岡山医学会 Acta Medica Okayama 0030-1558 86 1-2 1974 定期健康診断における尿蛋白陽性者の尿蛋白排泄patternによる検討 87 93 EN Mamoru Hirohata Yutaka Watanabe Kanji Miyoshi Takao Nishihara Kenji Seo Tadasuke Kondo Takahiro Yamabuki Tosio Takano Sixty-eight of Okayama university students who discovered by periodical examination was investigated by five urine specimen method, and classified in nine groups by the pattern of proteinuria. Simultaneously, past history, urinary sediment, hematocrit, PSP, Urea-N and total serum protein was investigated and comparative studies among each group was studied. Percentage of positive proteinuria discovered by two urine specimen examination (before bed and early morning) and three urine specimen examination (on arrival, one hour rest and two hours rest) was not coincided, so these results suggest the more urine examination make the better discovery of proteinuria, because intermitent proteinuria was 27.4% who showed negative urinary protein on the examined day. Type of urinary protein excretion pattern was classified as follows; proteinuria was negative both at before bed and in the early morning (a), positive urinary protein at before bed and negative in the early morning (b), urinary protein showed positive both at before bed and in the early morning (c): proteinuria was negative on arrival at health service center, after one hour rest, and after two hours rest, intermitent type (A), urinary protein changed from positive to negative by rest, positional type (B), and always positive urinary protein, persistent type (C). Nine groups was made by the combination of these types. Ditribution of groups was 27.9% (a-A group), 17.6% (b-B group), 14.7% (c-C group) and 0% (a-C group). Incidence of red blood cell in the urinary sediment in each group was under five red blood cell count in one high power field in negative group, and microhematuria was found in five of ten cases of persistent type and three of them showed over six blood cell count in one high power fieldIncidence of renal diseases in past hisotry decreased in the order of persistent type, positional type and intermitent type of proteinuria. High ASLO titer was found in over half cases of positional type and ASLO titer & proteinuria was decreased after administration of antibiotics (Sigmamicin). Possibility of infection influenced on the proteinuria of positional type was suspected. Results of PSP, Urea-N, Cholesterol, total protein and A/G ratio were in normal range and no signifficant difference among each group. Histological findings by renal biopsy from three cases of persistent type elucidated the presence of renal diseases. According to the results, examination of five urine specimen, past history, urinary sediment (red blood cell count) and ASLO was the important items of the examination of proteinuria discoverd by perioidical examination of college student. No potential conflict of interest relevant to this article was reported.

岡山医学会 Acta Medica Okayama 0030-1558 87 7-8 1975 硫酸抱合型bilirubinに関する研究 第2編 各種肝疾患患者の胆汁中bilirubin sulfate分画の臨床的意義 697 706 EN Yutaka Watanabe Clinical significance of the components of direct bilirubin in bile was investigated on the basis of the relation between bilirubin sulfate fraction in bile and serological liver function tests in various liver diseases. Forty-three examined cases were consisted of eight cases with cholecystopathy, seven cases with acute hepatitis, nine cases with chronic hepatitis, seven cases with cirrhosis of the liver, four cases with Gilbert's syndrome and eight normal subjects, and their bile were collected with duodenal tube. The sulfate radical in direct bilirubin was quantitatively determined by Weber & Schalm's method and the molar ratio of sulfate radical to bilirubin was calculated. The following results were obtained. 1) No difference was observed between male and female, and among the age of patients on the molar ratios of sulfate to bilirubin. 2) The molar ratio of glucuronic acid to ester-form bilirubin was inversely proportional to that of sulfate radical to direct bilirubin. 3) The mean molar ratio of sulfate radical to direct bilirubin was found to be 0.10 in normal subjects, 0.08 in the cases with cholecystopathy, 0.27 in chronic hepatitis, 0.39 in acute hepatitis, 0.51 in liver cirrhosis and 0.48 in Gilbert's syndrome. The each values of liver diseases was significantly higher than normal subjects, and no difference between normal subjects and the cases with cholecystopathy. 4) Significant correlation was observed between the molar ratio of sulfate radical to direct bilirubin and following items, that is, ZnTT, TTT and γ-globulin; but no correlation between the molar ratio of sulfate radical to direct bilirubin and S-GOT, S-GPT, serum alkaline phosphatase, serum bilirubin and BSP retention test. These results suggest that the sulfate conjugation of bilirubin was compensated as compared to the disturbance of glucuronide formation of bilirubin in liver parenchymal damage. No potential conflict of interest relevant to this article was reported.

