Studies on the cholelithiasis: especially on the difference in the process of gallstone formation between cholesterol stone and bile pigment stone

Blood destruction due to a single injury, as by sodium oleate, or acting through a short period of time, as by toluylenediamine or hemolytic immune serum, is not characterized, in the absence of hemoglobinuria, by an increased elimination of iron in the urine. This holds, not only for the evanescent injury caused by sodium oleate, but also for the severe type caused by hemolytic immune serum, in which a progressive destruction of the blood may persist for 2 weeks or more with constant evidence of the disintegration of erythrocytes as shown by bile pigment in the urine. This finding is in accord with previous investigations of anemia in both man and animals. Likewise, no striking increase is evident, under such circumstances, in the percentage of iron excreted in the feces. The total amount of iron in the feces has been notably increased in two experiments with hemolytic serum, but as the percentage was not appreciably altered, the difference depends presumably on variations in the bulk of feces rather than upon increased elimination. This evidence of the power of the body to conserve the iron rephagocytosis is negligible, is to be fragmented one by one, while still circulating, to a fine, hemoglobin-containing dust. The cell fragments are rapidly removed from the blood, but their ultimate fate remains to be determined. The facts indicate that they are removed from the blood by the spleen, and under exceptional conditions, by the bone marrow.

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Quantitative trait loci mapping for cholesterol gallstones in AKR/J and C57L/J strains of mice

Physiological Genomics ◽

10.1152/physiolgenomics.2000.4.1.59 ◽

2000 ◽

Vol 4 (1) ◽

pp. 59-65 ◽

Cited By ~ 58

Author(s):

BEVERLY PAIGEN ◽

NICHOLAS J. SCHORK ◽

KAREN L. SVENSON ◽

YIN-CHAI CHEAH ◽

JIAN-LONG MU ◽

...

Keyword(s):

Quantitative Trait ◽

Congenic Strain ◽

Cholesterol Gallstone ◽

Gallstone Disease ◽

Gallstone Formation ◽

Quantitative Trait Loci Mapping ◽

Cholesterol Gallstones ◽

Lithogenic Diet ◽

The Difference ◽

Trait Locus

Quantitative trait locus (QTL) mapping was used to locate genes that determine the difference in cholesterol gallstone disease between the gallstone-susceptible strain C57L/J and the gallstone-resistant strain AKR/J. Gallstone weight was determined in 231 male (AKR × C57L) F1× AKR backcross mice fed a lithogenic diet containing 1% cholesterol, 0.5% cholic acid, and 15% butterfat for 8 wk. Mice having no stones and mice having the largest stones were genotyped at ∼20-cM intervals to find the loci determining cholesterol gallstone formation. The major locus, Lith1, mapped near D2Mit56 and was confirmed by constructing a congenic strain, AK.L- Lith1s. Another locus, Lith2, mapped near D19Mit58 and was also confirmed by constructing a congenic strain AK.L- Lith2s. Other suggestive, but not statistically significant, loci mapped to chromosomes 6, 7, 8, 10, and X. The identification of these Lith genes will elucidate the pathophysiology of cholesterol gallstone formation.

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PIXE ANALYSIS OF GALLSTONES

International Journal of PIXE ◽

10.1142/s0129083505000453 ◽

2005 ◽

Vol 15 (03n04) ◽

pp. 147-152 ◽

Cited By ~ 5

Author(s):

T. R. RAUTRAY ◽

V. VIJAYAN ◽

M. ASHOK ◽

J. V. KENNEDY ◽

V. JAYANTHI ◽

...

Keyword(s):

Trace Elements ◽

Minor Element ◽

Southern Region ◽

Cholesterol Stone ◽

Eastern Region ◽

Accelerator Facility ◽

Pixe Analysis ◽

Pigment Stone ◽

Human Gallstone ◽

A Minor

Particle Induced X-ray Emission (PIXE) technique has been used to determine the trace elements present in fourteen representative human gallstone samples collected from eastern region (Orissa) and thirteen representative samples collected from southern region (Chennai) of India. PIXE irradiation of the samples has been carried out by using the 3 MV tandem type horizontal pelletron accelerator facility at Institute of Physics, Bhubaneswar with proton beam of energy 3 MeV. In the present investigation, twenty one trace elements like S , Cl , K , Ca , Ti , V , Cr , Mn , Fe , Ni , Cu , Zn , As , Se , Br , Rb , Sr , Y , Zr , Mo and Pb have been estimated in all the three types of gallstones viz. cholesterol stone, mixed stone and pigment stone. While sulphur in cholesterol stones in the eastern region was less than that of the southern region, sulphur was present as a minor element in the pigment stones of both the regions. Less concentration of copper in the gallstones from eastern region is another interesting observation. The lower values of copper in the patients of eastern region may be due to different types of food habits. The concentrations of all the elements in the southern region pigment stones have higher values than that of the eastern region. Moreover, the concentrations of Fe and Mo in cholesterol stone and pigment stone samples in southern region have also higher values than in eastern region. The current PIXE study is of its first kind in this eastern region of India.

