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At least 127 records · Page 7Linked to original sources
PubMed1977

In-situ-isolated perfused rat pancreas: a new method for pharmacological studies of the exocrine pancreas.

A method of in-situ-isolated perfused rat pancreas is described. In situ perfusion of the isolated rat pancreas allows a faster set-up, thanks to a simpler operating procedure. The sensitivity of the isolated rat pancreas has been tested with secretin and cholecystokinin. The pancreas responds to doses of secretin as low as 0.005 CU/kg-h. Such a highly sensitive model might prove to be useful for the bioassay of secretin and the study of the effects of pancreatic secretagogues.

Animals↗
PubMed1992

[Chronic pancreatitis of the head of the pancreas in hyperplasia of the body and tail of the pancreas].

We report a case of chronic pancreatitis of the head of the pancreas complicated with insulin-requiring diabetes mellitus, in a 44-year-old woman with hypoplasia of the dorsal pancreas. Preoperative ultrasonography, computerized tomography and angiography revealed a calcifying retroperitoneal mass, which on explorative laparotomy proved to be a severe chronic pancreatitis of the head of the pancreas with a finding of abnormal visibility of the confluens venosum and absence of both the corpus and the tail of the pancreas. The postoperative course following pylorus-preserving duodenopancreatectomy was uneventful.

Adult↗
PubMed1991

LH-RH receptors in the human pancreas. Basis for antihormonal treatment in ductal carcinoma of the pancreas.

LH-RH-, estrogen-, and progesterone-receptor binding was measured in the human pancreas of patients with ductal pancreatic cancer (n = 23) and chronic pancreatitis (n = 15), and of organ donors (n = 11). Receptor analysis was determined by incubation of the homogenized tissues with estrogen, progesterone, and the LH-RH analog buserelin labeled with iodine-125. Only one biopsy (9%) from normal pancreas had an LH-RH-receptor concentration greater than 3 fmol/mg membrane protein. LH-RH binding levels greater than 3 fmol/mg were detected in 67% of patients with chronic pancreatitis and in 57% of patients with pancreatic cancer. Progesterone levels greater than 15 fmol/mg membrane protein were found in 36% of normal pancreas, in 27% of chronic pancreatitis, and in 17% of pancreatic cancer cases, respectively. The highest concentration of estrogen receptors (greater than 15 fmol/mg membrane protein) was seen in normal pancreas (73%). The increase in LH-RH-receptor concentration in chronic pancreatitis and pancreatic cancer seems to be unspecific, but might be of benefit for antiproliferative treatment in pancreatic cancer.

Adult↗
PubMed1995

Simultaneous pancreas-kidney and sequential pancreas-after-kidney transplantation.

Simultaneous pancreas-kidney (SPK) or pancreas-after-kidney (PAK) transplantation has been advocated as an alternative to kidney transplant alone (KTA) for type 1 diabetics with end-stage renal disease. Advocates of combined transplant assert that the procedure reduces, prevents, or mitigates secondary complications of diabetes and improves the quality of life (QOL) of recipients. The combined procedures may be accomplished with a relatively low mortality, but the morbidity significantly exceeds that of KTA. The published data did not provide unambiguous support for the contention that SPK or PAK improved or ameliorated the secondary diabetic complications of retinopathy, neuropathy, and nephropathy, and it cannot be reasonably concluded that such benefit is likely to result. The majority of studies of QOL subsequent to combined transplant had significant methodologic deficiencies which made generalizations problematic. Notwithstanding, improvements in objective measures, such as return to employment or school, reduction in medical care requirements, days spent in hospital, social or physical activity, etc, have not been demonstrated for combined transplant; improvements in subjective measures were inconsistently reported. The United Network for Organ Sharing (UNOS) registry indicated that SPK represents 83 percent, and PAK about 8 percent of all pancreas transplants in the United States. Pancreas graft survival data are limited; UNOS reported 3-year survival rates of approximately 65 percent following SPK, and 35 percent after PAK. Renal graft survival following SPK appears comparable to that reported for most cadaver KTA. However, selection of SPK in lieu of KTA with a living-related donor or HLA-matched cadaver kidney may result in significant reduction in expected renal graft survival, in the range of 40-70 percent to as much as 350 percent. A cost-effectiveness analysis (CEA) model compared SPK with KTA and continued insulin therapy. The model employed a wide range of reported charges/payments, and postulated that SPK would provide significant improvements in quality of life. Sensitivity analyses indicated that SPK was equal in cost effectiveness to KTA only in patients who incurred very high annual costs for the treatment of hyper- or hypoglycemia. The literature does not indicate that such patients comprise the majority of SPK recipients. Additional evidence is necessary to unequivocally demonstrate the risks, costs, and ultimate benefits of combined transplant. Such information should include detailed and unambiguous patient selection criteria, prospective comparative studies of the effects of SPK/PAK upon secondary complications and quality of life, and accurate cost data for the transplant procedures and required followup care.

