Hypercalcemia induced pancreatitis as a rare presentation of primary hyperparathyroidism.

Acute pancreatitis (AP) is an inflammatory process of the pancreas. It is a relatively common cause of acute upper abdominal pain and is potentially associated with high morbidity and mortality. Underlying hypercalcemia as a cause of AP is very rare. We present a case of a hypercalcemia-induced acute pancreatitis with an underlying parathyroid adenoma in an 81-year-old woman with no previous symptoms of hypercalcemia. The parathyroid adenoma was semi-urgently surgically resected with normalization of calcium-levels. This case report summarizes the causes of acute pancreatitis and hypercalcemia and its management.

The intriguing role of soluble urokinase receptor in inflammatory diseases.

Inflammation is a key player in the development of an increasing amount of diseases. The soluble urokinase plasminogen activator receptor (suPAR) is a highly flexible molecule with intrinsic chemotactic properties. This glycoprotein has been evaluated as a biomarker of inflammation, immune activation, organ damage and clinical outcome in several pathologies, including cardiovascular disease, hepatitis, renal disorders and rheumatic pathologies. The use of this early warning inflammatory biomarker could potentially improve the prediction of the severity of these diseases and mortality. In the present paper, we describe the general characteristics of suPAR and its intriguing role as a biomarker in different inflammatory diseases.

In vitro maturation of sheep ovarian oocytes.

An in vitro system has been developed which induces full meiotic maturation in 98% ovarian sheep oocytes isolated from follicles 2-6 mm in diameter. 45.7% of these were fertilized, determined by the presence of two pronuclei, extrusion of the second polar body and the presence of the sperm flagellum. This culture system was used to describe the morphological changes during meiotic maturation, examining the nucleus, the cytoplasm and cumulus (corona)-oocyte relationship. 24 h are required for maturation of sheep oocytes. The culture medium must contain FSH, LH (10 micrograms/ml of each), estradiol-17 beta (1 micrograms/ml) and coculture of 10(6) mural granulosa cells in suspension (Crozet et al., 1987). Nuclear changes were the first evident transformations, showing that chromatin condensation leads to nuclear deformation, to germinal vesicle breakdown and to formation of the first and second meiotic metaphases. The axis of both spindles are oriented perpendicularly to the egg membrane. At each pole a bent disc composed of filamentous material represents the microtubule organizing centers (MTOC). The key event may be the initiation and control of chromosome condensation. Cytoplasmic changes include the development of a cortical layer of 1-4 microns thickness poor in cell organelles. Golgi complexes are localized in three distinct areas with possibly different functions: (1) around the germinal vesicle; (2) in the oocyte cortex, of regular distance; (3) in the central part of the oocyte. Cortical granules (CG) of different maturation stages (condensation) form clusters near the peripheral Golgi complexes while at Meta I they form a nearly continuous single layer. At Meta II the CGs are apparently anchored to the cell membrane by means of small spokes. The cumulus (corona) cells are attached by junctional complexes to each other and to the oocyte. Foot processes cross the zona and indent the oocyte. The termini are gradually exteriorized and contacts must be broken to isolate the oocyte. The sum of all the above changes represent meiotic maturation.

In vitro fertilization with normal development in the sheep.

Ovine tubal (n = 87) and ovarian in vitro matured oocytes (n = 99) were fertilized in vitro with ejaculated spermatozoa capacitated for 8 h in modified defined medium buffered with Hepes. High levels of fertilization were obtained as assessed by development to two- to six-cell stage within 40 h (75.8% for ovulated and 62.6% for in vitro matured oocytes). Electron microscope analysis of oocytes 20-22 h after insemination indicated that in vitro fertilization approximated the in vivo events. Embryos (two- to six-cell) were transferred surgically to the oviducts of pseudopregnant rabbits. Three days later, 42 (from ovulated oocytes) and 15 (from in vitro matured oocytes) embryos were recovered; 26 (61.9%) and 10 (66.6%), respectively, had cleaved at least once. Embryos incubated in vivo (n = 20 from ovulated oocytes; n = 9 from in vitro matured oocytes) were transferred surgically to the uteri of seven and four recipient ewes resulting in four and two pregnancies, respectively, from which three and one, respectively, have been maintained (greater than 3 months). The first lamb resulting from the in vitro fertilization of an ovulated oocyte was born. In addition, six embryos (two- to four-cell) from tubal oocytes and ten embryos (two- to six-cell) from in vitro matured oocytes were directly transferred to the oviducts of two and three ewes, respectively. Two pregnancies resulting from in vitro matured fertilized oocytes are in progress (greater than 3 months).