Molecular pathway of estrogen receptor (ER) action. Typically, estrogen binds to the ligand-binding domain of receptors in the nucleus, which causes a conformational change. Estrogen-responsive elements (ERE) mediate genomic effects. RE, response element; TF, transcription factor; GF, growth factor; GF-R, growth factor receptor; CoA, co-activator; CoR, co-repressor; MAPK, mictogen-activated protein kinase; PI3K, phophoinositide 3-kinase; Src, proto-oncogene tyrosine-protein kinase; AP-1, activating protein-1; Sp-1, stimulating protein-1. Adapted from Nie et al.16
Measurement parameters utilized to determine the esophageal motor function. (A) Esophagogastric junction (EGJ). (B) Esophageal body. EGJ-CI, esophagogastric junction-contractile integral; IRP, integrated relaxation pressure; LES, lower esophageal sphincter.
High-resolution manometry test swallows and maneuvers. (A) Supine 5 mL liquid; (B) upright 5 mL liquid; (C) viscous (apple sauce); (D) solid (graham cracker); (E) multiple rapid swallow; and (F) rapid drink challenge. Integrated relaxation pressure (IRP) and distal contractile integral (DCI) were 11 mmHg and 1760 mmHg·cm·sec (A), 8 mmHg and 1950 mmHg·cm·sec (B), 7 mmHg and 1600 mmHg·cm·sec (C), 10 mmHg and 1400 mmHg·cm·sec (D), 4 mmHg and 4600 mmHg·cm·sec (E), and 3 mmHg and 0 mmHg·cm·sec (F), respectively. Figure used with permission from the Esophageal Center at Northwestern.
Our diagnostic algorithm of defecation disorders using a colonic transit study. DD, defecation disorders; DRE, digital rectal examination; NTC, normal transit constipation; STC, slow transit constipation; RS, rectosigmoid colon.
Statistical maps showing voxel-mirrored homotopic connectivity (VMHC) differences between irritable bowel syndrome (IBS) and healthy controls (HCs;