| Popis: |
Summary Samples of deltoid and gastrocnemius muscle from six patients with proven cirrhosis of the liver complicated by ascites and edema were analyzed and compared with similar analyses in normal human skeletal muscle. Four patients were studied by the metabolic balance technique under the following conditions: 1) a control period with an intake of 3.0 gm. of sodium chloride; 2) a similar diet with 45 gm. of cation exchange resin added daily; 3) similar diet but with an intake of 1.5 gm. of sodium chloride per day, together with 45 gm. of cation exchange resin; and 4) a final period comprising the conditions of the third period and the administration of mercurial diuretic on alternate days. The deltoid and gastrocnemius muscles were biopsied again at the conclusion of the entire study, following obvious decreases in the ascites and edema. The gastrocnemius and deltoid muscles of edematous cirrhotics contained an increased amount of extracellular water without significant alteration in intracellular water; the fluid content of the gastrocnemius exceeded that of the deltoid, reflecting the influence of gravitational factors. After disappearance of the obvious edema, the volume of extracellular fluid in the gastrocnemius muscle decreased; the extracellular fluid of deltoid muscle did not change significantly; both remained higher than normal. The combined concentrations of intracellular cations, sodium and potassium, did not differ significantly from the normal. The pattern of weight loss during therapy was partitioned by utilizing the balance data and revealed that, under the conditions of this study, the loss of edema fluid was isotonic and extracellular in composition. |
