Despite considerable investigation the basic causes of this discrepancy remain unknown, although it is thought that the extensive processing applied to both plasma-derived and recombinant concentrates could lead to differences

in their rates of activation and inactivation in the two method types from the FVIII in normal plasma, and there is some evidence for this from recent studies [29]. A resolution of this problem is only possible when the exact causes of the discrepancy are discovered; it may then be possible to adjust one or both of the methods to give similar EPZ-6438 research buy values. In the meantime, a practical solution which has been discussed by the FVIII/FIX Subcommittee of ISTH/SSC is to regard the post infusion samples as concentrates, ‘diluted’ in a patient’s plasma, which is essentially what they are, selleck products and use a concentrate standard, diluted in haemophilic plasma, instead of a plasma standard, to construct the standard curve.

However, the nature of the concentrate standard needs to be carefully considered; it should be as similar as possible to the injected product. This approach has been tested in a number of in vivo recovery studies, and the discrepancy between one-stage and chromogenic methods using the plasma standard was completely abolished with the appropriate concentrate Cytidine deaminase standard [30]. However, in one case

the use of a concentrate standard, in this case not the same as the product infused, made the situation worse. Therefore, the use of concentrate standards needs to be product specific, and should probably be restricted to recombinant and very high-purity plasma-derived products. Most recently, a number of modified FVIII and FIX concentrates have been developed with novel properties, introduced through structural or chemical modifications (e.g. truncation, pegylation, fusion) to improve manufacturing yield or to prolong plasma half-life. These will challenge the traditional approach to potency labelling relative to the WHO IS [31, 32]. Potency estimation of pegylated versions of both FVIII and FIX, by the one-stage clotting method, appears to be associated with particular issues relating to the direct interference of the polyethylene glycol with some APTT reagents [33], and it may be necessary in some cases to use product specific standards for monitoring. However, there are indications that most modified products are amenable to potency estimation using conventional methods. Nonetheless, decisions on the potency labelling should be guided by a thorough characterization, in vitro relative to the WHO IS, which should include the effect of different reagents (e.g.

Endoscopic equipment was set up at the health center in Niijima, and skilled endoscopists performed screening using colonoscopy. Endoscopic removal or surgery was indicated

for all detected lesions. The participants were treated at the National Cancer Center Hospital within 6 months after colonoscopy. Results: A total of 656 (39.3%) individuals provided consent for this screening program, and 87.0% (571/656) of participants chose colonoscopy as the primary screening procedure. The participation rate of individuals aged 40–69 years was significantly higher than Selleck RG-7204 that of individuals aged 70–79 years (42.4 vs. 29.8%; P < .0001). The completion rate of total colonoscopy was 99.6% (569/571) and there was no complication during this program. Detection rates of invasive cancer, high-grade dysplasia (HGD), advanced neoplasia, and any adenoma were 0.52% (n = 3), 2.6% (n = 15), 12.1% (n = 70), and 50.0% (n = 289), respectively. The adenoma detection rate in men and women aged 40–49 years, 50–59 years, 60–69 years, and 70–79 years was 42.2% and 26.3%, 65.3% and 28.0%, 68.7% and 43.8%, and 73.3% and 50.0%, respectively. The adenoma detection rate and incidence AZD1208 supplier of advanced neoplasia were significantly

higher in men than in women in all age groups; however, there was no difference in the incidence of HGD and invasive cancer between men and women. Conclusion: The CRC screening program using colonoscopy that was conducted on an island achieved considerably higher participation rate than the conventional screening program using FIT. Completion rate and safety of screening colonoscopy were excellent during aminophylline this program. Detection rates of advanced neoplasia and any adenoma by skilled endoscopists in this program were considerably higher than those of previous reports. Key Word(s): 1. colon cancer screening; 2. colonoscopy; 3. adenoma detection rate Presenting Author: MITSUKO INUYAMA Additional Authors: AI FUJIMOTO, YOSHINORI IGARASHI Corresponding Author: MITSUKO INUYAMA Affiliations: Toho University Omori Medical Center, Toho University Omori Medical Center Objective: Many patients with

