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The uptake of glycine-N(15) into the trypsinogen and chymotrypsinogen of mouse pancreas is much higher than that into any ribonucleoprotein component of the pancreas that has so far been investigated.
Autopsy pancreases were studied from 14 patients who had idiopathic Addison's disease. One patient had been diabetic for 12 years and three patients were found to be diabetic during their terminal admission. While there was no evidence of diabetes or destruction of insulin-secreting beta cells in the remaining 10 patients, islets in one pancreas exhibited many of the histological and immunohistochemical features seen in the patients with recent onset diabetes. These included the presence of alpha-interferon in endocrine cells, hyper-expression of class I major histocompatibility complex molecules by endocrine cells in islets where alpha-interferon was also present, aberrant expression of class II major histocompatibility complex molecules by endocrine cells and the presence of insulitis. Since the combination of these changes has only been described in type 1 diabetes it is thought that the appearances seen in this pancreas were those of prediabetes.
Transthyretin (TTR) cDNA probes were used to determine the presence of TTR mRNA in Northern blots from rat, porcine, and human organs as well as from human endocrine tumors. We also used in vitro translation in our study of the human tissues. In accordance with previous findings, TTR mRNA was found in the choroid plexus and, to a lesser extent, in the liver of all three species. In addition low levels of TTR mRNA were identified in the rat and human pancreas. All of the endocrine pancreatic tumors (two glucagonomas, two insulinomas, and one nonfunctional tumor) and the gut carcinoid also contained TTR mRNA, whereas other endocrine tumors (two pheochromocytomas and one paraganglioma) and one adenocarcinoma of the pancreas were TTR mRNA negative. The level of TTR mRNA expression in most of the endocrine pancreatic tumors exceeded that in the liver. The in vitro translations produced pre-TTR molecules of similar size for all TTR mRNA-positive human organs and tumors.
The types of sulphated macromolecules produced by the exocrine pancrease were investigated. To determine whether this tissue utilized inorganic sulphate for protein production, the in-vitro behaviour of material labelled with 35S-sulphate was compared with material labelled with [3H]leucine (secretory proteins). While incubating tissue slices in the presence of cycloheximide resulted in an immediate and nearly complete inhibition of protein synthesis, a similar decrease in production of sulphated material was not observed until after 2 h of incubation in the presence of the drug. Likewise, the kinetics of pilocarpine-induced discharge of radioactive material from pancreatic slices pulse-labelled with either 3H-Leu. or 35S-sulphate was compared. During the first 90 min of stimulation sulphated macromolecules were detected in chase medium 10-15 min prior to the appearance of 3H-labelled secretory proteins. That in-vitro behaviour of sulphated material differed from radioleucine-labelled material is indicative of the fact that the pancreas utilizes inorganic sulphate for the production of macromolecules other than secretory proteins. Lipid and proteoglycan fractions were prepared from pancreatic tissue 4 h after intraperitoneal injection of radiosulphate. The recovery of a significant amount of radioactivity in both fractions deomonstrated the ability of the pancreas to use inorganic sulphate for the production of both sulphated lipids and sulphated proteoglycans. The possible function of sulphated macromolecules in pancreatic secretion is discussed.
OBJECTIVE: The purpose of this article is to highlight the imaging features of congenital anomalies and normal variants of the pancreatic duct and the pancreas using contemporary imaging techniques such as MR cholangiopancreatography (MRCP), MRI, and helical CT. CONCLUSION: Congenital anomalies and normal variants of the pancreatic duct and the pancreas may be clinically significant and may create a diagnostic challenge. Recognition of the updated imaging features of these entities is important in clinical management and for avoiding misdiagnosis.
The authors report the case of a 45-year-old woman who suffered from epigastric pain and was operated on 3 years before for colon cancer. The clinical investigation revealed that the patient had colon cancer metastasis to the dorsal pancreas of a pancreas divisum.
The evolution of enteric and portal venous drainage, better immunosuppression, and better patient care has elevated pancreas transplantation with dramatically improved results. At our center, long-term graft survival and rejection has significantly improved with portal venous drainage, which has become our gold standard. This improvement is exemplified by the excellent one-year patient and graft survival rates for SPLK transplants. SPLK has proven to be an ideal approach in uremic Type 1 diabetic patients with living donors and should become the procedure of choice for that population. Moreover, the improved monitoring of rejection has allowed a similar success of pancreas transplantation alone in non-uremic patients with brittle diabetes. The treatment of diabetes mellitus has room for great improvement, however, and there is no question that islet transplantation, xenotransplantation, and the pursuit of immunologic tolerance will play an extremely important role in that endeavor.
1. Glucose loading tests were undertaken on isolated pancreas or pancreas-duodenal preparations. 2. In 75% of cases a vasodilatation can be observed which leads to enhanced blood circulation under constant pressure in the isolated organ. 3. This vasodilatation persists until the level of blood sugar has normalized. 4. The experiment being carried out on an isolated organ, external factors such as the vagus nerve, do not become active.