Diabetic Nephropathies↗
PubMed1994

Simultaneous pancreas-kidney versus kidney-alone transplants in diabetics: increased risk of early cardiac death and acute rejection following pancreas transplants.

The decision between a simultaneous pancreas-kidney (SPK) or kidney-alone (KA) transplant for the treatment of diabetic end-stage renal disease depends on the risk-versus-benefit of each procedure. In this study we compared the mortality, morbidity, graft function and acute rejection after 88 SPK and 65 KA transplants. All acute rejection episodes were biopsy-proven. Patient survival was higher in the KA group (KA 92%, SPK 83%) at 1 year, but similar in both groups at 5 years (SPK 78%, KA 71%). Whereas myocardial infarction accounted for a similar proportion of deaths in both groups, sepsis and surgical complications were more common causes of death in the SPK group. The majority of cardiovascular deaths occurred early in the SPK group compared to the KA group. Kidney graft survival was similar at 1 year (SPK 79%, KA 81%) and 5 years (SPK 66%, KA 59%). Pancreas graft survival at 1 and 5 years was 75% and 60% respectively. Biopsy-proven acute rejection occurred more frequently in the SPK group (SPK 63%, KA 46%). Morbidity was greater in the SPK group and included vascular (SPK 19%, KA 3%), non-infectious urologic (SPK 23%, KA 3%) and infectious complications (SPK 86%, KA 33%). The majority of complications in the SPK group were related to the pancreas allograft. In summary, SPK transplants were associated with an increased risk of early cardiovascular death, greater morbidity and more frequent biopsy-proven acute rejection episodes. However, kidney graft survival was not affected by the addition of the pancreas allograft.

Adult↗
PubMed1989

Malignant fibrous histiocytoma (giant cell type) of the pancreas. A distinctive variant of osteoclast-type giant cell tumor of the pancreas.

Malignant giant cell tumors of the pancreas are rare neoplasms which have been generally thought to represent epithelial malignancies of either acinar or ductal epithelium. The authors have studied a tumor of the pancreas that was characterized histologically by a proliferation of benign-appearing osteoclast-type giant cells in association with atypical, often bizarre mononuclear cells. Immunohistochemical studies demonstrated negative staining of the tumor cells with epithelial markers, including low-molecular weight keratins, carcinoembryonic antigen and epithelial membrane antigen, and positive staining with vimentin antibodies, supporting a fibroblastic line of differentiation. Electron microscopic examination also showed absence of ultrastructural features of epithelial differentiation such as microvilli, intercellular junctions, or desmosomes. The authors believe the current case represents a true sarcoma of the pancreas, currently best classified as a malignant fibrous histiocytoma, giant cell type. This tumor should be distinguished from the epithelial type of osteoclastic giant cell tumor of the pancreas.

Aged↗
PubMed1988

[Left side renal cell carcinoma removed with the spleen, pancreas body, pancreas tail, and about one third of the left diaphragm: a case report].

A 61-year-old woman was admitted with the chief complaint of left lumbodorsal pain. Left renal cell carcinoma invaded to the spleen, pancreas body, pancreas tail and left diaphragm, which was diagnosed by computed tomography. Transabdominal radical nephrectomy with en bloc resection of the spleen, pancreas body, pancreas tail and one third of the left diaphragm was performed. A similar case was first reported by Suzuki et al. in 1982. This case seems to be the second in the Japanese literature.

Carcinoma, Renal Cell↗
PubMed2001

Desmopressin impairs microcirculation in donor pancreas and early graft function after experimental pancreas transplantation.

