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PubMed1975

Effects of hypoxia on early pregnancy and embryonic development in the mouse.

The efficacy of gestation during early pregnancy was investigated in mice exposed to either 14% or 7% oxygen environments. At Day 8 postinsemination, animals were killed and reproductive tracts were examined. Embryonic development was decelerated and an increased frequency of embryo death and resorption was apparent. At the 7% oxygen level, implantation was almost always blocked as evidenced by free blastocysts and uterine debris of embryonic origin. This blockage of nidation is attributed to altered progestational support due to ovarian luteolysis as demonstrated by decreased uterine volumes. These studies indicate that reproduction is impaired by hypoxia during preplacental stages. Abnormal gestation may be attributed to the direct effects of hypoxia on the conceptus and to its indirect effects which alter the tropic and endocrine support provided by the maternal system.

Animals↗
PubMed2000

Enzymes: the most important markers of pregnancy development.

From ethical and moral reasons, the progress in neonatology and anesthesiology must not obscure the iatrogenic labors, which begin at the time improper for individual child, especially after induction and - because of that - very often instrumental. Enzymatic monitoring has enabled reduction of the number of preterm and instrumental deliveries, and--more importantly--the elimination of statistical (so-called post-datism) indications for terminating pregnancies instead of natural their individual occurrence in the entire range of physiological norm of human labors from 37 0/7 to 43 2/7 weeks. During pregnancy the mothers organism has to secure a proper environment for the growth and development of the child, which is accompanied by the constant increase in oxytocinase and isoxytocinase. These enzymes are closely connected even with the regulation of ovulation as well as with the embryo nidation and development of early pregnancy. Both enzymes are very important indicator of the threatened life and health of the fetus. It is important since these changes precede clinical symptoms by several weeks. On the other hand, they enable monitoring of the efficiency of ACTH depot therapy as well as pregnancy complicated by diabetes, hypertension and endocrinopathies. The values of prenatal oxytocinasaemia make possible prediction the date and course of delivery. Also, they are highly positively correlated with the weight, length and maturity of the newborn, as well as the size of the placenta. In multifetal pregnancies, levels of both enzymes are higher than in single ones.

Adaptor Proteins, Signal Transducing↗
PubMed1975

Zona pellucida denudation, blastocyst proliferation and attachment in the rat.

The mode of zona pellucida denudation and blastocyst proliferation and attachment was investigated in Wistar rats during day 5 of pregnancy and in ovariectomized pregnant animals given 5-0 mg progesterone daily until the 10th day, when 0-2 mug oestradiol was injected together with progesterone. During day 5 of pregnancy, when only 5 empty zonae were detected from 32 animals, zona denudation occurred by lysis, which took 6 h. Zona denudation occurred by shedding in the ovariectomized pregnant animals; 190 empty zonae were detected from 40 animals. Oestradiol administration to the experimental animals caused lysis of the shed zonae 24-30 h after oestradiol treatment. Air-dried preparations of the embryos showed that the blastomeres proliferated exponentially from a mean of 27-52 +/- 4-0 cells per embryo at 12.00 h on day 5 of pregnancy to 53-96 %/- 2-58 cells per embryo at 22.00 h, with a cell doubling time of 10 h in normal animals. In the ovariectomized animals, blastocysts were arrested at about the 100-cell stage on the 10th day. Oestradiol administration to the experimental animals did not induce mitosis; the embryos implanted without further cell division. The number of free embryos recovered declined from a mean of 12-0 per animal at 12.00 h to 4-25 per animal at 22.00 h on day 5 of pregnancy. The number of embryos recovered from the ovariectomized animals varied between one and 11 per animal. The results show that cell division continued in embryos within ovariectomized pregnant animals in the absence of oestrogen, until about the 100-cell stage. There was no further cell division before nidation when oestradiol was administered. The empty zonae were, however, lysed between 24 and 30 h after oestradiol treatment. The zona lytic factor appears to be oestradiol dependent and of maternal origin. A causal relationship exists between zona lysis and embryo attachment, which is independent of the number of cells per blastocyst.

Animals↗
PubMed2002

Ovarian multifoetal pregnancy.

