The Diabetic Pancreas PDF
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The Diabetic Pancreas The Diabetic Pancreas Edited by Bruno W. Yolk Isaac Albert Research Institute, Brooklyn, New York and University of California, Irvine, California and Klaus F. Wellmann Isaac Albert Research Institute, Brooklyn, New York and Beekman Downtown Hospita~ New York Plenum Press· New York and London Library of Congress Cataloging in Publication Data Main entry under title: The Diabetic pancreas. Includes bibliographical references and index. 1. Diabetes. 2. Islands of Langerhans. I. Volk, Bruno W. II. Wellmann, Klaus F. [DNLM: 1. Diabetes mellitus. 2. Islands of Langerhans-Physiopathology. WK810 V916d] RC660.D57 616.4'62 77·7321 ISBN-13: 978-1-4684-2327-3 e-ISBN-13: 978-1-4684-2325-9 DOl: 10.1007/978-1-4684-2325-9 © 1977 Plenum Press, New York Softcover reprint of the hardcover 1st edition 1977 A Division of Plenum Publishing Corporation 227 West 17th Street, New York, N.Y. 10011 All rights reserved No part of this book may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, microfilming, recording, or otherwise, without written permission from the Publisher Contributors Charles H. Best University of Toronto, Ontario, Canada Lennart Boquist University of lTmea, Umea, Sweden John E. Craighead University of Vermont, Burlington, Vermont Werner Creutzfeldt Medizinische Klinik und Poliklinik der Universitat, GOttingen, West Germany William E. Dulin The Upjohn Company, Kalamazoo, Michigan Sture Falkmer University of Umea, Umea, Sweden Willy Gepts Universitair Ziekenhuis Brugmann, Vrije Universiteit Brussel, Brussels, Belgium Orion D. Hegre University of Minnesota, Minneapolis, Minnesota Claes Hellerstrom University of Uppsala, Uppsala, Sweden Paul E. Lacy Washington University, St. Louis, Missouri Arnold Lazarow Late of the University of Minnesota, Minneapolis, Minnesota Philip M. LeCompte Formerly Faulkner Hospital and Harvard Medical School, Boston, Massachusetts Rachmiel Levine City of Hope National Medical Center, Duarte, California Arthur A. Like University of Massachusetts, Worcester, Massachusetts Auguste Loubatieres Late of the Faculte de Medecine de Montpellier, Montpellier, France Lelio Orci Institute of Histology, Medical School, University of Geneva, Geneva, Switzerland Yngve Ostberg University of Umea, Umea, Sweden Alain Perrelet Institute of Histology, Medical School, University of Geneva, Geneva, Switzerland M. G. Soret The Upjohn Company, Kalamazoo, Michigan v vi Contributors Bruno W. Yolk Isaac Albert Research Institute of the Kingsbrook Jewish Medical Center, and Downstate Medical Center, State University of New York, Brooklyn, New York. Present address: University of California, Irvine, California Klaus F. Wellmann Isaac Albert Research Institute ofthe KingsbrookJewish Medical Center, and Downstate Medical Center, State University of New York, Brooklyn, New York. Present address: Beekman Downtown Hospital, New York, New York Foreword I consider it an honor to have been asked to write the Foreword for The Diabetic Pancreas. Although I have been involved in the study of the pancreas since 1921, my interest goes back even further to the time, in 1918, that my father's sister, a nurse who had trained at the Massachusetts General Hospit.al, devel oped diabetes, lost weight, and died in diabetic coma. This sad event made a deep impression on me and was certainly pardy responsible for my choosing to join the Department of Physiology of the University of Toronto to begin a career in research into diabetes. This is not the place to describe in detail the wide-ranging research and study of the diabetic pancreas in which I have engaged in the past 56 years. Suffice it to say that I am familiar enough with the subject area to be able to predict a great future for this book. The editors have undertaken a very ambitious and worthwhile project, and their efforts have been supported and strengthened by contributors who are respected authorities in their fields, thus ensuring a successful presentation of this major work. From my constant study of pertinent books and journals-and particularly from reading the accounts of the many seminars held on the fiftieth anniver sary of the discovery of insulin-I know the awesome extent of the literature that the editors and contributors to this volume had to review in order to prepare their chapters. This book, then, will fill a great need, and medical scientists and chemists from all over the world will profit from it. But ultimately, of course, it is the diabetic patient who is the beneficiary when a splendid source of information like The Diabetic Pancreas is added to the literature and made available to researchers and practitioners in the field. Charles H. Best vii Preface Since the publication of the monograph by Lazarus and Volk on The Pancreas in Human and Experimental Diabetes in 1962, important progress has been made in various fields of diabetes research, which contributed considerably to a better understanding of this disease. The significant advances in morphologic tech niques such as quantitative and qualitative histochemistry, staining with fluores cent antibodies, electron microscopy, and others, applied to human and experi mental diabetes, have contributed to a more fundamental