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).
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