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Biomedical subjects

A Norlander

Publications and source records attributed to A Norlander.

13 recordsLinked to original sources
PubMed1987

Bile acids in serum, ultrafiltrate of serum and saliva from patients with cholestatic jaundice.

Individual bile acid conjugates in serum, the ultrafiltrate of serum and in saliva from patients with cholestatic jaundice were determined by gas-liquid chromatography. The bile acid concentration in the ultrafiltrate was 4-20% of that in serum and had also a different composition, with higher ratio of cholic to chenodeoxycholic acid. In saliva, the bile acid concentration was 1-8% of that in serum and the composition was different due to a higher proportion of unconjugated cholic acid. The results indicate that neither the bile acid concentration in the ultrafiltrate, nor that in saliva corresponds to the non-protein-bound bile acids in serum.

Adult↗
PubMed1986

Bile acid conjugates present in tissues during extrahepatic cholestasis.

Bile acid concentrations in the muscle, subcutaneous fat and skin of patients with extrahepatic cholestasis were compared to those in serum. High concentrations were found in most tissue samples. In tissues from patients administered [24-14C]chenodeoxycholic acid, the specific activity was lower than that in serum, indicating a storage of bile acids in these tissues. In some patients, higher concentrations of bile acids were found in tissue samples than in serum. This was mainly due to increased concentrations of cholic acid. Monohydroxy bile acids were not found in increased concentrations. Bile acids covalently bound to tissues were not detected.

Adipose Tissue↗
PubMed1986

Bile acid transport by serum lipoproteins in patients with extrahepatic cholestasis.

Individual bile acid conjugates were determined by gas-liquid chromatography in very low density (VLDL), low density (LDL) and high density (HDL) lipoprotein fractions obtained by sequential ultracentrifugation of serum from cholestatic patients. In the lipoproteins were found 16-48% of the serum bile acids. In LDL, the amount found was twice that in VLDL and HDL together. More cholic than chenodeoxycholic acid was detected in the lipoproteins. The occurrence of bile acids in lipoproteins might be of importance for the transport of bile acids from blood to peripheral tissues during cholestasis.

Adult↗
PubMed1985

Conjugation, metabolism and excretion of [24-14C] chenodeoxycholic acid in patients with extrahepatic cholestasis before and after biliary drainage-analysis of conjugated bile acids by HPLC.

[24-14C] chenodeoxycholic acid (CDC) was given to patients with total extrahepatic cholestasis two or three days before an external drainage was made, and excretion of the isotope in urine and bile followed. Bile acids were group-separated by anion exchange chromatography on DEAP-Sephadex LH-20 and the individual conjugates isolated by HPLC. 51.0-75.4% of the administered isotope was excreted; 16.2-29.9% as sulphates, 0.1-2.4% as glucuronides and 20.7-58.7% as glycine and taurine conjugates. 5.2-21.0% of excreted isotope consisted of transformation products of CDC, mainly cholic acid, hyocholic acid and ursodeoxycholic acid. Labelled urinary sulphates were the 3-sulphates of glycochenodeoxycholic and taurochenodeoxycholic acid. During cholestasis the renal clearance was about ten times higher for the sulphates compared with the non-sulphated conjugate. The clearance of glycine conjugates and their sulphates was of the same magnitude as that of the corresponding taurine conjugates. During the biliary drainage period, most of the labelled sulphates were excreted in urine, while most of the glycine and taurine conjugates were excreted in bile.

Aged↗
PubMed1983

Cholic and chenodeoxycholic acids during drainage of cholestasis in man with and without bile refeeding. Determination of serum and urinary concentrations by radioimmunoassay.

Non-sulphated conjugates of cholic (C) and chenodeoxycholic (CDC) acids in serum and total conjugates in urine were determined by radioimmunoassay during drainage of extrahepatic cholestasis in twelve patients studied under three different situations: without refeeding of bile, with refeeding after a delay of one to eight days, and with immediate refeeding. The changes in the serum concentrations and renal excretion of C and CDC varied considerably between patients, but the following general features could be discerned: In patients without bile refeeding but with external drainage, the serum concentrations and renal excretion of C and CDC decreased rapidly. In patients with delayed bile refeeding during drainage, the serum concentrations of C and CDC increased when refeeding of bile was begun but only slightly and temporarily, and no influence on renal excretion could be observed. In patients with immediate bile refeeding through an internal drainage the serum concentrations decreased slowly and renal excretion increased during the first week. These differences in the pattern of serum bile acid concentrations were not reflected in the serum concentrations of bilirubin, alkaline phosphatase, alanine aminotransferase or gamma glutamyltransferase.

Aged↗
PubMed1982

Conjugation and excretion of 14C-chenodeoxycholic acid during total extrahepatic cholestasis.

14C-chenodeoxycholic acid was administered intravenously to two patients with total extrahepatic cholestasis subjected to external biliary drainage 38 and 132 h after administration. The disappearance from serum and the renal and hepatic excretion of labelled compounds were followed. Labelled conjugates were separated chromatographically and quantified. Two hours after administration almost all radioactivity in the serum was in the form of glycine or taurine conjugates and after 36 h about 20% of the labelled conjugates in serum were sulphates. The disappearance of radioactivity from the serum was slow, due to low renal elimination. Almost all the chenodeoxycholic acid excreted in the urine was sulphated. During the biliary drainage only a minor portion of the labelled chenodeoxycholic acid administered was excreted in the bile; hepatic elimination did not exceed the concomitant renal excretion.

