임상발표자료J.S. Lee, H.J.KIM, H.H.IM, K.R.HWANG, I.S.JUNG, B.M.KO, S.J.HONG,C.B.RYU, J.O.KIM & J.Y.CHO,M.S.LEE,C.S.SHIM & B.S.KIM
Institute for Digestive Research, Soon
국제 위전도 학회 2004
Background : Gastric electrical stimulation (GES) has been used to treat intractable gastroparesis. Three types of GES, according to frequency, have been applied up to date; gastric electrical pacing(GEP) of sub-Hertz range(≪1Hz), high frequency-gastric electrical stimulation (HI-GES, 0.2~20Hz), and neural GES(NGES, >5-10Hz). Of these, only NGES has shown gastric contractions. However, experiments in human are limited because of invasive implantation of electrode. The recent development of extracorporeal magnetic stimulation (MS) using current-changing magnetic field to induce electrical stimulation in deep tissue, makes it possible to induce NGES without invasive procedure.
Aims : To prove “whether MS-induced NGES can increase the power of electrical activity on cutaneous EGG”, and “if there is any different effect on EGG by different frequencies of MS”
Methods and Materials : Ninety-two patients (median age 50, 47males) with or without symptoms are randomly divided by four groups according to frequency of MS, Ⅰ(10Hz), Ⅱ(50Hz), Ⅲ(10/50 Hz mixed), and Ⅳ(Sham stimulation). After 50 minute recording of cutaneous EGG in fasting state, MS(on-off stimulation in 3-3 seconds for 10Hz. 3-6 second for 50Hz, strength 50-100%) by stimulator (BioCon-1000, Mcube Co, Korea) was applied in epigastrium including EGG electrode for 20 minutes. Then another 50 minute recording of EGG was performed. We analyzed the parameters of EGG, % bradygastria(<2.4 cpm), slow wave (2.4-3.7 cpm), tachygastria (3.7-9 cpm), power ratio (PR), DFIC and response rate (power ratio > 1 and decreased or normal DFIC) before and after MS in 4 groups using ANOVA and paired t-test.
Results : 1) No age and sex differences in 4 groups. 2) The % bradygastria, % 3cpm, % tachygastria and % DFIC were not different after MS in all groups 3) PR was significantly increased in group Ⅰ,Ⅱ,Ⅲ compared with group Ⅳ and in group Ⅱ,Ⅲ compared with Ⅰ(median PR of Ⅰ,Ⅱ,Ⅲ, and Ⅳ were 1.3, 1.5, 1.7, and 0.8 respectively, p<0.05). 4)Response rate after MS was tended to increase in group Ⅲ (14/23, 60.9%, p=0.067) compared with groups Ⅰ(8/23, 34.8%), Ⅱ(7/23, 30.4%) and Ⅳ(6/23, 26.%).