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This study used both purposive and stratified sampling techniques, the contribution of regional integration on financing infrastructural project, and regional policy on infrastructural management and technical skills in Côte d’Ivoire was assessed. The study found that over 80 per cent of respondents agreed that regional integration would increase infrastructural project financing evidenced by the country-specific plan for 2020–2022 under the African Development Bank. Moreover, 69 per cent of respondents agreed that the impacts of regional policy on infrastructural management and technical skill have positive effect on the economic development in Côte d’Ivoire. However, there was a significant difference (chi-square value = 0.042, p < 0.05) between the level of education and perception on policy, while the relationship between infrastructure financing and education level was insignificant. Despite the number of challenges limiting regional integration, there are more opportunities through continental and regional programmes and political willpower of Côte d’Ivoire for a successful integration. The study recommends that awareness of regional integration be increased to enhance the knowledge of citizens for easy adoption of regional policy into national activities for infrastructural development.

En las últimas décadas se ha producido un notable aumento en la concienciación del consumidor por alimentos de calidad, y producidos de una forma social y ambientalmente responsable. El ámbito agroalimentario presenta uno de los mayores mercados en lo que se refiere a este tipo de producción ética-sostenible, como el Comercio Justo, y abre nuevas oportunidades para los productores a través de otros sistemas como la producción social y ambientalmente responsable. El objetivo de este trabajo consiste en determinar los condicionantes en el consumo de alimentos de Comercio Justo, además de la disposición a comprar alimentos social y ambientalmente responsable para la población de Extremadura (España). Para ello se ha aplicado un cuestionario a una muestra representativa (n=461) de la población extremeña en términos de edad y sexo. El análisis empírico consta de un análisis conjunto para determinar las preferencias hacia ambos tipos de producto y un modelo probit para determinar qué factores inciden sobre la probabilidad de consumo/disposición a consumir. Los resultados muestran que los consumidores prefieren los dos tipos de producción responsable a la convencional. Asimismo, el perfil de individuo que tiene una mayor probabilidad de consumir alimentos de comercio justo es mujer, con conocimiento previo acerca del Comercio Justo y con sensibilidad hacia los problemas laborales y ambientales. Finalmente, las mujeres, las rentas más altas, y los consumidores sensibilizados y que eran consumidores de Comercio Justo, son las principales características que influyen positivamente sobre la disposición a consumir alimentos social y ambientalmente responsables.

So many factors have affected the welfare of households such as environmental hazards, changes in agricultural production, price fluctuations and population growth which have prompted researches to ameliorate the situation of households. This research paper however seeks to investigate the effect of education on food security among households in Cameroon. Using the ECAM IV survey data collected by the National Institute of Statistics in 2014 from 10,303 households in Cameroon and the food security index was measured using a polychoric principal component analysis (PCA). A Two-Stage Instrumental Variable (IV) technique was used to establish the relationship between education and food security. The Average Household Educational Attainment (AHEA) was calculated by calculating the average length of time that household members above the age of 18 years have spent in school. The normalized index and AHEA were regressed and the results obtained showed that AHEA was very significant in influencing household food security. Also, education was observed to have a positive and very significant variable in building the welfare index of the households. It was recommended that household members should pursue longer years of education as a means to guarantee the food security of their households.

The proof-of-concept, study to investigate the presence of microorganisms in presumed infectious endophthalmitis using Next generation sequencing (NGS) was carried out in vitreous biopsies from 34 patients with endophthalmitis, and thirty patients undergoing surgery for non-infectious retinal disorders as controls. Following DNA extraction using the Qiagen mini kit and PCR amplification of the V3–V4 regions of the bacterial 16S rRNA and ITS 2 region of fungus, they samples were sequenced on an Illumina HiSeq 2500 Machine. Paired reads were curated, taxonomically labeled, and filtered. Culture based diagnosis was achieved in 15/34 (44%) patients while NGS diagnosed the presence of microbes in 30/34 (88%) patients (bacteria in 26/30, fungi in 2/30, mixed infections in 2/30 cases). All 30 controls were negative for bacteria or fungus by NGS. There was good agreement between culture and NGS for culture-positive cases. Among culture negative cases, DNA of common culturable bacteria were identified like Streptococcus sp., Staphylococcus sp., Pseudomonas sp., Gemella sp., Haemophilus sp., Acinetobacter sp. The specificity of NGS with culture and clinical diagnosis was found to be 20% and 100% respectively and sensitivity of NGS with culture and clinical diagnosis was found to be 87.5% and 88% respectively. NGS appears to be promising diagnostic platform for the diagnosis of infectious culture negative endophthalmitis.