BACKGROUND: Protective effects of desmopressin in brain dead organ donors oppose reports on a hypercoagulatory potential and an increased leukocyte-endothelial interaction (LEI) after application of the drug. The aim was to evaluate the effect of desmopressin on organ donor's pancreas and early graft function. METHODS: Donor microcirculation was evaluated via intra-vital microscopy (IVM) in 24 BR (di/di) rats with central diabetes insipidus, randomly assigned to groups I (control without desmopressin application), II (single i.v. application, no pretreatment) or group III (single i.v. desmopressin application, s.c. pretreatment for 3 days). Microcirculation in recipients was evaluated 1 hr and 6 hr after syngenic pancreas transplantation. Groups III and I served as organ donors. After IVM specimens were taken for histology and immunohistochemistry. RESULTS: Desmopressin in II vs. I led to temporarily (30') increased LEI (Sticker 274.3+/-87.7 vs. 76.5+/-31.1/mm2 endothelial surface; P<0.01) and impaired microcirculation (MCEV 0.43+/-0.07 vs. 0.99+/-0.06 mm/s; P<0.01). Repeated application reduced MCEV and increased LEI for up to 12 hr. Histology in I vs. III showed increased inflammation (n.s.), necrosis (P<0.05) and vacuolization (P<0.01). Immunohistochemistry revealed increased endothelial P-selectin 20' after application. 6 hr after reperfusion organs from III showed reduced MCEV and increased LEI (P<0.01). CONCLUSION: Repeated application of desmopressin impairs graft microcirculation. Perfusion of the pancreas is significantly reduced at the beginning of organ tissue conservation as well as after reperfusion. These disturbances might partly be due to observed endothelial P-selectin expression. Application of desmopressin up to 12 hr prior to organ explantation may impact graft quality.

Animals↗
PubMed1981

Subcutaneous, isogeneic transplantation of duct-ligated pancreas in streptozotocin-diabetic mice. Relationships between carbohydrate tolerance and hormone content in transplant or host pancreas.

Mice with subcutaneous, isogeneic transplants of duct-ligated pancreas from either two or five donors displayed impaired glucose tolerance to gastric or intravenous glucose, or to an overnight fast followed by a 15-min meal of mouse food. Compared with peripheral insulin responses in normal controls, those of transplant recipients were less after gastric or intravenous glucose, but no different after the meal. Despite normalization of peak insulin levels in the peripheral circulation of isografted mice, glucose clearance was still impaired and this probably resulted, in part, from a relative insufficiency of insulin in the portal circulation. Results of glucose tolerance tests, after transplant recipients consumed a relatively small amount of food, suggested that near-normal glucose homeostasis may be present for these mice under normal feeding conditions. In mice that received incremental doses of streptozotocin, impaired glucose tolerance to a meal was observed if pancreatic insulin content fell below 26% of normal. We failed to show a similar relationship between glucose tolerance and pancreatic insulin content in transplant recipients since all showed impaired glucose tolerance. Despite the initial transplantation of different amounts of islet tissue, at termination insulin content (transplant plus endogenous pancreas) was essentially the same for all recipients, totaling 19-22% of that found in a normal mouse pancreas.

Animals↗
PubMed1991

Technique of pancreas revascularization after combined liver and pancreas harvesting in the same cadaveric donor.

Combined liver and pancreas harvesting in the same donor is nowadays a routine procedure in our institution. In terms of sharing of the vascular pedicule the priority is given in the majority of cases to the liver graft. Thus vascular reconstruction of the pancreatic graft is often required before transplantation. From February 1987 to June 1990 we transplanted 62 pancreases coming from a donor where also a liver graft had been harvested; 46 were segmental grafts prepared by duct injection with neoprene, 14 were pancreatico-duodenal grafts with bladder diversion of the exocrine secretion, and 2 were whole pancreas scheduled for bladder diversion and secondarily reconverted to duct injection (1 whole and 1 segmental graft) for poor duodenal blood supply. Among the 47 segmental grafts (46 + 1 reconverted from whole to segmental), in only 10 cases was the celiac axis with an aortic patch possible; conversely in 37 cases the splenic artery had been divided at its origin during the harvesting; bench surgery for vascular reconstruction was realized in 33 cases. Among the 14 pancreatico-duodenal grafts with bladder diversion and the whole pancreas with duct obstruction, in 5 cases the celiac axis and the superior mesenteric artery were harvested on the same aortic patch; in 10 cases the splenic artery was divided at its origin during the harvesting, requiring bench surgery for reconstruction.

Cadaver↗
PubMed1991

Metabolic control after kidney and pancreas transplantation: whole series results and effects of segmental duct obstruction versus whole pancreas with bladder diversion technique.

