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The effects of dopamine on renal function were studied in 10 patients with cirrhosis and various degrees of impairment of renal function. Dopamine caused a consistent increase in effective renal plasma flow but little change in glomerular filtration rate or sodium and water excretion. The hemodynamic change is attributed to a direct effect on the renal vasculature, resulting in reduction in both preglomerular and postglomerular resistance. Unlike other drugs, dopamine partially corrects the renal hemodynamic disturbance in cirrhosis, although its role as a therapeutic agent is limited.

l, 2 with the glass electrode for the continuous measurement of the acidity of the contents of the stomach and duodenum were primarily concerned with extraneous factors that might influence such records. In these early studies concentration of acid in the stomach and duodenum was recorded under basal conditions and after stimulation. In addition, the effects of commonly used antacids were noted, although these were not reported. The rather minor pH responses to antacids that we observed have not been completely confirmed by others. 3-11 Differences in instrumentation, principally the use of electrode shields and pumps, may account for some of the differences between our findings and the results of these investiga­ tors, whose studies deserve careful review. Aspiration studies have in some instances l2 - l4 shown only small changes in pH after the administration of antacids and are more in agreement with our findings. The purpose of this paper is to describe the changes in intragastric and intra­ duodenal pH during the use of diet, antacids, and anticholinergic drugs in the treatment of patients with duodenal ulcer.

In a previous communication, Snell and we have presented our studies of serum colloid changes in hepatobiliary disease, as measured by the turbidimetric procedures of Kunkel. The present paper extends these studies to patients whose diseases are not directly related to the liver or biliary tract. On the basis of our findings in 236 blood bank donors, we have established our upper limits of normal for gamma globulin turbidity (16 units), for thymol turbidity (3.5 units), and for total serum lipids (880 mg. per 100 cc. of serum). An evaluation of normality should be carried out in each laboratory using these tests, because of possible variation inherent in the barium sulfate suspensions employed as turbidity standards. Carter and Maclagan have reported a similar investigation of "liver function" tests in extrahepatic disease, based principally on the thymol turbidity and colloidal gold tests. These workers have found a high incidence of positive values in malaria, rheumatoid arthritis, congestive heart failure, glandular fever and subacute bacterial endocarditis. The higher degree of positivity noted with the colloidal gold reaction is ascribed to the narrower dependence of this test on gamma globulin. The data of these workers are in accord with the results obtained by Kunkel with the thymol turbidity reaction. In agreement with Carter and Maclagan, we have found elevated values for gamma globulin and for thymol turbidity in several disease entities not directly related to the hepatobiliary system. It has not been shown that these reactions are specifically indicative of liver damage. Elevated values may reflect liver damage secondary to systemic toxemia, increased antibody production or variable combinations of these possibly with other factors as yet unknown. We cannot as yet describe the basic mechanisms underlying these serum colloid changes. The clinical interpretation of these tests should nevertheless consider those conditions other than hepatobiliary disease in which elevated values may be expected. With caution, the tests may be of aid in the evaluation of liver changes secondary to those conditions.