The diagnosis and treatment of patients with pancreatic exocrine insufficiency after acute pancreatitis / 中华肝胆外科杂志

The incidence of acute pancreatitis is increasing year by year.However,there were very few studies focused on the clinical studies about the change of pancreatic exocrine function and pancreatic exocrine insufficiency after acute pancreatitis.Furthermore,there was insufficient understanding of the indications and applications for pancreatic enzyme replacement therapy in pancreatic exocrine function insufficiency.This review aimed to discuss the progress of the diagnosis and treatment of pancreatic exocrine dysfunction after acute pancreatitis.

Comparative histology in the liver and spleen of three species of freshwater teleost

We describe and compare the histology of liver and spleen ofGeophagus brasiliensis (Perciformes), Hypostomus francisci (Siluriformes) and Hoplias aff. malabaricus (Characiformes), tropical freshwater fishes. InG. brasiliensisandH. aff. malabaricusthe hepatocytes were arranged in tubular form whereas in H. franciscithey cord-like. In all species, hepatocytes presented glycogen, but in G. brasiliensis and H. aff. malabaricus they showed strong stained for hemossiderin in the cytoplasm. InG. brasiliensis and H. aff. malabaricus, melanomacrophage centres (MMCs) were associated to hepatic structures and only in G. brasiliensis was observed intrahepatic exocrine pancreas. The spleen, in all species, was characterized by red and white pulp without boundary between the two regions, but only in H. francisci was recorded nodular organization in splenic parenchyma. The G. brasiliensisandH. aff. malabaricuspresented in the white pulp MMCs linked mainly to ellipsoids. Besides, we observed large MMCs in the spleen in relation to liver of G. brasiliensis and H. aff. malabaricus. In liver, highest values of reticular fibers and collagen were observed inG. brasiliensis. In spleen, highest values of reticular fibers and collagen were recorded inH. aff. malabaricusandH. francisci, respectively. Histological differences confirm the hypothesis that the phylogenetic distance is reflected in liver and spleen.(AU)

Nós descrevemos e comparamos a histologia do fígado e do baço de Geophagus brasiliensis (Perciformes), Hypostomus francisci (Siluriformes) e Hoplias aff. malabaricus (Characiformes), peixes neotropicais de água doce. Em G. brasiliensis e H. aff. malabaricus os hepatócitos organizaram-se na forma tubular enquanto que em H. francisci eles apresentaram-se como cordões celulares. Em todas as espécies, os hepatócitos apresentaram glicogênio, mas em G. brasiliensis e H. aff. malabaricus, eles mostraram forte marcação para hemossiderina no citoplasma. Em G. brasiliensis e H. aff. malabaricus, centros melanomacrofágicos (CMMs) foram associados a estruturas hepáticas e somente em G. brasiliensis foi observado pâncreas exócrino intrahepático. O baço, em todas as espécies, foi caracterizado pela polpa vermelha e branca sem limites entre as duas regiões, mas somente em H. francisci foi registrado uma organização nodular no parênquima esplênico. G. brasiliensiseH. aff. malabaricusapresentaram na polpa branca CMMs associados principalmente a elipsoides. Além disso, nós observamos CMMs grandes no baço em relação ao fígado de G. brasiliensis e de H. aff. malabaricus. No fígado, valores altos de fibras reticulares e colágeno foram observado em G. brasiliensis. No baço, valores altos de fibras reticulares e colágeno foram registrados em H. aff. malabaricuseH. francisci, respectivamente. Diferenças histológicas confirmam a hipótese que a distância filogenética está refletida no fígado e no baço.(AU)

Progress in Study on Relationship between Autoantigens of PAB and Crohn 's Disease / 胃肠病学

It is reported that zymogen granule membrane glycoprotein 2 (GP2 )and CUB and zona pellucida-like domain-containing protein 1 (CUZD1 )are the major autoantigens of autoantibodies against exocrine pancreas (PAB).GP2 is mainly expressed in the pancreatic acinar cell and M cells in small intestine follicle-associated epithelium,and CUZD1 is mainly expressed in uterus,ovary and pancreatic acinar cell.PAB is a relatively specific antibody for Crohn's disease (CD).The article reviewed the progress in study on autoantigens of PAB in CD.

Pancreatogenic Diabetes / 임상당뇨병

Diabetes can develop as a direct consequence of diseases of the exocrine pancreas. Diabetes due to diseases of the exocrine pancreas is described as pancreatogenic diabetes or type 3c diabetes. Pancreatogenic diabetes is not commonly recognized by clinicians and is frequently misclassified as type 1 diabetes or, more commonly, type 2 diabetes. The prevalence and clinical importance of pancreatogenic diabetes have been underestimated and underappreciated. Pancreatogenic diabetes has a unique pattern of hormonal and metabolic characteristics. The failure to correctly diagnose pancreatogenic diabetes leads to failure to implement an appropriate medical therapy in these patients. We will review the clinical implications and relevance of pancreatogenic diabetes.