A 24 years Muslim lady was admitted to SSKM Hospital with the complaint of pain lower abdomen, more on left side with ultrasonography diagnosis of alive foetuses in a twin pregnancy of 19-20 weeks of gestational age. On the very next day, foetal heart sound disappeared with complaint of no foetal movement. Doppler study and USG confirmed death of the foetuses. Laparotomy performed 3 weeks after foetal death revealed soft bulky uterus of about 10 weeks gestational age. Left fallopian tube was found highly stretched over the upper aspect of gestational mass and left overy could not be traced. Total hysterectomy with removal of the mass and left tube with preservation of right ovary and tube was carried out. On pathological examination, the uterus and the gestational mass were found empty and separated from the mass. There were two gestational sacs with two separate placentae, cords and foetuses of 20 weeks maturity. Microscopic examination showed infiltration of ovarian stroma by intermediate trophoblast indicating ovarian nidation.

Adult↗
PubMed2002

[The current state of law as a mirror of social movements and currents].

The question of what movements and currents in society may have urged the legislator to grant to the life of the pre-implanted embryo complete legal protection, in obvious contradistinction to the total denial of the latter to a post-implantation foetus, when a pregnant woman is deem to be in a legally-recognised pregnancy-related conflict situation, is investigated. To the extent that it exacerbates the difficulties of sterile couples to have children, this state of affairs differs considerably from the legal situation of almost all other countries of the western world. It is dismaying to note the widespread lack of interest of the public regarding the question of how to bridge the inconsistencies of evaluation of the need for protection of human life before and after nidation. Arguments designed to explain this discrepancy in legal or ethical terms do not convince. Apart from the lessening impact of the role of women in reproduction, it is the awareness of the historic burden of national guilt created by the atrocities committed by the Third Reich that is said to account for the scrupulousness and backward as opposed to prospective orientation of large parts of German society. Sterile women and couples are those that suffer most on account of this situation and might ultimately be tempted to look for medical help in more liberal countries, should their wish to have children be thwarted in Germany for legal reasons.

Bioethics↗
PubMed1976

Pregnancy termination in dogs with novel nonhormonal compounds.

Resorption of the products of fertilization was induced in bitches given (subcutaneously) single or multiple doses of the nonhormonal compounds L-10492 and L-10503 during the first half of gestation; also resorption or expulsion of the conceptus was induced when these compounds were given during the latter part of pregnancy. The smallest doses were required at a time immediately after implantation of the fertilized ova in the uterus. Effectiveness and appearance of side effects were dose-dependent. These consisted of decreased appetite, loss of body weight, and diarrhea (feces sometimes containing streaks of blood). Bitches which had aborted returned to estrus within normal intervals of time, exhibited normal mating behavior, and were fertile. They had normal deliveries and lactation, and the pups were normal. The mechanism of action does not involve effects on nidation and the compounds were not luteolytic, but probably involved the uteroplacental complex.

Abortifacient Agents↗
PubMed2003

[Molecular and cytometric analysis of renal cell carcinoma cells. Concepts, techniques and prospects].

At the present time, there is no reliable laboratory marker for the diagnosis and prognosis of clear cell renal cell carcinoma (RCC), while about 20% of small tumours detected by modern imaging techniques are benign and the clinical course is difficult to predict with considerable differences for the same stage and same grade. The molecular identification of clear cell RCC cells could satisfy these new requirements in the context of diagnosis of atypical or small renal tumours, allowing a more refined prognostic assessment, which is currently uncertain. Some of the antigens used for molecular diagnosis of clear cell RCC, such as cadherin-6, are present in the normal kidney, while others are newly formed antigens (TuM2PK, MN/CA9, CA12, calpain) or ectopic (PSMA, PSA, KLKI, cytokeratin 7 vimentin) or induce abnormal glycosylation (sialyl Lewis'X, galectins) indicating the malignant nature of the cells. The tumour's capacity for progression is related to dysregulations of the cycle (ras, Pax2, Tiam 1, waf/p21), division (tetracyclines, MIB1, PCNA, Nor Ag), apoptosis (bcl2, p53, CD95/Apo1), and the capacities for tissue invasion (proteases), disorganization (cadherin, catenins) or nidation (ICAM-1, CD44). Finally, chromosomal anomalies (mutations, translocations) also occur. MN/CA9, cadherin-6, vimentin, mucin 1 and DNA content are particularly useful for the diagnosis and/or prognosis of clear cell RCC. These markers can be analysed by extremely sensitive cytometric (flow cytometry, plate cytometry) or molecular methods (RT-PCR, in situ hybridization). These techniques lower the limit of detection of tumour cells in biological products (aspiration cytology, microbiopsy) and eventually in circulating blood. Proteomic and genomic methods (biochips) should considerably accelerate research in this field leading to the development of routine clinical applications.

