F-2-06-05
BLADDER FUNCTION IN ARZHEIMER TYPE DEMENTIA
Toshiki HIYOSHI, K. KAWAHIRA, N.TANAKA, (Kagoshima University Kagoshima, Japan)
In Arzheimer type dementia (A.D.), urinary incontinence was frequently seen in its early stage. To clarify whether the incontinence is due to neurogenic origin or to intellectual defect for urination, we studied comparatively the bladder storage function of A.D. by CO2 gas-cystometry.
[Subjects and Methods] Thirty women patients with A.D. (78±8.6y.o., 4.9±2.0yrs duration) were studied criteria of dementia was due to DSM-III R and CT findings. HDS-R were also evaluated. All of them can walk and communicate to the others at least. Measurement of residual urine volume (RUV), urinalysis and CO2, gas-cystometry (DISA,50ml/min.flow rate) were performed. Normal bladder was estimated as the RUV lesser than 100ml and smooth filling pressure curve without involuntary contraction under low bladder filling. Maximum bladder volume and pressure were also rended. Four patients were observed by video tape recorder and incontinence sensor for 2-3 hrs. to see the expression and attitude changes before urinary incontinence.
[Results] Diaper was used in 30/30 patients (100%) of A.D.. RUV of the patients was 49±85.8ml. normal bladder storage on cystometry was observed in 67 % of A.D. In 30 patients of A.D. with diaper, 20 patients (67%) showed nodal maxim. blader volume and pressure and only 5 patients (17%) showed slightly decreased maxim. volume and increased (uninhibited type bladder). There was no significant correlation between dementia scale and bladder function. On video-monitoring, the patient showed the attitude to looking out the toilet before insistence on incontinence sensor.
(Conclusion) Bladder function of A.D. relatively well preserved. As the incontinence of A.D. is considered due to intellectual defect for voiding, educational approach for voiding is important.
F-2-07-01
EVALUATION OF DIFFEREN CESES BETWEEN MUSCLES IN MUSCLE FIBER REFRACTORY PERIOD WITH SURFACE ELECTRODES
Kunitsugu Kondo, Yasutomo Okajima, Akio Kimura, Ken Kondo, Naofumi Tanaka (Tsukigase Rehab. Ctr., Keio Univ., Japan), Naoichi Chino (Department of Rehab. Med., Keio Univ., Japan)
Purpose: We measured rats' muscle fiber refractory period by subtraction method with double stimulation in order to evaluate difference in the refractory period of three types of muscles.
Subjects: Wistar rats' tiblialis anterior, soleus, and Extensor digitorum longs
Method: We employed surface electrodes with stimulation and pickup electrode. First of all, we obtained three waves with negative peak by single stimulation to three different points of a muscle, so that we not only measured music fiber refractory period, but also we were able to confirm that we were stimulating not a nerve but a muscle. Then, double stimulation started on the same condition. Interval between the first and the second stimulation was made 0.2msec longer every three sets of the stimulation. Thus, we defined a certain interval as 50% refractory period, if the amplitude which was resulted from subtracting the standard wave from certain interval wave was 50% of the standard wave's amplitude.
Results: We can estimate muscle fiber refractory period by subtraction method in which we had preparatory measurement of music fiber conduction velocity. As the result, we found tendency that music fiber refractory period of soleus was prolonged .
