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The Key Ingredient Acacetin in Weishu Decoction Alleviates Gastrointestinal Motility Disorder Based on Network Pharmacology Analysis. Mediators Inflamm 2021; 2021:5265444. [PMID: 34594156 PMCID: PMC8478590 DOI: 10.1155/2021/5265444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 08/09/2021] [Accepted: 08/28/2021] [Indexed: 11/17/2022] Open
Abstract
Background Gastrointestinal motility disorder is a common gastrointestinal disease, which seriously affects life quality. Traditional Chinese medicine (TCM) has been widely used as an alternative therapy for gastrointestinal motility disorder. Acacetin is a natural flavonoid compound that has antioxidant and anti-inflammatory, antidepressant, and anticancer properties. However, the efficacy of Acacetin in the treatment of gastrointestinal motility disorders has not been studied. Our aim was to investigate the mechanism of Acacetin-alleviated gastrointestinal motility disorder and its efficacy based on network pharmacology. Methods We performed network pharmacology to predict the active components, match Weishu decoction (WSD) targets in gastrointestinal motility disorders, and investigate its potential pharmacological mechanisms. We performed the GO and KEGG enrichment analysis. In vivo, we investigated the effects of Acacetin in the gastrointestinal motility disorder model. Results Based on network pharmacological method, the key active ingredient of WSD was identified as Acacetin, and the enrichment signaling pathway was the PI3K-AKT signaling pathway. Acacetin and Mosapride accelerated gastric emptying time, reduced gastric remnant rate, and increased small intestinal propulsion rate. The levels of GAS and MTL were increased after using Acacetin. These results indicated that Acacetin could improve gastrointestinal motility disorders. Among them, high-dose Acacetin showed a better effect. Acacetin could regulate protein and lipid metabolism in mice with gastrointestinal motility disorder. Furthermore, Acacetin could modulate gastrointestinal inflammation and apoptosis. The detection of the PI3K-AKT signaling pathway-related proteins showed that Acacetin improved gastrointestinal motility disorder by inhibiting the activation of the PI3K-AKT signaling pathway. Conclusion The key ingredient Acacetin in WSD could alleviate gastrointestinal motility disorder by inhibiting the activation of the PI3K-AKT signaling pathway based on network pharmacology analysis. The efficacy and safety of Acacetin treatment provide strong experimental support for the clinical treatment of gastrointestinal motility disorder.
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de Jonge CS, Sprengers AMJ, van Rijn KL, Nederveen AJ, Stoker J. Assessment of fasted and fed gastrointestinal contraction frequencies in healthy subjects using continuously tagged MRI. Neurogastroenterol Motil 2020; 32:e13747. [PMID: 31828938 PMCID: PMC7027525 DOI: 10.1111/nmo.13747] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2019] [Revised: 09/25/2019] [Accepted: 09/25/2019] [Indexed: 02/06/2023]
Abstract
BACKGROUND Continuously tagged MRI during free breathing can assess bowel motility at frequencies as low as the slow wave, motility pattern range. This study aimed to evaluate noninvasive gastrointestinal-tagged MRI for small bowel motility assessment and to observe the physiological response to a 300-kcal meal challenge in healthy, overnight-fasted volunteers. METHODS After overnight fasting, 16 healthy subjects (7 women, mean age 25.5, range 19-37 years) underwent a free breathing, tagged MRI scan to capture small bowel motility. Each subject underwent a (a) baseline motility scan, (b) food challenge, (c) postchallenge scan, and (d) second postchallenge scan (after 20 minutes). Motility was quantified using a frequency analysis technique for measuring the spectral power of the strain, referred to as motility score. Motility score was assessed in 20 frequency intervals between 1 and 20 contractions per minute (cpm), and the data were analyzed with linear mixed-effect models. KEY RESULT The stimulation protocol demonstrated an immediate, food-induced, motility response in the low-frequency range (2-10 cpm), which is consistent with the stomach and small bowel frequency range (3-12 cpm). CONCLUSIONS AND INFERENCES This study shows that this MRI tagging technique is able to quantify the fasted-to-fed response to a 300-kcal meal challenge within the specific small bowel motility frequency range in healthy subjects. The food provocation MRI protocol provides a tool to explore the gut's response to a stimulus in specific motility frequency ranges in patients with gastrointestinal dysmotility and functional disorders.