Summary Background Many investigators have proposed an association between gastro-oesophageal reflux disease and laryngo-pharyngeal symptoms, suggesting that medical or surgical therapy for reflux may be useful. Aim To perform a meta-analysis assessing the effectiveness of medical or surgical therapy for reflux disease in adult patients with laryngeal or pharyngeal symptoms presumed to be due to gastro-oesophageal reflux disease. Methods Randomized controlled trials comparing medical or surgical treatments for gastro-oesophageal reflux disease against placebo were identified by searching MEDLINE (1966–September 2005), EMBASE (1974–September 2005), the CCRCT (until September 2005) and abstracts from gastroenterology and ENT meetings. The relative risks of reporting symptomatic improvement or resolution of symptoms was evaluated using a random-effects model. Results Five studies using high-dose proton pump inhibitor as intervention met the inclusion criteria and were included in the meta-analysis. No surgical studies met inclusion criteria. The pooled relative risk was 1.18 (95% confidence interval: 0.81–1.74). There was no heterogeneity between studies but evidence of significant publication bias. Sub-group analysis performed evaluating Jadad scores and symptom type, did not change the relative risk. Conclusions Therapy with a high-dose proton pump inhibitor is no more effective than placebo in producing symptomatic improvement or resolution of laryngo-pharyngeal symptoms. Further studies are necessary to identify the characteristics of patients that may respond to proton pump inhibitor therapy.

Purpose To determine the type of Candida species in ocular infections and to investigate the relationship of antifungal susceptibility profile to virulence factors. Methods Fifty isolates of yeast-like fungi from patients with keratitis, endophthalmitis, and orbital cellulitis were identified by Vitek-2 compact system and DNA sequencing of ITS1-5.8S-ITS2 regions of the rRNA gene, followed by phylogenetic analysis for phenotypic and genotypic identification, respectively. Minimum inhibitory concentration of six antifungal drugs was determined by E test/microbroth dilution methods. Phenotypic and genotypic methods were used to determine the virulence factors. Results Phylogenetic analysis showed the clustering of all isolates into eight distinct groups with a major cluster formed Candida parapsilosis (n = 21), which was the most common species by both Vitek 2 and DNA sequencing. Using χ2 test no significant difference was noted between the techniques except that Vitek 2 did not identify C. viswanathii, C. orthopsilosis, and two non-Candida genera. Of 43 tested Candida isolates high susceptibility to amphotericin B (39/43, 90.6%) and natamycin (43/43, 100%) was noted. While none of the isolates produced coagulase, all produced esterase and catalase. The potential to form biofilm was detected in 23/43 (53.4%) isolates. Distribution of virulence factors by heat map analysis showed difference in metabolic activity of biofilm producers from nonbiofilm producers. Conclusions Identified by Vitek 2 and DNA sequencing methods C. parapsilosis was the most common species associated with eye infections. Irrespective of the virulence factors elaborated, the Candida isolates were susceptible to commonly used antifungal drugs such as amphotericin B and natamycin.

The pupal parasitoidBrachymeria intermedia (Nees) was reared from the egg to adult stage on artificial media based on commercial meat homogenates for babies (Plasmon®), either with or devoid of host components. Six media containing 80% homogenate and 20% extract ofGalleria mellonella L. pupae were tested first. Two types of homogenates, intended for babies at the beginning of weaning (a) and well on in weaning (b), were utilized. Media were based on beef, veal and chicken meat, 3 on a-homogenates and 3 on b-homogenates. A significantly higher percentage of parasitoids developed as mature larvae on the a- than on the b-homogenate based diets. This was presumably related to the higher protein, carbohydrate, lipid and calorie level of the a- than of the b- homogenates. Diet veal-a produced the best mean adult yield (27.4%). Other two diets based on the veal-a homogenate were then tested. The first, composed of 80% homogenate, 10% host pupal extract, 7% chicken egg yolk, 1.5% yeast extract and 1.5% wheat germ, produced a mean adult yield of 66.7%, similar to that obtained inG. mellonella pupae. On the second medium, devoid of host components and containing 85% veal-a homogenate, 10% chicken egg yolk, 2.5% wheat germ and 2.5% yeast extract, the mean adult yield was 22.5%. In all media, the adults obtained were viable and fecund.

