Search PubMed⌕ Search

Biomedical subjects

H Sarles

Publications and source records attributed to H Sarles.

At least 37 records · Page 2Linked to original sources
PubMed1991

Immunoreactive forms of pancreatic stone protein in six mammalian species.

Secretory forms of the pancreatic stone protein (PSP S, Mr 17, 500-22,000) have been purified from human pancreatic juice. PSP S are inhibitors of CaCO3 crystal growth. The presence of similar proteins in bovine, canine, monkey, porcine, and rat pancreatic secretion was investigated in terms of biological role and immunological relationship. Pancreatic proteins were analyzed by electrophoretic separation and by subsequent immunoblotting with a rabbit polyclonal antibody against human PSP. A single immunoreactive form was detected in dog, pig, and rat (Mr 17,000), and two distinct immunoreactive forms were observed in cow and monkey (Mr 15,000 and 17,000). Inhibition of CaCO3 crystal growth was demonstrated in dog and rat. Further kinetic studies of the inhibition process in the rat showed that PSP S binds to the crystal surface according to a Langmuir adsorption isotherm with a dissociation constant (Kd) of 1.5 x 10(-6) M. These results suggest that proteins homologous to human PSP S are present in other mammalian species and may act as stabilizers of Ca(2+)-supersaturated pancreatic juice.

Animals↗
PubMed1991

The cephalogastric phase of the pancreatic response to food in the dog.

We studied post-meal pancreatic secretion and gastrin release in conscious dogs with duodenal Thomas cannulas. Normal dogs were tested in physiological conditions and with an i.v. infusion of atropine 20 micrograms/kg/h or secretin 0.5 CU/kg/h. The responses were also studied after antral and truncal vagotomy. In the early phase (0-20 min) of the response, before gastric emptying started, antral vagotomy reduced fluid and protein outputs, and truncal vagotomy reduced them still more. Atropine reduced only the protein response. Gastrin release reached a peak after 20-25 min. After antral and truncal vagotomy, gastrin release was reduced within 10 min after the meal. Late-phase (greater than 20 min) pancreatic secretion depended on the presence of chyme in the duodenum. The effects of atropine and antral vagotomy in the cephalogastric phase could be explained by antropancreatic reflexes stimulating fluid secretion (atropine-resistant pathway) and protein output (atropine-sensitive pathway).

Animals↗
PubMed1991

Involvement of tubular complexes in pancreatic regeneration after acute necrohemorrhagic pancreatitis.

Localized acute necrohemorrhagic pancreatitis was induced in rats by multiple trypsin injections. Morphological alterations were monitored by light and electron microscopy until complete recovery. In the acute phase, typical pictures of focal acute necrohemorrhagic pancreatitis were observed. In the postacute phase, fibrosis and tubular complexes are characteristic of damaged areas. Tubular complexes appear from the dedifferentiation of acinar cells. They are characterized by duct-like cells bordering wide, empty luminae. In the recovery phase, cellular proliferation was accompanied by differentiation, with progressive acquisition of the morphological characteristics of acinar cells at the periphery of the tubular complexes. In that instance, cellular proliferation was concomitant with the development of collagen septa in tubular complexes. In these structures both duct-like and acinar-like cells presented mitoses. Cell division persisted in the dedifferentiated cells until tubular complexes disappeared. A very similar process was observed in the embryonic pancreas, where organized parenchyma originated from proliferation and differentiation of protodifferentiated cells. We concluded that pancreatic repair following necrohemorrhagic pancreatitis involves proliferation of cells from intact acini and from tubular complexes, at variance with edematous pancreatitis, where regeneration is exclusively due to acinar cell proliferation.

Acute Disease↗
PubMed1991

Definitions and classifications of pancreatitis.

The historical progress of medical knowledge has followed two primary courses. One course has been based mostly on pathology: the description of specific groups of features and of the corresponding causes and symptoms, i.e., the description of different diseases that are progressively distinguished one from another. At the present time, disorders of molecular biology as well as pathological lesions are increasingly playing a role in the definition of diseases. The second course is a preliminary step to the first: when pathological data have not been available, patients have been classified according to symptoms. This does not lead to the description of the diseases but rather of the syndromes. It is puzzling to see that this obsolete method is still commonly used in pancreatology.

Humans↗
PubMed1991

Is tobacco a risk factor for chronic pancreatitis and alcoholic cirrhosis?

