[The effects of verapamil in experimental acute pancreatitis in the rat]. / Efectos del verapamil en la pancreatitis aguda experimental de la rata.

Experimental studies have shown that verapamil inhibits pancreatic exocrine secretion. In order to determine whether verapamil has any effect on acute pancreatitis (AP), we undertook an experimental study in Wistar rats. We used 72 animals divided into two groups. In all animals of both experimental groups, AP was induced by ligation of the biliary duct at its entrance in the duodenum. Animals were given saline (NaCl 0.9%), or 0.30 mgrs/hour verapamil. Subgroups of 9 animals, were treated for 6, 12, 18 and 24 hours; 6 animals group were then sacrificed, for biochemical studies (serum amilase, lipase, and calcium; and trypsin and chemotrypsin in the homogenized pancreas); the other 3 animals were used for morphologic study of the pancreas. Verapamil treatment decreased significantly tissue activity of trypsin (p less than 0.001) and chemotrypsin (p less than 0.0001) and increased serum lipase (p less than 0.05), and calcium. There was no statistical difference in serum amylase. Morphological findings include oedema, acinar necrosis, hemorrhage and vasculitis in non treated animals. Only oedema was observed in animals treated with verapamil. These results suggest a beneficial effect of verapamil on experimental AP induced by ligation of the bile duct in the rat.

[Hospital activities of surgery undergraduates]. / La actividad hospitalaria del pregraduado en cirugía.

A teaching-learning system of practices in Surgery named "Hospital Activity of undergraduates in surgery" has been performed over the last five academic courses in Alicante's Medical School. It is based on the stay and participation of 10 students over a 4 weeks period in the assistance tasks of one of the Teaching Hospital Surgery Department in the areas of: hospitalization, external visits and operating rooms. In order to fulfill the proposed teaching objectives a series of clinical sessions and special practices are performed. The hospital activity of 4 academic courses has been evaluated through the performance of a test addressed to the students and a evaluation using a multiple choice test. This educative method is accepted by the students although there are some aspects susceptible to be modified. A significant increase of knowledge between a pretest and a posttest (p less than 0.05) is observed and a significant absence of lacking of knowledge regarding the cognitive objectives fulfilled. Thus, this model of teaching-learning is valid and applicable in our environment.

[Biochemical and functional changes in experimental acute pancreatitis in the rat]. / Alteraciones bioquímicas y funcionales de la pancreatitis aguda experimental de la rata.

To discover the biochemical alterations occurring in the first 24 hours of acute pancreatitis (PA), we made an experimental study using rats. We used 90 animals in which necrosis and hemorrhage were induced by closing the choledochus. Animals underwent evolutive periods of 1, 2, 3, 4, 5, 6, 12, 18 and 24 hours. They were sacrificed and plasma (to determine amylase, lipase, creatinine and calcium), urine (amylase and creatinine), ascitic and pleural liquid (amylase and lipase) were obtained from 6 animals of each evolutive period. We made a post-mortem study of the pancreas of three animals of each subgroup. There was a significant increase in the amylasemia from the third hour (p less than 0.005) and of plasmatic lipase from the first hour (p less than 0.0001). Creatinine values remained in normal range and calcemia fell after the sixth hour (p less than 0.001). There was an increase in amylase concentration in urine and in ascitic and pleural liquids, and of the lipase in the last two. These changes correlated with the duration of the disease and with the histologic changes of the gland, which consist in edema, acinar necrosis, vasculitis and hemorrhage, which are present from the first hour and increase as time passes.

[Primary adenocarcinoma of the duodenum]. / Adenocarcinoma primitivo del duodeno.

Two cases are presented of primitive adenocarcinoma of the duodenum diagnosed and treated in the General Surgery Department of General Hospital of Elche (Spain) during the 10 years of its existence. The two patients were women, one a 45-year-old who consulted for pain, epigastric discomfort and melenas, and the other a 76-year-old who consulted for paraneoplastic syndrome and a palpable mass in the right lower quadrant. Radical resection was performed, with cephalic duodenopancreatectomy in the first case and atypical local resection of the first and second duodenal portions, gastric antrum and gallbladder in the second case. Six and 4 years after operation, respectively, the two patients are alive and asymptomatic. We comment the most important aspects of this rare disease in relation to the pecularities of our cases. We insist on the appropriateness of surgical resection as an effective therapeutic option.