Aged↗
PubMed1982

Bile acid metabolism in non-jaundiced patients with malignant liver tumours.

Bile acids were determined in the serum and urine of four non-jaundiced patients with secondary liver tumours by means of gas-liquid chromatography. In serum only the concentration of cholic and chenodeoxycholic acids were increased in two of the patients. The renal excretion of cholic and/or chenodeoxycholic acids was increased in all patients, whereas the excretion of hyocholic acid was increased in two. The renal excretion of 3 beta-hydroxy-5-cholenic acid was not increased in any of of the patients. One patient with multiple liver metastases was studied during the development of jaundice. During this period there was an increase of serum concentrations and renal excretion both of unsulphated cholic, hyocholic, and chenodeoxycholic acids and of sulphated chenodeoxycholic and 3 beta-hydroxy-5-cholenic acids. One non-jaundiced patient with a primary liver tumour, a hepatocarcinoma, had almost normal serum concentrations and renal excretion of bile acids.

Aged↗
PubMed1982

Effect of percutaneous transhepatic drainage upon liver function and postoperative mortality.

The results of the use of percutaneous transhepatic drainage in 109 patients between 1968 and 1980 were analyzed. The serum concentration of bilirubin decreased during the three week drainage period but not to normal values and more slowly than would be expected from normal hepatic bilirubin elimination, in site of adequate drained bile volumes. This decrease was most pronounced during the first week of drainage and in patients with high predrainage bilirubin levels. During refeeding of bile into the intestine, hepatic bilirubin excretion seemed to increase, possibly as a result of higher bile acid excretion. Of the 109 percutaneous transhepatic drainage patients, 58 underwent surgical treatment. Their postoperative mortality was compared with that of a control group of 65 patients, who were operated upon immediately after simple diagnostic percutaneous transhepatic cholangiography. It was not possible to demonstrate any significant difference in the postoperative mortality between these two groups. When the complications and, in addition, even mortality of the percutaneous transhepatic drainage procedure are taken into account, it seems doubtful that percutaneous transhepatic external drainage will benefit patients undergoing operation. This procedure may still be of great value in patients in whom only palliation is demanded.

Adult↗
PubMed1982

Bile acid excretion during drainage of extrahepatic cholestasis with refeeding of bile.

Hepatic and renal excretion of individual bile acid conjugates were studied in four patients with extrahepatic cholestasis during 3 weeks of percutaneous transhepatic drainage with bile refeeding. The study involved isolation and determination by gas chromatography-mass spectrometry of individual bile acids separated into glycine, taurine and sulphate conjugates simultaneously in bile, serum and urine. In bile cholic, chenodeoxycholic and deoxycholic acids were chiefly found as glycine or taurine conjugates and in high concentrations, which indicated a large capacity of the post-cholestatic liver to excrete these conjugates. A minor portion of cholic, chenodeoxycholic and deoxycholic acids and all of lithocholic and 3 beta-hydroxy-5-cholenic acids in the bile were recovered as sulphate conjugates. The biliary concentration of sulphated bile acids was low, but increased during drainage with refeeding of bile indicating a gradually more efficient hepatic elimination of sulphated bile acids. The urinary concentrations of the individual bile acid conjugates decreased when the biliary concentration increased.

Aged↗
PubMed1980

Bile acid synthesis and excretion following release of total extrahepatic cholestasis by percutaneous transhepatic drainage.

Urinary, biliary and serum bile acids were studied in three patients before and after percutaneous transhepatic drainage for total bile duct obstruction. Before drainage high urinary excretion of ten different bile acids occurred. The percentage distribution was: cholic and chenodeoxycholic acid (66-86%), hyocholic (3-16%), 3 beta, 12 alpha-dihydroxy-5-cholenoic (3-6%) and 3 beta-hydroxy-5-cholenoic acid (2-8%). These acids were regularly found in serum. In addition small amounts (less than 2%) of norcholic, allocholic, 3 beta, 7 alpha-dihydroxy-5 beta-cholanoic, 3 alpha, 7 alpha-dihydroxy-5 alpha-cholanoic and lithocholic acid were excrete in urine. Trace amounts of these bile acids were found in serum. After start of drainage biliary bile acid excretion increased rapidly during the first day, dropped to a minimum during the second or third day and then slowly increased again. In spite of normal volumes of bile produced, the total serum bile acids and the urinary excretion of bile acids remained increased during a drainage period of 19 days. The bile acids were of the same type as observed during cholestasis. In serum the increase was mainly due to high concentrations of chenodeoxycholic and 3 beta-hydroxy-5-cholenoic acid, as sulphate esters. Glycine and taurine conjugates of cholic, chenodeoxycholic and hyocholic acid were mainly excreted in bile. Bile acid sulphate esters were only present in trace amounts in bile and were mainly excreted in urine. This, combined with low renal clearance, explains the elevated serum levels of sulphate esters of chenodeoxycholic and 3 beta-hydroxy-5-cholenoic acid conjugates.

Aged↗