Nihon Naika Gakkai Zasshi
Online ISSN : 1883-2083
Print ISSN : 0021-5384
ISSN-L : 0021-5384
Volume 46 , Issue 9
Showing 1-17 articles out of 17 articles from the selected issue
  • Joji Kawamoto
    1957 Volume 46 Issue 9 Pages 981-992
    Published: December 10, 1957
    Released: February 22, 2011
    JOURNALS FREE ACCESS
    To investigate the effects of diuretics and hypotensive drugs on renal circulation and metabolism, renal venous catheterization was performed in 6 normal subjects and 21 patients with hypertension and renal diseases, and renal oxygen consumption (O2 Cons.), renal glucose (US.G), lactate (US.L) and pyruvate usage (US.P), renal excretion of electrolytes (sodium and potassium) and renal venous pressure (RVP) as well as renal blood flow (RBF) and glomerular filtration rate (GFR) were observed before and after the administration of theophylline, mercurial diuretic, carbonic anhydrase inhibitor, hydralazine, ganglionic blocker and reserpine.
    The results were as follows.
    (1) After the intravenous administration of Neophyllin (theophylline ethylenediamine) RBF and GFR were slightly increased, tubular reabsorption of water (TRW) was decreased and RVP was found to be lowered. O2 Cons. and US.G were observed to have a tendency to increase.
    It is presumed that the diuretic effect of theophylline is consequent to both the improvement of renal circulation and the direct action on renal tubules, and that the latter mechanism is referable to the increase of O2 Cons. and US.G.
    (2) During diuresis after the administration of Igrosin (a mercurial diuretic) RBF and GFR were slightly decreased, TRW lowered, and renal arterio-venous oxygen difference and O2 Cons. were found to be increased remarkably.
    It would seem that the mercurial diuresis is due to the direct action on renal tubules and is associated with the increase of oxygen consumption.
    (3) In marked diuresis after Diamox RBF and GFR were observed to have a tendency to decrease, O2 Cons. to decrease, US.L to increase and excretion of sodium and potassium to increase markedly.
    It is considered that the diuretic effect of carbonic anhydrase inhibitor is the result of increased renal excretion of sodium and potassium, and is not accompanied by increased oxygen consumption.
    (4) No consistent correlations were found between the diuretic effects of studied diuretics and O2 Cons., US.G, US.L and US.P. This is considered to be due to differences in the action on renal circulation and renal tubular enzymatic systems.
    (5) During reduction of blood pressure due to Apersoline, RBF was increased remarkably, filtration fraction and renal vascular resistance (RVR) lowered, and RVP was found to rise. These data suggest that Apresoline acts directly on renal vascular system. GFR, TRW, urine volume, renal extraction of PAH, O2 Cons., US.L and US.P did not change markedly, in spite of increase of RBF.
    (6) During reduced blood pressure due to Ansolysen RVP was found to fall, and RBF, urine volume, sodium excretion and O2 Cons. decreased.
    (7) During lowered blood pressure induced by Serpasil RBF, GFR and urine volume did not change significantly, RVR fell slightly, and O2 Cons. and US.G were observed to have a tendency to increase.
    (8) No consistent tendencies were found under the effects of hypotensive drugs studied here on renal circulation and metabolism. It is suggested, however, that the reactions of kidney to Apresoline and Serpasil are in the direction of reducing the influence of lowered blood pressure. On the other hand, the action of ganglionic blocker seems to block such an autonomic mechanism of kidney.
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  • Takashi Nakamura, Shozo Nakamura, Kanae Sugawara, Yoshiaki Katakura, T ...
    1957 Volume 46 Issue 9 Pages 993-999
    Published: December 10, 1957
    Released: February 22, 2011
    JOURNALS FREE ACCESS
    1. Liver biopsy, liver function tests, and nutritional investigation were carried out in 14 alcoholics. Those who entered the hospital with the complaints of liver diseases were excluded. Both fatty metamorphosis and fibrosis were observed in two cases, fatty metamorphosis in two, and fibrosis in one. Focal necrosis was noticed in two cases, and cellular infiltration in stroma in three.
