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  • 1
    Electronic Resource
    Electronic Resource
    [s.l.] : Nature Publishing Group
    Nature 256 (1975), S. 731-732 
    ISSN: 1476-4687
    Source: Nature Archives 1869 - 2009
    Topics: Biology , Chemistry and Pharmacology , Medicine , Natural Sciences in General , Physics
    Notes: [Auszug] The pancreases were removed from 6 to 24-week-old human foetuses obtained immediately after legal abortion, or from deceased premature infants. After fixation for 2 or 3 d in Bouin-Holland fluid, without acetic acid, and with 5% saturated Hg sublimate added, the tissues were carefully washed in ...
    Type of Medium: Electronic Resource
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  • 2
    Electronic Resource
    Electronic Resource
    Springer
    Langenbeck's archives of surgery 340 (1976), S. 231-247 
    ISSN: 1435-2451
    Keywords: Pancreatitis, acute ; Pancreatectomy, total
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Die verbesserte Diagnostik mit frühzeitiger Operation - meist als partielle Pankreatektomie-hat zur eindeutigen Verbesserung der Prognose der akuten nekrotisierenden Pankreatitis geführt. Die Erfahrung hat die Gefahr eines Operationsaufschubs, die fragwürdige Wirksamkeit der Enzyminhibitoren und die Unzulänglichkeit einfacher Drainageverfahren gezeigt. In Prof. Poilleux's Klinik wurden in den letzten 6 Jahren 32 Patienten mit akut nekrotisierender Pankreatitis behandelt. Es wurde die Taktik immer ausgedehnterer Pankreasresektionen - je nach Ausdehnung der Drüsennekrosen - verfolgt. In Fällen mit ausgedehnten Läsionen ziehen wir die sofortige Pankreatektomie vor. Hier wird an Hand von 9 Fällen über Indikation, Technik und Ergebnisse der totalen Pankreatektomie berichtet.
    Notes: Summary The place of total pancreatectomy in the treatment of pancreatitis is still not clear: the author is in favour of this operation and gives the indications, surgical technique, complications and results. The operation is indicated in cases of necrosis involving more than $${\raise0.5ex\hbox{$\scriptstyle 2$}\kern-0.1em/\kern-0.15em\lower0.25ex\hbox{$\scriptstyle 3$}}$$ rds of the gland, or the whole of the head and part of the body of the pancreas. The duodenum and pancreas should be removed in one piece and intestinal continuity should be restored performing choledocho-jejunal and gastro-jejunal anastomoses. It is important to carry out this operation early, between the 3rd and 6th days, treating all areas of necrosis before the lesions become the site of uncontrollable infection. Seven patients out of 9 are still alive, on the 25th of July 1975; they all have easily controlled diabetes, a low fat diet and are receiving pancreatic extract. We have recently operated a 10th case, and the patient is alive 2 months later.
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  • 3
    ISSN: 1432-0428
    Keywords: Metformin ; lactic acidosis ; acute renal failure ; blood alanine ; pyruvate ; 3-hydroxybutyrate ; acetoacetate
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Lactic acidosis occourred in 6 metformin-treated diabetic patients. Five of them had received 1.6 to 2.4 g metformin per day over a period of weeks or years. Acute renal failure, induced by i. v. pyelography, arteriography, or severe dehydration, preceded lactic acidosis by a few days and apparently precipitated it. The sixth patient had normal renal function prior to taking a massive overdose of metformin in an attempt at suicide. The metabolic pattern was very similar to that observed in phenformin-induced lactic acidosis: severe metabolic acidosis (pH: 7.02±0.95; HCO 3 − : 6.3±0.9 mmol/l; PaCO2: 25±4 mmHg; PaO2: 110±19 mmHg); hyperlactataemia (18.4±3.3 mmol/l) and high lactate/pyruvate ratio (51±5); high blood alanine (2.82±1.10 mmol/l); high 3-hydroxybutyrate (15.8±3.3 mmol/l) and high 3-hydroxybutyrate/ acetoacetate ratio (26±10). Hypoglycaemia (25 to 60 mg per 100 ml) was observed in 4 patients, in spite of high glucagon (760±148 pg/ml) and low insulin (13±5μU/ml) levels. A guanidine substance was characterized in the plasma at concentrations 45 to 110 μg/ml; it was similar to metformin and distinct from creatinine, according to chromatographic and other criteria; its concentration in the plasma decreased during dialysis, and the same substance appeared in the dialysis effluent. The treatment included massive alkalinization (710 ±130 mmol/l i. v. for 48 h), plasma volume expanders (5630±1000 ml/48 h), forced-diuresis and/or dialysis, insulin (30±10 U/48 h) and glucose (300 ±50 g/48 h). — It is concluded that: 1. metformin, like other biguanides, can induce lactic acidosis; 2. acute renal failure is a prominent causal factor; 3. pharmacokinetics of metformin account for this fact since metformin cannot be inactivated by the liver (as distinct from phenformin) and is normally excreted by the kidney; 4. accumulation of biguanide is suggested by guanidine assay in the plasma; 5. metformin should not be prescribed in the presence of renal failure.