From October 1976 to December 1990 181 pancreatic transplants were performed in our centre on 171 Type 1 (insulin-dependent) diabetic patients. Oral glucose tolerance test evaluated 1 year after surgery in 31 subjects showed an impaired glucose tolerance at 120 min (blood glucose 9.5 +/- 0.6 mmol/l). Similar results were obtained in seven patients 3 years after transplantation (blood glucose at 120 min 8.3 +/- 1.08 mmol/l). 24h metabolic profiles performed at the same intervals showed near normal blood glucose levels and good insulin release. Preliminary data concerning a randomized, comparative study between whole pancreas with bladder diversion and segmental pancreas transplantation, showed better metabolic control in the patients who received the whole pancreas, probably due to the greater islet mass grafted.

Adult↗
PubMed1989

[Insulin reserve and morphology of the tail of the pancreas following resection of the head of the pancreas using various surgical methods].

Four modifications of dealing surgically with the remaining pancreas after resection of the pancreatic head were compared to each other in dogs. Insulin response and corresponding blood sugar levels were controlled, the remaining pancreas was examined histologically. The obstruction of the pancreatic ducts by prolamine showed mainly sclerosis of the exocrine tissue whereas the duct ligation was followed by atrophy. The free intraperitoneal draining of the duct system showed both alterations, the pancreatojejunostomy did hardly impair the exocrine pancreas. According to the grade of sclerosis of the exocrine tissue, the insulin response was delayed followed by a pathologic glucose tolerance. This was shown particularly for the obstruction of the ducts by prolamine.

Amylases↗
PubMed1992

Heterotopic autotransplantation of the distal pancreas segment after total pancreatectomy for cancer of the head of the pancreas.

Autotransplantation of the distal pancreas segment with pancreaticojejunostomy was performed in four patients with cancer of the head of the pancreas to preserve endocrine pancreatic function after extended total pancreatectomy. All patients had tumor involvement of both the celiac axis and the portal vein. The pancreatic graft was determined to be cancer-free by frozen section histologic and pancreatic juice cytologic examinations. The distal pancreas segment was autotransplanted to the iliac vessels heterotopically and placed in the extraperitoneal pocket to avoid untoward effects of any local recurrence or pancreatic leakage. This procedure, in the form of reconstruction, might be called modified subtotal pancreatoduodenectomy. Postoperatively, all patients remained normoglycemic without exogenous insulin administration, and their quality of life was considered satisfactory.

Aged↗
PubMed1991

Plasma pancreatic secretory trypsin inhibitor as a marker of pancreas graft rejection after combined pancreas-kidney transplantation.

One of the major problems in clinical pancreas transplantation is the lack of a simple and sensitive marker for detecting the early process of allograft rejection. Plasma pancreatic secretory trypsin inhibitor (p-PSTI) levels were measured in recipients of combined pancreas-kidney transplants (SPKT) and isolated cadaveric renal transplants (CRT) as controls. In the postoperative courses of SPKT recipients without acute rejection episodes and any other complications, high preoperative and immediate postoperative concentrations of p-PSTI gradually declined from the third day after transplantation and returned to the baseline level (less than 87.9 ng/ml) by the 6th day, and then remained unchanged. In this study, 11 out of 17 SPKT recipients experienced 13 acute rejection episodes. Early in the rejection course, p-PSTI levels increased significantly (P less than 0.05) 1 day before the initial day of diagnosed rejection (peak value; 232.7 +/- 99.3 ng/ml), and then they decreased following antirejection therapy. In the control group, p-PSTI elevation was less dramatic (peak value: 70.5 +/- 22.8 ng/ml, P less than 0.01) and did not precede the rise in serum creatinine. We conclude that p-PSTI may be an early, sensitive, and reliable marker of clinical pancreas graft rejection.

Adult↗
PubMed2004

Impact of portal venous pancreas graft drainage on kidney graft outcome in simultaneous pancreas-kidney recipients reported to UNOS.