    2. Bromsulphalein test was abnormal in 38% of the alcoholics and in 6.3% of the controls. The difference was statistically significant. There was no statistically significant differences of incidences of abnormal values in icterus index, thymol turbidity test, thymol flocculation test, cephalin cholesterol flocculation test, Grcs's test, and urine urobilinogen between the alcoholics and the controls.
    3. The intakes of protein and carbohydrate in the alcoholics were decreased and total caloric intake including calories of alcohol was increased as compared with those in the controls.
    4. With regard to the relation between histological changes and alcoholic intake, all the cases who showed fatty metamorphosis or fibrosis had the history of drinking 6.5 go or more Sake daily for 10 years or more and their protein intake was less than 55g, and none of those who did not show fatty metamorphosis drank to such a degree. The more daily alcoholic intake and the less protein intake, the more frequently fatty metamorphosis or fibrosis observed.
    Bromsulphalein test was well correlated with histological changes.
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  • Yoshiyasu Hasegawa
    1957 Volume 46 Issue 9 Pages 1000-1007
    Published: December 10, 1957
    Released: February 22, 2011
    JOURNALS FREE ACCESS
    Experiment was carried out to explain the mechanism of cobalt polycythemia by using the bone marrow cell culture of the rabbit at 37 degree C.
    By adding ccbaltous chloride to the bone marrow culture, no direct increase of the erythrocytes, reticulocytes, and hemoglobin concentration was observed, however by the formation of methemoglobin in the hemoglobin of the bone marrow cell, an action takes place to inactivate the hemoglobin. This action is due to interference of the enzymatic reduction system of the bone marrow cell, impeding the transport of oxygen, resulting in anoxia of the bone marrow.
    Hematopoietic effect of cobalt is due chiefly to tissue anoxia of the organ. This was observed from its distribution in the body after administration of cobalt. On the other hand anoxia of the bone marrow cell and peripheral blood is also considered to be a contributive factor.
    In vitro the methemoglobin formation of cobalt was observed as same as in rabbit in non-responsive patients to cobalt, however, clinically the cobalt had no effect to these patients due to the lack of hematopoietic ability.
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  • Shigenari Yasukawa
    1957 Volume 46 Issue 9 Pages 1008-1019
    Published: December 10, 1957
    Released: February 22, 2011
    JOURNALS FREE ACCESS
    The Studies on pulmonary arterial pressure were made by the pulmonary arterial catheterization on 53 patients with chronic pulmonary emphysema, and the following results were obtained.
    1) The pulmonary arterial mean pressures of these patients were 9-66mmHg, the pulmonary arterial systolic pressures 9-121mmHg, the pulmonary arterial diastolic pressures 0-36mmHg.
    The fluctuation of the pulmonary arterial pressure by respiration was in the rarge of 0-20mmHg in systole and 0-25mmHg in diastole and was marked in the patients with high total pulmonary vascular resistance.
    No significant relation between the age of the patients and level of pulmonary arterial pressure was recognized.
    2) Many patients with high pulmonary arterial pressure had high ratioes of residual volume and dead space ventilation. However, the patients with high ratioes of residual volume and dead space ventilation had not high pulmonary arterial pressure.
    3) The relationships of the haematocrit, the O2 saturation and the CO2 pressure of the arterial blood with the pulmonary arterial pressure were nearly same as the reports of many other authors.
    The pulmonary arterial pressures increased during low O2 inhalation and decreased during high O2 inhalation.
    4) During the low O2 inhalation the elevated pulmonary and systemic arterial pressures were decreased by the injection of C6 and then the total pulmonary vascular resistances resulted in decrease hand in hand. From these results, it is considered that the autonomic nervous system would be concerned with the rise of pulmonary arterial pressure during low O2 inhalation.
    5) The degree of the elevation of the pulmonary arterial pressure compared with the decrease of the arterial blood O2 saturation were greater during exercise than during low O2 inhalation.
