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Clinical Hemorheology and... 2010Cholestasis is a frequent gastroenterological problem, which is tackled by endoscopic procedures. Little is known about bile viscosity, a major determinant of its flow....
Cholestasis is a frequent gastroenterological problem, which is tackled by endoscopic procedures. Little is known about bile viscosity, a major determinant of its flow. We measured the viscosity of bile from the common bile duct during endoscopic retrograde cholangiography. Bile was aspirated immediately after cannulation of the papilla and deep-frozen. Viscosity was measured with a rotational viscometer at 37 degrees C and a broad range of shear rates (0.08-69.5 s(-1)). The majority of the 138 patients (64.5%) had bile viscosities between water (0.7 mPa.s) and the lower limit of plasma (1.1 mPa.s). In 20 patients (14.5%) it was above that of plasma (>1.4 mPa.s), and showed a non-Newtonian behaviour, i.e. the viscosity increased exponentially with decreasing shear rate. Cholecystectomized patients had a lower bile viscosity. Bile viscosities did not differ between patient groups with either choledocholithiasis, sludge, cholangitis, biliary pancreatitis, pancreatic carcinoma, or cholangiocarcinoma. We conclude that bile viscosity in the common bile duct is usually lower than that of plasma, in 15% it is higher and increases exponentially with decreasing flow rate, which may lead to a vicious cycle.
Topics: Adult; Aged; Aged, 80 and over; Bile; Cholangiopancreatography, Endoscopic Retrograde; Cholestasis; Common Bile Duct; Female; Humans; Male; Middle Aged; Viscosity; Young Adult
PubMed: 20364063
DOI: 10.3233/CH-2010-1272 -
Annals of Internal Medicine Feb 1999Biliary sludge was first described with the advent of ultrasonography in the 1970s. It is defined as a mixture of particulate matter and bile that occurs when solutes in... (Review)
Review
Biliary sludge was first described with the advent of ultrasonography in the 1970s. It is defined as a mixture of particulate matter and bile that occurs when solutes in bile precipitate. Its composition varies, but cholesterol monohydrate crystals, calcium bilirubinate, and other calcium salts are the most common components. The clinical course of biliary sludge varies, and complete resolution, a waxing and waning course, and progression to gallstones are all possible outcomes. Biliary sludge may cause complications, including biliary colic, acute pancreatitis, and acute cholecystitis. Clinical conditions and events associated with the formation of biliary sludge include rapid weight loss, pregnancy, ceftriaxone therapy, octreotide therapy, and bone marrow or solid organ transplantation. Sludge may be diagnosed on ultrasonography or bile microscopy, and the optimal diagnostic method depends on the clinical setting. This paper proposes a protocol for the microscopic diagnosis of sludge. There are no proven methods for the prevention of sludge formation, even in high-risk patients, and patients should not be routinely monitored for the development of sludge. Asymptomatic patients with sludge can be managed expectantly. If patients with sludge develop symptoms or complications, cholecystectomy should be considered as the definitive therapy. Further studies of the pathogenesis, natural history, and clinical associations of biliary sludge will be essential to our understanding of gallstones and other biliary tract abnormalities.
Topics: Acute Disease; Bile; Cholecystitis; Cholelithiasis; Colic; Disease Susceptibility; Female; Humans; Microscopy; Pancreatitis; Pregnancy; Ultrasonography
PubMed: 10068389
DOI: 10.7326/0003-4819-130-4-199902160-00016 -
Hepatology (Baltimore, Md.) Mar 1991Using the isolated perfused rat and hamster liver, the relationship between bile flow, bile acid secretion rate and bile acid biotransformation after the injection of a...
