Effect of phenobarbital on biliary lipid metabolism in normal man.

The efficacy of phenobarbital in altering biliary lipid composition in normal man was investigated by determining parameters of biliary lipid metabolism in 8 human subjects without biliary tract disease before and after oral phenobarbital administration at a dose of approximately 3 mg per kg per day for 25 to 54 days. In 8 subjects studied, phenobarbital did not produce any statistically significant changes in the following parameters: bile lipid composition, cholesterol saturation index, total bile acid pool size, daily fractional turnover rate of cholic acid, hepatic secretion rates of cholesterol, bile acids, or phospholipids, and the fraction of the total bile acid pool represented by individual bile acids. Therefore, phenobarbital is not an effective agent, at least when used alone, in inducing changes in bile lipid composition during a short term of administration in normal man.

Hepatic 3-hydroxy-3-methylglutaryl CoA reductase activity in hamsters on a lithogenic diet.

The activity of hepatic 3-hydroxy-3-methylglutaryl-CoA reductase, the rate-limiting enzyme for liver cholesterol biosynthesis, has been determined in young hamsters given a diet known to produce cholesterol gallstones in this species and compared to the activity found in chow-fed hamsters. None of the hamsters fed the lithogenic diet for 15 days or less developed gallstones but 74 percent of those on the diet for 26 to 49 days had cholesterol gallstones. None of the chow-fed animals developed gallstones.

5. New approaches to the management of flail chest.

Although continuous positive-pressure ventilation (internal pneumatic fixation) was a great advance in the treatment of flail chest and is now the standard treatment of this condition, early and late complications related to tracheostomy and long-term ventilation are associated with this method. These complications can be avoided by use of three recently adopted techniques--expectant therapy, intermittent mandatory ventilation with positive end-expiratory pressure, and early surgical stabilization of fractures. All patients should continue to be treated in intensive care units so that impending respiratory failure can be identified and treated.

Effects of fasting on bile acid metabolism and biliary lipid composition in man.

The effects of a four to six day fast on gallbladder bile lipid composition, bile acid pool size, bile acid composition, and cholic acid metabolism have been determined in normal human subjects. Total bile acid pool size and cholic acid pool size were measured before and after fasting by a one-sample technique previously validated in our laboratory. The rate of synthesis of cholic acid and its fractional turnover rate before fasting were measured using standard techniques.

Effects of oral contraceptives on the gallbladder bile of normal women.

In view of the reported association between use of oral contraceptives and gallbladder disease, the effects of contraceptive steroids on the lipid composition of gallbladder bile were studied in 22 healthy women. Each subject was studied during routine use of oral contraceptives and also during normal menstrual cycles on no medication. Gallbladder bile was significantly more saturated with cholesterol during contraceptive therapy than during normal menstrual cycling (125 versus 92 per cent, P less than 0.

Innominate artery rupture. A major complication of tracheal surgery.

Innominate artery rupture is a life-threatening complication of tracheal reconstructive surgery. Early postoperative rupture of the innominate artery occurred in 8 of 100 consecutive patients undergoing tracheal resection and reconstruction (93, end-to-end anastomosis; 7, Marlex prosthesis). A premonitory transient hemoptysis occurred in 4 of the 8 patients.

Determination of bile acid pool size in man: a simplified method with advantages of increases precision, shortened analysis time, and decreased isotope exposure.

A simplified isotope dilution method for measurement of the bile acid pool size in normal subjects is described and compared with the traditional method of Lindstedt (Acta Physiol. Scand. 40: 1-9, 1957).

The effect of carbohydrates on ammonium and ketoacid excretion during starvation.

The metabolic effects of oral ingestion of minute quantities of carbohydrate during prolonged starvation were studied in nine obese subjects. Measurements were made during a control period of total starvation, during the ingestion of 7.5 g carbohydrate daily, and finally during the ingestion of 15.

Amphetamine and conditioned 'anxiety'.

1. Rats pressed a bar for milk reward at a steady rate, but this baseline responding was suppressed in the presence of an auditory stimulus associated with electric shock (conditioned suppression). The effects of (+)-amphetamine sulphate on this conditioned suppression were studied in two experiments.