A comparative study of gallstones from children and adults using FTIR spectroscopy and fluorescence microscopy

Quantitative phase analysis and molecular structure of human gallstones using synchrotron radiation X-ray diffraction and FTIR spectroscopy

Human gallstones are the most common disorder in the biliary system, affecting up to 20 % of the adult population. The formation of gallstones is primarily due to the supersaturating of cholesterol in bile. In order to comprehend gallstone disease in detail, it is necessary to have accurate information about phase identification and molecular structure. Different types of gallstone samples were collected from the Middle East area after surgical operations including; cholesterol, pigment, and mixed gallstones. To estimate the basic information about the stone formation and the pathophysiology of cholelithiasis as well as to classify the collected human gallstones, attenuated total reflection Fourier transform Infrared spectrometry (ATR-FTIR) was used to analyze the different gallstone structures in the wavenumber range from 400 to 4000 cm-1. Calcium bilirubinate was specified by the bands at 1662 cm-1, 1626 cm-1, and 1572 cm-1, while cholesterol rings were designated by the bands at 1464, 1438, 1055, and 1022 cm-1. It can be assumed that all samples consist of mixed gallstones based on the doublets at 1375 cm-1 and 1365 cm-1. The levels of calcium bilirubin and various minerals varied among the analyzed samples, indicating the heterogeneity in their composition and suggesting potential implications for gallstone formation. Based on the quantitative phase analysis using synchrotron radiation X-ray diffraction (SR-XRD), two phases of anhydrous cholesterol as a major content and one phase of monohydrate cholesterols as trace content represent the main components of most of the gallstones. Additional phases of calcium carbonate in the form of calcite, vaterite, aragonite, and bilirubinate were also quantified. According to the outcomes of the FTIR and the SR-XRD measurements, there exists a statistical correlation between the different types of chemical constituents of the gallstones.

Synthesis, characterization and optimization of chicken bile-mediated silver nanoparticles: a mechanistic insight into antibacterial and antibiofilm activity

The fast-growing urbanization and slow progress in the field of waste management have led to the accumulation of large quantities of animal wastes. The present work focused on the synthesis of low-cost and eco-friendly chicken bile juice-mediated silver nanoparticles (BJ-AgNP). Results reveal that bile juices have enough potentiality towards the synthesis of almost uniform sizes (average size < 50 nm) of BJ-AgNPs which remains stable for more than 6 months. Response surface methodology (RSM) successfully demonstrated the optimised condition of BJ-AgNP synthesis. Factors like concentration of salt and bile extract and temperature are significantly responsible for nanoparticle synthesis. The synthesis of nanoparticle was further characterized using UV-Vis, TEM, FESEM, XRD, FTIR, TGA, and EDS. The synthesised nanoparticle showed excellent bactericidal activity against both Gram positive and Gram negative bacteria with MIC and MBC of 40 and 50 μg/mL for Bacillus subtilis (MTCC-441) and 60 and 60 μg/mL for Eschecheria coli (MTCC-1687) respectively. The synthesised nanoparticle also exhibited as an antibiofilm activity against B. subtilis, with ~89% biofilm inhibition efficacy at 4 X MIC, having optimal bacterial concentration of 10⁶ CFU/mL. Therefore, the present findings clearly demonstrated that an absolute animal waste could be a valuable ingredient in the field of therapeutic nanoscience.

Pearl-white gallstones: A report of a case and a chemical analysis by FTIR and XRD

Introduction

Gallstones' color is usually yellow, brown, black or more commonly a mixture of two or more of these colors in different proportions, depending on their composition, with yellow being the most commonly encountered color. Pearl-white gallstones are a very rare entity that has not been studied and reported sufficiently.

Case presentation

Our patient is a 44-year-old lady who was suffering from recurrent attacks of epigastric and right hypochondrial abdominal pain that was aggravated by consumption of fatty meals. Ultrasound Imaging revealed multiple gallbladder stones. After an elective cholecystectomy unusual pearl-white gallstones were found inside a distended gallbladder filled with transparent thick fluid.

Chemical analysis

To evaluate the chemical composition of these stones Fourier-transform infrared (FTIR) spectroscopy and X-Ray Diffraction (XRD) tests were performed and revealed that these stones are composed of cholesterol (99.6%) and calcium carbonate (0.4%).

Discussion

Gallstones are bile depositions of a solid consistency formed inside the gallbladder. Cholesterol, bilirubin, and other substances are involved in the composition of different kinds of gallstones. The presence of gallstones alone inside the gallbladder is usually presented as colicky abdominal pain. Cholecystectomy is a simple surgical removal of the gallbladder from it bed and is the definitive treatment of gallstone disease.

Conclusion

Pearl-white gallstones are rarely encountered and lack information about their pathogenesis, thus prompting further evaluation and studying.

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Pearl-white coloration of gallstones in extremely rare.

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FTIR and XRD are useful tools to analyze the chemical composition of gallstones.

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Cholesterol is the major component of pearl-white gallstones.