Antigens, Neoplasm↗
PubMed2003

[Ovulation induction therapy and systemic lupus erythematosus].

Improvement in the prognosis of SLE prognosis has led to considering infertility therapy. The earliest reports displayed complications such as SLE revealed by ovulation induction or thrombophlebitis. Fertility is known to be normal in women with SLE, excepting amenorrhea accompanying severe flare-ups, renal insufficiency-related hypofertility and ovarian failure secondary to cyclophosphamide therapy. Anti-phospholipid antibodies are suspected to cause defective nidation and placental ischemia. An exponential rise of serum estradiol is observed irrespective of the ovulation induction protocol used, leading to SLE flare-up and thrombosis. We have experience with 114 cycles in 21 women with SLE and/or APS. A complication (fetal loss, SLE flare-up, thrombophlebitis) revealed the underlying disease in 8 women. Eighteen pregnancies led to 9 live-births, 4 fetal deaths and 5 embryonic losses. Pregnancy rate was higher after ovulation induction using gonadotropins (25% per cycle), than clomiphene (4%). Pregnancy rate was similar after IVFETE, whether the protocol was planned or not. However, three-quarters of the pregnancies after unplanned IVFETE led to abortions. On the contrary, 6 out of 7 pregnancies after planned IVFETE led to live-births. Two women developed thrombophlebitis after gonadotropins therapy. A SLE flare-up appeared after 13 out of 62 cycles, with a flare-up rate higher after gonadotropins (27% per cycle) than clomiphene therapy (6%), and after an unplanned (30%) than a planned procedure (10%). In conclusion, ovulation induction therapy can reveal SLE or APS. Clomiphene complications are uncommon. When gonadotropin therapy is considered, a preventive anti-inflammatory therapy should be discussed in SLE patients, in conjunction with heparin and/or anti-aggregate therapy for those with asymptomatic anti-phospholipid antibodies or prior thrombotic events.

Adult↗
PubMed2003

Final report on the safety assessment of aluminum silicate, calcium silicate, magnesium aluminum silicate, magnesium silicate, magnesium trisilicate, sodium magnesium silicate, zirconium silicate, attapulgite, bentonite, Fuller's earth, hectorite, kaolin, lithium magnesium silicate, lithium magnesium sodium silicate, montmorillonite, pyrophyllite, and zeolite.

