J.Jpn. Surg. Soc.. 58(1): 90-110, 1957
STUDY ON HYDRO-ELECTROLYTE-METABOLISM IN CASE OF “ILEUS”
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Surgery Research Lab. of Prof. Matsukura, Nihon Medical School Yoshio ASAKURA |
And as the results of the special research of electrolytes in the clearance process, the following conclusions were obtained :
1) The volume of renal blood, plasma in renal blood and filtering-value of the glomer ulus were remarkably decreased in case of ileus. But, the reduction of current volume of renal blood was more noticiable than the one of filtering-value of the glomerulus. Thus, the filtering-value had the upward tendency, in accordance with the progressive symptom of ileus and the reduction of total volume of water in a body and liquid of cell, interior were cheched.
2) The water volume of body and liquid volume of cell, interior and exterior were all remarkably reduced in the case of ileus. But the reduction of liquid volume of cell, interior was more noticiable than the one of liquid volume of cell, exterior. But, by dose of glucose solution, the reduction of liquid volume of cell, interior was checked. Further, by dose of Ringer's solution, the reduction of cell, exterior's was checked.
3) Na and Cl elements in serum were reduced in accordanc with a progressive symptom of ileus. But K-element in serum was gradually increased. Further, the fluctuation tendency of these electrolytes, Na and Cl plus K were recognized approxmately and equally secreted in urine. But compared to case of serum, these trends were more rapidly and remarkably appeared in urine. Na and Cl elements in urine were gradually reduced but Na-element was decreased more quickly than Cl-element in urine. Further, Na and Cl clearances were gradually decreased through Na-Cl-Electrolyte-Clearence-Tests. But the re-absorption-rates were increased. The re-absorption-rates of Na and Cl elements were approximately and equally increased. Compared to the re-absorption rate of water, both the Na and Cl-re-absorption-rates were equally lower. Against these tendencies or phenomena, clearance of K-element and re-absorprion rate of K were both decreaed.
4) The fluctuations of hydro-electrolytes caused by dose of “ATONIN”, an antidiuretic were increased through Na and Cl clearance test and both re-absorption-rates were approxmately and equally increased. But compared to the re-absorption-rate of water, these Na and Cl re-absorption rates were both lower. Against these facts, K-element fluctuation was not recognized. That is, the fluctuation of Na and Cl elements caused by “ATONIN” were well accorded. with the ones of Na and Cl clearances in the case of ileus.
5) By dose of acetylcholine, the increase of K-element in serum was recognized but slight K-increase was appeared through K-clearance test. Besides, K-re-absorption-rate was remarkably decreased. These facts were well accorded with the case of ileus so far as concern K-elements fluctuat ions .
6) Na and Cl elements in serum were remarkably decreased and K-element inserum was gradually increased in accordance with progressive course of ileus. By dose of “CORTISONE”, there was no definite sign of these fluctuations of electrolytes. But, by dose of “DOCA”, the fluctuations of these electrolytes were intermittently well checked. The above-mentioned facts, as Professor Matsukura has already published, verifying the radid decrease of chemo-corticoid in urine, were considered as the remarkable interference of secretion of mineral corticoid among of all adrenal cortex hormones. By demonstration of the dog which has been enucleated her adreanal glands, Na and Cl elements in serum were gradually decreased but the increase of Kelement in serum was recognized. And Na, Cl andkclearances were all increased through clearance tests. But re-absorption-rates of Na and Cl elements were decreased and the one of K-element was increased. Under these conditions, the filtering-value of the glomerulus was almost constant. The re-absorption-rate of water was rapidly decreased and the volume of urine was noticiably increased. As the final conclusion of the above mentioned facts at case of ileus, the volume of renal blood and glomerulu filtering value were remarkably decreased. Further, total volume of water in a body, liquid of cell, interior and exterior were all decreased. These facts naturally leaded to the remarkable change of the distribution of total volume of water and electrolytes in a living body. The causes of these fluctuations of hydroelctrolytes at case of ileus were infered as the fluctuations and increase of acctylcholine which naturally leaded to the fluctuations of an effective substance viz. serum-anti-diuretic in the blood current at the case of ileus, and the variations of disorder of adrenal cortex functions at the time of ileus shock, in addition to abnormal distribution of water by physical force.
(author's abstract)
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