Infected bile and intrahepatic gallstones

Currently, the incidence of the upper stenotic type and intrahepatic stenotic type have been increasing in number. These changes may be attributed to the improvements of the diagnostic tools for hepatobiliary diseases, especially in the progress of imaging methods. In view of the type of gallstone, most intrahepatic gallstones are the calcium bilirubinate stones generated on the basis of bile stasis and bacterial infection. For the formation of calcium bilirubinate stones the mutual relationship of bacterial beta-glucuronidase and glucaro-1, 4-lactone in the bile is thought to important. Free bile acids and fatty acids are detected in fairly large amount in calcium bilirubinate stones. This suggests that precipitation of calcium bilirubinate in the bile may coincidently occur with the deconjugation of the conjugated bile acids and decomposition of lecithin. In the formation of calcium bilirubinate stones, it is believed that diet and bacterial infection accompanying biliary stasis are important inducements. Since these stones are formed mainly in bile ducts and recurrence rates are likely to high, it is important to remove these inducements from therapeutic viewpoint.     

Multifaceted property tailoring of polyamide 6 by blending miscible and immiscible components: ternary blends of polyamide 6/polyethylene terephthalate/phenol novolac

Ternary polymer blends comprising miscible and immiscible components are examined to improve the mechanical properties of polyamide 6 (PA6) under humid and high-temperature conditions. Miscible polymers increase the glass transition temperature (T_g), owing to their strong inter-molecular interactions, while phase-separated immiscible polymers reinforce the physical properties of PA6 as filler materials. Ternary blends exhibit these combined miscible and immiscible component contributions. Thus, in this study, ternary blends comprising PA6, polyethylene terephthalate (PET, immiscible component), and phenol novolac (PN, miscible component) are prepared by melt mixing. The PA6 stiffness in the water-absorbed state is reinforced by PET. Moreover, the proposed PA6/PET/PN ternary blends exhibit higher T_g values and lower water absorption rates than those of the PA6/PET binary blend, owing to the PN contribution. The PET and PN contributions are achieved independently and can be controlled via the composition ratios of the component polymers. Multifaceted property tailoring is thus demonstrated.

Properties of polyamide 6 (PA6) under hygrothermal conditions are improved by blending polyethylene terephthalate (PET, immiscible) and phenol novolac (PN, miscible).     

Is the new potent acid-inhibitory drug vonoprazan effective for healing idiopathic peptic ulcers? A multicenter observational study in Akita Prefecture,Japan

Journal of Gastroenterology - The incidence of peptic ulcers unrelated to H. pylori infection and non-steroidal anti-inflammatory drugs (NSAIDs), termed idiopathic peptic ulcers (IPUs), has...     

Amylase levels in bile in patients with a morphologically normal pancreaticobiliary ductal arrangement

Background We investigated the presence of occult pancreaticobiliary reflux in patients with a morphologically normal pancreaticobiliary ductal arrangement by measuring biliary amylase levels and compared histopathological findings of the gallbladder between groups with high and low biliary amylase levels. Methods In 178 patients with a normal pancreaticobiliary ductal arrangement who had undergone endoscopic retrograde cholangiopancreatography (ERCP), we sampled bile from the bile duct and measured amylase levels. Then we compared clinical features and histological findings of the gallbladder between high (HALG) and low amylase level groups (LALG). Results A high biliary amylase level was observed in 25.8% (46/178) of the patients. The prevalence of a high biliary amylase level was high in patients with gallbladder carcinoma (40%) and in those with choledocholithiasis (28.4%). The level of amylase in bile was high in patients with gallbladder carcinoma, adenomyomatosis of the gallbladder, and chronic cholecystitis. A strong correlation between the levels of amylase and lipase in bile and the dominance of amylase of pancreatic origin in bile were confirmed by isozyme analysis. Thickening of the gallbladder mucosa was a significant manifestation in HALG. Histological examination of the gallbladder mucosa showed that incidences of metaplastic change and atypical epithelium and Ki67-LI in were higher in HALG than in LALG. Conclusions Occult pancreaticobiliary reflux is observed in a considerable number of ERCP candidates. Those who show an extremely high biliary amylase level, at least, may be at high risk for biliary malignancies.     

Visceral obesity is associated with an increased risk of developing esophago-gastric junctional adenocarcinoma in Japan: a population-based case–control study in Akita Prefecture

Esophagus - While an association between esophago-gastric junctional adenocarcinomas (EGJACs) and obesity, especially visceral obesity, has been suggested in Western countries, the association...