J.Jpn. Surg. Soc.. 54(1): 24-37, 1953
Original article
SOME CLINICAL STUDIES ON THE FUNCTION OF ADRENAL CORTEX
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II. Surgical Department, Tokyo University Medical School. (Directer: Prof. T. FUKUDA) Tadashi SAITO |
Every such patient had lower blood pressure, excreted less 17 Ketosteroid(17KS) than normal and tended to fall into shock or easily accompanied by complication in his clinical course. Eosinophile response by operative stress was in small scale.
2) Urinary excretion of 17KS was proportional to caloric intake per Kg. body weight preoperatively.
3) The reserve of adrenal cortex recovered to the preoperative level by the 3rd or 4th day after operation.
4) Urinary 17KS excretion increased greatly after major operation and showed peak at the day of operation or the 2nd-3rd day, then decreased to the preoperative level and recovered or suppressed at the 7-10th day after operation.
Urinary 17KS of the patient whose function of the pituitary adrenocortical system was insufficient remained low as was preoperatively.
5) Increase of urinary 17KS after operation was proportional to the intensity of stress (blood loss and duration of operation).
6) When the circulating blood volume decreased after operation, 17KS excretion increased. and by the time the former recovered to the normal level the latter again returned to the preoperative level.
7) When nitorgen excretion increased after operation, urinary 17KS was excreted greatly. In convalescence, when nitrogen intake increased, 17KS excretion correlated it.
8) Primary cummulative balance of water during 7 days after operation was proportional to the total sum of urinary 17KS during the same term. Patient who excreted little 17KS could hardly maintain water balance and tended to negative at about the 7th day after operation when diuresis appears.
9) Total of urinary sodium excretion during 7 days after operation was inversely proporional to the sum of urinary 17KS excreted during the same term.
10) Patients who were given ACE for 3-7 days before operation increased their extracellular fluid volume and urinary 17KS in excretion both before and after operation. In the case of insufficiency of the pituitary-adrenocortical system, the eosinophile response test was improved, urinary excretion of 17KS was increased, and operation and their clinical course was without complication.
When DOCA was given, extracellular fluid volume was increased and urinary sodium and chlorine excretion was greatly reduced.
When testosterone was used, water soluble protein, water of liver and urinary excretion of 17KS was increased, but after operation urinary 17KS remained little.
(author's abstract)
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