胰腺损伤的CT征象

目的 总结胰腺损伤的CT征象，评价CT在胰腺损伤中的诊断作用。方法 总结分析我院1997.5-2001.7间急性闭合性腹部外伤，经手术证实伴胰腺损伤的病例21例。其中男15例，女6例，年龄在7-50岁之间，平均年龄25.6岁。结果 在21例胰腺损伤中，7例首诊CT显示无明显异常，另14例胰腺损伤的CT表现有以下几种类型；（1）胰腺炎型：局限水肿型（6例），弥漫性急性胰腺炎型（3例）。（2）胰腺断裂型（4例）；CT平扫可见胰腺缺口和横行的低密度影；（3）胰腺血肿（1例）。在未进行手术处理的患者（４例），在随访CT见胰腺炎伴假性胰腺囊肿形成，胰周渗出表现17例，合并胰腺以外损伤15例，5/7例在早期CT影像中难以识别有无主胰管损伤。结论 胰腺损伤的CT征象包括；（1）直接征象；创伤后的胰腺弥漫性和局限性肿大，胰腺低密度裂口，胰腺内高密度影，随访中可见胰腺内假性囊肿形成，（2）间接征象；胰腺周围积液是重要的间接征象，主胰管损伤的CT诊断是困难的，胰腺创伤后立即CT检查可表现“正常”，合并伤也易导致诊断困难。对可疑病例随访是必要的。     

Rhythmic changes in protein synthesis induced in mouse pancreatic cells by food stimulation,alloxan diabetes,and isoproterenol

Department of Cytology, Faculty of Biology, M. V. Lomonosov Moscow State University. (Presented by Academician of the Academy of Medical Sciences of the USSR N. K. Permyakov.) Translated from Byulleten' Éksperimental'noi Biologii i Meditsiny, Vol. 111, No. 2, pp. 142–144, February, 1991.     

Are Criteria for Islet and Pancreas Donors Sufficiently Different to Minimize Competition?

Islet and pancreas transplantation may compete for a limited number of organs. We analyzed records from the national Swiss transplant registry during a 4-year period to investigate the proportion of donors that are suitable for islet and pancreas transplantation. Suitability for pancreas transplantation was mainly defined as: age 10-45 years; weight pancreas, islet transplantation, and both procedures, respectively. Giving priority to pancreas transplantation and accepting the absence of one selection criterion, 90 (28%) pancreas and 100 (31%) islet donors were identified. We conclude that with current allocation policies prioritizing pancreas transplantation, pancreas and islet transplantation may coexist with little competition.     

Morphological and functional changes induced by dalargin in the pancreas in the normal state and in experimental pancreatitis

Central Research Laboratory, Andizhan Medical Institute. Department of Pathomorphology, N. V. Sklifosovskii Moscow Emergency Aid Research Institute. (Presented by Academician of the Academy of Medical Sciences of the USSR D. S. Sarkisov.) Translated from Byulleten' Éksperimental'noi Biologii i Meditsiny, Vol. 105, No. 4, pp. 445–447, April, 1988.     

Risk Factors and Impact of Delayed Graft Function after Pancreas Transplants

Delayed graft function (DGF) occurs after many pancreas transplants (PTx), but is poorly characterized. We studied its incidence, course, and impact in a series of 531 pancreas transplants. Between January 1997 and September 2002, we performed 531 technically successful primary PTx. Of these 531 recipients, 176 (33%) had DGF, defined by their need for exogenous insulin at the time of hospital discharge. The incidence of DGF was roughly equivalent in the three transplant categories: SPK (36%), PAK (32%), and PTA (31%) (p = NS). By 3 months posttransplant, only 19 (3.5%) of all recipients remained on insulin. Only three recipients (0.56%) did not achieve insulin independence. The mean donor age of recipients with DGF was 35.1 years vs. 28.8 years without DGF (p = 0.003). By multivariate analysis, the most significant risk factor for DGF was donor age > 45 years (RR = 4.3, p = 0.0001). For SPK recipients with DGF, graft survival was 87% at 1 year and 82% at 3 years posttransplant; without DGF, 94% at 1 year and 87% at 3 years (p = 0.07). For PAK and PTA recipients, no difference was noted. Acute rejection rates were somewhat higher in recipients with DGF, but this did not reach statistical significance.     

