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PubMed1991

Fluorescent derivatives of bile salts. I. Synthesis and properties of NBD-amino derivatives of bile salts.

In order to visualize bile salt transport, fluorescent bile salt derivatives were synthesized by introduction of the relatively small fluorescent 4-nitrobenzo-2-oxa-1,3-diazol (NBD)-amino group in either the 3-, 7-, or 12-position of the steroid structure, thus providing a complete set of diastereomeric derivatives, 3 alpha-NBD-amino-7 alpha,12 alpha-dihydroxy-5 beta-cholan-24-oic acid, 3 beta-NBD-amino-7 alpha,12 alpha-dihydroxy-5 beta-cholan-24-oic acid, 7 alpha-NBD-amino-3 alpha,12 alpha-dihydroxy-5 beta-cholan-24-oic acid, 7 beta-NBD-amino-3 alpha,12 alpha-dihydroxy-5 beta-cholan-24-oic acid, 12 alpha-NBD-amino-3 alpha,7 alpha-dihydroxy-5 beta-cholan-24-oic acid, 12 beta-NBD-amino-3 alpha,7 alpha-dihydroxy-5 beta-cholan-24-oic acid, as well as their taurine conjugates. Their optical properties with absorption maxima at about 490 nm and emission maxima at 550 nm make them suitable for fluorescent microscopic studies. Fluorescence of the NBD-derivatives is strongly dependent on polarity of the solvent, on the concentration of the bile salt derivatives, and only slightly on temperature.

Bile Acids and Salts↗
PubMedDate not supplied

[Comparison of the chemical composition of bile calculi in the gallbladder and in bile ducts].

After a brief survey of the literature and description of the methods of the study the results are presented of macroscopic, microscopic and chemical analysis of bile calculi obtained during operations from the gallbladder and bile ducts from patients with cholelithiasis. The results showed that cholesterol was the main component of the calculi and that age and sex had no effect on the chemical composition of the calculi: no significant differences were found in the composition of the gallbladder calculi as compared to the calculi from the bile ducts.

Adult↗
PubMed1988

[Transient dilatation of the intra- and extra-hepatic bile ducts. A new aspect of bile duct involvement in scarlet fever].

An extra- and intra-hepatic bile duct dilatation has been observed in a child in the course of scarlet fever. Manifestations of cholestasis, cytolysis and inflammation were present. Pruritus disappeared within 2 months, biological abnormalities within 3 months and ultrasonic bile duct abnormalities between 3 and 6 months, with a follow-up of 9 months. This case report suggests a relationship between a transitory obstruction, possibly toxic in origin, of the bile ducts and the scarlet fever.

Bile Ducts, Intrahepatic↗
PubMed1985

Age and sex dependency of bile duct diameter and bile duct pressure--an ERC manometry study.

Using ERC-manometry diameters of the common bile duct (CBD) the common hepatic duct (CHD) as well as CBD pressure before and after opacification were determined in 35 non-cholecystectomized patients without extrahepatic cholestasis. We found a significant rise of both CBD and CHD diameters as well as CBD pressure recorded before the injection of contrast medium with increasing age. (p less than 0.005, less than 0.001 and less than 0.05 respectively). Following the opacification CBD pressure became elevated. Again this increase tended to be more pronounced in older patients although this association was lacking statistical significance. In the presence of comparable age female patients (n = 16) exhibited higher CBD and CHD diameters (n.s.) as well as CBD pressure values (p less than 0.05) than male patients (n = 19). We conclude that in the absence of extrahepatic cholestasis bile duct diameter as well as bile duct pressure rise significantly with increasing age. Furthermore women tend to have higher diameters and pressure values than men.

Adult↗
PubMed1979

[Bile-duct-stenosis after operation of the common bile-duct with T-tubes (author's transl)].

3 stenosis of the bile duct were observed in a postoperative study out of 25 patients, who underwent operations of the bile-duct-system and had T-tubes. These patients had no complaints. One patient had a reanastomosis of the bile duct, the stenosis was in the area of the anastomosis. The T-tubes of 2 patients were postoperatively under traction, which might have favoured the stenosis. The possibilities of intravenous cholangiography and endoscopic-retrograde cholangiography are discussed.

Biliary Tract↗
PubMed1966

The effect of bile duct ligation, bile duct cannulation, and hypothermia on alpha-naphthylisothiocyanate-induced hyperbilirubinemia and cholestasis in rats.

