Pancreatic Pathology

Measurement of glycosylated hemoglobin (HbAlc) is an excellent measurement of long-term exposure to hyperglycemia. 

Definition chronic systemic disease characterized by insulin deficiency or peripheral resistance, resulting in hyperglycemia and nonenzymatic glycosylation of proteins 

Diagnosis fasting glucose 126 mg/dl on at least two separate occasions or a positive glucose tolerance test 

Oral antidiabetic drugs iii. Insulin Vascular pathology 

Diabetic nephropathy is the most common reason for renal transplantation in adults. 

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The two most used hi-dimensional reformatting techniques in order to study pancreatic pathologies are, as reported in many works, average intensity multiplanar reformatted (MPR) and its variant, curved planar (CPR) reformatted imaging (Baek et al. 2001 Nino-Murcia et al. 2003). 

It is also mandatory to report that several investigators have found MRP to be nonetheless very much accurate (Rieker et al. 1997) in evaluating pancreatic pathologies and especially pancreatic tumour, avoiding then the use of 3D reconstructed images. 

About 3D imaging, given up the static surface-rendered (SSD) images, mainly because of its inability to show under (sub)-surface details, VR images have been preferred in the study of pancreatic pathologies, mainly in the evaluation of peri-pancreatic vessels in the pre-operative study of patients affected by carcinoma as well as in the evaluation of the arterial vasculature of patients candidates for pancreas transplantation. 

Not routinely performed, CT virtual pancreatoscopy, first reported in 1998 by Prassopoulos et al. and Nakagohri et al., is a new tool for diagnosis of pancreatic pathologies (Tanizawa et al. 2003). 

Merkord J, Henningshausen G (1989) Acute pancreatitis and biie duct iesions in rat induced by dibutyitin dichioride. Experimental Pathology, 36 59-62. 

Entrance of bile duct and pancreatic duct into the duodenum (diagrammatic). From William A. Sodeman, Pathologic Physiology (W. B. Saunders Co., Philadelphia, Pa., 1950), p. 346. 

Genetic mannosidosis has been described in man, Angus cattle and Murray Gray cattle, and is characterized by a deficiency of a-mannosidase leading to storage of excess mannose-rich oligosaccharides in lysosomes. Pathologically, there is vacuolation of reticuloendothelial cells in the liver and lymph nodes, pancreatic exocrine cells, and neurons. Affected cattle are ataxic, uncoordinated, fail to thrive, and die in the first year of life. 

A high rate of ethanol consumption can lead to inhibition of gastric secretion and irritation of the gastric mucosa. Ethanol irritates the entire gastrointestinal tract, which may lead to constipation and diminished absorption of nutrients. Other pathological effects include pancreatitis and peripheral neuropathy. Severe gonadal failure is often found in both men and women, accompanied by low blood levels of sex hormones. 

Fire-toxin, as a pathological product as well as a pathogenic factor, can accumulate in the intestines. Fire-toxin should be eliminated as soon as possible, especially before long-term accumulation and when the blood is not strongly disturbed, in order to prevent further development of disease, such as in chronic mild infections of the intestines, or at the primary stage of acute appendicitis, acute pancreatitis, acute cholecystitis, hepatitis and ulcer perforation and inflammation. 

When downward-draining formulas are used to treat acute abdominal syndromes, such as acute intestinal obstruction, appendicitis, cholecystitis and pancreatitis, it is also important to remember that these herbs are only suitable for certain periods in the whole pathological process of the disease, or certain types of disorder. These formulas should only be prescribed by doctors after modern medical examination. 

Sodium and fluid retention, congestive heart failure in susceptible patients, potassium loss, hypokalemic alkalosis, hypertension Muscle weakness, steroid myopathy, loss of muscle mass, vertebral compression fractures, aseptic necrosis of humeral and femoral heads, pathologic fracture of long bones, osteoporosis Peptic ulcer with possible perforation and hemorrhage, pancreatitis, abdominal distension, ulcerative esophagitis... 

For example, normal urine is supersaturated with calcium oxalate. To prevent formation of renal calculi (stones)719 an inhibitory glycoprotein is present and slows the formation and growth of crystals.720 Under some disease conditions calcium carbonate stones may form in pancreatic ducts. A17 kDa lectinlike glycoprotein called lithostatine has been proposed to inhibit stone formation by binding to certain planes on CaC03 microcrystals just as antifreeze proteins (Box 4-D) inhibit ice formation.721 However, this proposed function for lithostatine is doubtful.722 723 Pathological deposits of crystalline calcium pyrophosphate and basic calcium phosphates are sometimes present in joints,724 even in Neanderthal skeletons.725... 

Dreef-van der Meulen HC, Feron VJ, Til HP. 1974. Pancreatic atrophy and other pathological changes in rats following feeding of stannous chloride. Pathol Europ 9 185-192. 

Figure 26-1. Abdominal ultrasound showing pathological alterations typical of chronic pancreatitis, i.e. a nonhomogenous pancreatic tissue with calcifications (A several calcifications are marked with an arrow) and a widened and irregular pancreatic duct (B diameter of pancreatic duct D1 is 8.2 mm, upper limit of normal is 3 mm). Courtesy C. Pachmann, MD.

Measurement of stool weight and quantitative fecal fat excretion on three consecutive days during a balanced diet are common screening tests for both pancreatic insufficiency and other pathologies that result in malabsorption. However, these tests are insensitive and nonspecific for pancreatic malfunction Steatorrhea occurs only after loss of more than 90% of exocrine parenchyma, and other causes of malabsorption (e.g., celiac sprue or Crohn s disease) may also induce abnormal fecal fat excretion of more than 7 g/day or more than 5 g/100 g. 

Scheele GA (1975) Two-dimensional gel analysis of soluble proteins Characterization of guinea pig exocrine pancreatic proteins. J Biol Chem 250 5375-5385 Wetmore BA, Merrick BA (2004) Toxicoproteomics Proteomics Applied to Toxicology and Pathology. Toxicologic Pathology 32 619-642... 

Qll There is both a genetic and environmental component in type 1 diabetes. The pathological basis of the condition is autoimmune destruction of the pancreatic islet cells, which is said to be associated with genetic and environmental factors such as viral infection. It has been shown that antibodies to islet cells and insulin autoantibody (IAA) can exist for years before the occurrence of symptoms, possibly as a result of the autoimmune processes the IAA may form during the process of active islet and /1-cell destruction. Both insulin and glucagon play a role in the development of hyperglycaemia and hyperketonaemia, since both a- and /1-cell functions are abnormal in diabetes. Both a lack of insulin and a relative excess of glucagon coexist in type 1 diabetes, and so the metabolic abnormalities that occur are likely to be caused by both hormones. 

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