Effect of autophagy and mitochondrial coenzyme Q on exocrine function of pancreas in rats with acute sepsis / 中华危重病急救医学

ObjectiveTo investigate the effects of autophagy on exocrine function of pancreas in rats with acute sepsis, and to determine whether the mitochondrial coenzyme Q (Mito Q) can prevent exocrine dysfunction of pancreas mediated by autophagy.Methods ExperimentⅠ: 30 Sprague-Dawley (SD) rats were randomly divided into three groups, with 10 rats in each group. All the rats were given lipopolysaccharide (LPS, 10 mg/kg) intraperitoneally, and Wortmannin (2 mg/kg), the specific inhibitor of autophagy (LPS+ Wortmannin group), Mito Q (6.5μmol/kg, LPS+Mito Q group), or the same volume of normal saline (LPS group) was respectively injected via the tail vein 1 hour later. Survival rate was assessed within 12 hours after LPS injection. ExperimentⅡ: another 100 male SD rats were randomly divided into ten groups with 10 rats in each group: namely control 4, 6 and 12 hours groups, LPS 4, 6 and 12 hours groups, and LPS+ Wortmannin 4 hours group, Wortmannin 4 hours group, LPS+ Mito Q 6 hours group, and Mito Q 6 hours group. The protocols of model reproduction and drug administration were the same as in the experimentⅠ. Blood samples were collected at each time point, and the amylase content was determined with the velocity method. The levels of reactive oxygen species (ROS) in the pancreases were measured with enzyme-linked immunosorbent assay (ELISA). The expression of the autophagy-related protein LC3 was determined with Western Blot. The pathological changes in the pancreas were observed with microscopy.Results① The survival time in the LPS+ Wortmannin group was significantly shorter than that in the LPS group (hours: 7.50±0.64 vs. 11.90±0.13,χ2= 19.847,P= 0.001). There was no significant difference in the survival time between LPS+ Mito Q and LPS groups (hours: 11.60±0.24 vs. 11.90±0.13,χ2= 1.055,P= 0.137).② The serum amylase in the LPS 6 hours, LPS+ Wortmannin 4 hours, and LPS+ Mito Q 6 hours groups were significantly higher than those in the control group at the same time points (U/L:2 881.00±550.12 vs. 2 099.20±249.57, 3 672.00±779.24 vs. 2 081.36±245.18, 2 975.20±687.03 vs. 2 099.20± 249.57, allP 0.05). Light microscopy showed that obvious pathological changes were found in the pancreas in the LPS 6 hours and 12 hours groups, LPS+Wortmannin 4 hours group, and LPS+ Mito Q 6 hours group. Electron microscopy showed that the number of autophagic vacuoles increased 6 hours after LPS administration. There was no difference at any time point in the number of autophagic vacuoles between LPS+ Mito Q 6 hours group and LPS 6 hours group, and the autophagic vacuoles were not found after Wortmannin intervention. It was demonstrated by Western Blot that the levels of LC3 protein in the LPS 6 hours and 12 hours groups, and LPS+ Mito Q 6 hours group were significantly higher than those of the control group at the same time points (A value: 0.34±0.02 vs. 0.17±0.02, 0.37±0.03 vs. 0.18±0.04, 0.36±0.02 vs. 0.17±0.02, allP 0.05).Conclusions Autophagy prevents exocrine dysfunction of pancreas in septic rats, and the autophagic capacity or autophagosome-formation rate may determine the development of exocrine pancreatic dysfunction. The mitochondria-targeted antioxidant Mito Q does not prevent exocrine dysfunction of pancreas.

Effect of sodium cyclamate on the rat fetal exocrine pancreas: a karyometric and stereological study / Efectos del ciclamato de sodio en el pancreas exocrino fetal de ratas: estudio cariométrico y estereológico

The cyclamate, a sweetner substance derived from N-cyclo-hexyl-sulfamic acid, is largely utilized as a non-caloric artificial edulcorant in foods and beverages as well as in the pharmaceutical industry. The objective of this study was to evaluate karyometric and stereological alterations in the rat fetal pancreas resulting from the intraperitoneal administration of sodium cyclamate. The exocrine pancreas of ten fetuses of rats were evaluated, five treated and five controls chosen at random, in which five rats that received from the 10th to 14th days of pregnancy an intraperitoneal daily injection of sodium cyclamate at 60 mg/Kg of body weight during 5 days. At the 20th day of gestation, the animals were removed and weighed, as were their placentas; the length of the umbilical cords also were measured. After the laboratory processing, semi-seriated 6mm cuts stained with haematoxyline and eosine were performed. In seven karyometric parameters (major, minor, and medium diameters, volume, area, perimeter, and volume-area ratio), the increase was statistically significant in the treated group when compared with control group. Stereological parameters showed in the treated group a significant increase in the cellular volume and a significant reduction in the numerical cellular density. These results showed that the sodium cyclamate in pregnant rats led to retardation of fetal development and hypertrophy in the exocrine pancreas of the rat fetuses.

