Ghrelin's second life - World Journal of Gastroenterology

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mV 0 2 4 6 8 cpm FD patients are shown in Table 1. It can be seen that PNF in the FD group was obviously lower than that in the control group (P < 0.01), and FIC was higher than that in the control group (P < 0.01). The PNP and PIC showed similar differences between the two groups (P < 0.01). These results suggest that FD patients have a poorer rhythm in gastric motility and energy deficiency. This result is consistent with digestion pathology and physiology in FD. Figure 3 shows the EGG dynamic spectrum of FD patients before and 1 wk after administration of dompendone tablets, 10 mg, tid, po, taken half an hour before meals. The interval for each spectrum line was 1 min in WJG|www.wjgnet.com mV 0 2 4 6 8 cpm Figure 3 Electrogastrogram dynamic spectra of functional dyspepsia patients before treatment (left) and one wk after treatment (right). 0 2 4 6 8 cpm 0 2 4 6 8 cpm 0 2 4 6 8 cpm Figure 4 Impedance gastric motility dynamic spectra of functional dyspepsia patients before treatment (left) and 1 wk (middle) and 3 wk (right) after treatment. Table 1 Impedance gastric motility measurement results in healthy controls and patients with functional dyspepsia and gastritis (mean ± SD) Group Case PNF PNP FIC PIC Healthy 40 70.8 ± 25.5 59.3 ± 4.4 1.58 ± 0.48 0.18 ± 0.06 FD 28 28.3 ± 16.9 b 50.8 ± 9.9 b 2.08 ± 0.55 b 0.23 ± 0.05 b Gastritis 30 36.1 ± 21.8 a 44.6 ± 4.8 a 2.23 ± 0.55 a 0.24 ± 0.05 a a P < 0.05, b P < 0.01 vs healthy group. FD: Functional dyspepsia patients; PNF: Percentage of normal frequency; PNP: Percentage of normal power; FIC: Frequency instability coefficient; PIC: Power instability coefficient. Zhao S et al . Electrical bioimpedance gastric motility measurement duration. In Figure 3, the EGGs of FD patients were weak and the rhythms were disordered before treatment (left). After 1 wk of treatment, the EGG improved and the rhythm returned to 2-4 cpm (right). This suggested that the GEA of FD patients tended towards normal after 1 wk of treatment. The IGM signal spectrums of one FD patient before treatment and 1 wk and 3 wk after treatment are shown in Figure 4. Compared with the EGG dynamic spectrum in Figure 3, the IGM spectrum after 1 wk of treatment in Figure 4 showed little change and the rhythm was also disordered. After 3 wk of treatment, the IGM rhythm returned to 2-4 cpm. IGM measurement in gastritis patients The parameters for IGM and EGG in the gastritis patients before and 1 wk after administration of sodium rabeprazole tablets, 10 mg, qd, po, qm are shown in Tables 1 and 2. It can be seen from Table 1 that there was a significant difference in IGM parameters between the gastritis patients and healthy controls. The PNF and PNP of the gastritis patients were significantly lower than that of the healthy controls (P < 0.05). The FIC and PIC of the gastritis patients were evidently higher than the healthy 3285 July 7, 2012|Volume 18|Issue 25|
Zhao S et al . Electrical bioimpedance gastric motility measurement Table 2 Electrogastrogram and impedance gastric motility parameters in 30 gastritis patients before treatment and 1 wk after treatment (mean ± SD) Treatment 0-2 cpm PNP 2-4 cpm PNP > 4 cpm PNP FIC PIC EGG parameters Before 24.0 ± 5.6 51.5 ± 11.1 24.4 ± 5.5 2.22 ± 0.43 0.34 ± 0.03 After 1 wk 22.7 ± 3.4 54.3 ± 6.7 23.1 ± 3.3 1.77 ± 0.19 a 0.23 ± 0.02 a IGM parameters Before 27.5 ± 2.4 44.6 ± 4.8 27.9 ± 2.4 2.23 ± 0.55 0.24 ± 0.05 After 1 wk 27.4 ± 2.2 44.9 ± 4.4 27.8 ± 2.2 1.91 ± 0.65 0.21 ± 0.06 a P < 0.05 vs EGG before treatment. PNP: Percentage of normal power; FIC: Frequency instability coefficient; PIC: Power instability coefficient; IGM: Impedance gastric motility; EGG: Electrogastrogram. controls (P < 0.05). This suggests a weakening gastric motility function and disorder of stomach peristalsis in gastritis patients. Table 2 indicates that the EGG power of the normal rhythm (2-4 cpm) for the patients was raised and the power of the abnormal rhythm (0-2 cpm and > 4 cpm) declined after 1 wk of