摘要:

To study the morphologic and genetic events associated with the carcinogenic process in the pancreas, we have isolated and cultured a cell line of dog pancreatic duct epithelial cells and treated these cells with a carcinogen. The pancreatic duct epithelial cells were plated onto Vitrogen-coated Transwell inserts suspended above a feeder layer of human gallbladder my ofibroblasts. The epithelial cells grew steadily into polarized monolayers, could be passaged repeatedly, and demonstrated the typical morphologic, immunohistochemical, and flow cyto-metric profile of normal well-differentiated columnar pancreatic epithelial cells. After being treated with 10−5M N-methyl-N′-nitro-N-nitrosoguanidine (MNNG) for 48 h, the treated cells grew on plastic surfaces. When grown in organotypic culture, the MNNG-treated cells were cuboidal with a multilayered, pseudostratified architecture. Flow cytometry demonstrated aneuploidy and a high percentage of the cells in S phase after reaching confluency, in sharp contrast to untreated cells. Cytogenetic analysis of the MNNG-treated cells revealed frequent chromosomal trisomy and tetrasomy. The secretion of mucin was also different in the MNNG-treated cells versus the untreated cells. The cultured pancreatic epithelial cells may be useful as an assay system to study the genotoxicity of known and potential carcinogens.

ISSN:0885-3177    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

To study the effect subtotal gastrectomies have on exocrine pancreatic function, 12 dogs were prepared with gastric and duodenal cannulas using a rnodified technique of Thomas. In our study protocol, we collected pancreatic juice by selective ductal cannulation after having applied two types of stimulation [tryptophan intraduodenally together with secretin intravenously (i.v.) and cholecystokinin i.v. together with secretin i.v.]. Our results did not show a significant increase in pancre atic juice after performing the gastrectomies. In both cases the concentration of bicarbonate decreased significantly in contrast to that in the control group. After Billroth I anastomosis, however, a significant decrease in the first periods of stimulation in relation to the gastrojejunostomy was appreciated. In the case of proteins, a loss of the dose/effect relation in these parameters was seen only after Billroth II anastomosis.

ISSN:0885-3177    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

Surgical management of necrotizing pancreatitis (NP) may result in significant intraabdominal hemorrhage requiring intervention. To determine the incidence and management of hemorrhage complicating operative management of NP, we analyzed retrospectively all patients undergoing operative treatment of NP between 1985 and 1994. Thirteen of 61 patients (21%) developed intraabdominal hemorrhage requiring intervention. The five patients (38%) who experienced more than one bleeding episode had undergone more prior operative debridements (mean of 5.6 vs. 3.8), had had higher transfusion requirements during the first bleeding episode (mean of 27.4 vs. 11.3 U of packed red blood cells), and had a higher hospital mortality (60 vs. 38%) compared to patients with only one bleeding episode. Coexistence of pancreatic and/or gastrointestinal fistula was more common in patients who developed bleeding (36 vs. 11%). Seventeen bleeding sites (eight venous, seven arterial, two generalized oozing) were identified. Angiography was successful in one of two patients in whom it was employed. Surgical control was effective in the other 12 patients. There was no acute mortality related to hemorrhage, but the hospital mortality was greater than in those without hemorrhage (46 vs. 21%). We conclude that significant hemorrhage complicates the surgical management of NP in ∼20% of patients; while it can be effectively controlled surgically and does not lead to immediate mortality, it may predict worse prognosis.

ISSN:0885-3177    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

It is not known whether cigarette smoking plays a role as a risk factor in alcoholic pancreatitis. The aim of this study was to compare drinking and smoking habits in three groups of male subjects with an alcohol intake in excess of 40 g/day: (i) 67 patients with acute alcoholic pancreatitis, without other known potential causative agents; (ii) 396 patients with chronic alcoholic pancreatitis; and (iii) 265 control subjects randomly selected from the Verona polling lists and submitted to a complete medical checkup. The variables considered were age at onset of disease, years of drinking and smoking, daily alcohol intake in grams, number of cigarettes smoked daily, and body mass index (BMI). Cases differed from controls in daily grams of alcohol, number of cigarettes smoked and BMI (Mann-WhitneyUtest,p< 0.00001 for each comparison). Multivariate logistic regression analysis, comparing acute and chronic cases, respectively, versus controls, revealed an increased relative risk of pancreatitis in the two comparisons, associated in both cases with a higher alcohol intake (p< 0.00001) and cigarette smoking (p< 0.00001). No significant interaction between alcohol and smoking was noted, indicating that the two risks are independent. In conclusion, in males a higher number of cigarettes smoked daily seems to be a distinct risk factor in acute and chronic alcoholic pancreatitis.

