Histopathological and urodynamical study for the urinary passage in pelvo-ureteral junction

盆腔输尿管交界处尿道的组织病理学和尿动力学研究

• 批准号: 05671293
• 负责人: NONOMURA Katsuya
• 金额: $ 1.28万
• 依托单位: Hokkaido University
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for General Scientific Research (C)
• 财政年份: 1993
• 资助国家: 日本
• 起止时间: 1993 至 1994
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/en/grant/KAKENHI-PROJECT-05671293/
• 关键词: Pelvouretral junction stenosis; Scanning electron microscopy; Anti-PGP 9.5 antiby nerve staining; Constant pressure perfusion study; Prenatal diagnosis; Diuretic renogram; Split renal function; 腎盂定圧灌流試験

1. Stractural changes of collagen components and diminution of peripheral nerves in intrinsic pelvi-ureteric junction stenosisPelviureteric junction (PUJ) of congenital hydronephrosis was histopathologically observed by a scanning electron microscopy and an immunohistochemical staining to PGP 9.5 as a general nerve marker. PUJ of in trinsic stenosis had structal feature with 1) sparse and thin muscle bundles, 2) a dense felt-like collagen fibrils of smooth muscle cells, 3) compact and rigid interstitial collagen components, and 4) diminished perpheral nerve distribution.2. Radionuclide constant pressure perfusion studyA simple method, radionuclide constant pressure perfusion study (CPPS), was applied for clinical estimation of exit flow in hydronephrotic patients via nephrostomy. Exit flow in the kidney with non-obstructed upper urinary tract demonstrated a linear incrcase with the increased intrapelvic pressure. This technique will provide physiological measurement of the urine flow at variable levels of constant intrapelvic pressure in hydronephrotic patients.3. Management and outcome of antenatally diagnosed hydronephrosisDiuretic renography (DR) by using ^<99m>Tc-DTPA and furosemide was performed in patients with a suspicious ureteropelvic junction (UPJ) obstruction detected only on prenatal ultrasound. In the kidneys which split renal function (SRF) and diuretic drainage half-time clearance (DT 1/2) of radioagent were within their normal ranges (60% in initial DR) there were no aggravated signs on repeated DR.The renal function with prolonged DT 1/2 and normal SRF (28%) did not deteriorate and the diuretic response improved on repeat DR except one kidney. Although there is still no examination which can detect a definite UPJ obstruction, we can identify one as significant by careful repeat examinations.

1.先天性肾盂输尿管连接部狭窄中胶原成分的结构变化和周围神经的减少通过扫描电镜和以PGP 9.5作为一般神经标志物的免疫组织化学染色来观察先天性肾盂积水的肾盂输尿管连接部（PUJ）的组织病理学变化。本质性狭窄的PUJ具有以下结构特征：1）稀疏而薄的肌束；2）平滑肌细胞密集的毡状胶原原纤维；3）致密而刚性的间质胶原成分；4）周围神经分布减少。2．放射性核素恒压灌注研究一种简单的方法，放射性核素恒压灌注研究（CPPS），被应用于肾积水患者通过肾造口术的出口流量的临床估计。上尿路无阻塞时，肾脏的出口流量随着盆腔内压力的增加呈线性增加。该技术将为肾积水患者在不同水平的恒定盆腔内压力下提供尿流量的生理测量。3．产前诊断的肾积水的处理和结果使用^<99m>Tc-DTPA和速尿对仅通过产前超声检测到可疑肾盂输尿管连接部(UPJ)梗阻的患者进行利尿肾造影(DR)。在分裂肾功能（SRF）和放射剂的利尿引流半时清除率（DT 1/2）均在正常范围（初始 DR 中为 60%）的肾脏中，重复 DR 时没有加重的迹象。延长 DT 1/2 和正常 SRF（28%）的肾功能没有恶化，除一颗肾脏外，重复 DR 时利尿反应有所改善。虽然目前还没有任何检查可以检测出明确的 UPJ 梗阻，但我们可以通过仔细的重复检查来确定是否存在严重梗阻。

项目成果

Katsuya Nonomura et al: "Managemnt and outcome of antenatally diagnosed hydronephrosis" Int'l Journal of Urology. 1. 121-128 (1994)

Katsuya Nonomura 等人：“产前诊断的肾积水的管理和结果”国际泌尿学杂志。

Katsuya Nonomura et al: "Management and outcome of antenatally diagnosed hydronephrosis." Int'l Journal of Urology. 1. 121-128 (1994)

Katsuya Nonomura 等人：“产前诊断的肾积水的治疗和结果。”

Katsuya Nonomura: "Management and outcome of antenatally diagnosed hydronephrosis." Int' I Journal of Urology. 1. 121-128 (1994)

Katsuya Nonomura：“产前诊断的肾积水的治疗和结果。”