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Reverse-phase h.p.l.c. separation, quantification and preparation of bilirubin and its conjugates from native bile. Quantitative analysis of the intact tetrapyrroles based on h.p.l.c. of their ethyl anthranilate azo derivatives

Biochemical Journal ◽

10.1042/bj2250787 ◽

1985 ◽

Vol 225 (3) ◽

pp. 787-805 ◽

Cited By ~ 105

Author(s):

W Spivak ◽

M C Carey

Keyword(s):

Cholesterol Gallstone ◽

Sample Pretreatment ◽

Gallstone Formation ◽

Experimental Models ◽

Bile Pigment ◽

Bile Pigments ◽

Reverse Phase ◽

Standard Curve ◽

Preparative Separations ◽

Azo Derivatives

We describe a facile and sensitive reverse-phase h.p.l.c. method for analytical separation of biliary bile pigments and direct quantification of unconjugated bilirubin (UCB) and its monoglucuronide (BMG) and diglucuronide (BDG) conjugates in bile. The method can be ‘scaled up’ for preparative isolation of pure BDG and BMG from pigment-enriched biles. We employed an Altex ultrasphere ODS column in the preparative steps and a Waters mu-Bondapak C18 column in the separatory and analytical procedures. Bile pigments were eluted with ammonium acetate buffer, pH 4.5, and a 20 min linear gradient of 60-100% (v/v) methanol at a flow rate of 2.0 ml/min for the preparative separations and 1.0 ml/min for the analytical separations. Bile pigments were eluted in order of decreasing polarity (glucuronide greater than glucose greater than xylose conjugates greater than UCB) and were chemically identified by t.l.c. of their respective ethyl anthranilate azo derivatives. Quantification of UCB was carried out by using a standard curve relating a range of h.p.l.c. integrated peak areas to concentrations of pure crystalline UCB. A pure crystalline ethyl anthranilate azo derivative of UCB (AZO . UCB) was employed as a single h.p.l.c. reference standard for quantification of BMG and BDG. We demonstrate that: separation and quantification of biliary bile pigments are rapid (approximately 25 min); bile pigment concentrations ranging from 1-500 microM can be determined ‘on line’ by using 5 microliters of bile without sample pretreatment; bilirubin conjugates can be obtained preparatively in milligram quantities without degradation or contamination by other components of bile. H.p.l.c. analyses of a series of mammalian biles show that biliary UCB concentrations generally range from 1 to 17 microM. These values are considerably lower than those estimated previously by t.l.c. BMG is the predominant, if not exclusive, bilirubin conjugate in the biles of a number of rodents (guinea pig, hamster, mouse, prairie dog) that are experimental models of both pigment and cholesterol gallstone formation. Conjugated bilirubins in the biles of other animals (human, monkey, pony, cat, rat and dog) are chemically more diverse and include mono-, di- and mixed disconjugates of glucuronic acid, xylose and glucose in proportions that give distinct patterns for each species.

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The Ability of Bile to Scavenge Superoxide Radicals and Pigment Gallstone Formation in Guinea Pigs

HPB Surgery ◽

10.1155/1996/20687 ◽

1996 ◽

Vol 10 (2) ◽

pp. 73-77 ◽

Cited By ~ 3

Author(s):

Cong Lin ◽

Tao Shen ◽

Xianbo Fu ◽

Xiaosi Zhou

Keyword(s):

