This study was supported by grant No. 14-2020-002 from the SNUBH Research Fund and by the National Research Foundation of Korea (NRF) grant funded by the Korea government (MSIT) (NRF-2020R1F1A1058381, NRF-2020R1A2C3005694).

All procedures described in this paper were conducted in accordance with the 8th edition of the Guide for the Care and Use of Laboratory Animals (2011)26 and approved by the Institutional Animal Care and Use Committee at the Korea Advanced Institute of Science and Technology (KAIST) and Seoul National University Bundang Hospital (SNUBH).
1. Preparation of the window and other materials
<ol>
	<li>Custom design the pancreatic intravital imaging window to seclude the pancreas from the bowel in the abdominal cavity18 (Figure 1A,B). A detailed blueprint of the window is described in a supplementary figure of a previous study18.</li>
	<li>Use C57BL/6N mice, 8-12-week-old males, for intravital pancreatic imaging. Inject anti-CD31 antibody conjugated with an Alexa 647 fluorophore, 2 h prior to the imaging, for the purpose of vessel labeling18.</li>
	<li>For the islets study, prepare a transgenic mouse model in which the islets are tagged with a fluorescent reporter protein. Here, we utilized MIP-GFP, where green fluorescent protein was expressed under the control of the mouse insulin 1 gene promoter, which is active in the beta cells of all islets in the mouse24.</li>
	<li>For the pancreatic cancer study, prepare transgenic cancer cells tagged with a fluorescent reporter protein and BALB/C nude mice. In this study, the PANC-1 NucLight Red cells were used. PANC-1 cancer cells25 were labeled with the NucLight Red fluorescent probe.</li>
	<li>Sterilize all surgical tools, cover glass (with PEG or not), and imaging windows using an autoclave.</li>
	<li>Apply PEG coating to the cover glass to prevent inflammatory response and increase biocompatibility, which is suitable for long-term imaging.</li>
</ol>
2. Surgery
<ol>
	<li>Prepare a sterile surgical platform and sterilize the surfaces with 70% ethanol. 
	NOTE: For longitudinal imaging sessions, aseptic technique is essential.</li>
	<li>Anesthetize mice with a mixture of tiletamine/zolazepam (30 mg/kg) and xylazine (10 mg/kg). 
	NOTE: Use of tiletamine/zolazepam is recommended instead of ketamine because of its adverse effect of hyperglycemia. Optimal anesthesia should be selected for the purpose of the experiment9,27.</li>
	<li>Monitor the body temperature using a rectal probe with a homeothermic controlled heating pad.</li>
	<li>Shave the left flank of the mouse and apply three rounds of alternating alcohol and iodine-based scrub. 
	NOTE: If depilatory cream is used,&#160;do not leave longer than 1 minute to avoid chemical burn.</li>
	<li>Make a 1.5 cm incision on the left flank of the mouse and dissect the skin and muscle.</li>
	<li>Perform a purse-string suture with a black or nylon 4-0 suture in the incision margin.</li>
	<li>Use a micro retractor on the incision and gently expose the spleen.</li>
	<li>Carefully pool the spleen with ring forceps and identify the pancreas.</li>
	<li>Place the window at the flank of the mouse and pass the spleen and pancreas through the open space of the window.&#160;Manipulation of the pancreas has to be very gentile as it can cause bleeding or pancreatitis</li>
	<li>Gently place the pancreas on the plate of the imaging window; the spleen will be placed on the open space of the window.</li>
	<li>For the cancer cell study, inject PANC-1 NucLight Red (1.0 x 106 cells) directly into the pancreas. 
	NOTE: For imaging the orthotopic human pancreatic cancer xenografts, direct implantation of cancer cell such as PANC-1 or other human pancreatic cancer cell could be facilitated28. To visualize with intravital fluorescence microscopy, PANC-1 cells were transduced with red fluorescent protein using the NucLight Red lentiviral reagent that labels the nucleus29.&#160;Although maximal injection volume is uncertain, decrease the volume as possible to avoid the pressure effect in the pancreas.</li>
	<li>Apply drops of N-butyl cyanoacrylate glue on the margin of the imaging window.
	<ol>
		<li>To minimize the amount of the applied glue, use a 31 G catheter needle for the application. If the amount of the drop is large, then the tissue will unintentionally adhere to the window or cover glass.</li>
	</ol>
	</li>
	<li>Gently apply a 12 mm round cover glass to the margin of the imaging window.</li>
	<li>Pull the suture loop to fit into the lateral groove of the window and tie it three times.</li>
	<li>Cut the maximal proximal site of the knot&#160;to prevent the interruption of tight stitches when these mice are awake.</li>
	<li>Let mice recover from anesthesia (2-3 hours) and inject ketoprofen (5 mg/kg, subcutaneous in the loose skin at the base of neck or hip of the animal) for pain relief. Reassess for signs of pain every 12 hours and&#160;ketoprofen should be considered every 24 hours for 1-3 days. 
	&#8203;NOTE: Analgesia influences insulin secretion in response to glucose9. The choice and timing of analgesia must be individualized for the experimental purpose.</li>
	<li>Accomodate the mouse in the cage with sufficient bedding to avoid the contact of the window to the cage. Avoid housing the house with the mice without the window surgery.</li>
</ol>
3. Intravital imaging
<ol>
	<li>Turn on the intravital microscope including the laser power.</li>
	<li>Turn on the heating pad and set the homeothermic regulation to 37 &#176;C. 
	NOTE: Alternatively, use a passive heating pad or lamp with frequent control if there is no homeothermic regulation.</li>
	<li>Perform intramuscular anesthesia with a mixture of tiletamine/zolazepam (30 mg/kg) and xylazine (10 mg/kg). 
	NOTE: Use of tiletamine/zolazepam is recommended instead of ketamine because of its adverse effect of hyperglycemia. Optimal anesthesia should be selected for the purpose of the experiments9,27.</li>
	<li>Insert a vascular catheter for the injection.
	<ol>
		<li>Apply pressure on the proximal side of the tail with the index and third finger as an alternative to a tourniquet application. Heat the tail with a lamp if needed.</li>
		<li>Sterilize the tail vein with a 70% ethanol spray.</li>
		<li>Insert a 30 G catheter into the lateral tail vein. Regurgitation of blood will be visualized in the PE10 tube.</li>
		<li>Apply a silk tape on the catheter to stabilize it.</li>
		<li>Inject FITC/TMR dextran or other fluorescent probes (25 &#181;g of anti-CD31 conjugated with Alexa 647), as appropriate, according to the combination of fluorescent probes18. 
		NOTE: For fluorescent conjugated antibody probes, inject 2 h before the imaging session.</li>
	</ol>
	</li>
	<li>Transfer the mouse from the surgical platform to the imaging stage.</li>
	<li>Insert a rectal probe to automatically control the body temperature with the homeothermic heating pad system.</li>
	<li>Insert the pancreatic imaging window into the window holder prepared during the intravital microscopy setup (Figure 2). For an inverted microscope, a window holder might not be required.</li>
	<li>Perform intravital imaging.
	<ol>
		<li>For imaging the pancreas, start with a low magnification objective lens (e.g., 4x) for scanning the whole view of the pancreas in the pancreatic imaging window (recommended field of view: 2500 x 2500 &#181;m).</li>
		<li>After determination of the region of interest, switch to higher magnification objective lens (20x or 40x) to perform the cellular level imaging (recommended field of view: 500 x 500 &#181;m or 250 x 250 &#181;m). In this experiment, the lateral and axial resolution was approximately 0.5 &#181;m and 3 &#181;m, respectively.</li>
		<li>Perform z-stack or time-lapse imaging to observe the 3D structure or cellular-level dynamics, such as cell migration. 
		NOTE: For imaging the fluorescent protein expressing cells of transgenic animals (MIP-GFP), 30 s of intermittent 488 nm laser exposure with power up to 0.43 mW was tolerable without noticeable photobleaching or tissue damage. For imaging the fluorescent proteins labeled with Alexa 647, the 640 nm laser power up to 0.17 mW was tolerable without noticeable photobleaching or tissue damage. Prolonged excitation laser exposure with a power above this setting may lead to photobleaching or tissue damage by phototoxicity. Adjust the adequate gain and power to appropriately image the region of interest. Detailed setting of parameters in intravital microscopy must be individualized for each intravital microscopy prepared in the institute.</li>
	</ol>
	</li>
</ol>

