Cadmium toxicity and treatment.

Cadmium is a heavy metal of considerable toxicity with destructive impact on most organ systems. It is widely distributed in humans, the chief sources of contamination being cigarette smoke, welding, and contaminated food and beverages. Toxic impacts are discussed and appear to be proportional to body burden of cadmium.

Mercury toxicity and treatment: a review of the literature.

Mercury is a toxic heavy metal which is widely dispersed in nature. Most human exposure results from fish consumption or dental amalgam. Mercury occurs in several chemical forms, with complex pharmacokinetics.

Transport of fluid and biliary lipids in the canine gallbladder in experimental cholecystitis.

In acute cholecystitis the cystic duct is usually obstructed by a gallstone and the gallbladder is often tensely distended with clear fluid. Because these findings suggest that fluid absorption in the gallbladder may be reversed in cholecystitis, we examined the effect of inflammation on the gallbladder mucosal function in dogs. In 20 dogs cholecystitis was induced by ligating the cystic duct and allowing inflammation to develop from bile stasis and the presence of a chronic indwelling cannula in the gallbladder.

Cholangitis after endoscopic sphincterotomy in patients with stricture of the biliary duct.

Five patients with stricture of the common hepatic bile duct underwent endoscopic treatment without relief from cholangitis or successful stricture dilation. A Roux-en-Y hepaticojejunostomy was performed upon four patients who are now symptom-free. Endoscopic sphincterotomy leads to bactobilia and increases the risk of cholangitis, particularly in patients with residual obstruction of the bile duct.

Composition and morphologic and clinical features of common duct stones.

No systematic study of the composition of common duct stones has been carried out to date. In this study, we assessed the chemical composition and morphologic characteristics of common duct stones from 115 patients, and compared them with gallbladder stones in 67 patients who had both. Visually and chemically, common duct stones could be divided into two groups: cholesterol stones and pigment stones.

Variations in concentrating function of the gallbladder in the conscious monkey.

Hepatic bile is concentrated in the gallbladder by absorption of water and electrolytes. The rate of water absorption can be influenced in vitro and in vivo by gastrointestinal hormones and neurogenic transmitters. Recent studies have demonstrated that besides its absorbing activity, the gallbladder has the ability to secrete fluid into its lumen.

Pigment sludge and stone formation in the acutely ligated dog gallbladder.

We studied the effects of stasis of gallbladder bile in a dog model. Three days after cystic duct ligation, all gallbladders contained sludge, and the mucosa was covered by densely adherent mucus with solid particles 1-4 mm in diameter (gravel). Thirty percent of the animals developed stones (greater than 4 mm), which appeared grossly like human pigment stones and microscopically like condensed biliary sludge.

Nuclear magnetic resonance imaging characteristics of gallstones in vitro.

The nuclear magnetic resonance (NMR) imaging characteristics of gallstones of various composition from 36 patients were studied in vitro using a spin-echo imaging technique. The majority of gallstones (83%) produced no measurable NMR signal despite having a mean water content of 12% and a mean cholesterol content of 61%. Six (17%) of the stones had a weak but measurable signal in the center of the stone, which was thought to represent signal from water in clefts or pores within the stones.

Vesicular transport of horseradish peroxidase during chronic bile duct obstruction in the rat.

The vesicular transport system for biliary secretion of plasma-derived proteins was investigated in rats with chronic bile duct obstruction. Horseradish peroxidase, previously demonstrated to be a suitable tracer for vesicular transport, was employed in these studies. Both the time course of horseradish peroxidase secretion into bile and the morphological events in its uptake, transport, and biliary secretion were found to proceed in a manner essentially identical to that of sham-operated control animals.

Peritoneovenous shunt for refractory ascites: operative complications and long-term results.

We studied the clinical course of 35 patients with refractory ascites who underwent 51 peritoneovenous shunts. Nine of them had hepatorenal syndrome (HRS). Operative complications included shunt malfunction, shunt infection, ascitic leak, fluid overload, and disseminated intravascular coagulation.

Biliary stricture.

Comparison of our results for the past 14 years with those from the period 1940 through 1968 shows that surgical therapy in the repair of biliary stricture has plateaued at a consistent level of more than 90 per cent success. The selection of an operative procedure and its conduct have become standardized based on the principles discussed earlier. The patients that have an unsatisfactory outcome are for the most part predictable.

Sludge is calcium bilirubinate associated with bile stasis.

Biliary sludge is a frequent finding on abdominal sonography. It is most often found after prolonged stasis of gallbladder bile associated with other illness or mechanical obstruction of the common duct, and seldom indicates primary gallbladder disease. In most cases, sludge is a suspension of pigment precipitates in bile, and is at least in part calcium bilirubinate.

In vitro investigation of the origin of echoes with biliary sludge.

To investigate the origin of echoes from "biliary sludge," concentrated bile and bile from 5 patients with ultrasound findings of biliary sludge were examined in a tissue-equivalent phantom before and after filtration through progressively smaller pore sizes. Filtration converted echogenic bile to echo-free bile. Examination of the filtration residue by light microscopy established that the source of echoes in biliary sludge was particles, predominantly pigment granules, with lesser amounts of cholesterol crystals.

The effects of a low level of dietary cadmium on blood pressure, '24Na, '42K, andwater retention in growing rats.

The effects of 5 pg Cd per millilter of drinking water on body weight gain, food intake, systolic blood pressure, '24Na, '42K; and water retention and freference for NaCl solution in male and female rats were studied. After 205 days, Cd had no significant effect on weight gain, food intake, water intake, or feed efficiency. The'24Na retention of the Cd-fed male and female rats was greater at 161 days than in the control animals and was significantly greater (P less than 0.