    The elevation of the pulmonary arterial pressure during exercise may be not only due to the influence of the low O2 saturation of the arterial blood, but also due to the increased pulmonary blood flow by exercise.
    6) The patients with pulmonary hypertension have not always systemic hypertension, and the patients with systemic hypertension have not always pulmonary hypertension.
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  • Ryuzaburo Iwata
    1957 Volume 46 Issue 9 Pages 1020-1037
    Published: December 10, 1957
    Released: February 22, 2011
    JOURNALS FREE ACCESS
    A 2.5-3.5% solution of PVP is a plasma expander while its 20-30% solution is said to prolong the effect of medicinals.
    In animal and clinical experiments, 20-25% PVP solution was administered, alone or mixed with various pharmaceutics, by subcutaneous, intramuscular, or intravenous injection. It was thereby learned that PVP possessed the action of prolonging the effect of pharmaceutics and some experiments were carried out to find the action mechanism of PVP in prolonging the effect. The results obtained were as follows:
    (1) When PVP was administered as a mixture with insuline, penicillin, or hexamethonium chloride (subcutaneous, intramuscular, or intravenous injection), prolongation of pharmaceutical effect was clearly observed but when PVP and the same pharmaceutics were administered separately (PVP by intravenous injection, ph rmaceutics by subcutaneous or intramuscular injection), prolongation of the effect was not so distinct.
    (2) When 131I was dissolved in PVP and injected into the peritonium or into the muscles of a guinea pig, 131I was found to collect in the thyroid gland twice as much as when 131I was injected alone. This result suggests the use of such a method for the treatment of hyperthyroidism. Detailed result of this experiment will be reported in a forthcoming paper.
    (3) Effect of PVP on kidney functions was examined. Since the intravenous administration of PVP effects decreases both clearance and G. F. R., it is considered that PVP becomes a vehicle for pharmaceutics in the blood and thereby causes the prolongation effect.
    (4) Radioactivity at the site of injection of a mixture of 131I and PVP and that of 131I alone were measured and it was found that there was more radioactivity at the site of the injection of a mixture. This seems to suggest that PVP retards (suppresses) the absorption of pharmaceutics at the site of injection.
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  • Kunisaburo Takamatsu
    1957 Volume 46 Issue 9 Pages 1038-1048
    Published: December 10, 1957
    Released: February 22, 2011
    JOURNALS FREE ACCESS
    As mentioned in the first report, it was Cysteine to show the most remarkable action according to the effect of mobilization about several substances to be considered to hold the blood cells increasing action.
    Now, I guess the leucocyte increasing (promoting) action of cysteine would relate with existence of the main reaction radical (-SH) and the side reaction radical (-NH2) in view of characteristics of the molecular structure and the reaction radical. In consideration that Thiol B1 (B1SH) and Penicillamine under the form of open ring of Thiamine and Penicilline combine with SH radical and NH2 radical in the similar orthotropic relationship with Cysteine, I made each of them for the purpose of investigating the above-mentioned fact and compared with the original forms by administering the fixed quantities of them to the healthy rabbits. As a result, B1SH and Penicillamine demonstrated the effect of mobilization more remarkably than that of Thiamine and Penicilline.
    Namely, it seems that existence of SH and NH2 radicals in the molecular structure and configuration relationship for the molecular structure have the important significance for demonstrating the leucocyte increasing action of the said substance and Cysteine
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  • Hirobumi Ushiyama
    1957 Volume 46 Issue 9 Pages 1049-1059
    Published: December 10, 1957
    Released: February 22, 2011
    JOURNALS FREE ACCESS
    On the various diseases with ascites, the transfer rate of albumin was investigated by using radio iodinated human serum albumin (IHSA), following the intravenous and intraperitoneal injection. The results obtained were as follows:
    (1) The turnover rate of albumin following intravenously injected IHSA was decreased in patients with ascites. It's rate and albumin pool in tuberculous peritonitis and carcinomatous peritonitis were greater than those in cirrhosis of the liver and Banti's syndrome.