<ol>
	<li>Dimastromatteo, J., Brentnall, T., Kelly, K. A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Imaging+in+pancreatic+disease.">Imaging in pancreatic disease.</a> Nature Reviews. Gastroenterology &amp; Hepatology. 14 (2), 97-109 (2017).</li><li>Cote, G. A., Smith, J., Sherman, S., Kelly, K. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Technologies+for+imaging+the+normal+and+diseased+pancreas.">Technologies for imaging the normal and diseased pancreas.</a> Gastroenterology. 144 (6), 1262-1271 (2013).</li><li>Yachida, S., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Distant+metastasis+occurs+late+during+the+genetic+evolution+of+pancreatic+cancer.">Distant metastasis occurs late during the genetic evolution of pancreatic cancer.</a> Nature. 467 (7319), 1114-1117 (2010).</li><li>Hardt, P. D., Brendel, M. D., Kloer, H. U., Bretzel, R. G. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Is+pancreatic+diabetes+(type+3c+diabetes)+underdiagnosed+and+misdiagnosed.">Is pancreatic diabetes (type 3c diabetes) underdiagnosed and misdiagnosed.</a> Diabetes Care. 31, 165-169 (2008).</li><li>Baetens, D., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Alteration+of+islet+cell+populations+in+spontaneously+diabetic+mice.">Alteration of islet cell populations in spontaneously diabetic mice.</a> Diabetes. 27 (1), 1-7 (1978).</li><li>Holmberg, D., Ahlgren, U. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Imaging+the+pancreas:+from+ex+vivo+to+non-invasive+technology.">Imaging the pancreas: from ex vivo to non-invasive technology.</a> Diabetologia. 51 (12), 2148-2154 (2008).</li><li>Marciniak, A., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Using+pancreas+tissue+slices+for+in+situ+studies+of+islet+of+Langerhans+and+acinar+cell+biology.">Using pancreas tissue slices for in situ studies of islet of Langerhans and acinar cell biology.</a> Nature Protocols. 9 (12), 2809-2822 (2014).</li><li>Ravier, M. A., Rutter, G. A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Isolation+and+culture+of+mouse+pancreatic+islets+for+ex+vivo+imaging+studies+with+trappable+or+recombinant+fluorescent+probes.">Isolation and culture of mouse pancreatic islets for ex vivo imaging studies with trappable or recombinant fluorescent probes.</a> Methods in Molecular Biology. 633, 171-184 (2010).</li><li>Frikke-Schmidt, H., Arvan, P., Seeley, R. J., Cras-Meneur, C. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Improved+in+vivo+imaging+method+for+individual+islets+across+the+mouse+pancreas+reveals+a+heterogeneous+insulin+secretion+response+to+glucose.">Improved in vivo imaging method for individual islets across the mouse pancreas reveals a heterogeneous insulin secretion response to glucose.</a> Science Reports. 11 (1), 603 (2021).</li><li>Lee, E. M., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Effect+of+resveratrol+treatment+on+graft+revascularization+after+islet+transplantation+in+streptozotocin-induced+diabetic+mice.">Effect of resveratrol treatment on graft revascularization after islet transplantation in streptozotocin-induced diabetic mice.</a> Islets. 10 (1), 25-39 (2018).</li><li>Evgenov, N. V., Medarova, Z., Dai, G., Bonner-Weir, S., Moore, A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=In+vivo+imaging+of+islet+transplantation.">In vivo imaging of islet transplantation.</a> Nature Medicine. 12 (1), 144-148 (2006).</li><li>Mojibian, M., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Implanted+islets+in+the+anterior+chamber+of+the+eye+are+prone+to+autoimmune+attack+in+a+mouse+model+of+diabetes.">Implanted islets in the anterior chamber of the eye are prone to autoimmune attack in a mouse model of diabetes.</a> Diabetologia. 56 (10), 2213-2221 (2013).</li><li>Pittet, M. J., Weissleder, R. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Intravital+imaging.">Intravital imaging.</a> Cell. 147 (5), 983-991 (2011).</li><li>Ritsma, L., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Surgical+implantation+of+an+abdominal+imaging+window+for+intravital+microscopy.">Surgical implantation of an abdominal imaging window for intravital microscopy.</a> Nature Protocols. 8 (3), 583-594 (2013).</li><li>Ritsma, L., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Intravital+microscopy+through+an+abdominal+imaging+window+reveals+a+pre-micrometastasis+stage+during+liver+metastasis.">Intravital microscopy through an abdominal imaging window reveals a pre-micrometastasis stage during liver metastasis.</a> Science Translational Medicine. 4 (158), (2012).</li><li>Ritsma, L., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Intestinal+crypt+homeostasis+revealed+at+single-stem-cell+level+by+in+vivo+live+imaging.">Intestinal crypt homeostasis revealed at single-stem-cell level by in vivo live imaging.</a> Nature. 507 (7492), 362-365 (2014).</li><li>Dolensek, J., Rupnik, M. S., Stozer, A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Structural+similarities+and+differences+between+the+human+and+the+mouse+pancreas.">Structural similarities and differences between the human and the mouse pancreas.</a> Islets. 7 (1), 1024405 (2015).</li><li>Park, I., Hong, S., Hwang, Y., Kim, P. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=A+Novel+pancreatic+imaging+window+for+stabilized+longitudinal+in+vivo+observation+of+pancreatic+islets+in+murine+model.">A Novel pancreatic imaging window for stabilized longitudinal in vivo observation of pancreatic islets in murine model.</a> Diabetes &amp; Metabolism Journal. 44 (1), 193-198 (2020).</li><li>Park, I., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Neutrophils+disturb+pulmonary+microcirculation+in+sepsis-induced+acute+lung+injury.">Neutrophils disturb pulmonary microcirculation in sepsis-induced acute lung injury.