膀胱筋電圖の研究

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The electropotentials of the human urinary bladder were recorded by means of one needle electrode, which was transurethrally thrust into the bladder musculature under direct vision. The recording of the action potentials was obtained by an electrocardiograph connected to push-pull pre-amplifier. 1) The unipolar needle electrode method which was used was easier to apply, and gave less artefact than other methods in which bipolar blunt electrodes were used. 2) Electropotential changes in the normal urinary bladder were found to be constant in frequency (regularly 3 per minute). There was observed a wave which consisted of diphasic slow potential (i.e.A and B), Like the one which Boyce obtained. When the electrode was thrust into the bladder muscle at a point 1 cm above and 1 cm medial to the ureteral orifice, the duration and the electromotive force of this diphasic wave were: A. 1.2-1.9 seconds (average 1.4 seconds) 0.27-0.38 mV (average 0.32 mV). B. 2.0-4.2 seconds (average 3.1 seconds) 0.27-0.43 mV (average 0.35 mV). B was larger than A both in electromotive force and in duration. Changing the point of inducement caused some deviation of the wave form, but the frequency of the wave was not changed. In the recording of the same person with the same inducement, the variations of electromotive force and duration were small. 3) This diphasic slow potential had no direct relation with the peristaltic movement of the ureteral orifices. 4) By stimulation with parasympathomimetic drugs (such as Urecholin), the waves became more frequent and increased their electromotive forces, while sympathicolytic agents (such as Banthine) or lumbar anaesthesia reduced the bio-electric activity of the bladder. 5) (a) In the hypertonic neurogenic bladder, the rhythm of the waves was increased and very irregular, and in electromotive force. A wave was often larger than B. The variety of the wave form in the same person was remarkable, especially in the autonomous neurogenic bladder. (b) In the hypotonic neurogenic bladder, both frequency and electromotive force were reduced. Only one or two waves occurred in 3-5 minutes recording, and the apparent diphasic wave became difficult to observe. In the cases of bladder paralysis after radical operation for rectal or uterine cancer, the same results were observed. 6) In the obstruction of the lower urinary tract (prostatic hyperplasia and other diseases), It was found that increase and decrease of frequency and electomotive force were variable according to the state of the detrusor muscle which was compensatory hypertrophic or atrophied, but the variety of the wave form in the same person was not found.
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膀胱筋電圖の研究

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