This report reviews the safety of Aluminum, Calcium, Lithium Magnesium, Lithium Magnesium Sodium, Magnesium Aluminum, Magnesium, Sodium Magnesium, and Zirconium Silicates, Magnesium Trisilicate, Attapulgite, Bentonite, Fuller's Earth, Hectorite, Kaolin, Montmorillonite, Pyrophyllite, and Zeolite as used in cosmetic formulations. The common aspect of all these claylike ingredients is that they contain silicon, oxygen, and one or more metals. Many silicates occur naturally and are mined; yet others are produced synthetically. Typical cosmetic uses of silicates include abrasive, opacifying agent, viscosity-increasing agent, anticaking agent, emulsion stabilizer, binder, and suspending agent. Clay silicates (silicates containing water in their structure) primarily function as adsorbents, opacifiers, and viscosity-increasing agents. Pyrophyllite is also used as a colorant. The International Agency for Research on Cancer has ruled Attapulgite fibers >5 microm as possibly carcinogenic to humans, but fibers <5 microm were not classified as to their carcinogenicity to humans. Likewise, Clinoptilolite, Phillipsite, Mordenite, Nonfibrous Japanese Zeolite, and synthetic Zeolites were not classified as to their carcinogenicity to humans. These ingredients are not significantly toxic in oral acute or short-term oral or parenteral toxicity studies in animals. Inhalation toxicity, however, is readily demonstrated in animals. Particle size, fibrogenicity, concentration, and mineral composition had the greatest effect on toxicity. Larger particle size and longer and wider fibers cause more adverse effects. Magnesium Aluminum Silicate was a weak primary skin irritant in rabbits and had no cumulative skin irritation in guinea pigs. No gross effects were reported in any of these studies. Sodium Magnesium Silicate had no primary skin irritation in rabbits and had no cumulative skin irritation in guinea pigs. Hectorite was nonirritating to the skin of rabbits in a Draize primary skin irritation study. Magnesium Aluminum Silicate and Sodium Magnesium Silicate caused minimal eye irritation in a Draize eye irritation test. Bentonite caused severe iritis after injection into the anterior chamber of the eyes of rabbits and when injected intralamellarly, widespread corneal infiltrates and retrocorneal membranes were recorded. In a primary eye irritation study in rabbits, Hectorite was moderately irritating without washing and practically nonirritating to the eye with a washout. Rats tolerated a single dose of Zeolite A without any adverse reaction in the eye. Calcium Silicate had no discernible effect on nidation or on maternal or fetal survival in rabbits. Magnesium Aluminum Silicate had neither a teratogenic nor adverse effects on the mouse fetus. Female rats receiving a 20% Kaolin diet exhibited maternal anemia but no significant reduction in birth weight of the pups was recorded. Type A Zeolite produced no adverse effects on the dam, embryo, or fetus in either rats or rabbits at any dose level. Clinoptilolite had no effect on female rat reproductive performance. These ingredients were not genotoxic in the Ames bacterial test system. In primary hepatocyte cultures, the addition of Attapulgite had no significant unscheduled DNA synthesis. Attapulgite did cause significant increases in unscheduled DNA synthesis in rat pleural mesothelial cells, but no significant increase in sister chromosome exchanges were seen. Zeolite particles (<10 microm) produced statistically significant increase in the percentage of aberrant metaphases in human peripheral blood lymphocytes and cells collected by peritoneal lavage from exposed mice. Topical application of Magnesium Aluminum Silicate to human skin daily for 1 week produced no adverse effects. Occupational exposure to mineral dusts has been studied extensively. Fibrosis and pneumoconiosis have been documented in workers involved in the mining and processing of Aluminum Silicate, Calcium Silicate, Zirconium Silicate, Fuller's Earth, Kaolin, Montmorillonite, Pyrophyllite, and Zeolite. The Cosmetic Ingredient Review (CIR. The Cosmetic Ingredient Review (CIR) Expert Panel concluded that the extensive pulmonary damage in humans was the result of direct occupational inhalation of the dusts and noted that lesions seen in animals were affected by particle size, fiber length, and concentration. The Panel considers that most of the formulations are not respirable and of the preparations that are respirable, the concentration of the ingredient is very low. Even so, the Panel considered that any spray containing these solids should be formulated to minimize their inhalation. With this admonition to the cosmetics industry, the CIR Expert Panel concluded that these ingredients are safe as currently used in cosmetic formulations. The Panel did note that the cosmetic ingredient, Talc, is a hydrated magnesium silicate. Because it has a unique crystalline structure that differs from ingredients addressed in this safety assessment, Talc is not included in this report.

Animals↗
PubMed2003

[Reproductive toxicity of metadoxine in rats].

OBJECTIVE: To study the reproductive toxicity of metadoxine. METHODS: Male and female rats were given metadoxine before pregnancy and early gestation, i.e. to feed metadoxine to male rats for 60 days before copulation and continue feeding during copulation, and feed metadoxine to female rats for 14 days before copulation. RESULTS: No significant toxic effect was observed in the 400 mg/kg group. A few rats showed paralysis of hind leg in the 800 mg/kg group. The dosage of 1 600 mg/kg caused significant paralysis of hind legs, emaciation, and reduced weight gain. In the 1600 mg/kg group, the mating rate of male rats was significantly affected (P < 0.01). In the 800 and 1 600 mg/kg group, fertility of male rats was markedly reduced (P < 0.01). In the 800 mg/kg group, the effect on sperm counts of epididymis of male rats was markedly reduced (P < 0.05). In the 1 600 mg/kg group, testicle weight and body weight ratio and sperm counts of epididymis rate were significantly (P < 0.001) reduced. In the 1 600 mg/kg group, the fertility rate of female rats was remarkably (P < 0.001) reduced. In the 800 mg/kg group, the weight gain of pregnant rats was significantly reduced (P < 0.001). In both the 800 and 1 600 mg/kg groups, the gestation rate was greatly reduced (P < 0.001). In the 800 mg/kg group, mortality rate before nidation (P < 0.001) and average live fetus number were significantly reduced (P < 0.05). In the 400 mg/kg group, the fetal weight was significantly reduced (P < 0.001). In the 800 mg/kg group, body length, tail length, body weight and sternum development of fetal rats were significantly affected (P < 0.001). CONCLUSION: Under the presented experimental conditions, metadoxine has no teratogenic effects on SD rats and the no effect dose is 400 mg/kg. And the no effect dose for the developmental toxicity is less than 400 mg/kg.

