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1

Is preoperative diagnosis possible? A clinical and radiological review of lymphoepithelial cysts of the pancreas.  

PubMed

Lymphoepithelial cysts of the pancreas are rare lesions found mainly in middle-aged men. They are usually benign and have no clear natural history except one study linking their occurrence with HIV infection. Nevertheless, they often cause enormous psychological stress to patients as they tend to mimic pancreatic neoplasms which are known to carry poor prognosis. The authors have therefore assessed the published literature from PubMed in order to determine whether lymphoepithelial cysts can be diagnosed preoperatively using novel imaging techniques. Based on our findings, it is evident that three-dimensional computed tomography scans, in-phase and out-of phase magnetic resonance imaging studies, and endosonography have enabled better characterization of pancreatic lymphoepithelial cysts than a decade ago. Endoscopic ultrasound-guided fine needle aspiration has also added considerably to the promise of preoperative diagnosis. Thus, the authors can affirm that despite surgical excision of the cyst with pathological examination being the gold standard for diagnosis, it is possible that a combination of the modern imaging techniques and/or minimally-invasive approach can enable patients avoid unnecessary surgery in the future. PMID:23306330

Osiro, Stephen; Rodriguez, Jonier R; Tiwari, Kevin J; Rodriguez, Iliana I; Mathenge, Njambi; Tubbs, Robert Shane; Loukas, Marios

2013-01-01

2

Preoperative cyst fluid analysis is useful for the differential diagnosis of cystic lesions of the pancreas  

Microsoft Academic Search

Background\\/Aims: It has been suggested that activity of pancreatic enzymes and concentrations of tumoral markers in cyst fluid may help to distinguish pseudocyst, serous, and mucinous cystadenomas. The aim of this study was to prospectively assess the reliability of preoperative biochemical and tumor marker analysis in cyst fluids obtained by fine-needle aspiration for pathological diagnosis. Methods: Cyst fluid was obtained

Pascal Hammel; Philippe Levy; Hélène Voitot; Michaël Levy; Valérie Vilgrain; Marc Zins; Jean-François Flejou; Georges Molas; Philippe Ruszniewski; Pierre Bernades

1995-01-01

3

Diagnosis and Surgical Therapy of Pancreas Tumors.  

National Technical Information Service (NTIS)

The efficiency of surgery and presurgical diagnosis on several tumorous diseases of the pancreas is investigated. If there is the clinical suspicion of a pancreas carcinoma, sonography computerized tomography, and endoscopic-retrograde cholangio-pancreati...

A. Heid

1981-01-01

4

Diagnosis of early pancreas graft failure via antibody-mediated rejection: single-center experience with 256 pancreas transplantations.  

PubMed

Early pancreas graft loss is usually attributed to technical failure while the possibility of antibody-mediated rejection (AMR) is generally overlooked. To investigate the role of AMR in early pancreas graft loss, we retrospectively assessed 256 patients with simultaneous pancreas-kidney transplantation (SPK) between 1985 and 2010 at our institute. We included 33 SPK patients who lost their pancreas graft <1 year after transplantation. AMR was diagnosed based on donor-specific antibodies, C4d and histology in 7 cases, 8 cases were suspicious for AMR and 18 pancreas graft losses were not due to AMR. Acute AMR occurred >1 month after transplantation in 6/7 cases, whereas all other causes typically led to loss <1 month after transplantation. Thrombotic lesions occurred equally among the 33 cases. In 12/18 concurrent kidney specimens, the diagnostic results paralleled those of the pancreas graft. All patients with acute AMR of the pancreas graft lost their renal grafts <1 year after transplantation. In the setting of a thrombotic event, histopathological analysis of early pancreas graft loss is advisable to rule out the possibility of AMR, particularly because a diagnosis of acute AMR has important consequences for renal graft outcomes. PMID:24712331

de Kort, H; Mallat, M J K; van Kooten, C; de Heer, E; Brand-Schaaf, S H; van der Wal, A M; Roufosse, C; Roelen, D L; Bruijn, J A; Claas, F H; de Fijter, J W; Bajema, I M

2014-04-01

5

A new method for modelling preoperative diagnosis of ovarian tumours  

E-print Network

Leibler divergence, cancer classifica- tion, ovarian tumour, medical diagnosis, ultrasound Manuscript. In Europe and North America the age-adjusted standard- ised incidence rate of ovarian cancer is over 10 per1 A new method for modelling preoperative diagnosis of ovarian tumours Viktoriya Stalbovskaya

6

Primary gastric malignant melanoma: challenge in preoperative diagnosis  

PubMed Central

Primary gastric melanoma is an extremely rare clinical entity. The clinical manifestation is not specific and usually similar with other common malignancies at this site, such as gastric cancer and lymphoma. And there are no specific radiological features either. Preoperative diagnosis via biopsy is usually difficult, since melanoma pigment could be absent in the biopsy tissue. Here, we report a case of a 50-year-old woman with a mass in the stomach found by gastroscopy. Biopsy was taken twice preoperatively under gastroscope and it was diagnosed as gastric carcinoma and neuroendocrine tumor respectively. Radical surgery was performed with gastrectomy and D2 lymph node dissection. Postoperative pathological examination finally made a definite diagnosis of gastric melanoma by immunohistochemistry. We summarize the reasons for preoperative misdiagnosis and discuss the difficulty in diagnosing gastric melanoma according to literature.

Song, Wu; Liu, Fakeng; Wang, Shaochuan; Shi, Huijuan; He, Weiling; He, Yulong

2014-01-01

7

[Optimization of the preoperative diagnosis of herniated lumbar disks].  

PubMed

Pneumomyelography (PMG) and discography (DG) were employed to establish the exact diagnosis of Schmorl's bodies in the lumbar spine. Information concerning 101 patients with lumbar osteochondrosis is analysed. PMG was conducted in all patients. DG only in 29. The exact preoperative diagnosis was made in 98% due to PMG and DG and only in 64% of cases without these methods of examination. In view of the use of microsurgical techniques the authors show that additional rediocontrast examination must be conducted in all cases before the operation. They object to wide approaches for searching Shmorl's body during the operation. PMID:6528789

Chudnovski?, N A; Desnitskaia, E V

1984-01-01

8

Preoperative Diagnosis of Usual Leiomyoma, Atypical Leiomyoma, and Leiomyosarcoma  

PubMed Central

Uterine smooth muscle tumors (SMTs) are common pelvic tumors in women, and most of them are diagnosed as usual leiomyoma (UL). Exclusion of malignant disease is important in the management of SMTs. However, differentiation of SMTs remains difficult. In this study, we aimed to improve the preoperative diagnosis of SMTs. We examined 21 ULs, 7 atypical leiomyomas (ALs), and 6 leiomyosarcomas (LMSs), all of which were diagnosed by uterine tumor biopsy. Immunohistochemical findings (low-molecular-mass polypeptide 2 (LMP2) and Ki-67) and clinical features (serum lactate dehydrogenase level and menopause) were evaluated. Statistically significant differences in the expression of LMP2 and Ki-67 were observed between UL and AL and between UL and LMS. The combined LMP2 and Ki-67 score was significantly different between UL and AL, between UL and LMS, and between AL and LMS. The combined immunohistochemistry and clinical findings score (total score) was also significantly different between pathological types. The findings of this study suggest that the accuracy of the preoperative diagnosis of SMTs may be improved by using a combination of immunohistochemical and clinical findings.

Matsuda, M.; Ichimura, T.; Kasai, M.; Murakami, M.; Kawamura, N.; Hayashi, T.; Sumi, T.

2014-01-01

9

Surgical Resection of Hepatic Cystic Echinococcosis Impaired by Preoperative Diagnosis  

PubMed Central

Cystic echinococcosis (CE) is a rare afferent infectious disease in Japan. This paper reports a case of a hepatic cyst being diagnosed after surgical resection. A 40-year-old Syrian male was admitted for evaluation of a hepatic cyst. Serum antibodies of echinococcosis were negative. Enhanced computed tomography of the abdomen revealed a large cystic lesion, 9 cm in diameter, in the left lateral sector of the liver, which had many honeycomb-like septa and calcified lesions. Magnetic resonance imaging of this lesion revealed high intensity in the T2 weighted image. We preoperatively diagnosed this lesion as cystadenocarcinoma or CE and performed a left hepatectomy. Pathological examination revealed the presence of protoscolices in the fluid of the cysts and led to a diagnosis of this lesion as CE. In conclusion, on seeing patients with huge hepatic cysts who come from an epidemic area, we should consider hepatic CE. PMID:24454394

Yasuda, Tomohiko; Ueda, Junji; Mamada, Yasuhiro; Taniai, Nobuhiko; Yoshioka, Masato; Matsushita, Akira; Kawano, Youichi; Mizuguchi, Yoshiaki; Shimizu, Tetsuya; Takata, Hideyuki; Uchida, Eiji

2013-01-01

10

Intraductal papillary and mucinous tumors of the pancreas: accuracy of preoperative computed tomography, endoscopic retrograde pancreatography and endoscopic ultrasonography, and long-term outcome in a large surgical series  

Microsoft Academic Search

Background: Few data are available on the accuracy of preoperative imaging or on long-term outcome after surgery for intraductal papillary and mucinous tumors of the pancreas. The aims of this study were to assess the following: (1) the accuracy of preoperative computed tomography, endoscopic retrograde pancreatography, and endoscopic ultrasonography for determination of tumor invasion and pancreatic extension as compared with

Christophe Cellier; Emmanuel Cuillerier; Laurent Palazzo; Fabienne Rickaert; Jean-Francois Flejou; Bertrand Napoleon; Daniel Van Gansbeke; Natacha Bely; Philippe Ponsot; Christian Partensky; Paul-Henri Cugnenc; Jean-Philippe Barbier; Jacques Devière; Michel Cremer

1998-01-01

11

[Preoperative diagnosis of abdominal space-occupying lesions in childhood].  

PubMed

Between 1977 to 1986 results of ultrasonography in 56 patients has been compared with computed tomography (CT), excretory urography, and in 19 cases with arteriography. In comparison to ultrasonography CT proved superior in diagnosing dignity (87% vs. 78%); in appointing to the original organ, and in diagnosing the type of tumour angiography turned out to be clearly superior to CT (89% vs. 65%, and 79% vs. 43%, resp.) Addition of CT to ultrasonography resulted in a gain of 10% concerning dignity, of 30% concerning appointing to the origin, and of 24% with respect to typing. With the question of renal or extrarenal origin of a mass lesion the EUG proved to be indispencable. The following procedure is recommended: in kidney-related tumours US plus EUG, in other cases additional imaging techniques only for special problems, or specific questions preoperatively. The routine implementation of computed tomography in abdominal masses seems not to be necessary. PMID:3553901

Zieger, M; Berendonk, H

1987-02-01

12

[Testicular epidermoid cyst: uncommon lesion of difficult preoperative diagnosis].  

PubMed

Intratesticular epidermoid cysts are rare tumours that constitute one percent of all testicular masses. They are bening lesions that make differential diagnosis from malignant testicular tumours difficult. The absence of serum markers elevation and ultrasound imaging could support these lesions being bening epidermoid cysts, and in that case, conservative surgery is adequate. We present the case of a 22 years old patient who complains of a left testicular mass. In this case ultrasound diagnosis was non-specific and a left radical inguinal orchiectomy was performed. PMID:16353779

Aguilera Tubet, C; López Rasines, G; Roca Edreira, A; Martín García, B; Hernández Rodríguez, R; Portillo Martín, J A; Gutiérrez Baños, J L; Gómez Correas, M A; Del Valle Schaan, J I; Rado Velázquez, M A; Ruiz Izquierdo, F; Ballestero Diego, R

2005-10-01

13

Breast hemangioma with difficulty in preoperative diagnosis: a case report.  

PubMed

We report a rare case of breast hemangioma found in a 70-year-old Japanese female. Before seeking medical attention, the patient noticed a hard mass in her right breast but denied associated symptoms. A mammography revealed a well-circumscribed, highly dense, lobular nodule located in the middle inter portion of the right breast. To verify this finding, we used ultrasonography which revealed an irregular, iso-echoic nodule measuring 10 mm in the same portion. Based on these findings, we suspected a malignancy and performed a core needle biopsy. Unexpectedly, a histological examination of the biopsy displayed normal vasculature, adipose, and mammary tissues. In order to make an accurate diagnosis, the mass was surgically excised under general anesthesia and sent to pathology. Pathological findings of the mass were positive for breast hemangioma, and the patient has had no recurrence of the disease for the past 24 months. PMID:25312096

Funamizu, Naotake; Tabei, Isao; Sekine, Chikako; Fuke, Azusa; Yabe, Mitsuo; Takeyama, Hiroshi; Okamoto, Tomoyoshi

2014-01-01

14

Preoperative diagnosis of the Mirizzi syndrome: limitations of sonography and computed tomography  

SciTech Connect

Preoperative recognition of the Mirizzi syndrome permits avoidance of several serious pitfalls at surgery. The typical diagnostic signs of the Mirizzi syndrome are 1) dilatation of the common hepatic duct above the level of 2) a gallstone impacted in the cystic duct, with 3) normal duct width below the stone. Since jaundice is the leading clinical symptom, sonography and computed tomography (CT) are now the primary radiologic tests. The syndrome does not regularly have typical features, however, and therefore cannot be detected routinely on sonography or CT. Direct cholangiography is often necessary. On the other hand, direct cholangiography should follow either sonography or CT because these imagining methods are superior for demonstrating extraluminal signs of malignancy, which is the most important differential diagnosis. The findings at preoperative examinations in seven patients with surgically confirmed Mirizzi syndrome are analyzed retrospectively.

Becker, C.D.; Hassler, H.; Terrier, F.

1984-09-01

15

Utility of cell block in the cytological preoperative diagnosis of keratocystic odontogenic tumor.  

PubMed

In most cases involving jaw lesions, a biopsy and a histopathological analysis are necessary to establish the final diagnosis. However, biopsy may be a complex procedure at some maxillomandibular sites, and some systemic conditions could contraindicate the procedure. Thus, a search for new, less invasive techniques, which could eventually replace biopsy and simplify the diagnostic process, would benefit both professionals and patients. The aim of this study was to evaluate the cell block technique, prepared from the aspiration of luminal contents, in the preoperative diagnosis of keratocystic odontogenic tumors (KCOT). From 135 cases of lesions aspirated and processed by the cell block technique, we selected those containing keratin. In all cases selected, histological diagnosis was based on surgical biopsy. From 20 cases containing keratin in the cytological analyses, 19 were KCOTs and one was an orthokeratinized odontogenic cyst (OOC). In all KCOT cases, we observed the presence of parakeratin, even in those with intense inflammation. In the cytological analysis of the OOC, parakeratin was not observed. In conclusion, there is strong evidence that KCOT can be confidently diagnosed preoperatively by cytological analyses of lesions punctured and processed by the cell block technique. PMID:24433974

Rivero, Elena Riet Correa; Grando, Liliane Janete; de Oliveira Ramos, Grasieli; da Silva Belatto, Maria Fernanda; Daniel, Filipe Ivan

2014-04-01

16

Abdominal cocoon syndrome (idiopathic sclerosing encapsulating peritonitis): how easy is its diagnosis preoperatively? A case report.  

PubMed

The abdominal cocoon syndrome (or idiopathic encapsulating peritonitis) is a rare cause of intestinal obstruction. It has been reported predominantly in adolescent girls living in tropical/subtropical region in which diagnosis is only made at laparotomy in most cases. The cause and pathogenesis of the condition have not been elucidated. Prolonged administration of practalol, meconium peritonitis, and tuberculous infection of the female genital tract have been incriminated as possible causes. The author reports a case of a female patient with recurrent intestinal obstruction treated for years but failed to settle down on conservative treatment during her last hospital admission and had to undergo surgery. Preoperative diagnosis of this syndrome as the cause of her intestinal obstruction was not made until at laparotomy, when a thick fibrotic peritoneal wrapping of the bowel in a concertina-like fashion with some adhesions was found. Excision of this membrane and adhesiolysis were carried out without any need for bowel resection, and this led to relief of the obstruction and patient's complete recovery. Awareness of this benign condition in the differential diagnosis of intestinal obstruction will result in early diagnosis and correct management and prevent unnecessary bowel resections and bad outcomes. PMID:23738183

Awe, Julius A A

2013-01-01

17

The role of core needle biopsy in the preoperative diagnosis of follicular neoplasm of the thyroid.  

PubMed

Follicular neoplasm/suspicious for follicular neoplasm (FN/SFN) can often be challenging to diagnose using core needle biopsy (CNB) specimens. We have developed the histologic criteria for the CNB diagnosis of FN and validated the usefulness of CNB. We retrospectively reviewed 184 CNBs and 224 FNACs diagnosed with FN/SFN. CNBs were histologically classified into four subgroups, based on the histologic features of follicular proliferation, fibrous capsulation, and surrounding parenchyma. Among 184 CNBs, 103 (55.9%) had previous FNAC results of non-diagnostic or indeterminate. Overall malignancy rates in FNAC (48%) and CNB (46%) were nearly identical (p > 0.05), and the neoplasm rate was higher in CNB (88%) than FNAC (74%) (p = 0.007). There was no significant difference in the malignancy rates among the four histologic subgroups. Among the 40 nodules with simultaneous CNB and FNAC, only nine had the FNAC diagnosis of FN/SFN, and others were non-diagnostic, benign, or atypia of undetermined significance. Overall, CNB improved specimen adequacy and achieved better sensitivity of the FN/SFN diagnosis in thyroid nodules that were inconclusive by FNAC. In the preoperative diagnosis of FN/SFN, CNB has no advantage over FNAC in predicting the likelihood of malignancy, but helps to reduce the need for repeat biopsy. PMID:24673498

Min, Hye Sook; Kim, Ji-Hoon; Ryoo, Inseon; Jung, So Lyung; Jung, Chan Kwon

2014-10-01

18

Preoperative Diagnosis of Tubular Adenoma of Breast - 10 years of experience  

PubMed Central

Background: Tubular adenomas are rare benign neoplasms of female breast affecting women, predominantly of child-bearing age group. Definitive diagnosis of this tumor is usually achieved after histopathological study. Clinical, radiological, and even cytological features are often insufficient for accurate diagnosis. Aim: The aim of the present study was planned to analyze clinical and radiological features of histologically confirmed cases of tubular adenoma of breast to find out a clue for accurate preoperative cytological diagnosis. Materials and Methods: In our 10-year research program, all histologically confirmed tubular adenoma cases of breast were studied. Clinico-radio-cytological features, if available, were analyzed and tabulated. Results: Thirty-three cases of tubular adenoma of breast were studied. Radiological and cytological assessments are available for 12 and 26 cases, respectively. Tubular adenoma could be diagnosed in only two cases (7.7%) by cytological assessment, but in none by radiological assessment. Conclusions: Clinico-cyto-radiological assessment could identify the benign nature of the tumors in most cases, but final confirmation was possible only after histopathological study. PMID:24926447

Sengupta, Sanjay; Pal, Subrata; Biswas, Biplab Kr; Phukan, Jyoti Prakash; Sinha, Anuradha; Sinha, Rajani

2014-01-01

19

[Two cases of testicular infarction: the usefulness of enhanced MRI for preoperative diagnosis].  

PubMed

The differential diagnosis in acute scrotum, particularly torsion of spermatic cord and epididymitis, is sometimes difficult. An erroneous diagnosis may result in unnecessary and improper treatment. We report two cases of testicular infarction including torsion of spermatic cord, preoperatively diagnosed by enhanced magnetic resonance imaging (MRI). Case 1: A 16-year-old boy presented with a 3-day history of left scrotal swelling and left lower abdominal pain. He had fever and leukocytosis. Antibiotics for 2 days failed to relieve the symptoms. Enhanced MRI showed absence of blood flow in the left testis. Scrotal exploration revealed hemorrhage and necrosis in the left testis. Left orchiectomy and right orchiopexy were performed. Case 2: A 12-year-old boy visited with scrotal swelling and fever 30 hours after an acute onset of left scrotal pain. Enhanced MRI showed absence of blood flow in the left testis. Exploration revealed left necrotic testis with torsion of spermatic cord. Left orchiectomy and right orchiopexy were performed. Our two cases suggested that enhanced MRI, by which the intratesticular blood flow can be evaluated, may be useful for the diagnosis of testicular infarction. PMID:10331176

Ishizu, K; Shiraishi, K; Kawamura, H; Naito, K; Joko, K

1999-03-01

20

Pancreas Transplantation  

MedlinePLUS

The pancreas is a gland behind your stomach and in front of your spine. It produces the juices that ... hormones that help control blood sugar levels. A pancreas transplant is surgery to place a healthy pancreas ...

21

Diagnosis of infection by preoperative scintigraphy with indium-labeled white blood cells  

SciTech Connect

Scintigraphy with indium-labeled white blood cells has been reported to be sensitive and specific in the diagnosis of low-grade sepsis of the musculoskeletal system. We reviewed the records of fifty patients who had suspected osteomyelitis or suspected infection about a total joint prosthesis and who underwent scintigraphy with technetium-99m methylene diphosphonate and scintigraphy with indium-111 oxine-labeled white blood cells before an open surgical procedure. Any patient who received preoperative antibiotics was not included in the study. For all of the patients, gram-stain examination of smears, evaluation of a culture of material from the operative site, and histological examination were done. The patients were divided into two groups. Group I was composed of twenty-four patients, each of whom had a prosthesis in place and complained of pain. Group II was composed of twenty-six patients for whom a diagnosis of chronic osteomyelitis had to be considered. With the indium scans alone, there was only one false-negative result (in Group II), but there were eighteen false-positive results (eight patients in Group II and ten patients in Group I). Although scintigraphy with indium-labeled white blood cells is quite sensitive, it is not specific in detecting chronic osteomyelitis; a negative scan should be considered highly suggestive that osteomyelitis is not present. Specificity can be increased by interpreting the indium scan in conjunction with the technetium scan.

Wukich, D.K.; Abreu, S.H.; Callaghan, J.J.; Van Nostrand, D.; Savory, C.G.; Eggli, D.F.; Garcia, J.E.; Berrey, B.H.

1987-12-01

22

Pancreatic lymphoepithelial cysts express CEA and can contain mucous cells: potential pitfalls in the preoperative diagnosis.  

PubMed

Pancreatic lymphoepithelial cysts are rare benign cysts that cannot be reliably differentiated from neoplastic mucinous cysts preoperatively. Although elevated cyst fluid carcinoembryonic antigen (CEA) levels support a diagnosis of a mucinous cyst, the finding of increased CEA levels in lymphoepithelial cysts prompted this study. Nine resected lymphoepithelial cysts were examined for expression of CEA, carbohydrate antigen (CA) 19-9, CK7, p63, PAS-D and a panel of mucins. The pathology data were correlated with clinical information, including serum, cyst fluid and imaging studies. By computed tomography scan, although most lymphoepithelial cysts appeared cystic, 23% were described as masses. The endoscopic ultrasound findings were variable, but the lymphoepithelial cysts tended to be hypoechoic cystic lesions or masses. On cytology, 44% of the cysts had squamous cells, 67% had glandular cells and 56% had atypical cells. The cysts were resected because of size ?3?cm (89%), symptoms (44%) and/or elevated cyst fluid CEA levels (33%). The cyst fluid CEA levels in the three cysts tested were >450?ng/ml. Histopathologically, all cysts were lined by mature, stratified squamous-type cells and produced keratin. Mucous cells were present in 78% of the cysts. The immunohistochemical profile of the squamous lining was CK7+, p63+, MUC1+, MUC4+, MUC2-, MUC5AC- and MUC6-. Even though lymphoepithelial cysts are lined by squamous-type epithelium, all our resected lymphoepithelial cysts expressed CEA and/or CA19-9, many contained mucous cells, and three exhibited markedly elevated cyst fluid CEA levels. Although cyst fluid CEA levels >200?ng/ml support the diagnosis of mucinous neoplasms, this study emphasizes the need for clinicians and pathologists to recognize that lymphoepithelial cysts can mimic neoplastic mucinous cysts clinically, radiographically and on cyst fluid CEA analysis. PMID:20802468

Raval, Jay S; Zeh, Herbert J; Moser, A James; Lee, Kenneth K; Sanders, Michael K; Navina, Sarah; Kuan, Shih-Fan; Krasinskas, Alyssa M

2010-11-01

23

Extra-gastrointestinal stromal tumor of the pancreas: case report and review of the literature  

PubMed Central

Primary extra-gastrointestinal stromal tumor (EGISTs) arising in the pancreas is extremely rare: only 20 cases have previously been reported in the English literature from 2000 to 2013. We reported a case of EGIST of the pancreas in a 69-year-old woman who presented with abdominal pain and with a solid, heterogeneously enhancing neoplasm in the uncinate process of the pancreas, revealed preoperatively by an abdominal computed tomography scan. A diagnosis of neuroendocrine tumor was suggested. Positron emission tomography with 68Ga-DOTATOC did not show pathological accumulation of the tracer in the pancreas. The patient underwent enucleation, under ultrasonic guidance, of the pancreatic tumor that emerged to the surface of the pancreas. Histopathology and immunohistochemical examination confirmed the final diagnosis of EGIST of the pancreas (CD117+), with one mitosis per 50 high-power fields. Although rarely, GIST can involve the pancreas as a primary site, and this tumor should be considered in the differential diagnosis of pancreatic neoplasms. PMID:24755359

2014-01-01

24

Hyaline Globules in Neuroendocrine and Solid-Pseudopapillary Neoplasms of the Pancreas: A Clue to the Diagnosis  

PubMed Central

Distinguishing between solid-pseudopapillary neoplasms (SPNs) and pancreatic neuroendocrine tumors (PanNETs) may pose a diagnostic dilemma. Both can demonstrate solid growth patterns, and both can be immunoreactive with neuroendocrine markers such as synaptophysin and CD56. One well-established feature of SPNs is the presence of hyaline globules, which in contrast has only rarely been reported in PanNETs. Clinicopathologic features of 361 cases originally classified as PanNETs were examined. Of these, 24 tumors (6.6%) had hyaline globules, raising the possibility of SPN. Immunohistochemistry for ?-catenin was performed on these 24 neoplasms, and showed nuclear labeling in 6 cases. These 6 cases, which also demonstrated cytoplasmic CD10 staining, were reclassified as SPNs. The remaining 18 cases maintained their original diagnosis as PanNETs, and the hyaline globules in these cases were periodic acid-Schiff (PAS)-positive, diastase resistant and immunoreactive with alpha-1-antitrypsin. All 24 cases were histologically re-evaluated, and the pattern of invasion, presence of clear cells, and nuclear grooves were found to be helpful in distinguishing SPNs from PanNETs. We conclude that the presence of hyaline globules should raise SPNs in the differential diagnosis of a solid cellular neoplasm of the pancreas; however, these should not be used as the sole criterion in the diagnosis of SPNs, as hyaline globules may also been seen in 5% of PanNETs. Immunohistochemical and histologic features supporting the diagnosis of SPNs over PanNETs include CD10 and nuclear ?-catenin labeling, an insidious pattern of invasion, clear cells, and nuclear grooves. PMID:21677537

Meriden, Zina; Shi, Chanjuan; Edil, Barish H.; Ellison, Trevor; Wolfgang, Christopher L.; Cornish, Toby C.; Schulick, Richard D.; Hruban, Ralph H.

2011-01-01

25

Annular pancreas  

MedlinePLUS

An annular pancreas is a ring of pancreatic tissue that encircles the duodenum (the first part of the small intestine). The normal position of the pancreas is next to, but not surrounding the duodenum.

26

Portal Annular Pancreas  

PubMed Central

Abstract Portal annular pancreas (PAP) is an asymptomatic congenital pancreas anomaly, in which portal and/or mesenteric veins are encased by pancreas tissue. The aim of the study was to determine the role of PAP in pancreatic surgery as well as its management and potential complication, specifically, postoperative pancreatic fistula (POPF). On the basis of a case report, the MEDLINE and ISI Web of Science databases were systematically reviewed up to September 2012. All articles describing a case of PAP were considered. In summary, 21 studies with 59 cases were included. The overall prevalence of PAP was 2.4% and the patients' mean (SD) age was 55.9 (16.2) years. The POPF rate in patients with PAP (12 pancreaticoduodenectomies and 3 distal pancreatectomies) was 46.7% (in accordance with the definition of the International Study Group of Pancreatic Surgery). Portal annular pancreas is a quite unattended pancreatic variant with high prevalence and therefore still remains a clinical challenge to avoid postoperative complications. To decrease the risk for POPF, attentive preoperative diagnostics should also focus on PAP. In pancreaticoduodenectomy, a shift of the resection plane to the pancreas tail should be considered; in extensive pancreatectomy, coverage of the pancreatic remnant by the falciform ligament could be a treatment option. PMID:25207658

Harnoss, Jonathan M.; Harnoss, Julian C.; Diener, Markus K.; Contin, Pietro; Ulrich, Alexis B.; Buchler, Markus W.; Schmitz-Winnenthal, Friedrich H.

2014-01-01

27

Pancreas Transplantation  

PubMed Central

Diabetes mellitus is generally treated with oral diabetic drugs and/or insulin. However, the morbidity and mortality associated with this condition increases over time, even in patients receiving intensive insulin treatment, and this is largely attributable to diabetic complications or the insulin therapy itself. Pancreas transplantation in humans was first conducted in 1966, since when there has been much debate regarding the legitimacy of this procedure. Technical refinements and the development of better immunosuppressants and better postoperative care have brought about marked improvements in patient and graft survival and a reduction in postoperative morbidity. Consequently, pancreas transplantation has become the curative treatment modality for diabetes, particularly for type I diabetes. An overview of pancreas transplantation is provided herein, covering the history of pancreas transplantation, indications for transplantation, cadaveric and living donors, surgical techniques, immunosuppressants, and outcome following pancreas transplantation. The impact of successful pancreas transplantation on the complications of diabetes will also be reviewed briefly. PMID:21253293

Sutherland, David ER

2010-01-01

28

PREOPERATIVE OVARIAN CANCER DIAGNOSIS USING NEURO-FUZZY APPROACH E.O. Madu, V. Stalbovskaya, B. Hamadicharef, E.C. Ifeachor S. Van Huffel, D. Timmerman  

E-print Network

PREOPERATIVE OVARIAN CANCER DIAGNOSIS USING NEURO-FUZZY APPROACH E.O. Madu, V. Stalbovskaya, B the Adaptive Network based Fuzzy Inference System (ANFIS). Our model predicts ovarian cancer malignancy using operating characteristic curve of 0.85. Keywords: ovarian cancer, medical diagnosis, neural networks, neuro

29

Organ Facts: Pancreas  

MedlinePLUS

... Heart/Lung Kidney Pancreas Kidney/Pancreas Liver Intestine Pancreas Facts The pancreas is a five to six inch gland located behind the stomach. The pancreas produces enzymes that are used for digestion, and ...

30

Pancreas transplant  

MedlinePLUS

... type 1 diabetes also needs a kidney transplant. Pancreas transplant surgery is not usually done in persons who also have: A history of cancer HIV Infections such as hepatitis , which are considered to ...

31

Artifical Pancreas  

NASA Astrophysics Data System (ADS)

In 2006, JDRF launched the Artificial Pancreas Project (APP) to accelerate the development of a commercially-viable artificial pancreas system to closely mimic the biological function of the pancreas individuals with insulin-dependent diabetes, particularly type 1 diabetes. By automating detection of blood sugar levels and delivery of insulin in response to those levels, an artificial pancreas has the potential to transform the lives of people with type 1 diabetes. The 6-step APP development pathway serves as JDRF's APP strategic funding plan and defines the priorities of product research and development. Each step in the plan represents incremental advances in automation beginning with devices that shut off insulin delivery to prevent episodes of low blood sugar and progressing ultimately to a fully automated ``closed loop'' system that maintains blood glucose at a target level without the need to bolus for meals or adjust for exercise.

Fei, Jiangfeng

2013-03-01

32

A case of myxofibrosarcoma of the maxilla with difficulty in preoperative diagnosis.  

PubMed

Myxofibrosarcoma (MFS) is a very rare fibroblast-derived sarcoma that occurs in the head and neck region. Here, we report the case of a 52-year-old man in whom MFS generated from the maxilla and whose beginning of treatment was considerably delayed because he was initially diagnosed as having a benign inflammatory lesion. Because a definite diagnosis was not obtained via 2 independent biopsies, total maxillectomy was used for both diagnosis and treatment. Histopathological and immunohistochemical analyses suggested that the tumor was a low-grade MFS. Because soft tissue tumors in the head and neck region are rare and a definite diagnosis is relatively difficult, surgical excision is indispensable if malignancy of the tumor is suspected. PMID:21830085

Nakahara, Susumu; Uemura, Hirokazu; Kurita, Tomoyuki; Suzuki, Motoyuki; Fujii, Takashi; Tomita, Yasuhiko; Yoshino, Kunitoshi

2012-08-01

33

[Usefulness of computed tomography and magnetic resonance in the preoperative diagnosis for hyperparathyroidism].  