colonic diverticular bleeding experience recurrent bleeds within short periods, even when the site of the bleeding is detected and we performed endoscopic hemostasis with clipping. In this study we found the therapeutic barium enema to be effective for colonic diverticular rebleeding within 7 days after administration for lower gastrointestinal endoscopy. Methods: We retrospectively analyzed 219 cases of colonic diverticular bleeding treated between 2003 and 2011. Lower gastrointestinal endoscopy was performed immediately after admission in all cases. Some of these patients received a therapeutic barium enema with 600 ml of 60 w/v percentage barium in addition to conventional therapy. Results: The site of bleeding was identified in 138 (63%) of the 219 patients, and all of these patients underwent endoscopic hemostasis with clipping.

Methods: Twenty

refractory FD patients with high levels of emotional distress who have failed to all motility-type agents or other gastrointestinal treatments were as FD group. Twenty healthy people were chosen as control. Personality traits and VT were observed for every people. Eysenck Personality mTOR inhibitor Questionnaire (EPQ) was used to assess the personality of neuroticism (N), psychoticism (P), extroversion (E), phlegmatic temperament, sanguine temperament, choleric temperament and melancholic temperament. HF and RMSSD as the indices of HRV were measured by 24 h Holter, which were used to as the indicator of vagal tone (VT). The low VT was low HF and RMSSD declining. Results: (1) The value of HF and RMSSD were significantly lower in FD group than healthy group (P < 0.05); (2) The scores of P and N in FD group were higher Navitoclax than those of healthy group (P < 0.05);

But the scores of E in FD group was lower (P < 0.05); (3) The declining HF was related to neuroticism (N) in two groups (P < 0.05), which was no relationship with psychoticism (P) and extroversion (E) (P > 0.05); Interestingly, the patients with melancholic temperament have lower HF than other traits in healthy group (p < 0.05). Conclusion: The study found that the refractory FD patients have personality tendency of neuroticism, introversion, psychoticism, and low VT. In the healthy group, the personality of melancholic temperament (low scores of E and high scores of N) also has appeared low HF, and low HF was related to high N. These results show melancholic stiripentol temperament has tendency of vagus nerve dysfunction, and this trait may be more easily to suffer from refractory FD. Therefore, refractory FD may be based on personality traits, especially melancholic temperament. Key Word(s): 1.

Refractory FD; 2. Personality Traits; 3. Vagal Tone; Presenting Author: XINGYU LIU Additional Authors: HAO LIANG Corresponding Author: XINGYU LIU Affiliations: Chinese PLA General Hospital; Chinese PLA General Hospital Objective: To analyze the clinical and endoscopic characteristics, and treatment methods of 11 adult Henoch-Schonlein Purpura (HSP) with gastrointestinal involvement so as to improve the early diagnosis and treatment of this disorder. Methods: A retrospective study in 11 adult HSP patients with gastrointestinal involvement enrolled from 2008 to 2012 at Chinese PLA General Hospital was conducted. Results: The 11 adult HSP patients with gastrointestinal involvement enrolled in this study were mainly youth, and 5 patients (45.4%) have obvious inducing causes. All the patients had cutaneous purpura and abdominal pain, and the severity of abdominal pain was not concordant with physical signs. Abdominal pain occurred prior to cutaneous purpura in 7 patients (63.6%), and 8 patients (72.7%) had gastrointestinal bleeding.

