Tanaka J, Ise H, Takahashi W, Suzuki N, Sato T, Komatsu H
Dept. of Surgery, Tohoku Univ. School of Medicine, Sendai, Japan.
Nihon Geka Gakkai Zasshi. 1988 Nov;89(11):1834-42.
To understand the pathogenesis of cholesterol gallstones from a crystallographic point of view, we investigated gallstones and precipitates in gallbladder bile by the optical method used in crystallography. First, ground thin sections of cholesterol gallstones in 28 cases were examined by a polarizing microscope. The crystalline fragments which were peeled off from gallstones by sonication were also examined in the same manner. Secondly, the cholesterol monohydrate crystals in gallbladder bile were examined by a polarizing and phase contrast microscope. The bile samples were obtained from 15 patients with cholesterol gallstones by the needle puncture of gallbladder during surgery. The results of observation were as follows. 1) The cholesterol gallstones were composed of many small plated cholesterol monohydrate crystals aggregated radially. 2) Each small plated crystal was grown by the lateral growth mechanism in bile. Spiral growth patterns were often observed on the (001) faces. 3) The cholesterol gallstones were formed by two successive mechanisms: The aggregation of cholesterol monohydrate crystals and the lateral growth of each single crystal.
为了从晶体学角度理解胆固醇结石的发病机制，我们采用晶体学中使用的光学方法研究了胆囊胆汁中的结石和沉淀物。首先，用偏光显微镜检查了28例胆固醇结石的磨片薄切片。通过超声处理从结石上剥离的晶体碎片也以同样的方式进行了检查。其次，用偏光和相差显微镜检查了胆囊胆汁中的胆固醇一水合物晶体。通过手术期间胆囊穿刺从15例胆固醇结石患者中获取胆汁样本。观察结果如下：1）胆固醇结石由许多呈放射状聚集的小片状胆固醇一水合物晶体组成。2）每个小片状晶体在胆汁中通过横向生长机制生长。在（001）面上经常观察到螺旋生长模式。3）胆固醇结石由两个连续的机制形成：胆固醇一水合物晶体的聚集和每个单晶的横向生长。
