Clinical and experimental investigations were performed on the pathophysiology of death in acute intestinal obstruction, and the following results were obtained.
1) In clinical cases as well as in experimental animals, the number of intestinal coli-group bacilli was remarkably increased in intestinal contents both above and below the obstruction and in ascites. The increase was greatly inhibited by intraintestinal administration of fradiomycin, an unabsorbable antibiotic. Histological changes in other organs were suppressed, and the survival time of dogs was also remarkably prolonged by the treatment.
2) High molecular substances such as enclotoxin, cellular components or DNA fraction liberated from
Escherichia coil were increased in the blood and ascites from patients with acute intestinal obstruction. The increase was fairly well inhibited by the intraintestinal administration of fradiomycin. An intimate relation was consequently assumed between the increase of intestinal microorganisms, especially of coli-group bacilli and the development of clinical symptoms of ileus.
3) Blood acetylcholine level was extraordinarily elevated in ileus at the time of developing shock-symptoms accompanied by increase of' catecholamine group. The elevation was greatly suppressed by fradiomycin. The change in blood acetylcholine level seemed to be parallel with that in blood concentration of the high molecular substance of
E. coli, and a close relationship between them was suggested. The results substantiated the present authors' view that acetylcholine, one of the most important chemical mediators, was responsible for the development of shock-symptoms in ileus.
4) Comparative examination of inhibitory effects of pyribenzamine (antihistaminics), cyproheptadine (antiserotonin), DV-79 (antiplasmin drug), atropine (anti-acetylcholine) and cortisone (adrenocortical hormone) on ileus symptoms revealed that only atropine, which has a strong anti-acetylcholine activity, could exert a strong preventive effect on the lethal action of the endotoxin and DNA fraction of the
E. coli component.
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