Global Positioning System (GPS) collars placed on adult female animals representing the three ungulate

species enabled their locations and habitat use to be recorded in fine temporal and spatial detail, and allowed places where animals had recently been feeding to be located. Hence, we could record the resource use of all three species simultaneously across a comprehensive range of scales. Based on the concepts outlined above, we expected that: Following the resource availability hypothesis, buffalo (because of their large size) and zebra (because of their hindgut fermentation) would occupy a wide range of habitat selleck kinase inhibitor types, while sable would concentrate more narrowly in habitats less thoroughly exploited by the two more abundant competitors. In accordance with the niche breadth hypothesis, sable would (1) select foraging areas where grass was greener than in the broader landscape, whereas zebra and buffalo would more broadly exploit areas offering abundant but predominantly

brown grass; (2) precisely select feeding sites retaining green grass; (3) selectively feed on grass species regarded as relatively palatable because of high leaf : stem ratio, while buffalo and zebra would accept wider range of plant species. Dietary overlap between sable and buffalo or zebra would diminish over the course of the dry season as zebra and buffalo widened selleck compound their tolerance for the lower quality resources that remained abundantly available, while sable concentrated their resource use in places where some green grass remained. KNP covers almost 20 000 km2 along South Africa’s north-eastern border adjoining Mozambique. Our study area extended from Punda Maria camp in the far north of KNP (22°68′S, 31°018′E) towards the Mphongolo River, encompassing about 500 km2. This area formerly

supported among the highest local densities of sable antelope in KNP. However, sable numbers had decreased from a peak of 150–200 animals prior to 1988 to only around 25 animals at the time Clomifene of our study. Zebra numbers in the study area declined from around 600 to approximately 200 animals over the same period, while around 400 buffalo were present, up from the low of under 200 animals counted following the 1991/2 drought. Other grazers included about 700 Impala Aepyceros melampus, 50 Waterbuck Kobus ellipsiprymnus and fairly numerous African elephant Loxodonta africana. Wildebeest (Connochaetes taurinus) were absent. Buffalo and zebra constituted 90% of the regional grazer biomass, excluding elephant which feeds somewhat differently. Following Venter (1990), we distinguished the following habitat types, based on underlying geology and, hence, soils, vegetation composition and structure: (1) open bush savanna comprising Pterocarpus rotundifolius, Combretum collinum and Combretum apiculatum on mainly basalt-derived soils; (2) bush savanna comprising Terminalia sericea, C. collinum and C.

Global Positioning System (GPS) collars placed on adult female animals representing the three ungulate

species enabled their locations and habitat use to be recorded in fine temporal and spatial detail, and allowed places where animals had recently been feeding to be located. Hence, we could record the resource use of all three species simultaneously across a comprehensive range of scales. Based on the concepts outlined above, we expected that: Following the resource availability hypothesis, buffalo (because of their large size) and zebra (because of their hindgut fermentation) would occupy a wide range of habitat http://www.selleckchem.com/products/Methazolastone.html types, while sable would concentrate more narrowly in habitats less thoroughly exploited by the two more abundant competitors. In accordance with the niche breadth hypothesis, sable would (1) select foraging areas where grass was greener than in the broader landscape, whereas zebra and buffalo would more broadly exploit areas offering abundant but predominantly

brown grass; (2) precisely select feeding sites retaining green grass; (3) selectively feed on grass species regarded as relatively palatable because of high leaf : stem ratio, while buffalo and zebra would accept wider range of plant species. Dietary overlap between sable and buffalo or zebra would diminish over the course of the dry season as zebra and buffalo widened Selleck Bioactive Compound Library their tolerance for the lower quality resources that remained abundantly available, while sable concentrated their resource use in places where some green grass remained. KNP covers almost 20 000 km2 along South Africa’s north-eastern border adjoining Mozambique. Our study area extended from Punda Maria camp in the far north of KNP (22°68′S, 31°018′E) towards the Mphongolo River, encompassing about 500 km2. This area formerly

