MyMedR

Poorly controlled type 1 diabetes mellitus seriously impairs female reproduction via immune and metabolic disorders

Zhang S, Liu Q, Yang C, Li X, Chen Y, Wu J, et al.

Reprod Biomed Online, 2024 Apr;48(4):103727.

PMID: 38402677 DOI: 10.1016/j.rbmo.2023.103727

RESEARCH QUESTION: Does type 1 diabetes mellitus (T1DM) affect reproductive health of female patients? What is the potential mechanism of reproductive dysfunction in female patients caused by T1DM?

DESIGN: Preliminary assessment of serum levels of female hormones in women with or without T1DM. Then histological and immunological examinations were carried out on the pancreas, ovaries and uteri at different stages in non-obese diabetic (NOD) and Institute of Cancer Research (ICR) mice, as well as assessment of their fertility. A protein array was carried out to detect the changes in serum inflammatory cytokines. Furthermore, RNA-sequencing was used to identify the key abnormal genes/pathways in ovarian and uterine tissues of female NOD mice, which were further verified at the protein level.

RESULTS: Testosterone levels were significantly increased (P = 0.0036) in female mice with T1DM. Increasing age in female NOD mice was accompanied by obvious lymphocyte infiltration in the pancreatic islets. Moreover, the levels of serum inflammatory factors in NOD mice were sharply increased with increasing age. The fertility of female NOD mice declined markedly, and most were capable of conceiving only once. Furthermore, ovarian and uterine morphology and function were severely impaired in NOD female mice. Additionally, ovarian and uterine tissues revealed that the differentially expressed genes were primarily enriched in metabolism, cytokine-receptor interactions and chemokine signalling pathways.

CONCLUSION: T1DM exerts a substantial impairment on female reproductive health, leading to diminished fertility, potentially associated with immune disorders and alterations in energy metabolism.

Matched MeSH terms: Pancreas/metabolism; Pancreas/pathology

Genetic markers in a Malaysian population: variants of uridine monophosphate kinase (UMPK), phosphoglycolate phosphatase (PGP) and pancreatic amylase (AMY2)

Zarinah KH, Abdullah F, Tan SG

Ann Hum Biol, 1984 11 1;11(6):533-6.

PMID: 6084457

Three genetic markers, red-cell UMPK, PGP and serum AMY2 were investigated in Malaysians of Malay, Chinese and Indian ancestries using starch-gel and agarose-gel electrophoresis. UMPK was found to be polymorphic in all three races. Variants were observed for PGP in Malays; in Indians it is a polymorphic marker whereas it is monomorphic in Chinese. AMY2 was polymorphic only in Indians. The UMPK1 frequencies in Malays, Chinese and Indians, respectively, are 0.851, 0.880 and 0.942. The PGP1 frequencies are 0.991, 1.000, 0.962, and the AMY1(2) frequencies are 1.000, 1.000 and 0.983.

Matched MeSH terms: Pancreas/enzymology

The accumulation and distribution of trace metals in some localized marine species

Yusof AM, Rahman NA, Wood AK

Biol Trace Elem Res, 1994;43-45:239-49.

PMID: 7710833

Trace elements, such as As, Co, Cr, Hg, Sb, and Zn, were determined by neutron activation analysis (NAA), whereas Cd, Cu, and Pb were determined by graphite furnace atomic absorption spectroscopy (GFAAS) in clam, crab, prawn, swamp cerith, and mussel samples after digestion by microwave heating under controlled conditions before eluting the solutions through a column of a chelating resin, Chelex-100. The standard used in the determination of percentage volatile elements retained by microwave digestion and also in the activation process was Lobster Hepatopancreas TORT-1, whereas known mixed standards were prepared from nitrate salts to determine the efficiency of the separation procedure at a controlled pH. Mercury and lead detected in crabs exceeded the maximum permissible level. Some species also showed a high affinity toward certain elements, and their levels of accumulation in the tissues of these species corresponded with the concentration of these elements in sediments, especially at sites in the vicinity of an industrial zone.

Matched MeSH terms: Pancreas/chemistry

Fulltext Challenges in the classification and management of Asian youth-onset diabetes mellitus- lessons learned from a single centre study

Yeow TP, Aun ES, Hor CP, Lim SL, Khaw CH, Aziz NA

PLoS One, 2019;14(1):e0211210.

