A simple method for the determination of lipid composition of human bile

The Entero-Test, a device for easy sampling of gastrointestinal contents, including bile, has been used for determination of biliary lipid composition. The device consists of a weighted gelatin capsule containing 140 cm of a highly absorbent nylon line. The capsule is swallowed while one end of the string is taped to the face. After 3.5 h, when the line has reached the duodenum, gallbladder contraction is stimulated by intramuscular administration of ceruletide. The line is pulled out, and the last 15 cm are eluted four times in methanol. Total bile acids (by 3 alpha-hydroxysteroid-dehydrogenase assay), individual bile acids (by high performance liquid chromatography), phospholipids (by assay of lipid-soluble phosphorus), and cholesterol (by gas-liquid chromatography) are determined in the eluate. Tests in vitro demonstrated no preferential binding and a good recovery of biliary lipids from the thread. Similar values of biliary cholesterol saturation were obtained by means of duodenal intubation and of the Entero-Test in a series of 12 subjects (r = 0.952). In 5 subjects, individual bile acids were also measured and were found to be similar with both techniques (r = 0.948). When the test was repeated over 3 days in a series of 7 subjects, biliary cholesterol saturation was found to be remarkably reproducible (CV = 7.6%). Thus, the Entero-Test is a convenient technique for the determination of biliary lipid composition, which can be particularly useful in longitudinal studies

L' intervento chirurgico

L’odontoiatria è una branca chirurgica della medicina. Pertanto gli odontoia¬tn devono conoscere i principi generali della chirurgia operatoria: i tempi fon¬damentali di un intervento chirurgico, le linee guida da rispettare e i principali mezzi utilizzati per eseguire un’operazione sul paziente. Per quanto l’abilità tecnica possa essere imparata solo con la pratica clinica, cioè con la continua osservazione del gesto chirurgico e la sua ripetitiva esecuzione, una base teorica è indispensabile per motivi culturali e soprattutto per evitare errori procedurali che possono incidere sulla corretta esecuzione dell’atto chirurgico e provocare spiacevoli complicanze al paziente (e problemi anche medico-legali all’esecu¬tore!)