supported among the highest local densities of sable antelope in KNP. However, sable numbers had decreased from a peak of 150–200 animals prior to 1988 to only around 25 animals at the time Farnesyltransferase of our study. Zebra numbers in the study area declined from around 600 to approximately 200 animals over the same period, while around 400 buffalo were present, up from the low of under 200 animals counted following the 1991/2 drought. Other grazers included about 700 Impala Aepyceros melampus, 50 Waterbuck Kobus ellipsiprymnus and fairly numerous African elephant Loxodonta africana. Wildebeest (Connochaetes taurinus) were absent. Buffalo and zebra constituted 90% of the regional grazer biomass, excluding elephant which feeds somewhat differently. Following Venter (1990), we distinguished the following habitat types, based on underlying geology and, hence, soils, vegetation composition and structure: (1) open bush savanna comprising Pterocarpus rotundifolius, Combretum collinum and Combretum apiculatum on mainly basalt-derived soils; (2) bush savanna comprising Terminalia sericea, C. collinum and C.

, 1997). This polyP accumulation is due to the inhibition of polyP degradation by ppGpp rather than the loss of PhoU function (Kuroda & Ohtake, this website 2000; Kuroda, 2006). To determine whether YjbB reduces the levels of polyP under conditions of amino acid starvation, we introduced pMWyjbB into the wild-type strain and then subjected the transformant to amino acid starvation. The levels of polyP in the transformant were lower than those of the strain carrying a control vector plasmid (Fig. 2a). Escherichia coli also accumulates polyP when its growth is blocked by antibiotics that inhibit nucleic acid synthesis

(Kuroda & Ohtake, 2000; Kuroda, 2006). When treated with rifampicin, the levels of polyP in the transformant were also lower than those in the strain carrying a control vector plasmid (Fig. 2b). These results also supported the hypothesis that the reduction of polyP was not due to the suppression of the expression of Pho regulon genes including pstSCAB. As noted above, the N-terminal half of YjbB shows homology with Na+/Pi BMN 673 in vivo cotransporters, indicating the possible involvement of YjbB in the Pi flux. Escherichia coli possesses four Pi transporters (PitA, PitB, PhnCDE, and PstSCAB). Here, we constructed a mutant strain, MT2006, which lacks all four Pi transporters (Table 1). This mutant lost the ability to grow on a medium containing

Pi as the sole source of phosphorus (Pi medium) (Fig. 3a). To test whether YjbB is involved in Pi import, we introduced pMWyjbB into MT2006. However, this transformant still failed to grow on the Pi medium (Fig. 3a). Escherichia coli can utilize glycerol-3-phosphate as the sole source of Pi (Hayashi et al., 1964; Schweizer et al., 1982). The transformant could grow on a medium containing glycerol-3-phosphate as the sole source of phosphorus (GP medium) (Fig. 3b), indicating that YjbB has no or little Pi-uptake activity. On the other

hand, the transformant released approximately 1 mM Pi into the supernatant Forskolin datasheet when it grew for 8 h on the GP medium. To exclude the possibility that Pi was due to the degradation of glycerol-3-phosphate by an elevated alkaline phosphatase activity in the phoU mutant, we constructed MT2013 (phoA, yjbB, pitA, pitB, phnC, pstSCAB-phoU). Similar to MT2006, MT2013 and its transformant harboring pMWyjbB lost the ability to grow on Pi medium, but could grow on GP medium (Fig. 3). MT2013 carrying pMWyjbB still released a large amount of Pi into the GP medium, while MT2013 carrying a control vector plasmid only released a small amount of Pi during the lag phase (Fig. 4a and b). Escherichia coli can take up glycerol-3-phosphate via glycerol-3-phosphate transport systems (Ugp and GlpT) (Hayashi et al., 1964; Schweizer et al., 1982). The GlpT transport system can function in the exchange mode, so that glycerol-3-phosphate is taken up in exchange with internal Pi, while the Ugp system does not release Pi.

