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Volume 41, Issue 2, Pages 195-200 (August 2004)
Admirand WH, Small DM. The physicochemical basis of cholesterol gallstone formation in man [J Clin Invest 1968;47:1043–1052] Alan F. Hofmann Journal of Hepatology Volume 41, Issue 2, Pages (August 2004) DOI: /j.jhep
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Fig. 1 [Phase equilibria present in] the model system [consisting of bile salt, lecithin, and cholesterol, the three biliary lipids]. The tetrahedron shown in the upper right corner has been used to express the physical state of all possible combinations of bile salt, lecithin, and cholesterol. The section in the tetrahedron taken at 90% water results in a triangular phase diagram which has been enlarged and is shown on the left. This diagram shows the physical state of all possible combinations of bile salts, lecithin, and cholesterol in aqueous solutions containing a total of 10% solids and 90% water. The closed circles [indicate the upper limits of the micellar zone, and all mixtures having the composition under the line] form one liquid phase. The open circles represent mixtures forming two- or three-phase systems (clear liquid plus cholesterol crystals and/or islets of lamellar liquid crystal). The line separating the open and closed circles indicates the maximum amount of cholesterol solubilized by any mixture of lecithin and bile salt. From [1]. Brackets indicate additions to the original legend. Journal of Hepatology , DOI: ( /j.jhep )
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Fig. 2 The [biliary lipid] composition of gallbladder bile from normal subjects and patients with gallstones compared with the limits of cholesterol solubility, as determined from a model system. The lipid composition of bile from normal subjects, represented by closed circles, is such that all circles fall within the micellar zone. The bile samples from patients with cholesterol or mixed gallstones in which no microcrystals were present, [represented by] open triangles, fall or very near the line indicating maximum cholesterol solubilization. The bile samples from gallstone patients, which contained microcrystals of cholesterol, [represented by] closed triangles, fall well above the line of maximum saturation. The figure is from Ref. [1]. Brackets indicate modifications of the original legend. Journal of Hepatology , DOI: ( /j.jhep )
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