10 Dos the measurement.docVIP

Does The Measurement Of Impedance Allow Correlation Of Esophageal Motility With Time ? J. Fass, J. Silny, J. Braun, U. Heindrichs, B. Dreuw, V. Schumpelick, G. Rau (Aachen) Manometric investigations of esophageal motility disorders have reached a high standard today and are widely accepted. Despite the development of sophisticated manometry systems there are still methodological problems such as the breath dependant dislocation of the measuring points, the asymmetric distribution of the intraluminal pressure in sphincter areas and the flow dependant measuring kinetics are not solved in the least. Besides that, manometry by measuring intraluminal pressure only describes one phenomenon of esophageal motility [6]. The real motions of the esophageal wall and their correlation with time can only be imagined but not measured. So we tried to develop [3] a new measuring method which is able to describe the esophageal motility phenomena by the detection of diameter depending impedance variations (Multiple Impedancemetry — MIM). Methods The principle of measuring impedance in motility investigations was first used by A.G. Johnson in 1983 [7], technically improved by Silny et al. 1988 [5] and validated [4]. The method is based on the fact that the electrical impedance between two electrodes in a tube strongly depends on the diameter (Q) of the cavity if the specific electrical resistance of the wall is significantly different from that of the tube content (figure 1). So, if the specific electrical resistance of a bolus is below that of the esophageal wall, a contraction by swallowing causes a decrease of the impedance. Using that principle, 20 ring shaped electrodes were placed on a 2 mm thin catheter in 2 cm distances. Measuring value was the changing impedance between each two electrodes. After introducing the catheter into the esophagus, the signals after swallowing were modulated amplified and registered on a PCM recorder. Then again the modulated and filtered sig