The absorption and secretion of water and electrolytes across the healthy and the diseased human colonic mucosa measured in vitro

An ;in-vitro' technique is described for measuring quantitatively the absorption and secretion of water and electrolytes, the short circuiting current, and the simultaneous bidirectional flux rates of ions across the healthy and diseased colonic mucosa. The results show that the normal colon absorbs both sodium and water and secretes potassium. In both ulcerative colitis and Crohn's disease there is a reversal of sodium and water flux and potassium secretion is increased.A measure of the simultaneous bidirectional flux rates under conditions of zero potential has allowed us to use the Ussing equation to analyse some of the factors involved in sodium transport across the healthy and diseased mucosa.

Total hip replacement in osteoarthrosis using the Charnley prosthesis

Charnley low-friction arthroplasty was performed on 352 osteoarthritic hips, usually because of severe pain. Three hundred and twenty hips were reviewed at a special follow-up clinic or by postal questionnaire. After operation 89% of hips were pain-free or caused only occasional discomfort, and in 76% there was an increased range of movement. Of those patients actually seen for review 79% were judged to have a good or excellent result. The most frequent single complication was deep infection, which occurred in 5.3% of hips.

Total hip replacement in inflammatory hip disease using the Charnley prosthesis

The Charnley low-friction arthroplasty was performed on 73 hips in 55 patients with inflammatory joint disease, usually for intolerable pain. Sixty-five of these operations were reviewed at a special clinic or by postal questionnaire; 57 hips were painfree or gave rise to only occasional discomfort, in 58 there was an increased range of movement, and in 46 of the 59 hips assessed clinically, the results were excellent or good. The most serious complication was deep infection, which occurred in 7 operations.

Further experience with azathioprine in rheumatoid arthritis

Azathioprine has been shown to reduce the steroid requirements of patients with severe rheumatoid arthritis. Twenty-seven patients treated with azathioprine have now been followed up for 30 months. At the end of this period only 10 were still taking the drug. Maximum steroid reduction occurred within the first 12 months of treatment. Some steroid-sparing effect seemed to persist after the drug was stopped. There was no evidence that azathioprine prevented radiological deterioration. No deaths occurred and toxic effects always reversed on stopping the drug.

Conservative surgery in 100 patients with bleeding peptic ulcer

The results of treatment of 100 patients with bleeding peptic ulcer, using the conservative surgical approach of vagotomy and pyloroplasty with suture of the ulcer, have been analysed. This approach is satisfactory for patients with doudenal ulcer and in selected cases of gastric ulcer. It is not satisfactory in the treatment of erosive gastritis.

Immune function in multiple myeloma: impaired responsiveness to keyhole limpet hemocyanin

Twenty-three patients with multiple myeloma, four patients with treated localized plasmacytoma and 14 normal subjects were immunized with keyhole limpet hemocyanin (KLH). When compared to the normal subjects, the myeloma patients showed a prolonged induction time for IgM antibody formation, a more rapid switch from IgM to IgG production and a decline in the titre of total antibody produced. In vitro lymphocyte responses to KLH following immunization were reduced in the myeloma group and tended to decline with time in a manner similar to the serum antibody concentration. Most of the myeloma patients tested developed delayed hypersensitivity skin reactions to KLH, but these reactions were smaller than those of the control subjects. The patients with myeloma had also reduced in vitro lymphocyte responses to streptolysin-O and vaccinia. Immune function of the plasmacytoma patients was similar to that of the control subjects.Both humoral and cellular immunity in response to a newly encountered antigen, KLH, is impaired in patients with multiple myeloma.

Multiple gastrointestinal haemangiomata

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Absorption and secretion of water and electrolytes by the intact human colon in diffuse untreated proctocolitis

The net transport and unidirectional fluxes of water, sodium, and potassium were studied in four subjects with diffuse untreated proctocolitis, by perfusing the colon with isotopically-labelled solution instilled through a tube introduced by mouth. The results were compared to those obtained in 13 healthy subjects. In proctocolitis the colonic absorption of sodium and water was impaired and the secretion of potassium increased. The movement of electrolytes across the colonic mucosa into the lumen was increased and the movement in the opposite direction reduced. The close correlation between water and sodium absorption in healthy subjects was maintained in those with proctocolitis. These alterations in the colonic handling of water and electrolytes diminish the reserve capacity of the colon and may explain the diarrhoea of proctocolitis.

Structure and intraglyceride distribution of coriolic acid

Coriolic [(R)-13-hydroxy-cis-9,trans-11-octadecadienoic] acid (III, R=Z=H) was isolated as the methyl ester from twoCoriaria seed oils in 66 and 68% yields. The double bonds and hydroxyl group were located by periodate-permanganate oxidation before, and chromic acid oxidation after, hydrogenation of the double bonds. Alternatively the positions of the functional groups were indicated by a convenient micro-ozonolysis-gas-liquid chromatographic procedure. Determination of products from partial hydrolysis of theCoriaria oils with pancreatic lipase (EC 3.1.1.3) revealed a preference of the corioloyl group for the 1,3-positions in triglyceride molecules. The possible significance of coriolic acid as an intermediate in the biogenetic conversion of linoleic acid to conjugated trienoic acids is discussed.

Cross-over vein grafts for iliac and femoral venous occlusion

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