Milk of calcium renal stoneの2例 - 走査電子顕微鏡による観察を中心として -
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Two cases of milk of calcium renal stone are presented. The first case was a 55-yearold woman, who visited our clinic on June 23, 1980, with the complaints of pollakisuria, pain of urination and high fever for 5 months. An excretory pyelogram showed right renal stones and right movable kidney. Urinalysis revealed hematopyuria, and a urine culture grew more than 10[5] colonies of Escherichia coli per ml. No metabolic disorders concerning urolithiasis were detected. Right partial nephrectomy was performed, and a large stone and several hundreds of fine and granular stones in the form of milk of calcium renal stone were removed. Infrared spectrophotometry and X-ray microanalysis showed that the renal stones consisted of magnesium ammonium phosphate, calcium phosphate and calcium bicarbonate. Scanning electron microscopic studies of the cut surface of these fine stones showed the presence of concentric laminations of amorphous substance. The second case was a 28- year-old woman with a 4-month history of left flank pain and macroscopic hematuria. The patient had undergone left nephrolithotomy 6 years before, and a diagnosis of milk of calcium renal stone had been made. On the first visit to our clinic on June 5, 1981, a plain film in the supine position disclosed a typical half-moon-shaped calcific density in the upper position of the left kidney. A retrograde pyelogram demonstrated a parapelvic diverticulum containing the calcific density identified as milk of calcium renal stone. The patient had no evidences of urinary tract infection or hyperparathyroidism. Left partial nephrectomy was performed, and the parapelvic diverticulum and more than one hundred fine, granular stones were removed. These stones were found to consist of calcium phosphate by infrared spectrophotometry and X-ray microanalysis. A scanning electron microssopic examination of these stones showed a globular structure composed of concentric laminations of amorphous substance with a granular core. Scanning electron microscopy may be useful in the study of the calculogenesis of such concretions as milk of calcium renal stone.
- 泌尿器科紀要刊行会の論文
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