</a> The European Respiratory Journal. 53 (3), 1800786 (2019).</li><li>Park, I., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Intravital+imaging+of+a+pulmonary+endothelial+surface+layer+in+a+murine+sepsis+model.">Intravital imaging of a pulmonary endothelial surface layer in a murine sepsis model.</a> Biomedical Optics Express. 9 (5), 2383-2393 (2018).</li><li>Seo, H., Hwang, Y., Choe, K., Kim, P. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=In+vivo+quantitation+of+injected+circulating+tumor+cells+from+great+saphenous+vein+based+on+video-rate+confocal+microscopy.">In vivo quantitation of injected circulating tumor cells from great saphenous vein based on video-rate confocal microscopy.</a> Biomedical Optics Express. 6 (6), 2158-2167 (2015).</li><li>Moon, J., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Intravital+longitudinal+imaging+of+hepatic+lipid+droplet+accumulation+in+a+murine+model+for+nonalcoholic+fatty+liver+disease.">Intravital longitudinal imaging of hepatic lipid droplet accumulation in a murine model for nonalcoholic fatty liver disease.</a> Biomedical Optics Express. 11 (9), 5132-5146 (2020).</li><li>Hwang, Y., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=In+vivo+cellular-level+real-time+pharmacokinetic+imaging+of+free-form+and+liposomal+indocyanine+green+in+liver.">In vivo cellular-level real-time pharmacokinetic imaging of free-form and liposomal indocyanine green in liver.</a> Biomedical Optics Express. 8 (10), 4706-4716 (2017).</li><li>Hara, M., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Transgenic+mice+with+green+fluorescent+protein-labeled+pancreatic+beta+-cells.">Transgenic mice with green fluorescent protein-labeled pancreatic beta -cells.</a> American Journal of Physiology, Endocrinology and Metabolism. 284 (1), 177-183 (2003).</li><li>Lieber, M., Mazzetta, J., Nelson-Rees, W., Kaplan, M., Todaro, G. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Establishment+of+a+continuous+tumor-cell+line+(panc-1)+from+a+human+carcinoma+of+the+exocrine+pancreas.">Establishment of a continuous tumor-cell line (panc-1) from a human carcinoma of the exocrine pancreas.</a> International Journal of Cancer. 15 (5), 741-747 (1975).</li><li>National Institutes of Health. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Guide+for+the+Care+and+Use+of+Laboratory+Animals.+Committee+for+the+Update+of+the+Guide+for+the+Care+and+Use+of+Laboratory+Animals.">Guide for the Care and Use of Laboratory Animals. Committee for the Update of the Guide for the Care and Use of Laboratory Animals.</a> The National Academies Collection: Reports funded by National Institutes of Health. , (2011).</li><li>Windelov, J. A., Pedersen, J., Holst, J. J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Use+of+anesthesia+dramatically+alters+the+oral+glucose+tolerance+and+insulin+secretion+in+C57Bl/6+mice.">Use of anesthesia dramatically alters the oral glucose tolerance and insulin secretion in C57Bl/6 mice.</a> Physiological Reports. 4 (11), 12824 (2016).</li><li>Kim, M. P., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Generation+of+orthotopic+and+heterotopic+human+pancreatic+cancer+xenografts+in+immunodeficient+mice.">Generation of orthotopic and heterotopic human pancreatic cancer xenografts in immunodeficient mice.</a> Nature Protocols. 4 (11), 1670-1680 (2009).</li><li>Cichocki, F., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=GSK3+inhibition+drives+maturation+of+NK+cells+and+enhances+their+antitumor+activity.">GSK3 inhibition drives maturation of NK cells and enhances their antitumor activity.</a> Cancer Research. 77 (20), 5664-5675 (2017).</li><li>Zhu, S., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Monitoring+C-peptide+storage+and+secretion+in+islet+beta-cells+in+vitro+and+in+vivo.">Monitoring C-peptide storage and secretion in islet beta-cells in vitro and in vivo.</a> Diabetes. 65 (3), 699-709 (2016).</li><li>Reissaus, C. A., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=A+versatile,+portable+intravital+microscopy+platform+for+studying+beta-cell+biology+in+vivo.">A versatile, portable intravital microscopy platform for studying beta-cell biology in vivo.</a> Science Reports. 9 (1), 8449 (2019).</li><li>Kong, K., Guo, M., Liu, Y., Zheng, J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Progress+in+animal+models+of+pancreatic+ductal+adenocarcinoma.">Progress in animal models of pancreatic ductal adenocarcinoma.</a> Journal of Cancer. 11 (6), 1555-1567 (2020).</li><li>Bisht, S., Feldmann, G. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Animal+models+for+modeling+pancreatic+cancer+and+novel+drug+discovery.">Animal models for modeling pancreatic cancer and novel drug discovery.</a> Expert Opinion in Drug Discovery. 14 (2), 127-142 (2019).</li><li>Herreros-Villanueva, M., Hijona, E., Cosme, A., Bujanda, L. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Mouse+models+of+pancreatic+cancer.">Mouse models of pancreatic cancer.</a> World Journal of Gastroenterology. 18 (12), 1286-1294 (2012).</li><li>Feig, C., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+pancreas+cancer+microenvironment.">The pancreas cancer microenvironment.</a> Clinical Cancer Research. 18 (16), 4266-4276 (2012).</li><li>Garcia, P. L., Miller, A. L., Yoon, K. J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Patient-derived+xenograft+models+of+pancreatic+cancer:+overview+and+comparison+with+other+types+of+models.">Patient-derived xenograft models of pancreatic cancer: overview and comparison with other types of models.</a> Cancers (Basel). 12 (5), 1327 (2020).</li></ol>

