泌尿器科領域における尿乳酸脱水素の研究特に尿路悪性腫瘍と尿乳酸脱水素酵素について

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  • URINARY LACTIC DEHYDROGENASE ACTIVITY IN UROLOGICAL DISEASES, WITH SPECIAL REFERANCE TO URINARY TRACT MALIGNANCY
  • ヒニョウキカ リョウイキ ニ オケル ニョウ ニュウサン ダツスイソ ノ ケンキュウ トクニ ニョウロ アクセイ シュヨウ ト ニョウ ニュウサン ダツスイソ コウソ ニ ツイテ

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Urinary and serum activities of lactic dehydrogenase (LDH), which an enzyme necessary for the conversion of pyruvate to lactate in anaerobic phase of glycolysis, were investigated in patients with various urological diseases, both benign and malignant, as to know the clinical significance of urinary LDH activity in diagnosis of urinary tract malignancy, as advocated by Wacker and Dorfman in 1962. The authors' study was based on the data of LDH activity determination in the urine and serum of 24 normal controls and 44 patients with various urological conditions. Urinary LDH activity was determined by the method described by Wacker and Dorfman in 1962. And serum LDH activity was determined according to Wroblewski and Latue (1955). Electrophoretic separation of urinary LDH isozymes was performed according to Vesell and Beamn (1957). The results were as follows:<br>(1) Urinary LDH activity of 24 healthy adults was measured with a range from 279 to 2000 units per 8-hour volume, the average being 984 units per 8-hour volume with standard deviation of 436. The upper limit of normal was considered to be 2000 units per 8-hour volume. Addition of red blood cells resulted in the elevation of LDH activity, but the effect was negligible, when the amount of red blood cells was minimal such as the degree of hematuria remained microscopic. The activity showed a sgnificant elevation in heavily infected urine. Following urological instrumentation the urinary LDH activity was elevated for 4 days, which gradually subsided thereafter.<br>(2) Fourteen (82.4%) of 17 patients with urinary tract maligncy showed an elevation of urinary LDH activity, whereas in 5 (22.7%) of 22 patients with benign urological disorders a slight elevation of urinary LDH activity was observed. In patients with bladder carcinoma on whom surgical removal had been underwent, reccurence was accompanied with elevation of urinary LDH activity.<br>(3) Electrophoretic scparation of urinary LDH isozymes revealed a suggestive distribution of patterns.<br>(4) No correlation was observed between the urinary LDH activity and the serum LDH activity.<br>In conclusion, determination of urinary LDH activity may be of value as a screening test for malignat neoplasm of the urinary tract. The course of urinary tract malignancy should be followed by repeated determinations of urinary LDH activity. Electrophoretic separtion of the isozymes will afford an accurate information concerning LDH pattern changes.

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