PubMed

Sonnography and Tc-99m sestamibi scintigraphy are the most requested preoperative imaging tests nowdays in the surgery of hyperparathyroidism. The aim of our article is to know if Computerized Tomography (CT) and Magnetic Resonance Imaging (MRI) are useful as a location study and in which cases it would be more justified to ask these radiologic techniques. For that we report our results with 29 patients at all diagnosed as hyperparathyroidism (26 primary forms and 3 secondary ones) and operated by our E.N.T. Department later. On 20 of them a cervical CT was asked before the parathyroidectomy and on the rest 9, a MRI with sensitivities of 65% and 88.9% respectively. We think both complementary explorations must not be solicited by routine but they can represent a help in the cases in that sonnography and scintigraphy are not able to show the possible adenoma or hiperplasia, particularly in recurrent hyperparathyroidisms, reinterventions or suspect of parathyroid glands in an atypical location. PMID:16318093

Pino Rivero, V; Pantoja Hernández, C G; González Palomino, A; Trinidad Ruíz, G; Marcos García, M; Keituqwa Yáñez, T; Pardo Romero, G; Blasco Huelva, A

2005-01-01

34

Impact of preoperative diagnosis of congenital heart disease on the treatment of esophageal atresia  

Microsoft Academic Search

Congenital heart disease (CHD) has a major impact on the survival of babies with esophageal atresia (EA). The present study\\u000a assesses whether early diagnosis influences the management strategies in a large series of EA. Cases of EA treated between\\u000a 1982 and 2002 were retrospectively divided into groups according to the presence or absence of CHD and to whether this was

J. L. Encinas; A. L. Luis; L. F. Avila; L. Martinez; L. Guereta; L. Lassaletta; Juan A. Tovar

2006-01-01

35

Role of FNAC in the Preoperative Diagnosis of Salivary Gland Lesions  

PubMed Central

Background: The characteristic cytologic features of the common salivary gland lesions have been well-delineated in literature. However, there also exist cytologic pitfalls and overlapping features that make an accurate diagnosis difficult in few cases. The present study was designed to compare the cytologic findings of salivary gland lesions with the histologic diagnoses, in order to assess the sensitivity, specificity and diagnostic accuracy of FNAC, with an emphasis on discordant cases. Materials and Methods: Patients with suspected salivary gland enlargements, who were referred for FNAC, were included in this study, which was done over a 3 year period in a medical college hospital. FNAC was performed by using the standard procedure. Smears were stained by using Papanicolaou’s and MGG stains. Cytologic diagnosis was compared with histopathologic diagnosis wherever it was available. Results: Eighty eight patients with salivary gland swellings were included in the study. The ages of the patients ranged from 15 to 82 years, with the M:F ratio being 1.6:1. Out of 88 cases, 68 had swellings in parotid gland, 19 had them in submandibular gland and one had them in hard palate. Pleomorphic adenoma was the commonest neoplasm which was seen in our study. Mucoepidermoid carcinoma (MEC) was the only malignant lesion seen in our study. One each of Warthin’s tumour (WT) and MEC were overdiagnosed and underdiagnosed respectively, the reason being squamous metaplasia in WT and subtle nature of malignant cells in low-grade MEC. Conclusion: WT and MEC can pose problems in cytologicdiagnosis. Sampling errors and interpretational errors can lead todiscordant diagnoses. PMID:25386436

D'souza, Clement R S; Khosla, Charu; George, Lovely; Katte, Namitha Hegde

2014-01-01

36

Laparoscopy-Assisted Billroth I Gastrectomy for Ectopic Pancreas in the Prepyloric Region  

PubMed Central

Ectopic pancreatic tissue is an uncommon developmental anomaly. The condition mostly occurs in the gastrointestinal tract and is usually asymptomatic. It rarely causes symptoms of inflammation, bleeding and perforation, and has potential for malignant change. Though it is an uncommon condition, cases of ectopic pancreas have been reported worldwide. Preoperative diagnosis of ectopic pancreas is challenging because of its nonspecific symptoms and signs. Owing to the revolution of minimally invasive surgery, submucosal tumors of the stomach can be resected by laparoscopic techniques. We have earlier reported on a case of ectopic pancreas in the stomach treated by robotics-assisted laparoscopic wedge resection. Herein, we report a case of ectopic pancreas in the prepyloric region of the stomach. A 44-year-old female presented with a two-week history of epigastralgia with radiation to the back. She received endoscopy check-up which disclosed a mass in the stomach. By endoscopic findings, a submucosal lesion in the prepyloric region with umbilical folding on the mucosa was identified. The umbilical folding on the mucosa hint the orifice of the duct of ectopic pancreas into the gastric mucosa suggestive of ectopic pancreas. Contrast-enhanced abdominal computed tomography showed a 5 cm cystic mass with heterogeneous content. To sum it up, the patient was diagnosed as ectopic pancreas in the stomach. She underwent laparoscopy-assisted antrectomy with Billroth I anastomosis (excision of the antrum and prepyloric region with reconstruction of gastrointestinal continuity by gastroduodenostomy) and had an uneventful hospitalization course. The histopathology of the resected tumor demonstrated ectopic pancreatic tissue in the gastric wall. To the best of our knowledge, excision of gastric ectopic pancreas using laparoscopy-assisted antrectomy with Billroth I anastomosis has never been reported in the literature. PMID:23185154

Lee, Yueh-Tsung; Lin, Ho; Guo, Jen-Chang; Yan, Sheng-Lei; Hou, Hsiang-Jen; Lai, Yih-Shyong; Liu, Yi-Hsiang; Wu, Hurng-Sheng; Hwang, Min-Ho

2012-01-01

37

Annular Pancreas: A Cause of Gastric Outlet Obstruction in a 20-Year-Old Patient  

PubMed Central

Patient: Female, 20 Final Diagnosis: Annular pancreas Symptoms: Food intolerance • vomiting Medication:— Clinical Procedure: — Specialty: Gastroenterology and Hepatology Objective: Congenital defects/diseases Background: Annular pancreas is a congenital anomaly that consists of a ring of pancreatic tissue partially or completely encircling the descending portion of the duodenum. It is formed due to the failure of the ventral bud to rotate, thus it elongates and encircles the upper part of the duodenum. It can present in a wide range of clinical severities, and can affect neonates to the elderly, making it difficult to diagnosis. Although diagnosis of annular pancreas can be made pre-operatively by upper GI series, upper GI endoscopy, or CT scan, 40% of diagnoses require surgery for confirmation. Case Report: We report the case of a 20-year-old woman presenting with history of vomiting and weight loss since childhood. We present the clinical characteristics, surgical management in the form of bypass procedure done through a duodenojujenostomy, and follow-up of the patient. Conclusions: Annular pancreas occasionally presents in adults. Variable presentations have been described in the literature, including pancreatic neoplasm, pancreatitis, obstructive jaundice, duodenal obstruction, and peptic ulcer diseases. Most studies of these lesions are single case reports or small series, which do not allow a surgeon to accumulate extensive experience; therefore, reliance on the combined experience of others in recognition and appropriate management has been the norm. PMID:25300027

Alahmadi, Raha; Almuhammadi, Saud

2014-01-01

38

Cystic lymphangioma of the pancreas  

PubMed Central

Lymphangioma is a benign form of neoplasm arising from the lymphatic system. It occurs as a result of congenital malformations of the lymphatics leading to the obstruction of local lymph flow and the development of lymphangiectasia. Lymphangiomas are common in pediatric patients, in the soft tissues of the neck and the axillae, but lymphangioma of the pancreas is extremely rare, accounting for less than 1% of these tumors. It occurs more frequently in females and is often located in the distal pancreas. Although extremely rare, cystic lymphangioma of the pancreas should be taken into consideration as a differential diagnosis of pancreatic cystic or retroperitoneal lesions, especially in women. Herein, we report on a case of cystic lymphangioma of the distal pancreas in a 37-year-old woman who was treated with complete surgical resection with a review of the literature. PMID:22066114

Sohn, Bok-Kyung; Cho, Chang-Ho

2011-01-01

39

The importance of team work of cytologist and surgeon in preoperative diagnosis of intraoral minor salivary gland tumours.  

PubMed

Tumours arising from oral minor salivary glands may exhibit an overlap of clinical and morphological features that may produce diagnostic and therapeutic dilemmas. The aim of this study is to asses the value of fine needle aspiration cytology (FNAC) in differentiation of benign and malignant tumours and to render a specific diagnosis. We evaluated the team work of surgeon and cytologist to improve diagnostic accuracy. Two steps are important for accuracy: sampling aspirate that should be done together by surgeon and cytologist and cytological microscopic analysis of the smears that should be performed by an experienced cytologist. The study included 132 patients with intraoral minor salivary gland tumours between 2002 and 2011. Adequate material was obtained from 121 (91.7%) patients. FNAC was usually performed by cytologist in a team with maxillofacial surgeon at cytology department that is more convenient for preparing the samples and especially for ROSE procedure (rapid-on site evaluation) of smears. In such a way the cytologist checked the adequacy of samples and decided whether some ancillary techniques should be used and therefore repeat FNAC. A total of 82 patients underwent surgery, 40 with malignant and 42 with benign tumours. Preoperative cytological diagnoses were compared with histopathological ones using histopathology as a gold standard. The most common benign tumour was pleomorphic adenoma and among malignant tumours adenoid cystic carcinoma. The most commonly affected site was the palate. The team work of surgeon and cytologist achieved specificity of 95.1%, sensitivity of 97.6% and diagnostic accuracy of 96.3%. We can conclude that although subclassification of some tumour types of salivary glands remains poor, FNAC is invaluable in patient triage and therefore should be considered in the first line investigations of these lesions by the cytologist and surgeon. PMID:23397776

Ostovi?, Karmen Trutin; Luksi?, Ivica; Virag, Miso; Macan, Darko; Müllers, Danko; Manojlovi?, Spomenka

2012-11-01

40

Less common neoplasms of the pancreas  

PubMed Central

Recently, there has been an increased recognition of neoplasms of the pancreas other than ductal adenocarcinoma. Although not as well studied or characterized as pancreatic adenocarcinoma there are many distinct lesions which exhibit diverse biological behaviors and varying degrees of malignancy. These lesions include: endocrine neoplasms, cystic tumors, solid pseudopapillary tumors, acinar cell carcinoma, squamous cell carcinoma, primary lymphoma of the pancreas, and metastatic lesions to the pancreas. These less common neoplasms are being diagnosed more frequently as the number and sensitivity of diagnostic imaging studies increase. This review article discusses the clinical course, diagnosis, and treatment of these less common, but quite relevant, neoplasms of the pancreas. PMID:16718837

Mulkeen, Abby L; Yoo, Peter S; Cha, Charles

2006-01-01

41

Normal Pancreas Anatomy  

MedlinePLUS

... Pictures Browse Search Quick Search Image Details Normal Pancreas Anatomy View/Download: Small: 761x736 View Download Add to My Pictures Title: Normal Pancreas Anatomy Description: Anatomy of the pancreas; drawing shows ...

42

[Space-occupying lesion of the pancreas--how frequently not due to a suspected ductal adenocarcinoma?].  

PubMed

In patients with a space-occupying lesion of the pancreas at first a primary ductal adenocarcinoma is considered as the cause. Other tumours or metastases are assumed to occur very rarely. Therapy and prognosis of other pancreas tumours differ from therapy and prognosis of a primary ductal adenocarcinoma. We therefore examined the question of how frequently a space-occupying lesion of the pancreas was not due to a ductal adenocarcinoma in our case materials. Retrospectively 70 patients who had undergone a percutaneous puncture of a space-occupying mass of the pancreas under ultrasonographic control were included in the study (34 women, 36 men). In 62 patients a clear histological diagnosis was possible on the basis of the biopsy. In 53 cases (76 %) a primary adenocarcinoma of the pancreas could be diagnosed. In 5 patients (7 %) these masses turned out to be metastases of a previously known malignant tumour disease (2 x mammary carcinoma, 2 x gastric carcinoma, 1 x sigmoid carcinoma). Other tumours could be detected in 4 cases (6 %) including a tuberculoma, an endocrine tumour, a fusocellular sarcoma with partial neurogenic differentiation and a large-cell and pleomorphic-cell anaplastic, partly sarcomatoid carcinoma. In patients with a space-occupying lesion of the pancreas, tumours other than a ductal adenocarcinoma are not rare. In particular, in cases of a previously known malignant tumour disease a space-occupying lesion of the pancreas can also turn out to be a metastasis. Every other individual tumour entity is rare. Other tumour entities at large, however, are found in daily routine. The preoperative biopsy of space-occupying lesions of the pancreas, therefore, still has a clinical importance for the further therapy planning. PMID:16456757

Turi, S; Weickert, U; Bohrer, M H; Riemann, J F

2006-02-01

43

Endoscopic ultrasonography-guided trucut biopsy for the preoperative diagnosis of peripancreatic Castleman's disease: a case report.  

PubMed

Castleman's disease (CD) of the pancreas/peripancreas is extremely rare. The recently introduced, endoscopic ultrasonography (EUS)-guided trucut biopsy (TCB) is a useful diagnostic modality for obtaining tissue samples from peripancreatic lesions. However, its role in diagnosing CD remains unknown. We report a case of localized, peripancreatic, hyaline-vascular CD biopsied using EUS. The pathology results were initially interpreted as an extranodal, marginal-zone B-cell lymphoma. However, polymerase chain reaction (PCR) study for the IgH gene rearrangement revealed a polyclonal pattern. We also reviewed the relevant literature. To our knowledge, this is the first illustrated report on EUS-TCB findings of CD with its pathology results of EUS-TCB mimicked a B-cell lymphoma. PMID:18395917

Rhee, Kyoung-Hoon; Lee, Sang-Soo; Huh, Joo-Ryung

2008-04-01

44

Getting a New Pancreas: Facts about Pancreas Transplants  

MedlinePLUS

... December 2006 Revised March 2012 Getting A New Pancreas Facts About Pancreas Transplants American Society of Transplantation 1120 Route 73, ... represent the views of the Society. _________________________________ Facts About Pancreas Transplants When you get a pancreas transplant, there ...

45

Annular pancreas: a cause of gastric outlet obstruction in a 20-year-old patient.  

PubMed

Background Annular pancreas is a congenital anomaly that consists of a ring of pancreatic tissue partially or completely encircling the descending portion of the duodenum. It is formed due to the failure of the ventral bud to rotate, thus it elongates and encircles the upper part of the duodenum. It can present in a wide range of clinical severities, and can affect neonates to the elderly, making it difficult to diagnosis. Although diagnosis of annular pancreas can be made pre-operatively by upper GI series, upper GI endoscopy, or CT scan, 40% of diagnoses require surgery for confirmation. Case Report We report the case of a 20-year-old woman presenting with history of vomiting and weight loss since childhood. We present the clinical characteristics, surgical management in the form of bypass procedure done through a duodenojujenostomy, and follow-up of the patient. Conclusions Annular pancreas occasionally presents in adults. Variable presentations have been described in the literature, including pancreatic neoplasm, pancreatitis, obstructive jaundice, duodenal obstruction, and peptic ulcer diseases. Most studies of these lesions are single case reports or small series, which do not allow a surgeon to accumulate extensive experience; therefore, reliance on the combined experience of others in recognition and appropriate management has been the norm. PMID:25300027

Alahmadi, Raha; Almuhammadi, Saud

2014-01-01

46

Annular pancreas (image)  

MedlinePLUS

Annular pancreas is an abnormal ring or collar of pancreatic tissue that encircles the duodenum (the part of the ... intestine that connects to stomach). This portion of pancreas can constrict the duodenum and block or impair ...

47

Pancreas transplant - series (image)  

MedlinePLUS

The pancreas resides in the back of the abdomen. It functions to produce digestive enzymes which are delivered to ... of the most important hormones produced by the pancreas is insulin. Insulin is produced by specialized cells ...

48

Annular pancreas in adults. A report of two cases and a review of the literature.  

PubMed

Annular pancreas is an uncommon developmental abnormality of the ventral pancreas. Half of all patients present in adulthood. Abdominal pain and duodenal obstruction are the commonest presenting features. Despite newer imaging modalities, the diagnosis is mostly made at surgery. We report on two patients and review the embryology, presentation, diagnosis and the current surgical management options of annular pancreas. PMID:12397774

Douie, W J P; Krige, J E J; Bornman, P C

2002-01-01

49

Primary hydatid cysts of the pancreas.  

PubMed

Pancreatic involvement by hydatid disease is uncommon. Establishing a precise diagnosis may be difficult because the presenting symptoms and findings of investigations may be similar to other more commonly encountered cystic lesions of the pancreas. We report 4 patients with primary hydatid cysts in the head of the pancreas. The records of all patients treated for hydatid disease from 1980 to 2000 were reviewed. During the study period a total of 280 patients were treated, 4 of whom had hydatid disease involving only the pancreas. The 4 patients (3 women, 1 man) ranged in age from 17 to 60 years. Three patients presented with jaundice, abdominal pain and weight loss, 2 with hepatomegaly and 1 with an epigastric mass. All 4 lesions involved the head of the pancreas and ranged in size from 3 to 10 cm in diameter. In 2 patients the investigations incorrectly suggested a cystic tumour and both underwent pancreaticoduodenectomy. In 2 patients the correct diagnosis allowed local excision to be performed. Hydatid cyst is a rare cause of a cystic mass in the head of the pancreas, but should be included in the differential diagnosis of cystic lesions of the pancreas, especially in endemic areas. PMID:16035381

Krige, J E J; Mirza, K; Bornman, P C; Beningfield, S J

2005-05-01

50

Preoperative diagnosis and staging of rectal cancer using diffusion-weighted and water imaging combined with dynamic contrast-enhanced scanning  

PubMed Central

The aim of the present study was to evaluate the value of diffusion-weighted imaging (DWI) and water imaging combined with dynamic contrast-enhanced scanning for the preoperative diagnosis and staging of rectal cancer. In total, 72 patients with pathologically confirmed rectal cancer were selected for examination using magnetic resonance imaging (MRI) with phased-array coils, DWI, water imaging and dynamic contrast-enhanced scanning. The patients were divided into two groups, experimental (simple enhanced scanning plus diffusion combined with water imaging) and control (simple enhanced scanning), for the pathological observations. The sensitivity, specificity and accuracy for the T staging of the carcinomas using scan enhancement with DWI and the evaluation of cancer using water imaging were 98.5% (65/66), 66.7% (4/6) and 95.8% (69/72), respectively, and the accuracy for N staging was 89%. Whereas, the sensitivity, specificity and accuracy for the T staging of the carcinomas using simple scan enhancement were 85.7% (42/49), 78.3% (18/23) and 83.3% (60/72), respectively, and the accuracy for N staging was 61%. Therefore, the combination of multiple MRI techniques may be of high value for the early diagnosis and exact staging of rectal cancer. PMID:25360178

ZHAO, QILI; LIU, LIJIAN; WANG, QIUYAN; LIANG, ZEXIA; SHI, GAOFENG

2014-01-01

51

Primary monophasic synovial sarcoma of the pancreas.  

PubMed

We report a case of synovial sarcoma of the pancreas in a 44-year-old male who presented with multiple episodes of retroperitoneal hemorrhage; the diagnosis was confirmed by histology. The patient underwent distal pancreatectomy without complication, and the hospital stay was nine days. No adjuvant treatment was administered. The patient is alive at 1 year. PMID:23491856

Luc, G; Collet, D; Reich, S; Stanislas, S; Sa-Cunha, A

2013-04-01

52

Sclerosing epithelioid fibrosarcoma of the pancreas.  

PubMed

Sclerosing epithelioid fibrosarcoma (SEF) is a distinctive variant of fibrosarcoma characterized by epithelioid tumor cells arranged in nests, cords, or sheets embedded within a sclerotic collagenous matrix. It is a relatively newly described malignant fibroblastic tumor, with only fewer than 100 cases reported in English literature. Most cases are located in the lower extremities and limb girdles. Here, we present a case of SEF of the pancreas in a 67-year-old white man and provide a review of literature to date, with emphasis on the differential diagnosis. To our knowledge, this is the first reported case of SEF involving the pancreas. PMID:22056035

Bai, Shuting; Jhala, Nirag; Adsay, N Volkan; Wei, Shi

2013-04-01

53

Electroroentgenography of the Pancreas.  

National Technical Information Service (NTIS)

There was noted a positive influence of the marginal effect in electroroentgenography expressed in a more distinct detection of the borders and structure of the pancreas. This method is particularly beneficial in cases with a decreased function of the gla...

L. S. Rozenshtraukh, V. L. Krupitskii

1974-01-01

54

Occult donor malignancy in pancreas transplantation.  

PubMed

Tumor of the pancreas allograft is extremely rare. We report a case of an occult donor malignant undifferentiated tumor arising in a pancreas allograft. A 42-year-old female with Type 1 diabetes received a macroscopically normal pancreas allograft. The donor was a 22-year-old male who died of spontaneous intracerebral hemorrhage. She underwent transplant pancreatectomy, the histology of the pancreas allograft demonstrated a tumor measuring 5 mm in diameter, and a diagnosis of malignant undifferentiated tumor was made. In a different transplant center, the recipient of the left kidney transplant from the same donor had a nephrectomy, and the recipient of the liver transplant died of metastatic disease. Microscopic examination of the liver and kidney allografts subsequently revealed histological features identical to the pancreas tumor. Tumor transmission in transplantation may occur from an organ that contains metastatic cells or, less commonly, from the transmission of an unrecognized or occult primary tumor. A report from the United Network for Organs Sharing transplant data 1997-2002 is illustrated and discussed. This case illustrates the difficulties associated with identifying donors with occult primary tumor or metastases. PMID:17365945

Wong, Christopher; Hold, Phoebe; Mohteshamzadeh, Mobin; Dhanda, Raman; Sells, Robert

2007-01-01

55

Giant serous microcystic pancreas adenoma  

PubMed Central

Serous cystadenomas are rare tumors comprising 1–2% of exocrine pancreas tumors. They are mostly known as benign conditions but malign transformation as serous cystadenocarcinoma is also reported. It is usually seen in females. Non-specific symptoms, such as abdominal pain or symptoms due to mass affect, are usually seen. A 64-year old female patient was investigated for abdominal pain. Physical and laboratory findings were normal. Abdomen ultrasonography confirmed an 11×9.5 cm solid cystic lesion and abdomen computed tomography scan confirmed a 12×11 cm lobulated cystic solid lesion which had central cystic necrotic areas extending from liver hilus inferiorly. Fine needle biopsy confirmed benign cytology and trucut biopsy of the pancreatic mass reported chronic inflamation. Nevertheless, this mass could have malignant contents and transformation potential. A laparatomy was decided due to patient's symptoms and mass effect. Due to vascular invasion of the tumor, Whipple procedure was performed. The pathology report confirmed serous microcystic adenoma. These rare tumors are usually benign but pre-operative malignity criterias are not identified. There are few differential diagnostic tools for excluding malignity. We suggest surgical resection as best treatment approach for selected cases. PMID:23372920

Dikmen, Kursat; Bostanci, Hasan; Yildirim, Ali Cihat; Sakrak, Omer; Kerem, Mustafa

2012-01-01

56

Giant serous microcystic pancreas adenoma.  

PubMed

Serous cystadenomas are rare tumors comprising 1-2% of exocrine pancreas tumors. They are mostly known as benign conditions but malign transformation as serous cystadenocarcinoma is also reported. It is usually seen in females. Non-specific symptoms, such as abdominal pain or symptoms due to mass affect, are usually seen. A 64-year old female patient was investigated for abdominal pain. Physical and laboratory findings were normal. Abdomen ultrasonography confirmed an 11×9.5 cm solid cystic lesion and abdomen computed tomography scan confirmed a 12×11 cm lobulated cystic solid lesion which had central cystic necrotic areas extending from liver hilus inferiorly. Fine needle biopsy confirmed benign cytology and trucut biopsy of the pancreatic mass reported chronic inflamation. Nevertheless, this mass could have malignant contents and transformation potential. A laparatomy was decided due to patient's symptoms and mass effect. Due to vascular invasion of the tumor, Whipple procedure was performed. The pathology report confirmed serous microcystic adenoma. These rare tumors are usually benign but pre-operative malignity criterias are not identified. There are few differential diagnostic tools for excluding malignity. We suggest surgical resection as best treatment approach for selected cases. PMID:23372920

Dikmen, Kursat; Bostanci, Hasan; Yildirim, Ali Cihat; Sakrak, Omer; Kerem, Mustafa

2012-10-10

57

Agenesis of the Dorsal Pancreas with Chronic Calcific Pancreatitis. Case Report, Review of the Literature and Genetic Basis  

Microsoft Academic Search

Context Agenesis of the dorsal pancreas is a rare developmental anomaly. This anomaly may be complicated by recurrent acute and chronic pancreatitis. Case report We report the case of a 28-year- old female with agenesis of the dorsal pancreas and chronic calcific pancreatitis. The diagnosis of agenesis of the dorsal pancreas is discussed and the genetic changes leading to it

Vallath Balakrishnan; Vekateswara A Narayanan; Ismail Siyad; Lakshmi Radhakrishnan; Prem Nair

2006-01-01

58

The spectrum of serous cystadenoma of the pancreas. Clinical, pathologic, and surgical aspects.  

PubMed Central

Serous cystadenoma of the pancreas is a rare lesion thought to be almost invariably benign. Since 1978, 211 cases have been reported in the literature. Some have been recognized by computed tomography (CT) when small and asymptomatic. The authors have reviewed their experience with 40 patients (median follow-up of 1.9 years, maximum of 22.2 years) from 1936 to 1991. One third (13) were asymptomatic, of whom eight (20%) were discovered intraoperatively. Of those 20 who had CT, an unequivocal preoperative diagnosis was reached in none. Needle biopsy proved accurate in two patients. Endoscopic retrograde cholangiopancreatography (ERCP) and biopsy were performed with diagnostic success on one occasion. Three patients presented acutely. The tumor was resected in 90%, with an operative mortality rate of 10%. Enucleation of the tumor without formal anatomic pancreatectomy necessitated reoperation for complications in four of eight patients. Survival after successful resection paralleled expected survival. Serous cystadenoma may be associated with von Hippel-Lindau syndrome. The current role for conservative management remains questionable because of our current inability to reliably differentiate many of these benign neoplasms from malignant cystic neoplasms of the pancreas. Images FIG. 3. FIG. 4. FIG. 5. FIG. 6. PMID:1546898

Pyke, C M; van Heerden, J A; Colby, T V; Sarr, M G; Weaver, A L

1992-01-01

59

Fine needle aspiration cytology of neuroendocrine tumors of the pancreas. A cytologic, immunocytochemical and electron microscopic study.  

PubMed

We report the fine needle aspiration cytology findings in six cases of neuroendocrine tumor of the pancreas. Three cases were from the pancreas, two from hepatic metastases and one from a peripancreatic lymph node metastasis. The cytologic features that permitted a preoperative diagnosis of pancreatic neuroendocrine tumor were: a cellular aspirate; numerous isolated cells and irregular, loose, dyshesive cellular aggregates; minimal nuclear pleomorphism; infrequent mitoses; fine, evenly dispersed nuclear chromatin with occasional inconspicuous nucleoli; a scant-moderate amount of granular, amphophilic, well-defined cytoplasm; clustering of tumor cells around segments of capillaries; and rosette formation. The differential diagnosis includes cells derived from normal pancreatic acini, islet cell hyperplasia, acinic cell carcinoma, well-differentiated pancreatic adenocarcinoma, metastatic small cell undifferentiated carcinoma of the lung, pancreatic small cell anaplastic carcinoma and malignant lymphoma. The application of immunocytochemistry to cytologic smears can be easily and reliably performed to confirm the neuroendocrine nature of the tumor and identify the specific type of polypeptide hormone or hormones produced by these tumors. Four aspirates showed immunoreactivity for chromogranin, and one was positive for gastrin. Cells of a lipid-rich neuroendocrine tumor were negative for chromogranin; however, the tissue section contained neuron specific enolase, and neurosecretory granules were demonstrated by electron microscopy. PMID:1523921

al-Kaisi, N; Weaver, M G; Abdul-Karim, F W; Siegler, E

1992-01-01

60

Diagnosis and management of insulinoma  

PubMed Central

Insulinomas, the most common cause of hypoglycemia related to endogenous hyperinsulinism, occur in 1-4 people per million of the general population. Common autonomic symptoms of insulinoma include diaphroresis, tremor, and palpitations, whereas neuroglycopenenic symptoms include confusion, behavioural changes, personality changes, visual disturbances, seizure, and coma. Diagnosis of suspected cases is based on standard endocrine tests, especially the prolonged fasting test. Non-invasive imaging procedures, such as computed tomography and magnetic resonance imaging, are used when a diagnosis of insulinoma has been made to localize the source of pathological insulin secretion. Invasive modalities, such as endoscopic ultrasonography and arterial stimulation venous sampling, are highly accurate in the preoperative localization of insulinomas and have frequently been shown to be superior to non-invasive localization techniques. The range of techniques available for the localization of insulinomas means that blind resection can be avoided. Intraoperative manual palpation of the pancreas by an experienced surgeon and intraoperative ultrasonography are both sensitive methods with which to finalize the location of insulinomas. A high proportion of patients with insulinomas can be cured with surgery. In patients with malignant insulinomas, an aggressive medical approach, including extended pancreatic resection, liver resection, liver transplantation, chemoembolization, or radiofrequency ablation, is recommended to improve both survival and quality of life. In patients with unresectable or uncontrollable insulinomas, such as malignant insulinoma of the pancreas, several techniques should be considered, including administration of ocreotide and/or continuous glucose monitoring, to prevent hypoglycemic episodes and to improve quality of life. PMID:23430217

Okabayashi, Takehiro; Shima, Yasuo; Sumiyoshi, Tatsuaki; Kozuki, Akihito; Ito, Satoshi; Ogawa, Yasuhiro; Kobayashi, Michiya; Hanazaki, Kazuhiro

2013-01-01

61

Borderline Ovarian Tumors and Diagnostic Dilemma of Intraoperative Diagnosis: Could Preoperative He4 Assay and ROMA Score Assessment Increase the Frozen Section Accuracy? A Multicenter Case-Control Study  

PubMed Central

The aim of our study was to assess the value of a preoperative He4-serum-assay and ROMA-score assessment in improving the accuracy of frozen section histology in the diagnosis of borderline ovarian tumors (BOT). 113 women presenting with a unilateral ovarian mass diagnosed as serous/mucinous BOT at frozen-section-histology (FS) and/or confirmed on final pathology were recruited. Pathologists were informed of the results of preoperative clinical/instrumental assessment of all patients. For Group_A patients, additional information regarding He4, CA125, and ROMA score was available (in Group_B only CA125 was known). The comparison between Group A and Group B in terms of FS accuracy, demonstrated a consensual diagnosis in 62.8% versus 58.6% (P: n.s.), underdiagnosis in 25.6% versus 41.4% (P < 0.05), and overdiagnosis in 11.6% versus 0% (P < 0.01). Low FS diagnostic accuracy was associated with menopausal status (OR: 2.13), laparoscopic approach (OR: 2.18), mucinous histotype (OR: 2.23), low grading (OR: 1.30), and FIGO stage I (OR: 2.53). Ultrasound detection of papillae (OR: 0.29), septa (OR: 0.39), atypical vascularization (OR: 0.34), serum He4 assay (OR: 0.39), and ROMA score assessment (OR: 0.44) decreased the probability of underdiagnosis. A combined preoperative assessment through serum markers and ultrasonographic features may potentially reduce the risk of underdiagnosis of BOTs on FS while likely increasing the concomitant incidence of false-positive events.

Gizzo, Salvatore; Berretta, Roberto; Di Gangi, Stefania; Guido, Maria; Zanni, Giuliano Carlo; Franceschetti, Ilaria; Quaranta, Michela; Plebani, Mario; Nardelli, Giovanni Battista; Patrelli, Tito Silvio

2014-01-01

62

Portal annular pancreas: a systematic review of a clinical challenge.  

PubMed

Portal annular pancreas (PAP) is an asymptomatic congenital pancreas anomaly, in which portal and/or mesenteric veins are encased by pancreas tissue. The aim of the study was to determine the role of PAP in pancreatic surgery as well as its management and potential complication, specifically, postoperative pancreatic fistula (POPF).On the basis of a case report, the MEDLINE and ISI Web of Science databases were systematically reviewed up to September 2012. All articles describing a case of PAP were considered.In summary, 21 studies with 59 cases were included. The overall prevalence of PAP was 2.4% and the patients' mean (SD) age was 55.9 (16.2) years. The POPF rate in patients with PAP (12 pancreaticoduodenectomies and 3 distal pancreatectomies) was 46.7% (in accordance with the definition of the International Study Group of Pancreatic Surgery).Portal annular pancreas is a quite unattended pancreatic variant with high prevalence and therefore still remains a clinical challenge to avoid postoperative complications. To decrease the risk for POPF, attentive preoperative diagnostics should also focus on PAP. In pancreaticoduodenectomy, a shift of the resection plane to the pancreas tail should be considered; in extensive pancreatectomy, coverage of the pancreatic remnant by the falciform ligament could be a treatment option. PMID:25207658

Harnoss, Jonathan M; Harnoss, Julian C; Diener, Markus K; Contin, Pietro; Ulrich, Alexis B; Büchler, Markus W; Schmitz-Winnenthal, Friedrich H

2014-10-01

63

Unusual, Metastatic, or Neuroendocrine Tumor of the Pancreas: A Diagnosis with Endoscopic Ultrasound-guided Fine-needle Aspiration and Immunohistochemistry  

PubMed Central

Background/Aim: To determine the yield of endoscopic ultrasound–guided fine-needle aspiration (EUS–FNA) in combination with immunostains in diagnosing unusual solid pancreatic masses (USPM) in comparison with pancreatic adenocarcinoma (ACP). Patients and Methods: All EUS–FNA of solid pancreatic masses performed with a 22-gauge needle were included. Data on clinical presentations, mass characteristics, presence of pancreatitis, yield of tissue, and final diagnosis were compared between the two groups. On site cytopathology was provided and additional passes were requested to perform immunostains. Results: Two hundred and twenty-nine cases with either adenocarcinoma or USPM were included. The median age of the cohort was 65 years. ACP (210/229, 92%) accounted for the majority of the cases. The USPM included neuroendocrine (NET) masses (n=13), metastatic renal carcinoma (n=3), metastatic melanoma (n=1), lymphoma (n=1), and malignant fibrous histiocytoma (n=1). Subjects with ACP were significantly more likely to present with loss of weight (P=0.02) or obstructive jaundice (P<0.001). Subjects with ACP were more likely to have suspicious/atypical FNA biopsy results as compared with USPM (10% vs 0%). The sensitivity of EUS–FNA with immunostains was 93% in ACP as compared with 100% in USPM. Diagnostic accuracy was higher in USPM as compared with ACP (100% vs 93%). Conclusions: EUS–FNA using a 22-gauge needle with immunostains has excellent diagnostic yield in patients with USPMs, which is comparable if not superior to the yield in pancreatic adenocarcinoma. PMID:22421714

Eloubeidi, Mohamad A.; Tamhane, Ashutosh R.; Buxbaum, James L.

2012-01-01

64

Metastases to the pancreas.  

PubMed

Disparity in prognosis and management between primary and secondary pancreatic tumours makes recognition of metastases to the pancreas on CT and MRI an important goal. Three different patterns of secondary pancreatic tumours may be seen: localized, multifocal, or diffuse enlargement. CT findings include hypodense lesions, which show rim enhancement following intravenous contrast medium. On MR examination, the lesions are usually hypointense on T1 weighted and hyperintense on T2 weighted images. PMID:10434919

Merkle, E M; Boaz, T; Kolokythas, O; Haaga, J R; Lewin, J S; Brambs, H J

1998-11-01

65

Annular pancreas intra operatively discovered: a case report  

PubMed Central

Annular pancreas is a rare congenital abnormality. This entity can rarely be symptomatic. Patients can present with gastrointestinal obstruction or acute pancreatitis. We report a case with a rich iconography, of an annular pancreas discovered intraoperatively. A 46-year-old woman was operated with the diagnosis of acute cholecystitis with common bile duct stones. At operation, a strip of pancreatic tissue (2 cm) completely encircled the second duodenum. Open cholecytectomy with choledocotomy and stones extractionwas done. Postoperatively, she developed an acute pancreatitis. The post-operative cholangiography showed the annular duct surrounding the second duodenum. Annular pancreas is rare. Symptoms may occur in newborn children. In adults, annular pancreas discovering is radiological or intra operatively. PMID:24765382

Zeineb, Mzoughi; Sadri, Ben Abid; Nizar, Miloudi; Hassen, Hentati; Nafaa, Arfa; Taher, Khalfallah

2011-01-01

66

Heterotopic Pancreas: A Rare Cause of Ileo-Ileal Intussusception  

PubMed Central

Background Heterotopic pancreas is a rare developmental anomaly defined as pancreatic tissue found on ectopic sites without contiguity with the main pancreas. An isolated heterotopic pancreas as a cause of bowel intussusception is extremely rare. Case Report A case of 47-year old male with multiple episodes of melena, constipation and abdominal pain for one year duration is presented. CT eneterography revealed a large circumferential lesion involving the terminal ileum that acted as a leading point to an ileo-ileal intussusception. The resection of the lesion and related bowel segment was carried out. The histopathological examination confirmed the excised lesion as a heterotopic pancreatic tissue. Conclusions Though a rare entity, heterotopic pancreas should be considered in the differential diagnosis of bowel intussusception. PMID:25302087

Monier, Ahmed; Awad, Ahmed; Szmigielski, Wojciech; Muneer, Mohamed; Alrashid, Amal; Darweesh, Adham; Hassan, Heba

2014-01-01

67

Diagnosis by endoscopic ultrasound guided fine needle aspiration of tuberculous lymphadenitis involving the peripancreatic lymph nodes: a case report.  

PubMed

Pancreatic tuberculosis is an extremely rare form of extrapulmonary disease. The diagnosis preoperatively is difficult because clinical, laboratory and radiologic findings are nonspecific. Published data indicate that these lesions mimic cystic neoplasms of the pancreas and the confirmation of clinical suspicion could only be obtained by an open surgical biopsy. Recently, fine needle aspiration cytology has been shown to be a safe, reliable and cost-effective alternative. We report a new case of a peripancreatic tuberculosis in a 52 year old woman and review the relevant literature, paying special attention to the usefulness of endoscopic ultrasound guided-fine needle aspiration in the diagnosis of abdominal tuberculosis. PMID:17230623

Boujaoude, Joseph-D; Honein, Khalil; Yaghi, Cesar; Ghora, Claude; Abadjian, Gerard; Sayegh, Raymond

2007-01-21

68

MR imaging of the pancreas.  

