The number of peripheral segmental branches of the cervical and thoracic sympathetic chains are more variable and larger than assumed by textbooks and literature (Groen et al., 1987). This investigation aims to clarify and update the variable patterns of the cervical sympathetic chain, the incidence of fused thoracic ganglia and the contributions of the cervical and thoracic sympathetic chain to the cardiac plexus. The study involved the macro and micro-dissection of 89 cadaveric sides (foetal, 60 and adult, 29). The gross anatomy of the cervical sympathetic chain and variations is documented. This study confirms previous reports that the number of ganglia in the cervical region ranged from 2 (absent MCG) to four (double MCG) ganglia. A double MCG was found in 25.9%. This study reports the higher incidence of the normal/typical MCG (as per textbook definition) i.e. Type II MCG (46.6%) than the Type I MCG (27.6%) and Type III (32.8%). The number of thoracic ganglia in this study is 8-11. Fusion of ganglia was found to be more common in the lower thoracic chain than in the upper thoracic chain. This study reports the origin of cardiac rami from the thoracic sympathetic chain up to the interganglionic segment between T5 and T6 ganglia. The incidence if TCR5 was 60.4%. In 15/58 sides (25.9 %) TCR5 arose from the interganglionic segment of the chain, either above or below the ganglion. An accurate knowledge of the anatomy of the sympathetic nervous system and the adjacent structures is, inescapably a definite asset to the procedures used in interrupting the neural mechanism (Jamieson et al.) 1952). Successful sympathetic denervation of the heart, a field often beset with failure, is dependant on adequate morphological knowledge. It is hoped that this study using human foetuses as well as adult cadaveric specimens will draw the attention to important variations that are relevant to the surgeon. The intricate anatomical relations presented in this study attest the complex anatomy of the sympathetic nervous system. / Thesis (M.Sc.)-University of Durban-Westville, 2001.

Interest in the anatomy of the coronary arteries dates as far back as the early 1500's, at a time when anatomical inquiry was being cautiously aroused. Whilst the later 1700's encouraged academic domination of anatomical study, significant documentation of the coronary arteries was only been established by the late 1800's to early 1900's. There is no doubt that this topic continues to remain dynamic, favoured for its value in applied clinical research. Indeed, technological advancement in the 21 st century has transformed modem day anatomy into more than just a simple descriptive exercise. Whether to update standard literature, create ethnically specific banks of anatomical data, abate technical difficulties associated with coronary artery surgery or provide exciting interventional possibilities for clinicians, revisiting the anatomy of the coronary arteries is clearly warranted. The objective of this investigation was to review the anatomy of the coronary arteries using a clinical approach in order to investigate the morphologic presentation of these vessels within the South African population. On a more clinically universal level, this study aimed to elucidate two focal areas of anatomical interest: extra-cardiac collaterals and myocardial bridges. The investigation was conducted by means of micro-dissection, angiography, histology and scientific evaluation. A total of 323 sets of coronary arterial patterns consisting of patient angiograms (n=212) and cadaveric dissections (n=95) were studied. Specimens were harvested at post-mortem and angiograms and surgical reports were obtained from clinical centers within KwaZulu-Natal. Results of this study confIrmed the standard anatomical description of the coronary arteries as documented. Within the South African population, the ramus marginalis artery was found to be present in 13.3% (Females: 10.7%; Males: 5.6% and Blacks: 18.0%; Indians: 6.6%; Whites: 1.4%). The LAD and LCX arteries arose from independent aortic ostia in 14.5%, (Females: 7.5%; Males: 15% and Blacks: 6.5%; Indians 50%; Whites: 35%). Right dominance was observed most frequently in 85.9% (Blacks: 82.3%; Whites: 83.6% and Indians: 86.4% and Males: 82.6%; Females: 89.2%). A bifId LAD artery was noted in 52%, (Females: 6.2%; Males: 8.7% and Blacks: 17.6%; Indians: 6.3 %; Whites: 4.5 %). In 27.7%, (Females: 24.0%; Males: 28.8% and Blacks: 29.5%; Indians: ·50%; Whites: 20%) the LCX artery failed to continue along the atrioventricular groove. The conus artery arose from a high position off the RCA in 19.2%, (Females: 16%; Males: 21% and Blacks: 19.7%; Indians: 100%; Whites: 10%); and from an independent ostium in 3.61%, (Females: 4.0%; Males: 3.8% and Blacks: 4.9% only). The LCA measured 0.82cm (0.27-2.4cm), (Females: 0.84cm, Males: 0.96cm and Blacks: 0.88cm; Indians: 0.53 cm; Whites: 0.78cm). Myocardial bridges were recorded on the RCA in 2.5% and on the LAD in 50.6%. The bridge pattern depicted myocardial loops to complete arterial investment and ranged in length from 3.0 to 20.02 mm. Scientiftc evaluation of the intramural LAD indicated positive correlation between a straight appearance ofthe LAD on angiogram and a deep myocardial position upon surgical observation (mean "tortuosity index" = 1.147 [1.373-1.045] where 1= baseline for straightness). Results were confIrmed in the correlated cadaveric investigation. Extra-coronary collaterals were observed in 100% (n=9). The arterial pattern consisted of 1 to 2 main stems with secondary anastomotic branches. The average external diameter was measured to be 0.6mm (OA-0.7mm), length 52.5mm (1883mm) with at least 5 secondary branches (3-9) of external diameter O.3mm (0.20.5mm). Results of the histopathological investigation (n=20) indicated the presence of atherosclerotic disease within the intramural LAD artery segment (15%). A 60% incidence was recorded in the pre-mural segment and 25% incidence in the post-mural arterial segments. When analysed in terms of severity, the intramural segment reflected only mild signs of intimal alteration. Although not statistically significant, mean values for coronary artery size differed between