PMID: 30682116 DOI: 10.1371/journal.pone.0211210

It remains widely perceived that early-onset Type 2 Diabetes (T2D) in children and adolescents is rare and clinically distinct from Type 1 Diabetes (T1D). We studied the challenges of classifying subtypes of early-onset diabetes using clinical features and biomarkers, and management of these patients. We reviewed retrospectively the record of patients < 25 years old who attended the diabetes clinic in Penang General Hospital, Malaysia between 1st December 2012 and 30th June 2015. We examined their clinical features, C-peptide and pancreatic autoantibodies. Comparisons were made between T1D and T2D for magnitude, demographics, metabolic status and complications. We studied 176 patients with a mean age of 20 ± 3.7 years, 43.2% had T1D, 13.6% had T2D, and 13.6% had mixed features of both. When tested, pancreatic autoantibodies were positive in 59.4% of the T1D. T2D presented two years later than T1D at 14.3 years, 20% were asymptomatic at presentation, and 50% required insulin supplementation despite fasting c-peptide of > 250 pmol/L. HbA1C of ≤ 8.0% (64 mmol/mol) was achieved in 30.3% of T1D, 58.3% of T2D on OAD and 16.7% of T2D on insulin. The T2D had greater cardiovascular risk with higher body mass index, more dyslipidaemia, higher blood pressure and earlier onset of nephropathy. The overlapping clinical features, variable autoimmunity, and beta-cell loss complicate classification of young diabetes. Pancreatic autoantibodies and C-peptide did not always predict diabetes subtypes nor respond to insulin. The poor metabolic control and high cardiovascular risk burden among the T2D highlight the need for population-based study and focused intervention.

Matched MeSH terms: Pancreas

Successful En Bloc Resection of Complicated Giant Stomach Gastrointestinal Stromal Tumor in an Elderly Patient

Yeoh BZY, Chuan Hoe V, Kong SN, Ooi WK, Chiew KY, Hayati F

Am J Case Rep, 2022 Jan 07;23:e934492.

PMID: 34992206 DOI: 10.12659/AJCR.934492

BACKGROUND Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors of the gastrointestinal tract and mostly affect the stomach. The size of the tumors vary, ranging from 0.6 cm to 25.5 cm, with a median size of 6.8 cm. CASE REPORT We report a case of a giant GIST (25×18×8.5 cm) in an 83-year-old woman, which we believe is the largest reported GIST, in Borneo, Malaysia. She presented with gradually increasing abdominal distension with occasional discomfort on movement for 1 month. Computed tomography revealed a large multilobulated enhancing mass measuring 10×20×22 cm with no clear plane with the posterior gastric wall, duodenum, and pancreas. We performed a distal gastrectomy and transverse colon segmentectomy, as the tumor was plastered to the mesentery of the transverse colon. Despite extensive surgery, she recovered well after surgery. Due to her advanced age and the tumor size, a tyrosine kinase inhibitor was not given owing to the possibility of adverse effects. CONCLUSIONS The management of GIST is complicated, especially for a huge GIST with local invasion. Despite the benefits of a tyrosine kinase inhibitor, the role of surgery in managing GIST is crucial, especially for patients with huge tumor size, advanced age, and local complications from the tumor.

Matched MeSH terms: Pancreas

A modified technique of pancreaticogastrostomy with short internal stent: A single surgeon's experience

Yap PY, Hwang JS, Bong JJ

Asian J Surg, 2017 Mar 10.

PMID: 28286020 DOI: 10.1016/j.asjsur.2017.01.003

BACKGROUND/OBJECTIVE: Postoperative pancreatic fistula (POPF) remains an important cause of morbidity and mortality after pancreaticoduodenectomy. Pancreaticogastrostomy (PG) as a reconstruction method after pancreaticoduodenectomy is a safe and optional surgical technique in decreasing the risk of POPF. In this study, a retrospective analysis was carried out to evaluate a new modification of PG technique that uses a two-layer anastomoses with an internal stent.

METHODS: Forty-seven patients underwent this newly modified PG technique between February 2012 and August 2016. Demographics, histopathological findings, type of surgery performed, perioperative parameters, postoperative length of stay, postoperative complications and interventional procedures, follow-up, and mortality data were collected and analyzed. Clavien-Dindo classification was used to grade the complications' severity.