CONTEXT: We have isolated five stable clones from a primary culture of Syrian golden hamster pancreatic duct epithelial cells and have designated them as CK1 through CK5. DESIGN: Here we describe the ability of two of these, CK1 and CK5, to metabolize the pancreas carcinogen N-nitrosobis(2-oxopropyl)amine. The metabolism was assessed as the production of mutated V79 cells in a CK cell/V79 co-culture set up. RESULTS: At a dose of 0.1 mM N-nitrosobis(2-oxopropyl)amine, the CK1 cells produced 82.3 +/- 17.2 mutants/1,000,000 survivors while the CK5 cells produced only 33.2 +/- 10.8 mutants/1,000,000 survivors, both are mean +/- SD (n = 8). Furthermore, both cell types responded differently to two inducers of cytochrome P450 activity, namely Arochlor 1254 and EtOH. Arochlor 1254 treatment did not affect the metabolizing ability of CK1 cells while EtOH treatment resulted in a twofold increase in the mutation frequency. Arochlor and EtOH treatment inhibited the ability of CK5 cells to metabolize N-nitrosobis(2-oxopropyl)amine. CONCLUSIONS: These data show that the duct epithelium of the pancreas is a multi-cellular tissue and the different cell types within the epithelium have different abilities to metabolize xenobiotic chemicals.
We studied the frequency of the main types of hyperlipoproteinemia (HLP) by Fredrickson (1971) and the functional state of the pancreas in 53 patients with metabolic syndromes without any clinical signs of the digestive apparatus pathology and pancreatic diabetes. It was established that IIb [symbol: see text] IV types of the disease were observed in 26 and 13 cases (49 and 24.5%, respectively), type IIa was recorded in 9 cases (17%), and type V was recorded in 5 patients (9.5% of all cases). Functional pancreas disorders were recorded more often in cases of HLP of IIa, IV and V types. Excretory disorders were characterized mainly by insufficient production of lipase, bicarbonates and the liquid secretion fraction, while insular disorders were characterized by apparent disorders of glucose tolerance and pre-clinical pancreatic diabetes of type II.
This paper studies the advances that have participated in the development of preservation solutions for the combined kidney-pancreas transplantation. These developments have been associated most importantly with hypothermia, the use of colloid solutions with high oncotic pressure, and the maintenance of near-intracellular ionic concentration. At the present time, the more effective solutions are the plasma-like modified Silica Gel Fraction and the starch and lactobionate based solution such as, the UW. Further advances in this area, would allow for improved results in the combined kidney-pancreas transplant preparation.
Acute pancreatitis was produced in rats by a combination of dyschylic edema and short-term ischemia of the pancreas. The incidence of acute pancreatitis, reflected by peri- and extra-pancreatic fat necrosis, was found to be dependent on the duration of ischemia. Under most conditions there were no significant differences in enzyme activities between the animals with macroscopic signs and those without these. The time course of alpha-amylase and lipase release was investigated within 24 hours postoperatively. Additionally the quantitative correlation was estimated of the enzyme activities released from the pancreatic tissue and the activities determined in rat serum. The data show that the serum enzymes represent only a small and variable portion of the total amount of enzymes effused from the pancreas.
Pancreatic angiography was performed in 246 patients using various vasodilating drugs. A pancreatographic effect could be found in 79% of all cases; Tolazolin was particularly efficient, since the effect could be found in 91% of the cases receiving the drug. The diagnostic value of different parameters was assessed in patients with chronic pancreatitis and in patients with carcinoma of the pancreas, in particular concerning the presence or absence of the pancreatographic effect, and the structure, width and contours of this organ. Evaluating the pancreatographic effect and vascular changes a correct diagnosis could be obtained in 69% of all cases with chronic pancreatitis and in 78% of all cases with carcinoma of the pancreas. The pancreatographic effect was diagnostically essential in 26% of all cases, and turned out to be rather useful in patients with chronic pancreatitis, whereas its diagnostic value was less in patients with carcinoma. The diagnostic value of angiography can be improved by the superselective technique and by applying the vasodilator Tolazolin, which is well tolerated and gives an excellent pancreatographic effect.