Most cases showed cystic mass with mural nodule and periventricular location was common. Although radiological findings can provide some evidence for this newly established tumor entity, differential diagnosis is still needed. “
“In this article, we present two can’t-miss findings on preoperative magnetic resonance imaging (MRI) using a 3.0-T MR system resulting in a better surgical option in prolactinoma treatment after emergent of dopamine agonists. We reviewed six cases of pituitary prolactinoma; each had vague or occult bulk of

adenoma on 1.5-T MR imaging, which were finally confirmed by surgery. Four cases were preoperatively examined with a 3.0-T MR imaging system. With the 3.0-T MR system, 3-dimension-anisotropy-contrast (3DAC) MR imaging and 3-dimension fast spoiled gradient recalled acquisition in the steady state (3D-FSPGR) imaging were used for depiction PI3K Inhibitor Library purchase of the adenoma. 3DAC imaging revealed cavernous sinus (CS) pathology in three cases, and multiplanar reconstruction of 3D-FSPGR imaging revealed normal pituitary gland and invasive adenoma into the CS in three cases and creeping extension up to the contralateral side of the CS invasion in four cases. Two can’t-miss findings: (1) intrasellar creeping extension up to the opposite side of the adenoma

main body and (2) intracavernous-localized adenoma with indistinct intrasellar mass should be carefully considered when neurosurgeons perform adenomectomy buy DMXAA for patients with prolactinoma, even in cases of microprolactinoma. “
“Paradoxical embolism through

extracardiac right-to-left shunts (ECRLS) may represent an under-detected stroke mechanism. Stroke patients without evidence of cardiac right-to-left shunt (RLS) on echocardiogram may benefit from transcranial Doppler with bubble study (TCD-b) to aid in recognition of stroke etiology. This study assesses the usefulness of TCD-b in the stroke evaluation. Retrospective cohort study of consecutive patients undergoing TCD-b performed in our neurovascular laboratory from February 2005 to August 2009. Echocardiography results were reviewed in patients with positive TCD-b. Detailed medical record review was performed on patients with positive TCD-b and negative echocardiogram findings for RLS. Of 502 patients undergoing TCD-b, 48.4% heptaminol (n = 243) had a positive study suggesting the presence of RLS. Of these, 59.2% (n = 144) had an echocardiogram demonstrating a cardiac RLS, 26% (n = 63) had echocardiograms without evidence of cardiac RLS, and 14.8% (n = 36) had no echocardiogram. Data on the evaluation to determine source of potential shunting in patients with discrepant findings was available in 11(17.5%). Of these, 63.6% (7/11) had potential mechanisms for positive TCD-b: one pulmonary arteriovenous malformation (AVM), one arteriovenous fistula thrombus, one parietal AVM, and four had malignancy. TCD-bubble studies may prove useful in uncovering treatable causes of stroke.

21 The possible involvement of mitochondria in causation of T2D and fatty liver disease remains intriguing,32–35 but we are not aware of congenital mitochondrial disorders (Alpers syndrome, mitochondrial DNA depletion syndrome) causing other than macrovesicular or microvesicular steatosis, cirrhosis or acute liver failure, not NASH.36 None-the-less, we do think consideration needs to be given to the

fact that microvesicular steatosis is observed in some cases of NASH, and mitochondrial crystalline inclusions are commonly noted, particularly in severer cases;34,35 the implications will see more be discussed in Part 2. The list of causes of fatty liver that are not NAFLD/NASH presented in Cassiman and Jaekman’s Table 1, as in a 2001 review,2 is less than 100. Individually they are exceedingly rare, < 1 per 10 000 population, versus 2000–4000 per 10 000 for NAFLD check details and 700–1300 per 10 000 for NASH. So one hundred of them could not account for even 5% of NAFLD cases. It also does not seem logical

to us to exclude childhood monogenetic obesity syndromes (Bardet-Biedl, Alström, Prader-Willi syndromes) as causes of NASH when the associated metabolic factors (over-nutrition, obesity, insulin resistance, T2D, dyslipidemia) are identical to NASH, as discussed later. While we think it unlikely that even a minority of cases presently diagnosed as NAFLD will turn out to be syndromes based on single gene mutations, we agree that only a minority of ‘the metabolically challenged’ (those with over-nutrition) will develop cirrhosis; individual susceptibility to NASH versus SS is a key issue in pathogenesis.2–5 However, we note with irony that the authors

