Effects of subtotal pancreatectomy and long-term glucose and lipid overload on insulin secretion and glucose homeostasis in minipigs

INTRODUCTION

Nowadays, there are no strong diabetic pig models, yet they are required for various types of diabetes research. Using cutting-edge techniques, we attempted to develop a type 2 diabetic minipig model in this study by combining a partial pancreatectomy (Px) with an energetic overload administered either orally or parenterally.

METHODS

Different groups of minipigs, including Göttingen-like (GL, n = 17) and Ossabaw (O, n = 4), were developed. Prior to and following each intervention, metabolic assessments were conducted. First, the metabolic responses of the Göttingen-like (n = 3) and Ossabaw (n = 4) strains to a 2-month High-Fat, High-Sucrose diet (HFHSD) were compared. Then, other groups of GL minipigs were established: with a single Px (n = 10), a Px combined with a 2-month HFHSD (n = 6), and long-term intraportal glucose and lipid infusions that were either preceded by a Px (n = 4) or not (n = 4).

RESULTS

After the 2-month HFHSD, there was no discernible change between the GL and O minipigs. The pancreatectomized group in GL minipigs showed a significantly lower Acute Insulin Response (AIR) (18.3 ± 10.0 IU/mL after Px vs. 34.9 ± 13.7 IU/mL before, p < .0005). In both long-term intraportal infusion groups, an increase in the Insulinogenic (IGI) and Hepatic Insulin Resistance Indexes (HIRI) was found with a decrease in the AIR, especially in the pancreatectomized group (IGI: 4.2 ± 1.9 after vs. 1.5 ± 0.8 before, p < .05; HIRI (×10^-5 ): 12.6 ± 7.9 after vs. 3.8 ± 4.3 before, p < .05; AIR: 24.4 ± 13.7 µIU/mL after vs. 43.9 ± 14.5 µIU/mL before, p < .005). Regardless of the group, there was no fasting hyperglycemia.

CONCLUSIONS

In this study, we used pancreatectomy followed by long-term intraportal glucose and lipid infusions to develop an original minipig model with metabolic syndrome and early signs of glucose intolerance. We reaffirm the pig's usefulness as a preclinical model for the metabolic syndrome but without the fasting hyperglycemia that characterizes diabetes mellitus.

Characterization of one anastomosis gastric bypass and impact of biliary and common limbs on bile acid and postprandial glucose metabolism in a minipig model

The alimentary limb has been proposed to be a key driver of the weight-loss-independent metabolic improvements that occur upon bariatric surgery. However, the one anastomosis gastric bypass (OAGB) procedure, consisting of one long biliary limb and a short common limb, induces similar beneficial metabolic effects compared to Roux-en-Y Gastric Bypass (RYGB) in humans, despite the lack of an alimentary limb. The aim of this study was to assess the role of the length of biliary and common limbs in the weight loss and metabolic effects that occur upon OAGB. OAGB and sham surgery, with or without modifications of the length of either the biliary limb or the common limb, were performed in Gottingen minipigs. Weight loss, metabolic changes, and the effects on plasma and intestinal bile acids (BAs) were assessed 15 days after surgery. OAGB significantly decreased body weight, improved glucose homeostasis, increased postprandial GLP-1 and fasting plasma BAs, and qualitatively changed the intestinal BA species composition. Resection of the biliary limb prevented the body weight loss effects of OAGB and attenuated the postprandial GLP-1 increase. Improvements in glucose homeostasis along with changes in plasma and intestinal BAs occurred after OAGB regardless of the biliary limb length. Resection of only the common limb reproduced the glucose homeostasis effects and the changes in intestinal BAs. Our results suggest that the changes in glucose metabolism and BAs after OAGB are mainly mediated by the length of the common limb, whereas the length of the biliary limb contributes to body weight loss.NEW & NOTEWORTHY Common limb mediates postprandial glucose metabolism change after gastric bypass whereas biliary limb contributes to weight loss.

Application to proteomics to understand and modify meat quality

The use of proteomics in the field of meat science has gained in robustness and accuracy. This is consistent with the genomic and bioinformatic tools. Its application to sensorial and technological meat quality traits is discussed as well as the emergence of sanitary and nutritional issue which will grow in a next future.