ISSN:0885-3177    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

We report 11 families of hereditary pancreatitis characterized by the presence of calculi in pancreatic ducts. These were classified as (1) calcic lithiasis (one family with five cases), in which the calculi are composed of >95% calcium salts; and (2) protein lithiasis in 10 families, in which the calculi are composed of degraded amorphous residues of lithostathine, the pancreatic secretory protein that inhibits calcium salt crystallization. In both forms, transmission appears to be dominant. The average age at clinical onset of symptoms is 15 years. The clinical progression seems to be less severe than in alcoholic chronic pancreatitis (alcoholic calcic lithiasis). This report shows for the first time that hereditary chronic pancreatitis is a group of at least two diseases having a similar clinical picture and pathological features but different chemical compositions of calculi. This leads us to propose a revised Marseille-Rome classification.

ISSN:0885-3177    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

Our objective was to analyze conservative management in a large series of acute necrotizing pancreatitis (ANP) patients in a specialized center for pancreatic disease in the Internal Medicine and Emergency Department of a 1,500-bed hospital. One hundred ninety-nine patients with ANP w'ere considered (mean age, 55.4 ± 18.2 years; biliary etiology, 60.3%). Identification of necrotizing forms of acute pancreatitis was obtained by ultrasonography, computed tomography scan, and surgery (53 cases). Exclusion of infection of the necrosis was based on clinical findings and percutaneous aspiration with bacteriological sampling. Medical treatment was started in all cases: 37 patients required ICU treatment; 87 patients underwent early endoscopic cholangiopancre-atography (ERCP), and endoscopic sphincterotomy was performed in 61 cases; and percutaneous guided aspiration of necrosis and fluid collections was performed in 78 cases and in 9 patients with acute pseudocysts. Fifty-three patients (26.6%) underwent surgery; all patients (n= 30) with infected necrosis were in this group. One hundred forty-six patients were unoperated (73.3%): clinical resolution of ANP and biochemical normalization was achieved in 132 cases (66.3%) at discharge. Ultrasonographic follow-up documented morphological resolution of necrosis and fluid collections in 84 cases (57.5%) at different periods from the onset of ANP (range, 2.2–63.5 weeks); I6 patients dropped out and seven patients are still being followed. Spontaneous regression of acute pseudocysts was observed in 59.2%; percutaneous/endoscopic aspiration was successful in 33.3%. Mortality was 9.5%, significantly lower than the mortality observed in operated patients (28.3%;p= 0.002). Conservative treatment of ANP with sterile necrosis may allow healing in most cases, independent of the extent of necrosis or its association with major complications.

ISSN:0885-3177    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

Results of the SPT and the ERCP staged for their severity were compared in 202 patients. The correlation between both investigations was significant (p< 0.001); however, ERCP showed significantly more severe changes (p= 0.04). Furthermore, we found that 129 (64%) patients had parallel SPT and ERCP results, matching in all four gradings of severity. Forty-three (21%) patients had abnormal results for both SPT and ERCP, but the severity gradings did not parallel. Finally, 30 (15%) patients showed totally nonparallel results, a normal SPT and abnormal ERCP, or vice versa. Abnormal ERCP but normal SPT results were found in 23 of these 30 patients (group 1), and normal ERCP but abnormal SPT results in the seven remaining cases (group 2). In the first group, more patients had a history of acute pancreatitis compared to the second group (19 vs. one,p< 0.005). Based on medical history, laboratory and functional test results, and other morphological tests, chronic pancreatitis was diagnosed in two of 23 patients in group 1 and in all seven patients in group 2. Follow-up interviews (86 ± 54 months) were possible in 20 of the remaining 21 patients in group 1 and showed definite chronic pancreatitis in one and probable chronic pancreatitis in another two of them, whereas in the other 17 patients no symptoms of acute pancreatitis or abdominal pain suggestive of chronic pancreatitis had occurred. In conclusion, both SPT and ERCP should be used to complement each other when chronic pancreatitis is suspected. ERCP seems to over-diagnose the disease since duct changes mayonlyreflect scars after severe acute pancreatitis, or old age, and are not necessarily a sign of chronic pancreatitis. SPT seems to diagnose chronic pancreatitis with more reliability.