sexes. The findings were similar when evaluated in terms of the coronary artery anomalies studied. There were signifIcant differences between ethnic groups in terms of the length of the LCA. Mean values showed that Indians had the shortest LCA's when compared with Blacks and Whites. The highest incidence of the ramus marginalis branch was recorded amongst Blacks. Separate origin of the LCX and LAD was highest amongst Indians and high in comparison to reports documented in other countries. A high origin ofthe conus artery was found to be dominant amongst Blacks. A low incidence of separate origin of the conus from the aorta was recorded in the South African population. These findings are significantly lower than that reported in the literature. A right dominant system has the highest occurrence within this population. Statistical evaluation confirmed that neither sex, ethnicity, age nor height influenced dominance in a coronary arterial pattern. The presence and description of the bifid LAD has been recorded. Its occurrence is highest amongst Blacks. The anomalous path of the LCX has been documented and described. The significantly high occurrence of this disposition of the LCX within the South African population appears to be the highest reported fmd in the literature. In terms of the presence and patterns of myocardial bridges, there are no observable differences between ethnic groups or sex. Results ofthis study confirm a relationship between the straight appearance of the LAD on angiogram and its anatomical presence. Extra coronary collaterals have been successfully investigated and observed. Measurements of vessel dimensions and patterns have been recorded. Results of the histopathological investigation illustrate that the intra-mural LAD artery is relatively protected from vascular disease. It does not however support the theory that in such a sub-myocardial position, the LAD artery is never prone to the damaging effects of atherosclerosis. The "cardio-protective" effect of a muscular bridge, whilst prevalent, is dependant on the thickness and extent ofthe bridge itself The anatomy ofthe coronary arteries has been successfully documented and a bank of data, specific for a South African population has been presented. Significant aspects of coronary arterial patterns have been discussed and interpreted in terms of its clinical relevance. This study presents an original method for the investigation of EeC's using technologically advanced materials and equipment. In addition, a scientific method for confirmation of a "straight" appearance of the LAD artery has been developed in this study. Findings contribute to the bank of diagnostic indicators that may be used to predict myocardial bridges pre-operatively. Through the dissection experience of more than 150 hearts and observation of more than 200 angiograms, this study has been able to contribute to the anatomical description o fthe coronary arteries. In some ways new perspectives were afforded and on the same note, already existing concepts have been verified. The value of this study IS enhanced by the potential clinical impact that such data is envisaged to create. / Thesis (Ph.D.)-University of Durban-Westville, 2003.

Thesis (MScMedSc (Biomedical Sciences. Anatomy and Histology)--Stellenbosch University, 2008.

Thesis (MScMed (Dept. of Biomedical Sciences. Anatomy and Histology) --University of Stellenbosch, 2007. / Thyroid nodules are a common clinical problem encountered by physicians, surgeons and radiologists who deal with the head and neck region. However, most follicular lesions of the thyroid are benign, so that the indications for surgery should be as accurate as possible. The morphological difficulty on fine-needle aspiration biopsy (FNAB) of reliably distinguishing preoperatively between benign and malignant lesions has led to a search for ancillary methods that can assist with the diagnosis. The aim of the first study was to develop a cytological scoring system to improve diagnostic accuracy of fine-needle aspiration biopsy of papillary carcinomas with special reference to the follicular variant of papillary carcinoma. The objective of the second study was the application of immunodiagnostic markers Galectin-3 and HBME-1 to histology tissue sections and their corresponding fine-needle aspiration cytology smears to assess their value in distinguishing benign from malignant thyroid lesions. In the first study 16 different cytological features such as background, architecture and cellular morphology were quantatively assessed and scored. Only 14 of the 16 variables were statistically significant. The statistical analysis demonstrated that a score ≥ 4 was indicative of a papillary carcinoma with a sensitivity of 96%. A score < 4 suggested a benign multinodular goiter with a specificity of 97%. In the second study Galectin-3 and HBME-1 were applied to histology tissue sections and their corresponding fine-needle aspiration cytology smears. Statistical analyses showed that the sensitivity of immunohistochemistry for diagnosing malignancy was better than the immunocytochemistry, but the specificity of immunocytochemistry was superior. Furthermore the diagnostic accuracy of immunohistochemistry (86%) and immunocytochemistry (88%) using co-expression of these two antibodies was excellent. In this study on immunocytochemistry, papillary carcinomas were clearly identified with a 100% co-expression in the classic and 71% in the follicular variant of papillary carcinoma. For the surgeon the identification of papillary carcinoma is critical, as this determines the extent of surgery. Similary, the confirmation of a non-neoplastic lesion may prevent surgery. In most cases follicular neoplasms, benign or malignant, will usually be excised for histopathology, prior to definite therapy. These studies show that the implementation of ancillary methods such as a scoring system and immunodiagnostic markers can improve the diagnostic accuracy of thyroid fine-needle aspiration biopsies in our laboratory. This may lead to better management of thyroid nodules. However, it is advisable that cytopathologists always take all the clinical features and image analyses into consideration before making a diagnosis.