Clinical data on the potential immunologic impact of portal (PD) vs. systemic (SD) venous pancreas graft drainage on outcome remains controversial. We reviewed the UNOS database to study the effect of PD vs. SD on the incidence of kidney graft rejection and survival in first cadaveric simultaneous pancreas-kidney (SPK) recipients transplanted 1994-2001. We studied three groups: all SPK (n=6629, 13% PD) (group I), SPK on tacrolimus (n=3563, 17% PD) (group II), and SPK on tacrolimus performed at centers with significant PD experience (n=948, 46% PD) (group III). The cumulative kidney graft rejection incidence for PD vs. SD was only significantly different in group I (for PD vs. SD, respectively: at 6 months, 31% vs. 36% [p=0.015]; at 1 year, 37% vs. 43% [p=0.006]). Kidney graft survival was similar in all groups for PD vs. SD. Multivariate analysis of group III showed only transplantation during the earlier era (1994-96), but not SD, to be an independent risk factor for kidney graft rejection. Portal venous pancreas graft drainage does not affect kidney graft rejection and survival in SPK recipients on tacrolimus. Our data suggests that the efficacy of current immunosuppressive protocols and increasing center experience are clinically much more relevant than any potential immunologic advantage of portal venous drainage in SPK recipients.

Adult↗
PubMed2006

Epstein-barr virus-associated posttransplant lymphoproliferative disorder of donor origin after simultaneous pancreas-kidney transplantation limited to pancreas allograft: A case report.

A 45-year-old man was admitted with fever and elevated pancreas enzymes 6 months after simultaneous pancreas-kidney transplantation (SPKT). Function of the allografts was normal. Bacterial and fungal infections were excluded, while Epstein-Barr virus (EBV)-polymerase chain reaction (PCR) was positive. However, screening for EBV-associated lymphoma was negative. EBV infection did not respond to antiviral therapy. After an 18F-Fluorodeoxyglucose positron emission tomography positive signal and an abnormal computed tomography scan of the pancreas transplant, a biopsy revealed a diffuse large monomorphic B-cell lymphoma, which was confined to the grafted organ. Its origin was assigned to the donor by microsatellite analysis. Reduction of immunosuppression and immunotherapy with rituximab was unsuccessful. After 10 weeks, the patient developed an acute hemolytic uremic syndrome which required explantation of the allografts. Subsequent to the intervention, fever disappeared, EBV DNA became undetectable and lymphoma screening remained negative. In posttransplant lymphoproliferative disorder of donor origin after SPKT, transplantectomy may be a curative therapy.

Adult↗
PubMed2001

Multi--detector row helical CT of the pancreas: effect of contrast-enhanced multiphasic imaging on enhancement of the pancreas, peripancreatic vasculature, and pancreatic adenocarcinoma.

PURPOSE: To determine the optimal phase for enhancement of the normal pancreas and peripancreatic vasculature and the maximal tumor-to-pancreatic parenchymal enhancement difference by using multiphase, contrast material-enhanced, multi-detector row helical computed tomography (CT). MATERIALS AND METHODS: Forty-nine patients with a normal-appearing pancreas but suspected of having pancreatic abnormality and 28 patients with proved pancreatic adenocarcinoma underwent multiphase, contrast-enhanced, multi-detector row CT during the arterial phase (AP), pancreatic parenchymal phase (PPP), and portal venous phase (PVP). Attenuation values of the normal pancreas, pancreatic adenocarcinoma, celiac and superior mesenteric arteries, and superior mesenteric and portal veins were measured during all three imaging phases. Quantitative analysis of these measurements and subjective qualitative analysis of tumor conspicuity were performed. RESULTS: Maximal enhancement of the normal pancreatic parenchyma occurred during the PPP. Maximal tumor-to-parenchyma attenuation differences during the PPP and PVP were equivalent but greater than that during the AP. Subjective analysis revealed that tumor conspicuity during the PPP and PVP was equivalent but superior to that during the AP. Maximal arterial enhancement was seen during the PPP, and maximal venous enhancement was seen during the PVP. CONCLUSION: A combination of PPP and PVP imaging is sufficient for detection of pancreatic adenocarcinoma, because it provides maximal pancreatic parenchymal and peripancreatic vascular enhancement. AP imaging can be reserved for patients in whom CT angiography is required.

Adenocarcinoma↗
PubMed2006

Is the rat pancreas an appropriate model of the human pancreas?

During my lifetime in pancreatic research, rat and mouse have largely replaced dog and cat in experimental studies. However, as this review clearly demonstrates, the anatomy, physiology and molecular cell biology of the rat pancreas (and also probably the mouse pancreas) differ substantially from those in humans. Indeed, they differ more in rat/mouse than any other common laboratory species. These differences may be irrelevant if one is using the pancreas as a generic model in which to study, say, acinar cell exocytosis or signalling. But if one is interested in more specific aspects of human pancreatic function, especially ductal function, in health and disease, in my opinion the simple answer to the question posed by the title of this article is no: other species are more appropriate.

Animals↗