• Title, Summary, Keyword: Pancreas

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Clinical Analysis of Traumatic Pancreatic Injury (개복 수술로 확인된 외상성 췌장 손상 환자에 대한 임상적 고찰)

  • HwangBo, Seon-Mi;Kwon, Young-Bong;Yun, Kyung-Jin;Kwon, Hyung-Jun;Chun, Jae-Min;Kim, Sang-Geol;Park, Jin-Young;Hwang, Yun-Jin;Yun, Young-Gook
    • Journal of Trauma and Injury
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    • v.24 no.2
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    • pp.68-74
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    • 2011
  • Purpose: Although pancreas injury is rare in abdominal trauma, it poses a challenge to the surgeon because its clinical features are not prominent and the presence of main duct injury cannot be easily identified by imaging studies. Furthermore, severe pancreas injuries require a distal pancreatectomy or a pancreaticoduodnectomy which are associated considerable morbidity and mortality. We reviewed the clinical features of and outcomes for patients with pancreas injury. Methods: For 10 years from Jan. 2001 to Dec. 2010, thirty-four patients were diagnosed as having pancreas injury by using an explo-laparotomy. Patients successfully treated by non-operative management were excluded. Patients were divided into early (n=18) and delayed surgery groups (n=11) based on an interval of 24hours between injury and surgery. The clinical features of and the outcomes for the patients in both groups were compared. Results: Males were more commonly injured (82.4% vs.17.6%). The mean age was 37.2 years. The injury mechanisms included vehicle accidents (62.9%, 22/34), assaults (20%, 7/34), and falls (11.4%, 3/34). The head and neck of the pancreas was most commonly injured, followed by the body and the tail (16, 12, and 6 cases).Of the 34 patients, 26 (76.5%) patients had accompanying injuries. Grade 1 and 2 occurred in 14 (5 and 9) patients, and grade 3, 4, and 5 occurred in 20 (16, 3, and 1) patients. The early and delayed surgery groups showed no difference in surgical outcomes. Two patients with grade 3 in the early surgery group died after surgery,one due to massive hemorrhage and the other due to septic shock. Of the five patients initially managed non-operatively, three developed peripancreatic necrosis and two developed pseudocyst. All five patients were successfully cured by surgery. Conclusion: All cases of pancreas injury in this study involved blunt injury, and accompanying injury to major vessels or the bowel was the major cause of mortality. Surgery delayed for longer than 24 hours after was not associated with adverse outcomes.

A portable high-intensity focused ultrasound system for the pancreas with 3D electronic steering: a preclinical study in a swine model

  • Chang, Won;Lee, Jae Young;Lee, Jae Hwan;Bae, Jae Seok;Cho, Yeon Jin;Kang, Kook Jin;Son, Keonho;Chung, Yul Ri;Lee, Kyoung Bun;Han, Joon Koo
    • Ultrasonography
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    • v.37 no.4
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    • pp.298-306
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    • 2018
  • Purpose: The aim of this animal study was to evaluate the safety and feasibility of a portable, ultrasonography-guided, high-intensity focused ultrasound (USg-HIFU) system to treat the pancreas. Methods: Eight swine were included. Using a portable HIFU device (ALPIUS 900, Alpinion Medical Systems), ablations were performed on the pancreas in vivo. Different acoustic intensities were applied ($1.7kW/cm^2$ or $1.5kW/cm^2$, n=2 [group A for a pilot study]; $1.5kW/cm^2$, n=3 [group B]; and $1.2kW/cm^2$, n=3 [group C]). Magnetic resonance imaging (MRI) was performed immediately (group A) or 7 days (groups B and C) after HIFU treatment. In groups B and C, serum amylase and lipase levels were measured on days 0 and 7, and performance status was observed every day. Necropsy was performed on days 0 (group A) or 7 (groups B and C) to assess the presence of unintended injuries and to obtain pancreatic and peripancreatic tissue for histological analysis. Results: Ablation was noted in the pancreas in all swine on MRI, and all pathologic specimens showed coagulation necrosis in the treated area. The mean ablation areas on MRI were $85.3{\pm}38.1mm^2$, $90.7{\pm}21.2mm^2$, and $54.4{\pm}30.6mm^2$ in groups A, B, and C, respectively (P>0.05). No animals showed evidence of complications, except for one case of a pseudocyst in group B. Conclusion: This study showed that pancreas ablation using a portable USg-HIFU system may be safe and feasible, and that coagulation necrosis of the pancreas was successfully achieved with a range of acoustic intensities.

