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GENERAL LECTURES (I)

(1) T H E D I F F E R E N T I A L D I A G N O S I S O N J A U N D I C E BY A N A L Y S I S OF
U R I N E BILE A C I D C O N T E N T S .

T. Takao, M. Nishimura, and S. Nagamitsu,

First Department qf Surgery, Faculty of Medicine, Kyushu University, Fukuoka, Japan.

Urine bile acid contents give us an important information about jaundice. The ratio of cholic
to chenodeoxycholic acid content is very important to distinguish between an obstructive and
hepatocellular jaundice. Sandberg's method (1) was carried out gas-liquid chromatographically
for urine bile acid determination.
The results obtained were as follows;
1. Urine bile acid in normal human;
Total bile acid content ranged for 0.22 to 0.76 rag/1. Average deoxycholic, chenodeoxycholic
and cholic were 0.13, 0.17, 0.12 mg/1 respectively.
2. In obstructive jaundice cases;
The ratio of cholic to chenodeoxycholic acid content was more than one in 24 cases among 281
3. In hepatocellular jaundice cases ;
The ratio of cholie to chenodeoxycholic acid content was less than one in 24 among 30 Cases.

Reference
1) Sandberg, D.H. : Measurement of human serum bile acid by gas-liquid chromatography.
J. Lipid. Res. 6: 182-192, 1965.

(2) STUDY ON THE NONPROTEIN BOUND BILIRUBIN IN SERUM

H. Shibata
Y. Ito
Y. Tajima
The 2nd Tokyo National Hospital

It is well known that one mole of albumin bind to two moles or more bilirubin. Nevertheless
nonprotein bounded (NPBB) was determined and discussed the nature.

Method:
Gelfihration was used to separate nonprotein bounded bilirubin (second fraction) from protein
bounded (first fraction) bilirubin, 0.5 ml of serum applied to a 25 1.0 cm column of sephadex
G25. The column was eluted with phosphate buffer pH 7.4/1/15M and distillated water.
Bilirubin in each 2 ml of effluent was determinated with Autoanalyzer. Results were as follows.
1 g of albumin bind 28.5 mg of bilirubin. However, in serum of conjugated hyperbilirubinemia
over 11 mg/dl, nonprotein bounded bilirubin was found. The ratio of NPBB to total bilirubin
was 0-19%.
The nonprotein bounded bilirubin had peak at 445 m/t and 285 ml~ in spectrum, showed
positive ninhydrin reaction, positive direct diazo reaction (97% in Evelyn MaUoy method) and
photosensitivity.
Adding of bile acid Na to proten bound bililaabin showed reappearance of nonprotein bounded
bilirubin.
In serum of nonconjugated hyperbilirubinemia was not found nonprotein bound bilirubin but