IX. EFFECTS OF DEFICIENCY 673 



postoperative ileus. He was stimulated to try pantothenic acid in this situ- 

 ation as a result of the observations of Jurgens and Pfaltz-'^^ that rats kept 

 on a diet deficient in pantothenic acid showed atony and distension of the 

 gastrointestinal tract. Sixteen cases were studied. Pantothenic acid was 

 given intramuscularly in doses of 50 mg., and most of the patients received 

 two or three injections. Jacques reported a very encouraging response to 

 the use of pantothenic acid in that a return of bowel motility took place as 

 evidenced by the passage of flatus. Many of the patients did not receive 

 pantothenic acid until they had been under treatment with either pituitary 

 extract, neostigmine, or other drugs. The clinical observations should be 

 confirmed, but they are suggestive of a possible therapeutic role of panto- 

 thenic acid. 



Ralli et alP^ have reported the effects of large amounts of calcium panto- 

 thenate by mouth in normal male adults stressed by immersing them in 

 water of 9° for 8 minutes. When this stress was repeated after 6 w^eeks of 

 pantothenate therapy, it was observed that the initial eosinophile count 

 was higher and that there was less of an eosinopenia. The whole blood 

 ascorbic acid was significantly elevated, and there was no decrease in the 

 blood ascorbic acid following the stress. In the urine the uric acid/creati- 

 nine ratio was decreased after therapy. The oral administration of vitamin 

 Bi2 was not associated with any changes of this type. The authors suggest 

 that pantothenic acid may possibly increase the capacity of the tissues to 

 withstand stress, and this might result from the fact that pantothenic acid 

 constitutes part of coenzyme A. This coenzyme^^^ functions catalytically in 

 the condensation of pyruvate with oxalacetate to form citrate. An inter- 

 mediary in this reaction is acetyl-CoA, which is believed to represent an 

 essential step in the oxidative metabolism of carbohydrate. Therefore pan- 

 tothenate is an essential part of one of the key reactions for the oxidative 

 metabolism of cells, and when excessive amounts of pantothenate are pro- 

 vided to the tissues the production of coenzyme A might be facilitated and 

 so influence the response to stress. 



h. Pathological Lesions among Prisoners of War in the Far East, Suggestive 

 of a Deficiency of Pantothenic Acid 



It is obvious that more than one nutritional factor was involved in the 

 cases of gross malnutrition that occurred among the prisoners of war in the 

 Japanese prison camps. The diets were deficient in all fractions of the vita- 

 min B complex, in protein, and in fat. It is interesting that scurvy was 



233 R. Jurgens and H. Pfaltz, Z. Vitaminforsch. 14, 243 (1944). 

 "4 E. P. Ralli, Nutrition Sumposiinn Natl. Vitamin Found. Ser. 5, 78 (1952). 

 235 S. Korkes, A. Del Campillo, I. C. Gunsalus, and S. Ochoa, J. Biol. Chem. 193, 721 

 (1951). 