In a case control study alcohol intake and tobacco use were assessed between 1975 and 1987 in 103 male patients suffering from alcoholic cirrhosis of the liver, in 145 patients with chronic pancreatitis, and in 264 control subjects. The patients with chronic pancreatitis were significantly younger than the patients with cirrhosis (mean (SD) age 41.92 (2.4) v 60.9 (11.6) years). Among the patients with chronic pancreatitis, 94% were both smokers and drinkers compared with 83% of patients with cirrhosis of the liver. The relative risks for each disease were calculated by conditional multiple logistic regression. Whereas daily intake of alcohol was a major risk factor for both cirrhosis of the liver and chronic pancreatitis, smoking was significantly related only to the risk of having chronic pancreatitis. Moreover, the mean age at onset of pancreatitis was lower among smokers.

Adult↗
PubMed1991

Liver cirrhosis and chronic calcifying pancreatitis are associated with different morphotypes.

The different morphotypes of patients have been determined by sonography of the upper abdomen and statistical calculation according to a previously published method. Patients have been classified into the following 3 groups: 'longilignes', 'normotypes' and 'brèvilignes' which fit with ancient anatomical descriptions. In 74 normal controls, there were 21.6% brévilignes and 44.5% longilignes, in alcoholic cirrhosis (n = 31) 77.4 and 6.4%, respectively, in postnecrotic viral cirrhosis (n = 28). 25.0 and 17.8% and in alcoholic chronic calcifying pancreatitis (n = 25) 12.0 and 76.0%. These differences which are significant between all groups show that the morphotype of the human body is different in cirrhotic and pancreatitis patients. As morphotypes preexist to cirrhosis and chronic pancreatitis, this is an argument for the assumed predisposition (possibly hereditary) to cirrhosis and chronic pancreatitis.

Chronic Disease↗
PubMed1991

Persistence of the X-ray-transparent matrix of vanishing pancreatic stones.

We present three observations of patients with chronic calcifying pancreatitis with multiple pancreatic calculi visible on X-ray films of the abdomen. These patients were studied with plain films and sonography. On X-ray films, visible calcifications disappeared. In contrast, sonography and computerized tomography showed that the X-ray-transparent material of stones persisted. It is known that these stones are composed of different insoluble residues of PSP-S2-5, the secretory calcium stabilizer of pancreatic juice. This shows that the spontaneous or drug-induced disappearance of pancreatic stones on radiologic films is not sufficient for healing chronic calcifying pancreatitis.

Adult↗
PubMed1990

Predominance of sialomucin secretion in malignant and premalignant pancreatic lesions.

Sialomucin and sulphomucin-secreting cells were studied in the normal and pathologic human pancreas with the high iron diamine-alcian blue technique which allows differentiation between the two types of mucin. In six normal autopsy pancreata, only sulphomucin was found. In benign lesions of either calcifying chronic pancreatitis (seven cases) or obstructed chronic pancreatitis (six cases), sulphomucins were widely predominant. In contrast, malignant lesions (pancreatic adenocarcinoma [12 cases], cystadenocarcinoma [two cases]) or premalignant lesions (mucinous cystadenoma [one case], ductectatic mucinous cystadenoma [four cases], villous adenoma of the main pancreatic duct [two cases]) showed a predominant sialomucin secretion, except for three poorly differentiated pancreatic carcinomas that did not show mucin staining. The sialomucin positivity was not observed at distance from the malignant lesions. In one case of benign enteroid cyst, sulphomucins predominated. These findings indicate a preponderance of sialomucin secretion in malignant or premalignant pancreatic lesions.

Chronic Disease↗
PubMed1990

Eosinophilic pancreatitis: report of a case.

A case of relapsing pancreatitis in a young man is presented. Stenosis of the main duct and cystic lesions of the tail of the pancreas were shown by ultrasonography, CT scan, and endoscopic retrograde cholangiopancreatography (ERCP). After a wrong diagnosis of cancer, the pathological examination demonstrated an eosinophilic infiltration of the pancreatic tail, spleen, lymph nodes, and spleen flexure of the colon. After treatment with oral cromoglycate, the previously increased rate of polynuclear eosinophils in blood returned to normal. Similar observations were found in the medical literature.

Adult↗
PubMed1990

Structural and functional effects of long-term alcohol administration on the dog exocrine pancreas submitted to two different diets.

