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At least 19 recordsLinked to original sources
PubMed1977

Detection of bacterial infection of the pancreatic ducts in patients with pancreatitis and pancreatic cancer during endoscopic cannulation of the pancreatic duct.

Bacterial infections of the pancreas and bacteremia may occur during episodes of pancreatitis. Detection of bacterial infections of the pancreas in the past has required laparotomy. The present study was undertaken to determine whether bacterial infection of the pancreas occurred during nonsuppurative pancreatitis. During endoscopic cannulation of the main pancreatic duct, secretin was administered intravenously and pancreatic juice aspirated from within the duct was cultured. Bacterial infections were detected in 11 of 35 patients with pancreatitis and 3 of 5 with pancreatic cancer. The pancreatic juice was sterile in 25 controls. Cultures from the common bile duct in 9 controls were also sterile whereas 4 of 6 with pancreatitis showed infected bile. The infecting organisms were principally gram-negative and the infections were usually polymicrobial. Antibiotics, where used, successfully eradicated the infecting organisms but did not appear to affect the patient's clinical course.

Adult↗
PubMed1979

Studies on pancreatic duct system. II Comparative study of histological features, and three-dimensional reconstruction of pancreatic ducts.

Three-dimensional reconstruction of pancreatic ducts were made from specimens of pancreases from chronic pancreatic injury dogs following adjuvant injection, one patient with chronic non-alcoholic pancreatitis, and 2 patients with chronic alcoholic pancreatitis. The ductal alterations of alcoholic pancreatitis showed more apparent changes than those of non-alcoholic pancreatitis. The lesions in experiment such as uneven surface, irregular dilatation, tortuosity, and anastomosis, resembled to those of alocholic calcifying pancreatitis. Although gross appearance of the reconstructed ducts in advanced cases of experimental pancreatic injury revealed some resemblance to that of alcoholic calcifying pancreatitis, histologically, the epithelial changes of the former were different from those of the latter. Thus we concluded that more complicated factors than those considered in experiment play a role in combination in the pathogenesis of bead-like dilatation of the pancreatic ducts of chronic pancreatitis.

Alcoholism↗
PubMed1979

Pancreatic duct ligation in the therapy of chronic pancreatitis.

Total ligation of the pancreatic ducts of a normal gland in dogs and man results in atrophy of the acinar cells with preservation of islet cell function. Theoretically, this might be applied in the therapy of chronic pancreatitis since, in effect, an exocrine pancreatectomy results. Sustained islet cell function, as evidenced by a normal glucose tolerance test, following pancreatic duct ligation, was demonstrated in dogs for periods of up to two years. Resection of the head of the pancreas and ligation of the distal gland in six patients with chronic pancreatitis and an abnormal glucose tolerance test resulted in the development of insulin-dependent diabetes in all instances. Insulin-dependent diabetes was also demonstrated in one patient with a normal preoperative glucose tolerance test. Recurrent pancreatitis developed in only one patient. The study suggests that pancreatic duct ligation is effective in treating chronic pancreatitis but casts considerable doubt on the effectiveness of this procedure in preventing the development of diabetes, if the glucose tolerance test is abnormal

Adult↗
PubMed1978

Biochemical studies of pancreatic juice collected by duodenal aspiration and endoscopic cannulation of the main pancreatic duct.

Biochemical studies of pancreatic juice collected by duodenal aspiration and endoscopic cannulation of the main pancreatic duct were performed and compared in the same fasted normal subjects in seven cases. The comparison of the results shows that under the same stimulation (0.5 CU/kg/hr of GIH secretin and 75 ng/kg/hr of cerulein) the endoscopic cannulation of the main pancreatic duct provides the best values for the maximal secretory capacity. On the other hand, this technique is no better than our current method of duodenal aspiration for the exploration of the enzyme secretion.

Adult↗
PubMed1979

Clinical relevance of an unfused pancreatic duct system.

In man, the main pancreatic duct is normally derived from ventral and dorsal embryological buds of the pancreas. In a minority of people, failure of fusion of the two buds results in separate drainage of the dorsal and ventral pancreas, so that the accessory duct provides the main drainage for the gland. Patients with this anomaly demonstrated at endoscopic retrograde pancreatography (ERP) have been investigated to assess whether non-fusion of the main pancreatic duct predisposes to the development of pancreatitis. A failure of fusion of the pancreatic ducts was seen in 21 out of 449 (4.7%) successful pancreatograms; four of these 21 patients had definite clinical evidence of pancreatitis and two patients had possible pancreatic disease, but in the remainder the anomaly was not considered to be clinically relevant. An abnormal pancreatogram suggesting pancreatitis was present in 116 out of the 428 patients (27.1%) with a normally fused duct system. The anomaly was found as frequently in the whole series as it was seen in patients with pancreatitis. These findings suggest that embryological failure of pancreatic duct fusion does not predispose to the development of pancreatitis. However, the presence of this anomaly may lead to misinterpretation of ultrasonographic and CT scan findings.