RESULTS: Postoperative mortality was 4.25%, unrelated to POPF, and postoperative morbidity was 44.68%. Thirteen patients had severe (>Grade IIIa) complications, according to Clavien-Dindo classification. As classified in accordance to the International Study Group of Pancreatic Fistula, 24 (51.06%) patients developed Grade A POPF, and no occurrence of Grade B/C POPF was noted. All patients recovered uneventfully with successful treatment interventions.

CONCLUSION: The reported PG anastomotic technique is a safe and dependable reconstruction procedure with acceptable morbidity and mortality.

Matched MeSH terms: Pancreas

Fulltext Extrinsic factors involved in the differentiation of stem cells into insulin-producing cells: an overview

Wong RS

Exp Diabetes Res, 2011;2011:406182.

PMID: 21747828 DOI: 10.1155/2011/406182

Diabetes mellitus is a chronic disease with many debilitating complications. Treatment of diabetes mellitus mainly revolves around conventional oral hypoglycaemic agents and insulin replacement therapy. Recently, scientists have turned their attention to the generation of insulin-producing cells (IPCs) from stem cells of various sources. To date, many types of stem cells of human and animal origins have been successfully turned into IPCs in vitro and have been shown to exert glucose-lowering effect in vivo. However, scientists are still faced with the challenge of producing a sufficient number of IPCs that can in turn produce sufficient insulin for clinical use. A careful choice of stem cells, methods, and extrinsic factors for induction may all be contributing factors to successful production of functional beta-islet like IPCs. It is also important that the mechanism of differentiation and mechanism by which IPCs correct hyperglycaemia are carefully studied before they are used in human subjects.

Matched MeSH terms: Pancreas/growth & development; Pancreas/metabolism; Pancreas/physiology

Coadministration of alloxan and nicotinamide in rats produces biochemical changes in blood and pathological alterations comparable to the changes in type II diabetes mellitus

Vattam KK, Raghavendran H, Murali MR, Savatey H, Kamarul T

Hum Exp Toxicol, 2016 Aug;35(8):893-901.

PMID: 26429928 DOI: 10.1177/0960327115608246

In the present study, thirty six male Sprague Dawley rats were randomly divided into six groups and were injected with varying doses of alloxan (Ax) and nicotinamide (NA). The serum levels of glucose, insulin, and adiponectin were measured weekly up to 4 weeks.

Matched MeSH terms: Pancreas/drug effects; Pancreas/pathology

Intrapancreatic accessory spleen: An eluding diagnosis

Teoh KH, Balraj S, Navarasi SR

Med J Malaysia, 2017 02;72(1):68-70.

PMID: 28255147 MyJurnal

Intrapancreatic accessory spleen (IPAS) is a benign anomaly of splenic embryology and a rare cause of pancreatic pseudotumour. Here, we report a case of a 70-year-old Malay lady whose IPAS was discovered incidentally during her surveillance computed tomography for her underlying left lower lung fibrosis. Radiologically, the lesion mimicked a neuroendocrine pancreatic tumour and was only diagnosed pathologically as IPAS after surgery. In conclusion, recognising IPAS as a differential for enhancing pancreatic mass allows us to exhaust all non-invasive diagnostic means to diagnose this benign lesion. It will allow the patient to avoid unnecessary surgery and its accompanying complications.

Matched MeSH terms: Pancreas

Genetic markers in Malaysians: variants of soluble and mitochondrial glutamic oxaloacetic transaminase and salivary and pancreatic amylase, phosphoglucomutase III and saliva esterase polymorphisms

Teng YS, Tan SG, Lopez CG, Ng T, Lie-Injo LE

Hum Genet, 1978 Apr 24;41(3):347-54.

PMID: 649160

Malaysians of Malay, Chinese, and Indian ancestries were electrophoretically phenotyped for Amy1 and saliva esterase region 1 (Set-1) from saliva, Amy2 from plasma, soluble and mitochondrial GOT and PGM3 from leukocyte and placenta. Kadazans and Bajaus, the indigenous people of Sabah, East Malaysia were surveyed for Amy2. Three types of variants were observed for Amy1, one type for Amy2. Only Indians were found to be polymorphic for Amy1. Two GOTs 2-1 and three GOTm 2-1 variants were found among 281 Chinese while three GOTm 2-1 variants were found among 311 Malays. Malaysian Malays, Chinese, and Indians were found to be polymorphic for Set-1 and PGM3. The gene frequencies in Malays are Set-1F=0.601 +/- 0.021, Set-1S = 0.399 +/- 0.021; PGM13 = 0.788 +/- 0.020, PGM23 = 0.212 +/- 0.020; in Chinese Set-1F = 0.497 +/- 0.028, Set-1S = 0.503 +/- 0.028; PGM13 = 0.745 +/- 0.24, PGM23 = 0.255 +/- 0.024; in Indians, Set-1F = 0.449 +/- 0.031, Set-1S = 0.551 +/- 0.031; PGM13 = 0.755 +/- 0.029, PGM23 = 0.245 +/- 0.029.