    (2) The disappearance rate from the plasma following intravenously injected IHSA was increased in patients with ascites.
    (3) The transfer rate of albumin in patients with ascites showed the value of 0.591g per hour in cirrhosis of the liver and Banti's syndrome, and 1.7g per hour in tuberculous peritonitis and carcinomatous peritonitis with intravenously injected IHSA. It's rate of intraperitoneally injected IHSA was 0.341g per hour in cirrhosis of the liver and 0.816g per hour in carcinomatous peritonitis.
    (4) The transfer rate of albumin into the ascites was parallel to the clinical course of cirrhosis of the liver and it's rate was decreased and the turnover rate of albumin increased according to the clinical remission following intravenously injected IHSA.
    (5) The disappearance rate from the plasma of intravenously injected IHSA was decreased and the excretion of I131 increased in the cases which had showed the significant effect with mercurial diuretic.
    (6) The transfer rate of albumin was decreased after abdominocentesis following intravenously and intraperitoneally injected IHSA.
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  • Yutaro Takamura
    1957 Volume 46 Issue 9 Pages 1060-1079
    Published: December 10, 1957
    Released: February 22, 2011
    JOURNALS FREE ACCESS
    Studing on the relationship between Glucose (G) and potassium (K) metabolism of liver in normal subjects, hepatitis and cirrhosis etc., following results were obtained.
    1) In cases with liver disease, fasting arterial plasma potassium level (PKA) was somewhat lower than in normal subjects.
    2) In fasting state, hepatic mobilization of G and K was admitted in control subjects, but in hepatitis and cirrhosis, to less degree. Significant correlation was observed between the amount of G mobilized from liver and that of K.
    3) After intravenous injection of glucose (0.5gm per Kg), hepatic uptake of G and K occured, resulting in arterial blood sugar (GA) fall and PKA decrease in normal subjects, but the effect was lesser in hepatitis and cirrhosis. The rate of GA fall was significantly correlated with the decrease of PKA. Furthermore GA fall and PKA decrease seemed to be proportional with the grade of hepatic G and K uptake respectively.
    4) After intravenous injection of insulin (0.1unit per Kg), hepatic uptake of K and reduction of hepatic G mobilization occured, resulting in the decrease of GA and PKA in normal subjects, but the effect was lesser in hepatitis and cirrhosis. Significant correlation was observed between the decrease of GA and that of PKA. Furthermore the decrease of GA and PKA seemed to be proportional with the grade of reduction of hepatic G mobilization and the grade of hepatic K uptake respectively.
    5) Subcutaneous injection of adrenaline (0.01mg per kg) in normal subjects, caused GA increase and PKA decrease simultaneously, but had a lesser effect in cirrhosis. There was no close relationship between GA increase and PKA decrease, and for PKA decrease, apparent hepatic uptake of K was not observed. Intravenous rapid injection of adrenaline (0.02gm) to normal dogs, caused hepatic mobilization of G and K, resulting in the increase of GA and PKA, but had a lesser effect in dogs injured with CCl4. The increase of GA was significantly correlated with the increase of PKA. Furthermore the increase of GA and PKA seemed to be proportional with the grade of hepatic mobilization of G and K respectively. The change of K always preceded that of G.
    6) After the oral administration of KCl (5gm), slight increase of GA was observed in normal subjects, and the effect was quite similar in hepatitis and cirrhosis. After intravenous injection of KCl (20mg per kg as K), hepatic mobilization of G and K occured, resulting in the increase of GA. There was no close relationship between the increase of GA and the change of PKA, but the increase of GA seemed to be proportional with the grade of G mobilization from liver. The effect was lesser in dogs injured with CCl4, but the rate of K disappearance from arterial blood was not altered.
    7) In two cases with familial periodic paralysis, striking abnormality in G and K metabolism was observed. In them, the uptake of G and K after intravenous injection of glucose or insulin was more apparent in peripheral tissues than liver.
