The quantitative and gualitative aspects of transport of bilirubin from the hepatic sinusoidal blood to the bile were studied by the observation of bile pigments in plasma and bile after the intravenous administration of bilirubin on persons and dogs. As the subjects, thirty-four persons (6 normal, 10 acute hepatitis, 5 chronic hepatitis, 3 liver cirrhosis, 2 Dubin-Johnson syndrome, 2 Rotor syndrome, 2 Gilbert's disease, 1 post hepatitis syndrome and 3 haemolytic jaundice), and twenty-two dogs (11 normal, 6 carbon tetrchloride treated and 5 bile duct ligated) were included, of which eleven dogs were prepared with bile duct canulation (9 normal and 2 carbon tetrachloride treated). The standard dose of bilirubin administration was 2mg./kg. body weight on persons and 3mg./kg. on dogs. Changes of bile pigments in plasma and bile were continuously observed for 4 hours after the administration. The following results were obtained from these experiments in persons and dogs. 1) The disapperance of plasma total bilirubin after the administration was delayed in all jaundiced cases and nonjaundiced hepatic lesions (nonjaundiced hepatitis and liver cirrhosis, and carbon tetrachloride treated). 2) The increase of plasma conjugated bilirubin after the administration was found in the cases of conjugated hyperbilirubinaemia (jaundiced hepatitis and liver cirrhosis, Dubin-Johnson syndrome, Rotor syndrome and bile duct ligation) and nonjaundiced hepatic lesions. The increased conjugated bilirubin was almost composed of pigment I but pigment II also increased slightly in the cases of conjugated hyperbilirubinaemia. In the large dose of bilirubin, the increase of plasma conjugated bilirubin was found even in the normal cases. 3) The transfer rate of unconjugated bilirubin in the liver to the conjugated bilirubin compartment was reduced in the cases of hepatic lesions, Rotor syndrome, Gilbert's disease, post hepatitis syndrome and bile duct ligation. 4) The uptake rate of bilirubin by the liver was reduced in the cases of unconjugated hyperbilirubinaemia (Gilbert's disease, post hepatitis syndrome and haemolytic jaundice), jaundiced hepatitis and bile duct ligation. 5) Indirect bilirubin was found in the bile after the administration. 6) The transfer of plasma bilirubin to bile was delayed in the cases of hepatic lesion with carbon tetrachloride. 7) The bile flow was slightly increased by the bilirubin administration. 8) The diazo methode in combination with Eberlein's solvent partition was useful for determination of three types of bile pigments (bilirubin, pigment I and pigment II).
Patients with gastric diseases were divided into the group of gastric cancer, gastric ulcer and duodenal ulcer, on one hand, and the group of atrophic gastritis, diagnosed by the gastrocamera, on the other. Electrolytes in the gastric juice were studied on these cases, comparing with those of the normal subjects. Sodium, potassium and chlorine concentrations were compared with one another in the gastric juice of basal secretion, as well as in the gastric juice obtained 30 minutes and 120 minutes after injection of augumented histamine dose. In cancer of the stomach, sodium concentration was found to be highest, showing gradual decrease in the order of gastric ulcer, duodenal ulcer, and normal. About potassium, the concentration was slightly lower in cancer of the stomach, and no remarkable increase was shown in chlorine concentration of gastric cancer. In atrophic gastritis, sodium concentration was higher in proportion to the severity of at-tophic changes. While potassium and chlorine concentration showed reversed tendency. The ratio of Na/K was highest in gastric juice of cancer of the stomach and showed gradual decrease in order of gastric ulcer and duodenal ulcer, and also showed gradual increase in proportion to the severity of atrophy. Na/Cl ratio was statistically higher than other gastric deseases and normal at 30 minutes after injection of histamine. In conclusion, it was statietically proved that Na/K and Na/Cl ratio in cancer of the stomach was significantly higher in comparison with the other diseases.
