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The formation of gallstones.
Gilliland, Ian C
This is the first part of a talk by Hermon Dowling, Lecturer in Medicine in the postgraduate department at Hammersmith Hospital, London, and Deputy Director at the Medical Research Council's Intestinal Malabsorption Group. In this first part he talks about the different types of human gallstones, micelle formation, micellar solubilisation of biliary cholesterol, the enteropepatic circulation of bile acids, its role in blie lipid secretion and the formation of normal and supersaturated bile. The effect of ileal resection and a reduced bile acid pool on the formation of supersaturated bile and gallstones is also described.
Segment 1 Gilliland introduces Dowling. Dowling shows some gallstones which he holds in the palm of his hand. He discusses a diagram showing an illustration of the formation of gallstones. Time start: 00:00:00:00 Time end: 00:05:05:00 Length: 00:05:05:00 Segment 2 Dowling shows a series of slides illustrating different kinds of gallstones. He then shows a scanning electron micrograph of cholesterol gallstones, a micrograph of dust on the surface of a gallstone, a micrograph of melting crystals and a light micrograph of bile. Time start: 00:05:05:00 Time end: 00:10:29:00 Length: 00:05:24:00 Segment 3 Dowling discusses phospholipid molecules and shows a diagram illustrating the bilayered structure of hydrated phospholipid molecules. He then moves on to discuss bile salt molecules. Time start: 00:10:29:00 Time end: 00:15:06:00 Length: 00:04:37:00 Segment 4 Dowling shows a diagram illustrating the molecular structure of the sodium salt of a fatty acid. A further slide shows the molecular structure of sodium salt of cholic acid. This is also demonstrated as a 3D model. Time start: 00:15:06:00 Time end: 00:21:05:10 Length: 00:05:59:10 Segment 5 Dowling discusses, in depth, the composition of bile salts, using diagrams to illustrate his points. He differentiates between the liquid and crystal phases of bile salts. Time start: 00:21:05:10 Time end: 00:25:49:17 Length: 00:04:44:07 Segment 6 Dowling talks about how bile salts move through the body. He describes the relationship between beiliar cholesterol secretion an dbiliary bile acid secretion. Time start: 00:25:49:17 Time end: 00:30:03:00 Length: 00:04:13:08 Segment 7 Dowling talks about the cholesterol in bile salts, focusing on how the measurements of these differ in patients with gallstones. He shows various graphs and charts. Time start: 00:30:03:00 Time end: 00:34:54:00 Length: 00:04:51:00 Segment 8 Dowling summarises the lecture by going back over the primary and secondary abnormalities that lead to gallstone formation. Time start: 00:34:54:00 Time end: 00:41:55:24 Length: 00:07:01:24
Presented by Dr Hermon Dowling, Hammersmith Hospital, London. Introduced by Dr Ian Gilliland. Produced by Peter Bowen. Made by University of London Audio-Visual Centre. Made for British Postgraduate Medical Federation.
This video is one of around 310 titles, originally broadcast on Channel 7 of the ILEA closed-circuit television network, given to Wellcome Trust from the University of London Audio-Visual Centre shortly after it closed in the late 1980s. Although some of these programmes might now seem rather out-dated, they probably represent the largest and most diversified body of medical video produced in any British university at this time, and give a comprehensive and fascinating view of the state of medical and surgical research and practice in the 1970s and 1980s, thus constituting a contemporary medical-historical archive of great interest.The lectures mostly take place in a small and intimate studio setting and are often face-to-face. The lecturers use a wide variety of resources to illustrate their points, including film clips, slides, graphs, animated diagrams, charts and tables as well as 3-dimensional models and display boards with movable pieces. Some of the lecturers are telegenic while some are clearly less comfortable about being recorded; all are experts in their field and show great enthusiasm to share both the latest research and the historical context of their specialist areas.
The Scientific Basis of Medicine