Polypyrrole and enzyme free cholesterol flakes based composite: Selective determination of theophylline

In the present work, we demonstrated the non-enzymatic theophylline (TP) detection using nanostructured Polypyrrole (Ppy) and Cholesterol (Ch) flakes coordinated nanocomposite coated on Glassy Carbon Electrode. The higher active surface area and good mechanical stability of the Ppy integrated Ch composite exhibited better oxidation towards TP. The electron transfer across hydrogen bonding is of fundamental importance in enhancing the biochemical process in this biosensor system. Further, the scan rate analysis confirmed the quasi-reversible diffusion controlled electrochemical process. The differential pulse voltammetry report of the electrocatalyst shows a linear response of TP in the concentration range 1μM - 1 mM with detection limit of 720 nM (S/N = 3σ/b). The proposed electrochemical sensor exhibited intriguing sensing properties with good selectivity, reproducibility towards TP detection without any surface fouling. The overall analysis confirmed that the prepared nanocomposite modified electrode has quantified better accuracy towards target molecule without the aid of any bio receptors and binders in tea leaves and human urine samples.

Fiber attenuated total reflection infrared spectroscopy of kidney tissue during live surgery

More than 90% of solid kidney tumors are cancerous and have to be treated by surgical resection where surgical outcomes and patient prognosis are dependent on the tumor discrimination. The development of alternative approaches based on a new generation of fiber attenuated total reflection (ATR) probes could aid tumor identification even under intrasurgical conditions. Herein, fiber ATR IR spectroscopy is employed to distinguish normal and cancerous kidney tissues. Freshly resected tissue samples from 34 patients are investigated under nearly native conditions. Spectral marker bands that allow a reliable discrimination between tumor and normal tissue are identified by a supervised classification algorithm. The absorbance values of the bands at 1025, 1155 and 1240 cm^-1 assigned to glycogen and fructose 1,6-bisphosphatase are used as the clearest markers for the tissue discrimination. Absorbance threshold values for tumor and normal tissue are determined by discriminant analysis. This new approach allows the surgeon to make a clinical diagnosis.

Preliminary study on the correlation between the trace Mn2+ and the calcite polymorph in gallstones containing calcium carbonate from the northeast China via electron spin resonance

Gallstones containing calcium carbonate (GCCC) from the northeast China were analyzed using X-ray diffraction (XRD), infrared spectroscopy (IR), scanning electron microscopy (SEM), energy-dispersive X-ray spectroscopy (EDX), and electron spin resonance (ESR). The sextet signal arising from the allowed transitions of the trace Mn²⁺ ions in GCCC was found to be ESR-detectable and strong. The XRD technique revealed the crystal habit of calcite in GCCC. Of the three polymorphs of calcium carbonate, no calcite was present as a solitary crystallization form, accompanied by aragonite or vaterite or both. The sextet ESR signal and the (104) main XRD peak at 2θ = ∼29.4° were employed as two probes to explore the relationship between trace Mn²⁺ and calcite. The Mn content can be considered as an indicator of the amount of calcite in GCCC because of the existence of a correlation between Mn²⁺ and calcite. The correlation between Mn²⁺ and calcite, the relation between the levels of Mn²⁺ and the type of gallstones, the structural preference of Mn²⁺ to the calcite polymorph, and the influence of dietary habits on calcite in calcium carbonate gallstones are discussed.

Analysis of stones formed in the human gall bladder and kidney using advanced spectroscopic techniques

Stone diseases (gallstones and kidney stones) are extremely painful and often cause death. The prime aim of biomedical research in this area has been determination of factors resulting in stone formation inside the gallbladder and urinary tract. Many theories have been put forward to explain the mechanism of stone formation and their growth; however, their complete cycle of pathogenesis is still under debate. Several factors are responsible for stone formation; however, much emphasis is placed on the determination of elemental and molecular composition of the stones. In the present review article, we describe different kinds of spectroscopic techniques such as Fourier transform infrared spectroscopy (FTIR), X-ray fluorescence (XRF) spectroscopy, time-of-flight secondary ion mass spectrometry (TOF-SIMS), and laser-induced breakdown spectroscopy (LIBS) and highlight their use in the analysis of stone diseases. We have summarized work done on gallstones and kidney stones using these advanced techniques particularly over the last 10 years. We have also briefly elaborated the basics of stone formations inside the human body and their complications for a better understanding of the subject.

Multi-analyses of gallstones and correlation between their properties with the laboratory results

This study explores the morpho-structure of gallstones (GSs) removed from 36 patients in NW Romania and correlate it with the laboratory results of the patients. GSs were analyzed by SEM-EDS, X-ray diffraction and IR, UV-Vis and X-ray photoelectron spectroscopy. The laboratory studies consisted in hematological, coagulation, biochemistry, immunological and tumor markers tests. The morphological and structural investigations allowed to classify the GS in five different types and to establish their mechanism of formation. Only macroscopic evaluation, SEM microscopy, FTIR and UV-Vis spectroscopy give different easily noticeable information for each GS type. EDS, XPS and XRD diffraction are recommended to distinguish pigment and carbonate stones from the other GS types and a carefully examination is needed to establish the differences between the pure cholesterol, the mixed cholesterol and the composite cholesterol stones, due to the high similarities. The variation of specific markers cannot differentiate the patients with pure cholesterol GS from those with mixed cholesterol and pigment GS and those with mixed cholesterol from those with composite cholesterol stones. Seven laboratory parameters (RDW-CV, MPV, PCT, GLUC-HK, WBC, PT, GPT) are the key indicators for the GS disease and trend to present generally higher values than normal.

Clinical infrared microscopic imaging: An overview

New developments in Mid-infrared microscopic imaging instrumentation and data analysis have turned this method into a conventional technique. This imaging method offers a global analysis of samples, with a resolution close to the cellular level enabling the acquisition of local molecular expression profiles. It is possible to get chemo-morphological information about the tissue status, which represents an essential benefit for future analytical interpretation of pathological changes of tissue. In this review, we give an overview of Mid-infrared microscopic imaging and its applications in clinical research.