cite a review written by two of us as evidence in favor of ‘the magical two-hit hypothesis’ (sic) for progression from Cyclic nucleotide phosphodiesterase ‘NAFLD to NASH’ (sic, mis-using above terminology).21 In that review,4 we actually canvassed strongly, as we do here, the evidence against metabolic factors being self-limiting, and against the cytokine basis of a two-hit hypothesis. Like others in this field (including Day who proposed the two-hit hypothesis),[C Day, personal communication, EASL Single Topic Conference on NAFLD, Bologna, September 2009] we no longer think this is a helpful concept. This review will explore the evidence for what seems to us intuitively more plausible, the lipotoxicity concept of NASH pathogenesis. While NAFLD is near universal among the obese (body mass index [BMI] > 30 kg/m2 in Europeans, > 25 kg/m2 in Asians), the interaction between obesity and NAFLD is more nuanced. The most striking correlates are with visceral fat accumulation and insulin resistance. As such, ‘metabolically obese, normal weight’ individuals may exhibit features of NAFLD in the absence of obesity but in association with an abnormal metabolic phenotype. But there appears to be a reproducible connection between NAFLD and over-nutrition—energy intake that exceeds energy utilization.

Early identification of CD and correction may improve the outcome of patients with early SAP and hypotension. Key Word(s): 1. Acute pancreatitis; 2. Cardiac dysfunction; 3. Hypotension; Presenting Author: RAGESHBABU THANDASSERY Additional Authors: SREEKANTH APPASANI, USHA DUTTA, SAROJKANT SINHA, KARTAR selleckchem SINGH,

RAKESH KOCHHAR Corresponding Author: RAGESHBABU THANDASSERY Affiliations: Department of Gastroenterology, PGIMER Objective: The role of obesity and APACHE O score in predicting adverse outcome in acute pancreatitis (AP) has been variably described. The outcome could be influenced by the other co-existing metabolic derangements over and above obesity. Aims Study the role of metabolic syndrome (MS) and APACHE metabolic syndrome score (APACHE M) in predicting the outcome in patients with AP. Materials and methods: Methods: 141 patients of AP admitted between July 2010 and December 2011 were observed for the course in hospital and outcome. APACHE M score was calculated by adding APACHE II score (48 hours) and metabolic syndrome LDK378 score. [MS constituted

by hypertension, hypertriglyceridemia, hyperglycemia, low HDL level and increased abdominal skin fold thickness] Results: Of 141 patients, mean age 40.1 ±12.6, 56.7% patients were normal weight, 24.8% overweight and 18.4% obese. 9 (6.3%) patients underwent surgery and 25 (17.7%) patients died. The occurrence of infected necrosis (p<0.001), requirement for percutaneous drain insertion (p=0.04), surgery (p=0.008) and mortality (p<0.001) were significantly higher in group with MS. The area under the curve (AUC) for predicting mortality was 0.892 for APACHE II (95% confidence interval (CI)=0.824-0.957), 0.897 for

