Harold P. Roth

Cholesterol Solubilization by Solutions of Bile Salts and Bile Salts Plus Lecithin

Summary Model synthetic solutions were used to study cholesterol solubilization by the 6 conjugated bile salts found in human bile individually and as a mixture, and by lecithin in combination with bile salts. In the range of concentrations found in bile, bile salts alone solubilized only about one third as much cholesterol as might be found in comparable concentrated human gallbladder bile. Between 0.023 and 0.046 mmoles of cholesterol were solubilized per mmole of bile salts. Addition of lecithin to a bile salt solution increased the quantity of cholesterol dissolved to values observed in bile; 0.36 mmoles of cholesterol was solubilized per mmole of added lecithin. Cholesterol solubilization by lecithin was independent of the concentration and nature of the bile salt.

Compliance with disulfiram treatment of alcoholism

One hundred twenty-four men were randomly assigned to receive disulfiram with a riboflavin marker or riboflavin alone. During a one year follow-up urine specimens were collected at each visit and analyzed for riboflavin. There was a strong relationship between excellent attendance and infrequent drinking. For subjects taking disulfiram there was a high correlation between a subject submitting 15 or more positive urines during follow-up and infrequent drinking. For the disulfiram patients there was also a strong relationship between continuous usage of disulfiram and infrequent drinking. However, the correlation between percentage of urine specimens positive for the riboflavin marker and infrequent drinking was slight. This occurred because a person who was drinking tended to return for follow-up only when he was not drinking and thus submitted only a few specimens of which the majority were positive. We conclude that (1) excellent attendance, (2) submission of a large number of positive urines and (3) a period of continuous compliance to the disulfiram regimen were highly associated with infrequent drinking.

Method for the detection of diethylamine, a metabolite of disulfiram, in urine

Disulfiram is a drug used in the treatment of chronic alcoholism in man. Accurate assessment of patient compliance is important in this treatment. This paper describes a method for the detection and quantitative analysis of diethylamine, a metabolite of disulfiram, in urine. The method involves conversion of the water-soluble diethylamine in the urine to a derivative, N,N-diethyl-3,5-dinitrobenzamide, that is soluble in an organic solvent. This derivative is extracted from urine with diethyl ether and then subjected to thin-layer chromatography. A spectrophotometric procedure is used for quantification. This method provides a means of determining whether or not a patient is taking his prescribed disulfiram.

Patients' Beliefs about Peptic Ulcer and Its Treatment

Excerpt Peptic ulcer falls into an enlarging group of diseases in which the most important problem is the prevention of recurrences rather than the treatment of the acute phases. Such prevention us...

The effect of modifications of lecithin and cholesterol on the micellar solubilization of cholesterol.

Abstract 1. 1. Differences in the degree of unsaturation of lecithin and lysolecithin had little effect on the quantity of cholesterol solubilized by micellar solutions of bile salts and lecithin or lysolecithin. A lecithin containing 83% unsaturated fatty acids was isolated from cabbage. This lecithin, when added to solutions containing 180 mM sodium taurocholate, solubilized 0.35 ± 0.02 mmole of cholesterol per mmole of lecithin; an amount similar to that solubilized by egg lecithin (0.37 ± 0.02 mmole) and human bile lecithin (0.39 ± 0.04 mmole) which contain only 50% unsaturated fatty acids. 2. 2. Cabbage lysolecithin contained 61% unsaturated fatty acids. This lysolecithin, when added to solutions containing 180 mM sodium taurocholate, solubilized as much cholesterol (0.20 ± 0.01 mmole) as the lysolecithin from egg (0.19 ± 0.01 mmole) which contains only saturated fatty acids. 3. 3. Solutions of taurocholate and lecithin solubilized less cholestanol (0.29 ± 0.01 mmole) than cholesterol (0.37 ± 0.02 mmole) and considerably less cholesteryl acetate (0.04 ± 0.01 mmole).

Patients' accuracy in reporting their past medical history, a study of 90 patients with peptic ulcer

Abstract Ninety patients with peptic ulcer disease were interviewed concerning a hospitalization for active ulcer symptoms. Their interview responses were compared with data from their hospital charts. Significant discrepancies were found in the reporting of admission dates, weights, and the symptoms, vomiting and melena. Discrepancies were greater for more remote hospitalizations. No significant correlation was found between IQ and accuracy in reporting past medical history.

Objective assessment of cooperation with an ulcer diet: relation to antacid intake and to assigned physician.

In order to measure adherence to a dietary regimen, patients assigned to diets for peptic ulcers were observed under conditions that permitted them to choose a more lenient diet by using an unauthorized diet card. The median patient took his prescribed ulcer diet on 76 per cent of all observed days, but one-fourth of the patients cooperated on less than 60 per cent of all days. The groups of patients assigned to various physicians differed in mean cooperation level. No relationship was found between a patients level of cooperation with the diet and his cooperation with his antacid regimen.

Formula for approximating plasma concentration

The footnote on p. 231 of our article (this JOURNAL 11:228‐237, 1970) was to indicate the primacy [of Dr. John G. Wagner] in providing a formula for approximating plasma concentrations and was not meant to imply that our formula was superior. We regret that our method of expressing this was ambiguous.