抗結核剤(SM,PAS,INAH)使用腎結核の形態学的研究並に蛍光法(矢崎氏)による菌検索

Abstract

I) Histopathological Findings Histopathological o bservations as to their course of recovery were performed on 42 cases of renal tuberculosis. These patients were not treated with antitubrculous drugs, but 61 other cases treated (3 were operated segmentally). The type of diseases in the untreated co n trol series were all caseous cavity type, and one was disseminating tuberculous type. The treated group were divided into five groups, and they were arranged in accordance with amount of SM from 10 gm up to 40 gm and above respectively. 0 The lesions of papillae, calices and cavity walls. a) The obsorption of the caseous lesion was seen in the 2nd group or above, but was retarded with stenotic and obstructive cavity. b) Disappearance of inflammatory c Its was noted from the 2nd group above. c) Disappearance of epithelioid cells was noted from the 4th group or ab o ve. d) Regeneration of the epithelium was demonstrable from the 3rd grou p above. ii) Fresh disseminated lesions. Retarding of the fresh disseminated lesions may be noted from the 2nd group above, and complete depression was 2-3 months or more during treatnent, therefore, at least two months were necessary for pre-chemotherapy of segmental resection and nephrectomy. iii) Tubercle nodules of parenchyma. a) Depression of caseati o n was noted from the 2nd group. The effectiveness was delayed with the large nodules than the small. b) Connective tissue reactio n increases from about 10 gm of SM and the smaller nodules were more dominant than the larger. c) The newly formated capillaries were noted from the 3rd group above with the small nodules and the 2nd group above with large nodules. From the above histological findings, there was o ne complete healed case, few remnants of non-active tuberculous foci and thought to be almost cured, 4 cases. II) Tubercle bacilli in the tissue. Fluorescent microscapical observation was made on the localization of tubercle bacilli in the renal tuberculosis. The prime seat of tubercle bacilli were in the caseous substance of the pelves, in the ulcer of the papillae and calices region and caseous lesions of the cavity walls, when compared with the un-treated, the treated and its various groups and also in different administrative methods, there were no particular noticeable findings. The bacilli were few on the healed surface of ulcer an d cavity walls, but if ever a minute portion of the caseous substance was adhered, the bacillus remained there. Moreover, it may seem healed at one glance, but, still the bacillus was there, and therefore making it possible for the danger of late relapse.