Hepatitis B virus has been considered to be strictly organotropic and to infect and multiply only the hepatocytes of humans and chimpanzees. The localization of hepatitis B surface antigen in extrahepatic tissues has been regarded as due to deposition or phagocytosis of hepatitis B surface antigen circulating in the blood. In the present study, however, we demonstrated hepatitis B virus antigens in the pancreases of autopsied subjects with hepatitis B surface antigenemia by Shikata's orcein stain, and immunoperoxidase, immunofluorescent studies; hepatitis B surface antigen and hepatitis B virus core antigen were localized within the cytoplasm of pancreatic acinar cells in 18 and 6 cases, respectively, out of 30 cases studied. In contrast, 25 autopsy cases with no hepatitis B surface antigenemia failed to stain hepatitis B surface antigen or hepatitis B core antigen in the pancreas and liver. Therefore, it may be reasonable to assume that hepatitis B virus can infect and replicate in the human pancreatic acinar cells; however no convincing hepatitis B virus-associated ultrastructures were detected in the present study. Although there were some cases demonstrating chronic inflammatory reaction or fatty necrosis, or both, in the pancreas with hepatitis B virus antigens, the causal relationship between these pathologic changes and hepatitis B virus infection awaits further clarification.
The results of pancreas transplantation at the University of Minnesota according to technique, donor source, and immunosuppressive therapy are discussed. Preliminary evidence suggests that not only prevention but reversal of lesions resulting from diabetes may be possible with pancreas transplantation.
The endocrine function of the pancreas consists of the promotion of storage of nutritive substances after meals through the liberation of insulin and to guarantee the mobilization of this food energy through the secretion of glucagon during fasting. Increased hormone production may result from tumors of the islet cells (insulin: insulinoma; glucagon: glucagonoma; gastrin: Zollinger-Ellison syndrome). An absolute or relative insulin deficiency is a characteristic of diabetes mellitus, in which a relative hyperglucagonemia is also of possible pathophysiological significance. This increased secretion of glucagon can be suppressed by somatostatin. While the clinical application of somatostatin in diabetes mellitus seems problematic at present, the use of a glucose-controlled system of insulin infusion ("artificial pancreas") makes possible a metabolic state approaching the healthy condition.
OBJECTIVE: To compare clinicopathological findings in patients with mucinous cystic neoplasms and intraductal papillary-mucinous tumours. DESIGN: Retrospective study. SETTING: University department of surgery, Japan. SUBJECTS: 21 patients with mucinous cystic neoplasms (group 1) and 48 with intraductal papillary-mucinous tumours (group 2). RESULTS: The mean age was younger in group 1 (53(3.4) years) than in group 2 (65(1) years, p < 0.0001). The male:female ratio was smaller in group 1 than in group 2, being 0.17 (3/18) and 1.4 (28/20), respectively, (p = 0.0007). The main sites of the lesions were also significantly different: in group 1 four (19%) were located in the head and 17 in the body or tail, while 32 (67%) were in the head of the pancreas and 16 (33%) in the body or tail in group 2 (p = 0.0007). A unique endoscopic finding, excretion of mucin from the patulous orifice of the papilla, was present in two (9%) of the 21 mucinous cystic tumours and in 21 (45%) of the 47 intraductal papillary-mucinous tumours examined (p = 0.006). Metachronous or synchronous malignant diseases were found in the pancreas or other organs in one (5%) of the 21 patients with mucinous cystic neoplasm and in 13 (27%) of the 48 with intraductal papillary-mucinous tumours (p = 0.03). The three- and five-year survival rates of 11 patients with mucinous cystadenocarcinoma were 45% and 27%, while those of 15 with intraductal papillary-mucinous carcinoma were 85% and 42%. CONCLUSIONS: These findings suggest that mucinous cystic neoplasm and intraductal papillary-mucinous tumours are different clinicopathological entities. Aggressive surgery with peripancreatic lymph node dissection is recommended, particularly for mucinous cystadenocarcinoma, and postoperative follow-up with attention given to the presence of other malignancy is necessary as well as to local recurrence and haematogenous spread.
In previous studies, we have shown that rats fed a copper-poor diet have an impaired glucose tolerance and insulin response to an oral glucose load. Furthermore, CuCl2 X 2H2O added to the incubation medium stimulated glucose incorporation into the diaphragm glycogen and epididimal fat of rats. The purpose of the present study was to examine the effect of copper on insulin release in vivo and in the perfused pancreas. Copper chloride stimulated the insulin release by the perfused pancreas of rats fed laboratory chow (copper content, 6.7 ppm). Stimulation with 0.5 mg/dl CuCl2 X 2H2O for 20 min resulted in release of 14.7 +/- 3.1 compared with 18.9 +/- 4.3 mu insulin following stimulation with 16.7 mM glucose. The CuCl2 X 2H2O effect depended on the presence of calcium in the medium--as with other insulinotropic agents--but not on the presence of magnesium. Animals fed a copper-poor (1.2 ppm) sucrose diet have a selective impairment to i.v. glucose-induced insulin stimulation, but not to i.v. arginine or aminophylline stimulation when compared with controls fed a sucrose copper-supplemented diet or a laboratory chow diet. This selective beta cell defect is not necessarily genetically inherited and may be acquired. The role of copper on insulin release is discussed.