Contrary to common belief that Cameroon is a haven of peace in a turbulent Central African sub region, this paper demonstrates that the absence of war in the country does not imply that it is peaceful. Given the linguistic and cultural diversity of the country with its more than 289 ethnic groups and a colonial legacy of French and English cultures and languages, plus remnants of a German sub-stratum, it should be clear that there are many potential ingredients for conflicts in Cameroon. The politicians seem to have nurtured these cultural and/or linguistic diversities in ways that fuel conflict and can even spark civil war. The tension that results from these ethnic and/or linguistic and religious splinters is not overt, however, due to the repressive nature of the regime in place. However, this tension continues to grow, to the detriment of the country's socio-economic development. There is therefore an acute need for measures to defuse such cultural conflicts which have the potential of sparking future civil strife in the country. African Journal on Conflict Resolution Vol. 7 (2) 2007: pp. 193-218

Many investigators have proposed an association between gastro-oesophageal reflux disease and laryngo-pharyngeal symptoms, suggesting that medical or surgical therapy for reflux may be useful.To perform a meta-analysis assessing the effectiveness of medical or surgical therapy for reflux disease in adult patients with laryngeal or pharyngeal symptoms presumed to be due to gastro-oesophageal reflux disease.Randomized controlled trials comparing medical or surgical treatments for gastro-oesophageal reflux disease against placebo were identified by searching MEDLINE (1966-September 2005), EMBASE (1974-September 2005), the CCRCT (until September 2005) and abstracts from gastroenterology and ENT meetings. The relative risks of reporting symptomatic improvement or resolution of symptoms was evaluated using a random-effects model.Five studies using high-dose proton pump inhibitor as intervention met the inclusion criteria and were included in the meta-analysis. No surgical studies met inclusion criteria. The pooled relative risk was 1.18 (95% confidence interval: 0.81-1.74). There was no heterogeneity between studies but evidence of significant publication bias. Sub-group analysis performed evaluating Jadad scores and symptom type, did not change the relative risk.Therapy with a high-dose proton pump inhibitor is no more effective than placebo in producing symptomatic improvement or resolution of laryngo-pharyngeal symptoms. Further studies are necessary to identify the characteristics of patients that may respond to proton pump inhibitor therapy.

AIDS is frequently expressed through gastrointestinal o abdominal symptoms. In addition, patients with AIDS or ARC frequently have hepatic and biliary symptoms, while pancreatic alterations are found in 4-30% of patients hospitalised for AIDS. Since AIDS patients are immunodepressed, they are subject to opportunistic infection often multifocal and the pathological processes can be present simultaneously. About 2/3 of patients have enlarged liver, steatosis, splenomegaly, lymphoadenopathy, cholecystic and biliary tract abnormalities, alterations of liver function tests, and abdominal discomfort in the upper right quadrant. Jaundice is rare and hepatic failure is not common. Hepatic biopsy is often necessary to establish the diagnosis. The hepatic localisation of an opportunistic pathogenic agent is generally a sign of systemic dissemination which is expressed as granulomatous hepatitis (atypical mycobacteria, frequently mycobacterium avium, or M. tuberculosis representing the reactivation of latent diseases), peliosis hepatis, infection from CMV, HSV, EBV, Pneumocystis carinii, and mycotic infections. Coinfections with the hepatic virus (HBV, HDV, HCV) are also often present. Pharmacological damage may also be present (mainly caused by antibiotic therapies). Neoplasia are rare (hepatic Kaposi's sarcoma associated with cutaneous and gastrointestinal manifestations, or generally metastatic lymphoma). Damage of the biliary tract usually develops after other manifestations of the illness; the most frequent pictures are cholestatic syndromes and cholangitis, while cholecystitis and jaundice are rare. Pancreatic lesions are generally asymptomatic. They are diagnosed during autopsy and are caused principally by opportunistic agents.