Matched MeSH terms: Pancreas/enzymology

Fulltext Traumatic pseudocyst of the pancreas--a case report

Tay SKS, Abdul Wahab Y

Med J Malaysia, 1989 Dec;44(4):357-60.

PMID: 2520050

Blunt trauma to the pancreas is not common. The pancreatic injury can range from simple bruising to complete transection often associated with other visceral injuries. Pseudocyst of the pancreas is a late complication presenting usually within six weeks of the injury. The treatment of choice is distal pancreatectomy.

Matched MeSH terms: Pancreas/injuries*

The edema inducing activity of phospholipase A2 enzymes

Tan NH, Saifuddin MN, Yong WY

Biochem. Int., 1991 Jan;23(1):175-81.

PMID: 1863271

The edema inducing activity of phospholipase A2 (PLA2) enzymes from snake venoms and porcine pancreas was investigated using mouse paw as experimental model. All ten PLA2 enzymes exhibited potent edema inducing activity. PLA2, however, is generally not the major edema inducing component of snake venom. Chemical modification studies indicated that enzymatic activity of PLA2 was required for its edema inducing activity. All PLA2 enzymes examined displayed a rapid onset edema which was suppressed by pretreatment of the mice with antihistamine. Dexamethasone pretreatment also inhibited edemas elicited by some PLA2 enzymes.

Matched MeSH terms: Pancreas/enzymology

Acidimetric assay for phospholipase A using egg yolk suspension as substrate

Tan NH, Tan CS

Anal Biochem, 1988 May 1;170(2):282-8.

PMID: 3394929

A convenient acidimetric assay for phospholipase A using egg yolk suspension as substrate has been developed. The substrate mixture consists of 1 part egg yolk, 1 part 8.1 mM sodium deoxycholate, and 1 part 18 mM calcium chloride. Phospholipase A activity is measured by following the initial rate of pH change, which is linear between pH 8.0 and 7.75 and is proportional to enzyme concentration over a wide range. The assay is highly reproducible, with a coefficient of variation of 3%, and as sensitive as most established assays for phospholipase A. The assay uses inexpensive and easily available substrate and is simple to perform. It is particularly useful for monitoring phospholipase A activity in chromatography fractions.

Matched MeSH terms: Pancreas/enzymology

Fulltext Alternanthera sessilis Red Ethyl Acetate Fraction Exhibits Antidiabetic Potential on Obese Type 2 Diabetic Rats

Tan KK, Kim KH

Evid Based Complement Alternat Med, 2013;2013:845172.

PMID: 23606892 DOI: 10.1155/2013/845172

The antidiabetic potential of Alternanthera sessilis Red was investigated using the obese type 2 diabetic rats induced by high fat diet and streptozotocin. Three fractions (hexane, ethyl acetate, and water) were obtained from the crude ethanol extract of Alternanthera sessilis Red. Alternanthera sessilis Red ethyl acetate fraction (ASEAF) was found to possess the most potent antihyperglycemic effect through oral glucose tolerance test. The ASEAF was subsequently given to the diabetic rats for two weeks. It was found that two-week administration of ASEAF reduces the fasting blood glucose level, triglyceride level, and free fatty acid level of the rats. ASEAF-treated diabetic rats showed higher pancreatic insulin content and pancreatic total superoxide dismutase activity compared to the untreated diabetic rats. Also, the insulin sensitivity indexes suggested that ASEAF ameliorates the insulin resistant state of the diabetic rats. In conclusion, ASEAF could be developed into a potential antidiabetic agent for the management of type 2 diabetes.

Matched MeSH terms: Pancreas

Fulltext Heterotopic pancreas in the stomach

Sukumar N, Teoh CM

Med J Malaysia, 2004 Oct;59(4):541-3.

PMID: 15779591

A patient diagnosed with gastrointestinal stromal tumour of the stomach underwent gastrectomy. Post-operatively, histopathology was reported as heterotopic pancreas of the stomach. Heterotopic pancreas is very rare and though most of them appear asymptomatic, surgical resection is advisable.