appreciation of the physiological processes occurring in the islets of Langerhans. Particularly, the growing field of research in various animal species which exhibit spontaneous or hereditary disturbances of carbohydrate metabolism has remarkably wid ened the scope of our knowledge of diabetes. Various studies have contributed to the present-day concepts concerning the secretion of insulin and the importance of the A cells in blood sugar homeostasis and also to the clarification of the function of the D cells. More over, the availability of various drugs such as the sulfonylureas, streptozotocin, and others have immeasurably aided in the study of the islet physiology. As a result of these and other newly developed techniques, such as the isolation of islets, it became possible to better evaluate the physiology involved, particularly of the B cells of the islets of Langerhans. Because of the increasingly broad interest in diabetes mellitus and its complications, several handbooks and proceedings of various symposia dealing with this subject have been published in the past decade. However, there are few volumes which deal almost exclusively with the pancreatic changes in human and experimental diabetes. The aim of this book is to present a more integrated approach to the correlation between morphologic alterations and the various metabolic aspects of diabetes. Furthermore, the editors have attempted to integrate the more recent concepts of the pathogenesis of this disease which resulted from new fundamental physiological and experimental observations. The authors contributing to this monograph are recognized authorities in the various fields dealing with comparative morphology, pathology, and patho physiology of the endocrine pancreas. It is therefore hoped that these com bined efforts have produced a source book which is readable and thoroughly referenced. As this volume goes to press new areas of research are still being in vestigated. Although many are promising, they are not as yet sufficiently under- ix x Preface stood or developed. Experimental and clinical evidence indicates that the diabetic syndrome is more complex than originally thought. The chronologie aspects which have been incorporated in this volume are considered to be of importance to the evolution of our knowledge of the pathology and pathophysiology of the endocrine pancreas and its many interre lationships with other hormonal glands involved in carbohydrate metabolism. However, these considerations have been kept to a minimum, in keeping with the principal purpose of this monograph which deals primarily with the mor phologic aspects of the diabetic pancreas. There will be unavoidable overlaps of certain observations and ideas in various chapters. However, it appears to us that the incorporation of some similar material in different parts of this volume will help to elucidate the presented facts. The editors are indebted to Mrs. Renee Brenner and Mrs. Sarah Ginsberg for reviewing and typing the manuscripts and to Mr. Herbert A. Fischler, Chief Medical Photographer of the Isaac Albert Research Institute, who prepared some of the microphotographs. We gratefully acknowledge the cooperation of Plenum Publishing Corporation in making this book possible. Brooklyn, N.Y. B.W.V. K.F.W. Contents Introduction Rachmiel Levine Chapter 1 Historical Review .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 Klaus F. Wellmann and Bruno W. Volk Chapter 2 Comparative Morphology of Pancreatic Islets in Animals ............. 15 Sture Falkmer and Yngve Ostberg Chapter 3 Growth Pattern of Pancreatic Islets in Animals. . . . . . . . . . . . . . . . . . . . . . . 61 Claes H ellerstrom Chapter 4 Histology, Cell Types, and Functional Correlation of Islets of Langerhans 99 Klaus F. Wellmann and Bruno W. Volk Chapter 5 Quantitative Studies of the Islets of Nondiabetic Patients. . . . . . . . . . . . .. 121 Bruno W. Volk and Klaus F. Wellmann Chapter 6 Histochemistry and Electron Microscopy of Islets 129 Lennart Boquist Chapter 7 Morphology of Membrane Systems in Pancreatic Islets. . . . . . . . . . . . . . .. 171 Lelio Orci and Alain Perrelet xi xii Contents Chapter 8 The Physiology of Insulin Release . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 211 Paul E. Lacy Chapter 9 Idiopathic Diabetes 231 Bruno W. Volk and Klaus F. Wellmann Chapter 10 Pathogenic Considerations of Idiopathic Diabetes .................... 261 Bruno W. Volk and Klaus F. Wellmann Chapter 11 Hormonal Diabetes 271 Bruno W. Volk and Klaus F. Wellmann Chapter 12 Pancreatitis, Pancreatic Lithiasis, and Diabetes Mellitus. . . . . . . . . . . . . . .. 291 Klaus F. Wellmann and Bruno W. Volk Chapter 13 Cancer and Diabetes. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . .. 311 Bruno W. V olk and Klaus F. Wellmann Chapter 14 Hemochromatosis and Diabetes 317 Bruno W. Volk and Klaus F. Wellmann Chapter 15 The Pathology of Juvenile Diabetes. . . . .. . . . . .. . . . . . . . . . . . . . . . . . . ... 325 Philip M. LeCompte and Willy Gepts Chapter 16 The Islets of Infants of Diabetic Mothers. . . . . . . . . . . . . . . . . . . . . . . . . . .. 365 Klaus F. Wellmann and Bruno W. Volk Chapter 17 Spontaneous Diabetes in Animals 381 Arthur A. Like
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