scholarly journals Role of biochemical parameters in predicting histopathological changes at 24 and 48 hours from acute pancreatitis induction

2020 ◽  
Vol 75 (1) ◽  
pp. 6168-2020
Author(s):  
JACEK BAJ ◽  
IWONA ŁUSZCZEWSKA-SIERAKOWSKA ◽  
ELŻBIETA RADZIKOWSKA ◽  
JACEK SOMPOR ◽  
MARCIN MACIEJEWSKI ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Pancreatic Duct ◽  
Biochemical Parameters ◽  
Total Bilirubin ◽  
Sodium Taurocholate ◽  
Fatty Tissue ◽  
Tissue Necrosis ◽  
Inflammatory Infiltration ◽  
Biochemical Indicators ◽  
Histopathological Lesions

The aim of the study was to assess the relationships between the degree of changes in concentrations of the biochemical indicators in serum such as: creatinine, uric acid, total bilirubin, aspartate transaminase (AST), alanine transaminase (ALT), lipase, amylase, glucose, iron and magnesium, and histopathological lesions occurring in the pancreas within 24 and 48 hours from the induction of acute pancreatitis (AP). An attempt was made to assess the relation between the changes in concentrations of biochemical indicators and the enhancement of histological lesions in the pancreas based on Spormann score. In the experimental model, the laboratory and histological changes in the 24th hour from administration of taurocholan correspond to the seventh day of the disease in humans. Experiments were conducted on 55 male Wistar rats weighing from 250 g to 300 g. The animals were divided into three groups: Z – a group serving to establish the ranges of studied factors and histological structure; K – a group of animals operated on which were injected with 0.9% NaCl into the biliary-pancreatic duct; E – a group of animals operated on in which acute pancreatitis was induced by an injection of 5% sodium taurocholate into the biliary-pancreatic duct. The material for biochemical and histological examinations was collected after 24 and 48 hours from the induction of AP. Whole pancreases were dissected for histological examinations and the samples were dyed with hematoxylin and saturated alcoholic eosin solution. The degree of pancreatic lesions was assessed according to the Spormann score. Quantitative variables were characterised by arithmetic mean, standard deviation, median, minimum and maximum value and 95% CI. After administration of 0.9% NaCl in the K group, foci of purulent inflammation in the fatty tissue of the pancreas and minor foci of Balser’s necrosis appeared. In the E group, after injection of 5% sodium taurocholate into the biliary-pancreatic duct, more intense lesions were observed: foci of fatty tissue necrosis, hemorrhagic necrosis, multifocal fatty tissue necrosis and inflammatory infiltration. The model was developed in order to assess histological lesions, indicating the character of AP, taking into account edema, inflammatory infiltration, fatty tissue necrosis, glandular necrosis, and ecchymoses. In the period of 24 hours, statistically significant differences between the K group and E group were observed for creatinine, total bilirubin, ALT, lipase, amylase, iron and magnesium, while in the period of 48 hours, statistically significant differences were observed for total bilirubin and ALT. In the group E, in the period of 24 hours concentrations of creatinine, total bilirubin, ALT, lipase, amylase and magnesium were significantly higher than in the group K, but concentrations of iron were significantly lower. In the period of 48 hours, in the E group total bilirubin was significantly lower and ALT was significantly higher than in the K group. In the E group, the intensity of pancreatitis increased together with an increase in ALT concentration in the period of 24 hours; in the period of 48 hours, the intensity of pancreatitis increased together with a decrease in ALT in the E group. In the K group, in the period of 48 hours, intensity of fatty tissue necrosis increased together with a decrease in ALT level. In the period of 48 hours, in the E group intensity of glandular necrosis increased together with a decrease in total bilirubin and AST concentration. In the E group, in the period of 24 hours intensity of edema increased together with an increase in magnesium level. In the period of 48 hours, in the E group intensity of glandular necrosis increased together with a decrease in magnesium or AST level, and the intensity of lesions in the form of ecchymoses increased together with an increase in glucose level. Histopathological lesions occurred prior to changes in laboratory test results, whereas significant correlations with the Spormann score concerned changes in: total bilirubin, AST, ALT, glucose and magnesium. The use of regression analysis with the Spormann score shows statistically significant differences for most of the biochemical parameters in the period of 24 hours correspond to the seventh day of the disease in humans. The presented study results confirm the fact that diagnostics of acute pancreatitis is very difficult and requires monitoring of many laboratory parameters. A search is still going on for an ideal marker of AP which would enable an early prognosis of the progress of the disease and the confirmation of its etiology. A discovery of a simple marker which is cheap to use may turn out to be useful if it is confirmed in prospective studies. The current state of knowledge based on scientific and clinical findings makes it possible to apply interdisciplinary clinical procedures based on matching appropriate laboratory and radiological tests, and on implementing therapeutic procedures...