Assessing the potential of liposomes loaded with curcumin as a therapeutic intervention in asthma

Curcumin a component of turmeric, which is derived from Curcuma longa is used as a colouring agent and as a dietary spice for centuries. Extensive studies have been done on the anti-inflammatory activity of curcumin along with its molecular mechanism involving different signalling pathways. However, the physicochemical and biological properties such as poor solubility and rapid metabolism of curcumin have led to low bioavailability and hence limits its application. Current therapies for asthma such as bronchodilators and inhaled corticosteroids (ICS) are aimed at controlling disease symptoms and prevent asthma exacerbation. However, this approach requires lifetime therapy and is associated with a constellation of side effects. This creates a clear unmet medical need and there is an urgent demand for new and more-effective treatments. The present study is aimed to formulate liposomes containing curcumin and evaluate for its anti-inflammatory effects on lipopolysaccharide (LPS)-induced inflammation on BCi-NS1.1 cell line. Curcumin and salbutamol liposomes were formulated using lipid hydration method. The prepared liposomes were characterized in terms of particle size, zeta potential, encapsulation efficiency and in-vitro release profile. The liposomes were tested on BCI-NS1.1 cell line to evaluate its anti-inflammatory properties. The various pro-inflammatory markers studied were Interleukin-6 (IL-6), Interleukin-8 (IL-8), Interleukin-1β (IL-1β) and Tumour Necrosis Factor-a (TNF-a). Additionally, molecular mechanics simulations were used to elucidate the positioning, energy minimization, and aqueous dispersion of the liposomal architecture involving lecithin and curcumin. The prepared curcumin formulation showed an average size and zeta potential of 271.3 ± 3.06 nm and -61.0 mV, respectively. The drug encapsulation efficiency of liposomal curcumin is 81.1%. Both curcumin-loaded liposomes formulation (1 μg/mL, 5 μg/mL) resulted in significant (p < 0.05) reduction in the level of pro-inflammatory marker expression such as IL-6, IL-8, IL-1β and TNF-a compared to positive control group. Liposomal curcumin with the dose of 1 μg/mL reduced the inflammatory markers more effectively compared to that of 5 μg/mL. Liposomal curcumin could be a promising intervention for asthma therapy showing their efficacy in suppressing the important pro-inflammatory markers involved in the pathogenesis of asthma.

Classification of gallstones using Fourier-transform infrared spectroscopy and photography

Background

Gallstones have conventionally been classified by gross inspection into 4 categories: cholesterol gallstones, black pigment (calcium bilirubinate) gallstones, brown gallstones, and mixed gallstones that contain both cholesterol and calcium bilirubinate. Classification using Fourier-transform infrared (FT-IR) spectroscopy supplements gross inspection; however, the issue of ambiguity in gallstone classification has not been fully addressed to date.

Methods

Twenty-six gallstones obtained after surgical gallbladder removal were examined using FT-IR spectroscopy and digital photography, and classified into 6 gallstone groups according to characteristic FT-IR absorption bands.

Results

FT-IR spectra of nine gallstones matched well with that of pure cholesterol, and the gallstones were thus classified as cholesterol stones. Twelve gallstones were classified as calcium bilirubinate stones as they showed characteristic absorption bands of calcium bilirubinate. However, the FT-IR spectra of these gallstones always showed a broad absorption band of bound water at 3600–2400 cm^− 1. The other five gallstones were classified as mixed stones with combinations of cholesterol, calcium bilirubinate, and calcium carbonate.

Conclusion

FT-IR spectroscopy is a powerful and convenient method for gallstone classification. Nevertheless, one should take serious note of the superposition of FT-IR absorption bands of different chemical components of gallstones including that of bound water.

Variation of calcium, copper and iron levels in serum, bile and stone samples of patients having different types of gallstone: A comparative study

BACKGROUND

Epidemiological data among the human population has shown a significantly increased incidence of gallstone (GS) disease worldwide. It was studied that some essential (calcium) and transition elements (iron and copper) in bile play an important role in the development of GS.

METHOD

The estimation of calcium, copper and iron were carried out in the serum, gall bladder bile and different types of GS (cholesterol, mixed and pigmented) of 172 patients, age ranged 20-55years. For comparative purpose age matched referents not suffering from GS diseases were also selected. Biliary concentrations of calcium (Ca), iron (Fe) and copper (Cu) were correlated with their concentrations in serum and different types of GS samples. The ratio of Ca, Fe and Cu in bile with serum was also calculated. Understudy metals were determined by flame atomic absorption spectroscopy after acid decomposition of matrices of selected samples.

RESULTS

The Ca concentrations in serum samples were significantly higher in patients with pigmented GS as compared to controls (p<0.005), whereas for patients having cholesterol and mixed GS the concentrations were on the lower side. Biliary Ca concentrations of patients were found to be higher than controls, but difference was significant for pigmented GS patients (p>0.001). The contents of Cu and Fe in serum and bile of all patients (except female cholesterol GS patient have low serum iron concentration) were found to be higher than control, but difference was significant in those patients who have pigmented GS. The concentration of Ca, Fe and Cu in different types GS were found in the order, Pigmented>mixed>cholesterol. The bile/serum ratio for Ca, Cu and Fe was found to be significantly higher in pigmented GS patients. Gall bladder bile was slightly alkaline in patients as compared to referents. The density of bile was found to be higher in patients as compared to the referents. Various functional groups present in different types of GS samples were confirmed by Fourier transform infra-red spectroscopy.