Bile Duct ◽

Guinea Pigs ◽

Biochemical Analysis ◽

Gallstone Formation ◽

Control Group ◽

Exact Probability ◽

Pigment Gallstones ◽

Pigment Gallstone ◽

The Common ◽

The Difference

After partial ligation of the common bile duct (CBD) of guinea pigs, 14 of 16 animals developed pigment gallstones within one week (S group). Intraperitoneal injection of Vit. E and C, each 10 mg/kg daily from 3 days before CBD ligation to one week after the operation (S+V group), decreased the gallstone incidence to 5/14 (exact probability<0.01). The gallstone incidence in the control group, that only received laparotomy without ligation of the CBD, was 0/15. Biochemical analysis of the gallbladder bile showed that stricture of the CBD was associated with a significant increase in levels of unconjugated bilirubin (UCB) and Ca2+ (p<0.05 and <0.01). Simultaneously the scavenging rate (SR) of superoxide radical in bile significantly decreased (p<0.05). Comparing S+V group with S group, the effect of Vit. E and C on the concentrations of UCB and Ca2+ in bile was not significant (both p>0.05), but Vit. E and C normalized the SR, and the difference between S group and S+V group was significant (p<0.05). These results suggested that Vit. E and C, known as antioxidants, enhanced the ability to scavenge oxygen radical in S+V group; and that in addition to the increases of UCB and Ca2+ concentrations, the participation of oxygen radicals might be of importance for pigment gallstone formation induced by bile duct obstruction.

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Ultrastructural Analysis of Human Gallstones using Synchrotron Radiation µCT

Combinatorial Chemistry & High Throughput Screening ◽

10.2174/1386207322666190222122007 ◽

2019 ◽

Vol 22 (1) ◽

pp. 13-17

Author(s):

Weixin Chen ◽

Riming Liu ◽

Suo Tao ◽

Weixing Shen ◽

Weihong Zhou ◽

...

Keyword(s):

Synchrotron Radiation ◽

Phase Contrast ◽

Gallbladder Disease ◽

Three Dimensional ◽

Gallstone Formation ◽

Pathological Process ◽

Bile Pigment ◽

Imaging Data ◽

Depth Study ◽

Radiation Phase

Objective: Gallstone formation is a pathological process of mineralization in the human body. Determination of the morphology and ultrastructure of gallstones holds the key to understanding the pathophysiology of gallbladder disease. Synchrotron radiation phase-contrast Xray microtomography is a novel technology, which is designed for comprehensive analysis of gallstone ultrastructure. Materials and Methods: Nine human gallstones were obtained from the Department of Pathology, Qingpu branch of Zhongshan Hospital Affiliated to Fudan University (China), and scanned by synchrotron radiation µCT (SR µCT). The imaging data generated by SR µCT scan were analyzed. Results: The three-dimensional ultrastructure of human gallstones corresponding to their cholesterol and bile pigment composition was determined. Conclusions: The ultrastructure of gallstones exhibits considerable diversity and complexity. The synchrotron radiation phase-contrast X-ray microtomography is a valuable tool for in-depth study of human gallstones.

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Gallensteine – interdisziplinäre Behandlung

DMW - Deutsche Medizinische Wochenschrift ◽

10.1055/a-0944-8655 ◽

2020 ◽

Vol 145 (05) ◽

pp. 287-295

Author(s):

Philipp Robert Scherber ◽

Silvia Eugenia Zúniga ◽

Matthias Glanemann ◽

Frank Lammert

Keyword(s):

Physical Inactivity ◽

Genetic Factors ◽

Acute Cholangitis ◽

Gallstone Formation ◽

Current Treatment ◽

Bile Pigment ◽

Biliary Pancreatitis ◽

Interdisziplinäre Behandlung ◽

Treatment Algorithms ◽

Life Threatening

AbstractGallstones develop in the gallbladder or the bile ducts. According to their chemical composition, gallstones can be divided into cholesterol stones, which are common, and the rare bile pigment stones. Altogether, up to 20 % of all adults develop gallstones and more than 20 % of them symptoms or complications. Female sex, age, pregnancy, physical inactivity, obesity, overnutrition and genetic factors such as ABCB4 deficiency of the hepatic lecithin transporter are kown risk factors for gallstone formation. In about one half of all patients biliary symptoms precede the three common and potentially life-threatening complications (acute cholecystitis, acute cholangitis and biliary pancreatitis). Although our knowledge about the genetics and pathophysiology of gallstones has improved, current treatment algorithms are predominantly invasive (ERC and surgery). Thus, better strategies are needed to prevent the formation of gallstones in general.