Prediction of acute pancreatitis in the earliest stages – role of biochemical parameters and histopathological changes

2017 ◽  
Vol 89 (2) ◽  
pp. 31-38 ◽  
Author(s):  
Jacek Baj ◽  
Elżbieta Radzikowska ◽  
Marcin Maciejewski ◽  
Andrzej Dąbrowski ◽  
Kamil Torres
Keyword(s):  
Acute Pancreatitis ◽  
Pancreatic Duct ◽  
Correlation Coefficient ◽  
Creatinine Level ◽  
Biochemical Parameters ◽  
The Other ◽  
Inflammatory Infiltration ◽  
Biochemical Indicators ◽  
Stable Level ◽  
Histopathological Lesions

For many years, there has been a search for a set of biochemical parameters that could facilitate the assessment of severity, prognosis, and administration of early and appropriate treatment in acute pancreatitis. Administration of treatment within the first 48 hours since admission is associated with many problems of distinguishing patients with a mild form of acute pancreatitis (AP) from those with a severe form of acute pancreatitis. Study aim: To assess the relationship between the extent of change in the concentration of 10 selected biochemical indicators: amylase, lipase, total bilirubin, creatinine, uric acid, aspartate transaminase, alanine transaminase, glucose, magnesium, and iron and histopathological lesions in the pancreas within 2 and 6 hours since induction of AP. The selected time periods correspond to the first and the second day of the disease in people, respectively. Material and methods: The experiments were conducted in 110 male Wistar rats weighing from 250 to 300 g. Experimental animals were divided into three groups: Z – a group in which the ranges of the studied factors and histological structure were established; K – a group of animals operated on which were injected with 0.9% NaCl into the biliary-pancreatic duct; E – a group of animals operated on in which acute pancreatitis was induced by an injection of 5% sodium taurocholate into the biliary-pancreatic duct. Animals from the K and E groups were randomly assigned to one of five subgroups from which the material for biochemical and histological examinations was collected at 2 h and 6 h since the induction of AP. Whole pancreases were dissected for histological examinations, and the samples were dyed with hematoxylin and saturated alcoholic eosin solution. The degree of pancreatic lesions was assessed according to the Spormann score. Quantitative variables were characterized by arithmetic means, standard deviations, medians, minimum and maximum values, and 95% CIs. Results: In histological preparations from rats from the E group, after 2 hours, edematous lesions, neutrophilic infiltrations in the pancreatic parenchyma, together with single petechiae started to appear and were observed. After 6 hours, the lesions became more intense, and minor foci of coagulation necrosis and minor foci of purulent inflammation in the fatty tissue appeared. Within 2 hours, statistically significant differences in the amount of four markers: creatinine, ALT, amylase, and magnesium were observed. After six hours, statistically significant differences in the amount of two markers: AST and glucose were seen. The correlations between histological assessments according to the Spormann scale and biochemical indicators were investigated, and it was observed that within 2 hours the intensity of pancreatitis increased together with an increase in AST. In group K, within 6 hours, the intensity of inflammatory infiltration increased together with an increase in creatinine concentration (correlation coefficient 0.95; p=0.0138). In group E, in the period of 2 hours, lesion intensity in the form of inflammatory infiltration increased together with an increase in the AST level (correlation coefficient 0.90; p=0.0063) and an increase in the iron level (correlation coefficient 0.78; p=0.0399). In the same group and in the same period, an increase in the AST level (correlation coefficient 0.79; p=0.0343) was associated with an increase in lesion intensity in the form of ecchymoses. Inflammatory infiltration increased (correlation coefficient -0.87; p=0.0117) within 6 hours, whereas the creatinine level decreased. Interesting results were obtained with the use of regression analysis – forward stepwise regression. In the period of 2 hours, if the creatinine level increased by 1, the intensity of lesions in acute pancreatitis decreased by 9.02, according to the Spormann score, while the other variables remained at a stable level. However, if ALT level increased by 1, the intensity of lesions in acute pancreatitis increased by 0.02, according to the Spormann score; and if the amylase level increased by 1, the intensity of lesions in acute pancreatitis increased by 0.01, according to the Spormann score, while the other variables remained at a stable level. Conclusions: Histopathological lesions occurred prior to changes in laboratory test results, whereas significant correlations with Spormann scores were seen in the case of changes in AST and creatinine levels. The study results confirm the fact that diagnostics in acute pancreatitis is very difficult and requires monitoring of many laboratory parameters.

