Grases F, Costa-Bauzá A, Conte A
Dept. Chemistry, Univ. Balearic Islands, Palma de Mallorca, Spain.
Scanning Microsc. 1993 Sep;7(3):1067-73; discussion 1073-4.
A scanning electron microscopy study of the ultrastructure of 18 calcium oxalate monohydrate papillary calculi was performed with the purpose of establishing the main steps in calculus formation. It is concluded that these calculi originate in a "core" located near the central part of the calculus. Significant quantities of organic matter as well as calcium phosphates can be found in the "core" and at the surface of adhesion to the papilla and, in some cases, fibers and calcified tubules can also be found in the contact zone. In no case did this material affect the crystalline structure of the calculi, indicating that its formation follows the calculus genesis. The study of the compact columnar zone revealed that its formation starts in a practically continuous surface formed by organic matter and crystals that surround the core. This layer favors the growth of oriented calcium oxalate monohydrate crystals upon it. Based on these observations, a feasible mechanism of papillary calcium oxalate monohydrate calculus formation is proposed.
为了确定结石形成的主要步骤，对18颗一水草酸钙乳头结石的超微结构进行了扫描电子显微镜研究。得出的结论是，这些结石起源于位于结石中心附近的“核心”。在“核心”以及与乳头粘连的表面可以发现大量有机物和磷酸钙，在某些情况下，在接触区域还可以发现纤维和钙化小管。这种物质在任何情况下都不会影响结石的晶体结构，表明其形成遵循结石的发生过程。对致密柱状区的研究表明，其形成始于由围绕核心的有机物和晶体形成的几乎连续的表面。这一层有利于一水草酸钙定向晶体在其上生长。基于这些观察结果，提出了一种可行的乳头一水草酸钙结石形成机制。