Using the isolated perfused rat and hamster liver, the relationship between bile flow, bile acid secretion rate and bile acid biotransformation after the injection of a small, bolus dose of radioactive ursodeoxycholate or of its C23 homolog, norursodeoxycholate, was examined. Ursodeoxycholate was promptly secreted into bile mostly as amino acid conjugates; less than 3% was secreted in unchanged form in the rat and less than 2% in the hamster. In contrast, norursodeoxycholate was secreted slowly, and biotransformed into glucuronide conjugates and unconjugated trihydroxy derivatives; it was also secreted in part in unchanged form. In the rat, 7% was secreted in unconjugated trihydroxy derivatives and 3% in unchanged form; in the hamster, 7% was secreted as unconjugated trihydroxy derivatives and 4% in unchanged form. The secreted bile acid species that showed the highest correlation with bile flow by far was always the unconjugated form in both rat and hamster. By multiple regression analysis, the apparent choleretic activity (microliters of induced bile flow per micromoles recovered bile acid molecules) indicated marked hypercholeresis for the unconjugated bile acid marked hypercholeresis for the unconjugated bile acid with values ranging from 100 to 300 microliters/mumol. Bile flow also correlated with total bile acid recovery for ursodeoxycholate in rat and norursodeoxycholate in hamster, but in all studies the apparent choleretic activity was far lower. Other calculations indicated that most bile flow during the first 30 min was induced by secretion of the unconjugated bile acid species in all experiments, the proportion ranging from 50% to 90%. The results indicate that when a bolus of ursodeoxycholate or norursodeoxycholate is presented to the perfused rodent liver, the secretion of the unchanged bile acid appears to be responsible for most of the bile flow, probably by a cholehepatic shunting mechanism.
Topics: Animals; Bile; Bile Acids and Salts; Cholagogues and Choleretics; Liver; Ursodeoxycholic Acid
PubMed: 1999323
DOI: No ID Found -
Nihon Rinsho. Japanese Journal of... Jul 1986
Review
Topics: Bile; Bile Acids and Salts; Gallbladder; Humans; Liver
PubMed: 3531614
DOI: No ID Found -
Visualization of bile homeostasis using (1)H-NMR spectroscopy as a route for assessing liver cancer.Lipids Jan 2009Changes in bile synthesis by the liver or alterations in the enterohepatic circulation due to a variety of etiological conditions may represent a novel source of liver...
Changes in bile synthesis by the liver or alterations in the enterohepatic circulation due to a variety of etiological conditions may represent a novel source of liver disease-specific biomarkers. Bile from patients with liver diseases exhibited significant changes in the levels of glycine- and taurine-conjugated bile acids, phospholipids, cholesterol and urea relative to non-liver disease controls. Cholangiocarcinoma and non-malignant liver diseases (NMLD) showed the most significant alterations. Further, hepatocellular carcinoma (HCC) could be differentiated from NMLD (p = 0.02), as well as non-liver disease controls (p = 0.02) based on the amounts of bile acids, phospholipids and/or cholesterol. HCC also differed with cholangiocarcinoma although not significantly. Urea increases somewhat in non-malignant liver disease relative to non-liver disease controls, while the bile acids, phospholipids and cholesterol all decrease significantly. The ratio between some major bile metabolites also distinguished NMLD (p = 0.004-0.01) from non-liver disease controls. This snapshot view of bile homeostasis, is obtainable from a simple nuclear magnetic resonance (NMR) approach and demonstrates the enormous opportunity to assess liver status, explore biomarkers for high risk diseases such as cancers and improve the understanding of normal and abnormal cellular functions.
Topics: Bile; Homeostasis; Liver Neoplasms; Magnetic Resonance Spectroscopy; Molecular Structure; Protons
PubMed: 18982376
DOI: 10.1007/s11745-008-3254-6 -
Journal of Traditional Chinese Medicine... Dec 2020To identify the active ingredients and metabolites in rat bile after Guangtongxiao decoction (GTX) had been administered via the rectal route.
Identification of the active ingredients from Guangtongxiao decoction in rat bile based on ultra-performance liquid chromatography/Synapt G2 quadrupole time-of-flight tandem mass spectrometry.
OBJECTIVE
To identify the active ingredients and metabolites in rat bile after Guangtongxiao decoction (GTX) had been administered via the rectal route.
METHODS
Drug-containing bile samples were collected via a catheter in the bile duct and could be used 5 h after rectal administration. The main active components and their metabolites in rat bile following rectal administration of GTX were identified and analyzed using ultra-high-performance liquid chromatography-quadrupole time-of-flight mass spectrometry.
RESULTS
Positive and negative modes were applied to analyze and identify the chemical ingredients in the bioactive fractions of GTX. Eight peaks were identified by comparison with the standard compounds: berberine hydrochloride, dehydrocorydaline, tetrahydropalmatine, corydaline, magnoflorine, magnolol, obacunone and albiflorin. Furthermore, 60 metabolites were detected in rat bile based on mass-fragmentation behaviors, and 21 metabolites were reported for the first time.
CONCLUSION
Our findings provide a solid basis for further pharmacologic and pharmacokinetic studies of GTX.