Thesis (PhD)--Stellenbosch University, 2000. / ENGLISH ABSTRACT: Diabetes Mellitus (DM) is synonymous with "B-cell failure". Ligation of the pancreatic duct distally to its confluence into the bile duct has been shown to induce endocrine tissue regeneration from a number of probable sources. The cells responsible for regeneration are supposed to possess either dormant pluripotent stem cell ability and/or the plasticity to undergo metaplasia to form new and surplus endocrine tissue able to replace pathologically and/or experimentally compromised pancreas. The sequence of events (cell lineage) during this process of neogenesis, has been the source of controversy for quite some time as various studies suggest that the cell lineage differs from in vivo and in vitro studies, according to experimental model and species of laboratory animal. The object of this study was to utilise an established experimental laboratory animal model to study islet morphological changes, neogenesis and or both in vivo. Further aims of the study were to determine the extent, sequence and magnitude of pancreatic duct ligation (PDL) induced endocrine neogenesis/morphogenesis in a laboratory rat model using occlusive pancreatic duct ligation. PDL's were performed on six groups of 25 normal adult Sprague-Dawley (SD) rats (300g+) according to the method of Hultquist and Jonsson (1965). Experimental animals were sacrificed at 12 hr intervals from day one post-PDL to day 10 and every 24 hrs thereafter to day 14 as described by Wang, Klëppel, Bouwens (1995). Animals received BrdU (a thymidine marker and cell proliferation indicator) 50mglkg intraperitoneally as described by Wang et al. (1995), one hour prior to removal of the pancreas after which it was fixed in Bouin's solution and histologically processed. Seven consecutive 3-6 urn thick serial sections were sequentially stained with H & E, insulin (I), glucagon (G), somatostatin (ST), pancreatic polypeptide (PP), neuropeptide tyrosine (NPY) and peptide tyrosine tyrosine (PYY). Immunolabeling was done according to the method of Guesdon, Temynck , Avrameas (1979). Double immunolabeling for BrdU and each pancreatic peptide was performed on the sections on days 3,5, 7, 9 and 11 as described by Wang et al (1994). Cellular transformation between one and 3Yz days was characterised by simultaneous total deletion and/or transdifferentiation of the acinar compartment and the appearance of immunoreactive cells for I (11.53 ±1.5%), G (1.85 ±0.8%), pp (1.50 ±0.09%), and ST (1.96 ±0.24%). Changes in the endocrine composition in existing islets, occurred along a pathway that saw PP- and ST-cells invading the islet core, islet mantle glucagon deletion and random appearance of all endocrine cell types within the inter-islet interstitium on day 3Yz. Days 4 to 6Yz saw further endocrine expansion while days 7 to 14 were distinguished by islet reconstitution and consolidation. NPY immunoreactivity appeared on day 4Y2 and persisted intermittently throughout while PVV first appeared on day 4 and disappeared after day 7Yz. The results suggest that PDL firstly induced the development of endocrine tissue distributed haphazardly throughout the space previously occupied by acinar parenchyma. Secondly, the appearance of insulin is preceded by the appearance of PP, glucagon and somatostatin by 24-hours. A still to be determined proportion of the ligation induced endocrine formation appeared to be associated with existing islets, resulting in a number of very large islets, some of which might have secretory access through the glomerularlike capillary network known to occupy the islet core. The remainder appeared to form separate "new" islets, which have a dubious access to the blood stream. In conclusion, if it is true that the pancreas can regenerate some of its endocrine tissue then it has potential clinical implication for the stabilising of diabetes mellitus. Ligated exocrine pancreatic tissue, devoid of its acinar component, has been shown to contain notable quantities of insulin positive cells. This presents intriguing possibilities as an alternative for donor tissue, usually obtained from rat foetuses, during foetal rat pancreas transplantation studies. Pancreas tissue harvested from duct ligated rats could replace the foetal tissue currently used in the treatment of experimental diabetes mellitus in laboratory animals in this laboratory. / AFRIKAANSE OPSOMMING: Diabetes Mellitus is sinoniem met B-sel disfunksie. Endokriene regenerasie kan segmenteel bewerkstellig word deur eksperimentele afbinding van die pankreasbuis distaal tot sy samesmelting met die gemene galbuis. 