The presence and distribution of renin-like activity in hypophysis, pineal gland and some neural tissues were studies in both normal and salt-loaded rats. The Boucher micromethod was used to detect enzymatic activity. In normal rats both the pituitary and pineal glands contained significantly higher values of renin-like activity than did the other tissues examined. In salt-loaded animals there was a significant decrease of the renin-like activity of the glandular tissue while in the other brain areas the activity increased. The results are discussed in terms of the possible physiological role of the central renin-angiotensin system in the regulation of fluid and electrolyte balance.

Context. Nonalcoholic fatty liver disease (NAFLD) includes simple steatosis, steatohepatitis (NASH) which can evolve with progressive fibrosis, cirrhosis and hepatocellular carcinoma. As liver biopsy cannot be used as a screening method, noninvasive markers are needed.Objective. The aim of this study was to test if there is a significant association between vitamin D deficit and the severity of NAFLD.Design. The patients were divided into two groups (vitamin D insufficiency/deficiency) and statistical analyses were performed on the correlation of clinical and biochemical characteristics with histopathological hepatic changes.Subjects and methods. We prospectively studied 64 obese patients referred for bariatric surgery between 2014 and 2016 to our Surgical Unit. Anthropometric, clinical measurements, general and specific biological balance were noted. NAFLD diagnosis and activity score (NAS) were evaluated on liver biopsies.Results. Increased serum fibrinogen was correlated with NASH (p=0.005) and higher NAS grade. T2DM was positively correlated with liver fibrosis (p=0.002). 84.37% of the patients had vitamin D deficit and 15.62% were vitamin D insufficient. Lobular inflammation correlated with vitamin D deficit (p=0.040). Fibrosis (p=0.050) and steatohepatitis (p=0.032) were independent predictors of low vitamin D concentration.Conclusions. Vitamin D status in conjunction with other parameters -such as T2DM -or serum biomarkersnamely fibrinogen level and PCR level -may point out the aggressive forms of NAFLD and the need for liver biopsy for appropriate management.

No abstract

Journal of Surgery IntroductionPancreatic cancer is one of the most lethal malignancies worldwide, and ranks fourth in the total number of deaths related to cancer in patients of both genders. Moreover, in 2013 the United States registered about 45,000 new cases, and reported that the number of expected deaths was very similar to the number of new cases. Also, the median overall survival at 5 years is between 2 and 6% [1].Also, adenocarcinoma of the pancreas is the most common type of pancreatic neoplasm, with all of its subtypes accounting for 85% of cases [1,2].Currently, curative treatment is only possible in cases of resectable disease and during the initial stages [3]. Still, although complete surgical resection is the only potential curative approach of this disease, it can only be performed in 10 to 20% of patients, since most individuals present with advanced disease upon diagnosis [3,4]. Moreover, after surgical resection, 7 to 25% of patients have a 5-year survival rate [5], with better results in individuals which undergo curative resection (R0) [6].The prognosis for the patients with pancreatic cancer and which have indication for the resection with curative intent is determined by the lymphatic metastasis, the invasion of vascular walls and the peripancreatic nerve plexus or also by the degree of the micrometastases in nearby tissues and organs.As we mentioned before, unfortunately 95% of patients come to the doctor when the cancer is advanced and unresectable [7][8][9]. Moreover, in the recent decades the development of surgical techniques have only improved postoperative mortality, without having any significant impact on the survival, with specialized pancreatic surgery centres reporting a mortality below 5% [10,11].Approximately 60% of pancreatic cancers have cephalic location. With the reduction of operative mortality after duodenopancreatectomies, improved survival rates of 30% were reported [12], which is three times higher than previously published results [13,14]. AbstractPancreatic cancer is one of the most lethal malignancies worldwide and in some of the latest statistics ranks fourth in the total number of deaths related to cancer in patients of both genders. Currently, curative treatment is only possible in cases of resectable disease and during the initial stages. Still, although complete surgical resection is the only potential curative approach of this disease, it can only be performed in 10 to 20% of patients, since most individuals present with advanced disease upon diagnosis. Moreover, in the recent decades the development and improvement of surgical techniques have only improved postoperative mortality, without having any significant impact on the survival, with specialized pancreatic surgery centres reporting mortality below 5%. In this way, in the present study conducted on 188 patients from the "St. Spiridon" Clinical Emergency Hospital Iasi, we were interested in determining the survival rates in pancreatic cancer, as well as looking at the staging criteria for adenocarcinom...

Objective: Identifying the morphological features of thymus in patients with myasthenia gravis (MG) with anti-acetylcholine receptor (AChR) antibodies and concomitant Hashimoto's thyroiditis (HT), which were recruited from a single surgical unit of a tertiary referral hospital located in the North-Eastern region of Romania, over a period of 11 years. Patients, Materials and Methods: We retrospectively reviewed clinical, imaging, laboratory, thymic pathology, and outcome data that were obtained from medical records of patients with MG and concomitant HT, to whom a thymectomy was performed for a suspected thymic lesion. All the surgical interventions were done in the Third Clinic of

Lately there is some discussion about an inverse relationship exists between calcium intake and obesity markers such as body weight, weight gain or body fat percentage. However, numerous studies question the idea whether adequate calcium nutrition can prevent or even reduce obesity. However, the disagreement from many studies seems to have more to do with the interpretation of the data than the data itself, with different hypothesis which could be valid in different specific populations. Still, the major finding we present here are in line with previous research demonstrating that lower levels of serum calcium are common after bariatric surgeries.

We present the case of a 71-year-old male who suffered an episode of acute renal failure caused by the uncommon association of two different diseases (Clostridioides difficile infection and McKittrick-Wheelock syndrome). He presented with hypovolemic shock, severe hypokalemia, hyponatremia, metabolic acidosis and acute renal failure; consequences of secretory diarrhea caused by a giant rectal tumor revealed from colonoscopy. The biopsy results revealed tubulo-villous adenoma with low/high grade dysplasia. After correction of electrolyte imbalances and azotemia, the patient underwent surgical resection with full subsequent recovery. In the literature review, including papers published from which January 1945 to April 2021, we found only one case-report of acute renal failure associated with Clostridioides difficile infection and McKittrick-Wheelock syndrome.

Pancreatic cancer is one of the most severe malignant disease, with an extreme degree of lethality, considering that the survival rate at 5 years is up to 4%. In addition, a major disadvantage of this disease is the fact that the diagnosis is determined very late in the evolution of the disorder, despite the development of new technologies. In this way, the main symptoms are occurring later on, when the tumour is already locally advanced and unresectable. Up to now surgery is the only modality that can provide a greater chance of survival, but unfortunately the pancreatic resection has many unknowns and controversies around it. Moreover, the studies on endocrine pancreatic function after resection are very few and somehow controversial. In this way, in the present mini-review we will describe the most relevant experimental data regarding the post-resection pancreatogenic diabetes, the pancreatic polypeptide PP and the pancreatic glucose metabolism after resection or the glucose metabolism after partial or total pancreatectomy.