尿路・性器系結石の赤外線分光分析による検索, とくに臨床病像との関連について

The compositions of the 191 stones obtained from the genito-urinary tract were analysed by the method of infrared spectrophotometry utilizing potasium bromide (KBr) pressed-disk preparations of the materials.<br>The compositions of calculi of the urinary tract were investigated with respect to their clinical manifestations; namely, localization, recurrence, urinary infection or apparent metabolic disorders.<br>1) The compositions of the 184 urinary tract calculi were as follows: Calcium oxalate + calcium phosphate stones 44.0%, calcium oxalate stones 20.7%, and magnesium ammonium phosphate + calcium phosphate stones 13.0%. Oxalate stones comprised 20.7%, phosphate stones 14.1% and oxalate + phosphate stones 49. 5% respectively. Calcium stones comprised 64.7% and calcium salt + magnesium ammonium salt stones 17.8%.<br>Uric acid and urate stones were found in 7.1% and cystine stones in 4. 9%, respectively. These incidences were higher, compared with other Japanese reports.<br>2) Prostatic calculi were all multiple and composed of phosphate (in four cases, magnesium ammonium phosphate + calcium phosphate and in two cases, calcium phosphate).<br>3) The calculus in the as deferens was a so-called “soft stone”, composed mainly of protein with deposition of calcium phosphate.<br>4) Crystals deposited on the in-dwelling catheters of nephrostomy, ureterocutaneostomy and cystostomy were composed of magnesium ammonitun phosphate and calcium phosphate, accompanying urinary infection.<br>5) In calculi of the upper urinary tract, calcium oxalate + calcium phosphate stones comprised 43.5% and calcium oxalate stones 22.4%, about two thirds of which were ureteral calculi. On the contrary, about three fourths of renal calculi were phosphate-containing stones arid especially most staghorn calculi contained magnesium ammonium phosphate, accompanying marked urinary infection. Calculi of the lower urinary tract were accompanied by chronic urinary infection and were complicated with bladder neck obstruction.<br>6) Recurrent calculi revealed the same (in ten cases) and similar (in four cases) composition as the former calculi. This suggested that condition of stone formation in the recurrent stone-formers might remain the same.<br>7) Urinary infection was accompanied by about a fourth of calcium oxalate stones, whereas about a half of calcium oxalate + calcium phosphate stones and all stones containing magnesium ammonium phosphate were always demonstrated to be complicated with infection.<br>8) Calculi due to metabolic disorders were as follows: Five cases with hyperparathyroidism, whose calculi were mainly calcium oxalate + calcium phosphate. Eleven cases with uric acid and urate stones did not showed any symptoms of gout, but most of them showed hyperuricemia. Two cases in six cases of cystine stones were revealed to be in brotherhood.