J. Stanton King

Present concepts concerning the origin of matrix and stones.

Urinary concretions have a relationship to a variety of metabolic, endocrinologic, cancerous, infectious, degenerative, toxic, and nutritional diseases. Calculi exhibit considerable variation in crystalline composition, in rate of growth, and in relative content of inorganic and organic material, not only from patient to patient but from center to surface in the same calculus. Occuring a priori within the urine, many physical chemical factors contribute to the growth of concretions. This does not exclude the existence of a primary mechanism essential to the initiation of calculus formation and common to the ninety-two per cent of calculi that are calcigerous, if not to all urinary concretions. Indeed, the failure of calculi to develop in a large proportion of patients with hyper-crystalluria, renal infections, hyperparathyroidism, and all other “predisposing” diseases strongly suggests the presence of an initiating mechanism more definitive than chance agglomeration of urinary solids. Technological and theoretical advances in the past two decades have permitted extensive investigation of urinary calculi and of related abnormalities of the urine and the urinary system. The identification, frequency distribution, and common admixture of crystalline components of calculi were estab1ished.l A mucoid matrix was demonstrated in all calculi? and the urine was found to contain increased quantities of mucosubstances during calculous formation in both man3 and animals.4 The calcium binding properties of urinary mucosubstances were studies.6. Interrelations of matrix and crystalline components suggested. that the former served an architectonic function in calculous growth.’0 A published symposiume and a reviewlo by Boshamer served to assemble the existing knowledge in this field and to stimulate interest in the basic mechanisms of calculus formation.

Analysis of renal calculous matrix compared with some other matrix materials and with uromucoid.

Abstract Matrices recovered from pooled specimens of renal calculi, gall stones, and bone have been analyzed. The various matrices are clearly not identical in their over-all molecular composition. A urinary mucoprotein, uromucoid, is analytically more similar to renal calculons matrix than is matrix of other sorts examined.

OBSERVATIONS ON THE NINHYDRIN-POSITIVE SUBSTANCES IN HUMAN URINE.

Abstract The usefulness and routine capabilities of a commercially available semiautomatic amino acid analyzer in the study of the ninhydrin-positive components of urine are described. Some eighty such components can be demonstrated in a 0.001 aliquot of normal adult 24-h urine. The elution behavior of some known compounds with this apparatus is illustrated.

IMMUNOLOGICAL STUDIES ON SERUM AND URINARY PROTEINS IN UROLITH MATRIX IN MAN

Better and more convenient methods have been developed in the past decade for the resolution, detection, and relatively specific identification of substances capable of giving precipitin reactions with their specific antibodie~.’-~ Such techniques, applied to normal urine, have revealed the variety of its macromolecular constitution (TABLE 1) .38 5 4 It should also be remembered that an unknown number of colloidal constituents of urine, especially the polysaccharides, do not cause the production of precipitating antibodies.l0 Such substances therefore are not susceptible to demonstration by these techniques. Those substances in urine that are listed in TABLE 1 as common to both urine and blood have generally been found to be immunologically identical to their serum counterparts. Not surprisingly, the serum proteins normally missing from the urine are those having the largest molecular dimensions. TABLE 1also indicates a number of antigens in urine that have no serum counterpart and that must in each case reflect one of three situations: (I) the concentration in plasma is below the limits of detection, (2) origin is in the genitourinary tract itself, or (3) some antigenically distinct material has arisen from a serum precusor as a result of, e.g., the action of bacterial or urinary enzymes. There is no evidence for the last of these alternatives and some evidence against it.’, 9 The other two possibilities will require special techniques to distinguish which is the correct one for a given antigen. Clearly, many different macromolecules are present, even in normal urine, which could contribute adventitiously to the organic portion of renal and bladder calculi. In the preceding paper,” some of the immunoelectrophoretic studies of Keutel and his associates12 were summarized

Acid mucopolysaccharides in normal urine

Abstract Evidence is presented for a glucosamine-containing acid mucopolysaccharide in normal urine. It comprises a minor part of the total acid mucopolysaccharide, which amounts to about 8 mg/day, in terms of glucuronic acid. The acid muco-polysaccharides were separated into three ranges of particle sizes.

Total nondialyzable solids in human urine. XI. Chemical analysis of purified normal uromucoid.

Abstract A detailed chemical analysis of uromucoid is reported. Except for a smaller percentage of sialic acid, the data available for comparison indicate the identity of uromucoid and the urinary mucoprotein of Tamm and Horsfall.

TOTAL NONDIALYZABLE SOLIDS (TNDS) IN HUMAN URINE V. SUBFRACTIONATION OF THE ULTRAFILTRATE (UF-O) FRACTION *

A procedure has been reported (1) for the re-producible separation of the total nondialyzable solids (TNDS) of normal human urine into three primary fractions. The most abundant of the -three fractions, designated UF-O, was separated from the other two by virtue of its passage through a collodion ultrafilter membrane. The overall chemical composition of fraction UF-O was described, but no further information was then available. Accordinigly, we have devised a procedure for the separation of this material into subfractions. While these subfractions appear to be cleanly separated, they are all probably mixtures of various chemical compounds. The method yields consistent results and therefore seems to be a useful tool for the study of possible changes in physiological and pathological conditions, and as an intermediate step in the ultimate separation of the components of UF-O. This report describes the procedure for the subfractionation of the UF-O and the results obtained with it, including the range of normal daily variation in the excretion of the subfractions and their overall chemical composition. Some perti

Uromucoid content of urine of newborns and infants

Abstract Newborns excrete exceedingly little uromucoid in the urine. During the first months the excretion rate increases until it is comparable to that of adults. The total colloid excretion, as well as the subfraction containing the serum-identical proteins, has been measured for newborns and infants.