Studies on the Enzyme-releasing Mechanism of Aminoglycosides from Pancreas (Aminoglycosides의 취효소 분비항진기전에 관한 연구)

  • Shim, Ho-Shik;Kim, Kyung-Hwan;Hong, Sa-Suk
    • The Korean Journal of Pharmacology
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    • v.19 no.1
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    • pp.71-76
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    • 1983
  • Aminoglycoside antibiotics are reported to enhance the amylase release from isolated slices of pancreas in vitro and the mode of action of aminoglycosides on amylase release is considered different from those of acetylcholine or cholecystokinin(CCK), i.e., electronmicroscopically intact zymogen granules are appeared in the lumen of pancreatic acini by treatment of aminoglycosides. It is known that atropine blocks the secretagogue effect of acetylcholine, and phenoxybenzamine is reported to block the effects of CCK or its analogue caerulein. Present study was undertaken to investigate the mode of action of aminoglycosides on the amylase release using atropine, phenoxybenzamine and propranolol as a membrane stabilizing agent in slices of chicken pancreas. The results are summarized as follows : 1) Streptomycin and kanamycin increased the amylase release significantly from slices of chicken pancreas. 2) The effect of streptomycin was inhibited by atropine but not by phenoxybenzamine or propranolol. 3) The amylase release by acetylcholine was blocked by atropine tut the effect of cholecystokinin octapeptide(CCK-8) was not influenced by atropine, phenoxybenzamine or propranolol. 4) Pretreatment of streptomycin enhanced the secretagogue effect of acetylcholine or CCK-8. From these results it is suggested that amylase releasing effects of aminoglycosides are mediated in part by cholinergic stimulation and in part by membrane alteration and these effects are enhanced by acetylcholine or cholecystokinin.

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Studies on the Toxicity of Dietary Ethionine and Methionine to Pancreas and Liver (취장 및 간장에 미치는 식이성(食餌性) Ethionine 과 Methionine 의 독성에 관한 연구)

  • Kim, Jae-Joun
    • The Korean Journal of Pharmacology
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    • v.7 no.1
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    • pp.37-52
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    • 1971
  • It has been demonstrated repeatedly that the administration of ethionine, a methionine analogue, will produce destruction of pancreatic tissue and liver cells. Destruction of acinar cells of pancreas by the administration of excess methionine similar to that seen after feeding diets supplemented with ethionine was also reported, but the liver was not involved by this amino acid. In an attempt to reproduce the results of these investigators the tissue damages were found to be slight and seen only irregulary in rats receiving ethionine on a complete diet and the result of tissue damages by excess methionine were also controversial. The present studies describe the toxicity of dietary supplemented ethionine and methionine to liver and pancreas in rats fed a low protein diet. Hundred five albino rats weighing around 120 gm were divided into three groups as follows; 1) Control group: A low protein diet containing 8% casein was fed throughout the experimental period. 2) Methionine group: A low protein diet (7% casein) supplemented with 1% methionine was used. 3) Ethionine group: A similar diet as methionine group except the supplementation of 1% ethionine instead of methionine was used. Five animals per wee from each group were killed for 6 weeks. The liver and pancreas were fixed in 10% formalin and histologic sections were prepared and stained with hematoxylin eosin. Serum amylase was expressed as much of glucose liberated from a starch substrate. The glucose was determined by the method of Nelson (1944). Serum glutamic pyruvic transaminase (SGPT) and glutamic oxaloacetic transaminase (SGOT) were determined by the technique described in Sigma Bulletin.