The hyperbilirubinemic and cholestatic responses to alpha-naphthylisothiocyanate (ANIT) in the rat were altered by subjecting test animals to various environmental and surgical manipulations. Studies utilizing hypo- and hyperthermic conditions showed that a positive correlation exists between the rectal temperature and the effects of ANIT. In addition, it was observed that ANIT produced an apparent poikilothermic response, in that treated rats were unable to maintain normal rectal temperatures. Bile duct ligation inhibited the cholestatic and altered the hypothermic responses to ANIT treatment. Cannulation of the bile duct prior to ANIT administration significantly inhibited the hyperbilirubinemia and cessation of bile flow. These data demonstrate the importance of an intact enterohepatic circulation and normal body temperature in the actions of ANIT. The effect of the various parameters on the ANIT-induced hyperbilirubinemia and cholestasis suggests the involvement of a biotransformation product of ANIT.

1-Naphthylisothiocyanate↗
PubMed1979

[Pathomorphology and therapy of bile duct hypoplasia and -atresia: - lymphodigestive bile drainage (author's transl)].

In the treatment of extrahepatic biliary atresia Kasai's hepatic-porto-enterostomy brought an important improvement. A bile drainage from the liver into the bowel can be achieved in about 40% of the children suffering from extrahepatic bile duct atresia. Long-term results are nevertheless disappointing because cholangitis and the progression of fibrosis and the original disease aggravate the final results. Supported by the results of animal experiments and clinical findings we studied the possibility of bile drainage together with the hepatic lymph into the bowel. In the animal experiments we succeeded in developing a successful method. The method of operation is described and reasons are mentioned. The first clinical results achieved with a small number of patients are reported and some open questions are put up for discussion.

Animals↗
PubMed1984

Biochemical and morphological investigations of the toxicity of a Capmul preparation and a bile salt-EDTA solution in patients with bile duct stones.

Seventeen patients with bile duct calculi were treated alternately with a preparation of glycerol octanoate and a bile salt-EDTA solution via a nasobiliary tube. Of 14 patients (group I), it was necessary to operate on four immediately after irrigation therapy, success resulted from this conservative therapy in eight (57%) cases and two were unchanged. Laboratory investigations showed a decrease in zinc and copper concentrations in the serum. Of the patients 50-60% suffered from vomiting and diarrhea. For three patients (group II), there was an interval of 6-26 days between the end of the therapy and operation. Histological findings in the patients in group I and II subjected to operation included acute ulcerative and chronic inflammation in gallbladder and common bile duct walls. Since the alterations were of minor degree in four of the seven patients who subsequently underwent surgery the risk of irrigation therapy seems to be acceptable.

Aged↗
PubMed1984

[Present status and possibilities of radiotherapy in the interdisciplinary treatment of malignant tumors of the stomach, pancreas and bile ducts. III. Extrahepatic bile ducts and gallbladder].

The malignant tumors of the gall bladder and the extrahepatic bile ducts belong to those having the most unfavorable prognosis. Similarly to the carcinomas of the pancreas, most of these tumors are in a very advanced stage when they are diagnosed. The survival times have not been improved by radical and ultraradical operation techniques, the operation mortality, however, has increased. In the meantime, the efficacy of radiotherapy has been proved for these tumors, too. So an additional application of radiotherapy seems indicated regarding the fact that most of these patients present postoperative locoregional recurrences. As for the carcinomas of the stomach and the pancreas, the best effect of radiotherapy can be expected in case of an intraoperative irradiation; furthermore direct percutaneous intraductal irradiation techniques have been developed for suitable cases. A possible efficacy of additional chemotherapy cannot be assessed yet; a locally adjuvant effect, as in patients with carcinoma of the pancreas, could be imagined. The authors present the surgical, radiotherapeutic, and chemotherapeutic results achieved hitherto in the treatment of the carcinomas of the extrahepatic bile ducts and the gall bladder and propose further possibilities for the future use of radiotherapy. After the failure of surgery alone an improvement of the bad prognosis of these carcinomas by cooperative therapy conceptions is a vital necessity, the more as the role of obstructive jaundice as fatal factor has been eliminated by the non-surgical percutaneous transhepatic drainage of bile ducts.

Bile Duct Neoplasms↗
PubMed1984

Presence of monohydroxy bile acids in the urinary precipitates: a pitfall in the analysis of urinary bile acids.

The importance of the method of handling the urinary precipitates frequently present in urine samples, especially after freezing-thawing, for bile acid analysis is emphasized because of the presence of a considerable proportion of monohydroxy bile acids such as lithocholic and 3 beta-hydroxy-5-cholenoic acids. Filtration of the urinary precipitates may lead to the underestimation of these important bile acid species.

Bile Acids and Salts↗
PubMed1983

[Mechanism of the bile duct dilatation in congenital dilatation of the common bile duct].

