THE SIGNIFICANCE OF FOCAL INFECTION IN UROLITHIASIS

Abstract

Concerning the etiology of urolithiasis, many researches on infection of urinary tract have ever been reported.
But there has been almost no report from a viewpoint of focal infection—as a sort of abnormal general condition.
The author set up focus on a rabbit which had operatively been strictured at one side of ureter one week before. The focus was set up by injecting emulsion of staphylococcus by accesory nasal sinus window methed (Okabayashi).
Within three months, calculi in renal pelvis and koch's steinkrise were often found in Bowman's capsules and tubules.
Today noxes of focus on kidney are considered bacteria itself, bacterial toxin, bacterial detritus and tissue detritus of focus wall. Above all, allergic effects of these noxes are the most important.
So, by injecting ovoalbumin solution, which is usually used in the study of allergy, in the same way as before. Steinkrise was observed in high rate.
As control, the group, injected 5% glucose soluton, and the group, only strictured, proved positive in low rate. Not-strictured side proved less positive.
This result shows that urinary retention has an important significance for stone formation.
Histologically, perivascular fibrosis of strictured side was seen in all cases. But it was a remarkable finding that its swelling was observed in the group of focal infection and the group of ovoalbumin.
On the other not-strictured side, slight glomerulonephritis war observed. These findings are considered to be allergic changes.
And this suggests that there is the time of vasoconstriction of renal arterioles and vasa afferens which are regarded the most important in the early stage of Steinkrise.
As clinical observation, there are much more who have anamnesis of focal infection and allergic diathesis among the patients with urinary calculi than in th control group.
Besides the author researched the relation between antigen-antibody-reaction and Steinkrise by sensitizing the rabbits in intravenous injection of purified ovoalbumin solution. As a result, the severelysensitized rabbits showed hard tissue reaction with giant cells. And the moderately-sensitized ones revealed typical Steinkrise.
Judging from experimental results, clinical observations and literatures on this subject, it comes to the following conclusion.
1) As for those who suffer from focal infection, four noxes affect on renal Vessel neurally or humorally, and cause vaso-constriction, and then Steinkrise occurs.
2) On next stage, co-factor of urinary retention or secondary infection leads to clinical urolithiasis.
3) Through this process, allergy has a great significance.