Lithogenic bile in patients with ileal dysfunction

Ileal disease or resection causes bile salt malabsorption and a reduction in the bile salt content of bile. Since cholesterol solubility requires adequate bile salt concentrations, depletion of the bile salt content of bile might, therefore, jeopardize cholesterol solubility and predispose to cholesterol gallstone formation. To study this, we examined biliary lipid composition in 10 patients with ileal dysfunction and in 25 healthy controls. Biliary lipid composition, as analysed in cholecystokinin-stimulated, bile-rich duodenal fluid, was shown to be representative of gallbladder bile and reproducible on repeat duodenal intubation. Nine of the 10 patients with ileal dysfunction had an abnormal, supersaturated bile in which the limits of cholesterol solubility were exceeded, and while nine of 25 control subjects also had an unstable bile, the mean bile composition in the ileal dysfunction group was significantly different from the control population. These studies provide a physicochemical explanation for the clinical observation that patients with ileal dysfunction have an increased incidence of gallstones.

Membrane microfilaments of erythrocytes: alteration in intact cells reproduces the hereditary spherocytosis syndrome (vinblastine-colchicine-strychnine-electron microscopy-cell rigidity)

Membrane microfilaments are found throughout the animal world in situations suggesting that they fulfill a critical role in providing normal cell shape and plasticity. We have hypothesized that hereditary spherocytosis, a congenital hemolytic anemia associated with intrinsically rigid and mishapen erythrocytes, might result from genetically defective microfilaments in erythrocyte membranes. By using three different drugs (vinblastine, colchicine, and strychnine) that share one common attribute-that of potently precipitating purified microfilamentous protein-we have provided support for this hypothesis. Thus, all the known in vitro and in vivo characteristics of hereditary spherocytes are reproduced in normal erythrocytes briefly exposed to these precipitating agents.

THE RESULTS OF TRACTION INJURIES TO THE COMMON PERONEAL NERVE

1. A series of six traction lesions of the common peroneal nerve in association with a severe adduction force to knee is described.

2. The reasons for failure of the nerve repair are discussed.

3. A new system of radiological marking of the anastomosis is described.

4. A less pessimistic view of the prognosis is taken than heretofore, and the management of the injury is discussed with a recommendation that a more conservative resection be done three months after the injury.

Numerical taxonomy of gram-positive and catalase-positive rods isolated from frozen vegetables

One hundred isolates from peas, beans, and corn were compared with cultures of Corynebacterium, Microbacterium, and Arthrobacter by use of numerical taxonomic procedures. Six groups (clusters), representing 75% of the isolates, resembled Corynebacteriaceae. There was some doubt regarding the genera represented because the groups were not closely related to many of the known strains. The relationship of the different groups to each other, as well as a number of their properties, is presented.