Kiyoshi Kera

Measurement of hepatic arterial and portal venous blood flow in hepatic diseases. (Preliminary report).

The hepatic blood flow measured by the bromsulphalein or indocyanine green method includes both the hepatic arterial and the portal venous blood flow. However, both blood flow does not change parallel in hepatic diseases. Though separate estimation of both blood flow has been long hoped, exact measurement in clinical cases has not been easy. The authorsl measured it by the method of rapid inj ection of radioactive iodinated human serum albumin into the pulmo-

Hepatic Hemodynamics in Idiopathic Presinusoidal Portal Hypertension in Japan

Recently many cases of portal hypertension with large splenomegaly have been reported in which hepatic cirrhosis or other obvious causes of portal hypertension are not found.-10 In Japan this kind of portal hypertension has been found more frequently than in Europe and in the United States. Many arguments have been presented about pathogenesis of this disease,1-12 For understanding of nature of this disease, precise knowledge of hepatic hemodynamics is important, since portal hypertension is the most outstanding feature. In this study we have investigated hepatic hemodynamics, especially the portal blood flow, since little is known about it. From the viewpoint of hepatic hemodynamics, there seems to be two different theories; backward flow theory and forward flow theory. Backward flow theory, which ascribes portal hypertension to presinusoidal block, is supported by pathological studies showing obliteration of the intrahepatic portal vein branches5, 9 and steep gradient between the portal pressure and the wedged hepatic venous pressure. 2, 5, 8 On the other hand, recent evidence of the in-

Measurement of intrahepatic shunted blood flow by means of D-galactose-1-C14 in experimental hepatic injuries.

From the First Department of Internal Medicine, Tohoku University School of Medicine, Sendai, Japan. Pathological studies show that the anastomoses between the portal veins and the hepatic veins and between the hepatic arteries and the hepatic veins appear in hepatic cirrhosis.1-5 Through these pathological anastomoses (intrahepatic shunts) blood bypasses the hepatic parenchyma, and the functional hepatic blood flow decreases. Similar disadvantageous effect is also produced by capillarization of the sinusoids. 6, This intrahepatic shunted blood flow