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The dissolution of gallstones.
This is the second part of a talk by Herman 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 part he talks about factors which influence the rate of human cholesterol gallstone dissolution. Chenodeoxycholic acid feeding enhances cholesterol solubility in bile and promotes gallstone dissolution in man. The complications of this treatment are described and future gallstone research considered.
Segment 1 Dowling discusses bile salt composition. He shows slides of microcrystals in bile, before and after filtration. A further slide shows a test tube containing bile from a patient after cholecystokinin administration. Time start: 00:00:00:00 Time end: 00:06:12:00 Length: 00:06:12:00 Segment 2 Dowling shows a chart which details the composition of bile salts after centrifugation. A wall chart shows bile salt pool size in patients with gallstones and in control subjects. Time start: 00:06:12:00 Time end: 00:10:37:00 Length: 00:04:24:00 Segment 3 Dowling discusses some experiments on gallstone dissolution and shows the results in a series of charts and diagrams. Time start: 00:10:37:00 Time end: 00:14:33:00 Length: 00:03:56:00 Segment 4 We hear about an experiment which investigated bile composition in rhesus monkeys. A slide shows a glass chamber in which a gallstone is placed. A further chart illustrates the rates of gallstone dissolution of varying cholesterol content. Another chart illustrates the dissolution of gallstones in varying bile saturations. Some photomicrographs of gallstones are shown. Time start: 00:14:33:00 Time end: 00:19:55:13 Length: 00:05:22:13 Segment 5 A slide shows some gallstones and their x-rays. Dowling refers to a chart illustrating rates of dissolution of gallstones with calcified rim. Bile composition in a patient with gallstones before and after treatment is shown. Time start: 00:19:55:13 Time end: 00:25:53:19 Length: 00:05:58:00 Segment 6 A series of x-rays are shown to detail the results of treatment for gallstones. The complications of gallstones are discussed. Time start: 00:25:53:19 Time end: 00:30:23:09 Length: 00:04:29:15 Segment 7 Dowling discusses bile acid treatments and its complications. He summarises the lecture and concludes. Time start: 00:30:23:09 Time end: 00:34:56:09 Length: 00:04:33:00
Presented by Dr Hermon Dowling, Hammersmith Hospital, London. 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