'n Verskeidenheid van selle word vermoedelik by hierdie proses betrek. Dormante stamselle besit die vermoë en/of plastisiteit om 'n aantal vorms van metaplasie te ondergaan om nuwe en/of oortollige endokriene weefsel te vorm wat patologiese en/of eksperimenteel gekompromiseerde weefsel vervang. Die selontwikkelings volgorde wat tydens hierdie proses plaasvind is al vir 'n geruime tyd die middelpunt van 'n meningsverskil. Sommige studies dui daarop dat die in vivo selontwikkelingsvolgorde verskil van in vitro, volgens eksperimentele model en tipe proefdier gebruik. Die doel van die studie was die gebruik van 'n bestaande eksperimentele laboratorium proefdier model om pankreas eiland morfologiese verandering en/ofneogenese of beide in vivo te evalueer. Die oogmerk van die studie was om die omvang en volgorde van veranderings in die endokriene kompartement (neogenese/morfogenese) te bepaal deur gebruik te maak van 'n pankreas buis afbindings (PBA) model wat totale afsnyding van die buis tot gevolg het. PBA's is uitgevoer op ses groepe van 25 volwasse normale Sprague-Dawley (SD) laboratorium rotte (±300g) soos beskryf deur Hultquist en Jonsson (1965). Proefdiere is elke 12 uur geoffer vanaf dag een post-PBA tot dag tien en elke 24 uur daarna tot dag 14 soos beskryf deur Wang, Bouwens, Kloppel (1995) na die toediening van 50 mg/kg 5-Bromo-2-deoksi-uridien intraperitoneaal ('n selprolifererings aanduider) soos beskryf deur Wang et al. (1995). Die pankreas is werwyder, in Bouin se oplossing gefikseer en histologies geprosesseer. Sewe openvolgende seriesnitte (3-6 urn) is alternatiewelik gekleur met H & E, en immunositochemies, soos beskryf deur Guesdon, Terugnek, Avrameas (1979), vir insulien (I), glukagon (G), somatostatien (ST), pankreatiesepolipeptied (PP), neuropeptied tirosien (NPY) en peptied tirosien-tirosien (PYY). BrdU dubbel-immuunkleuring is ingesluit op dae 3,5, 7, 9 en 11 soos beskryf deur Wang et al. (1994). Sellulêre transformasie tussen dae een en 3~ dae is gekenmerk deur gelyktydige en totale uitwissing en/ofmetaplasie van die asinêre kompartement en die verskyning van selle immunorektiefvir I(11.53 ±1.5%), G (1.85 ±0.8%), PP (1.50 ±0.09%), ST (1.96 ±0.24%). Metaplasie was verantwoordelik vir merkbare veranderings in bestaande endokriene weefsel langs In transformasie weg waar eiland insulien kemselle vervang is deur PP- en ST-selle, glukagon buitelaag uitwissing en die toevallige verskyning van alle endokriene seltipes in the inter-eiland interstitium teen dag 3Y2. Dae 4Y2deur 6~ is gekenmerk deur verdere endokrinetoename terwyl dag 7 deur 14 gekenmerk is deur eiland hersamestelling en konsolidering. NPY immunoreaktiwiteit was vanaf dag 4~, met afwisseling, te bespeur terwyl PVV slegs tussen dae 4 en 7 In verskyning gemaak het. . Die resultate suggereer eerstens, PBA induseer die ontwikkeling van oortollige endokriene weefsel op In lukrake wyse versprei deur die ruimte voorheen deur asinêre parenchiem beset. Tweedens, dat die verskyning van insulien deur dié van PP, glukagon en somatostatien met minstens 24-uur voorafgegaan is. Die verhouding, van nuutgevormde endokriene weefsel wat met bestaande eilande assosieer om In aantal baie groot eilande te vorm, moet nog vasgestel word. Sulke strukture mag moontlik afskeidings toegang hê tot die bloedstroom, deur die glomerulusagtige kapillêre netwerk, in die eilandkern teenwoordig terwyl die oorblywende nuutgevormde endokrine weefsel "nuwe" apparte eilande vorm wat wel of gladnie toegang tot die bloedstroom mag hê nie. As gevolgtrekking, indien dit waar is dat volwasse pankreas eilandweefsel wel regenerasie kan ondergaan, dan het dit kliniese implikasie vir die stabilisering van diabetes mellitus. Weefsel verkry uit PBA bevat geen asinêre weefsel nie maar wel merkbare hoeveelhede endokriene weefsel, veral insulin positief. Dit bied dan interessante alternatiewe as skenker weefsel by fetal rot pankreas oorplantings. PBA en/of die oorplanting van pankreasbuis afgebinde weefsel, na in vitro weefsel kultuur, bied moontlikhede vir die behandeling van diabetes mellitus.

