Indocyanine green is a water-soluble tricarbocyanine dye developed by Brooker and introduced by Fox et aZ.(l,2) for measurement of cardiac output by the indicator dilution technic. For this purpose its absorption spectrum and protein-binding characteristics ( 1 ) are ideally suited. The results of the present investigation indicate that the dye may also be of great value in study of hepatic function.Methods. All studies were conducted on 2 trained unanesthetized female dogs weighing 18.9 and 2 2 . 0 kg. Several months previously each had undergone splenectomy, cholecystectomy, and preparation of a permanent duodenal fistula using the device described by Thomas(3), which permitted access to the common bile duct. The dogs remained in good health, and hepatic function, as judged by repeated measurements of sulfobromophthalein (BSP) transfer maximum ( 4 ) , continued unimpaired. At the time of each study an olive-tipped ureteral catheter (5 or 6 Fr.) was inserted through the ampulla of Vater and advanced about 5 to 6 cm into the common bile duct. The dogs were then placed upright in a sling and bile was collected by gravity or, when it was particularly viscous, by gentle *This work was made possible by grants from the New York Heart Assn. and the Department of the Army (Contract DA-49-007-MD-205). t MarkIe Scholar in Medical Science. $ Rockefeller Travelling Fellow in Medicine,aspiration with a tuberculin syringe. Intravenous injections were given through a polyethylene catheter introduced through a large bore needle in a vein of the foreleg and advanced to the region of the right atrium.Indocyanine green$ was made up to 2 5 0 mg% in distilled water for injections. In one study a continuous infusion of the dye was given. This was prepared by mixing 2 4 ml of SO0 mg% indocyanine green with 51 ml of normal saline and 5 ml of dog plasma. (Indocyanine green is unstable on standing in aqueous solution, and the presence of plasma was found empirically to retard its breakdown.) Concentration of indocyanine green in plasma was measured in a Beckman DU spectrophotometer at 8 1 0 mp after 1 1 -fold dilution with normal saline. Concentration standards for this determination were also prepared in dog plasma. (Dilute aqueous standards are unsatisfactory because of marked instability.) Bile samples were diluted 25 to 100 times with water. One ml of diluted bile was then added to 1 ml of dog plasma and 9 ml of normal saline and the absorption measured at 8 1 0 mp. Although the dye is quite stable in bile even when diluted, the addition of plasma, for reasons not apparent, was necessary for full color development. BSP concentrations 0 Kindly supplied as "Cardio-Green" by Hynson, Westcott and Dunning, Inc., Baltimore, Md., through the courtesy of Dr.

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A B S T R A C T The biliary excretion rates of bile acid, lecithin, and cholesterol were measured in unanesthetized dogs after interruption of enterohepatic circulation and during infusions of sodium taurocholate, sodium glycocholate, sodium dehydrocholate, SC2644 (a bicyclic organic acid with high choleretic potency), and secretin.Both lecithin output and cholesterol output were directly related to bile acid excretion rate. The curves describing these relationships were concave downward. Molar concentration ratios of lecithin-to-bile acid declined gradually from approximately 0. The data are consistent with the view that lecithin moves passively from cell membranes to intracanalicular micelles, that transport of cholesterol is coupled to lecithin transport, and that there is also a small amount of independent passive transport of cholesterol from membranes to micelles. A model developed on these assumptions has been shown to behave in a fashion consistent with the entire range of these observations.

EPCS permanently stopped variceal bleeding, rarely became occluded, was accomplished with a low incidence of portal-systemic encephalopathy, and compared with EST, produced greater longterm survival. The widespread practice of using surgical procedures mainly as salvage for failure of endoscopic therapy is not supported by the results of this trial (clinicaltrials.gov #NCT00690027).