The amylase activities of the serum, pancreatic juice and organ homogenates of dogs and humans were studied by means of paper electrophoresis, Sephadex gel filtration and polyacrylamide gel electrophoresis and measured by our modification of Noelting & Bernfeld's method. Results obtained were as follows. 1) Serum amylase activity of the normal dog; On the paper electrophoresis the major peak appeared at γ-globulin zone of serum protein and the minor peak did at α-β globulin zone. On Sephadex G-100 gel filtration, two peaks were also obtained. 2) Serum amylase activity of the dog with pancreatic impairments; When any increase happened, it was mainly at γ-globulin zone. 3) Serum amylase activity of the pancreatectomized dog; Remarkable decrease of activity at γ-globulin zone, as well as total activity in serum after the surgery was followed with recovery by degrees before the operation, in a couple of weeks. 4) Enzymologic characteristics (optimal pH and Michaelis-Menten's constant) of the separated amylase were different each other, which suggested that isoamylase existed. 5) Electrophoresis of various organ homogenates of the dog; Amylase activity was evident only at γ-globulin zone through all the cell fractions of the pancreas by differential centrifugation. The amylase activity of supernatant was dominant at γ-globulin zone and that of small particulate components so at α-β globulin zone, as for the liver and the mucosal cells of intenstine. 6) Serum amylase activity of the normal human; Electrophoresis revealed the major peak at γ-globulin zone and the minor peak at albumin zone. There appeared two peaks also in Sephadex G-100 gel filtration. 7) Serum amylase activity of cases with acute pancreatitis and chronic pancreatitis; Increase at γ-globulin zone was observed in cases of hyperamylasemia, while there was nothing abnormal in serum amylase pattern in those whose serum amylase activity remained within normal threshold. 8) Serum amylase activity of cases with epidemic parotitis; All the cases showed hyperamylasemia, especially increased at γ-globulin zone. 9) Comparison of amylase migration among human pancreatic juice, pancreatic homogenate and saliva using polyacrylamide gel plate electrophoresis; Saliva migrated the most, while pancreatic juice and pancreatic homogenate did with no different mobility.
It has been well known that vitamin B12 is absorbed from the intestinal tract in the presence of intrinsic factor. Suggestions have been made that liver B12 is absorbed without intrinsic factor, and that lack of B12 merely represents maldigestion in the stomach. This communication deals with our study to clarify the role of intrinsic factor in vitamin B12 absorption in subjects without stomach, and digestibility and absorbability of liver bound B12. Liver containing 57Co-B12 was prepared by repeated injection of the vitamin to rats, and was fed to test subjects. In addition, a patient with an intestinal fistulae was used for study. The following results were obtained; 1) Vitamin B12 malabsorption in patients with total gastrectomy was due mainly to absence of intrinsic factor. 2) No evidence was obtained that absorption of liver bound B12 was superior to that of aqueous B12. Hence, liver proteins have no intrinsic factor-like activity. 3) Following oral administration of hog intrinsic factor, the activity continued to be demonstrable in the small intestine for at least two hours. 4) A patient who had had total gastrectomy and showed normal absorption of vitamin B12 has been described.
Using radioactive colloidal gold (189Au), hepatic scintiscanning was performed in 600 patients with various diseases using our colour scanner. Visualization of the spleen was seen in liver diseases, particularly in liver cirrhosis and hepatoma, and also frequently in Band's syndrome. Frequency and intensity of visualization of the spleen were studies in each disease. Different degrees of liver injury were produced in rats by injections of carbon-tetrachloride, as well as by the Campbell's immunological method, and several experimental studies were carried out on these rats to clarify the mechanism for splenic visualization. Radioactive colloidal gold or india-ink was injected into the penile vein or mesenteric vein. In normal rats, the colloid clearance rate and hepatic uptake of the colloid were not influenced by splenectomy. The hepatic uptake of colloid was increased when the colloid was slowly infused into the portal vein, as compared with that after injection into the penile vein, and the uptake of colloid by the spleen and bone marrow was slightly decreased. After partial hepatectomy, colloid clearance rate was markedly impaird, and the uptake of colloid by the spleen and bone-marrow were slightly increased, but the hepatic per gram uptake increased considerably. In the rats with advanced liver injury, colloid clearance rate was decreased in the same degree as the partial hepatectomized rats, and hepatic uptake of colloid was decreased. While the spleen and bone marrow were found to have more markedly increased capacity to take up the colloid than that of partial hepatectomized rats. This finding suggests that the spleen and bone marrow have a limited capacity to for take up colloid in the normal state. In the rats with advanced cirrhosis, no difference was observed in the uptake by the liver, spleen and bone marrow, between the groups in which the colloid was infused into the mesenteric vein or into a peripheral vein. It seems to be accounted for by collateral circulation, intrahepatic vascular shunt and decreased hepatic uptake that occurred in these rats with hepatic damagede. These results suggest that, in liver cirrhosis, splenic visualization in liver scan is due, in part, to an increased capacity of the spleen to clear intravascular colloids.