J.Jpn. Surg. Soc.. 60(4): 599-614, 1959

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CLINICAL STUDY OF CALLSTONE REPORT II) SECTION II. A CHEMICAL AND MACROSCOPICAL CLASSIFICATION OF GALLSTONE WITH REFERENCE TO BILE ACID IN THE BILE, SERUM PROTEINS, COMPOUND PROTEINS, AND TO THE VALUE OF SERUM LIPIDS.

1. We classified 183 gallstone cases by chemical analysis as well as by macrospical observation, and got 53.6% cholesterin type to be distributed to 12 pure cholesterin stone cases, 65 cholesterin pigment stone cases, 21 mixed stone cases, 67 bilirubin stone cases, 6 parasitic stone cases, 11 mineral stone cases, and 1 fatty acid calcium stone case. This is quite different from the observations of other Japanes investigator.
2. The value of bile acid of gastroduodenal ulcer, intestinal adhesion, and gastric cancer was that the value was normal for the first two ailments when the liver function was normal (cholic acid 28 mg/cc- 51 mg/cc., dihydroxycholic acid 26 mg/cc -35 mg/cc), while in the instances with hepatic disfunction, bile acid was so low as 1 mg/cc-23 mg/cc for cholic acid and 5.3 mg/cc-19 mg/cc for dihydroxycholic acid. On the contrary, gallston cases had nothing to do with liver function and yet the cholic acid was also as low as 2 mg/cc- 28 mg/cc for cholic acid and 0 mg/cc- 32 mg/cc for dihydroxycbolic acid.
3. Serum protein in cholelithiasis was 7.2 gr/dl, and was almost normal, but the value of the serum protein fractions for albumin was 44.8% ; and Total globulin was 55.2% with α₁ 7.0%, α₂ 10.5%, β 14.9%, and γ 22.6%. This shows a decrease for albumin but an increase for α₁ and γ globulin.
Lipoprotein Fraction: The (β+γ)/α of lipoprotein fractions was normal at 2.25, but it gave 3.5 in cases of gallstone to show an increase in β+γ fractions. Normal serum lipid values, on the other hand were ; 140-220 mg/dl for total cholesterol ormal serum lipid 50-70 mg/dl for estercholesterol, 140-240 mg/dl for total phospholipid, 490-710 mg/dl for total fatacid and the cholesterol-ester ratio, 64. Figures in gall stone cases did not vary much with the fluctuation in the normal range, too. In other words, there was a significant difference in the value of lipoprotein fractions, even in cases where serum lipids were conclusion about the clinical significance of glyco protein fractions of the serum was deducted.
(author's abstract)

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