The Urinary Excretion of Adrenaline, Noradrenaline, and 17-Hydroxycorticosteroids in Mental Illness

The 24-hour excretions of adrenaline, noradrenaline, and 17-hydroxycortico-steroids were measured in normals and in a) acute and b) chronic schizophrenics, (c) non-schizophrenic psychotics, d) psychoneurotic disorders, and e) a miscellaneous group composed primarily of personality disorders. Some patients were studied over a period of time and the changes in hormone excretion and in clinical conditions compared.

On comparison between groups, no difference was found in adrenaline and noradrenaline output. Similarly, when the patients were grouped by dominant emotional reaction at the time of test, no significant differences were observed. The acute schizophrenics, however, did show a greater output of free corticoids, but not of total corticoids compared to the normals.

When the same patients were studied over a period of time, there appeared to be a relationship between catecholamine excretion and emotional tension and/or stages of illness. Depressed patients showed a decreased adrenaline and noradrenaline output on admission to hospital but only that of adrenaline was significant. Both adrenaline and noradrenaline showed a marked, but not significant decrease in acute schizophrenics after recovery. In the chronic schizophrenics, there was, after four months of withdrawal of tranquillizers, a significant rise in the output of both; the total and free corticoids showed a similar increase which, however, was not significant.

Although no significant differences in hormone excretion were observed among the groups studied, other than increased excretion of free corticoids in the acute schizophrenics, the longitudinal studies in several groups suggest significant correlations may occur between changes in clinical condition and/or emotional state and the excretion of some of the hormones measured.

Diuretic effect of some adrenocortical steroids in the rat

Cortisone, hydrocortisone and some of their Δ1- and fluorinated analogues have a pronounced diuretic effect in the rat; this is accompanied by increased urinary excretion of both Na+ and K+. Diuresis is maximal some 4 hr after oral administration, and in acute studies, the diuretic potency of some of the newer corticosteroids exceeds 100 times that of chlorothiazide.

Limitations of the Newtonian time scale in relation to non-equilibrium rheological states and a theory of quasi-properties

The behaviour of complex materials under stress is described in terms of entities which are not strictly ‘physical properties’. These so-called ‘quasi-properties’ range from entities hardly distinguishable from dimensionally true physical properties to concepts which are much less clearly defined. Quasi-properties measure an ordered process towards equilibrium rather than a state of equilibrium. The Newtonian definition for equality of tune intervals which leads to the concepts velocity, acceleration, momentum and force having whole-number dimensional exponents, does not apply to ‘quasi-equilibrium states’. In order to keep the Newtonian time scale, fractional differential equations are introduced. The simplest fractional differential equation relating stress, strain and time integrates to a series equation whose first term is a simple power law (Nutting’s equation) already known to describe the behaviour of many complex materials under constant stress. The physical meaning of the fractional differential is considered. An apparatus is described for loading test-pieces of plastics and the like under tension or compression at constant stress to a preselected strain, and for following the subsequent stress dissipation; and the results of tests on thirty-eight materials are studied statistically. Introducing a second term from the series equation (and, very rarely, a third term) greatly improves the fit for materials for which Nutting’s equation is inadequate and explains hitherto unaccountable anomalies when the Nutting plot is otherwise satisfactory. Constants derived by the equation from constant-stress and constant-strain conditions are compared. The form of the series equation suggests that the relative importance of the second term may sometimes disclose the presence of undissipated stresses in the materials. The accuracy of tests on individual test-pieces is high, but, on account of frequent lack of homogeneity in the samples available, the use of the unmodified Nutting equation is often adequate even when the addition of a second term would significantly improve individual curves. Some alternative treatments are discussed, but, both theoretically and practically, the fractional differential approach is preferred for most of the materials tested.

RELATIONSHIP OF PNH3 OF TUBULAR CELLS TO RENAL PRODUCTION OF AMMONIA

Renal excretion of ammonia, addition of ammonia to renal venous blood, and total renal production of ammonia were measured in acidotic dogs before and during the intravenous infusion of ammonium chloride at rates of 0.5 and 1.0 mmole/min. Infusion of ammonium chloride increased urinary excretion of ammonia, reversed the direction of diffusion of ammonia between tubular cells and blood, i.e., induced the extraction of ammonia from blood, and reduced cellular production of ammonia. Production of ammonia was an inverse function of pNH3 of tubular cells. The infusion of ammonium lactate-N15 into one renal artery increased total ammonia excretion but decreased production of ammonia-N14 from normal blood-borne precursors. The intravenous infusion of ammonium chloride reduced extraction of glutamine from renal blood, yet increased the concentration of free glutamine in renal cortical cells. Our data suggest that an increase in pNH3 of tubular cells results in competitive inhibition of the glutaminase-1 reaction. We further suggest that the pNH3 of tubular cells is one factor governing renal production of ammonia; i e., the higher the cellular pNH3, the lower is the renal production of ammonia.

INTRARENAL DISTRIBUTION OF AMMONIA DURING DIURESIS AND ANTIDIURESIS

The intrarenal distribution of ammonia was evaluated in the dog during antidiuresis and osmotic (mannitol) diuresis at various levels of urine pH. During antidiuresis, the concentration of ammonia in renal tissue water rose progressively from the cortex to the tip of the papilla. In contrast, the corticomedullary ammonia gradient was completely obliterated by osmotic diuresis. In both experimental groups, a close relationship was observed between urine pH and the logarithm of the ratio between the urine and papillary concentrations of ammonia. The data are compatible with a proposal that a medullary countercurrent exchange system is responsible for medullary ammonia accumulation, and that diffusion equilibrium exists between the pNH3 of loop of Henle fluid, vasa recta blood, and collecting duct fluid.