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腎結核의 尿路撮影像에 關한 臨床的硏究

A Clinical Study on the Uroaraphy in Renal Tuberculosis

부산의대잡지 1963년 3권 1호 p.241 ~ 253
李祐植, 文孝重,
소속 상세정보
李祐植 (  ) - 釜山大學校 醫科大學 皮膚泌尿器科學敎室
文孝重 (  ) - 釜山大學校 醫科大學 皮膚泌尿器科學敎室

Abstract


A clinical study was done on the urography of 8 patients with renal tuberculosis seen during the last 6 years.
1. The author advocated a new classification of the pyelographic changes associated with renal tuberculosis in which the changes( were divided into small and large lesions, and further the two lesions were subdivided into I, II, III and IV grades according to the extent and severity of the lesions. The results obtained from the author´s classification were as follows.
1) The number of kidneys with small lesions were 16, of which the grade I was 12 and grade l
was 4. The number ; of kidney with Large lesions were 74, of which the grade III was 3 and grade IV was 71.
2) The pyelographic findings listed in order of their frequency of occurence were found to be . (I) nonvisualization; (2) pyelocaliectasis to pyonephrotic destruction; (3) delayed visualization; (4) changes in nephrogram; (5) clubbing of one calyx; () changes in ureterogram; (7) rnath-eaten appearance t) cicatrical deformity of one calyx; (3) moth-eaten appearance to cicarical deformity of two calyces.
3) Examination in zde by A. P. and R, P. on the kidneys which are not visualized by I. V. P. disclosed large; lesions in the majority ranging from the pyelocaliectasis to pyonephrotic destruction.
4) The majority of the kidneys showing the changes in their nephrogram, ureterogram and cystogram were found to have lesions in the corresponding kidneys.
2. Clear pattern of the pyelocaliceal system was obtained by means of A. P. which was indicated in the relatively large number of cases in the roentgenologir_al evaluation of the renal tuberc ulosis.
3. Urinary symptoms including hematuria, pollakisuria and dysuria etc. were noted in the majority of the cages with renal tuberculosis without any relation to the grade of the pyelographic changes. while the general symptoms such as flask pain and fever etc, were noted chiefly in the cases with large lesions, particularly in those with bilateral large lesions.
4. The patients with pyelographically small lesions were almost normal in their renal function, while the patients with large lesions, particularly those with bilateral large lesions were impaired usually. Renal function was reflected more accurately by the concentration test than by the other tests including dilution test, P. S. P. test, determination of NPN level in blood and indigo carmine excretion test.
5. In renal tuberculosis the pyelooraphic changes were well correlated to the cystoscopic findings. The case with large lesions on the pyelogram usually revealed moderate to severe grade of bladder changes.

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