J.Jpn. Surg. Soc.. 58(1): 111-130, 1957

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STUDIES ON ACETYLCHOLINE-LIKE SUBSTANCE PRESENTING IN THE CENTRAL NERVOUS SYSTEM DURING ILEUS

The present report summarizes results of investigations, carried out in the Matsukura Department of Surgery as a part of researches on the cause of death in ileus, with particular reference to the fluctuation of an acetylcholine-like substance found in the central nervous tissues of the brain and spinal cord during ileus. The effects of vagotomy and of the administration of autonomic nerve blocking agents on the variation of such a substance have been determined. For the purpose of ascertaining if an acetylcholinelike substance is actually shed into the cerebrospinal fluid during ileus, a careful study was made of the changes in the amount of this substance in the serum. The results obtained may be summarized as follows :
1. (1) Under normal conditions the acetylcholine-like substance of the brain shows the highest value in the thalamus with the maximum of 3.2γ/g and the minimum of 2.3 γ/g (average 2.75 γ/g), followed in the order of the medulla (max. 2.6 γ/g, min. 1.6 γ/g with average of 2.1 γ/g), and the cerebrum (max. 1.7 γ/g, min. 1.0 γ/g, with average of 1.2 γ/g).
(2) However, during ileus the acetylcholine-like substance is remarkably reduced in every part of the central nervou. system in proportion to the severity of the symptom, so that at the time of death the content is only-78.2% in the thalamus,-76.2% in the medulla, and-67.7% in th cerebrum.
2. (1) In the central nervous tissue of the spinal cord in normal subjects the content of the acetylcholine-like substance gives the highest value in the lumbar cord max. 3.0 γ/g, min. 2.4 γ/g, with average of 2.8 γ/g), followed in the order of the cervical cord (max. 1.25 γ/g, min. 1.0 γ/g, averag 1.1 γ/g), and the thoracic cord (max. 0.9 γ/g, min. 0.4 γ/g, average 0.7 γ/g).
(2) On the other hand, in patients with ileus these levels are greatly diminished in every part of the spinal cord tissue, so that at the time of death the values are -42.9% in the thoracic, -45.5% in the cervical and -57.6% in the lumbar cord.
In short, it is evident that during ileus the level of the acetylonoline-like substance is markedly depressed in every part of the central nervous system of the brain and cord in association with the progr ss of th disease.
3. (1) In the ileus dogs with vagotomy on both sides of the neck, the decrease in the acetylcholine-like substance of the central nevous tissue or the brain is far less in percentage than in the untreated ileus dogs, being at the time of death only -30.9% in the thalamus, -28.5% in the medulla, and -25.4% in the brain.
(2) Likewise, the ilcus dogs given autonomic nerve blocking agents show marked reduction in the amount of acetylcholine-like substance, as compared with untreated controls, the values at the time of death being -27.3% for the thalamus, -18.1% for the medulla, and -20.7% for the cerebrum.
4. (1) The amount of acetylcholine-like substance in the spinal cord tissue is greatly decreased in the ileus dogs after bilateral (vagotomy in the neck, compared with the untreated ileus dogs the values at the time of death being -23.6% in the cervical, -17.2% in the thoracic and -35.0% in the lumbar cord.
(2) In the ileus dogs after autonomic nerve blocking agents have been given, the acetylcholine-like substance in the spinal cord is reduced in concentration to a far greater percentage than the untreated controls, the values at the time of death being -22.9% in the cervical, -29.8% in the thoracic and -27.3% in the lumbar cord.
These results indicate that the changes in the concentration of the acetylcholine-like substance in the central nervous tissues of the brain and cord can be effectively circumvented by either vagotomy or administration of the autonomic nerve blocking agents.
5. (1) The acetylcholine-like substance of the serum is markedly increased during the course of ileus, reaching the level of 1 γ/cc within 12 hours after the attack.
(2) During ileus the changes in the concentration of the acetylcholine-like substance in the cerebrospinal fluid comparable to those in serum can not be demonstrated.
This fact suggest that the acetylcholine-like substance present in the central nervous tissues of the brain and cord, which is markedly decreased during ileus, is chiefly transferred into the blood stream.
(author's abstract)

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