腎性血尿の研究

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The purpose of this work is to summerrize the study on renal hematuria performed at our department since 1955 under the direction of Prof. Harada. The discussion was described in three chapters. Chapter I: The auther proposed to classify the pathogenesis of renal hematuria into seven groups based on the literal, experimental studies and five year clinical experience at our department. 1) Renal hematuria due to abnormality of autonomic nervous system associated with disturbance of renal circulation. 2) Hematuria due to increased Permeability of renal capillaries following renal anoxia. 3) Hematuria due to various nephritis or pyelitis. 4) Hematuria due to allergy. 5) Hematuria due to communication between calyces and renal veins. 6) Hematuria due to focal infection. 7) Bleeding from minor lesions in the kidney. Chapter II: In order to demonstrate the pathogenesis of hemturia in localized pyelopapillitis, an animal experiment was carried out. The renal hematuria was induced in the dog after relieving the experimentally produced high intrapelvic pressure The autopsy finding of the dog was compatible with that of the focal pyelopapillitis and the histological study in removed human kidney was revealed the rupture of the apices of the calyces. From these observation, the auther explained the hematuria in pyelopapillitis by pyelovenous communication due to increased intrapelvic pressure. The experiment in rabbit demonstrated that the different hydrodynamic action to the individual calyces was dependent upon their shape, size and calyx angle. Chapter III: In this chapter, the usual treatment for hematuria was briefly described, then diagnosis and fundamental treatment for different types of hematuria were discussed. The auther especially stressed the following subjects. l) A screening test to differentiate the hematuria was presented. 2) There are two kinds of blocking agents, each of which works central or peripheral to treat the hematuria due to abnormal autonomic nervous system. 3) New method to diagnose diapedesing renal hematuria was created based upon the theory for diapedesing renal hematuria by Okamoto. 4) The measurement of plasma γ-globulin is necessary for the diagnosis of allergic renal hematuria and hematuria due to focal infection. 5) The operation to reduce glomerular and intratublar pressure is quite effective for diapedesing renal hematuria. 6) Emphasis was made to note that the kidney with dysuric pelvis would also induce the hematuria. 7) The first trial to discontinue the hematuria by the desensitization using staphylotoxoid was succesful in two patients. 8) A diagnosis of the hemorrhage from the minor lesion in the kidney was made by the clinical screening test before operation and was confirmed by the removed kidney. 9) As described above, the renal hematuria are differentiated into various types and the enthusiasm of the doctors for the individual cases are greatly demanded.
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腎性血尿の研究

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