Journal of Okayama Medical Association
Published by Okayama Medical Association

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Uropepsinに関する研究 第2編 外科的侵襲とUropepsin値並びにそれと好酸球との関連に就いて

Kojo, Takehiko
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1. After estimating the uropepsin content in urine by the Bucker-Mirsky method the author studied the relationship between the surgical invasion and uropepsin. and obtained the following results, a. In the estimation of uropepsin values in the urine according to different patients vith such trauma as contusion, fracture of bones and burn, in the face, head, thoracic part and limbs, the uropesin values estimated so many hours after receiving Injury and those stimated at a certain hous of the day when urine was drawn proved to show the maximum value at 3-4 hours after the injury in the former while the maximum around 11-12 A. M. in the latter. b. In estimating the uropepsin content of the head injury according to the grades, the greater the stress the higher is the uropepsin value, requiring a longer time to recover. Looking at this with the lapse of time in a simple case the uropepsin value demonstrates a monophasic curve whereas in the case of intermediate or advanced case it draws diphasic curve. c. In the from-day-to-day observations, in the case of burn, fracture of bones in limbs, and the compression fracture of spines likewise the uropepsin content rises in a direct proportion to the degree of stress, and before recovering to the normal level there is a transient fall in the value, and the duration of this fall is also longer in more advanced case with consequent prolongation in the time required for recovery. d. Laparotomy, tissue necrosis, and suppuration likewise react on the body strongly as a stress, showing results identical with those observed in the case of trauma and burn. Especially in the case of perforative peritonitis due to duodenal ulcer a marked rise in the uropepsin value can be observed 3 to 4 days after operation, but the value gradually decreases thereafter. e. In the far advanced case on the verge of death, the uropepsin value was ½ the normal level or even lower and the patient died without recovering it. The estimation of uropepsin has a significant bearing on knowing the function of adrenal cortex and the degree of trauma as well as on prognosis. II. For the study of relationship between uropepsin and eosinophils normal rabbits are used, and for the calculation of eosinophils the peroxidase test is used. a. In the observation of the uropepsin content and the number of eosinophils after intramuscular injnection of 5 mg ACTE it is evidently that both uropepsin and eosinophils are involved in the functions of the pituitary and adrenal cortex. b. When the fracture of leg bones, laparotomy, and burn are inflicted on test animals, the uropepsin content rises and eosinophils decrease in number. Following upon this there is a transient decrease in uropepsin before reaching the normel level, and as for eosinophils a temporary eosinophilia is noted. presenting inverse relationship to each other. c. By inflicting burn and fracture of bones with the aid of Hibernation and observing the uropepsin value and eosinophils, hardly any fluctuations in either one can be observed, and it has been recognized that the appearance of in vivo reactions as the stress is inhibited and the functions of the pituitary and adrenal cortex are suppressed.