Sequential intraluminal endoscopic and laparoscopic treatment for bile duct stones associated with gallstones

BACKGROUND: On the basis of a flowchart including prior or current jaundice or pancreatitis, abnormal liver function, ultrasound or IV cholangiography, bile duct (BD) stones were suspected in 71/593 patients referred for gallstones. METHODS: When endoscopic retrograde cholangiography detected BD stones, endoscopic sphincterotomy (ES) and endoscopic BD clearance were attempted, followed by laparoscopic cholecystectomy (LC). BD stones were found in 44/71 patients. The sensitivity values of preoperative conditions were: 92% for IV cholangiography, 88% for abnormal liver function, 50% for ultrasound, and 37% for jaundice at admission. RESULTS: Endoscopic clearance succeeded in 37 patients and LC was completed in 33 patients. Conversion to open surgery (9%) was comparable with the rate in patients without BD stones. The median hospital stay for the sequential endoscopic and laparoscopic treatments was 13 days (range 4-54) or 22 days if open surgery was used. CONCLUSIONS: In conclusion, BD stones can be endoscopically cleared preoperatively in most patients without interfering with LC.     

Physical fitness, physical activity, and functional limitation in adults aged 40 and older

PURPOSE: A cohort of middle-aged and older men and women were followed for an average of 5.5 yr to examine the association between physical fitness, physical activity, and the prevalence of functional limitation. METHODS: The participants received medical assessments between 1980 and 1988 and responded to a mail-back survey regarding functional status in 1990. RESULTS: Among 3495 men and 1175 women over 40 yr of age at baseline, 350 (7.5%) reported at least one functional limitation in daily or household activities at follow-up. The prevalence of functional limitation was higher among women than men. Physically fit and physically active participants reported less functional limitation than unfit or sedentary participants. After controlling for age and other risk factors, the prevalence of functional limitation was lower for both moderately fit (odds ratio = 0.4, 95% CI = 0.2-0.6) and high fit men (odds ratio = 0.3, 95% CI = 0.2-0.4), compared with low fit men. Corresponding figures for women were 0.5 (0.3-0.7) and 0.3 (0.2-0.5) for moderately fit and high fit women. The association between physical activity and functional limitation was similar to the data for physical fitness. CONCLUSIONS: These data support a protective effect of physical fitness and physical activity on functional limitation among older adults and extend this protective effect to middle-aged men and women.     

Hepatic damage produced by long-term alcohol consumption in well-nourished rats

A study of the effect of long-term alcohol consumption on the liver of well-nourished rats is described. Rats fed for 16 weeks on a semipurified diet supplemented with high levels of vitamins and lipotropic factors and alcohol corresponding to 35% of the total caloric intake developed marked fatty changes of the liver. Mild fatty changes were observed in pair-fed controls receiving as isoenergetic equivalent of sucrose instead of alcohol. Intracellular hyaline bodies, corresponding ultrastructurally to giant mitochondria were abundantly found in the hepatocytes of alcoholic rats, while in the controls they were not seen. Te findings in this investigation are postulated to provide further evidence that the long-term intake of alcohol exerts a direct causative role in the pathogenesis of liver damage.     

Lecithin-protein interaction in the GTP-dependent acyl-CoA synthase

The enzymic activity of the GTP-dependent acyl-CoA synthase isolated from rat liver mitochondria is affected by removal and addition of lecithin (3). Purified preparations of this enzyme contain bound lecithin. In this presentation the nature of the lecithin-protein interaction is examined. From binding measurements at different temperatures it is possible to postulate which type of secondary valence bonds is holding the protein and lecithin together. Presented at AOCS Meeting, Chicago, October 1967.     

Ability of reflection high energy electron diffraction (RHEED) to observe structural modifications in ion-implanted and annealed GaAs

GaAs 100 wafers were implanted and later annealed by using three different techniques: furnace thermal annealing (FTA), flash lamp (RTA) and low-power laser annealing (LPLA). The resulting modifications of the structure were studied by RHEED. The RHEED pattern analysis indicates that: (a) A well annealed structure is observed after thermal treatment in furnace at 850 °C for 30 min; (b) the particular RTA employed leads to some texturing, but is not sufficient to provide good structural effects; (c) best annealing under our conditions is obtained by the LPLA technique, especially for low ion doses (less than 10¹³ cm^–2); (d) variable-glancing-angle RHEED is an effective and convenient method to investigate the ion induced disorder in crystals at small depths.