CONCLUSION

The higher density and pH of bile, elevated concentrations of transition elements in all types of biological samples (serum, bile and GS), could be an important factor for the formation of different types of GS.

Chemical and structural analysis of gallstones from the Indian subcontinent

Representative gallstones from north and southern parts of India were analyzed by a combination of physicochemical methods: X-ray diffraction (XRD), infrared spectroscopy (IR), scanning electron microscopy (SEM), energy-dispersive X-ray spectroscopy (EDX), CHNS analysis, thermal analysis and Nuclear Magnetic Resonance (NMR) spectroscopy (¹H and ¹³C). The stones from north Indian were predominantly consisting of cholesterol monohydrate and anhydrous cholesterol which was confirmed by XRD analysis. FTIR spectroscopy confirmed the presence of cholesterol and calcium bilirubinate in the south Indian gallstones. EDX spectroscopy revealed the presence of carbon, nitrogen, oxygen, calcium, sulfur, sodium and magnesium and chloride in both south Indian and north Indian gallstones. FTIR and NMR spectroscopy confirmed the occurrence of cholesterol in north Indian gallstones. The respective colour of the north Indian and south Indian gallstones was yellowish and black. The morphology of the constituent crystals of the north Indian and south Indian gallstones were platy and globular respectively. The appreciable variation in colour, morphology and composition of south and north Indian gallstones may be due to different food habit and habitat.

A comparative study of mud-like and coralliform calcium carbonate gallbladder stones

To gain insight to underlying mechanism of the formation of calcium carbonate (CaCO₃ ) gallbladder stones, we did comparative study of stones with mud appearance and those with coralliform appearance. A total of 93 gallbladder stones with mud appearance and 50 stones with coralliform appearance were analyzed. The appearance, color, texture, and the detection of Clonorchis sinensis eggs by microscopic examination were compared between the two groups. Then, the material compositions of stones were analyzed using Fourier Transform Infrared spectroscopy and the spectrogram characteristics were compared. Moreover, microstructure characteristics of the two kinds of stones were observed and compared with Scanning Electron Microscopy. Mud-like gallbladder stones were mainly earthy yellow or brown with brittle or soft texture, while coralliform stones were mainly black with extremely hard texture, the differences between the two groups was significant (p < .05). The analytic results of FTIR spectroscopy showed that 95.7% (89/93) of the mud-like gallbladder stones were CaCO₃ stones, and mainly aragonite; while all of the coralliform stones were CaCO₃ stones, and mainly calcite (p < .05). Meanwhile, microscopic examination indicated that the detection rate of Clonorchis sinensis eggs in mud-like CaCO₃ stones was lower than that in coralliform CaCO₃ stones (p < .05), and that in aragonite CaCO₃ stones was lower than that in calcite CaCO₃ stones(p < .05). Mud-like CaCO₃ stones mainly happened to patients with cystic duct obstruction. Clonorchis sinensis infection was mainly associated with coralliform (calcite) CaCO₃ stones. Cystic duct obstruction was mainly associated with mud-like (aragonite) CaCO₃ stones.

Combined microstructural and mineralogical phase characterization of gallstones in a patient-based study in SW Spain - Implications for environmental contamination in their formation

This study explores the environmental impact of metal exposure on humans through detailed phase and structural characterization of gallstones from two environmentally contrasting populations in Huelva Province (SW Spain). A total of 42 gallstone samples, obtained after surgical intervention at the Riotinto Hospital, were studied by powder X-ray diffraction (XRD), Fourier Transformed Infra-Red spectroscopy (FTIR), FTIR-μ-ATR (Attenuated Total Reflection) coupled with an optical microscope, and by Environmental Scanning Electron Microscope with Energy Dispersive X-ray Spectroscopy (ESEM-EDS), and subsequently classified according to their phase composition and structure. Additionally, the patients were enquired for their living habits in order to analyze the source of possible exposure to metal contamination. The gallstones were classified into pure, mixed and composite cholesterol stones, black and brown pigment stones, and carbonate stones. The patients from the study group residing in a region with acknowledged metal contamination of both natural and anthropogenic origin have a higher risk of metal exposure through contaminated soil, particle matter in the air, and consumption of local water and food products. According to our findings, the metal exposure is related to a higher tendency of forming black pigment stones in the study group in comparison to the control group residing in a natural park with nearly pristine environmental conditions. Moreover, the gallstones from the study group showed to contain more abundant metal components, such as Cu, Fe, Ni, and Zn, than those from the control group. To our knowledge this is the first study to examine the regional environmental impact of metal exposure on human gallstones.

Gallstones: A Worldwide Multifaceted Disease and Its Correlations with Gallbladder Carcinoma

Background

Gallstones (GS) associated diseases are among the most recurrent and frequent diseases delineated in India and United Arab Emirates. Several reports suggest that the association of GS with gallbladder cancer (GBC) is very high in Northern part of India; however, its occurrence in UAE and Southern part of India is notably low. Therefore, in the present study, we aimed to perform compositional analysis of GS in three different geographical areas by Solid State Nuclear Magnetic Resonance and Fourier Transformed Infrared spectroscopy.

Methods

Natural abundance ¹³C cross polarization magic angle spinning Nuclear Magnetic Resonance and Fourier Transform Infrared spectroscopy is employed for the analysis of human gallstone.

