下部尿路の治療其他の藥物溶液吸収に關する實驗的研究 : 第V編(主として組織學的方面)膀胱に於けるプロテイン銀液液吸収に關する實驗的研究
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As a part of Prof. Tabayashi's investigations on the absorptive ability of the urinary bladder, the auther has made observations on the penetrability of protein silver (Argentum proteinicum) into the vesical tissue as determined by the silver reaction method. Such an investigation, however, is by no means easy. As is well known, protein silver was first marketed in 1897 under the trade name of Protargol which was highly recommended by A. Neisser, and numerous studies as to its clinical value have since been published. In this Department, both Aika (1942) and Abe (1949) have made attempts to ascertain without success the absorption of protein silver through the bladder wall. In 1952, however, Oi succeeded in demonstrating beyond any doubt the absorption of this drug to the extent of 15.9 per cent (15 minutes) up to 50.1per cent (24 hours) after its intravesical instillation. The present experiment has been undertaken to determine if the silver reaction technique could be utilized for demonstrating the presence of protein silver in the urinary tissue. 1. Utilizing the experimental method of Oi, the bladder was isolated in one group of (16) rabbits, and in the control group of similar number of animals the organ was left intact. In the bladders of all animals in both groups 3 cc of a 3 % protein silver solution were injected, after which the bladders of experimental animals were sutured. A tissue sample was removed from each animal for histological examination at intervals of 15 minutes, 30 minutes, 1 hour, 2 hours, 4 hours, 6 hours, 12 hours and 24 hours. Positive results were obtained in all 32 animals, 16 in each group (Fig. 1-10). 2. The presence of silver was demonstrated in almost every portion of the bladder tissue examined, including the epithelial layer, the basal membrane, the membrane propria, the interstitium of the connective tissue, the muscularis, the external membrane as well as the vascular and lymphatic system distributed between these structures. 3. The positive silver reaction can be identified in the form of fine granules of either dark brown, yellowish or light brown pigmented dots. The granules of all these varying intensities of pigmentation are usually found, although a few of these present the reaction of only one color intensity. 4. In the epithelial layer of the mucosa, the distribution of the granules with positive silver reaction takes the direction from the surface to the deeper portion, many between the cells in the form of a mesh, while some granules infiltrate the cells from the surface deep into the cytoplasm, these cells heavily loaded with silver granules being ultimately shed. The basement membrane as a rule is thickened with aggregated or dispersed silver granules. Practically identical pictures are encountered in the connective tissue interstices of the membrana propria, some specimens showing even complete focal irifiltrations. The external layer affears to ingest silver more intensely than the connective tissue portion. 5. The vascular and lymphatic tissues demonstrate the most extensive presence of silver, particularly the capillaries, the branching portion of venules, the lymphatics and the tissue spaces. 6. As to the speed of absorption,the mucosal epithelium shows the easiliest ingestion at 15 minutes, the basal membrane and other deeper portions being less speedy. The specimens taken after 30 minutes show most conspicuously the presence of silver granules. in the deeper portions including in the vascular and lymphatic structures. 7. Protein silver solution instilled into the bladder first infiltrates the mucosal epithelium and gradually migrates into the deeper structures. In the course of this process, desquamation of the epithelium occurs, which, however, regenerating later again ingests the silver. Thus, this repetition of shedding of old epithelium, followed by regeneration and re-ingestion, leads to the continued depositiori of silver granules in the tissues of specimen removed even as late as 24 hours after instillation. The present experiments also demonstrate that a practically identical mechanism is involved in intact bladders in which the excreted urine continuously mixes with and dilutes the silver solution. The author has been able to observe in these experiments a morphological picture of the penetration and infiltration of protein silver into the vesical tissue. These observations, then, offer certain confirmative evidence in support of the results of biochemical studies previously made by Oi.
- 社団法人日本泌尿器科学会の論文