泌尿器科疾患における尿表面張力並びに尿ムコ蛋白の研究

Abstract

Urinary surface tension in urological diseases, especially i n urolithiasis, was studied with its relation to urinary mucoprotein. Specific gravity of urine is a factor to be considered, because surface tension diminishes in accord with the increase of specific gravity. Therefore, as an index to compare surface tension, relative surface tension (R.S.T.) was applied. This is the ratio of surface tension of the specimen to that of the normal urine with the same specific gravity. For mucoprotein, relative urine concentration (R.U.C.) was determined on the same reason. Reaction of, and electrolytes in the urine were not considered because of negligible influence on the subject. 1) In normal urine, th e relation of surface tension (z) to specific gravity (x, last figures of specific gravity) is shown with the following formula. z= 76.7— 0 . 37x R.S.T. was 1.0 without difference between b o th sexes, whereas mucoprotein was 50-300 mg/dl with R.U.C. of 4--7 in male and 3-6 in female. 2) In urine of pregnancy, R.S.T. was 0.96 a n d R.U.C. 4-8, indicating that surface tension was slightly low and the mucoprotein was a little high in this group. No change in each month of pregnancy was observed. 3) In urine of urolithiasis before treatmen t , surface tension was remarkably low as R.S.T. 0.85-0.9, and the mucoprotein was largely increased as R.U.C. 6-13. After treatment such as spontaneous passage of stone, pyelo- or ureterolithotomy or nephrectomy, they showed return to the normal values as R.S.T. 0.93-0.95 and R.U.C. 5-11. It is strongly suggested that urinary tract infection accompanied to urolithiasis plays a great role in the above changes. On separated study with ureteral catheterization, the urine from the affected side also showed low specific gravity and high mucoprotein concentration. Mechanical influence of ureteral catheterization should be considered. 4) In renal tuberculosis, low s urface tension and high mucoprotein were observed, but the latter did not return to normal even after nephrectomy, the reason for which was probably the presence of vesical tuberculosis and a change in general physical condition, 5) In urinary tract infection, cystitis was responsible for low surface tension and high mucoprotein, however, upper urinaty tract infection did not produce any significant changes. 6) In renal tumor, similar results were obtained as in renal tuberculosis, but po s t operative return was not remarkable probably due to general physical factor. In vesical tumor, same tendency was noted as in renal tumor and return of surface tension and mucoprotein to normal value was soon recognized after partial cystectomy. 7) In prostatic hypertrophy and carcinoma, ch a nges were almost same as in cystitis. 8) No particular changes were observed in various diseases such renal hematu r i a, testicular tumor and undescended testis.