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Results for “CHOLELITHIASIS”

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At least 1,099 records · Page 61Linked to original sources
PubMed1973

Serum lipids in cholelithiasis: effect of chenodeoxycholic acid therapy.

Hypercholesterolaemia has been predicted as a possible complication of chenodeoxycholic acid treatment for gall stones. To exclude this, fasting serum lipids were measured in patients with stones before and at monthly intervals for six months after starting chenodeoxycholic acid. Before treatment half of a group of 36 patients with presumed cholesterol gall stones had serum cholesterol levels exceeding 260 mg/100 ml or serum triglyceride values greater than 160 mg/100 ml or both; these lipid levels were significantly greater than those in control subjects matched for age and sex. Treatment with chenodeoxycholic acid (0.5-1.5 g/day by mouth) did not change serum cholesterol levels but did significantly reduce serum triglyceride concentrations from a pretreatment level of 118 (+/- S.E. of mean 11.7) mg/100 ml to 95 (+/- 7.2) mg/100 ml after six months of therapy. The mechanism of this triglyceride-lowering action of chenodeoxycholic acid is not known, but it may have therapeutic value in patients with hypertriglyceridaemia.

Adult↗
PubMed1970

Cholelithiasis in Singapore. II. A clinical study.

In the present study of 241 patients submitted for gallbladder and biliary tract surgery, it is found that choledocholithiasis in cases in Singapore presents with a wide spectrum of clinical manifestations. It is essential that the less common clinical presentations should be recognized.

Adolescent↗
PubMed1977

Cholelithiasis in subjects with hypercalcaemia and primary hyperparathyroidism detected in a health screening.

The frequency of gallstone disease was studied in a group of 82 subjects (69 females and 13 males; mean ages 55-0 and 52-3 years, respectively) with verified hypercalcaemia (VHC) detected in a health screening in the Stockholm area. All non-cholecystectomised subjects were examined with a peroral cholecystography. Causes of hypercalcaemia other than primary hyperparathyroidism (PHPT) had been excluded as far as possible. Sixty-two patients had been operated upon and all but two males were found to have parathyroid adenomas. The patients were compared with a series of 82 normocalcaemic age- and sex-matched subjects, selected from the health screening register. The patients with VHC and/or PHPT had about the same frequency of gallstone disease as the controls. The results are at variance with those of other investigators who have reported that PHPT is associated with an abnormally high frequency of gallstone disease. Possible explanations of the discrepancy in results is discussed.

Cholelithiasis↗
PubMed1995

Biliary aminopeptidase-N and the cholesterol crystallisation defect in cholelithiasis.

Several biliary proteins have cholesterol crystallisation promoting activity. One of these glycoproteins is aminopeptidase-N, a canalicular ectoenzyme. This study attempted to localise aminopeptidase-N along the biliary tree, to assess its concentration in a series of 98 patients subjected to abdominal surgery, 40 of them without gall stones, and to correlate its concentration with cholesterol crystal formation time of gall bladder bile. Aminopeptidase-N was isolated from purified native biliary vesicles. A specific polyclonal rabbit anti-aminopeptidase-N antibody was prepared for quantitative immunoblotting and for immunolocalisation. Tissue was obtained from liver biopsy specimens and from gall bladders removed at surgery because of gall stone disease. Aminopeptidase-N was immunolocalised to the apical membranes of hepatocytes and to the apical pole of ductular and gall bladder mucosal cells. The nucleation time of gall bladder bile was mean (SD) 4 (3) days in the gall stone group, compared with 21 (18) days in the control group (p < 0.001). Total absolute biliary protein and aminopeptidase-N concentrations were similar in both the control and gall stone patients. There was a reciprocal significant correlation, however, between the nucleation time and the relative aminopeptidase-N concentration (r = -0.35, p < 0.01) only in the gall stone group of patients. This study shows that this apical transmembrane ectoenzyme with cholesterol crystallisation promoting activity is present along the biliary tree and the hepatocyte. These findings support the concept that high concentrations or qualitative changes of biliary aminopeptidase-N contribute to cholesterol gall stone formation.

Adult↗
PubMed1993

Cholecystitis, cholelithiasis, and ganglioneuromatosis of the gall bladder: an unusual presentation of MEN type 2b.

A 40 year old man with multiple endocrine neoplasia type 2b (MEN 2b) presented with cholecystitis caused by gall stones. Twenty four years earlier, he had had a partial thyroidectomy for a cold nodule. At his initial presentation MEN 2b with medullary carcinoma of the thyroid had not been made. This was diagnosed while investigating his gall bladder symptoms and he was found to have asymptomatic residual medullary thyroid carcinoma and bilateral adrenal phaeochromocytomas. The cholecystectomy specimen contained several mixed calculi and extensive ganglioneuromatosis with large, prominent nerves containing ganglion cells in the gall bladder wall.

Adult↗
PubMed2003

Unconjugated bilirubin in human bile: the nucleating factor in cholesterol cholelithiasis?

AIMS: To investigate the concentrations of bilirubin, bilirubin conjugates, phospholipid, and cholesterol in the gall bladder bile obtained at surgery from patients with and without cholesterol gallstones. METHODS: Gall bladder bile was collected during surgery, by puncture, from 20 patients with gallstones undergoing routine cholecystectomy and from eight patients with normal liver blood tests. Concentrations of bilirubin, bilirubin conjugates, phospholipid, and cholesterol were measured using standard procedures. RESULTS: The proportion of total bilirubin that was unconjugated was significantly higher in the bile from patients with stones than in bile from control patients, whether or not the bile from either group was saturated with cholesterol or not. Indeed, the mean concentration of cholesterol was significantly higher in control bile samples. CONCLUSION: The presence of stones was more closely related to the proportion of unconjugated bilirubin than to the degree of saturation of bile with cholesterol. Bilirubin and its metabolites probably play an important part in the formation of cholesterol gallstones.

Adult↗