The authors have nothing to disclose.

The protocol described here consists of intravital imaging of the pancreas using a novel supporting base integrated pancreatic intravital imaging window modified from an abdominal imaging window. Among the protocols described above, the first critical step is the implantation of the intravital pancreatic imaging window in the mouse. For the application of the glue in the window, it is important to apply the glue between the margin of the window and the cover glass, but not on the pancreatic tissue, as it may significantl...

The pancreas is an abdominal organ with an exocrine function in the digestive tract and an endocrine function of secreting hormones into the bloodstream. High-resolution cellular imaging of the pancreas could reveal the pathophysiology of various diseases involving the pancreas, including pancreatitis, pancreatic cancer, and diabetes mellitus1. Conventional diagnostic imaging tools such as computed tomography, magnetic resolution imaging, and ultrasonography are widely available in the clinical field1,2. However, these imaging modalities are restricted to visualizing only structural or anatomical changes, while alterations at the cellular or molecular level cannot be determined. Given that molecular changes in diabetes mellitus or pancreatic cancer in humans can initiate more than 10 years prior to the diagnosis3,4, the detection of pancreatic diseases from their molecular transition during the latent period has the potential to provide an early diagnosis and a timely intervention. Thus, imaging that will overcome the limitations of resolution and provide valuable insights into the function will remarkably gain attention by providing early diagnosis of pancreatic cancer or advanced identification of the alteration of the islets during the progression of diabetes mellitus5.
In particular with the islets, nuclear imaging, bioluminescence imaging, and optical coherence tomography have been suggested as non-invasive islet imaging techniques6. However, the resolution of these methods is substantially low, with typical values ranging from several tens to hundreds of micrometers, offering a limited capability to detect changes at the cellular level in the islets. On the other hand, previous high-resolution studies of islets were performed under ex vivo7,8 (e.g., slicing or digestion of the pancreas), non-physiologic9 (e.g., exteriorization of the pancreas), and heterotopic conditions10,11,12 (e.g., implantation under the kidney capsule, inside the liver, and in the anterior chamber of the eye), which restricts their interpretation and clinical implications. If in vivo, physiologic, and orthotopic model of high-resolution imaging can be established, it will be a critical platform for the investigation of pancreatic islets.
Intravital imaging, which reveals the pathophysiology at a microscopic resolution level in a live animal, has recently received great attention13. Of the in vivo imaging methods, the development of an abdominal imaging window14, which implants a window into the abdomen of a mouse, has allowed the discovery of novel findings (i.e., a pre-micrometastasis stage of early liver metastasis15 and mechanism of stem cell maintenance in the intestinal epithelium16). Although the abdominal imaging window provides valuable results, the applications of this window for the pancreas and the resulting intravital imaging research based on diseases involving pancreas, have not been extensively investigated.
Unlike the well-defined solid organ characteristics of the human pancreas, the pancreas of a mouse is a diffusely distributed soft tissue-like structure17. Therefore, it is incessantly affected by physiological movements including peristalsis and respiration. A previous study on the application of an abdominal imaging window for the pancreas demonstrated that wandering occurred due to motion-artifacts induced by bowel movements18. Severe blurring was observed in the resulting averaged image, which impeded the visualization and identification of the microscale structures.
Herein, we describe the use of a novel supporting base integrated pancreatic intravital imaging window combined with intravital microscopy19,20 to investigate the longitudinal cellular level events in diseases involving the pancreas. In addition to a detailed description of the methodology in the previous study18, the extended application of pancreatic imaging window for various diseases involving the pancreas will be addressed in this paper. In this protocol, a custom-built video-rate laser-scanning confocal microscopy system was utilized as an intravital microscopy system. Four laser modules (wavelengths at 405, 488, 561, and 640 nm) were utilized as an excitation source, and four channels of emission signals were detected by photomultiplier tubes (PMT) through bandpass filters (BPF1: FF01-442/46; BPF2: FF02-525/50; BPF3: FF01-600/37; BPF4: FF01-685/40). Laser scanning consisted of a rotating polygonal mirror (X-axis) and a galvanometer scanning mirror (Y-axis) that enabled the video-rate scanning (30 frames per second). Detailed information about intravital microscopy has been described in the previous studies10,18,19,20,21,22,23.
In our previous islet study18, we successfully and stably imaged the islets in live mice using a transgenic mouse model (MIP-GFP)24 in which the islets were tagged with GFP. The method enabled high-resolution visualization of the changes in the islets over a period of 1 week. It also facilitated imaging of the same islets for up to 3 weeks, which suggests the feasibility of long-term studies of the pancreatic islets for the functional tracking or monitoring during the pathogenesis of diabetes mellitus18. Furthermore, we developed an orthotopic pancreatic cancer model in which fluorescent pancreatic cancer cells (PANC-1 NucLight Red)25 were directly implanted into the pancreas of the mouse. With the application of the pancreatic intravital imaging window, this model could be utilized as a platform for investigating the cellular and molecular pathophysiology in the tumor microenvironment of pancreatic cancer and for the therapeutic monitoring of novel drug candidates.

