Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: EC:3.2.1.31 (beta-glucuronidase)
 7,680 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Hepatolithiasis is associated with bile stasis and bacterial infection. Gallstones found in the intrahepatic bile duct are mostly calcium bilirubinate stones, the presence of which is closely related to the presence of bacteria. In the present study, a high incidence of bile infection was found in hepatolithiasis: 52 of 54 cases (96.3%). This is in concordance with the other reports from Japan as well as from East Asia. E coli was the most frequent isolate followed by Klebsiella, Streptococcus (D), and Pseudomonas. Because of the frequent isolation of E coli in calcium bilirubinate stone cases, beta-glucuronidase from E coli has been thought to be responsible for the formation of calcium bilirubinate stones by effecting hydrolysis of bilirubin glucuronide to free bilirubin, which is insoluble in water. The recent introduction of improved anaerobic culture techniques has led to an increasing number of reports on the presence of anaerobes in the biliary tract. Anaerobes were isolated in 6 of 29 cases of hepatolithiasis (20.7%) in our series but more frequently in Kaohsiung, Taiwan (25 of 57 cases, or 44.4%). Bacteroides and Clostridium were the most frequent isolates from the biliary tract and were shown to have beta-glucuronidase activity. Anaerobes were often found together with aerobes, suggesting the possibility of a synergistic effect that may influence the occurrence and development of cholangitis, which is often associated with hepatolithiasis. Though the biliary tract and liver are usually sterile, when an infection of the biliary tract occurs the route by which bacteria reach the region is thought to be hematogenous, lymphatic, or direct intraluminal ascending infection, the last being the most likely. Treatment of cholangitis associated with hepatolithiasis should be directed toward the removal of stones and termination of bile stasis. When cholangitis ensues, control of bacterial infection by antibiotics should be started without delay. The choice of antibiotics in controlling cholangitis is presented.
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PMID:Bacteriology of hepatolithiasis. 638 75

The nature and occurrence of gallstones in Taiwan and their etiologic factors might not be the same as in Western countries and warranted a systematic investigation. Gallbladder biles and gallstones were obtained at surgery from 100 and 74 patients, respectively. Common duct bile and stones were either drained through an indwelling common duct T-tube or aspirated through a nasobiliary catheter in 108 patients. Gallstones were analyzed for bilirubin, cholesterol, bile acid, calcium, and residue, and biles for bile acid, cholesterol, phospholipid, bilirubin, and beta-glucuronidase. There were four major kinds of gallstones in Taiwan: cholesterol/mixed stones, high-residue black formed pigment stones, low-residue brown formed pigment stones, and muddy pigment stones. The surgical incidence of all types of stones increased steadily during the past four decades. During the past 15 years the relative frequencies for mixed, formed pigment, and muddy pigment stones had been roughly 40, 40, and 20%, respectively, with a further increase in the mixed stones and a decrease in the muddy pigment stones in recent years. Improvement of nutritional status and living standards might contribute to such changes. Cholesterol content in the common duct and gallbladder biles was higher in the mixed stone group than in other groups. Bacterial beta-glucuronidase activity was detected in 53% of patients with muddy pigment stones. Endogenous beta-glucuronidase activity and concentration were also highest in this group, intermediate in the formed pigment and mixed stone group, and lowest in the control. We concluded that hypercholesterobilia was responsible for increasing incidence of mixed stones during the past two decades, while both bacterial and human beta-glucuronidase might contribute to pigment cholelithiasis.
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PMID:Cholelithiasis in Taiwan. Gallstone characteristics, surgical incidence, bile lipid composition, and role of beta-glucuronidase. 755 51

Juxtapapillary duodenal diverticula (JPD) are observed in around 10-20% of patients undergoing endoscopic retrograde cholangiopancreatography (ERCP). They are acquired extraluminal outpouchings of the duodenal wall through 'locus minoris resistance' and their incidence increases with age. They have been studied mainly with regard to their association with pancreatobiliary disease. Choledocholithiasis is considered to be strongly associated with JPD, but the role of JPD in the development of cholecystolithiasis and pancreatitis is still disputable. Since JPD are located in the vicinity of the papilla of Vater, they not only cause mechanical compression of the bile duct but also induce dysfunction of the sphincter of Oddi. They are considered to lead to bile stasis and to allow reflux from the duodenum into the bile duct, which results in an ascending infection of beta-glucuronidase-producing bacteria. The ERCP procedure can be hampered by JPD, although recent papers have reported no difference in the successful cannulation rate or complications between patients with JPD and those without JPD. Disorders caused by JPD are amenable to appropriate therapy, e.g. endoscopic sphincterotomy and surgical intervention.
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PMID:Juxtapapillary duodenal diverticula and pancreatobiliary disease. 2055 52