PubMed

Magnetic resonance (MR) imaging of the pancreas is useful as both a problem-solving tool and an initial imaging examination of choice. With newer imaging sequences such as diffusion-weighted imaging, MR offers improved ability to detect and characterize lesions and identify and stage tumors and inflammation. MR cholangiopancreatography can be used to visualize the pancreatic and biliary ductal system. In this article, the use of MR to evaluate the pancreas, including recent advances, is reviewed and the normal appearance of the pancreas on different imaging sequences, as well as inflammatory diseases, congenital abnormalities, and neoplasms of the pancreas, are discussed. PMID:24889170

O'Neill, Erin; Hammond, Nancy; Miller, Frank H

2014-07-01

69

Endosonographic Features of Histologically Proven Gastric Ectopic Pancreas  

PubMed Central

Gastric ectopic pancreas is an uncommon developmental anomaly and its histological diagnosis is usually difficult by using a conventional biopsy forceps. In the literature, most cases of gastric ectopic pancreas were usually diagnosed by gross pattern during endoscopic examination or features of endoscopic ultrasound. In contrast, this disease was seldom diagnosed by histology in clinical practice. Although the typical endoscopic ultrasonographic features of ectopic pancreas include heterogeneous echogenicity, indistinct borders, and a location within 2 or more layers, it can also exhibit hypoechoic homogeneous echogenicity and a distinct border within the fourth sonographic layer (muscularis propria) similar to the endoscopic ultrasonographic features of gastrointestinal stromal tumors. In our study, we found that 53% of gastric ectopic pancreas originated within the fourth sonographic layer, demonstrating hypoechoic, homogeneous echogenicity, and distinct borders. Therefore, recognizing endoscopic ultrasonographic features, combining with deep biopsy, endoscopic ultrasound-guided fine needle aspiration/core needle biopsy can prevent conducting unnecessary resection. Surgical resection is the mainstay treatment for symptomatic gastric ectopic pancreas, but endoscopic resection using endoscopic mucosal resection or endoscopic submucosal dissection technique provides an alternative method of removing superficial-type and deep-type gastric ectopic pancreas. PMID:25371670

Cheng, Ken-Sheng; Ting, Chun-Fu; Feng, Chun-Lung; Huang, Wen-Hsin

2014-01-01

70

[Incidentaloma of the pancreas].  

PubMed

The term incidentaloma refers to an asymptomatic mass detected accidentally during a technical examination, mostly by radiological methods, when performed in a patient examined for other conditions or situations. Surgery is the adequate therapy for adrenal incidentalomas with increasing size, a size bigger than 4 cm at detection, hormone-activity or malignant histology. Incidentalomas of the adrenal and thyroid gland are still often dismissed because they are common and mostly benign. Incidentalomas of the pancreas are distinct and less frequent. At present, no evidence-based guidelines exist for the management of asymptomatic pancreatic lesions. Only few clinical studies describe pancreatic incidentalomas, however these studies claim a malignant histology of up to 30 % and of up to 50 % for pre-malignant incidentalomas of the pancreas. Thus, we recommend an early resection of pancreatic incidentalomas with a size of > 2 cm, in younger patients without concomitant diseases or increased operative risk, with a malignant histology, and with mucinous cells and increased tumour markers in blood samples. Organ-saving procedures or radical pancreatectomy are possible while both methods are safe and have a very low complication risk. The surgical resection of pancreatic incidentalomas offers a significant advantage in survival when the total collective of affected individuals is taken into account. PMID:18322885

Kubisch, C H; Flatz, W H; Göke, B

2008-03-01

71

Acinar cell cystadenoma of the pancreas in a cat.  

PubMed

Cystic tumours of the pancreas are heterogeneous lesions with a spectrum of morphology and biological behaviour in people. These are poorly characterized in animals. A multicystic tumour of the pancreas was identified in an 11-year-old, female, mixed breed cat. The tumour was 5.5 cm in diameter and the largest cysts were 1.5 cm in diameter. Microscopically, the cysts were lined by single layered or pseudostratified, flat, cuboidal or columnar epithelial cells that occasionally formed papillary structures with a thin fibrous core. The tumour cells had eosinophilic granules in the apical cytoplasm, similar to zymogen granules, and the nuclei were uniform in size and shape. Mitotic figures were not observed. Immunohistochemically, the tumour cells expressed trypsin, but not cytokeratin 7. A diagnosis of acinar cell cystadenoma of the pancreas was made and this is the first report of this tumour in a cat. PMID:23582928

Yoshimura, H; Matsuda, Y; Kawamoto, Y; Michishita, M; Ohkusu-Tsukada, K; Takahashi, K; Naito, Z; Ishiwata, T

2013-01-01

72

Preoperative CA 125 in endometrial cancer: Is it useful?  

Microsoft Academic Search

Objective: We sought to determine the clinical utility of preoperative CA 125 measurement in determining the need for lymphadenectomy in patients with endometrial carcinoma. Study Design: A prospective nonrandomized study was performed over a 2-year period. Patients referred with the diagnosis of endometrial carcinoma had CA 125 levels determined before surgical staging. Operative findings were then correlated with preoperative CA

Deborah J Dotters

2000-01-01

73

A case of invasive hemolymphangioma of the pancreas  

PubMed Central

Hemolymphangioma of the pancreas is a very rare benign tumor. There were only five reports of this disease until March 2008. Herein, we report a case of hemolymphangioma of the pancreas with gastrointestinal bleeding due to duodenal invasion. A 53-year-old man had been admitted a referral hospital because of severe anemia due to gastrointestinal bleeding in December 2005. He was then transferred to our institute with a diagnosis of a tumor of the head of the pancreas with duodenal invasion in January 2006. No abnormalities were revealed except for anemia in laboratory data including CEA and CA19-9. Gastrointestinal endoscopy revealed bleeding at the duodenum. Computed tomography also demonstrated a heterogenous mass at the pancreatic head and suspected invasion to the duodenal wall. Ultrasonography showed a huge mass at the pancreatic head with a mixture of high and low echoic areas. Pylorous-preserving pancreatoduodenectomy was performed. The pancreatic tumor was soft and had invaded to the duodenum. The pathological diagnosis was a hemolymphangioma of the pancreas invaded to the duodenum. His postoperative course was uneventful and he was discharged on the 26th d after surgery. Hemolymphangioma of the pancreas is a very rare benign tumor. In a literature review until March 2008, we found five case reports. Major symptoms are abdominal pain and distension due to the enlarged tumor. However, we experienced a case of hemolymphangioma of the pancreas with gastrointestinal bleeding due to invasion to the duodenum. This disease is a very rare entity, but should be considered when patients have gastrointestinal bleeding. PMID:18473426

Toyoki, Yoshikazu; Hakamada, Kenichi; Narumi, Shunji; Nara, Masaki; Kudoh, Daisuke; Ishido, Keinosuke; Sasaki, Mutsuo

2008-01-01

74

Preoperative Fasting in Children  

Microsoft Academic Search

hildren undergo a preoperative fast in an at- tempt to minimize the fluid and solid food com- ponent of gastric contents. The importance of a preoperative fast was acknowledged early in the evo- lution of anesthesia as a discipline of medicine. In response to concerns about the aspiration of gastric contents, a prolonged fast presumably came into vogue. With this

William M. Splinter; Mark S. Schreiner

1999-01-01

75

Heterotopic Pancreas Complicated by Pseudocyst in the Gastric Wall Diagnosed by Endoscopic Ultrasound-Guided Fine Needle Aspiration  

PubMed Central

Heterotopic pancreas is usually asymptomatic and does not change throughout the patient's life, but sometimes it can present symp-toms and complications, which are rarely discrete in the literature. We present here a case of heterotopic pancreas in the gastric wall complicated with pseudocyst, and suggest that heterotopic pancreatic pseudocyst should be included in the differential diagnosis of gastric wall cysts. PMID:24949386

Rocha, Haroldo Luis Oliva Gomes; Bueno, Fernanda Kistemarcker do Nascimento; Faraco, Jarbas; Assef, Mauricio Saab; Araki, Osvaldo Massatoshi; Nakao, Frank; Rossini, Lucio Giovanni Bapttista

2013-01-01

76

Gemcitabine and AMG 479 in Metastatic Adenocarcinoma of the Pancreas  

ClinicalTrials.gov

Adenocarcinoma of the Pancreas; Advanced Solid Tumors; Cancer; Cancer of Pancreas; Cancer of the Pancreas; Metastases; Metastatic Cancer; Metastatic Pancreatic Cancer; Pancreas Cancer; Pancreatic Cancer; Bone Metastases; Endocrine Cancer; Oncology; Oncology Patients; Solid Tumors; Advanced Malignancy

2014-03-28

77

Design of a bioartificial pancreas  

PubMed Central

Summary Islet transplantation has been shown to be a viable treatment option for patients afflicted with Type 1 diabetes. However, the severe shortage of human pancreas and the need to use risky immunosuppressive drugs to prevent transplant rejection remain two major obstacles to routine use of islet transplantation in diabetic patients. Successful development of a bioartificial pancreas using the approach of microencapsulation with perm-selective coating of islets in hydrogels for graft immunoisolation holds tremendous promise for diabetic patients because it has great potential to overcome these two barriers. In this review article, we will discuss the need for bioartificial pancreas, provide a detailed description of the microencapsulation process, and review the status of the technology in clinical development. We will also critically review the various factors that need to be taken into consideration in order to achieve the ultimate goal of routine clinical application. PMID:23652283

Pareta, Rajesh A; Farney, Alan C; Opara, Emmanuel C

2013-01-01

78

Cystic lymphangioma of the pancreas.  

PubMed Central

Cystic lymphangioma of the pancreas is a rare condition. A 14-year-old girl presented with a cystic abdominal mass and abdominal pain. She was initially treated by biopsy and cyst drainage, and subsequently with partial excision of the cystic mass. The mass, which was a cystic lymphangioma involving the pancreas, recurred after each operation. Persisting symptoms led to a pylorus-preserving pancreatectomy and hepaticojejunostomy. Total excision is the only effective method of treating this benign tumour. The patient remains symptom free 2 1/2 years after pancreatectomy. Images Figure 1 Figure 2 PMID:8949598

Daltrey, I. R.; Johnson, C. D.

1996-01-01

79

Cystic lymphangioma of the pancreas.  

PubMed

Cystic lymphangioma of the pancreas is a rare condition. A 14-year-old girl presented with a cystic abdominal mass and abdominal pain. She was initially treated by biopsy and cyst drainage, and subsequently with partial excision of the cystic mass. The mass, which was a cystic lymphangioma involving the pancreas, recurred after each operation. Persisting symptoms led to a pylorus-preserving pancreatectomy and hepaticojejunostomy. Total excision is the only effective method of treating this benign tumour. The patient remains symptom free 2 1/2 years after pancreatectomy. PMID:8949598

Daltrey, I R; Johnson, C D

1996-09-01

80

Model Predictive Control for an artical pancreas  

E-print Network

Model Predictive Control for an artical pancreas B.Sc. Thesis Matias Sørensen og Simon Kristiansen with linear Model Predictive Control, MPC, with the goal of making a controller for an articial pancreas

81

Arteriovenous Malformation of the Pancreas: Report of a Case  

Microsoft Academic Search

Arteriovenous malformation (AVM) of the pancreas (AVMP) is uncommon and generally asymptomatic; therefore, few cases have\\u000a so far been reported. The symptoms of AVMP include gastrointestinal bleeding, pain, and portal hypertension. Definitive diagnosis\\u000a is confirmed by angiographic study, and surgery is the only effective treatment. We report a case of AVMP confirmed by computed\\u000a tomography, magnetic resonance imaging, and angiographic

Jean M. Butte; Francisco Pacheco; Antonieta Solar; Fernando J. Crovari; Nicolás P. Jarufe

2007-01-01

82

Management of Mucin-Producing Cystic Neoplasms of the Pancreas  

PubMed Central

During the last decade small lesions of the pancreas have been increasingly recognized in clinical practice. Among these lesions, mucin-producing cystic neoplasms represent a recently described and unique entity among pancreatic tumors. In 1996, the World Health Organization distinguished two different types of mucinous cystic tumors: intraductal papillary mucinous neoplasms (IPMNs) of the pancreas, which are characterized by mucin production, cystic dilation of the pancreatic ducts, and intrapapillary growth, and mucinous cystic neoplasms (MCNs), which are defined by ovarian-like stroma and in most cases do not communicate with pancreatic ducts. Further, IPMNs can be subdivided into main-duct type, mixed-type, and branch-duct type tumors. Older data did not distinguish among different subsets of cystic neoplasms of the pancreas, and consequently many databases were inconsistent. Histopathologically, both IPMNs and MCNs demonstrate a wide spectrum of cellular atypia ranging from mild mucinous hyperplasia to invasive adenocarcinoma. Because mucinous cystic neoplasms of the pancreas show significant differences in clinical behavior from patient to patient, knowledge of the clinicopathologic characteristics and natural history of specific subtypes of IPMNs and MCNs has become crucial for physicians working in the field of gastroenterology. The present work offers an overview of current and generally accepted clinical guidelines for the diagnosis and treatment of IPMNs and MCNs. PMID:19211618

Fritz, Stefan; Warshaw, Andrew L.; Thayer, Sarah P.

2013-01-01

83

Diagnosis and Prognostication of Ductal Adenocarcinomas of the Pancreas Based on Genome-Wide DNA Methylation Profiling by Bacterial Artificial Chromosome Array-Based Methylated CpG Island Amplification  

PubMed Central

To establish diagnostic criteria for ductal adenocarcinomas of the pancreas (PCs), bacterial artificial chromosome (BAC) array-based methylated CpG island amplification was performed using 139 tissue samples. Twelve BAC clones, for which DNA methylation status was able to discriminate cancerous tissue (T) from noncancerous pancreatic tissue in the learning cohort with a specificity of 100%, were identified. Using criteria that combined the 12 BAC clones, T-samples were diagnosed as cancers with 100% sensitivity and specificity in both the learning and validation cohorts. DNA methylation status on 11 of the BAC clones, which was able to discriminate patients showing early relapse from those with no relapse in the learning cohort with 100% specificity, was correlated with the recurrence-free and overall survival rates in the validation cohort and was an independent prognostic factor by multivariate analysis. Genome-wide DNA methylation profiling may provide optimal diagnostic markers and prognostic indicators for patients with PCs. PMID:21197409

Gotoh, Masahiro; Arai, Eri; Wakai-Ushijima, Saori; Hiraoka, Nobuyoshi; Kosuge, Tomoo; Hosoda, Fumie; Shibata, Tatsuhiro; Kondo, Tadashi; Yokoi, Sana; Imoto, Issei; Inazawa, Johji; Kanai, Yae

2011-01-01

84

Sipple's syndrome: A case diagnosed preoperatively  

Microsoft Academic Search

A case of familial Sipple's syndrome diagnosed preoperatively is presented. Clinically, thyroid carcinoma and its metastasis\\u000a to the cervical and upper mediastinal lymph nodes were first noticed. The diagnosis of medullary carcinoma was strongly suspected\\u000a on the physical and roentgenologic evidences unique to this variety of thyroid cancer. Clinically pheochromocytomas were asymptomatic,\\u000a but urinary catecholamine study revealed an increased epinephrine

Takao Obara; Yoshihide Fujimoto; Atsushi Oka; Masayuki Fukumitsu

1974-01-01

85

Autoimmune diabetes recurrence should be routinely monitored after pancreas transplantation  

PubMed Central

Autoimmune type 1 diabetes recurrence in pancreas grafts was first described 30 years ago, but it is not yet completely understood. In fact, the number of transplants affected and possibly lost due to this disease may be falsely low. There may be insufficient awareness to this entity by clinicians, leading to underdiagnosis. Some authors estimate that half of the immunological losses in pancreas transplantation are due to autoimmunity. Pancreas biopsy is the gold standard for the definitive diagnosis. However, as an invasive procedure, it is not the ideal approach to screen the disease. Pancreatic autoantibodies which may be detected early before graft dysfunction, when searched for, are probably the best initial tool to establish the diagnosis. The purpose of this review is to revisit the autoimmune aspects of type 1 diabetes and to analyse data about the identified autoantibodies, as serological markers of the disease. Therapeutic strategies used to control the disease, though with unsatisfactory results, are also addressed. In addition, the author’s own experience with the prospective monitoring of pancreatic autoantibodies after transplantation and its correlation with graft outcome will be discussed. PMID:25346891

Martins, La Salete

2014-01-01

86

Preoperative bowel preparation  

Microsoft Academic Search

A survey of 500 clinically active, board-certified colon and rectal surgeons in the United States and Canada was conducted to obtain data regarding current methods of bowel preparation for elective colorectal surgery. A review of recent publications on preoperative bowel preparation was used to compare the current literature recommendations with the actual practice among the group surveyed. Responses were received

Julio A. Solla; David A. Rothenberger

1990-01-01

87

Serous cystadenocarcinoma of the pancreas  

Microsoft Academic Search

Summary  The mucinous type of cystadenoma of the pancreas is known to have malignant potential, whereas the serous type is believed\\u000a to be benign. Therefore, the therapeutic strategies for serous cystadenomas are less aggressive than in mucinous cystadenoma,\\u000a where complete operative resection is the procedure of choice.\\u000a \\u000a A patient with a biopsy-proven serous cystadenocarcinoma with a lymph node metastasis is reported.

Uwe Widmaier; Torsten Mattfeldt; Marco Siech; Hans Giinter Beger

1996-01-01

88

Solid pseudopapillary tumor of the pancreas: a rare entity.  

PubMed

Solid pseudopapillary tumor (SPT) of the pancreas is a rare neoplasm in children that mainly occurs in young females. We herein report a rare case of SPT arising from the tail of the pancreas. A 13-year-old girl was admitted to our clinic with abdominal pain and anorexia. A mass was palpated on the physical examination. A 90x72 mm, encapsulated, heterogeneous mass with solid and cystic components was defined on computerized tomography (CT). Distal pancreatectomy was performed during the operation. Histopathological examination revealed that the tumor was a SPT with negative surgical margins. A six-month follow-up after surgical resection showed no evidence of recurrent disease. SPT should always be considered in the differential diagnosis in a young female with a palpable mass. PMID:25341607

Karadeniz-Cerit, K?v?lc?m; Ergelen, Rabia; Kalyoncu, Aybegüm; Toper, Hasan; Da?l?, Tolga E

2014-01-01

89

Values of endoscopic ultrasonography for diagnosis and treatment of duodenal protruding lesions*  

PubMed Central

Objective: The diagnoses of patients with duodenal protruding lesions are difficult when using conventional examinations such as computed tomography (CT) and conventional endoscope etc. Thus, we investigated the clinical value of endoscopic ultrasonography (EUS) with miniature ultrasonic probes on the diagnosis and treatment of duodenal protruding lesions. Methods: Patients with duodenal protruding lesions who were indicated for EUS were examined by EUS with 12~15 MHz miniature ultrasonic probes and double-cavity electronic endoscope. According to diagnosis of EUS, those patients were indicated for biopsy and treatment received biopsy, endoscopic resection or surgical excision. The postoperative histological results were compared with the preoperative diagnosis of EUS. Those patients without endoscopic resection or surgical excision were periodically followed up with EUS. Results: A total of 169 patients with duodenal protruding lesions were examined by EUS, of which 40 were diagnosed with cysts, 36 with inflammatory protruding or polyp, 25 with Brunner’s gland adenoma, 19 with ectopic pancreas, 17 with gastrointestinal stromal tumor, 12 with extrinsic compression, 12 with minor papilla, 6 with lipoma, 1 with adenocarcinoma and 1 with lymphoma. After EUS examinations, 75 patients received biopsy, endoscopic resection or surgical excision respectively. The postoperative histological results of 70 patients were completely consistent with the preoperative diagnosis of EUS, with 93.33% diagnostic accuracy. The results of follow-up with EUS indicated that duodenal cyst, Brunner’s gland adenoma, ectopic pancreas, gastrointestinal stromal tumor and lipoma remained unchanged within 1~3 years. No related complications occurred among all patients that received EUS examinations. Conclusion: EUS is an effective and reliable diagnostic method for duodenal protruding lesions. PMID:18381809

Xu, Guo-qiang; Wu, Yi-qun; Wang, Li-jun; Chen, Hong-tan

2008-01-01

90

Design of a bioartificial pancreas+  

PubMed Central

Introduction In Type 1 diabetes, the ?-cells that secrete insulin have been destroyed such that daily exogenous insulin administration is required for the control of blood sugar in individuals afflicted with the disease. Following the development of reliable techniques for the isolation of islets from the human pancreas, islet transplantation has emerged as a therapeutic option, albeit, for only a few selected patients largely because there are not enough islets for the millions of patients requiring the treatment, and there is also the need to use immunosuppressive drugs to prevent transplant rejection. In 1980, the concept of islet immunoisolation by microencapsulation was introduced as a technique to overcome these two major barriers to islet transplantation. Microencapsulation of islets and transplantation in the peritoneal cavity was then described as a bioartificial pancreas. However, it is difficult to retrieve encapsulated islets transplanted in the peritoneal cavity, thus making it difficult to meet all the criteria for a bioartificial pancreas. A new design of a bioartificial pancreas comprising islets co-encapsulated with angiogenic protein in perm-selective multilayer alginate-poly-L-ornithine-alginate (APA) microcapsules and transplanted in an omentum pouch is described in this paper. Materials & Methods The multilayer APA microcapsules are made with ultrapure alginate using poly-L-ornithine as a semi-permeable membrane separating the two alginate layers. The inner alginate layer is used to encapsulate the islets and the outer layer is used to encapsulate angiogenic protein, which would induce neovascularization around the graft within the omentum pouch. Results In in vitro studies, we found that both the wild-type and the heparin binding-growth associated molecule (HBGAM)-FGF-1 chimera can be encapsulated and released in a controlled and sustained manner from the outer alginate layer with a mean diameter in the range of 113–164 microns when 1.25% high guluronic acid alginate is used to formulate this outer layer. Discussion We are currently performing in vivo experiments to determine the ability of angiogenic proteins released from this outer layer to induce neovascularization around the grafts in the omentum pouch. We will subsequently examine the effect of co-encapsulation of islets with angiogenic protein on blood sugar control in diabetic animals. It is hoped that addition of tissue engineering to encapsulated islet transplantation will result in long-term survival of the islets and their ability to control blood sugar in Type 1 diabetes without the necessity to use risky immunosuppressive drugs to prevent transplant rejection. PMID:20683347

Opara, Emmanuel C.; Mirmalek-Sani, Sayed-Hadi; Khanna, Omaditya; Moya, Monica L; Brey, Eric M.

2010-01-01

91

Arteriovenous malformation of the pancreas.  

PubMed

Pancreatic arteriovenous malformation (PAVM) is a very rare and mostly congenital lesion, with less than 80 cases described in the English-published literature. It is defined as a tumorous vascular abnormality that is constructed between an anomalous bypass anastomosis of the arterial and venous networks within the pancreas. It represents about 5% of all arteriovenous malformations found in the gastrointestinal tract. Herein, we present a 64-year-old patient with symptomatic PAVM involving the body and tail of the organ, which was successfully treated by transcatheter arterial embolization. The disease spectrum and review of the literature are also presented. PMID:21765845

Charalabopoulos, Alexandros; Macheras, Nikolas; Krivan, Sylvia; Petropoulos, Konstantinos; Misiakos, Evangelos; Macheras, Anastasios

2011-01-01

92

CASE REPORT Open Access Isolated granulocytic sarcoma of the pancreas  

E-print Network

CASE REPORT Open Access Isolated granulocytic sarcoma of the pancreas: A tricky diagnostic sarcoma of the pancreas that were diagnosed on the surgical specimen. Atypical clinical and morphological and therapeutic strategies. Keywords: Granulocytic sarcoma, Chloroma, Myeloid tumor, Pancreas. Background

Boyer, Edmond

93

Environmental Factors and Diseases of Pancreas.  

National Technical Information Service (NTIS)

The aggregate impact of 5 major diseases of the pancreas on mortality and morbidity in the U.S. is major. These diseases are diabetes, cystic fibrosis, acute and chronic pancreatitis, and carcinoma of the exocrine pancreas. The last of these is clearly in...

D. S. Longnecker

1976-01-01

94

Pancreas-Preserving Approach to "Paraduodenal Pancreatitis" Treatment: Why, When, and How? Experience of Treatment of 62 Patients with Duodenal Dystrophy  

PubMed Central

Background. The term “paraduodenal pancreatitis” (PP) was proposed as a synonym for duodenal dystrophy (DD) and groove pancreatitis, but it is still unclear what organ PP originates from and how to treat it properly. Objective. To assess the results of different types of treatment for PP. Method. Prospective analysis of 62 cases of PP (2004–2013) with histopathology of 40 specimens was performed; clinical presentation was assessed and the results of treatment were recorded.??Results. Preoperative diagnosis was correct in all the cases except one (1.9%). Patients presented with abdominal pain (100%), weight loss (76%), vomiting (30%), and jaundice (18%). CT, MRI, and endoUS were the most useful diagnostic modalities. Ten patients were treated conservatively, 24 underwent pancreaticoduodenectomies (PD), pancreatico- and cystoenterostomies (8), Nakao procedures (5), duodenum-preserving pancreatic head resections (5), and 10 pancreas-preserving duodenal resections (PPDR) without mortality. Full pain control was achieved after PPRDs in 83%, after PDs in 85%, and after PPPH resections and draining procedures in 18% of cases. Diabetes mellitus developed thrice after PD. Conclusions. PD is the main surgical option for PP treatment at present; early diagnosis makes PPDR the treatment of choice for PP; efficacy of PPDR for DD treatment provides proof that so-called PP is an entity of duodenal, but not “paraduodenal,” origin. PMID:24995273

Egorov, V. I.; Vankovich, A. N.; Petrov, R. V.; Starostina, N. S.; Butkevich, A. Ts.; Sazhin, A. V.; Stepanova, E. A.

2014-01-01

95

Multimodality Imaging Evaluation of an Uncommon Entity: Esophageal Heterotopic Pancreas  

PubMed Central

A 25-year-old male was referred to the Radiology Department with new onset of right upper quadrant and epigastric abdominal pain. He had no past medical or surgical history. Physical exam was unremarkable. The patient underwent computed tomography (CT), fluoroscopic upper gastrointestinal (GI) evaluation, endoscopic ultrasound (EUS), and positron emission tomography (PET) evaluation, revealing the presence of a heterogeneous esophageal mass. In light of imaging findings and clinical workup, the patient was ultimately referred for thorascopic surgery. Surgical findings and histology confirmed the diagnosis of esophageal heterotopic pancreas. PMID:24744946

Mack, Takman; Lowry, Debra; Carbone, Peter; Barbick, Brian; Kindelan, Joshua; Marks, Robert

2014-01-01

96

Aspergillus vertebral osteomyelitis after simultaneous kidney-pancreas transplantation.  

PubMed

Aspergillus osteomyelitis is a rare complication of invasive aspergillosis after organ transplantation. This is the report of a 46-year-old man who underwent a simultaneous pancreas and kidney transplantation, complicated by an Aspergillus osteomyelitis and diskitis of the lumbar spine. Prompt diagnosis with needle biopsy, followed by antifungal therapy using caspofungin, a new antifungal agent recommended for the treatment of refractory aspergillosis, in combination with amphotericin B and an early surgical intervention led to clinical resolution of the infection. Reported cases of spinal aspergillosis after transplantation are reviewed in terms of clinical presentation, risk factors, therapeutic options, and outcome. PMID:14987203

Salvalaggio, P R O; Bassetti, M; Lorber, M I; Micheletto, G C; Friedman, A L; Andriole, V T; Basadonna, G P

2003-12-01

97

Which preoperative respiratory evaluation?  

PubMed

The preoperative respiratory evaluation aims at predicting the occurrence of postoperative respiratory complications (PORC), such as: atelectasis, pulmonary infection (bronchitis and pneumonia), acute ventilatory distress, pleural effusion, prolonged mechanical ventilation, exacerbation of chronic respiratory disease and bronchospasm. The incidence of (PORC) all surgeries combined is 6.8%. Individual surgical and anesthetic factors are impacting on the occurrence of PORC. Simple scores, including anamnestic data, clinical examination and some biological parameters were validated to assess the risk of PORC depending on the type of surgery. Data from standard pulmonary function tests (PFT) is of little use to estimate the individual risk of PORC. Most of the time, PFT abnormal parameters only confirm the clinical assessment of the severity of the illness. PFT may however be useful to confirm an improvement in the clinical condition of the patient related to the preoperative preparation. Specialized EFR, including standardized testing efforts are sometimes required in the case of lung reduction surgery. These specialized explorations can predict lung function and post-interventional pulmonary oxygenation and ensure that these are viable. PMID:25168302

Zraier, S; Haouache, H; Dhonneur, G

2014-01-01

98

Robotic surgery of the pancreas  

PubMed Central

Pancreatic surgery is one of the most challenging and complex fields in general surgery. While minimally invasive surgery has become the standard of care for many intra-abdominal pathologies the overwhelming majority of pancreatic surgery is performed in an open fashion. This is attributed to the retroperitoneal location of the pancreas, its intimate relationship to major vasculature and the complexity of reconstruction in the case of pancreatoduodenectomy. Herein, we describe the application of robotic technology to minimally invasive pancreatic surgery. The unique capabilities of the robotic platform have made the minimally invasive approach feasible and safe with equivalent if not better outcomes (e.g., decreased length of stay, less surgical site infections) to conventional open surgery. However, it is unclear whether the robotic approach is truly superior to traditional laparoscopy; this is a key point given the substantial costs associated with procuring and maintaining robotic capabilities.

Joyce, Daniel; Morris-Stiff, Gareth; Falk, Gavin A; El-Hayek, Kevin; Chalikonda, Sricharan; Walsh, R Matthew

2014-01-01

99

Acute appendicitis in a kidney-pancreas transplant recipient: report of a case.  

PubMed

The prompt diagnosis and management of acute surgical conditions in immunocompromised solid organ transplant recipients are of critical importance. These conditions may or may not be related or to the transplanted allograft(s). This is a case report of a 41-year-old woman who received a simultaneous pancreas-kidney transplant. Nine years after the transplant, she developed acute appendicitis with a periappendiceal abscess and a fecalith, and she was treated with percutaneous drainage of the abscess and eventual semielective appendectomy. This is the first known report of acute appendicitis in a pancreas allograft recipient in the English literature. PMID:17112922

Verzaro, R M; Khan, A; Falcone, J L; Thai, N; Shapiro, R

2006-11-01

100

Preoperative chemotherapy in esophageal carcinoma  

Microsoft Academic Search

Preoperative chemotherapy for localized esophageal cancer is an area of increasing interest because neither surgery nor radiation has had a major impact on disease-free or overall survival. This is probably because, as several autopsy series have demonstrated, esophageal cancer is a systemic disease. Preoperative chemotherapy thus, in theory, allows a simultaneous attack on both the primary and metastatic disease. A

D. P. Kelsen

1987-01-01

101

Hydatid cyst of the pancreas: Report of an undiagnosed case of pancreatic hydatid cyst and brief literature review  

PubMed Central

AIM: To overview the literature on pancreatic hydatid cyst (PHC) disease, a disease frequently misdiagnosed during preoperative radiologic investigation. METHODS: PubMed, Medline, Google Scholar, and Google databases were searched to identify articles related to PHC using the following keywords: hydatid cyst, hydatid disease, unusual location of hydatid cyst, hydatid cyst and pancreas, pancreatic hydatid cyst, and pancreatic echinococcosis. The search included letters to the editor, case reports, review articles, original articles, meeting presentations and abstracts that had been published between January 2010 and April 2014 without any restrictions on language, journal, or country. All articles identified and retrieved which contained adequate information on the study population (including patient age and sex) and disease and treatment related data (such as cyst size, cyst location, and clinical management) were included in the study; articles with insufficient demographic and clinical data were excluded. In addition, we evaluated a case of a 48-year-old female patient with PHC who was treated in our clinic. RESULTS: A total of 58 patients, including our one new case, (age range: 4 to 70 years, mean ± SD: 31.4 ± 15.9 years) were included in the analysis. Twenty-nine of the patients were female, and 29 were male. The information about cyst location was available from studies involving 54 patients and indicated the following distribution of locations: pancreatic head (n = 21), pancreatic tail (n = 18), pancreatic body and tail (n = 8), pancreatic body (n = 5), pancreatic head and body (n = 1), and pancreatic neck (n = 1). Extra-pancreatic locations of hydatid cysts were reported in the studies involving 44 of the patients. Among these, no other focus than pancreas was detected in 32 of the patients (isolated cases) while 12 of the patients had hydatid cysts in extra-pancreatic sites (liver: n = 6, liver + spleen + peritoneum: n = 2, kidney: n = 1, liver + kidney: n = 1, kidney + peritoneum: n = 1 and liver + lung: n = 1). Serological information was available in the studies involving 40 patients, and 21 of those patients were serologically positive and 15 were serologically negative; the remaining 4 patients underwent no serological testing. Information about pancreatic cyst size was available in the studies involving 42 patients; the smallest cyst diameter reported was 26 mm and the largest cyst diameter reported was 180 mm (mean ± SD: 71.3 ± 36.1 mm). Complications were available in the studies of 16 patients and showed the following distribution: cystobiliary fistula (n = 4), cysto-pancreatic fistula (n = 4), pancreatitis (n = 6), and portal hypertension (n = 2). Postoperative follow-up data were available in the studies involving 48 patients and postoperative recurrence data in the studies of 51 patients; no cases of recurrence occurred in any patient for an average follow-up duration of 22.5 ± 23.1 (range: 2-120) mo. Only two cases were reported as having died on fourth (our new case) and fifteenth days respectively. CONCLUSION: PHC is a parasitic infestation that is rare but can cause serious pancreato-biliary complications. Its preoperative diagnosis is challenging, as its radiologic findings are often mistaken for other cystic lesions of the pancreas.

Akbulut, Sami; Yavuz, Ridvan; Sogutcu, Nilgun; Kaya, Bulent; Hatipoglu, Sinan; Senol, Ayhan; Demircan, Firat

2014-01-01

102

Lymphoepithelial cyst of the pancreas: report of a case.  

PubMed

The aim of this report is to describe the clinical and pathological features of a lympoepithelial cyst of the pancreas and to recommend fine-needle aspiration biopsy for the differential diagnosis of this lesion. A 55-year-old man was incidentally diagnosed as having a pancreatic tumor by abdominal ultrasonography. A hypoechoic cystic lesion was detected on the surface of the pancreatic body. A computed tomography revealed a cystic lesion surrounded by a smooth, flat wall. Magnetic resonance imaging revealed that the lesion was a low-intensity mass on the T1-image and a slightly high-intensity mass on the T2-image. The lesion was diagnosed as a benign cystic tumor, and enucleation of the tumor was scheduled. The fine needle aspiration biopsy was performed after laparotomy, and cytology of the contents was negative for malignant cells. The postoperative pathological diagnosis was a lymphoepithelial cyst of the pancreas. This cyst is an unusual but benign mass that requires minimal surgery. PMID:18705339

Kobayashi, Tsutomu; Shimura, Tatsuo; Araki, Ken-ichiro; Ogawa, Atsushi; Mochida, Yasushi; Suzuki, Hideki; Suehiro, Taketoshi; Kuwano, Hiroyuki

2008-01-01

103

Imaging of neuroendocrine tumors of the pancreas  

Microsoft Academic Search

Summary  \\u000a Background. Neuroendocrine tumors of the pancreas are uncommon neoplasms of the pancreas that can occur sporadically or in association\\u000a with various syndromes such as multiple endocrine neoplasia type 1 (MEN 1). Patients can present with a specific clinical\\u000a syndrome related to biochemically functioning tumors or with nonspecific symptoms related to mass effect or metastases. The\\u000a size, function, consistency, and

Jeff L. Fidler; C. Daniel Johnson

2001-01-01

104

Simultaneous Pancreas-Kidney and Sequential Pancreas-After-Kidney Transplantation. Health Technology Assessment Number 4.  

National Technical Information Service (NTIS)

Simultaneous pancreas-kidney (SPK) or pancreas-after-kidney (PAK) transplantation has been advocated as an alternative to kidney transplant alone (KTA) for type 1 diabetics with end-stage renal disease. Advocates of combined transplant assert that the pro...

T. V. Holohan

1995-01-01

105

Pancreas transplantation. An initial experience with systemic and portal drainage of pancreatic allografts.  