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  • Fujio Ikeno
    1957 Volume 46 Issue 9 Pages 1080-1089
    Published: December 10, 1957
    Released: February 22, 2011
    JOURNALS FREE ACCESS
    Myocardial potassium and sodium metabolism was studied by means of coronary sinus catheterization in the material of 58 cases in cluding 11 cases of normal control, 25 cases of congestive heart failure of valvular or hypertensive origin, 6 cases of hypertension, 6 cases of coronary sclerosis, 5 cases of hyperthyroidism, 4 cases of anemia and 1 case of beri-beri.
    In addition, the relationship between plasma potassium concentration and digitalis tolerance was investigated in 27 cases of congestive heart failure under digitalis maintenance.
    1) In the resting condition, no significant coronary arteriovenous potassium or sodium difference was observed in the group of congestive heart failure as well as in normal subjects. In two of six cases of congestive heart failure, the potassium leakage was noted upon excercise load. Some discussions were made in this regard with reference to the pertinent literature.
    2) The obvious trend of potassium leakage due to exercise load was noted among cases of hyperthyroidism.
    3) The above-mentioned finding of potassium loss was similar to what was observed in cases of hypertension following the injection of adrenalin. Some discussions were given about these points.
    4) In one case of advanced coronary sclerosis, the exercise load resulted in the massive loss of myocardial potassium, whereas in another in which the hypoxic load provoked the anginal attack, the potassium intake was observed unexpectedly. The discussions were also made concerning these apparently conflicting findings.
    5) Cardiac glycosides produced no definite effects upon myocardial potassium or sodium balance in cases of congestive failure.
    6) As to theophylline-ethylendiamine, also ro specific action was noted regarding myocardial potassium or sodium metabolism.
    7) In one case of beri-beri, myocardial uptake of potassium, simultaneous with the clinical improvement, was noted following the injection of large dose of thiamine.
    8) The correlation between plasma potassium concentration and digitalis tolerance was demonstrated in the group of congestive heart failure
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  • Takeshi Kimura, Minoru Ota, Ryuichi Korekawa, Makoto Tobai
    1957 Volume 46 Issue 9 Pages 1090-1096
    Published: December 10, 1957
    Released: February 22, 2011
    JOURNALS FREE ACCESS
    Normotensive and hypertensive farmers ranging from 18 to 72 years of age in rice-producing districts of Iwate-ken were examined in winter, then both total and esterified cholesterol in serum were determined.
    There was an increase in the total serum cholesterol levels with age until 59 years old, and the average cholesterol levels in hypertensive patients were higher than those in the normotensive subjects indifferently from sex distinction.
    The levels found by us were considerably low in comparison with the data reported by Keys et al. and Adlersberg et al. in U.S.A. and were similar to those by Fidanza in Southern Italy.
    In the group of advanced age, the average serum cholesterol levels in female were generally higher than that in male. The esterified and total cholesterol ratio was nearly constant from 30 to 59 years of age, but slightly higher from 18 to 29 years old and lower in the older group above sixty.
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  • Hidemasa Okumura
    1957 Volume 46 Issue 9 Pages 1097-1107
    Published: December 10, 1957
    Released: February 22, 2011
    JOURNALS FREE ACCESS
    (1) The average plasma iron level was 95 (58-139) γ/dl in eighteen healthy persons, 242 (128-635) γ/dl in fifty-seven patients with acute hepatitis, 87 (35-153) γ/dl in seventeen patients with liver cirrhos's, and 105 (47-147) γ/dl in twelve patients with obstructive jaundice.
    (2) In the patients with acute hepatitis, correlation between plasma iron level and B.SP. was found, but no correlation between plasma iron level and icterus in ex, C.C.F., cholesterol ester ratio were found.
    (3) The hypersideremia was also observed in toxic hepatitis of dog with CCl4 as well as human viral hepatitis. Granting that the mechanism of both hypersideremia is the same, the following conclusion is obtained from the several experiments, especially using the hepatic venous catheterization. The reticuloendothelial system of the whole body is functionally blocked by phagocytosis of necrotic substances, which followed the necrosis of liver cell. It may be safe to say that under such a condition a little iron released into blood can not completely be treated, so that the hypersideremia is caused.
