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ShareJan. 27, 2000 — Research May Lead to Earlier Diagnosis of Digestive Disease Affecting 10% of Americans
NEW YORK, N.Y. and HAIFA, Israel, (January 18, 2000) -- For the first time, researchers at the Technion-Israel Institute of Technology observed the initial stages of gallstone formation. Seeing how gallstones are formed can help physicians learn how to inhibit their formation through medication and dietary changes. This would eliminate the need for invasive treatment for one of the most common diseases of the digestive system. The observation, made possible by the use of two complementary state-of-the-art microscopy systems, will be published in the February 2000 Hepatology.
Gallstones are formed when microscopic particles of cholesterol are precipitated in the gallbladder from bile, which is a solution of lecithin, bile salts, and cholesterol. The American Liver Foundation estimates that half a million Americans, mostly women, will have their gallbladders surgically removed this year simply because of gallstones, making it the most common surgical procedure in the U.S.
"This is a beautiful example of what can be accomplished when a physician scientist collaborates with a world-class physical chemist," said Dr. Martin C. Carey, professor of medicine at Harvard Medical School and senior physician at Brigham and Women's Hospital. "The great power of the work is that it may lead to strategies that may prevent or reverse cholesterol gallstone formation, one of the commonest and most expensive digestive diseases in the Western world."
"Our research aims to answer why and how gallstones form so that physicians can direct their efforts towards inhibiting the process at the onset through medication and dietary changes," said Dr. Yeshayahu Talmon of the Department of Chemical Engineering. Working with Dr. Fred Konikoff of the Tel Aviv University Medical School, captured the formation of cholesterol crystals in bile taken from gallstone patients, and from synthetic bile.
"Until now, gallstone research has employed video-enhanced light microscopy (VELM) which has resolution capabilities that are relatively low - one one/millionth of a meter (one tenth of the diameter of a red blood cell)," said Talmon. "We now have the more advanced cryo-transmission electron microscopy (cryo-TEM) which can resolve details one thousand times smaller. The magnifying power is comparable to a telescope that would enable you to observe an ant from a satellite 800 miles above earth."
The team discovered that the combined use of VELM and cryo-TEM enabled them to see the gallstone microstructures from the moment of creation through subsequent growth into cholesterol crystals, which later form gallstones. And, they were able to observe crystals forming in human bile from gallstone patients in a few hours following extraction, and after 40 hours in the synthetic model.
Eighty percent of all gallstones are composed mainly of cholesterol. Excess cholesterol in the body is removed from the blood by the liver and is secreted into bile. When bile contains too much cholesterol, small crystals form in the bile and fall to the bottom of the gallbladder. The cholesterol crystals fuse together in the gallbladder and form gallstones of varying sizes.
According to the American Liver Foundation, this year more than 1 million people in the U.S. will discover they have gallstones. They will join an estimated 20 million Americans, approximately 10 percent of the population, who have gallstones. Symptoms of gallstones can range from severe and intermittent pain in the right upper abdomen to life threatening complications. Left untreated, gallstones can cause acute pancreatitis cholangitis and liver damage.
Removal of the gallbladder due to gallstones is the most common surgical procedure performed in the U.S. It is estimated that five percent of all medical expenses in America are related to gallbladder treatment and related complications, making advances in this field a vital healthcare consideration.
The Technion-Israel Institute of Technology is the country's premier scientific and technological center for applied research and education. It commands a worldwide reputation for its pioneering work in communications, electronics, computer science, biotechnology, water-resource management, materials engineering, aerospace and medicine, among others. The majority of Israel's engineers are Technion graduates, as are most of the founders and managers of its high-tech industries. The Technion's 13,000 students and 700 faculty study and work in its 19 faculties and 30 research centers and institutes in Haifa.
The American Technion Society (ATS) supports the Technion. Based in New York City, it is the leading American organization supporting higher education in Israel, with more than 20,000 supporters and 17 offices around the country. Technion societies are located in 24 countries around the world.
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