Inhibition of bradykinin B2receptor preserves microcirculation in experimental pancreatitis in rats

1998 ◽  
Vol 274 (1) ◽  
pp. G42-G51 ◽  
Author(s):  
Christian Bloechle ◽  
Klaus Kusterer ◽  
Regina M. Kuehn ◽  
Claus Schneider ◽  
Wolfram T. Knoefel ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Capillary Flow ◽  
Sodium Taurocholate ◽  
Pancreatic Tissue ◽  
Effective Dosage ◽  
Leukocyte Adherence ◽  
Tissue Necrosis ◽  
Beneficial Effects ◽  
Bradykinin Antagonist ◽  
Intraductal Injection

The effect of B2 receptor bradykinin antagonist icatibant on postcapillary leukostasis, microcirculatory stasis, and tissue necrosis was studied in acute pancreatitis. In rats, pancreatitis was induced by intraductal injection of sodium taurocholate (ST), intravenous caerulein and intraductal infusion of glucodeoxycholic acid (GDOC), or intravenous caerulein infusion alone. Intravital pancreatic microcirculation was observed. Icatibant or vehicle was given 30 min before induction of pancreatitis. In ST pancreatitis, the number of perfused capillaries increased in icatibant-pretreated rats (77% vs. 0% for controls, P < 0.001). Capillary flow was preserved in icatibant-treated rats; total stasis was observed in controls. Mean venular leukocyte adherence decreased in icatibant-treated rats (26% vs. 74% for controls, P < 0.001), and median histopathologic score was reduced (icatibant vs. controls, 5.0 vs. 12 points, respectively; P < 0.01). Kinase II inhibitor captopril or exogenous bradykinin in addition to an otherwise effective dosage of icatibant resulted in microcirculatory stasis, extensive venular leukocyte adherence, and severe histological damage. With a 100 times greater icatibant dosage, this adverse effect was compensated. The beneficial effects of icatibant were also observed in intermediate pancreatitis (caerulein + GDOC). In ST and intermediate pancreatitis, icatibant preserved microcirculation, reduced venular leukocyte adherence, and prevented pancreatic tissue damage. B2 receptor bradykinin-mediated postcapillary leukostasis plays an important role in the pathogenesis of severe forms of acute pancreatitis.

Acute lung injury in two experimental models of acute pancreatitis: Infusion of saline or sodium taurocholate into the pancreatic duct

2000 ◽  
Vol 28 (5) ◽  
pp. 1497-1502 ◽  
Author(s):  
Arnaldo Lichtenstein ◽  
Rodolfo Milani ◽  
Sandra M. Fernezlian ◽  
Adriana S. Leme ◽  
Vera L. Capelozzi ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Acute Lung Injury ◽  
Lung Injury ◽  
Pancreatic Duct ◽  
Sodium Taurocholate ◽  
Experimental Models

scholarly journals Animal Models of Chronic Pancreatitis

2010 ◽  
Vol 2010 ◽  
pp. 1-8 ◽  
Author(s):  
Makoto Otsuki ◽  
Mitsuyoshi Yamamoto ◽  
Taizo Yamaguchi
Keyword(s):  
Fluid Flow ◽  
Oleic Acid ◽  
Chronic Pancreatitis ◽  
Animal Models ◽  
Pancreatic Duct ◽  
Sodium Taurocholate ◽  
Pancreatic Injury ◽  
The Other ◽  
Fatty Tissue ◽  
Pancreatic Fluid