Serum amylase and lipase concentrations were determined in 78 patients with chronic liver diseases [26 chronic active hepatitis (CAH) and 52 liver cirrhosis] and in 15 healthy subjects. Pancreatic isoamylase concentrations and macroamylase complexes were assayed in hyperamylasemic sera. Serum amylase levels were abnormally elevated in 27 patients (35%; 22 liver cirrhosis, 5 CAH), whereas serum lipase levels were elevated in 16 patients (21%; 15 liver cirrhosis, 1 CAH). In 9 of the 27 hyperamylasemic patients, the hyperamylasemia was of pancreatic type. Macroamylasemic complexes were not detected in hyperamylasemic sera. Patients with liver cirrhosis had serum levels of amylase and lipase significantly higher than both the healthy subjects and the patients with CAH, while no significant differences were found in serum levels of these enzymes in patients with CAH as compared to the healthy subjects. A decreased liver metabolism of serum amylase and lipase in patients with chronic infective liver disease, especially in those having liver cirrhosis, may lead to an accumulation of these enzymes in the blood.

The relationships among maternal weight, gestational weight gain, fetal birth weight and birth injuries have been investigated in connection with 62 cases of shoulder dystocia that involved permanent impairment of the newborn or neonatal demise. A high prevalence of13.5 kgs. gestational weight increase between the first and last office visits (62%) obesity expressed asor = 87 kg. body weight at term (64.1%) andor = 4000 gm. birth weight (80%) was found in this group of patients. The results indicate that the relationship between excessive maternal and fetal body weights and shoulder dystocia related fetal or neonatal impairment is closer than previous studies have suggested. These results underline the importance of appropriate and intensive nutritional counselling of the mother throughout pregnancy, noting that arrest of the shoulders is only one of those obstetric complications that are closely related to maternal obesity. The findings underline the usefulness of medico-legal reviews in clinical research.

The epidemiological associations of gallstone disease were evaluated in a general population sample of 29,584 individuals (15,910 men and 13,674 women; age range, 30-39 years) belonging to 14 cohorts examined between December 1984 and April 1987. Subjects were screened for the presence of gallstones by gallbladder ultrasonography, completed a questionnaire, and underwent a physical examination and blood chemistry tests. Participants were considered to have gallstone disease if they had already had cholecystectomy or gallstones. Statistical associations were established by univariate analysis of the age-standardized data and by stepwise multiple logistic regression. Increasing age and body mass index and a maternal family history of gallstone disease were the most consistent associations (both at univariate and multivariate analysis and in both sexes) found in this study. Personal history of dieting was associated with gallstone disease in men, and at univariate analysis, in women. Decreasing serum total cholesterol levels and increasing serum triglycerides were associated with gallstone disease in both sexes in the multivariate analysis. In women, associations were also found with a number of pregnancies and paternal family history of gallstone disease. A slight but negative association with contraceptive pill use was identified only at multivariate analysis. Associations (investigated at univariate analysis) were also found with diabetes, cirrhosis, angina or myocardial infarction, and peptic ulcer. There was no association with smoking habits and use of aspirin or antirheumatic drugs.

The role of liver transplantation in the treatment of hepatocellular carcinoma (HCC) is still debated. Overall survival is poor because of the high recurrence rate. Negative prognostic factors are the presence of large, multiple lesions, lymph node involvement, gross vascular invasion and extrahepatic metastases. On the other hand a long term survival (5 yrs), can be achieved in about 30 to 48% of transplanted patients. In the case of incidental tumours, the survival rate can be as high as 90%. Fibrolamellar HCC have a better prognosis than non fibrolamellar HCC. Due to the short supply of donor livers, OLT should be offered to those patients who have the highest probability of surviving.

Primary graft non-function remains one of the most life-threatening problems after liver transplantation. Its etiology is still unclear. Liver retransplantation is the only therapeutic alternative to this problem. The PGE1 series of prostaglandins have recently been successfully used in the treatment of transplanted organ dysfunction. In this paper we describe a case of primary graft non-function successfully treated with continuous infusion of prostaglandin PGE1, and we briefly discuss the pathogenetic and therapeutic hypotheses.