treatment, although this was not statistically significant (P > 0.05). It should be noted that the FIC and PIC of the patients decreased significantly (P < 0.05). It suggests that the EGG of gastritis patients tended to be normal and stable after 1 wk of treatment, and the rhythm of the EGG improved. IGM parameters in Table 2 show that the power ratios of IGM signals for the patients in all frequency bands did not change much before and after treatment (P > 0.05), although the FIC and PIC showed a decreasing trend (P > 0.05). DISCUSSION The motility function of the stomach is regulated by nerve and body fluid and is accomplished by the coordinated movement of smooth muscle [4,20] . It can be seen from Figures 3 and 4 that for FD patients the IGM was not improved with 1 wk of treatment, while the EGG returned to normal. After 3 wk of treatment, the regular IGM rhythm of the FD subjects became normal and the contraction function of the stomach was recovered. It is understandable that although the EGG returned to normal by nerve regulation with 1 wk of treatment, improvement of the electric activity had not coupled with or transferred to the mechanical activity of the stomach. After 3 wk of treatment, when the electrical activity had already coupled with or transferred to the mechanical activity of the stomach via the regulation mechanism for nerve and body fluid, the normal IGM rhythm could be seen in the spectrum, which suggests the recovery of the contraction function of the stomach. There were significant differences in IGM parameters between the gastritis patients and healthy controls. After 1 wk of treatment, the EGG rhythm of the gastritis patients returned to normal while the IGM parameters only showed a tendency to improve, which had no statistical significance. This suggests that the influence of the GEA may not have coupled with the mechanical contraction of the stomach after only 1 wk of treatment. On the other WJG|www.wjgnet.com hand, although the patients felt some alleviation after 1 wk of treatment, the cardinal symptoms of gastritis were not completely relieved. This fact coincided with the results of Table 2, and therefore, the patients should be advised to continue the treatment. The mixed signal acquired from the abdominal surface contains not only IGM information but also the components of impedance blood flow, breath and some other disturbances. The normal rhythm of IGM is about 3 cpm. Within the mixed signal, the rhythm of the breath impedance signal is about 12 cpm, which is close to the rhythm of the IGM. Signals of the IGM and breath both are ultra-low frequency signals and the amplitude of the breath signal is usually much higher than that of the IGM signal. It is a challenge to extract the IGM signal from the mixed signals effectively. A low-pass filter may be good enough to reduce the effect of high-frequency noise and heart activity, however, it is difficult to eliminate respiration influence and separate the IGM signal from the mixed signal. Therefore, a narrow bandpass filter and a high-order active low-pass filter are required. In the measurement system for gastric motility described in this paper, a wavelet transform was introduced and the IGM signal was separated successfully from impedance signals, including breath and blood flow. In this study, we focused on the stomach contraction rhythm. Some events without a rhythm, such as gastric acid secretion, did not affect the measurement results. The EGG reflects GEA of the stomach and is sensitive to regulation mechanisms from nerve and electrical activity. The improvement of the EGG after treatment is only the beginning of improvement in gastric motility function and does not indicate a cure of gastric disorder or the recovery of gastric motility. The IGM is a veritable measure of gastric contraction and peristalsis, and reflects the gastric motility function. Gastric motility measurement is based on an electrical-mechanical composite mechanism. The combined measurement of IGM and EGG is a noninvasive, convenient and effective method that extracts information that directly reflects the gastric motility state. It can be used to measure gastric contraction and peristalsis during digestion and evaluate gastric motility function in different physiological and pathological conditions. 3286 July 7, 2012|Volume 18|Issue 25|
