- Email: [email protected]
Nor-epinephrine—the effect on renal hemodynamics
Southern
Society for Clinical Research
of infusion. It disappeared rapidly from the blood and only minimal amounts were excreted in the urine. That globin does not migrate with facility into loculated fluid compartments is demonstrated by the small amounts present in pleural or peritoneal transudate. Globin therapy produced a positive nitrogen balance and in hypoproteinemic patients there was a significant increase in plasma proteins. The degree of blood protein elevation, in relation to the amounts of globin infused, as well as the rapidity of such elevation suggests that globin may be converted directly into plasma protein. A significant elevation of serum albumin, measured both chemically and electrophoretically, was effected only in those patients with low serum albumin levels. In two of four patients with nephrosis the administration of globin was accompanied by a rapid loss of edema. One cirrhotic patient with edema and ascites showed no response to two separate courses of globin and, unlike all other hypoalbuminemic patients, failed to demonstrate a rise in serum albumin. It appears from these observations that modified human globin is a safe and useful source of protein, preferable in many respects to plasma or protein hydrolysates, with an especially marked effect on blood protein. CORRELATION OF THE VITAMIN A TOLERANCE CURVE WITH THE DEGREE OF FAT ABSORPTION. Clarence W. Legerton, Jr., E. Clinton Texter, Jr. and J. M. Rufin (introduced by J. D. Myers). (From the Department of Medicine, Duke University School of Medicine, Durham, N. C.) The five-hour vitamin A tolerance test was compared with the per cent of fat absorption as measured by the five-day fecal fat balance study to ascertain if a consistant correlation was present, in the hope that the simpler determination of vitamin A might replace the laborious balance studies in measuring the degree of steatorrhea. Fecal fat was determined by means of the wet extraction technic. Vitamin A was administered in the form of oleum percomorphum,@ 0.1 cc. per pound of body weight orally, with blood vitamin A levels determined at three and five hours. Thirty-three tests were performed on a total of twenty-seven patients. Nineteen of these had steatorrhea, while four healthy males and four patients without gastrointestinal disease were studied as a control group. These cases were divided into six groups based on the amount of fat absorbed as measured by the fat balance test
(above 95 per cent, 90-95. 85-90. 80-85, 75-80 and below 75, per cent). The vitamin A blood levels rose rapidly in the eight cases having fat absorption in excess of 95 per cent. The minimum vitamin A level at five hours was 366, the maximum 688, and the mean 489 gamma per cent. In eight cases having less than 75 per cent fat absorption the vitamin A blood levels remained flat. The maximum five-hour level was 68, the minimum 6 and the mean 38.5. In the remaining seventeen tests (75 to 95 per cent fat absorption) there was a direct correlation between the vitamin A tolerance curve and the percentage of fat absorbed. The absorption of vitamin A from an oily vehicle parallels the degree of fat absorption as measured by fecal fat balance studies. NOR-EPINEPHRINE-THE EFFECT ON RENAL HEMODYNAMICS.Lewis C. Mills, James Skelton (by invitation) and John H. Moyer. (From the Departments of Medicine and Pharmacology, Baylor University College of Medicine and the Cardiac Clinic, Jefferson Davis Hospital, Houston, Tex.) The effect of nor-epinephrine on renal hemodynamics was studied because of its potential therapeutic value as a vasopressor agent and because of its value as an investigative tool. The effect on glomerular filtration rate and renal plasma flow was determined in nine normal patients, and on glomerular filtration rate and TmPAH in another nine. In addition, effects on blood pressure, hematocrit, blood sugar and sodium and potassium excretion were evaluated. Following the constant intravenous administration of from 0.182 to 0.809 pg./kg./min., the mean blood pressure increased about 30 per cent; the renal plasma flow decreased 40 per cent due to a marked increase in renal vascular resistance. The glomerular filtration rate decreased only 8 per cent. There was no significant alteration of TmPAH, indicating constancy of tubular activity. Tubular transport of sodium and potassium was altered. The urine volume, hematocrit and blood sugar were increased. These observations were interpreted as indicating that nor-epinephrine is a renal vasoconstrictor and that the predominant effect is on the efferent arterioles. The decrease in renal plasma flow in the absence of a change in TmPAH indicates a decrease in circulation to each individual nephron rather than shunting mechanisms or changing numbers of functioning nephrons.