In this study we report the data obtained from extensive haemostatic testing of 25 patients undergoing orthotopic liver transplantation and the results of an open randomized pilot trial of antithrombin III concentrate administration during surgery. Marked differences in transfusional needs and in pre- and intraoperative blood coagulation and fibrinolytic changes were observed between recipients with liver cirrhosis and those with primary biliary cirrhosis. In the former, the increases in tissue-type plasminogen activator activity, total euglobulin fibrinolytic activity, and fibrin-derived degradation products occurred earlier and were more marked, as were the signs of increased thrombin formation. Supplementation of antithrombin III concentrate during surgery failed to induce significant changes in the main parameters studied and in the transfusional needs.

Summary Background Many investigators have proposed an association between gastro-oesophageal reflux disease and laryngo-pharyngeal symptoms, suggesting that medical or surgical therapy for reflux may be useful. Aim To perform a meta-analysis assessing the effectiveness of medical or surgical therapy for reflux disease in adult patients with laryngeal or pharyngeal symptoms presumed to be due to gastro-oesophageal reflux disease. Methods Randomized controlled trials comparing medical or surgical treatments for gastro-oesophageal reflux disease against placebo were identified by searching MEDLINE (1966–September 2005), EMBASE (1974–September 2005), the CCRCT (until September 2005) and abstracts from gastroenterology and ENT meetings. The relative risks of reporting symptomatic improvement or resolution of symptoms was evaluated using a random-effects model. Results Five studies using high-dose proton pump inhibitor as intervention met the inclusion criteria and were included in the meta-analysis. No surgical studies met inclusion criteria. The pooled relative risk was 1.18 (95% confidence interval: 0.81–1.74). There was no heterogeneity between studies but evidence of significant publication bias. Sub-group analysis performed evaluating Jadad scores and symptom type, did not change the relative risk. Conclusions Therapy with a high-dose proton pump inhibitor is no more effective than placebo in producing symptomatic improvement or resolution of laryngo-pharyngeal symptoms. Further studies are necessary to identify the characteristics of patients that may respond to proton pump inhibitor therapy.

In order to detect a possible relationship between alpha-fetoprotein (AFP) levels, total tumour volume at the moment of the discovery and the tumour volume doubling time, we studied a population of 138 patients, affected by Hepatocellular Carcinoma (HCC) discovered at abdominal ultrasound (US) examination and confirmed by liver biopsy in all cases. In each patient the serum AFP level was determined within a week before or after the US examination. A small therapy-free subgroup of 23 patients, was also serially observed for a mean period of 4 months, so making possible the evaluation of the tumour volume doubling time and its relationship with the initial value of AFP. In 81 patients (58.7%) the serum AFP resulted less than 20 ngr/ml in 21 (15.2%), between 20 and 200 and in 36 (26.1%) greater than 200ngr/ml. No statistical correlation was found between the tumour volume calculated on the basis of the US image at the moment of the discovery and the AFP level, even though very high levels (greater than 3000) were found only in large tumours. Furthermore the tumour doubling time was not correlated with the initial value of AFP.

In order to better evaluate some epidemiological findings observed during previous studies on large samples of free living populations we carried out a case-control study on a randomly selected group of subjects in a health spa, Boario Terme. Seven-hundred and thirty subjects, aged 40-69 years, participated in the study. The study protocol included an ultrasonographic examination of the upper abdomen, a physical examination, a questionnaire, and a blood sample. Prevalence of gallstone disease was two times higher in females (37.2%) than in males (19.7%) (RRMH = 1.88). Fifty out of the 80 gallstone subjects were not aware of the disease prior the study (62.5%), and 60 did not experience any specific biliary symptom (colic) in the 5 years prior the study. The so-called "nonspecific symptoms" were not found related to gallstone disease. Gallstone disease was positively related to number of pregnancies, obesity, and economical status. In conclusion the present study confirmed some results observed during previous epidemiological studies. In regards to symptoms present data suggest that biliary colic is the only specific symptom for gallstone disease. In addition, the high number of asymptomatic gallstones observed in this study suggests the need of more investigations on high-risk populations in order to make earlier diagnosis and eventually to prevent the disease.

A new device allowing sampling to be performed at any time, and using the filtrate obtained during hemodialysis is described. The device was used in 27 patients undergoing regular dialysis. Urea, creatinine and potassium were measured in samples taken both from arterial blood and from the device at 10, 40, 120 and 230 minutes after the beginning of the dialysis. The results were compared. A constant bias of about 10% was noted between the two sets of results but statistical analysis showed this was correctable.

