Alcohol related end-stage liver disease is a principal cause of liver failure. The scarcity of donor livers and the predominance of alcohol related end-stage liver disease has raised the issue of including alcoholics as candidates for liver transplantation. In rationalizing the arguments for and against the treatment of alcoholic end-stage liver disease with transplantation, factors such as recidivism, resource allocation and principles of medical practice must be considered. Public confidence in organ transplantation depends on the scientific validity and moral integrity of the policies adopted. Sound policies will prove defensible while policies based on perceptions or prejudices will, in the long run, harm the process.

Derniers developpements dans la physiologie du grele: Deuxieme partie RESUME: Le present article procede a la revue des progres recemment realises Jans les maladies Ju grc le qui son t d'interet clinique; neanmoins, nombre de ces progres cliniq ucs sont fondes sur des observations importantes des a lterntions de la physiologic du gre le, ainsi que sur des observations mecaniques Jes a lterations fonctionnelles du grele Jans des mode les experimentaux de maladies humaines. Les auteurs proposent un somm ai re de la line rature de l'annee precedente, soulignant ains i l'arnpleur considerable des progres realises dans la physiologic de l'inrestin grele, lesquels se Lraduiront bientol par une rne illeure compre hension Je la physiopathologie d'une varicte d'affections intestinales.

The recent advances in cl inically imporrnnt d iseases of the small mtestine have been reviewed; however, the basis for many of t hese clinical advances rests wi th important observations on alterations in the ph ysio logy of the small intestine, as well as mechanistic observa tions of altera tions in small intestinal function in mode ls of human disease. In th is review a summa ry of the past year's literature is p resented whic h will draw attention t0 the considerable areas of progres in small bowel physio logy wh ich will soon be rnmsla ted into an improved understanding of the pathophys iology of a varie ty of intestinal disorders. Can J Gastrocnterol 1990;4(6)243-254 Derniers developpements clans la physiologie du grele: Premiere partie RESUME: Le present article proccde a la rev ue des progres recemment realises dans les maladies du grele q ui sont d'interet clinique; neanmoins, nombre de ces progres cliniques sonr fondes sur des observations importances des alte rations de la physiologic du grele, ainsi que sur des observations mecaniques de altern tions fonctionnclles du grele clans des modeles e xperimenra ux de malad ies humaincs. Les auteurs proposen t un sommairc Je la lirrerature de l'annee preceden ce, soulignanr ainsi l'ampleur consi0011 be tra nslated into an 1mrroved understanding ot the pmhor,hy1,io lngy nt a variety o( imcst mal cl isnrdcrs.CARBO HYDRATES The muleculm organization o( the 111 tcst i nal h rush horde r me m hra n e (BBM) ha~ hccn reviewed (2). Un 14ue isuactms have heen idcmificd in the BBM of ra1 intestinal epithelial cells (3). The plasmn membranes of most mmnmal1an cells have an exrernall y exj)()Scd layer of carbohydrntcs. These ca rhohydrate mn1e1 1es arc associated with glycnprote1m ,1nd glycnlirids, playing an im ponanr rule in growth regulation, cell ad hesion, recognitton anJ antigcnici t y. There are diffe rences in the glycorrotcm and glycolip1d compositi ons of BBM and hasola t ernl mcmhranes (BLM) of rat small inrestine ( 4). Perhaps the hcst c haracterized ot t he stalked me mbrane proteins is the sucrasc-iM1111 altase comr lex wh ic h r,rojccts from the BBM surface into the mternrnd lumen. Phnspho l ipasc B also has the characteristtcs of a stalked BBM prnte m ( 5). G lucose: lntesrinal...