Thesis (MScMedSc)--University of Stellenbosch, 2011. / ENGLISH ABSTRACT: Introduction: A westernized diet rich in saturated fats and sugars, together with a sedentary lifestyle, has contributed to the dramatic increase in obesity during the last decade (Zimmett et al, 2001; Wild et al, 2004). Obesity is associated with dyslipidemia and insulin resistance which are major risk factors for the development of type 2 diabetes (T2D) (Zimmet et al, 2001, Kahn et al, 2006; Schröder et al, 2007). High-fat feeding in rodents induces symptoms similar to the human metabolic syndrome without progression to T2D (Woods et al, 2002; Weir and Bonner-Weir, 2007). The addition of fructose to a high-fat diet exacerbates the insulin resistance and leads to impaired pancreatic function of insulin secretion and glucose intolerance (Basciano et al, 2005; Stanhope et al, 2009). Aims: The aim of this study was to establish the effect of a high-fat and sucrose/fructose diet on glucose metabolism, the development of insulin resistance and β-cell dynamics. Methods: Weanling Wistar rats were randomized into two study groups; study one over an experimental period for three months and study two for twelve months. Each study consisted of a control group that received standard rat chow and water; and two experimental groups receiving either a high-fat diet and water (HFD) or a café diet consisting of HFD with the addition of 15% sucrose/fructose (CFD). Fasting glucose and insulin concentrations, intravenous glucose tolerance test (IVGTT), glucose stimulated insulin secretion rates and 2-deoxy-[3H]-D-glucose uptake in muscle, liver and fat were measured. The pancreata were harvested for immunohistochemical labeling of β-cells (insulin), α-cells (glucagon), GLUT2 (glucose transport) and MIB5 (proliferation). Samples of the pancreata were also collected for electron microscopy. Results and discussion: Feeding Wistar rats a CFD induced obesity, insulin resistance and glucose intolerance. By twelve months the rats had an impaired glucose response with increased IVGTT peak values, area under the curve (AUC) values and glucose clearance rates. Concomitantly, the glucose stimulated insulin secretion rate (GS-ISR) was attenuated. Stimulated glucose disposal as measured by 2-deoxy-[3H]-D-glucose uptake was reduced in muscle and adipose tissue at three months. By twelve months, due to the age of the rats, stimulated glucose uptake declined compared to three months with no difference between groups. After three months the diets had no observable effect on the islets using light microscopy. However, by twelve months morphological changes were observed in both the HFD and CFD groups. In the HFD group large hypertrophied irregular islets with fibrous changes were observed. In the CFD group these morphological changes were more prominent with fibrous segregation and disruption of the normal endocrine arrangement. In addition, the presence of inflammatory cells within the affected islets is consistent with T2D. Conclusion: High-fat diet fed to Wistar rats induced obesity, abdominal adiposity and insulin resistance. The addition of sucrose/fructose to a high-fat diet exacerbated the insulin resistance and resulted in glucose intolerance and mild hyperglycemia. Morphological changes in the large islets were observed which are consistent with the development of T2D. / AFRIKAANSE OPSOMMING: Inleiding: ‘n Verwesterde dieët, ryk aan versadigde vette en suikers tesame met 'n passiewe lewenstyl, het bygedra tot die dramatiese verhoging in vetsug gedurende die laaste dekade (Zimmett et al, 2001; Wild et al, 2004). Vetsug word met dislipidemie en insulienweerstandigheid geassosieer wat hoof risikofaktore is vir die ontwikkeling van tipe 2 diabetes (T2D) (Zimmet et al, 2001; Kahn et al, 2006; Schröder et al, 2007). Hoë-vet voeding in knaagdiere induseer simptome soortgelyk aan menslike metaboliese sindroom sonder die ontwikkeling van T2D (Woods et al, 2002; Weir and Bonner-Weir, 2007). Die byvoeging van fruktose tot 'n hoë-vet dieët vererger insulienweerstandigheid en lei tot verswakte pankreas funksie, insuliensekresie en glukoseintoleransie (Basciano et al, 2005; Stanhope et al, 2009). Doelwitte: Die doelwitte van die studie was om die effek van hoë-vet en sukrose/fruktose voeding op glukosemetabolisme, die ontwikkeling van insulienweerstandigheid en β-sel dinamika te bepaal. Metodes: Gespeende Wistar rotte was in twee groepe gerandomiseer; studie een oor ʼn tydperk van drie maande en studie twee oor ʼn tydperk van twaalf maande onderskeidelik. Elke studie het 'n kontrole groep met standaard rot kos en water (control); en twee experimentele diëte wat of ʼn hoë-vet dieët en water (HFD) of 'n kafeedieët groep wat die HFD met die byvoeging van 15% sukrose/fruktose in hul drink water (CFD) ontvang. Fastende glukose en insulien, binneaarse glukose toleransie toets (IVGTT), glukose gestimuleerde insulien sekresie tempo en 2-deoxi-[3H]-D-glukose opname in spier, lewer en vet is gebruik om die effek van die dieët op glukosemetabolisme te bepaal. Die pankreata is uitgehaal vir immunohistochemiese identifisering van β-selle (insulien), α-selle (glukagoon), GLUT2 (glukose transport) en MIB5 (proliferasie). Monsters van die pankreata was ook vir elektronmikroskopie versamel. Resultate en bespreking: Voeding van ʼn CFD aan Wistar rotte induseer vetsug, insulienweerstandigheid en glukose-intoleransie Teen twaalf maande toon die rotte 'n verswakte respons tot glukose met verhoogde IVGTT piekwaardes, AUC waardes en glukose opruimingswaardes. Terselfdetyd is die glukose gestimuleerde insuliensekresie tempo (GS-ISR) ook verswak. Gestimuleerde glukose opruiming, soos deur 2-deoxi-[3H]-D-glukose opname bepaal, was verlaag in spier en vetweefsel teen drie maande. Teen twaalf maande, weens die ouderdom van die rotte, is die gestimuleerde glukose opname verlaag in vergelyking met drie maande sonder 'n verskil tussen groepe. Na drie maande kon geen sigbare morfologiese verskille met ligmikroskopie tussen die diëte waargeneem word nie. Teen twaalf maande is morfologiese verskille waargeneem in beide die HFD en die CFD groepe. In die HFD groep is groot hipertrofiese onreëlmatige eilande met fibrotiese verandering waargeneem. In die CFD groep was die morfologiese verandering meer gevorder met fibrotiese onderverdeling en ontwrigting van die normale endokriene rangskikking. Die teenwoordigheid van inflammatoriese selle in die geaffekteerde eilande is verenigbaar met T2D. Afleiding: Die voer van 'n hoë-vet dieët aan Wistar rotte veroorsaak vetsug, abdominale adipositeit en insulienweerstandigheid. Die byvoeging van sukrose/ fruktose tot die hoë-vet dieët vererger die insulienweerstandigheid en veroorsaak glukoseintoleransie en matige hiperglukemie. Morfologiese veranderings in die groter eilande was verenigbaar met T2D.