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Affiliation(s)
- Catharina S. de Jonge
- Department of Radiology and Nuclear MedicineAmsterdam UMCLocation Academic Medical CenterAmsterdam Gastroenterology & MetabolismUniversity of AmsterdamAmsterdamThe Netherlands
| | - André M. J. Sprengers
- Department of Biomedical Engineering & PhysicsAmsterdam UMCLocation Academic Medical CenterAmsterdam Gastroenterology & MetabolismUniversity of AmsterdamAmsterdamThe Netherlands
| | - Kyra L. van Rijn
- Department of Radiology and Nuclear MedicineAmsterdam UMCLocation Academic Medical CenterAmsterdam Gastroenterology & MetabolismUniversity of AmsterdamAmsterdamThe Netherlands
| | - Aart J. Nederveen
- Department of Radiology and Nuclear MedicineAmsterdam UMCLocation Academic Medical CenterAmsterdam Gastroenterology & MetabolismUniversity of AmsterdamAmsterdamThe Netherlands
| | - Jaap Stoker
- Department of Radiology and Nuclear MedicineAmsterdam UMCLocation Academic Medical CenterAmsterdam Gastroenterology & MetabolismCancer Center AmsterdamUniversity of AmsterdamAmsterdamThe Netherlands
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Nasi A, Queiroz NSF, Michelsohn NH. PROLONGED GASTROESOPHAGEAL REFLUX MONITORING BY IMPEDANCE-PHMETRY: A REVIEW OF THE SUBJECT PONDERED WITH OUR EXPERIENCE WITH 1,200 CASES. ARQUIVOS DE GASTROENTEROLOGIA 2018; 55Suppl 1:76-84. [PMID: 30304290 DOI: 10.1590/s0004-2803.201800000-47] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/23/2018] [Accepted: 06/11/2018] [Indexed: 12/12/2022]
Abstract
BACKGROUND Prolonged monitoring increased our knowledge on gastroesophageal reflux (GER), and the disease became known as gastroesophageal reflux disease (GERD). Prolonged reflux monitoring permits the diagnosis of GERD when endoscopic findings are not enough to characterize it. OBJECTIVE The objective of this paper is to review the current knowledge on impedance-pH monitoring, taking into account the published literature and the authors experience with 1,200 exams. METHODS The different types of prolonged reflux monitoring, namely: conventional pHmetry, catheter-free pHmetry and impedance-pHmetry will be briefly described. The new possibilities of evaluation with impedance-pHmetry are emphasized, namely: the study of symptomatic patients in use of proton pump inhibitors (PPIs); evaluation of patients with symptoms suggestive of GERD although with normal endoscopy and normal pHmetry, diagnostic elucidation of patients with atypical symptoms or supra-esophageal symptoms, mainly chronic cough, study of patients complaining of belch, differentiating gastric and supra-gastric belching, and the proper work-up before anti-reflux surgery. RESULTS When impedance was associated to pH monitoring, an impressive technological evolution became apparent, when compared to pH monitoring alone. The main advantages of impedance-pHmetry are: the ability to detect all types of reflux: acid, non-acid, liquid, gaseous. In addition, other important measurements can be made: the ability of the esophagus in transporting the bolus, the measurement of basal mucosal impedance and the evaluation of primary peristalsis post reflux. CONCLUSION Impedance-pHmetry is a promising method, with great advantages over conventional pHmetry. The choice between these two types of monitoring should be very judicious. The authors suggest the importance of careful evaluation of each reflux episode by the physician responsible for the examination, necessary for the correct interpretation of the tracings.
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Affiliation(s)
- Ary Nasi
- Universidade de São Paulo, Faculdade de Medicina, Departamento de Gastroenterologia, São Paulo, SP, Brasil.,Centro Médico de Diagnóstico Fleury, Motilidade Digestiva, São Paulo, SP, Brasil
| | | | - Nelson H Michelsohn
- Centro Médico de Diagnóstico Fleury, Motilidade Digestiva, São Paulo, SP, Brasil
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Grønlund D, Poulsen JL, Sandberg TH, Olesen AE, Madzak A, Krogh K, Frøkjaer JB, Drewes AM. Established and emerging methods for assessment of small and large intestinal motility. Neurogastroenterol Motil 2017; 29. [PMID: 28086261 DOI: 10.1111/nmo.13008] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2016] [Accepted: 11/11/2016] [Indexed: 12/13/2022]
Abstract
BACKGROUND Gastrointestinal symptoms are common in the general population and may originate from disturbances in gut motility. However, fundamental mechanistic understanding of motility remains inadequate, especially of the less accessible regions of the small bowel and colon. Hence, refinement and validation of objective methods to evaluate motility of the whole gut is important. Such techniques may be applied in clinical settings as diagnostic tools, in research to elucidate underlying mechanisms of diseases, and to evaluate how the gut responds to various drugs. A wide array of such methods exists; however, a limited number are used universally due to drawbacks like radiation exposure, lack of standardization, and difficulties interpreting data. In recent years, several new methods such as the 3D-Transit system and magnetic resonance imaging assessments on small bowel and colonic motility have emerged, with the advantages that they are less invasive, use no radiation, and provide much more detailed information. PURPOSE This review outlines well-established and emerging methods to evaluate small bowel and colonic motility in clinical settings and in research. The latter include the 3D-Transit system, magnetic resonance imaging assessments, and high-resolution manometry. Procedures, indications, and the relative strengths and weaknesses of each method are summarized.
