A perspective on teaching medical ethics. Report of the Committee on Ethics of the American Heart Association.
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Biomedical subjects
Publications and source records attributed to C Dennis.
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The prairie dog was used as a model for human gallstone formation. Stones formed in the gallbladder of all animals on a lithogenic diet. Hepatic bile was nonlithogenic, whereas gallbladder bile promoted cholesterol precipitation. Addition of taurocholate to the diet reduced the number of stones and lithogenicity. Cholecystectomy resulted in an increased bile flow and reduced secretion of cholesterol in the animals on a high cholesterol diet. Reduction of cholesterol and bile acid synthesis by negative feedback was demonstrated in isolated hepatocyte culture. The shift of bile salt production to chenodeoxycholates on a high cholesterol intake was demonstrated both in vivo and in vitro. A theory of gallstone formation is presented which hypothesizes a defect in hepatocyte storage of cholesterol rather than bile acid synthesis as the primary effect, relegating the problems to one of a disease of lipid metabolism.
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Botrytis cinerea, Cladosporium spp., Penicillium spp., Aureobasidium pullulans, Mucor mucedo, Phoma state of Didymella applanata, Cryptococcus laurentii var. laurentii, C. albidus var. albidus, Candida sake and Sporobolomyces roseus were consistently present on freshly harvested loganberries. Botrytis cinerea was the main spoilage organism with Mucor mucedo of minor importance. The importance of benomyl-resistant strains of B. cinerea is discussed.
Seven patients were investigated after cholecystectomy and exploration of the common bile duct to determine bile composition and excretion rates. An initial depression of the major components of bile stabilized by the sixth postoperative day. Feeding of para-aminobenzoic acid and taurocholic acid to these patients demonstrated an increase in excretion of total bile acids, taurine and glycine conjugates, cholates and deoxycholates. Para-aminobenzoic acid in the doses used failed to block glycine conjugation. Preferential conjugation of bile acid with glycine is due to a deficient taurine pool and not a preferential metabolic pathway.
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Young rats, with more body water, had lower blood alcohol concentrations than did older ones at several times after various doses. The young also recovered sooner from intoxication. The age difference in recovery increased with increasing dose.
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Four patients were fed sodium benzoate after stabilization following common bile duct exploration. Bile collections revealed no change in the output of glycine conjugated bile acids. Three patients had taurocholic acid added to the regimen after 3 days and demonstrated a significant increase in total and taurine conjugated bile acid output with marked reduction of the G/T ratio. These latter changes are similar to those produced by taurocholic acid feeding alone and therefore no benefit of the combination of drugs on bile salt excretion or conjugation ratio was demonstrated.
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