Our purpose was to study the influence of two different levels of dietary protein and fat on the action of chronic alcohol feeding on the exocrine pancreatic secretion and the pancreatic morphology of conscious dogs. Ten animals were provided with gastric and duodenal cannulas. Five of them (group H) received a high-protein (39% of calories), high-fat (34%) diet, and the five others (group L) a moderately low-protein (15%), low-fat (20%) diet. Animals were housed in closed kennels lightened with artificial light and did not have free access to sunlight. Five series of experiments were performed just before and 5 and 12 months after daily alcohol administration through the gastric cannula (2 g/kg/day). Volume, bicarbonate, and protein were measured under basal conditions after intragastric ethanol infusion (1.5 g/kg), under hormonal stimulation with 1 clinical unit (CU)/kg/h secretin or 1 CU/kg/h secretin plus 3 Crick Harper Rate (CHR) U/kg/h cholecystokinin (CCK), before and after intravenous ethanol 1.3 g/kg for 20 min, and after intragastric ethanol (1 g/kg) given with a meal. Group H was the most sensitive to the action of chronic alcohol feeding. At the end of 1 year of alcohol administration, volume and bicarbonate were not affected, but protein secretion was significantly increased in basal conditions and under secretin infusion, but not under CCK infusion or in response to a meal. The secretory pattern of these dogs was different from the response of dogs studied in previous experiments having the same diet but housed in an open kennel and having free access to outside and sunlight. In group L, protein was less affected, but volume and bicarbonate were significantly decreased 1 year under secretin stimulation. Histological damages were seen in the two groups characterized by a slight periacinar fibrosis and alterations of ductal cells. Acinar and ductal luminae were dilated and filled with protein plugs also present in pancreatic juice and able to stop the flow of juice. At the difference from human beings, these plugs were built up of all secretory protein but not of an insoluble fibrillar molecular form of pancreatic stone protein. This study confirms the role of chronic alcoholism on the formation of protein plugs and shows the influence of nutritional and environmental conditions.

Alcoholism↗
PubMed1990

Is food allergy a cause of acute pancreatitis?

We reported two cases of acute recurrent pancreatitis lasting for 8 and 10 years, respectively, and characterized by acute abdominal pain associated with an increased serum level of pancreatic enzymes and in one case transient enlargement of the pancreas on sonography and CT scan. Exocrine and endocrine pancreatic function remained normal. Pain attacks were associated with headache or typical migraine, myalgia, pruritus, and diarrhea. In one case only, the IgE serum level was increased. In both cases, the symptoms were reproduced in the 2 h following the consumption of some particular food and cured for years by the suppression of this food and the use of cromoglycate, but recurred 1 month to 3 years after this treatment was stopped, to be again healed by the same treatment. We suggest that these cases are due to food allergy and that food allergy could be a rare cause of acute recurrent pancreatitis. Responsible foods were beef (twice), milk, potato, fish, and eggs, which is in agreement with the frequency of food allergens in southwestern Europe.

Acute Disease↗
PubMed1990

Pancreas divisum is a probable cause of acute pancreatitis: a report of 137 cases.

The incidence of pancreas divisum (PD) was evaluated in a retrospective series of 1,825 successful consecutive ERCPs. One hundred thirty-seven pancreas divisums (7.5%) were found in 80 males and 57 females at a mean age of 49.2 years. The ventral ducts were visualized in 82.5% and the dorsal ducts in 74.1% of attempted cannulations of the minor papilla. Pancreas divisum was significantly more frequent in patients presenting with acute idiopathic pancreatitis (50.0%) or acute biliary pancreatitis (23.7%) than in controls or in the general population. This difference was not found in acute pancreatitis due to other etiologies. Acute pancreatitis associated with PD is generally recurrent, is not severe, but may be complicated by necrotic pseudocysts. The frequency of PD was also significantly increased in patients with gallbladder stones but not with common bile duct stones. In other pathological groups--chronic pancreatitis and pancreatic cancer--the frequency of pancreas divisum was not statistically different from that observed in controls and/or in the general population. We conclude that on a statistical basis, PD is a probable cause of acute pancreatitis, especially in its idiopathic recurrent variety, and that its frequency is increased in patients with gallbladder stones.

Acute Disease↗
PubMed1990

Spontaneous healing of sclerosing cholangitis associated with stricture of the main pancreatic duct.