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Affiliation(s)
- D Grønlund
- Mech-Sense, Department of Gastroenterology and Hepatology, Aalborg University Hospital, Aalborg, Denmark.,Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - J L Poulsen
- Mech-Sense, Department of Gastroenterology and Hepatology, Aalborg University Hospital, Aalborg, Denmark.,Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - T H Sandberg
- Mech-Sense, Department of Gastroenterology and Hepatology, Aalborg University Hospital, Aalborg, Denmark
| | - A E Olesen
- Mech-Sense, Department of Gastroenterology and Hepatology, Aalborg University Hospital, Aalborg, Denmark.,Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.,Department of Drug Design and Pharmacology, University of Copenhagen, Copenhagen, Denmark
| | - A Madzak
- Mech-Sense, Department of Radiology, Aalborg University Hospital, Aalborg, Denmark
| | - K Krogh
- Neurogastroenterology Unit, Department of Hepatology and Gastroenterology, Aarhus University Hospital, Aarhus, Denmark
| | - J B Frøkjaer
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.,Mech-Sense, Department of Radiology, Aalborg University Hospital, Aalborg, Denmark
| | - A M Drewes
- Mech-Sense, Department of Gastroenterology and Hepatology, Aalborg University Hospital, Aalborg, Denmark.,Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
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Beyder A, de Lartigue G, Ghia JE, Hoffman JM. XIVth Little Brain Big Brain: next-generation enteric neuroscience. Nat Rev Gastroenterol Hepatol 2017; 14:135-136. [PMID: 28053339 PMCID: PMC5443684 DOI: 10.1038/nrgastro.2016.199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/08/2022]
Abstract
Little Brain Big Brain has been a biannual meeting organized and attended exclusively by young investigators in neurogastroenterology since 1989. The XIVth meeting featured cutting-edge work advancing several novel hypotheses in the main themes of motility, inflammation and metabolism.
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Affiliation(s)
- Arthur Beyder
- Enteric Neuroscience Program, Division of Gastroenterology & Hepatology, Department of Physiology & Biomedical Engineering, Mayo Clinic, 200 First Street SW, Rochester, Minnesota, 55905, USA
| | - Guillaume de Lartigue
- The John B. Pierce Laboratory/Cellular and Molecular Physiology Department, Yale Medical School, 290 Congress Ave, New Haven, Connecticut, 06519, USA
| | - Jean-Eric Ghia
- Department of Immunology, Internal Medicine Section of Gastroenterology, University of Manitoba, Apotex Centre 431, 750 McDermot Avenue, Winnipeg, Manitoba, R3E 0T5, Canada
| | - Jill M. Hoffman
- Center for Inflammatory Bowel Diseases, Division of Digestive Diseases, David Geffen School of Medicine, UCLA, 675 Charles E. Young Drive South, Los Angeles, California, 90095, USA
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Lin R, Wang W, Hou X. The self-evaluation of upper-gastrointestinal symptoms in Chinese patients with digestive disease: A multicenter questionnaire survey. J Gastroenterol Hepatol 2016. [PMID: 26224162 DOI: 10.1111/jgh.13064] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/09/2022]
Abstract
AIM To investigate the self-evaluation of upper gastrointestinal symptoms in Chinese patients. To observe the role of patients' characters, such as sex, age, education background, and clinic visits, which might affect the self-understanding of patients. METHODS The nationwide cross-sectional questionnaire was administered to 3000 patients with upper gastrointestinal symptoms at 50 hospitals across 9 provinces in China. Questionnaire items covered four basic patients' characters and five major upper gastrointestinal symptoms. RESULTS A total of 2799 questionnaires (response rate: 93.3%) were analyzed. Only 35.29% patients could precisely understand the definition of dyspepsia. The misunderstanding of lower-gastroenterology discomforts is the major reason leading to low accuracy rate of dyspepsia. The accuracy rate of early satiety and postprandial fullness is 37.7% and 52.27% separately; they are most interrelated and easily confused concepts to each other. The accuracy rate of heartburn is 30.02%, while the location of burning sensation is the key aspect for misunderstanding of heartburn. The self-understanding of symptoms in patients was decreased with increasing age, and enhanced with higher education background and time of clinic visits. Gender is not the independent factor. CONCLUSION Based on the low accuracy rate of self-understanding of patients, this survey suggests that the gastroenterologists should re-evaluate the symptoms of patients during the clinical inquiry.
