Stanley Levey

STUDIES IN CIRRHOSIS OF THE LIVER. I. RELATIONSHIP BETWEEN PLASMA VOLUME, PLASMA PROTEIN CONCENTRATIONS AND TOTAL CIRCULATING PROTEINS

Addis, Poo and Lew (1) aptly demonstrated the importance of the liver as a storage place for protein substances. The extensive studies of Whipple and his associates (2, 3) allowed some insight into the magnitude of this protein storage and its availability during time of need. It also seems well established that the liver is the principal site of formation of albumin and fibrinogen and to a lesser extent of globulin (4-10). In the presence of severe hepatic disease such as advanced cirrhosis, the functions of protein synthesis and storage are presumably inhibited and this inhibition is reflected by alterations in the various protein concentrations in the plasma. Supporting this concept are the observations (4, 5) which correlated the fibrinogen content of the blood with the degree of liver injury. Similarly, hypoalbuminemia has been established as a characteristic laboratory finding in patients with far advanced cirrhosis of the liver (6, 7). Plasma protein concentrations cannot, however, be used as an index for total circulating proteins or plasma volume (11, 12). It has already been shown that the plasma volume may be elevated in patients with cirrhosis of the liver (13). In a previous communication (14), data were presented from patients with cirrhosis of the liver, illustrating normal values for total circulating proteins despite the presence of low protein concentrations in the serum. The purpose of this communication is to record further data concerned with the plasma volume and the quantitative estimation of the various plasma proteins in patients with far advanced Laennecs cirrhosis of the liver.

Effect of Ascorbic Acid on Diabetogenic Action of Alloxan

Summary Administration of ascorbic acid to rats which are given low doses of alloxan increases the diabetogenic action of the alloxan. To obtain this effect the alloxan must be given within a minute after the administration of the ascorbic acid. d-Isoascorbic acid? on the other hand, does not produce the potentiation of the alloxan diabetes.

Effect of pepsin inhibitors on milk clotting activity of crystalline pepsin.

Summary While heparin, chondroitin sulfate, and sodium lauryl sulfate inhibit the proteolytic action of pepsin, chondroitin sulfate accelerates the milk clotting activity of pepsin and the other 2 compounds inhibit it.

Chemotherapy of Joint Involvement in Mice Produced by Streptobacillus moniliformis.

Summary A study of the chemotherapy of the arthritis produced in mice by inoculation with a virulent strain of Streptobacillus moniliformis was made. Three days after the animals developed joint involvement, therapy was initiated. Under the conditions studied streptomycin was the most effective agent in curing the joint involvement. Penicillin was also effective but to a lesser degree. No cures were obtained with promin, promizole, sulfathiazole, p-aminobenzoic acid, p-aminosalicylic acid, methylene blue, and two gold compounds (Myochrysine and Solgonal-B).

Glutamic acid and vomiting in dogs; its administration into the portal system and extremity veins.

Summary and Conclusions A method is presented by which the spleen may be readily transplanted subcutaneously in dogs and used for intraportal infusions. Dogs could tolerate more glutamic acid solution without vomiting when it was given either intrasplenically or directly into the portal vein by using the angiostomy technic, as compared to the peripheral venous administration. The increased tolerance to glutamic acid solution when given intraportally is attributed to the direct passage of these amino acids to the liver where they may be removed from the circulation.