供体抗原注入胸腺处理对大鼠胰腺移植功能存活的影响

在大鼠胰腺移植模型上将供体Ｗｉｓｔａｒ大鼠的脾细胞于移植前或移植时注入受体ＳＤ大鼠胸腺内，辅以短期免疫抑制剂，结果显示能明显延长胰腺移植物功能存活。崦单纯短期免疫抑制剂或单纯供体脾细胞注入胸腺均未能延长胰腺功能存活。提示供体脾细胞注入胸腺预处理延长胰腺功能存活效果优于移植时处理，但移植时处理可能更有实用价值。     

Pancreatic and duodenal ammonia in dogs: lowering by glucose infusion

Summary Ammonia is produced by some organs and removed by others. Glucose may influence ammonia formation. The contribution of the pancreas to ammonia metabolism is unknown. This study compares pancreatic and duodenal venous ammonia to arterial ammonia in dogs. Pancreatic venous ammonia exceeds arterial ammonia by a factor of 2.8 (range 1.3–9.3); and duodenal ammonia by a factor of 1.1 (range 0.9–2.8). Duodenal venous exceeds arterial ammonia by a factor of 2.4 (range 0.8–5.8). High-dose glucose infusion decreased pancreatic venous ammonia by approximately one-third and duodenal venous ammonia by approximately one quarter, but left arterial ammonia virtually unaltered. The mechanism of pancreatic ammonia production is unknown. We postulate that it may be related to pancreatic bicarbonate synthesis, binding the hydrogen ions which are liberated during this process.     

Management of chronic pancreatitis with pancreas cyst by endoscopic pancreatic prosthesis

Summary Cases of chronic pancreatitis accompanied by stenosis or dilation of the pancreatic duct were treated by endoscopic placement of an endoprosthesis and drainage. The purpose of the treatment was the alleviation of pain, restoration of extrapancreatic secretion and retardation of the progression of inflammation. The procedure was performed successfully in 9 of 13 patients, using an endoscopically placed pigtail prosthesis in the pancreatic duct. The successfully treated patients consisted of 9 cases of chronic pancreatitis, 2 cases being pancreas divisum. After disappearance of the symptoms and abnormal endoscopic findings, the drainage tubes were removed after a period of 5–12 months. No serious complications were encountered. Following the procedure, an improvement in appetite and increase of 2–13 kg in body weight was recognized. This method yielded satisfactory results in the treatment of chronic pancreatitis.     

抗人胎胰相关抗原单克隆抗体C1免疫组化研究

用人胎胰提取物免疫ＢＡＬＢ／ｃ小鼠，获得能稳定分泌ＩｇＧ２ａ单抗的杂交瘤细胞Ｃ１。免疫组化染色表明，Ｃ１与胎胰、胰腺癌、胃癌和大肠癌等组织有较强结合反应，与正常胰腺、十二指肠、胃、大肠等处的消化腺上皮细胞有轻度结合反应。初步表明，通过定量分析单抗，Ｃ１对消化道癌肿的诊断有一定参考价值。     

Comparative effects of secretin (SEC) and cholecystokinin-octapeptide (CCK-8) on pancreatic microcirculation

Using epifluorescent microscopy, we investigated the dynamic changes in pancreatic microcirculationin vivo after bolus administration of secretin (SEC) (0.1–10.0 µg/100 g body wt) and cholecystokinin-octapeptide (CCK-8) (0.005–1.2 µg/100 g body wt) in pentobarbital-anesthetized rats. Pancreatic capillary red cell velocity as a monitor for pancreatic capillary blood flow was measured in 1-min intervals from 2 min prior to 8 min following bolus infusion of SEC or CCK-8. Physiological concentrations of SEC did not increase pancreatic capillary blood flow. However, pharmacological SEC concentrations induced a dose-dependent increase in pancreatic capillary blood flow (to 162±19% of baseline;P<0.05), due to an increase in blood flow velocity (to 153±18% of baseline;P<0.05). In contrast, bolus administration of physiological CCK-8 concentrations, which have been proven to stimulate enzyme secretion, induced a transient and dose-dependent increase in pancreatic capillary blood flow (to 235±24% of baseline;P<0.05), due to an increase in blood flow velocity (to 184±13% of baseline;P<0.05) and capillary diameters (+0.63 ± 0.15 µm;P<0.05).