HARRY SENECA, M.D., F.A.C.P.; JOHN K. LATTIMER, M.D., F.A.C.S.; HANS H. ZINSSER, M.D.
Beginning with the premise that magnesium ammonium phosphate stones formed in the urinary tract were primarily the result of the enzymatic urea-splitting capacities of some types of urinary tract pathogens, both Gram-positive and Gram-negative, the possibilities of blocking this enzyme were explored by Walberg from 1951 to 1956.1 The kinetics and characteristics of some of the bacterial urea-splitting enzymes were elucidated, and several potent inhibitors were described.1 Shortly after this approach was applied clinically, it was found that the capacity of chlormerodrin to change the urinary pH to the acid side resulted in considerable dissolution of struvite stones within
SENECA H, LATTIMER JK, ZINSSER HH. THE CHEMOTHERAPY OF UREASE- AND CITRASE- PRODUCING BACTERIA OF THE URINARY TRACT1. Ann Intern Med. ;53:468–474. doi: 10.7326/0003-4819-53-3-468
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Published: Ann Intern Med. 1960;53(3):468-474.
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