[Differenciated function: prospects for the nursing profession in Belgium]

The hospital and medical contexts are undergoing profound change. All professions must follow this evolution, in particular, the nurse profession. The care offer and the care demand are unbalanced: the clinical situations become more complex and the staff is insufficient quantity. The function differentiation can be a solution for the nurse profession. The aim of this study is to evaluate the feasibility of the function differentiation for the nurse profession in Belgium. Based on 364 "patient situations a derived from hospital experiences, required activities and competencies are depicted by more 200 nurses; the complexity of each competency is also evaluated by standardized scales of complexity. A cluster analysis is performed in order to pool all identified competencies. For each department, four groups are identified; each group is relevant on the statistical level but also on the clinical level. The results speak for a function differentiation in a vertical way, but not in a horizontal way between several different departments, in particular for the competencies needed a clinical judgement because these competencies are too specific by department, In conclusion, a function differentiation can be envisaged for the nurse profession in Belgium. Several models from foreign countries set an example for the practical modalities. Several advices in terms of education, lawful framework, interdisciplinary, and collaboration are formulated

[Pharmacological treatment of hypercholesterolaemia in primary prevention. The use of the different sources of information]

In the first two articles of this series devoted to Evidence-Based Medicine, we have shown how to translate a clinical problem in a well formulated question and how to derive search terms from the PICO. In this article, we describe in more detail the different sources of information and how to use them. The strategy will be illustrated by answering the question whether it should be recommended to treat hypercholesterolaemia in a young woman without cardiovascular risk factors. In a following article, we will show how to adapt a search strategy to a specific question or PICO.

Cervical artery dissections

Cervical artery dissection (CAD) accounts for up to one fifth of ischemic strokes occurring before 45 years. Their increasing recognition is probably due to an increased clinical awareness of this condition in patients with painful ischemic events. The internal carotid artery is the most commonly affected vessel. Cerebral ischemia is the most serious consequence of a CAD. It may be due to hemodynamic factors or emboli. The enlargement of the artery may lead to a direct compression of the lower cranial nerves. CAD typically occurs in young adults with a mean age of 40 years with a male:female ratio of 1.5. After exclusion of traumatic cases, the average annual incidence rate of CAD is 2.6 per 100,000, but the reported incidence figures in the literature are likely to be an underestimation of the incidence of CAD. A spontaneous dissection is assumed when no or only minor trauma preceded the onset. However, the differentiation between spontaneous and traumatic dissections is artificial because of a continuum between both forms. The pathogenesis of dissections remains unknown in most cases. However, traumas and primary diseases of the arterial wall are the main predisposing factors. The clinical presentation of spontaneous dissections of the internal carotid artery includes cerebral ischemia, cervical or cranial pain, Horner's syndrome and cranial nerve palsy; CAD may also be silent. Brainstem ischemic deficits and occipital pain are the most common findings in vertebral artery dissections, but these features may be biased because the most benign and the most severe cases may escape detection. The favorable natural history of CAD emphasizes the need for a noninvasive approach to the detection, monitoring and follow-up. This noninvasive approach can be obtained by means of CT scan, MRI, magnetic resonance angiography and ultrasonography, although angiography remains the gold standard for the diagnosis of arterial dissections. Follow-up studies suggest a fairly good overall prognosis in adults and in children. In many centers, CAD are treated by heparin at the acute stage, although the benefit of such a potentially dangerous treatment has never been proven by a randomized trial.

Cranial nerve palsies due to internal carotid artery dissection: seven cases

Cranial nerve palsies are rare complications of internal carotid artery (ICA) dissections. The aim of this study is to evaluate the incidence of cranial nerve palsies in consecutive patients with ICA dissection and to describe clinical and radiological characteristics and their evolution over time. This study was conducted in 52 consecutive patients with dissection of the ICA. We have analyzed clinical data of patients with cranial nerve palsy as complication of ICA dissection. We defined ICA dissection as angiographic evidence of a string sign, double lumen, or internal flaps or visualization on magnetic resonance imaging (MRI) or computed tomographic scans of an enlarged arterial wall due to the hematoma. Of 52 consecutive patients with ICA dissection 7 had cranial nerve palsies: 2 had an involvement of the Vth cranial nerve and 5 had lower cranial nerve palsies. Five patients totally recovered while 2 did not after a 2 to 10-month period. The frequency of cranial nerve palsies associated with ICA dissection is higher in our study than in those of the literature. Many patients presenting with cranial nerve palsies due to ICA dissection without any ischemic event are probably not referred to stroke units. Angiography is less sensitive than cervical MRI to detect such patients. Cranial nerve palsies could either be due to compression by the enlarged ICA wall or an ischemia of the nerve.

