尿路感染症におけるBacteria L-formの意義 : 特に腎盂腎炎発生機序に関する問題について : 第1報Bacteria L-formに関する検討および臨床的検討
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A. Fundamental investigation of bacterial L-form : 1. Two kinds of media which make it possible to isolate L-form of E. coli, Proteus, Pseudomonas, Enterococcus or Staphylococcus at a high rate have been devised by improving the conventional media for L-form; first the concentration of sodium chloride was adjusted as to the problem of osmotic pressure of L-form, and next when some drugs to inhibit synthesis of bacterial cell walls were utilized essential amino acids were applied in combination with the drugs. 2. A new method to obtain rapidly L-form in comparison with an addition of penicillin has been designed by adding lysozyme in amounts of 0.1-3 mg/ml to the medium in vitro. 3. The method to isolate and detect L-form from urine, tissue and secretions has been established. B. Clinical investigation of bacterial L-form : 1. Among 313 urinalyses which were made in 114 cases of pyelonephritis and doubtful pyelonephritis, L-form could be detected in 118 examinations (the detection rate 37.70%). The cases that repetitive urinalysis in the same patient revealed L-form more than 3 times were 27 of them and the detection rate in this situation was 23.68%. No L-form could be observed in 897 urinalyses which were performed in 359 cases of various diseases except pyelonephritis. 2. In 3 of 8 patients with pyelonephritis, L-form could be demonstrated from renal tissues which were obtained by kidney biopsy. None of the biopsy specimens showed L-form when they were obtained from 147 cases of other diseases and examined with 405 times of cuture. 3. L-form could not once be detected in 174 cultures of prostate, urethral and vaginal secretions. 4. Survey of 27 patients with pyelonephritis who revealed L-form with the aid of an incubation : i) Seven cases demonstrated 3 A L-type colony, and 23 cases 3 B L-type colony. ii) Most of the patients were followed by the reduction in ability to concentrate urine. iii) No particular interrelationship could be observed among nonprotein nitrogen, creatinine and urea nitrogen.
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