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“Fingerprinting” the pigments in bile: Pigment gallstone formation

Gastroenterology ◽

10.1016/0016-5085(78)93115-3 ◽

1978 ◽

Vol 74 (5) ◽

pp. 1031 ◽

Cited By ~ 3

Author(s):

E. Englert ◽

E.E. Wales ◽

A.W. Wayne ◽

R.C. Straight

Keyword(s):

Gallstone Formation ◽

Bile Pigment ◽

Pigment Gallstone

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A Study on Bacterial Etiology of Cholecystitis due to Gallstones and their Antimicrobial Susceptibility Pattern in A Tertiary Care Hospital

International Journal of Current Microbiology and Applied Sciences ◽

10.20546/ijcmas.2021.1011.015 ◽

2021 ◽

Vol 10 (11) ◽

pp. 116-119

Author(s):

B. Gomathi Manju N. Rathna Priya ◽

G. Jayalakshmi

Keyword(s):

Adult Population ◽

Tertiary Care ◽

Cross Sectional Study ◽

Klebsiella Pneumonia ◽

Cholesterol Stone ◽

Care Hospital ◽

Cross Sectional ◽

Pigment Stone ◽

Antimicrobial Susceptibility Pattern ◽

Complications Of Cholelithiasis

Cholelithiasis is a very common condition affecting the Gallbladder. Gallstones are present in 10 -15 % of the adult population. Females are three times more likely to develop Gallstones than male. Gall stones are classified into cholesterol and pigment stone. About 80% of them are cholesterol stone and 15-20% pigment stone. Obstruction and infections are the common complications of Cholelithiasis. Approximately 1-2% of the patients become symptomatic and warrants cholecystectomy (1). With this background we conducted a cross sectional study in the Institute of Microbiology, MMC & RGGGH, for 72 consecutive patients who underwent cholecystectomy. The most common age group affected 41-60 yrs. The most common symptoms are abdominal pain, dyspepsia and Jaundice. In this study Gallstones are collected after surgery, processed and Antibiogram pattern also studied as per standard guidelines. Out of 72 samples studied 35 (48.6%) are culture positive. Escherichia coli is the predominant organism isolated followed by Klebsiella pneumonia(52). Most of the isolates were sensitive to commonly used antibiotics for Gram Negative bacilli.

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Non-enzymic hydrolysis of bilirubin mono- and diglucuronide to unconjugated bilirubin in model and native bile systems. Potential role in the formation of gallstones

Biochemical Journal ◽

10.1042/bj2420323 ◽

1987 ◽

Vol 242 (2) ◽

pp. 323-329 ◽

Cited By ~ 32

Author(s):

W Spivak ◽

D DiVenuto ◽

W Yuey

Keyword(s):

Guinea Pig ◽

Sodium Taurocholate ◽

Gallstone Formation ◽

Unconjugated Bilirubin ◽

Bile Pigment ◽

Bile Pigments ◽

Enzymic Hydrolysis ◽

Pigment Gallstones ◽

Model Bile ◽

Hydrolysis Of

Pigment gallstones contain considerable amounts of unconjugated bilirubin (UCB) in the form of calcium bilirubinate and/or bilirubin polymers. Since more than 98% of bile pigments are excreted as conjugates of bilirubin, the source of this UCB needs to be identified. By using a rapid h.p.l.c. method, we compared the non-enzymic hydrolysis of bilirubin monoglucuronide (BMG) and bilirubin diglucuronide (BDG) to UCB in model bile and in native guinea-pig bile. Model biles containing 50 microM solutions of pure BMG and BDG were individually incubated in 25 mM-sodium taurocholate (NaTC) and 0.4 M-imidazole/5 mM-ascorbate buffer (TC-BUF) at 37 degrees C. Over an 8 h period, BMG hydrolysis produced 4-6 times more UCB than BDG hydrolysis. At pH 7.4, 25% of the BMG was converted into UCB, whereas only 4.5% of BDG was converted into UCB. Hydrolysis rates for both BMG and BDG followed the pH order 7.8 greater than 7.6 approximately equal to 7.4 greater than 7.1 Incubation with Ca2+ (6.2 mM) at pH 7.4 in TC-BUF resulted in precipitated bile pigment which, at 100 X magnification, appeared similar to precipitates seen in the bile of patients with pigment gallstones. At pH 7.4, lecithin (crude phosphatidylcholine) (4.2 mM) was a potent inhibitor of hydrolysis of BMG and BDG. The addition of a concentration of cholesterol equimolar with that of lecithin eliminated this inhibitory effect. Guinea-pig gallbladder bile incubated with glucaro-1,4-lactone (an inhibitor of beta-glucuronidase) underwent hydrolysis similar to the model bile systems. The non-enzymic hydrolysis of bile pigments, especially BMG, may be an important mechanism of bile-pigment precipitation and, ultimately, of gallstone formation.

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