Fig 7 - uploaded by Mark Kidd
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Nicholas Senn of Chicago was an early pioneer of experimental surgical research, and his contributions to the evolution of pancreatic surgery were particularly noteworthy. Despite his enthusiasm for the area, his evaluation of contemporary work in the field led him to a pessimistic conclusion regarding the viability of pancreatic surgery. As a prescient, thoug~ttful individual he cautioned his colleagues as to the utility of surgery for pancreatic disease.
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The evolution of surgery for pancreatitic disease has been arduous owing to the technical difficulties of addressing the organ and the lack of understanding the mechanisms of the disease processes involving it. In particular, the tardy advance of surgery in the management of chronic pancreatitis exemplifies these problems. Because no specific targe...
Context in source publication
Context 1
... of the problems of pancreatic disease, Nicholas Senn ) in 1886 commented in one of his earliest papers, "The surgery of the pancreas, as based upon experiments and clinical research," on what he recognized as a vexatious problem (Fig. 7). Senn demonstrated that experimental extirpation of the pancreas in animals was "invariably followed by death" [42]. Although prior experiments by Brunner in 1672and Mering (1849-1908) in 1889 had not drawn such an absolute conclusion [43]. Nevertheless, it was evident to surgeons of any experience that most pancreatic surgery (whether ...
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Citations
... Ключові слова: жовчева кислота TLC-S (сульфат тауролітохолевої кислоти), піруват, аланін, ацинарні клітини підшлункової залози, виживаність, мембранний потенціал мітохондрій Найпоширенішою формою гострого панкреатиту є біліарний панкреатит. Він виникає внаслідок того, що жовчне каміння закупорює сфінктер Одді та призводить до біліарно-панкреатичного рефлюксу [1]. ...
To investigate the mechanism of action of bile acids, TLC-S, the viability of pancreatic acinar cells, and the level of mitochondrial membrane potential were studied using various oxidation substrates. The experiments were conducted on male Wistar rats weighing 250–300 g. A suspension of isolated pancreatic acinar cells was obtained using collagenase (type IV, 0.2 mg/ml). The trypan blue exclusion test assessed cell viability after isolation and the amount was >90 %. The survival of acinar cells after prolonged incubation in different environments was determined by fluorescent dyes propidium iodide (0.5 mg/ml) and Hoechst 33258 (5 mg/ml) dyes. Mitochondrial membrane potential was recorded by adding the dye TMRM (50 nM). Cells were photographed using an inverted microscope Olympus IX73 with a digital camera DP-74. Cell counting and fluorescence intensity of TMRM were analyzed using ImageJ software. It was found that the presence of TLC-S in the medium at a concentration of 0.5 mmol/L, when used as an oxidation substrate for glucose (10 mmol/L), pyruvate (2 mmol/L), or alanine (2 mmol/L), did not significantly affect the proportion of live cells after 2 and 4 hours of incubation. However, when TLC-S was added to the medium at a concentration of 2 mmol/L, the proportion of live cells significantly decreased. This decrease was least pronounced during pyruvate oxidation. Under the action of TLC-S (after 25 min) in the presence of glucose alone, the mitochondrial membrane potential decreased by 9.8 % (P<0.05, n=3), in the presence of alanine (in the presence of glucose) – by 23.5 % (P<0.05, n=4). When pyruvate was added to the medium (in the presence of glucose), the mitochondrial membrane potential likely did not change significantly. These results suggest the presence of several different mechanisms of TLC-S’s negative effects on pancreatic acinar cells: at low concentrations (or at early stages), it disrupts alanine transamination reactions, leading to the disruption of mitochondrial membrane potential generation, while at high concentrations, it affects the integrity of plasma and/or intracellular membranes.
... Writing on a 'singular case of diabetes. . .' in the London Medical Journal in 1788 (sourced from reference 9 in [1]), Cawley describes 'AH, aged 34, strong, healthy and corpulent, accustomed to free living and strong corporeal exertions in the pursuit of country amusements, was seized with diabetes. . .. . ...
The functional mass of beta-cells is decreased in type 2 diabetes. Replacing missing beta-cells or triggering their regeneration may thus allow for improved treatment of type 2 diabetes, to the extent that this is combined with therapy for improved insulin sensitivity. Although progress has been made in deriving beta-cell-like cells from stem or precursor cells in vitro, these cannot yet be obtained in sufficient quantities or well enough differentiated to envisage their therapeutic use in beta-cell replacement therapy. Likewise, our very limited understanding of beta-cell regeneration in adult man does not yet allow for development of a valid strategy for kick-starting such a process in individuals with type 2 diabetes, whether by bona fide neogenesis or self-replication of existing beta-cells. Regardless of how beta-cell mass is restored in type 2 diabetes, it will be important to prevent any renewed decrease thereafter. Current understanding suggests that islet inflammation as well as signals from (insulin-resistant/inflamed) adipose tissue and skeletal muscle contribute towards decreased beta-cell mass in type 2 diabetes. It will likely be important to protect newly formed or implanted beta-cells from these negative influences to ensure their long-term survival.
Dr. Charles Bernard Puestow (1902-1973) was an American surgeon who is well known for developing the longitudinal pancreaticojejunostomy, which is known as the "Puestow procedure" in his honor. Puestow served in the American military during the Second World War and commanded the 27th Evacuation Hospital, which provided medical and surgical services to wounded individuals in Europe and North Africa. In 1946, he founded the surgical residency training program at the Hines Veterans Hospital, which was the first such program in the United States based at a veterans hospital.
Resumen Abstract In 1879, the Gaceta Medica de Mexico published Dr. Pablo Gutiérrez's work, a notable Mexican physician of the XIX century, about Diabetes Sacarina. The purpose of the present communication is to identify, on the basis of that publication, the development reached by medicine by the end of the XIX century with regard to Diabetes Mellitus and its treatment.
