This study examined the hypothesis that filtration through the MW 300 kD cut-off membrane (XM-300) may influence factors affecting the cholesterol nucleation time (the appearance time of cholesterol monohydrate crystal). Differences in biliary lipids, biliary protein, mucous glycoprotein and vesicular composition were examined before and after the XM-300 filtration in control and cholesterol gallstone patients. The nucleation time in the cholesterol gallstone patients was significantly faster than that in the control patients. However, the nucleation time in the gallstone patients was significantly prolonged following the XM-300 filtration resulting in a similar value to that of the control patients. No differences in concentrations of total protein, mucous glycoprotein or lipids composition were observed. The nucleation time did not correlate with the total lipid concentration, the concentrations of biliary mucous glycoprotein or total protein. The prolonged nucleation time of gallstone bile by the XM-300 filtration was primarily ascribed to the removal of vesicles, which was confirmed by gel chromatography. It was concluded that vesicles greater than MW 300 kD are primarily responsible for the rapid nucleation time.

Bile↗

PubMedDate not supplied

Metastatic large-cell lung carcinoma presenting as gastrointestinal hemorrhage.

A rare case of severe small bowel hemorrhage due to jejunal metastases from a large-cell type carcinoma of the lung is reported. A 69-yr-old Japanese woman presented with complaints of mild abdominal pain and liquid tarry stools 6 months following surgery for lung carcinoma. Gastroduodenoscopy and barium enema yielded unremarkable findings, although a subsequent small bowel enema revealed a large, 15-cm ulcerated mass in the jejunum. This tumor was resected and histology confirmed to be consistent with a metastasis from the primary undifferentiated large-cell carcinoma of the lung. The patient had an uneventful postoperative course and survived for 9 months. There have been only two prior case reports of major intestinal hemorrhage secondary to pulmonary carcinoma metastases in the English literature. Previous reports of such metastases of the small bowel have bowel have documented a very poor prognosis and our patient demonstrated the longest survival period to date. The clinical course of this patient suggests that the early diagnosis and palliative surgery for this complication provide a more favourable outcome.

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