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			<td>Alexa Fluor 647 Succinimidyl Esters (NHS esters)</td>
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			<td>IMARIS 8.1</td>
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			<td>IMARIS</td>
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			<td>IVM-C</td>
			<td>Intravital Microscopy</td>
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			<td>IRIS Scissor</td>
			<td>JEUNGDO BIO &#38; PLANT CO, LTD</td>
			<td>S-1107-10</td>
			<td>This product can be replaced with the product from other company</td>
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			<td>Loctite 401</td>
			<td>Henkel</td>
			<td>401</td>
			<td>N-butyl cyanoacrylate glue</td>
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			<td>Micro Needle holder</td>
			<td>JEUNGDO BIO &#38; PLANT CO, LTD</td>
			<td>H-1126-10</td>
			<td>This product can be replaced with the product from other company</td>
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			<td>Micro rectractor</td>
			<td>JEUNGDO BIO &#38; PLANT CO, LTD</td>
			<td>17004-03</td>
			<td>This product can be replaced with the product from other company</td>
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			<td>Microforceps</td>
			<td>JEUNGDO BIO &#38; PLANT CO, LTD</td>
			<td>F-1034</td>
			<td>This product can be replaced with the product from other company</td>
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			<td>MIP-GFP</td>
			<td>The Jackson Laboratory</td>
			<td>006864</td>
			<td>B6.Cg-Tg(Ins1-EGFP)1Hara/J</td>
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			<td>Nylon 4-0</td>
			<td>AILEE</td>
			<td>NB434</td>
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			<td>Omnican N 100 30G</td>
			<td>B BRAUN</td>
			<td>FT9172220S</td>
			<td>For Vascular Catheter, Use only Needle part</td>
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			<td>PANC-1 NucLightRed</td>
			<td>Custom-made</td>
			<td>Custom-made</td>
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			<td>Pancreatic imaging window</td>
			<td>Geumto Engineering</td>
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			<td>Pancreatic imaging window - custom order</td>
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			<td>Physiosuite</td>
			<td>Kent Scientific</td>
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			<td>Ring Forceps</td>
			<td>JEUNGDO BIO &#38; PLANT CO, LTD</td>
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			<td>This product can be replaced with the product from other company</td>
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			<td>Rompun</td>
			<td>Bayer</td>
			<td>Rompun</td>
			<td>Anesthetic agent</td>
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			<td>TMR Dextran 65-85kDa</td>
			<td>Merck (Former Sigma Aldrich)</td>
			<td>T1162</td>
			<td>For vessel identification</td>
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			<td>Window holder</td>
			<td>Geumto Engineering</td>
			<td>Custom order</td>
			<td>Window holder - custom order</td>
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			<td>Zoletil</td>
			<td>Virbac</td>
			<td>Zoletil 100</td>
			<td>Anesthetic agent</td>
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stabilized longitudinal in vivo cellular-level visualization of the pancreas in a murine model with a pancreatic intravital imaging window

Direct in vivo cellular-resolution imaging of the pancreas in a live small animal model has been technically challenging. A recent intravital imaging study, with an abdominal imaging window, enabled visualization of the cellular dynamics in abdominal organs in vivo. However, due to the soft sheet-like architecture of the mouse pancreas that can be easily influenced by physiologic movement (e.g., peristalsis and respiration), it was difficult to perform stabilized longitudinal in vivo imaging over several weeks at the cellular level to identify, track, and quantify islets or cancer cells in the mouse pancreas. Herein, we describe a method for implanting a novel supporting base, an integrated pancreatic intravital imaging window, that can spatially separate the pancreas from the bowel for longitudinal time-lapse intravital imaging of the pancreas microstructure. Longitudinal in vivo imaging with the imaging window enables stable visualization, allowing for the tracking of islets over a period of 3 weeks and high-resolution three-dimensional imaging of the microstructure, as evidenced here in an orthotopic pancreatic cancer model. With our method, further intravital imaging studies can elucidate the pathophysiology of various diseases involving the pancreas at the cellular level.

Intravital microscopy combined with the supporting base integrated pancreatic intravital imaging window enables longitudinal cellular level imaging of the pancreas in a mouse. This protocol with the pancreatic intravital imaging window provides long-term tissue stability that enables the acquisition of high-resolution imaging to track individual islets for up to 3 weeks. As a result, mosaic imaging for an extended field of view, three-dimensional (3D) reconstruction of z-stack imaging, and longitudinal tracking of the sa...

