Title 所謂特発性腎出血に関する研究第 V 篇 : 自律神経系に関する臨床的蛇びに実験的研究 Author(s) 仁平, 寛巳 Citation 泌尿器科紀要 (1959), 5(1): 19-39 Issue Date 1959-01 URL http://hdl.handle.net/2433/111708 Right Type Departmental Bulletin Paper Textversion publisher Kyoto University
Studies on So-called Essential Hematuria Report V : Clinical and Experimental Studies on the Autonomic Nervous System Hiromi Ni HIRA From the Department of Urology, Faculty of Medicine, Kyoto University, Kyoto, Japan (Director : Prof. 7'. Inada) Twenty-eight cases of so-called essential hematuria were tested with pharmacologic agents to determine the sensitivity of the autonomic nervous system. Twenty-six cases of 28 showed the functional disorders, i. e. in 11 cases the overreaction to adrenalin was observed, in 7 to pilocarpine and in 8 to both agents. In treatment with the drugs blocking autonomic activity of these patients, 5 cases showed healing, in 3 hematuria was marked decreased and in 4 slightly decreased. Through the observation of these tests and treatments it was suggested that in several cases the onset of hematuria was closely connected with the functional disorders of autonomic nervous system. In experiments on rabbits subjected to repeated injections of adrenalin the urine began to show slight albumin and blood, and the kidney was found to have degenerative changes of tubules, but injections of pilocarpine produced no changes. Renal denervation produced slight vasodilatation but renal tissue was not affected. After denervation the kidney developed mild inflammatory changes when subjected to repeated injections of adrenalin or pilocarpine. Toxic agents such as uranium nitrate did not injure the normal kidney as much as the denervated kidney. Intravenous injection of bacterial filtrate produced marked hemorrhagic changes on the denervated kidney. In contradistinction to the denervated side, the normal (non-denervated) kidney showed mild changes. This phenomenon is possibly explained as follows, the normal kidney is not injured as much as the denervated kidney because of protective vasoconstriction.
38 仁 平 一一 所 謂 特発 性 腎 出血 に 関す る研究(第V篇) 難 図1ア ド レ ナ リ ン 長 期 聞 反 復 投 与,尿 (H.E.染 色,100 ) 灘 繋 図2 腎 神 経 遮 断,皮 欝 血(H.E.染 細 管変 性 質 に 於 け る 小 血 管 の 拡 張, 色,100 ) 礪r漱 影 魂洩 蝋 懇 箋響 ご' 齢 轡 漁 忌繋 図3同 上,髄 (H.E.染 歯 鞭の ' s' ゆ 嶋 血 図7同 鹸.. 難慧餐 購灘 藪継 慧 醸 騰.獄 図4 色,100 ) 覧 馳 一,や 鯨 レ 懸 腎神経遮断.硝 酸 投与,遮 断倶咀 の糸 球 体 の 著 明 な 変 化(H.E.染 ' u 醜 厩 齢, 鍛 藻1 ヴ 質 に 於 け る 小 血 管 の 孤 張,欝 色,100x) 愈覧 神経 遮 断+ピ ロ カル ピ ソ反復 投 与,糸 球 体 の軽 度変 化(H E.染 色,100 ) 一 灘鐡 麟灘 1 図5腎 腎 神 経 遮 断+ア ドレ ナ リ ン反 復 投 与,糸 体 の 軽 度 変 化(H.E.染 色,100 ) 球 鳥 上,強 拡 大(H.E.染 色,400 ) 雛鑛麟 繕 灘 臓 図8同 上 無 処 置 側(H E 染 色,100 )
39 仁平一所 謂特発性腎 出血に関す る研究(第V篇) 鐡 選 署糠 醗tr.琴 魏i醗 チパロコ.翫..'ツ 弓' ン ぐ コ 響 i き ぬ れ ロ φ 編 ロげ ロ. i.x' '獲h' ダ ン '.馨, ' 7ti,,弓 籔1 ロ 噸'義. 舗 舜'.. あ ロ リ ロノ おち 灘i羅 饗勲磯 講 図9腎 神 経遮 断+シ=ワ ル ッマ ソ濾液 投 与,遮 断 側 の糸 球 体 の 変化 及 び小 血管 の拡 張,出 血(H.E.染 色,100 ) 図11同 上,髄 質 に 於 け る 血 管 拡 張,出 血(H.E. 染 色,100 ) 灘繰 騰 騰灘 1灘 謬 '璽 醒購i 襲 欝 難 :i難 謙纏 図10 同 上,皮 髄 境 界 部 の 血 管 拡 張,出 染 色,100 ) 血(H.E. 図12同 上,無 処 置 側(H.E染 色,100 )