A new device measuring water removal during standard dialysis is evaluated. The filtrate, collected from a small hemofilter inserted into a normal Cuprophan hollow-fiber dialyzer, was used to evaluate the total water removed from the patient. The device was tested in 46 patients undergoing regular dialysis treatment; the body weight loss ranged from 300 to 5,600 ml for a total of 71 dialysis sessions. Results confirmed the reliability of the device, as the mean prediction error was 5.4%. No influence of the dialyzer blood rest volume on the prediction error was observed. The authors propose this system as an alternative to bed or armchair scales and emphasize its usefulness for experimental purposes.

Cytologic examination of peritoneal fluid showed only malignant squamous cells, without revealing adenocarcinomatous cell components, in a patient who had an endometrioid adenosquamous-cell carcinoma of the ovary. Histologic examination of the ovary demonstrated diffuse squamous-cell carcinoma with rare foci of endometrioid and abortive malignant glands, as well as isolated mucin-positive cells. The cytologic differential diagnosis of malignant squamous cells in peritoneal fluid and the pathogenesis of squamous-cell carcinoma of the ovary are discussed.

An investigation is made into the net flow rate and fluid viscosity influence on backmixing in multistage, baffled and unbaffled, mixer columns. Results are correlated with reference to both interstage backflow rate and intrastage backflow rate, the latter being a new fluid-dynamic parameter introduced in this paper. Consideration is also given to the problem of determining a limit of the reliability of the model of a cascade of ideal tanks with backmixing.

The effect of administration of primary and secondary bile acids on absorption of cholesterol was investigated in 15 volunteers. Eight Caucasians with radiolucent gallstones were studied before and after administration of chenodeoxycholic acid (all eight) and cholic acid (eight before, six after treatment) for 3 months, and seven healthy subjects were studied before and five were studied after administration of deoxycholic acid for 6 weeks. The hourly absorption of [3H]cholesterol was measured for 24 hours in a 20-cm duodenal segment by use of an intestinal perfusion technique. Fasting serum cholesterol and triglyceride levels were also measured before and after administration of bile acid. In patients with gallstones, absorption of cholesterol in the duodenum, expressed as the mean (+/- SEM) percentage of [3H]cholesterol absorbed hourly for 24 hours, was not significantly different after administration of chenodeoxycholic (22.5 +/- 4.4%) or cholic (25.6 +/- 5.9%) acid when compared with the pretreatment value (21.1 +/- 4.3%). Moreover, administration of chenodeoxycholic and cholic acid did not affect serum lipid levels. In contrast, administration of deoxycholic acid to healthy volunteers suppressed [3H]cholesterol absorption (13.2 +/- 3.2%) compared with that of the pretreatment period (26.5 +/- 3.8%) and decreased serum cholesterol levels by 15%. Our results suggest that chenodeoxycholic acid decreases the concentration of cholesterol in bile and dissolves gallstones by a mechanism other than inhibition of absorption of cholesterol. The data also indicate that the hypocholesterolemic effect of deoxycholic acid is due to the inhibition of intestinal absorption of cholesterol.

Chenodesoxycholic acid (500-750 mg/day Chenoxyl) was employed over a period of 9 months in the treatment of 40 patients with radiotransparent calculi in a functioning gallbladder and 8 with choledochal lithiasis. Radiological examination and complete hepatological exploration were carried out before and after the treatment in all cases. Complete dissolution was obtained in 6 and 2 cases respectively, with reduction of size in 13 and 2, and no change in 21 and 4. No significant variations were notes in the blood lipid picture or in liver function. There were no cases of diarrhoea.

Original and known methods and ordinary routine tests were used to evaluate changes in bile salts, phospholipids and cholesterol and in serum lipids induced in 50 patients during treatment with chenodeoxycholic acid (2-12 mg/Kg/day) for about 15 months. No significant differences in serum lipids, though a clear fall in triglycerides was noted in those who received 7-12 mg/Kg/day as opposed to 2-7 mg/Kg/day. There was a marked fall in the molar percentage of biliary cholesterol, followed by a significant reduction in the saturation index of Metzger. Once again, greater reduction was noted in patients receiving the higher dose range. A correlation between the dose used and the percentage of cholesterol in the bile was thus evident. After treatment, chenodeoxycholic acid was the main bile acid and there was a significant fall in cholic and deoxycholic acid. The desired drug effect can be obtained with low doses (7-12 mg/Kg/day) and a biliary chenodeoxycholic value well below 90%.