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Affiliation(s)
- Rong Lin
- Division of Gastroenterology, Union Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Weijun Wang
- Division of Gastroenterology, Union Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xiaohua Hou
- Division of Gastroenterology, Union Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Ma J, Pendharkar SA, O'Grady G, Windsor JA, Petrov MS. Effect of Nasogastric Tube Feeding vs Nil per Os on Dysmotility in Acute Pancreatitis: Results of a Randomized Controlled Trial. Nutr Clin Pract 2015; 31:99-104. [PMID: 26341916 DOI: 10.1177/0884533615603967] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Evidence from animal studies suggests that gastrointestinal motility is impaired in acute pancreatitis. Enteral nutrition, and more specifically nasogastric tube feeding, has emerged as a key treatment modality in patients with acute pancreatitis, but its effect on motility has not been investigated in this setting. The aim was to validate the Gastroparesis Cardinal Symptom Index (GCSI) in patients with acute pancreatitis and determine the effect of nasogastric tube feeding on GCSI. METHODS The study design was a randomized controlled trial. Patients were allocated to nasogastric tube feeding or nil per os within 24 hours of hospital admission. GCSI data from before randomization to 72 hours after randomization were analyzed. The test-retest reliability analysis was used to calculate Cronbach's α. RESULTS Seventeen patients were randomized to nasogastric tube feeding and 18 to nil per os. Overall, the total GCSI score significantly decreased over the study (F = 8.537; P = .001) but was not significantly different between the 2 study groups during hospitalization (F = 1.159; P = .322). However, patients on nasogastric tube feeding did show improved appetite compared with nil per os (F = 3.526; P = .036). The GCSI was found to be a reliable tool in the setting of acute pancreatitis (Cronbach's α = 0.852). CONCLUSIONS Nasogastric tube feeding does not appear to affect dysmotility symptoms in acute pancreatitis as measured by the GCSI, although appetite improved. Use of the simple, noninvasive, and inexpensive GCSI tool to evaluate motility is recommended in future clinical trials in pancreatology.
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Affiliation(s)
- Jiemin Ma
- Department of Surgery, University of Auckland, Auckland, New Zealand
| | | | - Gregory O'Grady
- Department of Surgery, University of Auckland, Auckland, New Zealand
| | - John A Windsor
- Department of Surgery, University of Auckland, Auckland, New Zealand
| | - Maxim S Petrov
- Department of Surgery, University of Auckland, Auckland, New Zealand
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Poscente MD, Wang G, Filip D, Ninova P, Muench G, Yadid-Pecht O, Mintchev MP, Andrews CN. Transcutaneous intraluminal impedance measurement for minimally invasive monitoring of gastric motility: validation in acute canine models. Gastroenterol Res Pract 2014; 2014:691532. [PMID: 25574163 PMCID: PMC4276285 DOI: 10.1155/2014/691532] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2014] [Revised: 11/18/2014] [Accepted: 11/18/2014] [Indexed: 12/19/2022] Open
Abstract
Transcutaneous intraluminal impedance measurement (TIIM) is a new method to cutaneously measure gastric contractions by assessing the attenuation dynamics of a small oscillating voltage emitted by a battery-powered ingestible capsule retained in the stomach. In the present study, we investigated whether TIIM can reliably assess gastric motility in acute canine models. Methods. Eight mongrel dogs were randomly divided into 2 groups: half received an active TIIM pill and half received an identically sized sham capsule. After 24-hour fasting and transoral administration of the pill (active or sham), two force transducers (FT) were sutured onto the antral serosa at laparotomy. After closure, three standard cutaneous electrodes were placed on the abdomen, registering the transluminally emitted voltage. Thirty-minute baseline recordings were followed by pharmacological induction of gastric contractions using neostigmine IV and another 30-minute recording. Normalized one-minute baseline and post-neostigmine gastric motility indices (GMIs) were calculated and Pearson correlation coefficients (PCCs) between cutaneous and FT GMIs were obtained. Statistically significant GMI PCCs were seen in both baseline and post-neostigmine states. There were no significant GMI PCCs in the sham capsule test. Further chronic animal studies of this novel long-term gastric motility measurement technique are needed before testing it on humans.
