尿管膀胱電図の研究

第II編 連続矩形波電流刺戟を1側尿管に与えた場合の尿管電図に就て

抄録

I. Electroureterographic responses of the bilateral ureter following continuous rectangular current stimulation of various intensities on one ureter were studied in 42 rabbits and in 28 patients.
II. Electroureterographic recording apparatus, electrodes and stimulators are described.
III. The experimental methods on the animals and hospital patients are presented in detail.
IV. The following results were established.
1) The shape of the peristaltic waves to became more complex after stimulation as compared with pre-stimulation control. No direct correlation between the intensity of the stimuli and the changes in the configuration of the waves was noted, however.
2) The mean maximal value of the amplitude of the peristaltic wave groups was 0.55mV on the right, 0.53mV on the left ureters in 42 rabbits, and 1.4mV on the right, 1.8mV on the left ureters in 28 humans.
3) The change in the conduction rate was measured in 15 patients and an increase in the rate of conduction was noted on the stimulated side in 5 cases (33%). There was no correlation between the intensity of the stimuli applied and the increase in the conduction rate.
4) Electroureterographic responses to continuous rectangular current stimuli of 4V 6V 10V and 20V on one side were studied in 20 rabbits. Ureteral peristalsis was inhibited bilaterally following stimuli of 4V, and 6V, and was augmented by an intense stimulus of 20V. Stimuli of intermediate intensity, i, e., 10V caused equivocal changes.
5) The effects of Banthine and Vagostigmine on ureters were studied electroureterographically. Banthine inhibits the ureteric motility, especially the duration of the peristaltic waves. Vagostigumin augments ureteric motility, especially in the increased amplitude of the waves.
6) Electroureterographic responses of the bilateral ureters to continuous rectangular current stimulations on one side in the 22 rabbits treated prior to stimulation with the above-mentioned drugs were found to be similar to those found in the un-treated 20 animals.
7) Continuous rectangular current stimulations were applied to the ureter on one side in 5 patients with normal ureter, 12 with nephroureterolithiasis and 11 with floating kidneys, and the electroureterographic responses were observed. Stimuli of less than 10V, caused inhibitory responses on bilateral ureters in most of the patients.
This finding is in accord with that of the animal experiments. Stimuli of greater intensity, such as 20V used in animal experiments, were not tried on the patient group.
In patients with nephro-ureterolithiasis, stimuli were applied on the affected ureter in 6 cases, and on the contralateral in 6 cases.
In the floating kidney group, the stimuli were applied on the affected side in 4 cases, and on the healthy side in 7 cases. The side of the stimulation did not seem to influence the direction of the responses.
8) Following the stimulation on one side, both ureters responded namely, augmenting one side and inhibiting the other side in 15 out of 42 rabbits (35.7%) and in 9 out of 28 clinical cases (32.1%).
This seemingly reciprocal response in the bilateral ureters were noted on stimuli of medium intensity, 6V, 10V, in animals and 10V to 14V in clinical cases.