LES pressure.
5) On 24-hour pH monitoring, pH score of GER infants was very much higher than that of normal infants. LES incompetence din GER infants was also recognized in this investigation.
Esophageal manometric study was very useful for diagnosis of LES dysfunction and assessment of therapeutic effect. For evaluation of anti-reflux cardiac function, multiple approaches were valuable, including not only manometric studies but also radiologic studies and 24-hour pH monitoring.

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To evaluate the effects of cisapride on gastric emptying, gastric emptying was measured in sixhealthy volunteers using radioisotopic techniques which were establised three areas of interest, i.e. the whole stomach, the proximal stomach and the antrum. Following results were obtained.
1. At the half emptying times, cisapride induced a more rapid gastric emptying than did placebo in 5 of 6 volunteers.
2. By analyzing gastric emptying curves obtained from three areas of interst, it was suggested that cisapride enhanced the transfer of gastric contents from the proximal stomach to the antrum together with the antral emptying, so that gastric emptying was accelerated.

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This study examined the function in vitro of aganglionic colon musculature in mice with hereditary aganglionosis-a strain of animals used as a model of Hirschsprung's disease. Double sucrose gap recordings from the muscle strips of both normal and aganglionic colon showed bursts of spike potentials with muscle contraction. Intracellular recordings of the membrane potentials of the circular muscle cells of normal, aganglionic and oligoganglionic colon had no statistical difference. Microelectrode recordings from the circular muscle cells of normal siblings, in the presense of nifedipine, irregular ongoing fluctuations in membrance potential, which were abolished by tetrodotoxin and reduced by d-tubocurarine or apamin. The fluctuations were less effected by atropine. These observations suggest that there is ongoing inhibitory neural activity to the circular smooth muscle of normal colon. These ongoing fluctuations were not recorded from the cells of aganglionic and oligoganlionic colon of affected animals. Although transmural stimulation of the intrinsic nerves produced cholinergic excitatory and inhibitory junction potentials in normal colon, no junction potentials were evoked by transmural stimulation in aganglionic colon. It was concluded that the ongoing tonic inhibitory activity may contribute to the compliance of the normal mouse colon and lack of the compliance may affect functional intestinal obstruction of the aganglionic colon in Hirschsprung's disease.

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Morbidly obese patients undergoing vertical banded gastroplasty were studied preoperatively and/or postoperatively to characterize its manometric pattern. The esophageal manometry using station pullthrough technique involved 14 preoperative patients with a mean age of 28±7 years who were a obesity index of 220±32% and 14 postoperative patients with a mean age of 30±7 years who were a obesity index of 158±23%.
Preoperative lower esophageal sphincter (LES) pressure using gastric base line as O was 16.1±8.5 cmH₂O and a LES length of 3.4±0.9 cm. Postoperatively, the vertical banded gastroplasty channel had a pressure of 17.7±7.1 cmH₂O and a length of 8.2±1.7 cm which was higher than gastric base line. No difference was seen between preoperative LES pressure and postoperative channel pressure, however postoperative channel length was signihcantly (p<0.01) larger than preoperative LES length.
We concluded that vertical banded gastroplasty for morbid obesity created a longer high pressure zone in accordance with channel which would inhibit reflux of gastric juice.

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