PubMed Central

Pancreas transplantation has evolved dramatically since its introduction in 1966. As new centers for transplantation have developed, the evaluation of complications associated with pancreas transplantation has led to advances in surgical technique. Furthermore, surgical alterations of the pancreas resulting from transplantation (systemic release of insulin and denervation) are of unproven consequence on glucose metabolism. Since 1988, the authors have performed 21 transplants (16 combined pancreas/kidney, 3 pancreas alone, which includes 1 retransplantation, 1 pancreas after previous kidney transplant, and 1 "cluster") in 20 patients aged 18 to 49 years; mean, 35 +/- 1 years. Overall patient survival is 95%. Three pancreatic grafts failed within the first year because of technical failure; one additional pancreas was lost to an immunologic event on postoperative day 449, for an overall pancreatic graft survival of 81%. No renal grafts were lost. To evaluate causes of graft failure, demographic data were compared, which included age and sex of the donor and the recipient, operative time, intraoperative blood transfusion, and ischemic time of the graft. No statistically significant differences were found between groups except for ischemic time (11.7 +/- 6.4 hours for the technical success group versus 19.8 +/- 3.7 hours for the technical failure group; p less than 0.05 by unpaired Student's t test). Quadruple immunosuppression was used, which included prednisone, cyclosporine, azathioprine, and antilymphoblast globulin. A mean of 1.2 (range, 0 to 3) rejection episodes per patient occurred. Mean hospital stay was 24 +/- 11 days. Surgical and infectious complications were evaluated by comparing the technical success (TS) group (n = 17) with the technical failure (TF) group. Surgical complications in the TS group revealed a mean of 1.3 episodes per patient, whereas the TF group had 3.7 episodes per patient. The TS also had a reduced incidence of infectious complications compared with the TF (1.7 versus 4.3 episodes per patient). Cytomegalovirus was common in both groups, accounting for 11 infectious episodes, and occurred on a mean postoperative day of 38. Mean postoperative HbA1C levels dropped to 5 +/- 1% from 11 +/- 3%. The authors developed a new technique that incorporates portal drainage of the pancreatic venous effluent in three recipients. Preoperative metabolic studies disclosed a mean fasting glucose of 211 +/- 27 mg/dL and a mean stimulated glucose value of 434 +/- 41 mg/dL for all patients; the mean fasting insulin was 23 +/- 4 microU/mL.(ABSTRACT TRUNCATED AT 400 WORDS) Images FIG. 5. PMID:1632680

Rosenlof, L K; Earnhardt, R C; Pruett, T L; Stevenson, W C; Douglas, M T; Cornett, G C; Hanks, J B

1992-01-01

106

Strategy to differentiate autoimmune pancreatitis from pancreas cancer  

PubMed Central

Autoimmune pancreatitis (AIP) is a newly described entity of pancreatitis in which the pathogenesis appears to involve autoimmune mechanisms. Based on histological and immunohistochemical examinations of various organs of AIP patients, AIP appears to be a pancreatic lesion reflecting a systemic “IgG4-related sclerosing disease”. Clinically, AIP patients and patients with pancreatic cancer share many features, such as preponderance of elderly males, frequent initial symptom of painless jaundice, development of new-onset diabetes mellitus, and elevated levels of serum tumor markers. It is of uppermost importance not to misdiagnose AIP as pancreatic cancer. Since there is currently no diagnostic serological marker for AIP, and approach to the pancreas for histological examination is generally difficult, AIP is diagnosed using a combination of clinical, serological, morphological, and histopathological features. Findings suggesting AIP rather than pancreatic cancer include: fluctuating obstructive jaundice; elevated serum IgG4 levels; diffuse enlargement of the pancreas; delayed enhancement of the enlarged pancreas and presence of a capsule-like rim on dynamic computed tomography; low apparent diffusion coefficient values on diffusion-weighted magnetic resonance image; irregular narrowing of the main pancreatic duct on endoscopic retrograde cholangiopancreatography; less upstream dilatation of the main pancreatic duct on magnetic resonance cholangiopancreatography, presence of other organ involvement such as bilateral salivary gland swelling, retroperitoneal fibrosis and hilar or intrahepatic sclerosing cholangitis; negative work-up for malignancy including endoscopic ultrasound-guided fine needle aspiration; and steroid responsiveness. Since AIP responds dramatically to steroid therapy, accurate diagnosis of AIP can avoid unnecessary laparotomy or pancreatic resection. PMID:22416175

Takuma, Kensuke; Kamisawa, Terumi; Gopalakrishna, Rajesh; Hara, Seiichi; Tabata, Taku; Inaba, Yoshihiko; Egawa, Naoto; Igarashi, Yoshinori

2012-01-01

107

Heterotopic pancreas in Meckel's diverticulum in a 7-year-old child with intussusception and recurrent gastrointestinal bleeding: Case report and literature review focusing on diagnostic controversies.  

PubMed

Meckel's diverticulum, the most common congenital abnormality of the small intestine, may be associated to heterotopic pancreas, often diagnosed incidentally on histopathological examination. Intussusception affects infants between the ages of 5 and 9 months, but it may also occur in older children, teenagers and adults, and in some cases can be derived by a Meckel's diverticulum resulting in acute abdomen. We analyse the management and the recent literature on similar cases, describing diagnostic options. In May 2013, a 7-year-old girl admitted to our hospital with recurrent gastrointestinal bleeding, was discovered to have an ileoileal intussusception with a leading Meckel's diverticulum with heterotopic pancreatic tissue. This association is rare evidence in children and its proper management can be controversial, in particular from a diagnostic point of view. In such cases, preoperative radiological diagnosis can be only suspected in the presence of suggestive signs, more often depicted by ultrasound or computed tomography scan. During laparotomy an accurate exploration of all ileum is recommended, for the possibility to find others heterotopic segments. PMID:25323189

Riccardo, Guanà; Valeria, Bucci; Giulia, Carbonaro; Alessia, Cerrina; Luisa, Ferrero; Elisabetta, Teruzzi; Alessandro, Mussa; Isabella, Morra; Jürgen, Schleef

2014-01-01

108

Hyperinsulinaemic hypoglycaemia: genetic mechanisms, diagnosis and management.  

PubMed

Hyperinsulinaemic hypoglycaemia (HH) is due to the unregulated secretion of insulin from pancreatic ?-cells. A rapid diagnosis and appropriate management of these patients is essential to prevent the potentially associated complications like epilepsy, cerebral palsy and neurological impairment. The molecular basis of HH involves defects in key genes (ABCC8, KCNJ11, GLUD1, GCK, HADH, SLC16A1, HNF4A and UCP2) which regulate insulin secretion. The most severe forms of HH are due to loss of function mutations in ABCC8/KCNJ11 which encode the SUR1 and KIR6.2 components respectively of the pancreatic ?-cell K(ATP) channel. At a histological level there are two major forms (diffuse and focal) each with a different genetic aetiology. The diffuse form is inherited in an autosomal recessive (or dominant) manner whereas the focal form is sporadic in inheritance and is localised to a small region of the pancreas. The focal form can now be accurately localised pre-operatively using a specialised positron emission tomography scan with the isotope Fluroine-18L-3, 4-dihydroxyphenyalanine (18F-DOPA-PET). Focal lesionectomy can provide cure from the hypoglycaemia. However the diffuse form is managed medically or by near total pancreatectomy (with high risk of diabetes mellitus). Recent advances in molecular genetics, imaging with 18F-DOPA-PET/CT and novel surgical techniques have changed the clinical approach to patients with HH. PMID:22231386

Senniappan, Senthil; Shanti, Balasubramaniam; James, Chela; Hussain, Khalid

2012-07-01

109

Health Technology Review No. 11, August 1995. Isolated Pancreas Transplantation.  

National Technical Information Service (NTIS)

Pancreas transplants have been successfully performed and have effectively freed some diabetics from dependence on insulin injections. Most of the transplants have been done as simultaneous pancreas-kidney transplants, with only a small fraction having be...

S. S. Hotta

1995-01-01

110

Software for in Silico Testing of an Articial Pancreas  

E-print Network

Software for in Silico Testing of an Articial Pancreas Master's Thesis By Stefan Høngaard Andersen. A fully automated closed-loop Articial Pancreas (AP) has the potential to become the new stan- dard

111

Fine-needle biopsy of the pancreas: Results of 204 routinely performed biopsies in 190 patients  

Microsoft Academic Search

Two-hundred and four fine-needle aspiration biopsies of the pancreas have been performed in 190 patients during a 12-year period. Sixty-one of these were performed percutaneously guided by endoscopic retrograde cholangio-pancreatography, percutaneous transhepatic cholangiography, angiography, or ultrasonography; and 143 were taken intraoperatively. In 77 (67%) out of 115 patients with pancreatic cancer, a correct cytological diagnosis was obtained. Two biopsies were

Odd Søreide; Elsa Skaarland; Ole M. Pedersen; Trond B. Larssen; Bo Arnesjø

1985-01-01

112

Agenesis of dorsal pancreas confirmed by three-dimensional reconstruction CT  

PubMed Central

Agenesis of the dorsal pancreas (ADP) is a rare congenital pancreatic malformation in which all or part of the dorsal pancreatic body is absent. ADP is usually confirmed by magnetic resonance cholangiopancreatography (MRCP) or endoscopic retrograde cholangiopancreatography (ERCP), but these methods are undesirable to patients because of strict limitations or invasiveness. We propose abdominal contrast-enhanced and three-dimensional reconstruction CT images as an improved method for ADP diagnosis, and present a case study of ADP confirmed with these methods.

Zhou, Yang; Chen, Munan; Liu, Yang

2014-01-01

113

Stenting of the Superior Mesenteric Artery as a Preoperative Treatment for Total Pancreatectomy  

SciTech Connect

The patient was a 58-year-old male with mucinous cyst adenocarcinoma of the pancreas. Prior to total pancreatectomy, preoperative CT and angiography showed a high-grade arteriosclerotic stenosis of about 1.0 cm in length in the ostium of the superior mesenteric artery (SMA), as well as the development of collateral vessels in the area around the head of the pancreas. A stent was placed in the SMA stenosis to preserve the intestinal blood flow in the SMA region after total pancreatectomy, which was performed 25 days after stent placement. The postoperative SMA blood flow was favorable, with no postoperative intestinal ischemia, and the patient had an uneventful postoperative course.

Tanigawa, Noboru, E-mail: tanigano@takii.kmu.ac.jp; Kariya, Shuji; Komemushi, Atsushi [Kansai Medical University, Department of Radiology (Japan); Satoi, Sohei; Kamiyama, Yasuo [Kansai Medical University, 1st Department of Surgery (Japan); Sawada, Satoshi; Kojima, Hiroyuki; Sougawa, Mitsuharu [Kansai Medical University, Department of Radiology (Japan); Takai, Yuichirou [Kansai Medical University, 1st Department of Surgery (Japan)

2004-09-15

114

Cell Stem Cell The Adult Mouse and Human Pancreas Contain  

E-print Network

Cell Stem Cell Article The Adult Mouse and Human Pancreas Contain Rare Multipotent Stem Cells.smukler@utoronto.ca DOI 10.1016/j.stem.2011.01.015 SUMMARY The search for putative precursor cells within the pancreas has been the focus of extensive research. Previously, we identified rare pancreas-derived mul- tipotent

115

Microendoscopes for imaging of the pancreas Angelique Kano*  

E-print Network

Microendoscopes for imaging of the pancreas Angelique Kano* , Andrew R. Rouse, Shona M. Kroto imaging of the pancreas is limited by the small size of the pancreatic duct, which has an average size the miniature endoscope and confocal microendoscope are presented. Keywords: pancreas, cancer, broadfield, white

Gmitro, Arthur F.

116

Expression of Sox Transcription Factors in the Developing Mouse Pancreas  

E-print Network

PATTERNS Expression of Sox Transcription Factors in the Developing Mouse Pancreas Oleg Lioubinski,1 family in the mouse pancreas. We detected transcripts for Sox11, Sox4, Sox13, Sox5, Sox9, Sox8, Sox10, Sox7, Sox17, Sox18, Sox15, and Sox30 in embryonic pancreas and found Sox4, Sox9, and Sox13 in adult

Sander, Maike

117

[Patient blood management--The preoperative patient].  

PubMed

Preoperative anaemia is an independent risk factor for an increase in perioperative morbidity and mortality. Patient Blood Management (PBM) aims for an early detection of anaemia in elective surgery patients. Reasons for anaemia should be detected and causally treated if possible. A multidisciplinary team of specialists aims for diagnosis and causative treatment of easily treatable and frequent causes of anaemia like iron deficiency, bleeding or (autoimmune) haemolysis using patients' specific history, examination, laboratory and technical methods. Such an outpatient PBM programme is only feasible, if anaesthesiologists, surgeons, haematologists, gastroenterologists, gynecologists, laboratory and transfusion medicine specialists work together in a PBM team using a common PBM plan. Communication within this team as well as with the patients' physicians in their private offices is key for a long lasting success of such a PBM programme. PMID:24792598

Müller, Markus M; Fischer, Dania; Stock, Ulrich; Geisen, Christof; Steffen, Björn; Nussbaumer, Judith; Meybohm, Patrick

2014-04-01

118

Carcinoma of the Exocrine Pancreas in Medaka.  

National Technical Information Service (NTIS)

Eight cases of acinar cell carcinoma of the exocrine pancreas were diagnosed in Japanese medaka (Oryzias latipes) from a pool of approximately 10,000 specimens used in a variety of carcinogenesis bioassays. Three cases occurred in specimens from control g...

J. W. Fournie, W. E. Hawkins, M. S. J. Battalora, W. W. Walker

1991-01-01

119

CARCINOMA OF THE EXOCRINE PANCREAS IN MEDAKA  

EPA Science Inventory

Eight cases of acinar cell carcinoma of the exocrine pancreas were diagnosed in Japanese medaka (Oryzias latipes) from a pool of approximately 10,000 specimens used in a variety of carcinogenesis bioassays. hree cases occurred in specimens from control groups and one case in a sp...

120

Polypoid tumors of the major duodenal papilla: preoperative staging with intraductal US, EUS, and CT — a prospective, histopathologically controlled study  

Microsoft Academic Search

Background: An adenoma-carcinoma sequence also applies to adenomas of the major duodenal papilla. Therefore accurate preoperative diagnosis and tumor staging are essential to select the appropriate patients for adequate treatment. In a prospective, histopathologically controlled study of tumors of the main duodenal papilla, the preoperative diagnostic value of ultrasound (US) catheter probes applied during endoscopic retrograde cholangiopancreatography (ERCP) was investigated.

Josef Menzel; Nicolas Hoepffner; Udo Sulkowski; Peter Reimer; Axel Heinecke; Christopher Poremba; Wolfram Domschke

1999-01-01

121

Assessment of the usefulness of the standardized uptake values and the radioactivity levels for the preoperative diagnosis of thyroid cancer measured by using 18F-FDG PET/CT dual-time-point imaging  

NASA Astrophysics Data System (ADS)

The purpose of this study was to assess and compare the changes in the SUV (standardized uptake value), the 18F-FDG (18F-fluorodeoxyglucose) uptake pattern, and the radioactivity level for the diagnosis of thyroid cancer via dual-time-point 18F-FDG PET/CT (positron emission tomographycomputed tomography) imaging. Moreover, the study aimed to verify the usefulness and significance of SUV values and radioactivity levels to discriminate tumor malignancy. A retrospective analysis was performed on 40 patients who received 18F-FDG PET/CT for thyroid cancer as a primary tumor. To set the background, we compared changes in values by calculating the dispersion of scattered rays in the neck area and the lung apex, and by comparing the mean and SD (standard deviation) values of the maxSUV and the radioactivity levels. According to the statistical analysis of the changes in 18F-FDG uptake for the diagnosis of thyroid cancer, a high similarity was observed with the coefficient of determination being R2 = 0.939, in the SUVs and the radioactivity levels. Moreover, similar results were observed in the assessment of tumor malignancy using dual-time-point. The quantitative analysis method for assessing tumor malignancy using radioactivity levels was neither specific nor discriminative compared to the semi-quantitative analysis method.

Lee, Hyeon-Guck; Hong, Seong-Jong; Cho, Jae-Hwan; Han, Man-Seok; Kim, Tae-Hyung; Lee, Ik-Han

2013-02-01

122

Resectable carcinoma developing in the remnant pancreas 7 years and 10 months after distal pancreatectomy for invasive ductal carcinoma of the pancreas: report of a case  

PubMed Central

Background Pancreatic ductal adenocarcinoma, which represents 90% of pancreatic cancers, is one of the most lethal and aggressive malignancies. Operative resection remains the only treatment providing prolonged survival, however, recurrence of pancreatic ductal adenocarcinoma occurs in up to 80% of patients with pancreatic cancer within 2 years of a potential curative resection. There are few reports of pancreatic carcinoma recurrence (primary second cancer) in the remnant pancreas after pancreatectomy. Case presentation A 52-year-old woman underwent a distal pancreatectomy for pancreatic cancer in September 2004. Adjuvant chemotherapy was started after surgery and continued for 4 years. In March 2012, marked elevation of DUPAN-II was observed, followed by an irregular stenotic finding in the main duct. We performed an en bloc resection of the remnant pancreas in July 2012. Histologically, the tumor contained a second primary pancreatic carcinoma with lymph node metastasis. At follow-up 20 months after the second operation, the patient was alive without recurrence. Fourteen cases of resectable cancer developing in the remnant pancreas after a pancreatectomy for cancer have been reported; a minority of these was identified as second primary tumors. Therefore, our patient’s primary second cancer is a rare event. Conclusion The patient is considered to have shown a rare, unique pancreatic cancer recurrence. Persistent elevation of a tumor marker and extensive imaging led to proper diagnosis and treatment. PMID:25034035

2014-01-01

123

Functional reserve capacity of the exocrine pancreas.  

PubMed

The functional reserve capacity of the pancreas, as reflected by the absence of steatorrhea, was correlated with the results of a secretin-pancreozymin test (SPT) in 47 patients with exocrine pancreatic insufficiency due to chronic pancreatitis. The results indicate that a severe reduction in enzyme output (but not in bicarbonate concentration and output) is usually associated with steatorrhea. However, there were a number of patients with steatorrhea despite only moderate enzyme output impairment, while others had normal fat excretion but severely reduced enzyme secretion. Thus, the degree of impaired pancreatic function, as measured by the SPT, cannot be predicted by the presence of steatorrhea; vice versa, a moderately abnormal SPT does not exclude the presence of pancreatic steatorrhea. Therefore, for a sophisticated evaluation of the functional reserve capacity of the exocrine pancreas, both the SPT and fecal fat analysis are considered necessary. The correlation between impaired glucose tolerance and exocrine pancreatic function was poor. PMID:3781113

Lankisch, P G; Lembcke, B; Wemken, G; Creutzfeldt, W

1986-01-01

124

Fine needle aspiration diagnosis of isolated pancreatic tuberculosis: A case report  

PubMed Central

Tuberculosis (TB) involving the pancreas are uncommon, especially when present in immunocompetent hosts. Pancreatic TB is more frequently associated with miliary TB or widely disseminated disease. Pancreatic TB may present as cystic or solid pancreatic masses, pancreatic abscess or acute or chronic pancreatitis. Majority of the cases are diagnosed after surgical exploration for presumed pancreatic malignancy and pre-operative diagnosis is quite difficult. However, improvement in imaging techniques and the resulting image-guided interventions gradually can obviate the need for more invasive diagnostic surgical procedures and expedite the planning of therapy. Herein, we report a rare case of isolated pancreatic TB which presented with pancreatic mass lesion in an immunocompetent host. Diagnosis was made by contrast enhanced computed tomography and guided fine needle aspiration of the pancreatic mass which revealed acid-fast bacilli on Ziehl-Neelsen stain. The case was treated successfully with antituberculous drugs. Pancreatic tuberculosis should be considered in the differential diagnosis of a pancreatic mass when the patient is young, residing in the endemic zone of tuberculosis. Every attempt should be made to diagnose the cases to prevent unnecessary operation. PMID:24303497

Sonthalia, Nikhil; Ray, Sayantan; Pal, Partha; Saha, Avishek; Talukdar, Arunansu

2013-01-01

125

Outcomes of Kidney and Pancreas Transplantation  

Microsoft Academic Search

\\u000a The transplant physician and surgeon need to have a sound understanding of transplant outcomes. The authors review various\\u000a factors that impact survival of kidney and pancreas transplantation. Also discussed are the implications of outcomes data\\u000a on patient and regimen selection. The basic premises of survival analysis and relevant terminology are presented in the context\\u000a of a framework for clinical practice.

Titte R. Srinivas; Herwig-Ulf Meier-Kriesche; Jesse D. Schold

126

Islet Cell Carcinoma of the Pancreas  

Microsoft Academic Search

. Islet cell carcinoma (ICC) of the pancreas is a rare, indolent malignancy associated with higher resectability rate\\u000a and better survival than ductal carcinoma. This retrospective study presents results of surgical treatment from a single institution.\\u000a From 1985 through 1993 a total of 64 patients (36 men, 28 women) were surgically treated for ICC. Ages ranged from 22 to 80

Chung Yau Lo; Jon A. van Heerden; Geoffrey B. Thompson; Clive S. Grant; Jon Arne Söreide; William S. Harmsen

1996-01-01

127

Pancreas transplants: Evaluation using perfusion scintigraphy  

SciTech Connect

To determine the value of scintigraphic perfusion studies in evaluating pancreas transplant patients, we reviewed 56 of these studies in 22 patients who had 27 transplants. Seventeen patients underwent two or more studies. The perfusion studies were performed with 20 mCi (740 MBq) of 99mTc-DTPA injected as a bolus followed by eight to 16 serial 2-sec images and a 500,000-count immediate static image. Images were evaluated for (1) the time and intensity of pancreatic peak radioactivity relative to the time and intensity of the iliac arterial peak; (2) relative pancreatic to iliac arterial intensity on the static image; and (3) size, homogeneity, and definition of the pancreas. Clinical diagnoses at the time of scintigraphy of normal function (n = 36), rejection (n = 13), pancreatitis (n = 6), or arterial thrombosis (n = 1) were based on insulin requirement, urine amylase, serum glucose, serum amylase, response to therapy, cultures, CT, MR, sonography, scintigraphy with 67Ga or 111In-WBCs, percutaneous drainage results, angiography, surgery, and pathologic examination of resected transplants. Three 99mTc-DTPA perfusion studies showed no pancreatic perfusion, four showed decreasing perfusion on serial studies, and five showed progressive loss of definition of the pancreas on serial studies. Of the three patients with no detectable perfusion, one had a normally functioning transplant, one had arterial thrombosis with transplant infarction, and one had severe rejection with minimal function. Decreasing perfusion was associated with rejection in three patients and pancreatitis in one. Decreasing definition was seen in four patients with rejection and one with pancreatitis. We conclude that perfusion scintigraphy is useful, primarily when performed serially, although nonspecific for evaluating pancreas transplants.

Kuni, C.C.; du Cret, R.P.; Boudreau, R.J.

1989-07-01

128

FFTF preoperational survey. Program report  

SciTech Connect

The FFTF will become operational with criticality early in 1980. This facility is composed of the test reactor, fuel examination cells, expended fuel storage systems and fuel handling systems. The reactor and storage systems are sodium-cooled with the heat load dumped to the ambient air through heat exchangers. In order to assure that the operation of the FFTF has minimal impact on the environment, a monitoring program has been established. Prior to operation of a new facility, a preoperational environmental survey is required. It is the purpose of this report to briefly describe the environmental survey program and to provide the background data obtained during the preoperational phase of the survey program. Nine stations in the program of particular importance to FFTF are discussed in detail with results of monitoring given. No unexplained trends were noted.

Twitty, B.L.; Bicehouse, H.J.

1980-12-01

129

Intraductal Papillary Mucinous Neoplasm of the Pancreas: An Update  

PubMed Central

Intraductal papillary mucinous neoplasm (IPMN) is a cystic tumor of the pancreas. The etiology is unknown, but increasing evidence suggests the involvement of several tumorigenesis pathways, including an association with hereditary syndromes. IPMN occurs more commonly in men, with the mean age at diagnosis between 64 and 67 years old. At the time of diagnosis, it may be benign, with or without dysplasia, or frankly malignant with an invasive carcinoma. Tumors arising from the main pancreatic duct are termed main-duct IPMNs, those involving the branch ducts, branch-duct IPMNs. In general, small branch-duct IPMNs are benign, particularly in asymptomatic patients, and can be safely followed. In contrast, main-duct tumors should be surgically resected and examined carefully for an invasive component. In the absence of invasion, patient's survival is excellent, from 94 to 100%. For patients with an IPMN-associated invasive carcinoma, the prognosis overall is better than those with a de novo pancreatic ductal adenocarcinoma, with a 5-year survival of 40% to 60% in some series. However, no survival advantage can be demonstrated if the invasive component in an IPMN patient is that of the conventional tubular type (versus mucinous carcinoma). Several histomorphologic variants are recognized, although the clinical significance of this “subtyping” is not well defined. PMID:24278753

Xiao, Shu-Yuan

2012-01-01

130

Encephalitis caused by human herpesvirus-6B in pancreas-after-kidney transplantation.  

PubMed

Human herpesvirus-6 (HHV-6) is a common pathogen among children, classically presenting with fever and rash that resolves without specific therapy. HHV-6 can be reactivated in the immunosuppressed patient. After bone marrow and solid organ transplantation, HHV-6 has been linked to various clinical syndromes, including undifferentiated febrile illness, encephalitis, myelitis, hepatitis, pneumonitis, and bone marrow suppression. However, HHV-6 encephalitis after pancreatic transplant has rarely been reported. Early diagnosis and treatment of HHV-6 encephalitis may be important for affected patients. We report the case of a 53-year-old pancreas-after-kidney transplant recipient who initially presented with high fever and confusion 3 weeks after operation. We managed to save the patient's life and preserve the pancreas graft function. We also review previously reported cases of HHV-6B encephalitis in solid organ transplant recipients. PMID:25040797

Yamamoto, T; Watarai, Y; Goto, N; Horikoshi, Y; Yamada, S; Yasui, K; Tsujita, M; Hiramitsu, T; Narumi, S; Katayama, A; Uchida, K; Kobayashi, T

2014-10-01

131

Acute gallbladder torsion - a continued pre-operative diagnostic dilemma  

PubMed Central

Acute gallbladder volvulus continues to remain a relatively uncommon process, manifesting itself usually during exploration for an acute surgical abdomen with a presumptive diagnosis of acute cholecystitis. The pathophysiology is that of mechanical organo-axial torsion along the gallbladder's longitudinal axis involving the cystic duct and cystic artery, and with a pre-requisite of local mesenteric redundancy. The demographic tendency is septua- and octo-genarians of the female sex, and its overall incidence is increasing, this being attributed to increasing life expectancy. We discuss two cases of elderly, fragile women presenting to the emergency department complaining of sudden onset right upper quadrant abdominal pain. Their subsequent evaluation suggested acute cholecystitis. Ultimately both were taken to the operating room where the correct diagnosis of gallbladder torsion was made. Pre-operative diagnosis continues to be a major challenge with only 4 cases reported in the literature diagnosed with pre-operative imaging; the remainder were found intra-operatively. Consequently, a delay in diagnosis can have devastating patient outcomes. Herein we propose a necessary high index of suspicion for gallbladder volvulus in the outlined patient demographic with symptoms and signs mimicking acute cholecystitis. PMID:21489292

2011-01-01

132

Posttraumatic intrahepatic biloma: sonographic diagnosis  

SciTech Connect

Posttraumatic intrahepatic biliary cysts or bilomas were once thought to be rare. With increased use of sonography and /sup 99m/Tc-HIDA cholescintigraphy, this entity will probably be detected more often. Preoperative sonographic diagnosis of posttraumatic biloma was made in five patients. A well circumscribed, anechoic hepatic lesion with excellent distal sonic enhancement strongly suggests the diagnosis. Cholescintigraphy especially using delayed scans or percutaneous aspiration, can confirm the diagnosis.

Esensten, M.; Ralls, P.W.; Colletti, P.; Halls, J.

1983-02-01

133

The molecular mechanisms, diagnosis and management of congenital hyperinsulinism.  

PubMed

Congenital hyperinsulinism (CHI) is the result of unregulated insulin secretion from the pancreatic ?-cells leading to severe hypoglycaemia. In these patients it is important to make an accurate diagnosis and initiate the appropriate management so as to avoid hypoglycemic episodes and prevent the potentially associated complications like epilepsy, neurological impairment and cerebral palsy. At a genetic level abnormalities in eight different genes (ABCC8, KCNJ11, GLUD1, GCK, HADH, SLC16A1, HNF4A and UCP2) have been reported with CHI. Loss of function mutations in ABCC8/KCNJ11 lead to the most severe forms of CHI which are usually medically unresponsive. At a histological level there are two major subgroups, diffuse and focal, each with a different genetic etiology. The focal form is sporadic in inheritance and is localized to a small region of the pancreas whereas the diffuse form is inherited in an autosomal recessive (or dominant) manner. Imaging using a specialized positron emission tomography scan with the isotope fluroine-18 L-3, 4-dihydroxyphenyalanine (18F-DOPA-PET-CT) is used to accurately locate the focal lesion pre-operatively and if removed can cure the patient from hypoglycemia. Understanding the molecular mechanisms, the histological basis, improvements in imaging modalities and surgical techniques have all improved the management of patients with CHI. PMID:23776849

Senniappan, Senthil; Arya, Ved Bhushan; Hussain, Khalid

2013-01-01

134

Osteoclastic giant cell tumor of the pancreas?  

PubMed Central

INTRODUCTION Pancreatic giant cell tumors are rare, with an incidence of less than 1% of all pancreatic tumors. Osteoclastic giant cell tumor (OGCT) of the pancreas is one of the three types of PGCT, which are now classified as undifferentiated carcinoma with osteoclast-like giant cells. PRESENTATION OF CASE The patient is a 57 year old woman who presented with a 3 week history of epigastric pain and a palpable abdominal mass. Imaging studies revealed an 18 cm × 15 cm soft tissue mass with cystic components which involved the pancreas, stomach and spleen. Exploratory laparotomy with distal pancreatectomy, partial gastrectomy and splenectomy was performed. Histology revealed undifferentiated pancreatic carcinoma with osteoclast-like giant cells with production of osteoid and glandular elements. DISCUSSION OGCT of the pancreas resembles benign-appearing giant cell tumors of bone, and contain osteoclastic-like multinucleated cells and mononuclear cells. OGCTs display a less aggressive course with slow metastasis and lymph node spread compared to pancreatic adenocarcinoma. Due to the rarity of the cancer, there is a lack of prospective studies on treatment options. Surgical en-bloc resection is currently considered first line treatment. The role of adjuvant therapy with radiotherapy or chemotherapy has not been established. CONCLUSION Pancreatic giant cell tumors are rare pancreatic neoplasms with unique clinical and pathological characteristics. Osteoclastic giant cell tumors are the most favorable sub-type. Surgical en bloc resection is the first line treatment. Long-term follow-up of patients with these tumors is essential to compile a body of literature to help guide treatment. PMID:24631915

Temesgen, Wudneh M.; Wachtel, Mitchell; Dissanaike, Sharmila

2014-01-01

135

A case report of anaplastic carcinoma of the pancreas with remarkable intraductal tumor growth into the main pancreatic duct  

PubMed Central

We herein report a case of anaplastic carcinoma of the pancreas with remarkable intraductal tumor growth into the main pancreatic duct. A 76-year-old male was referred to our hospital for treatment of a pancreatic tumor. Preoperative examinations revealed a poorly defined tumor in the main pancreatic duct in the body of the pancreas, accompanied with severe dilatation of the main pancreatic duct, which was diagnosed as an intraductal papillary-mucinous neoplasm. We performed distal pancreatectomy and splenectomy. The pathological examination revealed that the tumor consisted of a mixture of anaplastic carcinoma (giant cell type) and adenocarcinoma in the pancreas. There was a papillary projecting tumor composed of anaplastic carcinoma in the dilated main pancreatic duct. The patient is now receiving chemotherapy because liver metastasis was detected 12 mo after surgery. In this case, we could observe a remarkable intraductal tumor growth into the main pancreatic duct. We also discuss the pathogenesis and characteristics of this rare tumor with specific tumor growth. PMID:24574758

Okazaki, Mitsuyoshi; Makino, Isamu; Kitagawa, Hirohisa; Nakanuma, Shinichi; Hayashi, Hironori; Nakagawara, Hisatoshi; Miyashita, Tomoharu; Tajima, Hidehiro; Takamura, Hiroyuki; Ohta, Tetsuo

2014-01-01

136

A case report of anaplastic carcinoma of the pancreas with remarkable intraductal tumor growth into the main pancreatic duct.  

PubMed

We herein report a case of anaplastic carcinoma of the pancreas with remarkable intraductal tumor growth into the main pancreatic duct. A 76-year-old male was referred to our hospital for treatment of a pancreatic tumor. Preoperative examinations revealed a poorly defined tumor in the main pancreatic duct in the body of the pancreas, accompanied with severe dilatation of the main pancreatic duct, which was diagnosed as an intraductal papillary-mucinous neoplasm. We performed distal pancreatectomy and splenectomy. The pathological examination revealed that the tumor consisted of a mixture of anaplastic carcinoma (giant cell type) and adenocarcinoma in the pancreas. There was a papillary projecting tumor composed of anaplastic carcinoma in the dilated main pancreatic duct. The patient is now receiving chemotherapy because liver metastasis was detected 12 mo after surgery. In this case, we could observe a remarkable intraductal tumor growth into the main pancreatic duct. We also discuss the pathogenesis and characteristics of this rare tumor with specific tumor growth. PMID:24574758

Okazaki, Mitsuyoshi; Makino, Isamu; Kitagawa, Hirohisa; Nakanuma, Shinichi; Hayashi, Hironori; Nakagawara, Hisatoshi; Miyashita, Tomoharu; Tajima, Hidehiro; Takamura, Hiroyuki; Ohta, Tetsuo

2014-01-21

137

Xanthogranulomatous Cholecystitis Masquerading as Gallbladder Cancer: Can It Be Diagnosed Preoperatively?  

PubMed Central

Background. Xanthogranulomatous cholecystitis (XGC) is often misdiagnosed as gallbladder cancer (GBC). We aimed to determine the preoperative characteristics that could potentially aid in an accurate diagnosis of XGC masquerading as GBC. Methods. An analysis of patients operated upon with a preoperative diagnosis of GBC between January 2008 and December 2012 was conducted to determine the clinical and radiological features which could assist in a preoperative diagnosis of XGC. Results. Out of 77 patients who underwent radical cholecystectomy, 16 were reported as XGC on final histopathology (Group A), while 60 were GBC (Group B). The incidences of abdominal pain, cholelithiasis, choledocholithiasis, and acute cholecystitis were significantly higher in Group A, while anorexia and weight loss were higher in Group B. On CT, diffuse gallbladder wall thickening, continuous mucosal line enhancement, and submucosal hypoattenuated nodules were significant findings in Group A. CT findings on retrospect revealed at least one of these findings in 68.7% of the cases. Conclusion. Differentiating XGC from GBC is difficult, and a definitive diagnosis still necessitates a histopathological examination. An accurate preoperative diagnosis requires an integrated review of clinical and characteristic radiological features, the presence of which may help avoid radical resection and avoidable morbidity in selected cases.

