Comparative studies on iodine levels in gallstones and bile of Japanese and Thais (Chiang Mai and Bangkok).

We measured the iodine content of gallstones and bile from patients in three areas (Kawasaki in Japan, and Chiang Mai and Bangkok in Thailand) by means of neutron activation analysis. The mean values for iodine content in three types of gallstones (cholesterol, pigment and rare stones) and bile from patients living in Chiang Mai were clearly smaller than those from patients living in Kawasaki and Bangkok. The low iodine intake by Chiang Mai patients continued from the start of gallstone formation until the time when the stones were excised, and the iodine intake was low when bile was collected. The PBI levels in the sera of Chiang Mai residents with low iodine intake over a long period were clearly lower than those of Bangkok patients with normal intake, and the levels in goiter patients were similar to those in healthy people and patients with gallstones among Chiang Mai residents.

Hepatolithiasis: epidemiology and classification.

Hepatolithiasis or intrahepatic stone is more common among East Asian countries than in Western world. The relative incidence (i.e. hepatolithiasis cases against all cases with gallstone disease) in the Western countries is approximately 1% whereas in Taiwan, South Korea, the People's Republic of China it has been reported to be 20%, 18% and 38-45% respectively. There are two types of hepatolithiasis and in East Asian countries one usually finds pigmented stone. The disease appears to be more common among people with low socio-economic status. No single worldwide accepted classification of hepatolithiasis exists at present.

Mercury content in the gallstones and bile of Thai people (Chiang Mai and Bangkok) and Japanese.

Mercury contents in the gallstones and bile of patients living in Thailand (Chiang Mai and Bangkok) and Japan were studied by neutron activation analysis. The correlation between contents in the gallstones and bile, and the amount of mercury in the diet and environment was investigated by comparing the contents in patients living in three different areas. The content in the bile of the Japanese patients was significantly greater than that of the Thai patients. The distribution of mercury contents in the pigment and rare stones of patients living in Bangkok indicated a bipolarity. However, the distribution of the contents in cholesterol, pigment, and rare stones of Japanese patients did not indicate a bipolarity. Bipolarity would indicate the amount of mercury in dietary foods, and the pollution level of mercury. The mercury contents in the gallstones and bile would reflect the amount of mercury in the diet and environment.

Establishment and characterization of a cholangiocarcinoma cell line from a Thai patient with intrahepatic bile duct cancer.

A new human cholangiocarcinoma cell line (HuCCA-1) was established from cholangiocarcinoma (CCA) tissue fragments surgically removed from a Thai patient with intrahepatic bile duct cancer. The growth medium used for the primary cell culture was Ham's F12 supplemented with 10% fetal bovine serum (FBS) and 10 ng/ml epithelial growth factor (EGF). Approximately one month later, the cells were subcultured in Ham's F12 supplemented with only 10% FBS. The population doubling time was approximately 55 hr. Staining of the cells for cytokeratin and mucin confirmed that the cells were mucin-secreting tumor of epithelial cell origin. The supernatant fluid secreted a number of non-specific tumor markers including CA125 and traces of MCA and AFP. The ability of the HuCCA-1 cell line to synthesize specific marker that may have potential in the diagnosis of cholangiocarcinoma is now being investigated.

Tuberculosis of the common bile duct.

The intrahepatic biliary tree can occasionally be infected by Mycobacterium tuberculosis, but tuberculosis of the common bile duct has not previously been reported. A 38-year-old man with obstructive jaundice, who was originally thought to have cholangiocarcinoma associated with opisthorchiasis (a common combination in Thailand), was finally proved to have tuberculosis of the common bile duct with adjacent tuberculous lymphadenitis. Following T-tube drainage and antitubercular therapy, he made a complete recovery. The importance of a tissue diagnosis in all cases of obstructive jaundice is emphasized to avoid missing rare but curable diseases.