岡山医学会 Acta Medica Okayama 0030-1558 87 7-8 1975 硫酸抱合型bilirubinに関する研究 第1編 Heterozygote Gunn ratの胆汁中への硫酸抱合型bilirubinの排泄能 687 696 EN Yutaka Watanabe The nature of biochemically synthetic bilirubin sulfate was examined on detail, and bilirubin sulfate and bilirubin glucuronide were measured in bile of heterozygote Gunn rat and Wister strain rat. Further, after the intrvenous injection of (3)H-bilirubin sulfate into heterozygote Gunn rats and Wister strain rats, the biliary excretion rate of bilirubin sulfate was studied in them. The following results were gained by these studies. 1) The absorption peak was 452 nm in the synthetic bilirubin sulfate solution, pH 2.2, and its azo pigment showed each peak absorptions at 535-545 nm in pH 2.0 and at 565-575 nm in pH 1.0. The molar ratio between bilirubin and sulfate in the band of thin layer chromatography showing an Rf of 0.26 was determined from 1.72 to 1.96 with a mean of 1.78±0.09 S.D.. These data suggest that this compound is bilirubin disulfate. 2) In the bile of Gunn rats and Wister strain rats, the molar ratio of glucuronic acid to esterfrom bilirubin was inversely proportional to that of sulfate radical to direct bilirubin (r=-0.74, p<0.05). This implies that the conjugation of bilirubin with sulfate increases compensatedly as compared to the disturbance of that of bilirubin with glucuronic acid. 3) The excretion ratios of 2 hours to 24 hours in the intravenous (3)H-bilirubin sulfate loading were 54.2% in Gunn rats and 63.4% in Wister strain rats. This finding supports the concept that bilirubin sulfate is easily excreted in the bile. The biliary excretion within 24 hours following the administration of bilirubin sulfate was 40.4% in Gunn rats and 69.4% in Wister strain rats, and these excretion rates decreased in parallel with the decrease of molar ratio in bilirubin glucuronide (r=0.96, p<0.01). It is suggested that the ability to excrete bilirubin sulfate may be the limiting factor in the existence of defective hepatic bilirubin glucuronidation. No potential conflict of interest relevant to this article was reported.

岡山医学会 Acta Medica Okayama 0030-1558 87 7-8 1975 Gunn rat （Hetero）の胆汁中非bilirubin-diazo反応陽性分画 611 614 EN Tadasuke Kondo Mamoru Hirohata Kenji Seo Yutaka Watanabe Non-bilirubin fraction was extracted from the bile obtained from Wister strain rats and heterozygote Gunn rats, and separated by Ostrow(1)s method with minor modification. Azo-pigments was prepared with the non-bilirubin fraction after addition of Ehrlich(1)s diazo reagent. Significance of non-bilirubin fraction showing positive diazo reaction (NBAPF) was studied on the basis of the relation between the percentage of NBAPF to total bile azo pigments (proportion of NBAPF) and molar ratio of glucuronic acid to the ester-form bilirubin. The following results were obtained; 1) Averaged proportions of NBAPF were 0.94% in Wister strain rats and 2.50% in heterozygote Gunn rats, respectively. The latter proportion was higher than the former but not significant due to the wide variation of the measured values of the latter group. 2) Good correlation between the proportion of NBAPF and the molar ratio of glucuronic acid to the ester-form bilirubin was observed. 3) No significant correlation was observed between the bilirubin concentration in the bile and the molar ratio of glucuronic acid to the ester-form bilirubin or the proportion of NBAPF. 4) These results suggest when the conjugation of bilirubin and glucuronic acid in the liver was impaired, both the excretion of dipyrryl substance yielded from bilirubin and other conjugation mechanism increase compensatory. No potential conflict of interest relevant to this article was reported.