Rammohan, Ashwin; Cherukuri, Sathya D.; Sathyanesan, Jeswanth; Palaniappan, Ravichandran; Govindan, Manoharan

2014-01-01

138

Resection of the uncinate process of the pancreas due to a ganglioneuroma  

PubMed Central

A 33-year-old woman who presented with epigastric discomfort and diarrhea underwent an abdominal ultrasound (US). This investigation and subsequent contrast-enhanced computed tomography, magnetic resonance imaging and endoscopic US with fine needle aspiration (FNA) revealed a 40 mm well-circumscribed mass in the uncinate process of the pancreas. Findings were suggestive of a mucinous or solid-cystic pseudopapillary tumor of the pancreas, although other lesions such as a non-functioning neuroendocrine tumor could not be ruled out. FNA samples were negative for malignant cells, but of limited value due to poor cellularity. It was decided to surgically remove the tumor because malignancy could not be discounted. Multiple intraoperative biopsies were suggestive of mesenchymal tumor and consequently a conservative resection (uncinatectomy) was performed. The postoperative course was uneventful. The definitive diagnosis was ganglioneuroma. Immunocytochemistry showed positive staining with vimentin, S-100 protein, neurofilament and neuron-specific enolase. Ganglioneuroma is a rare benign tumor that can also present as a pancreatic tumor. Uncinatectomy is feasible, safe and a good surgical technique for the treatment of non-malignant tumors located in the uncinate process of the pancreas. PMID:19750580

Poves, Ignasi; Burdio, Fernando; Iglesias, Mar; Martinez-Serrano, Maria de los Angeles; Aguilar, Guadalupe; Grande, Luis

2009-01-01

139

Lymphoepithelial cysts and cystic lymphangiomas: Under-recognized benign cystic lesions of the pancreas  

PubMed Central

AIM: To identify their diagnostic and prognostic clinical characteristics in a large series. METHODS: Retrospective review of clinicopathologic and imaging characteristics of patients diagnosed with lymphoepithelial cysts and cystic lymphangiomas of the pancreas at Massachusetts General Hospital. RESULTS: Twelve patients were identified between 1/1/1997 and 8/1/2007. Their median age was 55.5 years (range 19-78 years), and 6 were females. The lesion was incidentally discovered in half of the patients. Contrast enhanced computed tomography demonstrated that the cysts had thin walls, without calcifications, pancreatic duct dilation or pancreatic parenchyma invasion. Endoscopic ultrasound with fine needle aspiration (EUS/FNA) confirmed the diagnosis of a lymphoepithelial cyst in 3 patients, one of whom was spared an operation and continues to do well after 6 years. Eleven patients had a resection: 3 pancreaticoduodenectomies, 7 distal pancreatectomies, and 1 enucleation. The median size of the cysts was 3 cm (range 2-20 cm). At a median follow-up of 57 mo no recurrences or other pancreas-related conditions occurred. CONCLUSION: Lymphoepithelial cysts and cystic lymphangiomas of the pancreas can be diagnosed with a combination of contrast-enhanced computed tomography scans and EUS/FNA. If the lesion is asymptomatic, an operation might be avoided. PMID:25068011

Konstantinidis, Ioannis T; Kambadakone, Avinash; Catalano, Onofrio A; Sahani, Dushyant V; Deshpande, Vikram; Forcione, David G; Wargo, Jennifer A; Fernandez-del Castillo, Carlos; Lillemoe, Keith D; Warshaw, Andrew L; Ferrone, Cristina R

2014-01-01

140

Pancreas-preserving total gastrectomy for proximal gastric cancer  

Microsoft Academic Search

Lymph node (LN) dissection along the upper border of the pancreas is one of the essential parts of curative surgery for gastric cancer, and the distal portion of the pancreas was frequently resected for complete removal of LNs along the splenic artery. Hoever, pancreatic juice leakage, subphrenic abscess, and postoperative diabetes were common complications in patients treated by pancreatic resection.

Keiichi Maruyama; Mitsuru Sasako; Taira Kinoshita; Takeshi Sano; Hitoshi Katai; Kazuo Okajima

1995-01-01

141

Prenatal Three-Dimensional Sonographic Findings Associated with Annular Pancreas  

Microsoft Academic Search

Annular pancreas is a rare developmental anomaly that accounts for 1% of neonatal intestinal obstructions. For the first time, we describe 3D sonographic findings associated with this condition. In addition to stringent diagnostic criteria based on 2D ultrasound, this case suggests the possible contribution of 3D ultrasound in rare cases of suspected annular pancreas. Verification of prenatal findings was performed

Robert Dankovcik; Stela Muranska; Eduard Kucera; Jan Evangelista Jirasek; Jaroslav Feyereisl; Milan Sudak; Marek Dudas

2010-01-01

142

Autonomous and Continuous Adaptation of a Bihormonal Bionic Pancreas in Adults and  

E-print Network

Autonomous and Continuous Adaptation of a Bihormonal Bionic Pancreas in Adults and Adolescents pancreas algorithm, initialized with only subject weight; to adapt automatically to the different insulin

143

Total pancreatectomy for recurrent intraductal papillary mucinous carcinoma in remnant pancreas of pancreaticoduodenectomy for intraductal papillary mucinous adenocarcinoma.  

PubMed

A 62-year-old man underwent pancreaticoduodenectomy (PD) for intraductal papillary mucinous carcinoma (IPMC) in 2006. No signs of adenocarcinoma at the resection margin were found by intraoperative pathological examination of frozen sections. The postoperative pathological diagnosis was invasive carcinoma derived from IPMC and moderately differentiated tubular adenocarcinoma. A blood analysis in 2011 showed serum (CA19-9) to be increased since the initial resection. Imaging test showed a recurrent tumour at the site of the pancreaticogastrostomy (PG) in the remnant pancreas. We conducted total remnant pancreatectomy for recurrent IPMC and partial gastrectomy. Because both lesions had a histopathological resemblance, the pathological diagnosis was recurrent invasive IPMC. Based on this experience, it is important to facilitate early detection by annual check-up. And also, we recommend PG as a reconstructive intervention in patients at high risk of IPMC recurrence in the remnant pancreas following PD as it is grossly visible on upper gastrointestinal endoscopy. PMID:23709152

Ohkura, Yu; Sasaki, Kazunari; Matsuda, Masamichi; Hashimoto, Masaji

2013-01-01

144

Preoperative Imaging Staging of Rectal Cancer  

Microsoft Academic Search

Carcinomas of the rectum are associated with a significant local and distant recurrence rate. Not all patients are appropriate candidates for preoperative radiation therapy. Preoperative identification of those most likely to benefit from neoadjuvant therapy is important. There is no general consensus on the role of endorectal ultrasonography, computed tomography (CT), and magnetic resonance imaging (MRI) in staging patients with

A. H. Karantanas; S. Yarmenitis; N. Papanikolaou; N. Gourtsoyiannis

2007-01-01

145

The Preoperative Assessment of Hepatic Tumours: Evaluation of UK Regional Multidisciplinary Team Performance.  

PubMed

Introduction. In the UK, patients where liver resection is contemplated are discussed at hepatobiliary multidisciplinary team (MDT) meetings. The aim was to assess MDT performance by identification of patients where radiological and pathological diagnoses differed. Materials and Methods. A retrospective review of a prospectively maintained database of all cases undergoing liver resection from March 2006 to January 2012 was performed. The presumed diagnosis as a result of radiological investigation and MDT discussion is recorded at the time of surgery. Imaging was reviewed by specialist gastrointestinal radiologists, and resultswereagreedonby consensus. Results. Four hundred and thirty-eight patients were studied. There was a significant increase in the use of preoperative imaging modalities (P ? 0.01) but no change in the rate of discrepant diagnosis over time. Forty-two individuals were identified whose final histological diagnosis was different to that following MDT discussion (9.6%). These included 30% of patients diagnosed preoperatively with hepatocellular carcinoma and 25% with cholangiocarcinoma of a major duct. Discussion. MDT assessment of patients preoperatively is accurate in terms of diagnosis. The highest rate of discrepancies occurred in patients with focal lesions without chronic liver disease or primary cancer, where hepatocellular carcinoma was overdiagnosed and peripheral cholangiocarcinoma underdiagnosed, where particular care should be taken. Additional care should be taken in these groups and preoperative multimodality imaging considered. PMID:24062601

Wiggans, M G; Jackson, S A; Fox, B M T; Mitchell, J D; Aroori, S; Bowles, M J; Armstrong, E M; Shirley, J F; Stell, D A

2013-01-01

146

The Preoperative Assessment of Hepatic Tumours: Evaluation of UK Regional Multidisciplinary Team Performance  

PubMed Central

Introduction. In the UK, patients where liver resection is contemplated are discussed at hepatobiliary multidisciplinary team (MDT) meetings. The aim was to assess MDT performance by identification of patients where radiological and pathological diagnoses differed. Materials and Methods. A retrospective review of a prospectively maintained database of all cases undergoing liver resection from March 2006 to January 2012 was performed. The presumed diagnosis as a result of radiological investigation and MDT discussion is recorded at the time of surgery. Imaging was reviewed by specialist gastrointestinal radiologists, and resultswereagreedonby consensus. Results. Four hundred and thirty-eight patients were studied. There was a significant increase in the use of preoperative imaging modalities (P ? 0.01) but no change in the rate of discrepant diagnosis over time. Forty-two individuals were identified whose final histological diagnosis was different to that following MDT discussion (9.6%). These included 30% of patients diagnosed preoperatively with hepatocellular carcinoma and 25% with cholangiocarcinoma of a major duct. Discussion. MDT assessment of patients preoperatively is accurate in terms of diagnosis. The highest rate of discrepancies occurred in patients with focal lesions without chronic liver disease or primary cancer, where hepatocellular carcinoma was overdiagnosed and peripheral cholangiocarcinoma underdiagnosed, where particular care should be taken. Additional care should be taken in these groups and preoperative multimodality imaging considered. PMID:24062601

Wiggans, M. G.; Jackson, S. A.; Fox, B. M. T.; Mitchell, J. D.; Aroori, S.; Bowles, M. J.; Armstrong, E. M.; Shirley, J. F.; Stell, D. A.

2013-01-01

147

Control of Cell Identity in Pancreas Development and Regeneration  

PubMed Central

The endocrine and exocrine cells in the adult pancreas are not static, but can change differentiation state in response to injury or stress. This concept of cells in flux means that there may be ways to generate certain types of cells (such as insulin-producing ?-cells) and prevent formation of others (such as transformed, neoplastic cells). We review different aspects of cell identity in the pancreas, discussing how cells achieve their identity during embryonic development and maturation, and how this identity remains plastic, even in the adult pancreas. PMID:23622126

Stanger, Ben Z.; Hebrok, Matthias

2013-01-01

148

Simultaneous pancreas kidney transplantation in the HIV-positive patient.  

PubMed

HIV is no longer an absolute contraindication to solid organ transplantation. However, few reports have been published with regards to pancreas or simultaneous pancreas kidney transplantation in the HIV-positive recipient. We report, to our knowledge, the first simultaneous pancreas kidney transplantation (SPK) performed in an HIV-positive patient in the United Kingdom. We reflect on the article recently published by Miro et al in Transplantation Proceedings and highlight strategies used by our department to prevent drug interactions in these complex patients. PMID:22172869

Akhtar, M Z; Patel, N; Devaney, A; Sinha, S; Shankar, S; Vaidya, A; Friend, P J

2011-12-01

149

Percutaneous Ultrasound-Guided Pancreas Allograft Biopsy: A Single-Center Experience  

Microsoft Academic Search

Percutaneous ultrasound-guided pancreas allograft biopsy is the preferred technique for evaluating pancreas allograft rejection. Experience from large centers has shown it to be safe and effective. We report our experience with 120 percutaneous allograft biopsies performed at a single center. Biopsy tissue was obtained in 54 patients. Thirty-three patients received simultaneous pancreas and kidney transplants, 14 received isolated pancreas transplants,

S. K. Malek; S. Potdar; J. A. Martin; M. Tublin; R. Shapiro; J. J. Fung

2005-01-01

150

Pulmonary tuberculosis in an HIV- and hepatitis C virus-coinfected kidney-pancreas transplant recipient: a case report.  

PubMed

Tuberculosis (TB) is a serious infection in immunocompromised patients, such as solid organ transplant recipients and HIV-infected patients. The diagnosis and treatment in this population present several challenges because of the aspecific clinical manifestations, the difficulty in diagnosis, and the choice of the most appropriate therapeutic regimen. Therapeutic challenges arise from drug-related toxicities, interactions between immunosuppressive, antiretroviral, and antituberculous drugs. We present a case of primary TB infection that occurred 3 years after transplantation in a HIV-and hepatitis C virus-coinfected kidney-pancreas recipient. The infection was successfully treated with no hepatotoxicity or rejection with a non-rifampin-containing regimen. PMID:21620090

Dalla Gasperina, D; Tozzi, M; Astuti, N; Balsamo, M L; Donati, D; Rossi, A; Dionigi, R; Grossi, P A

2011-05-01

151

Cholangiocarcinoma: preoperative biliary drainage (Con)  

PubMed Central

Aim. In patients with malignant hilar obstruction, liver resection is associated with an increased risk of postoperative liver failure attributed to the need for major liver resection in a context of obstructive jaundice. To overcome this issue, most authors recommend preoperative biliary drainage (PBD). However, PBD carries risks of its own, including, primarily, sepsis and, more rarely, tumor seeding, bile peritonitis, and hemobilia. We, unlike most authors, have not used routine PBD before liver resection in jaundiced patients. Material and methods. Our series includes 62 patients who underwent major liver resection for cholangiocarcinoma; 33 of these had elevated bilurubin (60–470 µmol/l) and were operated without PBD. There were 43 extended right hepatectomies and 18 extended left hepatectomies. Results. Hospital deaths occurred in 5 patients (8%) including 3 of 33 jaundiced patients (9%, ns). All deaths occurred after extended right hepatectomy (12%), including 3 patients with a serum bilirubin level above 300 µmol/l and 2 with normal bilirubin. There were no deaths after left-sided resections, whatever the level of bilirubin. Conclusions. PBD can be omitted in the following situations: recent onset jaundice (<2–3 weeks), total bilirubin <200 µmol/l, no previous endoscopic or transhepatic cholangiography, absence of sepsis, future liver remnant >40%. These criteria include most patients requiring left-sided resections and selected patients requiring right-sided resections. In other cases, PBD is required, associated with portal vein embolization in the event of a small future liver remnant. PMID:18773089

Laurent, A.; Tayar, C.

2008-01-01

152

[Primary lymphoma of the rectum: diagnosis and treatment].  

PubMed

The authors report a rare case of primary rectal lymphoma non Hodgkin in a young non HIV infected man. Preoperative diagnostic problems, the standards for classification and staging and the proper treatment are briefly discussed. The importance of an accurate histological and immunohistochemical study on preoperative multiple biopsies for a correct diagnosis, staging and treatment, are emphasised in this report. PMID:7659268

De Toma, G; Sgarzini, G; Gabriele, R; Campli, M; Plocco, M; Limiti, M R

1995-03-01

153

Double-Nuclide Subtraction Scintiscanning of the Pancreas.  

National Technical Information Service (NTIS)

The paper intends to find out if there is a correlation between clinical pancreas diagnoses and diagnoses by subtraction scintiscanning; furthermore, the findings of scintiscanning are compared with those of radiological and sonographic methods. In order ...

E. C. Streithoff

1978-01-01

154

Recurrence of autoimmunity in pancreas transplant patients: research update  

PubMed Central

SUMMARY Type 1 diabetes is an autoimmune disorder leading to loss of pancreatic ?-cells and insulin secretion, followed by insulin dependence. Islet and whole pancreas transplantation restore insulin secretion. Pancreas transplantation is often performed together with a kidney transplant in patients with end-stage renal disease. With improved immunosuppression, immunological failures of whole pancreas grafts have become less frequent and are usually categorized as chronic rejection. However, growing evidence indicates that chronic islet autoimmunity may eventually lead to recurrent diabetes, despite immunosuppression to prevent rejection. Thus, islet autoimmunity should be included in the diagnostic work-up of graft failure and ideally should be routinely assessed pretransplant and on follow-up in Type 1 diabetes recipients of pancreas and islet cell transplants. There is a need to develop new treatment regimens that can control autoimmunity, as this may not be effectively suppressed by conventional immunosuppression. PMID:21927622

Pugliese, Alberto; Reijonen, Helena K; Nepom, Jerry; Burke, George W

2011-01-01

155

What You Need to Know about Cancer of the Pancreas  

MedlinePLUS

... in the pancreas . This disease is also called pancreatic cancer. In 2013, more than 45,000 Americans will ... years old. There are two main types of pancreatic cancer. Most often, pancreatic cancer starts in the ducts ...

156

Idiopathic retroperitoneal fibrosis of the pancreas versus pancreatic carcinoma.  

PubMed

We report one of few cases of idiopathic retroperitoneal fibrosis of the pancreas, which is different from the classical retroperitoneal fibrosis that affects ureters and vessels that mimicking locally advanced pancreatic carcinoma at presentation. PMID:20699053

Baker, Bilal; Salameh, Habeeb; Daoud, Faiez

2010-10-01

157

Proteomic analysis of pancreas derived from adult cloned pig  

SciTech Connect

The potential medical applications of animal cloning include xenotransplantation, but the complex molecular cascades that control porcine organ development are not fully understood. Still, it has become apparent that organs derived from cloned pigs may be suitable for transplantation into humans. In this study, we examined the pancreas of an adult cloned pig developed through somatic cell nuclear transfer (SCNT) using two-dimensional electrophoresis (2-DE) and Western blotting. Proteomic analysis revealed 69 differentially regulated proteins, including such apoptosis-related species as annexins, lamins, and heat shock proteins, which were unanimously upregulated in the SCNT sample. Among the downregulated proteins in SCNT pancreas were peroxiredoxins and catalase. Western blot results indicate that several antioxidant enzymes and the anti-apoptotic protein were downregulated in SCNT pancreas, whereas several caspases were upregulated. Together, these data suggest that the accumulation of reactive oxygen species (ROS) in the pancreas of an adult cloned pig leads to apoptosis.

Chae, Jung-Il; Cho, Young Keun [Centre for Regenerative Medicine, Korea Research Institute of Bioscience and Biotechnology (KRIBB), 111 Gwahangno, Yuseong-gu, Daejeon 305-806 (Korea, Republic of); Cho, Seong-Keun [Division of Applied Life Science, College of Agriculture and Life Science, Gyeongsang National University, Jinju, GyeongNam (Korea, Republic of); Kim, Jin-Hoi [Department of Animal Biotechnology, College of Animal Bioscience and Technology, KonKuk University, Seoul (Korea, Republic of); Han, Yong-Mahn [Department of Biological Sciences, Korea Advanced Institute of Science and Technology, Daejeon 305-701 (Korea, Republic of); Koo, Deog-Bon [Centre for Regenerative Medicine, Korea Research Institute of Bioscience and Biotechnology (KRIBB), 111 Gwahangno, Yuseong-gu, Daejeon 305-806 (Korea, Republic of)], E-mail: dbkoo@kribb.re.kr; Lee, Kyung-Kwang [Centre for Regenerative Medicine, Korea Research Institute of Bioscience and Biotechnology (KRIBB), 111 Gwahangno, Yuseong-gu, Daejeon 305-806 (Korea, Republic of)], E-mail: leekk@kribb.re.kr

2008-02-08

158

Testosterone biotransformation by the isolated perfused canine pancreas  

SciTech Connect

There is strong evidence indicating that the pancreas is under the influence of sex steroid hormones, and that it may even participate in their biosynthesis and metabolism. In the present study, (3H)testosterone was perfused into the isolated canine pancreas, and measured in the effluent with several of its metabolites (5 alpha-dihydrotestosterone, androstenedione, and estradiol). Results show that testosterone is readily transformed by the canine pancreas. The main product found in the effluent is androstenedione. The testis and spleen were also perfused with (3H)testosterone and used as controls. In both cases, this hormone appeared mostly unchanged in the effluent as compared to the pancreatic perfusion (p less than 0.0001). From our data, we conclude that the canine pancreas has the capacity to transform sex steroid hormones, and could be considered an extragonadal site of sex steroid biosynthesis.

Fernandez-del Castillo, C.; Diaz-Sanchez, V.; Varela-Fascinetto, G.; Altamirano, A.; Odor-Morales, A.; Lopez-Medrano, R.M.; Robles-Diaz, G. (Instituto Nacional de la Nutricion Salvador Zubiran, Mexico City (Mexico))

1991-01-01

159

Endovascular Management of Acute Enteric Bleeding from Pancreas Transplant  

SciTech Connect

Arterioenteric fistula is a rare but serious complication of enteric drained pancreas transplant, which may lead to massive gastrointestinal bleeding. We present 3 patients with failed enteric drained pancreas transplants and massive gastrointestinal bleeding secondary to arterioenteric fistula. One patient was treated by embolization and the 2 others by stent graft placement. Bleeding was successfully controlled in all cases, at follow up of 5 days, 8 months, and 12 months, respectively. One patient died 24 days after embolization, of unknown causes.

Semiz-Oysu, Aslihan; Cwikiel, Wojciech [University of Michigan Hospital, Vascular and Interventional Radiology (United States)], E-mail: cwikiel@umich.edu

2007-04-15

160

Preoperative prediction of severe postoperative pain.  

PubMed

We developed and validated a prediction rule for the occurrence of early postoperative severe pain in surgical inpatients, using predictors that can be easily documented in a preoperative setting. A cohort of surgical inpatients (n=1416) undergoing various procedures except cardiac surgery and intracranial neurosurgery in a University Hospital were studied. Preoperatively the following predictors were collected: age, gender, type of scheduled surgery, expected incision size, blood pressure, heart rate, Quetelet index, the presence and severity of preoperative pain, health-related quality of life the (SF-36), Spielberger's State-Trait Anxiety Inventory (STAI) and the Amsterdam Preoperative Anxiety and Information Scale (APAIS). The outcome was the presence of severe postoperative pain (defined as Numeric Rating Scale > or =8) within the first hour postoperatively. Multivariate logistic regression in combination with bootstrapping techniques (as a method for internal validation) was used to derive a stable prediction model. Independent predictors of severe postoperative pain were younger age, female gender, level of preoperative pain, incision size and type of surgery. The area under the receiver operator characteristic (ROC) curve was 0.71 (95% CI: 0.68-0.74). Adding APAIS scores (measures of preoperative anxiety and need for information), but not STAI, provided a slightly better model (ROC area 0.73). The reliability of this extended model was good (Hosmer and Lemeshow test p-value 0.78). We have demonstrated that severe postoperative pain early after awakening from general anesthesia can be predicted with a scoring rule, using a small set of variables that can be easily obtained from all patients at the preoperative visit. Before this internally validated preoperative prediction rule can be applied in clinical practice to support anticipatory pain management, external validation in other clinical settings is necessary. PMID:14527702

Kalkman, C J; Visser, K; Moen, J; Bonsel, G J; Grobbee, D E; Moons, K G M

2003-10-01

161

[Value of core needle biopsy in preoperative diagnostics of soft tissue tumors : Possibilities and limitations].  

PubMed

The differential diagnosis of soft tissue swellings encompasses a variety of benign, intermediate, low-grade malignant and high-grade neoplastic lesions in addition to tumor-like reactive processes. As treatment of these heterogeneous conditions varies greatly from conservative observation and simple local excision up to extensive radical surgical resection, treatment decisions are based mainly on a precise preoperative histological diagnosis on limited biopsy material. Even for clinically unequivocal sarcomas, the importance of the preoperative histological diagnosis has been increasingly emphasized as different therapeutic regimens have been established for different sarcoma types and the indications for preoperative treatment is influenced by the tumor grade and by the entity itself. Other factors positively influencing the increasing use of core needle biopsy for preoperative tumor diagnosis in soft tissue pathology are the availability of modern high-resolution imaging modalities as well as the establishment of several new second generation immunohistochemical markers and the discovery of entity-specific translocations detected by fluorescence in situ hybridization (FISH) in several sarcoma subtypes. In this review it will be shown that a targeted approach for processing core needle biopsies oriented towards the characteristic topographical, demographic, cytomorphological and architectural features of soft tissue lesions facilitates a precise diagnosis of soft tissue neoplasms in most cases. However, profound knowledge of the different aspects of soft tissue tumor diagnostics and familiarity with the frequent as well as the less common and rare tumor entities and variants is a prerequisite for appropriate interpretation of core needle biopsy findings and for selecting a limited but well-suited marker panel. The utilization of modern immunohistochemistry and/or FISH methods is highly useful for establishing the diagnosis of rare and unusual neoplasms in core needle biopsies. PMID:25394967

Agaimy, A

2014-11-01

162

High precision innovative micropump for artificial pancreas  

NASA Astrophysics Data System (ADS)

The concept of artificial pancreas, which comprises an insulin pump, a continuous glucose meter and a control algorithm, is a major step forward in managing patient with type 1 diabetes mellitus. The stability of the control algorithm is based on short-term precision micropump to deliver rapid-acting insulin and to specific integrated sensors able to monitor any failure leading to a loss of accuracy. Debiotech's MEMS micropump, based on the membrane pump principle, is made of a stack of 3 silicon wafers. The pumping chamber comprises a pillar check-valve at the inlet, a pumping membrane which is actuated against stop limiters by a piezo cantilever, an anti-free-flow outlet valve and a pressure sensor. The micropump inlet is tightly connected to the insulin reservoir while the outlet is in direct communication with the patient skin via a cannula. To meet the requirement of a pump dedicated to closed-loop application for diabetes care, in addition to the well-controlled displacement of the pumping membrane, the high precision of the micropump is based on specific actuation profiles that balance effect of pump elasticity in low-consumption push-pull mode.

Chappel, E.; Mefti, S.; Lettieri, G.-L.; Proennecke, S.; Conan, C.

2014-03-01

163

Microendoscopes for imaging of the pancreas  

NASA Astrophysics Data System (ADS)

Patients diagnosed with pancreatic cancer have a 5-year survival rate of only 3%. Endoscopic imaging of the pancreas is limited by the small size of the pancreatic duct, which has an average size of 3 mm. To improve imaging capabilities for the pancreatic duct, two small catheter-based imaging systems have been developed that will fit through the therapeutic channel of a clinical endoscope and into the pancreatic duct. One is a miniature endoscope designed to provide macro-imaging of tissue with both white light reflectance and fluorescence imaging modes. The 1.75 mm diameter catheter consists of separate illumination and imaging channels. At a nominal focal distance of 10 mm, the field of view of the system is ~ 10 mm, and the corresponding in-plane resolution is 60 microns. To complement the broadfield view of the tissue, a confocal microendoscope with 2 micron lateral resolution over a field of view of 450 microns and 25 micron axial resolution has been developed. With an outer diameter of 3 mm, the catheter in this system will also fit through the therapeutic channel and into the pancreatic duct. Images of tissue with both the miniature endoscope and confocal microendoscope are presented.

Kano, Angelique L.; Rouse, Andrew R.; Kroto, Shona M.; Gmitro, Arthur F.

2004-07-01

164

Transepithelial Bicarbonate Secretion: Lessons from the Pancreas  

PubMed Central

Many cystic fibrosis transmembrane conductance regulator (CFTR)-expressing epithelia secrete bicarbonate (HCO3?)-containing fluids. Recent evidence suggests that defects in epithelial bicarbonate secretion are directly involved in the pathogenesis of cystic fibrosis, in particular by building up hyperviscous mucus in the ductal structures of the lung and pancreas. Pancreatic juice is one of the representative fluids that contain a very high concentration of bicarbonate among bodily fluids that are secreted from CFTR-expressing epithelia. We introduce up-to-date knowledge on the basic principles of transepithelial bicarbonate transport by showing the mechanisms involved in pancreatic bicarbonate secretion. The model of pancreatic bicarbonate secretion described herein may also apply to other exocrine epithelia. As a central regulator of bicarbonate transport at the apical membrane, CFTR plays an essential role in both direct and indirect bicarbonate secretion. The major role of CFTR in bicarbonate secretion would be variable depending on the tissue and cell type. For example, in epithelial cells that produce a low concentration of bicarbonate-containing fluid (up to 80 mm), either CFTR-dependent Cl?/HCO3? exchange or CFTR anion channel with low bicarbonate permeability would be sufficient to generate such fluid. However, in cells that secrete high-bicarbonate-containing fluids, a highly selective CFTR bicarbonate channel activity is required. Therefore, understanding the molecular mechanism of transepithelial bicarbonate transport and the role of CFTR in each specific epithelium will provide therapeutic strategies to recover from epithelial defects induced by hyposecretion of bicarbonate in cystic fibrosis. PMID:23028131

Park, Hyun Woo; Lee, Min Goo

2012-01-01

165

Regeneration of the Pancreas in Adult Zebrafish  

PubMed Central

OBJECTIVE Regenerating organs in diverse biological systems have provided clues to processes that can be harnessed to repair damaged tissue. Adult mammalian ?-cells have a limited capacity to regenerate, resulting in diabetes and lifelong reliance on insulin. Zebrafish have been used as a model for the regeneration of many organs. We demonstrate the regeneration of adult zebrafish pancreatic ?-cells. This nonmammalian model can be used to define pathways for islet-cell regeneration in humans. RESEARCH DESIGN AND METHODS Adult transgenic zebrafish were injected with a single high dose of streptozotocin or metronidazole and anesthetized at 3, 7, or 14 days or pancreatectomized. Blood glucose measurements were determined and gut sections were analyzed using specific endocrine, exocrine, and duct cell markers as well as markers for dividing cells. RESULTS Zebrafish recovered rapidly without the need for insulin injections, and normoglycemia was attained within 2 weeks. Although few proliferating cells were present in vehicles, ablation caused islet destruction and a striking increase of proliferating cells, some of which were Pdx1 positive. Dividing cells were primarily associated with affected islets and ducts but, with the exception of surgical partial pancreatectomy, were not extensively ?-cells. CONCLUSIONS The ability of the zebrafish to regenerate a functional pancreas using chemical, genetic, and surgical approaches enabled us to identify patterns of cell proliferation in islets and ducts. Further study of the origin and contribution of proliferating cells in reestablishing islet function could provide strategies for treating human diseases. PMID:19491207

Moss, Jennifer B.; Koustubhan, Punita; Greenman, Melanie; Parsons, Michael J.; Walter, Ingrid; Moss, Larry G.

2009-01-01

166

Pharmacogenetics in neuroendocrine tumors of the pancreas.  

PubMed

Neuroendocrine tumors (NETs) arise from cells distributed throughout the endocrine system. Although, NETs are heterogeneous in their behavior, they tend to be more aggressive when arising in the pancreas. Pancreatic NET (panNET) represents three percent of all primary pancreatic neoplasms. Symptomatic and progressive panNETs are generally treated with cytotoxic chemotherapy, whereas molecular targeted therapy is used for nonfunctional tumors without aggressive features. Pharmacogenetics has increasingly been used recently to better identify potential targets for therapy and help select patient-specific therapy. In this review, we discuss two abstracts (Abstracts #4113 and #e15169) presented at the ASCO Annual Meeting in Chicago this year, outlining the potential role of tumor gene and gene product profiling in disease management. We describe what is known about the pathogenesis of these tumors, role of decreased gene product expression (MGMT, RRM1, MET) and its application in cytotoxic therapy selection, as well as genetic mutations that can be used for molecular targeted therapy. With an overall shift towards personalized medicine, it has become ever more important to identify the molecular signature of a tumor as it appears to dictate the clinical behavior and response to therapy. PMID:25076325

Rizvi, Syed Mujtaba; Wong, Joyce; Saif, Muhammad Wasif; Jia, Yuxia

2014-07-01

167

Biochemical characterization of salmon pancreas disease virus.  

PubMed

Salmon pancreas disease virus (SPDV) has been shown to cause severe economic losses in farmed Atlantic salmon (Salmo salar) and has been reported to occur in Europe, Scandinavia and the United States. This paper describes the biochemical characterization of SPDV in terms of its RNA and protein composition. SPDV was purified by precipitation from infected Chinook salmon embryo (CHSE-214) cell-culture supernatant and sucrose density-gradient centrifugation. Fractions containing virus were identified by an immunodot blot assay using an SPDV-specific MAb. Two major proteins with molecular masses of approximately 55 and 50 kDa, putatively identified as the E1 and E2 alphavirus glycoproteins respectively, were detected when purified virus preparations were analysed by PAGE. Radiolabelling experiments indicated that SPDV infection of CHSE-214 cells did not shut-off host-cell protein synthesis, making attempts to identify virus-specific proteins unsuccessful. However, radioimmunoprecipitation assay (RIPA) experiments showed that two SPDV-specific MAbs reacted with a protein in the 50-55 kDa range. Northern blot hybridization with cloned cDNA probes indicated that infected cells contained RNA species of approximately 11.4 and 4 kb, which correspond to the genomic and subgenomic RNAs specified by SPDV. The results described are consistent with SPDV being characterized as an alphavirus. PMID:10675419

Welsh, M; Weston, J; Borghmans, B J; Mackie, D; Rowley, H; Nelson, R; McLoughlin, M; Todd, D

2000-03-01

168

The relationship between pre-operative symptoms, operative findings and postoperative complications in schwannomas.  

PubMed

This study presents a retrospective review of the management of schwannomas in the limbs and examines the relationship between pre-operative clinical examination, operative findings and postoperative neurological complications. Eighteen tumours with a histological diagnosis of schwannoma in 17 patients who underwent surgery between 1998 and 2004 were the basis of this study. Enucleation of the tumour was possible in 14 cases. None of these patients had neurological complications pre-operatively but eight had mild neurological complications postoperatively. The complications consisted of sensory deficit in five cases, motor weakness in one and both in two. Enucleation of the tumours was impossible in four cases. These schwannomas originated in the brachial plexus in three cases and the ulnar nerve in the proximal arm in one case. Tumours with pre-operative symptoms and masses located at a proximal site in the limb were more likely to be impossible to enucleate completely. PMID:16928412

Sawada, T; Sano, M; Ogihara, H; Omura, T; Miura, K; Nagano, A

2006-12-01

169

Preoperative biliary drainage for periampullary tumors causing obstructive jaundice; DRainage vs. (direct) OPeration (DROP-trial)  

PubMed Central

Background Surgery in patients with obstructive jaundice caused by a periampullary (pancreas, papilla, distal bile duct) tumor is associated with a higher risk of postoperative complications than in non-jaundiced patients. Preoperative biliary drainage was introduced in an attempt to improve the general condition and thus reduce postoperative morbidity and mortality. Early studies showed a reduction in morbidity. However, more recently the focus has shifted towards the negative effects of drainage, such as an increase of infectious complications. Whether biliary drainage should always be performed in jaundiced patients remains controversial. The randomized controlled multicenter DROP-trial (DRainage vs. Operation) was conceived to compare the outcome of a 'preoperative biliary drainage strategy' (standard strategy) with that of an 'early-surgery' strategy, with respect to the incidence of severe complications (primary-outcome measure), hospital stay, number of invasive diagnostic tests, costs, and quality of life. Methods/design Patients with obstructive jaundice due to a periampullary tumor, eligible for exploration after staging with CT scan, and scheduled to undergo a "curative" resection, will be randomized to either "early surgical treatment" (within one week) or "preoperative biliary drainage" (for 4 weeks) and subsequent surgical treatment (standard treatment). Primary outcome measure is the percentage of severe complications up to 90 days after surgery. The sample size calculation is based on the equivalence design for the primary outcome measure. If equivalence is found, the comparison of the secondary outcomes will be essential in selecting the preferred strategy. Based on a 40% complication rate for early surgical treatment and 48% for preoperative drainage, equivalence is taken to be demonstrated if the percentage of severe complications with early surgical treatment is not more than 10% higher compared to standard treatment: preoperative biliary drainage. Accounting for a 10% dropout, 105 patients are needed in each arm resulting in a study population of 210 (alpha = 0.95, beta = 0.8). Discussion The DROP-trial is a randomized controlled multicenter trial that will provide evidence whether or not preoperative biliary drainage is to be performed in patients with obstructive jaundice due to a periampullary tumor. PMID:17352805

van der Gaag, Niels A; de Castro, Steve MM; Rauws, Erik AJ; Bruno, Marco J; van Eijck, Casper HJ; Kuipers, Ernst J; Gerritsen, Josephus JGM; Rutten, Jan-Paul; Greve, Jan Willem; Hesselink, Erik J; Klinkenbijl, Jean HG; Rinkes, Inne HM Borel; Boerma, Djamila; Bonsing, Bert A; van Laarhoven, Cees J; Kubben, Frank JGM; van der Harst, Erwin; Sosef, Meindert N; Bosscha, Koop; de Hingh, Ignace HJT; Th de Wit, Laurens; van Delden, Otto M; Busch, Olivier RC; van Gulik, Thomas M; Bossuyt, Patrick MM; Gouma, Dirk J

2007-01-01

170

Histological comparison between preoperative and surgical specimens of non-small cell lung cancer for distinguishing between "squamous" and "non-squamous" cell carcinoma  

PubMed Central

Background Non-small cell lung cancers (NSCLCs) are frequently heterogeneous and in approximately 70% of cases, NSCLCs are diagnosed and staged by small biopsies or cytology rather than by examination of surgically resected specimens. Thus, in most patients, the diagnosis is established based on examination of preoperative specimens alone. Recently, classification of NSCLC into pathologic subtypes has been shown to be important for selecting the appropriate systemic therapy, from both the point of view of treatment efficacy and prevention of toxicity. Methods We retrospectively reviewed the data of 225 patients to compare the preoperative classification of the NSCLC subtype on biopsy specimens with the postoperative classification based on examination of the resected specimens, in order to compare the accuracy of the two for the diagnosis of various histological subtypes of NSCLC. Results In 169 of the 225 (75.1%) patients, the preoperative diagnosis was definite malignancy. Histologically, the final pathologic diagnosis made from the surgical specimens was adenocarcinoma (ADC) in 169 patients, and in 75.5% of these cases, the diagnosis was concordant with the preoperative diagnosis. Among the patients who had squamous cell carcinoma (SQC) in the preoperative specimens, the diagnosis was concordant with the preoperative diagnosis in 65.7% of cases. Misclassified preoperative biopsies included an even number of SQCs and ADCs, with all the misclassified biopsies being ADCs morphologically mimicking SQC due to solid growth. Significantly higher specificity, negative predictive value and accuracy were observed for the diagnosis of SQC. Conclusions Our study suggested that the concordance rates for diagnosis of the NSCLC subtypes, especially the "squamous" or "non-squamous" histologies, between preoperative and surgical specimens were satisfactory, as compared with previous reports. Therefore, pretreatment diagnosis of lung cancer using small samples is reasonable for selecting the optimal treatment. However, in order not to lose the opportunity for selecting an effective treatment, we should be aware that the diagnosis in preoperative small samples might be different from that based on examination of the surgical specimens. Virtual Slides The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/2032698427120488 PMID:24885169

2014-01-01

171

Pancreas Transplant Venous Thrombosis: Role of Endovascular Interventions for Graft Salvage  

SciTech Connect

Venous thrombosis of pancreas transplant allografts often leads to graft loss. We evaluated the efficacy of emergent endovascular techniques to salvage thrombosed pancreatic allografts in a series of six patients. Of the 76 pancreas transplants performed between 2002 and 2006, six patients were diagnosed with venous thrombosis on MRI between 2 and 28 days posttransplant (mean, 9 days). Five patients were systemic-enteric (donor portal vein anastomosis to recipient iliac vein) and one patient was portal-enteric (donor portal vein anastomosis to recipient superior mesenteric vein). Conventional venography confirmed the diagnosis of venous thrombosis in all patients. One patient was treated with catheter-directed venous thrombolysis and balloon thrombectomy. Another patient was treated with rheolytic thrombectomy alone. The remaining four patients were treated with a combination of these mechanical and thrombolytic techniques. Completion venography revealed >50% clot reduction and resumption of venous drainage in all patients. One patient required additional intervention 16 days later for recurrent thrombosis. Two patients required metal stent placement for anastomotic stenoses or kinks. One patient required pancreatectomy 36 h after attempted salvage secondary to a major hemorrhage and graft necrosis. Two patients recovered pancreatic function initially but lost graft function at 8 and 14 months, respectively, from severe chronic rejection. Patient survival was 100%, long-term graft survival was 50%, rethrombosis rate was 16.6%, and graft loss from rejection was 33%. In conclusion, early recognition and treatment of venous thrombosis after pancreas transplantation has acceptable morbidity and no mortality using short-term endovascular pharmacomechanical therapy.

