FACTORS ALTERING CONCENTRATION OF BLOOD LIPIDS 461 



occurred. When cholesterol was injected into such rats, an increase in 

 free cholesterol was noted in the plasma; this augmentation was super- 

 imposed upon that attributable to the biliary obstruction, and did not 

 affect the rate of the development of the latter. Byers et a/. 681 suggest that 

 the regulation of the free cholesterol level in the plasma of the rat may be 

 dependent upon its destruction or excretion by the hepatobiliary system. 



In spite of the rather clear-cut changes of free cholesterol which occur in 

 the blood of rats after ligation of the bile duct, the blood changes occurring 

 in obstructive jaundice in man are less decisive. Epstein and Greenspan 672 

 observed an increase in the cholesterol ester in the blood of a majority of 

 their patients suffering from obstructive jaundice. On the other hand. 

 Man et al. 215 actually noted a reduction of cholesterol ester in the blood of 

 such patients. 



(c) In Acute Hepatitis. In acute diseases of the liver, the serum chole- 

 sterol may rise, 306,610,682 ~ 686 or there may be no change. 306 ' 410 - 610 The explana- 

 tion for the differences is obscure, but the cholesterol level may be asso- 

 ciated with the nature of the infection, with its duration, or with the nu- 

 tritional state of the patient. In the condition referred to as catarrhal 

 jaundice or infectious hepatitis, higher levels of serum cholesterol are usu- 

 ally found, 215,361,687 together with an increase in the ratio of free to esteri- 

 fied cholesterol, 677 and also an increase in the level of lipid phosphorus. 

 Neutral fat increased in this condition to a greater extent than in obstructive 

 jaundice. Oser and Karr 303 made the interesting observation that, whereas 

 the cell cholesterol increases in the jaundice of infectious diseases, the plasma 

 cholesterol is usually diminished. Thus, an analysis of whole blood might 

 indicate that no change in cholesterol content had occurred in this 

 condition. 



In the so-called "yellow atrophy of the liver," which is a particularly 

 toxic form of hepatitis, cholesterol may increase 687 or decrease, 672 while the 

 proportion of esters falls. In a number of other cases of liver disease, 

 serum cholesterol values are actually lower than normal for some of the 

 patients suffering from hepatitis. 215 - 675 ' 676 - 688 It is not known what particu- 

 lar condition is responsible for the hypocholesterolemia, although it is 

 suspected that it is related to the severity of the disease. 



682 A. Adler and H. Lemmel, Deut. Arch. klin. Med., 158, 173-213 (1927-1928). 

 688 J. Feigl, Biochem. Z., 86, 1-47 (1918). 



684 J. M. H. Campbell, Quart. J. Med., 18, 123-31, 393-422 (1924). 



685 A. Grigaut and A. L'Huillier, Compt. rend. soc. biol, 73, 202-203 (1912). 



686 A. Chauffard, G. Laroche, and A. Grigaut, Compt. rend. soc. biol., 73, 23-25 (1912). 



687 R. Mancke, Deut. Arch. klin. Med., 170, 358-368 (1931). 



688 E. M. Boyd and W. F. Connell, Arch. Internal Med., 61, 755-761 (1938). 