    Type of Medium: Electronic Resource
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  • 4
    ISSN: 1432-0428
    Keywords: Colchicine ; vincristine ; puromycin ; cycloheximide ; cytochalasin B ; microfilaments ; microtubules ; glucagon ; A2 cell
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary In order to document the cytophysiology of glucagon release by A2 cells, isolated perfused rat pancreases were stimulated by arginine after exposure to colchicine, vincristine, cytochalasin B, cycloheximide and puromycin. Colchicine, 10−4 mol/l, enhanced the early phase of glucagon release after a short exposure time (35 min). This potentiation vanished with longer exposure (45 to 100 min) and was replaced by a reduction in glucagon release, affecting both phases of secretion, but more the second phase than the first. When exposure time was kept constant (45 min) and the concentration of colchicine varied, a similar potentiating effect was observed for colchicine 10−7 mol/l (first phase) and 10−6 mol/l (both phases); an inhibitory influence was apparent with higher concentrations (10−5 to 10−3 mol/l) affecting mainly the second phase of release. Similar results were obtained with vincristine, 10−5 mol/l (infused for 35 to 100 min) and vincristine 10−8 to 10−4 mol/l, after a constant 45 min exposure. These findings are compatible with a participation of microtubules in the dynamics of glucagon release: a reduction of both phases of secretion being caused by an extended disruption in the microtubular apparatus, whereas more limited disturbance of this system is associated with facilitated glucagon release. Cytochalasin B, 10 μg/ml, potentiated the A2 cell response to arginine and the basal glucagon release in the presence of glucose 4.4 mmol/l. Puromycin 100 μg/ml and cycloheximide 0.5 mg/ml reduced selectively the second phase of glucagon release; cycloheximide, 1 mg/ml, completely inhibited the basal release, and the early and late phases of the arginine-stimulated release. These results suggest that emiocytosis in A2 cells is very similar to that in B cells. The specificity of antitubulins and other agents as dissecting tools for the secretory process depends upon the experimental conditions.
    Type of Medium: Electronic Resource
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  • 5
    ISSN: 1432-0428
    Keywords: Plasma amino acids ; liver gluconeogenesis ; glucose ; insulin ; glucagon ; cortisol ; fetus ; newborn ; rat
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The present study examines the role of insulin, glucagon and cortisol in the regulation of gluconeogenesis from lactate and amino acids in fetal and newborn rats. Injection of glucagon in the fullterm fetal rat caused a rise in glucose (and insulin) and a fall in blood levels of most individual amino acids, stimulated hepatic accumulation of 14C-amino isobutyric acid and 14C-cycloleucine and increased the conversion of 14C lactate, alanine and serine to glucose in vivo and in vitro (liver slices). Such changes were equivalent to the changes seen in 4 h old newborn rats. When glucagon was administered at birth, little difference was observed between control and treated animals in plasma amino acids and a smaller increment in conversion of 14C substrate to glucose occurred. By contrast, insulin injection at birth caused hypoglycemia, suppression of levels of certain amino acids and inhibition of conversion of 14C substrates into glucose. Glucose injection at birth caused elevated glycemia and plasma insulin and suppression of most amino acid levels and of conversion of 14C substrate into glucose. Cortisol injection at birth caused a marked, generalized hyperaminoacidemia, a stimulation of glucagon secretion and of conversion of 14C substrates into glucose. These observations support the thesis that glucagon plays a major role in the induction of hepatic gluconeogenesis and that insulin acts as an antagonist hormone.
    Type of Medium: Electronic Resource
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  • 6
    Electronic Resource
    Electronic Resource
    Springer
    Diabetologia 14 (1978), S. 261-267 
    ISSN: 1432-0428
    Keywords: Lactic acidosis ; phenformin ; biguanides
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary An experimental model of phenformininduced lactic acidosis was established in rats. Following a subtotal nephrectomy, renal failure developed (serum creatinine 4.5±0.1mg/100ml and 2.8±0.1 mg/100 ml on the 1st and 8th postoperative days respectively). Immediately after nephrectomy intra-peritoneal phenformin treatment, 16 mg/day, was commenced. Lactic acidosis developed progressively within 8 days, or earlier in the rats with the most severe renal insufficiency. The metabolic pattern was very similar to that observed in diabetic patients with a biguanide-induced lactic acidosis: on the 8th day, 2 h after the last phenformin injection, blood lactate was 10.8±1.0 mmol/1 (controls: 1.50±0.03); pyruvate was 0.56±0.06 mmol/1 (controls: 0.10±0.01) and blood pH: 7.00 ± 0.02 (vs 7.34±0.02); 3-hydroxybutyrate was 1.41±0.37 mmol/1 (vs 0.32 ±0.03); acetoacetate: 0.51±0.15 mmol/1 (vs 0.17 ±0.01), and free glycerol: 0.63 ±0.07 mmol/1 (vs 0.14 ±0.02). Increased concentrations of alanine (1.66±0.26 mmol/1, vs 0.48 ± 0.04 in controls) and low blood glucose levels (23± 8 mg/ 100 ml vs 70 ± 2, after a 12 hours fast) accompanied the lactic acidosis in spite of high glucagon levels (2030±170 pg/ml vs 108±10 in controls) and low insulin/glucagon molar ratio (0.19 vs 6.9 in controls). Normal rats, treated with phenformin at same doses, and nephrectomized rats injected with saline served as controls and remained free of lactic acidosis. Hydroxyphenformin (16 mg/day) injected in nephrectomized rats, was biologically inactive. Glucose production from14C-lactate was 425 ±85 μmol/100 g body wt/h, vs 1050 ± 90 in control animals. Blood lactate specific activity declined more slowly in the lactic acidotic rats than in controls, suggesting that a decrease in lactate utilization contributed to hyperlactataemia more than an increased lactate production.
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