Download e-book for iPad: Clinical Pancreatology for Practising Gastroenterologists by Juan Enrique Dominguez-Munoz

By Juan Enrique Dominguez-Munoz

ISBN-10: 1405122765

ISBN-13: 9781405122764

Such a lot sufferers struggling with pancreatic ailments are controlled via basic internists, gastroenterologists and/or surgeons in non-specialized facilities. simple and scientific examine in pancreatology is always resulting in alterations within the administration of pancreatic ailments, yet those advances are utilized to the medical perform virtually solely in really good facilities via really good groups.The books and journals presently on hand are directed at pancreatologists and the knowledge doesn't succeed in such a lot basic clinicians and surgeons who deal with sufferers being affected by pancreatic illnesses. the purpose of this publication is to supply training gastroenterologists and surgeons with transparent information about the prognosis and therapy of pancreatic illnesses.

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Example text

In our studies, animals were sacrificed at planned intervals during the initial 24 hours after duct ligation and the pancreas was examined by light microscopy. The earliest changes were noted to occur within acinar cells. Within 3 hours of duct ligation, the acinar cells lost their basal–apical polarity, developed altered staining characteristics, and demonstrated changes suggestive of early acinar cell necrosis. These changes increased with time, and by 6 hours after duct ligation larger groups of acinar cells were noted to be necrotic.

This inhibition of secretion has been noted to occur in each of the models of acute pancreatitis. Acinar cell injury Acinar cell injury is an early event in each of the experimental models of pancreatitis and, as noted above, the earliest morphologic changes in the opossum model of pancreatitis involve acinar cells. The mechanisms responsible for acinar cell injury in pancreatitis are not entirely clear. In vitro studies, using acini exposed to supramaximally stimulating concentrations of cerulein, have shown that inhibition of pancreatic proteases such as trypsin protects acinar cells from cerulein-induced injury.

Furthermore, access to pancreatic tissue in patients with early acute pancreatitis is generally not possible. For this reason, most investigators have recognized the necessity for experimental models of pancreatitis in animals for studies designed to examine early events in pancreatitis. To complicate matters further, however, most experimental animals do not develop severe pancreatitis when their pancreatic duct is obstructed; rather, they develop mild changes of inflammation, acinar cell apoptosis, and pancreatic atrophy.

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Clinical Pancreatology for Practising Gastroenterologists and Surgeons by Juan Enrique Dominguez-Munoz


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