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Pancreatic encephalopathy is a serious, often lethal complication of acute pancreatitis (AP). Its pathomechanism remains obscure. We have previously described increased blood levels of quinolinic acid (QUIN) -an endogeneous neurotoxine -during edematous experimental acute pancreatitis. Several other metabolites of tryptophan (TRP) are also known to be neuroactive. The aim of the present study was to assess tryptophan and its main metabolites: kynurenine (KYN), 3-hydroxykynurenine, quinolinic acid (QUIN), kynurenic acid (KYNA), serotonin (5HT) during experimental acute necrotizing acute pancreatitis. Experimental necrotizing acute pancreatitis was induced in rats by intraductal injection of 5% sodium taurocholate. Control groups consisted of sham-operated and not operated rats. The animals were sacrificed 5 and 24 hours after the operation. We evaluated -amylase, pancreas weight and histology as parameters of pancreatitis. A simplified neurological scoring system was applied. To assess TRP and its metabolites in plasma, we used high performance liquid chromatography. Five hours after the onset of AP we found significant increase in TRP metabolites: QUIN, KYNA, KYN, and 3HKYN in the plasma of animals with AP, as compared to the control group. When assessed 24 hours after induction of AP, those changes were no longer observed in blood. Instead, a decrease in TRP level appeared. Increase in plasma QUIN was associated with neurologic disturbances. In the present study we demonstrated transient activation of kynurenine pathway during early stages of experimental necrotizing AP, with increased blood levels of QUIN, KYNA, KYN, and 3HKYN and subsequent depletion of TRP. As some kynurenine derivatives, e.g. quinolinic acid, are endogenous toxins, they might contribute to neurologic and other organs disturbances during AP.

Insulin Like Growth Factor (IGF I) as the one of the strongest growth factors which can affect cancers development including colorectal cancer. IGF I induces processes of the cells growth and division. It regulates cells cycle and inhibits apoptosis. There is limited data about correlation between IGF I and staging of the tumor. the aim of the study was estimation of the clinical usefulness of IGF I concentration in the serum of the patients with colorectal cancer. Material and methods. We have examined 125 individuals with colorectal cancer. The age range was 36 to 92 years. They have been operated in the 2nd Departament of The Gastrointestinal Surgery of the Medical University in Białystok. Serum concentration of the IGF I have been estimated using immunoassay ELISA before and after operation. Correlation between serum level of IGF I and clinicopathologic features: age, gender, localisation of the primary tumor, TNM stage of tumor, histological type and histological grade (G) of the cancer have been estimated. Results. Our study revealed statistically significant increased serum concentration of IGF I in patients with locally advanced colorectal cancer (pT3 and pT4) comparing to less advanced (pT2) The investigations showed higher serum concentration of IGF I in patients with poorly differentiated cancers (G3) than in moderately differentiated. Similarly higher serum concentration of IGF I were found in male, in patients older than 60 years and in mucigenous colorectal cancers. conclusions. Our results indicated that IGF I can be one of the factors of the prognosis in colorectal cancer development.

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SummaryBackgroundSplenic artery aneurysm is the third most common abdominal aneurysm. Most often it is due to pancreatitis. There were only 19 cases of aneurysms larger than 5 cm in diameter described in the literature. Management of splenic artery aneurysms depends on the size and symptoms. Invasive treatment modalities involve open procedures and interventional radiology methods (endovascular).Case ReportsA 44-years-old male with chronic pancreatitis, in a gradually worsening general condition due to a large splenic artery aneurysm, was subjected to the procedure. Blood flow through the aneurysm was cut-off by implanting a covered stent between celiac trunk and common hepatic artery. Patient’s general condition rapidly improved, allowing discharge home in good state soon after the procedure.ConclusionsPercutaneous embolization appears to be the best method of treatment of large splenic artery aneurysms. Complications of such treatment are significantly less dangerous than those associated with surgery.