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C P Sanmiguel

Publications and source records attributed to C P Sanmiguel.

6 recordsLinked to original sources

Neural gastrointestinal electrical stimulation enhances colonic motility in a chronic canine model of delayed colonic transit.

Neural gastrointestinal electrical stimulation (NGES) induces sequential contractions and enhances emptying in acute canine gastric and colonic models. This study was set to determine (i) the effect of NGES in a chronic canine model of delayed colonic transit and (ii) possible mechanism of action. Four pairs of electrodes were implanted in the distal colon of nine mongrel dogs. Delayed colonic transit was induced by diphenoxylate/atropine and alosetron. Transit was fluoroscopically determined by the rate of evacuation of radiopaque markers, and was tested twice in each dog, in random order, on and off stimulation. Two stimulation sequences, separated by 1 min, were delivered twice a day via exteriorized electrodes. Colonic manometry during stimulation was performed before and after intravenous (i.v.) injection of 1 mg of atropine. Complete evacuation of all markers was significantly shortened by NGES, from 4 days to 2 days, interquartile range 3-4 days vs 2-3 days, respectively, P = 0.016. NGES induced strong sequential contractions that were significantly diminished by atropine: 190.0 +/- 14.0 mmHg vs 48.7 +/- 19.4 mmHg, respectively (P < 0.001). NGES induces strong sequential colonic contractions and significantly accelerates movement of content in a canine model of delayed colonic transit. The effect is atropine sensitive.

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Microprocessor-controlled movement of solid gastric content using sequential neural electrical stimulation.

BACKGROUND & AIMS: Gastric electrical stimulation has been attempted for years without much success. The aim of this study was to determine if movement of solid gastric content could be achieved using microprocessor-controlled sequential electrical stimulation. METHODS: The study was performed on 9 anesthetized dogs. The dogs underwent laparotomy, pyloroplasty, and implantation of 4-6 sets of bipolar stainless-steel wire electrodes. Each set consisted of 2-6 electrodes (10 x 0.25 mm, 3 cm apart) implanted circumferentially. The stomach was filled with solid food mixed with plastic pellets, and the process of gastric emptying was monitored. Artificial contractions were produced using microprocessor-controlled phase-locked bipolar trains of 50-Hz rectangular voltage with flexible amplitudes. RESULTS: Using the above stimulating parameters, we were able to produce circumferential gastric contractions that were artificially propagated distally by embedding and phase-locking the stimulating voltage. The number of expelled pellets after the stimulation sessions was significantly higher than the number of pellets emptied during the nonstimulation sessions (P < 0.01). CONCLUSIONS: Microprocessor-controlled electrical stimulation produced artificial peristalsis and markedly accelerated the movement of solid gastric content.

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Dynamics of level of randomness of electrogastrograms can be indicative of gastric electrical uncoupling in dogs.

Gastric electrical uncoupling is the lack of electrical synchronization in different parts of the stomach. The aim of this study was to investigate the impact of gastric electrical uncoupling on the level of randomness of canine electrogastrograms (EGG). Electrogastrograms were obtained from 11 unconscious acute dogs. Gastric electrical uncoupling was produced surgically by performing two consecutive circumferential cuts through the entire thickness of the gastric muscle layer. Three separate 1/2-hr eight-channel bipolar EGGs were obtained from each dog in the basal state and after each cut. The signals were amplified using amplifiers with a flexible frequency range, digitized with 10-Hz sampling frequency, and 4.27-min portions of the digital EGGs were subjected to a turning point test for randomness. The number of turning points (NTPs) was determined from successive time intervals calculated from all EGG channels. Distributions of NTPs were calculated for each dog. An average NTPs (ANTP) for each dog in a given state (basal, after the first cut, and after the second cut) was calculated from the ANTPs of all channels. In six of 11 dogs the ANTP were greater after the first cut. The number rose to nine of 11 dogs after the second cut. In only 45% of the dogs were the ANTP distributions significantly different (P < 0.01) after the first cut (sensitivity 45%). After the second cut the sensitivity rose to 64%. In two specific EGG channels NTP distribution was significantly different (P < 0.01) in nine of 11 dogs (sensitivity: 82%) after the second cut. The dynamics of the level of randomness in EGG can be indicative of severe gastric electrical uncoupling. Some EGG channel configurations are more sensitive than others in recognizing gastric electrical uncoupling.