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World Journal of Gastroenterology W
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Phillip S Oates, Perth Ross C Smith
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Deepak N Amarapurkar, Mumbai Abhiji
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Trine Olsen, Tromsø Eyvind J Pauls
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Conor P Delaney, Cleveland Sharon D
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S Contents EDITORIAL TOPIC HIGHLIGH
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Contents ACKNOWLEDGMENTS APPENDIX A
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Verhulst PJ et al . Ghrelin and glu
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Online Submissions: http://www.wjgn
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Ishikawa T. Zinc during interferon
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Sitarz R et al . Gastroenterostoma
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Sitarz R et al . Gastroenterostoma
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Morais TC et al . Gastrointestinal
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Page 45 and 46:
Page 47 and 48:
Song MJ et al . Usefulness of PET/C
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A Sensitivity B Sensitivity C Sensi
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Page 55 and 56:
Bae GS et al . Anti-inflammatory ef
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Bae GS et al . Anti-inflammatory ef
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B Myeloperoxidase activity (U/mg pr
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A Time (h) - 1 3 6 NJ4 B Relative H
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A C Time (h) - 1 3 6 NJ4-2 B Relati
Page 65 and 66: Bae GS et al . Anti-inflammatory ef
Page 70 and 71: A Collagen staining (fold change) C
Page 72 and 73: CCl4/YGJ CCl4-13 wk CCl4-7 wk Contr
Page 74 and 75: CCl4/YGJ CCl4-13 wk CCl4-7 wk Contr
Page 76 and 77: liver and have potent proliferative
Page 78 and 79: A 8 wk 9 wk 10 wk 13 wk CCl4/YGJ CC
Page 80 and 81: Cheng JC. A Chinese Herbal Decoctio
Page 82 and 83: Singh R, Neo EN, Nordeen N, Shanmug
Page 84 and 85: etter patient tolerance with regard
Page 86: Key words: Intestinal alkaline phos
Page 89 and 90: Molnár K et al . iAP in pediatric
Page 97 and 98: Chung WC et al . Ulcer after gastre
Page 99: Yang HY et al . Early resection of
Page 102 and 103: indicate a later timing for radical
Page 104 and 105: Zhao WC, Zhang HB, Yang N, Fu Y, Qi
Page 106 and 107: level, or rapid enlargement of lesi
Page 108 and 109: Table 3 Area under the receiver ope
Page 111 and 112: Zhao WC et al . Prognostic factors
Page 113 and 114: Online Submissions: http://www.wjgn
Page 118 and 119: COMMENTS Background Gastric motilit
Page 120 and 121: thirds partial hepatectomy (PH) in
Page 122: A Serum ALT (U/L) C Serum alkaline
Page 126 and 127: REFERENCES 1 Schibler U. Circadian
Page 132 and 133: positive patients were found to hav
Page 134: Online Submissions: http://www.wjgn
Page 140: 21 Tosolini M, Kirilovsky A, Mlecni
Page 147 and 148: Diao TJ et al . NO and hepatopulmon
Page 149 and 150: Gallegos M et al . Lymphogranuloma
Page 151 and 152: Gallegos M et al . Lymphogranuloma
Page 155 and 156: A Hadžić N et al . Diagnosis in B
Page 157 and 158: Hadžić N et al . Diagnosis in BAA
Page 159 and 160: A B Chung HJ et al . Choledocholith
Page 161 and 162: Chung HJ et al . Choledocholithiasi
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Instructions to authors ISSN and EI
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Instructions to authors AIM (no mor
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Instructions to authors Guidelines
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