APACHE O (CI=0.830-0.963) and 0.937 for APACHE M (CI=0.891-0.983). At a cut off of 8.5, APACHE II score had sensitivity of 92% and specificity of 67.2% Adenosine and APACHE O, 92% and 64.7% and APACHE M 96% and 63.8%respectively. Conclusion: Metabolic derangements are important predictors of outcome. Predictive accuracy for mortality of APACHE M is higher than APACHE II and APACHE O. Key Word(s): 1. Acute pancreatitis.; 2. Obesity ; 3. Metabolic Syndrome; Presenting Author: RUPJYOTI TALUKDAR Additional Authors: SASIKALA MITNALA, P PAVAN KUMAR, A MAHESHWARI, GV RAO, R PRADEEP, DNAGESHWAR REDDY Corresponding Author: RUPJYOTI TALUKDAR Affiliations: [email protected]; Asian Healthcare Foundation Objective: Pancreatic stellate cell (PSCs) activation leading to fibrosis, increased pancreatic IFN-ã causing early â-cell dysfunction and â-cell apoptosis manifesting into clinical diabetes in chronic pancreatitis (CP) are reported earlier. It was demonstrated that early â-cell dysfunction in CP can result from increase in IFN-ã secreting T-helper (Th) cell mediated inflammation. The objective of this study was to evaluate the association of PSCs, T-helper cells and â-cell dysfunction.

Early identification of CD and correction may improve the outcome of patients with early SAP and hypotension. Key Word(s): 1. Acute pancreatitis; 2. Cardiac dysfunction; 3. Hypotension; Presenting Author: RAGESHBABU THANDASSERY Additional Authors: SREEKANTH APPASANI, USHA DUTTA, SAROJKANT SINHA, KARTAR Selleckchem Vismodegib SINGH,

RAKESH KOCHHAR Corresponding Author: RAGESHBABU THANDASSERY Affiliations: Department of Gastroenterology, PGIMER Objective: The role of obesity and APACHE O score in predicting adverse outcome in acute pancreatitis (AP) has been variably described. The outcome could be influenced by the other co-existing metabolic derangements over and above obesity. Aims Study the role of metabolic syndrome (MS) and APACHE metabolic syndrome score (APACHE M) in predicting the outcome in patients with AP. Materials and methods: Methods: 141 patients of AP admitted between July 2010 and December 2011 were observed for the course in hospital and outcome. APACHE M score was calculated by adding APACHE II score (48 hours) and metabolic syndrome find more score. [MS constituted

by hypertension, hypertriglyceridemia, hyperglycemia, low HDL level and increased abdominal skin fold thickness] Results: Of 141 patients, mean age 40.1 ±12.6, 56.7% patients were normal weight, 24.8% overweight and 18.4% obese. 9 (6.3%) patients underwent surgery and 25 (17.7%) patients died. The occurrence of infected necrosis (p<0.001), requirement for percutaneous drain insertion (p=0.04), surgery (p=0.008) and mortality (p<0.001) were significantly higher in group with MS. The area under the curve (AUC) for predicting mortality was 0.892 for APACHE II (95% confidence interval (CI)=0.824-0.957), 0.897 for

APACHE O (CI=0.830-0.963) and 0.937 for APACHE M (CI=0.891-0.983). At a cut off of 8.5, APACHE II score had sensitivity of 92% and specificity of 67.2% LY294002 and APACHE O, 92% and 64.7% and APACHE M 96% and 63.8%respectively. Conclusion: Metabolic derangements are important predictors of outcome. Predictive accuracy for mortality of APACHE M is higher than APACHE II and APACHE O. Key Word(s): 1. Acute pancreatitis.; 2. Obesity ; 3. Metabolic Syndrome; Presenting Author: RUPJYOTI TALUKDAR Additional Authors: SASIKALA MITNALA, P PAVAN KUMAR, A MAHESHWARI, GV RAO, R PRADEEP, DNAGESHWAR REDDY Corresponding Author: RUPJYOTI TALUKDAR Affiliations: [email protected]; Asian Healthcare Foundation Objective: Pancreatic stellate cell (PSCs) activation leading to fibrosis, increased pancreatic IFN-ã causing early â-cell dysfunction and â-cell apoptosis manifesting into clinical diabetes in chronic pancreatitis (CP) are reported earlier. It was demonstrated that early â-cell dysfunction in CP can result from increase in IFN-ã secreting T-helper (Th) cell mediated inflammation. The objective of this study was to evaluate the association of PSCs, T-helper cells and â-cell dysfunction.