J.Jpn. Surg. Soc.. 59(8): 1257-1289, 1958
CHEMIAL INVESTIGATION OF PLEURAL FLUIDS AFTER PULMONARY RESECTION FOR TUBERCULOSIS.
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Department of Biochemistry, Tokyo University School of Medicine (Director: Prof. K. Kodama) Isao SHIBUYA |
1. The pleural effusion after pulmonary resection resembled to the other inflammatory pleural fluid regarding their chemical properties.
2. Ratio of total protein content of sero-sangineous pleural fluid to serum protein of the patient was the highest in early period after operation, and become lower with passage of time. There was no significant difference in early period after operation among ratios of the individual protein fractions of pleural fluid to thos of serum, nevertheless appreciable difference became to appear later when regional influence of surgical intervention was going out. This difference was related to magnitude of molecules of protein fractions and might be caused by moving of serum protein fraction into pleural fluid mainly through blood capillary wall. The appearance of serum protein into pleural cavity occurred in the order of albumin, α-globulin, γ-globulin and β-globulin.
3. Once suppuration occurred in the pleural cavity, total protein and γ-globulin of fluid increased, on the other hand albumin and fibrinogen of fluid decreased. The increase of total protein and γ-globulin were based on increased moving of serum protein through acceleration of capillary permeablility, liberation of interior protein of destroyed cell in the pleural fluid, and concentration of fluid in consequence of delay of pleural absorption. The decreases of albumnin and fibrinogen were caused by proteolysis which occurred in presence of proteinase in fluid.
4. Non-protein nitrogens of pleural fluid were in serosanginous ftind about on the same level with those of blood serum but their content was increased in suppurative fluid and consequently became higher than in serum. The increase of non-protein nitrogen of pleural fluid was ascribed mosty to increase of amino acid nitrogen which was brought abont through proteolysis of albumin.
5. Values of pleural fluid sugar were as great as those of correspondent blood sugar. This equality of both sugar values of body fluids might be attributable to free diffusibility of glucose through blood capillary wall.
6. Ratio of total cholesterin of serous pleural exudate to that of serum showed .approximate number of ratio in α- and β-globulin of both fluids. This similarity ot both ratio could be explained on the basis of the fact that cholesterin was contained in serum as larger complex particle as lipoprotein combined with α- and β-globulin.
7. Concentration of chlorides in pleural fluid was higher than that in serum. On the c ontrary, that of sodium in pleural fluid tendet to be lower than that in serum.
8. Pottasium content of pleural fluid was greater than that of serum in general.
9. Calcium content of pleural exudate in general was lower than that of serum. When suppurative process was broken out, fluid calcium value fell still lower. This phenomenon was presumably due to change of content and fractional composition of fluid protein.
10. It was suggested that Gibbs Donnan's law was allowed between chloride-and sodium ion of serous pleural fluid and those of serum.
11. Amonnt of inoganic phosphate of pleural serosanginous fluid was less than that of serum.
12. Activity of alkaline phosphatase of pleural serous exudate was lower than that of normal serum. On the other hand activity of acid phosphatase was higher in sanginous fluid than normal serum value.
13. Distinction in chemical properties between pleural fluid after pulmonary resection and other pathological conditions consisted in their particular feature of amount and composition of protein in early period of their developmeut after operation.
(author's abstract)
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