A method for the simultaneous analysis of unconjugated and glycine-conjugated bile acids by capillary gas-liquid chromatography

A method for the simultaneous analysis of unconjugated and glycine-conjugated bile acids by means of capillary gas-liquid chromatography without need for prior deconjugation is described. The method involves: i) the use of an aluminum-clad fused-silica capillary column coated with a very thin film (0.1 micron) of a highly thermostable bonded and crosslinked methyl polysiloxane, and ii) the analysis of the bile acids as their methyl ester-dimethylethylsilyl ether derivatives. This method, used to separate the major free and glycine-conjugated bile acids from human gall bladder bile, should be applicable for the analysis of other biological fluids.

Potential bile acid metabolites. 14. Hyocholic and muricholic acid stereoisomers

The complete set of the eight theoretically possible stereoisomeric 3,6,7-trihydroxy-5 beta-cholanic acids, four of which are new, related to hyocholic and muricholic acids were prepared from chenodeoxycholic acid. The principal reactions used were 1) cis-dihydroxylation of delta 6-compounds with osmium tetroxide/N-methylmorpholine N-oxide; 2) trans-dihydroxylation of 6 alpha, 7 alpha-epoxy compounds with boron trifluoride etherate in N,N-dimethyl-formamide; 3) inversion of equatorial 3 alpha-hydroxylated compounds to the corresponding 3 beta-epimers with diethyl azodicarboxylate/triphenylphosphine/formic acid; and 4) stereoselective reduction of 7-keto derivatives with zinc borohydride (or sodium borohydride) and by metallic potassium/tert-amyl alcohol.

A procedure for chronic recording of diaphragmatic electromyographic activity

A simple procedure for recording of diaphragmatic electromyographic activity in awake, freely behaving animals is described. This procedure produces highly stable recording of muscle activity for very long periods. Because of its ease of use, the procedure has become the technique of choice for acute recording in our laboratories as well. The present procedure can also be adapted for chronic recording of electromyographic activities from nonrespiratory muscles. This option thus offers a variety of applications to those involved in investigations into the central neuromotor control of movement, pattern generation and autonomic functions.

Dihydropyridine and phenylalkylamine receptors associated with cardiac and skeletal muscle calcium channels are structurally different

We have purified putative L-type Ca2+ channels from chick heart by virtue of their associated high affinity receptors for the Ca2+ channel effectors, dihydropyridines (DHPs), and phenylalkylamines (PAAs). A peptide of 185,000-190,000 daltons was found to comigrate with the peak of DHP binding activity during purification through two successive cycles of lectin affinity chromatography and sucrose density gradient centrifugation. A previously described peptide of 140,000 daltons, whose Mr was increased to approximately 180,000 under nonreducing conditions, also copurified with the 185-kDa peptide and dihydropyridine binding activity. When cardiac membranes were photolabeled with either the dihydropyridine [3H]azidopine or the PAA [3H]azidopamil prior to purification, a single, specifically labeled component of 185,000-190,000 daltons was present in the purified fractions. The properties of this 185-kDa cardiac DHP/PAA receptor were compared to the smaller 165-kDa DHP/PAA receptor previously purified from skeletal muscle. Antibodies raised against the 165-kDa skeletal muscle DHP/PAA receptor reacted with both rabbit and chick skeletal muscle receptors, but only poorly recognized, if at all, the cardiac 185-190 kDa component. The 185-kDa peptide present in the purified fractions obtained from cardiac muscle did not undergo substantial phosphorylation by cAMP-dependent protein kinase, while the purified 165-kDa peptide from rabbit and chick skeletal muscle was a good substrate for this kinase. The results show that the DHP and PAA receptors in cardiac muscle are contained in a 185-190-kDa peptide that is significantly larger than, and structurally and immunologically different from, it skeletal muscle counterpart.

Hemoccult screening for colorectal cancer

A community hemoccult screening project for colorectal cancer resulted in the processing of 18,198 specimens. Positive test results were reported in 3 percent of the total, which ultimately resulted in the identification of 20 colorectal malignancies (0.1 percent) and 53 benign polyps (0.3 percent). The number of malignancies and polyps identified was disappointingly low. Our findings would challenge the concept of unsupervised mass screening from the viewpoint of cost-effectiveness; however, because of the numerous voluntary services and supplies, this particular project was useful in educating the public about early colon cancer detection.