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Biosynthesis of Nitric Oxide in Pancreatic Tissues (췌조직내 Nitric Oxide의 생합성)

  • Kim, Yong-Kee;Nam, Suk-Woo;Park, Seung-Hee;Yoo, Se-Geun;Hong, Sung-Youl;Lee, Hyang-Woo
    • YAKHAK HOEJI
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    • v.38 no.1
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    • pp.24-30
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    • 1994
  • Nitric oxide(NO) synthase was identified and characterized by determining the L-citrulline formed in the NO-Arg pathway in pancreatic tissues. NO synthase activities in chicken pancreas were dependent upon the concentration of L-Arg which is the substrate molecule for the NO synthase, the amount of the enzyme protein used, and linearly on the incubation time. NO synthase in mouse pancreas was found to be constitutive, not induced by lipopolysaccharide treatment. In vitro NO synthase activities of chicken pancreas were inhibited 36%, 21%, 12% and 44% by $200\;{\mu}M$ of MMA, DMA, D'MA and NAME respectively. These results suggest the presence of NO and NO synthase in the pancreas.

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Effect of Several Drugs of DNA, RNA and Protein Damage induced by Dimethylnitrosamine in Mouse Tissues (수종약물이 Dimethylnitrosamine에 의한 DNA, RNA 및 단백질 손상도에 미치는 영향)

  • Kim, Jea-Hyun;Park, Jung-Sik;Hong, Sung-Ryul;Kweon, O-Cheul;Park, Chang-Won;Rhee, Dong-Kwon
    • YAKHAK HOEJI
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    • v.35 no.6
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    • pp.522-529
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    • 1991
  • The purpose of this research is to evaluate effects of chloramphenicol, phenobarbital and progesterone on damage of DNA, RNA and protein which was induced by dimethylnitrosamine. $N,N-Di[^{14}C]$ methyl-nitrosamine (DMN) was used as a damaging agent and levels of DNA, RNA and protein damage in liver, brain and pancreas were compared with a control group. Pretreatment of mice with chloramphenicol increased protein damage in pancreas two times more than the control level. Liver RNA damage was increased up to 5.8 times and brain DNA damage up to 6.95 times by treatment of phenobarbital but brain RNA damage was decreased significantly down to 21% of the control group. The damage of liver RNA was significantly decreased by treatment of progesterone, although liver protein damage, pancreas RNA damage and pancreas protein damage were increased.

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Fine Needle Aspiration Cytology of Solid and Papillary Neoplasm of the Pancreas -Report of a Case- (췌장의 고형성 유두상 암종의 세침흡인 세포학적 소견)

  • Cho, Mee-Yon;Lee, Kwang-Gil;Lee, Kyi-Beom;Jeong, Hyeun-Joo;Jung, Woo-Hee
    • The Korean Journal of Cytopathology
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    • v.1 no.1
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    • pp.85-92
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    • 1990
  • We present the cytologic features of a case of solid and papillary neoplasm of the pancreas. Cytologically, the tumor was composed of a monotonous population of polygonal cells containing eccentrically located round nuclei with one or two distinct small nucleoli and a finely stippled chromatin pattern. The tumor cells were similar to those of the islet cell tumor and showed isolated loosely aggregated and solid sheets or large cell clumps. The large cell clumps revealed a branching papillary structure containing fibrovascular central core, which is characteristic histologic feature of solid and papillary neoplasm of the pancreas. This case was confirmed by tissue examination including histochemical, immunohistochemical and electron microscopical studies. Ultrastructurally, the tumor cells contained a few membrane- bound electron dense granules.