Animals↗
PubMedDate not supplied

Indomethacin and fertility in experimental endometriosis.

Clinical and experimental evidence showed an increased concentration of prostaglandins in peritoneal fluid in cases of endometriosis. The aim of this study was to verify whether an antiprostaglandin drug can restore fertility in cases of endometriosis. For this reason endometriosis was induced in 4 groups of 10 rats. Group A was treated with indomethacin both in the pre-ovulatory and in the post-ovulatory phase. Group B was treated in the pre-ovulatory phase. Group C was treated in the post-ovulatory phase. Group D was not treated. Ten other rats (group E) underwent a sham operation and were used as a control. Twelve days after mating, gestational sacs and corpora lutea were counted and the nidation index was calculated. Only indomethacin administered during the pre-ovulatory phase completely restored fertility in these rats.

Animals↗
PubMed2005

[Expression of matrix metalloproteinase-9 and tumor necrosis factor-alpha in the placenta of patients with pregnancy-induced hypertension].

OBJECTIVE: To investigate the role of matrix metalloproteinase-9 (MMP-9) and tumor necrosis factor-alpha (TNF-alpha) in the pathogenesis of pregnancy-induced hypertension (PIH). METHODS: The placenta samples were collected from 57 patients with PIH and 24 normal pregnant women. Immunohistochemical staining was used to examine positive expression of MMP-9 and TNF-alpha in these samples. RESULTS: The positive expression of MMP-9 in the normal group was significantly higher than that in patients with moderate or severe PIH (P<0.01), while no significant difference was found between normal pregnant women and patients with mild PIH (P>0.05), and expression decreased drastically with the progression of PIH (P<0.05). The expression of TNF-alpha in the patients with mild, moderate and severe PIH groups were significantly higher than that in the normal group (P<0.05, P<0.01 and P<0.01, respectively), and the differences were also significant between the PIH groups of different severities (P<0.01). No correlation was found between MMP-9 and TNF-alpha expressions in the normal and mild PIH groups (r=0.287, P>0.05; r=0.382, P>0.05), in the patients with moderate and severe PIH, MMP-9 expression showed inverse correlation with TNF-alpha expression (r=-0.563, P<0.05; r=-0.681, P<0.01). CONCLUSION: Lowerd MMP-9 expression in syncytiotrophoblast might result in defective nidation in the placenta where local ischemia and hypoxia cause abnormal TNF-alpha elevation, which might be one of the important factors inducing PIH.

Adult↗
PubMed2006

[Study on reproductive and developmental toxicity of the pregnant mice and their foetus co-administered by p, p'-DDE and beta-BHC].

OBJECTIVE: To explore effects of p, p'-DDE and beta-BHC on reproduction and development in mice. METHODS: The pregnant Kunming SPF mice of 12 to 14 days were co-administered by oral gavage for 3 days at different concentrations of 0, 1, 5 and 10 mg/kg bw of p, p'-DDE and beta-BHC. The concentrations of estradiol (E2) and progesterone (P) in sera of the dosed mice were determined by the Serozyme kits (Bio-Ekon biotechnology Co., Beijing, China), following the procedures described by the manufacturer. RT-PCR was employed to detect abundant expression of alpha-estrogen receptor (alpha-ER) gonadtropin releasing hormone (GnRH) and beta-endorphin (beta-EP) mRNA in placentae. RESULTS: (1) Reproductive effects: with increase of the administered p,p'-DDE and P-BHC,the organ coefficient of uterus and its intraluminal fluid increased, the unterine nidation quantity decreased, the anogenital distance (AGD) and ratio of female to male raised, the concentration of estradiol and progesterone in sera of the dosed mice went up, and the abundant expression of alpha-ER and GnRH mRNA rised while beta-EP dropped in placentae in a dose-dependant manner. Significant difference of these indexes were found between the treat groups and control (P < 0.05). (2) Developmental effects: with increase of the administered p,p'-DDE and beta-BHC, the gained weights of pregnant mice reduced, organ coefficient of liver increased,the quantity of live foetus decreased, the times of adverse pregnancy outcome went up, and the percent of female foetus increased. They all presented a dose-effect relation and significance of difference (P < 0.05). CONCLUSION: p, p'-DDE and beta-BHC disrupt reproductive function, thereby result in dysreproduction and maldevelopment, and unbalance of ratio of female to male.

