日本泌尿器科學會雑誌
Online ISSN : 1884-7110
Print ISSN : 0021-5287
51 巻, 9 号
選択された号の論文の5件中1~5を表示しています
  • Peter A. Narath
    1960 年 51 巻 9 号 p. 849-863
    発行日: 1960/09/20
    公開日: 2010/07/23
    ジャーナル フリー
    Nephroptosis, unilateral or bilatral, must not necessarily produce subjective or objective symptoms. This we may call “benign” nephroptosis which does not require surgical correction.
    The evaluation of evident subjective and objective symptoms is difficult. To establish clearly the kidney as causative factor the following tests are suggested:
    1) After the horizontal pyelogram the vertical pyelogram should be taken only after the patient has left the table, has jumped hard several times and has coughed to dislocate the kidney. Otherwise the kidney may remain in its bed and hide a nephroptosis (Fig. 2).
    2) The patient can demonstrate on the x-ray film with his own hand relieve and increase of pain in pressing the kidney upward or downward, placing it in its bed or to its lowest possible point (Narath) (Fig. 3. 4 & 5).
    3) Hypotony of the renal pelvis, often encounted in nephroptosis, may be visible by the Hutter or psoasedge symptom (Fig. 6 & 7).
    4) A better proof of demonstrating hypotony is acomplished by slow filling of the renal pelvis with a small amount of contrast medium in vertical position. Due to retarded dynamics the heavy contrast medium is not readily mixed with the residual urine in the pelevis. This leads to meniscus formation (Narath symptom) (Fig. 8 & 9).
    A typical case of suburemia due to nephroptosis is presented (Fig. 10), another of hypertensison (Fig. 11).
    Repercussions on the parenchyma of urine or contrast material in the renel pelvis under pressure due to blocking of the ureter are shown in Fig. 12, A-D.
    The reader is referred to the legends of the illustrations.
  • 阿曽 佳郎
    1960 年 51 巻 9 号 p. 864-871
    発行日: 1960/09/20
    公開日: 2010/07/23
    ジャーナル フリー
  • 長谷川 真常
    1960 年 51 巻 9 号 p. 872-895
    発行日: 1960/09/20
    公開日: 2010/07/23
    ジャーナル フリー
    Before making a histopathological study of essential renal hematuria, the author researched the structure of vessels about the renal calyces, which were obtained by injecting acryc resin into renal arteries. As a result, it was found that in the renal calyces there are the spiral arteries, which are branched off interlobar arteries.
    The author made researches in the nine removed kidneys. They were all diagnosed essential renal hematuria, and had resistance to various conservative treatments. They were observed as serial sections, contained renal parenchyma, calyx and pelvis together in one section. And there were used such stains as Hematoxylin-Eosin, Masson's Trichrome, etc.
    The findings are as follows. The bleeding region is the renal calyces in all cases. And moreover, the bleeding appeared at medulla, especially about cortico-medullary junction in five cases. At region of calcium plaque ablation in papillary apex, and the localized glomerular bleeding was accompanied at cortex in one case. In all cases, each kidney had hemorrhagic change in one or two calyces, although there was no special localization. And moreover, spiral artery showed the marked sclerotic change at those damaged calyces. On the other hand, remarkable congestions tendency was observed in the renal vessels everywhere; particularly calyx-wall showed the dilatation of capillaries, hemorrhagia per diapedesin, and early stage of granulation. As a more interesting view ie calyx-wall, having hard degeneration of the spiral artery, there were remarkably seen sclerosis of connective tissue and atrophic degeneration of the smooth muscle fibers. Consequently the calyx-wall gren thin, and at the same time, fissure of tissue (hemorrhagia per rhexin of capillaries) were observed at calyx-papilla angle and so on.
    Judging from the above histological findings and literatures, the following is considered to be important.
    One of etiological factors of essential hematuria exists in Locus minoris resistentiae. It is the region of tissue degeneration, which is due to disturbance of hemodynamics of the spiral artery, at the calyx-wall.