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  • Senshi Sassa
    1957 Volume 46 Issue 9 Pages 1108-1120
    Published: December 10, 1957
    Released: February 22, 2011
    JOURNALS FREE ACCESS
    The author studies the relationship between the blood pressure and the pathological changes of the kidney in aged persons above 60 years refering to renal clearance test, retinoscopy, auto sy and biopsy findings of the kidney.
    (1) About a half of 1162 aged persons examined showed hypertension above 160mmHg in systolic pressure and above 90mmHg in diastolic pressure, and systolic hypertension increased in number with the advance of the age, and in general the blood pressure is higher in the female than in the male.
    (2) Renal clearance studies (79 cases): 1) Even among normotensive persons, fifty percent of them showed low RPF values below 350cc/min. 2) Among the hypertensives the percentage of persons with RPF below 350cc/min increased more paralleling to the diastolic pressure than to the systolic pressure. 3) Average value of FF of normotensive persons was 0.27 and that of hypertensive persons was 0.28, therefore FF values of the aged were higher than the average of essential hypertensive persons counting 0.26. 4) The death rate of the persons whose RPF abnormally decreased is far higher than that of the persons whose RPF is normal. The remainder of the life of the aged persons with decreased RPF tends to be shortened.
    (3) Retinal findings (121 cases): Almost all of the aged persons showed to some extent retinal sclerosis, but advanced retinosclerosis at the grade of IV following Keith-Wagener's classification was rare.
    (4) Autopsy findings of the kidney: The pathological findings of kidneys of aged could be classified into three types: Arteriolosclerotic nephrosclerosis, arteriosclerotic nephrosclerosis and chronic nephritis.
    (5) Kidney biopsy: The needle biopsy was performed in each of the three types mentioned above, and their histological findings were the same with that of autopsy.
    (6) It is important for the clinical management of the hypertension of the aged to classify it so far as possible into three types mentioned above and the criteria of classification should be given by clinical picture, the retincscopical findings and renal clearance tests.
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  • Toshiyuki Atsumi
    1957 Volume 46 Issue 9 Pages 1121-1136
    Published: December 10, 1957
    Released: February 22, 2011
    JOURNALS FREE ACCESS
    Coronary sinus catheterization was performed in 101 human subjects, including 23 normal subjects, 43 patients with cardiac failure, 5 patients with hypertension, 11 patients with coronary sclerosis, 8 patients with anemia, 10 patients with hyperthyroidism, and one case with beri-beri. In these subjects myocardial pyruvate and α-ketoglutarate metabolism were investig ted in the resting state. And the effects of exercise and hypoxia (10% Oxygen) were tested. The results thus obtained were as follows.
    1. Pyruvate and α-ketoglutarate was extracted in the healthy heart. In the healthy individuals, the mean arterial pyruvate concentration was 1.23±0.19mg per dl and the coronary arterio-venous pyruvate difference was 0.58±0.13mg per dl. And linear correlation between arterial pyruvate concentration (Pa) and coronary arterio-venous pyruvate difference (ΔP) was demonstrated, giving the following formula
    ΔP=0.75Pa-0.34 (1)
    As for α-ketoglutarate, it tended to increased coronary A-V difference with arterial level, although any definite correlation could not be obtained.
    2. In the moderate and severe cadiac failure, myocardial pyruvate extraction and extraction coefficient ratio were reduced, but myocardial α-ketoglutarate extraction was increased.
    3. In patients with hypertension and coronary sclerosis, myocardial pyruvate and α-ketoglutarate extraction did not differ from normal, but myocardial pyruvate extraction c efficient ratio was reduced.
    4. Myocardial pyruvate extraction and extraction coefficient ratio were reduced in patients with anemia and hyperthyroidism.
    5. In general, myocardial pyruvate metabolism in pathologic hearts was disturbed.
    6. By exercise test, both arterial pyruvate level and coronary arterio-venous difference increased according to the formula (1), whereas in pathologic hearts, this correlation was disturbed.
