WO2007134369A1 - Procédé d'affichage de changements de pression ou de tension à différents emplacements le long d'une lumière corporelle - Google Patents

Procédé d'affichage de changements de pression ou de tension à différents emplacements le long d'une lumière corporelle Download PDF

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Publication number
WO2007134369A1
WO2007134369A1 PCT/AU2007/000652 AU2007000652W WO2007134369A1 WO 2007134369 A1 WO2007134369 A1 WO 2007134369A1 AU 2007000652 W AU2007000652 W AU 2007000652W WO 2007134369 A1 WO2007134369 A1 WO 2007134369A1
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WO
WIPO (PCT)
Prior art keywords
changes
body lumen
pressure
tension
along
Prior art date
Application number
PCT/AU2007/000652
Other languages
English (en)
Inventor
John William Arkwright
Original Assignee
Commonwealth Scientific And Industrial Research Organization
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Priority claimed from AU2006902671A external-priority patent/AU2006902671A0/en
Application filed by Commonwealth Scientific And Industrial Research Organization filed Critical Commonwealth Scientific And Industrial Research Organization
Publication of WO2007134369A1 publication Critical patent/WO2007134369A1/fr

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/03—Detecting, measuring or recording fluid pressure within the body other than blood pressure, e.g. cerebral pressure; Measuring pressure in body tissues or organs
    • A61B5/036—Detecting, measuring or recording fluid pressure within the body other than blood pressure, e.g. cerebral pressure; Measuring pressure in body tissues or organs by means introduced into body tracts
    • A61B5/037—Measuring oesophageal pressure
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/02—Detecting, measuring or recording pulse, heart rate, blood pressure or blood flow; Combined pulse/heart-rate/blood pressure determination; Evaluating a cardiovascular condition not otherwise provided for, e.g. using combinations of techniques provided for in this group with electrocardiography or electroauscultation; Heart catheters for measuring blood pressure
    • A61B5/021—Measuring pressure in heart or blood vessels
    • A61B5/0215—Measuring pressure in heart or blood vessels by means inserted into the body
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/45—For evaluating or diagnosing the musculoskeletal system or teeth
    • A61B5/4519—Muscles

