By Oscar Bodansky (ed.), C.P. Stewart (ed.)
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Extra info for Advances in Clinical Chemistry, Vol. 12
Holzbauer (H13) has investigated the part played by ACTH in stimulating aldosterone secretion during operative stress. She found a fall in cortisol and in aldosterone in adrenal venous blood up to 2 hours after hypophysectomy. The fall in aldosterone was much less marked than that of cortisol. 0 mU/min/kg. 3 mU/min/kg. It would appear that ACTH plays an important part in the response of cortisol secretion to physical injury, but that aldosterone secretion is more liable to be influenced by other factors, including the renin-angiotensin system (SlOa).
Thus our results on skin-wound healing, although interesting in themselves, could not be interpreted vis ii vis the metabolic response to injury, and so we decided to study healing in a nonsurface nonepithelial tissue, namely bone. Bone is a very difficult tissue in which to study repair, but using a combination of histology and radioisotope tracer studies, we concluded that bone healing was probably not affected by exposure to 30°C (C31, C32). One of the salient features of stress is an increased secretion of cortisol or corticosterone from very shortly after the moment of injury and lasting for 3 days or more, although plasma levels rise to a peak of about three times basal and return to normal within a few hours (52).
However, Moore and Ball (M14) and Cuthbertson and Tilstone (C30) have pointed out that artificial feeding in the first week or so following injury is unnecessary except in cases where normal oral nutrition is impossible, as in comatose subjects, or where a lengthy period of artificial feeding is foreseen. In cases requiring artificial feeding, tube feeding is to be preferred, but if necessary, as in cases of paralytic ileus, adequate parenteral nutrition is possible for a time, using glucose or fructose, ethanol and fat emulsions for energy, and protein hydrolyzates for essential amino acids and additional nitrogen (C30).
Advances in Clinical Chemistry, Vol. 12 by Oscar Bodansky (ed.), C.P. Stewart (ed.)