Results

Cholesterol, bilirubin and calcium carbonate were present in variant concentrations in GS obtained from three different geographical regions. Cholesterol was present predominantly in gallstones from North India. Bilirubin was found to be a main constituent in gallstones pertaining to South India. Whereas GS from UAE showed both cholesterol and bilirubin as their major constituents. Calcium carbonate was found in varying concentrations in gallstones acquired from different regions.

Conclusion

Variation in environmental condition and dietary habits may contribute and affect the GS formation. Alterations in bile composition influence the GB and augment the crystallization of cholesterol. Analysis of different geographical regions GS could be an important stride to understand the etiology of GS diseases.

Spectral and morphological classification of different chronic and acute Taiwanese gallstones via FTIR, SEM and ESEM-EDX microanalyses

BACKGROUND

Gallstone disease is one of the leading upper gastrointestinal surgical problems in different countries.

AIMS

To analyze the chronic gallstones and acute gallbladder sludge retrieved from 36 Taiwanese patients.

METHODS

FTIR microspectroscopy was used to classify the types of gallstones, and an ESEM-EDX microanalysis was first applied to determine the microstructural features and elemental compositions of the various gallstones. Bacteria presented on the surface of gallstones were also detected by SEM.

RESULTS

Four types of gallstones were obtained from these 36 Taiwanese patients: calcium bilirubinate (CaBR) stones (30.6%), cholesterol stones (19.4%), mixed stones including 6 subtypes (47.2%), and acute gallbladder sludge (2.8%) made of CaBR and protein/insoluble biomaterials. Bacteria imprints and bacterial discharges or bacterial biofilms were also found on the surface of gallstones and acute sludge under a SEM observation. ESEM-EDX results revealed that calcium was found to be the main constituent of all of the types of stones except cholesterol stones, and aluminum was also presented in most of the stones and sludge samples. Chloride was only detected in the acute gallbladder sludge.

CONCLUSION

FTIR spectra, morphological features, and elemental compositions of the acute gallbladder sludge were different from those of the chronic gallstones.

Chemical characterization of gallstones: an approach to explore the aetiopathogenesis of gallstone disease in Sri Lanka

Introduction

Records on gallstones and associated ailments in Sri Lankan community are scarce, despite frequent detection of gallstone disease. Identification of the chemical composition of gallstones in the local setting is important in defining aetiopathogenic factors which in turn are useful in implementing therapeutic and preventive strategies. This study aimed to describe the chemical composition of gallstones and the socio-demographic factors of a cohort of Sri Lankan patients with gallstone disease.

Materials and Methods

Data on clinical and socio-demographic factors, and gallstones removed at surgery were collected from patients with cholelithiasis admitted to Teaching Hospital, Peradeniya, Sri Lanka from May 2011 to December 2012. External and cross sectional morphological features of gallstones were recorded by naked eye observation. Compositional analysis was carried out by Fourier Transform Infrared Spectroscopy, X - ray Powder Diffraction, and Atomic Absorption Spectrophotometry. Scanning Electron Microscopy was used to identify the microstructure of gallstones.

Results

Data of 102 patients were analyzed. Of them majority (n = 77, 76%) were females with a female: male ratio of 3:1. Mean age of the study group was 46.1±11.6 years. All the patients had primary gallbladder stones. According to the physical and chemical analysis, majority (n = 54, 53%) were pigment gallstones followed by mixed cholesterol gallstones (n = 38, 37%). Only 10 (9%) had pure cholesterol gallstones. Calcium bilirubinate, calcium carbonate and calcium phosphate were the commonest calcium salts identified in pigment gallstones and core of mixed cholesterol gallstones.

Conclusion

Presence of a pigment nidus in gallstones is a common feature in majority of Sri Lankan patients denoting the possible role of elevated unconjugated bilirubin in bile on the pathogenesis of GS. Hence it is imperative to explore this further to understand the aetiopathogenesis of GS among Sri Lankans.

Serum lipid concentrations in patients with cholesterol and pigment gallstones

Background

Gallstones (GS) are formed as a result of impaired metabolic regulation of the human body. Abnormal lipid metabolism is partly responsible for the pathogenesis of GS mainly rich in cholesterol. Thus abnormalities of serum lipids would reflect the possibilities of the formation of cholesterol GS. This study aims to identify the significance of serum lipids on the development of GS disease.

Methods

Serum lipid profiles were estimated in 73 patients with symptomatic GS, admitted to the Teaching Hospital, Peradeniya, Sri Lanka for GS removal surgeries from May 2011 to December 2012. Patients with normal serum bilirubin level and not being on lipid lowering drugs were recruited for the study. Serum lipid profile of each patient was analyzed by enzymatic kit assays and the chemical composition of GS was analyzed by Fourier Transform Infrared spectroscopy.

Results

Of the 73 patients, 37 (51%) had cholesterol GS while 36 (49%) had pigment GS. Serum lipid parameters of a majority of patients were within the normal range. Body mass index values of the patients with two types of GS were not significantly different (Two sample t test, p = 0.335). Out of the lipid parameters tested, only serum triglyceride concentration was significantly high in patients with cholesterol GS than that of pigment GS (Two sample t test, p = 0.038). None of the lipid parameters were significantly different between males and females (Two sample t test, p > 0.05). Compared to the patients with pigment GS who were aged below 50 years, mean total cholesterol and triglyceride concentrations were higher in the same age category patients with cholesterol GS.

