Biomedical subjects
Publications and source records attributed to W E Klee.
Visual examination, electron-microscopic observation and infrared-spectroscopic analysis demonstrate that the thermodynamically unstable calcium oxalate trihydrate, which supposedly plays an important role in the formation of certain urinary calculi, is a commonly occurring constituent of urinary stones.
Success or failure of an attempted dissolution of gallstones depends--among other factors--on the nature, the quantity and the distribution of the different components. This paper presents an investigation of the distribution of the various components by X-ray microradiography. Due to their different absorption behaviour the following three classes of components could be distinguished: I. Components with low absorption: Cholesterol, II. Components with moderate absorption: Calcium palmitate monohydrate, calcium bilirubinate, III. Components with high absorption: Vaterite, aragonite, calcite, carbonate apatite. The distribution patterns of these classes of components showed that in all probability 12 out of the 27 gallstones which were examined would have resisted a dissolution.
208 gallstones were collected in sequence and subjected to chemical analysis. Only 10.6% of these stones turned out to be purely composed by cholesterol and only these can be considered to be suited for therapy with chenodesoxycholic acid (CDC). Gallstones composed exclusively by cholesterol cannot be identified in vivo; therapy with CDS has to be followed closely by multiple X-ray and laboratory examinations; in addition there are many relapses after therapy with CDC. For these reasons we still tend to prefer surgery as the therapy of choice in gallstone disease.
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