A 78-year-old man was admitted for jaundice. Strictures of the main pancreatic duct and of the main bile duct in the head of the pancreas were showed by ERCP. This association initially evoked a cancer of the head of the pancreas. A prosthesis was endoscopically inserted in the main bile duct. Three months later, strictures of intrahepatic bile ducts appeared, demonstrated by ERCP. The diagnosis of sclerosing cholangitis or of liver metastases was suggested. Twenty-eight months later, cholangiography and pancreatography were normal, ruling out a malignant lesion. Presently, the patient is in good condition with no biological abnormality. This observation is interesting because it shows that some cases of sclerosing cholangitis may heal spontaneously. It shows the necessity of having histological proof of pancreatic cancer.

Aged↗
PubMed1990

Diameter of the main pancreatic duct in chronic calcifying pancreatitis. Measurement by ultrasonography versus pancreatography.

The aim of this study was to compare the diameter of the main pancreatic duct measured by ultrasonography (US) and endoscopic pancreatography (ERCP) in cases of chronic pancreatitis and to evaluate the ability of US to gauge the dilation of the main duct accurately enough to do a side-to-side wirsungo-jejunostomy. Sixty-one measurements were recorded in 50 patients (47 men and 3 women; age: 43.7 +/- 10 years). In 11 cases, two measurements were made at an interval of more than one year. US always preceded ERCP. The measurements were compared in only 43 cases (71%), because evaluation by US was inaccurate in 14 cases (23%) and by ERCP in nine cases (15%). The mean value of the diameter measured by US was 4.30 +/- 3.01 mm, and by ERCP, 5.52 +/- 3.08 mm (mean +/- SD). When the diameter assessed by US (y) was greater than or equal to 3 mm, the diameter assessed by ERCP (x) was always greater than or equal to 4 mm. The value of x could be determined from y by the equation: x = y + 1.2 mm (r = 0.91, p less than 0.05) The difference between x and y was constant and did not depend on the size of the duct. It could be owing to the hyperechogenicity of the duct walls. We conclude that US is a reliable way to assess the dilation of the main pancreatic duct and might be an acceptable method of judging whether a side-to-side wirsungo-jejunostomy can be performed.

Adult↗
PubMed1990

[Diet, alcohol and liver cirrhosis: an epidemiologic study].

A retrospective case-control study was conducted over three years in a Gastroenterology Department. Alcohol consumption and dietary habits of 152 male patients with liver cirrhosis and 304 hospital controls selected in the same age range, were assessed from a standardized questionnaire by a highly trained dietician. The variations of the relative risk of liver cirrhosis as a function of the estimated mean daily intakes of alcohol, fats, carbohydrates and proteins were studied using stratified conditional logistic regression models. Thus the relative risk of liver cirrhosis was found to be positively correlated with alcohol and fat consumption. Whereas in the control group, the calorie percentage from fats was 33.8, it was 39.6 in the cirrhotic group (87.11 g/d vs. 102.1 g/d). In contrast, the relative risk of liver cirrhosis was found to be negatively correlated with the mean daily carbohydrate and protein intakes. These findings indicate that in addition to alcohol consumption, dietary habits and in particular daily fat intake, should be considered for studying liver cirrhosis and for monitoring these patients.

Age Factors↗
PubMed1990

Diet and alcohol in liver cirrhosis: a case-control study.

A retrospective case-control study on alcohol and dietary habits was conducted over 3 years in a Gastroenterology Department on 152 male patients with liver cirrhosis. The study also included 304 hospital controls, selected within the same age range (32-83 years). Alcohol consumption and dietary habits were assessed from a standardized questionnaire by a highly trained dietician. The variations of the relative risk (RR) of liver cirrhosis as a function of the estimated mean daily intakes of alcohol, fats, carbohydrates and proteins were studied using stratified conditional logistic regression models. Obviously the relative risk of liver cirrhosis was found to be strongly and positively correlated with alcohol consumption but, in addition, this study has been able to show a significant and positive association with the mean daily fat intake and negative associations with the mean daily carbohydrate and protein intakes. Whereas in the control group, the calorie percentage from fats was 33.8 (87.11 g/d), it was 39.6 in the cirrhotic group (102.1 g/d). These findings indicate that in addition to alcohol consumption, dietary habits and in particular, high mean daily fat intake, should be considered.

Adult↗