    The author concludes that, when a factor of renal circulatory disturbance (particularly increasement of capillary blood pressure) joins in such Locus minoris resistentiae, at first hemorrhagic per diapedesin of capillaries is observed and then in the next stage hemorrhagia per rhexin of capillaries occurs, at the calyx-wall.
  • 瀬川 昭夫
    1960 年 51 巻 9 号 p. 896-942
    発行日: 1960/09/20
    公開日: 2010/07/23
    ジャーナル フリー
  • 胎児の測定線を基調とする成人ピエログテムの測定とその異同に就て
    藤沢 秀行
    1960 年 51 巻 9 号 p. 943-990
    発行日: 1960/09/20
    公開日: 2010/07/23
    ジャーナル フリー
    In the easly stage of embryonic life the Kidney lies behind and below the allantois and cloaca, but begins to ascend and assume the normal position at about 7-9 weeks of gestation. During this period of ascension the organ shows a certain degree of the weakness of its sustaining ligament as well as of surrounding tissue the position of the organ presents a considerable variation from case to case.
    The Kidney as well as the renal pelvis occupies the foremost place among all organs of the body in exhibiting abnormalities, variations and deformities.
    Determinations of the Kidney and pelvis are usually made anatomically and in recent years mostly by pyelography. The efforts of previous investigators appear to leave little to be added, such as the studies by Hyrtl, Braasch, Legueu, Papin, Eisendraht, Joseph, Lichtenberg, Lauber, Behrenroth, Hauch, Marion and others in foreign countries, while in Japan those of Takahashi, Ichikawa, Namiki, Yamanouchi, Tsuchiya, Shiga, Hirose, Cho, Nozaki, Hasebe, Tomikawa, Mitani, Kobayashi and Hori. Upon examination of the works by these observers, however it is difficult to find results that are in absolute agreement with each other.
    These studies were done mostly by using adult materials. In our department, Takashima and Nagamine made observations on these problems in detail anatomically as well as by the use of pyelography in 100 normal fetuses. The determination of the positions of the Kidneys, pelves and calyces was made by utilizing newly established measurement curve and base line. The procedures of measurement are as follows:
    1) The longitudinal line passing through the middle of vertebral bodies, used by Yamanouchi, was utilized as the first base line while the second base line is the conjugate of the iliac crests on both sides perpendicularly crossing the first base line.
    2) The measurement of the long axis of the pelvis was made by the following methods:
    1) The long axis of pelvis I is determined by first drawing a line along the pelvis starting from the intersection of the first and second base lines, then by finding a line connecting this line with the intersection of lines from the upper and lower poles of the pelvis perpendicular to the first base line.
    2) The long axis of pelvis II is the diagonal line of a parallel rectangle bound by the four lines along the pelvis paralleling the first and second base lines.
    3) The long axis of pelvis III is the Yamanouchi line connecting the upper and lower poles of pelvis.
    3) The angle of inclination of the long axis of pelvis is that which is formed by the long axes of pelves I, II and III with the first base line.
    4) The theoretical center of pelvis is assumed to correspond with the center of each of the three pelvic axes, and the positional relation of the Kidney is expressed by the rectangular coordinate of these centers.
    5) For estimating the area of each pelvis, the use of calculated values of pyelograms reproduced on 1mm coordinated papers in combination with planimetric measurements was utilized.
    The investigations on the Kidney position, major and minor calyces of the fetus are important in themslves, but the comparison of these findings with those of the adult is even more significant. Direct comparison of the results of study, however is difficult because of the difference in the methods of measurement.
    The author undertook to measure the adult Kidney by using the base line for the fetla Kidney established by Takashima.
    For this purpose 338 diagnostic pyelograms collected in our department suitable for demonstrating the normal position of the Kidney have been chosen. Various points investigated by Takashima have been checked and the position and shape of the Kidney and pelvis as reported in the literature have been consulted.
    The findings thus obtained have been compared with the results of measurement in the fetus obtained by Takashima and Nagamine. By so doing the author has been able to
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