The mechanisms of hyperbilirubinemia caused by obstructive jaundice, intrahepatic cholestasis and acute hepatitis were studied experimentally and clinically.
For obstructive jaundice which is a typical disease of conjugated hyperbilirubinemia, they were investigated in animal experiments, where after intravenous injection of
3H-bilirubin to bile duct ligated rats, the changes of plasma
3H-bilirubin concentration and the liver microautoradiograms were observed.
For intrahepatic cholestasis and acute hepatitis, they were investigated with obstructive jaundice in clinical cases, where conjugated and unconjugated bilirubin concentrations in the sera were determined by use of Weber-Schalm's method and the proportions of the conjugated to the unconjugated were observed.
From the results, it could be concluded that 1) the conjugated hyperbilirubinemia of obstructive jaundice is due to the disturbance of the liver cell's biliary excretion so that conjugated bilirubin overflowing the liver cell directly enters the blood stream, 2) the conjugation of bilibubin by the liver is not disturbed in obstructive jaundice, 3) the disturbed uptake of bilirubin by the liver takes part in the unconjugated hyperbilirubinemia of obstructive jaundice, 4) the mechanism of jaundice in intrahepatic cholestasis is similar to that of obstructive jaundice, 5) the uptake and conjugation of bilirubin by the liver is more disturbed in acute hepatitis than in obstructive jaundice, 6) the grade of the conjugated hyperbilirubinemia is closely related to that of the unconjugated hyperbilirubinemia in these three diseases, 7) Weber-Schalm's method is practically useful to determine conjugated and unconjugated bilirubin in the serum.
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