Factors affecting cholesterol monohydrate crystal nucleation time in model systems of supersaturated bile.

We explored the influence of several compositional factors considered capable of influencing the nucleation time of model biles supersaturated in cholesterol. In addition to the classical techniques, e.g.

The everted rectal stump technique for the application of the distal pursestring suture in the construction of stapled anastomoses.

The everted rectal stump technique for the application of the distal pursestring suture was used successfully in three patients to perform a low stapled reconstructive anastomosis in the treatment of carcinoma of the rectum. Two of the patients were Dukes' Stage B and one patient was classified as Dukes' Stage C. The postoperative course was uneventful.

Effect of (+)-cyanidanol-3 on chronic active hepatitis: a double blind controlled trial.

Forty patients with biopsy proven chronic active hepatitis were studied, 22 received (+)-cyanidanol-3 in a dose of 3 g daily and 18 placebo. Side effects related to cyanidanol were fever (four patients), haemolysis (one patient) and urticaria (one patient). All side effects subsided on discontinuation of the medication.

Pseudoaneurysm of the dorsalis pedis artery.

Two cases of post-traumatic pseudoaneurysm of the dorsalis pedis artery are presented. Both were managed by resection and vascular reconstruction with a successful result. It is suggested that this, rather than resection and ligation, is the preferred treatment in these cases.

Sulfasalazine pneumonitis.

A patient with ulcerative colitis developed skin allergy to sulfasalazine, manifested by rash urticaria and generalized angioedema. The patient underwent desensitization with the drug. After desensitization, the drug was reinstituted without any adverse skin reaction.

Gallstones and diet in Tel Aviv and Gaza.

To study the possible association between diet and gallstones we investigated these two variables in two populations in Tel Aviv and Gaza with presumed differences in both. Gallstones were more frequent in Jews in Tel Aviv than in Arabs in Gaza, 12.1% versus 3.

Severe hemochromatosis: the predominant clinical manifestation of congenital dyserythropoietic anemia type 2.

A patient with multiorgan involvement of non-iatrogenic hemochromatosis secondary to congenital dyserythropoietic anemia (CDA) type 2 is described. The clinical manifestations of hemochromatosis preceded the diagnosis of CDA. CDA should be included among the hematological disorders associated with iron overload.

Failure of balloon membranotomy of the inferior vena cava.

A young woman with membranous obstruction and coarctation of the inferior vena cava is described. A balloon membranotomy was performed with a transient improvement. Three months later massive thrombosis of the inferior vena cava developed.

Coumadin-induced skin necrosis.

Two women developed coumadin-induced skin necrosis. A 16-year-old woman sustained necrosis on the leg after a single dose of the drug, and a 59-year-old woman developed gangrene of most of her left breast.

Frequency of papillary dysfunction among cholecystectomized patients.

Four hundred and fifty-four consecutive patients who had had their gallbladder removed were interviewed to determine the presence of upper abdominal pain, increased serum alkaline phosphatase and/or serum amylase activity. Patients with unexplained upper abdominal pain and/or enzyme abnormalities were offered endoscopic retrograde cholangiopancreatography (ERCP) and manometric evaluations. Dysfunction of the sphincter of Oddi diagnosed by ERCP manometry may account for the abdominal pain seen in 14% of the patients with postcholecystectomy syndrome.

The significance of the diameter of the common bile duct in cholecystectomized patients.

In the cholecystectomized patients there is no correlation between the diameter of the common bile duct and the pressure in the biliary system or in the sphincter of Oddi. It is most probably due to unresolved dilatation of the common bile duct. ERCP manometry is probably a more accurate technique for establishing the diagnosis of papillary stenosis in patients who had their gallbladder removed.

Cellular sensitivity to collagen in thromboangiitis obliterans.

We studied 39 patients with thromboangiitis obliterans to determine their cellular and humoral immune responses to native human collagen Type I and Type III, which are constituents of blood vessels. Cell-mediated sensitivity to these collagens was measured by an antigen-sensitive thymidine-incorporation assay. The mean stimulation index--the ratio of thymidine incorporation in the presence of antigen to that in its absence--with both Type I and Type III collagens used as antigens was significantly higher in patients with thromboangiitis obliterans than in patients with arteriosclerosis obliterans or in healthy male controls.

An increased familial frequency of gallstones.

Despite the very high prevalence of gallstone disease, studies of familial factors are very few, and asymptomatic family members were not studied. We studied, in a prospective manner, the frequency of gallstones in 171 first-degree relatives of patients with proven gallstones compared with 200 matched controls. All subjects were studied by oral cholecystography, and their height, weight, blood glucose, cholesterol, and other parameters were measured.

Nitrate therapy in a patient with papillary dysfunction.

A 64-yr-old woman with ERCP manometry proven papillary dysfunction is described. This patient responded to nitrate therapy with disappearance of the pain and decrease in both basal and phasic sphincter activity. It is suggested that nitrate administration should be used to distinguish between patients with functional and organic pathology of the sphincter of Oddi.

Manometric study during endoscopic retrograde cholangiopancreatography--a new technique for the evaluation of pathology in the pancreatic and biliary systems.

During endoscopic retrograde cholangiopancreatography, pressures of the common bile duct, the pancreatic duct and the sphincter of Oddi were recorded in 64 patients with various diseases of the pancreaticobiliary system. The manometric study was found to be helpful in the diagnosis of papillary dysfunction and in the assessment of the adequacy of papillotomy and the size of a choledochoduodenostomy. Furthermore, it is possible that nitrates may be effective in the treatment of patients with papillary dysfunction.

Isolated colonic loop in the rabbit: an in vivo system for studying intestinal mucus.

A method for preparing an isolated colonic loop (Thiry-Vella) in a living rabbit is described. The loop, with its intact neurovascular supply, continues to secrete clear colonic mucus for more than 2 months. The chemical composition of the mucus, collected daily for 2 months, was analyzed and shown to be a high molecular weight glycoprotein composed of approximately equimolar amounts of protein and carbohydrate.