Thesis (MScMedSc)--University of Stellenbosch, 2011. / ENGLISH ABSTRACT: Introduction: Athrixia phylicoides is an aromatic, indigenous shrub with high antioxidant content and numerous indigenous medicinal properties inferred by ingestion of an herbal brew of the plant. Commercialization of “bush tea” (derived from A. phylicoides) holds economic and developmental potential for indigenous communities provided the safety and efficacy of the herbal tea is established. Recently A. phylicoides has been shown by McGaw et al. (2007) to have similar antioxidant activity to Rooibos tea, and a unique, new flavonol (i.e. a polyphenolic antioxidant plant metabolite) 5-hydroxy-6,7,8,3′,4′,5′-hexamethoxyflavon-3-ol, unique to A. phylicoides, was isolated by Mashimbye et al. in 2006. With changes in the socio-economic climate and a new trend in merging Western lifestyle with traditional practices, new interest has been shown in herbal/natural remedies. Study Aim: The aim of this study was to firstly, determine the in vitro effect of A. phylicoides aqueous extract on glucose metabolism in cell lines that mimic the three key organs implicated in glucose homeostasis. Secondly, the study aimed to determine the potential ex vivo antioxidant and anti-inflammatory effect of the extract in pancreatic β-cells and peripheral mononuclear cells respectively. Methods: Leaves and fine twigs of A. phylicoides were processed into an aqueous extract. C2C12, Chang and 3T3-L1 cells were cultured under standard conditions and acutely exposed to increasing concentrations of extract and water vehicle, as well as 1 μM insulin and metformin as positive controls. Glucose uptake from 8 mM glucose culture media was determined using a fluorimetric oxidase method. Radioactive 14C-glucose oxidation to 14CO2 and determination of glycogen content of cells were used to assess the fate of intracellular glucose. RT-PCR was used to assess the extract effect on insulin-signalling gene expression. The antioxidative effect of A. phylicoides extract in pancreatic β-cells isolated from Wistar rats was determined by measuring nitric oxide (NO) production in response to hyperglycemic conditions. NO was labelled with diaminofluorocein diacetate and fluorescence was measured using flow cytometry. Insulin secretion of pancreatic β- cells was measured using radio-immuno assay. The anti-oxidative effect of the extract in lipopolysaccharide-stimulated peripheral mononuclear cells isolated from Wistar rats was determined by measuring the production of TNF-α using an ELISA kit. Results: C2C12 myocytes showed maximal increased glucose uptake at the 0.05 μg/μl extract concentration (228.3% ± 66.2, p<0.001). In Chang cells, A. phylicoides extract maximally increased the amount of glucose taken up at the 0.05 μg/μl concentration (134.5% ± 2.5, p<0.05). In 3T3-L1 cells, the extract maximally increased the amount of glucose taken up at the 0.025 μg/μl concentration (143.5% ± 10.3, p<0.001). An extract-induced increase in insulin receptor and glucose transporter four expression was seen in C2C12 myocytes. The oxidation of 14C-glucose to 14CO2 by C2C12 myocytes was maximally increased following acute exposure to the extract at 0.1 μg/μl (2919.3 fmol/1x10^6 cells ± 428, p<0.01). The oxidation of 14C-glucose to 14CO2 by Chang cells was maximally increased following acute exposure to extract at 0.1 μg/μl (4476.7 fmol/1x10^6 cells ± 1620, p<0.05); as seen in the C2C12 cells. A. phylicoides extract increased glycogen storage at all three concentrations tested in Chang cells, but maximally at the 0.025 μg/μl concentration (13.6 μg/1x10^6 cells ± 0.7, p<0.05). A. phylicoides extract did not have any measurable effect on the oxidative status of β-cells or the anti-inflammatory status of peripheral mononuclear cells. The extract did show an increase in first phase insulin secretion of β-cells in hyperglycemic conditions, although it was not significant. Conclusion: Athrixia phylicoides aqueous extract stimulates in vitro glucose uptake and metabolism in an insulin-mimetic manner, suggesting that this extract could potentially be beneficial to type two diabetics as an adjunct therapy. / AFRIKAANSE OPSOMMING: Inleiding: Athrixia phylicoides is 'n aromatiese, inheemse struik met 'n hoë antioksidant inhoud. Vele tradisionele medisinale eienskappe is gekoppel aan die ingestie van 'n kruie brousel van die plant, wat ook bekend as “bostee” is. Kommersialisering van “bostee” hou ekonomiese en ontwikkelings potensiaal in vir inheemse gemeenskappe mits die veiligheid en effektiwiteit van die kruietee bevestig kan word. McGaw et al. (2007) het onlangs bevind dat A. phylicoides se antioksidant aktiwiteit vergelykbaar is met die van rooibostee. 