Methods of single unit recording from medullary neural substrates in awake, behaving guinea pigs

An electrophysiological procedure that permits extracellular single neuronal recording in the medulla of unanesthetized, freely behaving animals is described. System components consist of 1) a flexible, single-strand microwire as recording electrode; 2) a miniature, skull-mounted miniature microdrive used for isolation of single unit activity; and 3) a head-mounted voltage follower that conditions and stabilizes the neuronal signals prior to amplification and transmission for further processing. A unique advantage of this procedure is the latitude and provision for microwire replacement in the event that multiple penetrations are desired or the tip of the microwire recording electrode is insulated as a result of gliomatosis. With minor modification, this technique can be used for single unit recording virtually anywhere along the supra-segmental neuraxis. Technical aspects of this procedure, together with details of design and fabrication of implantable devices, chronic instrumentation procedure, and potentials for other chronic applications, are discussed.

CT of small pyogenic hepatic abscesses: the cluster sign

Of 36 consecutive patients with pyogenic liver abscesses evaluated by CT, five (14%) had multiple small abscesses less than 2 cm in size. The CT appearance of the small pyogenic abscesses was compared with that of 10 patients who had either fungal or mycobacterial abscesses and with that of 50 patients who had hepatic metastases. In all five patients who had small pyogenic abscesses, the abscesses appeared to cluster, or aggregate, in a pattern that suggested the beginning of coalescence into a single, larger abscess cavity (cluster sign). This cluster appearance was not seen in in any of the patients who had fungal or mycobacterial microabscesses. It was present in only one of the patients who had confirmed hepatic metastasis. Despite the small size of the abscesses, guided needle aspiration was successful in recovering pyogenic organisms in four of the five patients. In our experience, the presence of the cluster sign suggests that the lesions are pyogenic abscesses.

A facile one-step synthesis of delta 1,4-3-keto bile acid esters by iodoxybenzene and benzeneselenic anhydride

A facile one-step conversion of stereoisomeric methyl 3-hydroxycholanoates to 1,4-dien-3-one, by treatment in boiling toluene with iodoxybenzene catalyzed by benzeneselenic anhydride, is described. The direct oxidation-dehydrogenation at C-3 is applicable to other cholanoates (hyodeoxycholic, chenodeoxycholic, ursodeoxycholic, deoxycholic, and cholic) when the hydroxyl groups at C-6, C-7, or C-12 are protected. Without protection at C-6 and C-7, the products from hyodeoxycholic, chenodeoxycholic, ursodeoxycholic, and cholic esters are complex mixtures, whereas, methyl deoxycholate yields the 1,4-dien-3,12-dione cleanly.

Taste responses in the nucleus tractus solitarius of the chronic decerebrate rat

The ingestive behavior of decerebrate rats has been studied for some time, yet little is known of its neural substrates. While taste fibers in rats proceed from hindbrain to thalamus and ventral forebrain, these regions return centrifugal fibers to the hindbrain by which lower-order taste activity may be influenced. We examined the functional characteristics of taste neurons in the nucleus tractus solitarii (NTS) of chronic decerebrate rats in which this reciprocal communication was disrupted and compared them with those of intact controls. Nine Wistar rats were decerebrated at the supracollicular level. After a minimum of one week recovery, they were immobilized with Flaxedil, anesthetized locally and prepared for recording. The responses of 50 taste cells were isolated bilaterally from the NTS of these animals, while the activity of 50 additional neurons was recorded from 12 intact rats under the same conditions. Taste stimuli included 7 Na-Li salts, 3 sugars, HCl and citric acids, quinine HCl and NaSaccharin. Mean spontaneous activity in decerebrates was 6.5 spikes/s, 36.0% lower than the level in intact animals. Mean evoked activity was reduced by 32.6%. Analyses of the effects of stimulus quality, intensity and time course of the responses all indicated that the decrease in activity was attributable to the inability of taste cells in decerebrate rats to respond to demands for high discharge rates. This deficit could be responsible for the failure of these animals to develop conditioned taste aversions. Neurons from decerebrate preparations did, however, retain the broad sensitivity across stimuli that characterized taste cells in intact preparations. It was also typical that most neuron response profiles from decerebrates could be grouped into 3 loose clusters with peak sensitivities to acid-salt, salt or sugar. An analysis of similarities among stimulus activity profiles indicated that Na-Li salts, sugars and an acid-quinine complex represented 3 groups of stimulus quality; in intact animals, the primary distinction was between sweet and non-sweet stimuli. Moreover, the response to sodium saccharin lost its bitter component in decerebrates. These findings were in general agreement with those derived from acute decerebrate rats.