Radiographic studies including operative cholangiography, endoscopic retrograde cholangiopancreaticography and percutaneous transhepatic cholangiography were performed in 44 patients with congenital dilatation of the common bile duct. The relation between the maximum transverse diameter of the common bile duct (CBD) as an indicator of the degree of dilatation and various possible factors causing dilatation of CBD was studied. Among these factors, the length of the narrow segment (X) was closely related with the maximum transverse diameter (Y). The relation of these two was expressed by a simple equation; log Y = 0.068X + 1.06 (r = 0.934, p less than 0.001, n = 19) Dilatation of CBD has been successfully produced by narrowing the ductal lumen with a small plastic tube encirculating the distal common bile duct in dogs. Experimental dilatation was quite similar with congenital dilatation. In addition, the relation between the maximum transverse diameter (Y') and the length of the narrow segment (X') was also expressed in the following simple equation; log Y' = 0.060X' + 0.88 (r = 0.972, p less than 0.001, n = 18) The present studies did not support the hypothesis that abnormal junction of the pancreatico-biliary system might be the primary cause of congenital dilatation of CBD. They suggest that the stenosis of the distal CBD in the fetal life may determine dilatation of CBD.

Animals↗
PubMed1982

Primary bile acid malabsorption: defective in vitro ileal active bile acid transport.

Two boys with congenital diarrhea, steatorrhea, and growth failure were studied. Preliminary investigations indicated that the enterohepatic circulation of bile acids was interrupted. Radiographically, ileal structure was normal; ileal function was normal when assessed by vitamin B12 absorption. To confirm our clinical suspicion that the patients had an isolated defect of ileal active bile acid transport, peroral terminal ileal biopsies were performed. Ileal mucosa was incubated in vitro in oxygenated Krebs-Ringer bicarbonate buffer containing 10 mM glucose and 0.1, 1.0, or 10.0 mM taurocholic acid at 37 degrees C. Ileal uptake from the patients was 0.10 and 0.34 mumol/g dry wt . min in 0.1 mM taurocholic acid, 1.20 and 2.39 mumol/g dry wt . min in 1.0 mM taurocholic acid, and 21.19 and 11.14 mumol/g dry wt . min in 10.0 mM taurocholic acid. At every concentration, significant (p less than 0.05) reductions were present compared with ileum from 7 ileostomy controls, 0.5 to 27 yr old whose uptake was 1.40 +/- 0.28 mumol/g dry wt . min (mean +/- SEM) at 0.1 mM; 6.36 +/- 1.33 mumol/g dry wt . min at 1.0 mM, and 76.20 +/- 19.30 mumol/g dry wt . min at 10.0 mM taurocholic acid. Ultrastructural examination of the ileal mucosa failed to demonstrate a significant structural abnormality. Significant reduction in ileal uptake of taurocholic acid accompanying clinical and biochemical findings of interruption of the enterohepatic circulation in the absence of mucosal disease suggests that these children have a previously undescribed, congenital transport defect that includes absence of active ileal bile acid transport presenting as diarrhea in infancy.

Bile Acids and Salts↗
PubMed1981

Meal stimulated response of serum bile acids levels in normal and altered bile acids enterohepatic circulation.

Sequential measurement of postprandial serum levels of bile acids was carried out in ten healthy controls and in four patients with different impairment of bile acids enterohepatic circulation. An enzymathic fluormetric method was used for SBA analysis. The peak of increase above fasting baseline in normal subjects was 11.8 +/- 1.2 microM/1 (mean +/- SD). In a cholecystectomized subject no SBA peak was observed. Two patients with mild and severe liver impairment (i.e. alcoholic steatosis and Summerskill-Walshe disease during an acute attack of jaundice) had postprandial SBA increase of 20 microM/1 and 70 microM/1 respectively. In a patient affected by Crohn's disease, with proved bile acids malabsorption, a negligible postprandial SBA increase was noted (6.65 microM/1). It is concluded that meal stimulated response of SBA levels might be useful index of altered hepatobiliary and intestinal function.

Adult↗
PubMed1980

Spontaneous cholecystocolonic fistula: a model situation for bile acid diarrhea and fatty acid diarrhea as a consequence of a disturbed enterohepatic circulation of bile acids.

Fistulas between the biliary and gastrointestinal tract complicate 12% of cases with cholecystitis. Communications of the biliary tract occur with decreasing frequency into the duodenum, colon and stomach. Clinical symptoms of cholecysto-colonic fistulas are chills and temperature elevation indicating ascending cholangitis. As bile acids bypass the small intestine, diminished fat absorption results. The unusual amount of bile acids in the colon delays water absorption, causing bile acid diarrhea. A pneumocholangiogram is seen in only 50% of the cases. Barium enema will visualize the fistula most often.

Aged↗
PubMed1994

Evaluation of total serum bile acids concentration and bile acid profiles in healthy cats after oral administration of ursodeoxycholic acid.