Stockland, Andrew H. [Mayo Clinic, Department of Radiology (United States); Willingham, Darrin L. [Mayo Clinic, Department of Transplantation (United States); Paz-Fumagalli, Ricardo [Mayo Clinic, Department of Radiology (United States); Grewal, Hani P. [Mayo Clinic, Department of Transplantation (United States); McKinney, J. Mark [Mayo Clinic, Department of Radiology (United States); Hughes, Christopher B. [Mayo Clinic, Department of Transplantation (United States); Walser, Eric M., E-mail: Walser.eric@mayo.ed [Mayo Clinic, Department of Radiology (United States)

2009-03-15

172

[Results of preoperative preparation with mannitol in colorectal surgery. January-December 1995].  

PubMed

A study on the results obtained in 20 patients selected by the simple randomized method, who were preoperatively prepared for colorectal surgery with the oral administration of manitol and complementary antimicrobial therapeutics at the ASaturnino Lora@ Provincial Teaching Hospital, in Santiago de Cuba, from January to December, 1995, was conducted aimed at evaluating the results attained with the use of manitol in the preoperative preparation for colorectal surgery, determining its complications, analyzing its advantages, and assessing the patient, nurse and surgeon's opinion about the new procedure. The following variables were taken into account: age, preoperative diagnosis and previous operations. The percentage statistical method was used. Most of the patients were elderly, who were able to undergo surgery. There were no complications in connection with the preoperative preparation, which has the following advantages: it is simpler and more efficient that the traditional use of enemas, it is easy to apply, it saves time and resources on reducing the preoperative stay, it is considered as more comfortable for patients and nurses, and it is much more economic and effective, which was proved by surgeons during the operation. PMID:9934233

Torres Panuncia, B; Rodríguez Fernández, Z; Piña Prieto, L R

1998-01-01

173

Sensitivity of EUS and ERCP Endoscopic Procedures in the Detection of Pancreatic Cancer During Preoperative Staging Correlated with CT and CT Angiography Imaging Methods  

PubMed Central

The goal: The goal of this work was to give advantage to EUS as endoscopic method in diagnosis and following therapeutic treatment of pancreatic cancer in relation to radiological methods of CT and CTA. Material and Methods: The study included 49 patients, 20 women and 29 men hospitalized at the Clinic for gastroenterohepatology, due to suspicion on pancreatic cancer during observed 2 years period. All cancers were histologically and cytologically confirmed. The patients underwent ERCP as a mandatory part of staging and all patients underwent endoscopic ultrasound as well as CT or CT angiography. Results: Testing of differences was carried out using Fisher’s exact test in open-source software R. The following characteristics were tested: involvement of the blood vessels, lymph nodes, metastases, tumor size and duodenum infiltration. Results showed statistically significant difference at the 0.05 level for EUS, CT and CT angiography. Risk ratio showed that EUS is less effective in detecting infiltration of blood vessels within a malignant process then CTA where RR=0.52, CI 0.2–1.38, p-value=0.33. EUS and CTA are equal in the diagnosis of enlarged lymph nodes affected by malignancy where RR=1.3, CI 0.75–1.42, p-value=0.09. Comparison according to distant metastases showed that EUS is less effective compared to CT in approximately 30% of cases. In the diagnosis of duodenal infiltration EUS is in 5% of cases less accurate than the CT with the RR=0.95, CI 0.27–3.32, p-value=0.76, but the CTA method is more efficient because the comparison of EUS and CTA showed RR=12.52, CI 0.2–1.38, p-value=0.33. EUS as a diagnostic method is dominant in determining the size of malignant lesions located in the pancreas as compared to CT and CTA. Conclusion: EUS as endoscopic method compared to CT and CTA is one of the more invasive methods of examination but due to its ability to be performed immediately, to locate a changes smaller than 5 mm and the target biopsy option, to measure the change and that in many cases determine the relationship of malignant lesions with blood vessels, along with visualization of the surrounding lymph nodes and metastases in neighboring organs, we may give this method an advantage over other methods in the preoperative staging of patients with pancreatic cancer. PMID:25132706

Vukobrat-Bijedic, Zora; Husic-Selimovic, Azra; Bijedic, Nina; Gornjakovic, Srdjan; Sofic, Amela; Gogov, Bisera; Bjelogrlic, Ivana; Mehmedovic, Amila; Glavas, Sanjin

2014-01-01

174

Preoperative Serum Tumor Marker Levels in Gastric Cancer  

PubMed Central

Objective: Tumor markers have shown little benefit as a method for screening. However, they can be used clinically for the monitoring of tumor recurrence and used as prognostic factors because higher levels have been observed in advanced disease. This study aimed to investigate the relationship between the preoperative tumor marker levels and different clinical aspects of gastric cancer. Methods: One hundred and six consecutive patients with confirmed diagnosis of gastric cancer and 106 subjects (age and sex matched) with no malignancy as control group were included prospectively in this study in 3 years. The relationships between tumor markers CEA, CA 19-9 and stage of disease, tumor differentiation, presence of ringlet cell type, presence of peritoneal carcinomatozis were investigated. Results: The serum CEA and CA 125 levels were found to be significantly elevated in gastric cancer patients than in controls. The serum level of CEA had showed a significant elevation with the presence of distant metastasis. The CA 19-9 and CA 125 levels had showed significant elevations with the presence of peritoneal carcinomatozis. Conclusions: This study showed that there is a limited clinical benefit of preoperative tumor marker measurements in gastric cancer such as estimation of peritoneal dissemination. PMID:24639849

Polat, Erdal; Duman, Ugur; Duman, Mustafa; Derya Peker, Kivanc; Akyuz, Cebrail; Fatih Yasar, Necdet; Uzun, Orhan; Akbulut, Sabiye; Birol Bostanci, Erdal; Yol, Sinan

2014-01-01

175

Allograft tympanoplasty: predictive value of preoperative status.  

PubMed

The functional and anatomical results of a series of 181 consecutive allograft tympanoplasties for ears with drum perforation and an intact ossicular chain were retrospectively reviewed and related to preoperative factors. Drum closure was realized in 92% (166 of 181 cases evaluated 1 year after surgery), and 96.6% of the reconstructed drums were still intact 3 years after surgery (118 cases evaluated). An air-bone gap of less than 21 dB was reached in 79.6% (of a total of 162 cases) 1 year after surgery, and in 78% (of a total of 118 cases) 3 years after surgery. Age, contralateral pathology, the wet or dry status of the ear preoperatively, and the preoperative air-bone gap had no influence on anatomical results. The preoperative air-bone gap did not predict the postoperative air-bone gap. The influence of age and existence of contralateral pathology on hearing gain was only visible in some of the strictly defined patient groups. The wet preoperative status of the ear generally predicted lower functional gain. PMID:2243525

Claes, J; Van de Heyning, P H; Creten, W; Koekelkoren, E; Van Laer, C; De Saegher, D; Graff, A

1990-12-01

176

In vitro pancreas organogenesis from dispersed mouse embryonic progenitors.  

PubMed

The pancreas is an essential organ that regulates glucose homeostasis and secretes digestive enzymes. Research on pancreas embryogenesis has led to the development of protocols to produce pancreatic cells from stem cells (1). The whole embryonic organ can be cultured at multiple stages of development (2-4). These culture methods have been useful to test drugs and to image developmental processes. However the expansion of the organ is very limited and morphogenesis is not faithfully recapitulated since the organ flattens. We propose three-dimensional (3D) culture conditions that enable the efficient expansion of dissociated mouse embryonic pancreatic progenitors. By manipulating the composition of the culture medium it is possible to generate either hollow spheres, mainly composed of pancreatic progenitors expanding in their initial state, or, complex organoids which progress to more mature expanding progenitors and differentiate into endocrine, acinar and ductal cells and which spontaneously self-organize to resemble the embryonic pancreas. We show here that the in vitro process recapitulates many aspects of natural pancreas development. This culture system is suitable to investigate how cells cooperate to form an organ by reducing its initial complexity to few progenitors. It is a model that reproduces the 3D architecture of the pancreas and that is therefore useful to study morphogenesis, including polarization of epithelial structures and branching. It is also appropriate to assess the response to mechanical cues of the niche such as stiffness and the effects on cell´s tensegrity. PMID:25079453

Greggio, Chiara; De Franceschi, Filippo; Figueiredo-Larsen, Manuel; Grapin-Botton, Anne

2014-01-01

177

Rare pancreas tumor mimicking adenocarcinoma: Extramedullary plasmacytoma  

PubMed Central

Neoplastic proliferation of plasma cells is called plasma cell dyscrasias, and these neoplasms can present as a solitary neoplasm or multiple myeloma. Extramedullary plasmacytoma, in particular pancreatic plasmacytoma, is a rare manifestation of multiple myeloma. Although computerized tomography is useful for the diagnosis of extramedullary plasmacytoma, there are no specific radiologic markers that distinguish it from adenocarcinoma. Histological confirmation by biopsy is necessary for accurate diagnosis and management of the tumor. Endosonography is the most sensitive method for the diagnosis of pancreatic tumors, and the use of fine needle aspiration by endosonography is associated with a lower risk for malignant seeding and complications. Here, we report a case of pancreatic plasmacytoma in newly identified multiple myeloma as diagnosed by endosonography. Endosonography is a reliable and rapid method for the diagnosis of extramedullary plasmacytoma. Therefore, endosonographic fine needle aspiration should be the first choice for histological evaluation when pancreatic plasmacytoma is suspected. Ideally, the pathology would be performed at the same site as endosonographic biopsy. PMID:24634714

Akyuz, Filiz; Sahin, Davut; Akyuz, Umit; Vatansever, Sezai

2014-01-01

178

Rare pancreas tumor mimicking adenocarcinoma: Extramedullary plasmacytoma.  

PubMed

Neoplastic proliferation of plasma cells is called plasma cell dyscrasias, and these neoplasms can present as a solitary neoplasm or multiple myeloma. Extramedullary plasmacytoma, in particular pancreatic plasmacytoma, is a rare manifestation of multiple myeloma. Although computerized tomography is useful for the diagnosis of extramedullary plasmacytoma, there are no specific radiologic markers that distinguish it from adenocarcinoma. Histological confirmation by biopsy is necessary for accurate diagnosis and management of the tumor. Endosonography is the most sensitive method for the diagnosis of pancreatic tumors, and the use of fine needle aspiration by endosonography is associated with a lower risk for malignant seeding and complications. Here, we report a case of pancreatic plasmacytoma in newly identified multiple myeloma as diagnosed by endosonography. Endosonography is a reliable and rapid method for the diagnosis of extramedullary plasmacytoma. Therefore, endosonographic fine needle aspiration should be the first choice for histological evaluation when pancreatic plasmacytoma is suspected. Ideally, the pathology would be performed at the same site as endosonographic biopsy. PMID:24634714

Akyuz, Filiz; Sahin, Davut; Akyuz, Umit; Vatansever, Sezai

2014-03-16

179

Frey operation for chronic pancreatitis associated with pancreas divisum: case report and review of the literature  

PubMed Central

Pancreas divisum (PD) is the most common congenital anomaly of the pancreas, which increases susceptibility to recurrent pancreatitis. Usually, after failure of initial endoscopic therapies, surgical treatment combining pancreatic resection or drainage is used. The Frey procedure is used for chronic pancreatitis, but it has not been reported to be applied in an adult patient with PD-associated pancreatitis. The purpose of the paper was to describe effective treatment of this rare condition by the Frey procedure after failure of interventional endoscopic treatment. A 39-year-old female patient was initially treated for recurrent acute pancreatitis. After endoscopic diagnosis of PD, the minor duodenal papilla was incised and a plastic stent was inserted into the dorsal pancreatic duct. During the following 36 months, the patient was hospitalised several times because of recurrent episodes of pancreatitis. Thereafter, local resection of the pancreatic head combined with lateral pancreaticojejunostomy was performed with no complications. After 54 months of follow-up, the patient demonstrates abnormal glucose metabolism, with a need for enzyme supplementation, and she is free of pain. Local resection of the pancreatic head combined with lateral pancreaticojejunostomy (Frey procedure) offers a favourable outcome after failure of endoscopic papillotomy and duct stenting for pancreatitis associated with PD. PMID:25097717

Skorzewska, Magdalena; Romanowicz, Tomasz; Mielko, Jerzy; Kurylcio, Andrzej; Pertkiewicz, Jan; Zymon, Robert

2014-01-01

180

Tissue-specific deletion of c-Jun in the pancreas has limited effects on pancreas formation  

SciTech Connect

It is well known that activating protein-1 (AP-1) is involved in a variety of cellular functions such as proliferation, differentiation, apoptosis, and oncogenesis. AP-1 is a dimer complex consisting of different subunits, and c-Jun is known to be one of its major components. In addition, it has been shown that mice lacking c-Jun are embryonic lethal and that c-Jun is essential for liver and heart development. However, the role of c-Jun in the pancreas is not well known. The aim of this study was to examine the possible role of c-Jun in the pancreas. First, c-Jun was strongly expressed in pancreatic duct-like structures at an embryonic stage, while a lower level of expression was observed in some part of the adult pancreas, implying that c-Jun might play a role during pancreas development. Second, to address this point, we generated pancreas-specific c-Jun knock-out mice (Ptf1a-Cre; c-Jun{sup flox/flox} mice) by crossing Ptf1a-Cre knock-in mice with c-Jun floxed mice. Ptf1a is a pancreatic transcription factor and its expression is confined to pancreatic stem/progenitor cells, which give rise to all three types of pancreatic tissue: endocrine, exocrine, and duct. Contrary to our expectation, however, there was no morphological difference in the pancreas between Ptf1a-Cre; c-Jun{sup flox/flox} and control mice. In addition, there was no difference in body weight, pancreas weight, and the expression of various pancreas-related factors (insulin, glucagon, cytokeratin, and amylase) between the two groups. Furthermore, there was no difference in glucose tolerance between Ptf1a-Cre; c-Jun{sup flox/flox} and control mice. Taken together, although we cannot exclude the possibility that c-Jun ablation is compensated by some unknown factors, c-Jun appears to be dispensable for pancreas development at least after ptf1a gene promoter is activated.

Yamamoto, Kaoru; Miyatsuka, Takeshi; Tanaka, Ayako; Toyoda, Shuichi; Kato, Ken; Shiraiwa, Toshihiko; Fujitani, Yoshio; Yamasaki, Yoshimitsu; Hori, Masatsugu; Matsuhisa, Munehide; Matsuoka, Taka-aki [Department of Internal Medicine and Therapeutics, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka 565-0871 (Japan); Kaneto, Hideaki [Department of Internal Medicine and Therapeutics, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka 565-0871 (Japan)], E-mail: kaneto@medone.med.osaka-u.ac.jp

2007-11-30

181

Mangafodipir trisodium (MnDPDP)-enhanced magnetic resonance imaging of the liver and pancreas.  

PubMed

Contrast-enhanced magnetic resonance imaging (MRI) of the liver and pancreas is frequently performed to improve the sensitivity and specificity of lesion detection in these organs. The concept of using tissue-specific contrast media is to selectively enhance the normal parenchyma, but not lesions, so that the contrast between tumorous and normal tissue is increased, and lesion detectability improved. Mangafodipir trisodium (MnDPDP) has been developed as a hepatocellular-specific contrast agent, but uptake has also been found in pancreatic tissue. In this study the safety and diagnostic efficacy of MnDPDP were investigated in both healthy volunteers and in patients with liver and pancreatic tumors. In healthy volunteers (n = 8), dose-dependent enhancement in T1-weighted images was observed in the normal liver and pancreatic parenchyma after infusion of MnDPDP at doses of 5 and 10 mumol/kg. The maximal enhancement in the two dose groups was 77 and 110% in the liver, and 57 and 84% in the pancreas, respectively. The enhancement-over-time profiles demonstrated that the effective imaging window was about 2 h for the liver, and over 4 h for the pancreas. There was no measurable enhancement in brain structures protected by intact blood-brain barrier, and no changes of clinical importance were found in vital signs or in blood and urinary chemistry variables. Compared with unenhanced images (including T2-weighted images), significantly more lesions were detected on MnDPDP-enhanced T1 images in 82 patients with liver tumors (mostly metastases). Features such as rim enhancement and the enhancement in hepatocellular carcinomas can provide information for differential diagnosis. In a study on patients with pancreatic tumors, mainly adenocarcinomas (n = 21) and islet cell tumors (n = 19), two additional lesions were found in the MnDPDP-enhanced images. The contrast enhancement in the pancreatic parenchyma can vary greatly, depending on the site of the enhancing part of the organ in relation to a large tumor. The tumors of both origins were also enhanced post-contrast, but to a lesser degree than the normal pancreatic tissue. MnDPDP enhancement was investigated in 30 liver metastases from endocrine tumors in 13 patients. These lesions showed a signal increase of about 49% post-contrast, which lasted longer than that in the normal liver tissue. The findings may help to distinguish these tumors from other metastatic tumors. T1-weighted sequences of four types, including a spin-echo and three variants of fast gradient-echo sequences, and various parameter combinations, were investigated in healthy volunteers (n = 6), with the aim of finding the optimal sequence for MnDPDP-enhanced MRI of the liver and pancreas. The fat-and-water out-of-phase, fast field (gradient)-echo sequence was the best for imaging of both the liver and pancreas. The studies have shown that MnDPDP is safe when given as an infusion, and is effective as a liver- and pancreas-specific contrast medium, with improved lesion detection in MRI of these organs. It is also useful for the characterization of liver tumors. PMID:9571956

Wang, C

1998-01-01

182

showed that the calf's pancreas during the trough of the PPS cycle did not secrete the  

E-print Network

showed that the calf's pancreas during the trough of the PPS cycle did not secrete the same pattern). These results demonstrated that the diet containing soybean meal modified the exocrine function of the pancreas

Paris-Sud XI, Université de

183

ULTRASTRUCTURE OF NORMAL AND NEOPLASTIC EXOCRINE PANCREAS IN THE MUMMICHOG, FUNDULUS HETEROLCLITUS  

EPA Science Inventory

The ultrastructure of normal exocrine pancreas and exocrine pancreatic neoplasms in Fundulus heteroclitus from a creosote-contaminated environment in the Elizabeth River, Virginia, is described. he normal exocrine pancreas in this species was an anastomosing tubular rather than a...

184

Incidence of minor and major amputations after pancreas\\/kidney transplantation  

Microsoft Academic Search

Among other complications, diabetes mellitus leads to peripheral vascular disease with the risk of limb amputation. This retrospective study analyzed the incidence of amputations after simultaneous pancreas-kidney transplantation (SPK). Between June 1994 and February 2001, 200 SPKs, nine pancreas-after-kidney- (PAK) and one pancreas transplantation alone (PTA) were performed. The overall 5-year patient, pancreas-, and kidney-graft survival rates were 92.4%, 80.2%

Guido Woeste; Christoph Wullstein; Olaf Pridöhl; Peter Lübke; Rene Schwarz; Kay Kohlhaw; Wolf Otto Bechstein

2003-01-01

185

Pearson marrow pancreas syndrome in patients suspected to have Diamond-Blackfan anemia.  

PubMed

Pearson marrow pancreas syndrome (PS) is a multisystem disorder caused by mitochondrial DNA (mtDNA) deletions. Diamond-Blackfan anemia (DBA) is a congenital hypoproliferative anemia in which mutations in ribosomal protein genes and GATA1 have been implicated. Both syndromes share several features including early onset of severe anemia, variable nonhematologic manifestations, sporadic genetic occurrence, and occasional spontaneous hematologic improvement. Because of the overlapping features and relative rarity of PS, we hypothesized that some patients in whom the leading clinical diagnosis is DBA actually have PS. Here, we evaluated patient DNA samples submitted for DBA genetic studies and found that 8 (4.6%) of 173 genetically uncharacterized patients contained large mtDNA deletions. Only 2 (25%) of the patients had been diagnosed with PS on clinical grounds subsequent to sample submission. We conclude that PS can be overlooked, and that mtDNA deletion testing should be performed in the diagnostic evaluation of patients with congenital anemia. PMID:24735966

Gagne, Katelyn E; Ghazvinian, Roxanne; Yuan, Daniel; Zon, Rebecca L; Storm, Kelsie; Mazur-Popinska, Magdalena; Andolina, Laura; Bubala, Halina; Golebiowska, Sydonia; Higman, Meghan A; Kalwak, Krzysztof; Kurre, Peter; Matysiak, Michal; Niewiadomska, Edyta; Pels, Salley; Petruzzi, Mary Jane; Pobudejska-Pieniazek, Aneta; Szczepanski, Tomasz; Fleming, Mark D; Gazda, Hanna T; Agarwal, Suneet

2014-07-17

186

The circulating hormonal milieu of the endocrine pancreas in healthy individuals, organ donors, and the isolated perfused human pancreas.  

PubMed

Although basal circulating levels of individual islet cell hormones have been measured, few studies compared the molar ratios of the major hormones secreted by the endocrine pancreas. This study examined the basal levels of four major islet hormones: insulin, C-peptide (C-P), glucagon (G), and pancreatic polypeptide (PP) in normal subjects, in organ donors with brain death, and in the isolated perfused human pancreas. Basal blood samples were taken from normal, fasted control subjects (NCs). Pancreata were obtained from 17 organ donors (ODs) with donor portal vein (DPV) and radial arterial (DRA) blood samples taken before organ procurement. Single-pass perfusion was performed on the procured pancreata, and after rewarming and equilibration, basal samples were collected from the splenic vein (SV) for 30 min. Radioimmunoassays of insulin, C-P, G, and PP were performed on all samples, and basal levels of all hormones were expressed as a common unit, femtomoles per milliliter. The data suggest that in the basal state, these four major islet hormones circulate in a relatively constant molar ratio. The ratio of the hormones is altered in brain death and with in vitro perfusion of the pancreas. The isolated perfused human pancreas secretes a relatively constant molar ratio of these hormones; however, this ratio is markedly different from the circulating ratio seen in either the NC group or the OD group. We conclude that a relatively constant hormonal milieu is secreted from the normal endocrine pancreas, and this hormonal milieu is altered after brain death and with isolation and perfusion of the human pancreas. PMID:10975715

Brunicardi, F C; Dyen, Y; Brostrom, L; Kleinman, R; Colonna, J; Gelabert, H; Gingerich, R

2000-08-01

187

Preoperative Localization and Radioguided Parathyroid Surgery  

Microsoft Academic Search

Clinical or subclinical hyperparathyroidism is one of the most com- mon endocrine disorders. Excessive secretion of parathyroid hor- mone is most frequently caused by an adenoma of 1 parathyroid gland. Unsuccessful surgery with persistent hyperparathyroidism, due to inadequate preoperative or intraoperative localization, may be observed in about 10% of patients. The conventional surgical approach is bilateral neck exploration, whereas minimally

Giuliano Mariani; Seza A. Gulec; Domenico Rubello; Giuseppe Boni; Marco Puccini; Maria Rosa Pelizzo; Gianpiero Manca; Dario Casara; Guido Sotti; Paola Erba; Duccio Volterrani; Armando E. Giuliano

188

Pre?operational Children and Educational Television  

Microsoft Academic Search

Statements made about educational television and learning are usually general, but they should refer to specific developmental stages of thought and mental development. Evaluation of the medium's efficacy in pre?operational children's learning has received scant attention. Some suggestions are made whereby production and teachers’ use of programmes can align to Piaget's theory, but this is insufficient. Scope remains for ample

E. Choat

1984-01-01

189

Preoperational test report, vent building ventilation system  

SciTech Connect

This represents a preoperational test report for Vent Building Ventilation Systems, Project W-030. Project W-030 provides a ventilation upgrade for the four Aging Waste Facility tanks. The system provides Heating, Ventilation, and Air Conditioning (HVAC) for the W-030 Ventilation Building. The tests verify correct system operation and correct indications displayed by the central Monitor and Control System.

Clifton, F.T.

1997-11-04

190

PREDICTIVE SURGICAL SIMULATION FOR PREOPERATIVE PLANNING OF  

E-print Network

PREDICTIVE SURGICAL SIMULATION FOR PREOPERATIVE PLANNING OF COMPLEX CARDIOVASCULAR SURGERIES LI PLANNING OF COMPLEX CARDIOVASCULAR SURGERIES LI, HAO (HT050623N) (B.Sc., Fudan University, China, 2005. Leow involved me in the project of cardiovascular surgery simulation in the first place. He taught me

Leow, Wee Kheng

191

Congenital anomaly of pancreas divisum as cause of obstructive pain and pancreatitis  

Microsoft Academic Search

Pancreas divisum occurs when the embryological ventral and dorsal parts of the pancreas fail to fuse, so that pancreatic drainage is mainly through the accessory papilla. In 169 patients with primary biliary tract disease who underwent pancreatography incidental to endoscopic cholangiography, the incidence of pancreas divisum was 3.6%. Among 78 patients with unexplained recurrent pancreatitis, the incidence was 25.6%. The

P B Cotton

1980-01-01

192

Insulin-promoter-factor 1 is required for pancreas development in mice  

Microsoft Academic Search

THE mammalian pancreas is a mixed exocrine and endocrine gland that, in most species, arises from ventral and dorsal buds which subsequently merge to form the pancreas. In both mouse and rat the first histological sign of morphogenesis of the dorsal pancreas is a dorsal evagination of the duodenum at the level of the liver at around the 22-25-somite stage,

Jörgen Jonsson; Lena Carlsson; Thomas Edlund; Helena Edlund

1994-01-01

193

Age-dependent accumulation of recombinant cells in the mouse pancreas revealed by in situ  

E-print Network

Age-dependent accumulation of recombinant cells in the mouse pancreas revealed by in situ in the pancreas throughout life, that HR is induced in vivo by exposure to a cancer chemotherapeutic agent chemotherapeutic agent increase the frequency of recom- binant cells in the pancreas, and it also provides a rapid

Engelward, Bevin

194

Building an artificial pancreas U, Mayo Clinic working to develop a revolutionary treatment  

E-print Network

Fall 2012 Building an artificial pancreas U, Mayo Clinic working to develop a revolutionary are working together to build an artificial pancreas that would eliminate this burden. As part of this work continuous glucose sensor that would make the artificial pancreas a better treatment option. Tackling

Minnesota, University of

195

Nutritional and circadian variations in lipase activity and colipase saturation in rat pancreas  

E-print Network

Nutritional and circadian variations in lipase activity and colipase saturation in rat pancreas was to determine if lipase follows the same pattern as the other hydrolases in the pancreas, and whether variations-hour period. The pancreas was excised and quick-frozen. Lipase content was determined on 10 p. 100

Paris-Sud XI, Université de

196

Enzyme potentialities of the abomasum and pancreas of the calf. II. —  

E-print Network

Enzyme potentialities of the abomasum and pancreas of the calf. II. — Effects of weaning weight in the three groups was similar. At slaughter, the abomasum and pancreas of each animal were to ruminant calves had a depressive effect on the activities of the enzymes (except chymosin), in the pancreas

Paris-Sud XI, Université de

197

FINAL Draft Feb 23 Predicting pancreas cell fate decisions and reprogramming with a  

E-print Network

FINAL Draft Feb 23 Predicting pancreas cell fate decisions and reprogramming with a hierarchical-producing cells from other pancreas cells can be achieved by external modulation of key transcription factors as regenerative medicine, such as insulin-secreting pancreas cells and cardiac muscle cells. However, the current

Ahlers, Guenter

198

RESEARCH ARTICLE Open Access Is there adaptation of the exocrine pancreas in  

E-print Network

RESEARCH ARTICLE Open Access Is there adaptation of the exocrine pancreas in wild animal? The case: Physiology of the exocrine pancreas has been well studied in domestic and in laboratory animals as well death, the pancreas was removed for tissue sample collection and then analyzed. When expressed

Boyer, Edmond

199

Preoperative Anxiety in Candidates for Heart Surgery  

PubMed Central

Objective: The goal of this study was to evaluate preoperative anxiety and its predisposing factors in a group of adult patients who were candidate for any kind of heart surgery. Methods: We evaluated preoperative anxiety in 300 patients undergoing heart surgery whose ages ranged between 18-65 years. Relationship of probable demographic factors like gender, educational level, marital status, number of children, family support, opium addiction, occupational status, and left ventricular ejection fraction (LVEF) with anxiety level of the patients were evaluated. To determine anxiety, the State-Trait Anxiety Inventory (STAI) was completed by the subjects. Results: Descriptive anxiety levels showed that mean of state and trait anxiety of our studied patients were in moderate scaling. Correlation between state and trait anxiety was more prominent in females (r = 0.80) than in males (r = 0.70) (p < 0.001). Distribution of males and females was significantly different (p = 0.048). All the patients had significantly different underlying diseases (p = 0.018), opioid addiction (yes/no) was significantly different in all of the patients (p < 0.001), while family support (yes/no) was not significantly different in all of the patients (p = 0.453). There were significant differences between mean of preoperative anxiety at different LVEF values of any EF level (p < 0.001, F = 6.47); those who had LVEF of more than 50% had significantly lower mean anxiety scores. Conclusion: Preoperative psychiatric consultation should be focused more on women and patients with higher EF. Moreover, physical activity strength may be effective on reducing preoperative anxiety. PMID:25053963

Fathi, Mehdi; Alavi, Seyed Mostafa; Joudi, Marjan; Joudi, Mitra; Mahdikhani, Helia; Ferasatkish, Rasool; Bakhshandeh, Houman; Jabbari Nooghabi, Mehdi

2014-01-01

200

Primary enteric drainage of the pancreas allograft revisited  

Microsoft Academic Search

Background:Historically, primary enteric drainage (ED) of exocrine secretions in pancreas allografts was associated with a poor outcome, mostly as a result of infectious complications. On the other hand, bladder drainage (BD), which is presently used in the majority of institutions, is associated with substantial urologic morbidity. The aim of this study is to reassess the role of primary ED by

Viken Douzdjian; Prathivadi R Rajagopalan

1997-01-01

201

Acinar cell carcinoma with fatty change arising from the pancreas  

PubMed Central

Acinar cell carcinoma of the pancreas is a rare malignant tumour developing from acinar cells, accounting for approximately 1% of pancreatic exocrine tumours. We experienced a case of an acinar cell carcinoma with fatty change. To the best of our knowledge, this is the first case report of an acinar cell carcinoma with fatty change in the clinical literature. PMID:22101587

Chung, W-S; Park, M-S; Kim, D W; Kim, K W

2011-01-01

202

Somatostatin: Abundance of Immunoreactive Hormone in Rat Stomach and Pancreas  

Microsoft Academic Search

Growth hormone release inhibiting hormone (somatostain), a hypothalamic peptide that inhibits the release of growth hormone and also the secretion of insulin, glucagon, and gastrin, was found in the rat stomach and pancreas in a concentration similar to that in the hypothalamus, as measured by radioimmunoassay. Somatostatin was also found in the duodenum and jejunum, but in a smaller concentration.

Akira Arimura; Haruko Sato; Andre Dupont; Nozomu Nishi; Andrew V. Schally

1975-01-01

203

Effect of Glucagon and Insulin on the Isolated Exocrine Pancreas  

Microsoft Academic Search

The effect of insulin and glucagon on exocrine pancreatic secretion (volume and amylase output) was tested in an isolated cat pancreas preparation. Glucagon reversibly inhibited volume and amylase secretion, whereas insulin did not show an influence on fluid and enzyme output.Copyright © 1974 S. Karger AG, Basel

V. Wizemann; P. Weppler; R. Mahrt

1974-01-01

204

Proteomic analysis of pancreas derived from adult cloned pig  

Microsoft Academic Search

The potential medical applications of animal cloning include xenotransplantation, but the complex molecular cascades that control porcine organ development are not fully understood. Still, it has become apparent that organs derived from cloned pigs may be suitable for transplantation into humans. In this study, we examined the pancreas of an adult cloned pig developed through somatic cell nuclear transfer (SCNT)

Jung-Il Chae; Young Keun Cho; Seong-Keun Cho; Jin-Hoi Kim; Yong-Mahn Han; Deog-Bon Koo; Kyung-Kwang Lee

2008-01-01

205

Smith-Lemli-Opitz Syndrome: A Case with Annular Pancreas  

PubMed Central

Smith-Lemli-Opitz syndrome is an autosomal recessive disease of cholesterol metabolism. It is a multiple malformation syndrome with typical dysmorphic features such as bitemporal narrowing, ptosis, epicanthus, microcephaly, micrognathia, and cardiovascular, skeletal, urogenital, and gastrointestinal anomalies. This report presents a typical case of Smith-Lemli-Opitz syndrome with annular pancreas which is an unreported gastrointestinal abnormality. PMID:25165593

Demirdoven, Mehmet; Yazgan, Hamza; Korkmaz, Mevlit; Gebesce, Arzu; Tonbul, Alparslan

2014-01-01

206

Stimulus-secretion coupling in the developing exocrine pancreas  

SciTech Connect

Acinar cells of the embryonic pancreas are filled with zymogen granules containing, among others, the secretory protein, cholecystokinin (CCK) ..cap alpha..-amylase, the rate of amylase secretion from pancreatic lobules incubated in vitro was not increased in response to CCK. In contrast, the rate of CCK-stimulated amylase discharge from the neonatal pancreas was increased 4- to 8-fold above that seen in the embryonic gland. The postnatal amplification of secretory responsiveness was not associated with an increase in the level of /sup 125/I-CCK octapeptide specifically bound/cell equivalent or a change in the affinity of binding. Light microscopic autoradiography revealed a similar /sup 125/I-CCK-33 labeling pattern in pancreatic lobules from both ages with autoradiographic grains specifically localized at the periphery of acinar cells. In order to determine whether CCK binding is coupled to a rise in the cytosolic Ca/sup + +/concentration, (Ca/sup + +/)c, in the embryonic pancreas, /sup 45/Ca/sup + +/ efflux from tracer-loaded lobules was measured. Efflux of /sup 45/Ca/sup + +/ from both embryonic and neonatal pancreas was comparably increased in the presence of CCK.