Adolescent↗
PubMed2026

Loss of function of ALDH3B2 transdifferentiates human pancreatic duct cells into β-like cells.

Replenishment of pancreatic β cells is key to a cure for diabetes. β cell regeneration is achieved predominantly by self-replication, especially in rodents, but it was also shown that pancreatic duct cells can transdifferentiate into β cells. How pancreatic duct cells are transdifferentiated and whether we can manipulate transdifferentiation to replenish β cell mass are not well understood. Using a genome-wide clustered regularly interspaced short palindromic repeats (CRISPR) screen, we found that the loss of function of aldehyde dehydrogenase family 3 member B2 (ALDH3B2) was sufficient to transdifferentiate cell line-based and human pancreatic duct cells into functional β-like cells. The transdifferentiated cells had substantially increased the expression of β cell marker genes, secreted insulin in response to glucose, and lowered blood glucose to near normal for 6 weeks after transplantation into streptozotocin-induced diabetic mice under the kidney capsule. Our study identifies a gene that could potentially be targeted in human pancreatic duct cells to replenish β cell mass for diabetes therapy.

Humans↗
PubMed1979

Ultrasonic demonstration of the pancreatic duct: an analysis of 41 cases.

Ultrasonically visualized pancreatic ducts seen in patients over two and a half years were reviewed. Pancreatic ducts ranging from 2 to 16 mm were identified in 41 patients. All proved to have pancreatic disease. Of these, 25 had inflammatory disease, including acute pancreatitis, chronic pancreatitis, and pancreatolithiasis, and 16 had ampullary or pancreatic head tumors. There was no correlation between the pancreatic duct diameter and the underlying pathology. A careful search for tumor must be made in all patients in whom the pancreatic duct is demonstrated, using current gray-scale instrumentation.

Acute Disease↗
PubMed1979

The pancreatic duct mucosal barrier.

The main pancreatic duct in cats possesses a relatively strong barrier to the diffusion of bicarbonate ions (HCO3-). We studied some of the characteristics of this barrier by perfusing the duct with a solution similar in composition to pancreatic juice before and after exposing the duct mucosa to various test agents. The difference in net flux of HCO3- across the duct before and after exposure to the test agent reflected damage to the barrier. The barrier was damaged by infected bile, aspirin (pH 2.3), hydrochloric acid (pH 2.3), ethanol (5 to 10 per cent), and secondary bile acids. It was not damged by sterile bile, aspirin (pH 6.5), and primary bile acids. These data indicate that the barrier to back diffusion in the pancreatic duct has unique properties, different in some respects from the properties of the gastric mucosal barrier. Furthermore, the barrier is vulnerable to some agents thought possibly to have a role in the pathogenesis of pancreatitis and pancreatic cancer.

Animals↗
PubMed1977

[Practical use of external drainage of the pancreatic duct].

The authors have employed external drainage of the pancreatic duct in 96 patients. Pancreaticostomy was performed with prophylactic and therapeutic purposes. Prophylactic pancreaticostomy after the Doubilet technic was accomplished in all cases of papillosphincteroplasty. In case of evident stenosis of the pancreatic duct ostimum (6 patients) papillosphinctero-wirsungoplasty with external drainage of the duct was performed. In acute pancreatitis pancreaticostomy would contribute to prompt normalization of pancreatic enzymes and subsidence of the inflammatory process. In chronic pancreatitis with involvement of the duct system along with papillosphinctero-wirsungoplasty and transpapillary drainage of the pancreatic duct terminal portion also cystodigestive and pancreaticodigestive anastomoses were constructed with external transanastomosis transenteric (after the Folker technic) drainage of the cyst cavity of pancreatic duct.

Drainage↗
PubMed2024

Loss-of-function of ALDH3B2 transdifferentiates human pancreatic duct cells into beta-like cells.

Replenishment of pancreatic beta cells is a key to the cure for diabetes. Beta cells regeneration is achieved predominantly by self-replication especially in rodents, but it was also shown that pancreatic duct cells can transdifferentiate into beta cells. How pancreatic duct cells undergo transdifferentiated and whether we could manipulate the transdifferentiation to replenish beta cell mass is not well understood. Using a genome-wide CRISPR screen, we discovered that loss-of-function of ALDH3B2 is sufficient to transdifferentiate human pancreatic duct cells into functional beta-like cells. The transdifferentiated cells have significant increase in beta cell marker genes expression, secrete insulin in response to glucose, and reduce blood glucose when transplanted into diabetic mice. Our study identifies a novel gene that could potentially be targeted in human pancreatic duct cells to replenish beta cell mass for diabetes therapy.