Topics: Animals; Bile; Chromatography, High Pressure Liquid; Drugs, Chinese Herbal; Male; Molecular Structure; Rats; Rats, Sprague-Dawley; Tandem Mass Spectrometry
PubMed: 33258352
DOI: 10.19852/j.cnki.jtcm.2020.06.011 -
Progress in Liver Diseases 1992
Review
Topics: Bile; Bile Acids and Salts; Chemical Phenomena; Chemistry, Physical; Cholelithiasis; Cholesterol; Humans; Lipid Metabolism; Lipids
PubMed: 1296228
DOI: No ID Found -
Journal of Hepatology Jan 1989We report a novel method to assess bile secretory pressure using a Statham pressure transducer. The studies were performed in vivo in male Sprague-Dawley rats under...
We report a novel method to assess bile secretory pressure using a Statham pressure transducer. The studies were performed in vivo in male Sprague-Dawley rats under pentobarbital anesthesia. Maximal secretory pressure averaged 21.8 +/- 1.1 (S.D.) cmH2O. The bile accumulated after 10 min of obstruction was 7.7 +/- 2.8 microliters.g-1; assuming a basal biliary dead space of 2.3 microliters.g-1, the distended capacity of the biliary tree averaged 10 microliters.g-1. The small volume of the strain gauge permitted calculation of compliance of the biliary tree which averaged 0.35 +/- 0.12 microliters.cmH2O-1.g-1. Stimulation of bile flow by bile salts reduced the time required to reach maximal bile secretory pressure. Taurocholate but not taurodehydrocholate decreased maximal secretory pressure within minutes, the pressure-time curves showing a new equilibrium between bile formation and regurgitation forces. Both bile flow and bile salt recoveries were decreased by taurocholate but not by taurodehydrocholate. Taurocholate decreased biliary compliance while taurodehydrocholate had no effect. This provides further evidence that taurocholate increases the biliary permeability and suggests that this bile salt also affects the elastic properties of the biliary tree.
Topics: Animals; Bile; Bile Acids and Salts; Biliary Tract; Compliance; Male; Pressure; Rats; Rats, Inbred Strains
PubMed: 2921500
DOI: 10.1016/0168-8278(89)90156-6 -
Pharmacology & Therapeutics. Part B:... 1979
Review
Topics: Animals; Bile; Biliary Tract; Cholelithiasis; Cholesterol; Dogs; Drug Evaluation, Preclinical; Rats
PubMed: 386366
DOI: 10.1016/0163-7258(79)90086-x -
Journal of Veterinary Internal Medicine 2016Cholecystocentesis can be part of the diagnostic workup of hepatobiliary disease in small animals, but literature on cytological evaluation of bile is scant.
BACKGROUND
Cholecystocentesis can be part of the diagnostic workup of hepatobiliary disease in small animals, but literature on cytological evaluation of bile is scant.
OBJECTIVES
To determine the diagnostic utility of cytological assessment of bile aspirates.
ANIMALS
Fifty-six and 78 client-owned dogs and cats, respectively, with bile collected by cholecystocentesis and submitted to our diagnostic laboratory between 1999 and 2014.
METHODS
Retrospective study describing cytological findings of bile, concurrent bacterial culture results, hematological and serum biochemical data, gallbladder biopsy results, as well as final diagnosis and complications after cholecystocentesis.
RESULTS
Infectious agents were found in 30% of canine and 22% of feline bile aspirates, and inflammation in 5% and 19% respectively. Presence of microorganisms was more often detected on cytological examination (24%) than by culture (21%). The most common bacterial isolates were Escherichia coli and Enterococcus spp., isolated from 14.8% and 6.7% of cultured samples respectively. Only increased canine pancreatic lipase immunoreactivity concentration (cPLI) was significantly associated with the presence of microorganisms, inflammatory cells, or both in bile. Clinically relevant complications of cholecystocentesis occurred in 2 dogs. The majority of the animals undergoing cholecystocentesis suffered from hepatic, pancreatic, gastrointestinal disease, or a combination thereof.
CONCLUSIONS AND CLINICAL IMPORTANCE
Cytological examination of bile is inexpensive and straightforward, and yields diagnostically relevant information that precedes and complements bacterial culture.
Topics: Animals; Bacteria; Bile; Cat Diseases; Cats; Dog Diseases; Dogs; Gallbladder Diseases; Retrospective Studies
PubMed: 26566964
DOI: 10.1111/jvim.13645