Chang, A.Y.S.

1986-01-01

207

A novel strategy for long-term implantable artificial pancreas  

Microsoft Academic Search

Technology has recently changed type 1 diabetes treatment by introducing several advancements able to improve patients' quality of life. However, despite of several decades of research efforts, the dream of a fully-automated implanted artificial pancreas is quite far from its realization. The need for periodically restoring the implanted battery charge and refilling the implanted insulin reservoir are the main issues,

Leonardo Ricotti; Tareq Assaf; Arianna Menciassi; Paolo Dario

2011-01-01

208

Potential usefulness of mucin immunohistochemical staining of preoperative pancreatic biopsy or juice cytology specimens in the determination of treatment strategies for intraductal papillary mucinous neoplasm  

PubMed Central

We classified resected intraductal papillary mucinous neoplasms (IPMNs) into four subtypes (gastric, intestinal, pancreatobiliary and oncocytic) according to their morphological features and mucin expression, determined their clinicopathological characteristics and investigated the possibility of preoperatively diagnosing these subtypes. Sixty resected tumors, 4 preoperative tumor biopsies and 10 preoperative pancreatic juice cytology specimens were analyzed. The gastric and intestinal types accounted for the majority of IPMNs. Non-gastric type IPMNs were of high-grade malignancy. Many of the pancreatobiliary-type IPMNs were in an advanced stage and were associated with a poor prognosis. The results of mucin immunohistochemical staining of preoperative biopsy and surgically resected specimens were in agreement with each other, and in close agreement with those for pancreatic juice cytology specimens obtained from 10 patients during endoscopic retrograde cholangiopancreatography (ERCP). The immunostaining of preoperative biopsy specimens and ERCP-obtained pancreatic juice cytology specimens may be useful in the differential diagnosis of gastric and intestinal types of IPMN. If such techniques enable the preoperative diagnosis of IPMN subtypes, their use in combination with conventional preoperative imaging modalities may lead to surgical treatment best suited for the biological characteristics of the four subtypes. PMID:24008495

HISAKA, TORU; HORIUCHI, HIROYUKI; UCHIDA, SHINJI; ISHIKAWA, HIROTO; KAWAHARA, RYUICHI; KAWASHIMA, YUSUKE; AKASHI, MASANORI; MIKAGI, KAZUHIRO; ISHIDA, YUSUKE; OKABE, YOSHINOBU; NAKAYAMA, MASAMICHI; NAITO, YOSHIKI; YANO, HIROHISA; TAIRA, TOMOKI; KAWAHARA, AKIHIKO; KAGE, MASAYOSHI; KINOSHITA, HISAFUMI; SHIROZU, KAZUO

2013-01-01

209

Diagnostic and prognostic significance of different mucin expression, preoperative CEA, and CA-125 in colorectal carcinoma: A clinicopathological study  

PubMed Central

Background: Colorectal carcinoma (CRC) is the fourth most commonly diagnosed malignant disease worldwide, with over 1 million new cases and approximately 5,00,000 deaths each year. Aims and Objectives: This prospective observational study was done to study the clinicopathological characteristics of CRC including mucin stains and correlate the preoperative serum carcinoembryonic antigen (CEA) and cancer antigen (CA)-125 levels with the prognosis. Materials and Methods: A total of 90 CRCs were included from December 2010 to June 2013. Detailed history and relevant clinical/radiological findings were noted in all clinically and/or radiologically suspected cases of CRC. Preoperative blood samples were collected for serum CEA and CA-125 level estimation. The mucin expression was evaluated with special stains. Results: The combined Alcian blue-periodic acid Schiff (PAS) staining was positive for both stains in 68.88% cases indicating that both neutral and acidic mucins are increased in CRC. High preoperative serum CEA levels were seen in 82.22% cases, whereas preoperative serum CA-125 levels showed an increase in 20% cases. Higher levels of these tumor markers corresponded with higher TNM stage. Conclusions: Mucin evaluation in CRCs remains one of the valuable methods as mucinous variants correlate with worse prognosis. Preoperative serum CEA level assessment is an indispensible adjunct to the diagnosis and prognosis of CRC. However, preoperative serum CA-125 level measurement is not an efficient tool for prognostication in CRC and should not be recommended for routine use. PMID:25097424

Jain, Parul; Mondal, Santosh Kumar; Sinha, Swapan Kumar; Mukhopadhyay, Mrityunjoy; Chakraborty, Indranil

2014-01-01

210

[Intraoperative localization of recurrent pancreatic insulinoma-a resected case of the metastatic lesions in the residual pancreas and the lymph node].  

PubMed

We describe herein a 39-year-old woman with tumor recurrence in the residual pancreas and metastasis to the lymph node about 5 years after an eneclation for insulinoma in the body of the pancreas. A certain day in the morning in June 2002, she was immediately admitted to our hospital due to impairment of consciousness based hypoglycemia. On diagnostic imaging including an arterial stimulation venous sampling, localization of the recurrent lesions was not identified. In October 2002, we underwent laparotomy for the purpose of localization of the recurrent lesions and treatment. During the operation, peripheral blood glucose level, portal blood glucose level and portal insulin level were measured periodically. The mobilization started from the tail of the pancreas. Blood glucose levels were gradually elevated during the mobilization. The pancreas was mobilized to the right edge of the portal vein and was resected. Histopathological diagnosis was recurrent insulinoma in a peripancreatic lymph node and intra-pancreatic subcapsular tumor embolization. Postoperative course was uneventful. More than 8 years after surgery, she is doing well without signs of recurrence. PMID:22202272

Fujisaki, Shigeru; Tomita, Ryouichi; Park, Eichi; Hirano, Tomohiro; Sakurai, Kenichi; Takayama, Tadatoshi; Nemoto, Norimichi

2011-11-01

211

Incidence and prediction of invasive disease and nodal metastasis in preoperatively diagnosed ductal carcinoma in situ.  

PubMed

For breast cancer patients with a preoperative diagnosis of ductal carcinoma in situ (DCIS), sentinel lymph node (SN) biopsy has been proposed as an axillary staging procedure in selected patients with a higher likelihood of having occult invasive lesions. With detailed histological examination of primary tumors and molecular whole-node analysis of SNs, we aimed to validate whether this selective application accurately identifies patients with SN metastasis. The subjects were 336 patients with a preoperative needle-biopsy diagnosis of DCIS who underwent SN biopsy using the one-step nucleic acid amplification assay in the period 2009-2011. The incidence and preoperative predictors of upstaging to invasive disease on final pathology and SN metastasis, and their correlation, were investigated. Of the 336 patients, 113 (33.6%) had invasive disease, and 6 (1.8%) and 17 (5.0%) had macro- and micrometastasis in axillary nodes respectively. Of the 113 patients with invasive disease, 4 (3.5%) and 9 (8.0%) had macro- and micrometastasis. Predictors of invasive disease included palpability, mammographic mass, and calcifications (spread >20 mm), and intraductal solid structure, but no predictor was found for SN metastasis. Therefore, even though occult invasive disease was found at final pathology, most of the patients had no metastasis or only micrometastasis in axillary nodes. Predictors of invasive disease and SN metastasis were not completely consistent, so the selective SN biopsy for patients with a higher risk of invasive disease may not accurately identify those with SN metastasis. More accurate application of SN biopsy is required for patients with a preoperative diagnosis of DCIS. PMID:24533797

Osako, Tomo; Iwase, Takuji; Ushijima, Masaru; Horii, Rie; Fukami, Yasuyoshi; Kimura, Kiyomi; Matsuura, Masaaki; Akiyama, Futoshi

2014-05-01

212

New surgical technique for pediatric en-bloc kidney and pancreas transplantation: the pancreas piggy-back.  

PubMed

Combined pancreas and kidney transplantation is the therapy of choice for type I diabetes patients with associated end-stage renal disease. To counterbalance increasing waiting lists, there is a clear need to extend the organ donor pool. Although results following simultaneous pancreas and kidney transplantation (SPK) using pediatric organs are encouraging, there is still reluctance in accepting them. This reflects the fear of graft thrombosis and graft failure because of small vessels and little absolute islet cell mass. Simpler transplant techniques for pediatric SPK might lower this threshold. In this article, a novel technique using a "piggy-back" implantation of the pancreas onto the conduits of en-bloc grafted kidneys, performed in two consecutive cases, is presented. This technique is associated with less vascular manipulation, requiring only one arterial anastomosis onto the frequently arteriosclerotic arteries of the recipient for all three organs. One-year follow-up (14 and 12 months) proved excellent graft function of kidneys and pancreas. PMID:23072376

Waldner, Matthias; Bächler, Thomas; Schadde, Erik; Schiesser, Marc; Immer, Franz; Clavien, Pierre-Alain; Brockmann, Jens Gunther

2013-01-01

213

JOP. J. Pancreas (Online) 2001; 2(4 Suppl):229-236. JOP. Journal of the Pancreas http://www.joplink.net Vol.2, No.4 Suppl. July 2001 229  

E-print Network

JOP. J. Pancreas (Online) 2001; 2(4 Suppl):229-236. JOP. Journal of the Pancreas ­ http) and glycolipids (asialo-GM1, proposed to be an important bacterial binding site on the #12;JOP. J. Pancreas (Online) 2001; 2(4 Suppl):229-236. JOP. Journal of the Pancreas ­ http://www.joplink.net ­ Vol.2, No.4

Machen, Terry E.

214

Preoperative cognitive impairment and psychological distress in hospitalized elderly hip fracture patients.  

PubMed

We conducted a prospective study to evaluate the prevalence of cognitive impairment (CI) in elderly inpatients awaiting surgery for hip fracture, and to compare CI and normal cognition (NC) patients with respect to preoperative pain, fear, and anxiety. The study included patients who were older than 65 years when admitted to a hospital after acute hip fracture. Preoperative assessment involved use of Confusion Assessment Method-Short Form, Montreal Cognitive Assessment (MoCA), visual analog scales for anxiety and fear, and Wong-Baker Faces Pain Scale. Patients with delirium were excluded from the study. Patients with CI and NC, as determined by MoCA score, were compared for each assessment. Of the 65 hip fracture patients enrolled, 62 had evaluable cognitive data. Of these 62 patients, 23 (37.1%) had NC (MoCA score, ? 23) and 39 (62.9%) had CI (MoCA score, < 23). Only 5 (7.7%) of the 65 patients had a documented diagnosis of CI or dementia at time of hospitalization. Mean preoperative pain scores were significantly (P < .001) higher for CI patients (5.3) than for NC patients (2.8). Our study results showed that many elderly hip fracture patients had unrecognized CI before surgery, and CI patients had significantly more pain than NC patients did. Appropriate identification of preoperative CI and treatment of pain are crucial in optimizing patient outcomes. PMID:25046191

Daniels, Alan H; Daiello, Lori A; Lareau, Craig R; Robidoux, Kathryn A; Luo, Wylie; Ott, Brian; Hayda, Roman A; Born, Christopher T

2014-07-01

215

Secondary tumors of the pancreas diagnosed by endoscopic ultrasound-guided fine-needle aspiration: a 10-year experience.  

PubMed

Determining whether a pancreatic mass is a primary or secondary neoplasm is necessary for appropriate treatment. We reviewed our experience using endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) for diagnosis of pancreatic tumors to identify clinical and cytopathologic characteristics of metastatic disease. We reviewed all cases of tumors metastatic to the pancreas evaluated at The University of Texas MD Anderson Cancer Center and The Methodist Hospital in Houston, Texas during the period from 2002 to 2012. The review included cytologic specimens, clinical history, radiologic findings, primary tumor type, and clinical follow-up. We identified 66 patients with disease metastatic to the pancreas for which cytologic material was available: 38 (58%) men and 28 (42%) women, with an average age of 63 years (range, 40-89 years). Most metastases (98%) were single lesions, and nearly half were located in the head of the pancreas (30/66). The most common site of origin for these metastases was kidney (27 [41%] cases). Follow-up information was available for 65 (98%) patients, and duration of follow-up ranged from <1 to 10 years (mean, 2.3 years). Thirty-three patients (50%) were alive at the time of the most recent follow-up contact. Of the 25 patients with metastatic renal cell carcinoma, clear cell type, 19 (76%) were alive at the time of the most recent follow-up. It was concluded that metastases may mimic primary pancreatic carcinomas both clinically and cytologically. Ancillary studies in conjunction with clinical history are necessary for the accurate diagnosis of FNAs of secondary pancreatic tumors. PMID:24554612

Waters, Lindsay; Si, Quisheng; Caraway, Nancy; Mody, Dina; Staerkel, Gregg; Sneige, Nour

2014-09-01

216

Preoperative Embolization of Cervical Spine Tumors  

SciTech Connect

Purpose: To assess the technical success rate, complications, and effect on intraoperative blood loss of preoperative transarterial embolization of cervical spine tumors. Methods: A retrospective analysis was performed on 38 patients with tumors of the cervical spine; 69 vertebrae were affected. Polyvinyl alcohol particles, coils, gelfoam particles, either alone or in combination, were used for preoperative tumor embolization. After embolization a total of 57 corporectomies with titanium basket implantation were performed. Results: In 36 of 38 patients, complete (n= 27) or partial (n= 9) embolization was achieved. In 23 patients one vertebral artery was completely occluded by coil placement, and in one patient the ipsilateral internal and external carotid arteries were occluded in addition. No neurological complications could be directly related to the embolization, but two postoperative brain stem infarctions occurred. The mean intraoperative blood loss was 2.4 L. Conclusion: Transarterial embolization of cervical spine tumors is a safe and effective procedure to facilitate extensive surgery.

Vetter, Sylvia C.; Strecker, Ernst-Peter [Department of Radiology and Nuclear Medicine, Diakonissenkrankenhaus, Diakonissenstrasse 28, D-76199 Karlsruhe (Germany); Ackermann, Ludwig W.; Harms, Juergen [Department of Orthopedic Surgery, Klinikum Karlsbad-Langensteinbach Guttmannstrasse 1, D-76307 Karlsbad (Germany)

1997-09-15

217

CONFIDENTIAL Thank you for your interest in the Pancreas Transplant Program at Massachusetts General Hospital. Below is a list  

E-print Network

General Hospital. Below is a list of all of the medical records required for listing on the kidney/pancreas or pancreas after kidney transplant list, but only the tests indicated with an * are required to initiate meets criteria to be scheduled for a multidisciplinary kidney/pancreas or pancreas after kidney

Mootha, Vamsi K.

218

Behaviour of digestive enzymes in the pancreatic juice and pancreas of rats fed on a low-protein diet  

E-print Network

Behaviour of digestive enzymes in the pancreatic juice and pancreas of rats fed on a low of their secretion. Parraliel studies were carried out on the pancreas and its exocrine secretion. 1) With a low of the pancreas declined. However, during balanced refeeding, the ponderal weight of the pancreas returned

Boyer, Edmond

219

A Case of a Metastatic Disease to the Pancreas from a Small-Cell Lung Carcinoma Documented by a CT-Scan-Guided Trucut Biopsy: The Diagnostic Role of Cytomorphology and Immunohistochemistry  

PubMed Central

Unlike primary pancreatic carcinoma, metastatic lesions of the pancreas are uncommon and account for approximately 2% of pancreatic malignancies. Small-cell lung carcinoma (SCLC) represents a group of highly malignant tumors giving rise to early and widespread metastasis at the time of diagnosis. However, the pancreas is a relatively infrequent site of metastasis by this neoplasm, and reports on metastatic small-cell carcinoma (SCC) in the pancreas, either of pulmonary or extrapulmonary origin, to be diagnosed by CT-scan-guided trucut biopsy (CT-TCB) are very rare. A 56-year-old man presented with a laterocervical lymphadenopathy associated to a mixed-density lung mass and a mass in the pancreatic body. CT-TCB slides from the pancreatic mass contained small, round tumor cells with extensive nuclear molding. The cytomorphological and histological diagnosis was metastatic SCC. Immunocytochemical staining showed that a variable number of neoplastic cells were positive for cytokeratin 7, TTF1, chromogranin A, and synaptophysin but negative for leukocyte common antigen and cytokeratin 20 with a very high expression of KI67. The transbronchial needle biopsy confirmed the diagnosis of an SCC. This case represents a rare metastatic lesion in the pancreas from SCLC, diagnosed by CT-TCB histological and immunohistochemical studies. PMID:23119202

Bouyahia, N.; Daoudi, K.; Moumna, K.; Hijri, F. Z.; Benhammane, H.; Brahmi, S. A.; Arifi, S.; Mellas, N.; Amarti, A.; El Mesbahi, O.

2012-01-01

220

Glucagonoma and its angiographic diagnosis  

SciTech Connect

Four patients with metastatic glucagonoma are described. Angiography demonstrated a small avascular primary tumor of the tail of the pancreas in one patient and large hypervascular tumors of the pancreatic head in the other three. Liver metastases were hypervascular in all four. 21 cases from the literature, including our 4 of glucagonomas show a 92% incidence of increased tumor vascularity - thus increasing the likelihood of successful angiographic diagnosis. The awareness of clinically subtle or atypical glucagonomas and use of plasma glucagon determination are important factors leading to early diagnosis of these neoplasms. Since angiography can localize the tumor, assess its extent, and detect hepatic metastases, it is essential to the detailed evaluation of glucagonomas.

Wawrukiewicz, A.S.; Roesch, J.; Keller, F.S.; Lieberman, D.A.

1982-01-01

221

Fail-safe systems for the wearable artificial endocrine pancreas.  

PubMed

For the long-term clinical use of the wearable artificial endocrine pancreas, a fail-safe system is an essential mechanism. Several hardware alarm systems have been incorporated for battery-down, and short-run of the pumps. Software alarm systems for overflow or underflow of the AD converter, empty bags, hypoglycemia, hyperglycemia, abnormal values of parameters, and excessive insulin infusion have also been built into the system. The software noise filter was effective in eliminating superimposed artificial noises and the noises induced by muscle exercise. Sudden changes in sensor output during glycemic control of diabetics due to short circuit, or disconnection of the sensor lead, were detected as overflow or underflow of the AD converter. A gradual change in the sensor output was heralded by the hyper- or hypoglycemia alarm sound. These data indicated that the fail-safe system built into the wearable artificial endocrine pancreas is useful for the long-term glycemic control of diabetics. PMID:3203976

Goriya, Y; Ueda, N; Nao, K; Yamasaki, Y; Kawamori, R; Shichiri, M; Kamada, T

1988-11-01

222

Induction Gemcitabine and Stereotactic Body Radiotherapy for Locally Advanced Nonmetastatic Pancreas Cancer  

SciTech Connect

Purpose: Stereotactic body radiotherapy (SBRT) has been used successfully to treat patients with locally advanced pancreas cancer. However, many patients develop metastatic disease soon after diagnosis and may receive little benefit from such therapy. We therefore retrospectively analyzed a planned strategy of initial chemotherapy with restaging and then treatment for those patients with no evidence of metastatic progression with SBRT. Methods and Materials: Forty-seven patients received gemcitabine (1,000 mg/m{sup 2} per week for 3 weeks then 1 week off) until tolerance, at least six cycles, or progression. Patients without metastases after two cycles were treated with SBRT (tolerance-based dose of 24-36 Gy in 3 fractions) between the third and fourth cycles without interrupting the chemotherapy cycles. Results: Eight of the 47 patients (17%) were found to have metastatic disease after two cycles of gemcitabine; the remaining 39 patients received SBRT. The median follow-up for survivors was 21 months (range, 6-36 months). The median overall survival for all patients who received SBRT was 20 months, and the median progression-free survival was 15 months. The local control rate was 85% (33 of 39 patients); and 54% of patients (21 of 39) developed metastases. Late Grade III toxicities such as GI bleeding and obstruction were observed in 9% (3/39) of patients. Conclusion: For patients with locally advanced pancreas cancer, this strategy uses local therapy for those who are most likely to benefit from it and spares those patients with early metastatic progression from treatment. SBRT delivers such local therapy safely with minimal interruption to systemic chemotherapy, thereby potentially improving the outcome in these patients.

Mahadevan, Anand, E-mail: amahadev@bidmc.harvard.edu [Department of Radiation Oncology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts (United States); Miksad, Rebecca; Goldstein, Michael; Sullivan, Ryan; Bullock, Andrea; Buchbinder, Elizabeth [Department of Medical Oncology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts (United States); Pleskow, Douglas; Sawhney, Mandeep [Department of Interventional Gastroenterology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts (United States); Kent, Tara; Vollmer, Charles; Callery, Mark [Department of Surgery, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts (United States)

2011-11-15

223

Laparoscopic Surgery for Solid Pseudopapillary Tumor of the Pancreas  

PubMed Central

Background and Objectives: Solid pseudopapillary tumors of the pancreas are rare and occur most frequently in young women. They have an uncertain pathogenesis and unclear clinical behavior. Our aim was to evaluate the clinical presentation of solid pseudopapillary tumors and assess the efficacy of treatment with minimally invasive surgery. Methods: From March 1997 to February 2011, 13 of 273 patients who underwent laparoscopic procedures on the pancreas were found to have solid pseudopapillary tumors. There were 12 female patients and 1 male patient. The median age was 21 years (range, 15–77 years). Abdominal pain was the most common presenting symptom (n = 9). Tumors were incidentally found in 3 patients on computed tomography scans obtained for other reasons. Results: Enucleation of the tumor was performed in 4 patients, including 3 in whom the tumor was located in the head of the pancreas. Eight patients underwent distal pancreatectomy with splenectomy, whereas spleen-preserving distal pancreatectomy was performed in one case. The median tumor size was 6 cm (range, 1.5–11 cm), the median operative time was 197 minutes (range, 68–320 minutes), and the median blood loss was 50 mL (range, <50–750 mL). Distal resections were performed with a linear stapler. Four patients had postoperative complications. The median length of hospital stay was 5 days (range, 2–12 days). During a median follow-up period of 11 months (range, 3–121 months), no local recurrences or distant metastases were found. Conclusion: Laparoscopic resections and enucleations of solid pseudopapillary tumors of the pancreas can be performed safely and with adequate resection margins even if the tumors are located in the head of the organ. PMID:24960486

Afridi, Shabbir A.; Kazaryan, Airazat M.; Marangos, Irina Pavlik; Røsok, Bård I.; Fretland, Åsmund A.; Yaqub, Sheraz

2014-01-01

224

Perioperative and Anesthetic Management in Kidney and Pancreas Transplantation Management  

Microsoft Academic Search

\\u000a Comorbid medical and surgical conditions dictate the complexity of kidney and pancreas transplantation. Patients who present\\u000a for kidney and\\/or pancreatic transplantation share similar perioperative concerns (risks associated with diabetes, hypertension,\\u000a vascular access, and cardiovascular disease) in performing a successful transplantation. This chapter discusses specific anesthetic\\u000a management issues related separately to kidney and pancreatic transplantation.

Jerome F. O'Hara Jr; Samuel A. Irefin

225

The surgical management of malignant lesions of the pancreas  

Microsoft Academic Search

Over the past 20 years, carcinoma of the pancreas has increased in incidence by 20 percent. In spite of this marked increase,\\u000a there continues to be controversy in some areas regarding the proper surgical management of ductal lesions.\\u000a \\u000a To date, there have been 122 total pancreatectomies performed at the Mayo Clinic; 63 of these were performed for carcinoma\\u000a of the

W. H. ReMine

1979-01-01

226

Management of Carcinoid Tumors of the Stomach, Duodenum, and Pancreas  

Microsoft Academic Search

. Carcinoids of the stomach, duodenum, and pancreas are represented by a variety of tumors with variable histologic\\u000a and clinical features. Multicentric gastric carcinoids and concomitant nonantral argyrophilic hyperplasia are common in chronic\\u000a atrophic gastritis, more rarely due to a multiple endocrine neoplasia (MEN)-related Zollinger-Ellison syndrome (ZES). These\\u000a tumors are infrequently associated with metastases and may generally be dealt with

Göran ?kerström

1996-01-01

227

Role of preoperative tracheobronchoscopy in newborns with esophageal atresia: A review  

PubMed Central

Preoperative tracheobronchoscopy (TBS) in the diagnostic assessment of newborns affected by esophageal atresia (EA) was described in 1981. Nevertheless, the value of the procedure is actually much debated; only a few studies have clearly explored the advantages of TBS and this procedure is not yet routinely included in the diagnostic and therapeutic assessment in many international pediatric surgery settings. Routine preoperative TBS is a safe procedure that enables the accurate examination of the tracheobronchial tree, the visualization of tracheoesophageal fistula and the diagnosis of tracheomalacia or associated respiratory anomalies. When a distal fistula is found, its occlusion with a Fogarty balloon catheter improves mechanical ventilation and facilitates surgical repair. This review provides a detailed overview on the use of TBS in newborns with EA, focusing on technical aspects, anesthesiological management, indications and limits. The benefits and risks of the procedure are also compared with alternative diagnostic tools, such as an esophageal contrast study, computed tomography scan and ultrasound.

Parolini, Filippo; Boroni, Giovanni; Stefini, Stefania; Agapiti, Cristina; Bazzana, Tullia; Alberti, Daniele

2014-01-01

228

Role of preoperative tracheobronchoscopy in newborns with esophageal atresia: A review.  

PubMed

Preoperative tracheobronchoscopy (TBS) in the diagnostic assessment of newborns affected by esophageal atresia (EA) was described in 1981. Nevertheless, the value of the procedure is actually much debated; only a few studies have clearly explored the advantages of TBS and this procedure is not yet routinely included in the diagnostic and therapeutic assessment in many international pediatric surgery settings. Routine preoperative TBS is a safe procedure that enables the accurate examination of the tracheobronchial tree, the visualization of tracheoesophageal fistula and the diagnosis of tracheomalacia or associated respiratory anomalies. When a distal fistula is found, its occlusion with a Fogarty balloon catheter improves mechanical ventilation and facilitates surgical repair. This review provides a detailed overview on the use of TBS in newborns with EA, focusing on technical aspects, anesthesiological management, indications and limits. The benefits and risks of the procedure are also compared with alternative diagnostic tools, such as an esophageal contrast study, computed tomography scan and ultrasound. PMID:25324919

Parolini, Filippo; Boroni, Giovanni; Stefini, Stefania; Agapiti, Cristina; Bazzana, Tullia; Alberti, Daniele

2014-10-16

229

What is artificial endocrine pancreas? Mechanism and history  

PubMed Central

The artificial endocrine pancreas is a feedback control instrument that regulates insulin delivery on a minute-by-minute basis according to measured blood glucose levels. Only one type of bedside-type artificial endocrine pancreas is now available in Japan: STG-22 (Nikkiso Co. Ltd., Japan). In the insulin infusion algorithm, insulin is infused on the basis of its proportional and derivative actions, to blood glucose concentrations with a constant time delay. The bedside-type artificial endocrine pancreas has been proven to be useful not only as a therapeutic tool for diabetes mellitus, but also as an elegant research tool for investigating the pathophysiology of the disease, by using the euglycemic hyperinsulinemic glucose clamp technique. The wearable type of closed-loop system has been developed recently. The breakthrough is the establishment of a needle-type glucose sensor. The development of closed-loop glycemic control systems that enable long-term physiological regulation has focused on implantable devices. Much effort has been expended to realize these devices. PMID:19725141

Nishida, Kenro; Shimoda, Seiya; Ichinose, Kenshi; Araki, Eiichi; Shichiri, Motoaki

2009-01-01

230

Scabies Diagnosis  

MedlinePLUS

... CDC.gov . Parasites - Scabies Parasites Home Share Compartir Diagnosis Diagnosis of a scabies infestation usually is made based ... and the presence of burrows. Whenever possible, the diagnosis of scabies should be confirmed by identifying the ...

231

Association of Preoperative Biliary Drainage With Postoperative Outcome Following Pancreaticoduodenectomy  

PubMed Central

Objective To determine whether preoperative biliary instrumentation and preoperative biliary drainage are associated with increased morbidity and mortality rates after pancreaticoduodenectomy. Summary Background Data Pancreaticoduodenectomy is accompanied by a considerable rate of postoperative complications and potential death. Controversy exists regarding the impact of preoperative biliary instrumentation and preoperative biliary drainage on morbidity and mortality rates after pancreaticoduodenectomy. Methods Two hundred forty consecutive cases of pancreaticoduodenectomy performed between January 1994 and January 1997 were analyzed. Multiple preoperative, intraoperative, and postoperative variables were examined. Pearson chi square analysis or Fisher’s exact test, when appropriate, was used for univariate comparison of all variables. Logistic regression was used for multivariate analysis. Results One hundred seventy-five patients (73%) underwent preoperative biliary instrumentation (endoscopic, percutaneous, or surgical instrumentation). One hundred twenty-six patients (53%) underwent preoperative biliary drainage (endoscopic stents, percutaneous drains/stents, or surgical drainage). The overall postoperative morbidity rate after pancreaticoduodenectomy was 48% (114/240). Infectious complications occurred in 34% (81/240) of patients. Intraabdominal abscess occurred in 14% (33/240) of patients. The postoperative mortality rate was 5% (12/240). Preoperative biliary drainage was determined to be the only statistically significant variable associated with complications (p = 0.025), infectious complications (p = 0.014), intraabdominal abscess (p = 0.022), and postoperative death (p = 0.037). Preoperative biliary instrumentation alone was not associated with complications, infectious complications, intraabdominal abscess, or postoperative death. Conclusions Preoperative biliary drainage, but not preoperative biliary instrumentation alone, is associated with increased morbidity and mortality rates in patients undergoing pancreaticoduodenectomy. This suggests that preoperative biliary drainage should be avoided whenever possible in patients with potentially resectable pancreatic and peripancreatic lesions. Such a change in current preoperative management may improve patient outcome after pancreaticoduodenectomy. PMID:10450725

Povoski, Stephen P.; Karpeh, Martin S.; Conlon, Kevin C.; Blumgart, Leslie H.; Brennan, Murray F.

1999-01-01

232

Preoperational test report, primary ventilation condensate system  

SciTech Connect

Preoperational test report for Primary Ventilation Condensate System, Project W-030. Project W-030 provides a ventilation upgrade for the four Aging Waste Facility tanks. The system provides a collection point for condensate generated by the W-030 primary vent offgas cooling system serving tanks AYIOI, AY102, AZIOI, AZI02. The system is located inside a shielded ventilation equipment cell and consists of a condensate seal pot, sampling features, a drain line to existing Catch Tank 241-AZ-151, and a cell sump jet pump. The tests verify correct system operation and correct indications displayed by the central Monitor and Control System.

Clifton, F.T.

1997-01-29

233

Preoperative evaluation of the vascular surgery patient.  

PubMed

Patients undergoing vascular surgery present a myriad of perioperative challenges due to the complex comorbidities affecting them in conjunction with high-risk surgical procedures. Additionally, advances in endovascular technology have enabled surgical procedures to be performed on patients who would not have been considered surgical candidates in the past. This combination of increasing patient morbidity and evolving surgical technique requires a well-planned preoperative assessment and close communication with surgical and perioperative colleagues. This article outlines an appropriate approach by first considering each organ system, followed by review of considerations unique to various surgical procedures, and then an overall assessment of risk. PMID:25113723

Sams, Stephen; Grichnik, Katherine; Soto, Roy

2014-09-01

234

Crossed testicular ectopia with preoperative ultrasound.  

PubMed

Crossed testicular ectopia/transverse testicular ectopia is a rare congenital anomaly. It is most commonly identified intraoperatively in the setting of inguinal hernia repair with contralateral cryptorchidism. We report a case of crossed testicular ectopia identified in a 3-month-old male who presented with right cryptorchidism. Preoperative ultrasound revealed no testicle on the right and two testicles on the left - one within the left hemiscrotum and one within the left inguinal canal. Laparoscopy at 7 months of age revealed a closed right external ring and right ectopic testicle at the left external ring. Bilateral orchiopexy was performed. PMID:23930617

Lacy, John M; Stewart, Greg E; Ziada, Ali M

2013-08-01

235

Clinical diagnosis of pyloric stenosis: a declining art  

Microsoft Academic Search

OBJECTIVE--To assess whether diagnostic imaging of pyloric stenosis has made a difference in rapidity of diagnosis, duration of pre-operative hydration, and length of stay in hospital. DESIGN--Chart review of infants with confirmed diagnosis of pyloric stenosis. SETTING--Paediatric teaching hospital. SUBJECTS--215 infants with a confirmed diagnosis of pyloric stenosis seen during 1974-7 and 187 infants with pyloric stenosis seen during 1988-91.

J Macdessi; R K Oates

1993-01-01

236

Characterization and reduction of ischemia\\/reperfusion injury after experimental pancreas transplantation  

Microsoft Academic Search

Reperfusion injury after pancreas transplantation is a cause of early graft pancreatitis. The aim of this study was to quantify\\u000a pancreatic microcirculation after pancreas transplantation in correlation with cold ischemia time. In a second step the effect\\u000a of N-acetylcysteine on reperfusion damage was tested. Pancreas transplantation was performed in three different groups of\\u000a male Lewis rats. Groups 1 and 2

Herbert Mayer; Jan Schmidt; Jochen Tbies; Eduard Ryschich; Martha Maria Gebhard; Christian Herfarth; Ernst Klar

1999-01-01

237

Solid pseudo papillary tumor of pancreas: Presenting as acute abdomen in a female child  

PubMed Central

Solid pseudo papillary tumor (SPT) or Frantz's tumor is a slow-growing low-grade malignant tumor, commonly seen in young patients with a female predominance, which is commonly located in the body and tail of the pancreas. We report a case of SPT arising from the body of the pancreas in a 12-year-old girl who presented with acute abdomen and was treated successfully by local excision of the tumor with preservation of head of pancreas and spleen.

Pattanshetti, Vishwanath M.; Vinchurkar, Kumar; Pattanshetti, Sheetal V.

2014-01-01

238

Preoperative screening for sickle cell disease in children: clinical implications  

Microsoft Academic Search

Purpose  Preoperative screening of at-risk patients for sickle cell disease (SCD) is recommended as a method to decrease perioperative\\u000a morbidity. However, the effectiveness of preoperative screening in accomplishing this goal has never been demonstrated. We\\u000a undertook a retrospective study to determine the prevalence of positive test results among those screened preoperatively at\\u000a our institution and to determine whether amendments to present

Mark W. Crawford; Seth Galton; Mohamed Abdelhaleem

2005-01-01

239

Preoperative evaluation for lung cancer resection.  