Watch this Scientific Journal Video about Stabilized Longitudinal In Vivo Cellular-Level Visualization of the Pancreas in a Murine Model with a Pancreatic Intravital Imaging Window at JoVE.com

Stabilized Longitudinal In Vivo Cellular-Level Visualization of the Pancreas in a Murine Model with a Pancreatic Intravital Imaging Window

In vivo high-resolution imaging of the pancreas was facilitated with the pancreatic intravital imaging window.

Stabilized Longitudinal In Vivo Cellular-Level Visualization of the Pancreas in a Murine Model with a Pancreatic Intravital Imaging Window

Direct in vivo cellular-resolution imaging of the pancreas in a live small animal model has been technically challenging. A recent intravital imaging ...

stabilized-longitudinal-vivo-cellular-level-visualization-pancreas

Research

JoVE Journal

Medicine

3.9K Views.  Seoul National University Bundang Hospital. In vivo high-resolution imaging of the pancreas was facilitated with the pancreatic intravital imaging window.

Video: Stabilized Longitudinal In Vivo Cellular-Level Visualization of the Pancreas in a Murine Model with a Pancreatic Intravital Imaging Window

Imaging Glioma Initiation In Vivo Through a Polished and Reinforced Thin-skull Cranial Window

Glioma is the one of the most lethal forms of human cancer. The most effective glioma therapy to date-surgery followed by radiation treatment-offers patients only modest benefits, as most patients do not survive more than five years following diagnosis due to glioma relapse 1,2. The discovery of cancer stem cells in human brain tumors holds promise for having an enormous impact on the development of novel therapeutic strategies for glioma 3. Cancer stem cells are defined by their ability both to self-renew and to differentiate, and are thought to be the only cells in a tumor that have the capacity to initiate new tumors 4. Glioma relapse following radiation therapy is thought to arise from resistance of glioma stem cells (GSCs) to therapy 5-10. In vivo, GSCs are shown to reside in a perivascular niche that is important for maintaining their stem cell-like characteristics 11-14. Central to the organization of the GSC niche are vascular endothelial cells 12. Existing evidence suggests that GSCs and their interaction with the vascular endothelial cells are important for tumor development, and identify GSCs and their interaction with endothelial cells as important therapeutic targets for glioma. The presence of GSCs is determined experimentally by their capability to initiate new tumors upon orthotopic transplantation 15. This is typically achieved by injecting a specific number of GBM cells isolated from human tumors into the brains of severely immuno-deficient mice, or of mouse GBM cells into the brains of congenic host mice. Assays for tumor growth are then performed following sufficient time to allow GSCs among the injected GBM cells to give rise to new tumors-typically several weeks or months. Hence, existing assays do not allow examination of the important pathological process of tumor initiation from single GSCs in vivo. Consequently, essential insights into the specific roles of GSCs and their interaction with the vascular endothelial cells in the early stages of tumor initiation are lacking. Such insights are critical for developing novel therapeutic strategies for glioma, and will have great implications for preventing glioma relapse in patients. Here we have adapted the PoRTS cranial window procedure 16and in vivo two-photon microscopy to allow visualization of tumor initiation from injected GBM cells in the brain of a live mouse. Our technique will pave the way for future efforts to elucidate the key signaling mechanisms between GSCs and vascular endothelial cells during glioma initiation.

Imaging Glioma Initiation In Vivo Through a Polished and Reinforced Thin-skull Cranial Window

By combining a polished and reinforced thin-skull (PoRTS) cranial window and glioblastoma (GBM) cell injection, we can observe glioma initiation and growth from injected GBM cells in the brain of a live mouse longitudinally.

Glioma is the one of the most lethal forms of human cancer. The most effective glioma therapy to date-surgery followed by radiation treatment-offers ...

A Murine Model of Stent Implantation in the Carotid Artery for the Study of Restenosis

Despite the considerable progress made in the stent development in the last decades, cardiovascular diseases remain the main cause of death in western countries. Beside the benefits offered by the development of different drug-eluting stents, the coronary revascularization bears also the life-threatening risks of in-stent thrombosis and restenosis. Research on new therapeutic strategies is impaired by the lack of appropriate methods to study stent implantation and restenosis processes. Here, we describe a rapid and accessible procedure of stent implantation in mouse carotid artery, which offers the possibility to study in a convenient way the molecular mechanisms of vessel remodeling and the effects of different drug coatings.

A model of stent implantation in mouse carotid artery is described. Compared to other similar methods, this procedure is very rapid, simple and accessible, offering the possibility to study in a convenient way the vascular wall reaction to different drug-eluting stents and the molecular mechanisms of restenosis.

Despite  the considerable progress made in the stent development in the last decades,  cardiovascular diseases remain the main cause of death in western ...

Rose Bengal Photothrombosis by Confocal Optical Imaging In Vivo: A Model of Single Vessel Stroke

In vivo imaging techniques have increased in utilization due to recent advances in imaging dyes and optical technologies, allowing for the ability to image cellular events in an intact animal. Additionally, the ability to induce physiological disease states such as stroke in vivo increases its utility. The technique described herein allows for physiological assessment of cellular responses within the CNS following a stroke and can be adapted for other pathological conditions being studied. The technique presented uses laser excitation of the photosensitive dye Rose Bengal in vivo to induce a focal ischemic event in a single blood vessel. 
The video protocol demonstrates the preparation of a thin-skulled cranial window over the somatosensory cortex in a mouse for the induction of a Rose Bengal photothrombotic event keeping injury to the underlying dura matter and brain at a minimum. Surgical preparation is initially performed under a dissecting microscope with a custom-made surgical/imaging platform, which is then transferred to a confocal microscope equipped with an inverted objective adaptor. Representative images acquired utilizing this protocol are presented as well as time-lapse sequences of stroke induction. This technique is powerful in that the same area can be imaged repeatedly on subsequent days facilitating longitudinal in vivo studies of pathological processes following stroke.