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Microprocessor controlled movement of liquid gastric content using sequential neural electrical stimulation.

BACKGROUND: Gastric electrical stimulation has been attempted for several years with little success. AIMS: To determine whether movement of liquid gastric content could be achieved using microprocessor controlled sequential electrical stimulation. METHODS: Eight anaesthetised dogs underwent laparotomy and implantation of four sets of bipolar stainless steel wire electrodes. Each set consisted of two to six electrodes (10x0.25 mm, 3 cm apart) implanted circumferentially. The stomach was filled with water and the process of gastric emptying was monitored. Artificial contractions were produced using microprocessor controlled phase locked bipolar four second trains of 50 Hz, 14 V (peak to peak) rectangular voltage. In four of the dogs four force transducers were implanted close to each circumferential electrode set. In one gastroparetic patient the effect of direct electrical stimulation was determined at laparotomy. RESULTS: Using the above stimulating parameters circumferential gastric contractions were produced which were artificially propagated distally by phase locking the stimulating voltage. Averaged stimulated gastric emptying times were significantly shorter than spontaneus emptying times (t1/2 6.7 (3.0) versus 25.3 (12.9) minutes, p<0.01). Gastric electrical stimulation of the gastroparetic patient at operation produced circumferential contractions. CONCLUSIONS: Microprocessor controlled electrical stimulation produced artificial peristalsis and notably accelerated the movement of liquid gastric content.

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Electrogastrography: a noninvasive technique to evaluate gastric electrical activity.

Electrogastrography (EGG) is the recording of gastric electrical activity (GEA) from the body surface. The cutaneous signal is low in amplitude and consequently must be amplified considerably. The resultant signal is heavily contaminated with noise, and visual analysis alone of an EGG signal is inadequate. Consequently, EGG recordings require special methodology for acquisition, processing and analysis. Essential components of this methodology involve an adequate system of digital filtering, amplification and analysis, along with minimization of the sources of external noise (random motions of the patient, electrode-skin interface impedance, electrode bending, obesity, etc) and a quantitative interpretation of the recordings. There is a close relationship between GEA and gastric motility. Although it has been demonstrated that EGG satisfactorily reflects internal GEA frequency, there is not acceptable correlation with gastric contractions or gastric emptying. Many attempts have been made to relate EGG 'abnormalities' with clinical syndromes and diseases; however, the diagnostic and clinical value of EGG is still very much in question.

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Electrogastrographic impact of multi-site functional gastric electrical stimulation.

Microprocessor-controlled multi-site functional gastric electrical stimulation using synchronized higher frequency (above 25 Hz) bipolar voltages has been suggested as a possible new avenue towards efficient artificial control of gastric motility. However, the effect of this sequential stimulation on gastric electrical activity is unknown. Because of the substantial strength of the invoked sequential contractions, using implanted electrodes to assess gastric electrical activity (GEA) in experimental animals is difficult, if not impossible. Electrogastrography (EGG), the non-invasively obtained recording of GEA, provides an excellent opportunity to study the changes associated with the multi-site functional stimulation. In this study, we investigated 4 unconscious dogs with 4 circumferential sets of subserosally-implanted stimulating electrodes and 4 force transducers attached close to each stimulating electrode set at operation. The abdominal cavity of each dog was closed after the electrode implantations and 3 standard neonatal electrocardiographic electrodes were attached overlying the abdominal projection of the gastric axis. Two-channel EGG recordings were obtained for 1/2 h before any electrical stimulation and during 1/2 h of intensive sequential stimulation. Significant changes were observed in the EGG pattern during stimulation. These changes were quantified and compared to the basal recordings. Our findings indicate that the interrelation between spectral changes in cutaneous EGG and mechanical activity of the stomach could be far more complex than previously speculated.

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