Definitions

  • the present invention broadly relates to a method of displaying changes in pressure or tension along a body lumen.
  • the human body has many lumen in which changes in pressure or tension cause moving of matter.
  • the human heart pumps blood through the body.
  • Muscles around the alimentary canal apply a pressure to the canal which moves food from the mouth into the stomach.
  • Monitoring pressure or tensions in body lumen can provide information about the function of the human body and can be used to detect disorders and diseases or can be used to control a recovery from a disease.
  • dysphagia which is a disorder that causes difficulty in swallowing, typically affects infants and elderly people and is especially prevalent in post-stroke patients. Pressure or tensions are measured along the throat and the oesophagus and then displayed.
  • Data representing changes in pressure or tension in the body lumen typically are displayed in XY graphs (y- coordination: location along the body lumen; x- coordination: time) and a scale of colours is used to indicate changes in pressure or tensions in such graphs.
  • XY graphs y- coordination: location along the body lumen; x- coordination: time
  • a scale of colours is used to indicate changes in pressure or tensions in such graphs.
  • the present invention provides in a first aspect a method of displaying changes in pressure or tension at positions along a body lumen, comprising: providing data that represent the changes in pressure or tension at the positions along the body lumen as a function of time; and displaying a representation of the body lumen with a visual property that is a measure for the changes in pressure or tension along the body lumen.
  • the representation of the body lumen typically is displayed in form of a plot having opposite first and second plot portions which are spaced apart by a distance.
  • Each plot portion typically has a shape that changes in response to the changes in pressure or tension at the positions along the body lumen in a manner such that the distance between the plot portions is a visual measure for the change in pressure or tension along the body lumen.
  • colour or grey-scale changes at or between the plot portions may be provided as a visual measure for the changes in pressure or tension change along the body lumen.
  • the body lumen may be a pharyngeal or oesophageal tract, the throat, the colon, rectum, a lumen at or in the vagina, a vein, an artery, or any other lumen in a human or animal body.
  • the data that represent the changes in pressure or tension typically represent changes in pressure or tension along the body lumen resulting from muscular action at the body lumen.
  • the body lumen is the throat or the oesophagus and the data represent changes in muscular pressure during a swallowing action along the throat or the oesophagus.
  • the method typically is conducted so that the changes in pressure or tension can be displayed substantially in real time. This has the particular advantage that the changes in pressure or tension along the body lumen are intuitive for both clinical diagnostics and rehabilitation therapy.
  • the step of providing data that represent the changes in pressure or tension typically comprises providing data that represent the changes in pressure or tension at a series of positions along the body lumen. If the positions are not immediately adjacent, the method typically also comprises the step of extrapolating or interpolating the data, or a function of the data, so that a substantially continuos plot can be displayed.
  • the method typically comprises the step of training a patient by displaying the representation of the body lumen displaying the changes in pressure or tension of the patient's body lumen to the patient.
  • the method typically is conducted so that the a representation of the body lumen is displayed substantially in real time and visualises muscular action at the body lumen substantially during the muscular action so that training of the muscular action by the patient is facilitated.
  • the visual property includes a property that changes if the pressure or tension increases to a value at or near a predetermined threshold value or decreases to a value at or near the predetermined threshold value .
  • the change in the property may be an abrupt change or may a gradual change.
  • the property may be a colour that changes gradually or abruptly.
  • the predetermined threshold value may be a value for which a patient aims during training of the muscular action or that is set for diagnostic purposes. The colour change further facilitates the training and diagnosis. It is to be appreciated that in variations of this embodiment other parameters, such as size of a portion of the display, line thickness, greyscale or brightness, may change instead of, or in addition to, the colour.
  • the method may comprise the step of diagnosing a dysfunction of a body lumen using the displayed representation of the body lumen wherein the displayed representation facilitates the diagnosis.
  • the body lumen may be the throat or the oesophagus and the data may represent changes in muscular pressure during a swallowing action along the throat or the oesophagus.
  • the method may provide substantially real time indication of the performance of the oespohageal sphincters and of the presence or otherwise of a peristaltic pressure wave. Consequently the method provides in this embodiment a patient suffering from dyspahgia with substantially real-time feedback of the muscular action of the throat so that the patient can train the musculature or the posture during the swallowing event in order to improve swallowing efficiency.
  • the method may used for example for muscular re-training after childbirth or other trauma.
  • the method typically is computer software implemented and the step of displaying the representation of the body lumen typically comprises displaying the representation on a computer screen.
  • the plot typically is displayed so that the first and second plot portions are formed by lines, boundaries between adjacent areas or a line of delineation that may have substantially vertical components.
  • the present invention provides in a second aspect computer software in which the method according the first aspect of the present invention is implemented.
  • the present invention provides in a third aspect a method of training muscular action along a body lumen of a patient, comprising: providing data that represent changes in pressure or tension at the positions along the body lumen as a function of time, the changes in pressure or tension being caused by the muscular action along the body lumen, displaying a representation of the body lumen with a visual property that is a measure for the changes in pressure or tension along the body lumen.
  • the visual property includes a property that changes if the pressure or tension increases to a value at or near a predetermined threshold value or decreases to a value at or near the predetermined threshold value.