Rose Bengal Photothrombosis by Confocal Optical Imaging In Vivo:  A Model of Single Vessel Stroke

Here, we describe a semi-invasive optical microscopy approach for the induction of a Rose Bengal photothrombotic clot in the somatosensory cortex of a mouse in vivo. The technical aspects of the imaging procedure are described from induction of a photothrombotic event to application and data collection.

In vivo imaging techniques have increased in utilization due to recent advances in imaging dyes and optical technologies, allowing for the ability to ...

Longitudinal In Vivo Imaging of the Cerebrovasculature: Relevance to CNS Diseases

Remodeling of the brain vasculature is a common trait of brain pathologies. In vivo imaging techniques are fundamental to detect cerebrovascular plasticity or damage occurring overtime and in relation to neuronal activity or blood flow. In vivo two-photon microscopy allows the study of the structural and functional plasticity of large cellular units in the living brain. In particular, the thinned-skull window preparation allows the visualization of cortical regions of interest (ROI) without inducing significant brain inflammation. Repetitive imaging sessions of cortical ROI are feasible, providing the characterization of disease hallmarks over time during the progression of numerous CNS diseases. This technique accessing the pial structures within 250 &#956;m of the brain relies on the detection of fluorescent probes encoded by genetic cellular markers and/or vital dyes. The latter (e.g., fluorescent dextrans) are used to map the luminal compartment of cerebrovascular structures. Germane to the protocol described herein is the use of an in vivo marker of amyloid deposits, Methoxy-O4, to assess Alzheimer&#39;s disease (AD) progression. We also describe the post-acquisition image processing used to track vascular changes and amyloid depositions. While focusing presently on a model of AD, the described protocol is relevant to other CNS disorders where pathological cerebrovascular changes occur.

Longitudinal In Vivo Imaging of the Cerebrovasculature: Relevance to CNS Diseases

This manuscript describes a procedure to track the remodeling of the cerebrovasculature during amyloid plaque accumulation in vivo using longitudinal two-photon microscopy. A thinned-skull preparation enables the visualization of fluorescent dyes to assess the progression of cerebrovascular damage in a mouse model of Alzheimer&#39;s disease.

Remodeling of the brain vasculature is a common trait of brain pathologies. In vivo imaging techniques are fundamental to detect cerebrovascular ...

Quantitative Visualization of Leukocyte Infiltrate in a Murine Model of Fulminant Myocarditis by Light Sheet Microscopy

Light-sheet fluorescence microscopy (LSFM), in combination with chemical clearing protocols, has become the gold standard for analyzing fluorescently labelled structures in large biological specimens, and is down to cellular resolution. Meanwhile, the constant refinement of underlying protocols and the enhanced availability of specialized commercial systems enable us to investigate the microstructure of whole mouse organs and even allow for the characterization of cellular behavior in various live-cell imaging approaches. Here, we describe a protocol for the spatial whole-mount visualization and quantification of the CD45+ leukocyte population in inflamed mouse hearts. The method employs a transgenic mouse strain (CD11c.DTR)that has recently been shown to serve as a robust, inducible model for the study of the development of fulminant fatal myocarditis, characterized by lethal cardiac arrhythmias. This protocol includes myocarditis induction, intravital antibody-mediated cell staining, organ preparation, and LSFM with subsequent computer-assisted image post-processing. Although presented as a highly-adapted method for our particular scientific question, the protocol represents the blueprint of an easily adjustable system that can also target completely different fluorescent structures in other organs and even in other species.

Here, we describe a light-sheet microscopy approach to visualize the cardiac CD45+ leukocyte infiltrate in a murine model of aseptic fulminant myocarditis, which is induced by the intratracheal diphtheria toxin treatment of CD11c.DTR mice.

Light-sheet fluorescence microscopy (LSFM), in combination with chemical clearing protocols, has become the gold standard for analyzing fluorescently ...

Visualization of Endogenous Mitophagy Complexes In Situ in Human Pancreatic Beta Cells Utilizing Proximity Ligation Assay

Mitophagy is an essential mitochondrial quality control pathway, which is crucial for pancreatic islet beta cell bioenergetics to fuel glucose-stimulated insulin release. Assessment of mitophagy is challenging and often requires genetic reporters or multiple complementary techniques not easily utilized in tissue samples, such as primary human pancreatic islets. Here we demonstrate a robust approach to visualize and quantify formation of key endogenous mitophagy complexes in primary human pancreatic islets. Utilizing the sensitive proximity ligation assay technique to detect interaction of the mitophagy regulators NRDP1 and USP8, we are able to specifically quantify formation of essential mitophagy complexes in situ. By coupling this approach to counterstaining for the transcription factor PDX1, we can quantify mitophagy complexes, and the factors that can impair mitophagy, specifically within beta cells. The methodology we describe overcomes the need for large quantities of cellular extracts required for other protein-protein interaction studies, such as immunoprecipitation (IP) or mass spectrometry, and is ideal for precious human islet&#160;samples generally not available in sufficient quantities for these approaches. Further, this methodology obviates the need for flow sorting techniques to purify beta cells from a heterogeneous islet population for downstream protein applications. Thus, we describe a valuable protocol for visualization of mitophagy highly compatible for use in heterogeneous and limited cell populations.

This protocol outlines a method for quantitative analysis of mitophagy protein complex formation specifically in beta cells from primary human islet samples. This technique thus allows analysis of mitophagy from limited biological material, which are crucial in precious human pancreatic beta cell samples.

Mitophagy is an essential mitochondrial quality control pathway, which is crucial for pancreatic islet beta cell bioenergetics to fuel glucose-stimulated ...