A case of monolobar localization of Caroli's disease with intrahepatic cholesterol gallstones is described. The patient was successfully treated with left hepatic resection. Residual intrahepatic cholesterol gallstones causing frequent cholangitis dissolved with chenodeoxycholic acid treatment.

58 patients suffering from cholesterol gallstones were treated with chenodesoxycholic acid at a dose of 2-15 mg/Kg/die for about 15 months so as to determine its effettiveness and establish a minimum effective dose. 8 of these patients presented stones in the common bile duct. The results showed: a complete dissolution of the stones in 16 of the 50 patients considered to be suffering from cholecystic lithiasis; partial dissolution in 15; no change in the remaining 19. Of the 8 patients with bile duct stones, 3 presented complete dissolution, 2 partial, and 3 no change. An improvement in digestive function was observed in most cases. The liver function tests carried out in each patient before, during and after treatment with chenodesoxycholic acid were completely normal.

A multicompartmental model was applied to the study of the plasmatic and biliary kinetics of the 14C-Cholic acid intravenously injected into a baboon in normal and cholestatic condition. For the evaluation of transfer rates FORTAN IV procedures were used, utilizing Powell method. The degree of fitting was: in normal condition in serum 7% for free and 35% for conjugated Cholic acid, while in bile 5% and 4% respectively; in serum in cholestatic condition 7% for free and 12% for conjugates. The high degree of fitting and reliable estimation of transfer rates suggest that the multicompartmental model applied represents most likely the physio-pathological conditions studied.

Use of dermal graft for a urethral sling in treating urinary stress incontinence is described. This tissue has potential advantages of availability, strength, and freedom from side effects.

The relation between malabsorption of bile acids, the bile lipid composition, and biliary stones was examined in 8 patients subjected to ileal resection (particularly for Crohn's disease), 6 with ileal bypass for morbid obesity, and 10 healthy controls. The 1-14C-cholylglycine breath test was employed to detect of the absorption and deconjugation of bile acids. Bile lipid composition was expressed according with Metzger's saturation index. Healthy subjects gave normal findings in all respects, whereas ileal resection was accompanied by malabsorption, increased deconjugation, and faecal loss of 14C. These changes, particularly malabsorption, were more evident after ileal bypass. Preoperative saturation values rose to more than 1 in all cases, especially after resection. Liver disease (steatosis and cirrhosis) 6 months after bypass, together with cholesterol lithiasis in 2/6 patients.

The results of a tiral using chenodeoxycholic acid in 400 patients with cholesterol gallstones are reported. The "qualifying points" of such treatment are compared with the literature data in clinical and laboratory terms. 54% of 300 in clinical and laboratory terms. 54% of 300 patients who received less than 12 mg/kg/day achieved dissolution in a mean time of 11 months, while 64% of the remainder (12-15 mg/kg/day) did so in an average of 8 months. Microcalculi proved most sensitive to treatment (65% of positive results). Lithiasis over 5 years standing and over-weight (10% over the ideal figure) were factors that imposed more protracted treatment. Careful selection of candidates was proved important by the results of quarterly liver and intestine performance examinations. These were more extensive and more clearly aimed than those proposed by other workers. They showed that the acid is neither hepato nor enterotoxic. Indeed, no serious side-effects were noted.

In a double-blind crossover design we compared dihydroxydibutylether (DHBE) with placebo in ten patients with cholesterol gallstones. The results showed that DHBE reduced (p less than 0.01) the bile saturation index (SI). The bile lipid composition demonstrated that the reduced SI was due to a decrease (p less than 0.01) in the molar percentage of cholesterol. There was no significant modification in biliary acid and phospholipid molar percentage.

A novel integration scheme for the formation of stack capacitor electrodes and diffusion barriers is presented. The concept makes use of chemical mechanical polishing of noble metals and allows the integration of a dielectric barrier. Electrical data is presented showing excellent parametric yield of contact resistance comparable to standard integration using RIE. Based on the data presented, a variety of new integration schemes for new materials can be deducted.