GAS-FORMING INFECTION OF THE URINARY-TRACT - AN INVESTIGATION OF FERMENTATION AS A MECHANISM
GAS-FORMING INFECTION OF THE URINARY-TRACT - AN INVESTIGATION OF FERMENTATION AS A MECHANISM
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DOI：
10.1016/s0022-5347(17)40151-0
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发表时间：
1990-05-01
影响因子：
6.6
通讯作者：
SHEN, NC
中科院分区：
文献类型：
--
作者：
YANG, WH;SHEN, NC
大多数产气感染发生在糖尿病患者中。二氧化碳的形成，由于高浓度的糖在尿液和组织中的感染生物发酵，被认为是气体形成的关键因素在以前的报告。分析多囊肾气肿感染产生的气体，以更好地了解尿路气体形成感染的机制。术语肺气肿性肾多囊感染是针对这种特殊情况提出的。从孢囊中释放的气体含有4.1%的二氧化碳、10.5%的氧气、67.3%的氮气和18.1%的未知气体。这一发现与惠勒在1954年的发现极为相似，不能完全用糖发酵理论来解释。因此，我们提出了一个新的假设。由快速catalysts产生的气体运输受损导致组织中的气体积聚，其将逐渐膨胀并产生腔室以形成气泡。邻近组织的气体将试图与气泡达到平衡。正平衡会导致病变泡不断扩大。然而，如果腔室不能承受增加的压力，则可能发生气泡的破裂或自发排出。在负平衡期间，气泡中的气体逐渐模拟组织气体，最终气泡收缩。如果腔室无法维持压力，它就会崩溃，气泡就会消失。然而，如果腔室能够维持压力，则即使当气体含量等于组织气体时，气泡仍然可以持续存在。这一假说可能会导致更好地了解肺气肿感染的尿路，也可能投光对肺气肿感染的其他器官系统。
Most gas-forming infections occur in patients with diabetes. Carbon dioxide formation, resulting from fermentation of the high concentration of sugar in the urine and tissue by infecting organisms, was regarded as the key factor of gas formation in previous reports. Gas from an emphysematous infection of a polycystic kidney was analyzed to understand better the mechanisms involved in gas-forming infections of the urinary tract. The term emphysematous renal polycystic infection is proposed for this particular condition. Gas from the cysts contained 4.1% carbon dioxide, 10.5% oxygen, 67.3% nitrogen and 18.1% unknown gas. This finding is astonishingly similar to that of Wheeler in 1954 and cannot be fully explained by the sugar fermentation theory. Therefore, we propose a new hypothesis. Impaired transportation of gas produced by rapid catabolism leads to gas accumulation in the tissue, which will gradually expand and create chambers to form gas bubbles. Gas of adjacent tissues will attempt to come into equilibrium with the gas bubbles. Positive equilibrium will lead to continuous expansion of the lesion bubble. However, if the chamber is unable to withstand the increasing pressure then rupture or spontaneous drainage of the gas bubble may occur. During negative equilibrium gas in the bubble gradually simulates tissue gas with eventual shrinkage of the bubble. If the chamber is unable to sustain the pressure it collapses and the bubble disappears. However, if the chamber is capable of sustaining the pressure the bubble still may persist even when the gas content is equivalent to tissue gas. This hypothesis may lead to better understanding of emphysematous infections of the urinary tract and also may cast light on emphysematous infections of other organ systems.