New developments in defecatory studies based on biomechatronics.
New developments in defecatory studies based on biomechatronics.
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DOI：
10.1016/j.jare.2021.05.005
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发表时间：
2022-01
影响因子：
10.7
通讯作者：
Kassab GS
中科院分区：
文献类型：
--
作者：
Gregersen H;Sun D;Chen SC;Leung WW;Wong C;Mak T;Ng S;Futaba K;Lo KM;Kassab GS
排便生理学和排便障碍的病理生理学已在许多研究中描述。肛门直肠试验结果之间存在分歧，它们与症状的相关性很差。我们测试了一种新的无线Fecobionics设备，一个模拟的集成凳子在正常受试者。提出了基于前负荷-后负荷图的扩张性指数的新分析，并推导出描述排便的关键参数。Fecobionics在生理条件下获得了可靠的数据。研究表明，Fecobionics在评价关键排便参数方面是安全有效的。新的参数产生的，可能是重要的肛门直肠疾病患者的亚型。排便是一个复杂的过程，很难直接研究和分析。在肛门直肠疾病的条件下，排便过程可能会受到干扰，导致症状，包括大便失禁和便秘。目前最先进的技术测量肛门直肠功能的各个方面，但详细的分析是不可能的，因为它们是独立的测试，而不是一个集成的多维测试。需要生理相关的和易于使用的诊断测试，以确定潜在的机制是巨大的。我们的目的是推进该领域的综合技术，肛门直肠功能评估。我们开发了一种名为Fecobionics的模拟凳子，它集成了几个测试来评估排便压力，尺寸，形状，方向和排泄过程中的弯曲。新颖之处在于，在轴向方向上，即在轨迹的方向上测量压力。使用这种新的工具，我们提出了新的分析方法来计算正常人受试者在驱逐过程中的生理相关参数。报告了来自28名人类受试者的数据，这些受试者使用了越来越先进的Fecobionics版本。一个新的概念，利用后-前压力（前负荷-后负荷）图计算新的排便指数。Fecobionics获得了目前最先进技术无法获得的生理数据。Fecobionics测量众所周知的参数，如排出时间和压力，以及包括排便指数在内的新指标。研究表明，Fecobionics是有效的，在关键排便参数的评估和良好的定位作为一个综合技术，用于评估肛门直肠功能和功能障碍。
The physiology of defecation and the pathophysiology of defecation disorders have been described in numerous studies. Disagreement exists between results of anorectal tests and they correlate poorly with symptoms. We tested a novel wireless Fecobionics device, a simulated integrated stool in normal subjects. Novel analysis of distensibility indices is presented based on preload-afterload diagrams and key parameters describing defecation are derived. Fecobionics obtained reliable data under physiological conditions. The study suggests that Fecobionics is safe and effective in evaluation of key defecatory parameters. Novel parameters were generated that may be important for subtyping of patients with anorectal disorders. Defecation is a complex process that is difficult to study and analyze directly. In anorectal disease conditions, the defecation process may be disturbed, resulting in symptoms including fecal incontinence and constipation. Current state-of-the-art technology measures various aspects of anorectal function but detailed analysis is impossible because they are stand-alone tests rather than an integrated multi-dimensional test. The need for physiologically-relevant and easy-to-use diagnostic tests for identifying underlying mechanisms is substantial. We aimed to advance the field with integrated technology for anorectal function assessment. We developed a simulated stool named Fecobionics that integrates several tests to assess defecation pressures, dimensions, shape, orientation and bending during evacuation. A novelty is that pressures are measured in axial direction, i.e. in the direction of the trajectory. Using this novel tool, we present new analytical methods to calculate physiologically relevant parameters during expulsion in normal human subjects. Data are reported from 28 human subjects with progressively more advanced versions of Fecobionics. A new concept utilizes the rear-front pressure (preload-afterload) diagram for computation of novel defecation indices. Fecobionics obtained physiological data that cannot be obtained with current state-of-the-art technologies. Fecobionics measures well known parameters such as expulsion time and pressures as well as new metrics including defecation indices. The study suggests that Fecobionics is effective in evaluation of key defecatory parameters and well positioned as an integrated technology for assessment of anorectal function and dysfunction.
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影响因子：
29.4
作者：
Rao, Satish S. C.;Bharucha, Adil E.;Wald, Arnold
通讯作者：
Wald, Arnold
影响因子：
2.4
作者：
GIBBONS, CP;BANNISTER, JJ;READ, NW
通讯作者：
READ, NW
影响因子：
3.1
作者：
Casares-Magaz, Oscar;Thor, Maria;Muren, Ludvig P.
通讯作者：
Muren, Ludvig P.
影响因子：
4.3
作者：
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通讯作者：
Gregersen, Hans
影响因子：
3.2
作者：
Lin, C. X.;Li, W.;Zhou, Z. R.
通讯作者：
Zhou, Z. R.