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Affiliation(s)
- Michael D. Poscente
- Centre for Bioengineering and Research, University of Calgary, Engineering Complex, 2500 University Drive NW, Calgary, AB, Canada T2N 1N4
| | - Gang Wang
- Centre for Bioengineering and Research, University of Calgary, Engineering Complex, 2500 University Drive NW, Calgary, AB, Canada T2N 1N4
| | - Dobromir Filip
- Department of Electrical and Computer Engineering, University of Calgary, Engineering Complex, 2500 University Drive NW, Calgary, AB, Canada T2N 1N4
| | - Polya Ninova
- Division of Pediatrics, Faculty of Medicine, University of Calgary, Calgary, AB, Canada T2N 1N4
| | - Gregory Muench
- Faculty of Veterinary Medicine, University of Calgary, Calgary, AB, Canada T2N 1N4
| | - Orly Yadid-Pecht
- Department of Electrical and Computer Engineering, University of Calgary, Engineering Complex, 2500 University Drive NW, Calgary, AB, Canada T2N 1N4
| | - Martin P. Mintchev
- Centre for Bioengineering and Research, University of Calgary, Engineering Complex, 2500 University Drive NW, Calgary, AB, Canada T2N 1N4
- Department of Electrical and Computer Engineering, University of Calgary, Engineering Complex, 2500 University Drive NW, Calgary, AB, Canada T2N 1N4
- Department of Surgery, Faculty of Medicine, University of Alberta, Edmonton, AB, Canada T6G 2B7
| | - Christopher N. Andrews
- Division of Gastroenterology, Faculty of Medicine, University of Calgary, Calgary, AB, Canada T2N 1N4
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Poscente MD, Wang G, Filip D, Ninova P, Yadid-Pecht O, Andrews CN, Mintchev MP. Real-time gastric motility monitoring using transcutaneous intraluminal impedance measurements (TIIM). Physiol Meas 2014; 35:217-29. [PMID: 24398539 DOI: 10.1088/0967-3334/35/2/217] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
The stomach plays a critical role in digestion, processing ingested food mechanically and breaking it up into particles, which can be effectively and efficiently processed by the intestines. When the motility of the stomach is compromised, digestion is adversely affected. This can lead to a variety of disorders. Current diagnostic techniques for gastric motility disorders are seriously lacking, and are based more on eliminating other possibilities rather than on specific tests. Presently, gastric motility can be assessed by monitoring gastric emptying, food transit, intragastric pressures, etc. The associated tests are usually stationary and of relatively short duration. The present study proposes a new method of measuring gastric motility, utilizing the attenuation of an oscillator-induced electrical signal across the gastric tissue, which is modulated by gastric contractions. The induced high-frequency oscillator signal is generated within the stomach, and is picked up transluminally by cutaneous electrodes positioned on the abdominal area connected to a custom-designed data acquisition instrument. The proposed method was implemented in two different designs: first a transoral catheter was modified to emit the signal inside the stomach; and second, a gastric retentive pill was designed to emit the signal. Both implementations were applied in vivo on two mongrel dogs (25.50 kg and 25.75 kg). Gastric contractions were registered and quantitatively compared to recordings from force transducers sutured onto the serosa of the stomach. Gastric motility indices were calculated for each minute, with transluminal impedance measurements and the measurements from the force transducers showing statistically significant (p < 0.05) Pearson correlation coefficients (0.65 ± 0.08 for the catheter-based design and 0.77 ± 0.03 for the gastric retentive pill design). These results show that transcutaneous intraluminal impedance measurement has the potential with further research and development to become a useful diagnostic technique.
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Affiliation(s)
- M D Poscente
- Centre for Bioengineering Research and Education, University of Calgary, Calgary, Alberta, Canada
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