ISSN:0885-3177    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

The severity of pancreatic fibrosis, a characteristic feature of patients with chronic pancreatitis (CP), can be assessed only by direct histologic analysis of pancreatic tissue. Since serum levels of the amino-terminal type III procollagen propeptide (PIIIP) can reflect the degree of fibrogenic activity in several diseases associated with fibrosis, the current study was aimed at investigating whether PIIIP are increased in chronic pancreatitis, the relationship between PIIIP and pancreatic fibrogenic activity, and the influence of pancreatectomy, pancreatic exocrine function, and duration of disease on PIIIP levels. Serum PIIIP was measured in 18 patients with CP (15 without liver disease and three with cholestasis) and in 21 healthy controls. The effect of pancreatectomy on PIIIP was evaluated in seven patients, in whom PIIIP was measured immediately before and 2 months after surgery. Prolylhydroxylase (PHase) activity as an index of pancreatic fibrogenesis was evaluated in pancreatic tissue from 11 patients who had undergone subtotal pancreatectomy and from 11 organ donors. The bentiromide (BT)-PABA test as an index of exocrine pancreatic function was measured in all patients. PIIIP was significantly higher in patients who had or had not undergone pancreatectomy (17.3 ± 4.0 and 25 ± 11.4 ng/ml, respectively) than in controls (12.3 ± 3.1 ng/ml) (p< 0.001). PIIIP decreased significantly after pancreatectomy (before, 32.0 ± 9.3 ng/ml; after, 18.4 ± 4.8 ng/ml;p= 0.00s). PHase was significantly higher in patients (773 ± 250 cpm/mg protein) than in controls (405 ± 121 cpm/mg protein) (p< 0.001). PIIIP was correlated with pancreatic PHase (r= 0.7,p= 0.001) but not with BTPABA or with the duration of the disease. In conclusion, serum PIIIP levels are increased in patients with CP and reflect the severity of pancreatic fibrogenic activity. No relationship between the serum PIIIP levels and the pancreatic exocrine function and duration of disease was found.

ISSN:0885-3177    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

The effect of prostaglandin E1(PGEI) on the severity of acute pancreatitis induced by a closed duodenal loop in the rat was tested. PGEl was administered subcutaneously at various doses (3, 6, 12, and 24 μg/kg) at hourly intervals, from the induction of acute pancreatitis up to the 24th hour. A saline-treated group served as the control. The mortality rate was recorded, and pancreatic histology was evaluated by a scoring system. Serum amylase activity and pancreatic amylase, trypsin, protein, and desoxyribonucleic acid (DNA) contents were determined at 24 h. Administration of PGEl influenced the severity of acute pancreatitis biphasically. Serum amylase was reduced significantly (p< 0.01) at a dose of 12 μg/kg/h, but less at 24 μg/kg/h. Pancreatic weights did not differ in the groups. Pancreatic amylase, trypsin, and protein contents showed significant elevations (p< 0.01), yet the mortality rate was reduced using 6 and 12 μg/kg/h doses of PGEl compared to controls, but not at higher and lower doses. The DNA content was significantly higher at the 6 μg/kg/h dose, compared to the control. The extent of necrosis and the severity of hemorrhage were reduced significantly (p< 0.05) at doses of 6 and 12 μg/kg/h of PGE1, but less at 24 μg/kg/h. Leukocyte infiltration was not affected. In conclusion, optimal doses of PGE1 can ameliorate, but higher doses increase, the severity of acute pancreatitis in this experimental model.

ISSN:0885-3177    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

The effects of a newly developed compound having antiulcer action, (Z)-2-(4-methylpiperazin-1-yl)-1-[4-(2-phenyl-ethyl)phenyl]-ethanone oxime hydrochloride monohydrate (MCI-727), on pancreatic exocrine secretion were studied in anesthetized rats and evaluated its preventive and therapeutic effects on acute pancreatitis in two experimental rat models. Intraduodenal administration of MCI-727 [25, 50, or 100 mg/kg body weight (wt)] stimulated a dose-dependent increase in pancreatic juice and bicarbonate output without increasing the protein output or plasma cholecystokinin concentration. MCI-727-stimulated pancreatic exocrine secretion was completely abolished by antisecretin serum but not by the cholecystokinin receptor antagonist loxiglumide (50 mg/kg body wt/h) or cholinergic receptor antagonist atropine (100 μg/kg body wt/h). In rats with acute pancreatitis induced by four subcutaneous injections of 20 μg/kg body wt cerulein at hourly intervals over 3 h, MCI-727 administered orally at a dose of 100 mg/kg body wt 30 min before the first cerulein injection significantly reduced the increases in serum amylase and lipase activity and pancreatic wet weight and induced improvements in the results of histologic examination. Moreover, when given 30 min before and 90 min after the first cerulein injection, MCI-727 had even more dramatic protective effects on all these parameters. In addition, even when administered immediately after the last cerulein injection, MCI-727 effectively ameliorated all these alterations of acute pancreatitis. However, MCI-727 had no apparent beneficial effects on the biochemical and histologic alterations of acute pancreatitis in the severe form induced by retrograde intraductal injection of 1.0 ml/kg body wt of 4% sodium taurocholate. These findings suggest that oral administration of MCI-727 stimulates pancreatic exocrine secretion by endogenous secretin release and that it has therapeutic as well as preventive effects on mild forms of acute pancreatitis in rats.

ISSN:0885-3177    

出版商:OVID    

年代:1996

数据来源: OVID