神経循環衰弱症及び類似疾患の呼吸商に関する臨床的研究
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In order to investigate the pathological physiology in patients with neurocircuratory asthenia (abbreviated as NCA), with special reference to metabolism, respiratory Quotient in the basal metabolic state (abbreviated as basal R. Q.) was measured in 106 cases of NCA and allied diseases. (Allied disease means atypical NCA which has only 2 or 3 out of 4 cardinal systoms of NCA.)Method The expired air, collected by the face mask and the Douglas' bag in the basal metabolic state, was analysed by a gas analyser of the Japan Labour Research Institute (Roken) type-a modified Haldana type analyser.Results 1) Under almost constant conditions, the basal R.Q. of an individual is kept almost constant for several days. Therefore, it can be used as an indicator of the individual's metabolic state.2) Influence of the food composition upon the basal R.Q. lasts more than twelve hours after eating. It is suggested, therefore, that the basal R.Q., as an indicator of an individual's metabolic state, should be measured after having a diet of constant compositions. The basal R.Q. in this article was measured 12 to 15 hours after giving the regular hospital diet.3) The basal R.Q. in patients with NCA and allied disease showed no significant difference by age or sex. The type of NCA had no significant influence on it, as well.4) The mean value of the basal R. Q. s in NCA and allied disease was 0.848. This value was lower than that in patients with heart disease or hypertension, while it was similar to that in patients with chronic nephritis or diabetes mellitus.5) The relation between the basal metabolic rate and the basal R.Q. differs according to the kind of disease.6) The mean value of the basal R.Q. in NCA and allied disease was high in patients complaining of dyspnea (0.881) and stiffness of the shoulder or neck (0.872), while it was low in patients complaining of general malaise (0.796) and fatiguability (0.812).7) The mean value of the basal R.Q. in 37 patients with NCA and allied diseases showing favourable clinical course generally increased from 0.856 to 0.921 as the symptoms improved. Especially among 8 patients with the basal R.Q. below 0.70 at the time of admission, all but one showed an increase in the basal R.Q. by the time of discharge.On the contrary, 19 patients showing no favourable clinical course revealed a decrease in the mean value of the basal R.Q. from 0.859 to 0.837.8) The group of the patients with the basal R.Q. below 0.80 indicate a delayed return to fasting blood sugar level in the glucose tolerance curve.9) In the four-hour epinephrine test in the patients with NCA and allied disease, the basal R.Q. showed no significant difference between the group responding normally and that with decreased response.10) In the eight-hour intravenous ACTH test, the mean value of the basal R.Q. was low in the group of the patients with poor responce of eosinophiles.11) The mean value of the bassal R.Q. in patients with the normal serum cholesterol level (both total and ester form) was 0.843,while the patients with the above or below normal serum cholesterol level showed the mean value of the basal R.Q. above 0.843.12) The patients with the high basal R.Q. responded to the three drugs, i.e. epinephrine, pilocarpine and atropine, more strongly than the patients with the low basal R.Q. did.13) In 10 patients with NCA and allied disease the changes in the R.Q. were measured during pharmacodynamic test. There was a greater distribution of the R.Q. values prior to and during the test in the NCA group than in the healthy subjects. And in the epinephrine, pilocarpine and atropine tests the mean values of the R.Q. in NCA were always lower than those in the healthy subjects.14) In 95 cases performed myelography, relations between the segment of adhesions and the basal R.Q. were obtained. No significant differences were seen in the ventral myelogram, while the dorsal myelogram revealed a significantly high incidence of arachnoid adhesions at the l
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