{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T21:41:47Z","timestamp":1791841307410,"version":"4.3.4"},"reference-count":28,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2016,10,3]],"date-time":"2016-10-03T00:00:00Z","timestamp":1475452800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"JSPS Grants-in-Aid for Scientific Research","award":["16K19332"],"award-info":[{"award-number":["16K19332"]}]},{"name":"Japanese Foundation for Research and Promotion of Endoscopy"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Neurogastroenterology Motil"],"published-print":{"date-parts":[[2017,3]]},"abstract":"Abstract<\/jats:title>Background<\/jats:title>Histopathology of muscularis externa in primary esophageal motility disorders has been characterized previously. We aimed to correlate the results of high\u2010resolution manometry with those of histopathology.<\/jats:p><\/jats:sec>Methods<\/jats:title>During peroral endoscopic myotomy, peroral esophageal muscle biopsy was performed in patients with primary esophageal motility disorders. Immunohistochemical staining for c\u2010kit<\/jats:italic> was performed to assess the interstitial cells of Cajal (ICC<\/jats:styled-content>s). Hematoxylin Eosin and Azan\u2010Mallory staining were used to detect muscle atrophy, inflammation, and fibrosis, respectively.<\/jats:p><\/jats:sec>Key Results<\/jats:title>Slides from 30 patients with the following motility disorders were analyzed: achalasia (type I: 14, type II: 5, type III: 3), one diffuse esophageal spasm (DES<\/jats:styled-content>), two outflow obstruction (OO<\/jats:styled-content>), four jackhammer esophagus (JE<\/jats:styled-content>), and one nutcracker esophagus (NE<\/jats:styled-content>). ICC<\/jats:styled-content>s were preserved in high numbers in type III achalasia (n<\/jats:italic>=9.4\u00b11.2 cells\/high power field [HPF<\/jats:styled-content>]), compared to types I (n<\/jats:italic>=3.7\u00b10.3 cells\/HPF<\/jats:styled-content>) and II (n<\/jats:italic>=3.5\u00b11.0 cells\/HPF<\/jats:styled-content>). Moreover, severe fibrosis was only observed in type I achalasia and not in other types of achalasia, OO<\/jats:styled-content>, or DES<\/jats:styled-content>. Four of five patients with JE<\/jats:styled-content> and NE<\/jats:styled-content> had severe inflammation with eosinophilic infiltration of the esophageal muscle layer (73.8\u00b150.3 eosinophils\/HPF<\/jats:styled-content>) with no epithelial eosinophils. One patient with JE<\/jats:styled-content> showed a visceral myopathy pattern.<\/jats:p><\/jats:sec>Conclusions & Inferences<\/jats:title>Compared to types I and II, type III achalasia showed preserved ICC<\/jats:styled-content>s, with variable data regarding DES<\/jats:styled-content> and OO<\/jats:styled-content>. In disorders considered as primary esophageal motility disorders, a disease category exists, which shows eosinophilic infiltration in the esophageal muscle layer with no eosinophils in the epithelium.<\/jats:p><\/jats:sec>","DOI":"10.1111\/nmo.12968","type":"journal-article","created":{"date-parts":[[2016,10,11]],"date-time":"2016-10-11T16:01:09Z","timestamp":1476201669000},"source":"Crossref","is-referenced-by-count":58,"title":["Muscle layer histopathology and manometry pattern of primary esophageal motility disorders including achalasia"],"prefix":"10.1111","volume":"29","author":[{"given":"N.","family":"Nakajima","sequence":"first","affiliation":[{"name":"Division of Gastroenterology and Hepatology Niigata University Medical and Dental Hospital Niigata Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H.","family":"Sato","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology Niigata University Medical and Dental Hospital 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