Conclusion

Abnormal serum lipid profiles doesn’t seem to be an essential feature in patients with cholesterol GS. However when the two groups of patients with cholesterol and pigment GS with no significant difference of body mass indexes were compared, patients with cholesterol GS are more likely to have serum lipid parameters towards the undesirable cutoff levels of their respective normal ranges. However an effect of serum lipid concentrations on high incidence of GS among females has not been identified.

Can the type of gallstones be predicted with known possible risk factors?: A comparison between mixed cholesterol and black pigment stones

BACKGROUND

Pathogenesis of gallstones (GS) is multifactorial and multiple genetic and environmental factors have been identified in different populations for different types of GS with varying prevalence. However the role of the each aetiological factor on the formation of mixed cholesterol and black pigment GS has not being addressed adequately. Hence in this study we attempted to compare known possible risk factors for mixed cholesterol and black pigment GS among two groups of patients with two types of GS.

METHODS

The study was done on a cohort of patients with symptomatic GS admitted to the Teaching Hospital Peradeniya, Sri Lanka over a period of 18 months. Clinical and epidemiological data and physical parameters of the patients were recorded and surgically removed GS were analyzed chemically and physically to identify the type of GS. In addition lipid profile was done in all the patients with normal serum bilirubin levels.

RESULTS

A total of 86 patients were included in the study. Mixed cholesterol GS was significantly common among females than males (χ2 test, p = 0.029). Mixed cholesterol GS was commonly seen among patients belonging to Moor ethnicity (χ2 test, p = 0.009). Majority of patients with mixed cholesterol GS had body mass index above 25 kg/m2 (χ2 test, p = 0.018). Black pigment GS were significantly common among patients with type II diabetes mellitus (Fisher's exact test, p = 0.035). Further all the patients with chronic haemolytic anaemia and alcoholic cirrhosis had black pigment GS. Age, family history, Fasting Blood Glucose, dyslipidaemia, lipid profile, parity and use of oral contraceptive pills in females, smoking and alcohol intake in males did not differ significantly among patients in the two groups.

CONCLUSION

Gender, ethnicity and body mass index can be used to predict the formation of mixed cholesterol GS and black pigment GS.

Temperature oscillation modulated self-assembly of periodic concentric layered magnesium carbonate microparticles

Intriguing patterns of periodic, concentric, layered, mineral microstructure are present in nature and organisms, yet they have elusive geneses. We hypothesize temperature oscillation can be an independent factor that causes the self-assembly of such patterns in mineral phases synthesized in solution. Static experiments verify that rhythmic concentric multi-layered magnesium carbonate microhemispheres can be synthesized from bicarbonate solution by temperature oscillation, without use of a chemical template, additive or gel-diffusion system. Appropriate reactant concentration and initial pH value can restrain the competitive growth of other mineral generations. Polarized light microscopy images indicate the microhemispheres are crystalline and the crystallinity increases with incubation time. The thickness of a single mineral layer of microhemisphere in microscale is precisely controlled by the waveform parameters of the temperature oscillation, while the layer number, which can reach tens to about one hundred, is constrained by the temperature oscillation period number. FT-IR spectra show that these microhemispheres synthesized under different conditions can be identified as the basic form of magnesium carbonate, hydromagnesite (Mg₅(CO₃)₄(OH)₂⋅4H₂O). SEM images exhibit the characteristic microscopic texture of the alternating dark and light rings of these microhemispheres. TEM images and ED patterns suggest the nanoflakes of microhemispheres are present in polycrystalline form with some degree of oriented assembly. The temperature oscillation modulated self-assembly may offer a new mechanism to understand the formation of layered microstructure of minerals in solution, and provide a non-invasive and programmable means to synthesize hierarchically ordered materials.

Tiny cystine stones in the gallbladder of a patient with cholecystolithiasis complicating acute cholecystitis: a case report

Cystine stones, the main component of which is cystine, are very common urinary calculi, but are rare in the gall bladder. In animals, there has been only one report of cystine gallstones in tree shrews, and to our knowledge, this is the first report of cystine gallstones in humans.

Particle-induced X-ray emission (PIXE) analysis of minor and trace elements in gallstones of Nigerian patients

Gallstone disease is a major health problem in many parts of the world. In Nigeria, however, only a few cases of gallstone disease are reported. Minor/trace elements are reported to play a significant role in the formation of gallstones. This study was conducted to assess the minor elements in gallstone of Nigerian patients who had cholecystectomy in our institution using particle-induced X-ray emission (PIXE) technique. We also compare the findings with previous reports from outside Nigeria. Fourteen patients who had cholecystectomy for calculous cholecystitis at Obafemi Awolowo University Teaching Hospital Complex, Ile-Ife, Nigeria, between March 2006 and July 2008, had the stone retrieved. The stones were analyzed for trace elements at the Center for Energy Research and Developments of the University using PIXE experiments. Certified standard reference material, NIST 1577a (bovine liver), was equally analyzed to confirm the accuracy of the experimental procedure. Computer code GUPIXWIN was used to analyze the data. Fourteen elements, phosphorus, sulfur, chlorine, potassium, calcium, manganese, iron, copper, zinc, bromide, lead, titanium, rubidium, and strontium, were detected in most of the samples. The concentrations of the elements varied in the different samples, ranging from a few parts per million to a few percent. Ca was the major constituent of all samples. The black sand-like samples had very high levels of P, S, K, and Pb, which were different from a previous report. The distribution of trace elements in stones in Nigeria patients is different from previous report outside Nigeria, and this may have some role in the occurrence of gallstones in the black African.