  • the change in the property may be an abrupt change or may be a gradual change.
  • the property may be a colour that changes gradually or abruptly.
  • the predetermined threshold value may be a value for which a patient aims during training of the muscular action and the colour change further facilitates the training. It is to be appreciated that in variations of this embodiment other parameters., such as size of a portion of the display, line thickness, greyscale or brightness, may change instead of, or in addition to, the colour.
  • Figures 1 (a) to (e) show a sequence of plots displaying changes in pressure or tension at positions along a body lumen according to an embodiment of the present invention
  • Figure 2 shows a plot displaying pressures or tensions at positions along a body lumen according to another embodiment of the present invention.
  • the body lumen may for example be the throat, the oesophagus, the colon, rectum, a lumen at or in the vagina, a vein, an artery, or any other lumen in a human or animal body.
  • the data that represent the changes in pressure or tension typically represent pressure or tension changes along the body lumen resulting from muscular action at the body lumen.
  • the data representing a change in pressure or tension at a series of the positions along the body lumen may be provided by any suitable device including for example a
  • HRM catheter High Resolution Manometric
  • a HRM catheter in form of a multi-bore catheter tube is commonly used for diagnosis of dysphagia.
  • the multi-bore catheter tube is inserted into the oesophagus and exit ports of the bores of the catheter tube are positioned at different axial positions along the catheter allowing a steady flow of water through each port.
  • Measurement of the hydraulic water pressure at an input of each bore gives an indication of the pressure distribution and associated electronic data representing changes pressure may be provided in a form suitable for computer software analysis.
  • the data may for example be provided by an apparatus for pressure sensing substantially as described in international patent application PCT/AU2006/000308 by the present applicant.
  • the reference to international patent application PCT/AU2006/000308 does not constitute an admission that the disclosure of this international patent application is part Of the common general knowledge of a skilled person in Australia or in any other country.
  • computer software routines are used to generate a cubic spline fit for fitting the data recorded at each measurement site of the HRM catheter at any given time.
  • a resultant curve is then plotted on an XY graph with the Y-axis indicating a location along the body lumen and the X-axis indicating a pressure or tension.
  • a simulated schematic image of the body lumen is formed by creating a second curve by subtracting a corresponding X- value of each data point from a constant, to form a similar curve having a complimentary shape compared with the original curve. Both curves are then positioned opposite to each other so that they represent a schematic cross-sectional cut along the body lumen.
  • the constant typically is set so that the two complimentary curves do not overlap during the strongest contraction of the throat.
  • the distance between opposite points on the opposite curves is inversely proportional to the local pressure/tension present at corresponding locations along the body lumen. If the body lumen is the throat or any other vertical body lumen, the curves typically are positioned and the lumen visualized substantially vertically.
  • a simulated schematic image of the body lumen may be formed by creating a second curve by subtracting a corresponding X-value of each data point from a variable, such as a variable that depends on a position along the body lumen.
  • Figures 1 (a) to (e) show a sequence of such plots.
  • a typical display comprises one plot frame and a plot that changes as a function of time and in response to changes in pressure or tension along the body lumen.
  • Figure 1 (a) to (e) show a sequence of plots which were taken from the same plot frame at different times T and which display muscular pressure at or in the oesophagus along a region spanning the upper oesophageal sphincter (UOS) .
  • the plots are generated and displayed in real-time and are used to facilitate treatment of a patent.
  • the patient may train muscular action at the body lumen while the plots are displayed.
  • Plot 1 (a) corresponds to a time before a swallowing action at which the upper oesophageal sphingter is normally closed and no muscular pressure is applied near the top of the oesophagus at position 0. Plots 1 (b) to
  • a portion adjacent the plot is plotted in a first colour for a pressure or tension below a predetermined threshold value and in a second colour if the pressure or tension is above the threshold value so that the colour changes if the pressure or tension falls below or increases above the threshold value.
  • the predetermined threshold value is a value for which a patient aims during training of the muscular action.
  • the threshold value may be determined for diagnostic purposes.
  • the change in colour is abrupt, but in variations of this embodiment the change in colour may also be gradual. The colour change facilitates the training and diagnosis.
  • plots are shown in form of two opposing lines. It is to be appreciated that in an alternative embodiment the plots may be visualized in any other form, for example in form of two opposing boundaries between adjacent regions as shown in Figure 2 described below.
  • Figure 2 shows a plot displaying a pressure or tension at positions along a body lumen according to another embodiment of the present invention.
  • the plot 2 may be generated using the same methods as described above in the context of the generation of the plots shown in Figure 1 and also displays pressure applied to the oesophagus.
  • the plot shown in Figure 2 includes a grey-scale which is a further visual measure for the pressure applied to the oesophagus.
  • lighter grey tones correspond to sections with higher pressure.
  • grey-scale may be replaced by a colour-scale.
  • a typical display comprises in this embodiment one plot frame and a plot that changes as a function of time and in response to changes in pressure or tension along the body lumen.
  • the plots are generated and displayed in real-time.
  • the invention has been described with reference to particular examples, it will be appreciated by those skilled in the art that the invention may be embodied in many other forms.
  • the plots may be arranged so that an increase in pressure along a body lumen is not displayed in form of a decrease between two opposing plot portions, but is displayed in form of an increase of a distance between two opposing plot portions.

