膀胱結石並ニ尿道結石ニ就テ

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Statistical observations, chemical proofs and skiagrams of 76 cases of calculi in the urinary bladdar and 28 cases of the calculi in the urethra were made and the following conclusions were drawn: 1) Vesical and urethral calculi occurred oftener in men than in women, while recurrent vesical calculi developed in both men and women almost in the same percentage. Recurrent vesical calculi developed from the calculi descended from the kidneys while the often developed in comp lication with the hypertrophy of the prostata. Descendent calculi had almost always developed from the calculi having such an irregular from as easily liable to be detained in the urethra and they occurred most frequently at the pars pendula while the pars prostatica standing next in order of frequency. In any other regions, the descendent calculi wers rearely met with while, if they were found in these regions after all, they were almost always complicated by urethrostenosis. 2) Lithotrypsy was preferably made with the forceps devised by Dr. Saburo Akutsu. If complicated by the hypertrophy of the prostata small calculi were removed by means of Young's forceps while larger ones crushed into several pieces and removed one after another. 3) Most of the vesical calculi were composed of urates. The phosphate, uric acid and cystin stones stood next in order of frequency. Most of the vesical calculi , however, in the sizes of a sparrow's egg or smaller were composed of oxalates. All the cases of multiple vesical calculi were composed of. urates. The recurrent vesical calculi were also composed of either uric acid or urates, but they had not necessarily the same chemical composition as the initial stones. Most cases of descendent urethral calculi were composed of oxalates. 4) The surface of the vesical stone which was in immediate contact with the surface of the mucous membrane of the urinary bladdar presented comparatively a smooth surface composed of more consistent nature, but toward the free lying surface, it appeared more and more zig-zag in form and coarse in nature. The nucleus of this kind of the stones lay rather excentrically near the lower sorface. All the surfaces of the stones were not necessarily covered by homogenous chemical compounds, but of the sedimentations of various chemical substances, which might answer for the formation of the irregular surface. For the development of vacuoles and splits, the following three factors might answer; (1) Stagnation or desiccation of the organic substances contained the stone; (2) Partial dissolution or corrosion; and (3) Coarseness of the composition of the sedimentation. Unless the nuclei were composed of heterogenous substances than the bodies of the stones, the determination of the nuclei were so far impossible. 5) In skiagraphy, the calculi composed of oxalates give the darkest shades, those of carbonates, sulphates and cystine stand next in order of the deepness of the shades, those of the urates and uric acid giving the lightest shades. If the radiation should be given from different directions, the selfsame calculus presents shades having different shapes. In this case, the position of the nucleus, its shape and size, layers of the different chemical substances, the form of the radial construction, arrangements, tonus of the shades at various portions of the stone etc, are also variable. These facts are of matter of especial notice in the skiagraphy of the stones in vivo. Generally considered, the stone gives the shade in Rhaentgenogram the shape and construction agreeing with the cut surface of the nucleus along the perpendicular surface to the radius of the irradiation.
社団法人日本泌尿器科学会の論文

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小山正篤
阿久津病院

膀胱結石並ニ尿道結石ニ就テ

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