EPR and IR spectral investigations on some leafy vegetables of Indian origin

EPR spectral investigations have been carried out on four edible leafy vegetables of India, which are used as dietary component in day to day life. In Rumex vesicarius leaf sample, EPR spectral investigations at different temperatures indicate the presence of anti-ferromagnetically coupled Mn(IV)-Mn(IV) complexes. EPR spectra of Trigonella foenum graecum show the presence of Mn ions in multivalent state and Fe(3+) ions in rhombic symmetry. EPR spectra of Basella rubra indicate the presence of Mn(IV)-O-Mn(IV) type complexes. The EPR spectra of Basella rubra have been studied at different temperatures. It is found that the spin population for the resonance signal at g=2.06 obeys the Boltzmann distribution law. The EPR spectra of Moringa oliefera leaves show the presence of Mn(2+) ions. Radiation induced changes in free radical of this sample have also been studied. The FT-IR spectra of Basella rubra and Moringa oliefera leaves show the evidences for the protein matrix bands and those corresponding to carboxylic CO bonds.

Visfatin--a proinflammatory adipokine-in gallstone disease

BACKGROUND

Visfatin is increasingly associated with several obesity-related diseases. The study is to evaluate if aberrant expression of circulating visfatin occurs in gallstone disease.

METHODS

An enzyme-linked immunosorbent assay was used to examine serum visfatin levels in 79 patients with cholesterol gallstones, 71 with pigment gallstones, and 223 healthy controls. The chemical composition of extracted gallstones was determined by Fourier transform infrared spectroscopy.

RESULTS

Serum visfatin levels were markedly elevated in the cholesterol and pigment gallstones in comparison with healthy controls. Furthermore, increased visfatin levels were associated with formation of the cholesterol and pigment gallstones. Intriguingly, a significant positive correlation between serum visfation levels and white cell count was noted in the cholesterol gallstones and controls. Moreover, the positive correlation in the cholesterol gallstones was more significant in the body mass index >/=25 subgroup than in the body mass index <25 subgroup.

CONCLUSIONS

Gallstone disease is associated with altered circulating visfatin. The proinflammatory effect of circulating visfatin in gallstone disease deserves further investigation.

FTIR spectroscopic analysis of sputum: preliminary findings on a potential novel diagnostic marker for COPD

COPD is a common, progressively disabling disease and a major health burden worldwide. Fourier transform infrared (FTIR) spectroscopy provides for sensitive analysis of complex biological samples. COPD pathogenesis involves quantitative and qualitative changes in sputum biosynthesis. This first study explores whether FTIR can produce distinct spectral profiles of human sputum, and capture differences between COPD and health. Sputum obtained from 15 COPD patients and 15 healthy volunteers was analysed using FTIR spectroscopy; differences in peak positions, height and configuration were identified and measured. All samples gave reproducible characteristic IR absorption spectra. The most relevant regions identified were the amide and glycogen rich regions, showing crucial spectral differences between health and COPD relating to peak position shifts or intensity alteration. These novel preliminary findings support further exploration of FTIR sputum profiling in a clinical study to determine its potential as a practical method for monitoring COPD.

Disease recognition by infrared and Raman spectroscopy

Infrared (IR) and Raman spectroscopy are emerging biophotonic tools to recognize various diseases. The current review gives an overview of the experimental techniques, data-classification algorithms and applications to assess soft tissues, hard tissues and body fluids. The methodology section presents the principles to combine vibrational spectroscopy with microscopy, lateral information and fiber-optic probes. A crucial step is the classification of spectral data by a variety of algorithms. We discuss unsupervised algorithms such as cluster analysis or principal component analysis and supervised algorithms such as linear discriminant analysis, soft independent modeling of class analogies, artificial neural networks support vector machines, Bayesian classification, partial least-squares regression and ensemble methods. The selected topics include tumors of epithelial tissue, brain tumors, prion diseases, bone diseases, atherosclerosis, kidney stones and gallstones, skin tumors, diabetes and osteoarthritis.

Predictors of gallstone composition in 1025 symptomatic gallstones from Northern Germany

Background

Gallstones represent a prevalent and costly health problem. The changing epidemiology and the emerging non-surgical interventions for gallstone disease necessitate the definition of target populations for future therapies. This study aimed to define patterns of gallstone composition and identify demographic predictors of gallstone composition in a large sample of symptomatic gallstones from Northern Germany.

Methods

One thousand and seventy-four post-cholecystectomy gallstone specimens were obtained. Demographic and clinical information was provided by questionnaire (N = 1025 independent individuals with complete information). Two samples from each gallstone were analyzed using Fourier transformed infrared spectrometry.

Results

The most prevalent substance was cholesterol, which was detected in 95.0% of gallstone specimens. Bilirubin and bilirubinate were present in 30.0% and calcium was detected in 10.0% of the spectra. Ninety-two percent of measurements from the same stone yielded the same "main" substances, indicating a homogenous stone composition in most cases. Female sex and higher body mass index (BMI) were associated with the presence of cholesterol as a main substance in the gallstones (p < 0.001).

Conclusion

The changing epidemiology of gallstone disease is reflected by a marked shift in stone composition: Only two percent of stones in this study were pigment stones as compared to 91% percent of stones containing cholesterol as a main substance. Obese individuals from Germany with a BMI > 30 kg/m² have in 95% cholesterol-dominant gallstones and represent a potential target population for non-surgical interventions for the prevention or treatment of cholesterol stones.

