Y. Sugawara

Studies of serum cholinesterase activity in patients with liver disease, especially effect of di-iso propyl fluorro phosphate (DFP) on cholinesterase

The investgation represents a fur ther study of the relationship between the alteration of serum cholinesterase value and the course or prognosis in pat ients with varias type of liver disease, in using Sibata-Takabasis method. In addition, the regeneration of this enzyme following administrat ion of DFP was studied in normal individuals and patients with liver disease. The results were as follows; 1) In acute hepatitis, S-ch, E. activity was slightly decreased and rapidly returned to the range of normal value, within 2 or 3 months, but in prolonged case was not satisfactorily returned S-ch, E. activity to normal activity level. In chronic hepatitis, generally decreased. However in change with liver cirrhosis, S-ch, E. activity was determind the most remarked depression as turning the illness to severer. 2) The rate of regenerat ion of serum cholinesterase activity following intramuscular administration of DFP (powerful and irreversible inhibitor) differed remarkablly according to period of liver damage. The percent regeneration of the enzyme reflected generally intial activity level. However, the percent regeneration was remarkablly delayed in patient with liver cirrhosis, chronic active hepatit is and the extreme period of acute hepatitis, even though existed initial level within the range of normal limit.

Experimental investigations on bile and bilirubin excretion in liver damages

The incorporat ion of 4 14C delta aminolebulinic acid (ALA)and 2 14C glycine into heme, fecal coproporphyrin (FCP) and stercobil in (STB) were studied in cases with various disorders. Following the adminis t ra t ion of 4 14C ALA, activi t ies of FCP and STB appeared and declined within 4 or 5 days and the changes of two kinds of activity were associated with each other. This relat ionship suggested tha t they were produced from the common source. When 2 14C glycine was given, the r ise and the fall of FCP activity was independent of those of STB act ivi ty and FCP showed activi ty only on earl iest few days and no activity at the t ime of the end of red cell life span. STB activi ty kept a plateau for several days after the disappearance of FCP activity and then declined to lower level. The incorporat ion of 2 14C glycine into heme was active whereas tha t of 4 14C ALA was minimal. These re la t ions suggested the exis tence of two components of early appearing stercobilin. The first component associated with FCP activity and was independent of erythropoiesis and the second component was free f rom FCP product ion and dependent on erythropoiesis. In two cases of normal red cell life span who received 2 14C glycine the first component of STB was much less than the second component in each case (1 : 3.7, 1 : ]0.4). FCP activit ies showed no relat ion to the red cell destruct ion but associated with hepatic production of b i l i rubin tha t was observed in 4 14C ALA exper iments . It seems likely from these relat ions tha t FCP is of hepatic in origin.

Clinical studies of fatty metamorphosis in liver diseases

SummaryEvidence has been presented; The degree of fat droplets was changed liver discases and fatty metamorphosis was correlated with some liver function tests

Hemorrhagic diathesis in liver diseases

The cause of hemorrhagic tendency in liver diseases is very complicated, and increased portal pressure, abnormalities of protein and lipids metabolism and organic-functional injure of platelets-vessel system and other elements might probably result the hemorrhagic diathesis of liver diseases.