先天性腎発育障害 : 第II報上部尿路の発育からみた腎発育障害の発生時期に関する考察

概要

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A maldevelope kidney frequently occurrs in association with a congenital obstruction of the upper urinary tract, which is considered to have muscular abnormality as the etiology. As part II of the study in a maldeveloped kidney, a development of the musculatures in the upper urinary tract was investigated histologically by serial sections in human fetuses. The musculatures of the pelvis develop as early as those of the middle ureter in around the 16 week fetus. These musculatures extend to the each caliceal infundibulum around the 21 week and the caliceal musculatures develop in the latest stage as those of the intravesical ureter in the 23 week, but still showing immaturity even in the 27 week. Therefore, there is a discrepancy in comparison with the development of the caliceal musculatures and papillae, which already develop more prominent in the same stage, even in the 23 week. This may be the reason why a primary megacalicosis demonstrated with the abscence of the caliceal musculatures in the clinical case occurrs with the thin wall of the maldeveloped musclatures in the caliceal wall and shows non-obstructive dilatation, as a primary vesicoureteral reflux has been demonstrated to have an abnormal muscular development of the intravesical ureter.
社団法人日本泌尿器科学会の論文