Robotic Lateral Pancreaticojejunostomy for Chronic Pancreatitis

Lateral pancreaticojejunostomy (LPJ) has shown good postoperative outcomes in patients with painful, morphine dependent, chronic pancreatitis (CP). The recent rise of robotic and laparoscopic pancreatic surgery has found benefits such as reduced time to functional recovery. Few studies have reported on the feasibility, technique and outcome of robotic LPJ, especially including transection of the gastroduodenal artery. The present study describes the main steps for robotic LPJ in a patient with painful chronic pancreatitis with a dilated main pancreatic duct. The patient underwent robotic LPJ. The LPJ anastomosis is performed using a running suture technique in a longitudinal side-to-side manner. Routinely, the gastroduodenal artery is transected to drain the entire length of the main pancreatic duct. The patient is in French position; 7 trocars are placed (4 robotic, 2 laparoscopic assistants, 1 liver-retractor). After docking of the robot system, the omental bursa is opened, and the right gastroepiploic artery and vein are ligated at their base at the lower border of the pancreas. Intraoperative ultrasonography is performed in order to determine trajectory of the dilated main pancreatic duct which is opened for its entire length after the gastroduodenal artery has been suture ligated both cranially and caudally from the main pancreatic duct. A Roux limb is created, and a latero-lateral PJ is fashioned using several 3-0 barbed sutures. A stapled jejuno-jejunostomy is created at sufficient distance from the pancreatic anastomosis, aided by a 50 cm suture. The described technique for robotic LPJ is a complex but feasible operation for patients with treatment refractory CP and a dilated main pancreatic duct. Due to its complexity, implementation in high volume centers with extensive experience with CP surgery may improve outcomes.

Robotic lateral pancreaticojejunostomy (RLPJ) may be used in patients with painful, morphine dependent, chronic pancreatitis and a dilated main pancreatic duct. We describe a standardized and reproducible technique for RLPJ, which includes transection of the gastroduodenal artery.

Lateral pancreaticojejunostomy (LPJ) has shown good postoperative outcomes in patients with painful, morphine dependent, chronic pancreatitis (CP). The ...

Murine Precision-Cut Liver Slices as an Ex Vivo Model of Liver Biology

Understanding the mechanisms of liver injury, hepatic fibrosis, and cirrhosis that underlie chronic liver diseases (i.e., viral hepatitis, non-alcoholic fatty liver disease, metabolic liver disease, and liver cancer) requires experimental manipulation of animal models and in vitro cell cultures. Both techniques have limitations, such as the requirement of large numbers of animals for in vivo manipulation. However, in vitro cell cultures do not reproduce the structure and function of the multicellular hepatic environment. The use of precision-cut liver slices is a technique in which uniform slices of viable mouse liver are maintained in laboratory tissue culture for experimental manipulation. This technique occupies an experimental niche that exists between animal studies and in vitro cell culture methods. The presented protocol describes a straightforward and reliable method to isolate and culture precision-cut liver slices from mice. As an application of this technique, ex vivo liver slices are treated with bile acids to simulate cholestatic liver injury and ultimately assess the mechanisms of hepatic fibrogenesis.

This protocol provides a simple and reliable method for the production of viable precision-cut liver slices from mice. The ex vivo tissue samples can be maintained under laboratory tissue culture conditions for multiple days, providing a flexible model to examine liver pathobiology.

Understanding the mechanisms of liver injury, hepatic fibrosis, and cirrhosis that underlie chronic liver diseases (i.e., viral hepatitis, non-alcoholic ...

A Doxorubicin-Induced Murine Model of Dilated Cardiomyopathy In Vivo

Dilated cardiomyopathy (DCM) refers to a spectrum of heterogeneous myocardial disorders characterized by ventricular dilation and depressed cardiac performance in the absence of hypertension, valvular, congenital, or ischemic heart diseases, and which may be related to infection, autoimmune or metabolic abnormalities, or family inheritance. It can progress into congestive heart failure with a poor prognosis. Doxorubicin (Dox) is widely employed as a chemotherapeutic drug, but its use is limited because it causes DCM-like changes of the myocardium. Its myocardial toxicity is attributed to oxidative stress, chronic inflammation, and cardiomyocyte apoptosis. A model of DCM exploiting these Dox-induced DCM symptoms has not been established.

Described is a protocol to establish a Doxorubicin-induced dilated cardiomyopathy (DCM) model in mice via long-term intraperitoneal injection of Doxorubicin.

Dilated cardiomyopathy (DCM) refers to a spectrum of heterogeneous myocardial disorders characterized by ventricular dilation and depressed cardiac ...

Longitudinal In Vivo Imaging and Quantification of Human Pancreatic Islet Grafting and Contributing Host Cells in the Anterior Eye Chamber

Imaging beta cells is a key step towards understanding islet transplantation. Although different imaging platforms for the recording of beta cell biology have been developed and utilized in vivo, they are limited in terms of allowing single cell resolution and continuous longitudinal recordings. Because of the transparency of the cornea, the anterior chamber of the eye (ACE) in mice is well suited to study human and mouse pancreatic islet cell biology. Here is a description of how this approach can be used to perform continuous longitudinal recordings of grafting and revascularization of individual human islet grafts. Human islet grafts are inserted into the ACE, using NOD.(Cg)-Gt(ROSA)26Sortm4-Rag2-/-mice as recipients. This allows for the investigation of the expansion of recipient versus donor cells and the contribution of recipient cells in promoting the encapsulation and vascularization of the graft. Further, a step-by-step approach for image analysis and quantification of the islet volume or segmented vasculature and islet capsule forming recipient cells is outlined.

The goal of this protocol is to continuously monitor the dynamics of the human pancreatic islet engraftment process and the contributing host versus donor cells. This is accomplished by transplanting human islets into the anterior chamber of the eye (ACE) of an NOD.(Cg)-Gt(ROSA)26Sortm4-Rag2-/-mouse recipient followed by repeated 2-photon imaging.

Imaging beta cells is a key step towards understanding islet transplantation. Although different imaging platforms for the recording of beta cell biology ...