Serum adiponectin levels in cholesterol and pigment cholelithiasis

Background

Altered adiponectin levels are associated with metabolic abnormalities. The aim of this study was to explore the role of adiponectin in cholelithiasis.

Methods

A radioimmunoassay was used to determine serum adiponectin levels in 58 patients with cholesterol gallstones and 47 with pigment gallstones, and 101 healthy controls. The chemical composition of extracted gallstones was determined by Fourier transform infrared spectroscopy.

Results

The mean(s.d.) adiponectin level was decreased in patients with cholesterol gallstones (7·6(4·1) µg/ml; P &lt; 0·001) but raised in patients with pigment gallstones (17·9(9·0) µg/ml; P &lt; 0·001) in comparison with healthy controls (11·7(6·5) µg/ml). Decreased adiponectin levels (odds ratio (OR) 0·85 (95 per cent confidence interval (c.i.) 0·76 to 0·96); P = 0·008) and female sex (OR 6·06 (95 per cent c.i. 2·10 to 17·46); P = 0·001) were associated with cholesterol gallstone formation. Increased adiponectin levels (OR 1·11 (95 per cent c.i. 1·01 to 1·22); P = 0·025) and increased age (OR 1·06 (95 per cent c.i. 1·01 to 1·12); P = 0·029) were associated with pigment gallstone formation. Raised serum aspartate aminotransferase concentration was a risk factor for both cholesterol (OR 1·16 (95 per cent c.i. 1·03 to 1·30); P = 0·013) and pigment (OR 1·23 (95 per cent c.i. 1·10 to 1·38); P &lt; 0·001) gallstones.

Conclusion

Gallstone formation is associated with altered serum adiponectin levels. Serum adiponectin might serve as a novel marker for cholesterol and pigment cholelithiasis.

Structural studies of the biomineralized species of calcified pancreatic stones in patients suffering from chronic pancreatitis

The pancreatic stones (Pancreatic calculi) collected from patients suffering from chronic calcific pancreatitis were studied in a view to explore the constituents involved in the calcification. The calcified stones were characterized by XRD, EPR and IR spectroscopic techniques. The detailed studies indicate that these stones consist of calcium carbonate as a major component, besides phosphates and other protein content. The presence of aragonite phases in the biomineralized stones is also discussed. The EPR spectra gave an evidence of the presence of traces of manganese in different oxidation states, which is used as one of the EPR probes in the present work. The samples were sintered at different temperatures to remove all the organic matter, and their EPR spectra have been studied to obtain detailed information regarding the changes in the symmetry of these stone samples. The X-irradiated sample was also characterized by EPR and the resonance signals are attributed to freely rotating CO(2)(-) radicals. The infrared spectrum reveals the presence of many organic bands corresponding to the protein amides.

Determination of chemical composition of gall bladder stones: Basis for treatment strategies in patients from Yaounde, Cameroon

AIM: Gallstone disease is increasing in sub-saharan Africa (SSA). In the west, the majority of stones can be dissolved with bile salts, since the major component is cholesterol. This medical therapy is expensive and not readily accessible to poor populations of SSA. It was therefore necessary to analyze the chemical composition of biliary stones in a group of patients, so as to make the case for introducing bile salt therapy in SSA.

METHODS: All patients with symptomatic gallstones were recruited in the study. All stones removed during cholecystectomy were sent to Houston for x-ray diffraction analysis. Data on age, sex, serum cholesterol, and the percentage by weight of cholesterol, calcium carbonate, and amorphous material in each stone was entered into a pre-established proforma. Frequencies of the major components of the stones were determined.

RESULTS: Sixteen women and ten men aged between 27 and 73 (mean 44.9) years provided stones for the study. The majority of patients (65.38%) had stones with less than 25% of cholesterol. Amorphous material made up more than 50% and 100% of stones from 16 (61.53%) and 9 (34.61%) patients respectively.

CONCLUSION: Cholesterol is present in small amounts in a minority of gallstones in Yaounde. Dissolution of gallstones with bile salts is unlikely to be successful.

[Crystalline microstructure and microanalysis of gallstones in childhood and adolescence]

OBJECTIVES

To determine the crystalline structure and chemical composition of gallstones in children and adolescents. Design of the studyA simple descriptive study was performed in 21 gallstones from pediatric patients with chronic cholecystitis who underwent elective cholecystectomy. Only two patients had an underlying disease that could explain the presence of gallstones. Crystalline structure was determined by X-ray diffraction and visualization with scanning electron microscopy. Emission and atomic absorption spectroscopy were used to study composition. An X-ray-dispersion energy spectroscope joined to the microscope was used to confirm the crystalline composition of some of the areas examined with the microscope.

RESULTS

Bilirubinate and calcium carbonate predominated in the crystalline composition, demonstrating the pigmented appearance of idiopathic gallstones. Cholesterol was a secondary element. Microanalysis confirmed calcium as a fundamental constituent of gallstones irrespective of age. Other elements, such as sodium, potassium, magnesium and manganese, etc., were detected.

CONCLUSIONS

The present study confirms the pigmented character of idiopathic gallstones in childhood. The high levels of calcium carbonate and bilirubinate, despite a lack of evidence for any risk factors for the formation of bilirubinate, was striking. Calcium was the most predominant element of the calculi.