    7. Myocardial pyruvate and α-ketoglutarate extractions decreased by 10% oxygen hypoxia test.
    8. Metabolic disturbances due to exercise test and hypoxia test were more sensitive in pyruvate than in lactate.
    9. Finally, in one beri-beri heart, it was demonstrated the disturbances of pyruvate and α-ketoglutarate metabolism, which were improved by the intravenous injection of thiamine.
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  • Keigo Suzuki
    1957 Volume 46 Issue 9 Pages 1137-1152
    Published: December 10, 1957
    Released: February 22, 2011
    JOURNALS FREE ACCESS
    The measurement of RBF is now considered to be the most sensitive method for evaluating the renal function. However, the relation between RBF and prognosis is not yet thoroughly clarified in essential hypertension and glomerulonephritis.
    In the present studies, correlations among RBF by clearance method, other cardinal symptoms, complications and prognosis were examined in 271 patients with essential hypertension and 71 patients with glomerulonephritis.
    In essential hypertension, RBF was observed to decrease gradually and progressively with duration of hypertension, and significant changes of RBF observed after average 24.8 months in patients under no antihypertensive treatment were as follows; increased in 0, no change in 31.2%, decreased in 68.8%. In chronic glomerulonephritis, RBF showed the following changes after average 19.1 months; increased in 26.7%, no changes in 20.0%, decreased in 53.3%. However in active stage of this disease RBF showed more rapid decrease than in essential hypertension.
    Correlations between decrease of RBF and severity of retinal findings as found in essential hypertension were not observed in chronic glomerulonephritis, and it was suggested that both hypertension and renal damages were participated in the pathogenesis of retinal changes.
    In chronic glomerulonephritis the hemoglobin content of blood was found to have correlation with decrease of RBF, but there were observed no correlations between edema or proteinuria and RBF. Many cases of both diseases with severe electrocardiographic changes, showed significant decrease of RBF, however, no direct relation was observed between severity of ECG and decrease of RBF.
    In essential hypertension cerebral and cardiac complications occured in high percentage in patients with decreased RBF, but it was noted that they might sometimes occur in patients whose RBF remained in normal range. Cors quently, no direct relations were found between occurance of these complications and decrease of RBF.
    Prognosis became poor and life survival shortend with the progress of decrease of RBF in both diseases. It was further noted that the decrease of RBF predicted generally more severe prognosis in essential hypertension than in chronic glomerulonephritis, because of the fact that in the latter the most common cause of death is uremia, while in the former cerebral and cardiac complications as well as uremia may be common cause of death
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  • Yukimasa Takeuchi
    1957 Volume 46 Issue 9 Pages 1153-1164
    Published: December 10, 1957
    Released: February 22, 2011
    JOURNALS FREE ACCESS
    1) By coronary sinus catheterization, oxygen and carbon dioxide tension of arterial and coronary venous blood were investigated in 8 normal subjects and 46 patients, including 15 patients with cardiac failure, 9 with coronary sclerosis, 4 with hypertension, 9 with hyperthyroidism, 7 with anemia and 2 with beri-beri, at resting stase, in the exercise test, in 10% oxygen hypoxia test, and after administration of drugs (digitalis preparations and theophylline-ethylendiamine).
    2) The oxygen tension of the coronary venous blood seems to reflect exactly the myocardial oxygen tension. It is almost constant in normal snbjects ranging from 20.0mmHg to 24.0mmHg, with an average 21.8±0.9mmHg, but it fell remarkably in the moderate or severe cardiac failure with an average 14.2±5.9mmHg, slightly in the mild cardiac failure with an average 18.2±1.9mmHg, and in some cases with coronary sclerosis and hyperthyroidism, it fell also below the normal range; suggesting the presence of myocardial hypoxia in these patients.
