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  • 1
    Electronic Resource
    Electronic Resource
    Modified intra-arterial calcium stimulation with venous sampling test for preoperative localization of insulinomas (1998)
    Springer
    Abdominal imaging 23 (1998), S. 322-331 
    Details
    ISSN: 1432-0509
    Keywords: Key words: Pancreas angiography—Pancreas neoplasms—Venous blood sampling—Hormones.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. Background: To determine the accuracy and safety of a modified intra-arterial calcium stimulation with the venous sampling test (ASVS) for preoperative localization of insulinomas. Modification included stimulation with a fixed low dose of calcium gluconate, additional stimulation in the distal splenic artery, and no insulin sampling in the left hepatic vein. Methods: In 10 patients showing biochemical evidence of organic hyperinsulinemia, 0.45 mmol of Ca2+ was injected into the gastroduodenal, superior mesenteric, proper hepatic, proximal, and distal splenic arteries during angiography. Insulin levels were measured in samples taken from the right hepatic vein before and 30, 60, 90, 120, 180, and 300 s after Ca2+ injection. Results: Insulin gradients with an increase of more than fourfold indicated direct tumor supply, two- to fourfold correlated with collateral supply, and less than twofold correlated with normal tissue vascularization. ASVS localized all the adenomas of the pancreatic head (n = 3) and body (n = 2) and two of four adenomas of the tail correctly, as confirmed by surgery. Two adenomas of the proximal pancreatic tail were erroneously localized to the body segment, but the fault was rectified by angiography. In one patient with a negative ASVS and without exploration, the diagnosis of an insulinoma was revised. Conclusion: ASVS with a fixed low dose of calcium gluconate is a highly accurate and safe method for preoperative localization of insulinomas. Sampling in the left hepatic vein can be routinely omitted. Additional stimulation in the distal splenic artery seems helpful in surgical decision making, but additional experience is needed.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002619900350
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  • 2
    Electronic Resource
    Electronic Resource
    Die Beziehung zwischen implantierter Betazellmasse und metabolischer Stoffwechsellage nach Transplantation pankreatischer Fragmente beim Hund (1987)
    Springer
    Langenbeck's archives of surgery 370 (1987), S. 211-221 
    Details
    ISSN: 1435-2451
    Keywords: Islet transplantation ; Dogs ; Metabolic function
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Die Pancreata von 20 Hunden wurden total excidiert, mittels einer intraductalen Kollagenaseperfusionstechnik und mechanischer Zerkleinerung zu insulinproduzierenden Pankreasfragmenten verarbeitet und als Autotransplantat in die Milz eines jeden Tieres mittels intravenösem Reflux in die V. lienalis injiziert. Bei 75% aller transplantierten Tiere wurde eine langfristige normoglykämische Stoffwechsellage hergestellt, wobei die Glucosetoleranzteste im Vergleich zu 13 Kontrolltieren pathologisch verändert waren. Der Milzinsulingehalt der erfolgreich transplantierten Tiere war auf ca. 5 bis 15% des urspünglichen Pankreasinsulingehaltes reduziert, was für die Funktionseinschränkung verantwortlich sein dürfte. Die angewandte intraductale Kollagenaseperfusionstechnik ist eine zuverlässige Methode zur Wiederherstellung einer normoglykämischen Stoffwechsellage nach totaler Pankreatektomie im Autotransplantationsmodell. Zur Steigerung der Funktionsfähigkeit des Inseltransplantates ist eine erhöhte Inselimplantationsrate erforderlich.
    Notes: Summary 20 dogs underwent total pancreatectomy. Pancreatic fragments were produced using an intraductal collagenase perfusion technique and mechanical disruption of the pancreatic gland. The resulting tissue suspension was transplanted as an autotransplant to the spleen of each animal by intravenous reflux injection into the splenic vein. In 75% of all transplanted animals long-term function with normoglycemia was restored while i.v. glucose tolerance tests were impaired as compared to 13 controls. The spleen insulin content of these sucessfully transplanted animals corresponded to only 5 to 15% of the original pancreas insulin content which was responsible for the reduced function. Intraductal collagenase perfusion is a reliable method to restore normoglycemia after total pancreatectomy in the autotransplant model using pancreatic fragments. To improve the metabolic function of the islet transplant an increased number of islets has to be implanted.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01259309
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  • 3
    Electronic Resource
    Electronic Resource
    In-vitro- und In-vivo-Studien zur Isolierung, Transplantation und Funktion von Langerhans-Inseln am Schwein (1990)
    Springer
    Langenbeck's archives of surgery 375 (1990), S. 259-265 
    Details
    ISSN: 1435-2451
    Keywords: Islets of Langerhans transplantation ; Pig
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Grenzen und Möglichkeiten der Transplantation von Langerhans-Inseln wurden am Schwein erprobt. Nach totaler Pankreatektomie wurden durch intraduktale Kollagenaseandauung zwischen 6mal 104 and 3mal 106 Inseln and inseltragende Fragmente pro Pankreas gewonnen. Nach Injektion des Transplantates in die Milz oder wahlweise in die Leber konnte bei den Tieren ein normoglykämischer Zustand mit normalen intravenösen Glukosetoleranztesten und ein Überleben bis zu 1 Jahr erreicht werden. Apankreatische Kontrollen verstarben im diabetischen Koma 10–12 Tage postoperativ. Eine gute Korrelation zwischen der Anzahl transplantierter Inseln und Normoglykämie nach Transplantation konnte demonstriert werden. Darüber hinaus war die synchrone In-vitro-Stimulation der Inseln mit Glukose und die daraus resultierende Inselsekretion ein wichtiger Indikator für die funktionelle Integrität der Inseln nach der Transplantation. Das Schwein bietet somit auch aufgrund der dem Menschen sehr ähnlichen immunologischen, physiologischen und anatomischen Eigenschaften bezüglich des Pankreas und der Ernährung ein gutes Modell zur weiteren präklinischen Erforschung der Inseltransplantation als Therapie des Diabetes mellitus.
    Notes: Summary Limits and possibilities of the transplantation of islets of Langerhans in pigs were studied. 6 × 104 to 3 × 106 islets and insulin producing fragments per pancreas were obtained by intraductal collagenase digestion of the pancreatic gland following total pancreatectomy. Islets grafted into the spleen or liver rendered normoglycemia to the pancreatectomized animals as demonstrated by normal fasting blood sugars and normal intravenous glucose tolerance tests as compared to not operated animals permitting a survival time of up to one year. Apancreatic controls died of ketoacidosis and diabetic coma 10 to 12 days posttransplant. The number of isolated and transplanted islets correlated well to the normoglycemic state of the animal. Beyond that the in vitro challenge of the islets with glucose and resulting insulin secretion was a very important indicator for the functional status and integrity of the islets after transplantation. Thus the pig appears to be a suitable model for the preclinical studying of islet transplantation especially since immunologic, physiologic and anatomic features of the pig are similar to those in the human regarding pancreas and nutrition.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00184165
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    Paper (German National Licenses)
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