Journal Article↗
PubMed1979

Significance of a dilated pancreatic duct on CT examination.

The infrequency of reports demonstrating dilatation of the pancreatic ducts in patients with chronic pancreatitis by CT, despite its frequent demonstration on endoscopic retrograde cholangiopancreatography (ERCP), prompted a review of 500 cases performed at the University of Miami School of Medicine/Jackson Memorial Hospital for suspected pancreatic disease. Pancreatic duct dilatation was demonstrated in 10 patients. An equal occurrence was documented in patients with chronic pancreatitis and with carcinoma. Therefore, the presence of dilated pancreatic duct only confirms the presence of pancreatic disease. No etiology should be favored by the isolated finding of a dilated duct on CT scanning.

Chronic Disease↗
PubMed1978

Pancreatic secretion obtained by endoscopic cannulation of the main pancreatic duct and secretin release after duodenal acidification in man.

The main pancreatic duct was cannulated in 12 individuals with a teflon catheter by means of a side-viewing duodenscope. Six individuals received a duodenal infusion of 40 ml 100 mmol/l HCl over 5 min, while the other six served as controls for basal pancreatic secretion. Pancreatic juice was collected in 5-min samples, and blood was frequently drawn for radioimmunoassay of immunoreactive secretin (IRS). In the control group, during 20-min cannulation of the main pancreatic duct, no effect was seen on basal secretion of water, bicarbonate, or alpha-amylase--nor did the IRS levels change. After duodenal acidification there was a significant increase in IRS (p less than 0.02), reaching the highest level at 7 min. The mean flow rate, bicarbonate concentration, and bicarbonate output showed a significant increase as compared to the control group (p less than 0.02), the highest levels being reached in the third 5-min period after the start of the duodenal acidification. The alpha-amylase output was also significantly higher after acidification (p less than 0.02) than in the control group, but the mean alpha-amylase concentration decreased after acidification, reaching its nadir in the third 5-min sample (p less than 0.02). The present results demonstrate a basal and HCl-stimulated pancreatic secretion collected by endoscopic cannulation of the main pancreatic duct in man together with plasma IRS levels.

Adult↗
PubMed1979

Ultrasonographic demonstration of the pancreatic duct.

During a 4-year period, 375 patients with clinically suggestive pancreatic disease were examined with gray scale ultrasound. In 14 patients, the pancreatic duct itself was demonstrated. All of these had clinical or laboratory evidence for, and radiologically or surgically proven, pancreatic duct obstruction. Etiology of the obstruction was either tumor, chronic pancreatitis, pancreatic abscess, pseudocyst, or stricture of the duct at the papilla of Vater. Two patients had Crohn's disease of the duodenum.

Adult↗
PubMed1977

Carcinogenesis in the pancreas. I. Long-term explant culture of human and bovine pancreatic ducts.

Bovine and human pancreatic ductal explants were maintained in long-term culture. Bovine ducts were cultured for 85 days, whereas human ducts have been cultured for up to 60 days. The explants all maintained good ultrastructural preservation for these periods and also incorporated radioactive precursors into protein, RNA, and DNA. Uncultured ducts, which were fixed for electron micrsoscopic study, demonstrated classical signs of reversible cell injury (dilated endoplasmic reticulum and swollen mitochondria), and cultured explants did not. However, the cultured tissues did show sublethal alterations such as the formation of numerous autophagic vacuoles and residual bodies and the accumulation of large lipid droplets. This study demonstrated the feasibility of maintaining pancreatic ducts in long-term explant culture, which enables them to be used in experimental studies involving chemical carcinogens and in structural and functional studies.

Animals↗
PubMed1979

Pancreatic duct arteriovenous fistula and the metastatic fat necrosis syndrome.

This report summarizes the course of a patient with asymptomatic chronic pancreatitis associated with hemorrhage into the pancreatic duct and metastatic fat necrosis. Retrograde cannulation of the pancreatic duct and superior mesenteric arteriography established the presence of a pseudocyst with a pancreatic duct-arteriovenous (DAV) fistula as the cause of the syndrome. Ligation of feeder vessels with external drainage of the cyst as the initial surgical procedure stopped the bleeding but failed to prevent recurrence of the pancreatic duct-venous fistula. A pancreaticoduodenectomy with resection of the cyst and fistula was required to arrest destruction of distant tissues. Although serum and urine amylase concentrations were markedly elevated, serum lipase levels were normal throughout the patient's course. Elevation of serum lipase does not seem to be a necessary condition for the development of the metastatic fat necrosis syndrome.

Adult↗