Ursodeoxycholic acid (UDCA; 10 mg/kg of body weight) was administered orally to 5 healthy cats for 3 months. Signs of illness were not apparent in any cat during treatment with UDCA. Results of monthly CBC, serum biochemical analysis, and urinalysis were unchanged during drug administration. There was a decrease in serum cholesterol concentration in 4 cats. Total postprandial serum bile acids (PPSBA) concentration was significantly (P = 0.0003) increased over total preprandial serum bile acids (PRSBA) concentration at all sample collection periods. The PRSBA and PPSBA concentrations were significantly (P < 0.05) increased at all sample collection periods after administration of UDCA, compared with baseline values. Ursodeoxycholic and tauroursodeoxycholic acids were not detected in serum prior to initiating administration of UDCA. Both bile acids were detected in the serum of all cats 1 and 2 months after UDCA administration and were detected in the serum of 2 cats 3 months after initiating UCDA administration. Hepatic ultrasonographic findings were normal before and after completion of UDCA administration. A mild, focal lymphocytic infiltrate was observed in 3 cats 3 months after initiating UDCA administration. Results of the study indicate that UDCA is absorbed into the systemic circulation of cats after oral administration, undergoes hepatic conjugation, and appears to be safe.

Administration, Oral↗
PubMed1994

The accessory bile duct of Luschka and bile leakage in laparoscopic cholecystectomy.

Postoperative bile leakage has been reported to occur in 0.2% to 1.5% of patients undergoing laparoscopic cholecystectomy. One of the not-so-common causes is the unrecognized accessory cystic duct of Luschka. We have prepared a case report of bile leakage due to unrecognized accessory bile duct during a laparoscopic cholecystectomy and a recommended technique for recognition and prevention.

Bile Ducts↗
PubMed1977

Interaction of uncharged bile salt derivatives with the ileal bile salt transport system.

Two series of uncharged conjugated bile salt derivatives, N-conjugates of ethanolamine and 3-amino-1,2-propanediol were studied for interaction with the ileal bile salt transport system. Evidence for interaction is threefold. 1) In everted gut sac experiments more material was removed from the mucosal compartment when ileal sacs were used. 2) These derivatives inhibited the in vitro transport of taurocholate. 3) In vivo intestinal perfusion demonstrated greater absorption from ileum than from jejunum. Number three demonstrates that such interactions are followed by transmucosal movement. Their uphill transport was less than taurocholate transport. The Na(+) requirement for cholyl-3-amino-1,2-propanediol interaction with the system was greater than for taurocholate. This observation is similar to that previously observed with taurodehydrocholate, which had a greater Na(+) requirement for transport than taurocholate. Therefore removal of the anionic charge, as well as distortion of steroid shape, increases the Na(+) requirement for substrate interaction with the transport system. These observations support our hypothesis that this interaction involves two recognition components; one includes the steroid moiety, the other a coulombic interaction between the anionic bile salt and a cationic membrane site. Additionally the membrane would have an anionic group to accomodate the Na(+). Both factors (steroidal and coulombic) operate for optimal substrate attachment. Simultaneously the system's affinity for Na(+) increases and active transport then proceeds.

Animals↗
PubMed1996

Comparison of side chain oxidation of potential C27-bile acid intermediates between mitochondria and peroxisomes of the rat liver: presence of beta-oxidation activity for bile acid biosynthesis in mitochondria.

The oxidation of the side chains of two potential bile acid intermediates, 3 alpha,7 alpha,12 alpha-trihydroxy-5 beta-cholestanoic acid (THCA) and 3 alpha,7 alpha-dihydroxy-5 beta-cholestanoic acid (DHCA), were investigated in rat liver mitochondria and peroxisomes. Both THCA and DHCA were efficiently oxidized to yield cholic acid and chenodeoxycholic acid, along with 3 alpha,7 alpha,12 alpha-trihydroxy-5 beta-cholest-24-enoic acid and 3 alpha,7 alpha-dihydroxy-5 beta-cholest-24-enoic acid, respectively, in both the mitochondria and peroxisomes. However, the spectrum of the metabolites in the mitochondria differed greatly from those in the peroxisomes. The major products from THCA and DHCA in the mitochondria were 3 alpha,7 alpha,12 alpha-trihydroxy-5 beta-chol-22-enoic acid and 3 alpha,7 alpha-trihydroxy-5 beta-chol-22-enoic acid, respectively, which were tentatively identified from the mass spectral data. However, the formation of these C24-unsaturated bile acids was not observed in the peroxisomes. These results strongly suggest that the cleavage of the side chain of the C27-intermediates for bile acid biosynthesis also occurs independently in the mitochondria, not due to the contamination of peroxisomes.

Animals↗