腎糖質代謝に関する臨床病態生理学的研究(前編) : 安静時の腎糖質代謝に就いて

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  • Clinical Pathophysiological Investigation on the Renal Carbohydrate Metabolism

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While a number of methods to study the metabolism of the kidney have been advanced and used, including indirect methods and those based on the analogy from the results of animal experiments, the recent development of the renal venous catheterization method made possible the direct sampling of the renal venous blood in man and so to study the human renal metabolism under the physiological and pathological conditions. The reports based on the renal catheterization have been accumulated recently both abroad and in this country and these studies shed light upon the renal blood circulation in man, but the study concerning the carbohydrate metabolism of the kidney with special reference to renal circulation and renal oxygen metabolism has been little reported. As an approach to the problem of the carbohydrate metabolism of the kidney, the author studied healty subjects and patients by the renal venous catheterization method in a resting condition (Part I) and during induced hypoxemia by 10% O2 gas inhalation(Part II). Investigation was made on several problems with special reference to the renal uptake and release of such substances, as glucose, lactic acid and pyruvic acid. Subjects Subjects used, were a total of 20 cases, consisting of the following groups. a. Healthy subjects 7 cases b. Patients with pulmonary tuberculosis 5 cases c. Patients with essential hypertension 5 cases d. Patients with nephrosclerosis 3 cases Methods Under resting condition, arterial blood (obtained directly through a needle attached to shringe that had been inserted into the femoral artery) and renal venous blood (obtained by the renal venous catheterization method) were obtained as simultaneously as possible. After the initial samplings of blood were done, hypoxemia was induced and maintained by the method of Levy with 10% O2 gas inhalation for 20 minutes ; the blood samples were obtained between 15 and 20 minutes of the hypoxia test. The concentration of glucose was determined by the Somogyi's method, that of lactate by the hydroxybiphenyl method, and that of pyruvate by the dinitrophenylhydrazine method. For the calculation of the renal uptake and release of various substances, the renal blood blow (T. R.B.F.), as reported by FUKUDA, the author's collaborator, was used.

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