Matched MeSH terms: Pancreas*

Evaluating the toxic and beneficial effects of jering beans (Archidendron jiringa) in normal and diabetic rats

Shukri R, Mohamed S, Mustapha NM, Hamid AA

J Sci Food Agric, 2011 Nov;91(14):2697-706.

PMID: 21744354 DOI: 10.1002/jsfa.4516

Jering (Archidendron jiringa) is eaten in the tropics and traditionally extolled for treating diabetes, high blood pressure and eliminating bladder stones. Jering contains an unusual amino acid-djenkolic acid (S,S'-methylenebiscysteine)-which may form sharp crystals in the urinary tract, causing pain and haematuria. This study evaluates the beneficial and toxic effects of dietary jering on tissues and organs in normal and diabetic rats.

Matched MeSH terms: Pancreas/pathology

Management of a rare case of arteriovenous malformation of the head of the pancreas

Shahrudin MD, Noori SM

Hepatogastroenterology, 1997 Jan-Feb;44(13):284-7.

PMID: 9058160

Arterio-venous malformation (AVM) of the head of the pancreas is a rare condition that may cause upper gastro-intestinal tract (GIT) bleeding. A 45-year-old man with a large AVM at the pancreato-biliary region is described. The patient had recurrent episodes of hematemesis and melena. Enlargement of the AVM was documented by serial abdominal CT scans performed after each bleed. Whipple procedure was successfully performed in this patient.

Matched MeSH terms: Pancreas/blood supply*; Pancreas/radiography; Pancreas/surgery

Bilateral adrenal cysts and ectopic pancreatic tissue in Beckwith-Wiedemann syndrome: is a conservative approach acceptable?

Rahmah R, Yong JF, Sharifa NA, Kuhnle U

J Pediatr Endocrinol Metab, 2004 Jun;17(6):909-12.

PMID: 15270410

Beckwith-Wiedemann syndrome is a common overgrowth syndrome associated with an increased risk of neoplasias which might be explained by the nature and localization of the genetic defect. While malignant tumors are often associated with hemihypertrophy, benign tumors are also found. We report a patient with the typical features of Beckwith-Wiedemann syndrome with two histologically different abdominal tumors, bilateral cystic adrenals and ectopic pancreatic tissue present at birth. In both tumors no malignancy could be detected. Ectopic pancreatic tissue is rarely seen and has been described in Beckwith-Wiedemann syndrome only once. After extirpation of the ectopic pancreatic tissue the cystic adrenals were left in situ since macroscopically no normal adrenal tissue could be identified and separated. Regular ultrasound examinations revealed complete resolution of the cystic adrenals within 24 months. Thus it seems that a conservative approach in selected tumors associated with the Beckwith-Wiedemann syndrome might be acceptable.

Matched MeSH terms: Pancreas*

Pseudocyst and cystic lesions of the pancreas--a diagnostic dilemma

Ponnudurai R

Med J Malaysia, 2005 Jul;60 Suppl B:101-3.

PMID: 16108187

Matched MeSH terms: Pancreas/physiopathology; Pancreas/ultrasonography

Fulltext Three cases of permanent neonatal diabetes mellitus: genotypes and management outcome

Ooi HL, Wu LL

Singapore Med J, 2012 Jul;53(7):e142-4.

PMID: 22815030

Neonatal diabetes mellitus (DM) is defined as insulin-requiring DM in the first six months of life. Unlike type 1 DM, it is a monogenic disorder resulting from a de novo mutation in the genes involved in the development of the pancreas, β-cell mass or secretory function. The majority of neonatal DM cases are caused by a heterozygous activating mutation in the KCNJ11 or ABCC8 genes that encode the Kir6.2 and SUR1 protein subunits, respectively, in the KATP channel. Sulphonylurea, a KATP channel inhibitor, can restore insulin secretion, hence offering an attractive alternative to insulin therapy. We report three cases of neonatal DM and their genetic mutations. Two patients were successfully switched over to sulphonylurea monotherapy with resultant improvement in the quality of life and a more stable blood glucose profile. Patients with neonatal DM should undergo genetic evaluation. For patients with KCNJ11 and ABCC8 gene mutation, oral sulphonylurea should be considered.

Matched MeSH terms: Pancreas/physiology

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