Animal models for CP in rats can be classified into 2 groups: one is noninvasive or nonsurgical models and the other is invasive or surgical models. Pancreatic injury induced by repetitive injections of supramaximal stimulatory dose of caerulein (Cn) or by intraductal infusion of sodium taurocholate (NaTc) recovered within 14 days, whereas that caused by repetitive injection of arginine or by intraductal infusion of oleic acid was persistent. However, the destroyed acinar tissues were replaced by fatty tissues without fibrosis. Transient stasis of pancreatic fluid flow by 0.01% agarose and minimum injury of the pancreatic duct by 0.1% NaTc solution induced progressive pancreatic injury although one alone is insufficient to cause persistent pancreatic injury. However, the damaged tissue was replaced by fatty tissue without fibrosis. Continuous pancreatic ductal hypertension (PDH) caused diffuse interlobular and intralobular fibrosis closely resembling human CP.

scholarly journals Qingyi decoction attenuates severe acute pancreatitis in rats via inhibition of inflammation and protection of the intestinal barrier

2019 ◽  
Vol 47 (5) ◽  
pp. 2215-2227 ◽  
Author(s):  
Song Su ◽  
Tiancheng Liang ◽  
Xiang Zhou ◽  
Kai He ◽  
Bo Li ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Severe Acute Pancreatitis ◽  
Sodium Taurocholate ◽  
Intestinal Barrier ◽  
Pancreatic Tissue ◽  
Small Intestinal Mucosa ◽  
Barrier Dysfunction ◽  
Ileal Mucosa ◽  
Inflammatory Infiltration ◽  
Tnf Α

Objective Qingyi decoction (QYD) has beneficial effects in severe acute pancreatitis (SAP). We assessed the therapeutic effect and mechanisms of QYD in SAP. Methods A rat model of SAP was induced by pancreatic ductal injection of sodium taurocholate. QYD was administered intragastrically immediately postoperatively and once every 12 hours. Serum amylase, endotoxin, interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), and D-lactate levels were measured at 12, 24, and 48 hours. Histological changes in the pancreas and ileum were analyzed. Expression of nuclear factor kappa-light-chain-enhancer of activated B cells p65 (NF-κB p65), Toll-like receptor 4 (TLR4), and zonula occludens-1 (ZO-1) in the small intestinal mucosa was also assessed. Results Pancreatic tissue showed extracellular space expansion, inflammatory infiltration, vessels with necrotic walls, and hemorrhage. Ileal tissue showed hemorrhage, inflammatory infiltration, and ileal mucosa destruction. These histological features were dramatically improved by QYD. Increased serum levels of amylase, endotoxin, TNF-α, IL-6, and D-lactic acid were significantly decreased by QYD administration. Increased expression of NF-κB p65 and TLR4 and decreased expression of ZO-1 in the ileal mucosa were also restored to normal levels by QYD treatment. Conclusion QYD alleviates SAP by reducing intestinal barrier dysfunction, inhibiting intestinal bacteria and endotoxin translocation, and preventing NF-κB activation.

scholarly journals Experimental model of severe acute pancreatitis in rabbits

2007 ◽  
Vol 22 (5) ◽  
pp. 366-371 ◽  
Author(s):  
Alberto Goldenberg ◽  
Ana Celia Diniz Cabral Barbosa Romeo ◽  
Márcia Bento Moreira ◽  
Franz Robert Apodaca ◽  
Marcelo Moura Linhares ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Pancreatic Duct ◽  
Experimental Model ◽  
Severe Acute Pancreatitis ◽  
Sodium Taurocholate ◽  
Optical Microscope ◽  
Control Group ◽  
Cellular Necrosis ◽  
The Difference ◽  
Group B

PURPOSE: To develop an experimental model of severe acute pancreatitis in rabbits through a pancreatic ductal injection of sodium taurocholate. METHODS: Twenty-four albino rabbits of the New Zealand lineage were distributed into four groups of six animals (A, B, C and S). The rabbits of three experimental groups (A, B and C) were submitted to a laparatomy and received a pancreatic ductal injection of 1ml/kg sodium taurocholate 5%. Also, they were submitted to further laparatomies after 4h, 8h and 12h, respectively. The control group (S) was subdivided into two groups of three animals: in subgroup S1 only the pancreatic duct catheterization was performed whereas in subgroup S2 the pancreatic duct catheterization as well as an injection of 1ml/kg physiologic solution 0.9% were carried out. After 12 hours, the rabbits were evaluated. In the re-intervention, blood was collected to determine the amylasemia and a pancreatectomy was carried out to investigate interstitial infiltration, steatonecrosis and necrosis of the organ, using an optical microscope. RESULTS: There was an elevation of amylase in all groups thus proving the existence of acute pancreatitis. The size of the interlobular septum increased progressively with a greater variation between group S1 (0.13) and group C (0. 53) (p=0.035). While all the animals in group A exhibited focal cellular necrosis, it was more intense in the rabbits of group B and culminated with a high proportion of severe pancreatic necrosis in group C animals. The difference in the intensity of cellular necrosis showed statistic significance (p=0.001). CONCLUSION: The proposed experimental model demonstrated its reproducibility and effectiveness in producing severe acute pancreatitis in rabbits.