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Effects of Nutritional Level on Digestive Enzyme Activities in the Pancreas and Small Intestine of Calves Slaughtered at Same Body Weight

  • Wang, X.B.;Ogawa, T.;Suda, S.;Taniguchi, K.;Uike, H.;Kumagai, H.;Mitani, K.
    • Asian-Australasian Journal of Animal Sciences
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    • v.11 no.4
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    • pp.375-380
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    • 1998
  • Six Holstein heifer calves weaned at 45 days-of-age were randomly allocated into high daily gain (1.1 kg/d, HDG) and low daily gain (0.56 kg/d, LDG) groups, and were slaughtered at 170 kg of live weight. Energy intake level in the feeding period was 2.4 $\times$ maintenance in 105 days for HDG and 1.4 $\times$ maintenance in 216 days for LDG calves. Total length of the small intestine was identical between groups, but both weights of the pancreas and of the small intestinal mucosa were greater (p < 0.01) for HDG calves. Alpha-amylase, lipase, proteinase, and trypsin activities of the whole pancreas were higher (p < 0.05) in HDG calves. Disaccharidase activity of the whole small intestinal mucosa was also higher (p < 0.10) for HDG than for LDG calves. However, the enzymatic activities, expressed as per gram or per protein of the pancreas and the small intestinal mucosa, were not affected (p > 0.10) by the plane of nutrition. These results suggest that the digestive enzyme activity in the small intestine varies primarily with the weight of tissues synthesizing the enzyme.

Solid and Papillary Epithelial Neoplasm of the Pancreas in Children (소아에서의 췌장의 고형유두상 상피성종양)

  • Choi, Seok-Ho;Kim, Dae-Yeon;Park, Kwi-Won;Jung, Sung-Eun;Lee, Seong-Cheol;Kim, Woo-Ki;Jang, Ja-Jun
    • Advances in pediatric surgery
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    • v.4 no.1
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    • pp.55-60
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    • 1998
  • Six children with solid and papillary epithelial neoplasm of the pancreas were studied retrospectively. There were 2 boys and 4 girls. The mean age at operation was 11 years(range; 8-13years). Three patients had incidental abdominal mass, in two patients the mass was non-tender, in one patient the mass was tender. The minimum size of tumor was $6.5{\times}6.0$ cm and the maximum was $10.5{\times}8.0$ cm. Five tumors were located in the head of the pancreas, and the other one in the tail. Local invasion or metastasis was not noticed. Tumors were removed completely by performing the following operations: 3 pylorous preserving pancreaticoduodenectomy, 2 Whipple's operation and 1 distal pancreatectomy. There was no mortality. The histologic findings were characteristic. There were no recurrences during a follow-up of 0.5 to 12 years (mean; 5.0 years).

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Immunohistochemical study on insulin, glucagon and somatostatin immunoreactive cells of the pancreas of the duck(Anas platyrhynchos platyrhyncos, Linne) (청둥오리 췌장의 insulin, glucagon 및 somatostatin 면역반응세포에 관한 연구)

  • Lee, Jae-hyun;Ku, Sae-kwang;Lee, Hyeung-sik
    • Korean Journal of Veterinary Research
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    • v.38 no.2
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    • pp.239-245
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    • 1998
  • The distributions and relative frequencies of insulin-, glucagon-, and somatostatin-immunoreactive cells in the pancreas of the duck(Anas platyrhynchos platyrhyncos, Linne) were investigated immunohistochemically on 23 days of incubation, at hatching, 1 week, 2 weeks, 3 weeks, 5 weeks, 6 weeks, 7 weeks, 9 weeks, 10 weeks, and 32 weeks after hatching. In the duck pancreas on 23 days of incubation and at hatching, mammalian type islets(mixed type) were only observed, thereafter three type's islets(mamalian, A and B type's islets) were identified. Insulin-immunoreactive cells were detected in central region of the islets, while glucagon- and somatostatin-immunoreactive cells were detected in marginal region of light(B type) or mammalian type islets, and in central region of dark islets(A type). Insulin-, and somatostatin-immunoreactive cells were also detected in the exocrine regions. In this region the insulin-immunoreactive cells were detected from 23 days of incubation to 6 weeks, however not detected after 7 weeks. At hatching the relative numbers of somatostatin-immunoreactive cells were more frequent than those of other groups, and then decreased with ages.

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