Potential bile acid metabolites. 13. Improved routes to 3 beta, 6 beta- and 3 beta, 6 alpha-dihydroxy-5 beta-cholanoic acids

New synthetic routes to three possible stereoisomers of hyodeoxycholic (3 alpha, 6 alpha-dihydroxy-5 beta-cholanic) acid are described. The principal reactions involved were inversion at C-3 of 3 alpha-hydroxy-6-oxo derivatives with diethyl azodicarboxylate-triphenylphosphine-formic acid and with N,N-dimethylformamide, without allomerization to the more stable 5 alpha form. On the basis of physical and chromatographic data, previously reported 3 beta, 6 alpha-dihydroxy-5 beta-cholanic acid and its methyl ester are shown to be C-3 epimeric mixtures. The 13C nuclear magnetic resonance spectra were of key importance in characterizing the stereoisomers and estimating their purity.

Is nasogastric intubation necessary in colon operations?

Fifty-six patients undergoing elective colonic resection were prospectively randomized into two groups either with or without postoperative nasogastric decompression. The results demonstrated only minimal differences between the two groups. Postoperative abdominal distention was more common in patients without nasogastric tubes, whereas pulmonary complications were more common in patients with nasogastric tubes. Other morbidity and mortality and hospital stay were the same in both groups. We conclude that in elective colon operations, the routine use of postoperative nasogastric decompression is unnecessary and can safely be omitted.

Capillary gas chromatography of hydroxylated bile acid stereoisomers of the allo and normal series

Relative retention times and methylene unit (MU) values were determined for 56 bile acids of the allo (5 alpha, A/B-trans) and normal (5 beta, A/B-cis) series, which differ from one another in the number, position and configuration of the hydroxyl groups at positions C-3, C-6, C-7 and/or C-12. The bile acids were derivatized to their methyl ester O-trimethylsilyl ethers (Me-TMS) and methyl ester O-dimethylethylsilyl ethers (Me-DMES), and chromatographed on fused-silica capillary columns, chemically bonded with non-selective OV-1 and selective PEG-20M liquid phases. Of the four possible combinations of derivatives and columns examined, Me-DMES on OV-1 and Me-TMS on PEG-20M were most suitable. The differences in the MU values between the 5 alpha- and 5 beta-series, and between the Me-DMES and Me-TMS ether derivatives, are also summarized. These retention data would be helpful in the identification of closely related bile acid stereoisomers or for estimation of their structures. photolysis.

Traumatic rupture of the aorta: still a lethal injury

A 10 year retrospective review of a community experience with blunt trauma of the aorta has been presented. We found that an overall mortality of 84 percent was associated with this injury. Fourteen patients reached the emergency department with stable vital signs. Of these patients, 10 underwent successful treatment (71 percent). Despite advances in many areas of trauma care, blunt trauma of the aorta remains a highly lethal injury. However, this review has demonstrated that with prompt diagnosis and treatment, a significant number of these patients can be salvaged. It is for this reason that we have adopted an aggressive approach toward victims of blunt trauma. We now proceed with diagnostic aortography in any patient who has undergone a significant deceleration injury.

Incidence and associated mortality of retained common bile duct stones

A hundred consecutive patients who underwent cholecystectomy and exploration of the common bile duct were studied. The traditional indications for exploration resulted in a yield of 55 percent positive explorations. There were nine patients with retained stones, three of whom died. The high mortality rate of patients with retained stones stresses the importance of systematic and thorough exploration of the biliary tree during initial operation. Choledochoscopy, when combined with cholangiography, may decrease the incidence of retained stones.

Complications of the Angelchik antireflux prosthesis. A community experience

The use of the Angelchik antireflux prosthesis has increased rapidly in our community since its introduction in 1979. Our experience with two patients who had serious complications associated with this prosthesis led us to review all 76 patients in our community who had undergone implantation of the device. Complications developed in 20 patients after placement of the prosthesis, and 12 of them required subsequent laparotomy for removal of the prosthesis. The complications observed were persistent dysphagia, late-onset dysphagia, transient dysphagia, persistent vomiting, esophageal obstruction, early gas bloat syndrome, gastric erosion, slippage of the prosthesis over the gastric fundus, disruption of the prosthesis, and migration of the prosthesis. Because of the frequency of potentially serious complications, we cannot recommend its use in the surgical treatment of esophageal reflux.

Potential bile acid metabolites. 9. 3,12-Dihydroxy- and 12 beta-hydroxy-5 alpha-cholanoic acids

Syntheses of the heretofore unreported 3 alpha, 12 beta-, 3 beta, 12 beta-dihydroxy-, and 12 beta-hydroxy-5 alpha-cholanic acids of the 5 alpha-series, their methyl esters, and some related derivatives are described. In addition, allodeoxycholic (3 alpha, 12 alpha-dihydroxy) acid was prepared by a new route. The principal reactions involved were the stereoselective reduction of C-12 ketones with an amino-borane reagent and of a C-3 ketone with K-Selectride, and inversion of a 3 beta-tosylate derivative with N,N-dimethylformamide.