LSG is an effective procedure for the treatment of morbid obesity and its associated inflammatory state. One year after surgery, development of iron deficiency was insignificant.

Massive weight loss in morbidly obese patients induced by LSG causes a significant decrease in CRP levels, which could reduce the risk of cardiovascular diseases in these patients.

1. Plasma oxalate has been measured by a radioisotopic method applicable to all concentrations of plasma oxalate and renal function, and also by an enzymatic method which was only applicable to raised concentrations of plasma oxalate. 2. Where the two methods could be applied simultaneously, the agreement between them was good. 3. Plasma oxalate was 86% ultrafiltrable at concentrations of up to 44 micromol/l. 4. Oxalate clearance and the exchangeable oxalate pool were also measured. The ratio of oxalate clearance to creatinine clearance was greater than unity in most normal subjects and patients. 5. These methods were used in normal subjects and in patients with primary hyperoxaluria and/or chronic renal failure. A raised plasma oxalate concentration was found in both conditions. Chronic renal failure is probably the most common cause of a raised plasma oxalate.

Advanced laparoscopic biliary procedures can be undertaken in a pig model, but the small size of the normal common bile duct makes learning difficult. We have developed a prepared pig model of common bile duct ligation on which to practice advanced laparoscopic biliary surgery. The pig's distal common bile duct was occluded using several different methods via a minilaparotomy. Laparoscopic biliary procedures were undertaken 6-21 days later. The common bile duct became dilated to between 2 and 3 cm in diameter in all cases, and this was well tolerated by the animals. All advanced laparoscopic biliary procedures were possible, including choledochoscopy, exploration of the bile duct, and cholecystojejunostomy. Short-term common bile duct ligation is well tolerated in pigs and can be used to create a model for practicing advanced laparoscopic biliary procedures.

A common variety of Myopovum deserti A. Cunn. (Ellangowan Poison Bush) yields an essential oil consisting largely of the iridoid monoterpene, (1R)-1-methoxymyodesert-3-ene, C11Hls02, (1 R,4aS,7R,7aR)-1-methoxy-4,7-dimethyl-l,4a,5,6,7,7a-hexahydrocycopenta[c]pyran, b.p. 6772 mm, [@lo -165'. This cyclic acetal is hydrolysed to methanol and a mixture of two epimeric cyclopentanoid dialdehydes which are oxidized to the two epimeric trans,trans-nepetalinic acids and yield (+)-(R)actinidine with Brady's reagent. (1R)-1-Methoxymyodesert-3-ene is oxidized by ozone/hydrogen peroxide to (1R,2R,5R)-2-acetyl-5-methylcyclopentanecarboxylic acid.Hydrogenation yields mainly (1R)-methoxymyodesertan, hydrolysed by aqueous maleic acid at room temperature to methanol and a cyclic hemiacetal, (lR,4R,4aR,7R,7aR)-4,7-dimethyl-1,3,4,4a,5,6,7,7a-octahydrocyclopenta[c]pyran-1-01, Oxidation of this cis&-hemiacetal by bromine in acetate buffer yields a lactone further oxidized by chromic acid to (2R,1'S,2'R,3'R)-2-(2'-carboxy-3'-methylcyclopentyl)propionic acid.(1R)-1-Methoxymyodesertan, refluxed with aqueous phthalic acid, yields (+)-(4R,4aR,7R)-4,7-dimethyl-3,4,4a,5,6,7-hexahydrocyclopenta[c]pyran. Treatment of the hexahydropenta[c]pyran, the cis,cis-hemiacetal or (1R)-1-methoxymyodesertan with hydrochloric acid yields a tvans,transhemiacetal, (1 R,4R,4aR,7R,7aS)-4,7-dimethyl-1,3,4,4a,5,6,7,7a-octahydrocyclopenta[c]pyran-l-ol, which equilibrates in solution to a mixture of a-and j3-anomers. Spectral studies of these and other products establish the configuration of the natural product at C 1.(1R)-1-Methoxymyodesert-3-ene is not toxic to sheep as are the j3-substituted furans characteristic of most other chemovarieties of M. desevti.The shrub Myoporum deserti A. Cunn. (Ellangowan Poison Bush), which is found in the drier areas of Australia, is a well authenticated stock poison.' Previous parts2 of this series have described the isolation and chemistry of 11 toxic furanoid sesquiterpene ketones, such as (1) and (2), from various chemovarieties of the species but certain others contain iridoid monoterpenes accompanied by little or none of the toxic furanoid derivatives.