의학과/박사[한글]
[영문]
The association of plasma lactescence with pancreatitis in man was first observed
approximately 100 years ago. Since that time, there has been various clinical and
experimental reports concerning the appearance of hyperlipemia associated with
pancreatitis. However, the mechanism by which pancreatitis is associated with the
alteration of plasma lipids is obscure. The present experiment is undertaken to
clearify the relationship of total plasma lipids, lipid phosphorus, cholesterol and
serum lipase in experimental pancreatitis and also to observe the lipid change in
liver tissue.
The rabbits weighing approximately 2kg irrespective of sect, were used and
divided into the following groups:
1) Intraductal instillation of 1% sodium desoxycholate in saline and complete
ligation of the pancreatic duct;
2) Intraductal instillation of 20% ethyl alcohol in saline and complete ligation
of the pancreatic duct;
3) Intraductal instillation of 10% bile in saline and complete ligation of the
pancreatic duct;
4) Intraductal instillation of saline and complete ligation of the pancreatic
duct as a control;
5) Simple ligation of the pancreatic duct as a control.
The abdomen of the rabbit was opened through an upper midline incision under
sodium pentothal anesthesia and aseptic technique was used throughout the operative
procedure. The major pancreatic duct, which enters into the duodenum at a point
approximately 20cm from the pylorus, was easily cannulated in its intramural
portion with a small polyethylene tube. With a syringe 2.0ml of each prepared
solution was infused slowly without too much pressure. Then, the cannula was
removed during libation of the pancreatic duct, and the abdominal incision was
closed.
The blood samples were drawn 12, 24, 36, 48, 72 hours, one week, two weeks, three
weeks following the surgery, these samples were studied for serum lipase activity,
total lipid, lipid phosphorus, cholesterol.
When the animal died or wart sacrificed, the pancreatic tissue and liver tissue
were fixed in 10% formalin, and routine hematoxylin-eosin stains were done after
sectioning the paraffin embedded tissue. Some of the liver tissue was prepared as a
fat-staining with "Oil-red-0".
In order to determine total lipid in liver tissue, five grams of liver tissue was
weighed on a torsion balance immediately following sacrifice of animal, dried in an
oven with temperature ranging 60∼70 degree centigrade for about twelve hours. This
dessicated liver tissue was extracted with chloroform and transfered to a
pre-measured flask, and the chloroform was evaporated in a hot water bath at 50
degree centigrade. Then, the specimen wart kept in a dessicater for at least six
hours, following which it's weight was determined on the chemical balance.
The serum lipase was determined by the Cherry and Grandall's Method; total lipid
by modified Sperry and Brand's Method: lipid phosphorus by the modified Youngburg's
Method: cholesterol by the Kingsley's modified Yanasawa Method.
Results
Animal died or sacrificed within one week fellowing surgery, showed focal or
diffuse parenchymal necrosis, and intra-pancreatic and peri-pancreatic fat necrosis
typical of acute hemorrhagic pancreatitis, and those who survived until the third
post-operative week showed findings of chronic pancrestitis namely atrophy of
pancreatic lobules, ductal transformation of acini, dilation of the pancreatic
duct, inter and intra-lobular fibrosis and chronic inflammatory cellular
infiltration. The histological examination of liver tissue revealed no remarkable
fat metamorphosis.
The maximum rise in serum lipase usually occurred on the first post-operative day
and returned to pre-operative levels on the third day. Thereafter, the lipase level
was stabilized and did net vary significantly throughout the duration of the
experiment. The elevation of the lipase activity was noted in saline control group
although the simple ligation group showed a remarkably lower lipase level than the
study group.
The maximum rise in plasma total lipid, lipid phosphorus, cholesterol usually
occurred on the second to the third day following the instillation of various
solution, declined about one week following the operation, then, gradually returned
to the pre-operative level by the third week. The experimental groups showed
remarkably higher value than the control groups.
Total lipid content of liver tissue in the study groups was not remarkably higher
than the control groups. However, the total lipid level of liver tissue was
parallel with the plasma total lipid level.restrictio
