급성췌장염으로 인한 혈장 및 간장의 지질변동에 관한 실험적 연구

Abstract

[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.