Society for Clinical Research
of infusion. It disappeared rapidly from the blood and only minimal amounts were excreted in the urine. That globin does not migrate with facility into loculated fluid compartments is demonstrated by the small amounts present in pleural or peritoneal transudate. Globin therapy produced a positive nitrogen balance and in hypoproteinemic patients there was a significant increase in plasma proteins. The degree of blood protein elevation, in relation to the amounts of globin infused, as well as the rapidity of such elevation suggests that globin may be converted directly into plasma protein. A significant elevation of serum albumin, measured both chemically and electrophoretically, was effected only in those patients with low serum albumin levels. In two of four patients with nephrosis the administration of globin was accompanied by a rapid loss of edema. One cirrhotic patient with edema and ascites showed no response to two separate courses of globin and, unlike all other hypoalbuminemic patients, failed to demonstrate a rise in serum albumin. It appears from these observations that modified human globin is a safe and useful source of protein, preferable in many respects to plasma or protein hydrolysates, with an especially marked effect on blood protein. CORRELATION OF THE VITAMIN A TOLERANCE CURVE WITH THE DEGREE OF FAT ABSORPTION. Clarence W. Legerton, Jr., E. Clinton Texter, Jr. and J. M. Rufin (introduced by J. D. Myers). (From the Department of Medicine, Duke University School of Medicine, Durham, N. C.) The five-hour vitamin A tolerance test was compared with the per cent of fat absorption as measured by the five-day fecal fat balance study to ascertain if a consistant correlation was present, in the hope that the simpler determination of vitamin A might replace the laborious balance studies in measuring the degree of steatorrhea. Fecal fat was determined by means of the wet extraction technic. Vitamin A was administered in the form of oleum percomorphum,@ 0.1 cc. per pound of body weight orally, with blood vitamin A levels determined at three and five hours. Thirty-three tests were performed on a total of twenty-seven patients. Nineteen of these had steatorrhea, while four healthy males and four patients without gastrointestinal disease were studied as a control group. These cases were divided into six groups based on the amount of fat absorbed as measured by the fat balance test
(above 95 per cent, 90-95. 85-90. 80-85, 75-80 and below 75, per cent). The vitamin A blood levels rose rapidly in the eight cases having fat absorption in excess of 95 per cent. The minimum vitamin A level at five hours was 366, the maximum 688, and the mean 489 gamma per cent. In eight cases having less than 75 per cent fat absorption the vitamin A blood levels remained flat. The maximum five-hour level was 68, the minimum 6 and the mean 38.5. In the remaining seventeen tests (75 to 95 per cent fat absorption) there was a direct correlation between the vitamin A tolerance curve and the percentage of fat absorbed. The absorption of vitamin A from an oily vehicle parallels the degree of fat absorption as measured by fecal fat balance studies. NOR-EPINEPHRINE-THE EFFECT ON RENAL HEMODYNAMICS.Lewis C. Mills, James Skelton (by invitation) and John H. Moyer. (From the Departments of Medicine and Pharmacology, Baylor University College of Medicine and the Cardiac Clinic, Jefferson Davis Hospital, Houston, Tex.) The effect of nor-epinephrine on renal hemodynamics was studied because of its potential therapeutic value as a vasopressor agent and because of its value as an investigative tool. The effect on glomerular filtration rate and renal plasma flow was determined in nine normal patients, and on glomerular filtration rate and TmPAH in another nine. In addition, effects on blood pressure, hematocrit, blood sugar and sodium and potassium excretion were evaluated. Following the constant intravenous administration of from 0.182 to 0.809 pg./kg./min., the mean blood pressure increased about 30 per cent; the renal plasma flow decreased 40 per cent due to a marked increase in renal vascular resistance. The glomerular filtration rate decreased only 8 per cent. There was no significant alteration of TmPAH, indicating constancy of tubular activity. Tubular transport of sodium and potassium was altered. The urine volume, hematocrit and blood sugar were increased. These observations were interpreted as indicating that nor-epinephrine is a renal vasoconstrictor and that the predominant effect is on the efferent arterioles. The decrease in renal plasma flow in the absence of a change in TmPAH indicates a decrease in circulation to each individual nephron rather than shunting mechanisms or changing numbers of functioning nephrons.