    3) The coronary veno-arterial pressure gradint of carbon dioxide (ΔPCO2) may be also used to presume the state of coronary circulation. It averaged in normal subjects 10.7±1.7mmHg, while it decreased markedly in anemia with an average 7.7±1.2mmHg, and in hyperthyroidism with an average 6.1±1.3mmHg, which suggests the largely increased coronary blood flow.
    4) The coronary arterio-venous difference of pH ranged in normal subjects from 0.02 to 0.04 with an average 0.030±0.002, but some of cases with severe cardiac failure and with coronary sclerosis show increased difference of pH.
    5) The coronary arterio-venous buffer base difference was within the range of technical error both in normal subjects and patients.
    6) In the exercise test, oxygen tension of coronary venous blood shows little or no cdange both in normals and in patients. ΔPCO2 increased in normal subjects, but it decreased in a casd with coronary sclerosis and a case with congestive heart failure, suggesting that in some cardiac patients the coronary blood flow may increase in the exercise more largely than in normal subjects.
    7) In the 10% oxygen hypoxia test, oxygen tension of coronary venous blood fell below the normal range at rest, both in normals and in patients. ΔPCO2 decreased in normals and the cases with anemia, but it increased in a case with coronary sclerosis, in which case ΔpH also increased largely.
    8) On patients with cardiac failure, acetyl-digitoxin, lanatocide C, and theophyllin-ethylenediamine were administrated. Of the effects of digitalis, we could not get definite results, but in all cases of theophyllin-ethylene diamine, there was a fall of oxygen tension of coronary venous blood.
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  • Masao Aisaka
    1957 Volume 46 Issue 9 Pages 1165-1183
    Published: December 10, 1957
    Released: February 22, 2011
    JOURNALS FREE ACCESS
    To clarify the effects of acute renal ischemia, congestion and anoxic anoxia on renel hemodynamics and metabolism, renal catheterization was carried out in 32 dogs, composed of 12 cases of ischemia, 14 cases of congestion and 6 cases of anoxic anoxia. Renal ischemia was produced by clamping of A. renalis, renal congestion by clamping of V. re-nalis and anoixia by inhalation of N2 gas. Under these conditions, renal oxygen and glucose consumption Na and K excretion, renal PAH extraction (EPAH), RBF, GFR, FF and urine volume were determined, and further the relation between occurence of proteinuria and changes of renal hemodynamics was investigated. The results obtained were as follows.
    The decrease of RBF caused increase of renal arterio-venous O2 difference (ΔO2) and fall of tubular reabsorption rate of Na (RNa), and when RBF decreased unde 30% of control value, EPAH showed to fall and FF to rise. Severe decrease of GFR caused oliguria. Following progressive elevation of renal venous pressure (RVP), RBF showed to decrease, FF to rise, ΔO2 to increase and RNa to fall.
    RBF, GFR, urine volume and CNa showed no change or slight increase in mild anoxic anoxia, they decreased, however, in severe anoxia.
    Renal O2 consnmption was observed to be maintained normal unless RBF decreased under 30% of control value or below, because renal ΔO2 rised compensationally as renal O2 supply decreased.
    No relation was found between renal glucose supply and consumption, and no difinite changes were observed in renal glucose metabolism by ischemia, congestion or anoxia.
    Proteinuria was found to occur, both when renal O2 supply decreased under 30% of control value by decrease of RBF or by fall of renal arterial O2 content, and when RVP rised over about 250mm H2O.
    It was suggested that decrease of renal O2 surpply and elevation of RVP might be both causative factors of proteinuria independent with each other.
    Minimum glomerular protein content (Min. G. prot.) was observed to rise before proteinuria became manifest, and it was presumed that proteinuria in these cases was caused by way of elevation of glomerular permeability to protein.
    In these experimental proteinuria A/G ratio of urinary protein and CA1/CG1 showed rema kable rise as compared to normal control values.
    It was further noted in discussion that some clinical findings could be explained by these experimental results.
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  • 1957 Volume 46 Issue 9 Pages 1184-1227
    Published: December 10, 1957
    Released: February 22, 2011
    JOURNALS FREE ACCESS
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