Newly development of CCD videomicroscope with a fine needle probe of side and straight angle mirror

为了观察人体肾脏微血管，我们研制了细针式CCD显微镜。针探头（直径：3.5 mm，长度：65 mm）包含一个梯度指数（GRIN）透镜，由环形光导包围。采用两种针头进入浅肾单位的方法。第一个是直接接触肾脏。术中探头（视野角度：0°）经肾外缘肾包膜插入肾浅层皮质（肾损伤=1）。肾癌3例，输尿管癌1例；全身麻醉下的肾脏。第二种方法是在不麻醉的情况下，在肾造瘘换管（术后子宫癌2例，术后直肠癌1例，共4个肾）时，通过肾造瘘经皮将针头（视野角90°）插入肾内组织。在观察肾内微血管前4-5分钟将染料（Indicocarmine, 20mg）注射到静脉根。染料从肾小球囊排出至近端小管。远端小管也通过染料注射可见。在这些小管中观察到一些直径约为20mm的气泡，并通过小管的蠕动向下游移动。我们可以清楚地看到体内的人肾内血管（传入小动脉、肾小球毛细血管袢、传出小动脉、小管周围网络和直血管）和近端和远端小管，通过我们的新系统将染料注射到静脉根。

To visualize the human renal microvessels, we have developed a fine needle type CCD microscope. The needle probe (diameter : 3.5 mm, length : 65 mm) contains a gradient index (GRIN) lens, surrounded by an annular light guide. Two access methods of the needle probe to superficial nephrons were applied. The first one was direct access to a kidney. The probe (angle of viewing field : 0 deg) was introduced into the superficial renal cortex through the renal capsule at the lateral renal border during operation (renal injury=1.renal cancer=3, ureteral cancer=1 ; 5 Kidneys in total) under general anesthesia. In the second method, the needle probe (angle of viewing field : 90 deg) was introduced percutaneously into the intra-renal tissue through nephrostomy during nephrostomy tube exchange (postoperative uterine cancer=2, postoperative rectal cancer=1 ; 4 kidneys in total) under no anesthesia. We injected the dye (Indicocarmine, 20 mg) into the intravenous root at 4-5 minutes before observation of intra-renal microvessels. The dye was excreted from a glomerular capsule to a proximal tubulus. The distal tubulus was also visualized by dye injection. Some bubbles of about 20 mm in diameter were observed in these tubules and were moved toward downstream by the peristalsis of the tubules. We could clearly visualize the in vivo human intrarenal vessels (afferent arterioles, glomerular capillary loops, efferent arterioles, peritubular networks, and vasa recta) and proximal and distal tubulus with the dye injected to intravenous root by our novel system.