Animals↗
PubMed1991

Diagnosis of ectopic pregnancy.

The diagnosis of ectopic pregnancy remains a challenge to the clinician, despite advances in sonographic and biochemical technology. Contemporary practice requires an understanding of the normal sonographic features and hormonal profiles for normal pregnancy as well as the pathogenesis of an ectopic nidation. Frequently, the diagnosis remains uncertain until laparoscopy or dilatation and curettage have been performed.

Chorionic Gonadotropin↗
PubMed1991

Ovarian surgery on the rabbit. Effect of cortex closure on adhesion formation and ovarian function.

Surgical reapproximation of serosal surfaces in an attempt to reduce adhesiogenesis remains a controversial issue. For the reproductive gynecologist, this tenet is especially appropriate to the ovarian cortical surface. Using a rabbit model (n = 22), an ovarian unipolar cautery incision was created, and surgical closure versus nonclosure was evaluated. Closure with continuous 6-0 polyglactin resulted in a significant increase in the degree of ovarian adhesion envelopment versus nonclosure (1.8 +/- 0.2 vs. 0.9 +/- 0.2, P less than .01). Surgical closure also resulted in a significant increase in the vascularity of the adhesions (P less than .05). Despite the increase in adhesion formation, ovarian function, as determined by the mean number of corpora lutea, pregnancies and the nidation index, was not different in sutured ovaries, unsutured ovaries or nonsurgically treated controls.

Animals↗
PubMed1991

[The relief characteristics of the apical cell surface of endometrial epitheliocytes in women suffering from sterility].

Functional changes in the surface topography of the uterus in women of reproductive age have been studied using scanning electron microscopy. The state of the cell surface relief was estimated at different phases of the menstrual cycle and in sterile women. The presence of wide and short ruffles of epithelial cells covered with mucus is typical of the secretory phase of the cycle. No microvilli or cilia are seen on the epitheliocyte surface. In contrast, the follicular phase is characterized with numerous deep ruffles of epithelium covered with cylindrical cells. The apical surface is studded with numerous microvilli and cilia persisting even in sterile women at all the stages of the cycle. The disturbances of nidation processes in the fertilized ovule may apparently be associated with the patterns of the cell surface relief.

Biopsy↗
PubMedDate not supplied

Contraception--a look forward, Part II: Mifepristone and gossypol.

Part II of this series examines two compounds that are or have been in use in countries other than the United States. Mifepristone (RU486) is the first of the clinically useful progesterone antagonists; it competes with progesterone for receptors in the uterus, ovary, and pituitary gland. When taken by women in the follicular phase, it might be capable of inhibiting folliculogenesis while still allowing endometrial proliferation for normal menstrual cycling. When the drug is taken in the late luteal phase, endometrial shedding can usually be induced even after nidation. Mifepristone could thus serve as an emergency postcoital agent. In principle, it could also be used as a monthly emmenagogue, but clinical trials have been unsuccessful due to disruption of the following cycle's length. Shorter-acting antiprogesterones now under development may overcome this difficulty. Political constraints ultimately may be more limiting than pharmacological ones. Gossypol is a Chinese cottonseed derivative, which, taken orally, inhibits spermatogenesis in men. Its efficacy is very high, but use is presently limited by two adverse effects: occasional symptomatic hypokalemia and a 10 percent chance of irreversibility of aspermia. Current research is directed at understanding and overcoming these obstacles.

Contraception↗
PubMed1990

Backscattered electron imaging and windowless energy dispersive x-ray microanalysis: a new technique for gallstone analysis.

Scanning electron microscopy with or without conventional energy dispersive x-ray microanalysis is currently used to identify gallstone microstructure and inorganic composition. Organic calcium salts are among many biliary constituents thought to have a role in gallstone nidation and growth. However, current analytical techniques which identify these salts are destructive and compromise gallstone microstructural data. We have developed a new technique for gallstone analysis which provides simultaneous structural and compositional identification of calcium salts within gallstones. Backscattered electron imaging is used to localize calcium within cholesterol at minimum concentrations of 0.01%. Windowless energy dispersive x-ray microanalysis produces elemental spectra of gallstone calcium salts which are qualitatively and quantitatively different. These combined techniques provide simultaneous structural and compositional information obtained from intact gallstone cross-sections and have been used to identify calcium salts in gallstones obtained at cholecystectomy from 106 patients.

Calcium↗