2005 Fiscal Year Final Research Report Summary
Establishment of the method to explore neural interaction between the sacrum and anorectum using a repetitive magnetic stimulation in children
| Project/Area Number |
14370566
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| Research Category |
Grant-in-Aid for Scientific Research (B)
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| Allocation Type | Single-year Grants |
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| Section | 一般 |
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| Research Field |
Pediatric surgery
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| Research Institution | Niigata University |
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Principal Investigator |
KUBOTA Masayuki Niigata University, Institute of Medicine and Dentistry, Professor, 医歯学系, 教授 (50205150)
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| Co-Investigator(Kenkyū-buntansha) |
YAGI Minoru Kurume University, Hospital, Professor, 医学部附属病院, 教授 (10251802)
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| Project Period (FY) |
2002 – 2005
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| Keywords | magnetic stimulation / repetitive magnetic stimulation / Anorectal reflex / sacral nerve / sacro-rectal interaction / Hirschsnrung's disease / chronic constipation / anorectal manometry |
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| Research Abstract |
The intestinal activity is well known to be secondarily controlled by the central nervous, system through the sympathetic and parasympathetic systems. In the pelvic region, the sacral nervous system influences the bladder and rectoanal function. However, the sacro-anorectal neural interactions in these diseases remain unclear due to the absence of a proper examination modality. We therefore examined the usefulness of sacral magnetic stimulation as a new modality for examining sacro-anorectal interaction.
Patients and Methods : Control data was obtained from 25 children without bowel dysmotility. 45 patients with chronic constipation (age range ; 1 m/o to 11 y/o), 8 pre-operative patients with Hirschsprung's disease (1 m/o to 6 y/o) and one female patient with MMIHS (1 y/o) were examined. Magnetic stimulation with a duration of one second delivered at 10 to 15Hz was applied at the S3 level using MagPro(Medtronic) with a figure eight coil while simultaneously performing the manometric rec
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ordings of the anorectal activity.
Results : In the 45 patients with chronic constipation and one patient with MMIHS, the rectoanal reflex was demonstrated by balloon rectal dilatation in all patients. Control patients uniformly exhibited a biphasic response consisting of the initial contraction followed by a relaxation. On the other hand, the sphincter response to magnetic stimulation varied among the patients with chronic constipation including no response in 5 patients, a biphasic response of an initial rise followed by a decrease in the sphincter pressure in 36 patients and only a transient rise in pressure in two patient. The MMIHS patient exhibited a transient rise in the sphincter to magnetic stimulation. In eight pre-operative patients with Hirschsprung's disease, no rectoanal reflex was observed, however, the sphincter pressure increased due to magnetic stimulation in five patients, while three patients exhibited no recordable responses.
Conclusion : These results suggest that the repetitive magnetic stimulation technique is a valuable modality for elucidating the neural interaction between the sacral nervous system and the anorectum, thereby suggesting its usefulness for obtaining a better understanding of the anorectal pathology. Less
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[Book] 講義録 消化器学2005
Author(s)
窪田 正幸
Total Pages
7
Publisher
メディカルビュー社
Description
「研究成果報告書概要(和文)」より
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