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  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Medical Informatics (AREA)
  • Biophysics (AREA)
  • Pathology (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Hematology (AREA)
  • Physics & Mathematics (AREA)
  • Molecular Biology (AREA)
  • Surgery (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Measurement Of The Respiration, Hearing Ability, Form, And Blood Characteristics Of Living Organisms (AREA)

Abstract

La présente invention concerne un procédé d'affichage de changements de pression ou de tension à différents emplacements le long d'une lumière corporelle. Le procédé comprend l'étape consistant à fournir les données qui représentent les changements de pression ou de tension à ces emplacements le long de la lumière corporelle en fonction du temps. En outre, le procédé comprend l'étape consistant à afficher une représentation de la lumière corporelle avec une propriété visuelle qui est une mesure pour les changements de pression ou de tension de long de la lumière corporelle.
PCT/AU2007/000652 2006-05-18 2007-05-15 Procédé d'affichage de changements de pression ou de tension à différents emplacements le long d'une lumière corporelle WO2007134369A1 (fr)

Applications Claiming Priority (4)

Application Number Priority Date Filing Date Title
AU2006902671 2006-05-18
AU2006902671A AU2006902671A0 (en) 2006-05-18 A method of displaying changes in pressure or tension at positions along a body lumen
AU2006904022 2006-07-26
AU2006904022A AU2006904022A0 (en) 2006-07-26 A method of displaying changes in pressure or tension at positions along a body lumen

Publications (1)

Publication Number Publication Date
WO2007134369A1 true WO2007134369A1 (fr) 2007-11-29

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Citations (7)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP0238170A2 (fr) * 1986-01-22 1987-09-23 Daniel A. Goor Appareil de détection de l'ischémie du myocarde
US4887610A (en) * 1988-10-19 1989-12-19 University Of Virginia Alumni Patents Foundation Device to measure electrical and mechanical events in the human sphincters
WO1994023644A1 (fr) * 1993-04-16 1994-10-27 The Trustees Of Columbia University In The City Of New York Appareil de mesure du tractus digestif et respiratoire superieur
WO1998047424A1 (fr) * 1997-04-18 1998-10-29 Sunscope International, Inc. Transducteur de pression muni d'une coupole jetable
US6773452B2 (en) * 2000-03-27 2004-08-10 Wilson-Cook Medical Incorporated Manometry apparatus for measuring esophageal sphincter compliance
US20050197585A1 (en) * 2004-03-06 2005-09-08 Transoma Medical, Inc. Vascular blood pressure monitoring system with transdermal catheter and telemetry capability
WO2006083217A1 (fr) * 2005-02-03 2006-08-10 Hoegosta Sture Systeme, dispositif et methode pour enregistrer des profils de pression dans le pharynx et dans le sphincter oesophagien superieur, lors de la deglutition

Patent Citations (7)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP0238170A2 (fr) * 1986-01-22 1987-09-23 Daniel A. Goor Appareil de détection de l'ischémie du myocarde
US4887610A (en) * 1988-10-19 1989-12-19 University Of Virginia Alumni Patents Foundation Device to measure electrical and mechanical events in the human sphincters
WO1994023644A1 (fr) * 1993-04-16 1994-10-27 The Trustees Of Columbia University In The City Of New York Appareil de mesure du tractus digestif et respiratoire superieur
WO1998047424A1 (fr) * 1997-04-18 1998-10-29 Sunscope International, Inc. Transducteur de pression muni d'une coupole jetable
US6773452B2 (en) * 2000-03-27 2004-08-10 Wilson-Cook Medical Incorporated Manometry apparatus for measuring esophageal sphincter compliance
US20050197585A1 (en) * 2004-03-06 2005-09-08 Transoma Medical, Inc. Vascular blood pressure monitoring system with transdermal catheter and telemetry capability
WO2006083217A1 (fr) * 2005-02-03 2006-08-10 Hoegosta Sture Systeme, dispositif et methode pour enregistrer des profils de pression dans le pharynx et dans le sphincter oesophagien superieur, lors de la deglutition

Non-Patent Citations (2)

* Cited by examiner, † Cited by third party
Title
HUNT P.S. ET AL.: "The cricopharyngeal sphincter in gastric reflux", GUT, vol. 11, no. 4, April 1970 (1970-04-01), pages 303 - 306, XP008090533 *
MCMAHON B.P. ET AL.: "A New Technique for Evaluating Sphincter Function in Visceral Organs: Application of The Functional Lumen Imaging Probe (Flip) for the Evaluation of the Oesophago-Gastric Junction", PHYSIOL. MEASUREMENTS, vol. 26, 2005, pages 823 - 836, XP020092232 *

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