THE DIAGNOSTIC VALUE OF SERUM LEUCINE AMINOPEPTIDASE

Serum leucine aminopeptidase determination was found to be a useful screening procedure for hepatobiliary disease in jaundiced and unjaundiced patients. Values under 1,000 units are of no help in the differential diagnosis of jaundice but values above 1,000 units are highly indicative of biliary obstruction. The differentiation of intra- from extrahepatic obstruction as well as of malignant from benign jaundice cannot generally be established by this single test.

LIVER PARENCHYMAL CELL INJURY. I. INITIAL ALTERATIONS OF THE CELL FOLLOWING POISONING WITH CARBON TETRACHLORIDE

The structure of the endoplasmic reticulum, plasma membrane, mitochondria, and Golgi apparatus of the liver parenchymal cell is strikingly altered within 1 hour following the administration of a single oral dose of carbon tetrachloride to rats. Progressive loss of glucose-6-phosphatase activity accompanies dispersal of the ergastoplasm. Electron microscopy reveals that these changes are associated with vacuolization of the cisternae of the granular endoplasmic reticulum, degranulation of its membranes, and the appearance of increased number of free ribosomes in the adjacent cytoplasmic matrix. Concomitantly, calcium enters the liver parenchymal cell and is sequestered by mitochondria. First increased at 30 minutes, calcium content is maximal at 1 hour and returns to normal at 2 hours. Although succinic and glutamic dehydrogenase activity patterns within the liver lobule are unaffected, liver cell mitochondria enlarge and some appear to fuse or assume cup-like configurations. Microvilli lining the space of Disse become irregularly indistinct and increasingly pleomorphic by 30 minutes when the plasma membrane becomes increasingly permeable to calcium. Golgi vesicles swell and discharge their granules during the period of poisoning studied. Although all the changes observed may be the result of direct interaction of carbon tetrachloride with the membranes of the cytoplasmic constituents of the liver parenchymal cell, the possibility that the irreversible changes observed in the granular endoplasmic reticulum may be due to the chemical interaction between the poison and this system is discussed.

THE VALUE OF JIRGL'S FLOCCULATION TEST IN THE DIAGNOSIS OF JAUNDICE

Jirgl's serum flocculation reaction was examined in a series of 121 patients with varying types of liver disease. Positive results were found in 90% of patients with proven extrahepatic obstructive jaundice. Strongly positive reactions were also obtained in primary biliary cirrhosis and chlorpromazine jaundice. One out of three cases of ;cholestatic' hepatitis gave a weakly positive reaction and the test may be of value in the diagnosis of this condition and in the rare recurrent conjugated hyperbilirubinaemia in which it is also negative.Eighty-four per cent of cases of portal cirrhosis were negative and the finding of a positive result in this condition may indicate the presence of a hepatoma.No correlation could be found either in intra- or extrahepatic obstructive jaundice between the degree of flocculation present and the severity of the obstruction as judged by serum bilirubin and alkaline phosphatase levels.

ACUTE TOXICITY OF AFLATOXIN B-1 IN RATS

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EFFECTS OF WHOLE BODY IRRADIATION AND OF PARTIAL HEPATECTOMY ON THE LIVER LESIONS INDUCED IN RATS BY A SINGLE DOSE OF RETRORSINE, A PYRROLIZIDINE (SENECIO) ALKALOID

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