lead poisoning has several clinical manifestations so the diagnosis may be troublesome. these manifestations consist of anemia, neurologic abnormalities, liver and biliary tract problems and abdominal pain. not only opium addiction, but also lead toxicity can cause biliary tract problems.when both etiologies occur at the same time, the diagnosis is difficult. a 46 year old opium addicted man wi...

Bile acids are cholesterol derivatives that serve as detergents in bile and the small intestine. Approximately 95% of bile acids secreted by hepatocytes into bile are absorbed from the distal ileum into the portal venous system. Extraction from the portal circulation by the hepatocyte followed by reexcretion into the bile canaliculus completes the enterohepatic circulation of these compounds. O...

microdialysis probe enables the study of the concentration of analytes in the bile in awake animals where the bile flow is intact (1-3). A diagram of the shunt microdialysis probe is shown in F1. The probe’s shunt, which carries the bile flow, is of appropriate dimensions for implantation into the bile duct of an adult rat. Suspended inside the shunt is a linear microdialysis probe that continu...

HYPOTHESIS The clinical syndromes caused by bile collections in the abdomen span a wide spectrum and their natural history and risks are not fully appreciated. DESIGN Analysis of 179 patients with bile fistulas after cholecystectomy, of which 154 patients had undrained bile collections. OBJECTIVE To characterize the manifestations and natural history of abdominal bile collections. SETTING...

Fecal microbiota transplantation (FMT) has emerged as a highly effective therapy for refractory, recurrent Clostridium difficile infection (CDI), which develops following antibiotic treatments. Intestinal microbiota play a critical role in the metabolism of bile acids in the colon, which in turn have major effects on the lifecycle of C. difficile bacteria. We hypothesized that fecal bile acid c...

Bile acid malabsorption, which in patients leads to excessive fecal bile acid excretion and diarrhea, is characterized by a vicious cycle in which the feedback regulation of bile acid synthesis is interrupted, resulting in additional bile acid production. Feedback regulation of bile acid synthesis is under the control of an endocrine pathway wherein activation of the nuclear bile acid receptor,...

Molecular medicine has led to rapid advances in the characterization of hepatobiliary transport systems that determine the uptake and excretion of bile salts and other biliary constituents in the liver and extrahepatic tissues. The bile salt pool undergoes an enterohepatic circulation that is regulated by distinct bile salt transport proteins, including the canalicular bile salt export pump BSE...

OBJECTIVES We attempted to clarify the mechanism underlying lower bile duct stricture in autoimmune pancreatitis. METHODS Imaging and histologic finding of the bile duct were assessed for 73 patients with autoimmune pancreatitis to clarify whether IgG4-related biliary inflammation or pancreatic head swelling is associated with lower bile duct stricture. RESULTS Lower bile duct stricture was...

Large quantities of C27 bile alcohols hydroxylated at C-25 are excreted in the bile and urine of patients with cerebrotendinous xanthomatosis, a lipid storage disease that results from defective bile acid synthesis. The presence of both biliary and urinary bile alcohols reflects impaired bile acid synthesis. After treatment of samples with beta-glucuronidase, plasma bile alcohols were quantitat...