[The participation in sports of diabetic children. A survey in the Rouen region]

The purpose of this survey conducted during the 1987 academic year was to collect information on the participation in sports, whether at school or in athletic clubs, of 63 children followed on an outpatient basis for diabetes mellitus and to determine what steps are effectively taken by these children to prevent hypoglycemia. Simultaneously, the participation in sports of 200 children seen in a surgical outpatient clinic for any reason was determined. The data collected demonstrated that the diabetic children participated as actively as non-diabetic children in athletics at school and, in addition, were likely to participate in out-of-school non-compulsory sports (40% versus 27%). Approximately two out of three diabetic children reported attempting to prevent hypoglycemia during sports at school by an intake of carbohydrates before or after the activity and/or by a reduction in the dose of insulin acting during the activity, with variable results. Results suggested that hypoglycemic episodes tended to be overtreated, perhaps in part because the teachers were apprehensive about the possible negative effects of hypoglycemia. During out-of-school non-compulsory athletic activities, especially competitive sports, preventive measures against hypoglycemia were consistently taken and diary results seemed to improve steadily in patients who trained regularly several times a week. Lastly, in the population studied no correlation was found between the time spent every week participating in sports and glycated hemoglobin levels.

Nonmetastatic tumor cells acquire metastatic properties following somatic hybridization with normal cells

Somatic cell hybridization between nonmetastatic tumor cells and normal cells of the lymphoreticular system results in hybrid cells manifesting metastatic properties of defined target organ specificity. Thus, fusion of the nonmetastatic BALB/c originated NSI plasmacytoma with C57BL B lymphocytes resulted in hybridomas, each of which were metastatic. Of 10 hybridomas, 7 generated metastases in the spleen and liver, whereas 3 generated liver metastases. The generation of liver metastases by hybridomas which homed to both spleen and liver, but not by those which homed to the liver only, was controlled by the spleen. The acquisition of metastatic properties via somatic cell fusion seems to represent a general principle, in which the normal partner determines the target organ specificity for the metastatic growth. Thus, fusion of SP2/O myeloma cells with syngeneic B lymphocytes also resulted in a hybrid cell metastasizing to the spleen and liver, yet a somatic hybrid between NSI and a macrophage or dendritic-like cell metastasized to the lung. Cell surface molecules encoded by the genome of the normal partner was demonstrated to control the target organ specificity: antibodies against MHC-encoded antigens of the normal B cell partner prevented the generation of metastases by hybridomas metastasizing to the spleen and liver, but not by those metastasizing to the liver only. This is in accordance with the function of MHC molecules on lymphocytes in controlling their homing to lymphoid organs. Hybridomas of T cell lymphomas also manifested metastatic properties. Analysis of the cell surface Thy-1 antigens of a hybridoma (DCH10), produced via somatic fusion between BW5145 lymphoma and a putative macrophage cell indicated that cells of liver metastases (DCH10-Li) generated by the hybrid cells might have undergone further somatic cell fusion in vivo with host (T?) cells. These cells have acquired new metastatic properties, generating metastases in spleen, liver and kidneys. In fact, even the inoculation of the parental BW lymphoma cells resulted in a case of liver metastasis (BW-Li). Such BW-Li cells, upon reinoculation, also generated metastases in the spleen, liver and kidneys. Analysis of the Thyl phenotype indicated that BW-Li cells may also have undergone somatic cell fusion in vivo with host (T?) cells, resulting in the acquisition of metastatic properties. The pattern of cell-cell interactions (adhesion, infiltration) with liver cell monolayers of BW-Li cells and of DCH10-Li (T-cell lymphomas) was identical, and differed from cells of liver metastases of the myeloma-B cell hybridomas which might be based on responses to liver growth signals.(ABSTRACT TRUNCATED AT 400 WORDS)