'n Unieke nuwe flavonol ('n polifenoliese antioksidant plant metaboliet) 5-hydroksie-6,7,8,3′,4′,5′-hexamethoksieflavon-3-ol, eie aan A. phylicoides, is deur Mashimbye et al. in 2006 geïsoleer. Met veranderings in die sosio-ekonomiese klimaat en 'n nuwe tendens om die westerse lewenstyl met tradisionele gebruike aan te vul word nuwe belangstelling in kruie/natuurlike rate ondervind. Studie Doelwitte: Die doelwitte van hierdie studie was eerstens om die in vitro effek van A. phylicoides waterekstrak op die glukosemetabolisme van drie sellyne wat die sleutel organe naboots wat glukosehomeostase beheer, te bepaal. Tweedens, is die potensiële ex vivo antioksidant en anti-inflammatoriese effek van die ekstrak op pankreatiese β-selle en perifere mononuklêere-selle onderskeidelik ondersoek. Metodes: n Waterige ekstrak is van die blare en fyn takkies van A. phylicoides berei. C2C12, Chang and 3T3-L1 selle is gekultuur onder standaard kondisies en akuut blootgestel aan stygende ekstrakkonsentrasies. Water het as kontrole gedien, met 1 μM insulien en metformien as positiewe kontroles. Glukose opname vanuit 8 mM glukose kultuurmedia is bepaal deur 'n fluorimetriese oksidase metode. Radioaktiewe 14C-glukose-oksidasie na 14CO2 en die bepaling van die glukogeen inhoud van selle is gebruik om die lot van intrasellulêre glukose te bepaal. RT-PKR is gebruik om die effek van die ekstrak op die insulien-seinpad geen-uitdrukking te ondersoek. Die antioksidant effek van A. phylicoides ekstrak in pankreatiese β-selle geïsoleer van Wistar rotte, is bepaal deur stikstofoksied (NO) produksie na aanleiding van hiperglukemiese kondisies. NO is met diaminofluorosien diasetaat gemerk en die fluoresensie gemeet deur vloeisitometrie. Insulien afskeiding deur die pankreatiese β-selle is deur radio-immuno metode bepaal. Die anti-oksidatiewe effek van die ekstrak op lipopolisakkaried-gestimuleerde perifere mononuklêere-selle afkomstig van Wistar rotte is bepaal deur die meting van TNF-α produksie met 'n ELISA kit. Resultate: C2C12 miosiete het 'n maksimale toename in glukoseopname by 'n 0.05 μg/μl ekstrakkonsentrasie (228.3% ± 66.2, p<0.001) gehad. Dieselfde ekstrakkonsentrasie het maksimale toename in glukoseopname in Chang selle (134.5% ± 2.5, p<0.05 getoon. In 3T3-L1 selle is maksimale toename in die glukoseopname by 'n konsentrasie van 0.025 μg/μl (143.5% ± 10.3, p<0.001) bereik. 'n Ekstrak-geinduseerde verhoging in die insulienreseptor en glukosetransporter vier ekspressie is in C2C12 miosiete waargeneem. Die oksidasie van 14C-glukose na 14CO2 deur C2C12 miosiete is maksimaal verhoog deur akute blootstelling aan die ekstrak by 'n konsentrasie van 0.1 μg/μl (2919.3 fmol/1x10^6 cells ± 428, p<0.01). Die oksidasie van 14C-glukose na 14CO2 deur Chang selle was maksimaal verhoog deur akute blootstelling aan die ekstrak by 'n konsentrasie van 0.1 μg/μl (4476.7 fmol/1x10^6 cells ± 1620, p<0.05) soos gevind in die C2C12 selle. Die ekstrak het glukogeenstoring verhoog teen al drie die konsentrasies waarteen getoets is in Chang selle, maar 'n maksimale effek is gevind by 'n konsentrasie van 0.025 (13.6 μg/1x10^6 cells ± 0.7, p<0.05). A. phylicoides ekstrak het nie 'n meetbare effek op die oksidatiewe status van β-selle of die anti-inflammatoriese status van perifere mononuklêere-selle gehad nie. Die ekstrak het wel 'n verhoging in die eerstefase insuliensekresie van β-selle in hyperglukemiese kondisies gehad, alhoewel die verhoging nie statisties betekenisvol was nie. Afleiding: Athrixia phylicoides waterekstrak stimuleer in vitro glukoseopname en metabolisme in 'n insulin-mimetiese manier, wat beteken dat die ekstrak potensiëel voordele vir tipe twee diabete kan inhou as aanvullingsterapie.