El ciclamato, es una substancia derivada del ácido N-ciclo-hexil-sulfámico, bastante usada como edulcorante no calórico en los alimentos y bebidas, así como en la industria farmacéutica. El objetivo de este estudio fue evaluar las alteraciones cariométricas y estereológicos en páncreas fetal de rata tras la administración intraperitoneal de ciclamato de sodio. El páncreas exocrino de diez de los fetos de rata fueron evaluados, cinco tratados y cinco controles seleccionados al azar, en el que cinco ratas recibieron del día 10 al día 14 de preñez una inyección intraperitoneal diaria de ciclamato de sodio a 60 mg/Kg de peso corporal durante 5 días. En el día 20 de gestación, los animales fueron retirados y pesados, al igual que sus placentas. Asimismo, se midió la longitud de los cordones umbilicales. Después del procesamiento de laboratorio, cortes semi-seriados de 6µm, se tiñeron con hematoxilina-eosina. En siete parámetros cariométricos (diámetros mayor, menor y medio, volumen, área, perímetro y relación área/volumen). El aumento fue estadísticamente significativo en el grupo tratado comparado con el grupo control. Los parámetros estereológicos mostraron en el grupo tratado un aumento significativo del volumen celular y una reducción significativa en la densidad numérica celular. Estos resultados mostraron que el uso del ciclamato de sodio en las ratas preñadas causa retardo en el desarrollo fetal e hipertrofia en el páncreas exocrino de los fetos de rata.

Morphological Study of the Liver in the Teleost Oreochromis niloticus / Estudio Morfológico del Hígado en el Teleósteo Oreochromis niloticus

Liver samples of Oreochromis niloticus cultivated in floating net cages were fixed for histological and ultrastructural studies with the objective of describing the hepatic parenchymal structure and the intrahepatic exocrine pancreatic tissue. Anatomically, the liver showed only two hepatic lobes. Histological analysis demonstrated that the hepatocytes were spread out as anastomotic cords, arranged in two cellular layers and surrounded by sinusoids. The intrahepatic exocrine pancreatic tissue exhibited an acinar arrangement and was diffused in the hepatic parenchyma. Structural analysis showed that the hepatocytes had a rounded nucleus and a rough endoplasmic reticulum with a parallel disposition to the nuclear membrane. The exocrine pancreatic cells showed secretion granules at the apical portion and the rough endoplasmic reticulum was concentrically distributed.

Con el objetivo de describir la estructura del parénquima hepático y del páncreas exocrino intrahepático del Oreochromis niloticus, fueron fijados para estudios histológicos y ultraestructurales fragmentos de hígado de peces cultivados en jaulas flotantes. Se evidenciaron sólo 2 lóbubos hepáticos. El análisis histológico demostró que los hepatocitos se encontraban organizados en forma de cordones anastomosados, dispuestos en dos capas celulares y cercados por sinusoides. El tejido pancreático exocrino intrahepático se encontró difuso en el parénquima hepático y se destacó por su organización acinar. El análisis ultraestructural demostró que los hepatocitos presentaban núcleos redondos y el retículo endoplasmático rugoso estaba dispuesto paralelamente a la membrana nuclear. Las células pancreáticas exocrinas presentaban gránulos de secreción localizados en la porción apical y el retículo endoplasmático rugoso estaba organizado de manera concéntrica.

Effect of 5-Fluorouracil on the Exocrine Pancreas / 中国普外基础与临床杂志

Objective To observe the effect of 5 Fluorouracil(5 FU) on the exocrine pancreas. Methods The effects of 5 FU were investigated in 8 patients who had undergone pancreatoduodenectomy. The pancreatic juice was temporarily diverted to the exterior via a pancreatic duct catheter.Ten days after operation,the patients were injected intravenously with 5 FU 500 mg/d for three days. The samples of pancreatic juice were taken for measurement of amylase,pH, HCO 3 -, Na +, K +, Cl -, Ca 2+ and Mg 2+ .Results The amylase, pH, HCO 3 -, Na +, K +, Cl -, Ca 2+ and Mg 2+ did not alteredsignificantly before and after 5 FU injection.Conclusion 5 FU has no short term effect on exocrine pancreas. Therefore, improvement of acute pancreatitis cannot be achieved through inhibiting pancreatic enzymes synthesis.