Impact of heliogeophysical factors on the clinical-biochemical indices in pregnant women

2018 ◽  
Vol 8 (2) ◽  
pp. 329-333
Author(s):  
I. V. Bobina ◽  
G. G. Sokolova ◽  
E. A. Sharlaeva
Keyword(s):  
Magnetic Field ◽  
Pregnant Women ◽  
Geomagnetic Activity ◽  
Biochemical Parameters ◽  
Total Bilirubin ◽  
Blood Platelets ◽  
Coefficient Of Determination ◽  
Functional Dependencies ◽  
Biochemical Indicators ◽  
Heliogeophysical Factors

<p>The influence of heliogeophysical factors on the clinical and biochemical parameters of pregnant women with easy and complicated births was studied. The influence of the events of the current day and the previous solar and geomagnetic activity on clinical and biochemical parameters of pregnant women with normal and complicated births was revealed. 164 pregnant women aged from 17 to 44 years, living in Barnaul, Altai region, were examined. According to the type of delivery two groups of women were identified:1) women with easy birth (46 people), 2) women with complicated birth (118 people). The following indicators were used to estimate the level of solar and geomagnetic activity: the number of sunspots, the number of Wolff, radiation at a wavelength of 10.7 cm, the average daily magnetic field perturbation (A<sub>p</sub>– index), and the local geomagnetic disturbance index (A<sub>k </sub>– index). Pregnant women were examined using the following parameters: the number of erythrocytes, leukocytes, blood platelets, leukocyte count, clotting time, erythrocyte sedimentation rate, prothrombin index, hemoglobin, sugar, fibrinogen, bilirubin (direct, indirect and total), total blood protein, and specific gravity. It has been established that the influence of heliogeophysical factors consists of immediate and delayed reactions with different latent periods: among women with normal births the most significant events are the events of the current day, as well as the 3rd, 6th and 7th days before the examination; among women with difficult births - on the 2nd, 4th, 5th and 7th days. Among heliogeophysical factors the average daily disturbance of the Earth's magnetic field has the greatest influence on clinical and biochemical parameters. 60% of the clinical and biochemical parameters analyzed among pregnant women depend on this factor. Clinical and biochemical indicators are less susceptible to heliogeophysical factors among women with complicated births. The coefficient of determination by the factors of solar activity reaches 25% (direct bilirubin) among them; factors of geomagnetic activity - 31.5% (urine protein), whereas in the group of women with normal births the coefficient of determination is 50% (total bilirubin) and 71% (total bilirubin). According to clinical-biochemical indicators 8 types of correlations were found: 1 type – at low level of solar and geomagnetic activity, 4 types – at medium and 3 types at high level. Linear and nonlinear functional dependencies of the indicators on heliogeophysical factors are revealed for each typological group.</p>

scholarly journals Acute Pancreatitis Secondary to an Incarcerated Paraoesophageal Hernia: A Rare Cause for a Common Problem

2014 ◽  
Vol 7 ◽  
pp. CCRep.S13079 ◽  
Author(s):  
Kathryn Boyce ◽  
William Campbell ◽  
Mark Taylor
Keyword(s):  
Acute Pancreatitis ◽  
Case Report ◽  
Pancreatic Duct ◽  
Rare Case ◽  
Open Repair ◽  
Pancreatic Head ◽  
Good Recovery ◽  
Type Iv ◽  
Rare Case Report ◽  
Paraoesophageal Hernia

This is a rare case report of acute pancreatitis secondary to a massive incarcerated paraoesophageal hernia. The pathogenesis resulted from obstruction of the distal pancreatic duct after displacement of the pancreatic head and body into the thorax as part of a Type IV paraoesophageal hernia. Although this condition is rare, the patient made steady progress following laparotomy and open repair of hernia. She made a good recovery after prompt therapy, therefore, this report can be a guide to the diagnosis and treatment of similar conditions.

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