Thesis (PhD)--University of Stellenbosch, 2011. / ENGLISH ABSTRACT: Diabetes mellitus is amongst the leading causes of morbidity and mortality in the world, affecting young, adult and old people. Beta cell replacement therapy for insulin delivery remains the ultimate remedy for diabetes. However, insufficient donor pancreas and the use of immunosuppressive drugs prevent the wide-spread of this therapy. Other avenues of self generated beta cells within the organ itself need to be explored. Therefore, understanding the chronobiology of cellular mechanisms in the lineage of beta cell induced neogenesis is a valuable tool in improving beta cell replacement in patients with diabetes. The aim of this study was to induce recapitulation of the morpho-genetic sequence of endocrine cells development in the pancreas of rats after the pancreatic duct ligation (PDL) procedure. Serial sections of PDL tissues of the pancreas were obtained from 78 Sprague- Dawley rats and were assessed morphologically. The immunofluorescent tissues were statistically analysed using a computerized morphometry technique. The protein expression indices of Caspase3, Insulin, Pdx1, Ngn3, NeuroD and Pax6 were quantified. The efficiency levels of coexpression of these homeodomain proteins separately with insulin were defined by the ratio of the mean value of insulin expression to the mean value of their respective protein expression. The morphological changes were characterized by the appearance of granulated acinar cells at 6 hours post-PDL and the proliferation of endocrine tissues from 84 hours through to 120 hours. The morpho-immunofluorescent evaluation showed the highest immunoreactivity of Caspase3 and Pdx1 at 6 hours, Ngn3 at 36 hours, Pax6 and insulin at 84 hours while NeuroD expression was at 120 hours. The immunohistofluorescent analysis showed that caspase3 and Pdx1 were the first to be expressed at 6 hours while the insulin and NeuroD expression appeared later at 84 hours and 120 hours, respectively. However, Pax6 expression was continuous across time periods post-PDL, while Ngn3 expression showed a peak at 36 hours. The efficiency (highest and earliest expression) of co-expression of all these homeodomain proteins with insulin was restricted between 12 hours and 24 hours. The optimal efficiency was at 12 hours by Ngn3 with insulin. A good efficiency was shown for Pdx1 with insulin, NeuroD with insulin and Pax6 with insulin at 12 hours and 24 hours, respectively. A low efficiency was observed for insulin and caspase3 co-expression at 24 hours. This study suggests that for transplantation, PDL tissues harvested at an early time post-PDL (between 12 and 24 hours) could yield a higher success rate; the study also provides evidence for a connection between morphological changes in the PDL pancreas and the protein synthesis necessary for the lineage of endocrine cell development. / AFRIKAANSE OPSOMMING: Diabetes Mellitus resorteer onder die vernaamste oorsake van morbiditeit en mortaliteit wêreldwyd, en tuister jongmense, volwassenes en bejaardes. Daar bestaan egter ‘n wêreldwye tekort aan skenkerorgane met immuun-onderdrukingsterapie as ondersteuningsbehandeling. Beta-sel vervangingsterapie, vir die voorsiening van insulien, bly daarom die voorkeur behandeling vir die siekte wat noodsaak dat die wetenskap kyk na alternatiewe behandelingsregimens wat meganismes rondom orgaanregenerasie insluit. Begrip van die chronobiologie van die sellulêre meganismes betrokke rondom beta-sel ontwikkeling mag waardevolle lig werp op die neogenese van beta-selle wat gevolglik daartoe mag lei dat beta-sel vervanging as ‘n moontlike behandelingsterapie oorweeg mag word vir pasiënte met suikersiekte. Die oogmerk van hierdie studie is om die rekapitulasie van die morfo-genetiese volgorde van die endokriene pankreas na afbinding van die pankreasbuis te bepaal. Pankreasbuis afbinding is op 78 Sprague-Dawley laboratorium rotte onder algemene narkose uitgevoer, die pankreas is na voorafbepaalde tydsvakke verwyder en in histologiese seriesnitte gesny. Snitte is immunositochemiese gekleur en morfometries assesseer. Die afskeidingsindeks vir selboodskappers vir Caspase3, Insulien, Pdx1, Ngn3, NeuroD en Pax6 is kwantifiseer. Die gelyktydige afskeiding van elk van bogenoemde boodskappers tesame met insulien is omskryf as ‘n verhouding tot mekaar en in terme van dié van insulien. Die morfologiese verandering in die weefsel bespeur is gekenmerk deur die verskyn van gegranuleerde asinêre selle ses (6) ure na buisafbinding en die proliferasie van endokriene weefsel vanaf vier-en-tagtig (84) ure deurlopend tot een-honderd-en-twintig (120) ure. Die morfo-immunofluoresserende evaluering toon dat Caspase3 en Pdx1 by 6 uur die hoogste is, die van Ngn3 by 36 ure, Pax6 en insulien by 84 ure en NeuroD by 120 ure. Verder toon die analise dat Caspase3 en Pdx1 rondom 6 ure hul verskyning gemaak het terwyl dié van insulien en NeuroD eers rondom 84 tot 120 uur verskyn het. Die verskyning van Pax6 het deurlopend regoor al die tydsduurtes verskyn en Ngn3 het rondom 36 uur sy hoogste vlak bereik. Die gelyktydige uitdrukking van homeodomein proteïene tesame met insulien het slegs tussen die tydperke van 12 en 24 ure plaasgevind. Die uitdrukking van Pdx1 met insulien, NeuroD met insulien en Pax6 met insulien het almal tussen 12 en 24 ure plaasgevind. Caspase3 tesame met insulien is slegs by die 24 uur tydsperiode bespeur. Vir die oorplant van pankreas weefsel wat aan buisafbinding onderwerp is suggereer hierdie studie dat die geskikste tyd vir die oes van endokriene weefsel liewer vroeër (12 to 24 ure) as later uitgevoer behoort te word. Verder wil dit voorkom of hierdie tydsperiode ook die hoogste seltelling lewer. Die studie lewer waardevolle inligting oor die verwantskap tussen die morfologiese veranderings wat na buisafbinding plaasvind en die proteïen sintese wat sel-opvolgontwikkeling bevorder.