PubMed

During the last decades lung cancer is the leading cause of death worldwide for both sexes. Even though cigarette smoking has been proved to be the main causative factor, many other agents (e.g., occupational exposure to asbestos or heavy metals, indoor exposure to radon gas radiation, particulate air pollution) have been associated with its development. Recently screening programs proved to reduce mortality among heavy-smokers although establishment of such strategies in everyday clinical practice is much more difficult and unknown if it is cost effective compared to other neoplasms (e.g., breast or prostate cancer). Adding severe comorbidities (coronary heart disease, COPD) to the above reasons as cigarette smoking is a common causative factor, we could explain the low surgical resection rates (approximately 20-30%) for lung cancer patients. Three clinical guidelines reports of different associations have been published (American College of Chest Physisians, British Thoracic Society and European Respiratory Society/European Society of Thoracic Surgery) providing detailed algorithms for preoperative assessment. In the current mini review, we will comment on the preoperative evaluation of lung cancer patients. PMID:24672690

Spyratos, Dionysios; Zarogoulidis, Paul; Porpodis, Konstantinos; Angelis, Nikolaos; Papaiwannou, Antonios; Kioumis, Ioannis; Pitsiou, Georgia; Pataka, Athanasia; Tsakiridis, Kosmas; Mpakas, Andreas; Arikas, Stamatis; Katsikogiannis, Nikolaos; Kougioumtzi, Ioanna; Tsiouda, Theodora; Machairiotis, Nikolaos; Siminelakis, Stavros; Argyriou, Michael; Kotsakou, Maria; Kessis, George; Kolettas, Alexander; Beleveslis, Thomas; Zarogoulidis, Konstantinos

2014-03-01

240

Preoperative evaluation for lung cancer resection  

PubMed Central

During the last decades lung cancer is the leading cause of death worldwide for both sexes. Even though cigarette smoking has been proved to be the main causative factor, many other agents (e.g., occupational exposure to asbestos or heavy metals, indoor exposure to radon gas radiation, particulate air pollution) have been associated with its development. Recently screening programs proved to reduce mortality among heavy-smokers although establishment of such strategies in everyday clinical practice is much more difficult and unknown if it is cost effective compared to other neoplasms (e.g., breast or prostate cancer). Adding severe comorbidities (coronary heart disease, COPD) to the above reasons as cigarette smoking is a common causative factor, we could explain the low surgical resection rates (approximately 20-30%) for lung cancer patients. Three clinical guidelines reports of different associations have been published (American College of Chest Physisians, British Thoracic Society and European Respiratory Society/European Society of Thoracic Surgery) providing detailed algorithms for preoperative assessment. In the current mini review, we will comment on the preoperative evaluation of lung cancer patients. PMID:24672690

Spyratos, Dionysios; Porpodis, Konstantinos; Angelis, Nikolaos; Papaiwannou, Antonios; Kioumis, Ioannis; Pitsiou, Georgia; Pataka, Athanasia; Tsakiridis, Kosmas; Mpakas, Andreas; Arikas, Stamatis; Katsikogiannis, Nikolaos; Kougioumtzi, Ioanna; Tsiouda, Theodora; Machairiotis, Nikolaos; Siminelakis, Stavros; Argyriou, Michael; Kotsakou, Maria; Kessis, George; Kolettas, Alexander; Beleveslis, Thomas; Zarogoulidis, Konstantinos

2014-01-01

241

MRI appearance of the pancreas in patients with cystic fibrosis: a comparison of pancreas volume in diabetic and non-diabetic patients  

PubMed Central

We investigated differences in the volume of the pancreas in cystic fibrosis (CF) patients with and without diabetes using MRI to study the natural history of CF-related diabetes (CFRD). We investigated 29 pancreas-insufficient adult CF patients, 13 with CFRD and 16 without diabetes. Patients with CFRD were receiving insulin therapy at the time of study. None of the non-diabetic CF patients had evidence of impaired glucose tolerance. Pancreas volume was estimated by MRI scans using T1 weighted fat-suppression sequences and assessed by an examiner who was unaware of the patients’ diabetes status. Pancreas volume of CF patients was measured and subsequently compared with that of non-CF age-matched Type 1 diabetes (T1DM) patients and healthy controls previously investigated. The two CF groups were matched for age and gender. There were no differences in spirometry values, body mass index or pancreatic exocrine function. The pancreas was visible by MRI in only 3 of 13 (23.1%) patients with CFRD and in 5 of 16 (31.3%) patients without diabetes (p-value = 0.7). In total, the pancreas was not detected by MRI as an anatomical entity in 21 of 29 (72.4%) CF patients, irrespective of their diabetes status. When comparing the four study groups, the pancreas was significantly smaller in CF patients than in T1DM patients and healthy controls. PMID:20965902

Sequeiros, I M; Hester, K; Callaway, M; Williams, A; Garland, Z; Powell, T; Wong, F S; Jarad, N A

2010-01-01

242

Immunosuppression in simultaneous pancreas-kidney transplantation: progress to date.  

PubMed

Simultaneous pancreas-kidney transplantation (SPKT) is the treatment of choice for patients with end-stage renal failure due to type 1 diabetes mellitus. With advances in surgical techniques and immunosuppression management, outcomes have improved, with current 1- and 10-year pancreas graft survival rates of 86% and 53%, respectively. Induction therapy with either alemtuzumab or rabbit antithymocyte globulin (rATG) in combination with a calcineurin inhibitor (CNI) and mycophenolate mofetil (MMF) or sirolimus appears to be safe and effective in the setting of rapid steroid withdrawal (RSW), with excellent graft survival and low rejection rates. There are no large randomized trials between alemtuzumab and rATG to determine whether one is better than the other. Anti-interleukin (IL)-2 receptor antibody induction and no induction in combination with a CNI, MMF or sirolimus, and prednisone have demonstrated excellent graft survival rates but are associated with a higher incidence of acute rejection. The efficacy of anti-IL-2 receptor antibodies or no induction in the setting of RSW is unproven. Both of the CNIs, ciclosporin and tacrolimus, are effective in preventing acute rejection in SPKT recipients; however, pancreas allograft survival may be better with tacrolimus. MMF is more effective than azathioprine in preventing acute rejection. Sirolimus appears to be effective in preventing acute rejection, but the combination of sirolimus with a CNI may accentuate the nephrotoxicity of the CNI. RSW with induction therapy is safe and effective in SPKT recipients, but longer follow-up data on outcomes are needed. Recent analysis of registry data shows that most transplant centres are using an induction agent followed by a combination of tacrolimus, MMF and corticosteroids in SPKT recipients. PMID:20426494

Heilman, Raymond L; Mazur, Marek J; Reddy, K Sudhakar

2010-05-01

243

Solid and papillary epithelial neoplasm of the pancreas  

SciTech Connect

Solid and papillary epithelial neoplasm of the pancreas is an uncommon low grade malignant tumor histologically distinct from the usual ductal adenocarcinoma and amenable to cure by surgical excision. It tends to occur in black women in their second or third decade of life and has often been misclassified as nonfunctional islet cell tumor or as cystadenoma or cystadenocarcinoma. Twelve cases were reviewed. Sonography and CT of solid and pipillary epithelial neoplasms depict a well-demarcated mass that can be solid, mixed cystic and solid, or largely cystic. The radiologic appearance is dependent on the maintenance of the integrity of the neoplasm versus the extent of retrogressive changes that have occurred.

Friedman, A.C.; Lichtenstein, J.E.; Fishman, E.K.; Oertel, J.E.; Dachman, A.H.; Siegelman, S.S.

1985-02-01

244

Maximum Standardized Uptake Value on 18F-Fluoro-2-Deoxy-Glucose Positron Emission Tomography/Computed Tomography and Glucose Transporter-1 Expression Correlates With Survival in Invasive Ductal Carcinoma of the Pancreas  

PubMed Central

Objectives The purpose of this study was to assess the correlations among the maximum standardized uptake value (SUVmax) on 18F-fluoro-2-deoxy-glucose positron emission tomography/computed tomography (FDG-PET/CT); the expressions of glucose transporter 1 (GLUT-1), glucose transporter 3, and epidermal growth factor receptor (EGFR); as well as prognosis in patients with invasive ductal carcinoma of the pancreas. Methods A total of 41 patients with surgically resected and histologically proven invasive ductal carcinoma of the pancreas who underwent preoperative FDG-PET/CT were assessed. The SUVmax at the primary tumor site was measured by FDG-PET/CT, and immunohistochemical staining of tumor sections was performed for GLUT-1, glucose transporter 3, and EGFR. Results Higher FDG uptake (SUVmax, >3.40) and GLUT-1 expression were significantly associated with shorter overall survival (P < 0.05). The SUVmax was not found to be significantly correlated with clinicopathological characteristics such as TNM classification, lymph node metastasis, and tumor differentiation. The EGFR expression was significantly correlated with the SUVmax (P = 0.024). Conclusions Higher FDG uptake and GLUT-1 expression in invasive ductal carcinoma of the pancreas seems to be an important prognostic factor. In addition, the EGFR expression was significantly correlated with the SUVmax. PMID:25121413

Kitasato, Yuhei; Yasunaga, Masafumi; Okuda, Koji; Kinoshita, Hisafumi; Tanaka, Hiroyuki; Okabe, Yoshinobu; Kawahara, Akihiko; Kage, Masayoshi; Kaida, Hayato; Ishibashi, Masatoshi

2014-01-01

245

Preoperative anemia increases postoperative morbidity in elective cranial neurosurgery  

PubMed Central

Background: Preoperative anemia may affect postoperative mortality and morbidity following elective cranial operations. Methods: The American College of Surgeons National Surgical Quality Improvement Program (NSQIP) database was used to identify elective cranial neurosurgical cases (2006-2012). Morbidity was defined as wound infection, systemic infection, cardiac, respiratory, renal, neurologic, and thromboembolic events, and unplanned returns to the operating room. For 30-day postoperative mortality and morbidity, adjusted odds ratios (ORs) were estimated with multivariable logistic regression. Results: Of 8015 patients who underwent elective cranial neurosurgery, 1710 patients (21.4%) were anemic. Anemic patients had an increased 30-day mortality of 4.1% versus 1.3% in non-anemic patients (P < 0.001) and an increased 30-day morbidity rate of 25.9% versus 14.14% in non-anemic patients (P < 0.001). The 30-day morbidity rates for all patients undergoing cranial procedures were stratified by diagnosis: 26.5% aneurysm, 24.7% sellar tumor, 19.7% extra-axial tumor, 14.8% intra-axial tumor, 14.4% arteriovenous malformation, and 5.6% pain. Following multivariable regression, the 30-day mortality in anemic patients was threefold higher than in non-anemic patients (4.1% vs 1.3%; OR = 2.77; 95% CI: 1.65-4.66). The odds of postoperative morbidity in anemic patients were significantly higher than in non-anemic patients (OR = 1.29; 95% CI: 1.03-1.61). There was a significant difference in postoperative morbidity event odds with a hematocrit level above (OR = 1.07; 95% CI: 0.78-1.48) and below (OR = 2.30; 95% CI: 1.55-3.42) 33% [hemoglobin (Hgb) 11 g/dl]. Conclusions: Preoperative anemia in elective cranial neurosurgery was independently associated with an increased risk of 30-day postoperative mortality and morbidity when compared to non-anemic patients. A hematocrit level below 33% (Hgb 11 g/dl) was associated with a significant increase in postoperative morbidity.

Bydon, Mohamad; Abt, Nicholas B.; Macki, Mohamed; Brem, Henry; Huang, Judy; Bydon, Ali; Tamargo, Rafael J.

2014-01-01

246

Comparison of Preoperative Temporal Bone CT with Intraoperative Findings in Patients with Cholesteatoma  

PubMed Central

Introduction: Cholesteatoma is traditionally diagnosed by otoscopic examination and treated by surgery. The necessity for imaging in an uncomplicated case is controversial. This study was planned to investigate the usefulness of a preoperative high-resolution computed tomography (HRCT) scan in depicting the status of middle ear structures in the presence of cholesteatoma and also to compare the correspondence between pre- and intraoperative CT findings in patients with cholesteatoma. Materials and Methods: This prospective descriptive study was performed from January 2009 to May 2011 in 36 patients with cholesteatoma who were referred to the Kashani and Al-Zahra Clinics of Otolaryngology. Preoperative high-resolution temporal bone CT scans (axial and coronal views) were carried out and compared with intraoperative findings. Results: Evaluation of 36 patients and their CT scans revealed excellent correlation for sigmoid plate erosion, widening of aditus, and erosion of scutum; good correlation for erosion of malleus and tegmen; moderate correlation for lateral canal fistula (LCF) and erosion of mastoid air cells; and poor correlation for facial nerve dehiscence (FND), incus, and stapes erosion. Conclusion: A preoperative CT scan may be helpful in relation to diagnosis and decision making for surgery in cases of cholesteatoma and ossicular erosion. The CT scan can accurately predict the extent of disease and is helpful for detection of lateral canal fistula, erosions of dural plate, and ossicular erosions. However it is not able to distinguish between cholesteatoma and mucosal disease, facial nerve dehiscency, incus, and stapes erosion. PMID:24505568

Rogha, Mehrdad; Hashemi, Sayyed Mostafa; Mokhtarinejad, Farhad; Eshaghian, Afrooz; Dadgostar, Alireza

2014-01-01

247

Pancoast tumors: characteristics and preoperative assessment  

PubMed Central

Superior sulcus tumors (SSTs), or as otherwise known Pancoast tumors, make up a clinically unique and challenging subset of non-small cell carcinoma of the lung (NSCLC). Although the outcome of patients with this disease has traditionally been poor, recent developments have contributed to a significant improvement in prognosis of SST patients. The combination of severe and unrelenting shoulder and arm pain along the distribution of the eighth cervical and first and second thoracic nerve trunks, Horner’s syndrome (ptosis, miosis, and anhidrosis) and atrophy of the intrinsic hand muscles comprises a clinical entity named as “Pancoast-Tobias syndrome”. Apart NSCLC, other lesions may, although less frequently, result in Pancoast syndrome. In the current review we will present the main characteristics of the disease and focus on the preoperative assessment. PMID:24672686

Panagopoulos, Nikolaos; Leivaditis, Vasilios; Koletsis, Efstratios; Prokakis, Christos; Alexopoulos, Panagiotis; Baltayiannis, Nikolaos; Hatzimichalis, Antonios; Tsakiridis, Kosmas; Zarogoulidis, Konstantinos; Katsikogiannis, Nikolaos; Kougioumtzi, Ioanna; Machairiotis, Nikolaos; Tsiouda, Theodora; Kesisis, Georgios; Siminelakis, Stavros; Madesis, Athanasios; Dougenis, Dimitrios

2014-01-01

248

Prevention and Intervention Strategies to Alleviate Preoperative Anxiety in Children  

ERIC Educational Resources Information Center

Preoperative anxiety (anxiety regarding impending surgical experience) in children is a common phenomenon that has been associated with a number of negative behaviors during the surgery experience (e.g., agitation, crying, spontaneous urination, and the need for physical restraint during anesthetic induction). Preoperative anxiety has also been…

Wright, Kristi D.; Stewart, Sherry H.; Finley, G. Allen; Buffett-Jerrott, Susan E.

2007-01-01

249

Metastatic tumors to the pancreas: The role of surgery  

PubMed Central

Pancreatic metastases from other primary malignancies are a rare entity. By far, the most common primary cancer site resulting in an isolated pancreatic metastasis is the kidney, followed by colorectal cancer, melanoma, breast cancer, lung carcinoma and sarcoma. Only few data on the surgical outcome of pancreatic resections performed for metastases from other primary tumor have been published, and there are no guidelines to address the surgical treatment for these patients. In this study, we performed a review of the published literature, focusing on the early and long-term results of surgery for the most frequent primary tumors metastasizing to the pancreas. Results for the Literature’s analysis show that in last years an increasing number of surgical resections have been performed in selected patients with limited pancreatic disease. Pancreatic resection for metastatic disease can be performed with acceptable mortality and morbidity rates. The usefulness of pancreatic resection is mainly linked to the biology of the primary tumor metastasizing to the pancreas. The benefit of metastasectomy in terms of patient survival has been observed for metastases from renal cell cancer, while for other primary tumors, such as lung and breast cancers, the role of surgery is mainly palliative. PMID:25320654

Sperti, Cosimo; Moletta, Lucia; Patane, Giuseppe

2014-01-01

250

Laparoscopic distal pancreatectomy for adenocarcinoma of the pancreas  

PubMed Central

Since the first report on laparoscopic distal pancreatectomy (LDP) appeared in the 1990s, the procedure has been performed increasingly frequently to treat both benign and malignant lesions of the pancreas. Many earlier publications have shown LDP to be a good alternative to open distal pancreatectomy for benign lesions, although this has never been studied in a prospective, randomized manner. The evidence for the use of LDP to treat adenocarcinoma of the pancreas is not as well established. The purpose of this review is to evaluate the current evidence for LDP in cases of pancreatic adenocarcinoma. We conducted a review of English language publications reporting LDP results between 1990 and 2013. All studies reporting results in patients with histologically proven pancreatic adenocarcinoma were included. Thirty-nine publications were found and included in the results for a total of 309 cases of pancreatic adenocarcinoma (potential double publications were not eliminated). Most LDP procedures are performed in selected cases and generally involve smaller tumors than open distal pancreatectomy (ODP) procedures. Some of the papers report unselected cases and include procedures on larger tumors. The number of lymph nodes harvested using LDP is comparable to the number obtained with ODP, as is the frequency of R0 resections. Current data suggest that similar short term oncological results can be obtained using LDP as those obtained using ODP. PMID:25309072

Bjornsson, Bergthor; Sandstrom, Per

2014-01-01

251

miR-24 regulates menin in the endocrine pancreas.  

PubMed

Menin, the product of the MEN1 gene, functions as a tumor suppressor and was first identified in 1997 due to its causative role in the endocrine tumor disorder multiple endocrine neoplasia, type 1 (MEN1). More recently, menin has been identified as a key player in pancreatic islet biology with the observation of an inverse relationship between menin levels and pancreatic islet proliferation. However, the factors regulating menin and the MEN1 gene in the pancreas are poorly understood. Here, we describe the regulation of menin by miR-24 and demonstrate that miR-24 directly decreases menin levels and impacts downstream cell cycle inhibitors in MIN6 insulinoma cells and in ?lox5 immortalized ?-cells. This regulation of menin impacts cell viability and proliferation in ?lox5 cells. Furthermore, our data show a feedback regulation between miR-24 and menin that is present in the pancreas, suggesting that miR-24 regulates menin levels in the pancreatic islet. PMID:24824656

Vijayaraghavan, Jyothi; Maggi, Elaine C; Crabtree, Judy S

2014-07-01

252

Phosphorus nuclear magnetic resonance in isolated perfused rat pancreas  

SciTech Connect

Phosphorus nuclear magnetic resonance spectroscopy was applied to measure phosphorus energy metabolites in isolated perfused rat pancreas. The gland was perfused with a modified Krebs-Henseleit solution at room temperature (25{degree}C). {sup 31}P resonances of creatine phosphate (PCr), ATP, ADP, inorganic phosphate (P{sub i}) and phosphomonoesters (PMEs) were observed in all the preparations of pancreas. In different individual preparations, the resonance of PCr varied, but those of ATP were almost the same. The initial levels of PCr and ATP in individual preparations, however, remained almost unchanged during perfusion with the standard solution for 2 h. When the perfusion was stopped, the levels of ATP and PCr decreased, while the levels of PME and P{sub i} increased. At that time, the P{sub i} resonance shfted to a higher magnetic field, indicating that the tissue pH decreased. On reperfusion, the tissue levels of phosphorus compounds and the tissue pH were restored to their initial resting levels. Continuous infusion of 0.1 {mu}M acetylcholine caused marked and sustained increases in the flow of pancreatic juice and protein output. During the stimulation the tissue levels of phosphorus compounds remained unchanged, while the tissue pH was decreased slightly.

Matsumoto, Takehisa; Kanno, Tomio; Seo, Yoshiteru; Murakami, Masataka; Watari, Hiroshi (Hokkaido Univ., Sapporo (Japan) National Institute for Physiological Sciences, Okazaki (Japan))

1988-04-01

253

Isolation of genes involved in pancreas regeneration by subtractive hybridization.  

PubMed

The deterioration of ? cells in the pancreas is a crucial factor in the progression of diabetes mellitus; therefore, the recovery of ? cells is of vital importance for effective diabetic therapeutic strategies. Partially pancreatectomized rats have been used for the investigation of pancreatic regeneration. Because it was determined that tissue extract from the partially-dissected pancreas induces pancreatic differentiation in embryonic stem cells, paracrine factors were thought to be involved in the regeneration. In this study, we screened for genes that had higher mRNA levels 2 days after 60%-pancreatectomy. The genes were isolated using subtractive hybridization and DNA sequencing. Twelve genes (adipsin, Aplp2, Clu, Col1a2, Glul, Krt8, Lgmn, LOC299907, LOC502894, Pla2g1b, Reg3? and Xbp1) were identified, and RT-PCR and real-time PCR analyses were performed to validate their expression levels. Among the genes identified, three genes (Glul, Lgmn and Reg3a) were selected for further analyses. Assays revealed that Glul and Reg3? enhance cell growth. Glul, Lgmn and Reg3? change the expression level of islet marker genes, where NEUROD, NKX2.2, PAX4 and PAX6 are up-regulated and somatostatin is down-regulated. Thus, we believe that Glul, Lgmn and Reg3a can serve as novel targets in diabetes mellitus genetic therapy. PMID:20536387

Choi, Jong-Ho; Lee, Min-Young; Kim, Yoolee; Shim, Jeong-Yun; Han, Sang-Moon; Lee, Kyung-Ah; Choi, Young-Kil; Jeon, Hae-Myung; Baek, Kwang-Hyun

2010-09-01

254

Metabolic regulation of cellular plasticity in the pancreas  

PubMed Central

SUMMARY Obese individuals exhibit an increase in pancreatic ?-cell mass; conversely, scarce nutrition during pregnancy has been linked to ?-cell insufficiency in the offspring (reviewed in [1, 2]). These phenomena are thought to be mediated mainly through effects on ?-cell proliferation, since a nutrient sensitive ?-cell progenitor population in the pancreas has not been identified. Here, we employed the FUCCI (Fluorescent Ubiquitination-based Cell Cycle Indicator) system to investigate ?-cell replication in real-time, and found that high nutrient concentrations induce rapid ?-cell proliferation. Importantly, we found that high nutrient concentrations also stimulate ?-cell differentiation from progenitors in the intrapancreatic duct (IPD). Using a new zebrafish line where ?-cells are constitutively ablated, we further show that ?-cell loss and high nutrient intake synergistically activate these progenitors. At the cellular level, this activation process causes ductal cell reorganization as it stimulates their proliferation and differentiation. Notably, we link the nutrient-dependent activation of these progenitors to a down-regulation of Notch signaling specifically within the IPD. Furthermore, we show that the nutrient sensor mechanistic Target Of Rapamycin (mTOR) is required for endocrine differentiation from the IPD under physiological conditions as well as in the diabetic state. This study thus reveals critical insights into how cells modulate their plasticity in response to metabolic cues and identifies nutrient sensitive progenitors in the mature pancreas. PMID:23791726

Ninov, Nikolay; Hesselson, Daniel; Gut, Philipp; Zhou, Amy; Fidelin, Kevin; Stainier, Didier Y.R.

2013-01-01

255

Survival Estimates, by Race, Sex, Diagnosis Year, Stage and Age (Pancreas)  

Cancer.gov

SEER Cancer Statistics Review 1975-2008 National Cancer Institute a Based on End Results data from a series of hospital registries and one population-based registry. b SEER 9 areas (San Francisco, Connecticut, Detroit, Hawaii, Iowa, New Mexico, Seattle,

256

The Use of Protein-Based Biomarkers for the Diagnosis of Cystic Tumors of the Pancreas  

PubMed Central

Proteomics is a powerful method used to identify, characterize, and quantify proteins within biologic samples. Pancreatic cystic neoplasms are a common clinical entity and represent a diagnostic and management challenge due to difficulties in accurately diagnosing cystic lesions with malignant potential and assessing the risk of malignant degeneration. Currently, cytology and other biomarkers in cyst fluid have had limited success in accurately distinguishing both the type of cystic neoplasm and the presence of malignancy. Emerging data suggests that the use of protein-based biomarkers may have greater utility in helping clinicians correctly diagnose the type of cyst and to identify which cystic neoplasms are malignant. Several candidate proteins have been identified within pancreatic cystic neoplasms as potential biomarkers. Future studies will be needed to validate these findings and move these biomarkers into the clinical setting. PMID:22110950

Kwon, Richard S.; Simeone, Diane M.

2011-01-01

257

Are criteria for islet and pancreas donors sufficiently different to minimize competition?  

PubMed

Islet and pancreas transplantation may compete for a limited number of organs. We analyzed records from the national Swiss transplant registry during a 4-year period to investigate the proportion of donors that are suitable for islet and pancreas transplantation. Suitability for pancreas transplantation was mainly defined as: age 10-45 years; weight pancreas, islet transplantation, and both procedures, respectively. Giving priority to pancreas transplantation and accepting the absence of one selection criterion, 90 (28%) pancreas and 100 (31%) islet donors were identified. We conclude that with current allocation policies prioritizing pancreas transplantation, pancreas and islet transplantation may coexist with little competition. PMID:15084172

Ris, Frédéric; Toso, Christian; Veith, Florence Unno; Majno, Pietro; Morel, Philippe; Oberholzer, José

2004-05-01

258

Phase II trial of gemcitabine (2,2?-difiuorodeoxycytidine) in patients with adenocarcinoma of the pancreas  

Microsoft Academic Search

Gemcitabine is a novel nucleoside analog which demonstrated a broad spectrum of preclinical acitivity in solid tumor models, and responses in patients with pancreas cancer during phase I evaluation. Patients with measurable adenocarcinoma of the pancreas who had received no previous chemotherapy were eligible for this multicenter phase II clinical trial. Gemcitabine 800 mg\\/m2 was administered intravenously weekly for 3

Ephraim S. Casper; Mark R. Green; David P. Kelsen; Robert T. Heelan; Thomas D. Brown; Carlos D. Flombaum; Bonnie Trochanowski; Peter G. Tarassoff

1994-01-01

259

Pancreas Modeling from IVGTT Data Using a Deterministic Optimal Search Method  

Microsoft Academic Search

Metabolism modeling has the potential to provide guidance on medicine manufacture and medical treatment in an efficient and economic way. A pancreas model developed from a mathematical description of the relevant physiology will demonstrate insulin dynamics and provide a platform for comparing metabolic abilities among different health conditions. As a part of whole body metabolism model, the pancreas model is

Lv Dayu; Bill Goodwine

2009-01-01

260

Autonomous and continuous adaptation of a bihormonal bionic pancreas in adults and adolescents  

E-print Network

Autonomous and continuous adaptation of a bihormonal bionic pancreas in adults and adolescents at different times in their lives. Objectives: To test the ability of a third-generation bihormonal bionic monitoring (CGM) technology with insulin pumps and a control algorithm to create a bionic endocrine pancreas

261

Dynamic imaging of the pancreas using real-time endoscopic ultrasonography with secretin stimulation  

Microsoft Academic Search

Background: Obstructive disorders of the pancreas, including strictures, stones, sphincter of Oddi dysfunction, and pancreas divisum, are diagnostic and therapeutic challenges. Conventional extracorporeal ultrasound with secretin stimulation has been used as a noninvasive study to detect obstruction and predict outcome of therapy. Inconsistent results have been obtained because of the inherent limitations of standard ultrasonography. The aim of this study

Marc F. Catalano; Sandeep Lahoti; Eduardo Alcocer; Joseph E. Geenen; Walter J. Hogan

1998-01-01

262

Case Report: Lymphoepithelial Cyst of the Pancreas: A Case Report and Review of the Literature  

Microsoft Academic Search

Lymphoepithelial cysts of the pancreas (LECP) are rare lesions. They are squamous cell-lined cysts closely associated with the pancreas, ® lled with keratinized material and surrounded by lymphoid tissue. To our knowledge there have only been seventeen reported cases (1± 16). We describe a patient with LECP and review the literature.

Andrej Strapko; Robert J. Botash; Uma K. Murthy; Steve K. Landas

1998-01-01

263

Total pancreatectomy for metachronous mixed acinar-ductal carcinoma in a remnant pancreas  

PubMed Central

In October 2009, a 71-year-old female was diagnosed with a cystic tumor in the tail of the pancreas with an irregular dilatation of the main pancreatic duct in the body and tail of the pancreas. A distal pancreatectomy with splenectomy, and partial resection of the duodenum, jejunum and transverse colon was performed. In March 2011, a follow-up computed tomography scan showed a low density mass at the head of the remnant pancreas. We diagnosed it as a recurrence of the tumor and performed a total pancreatectomy for the remnant pancreas. In the histological evaluation of the resected specimen of the distal pancreas, the neoplastic cells formed an acinar and papillary structure that extended into the main pancreatic duct. Mucin5AC, ?1-antitrypsin (?-AT) and carcinoembryonic antigen (CEA) were detected in the tumor cells by immunohistochemistry. In the resected head of the pancreas, the tumor was composed of both acinar and ductal elements with a mottled pattern. The proportions of each element were approximately 40% and 60%, respectively. Strongly positive ?-AT cells were detected in the acinar element. Some tumor cells were also CEA positive. However, the staining for synaptophysin and chromogranin A was negative in the tumor cells. Ultimately, we diagnosed the tumor as a recurrence of mixed acinar-ductal carcinoma in the remnant pancreas. In conclusion, we report here a rare case of repeated pancreatic resection for multicentric lesions of mixed acinar-ductal carcinoma of the pancreas. PMID:25206298

Shonaka, Tatsuya; Inagaki, Mitsuhiro; Akabane, Hiromitsu; Yanagida, Naoyuki; Shomura, Hiroki; Yanagawa, Nobuyuki; Oikawa, Kensuke; Nakano, Shiro

2014-01-01

264

Possible Involvement of the Local Renin-Angiotensin System in Exocrine Pancreas Responses to Food Components  

Microsoft Academic Search

Summary The functioning of the exocrine and endocrine pancreas is strictly co-ordinated through an interdependent array of neural and endocrine, paracrine and autocrine hormonal factors. The responses of the exocrine pancreas to food are primarily initiated via hormones secreted by neuroendocrine cells in the gut. No role for the pancreatic renin-angiotensin system in these mechanisms has so far been established.

George Grant

2001-01-01

265

Acinic Cell Carcinoma of the Salivary Gland with Metastatic Spread to the Pancreas  

PubMed Central

Metastatic disease to the pancreas is rare among solid tumors and has not been well described for salivary cancers. We report a patient who developed an isolated metastatic lesion in the pancreas from acinic cell carcinoma of the salivary gland, presenting as acute pancreatitis. PMID:24748870

Geiger, Jessica L.; Garcia, Joaquin J.; Price, Katharine A.R.

2014-01-01

266

Primary hepatocellular carcinoma ("hepatoid" carcinoma) of the pancreas: a case report and review of the literature  

PubMed Central

Key Clinical Message We present a case of hepatocellular carcinoma located within the pancreas. These tumors occur in the body and tail of the pancreas, with a male predominance, and at a younger age. Tumors with pure hepatocellular histopathology have better survival and recurrence rates and should be offered surgical therapy if possible. PMID:25356215

Steen, Shawn; Wolin, Edward; Geller, Stephen A; Colquhoun, Steven

2013-01-01

267

Using pancreas tissue slices for in situ studies of islet of Langerhans and acinar cell biology.  

PubMed

Studies on the cellular function of the pancreas are typically performed in vitro on its isolated functional units, the endocrine islets of Langerhans and the exocrine acini. However, these approaches are hampered by preparation-induced changes of cell physiology and the lack of an intact surrounding. We present here a detailed protocol for the preparation of pancreas tissue slices. This procedure is less damaging to the tissue and faster than alternative approaches, and it enables the in situ study of pancreatic endocrine and exocrine cell physiology in a conserved environment. Pancreas tissue slices facilitate the investigation of cellular mechanisms underlying the function, pathology and interaction of the endocrine and exocrine components of the pancreas. We provide examples for several experimental applications of pancreas tissue slices to study various aspects of pancreas cell biology. Furthermore, we describe the preparation of human and porcine pancreas tissue slices for the validation and translation of research findings obtained in the mouse model. Preparation of pancreas tissue slices according to the protocol described here takes less than 45 min from tissue preparation to receipt of the first slices. PMID:25393778

Marciniak, Anja; Cohrs, Christian M; Tsata, Vasiliki; Chouinard, Julie A; Selck, Claudia; Stertmann, Julia; Reichelt, Saskia; Rose, Tobias; Ehehalt, Florian; Weitz, Jürgen; Solimena, Michele; Slak Rupnik, Marjan; Speier, Stephan

2014-12-01

268

Carrier Diagnosis  

MedlinePLUS

... Bleeding Symptoms Carrier Diagnosis When to Test for Carrier Status Family Planning and Pregnancy Conception Options Prenatal Diagnosis Fetal Sex Determination Labour and Delivery Treatment of Bleeding Quality of Life Resources Inhibitors ...

269

Dermatomyositis: Diagnosis  

MedlinePLUS

... to Help MDA Search form Search Dermatomyositis (DM) Diagnosis As with other muscle diseases, a doctor diagnoses ... biopsy can enable the physician to pinpoint the diagnosis to a type of myositis. In DM, the ...

270

Polymyositis: Diagnosis  

MedlinePLUS

... to Help MDA Search form Search Polymyositis (PM) Diagnosis As with other muscle diseases, a doctor diagnoses ... biopsy can enable the physician to pinpoint the diagnosis to a type of myositis. In PM, the ...

271

Isolated torsion of the fallopian tube with hydrosalpinx mimicking a multiloculated ovarian cyst: whirlpool sign on preoperative sonography and MRI.  

PubMed

Isolated torsion of the fallopian tube is a rare case of lower abdominal pain. Early diagnosis of such cases is crucial because it allows for the possibility of salvage surgery and the prevention of irreversible vascular damage. However, diagnosis is rarely made before surgery due to nonspecific clinical and imaging features. We report a case of isolated tubal torsion with specific imaging findings on preoperative ultrasonography, color Doppler ultrasonography, and magnetic resonance imaging that was misdiagnosed as a multiloculated ovarian cyst at a local hospital. PMID:23505037

Aydin, Ramazan; Bildircin, Devran; Polat, Ahmet Veysel

2014-01-01

272

Cystic Lymphangioma of the Pancreas with Spontaneous Rupture: Report of a Case  

PubMed Central

Lymphangioma is a benign and congenital malformation of the lymphatic system. Most lymphangiomas are preferentially located in the head and neck region. The abdominal organs are uncommon sites of origin. Several cases of lymphangioma in abdominal organs were reported, however, the pancreas is one of the rarest origins. Generally, intra-abdominal lymphangioma is asymptomatic and found incidentally, but in some cases, the patient complains of abdominal distension or a palpable mass. We describe the case of a 38-year-old male who presented with sudden-onset upper abdominal pain. Rupture of a cystic tumor of the pancreatic head was suspected, based on the findings of computed tomography, magnetic resonance imaging and endoscopic ultrasonography. Subtotal stomach-preserving pancreaticoduodenectomy was undertaken. The tumor, which was 4 × 4.5 × 8 cm in size, was pathologically diagnosed as a cystic lymphangioma. In conclusion, pancreatic lymphangioma is mostly asymptomatic, a ruptured case causing ‘acute abdomen’ has never been reported. Since lymphangioma is benign, it could be observed with accurate diagnosis. The surgical indication would be limited to cases of symptomatic lymphangiomas. PMID:21712979

Kawaguchi, Kei; Motoi, Fuyuhiko; Ohtsuka, Hideo; Fukuyama, Shoji; Rikiyama, Toshiki; Katayose, Yu; Egawa, Shinichi; Satoh, Masahiro; Asakura, Toru; Shimosegawa, Toru; Unno, Michiaki

2011-01-01

273

Poorly differentiated endocrine carcinoma of the pancreas responded to gemcitabine: Case report  

PubMed Central

Poorly differentiated endocrine carcinoma (PDEC) of the pancreas is a rare and aggressive tumor. First-line treatment is commonly a combination of etoposide and cisplatin, but there is no consensus regarding further treatment recommendations. In this report, we describe a case of pancreatic PDEC treated with gemcitabine as third-line chemotherapy. A 62-year-old man with pancreatic PDEC was administered etoposide plus cisplatin as first-line treatment; he then received irinotecan for tumor relapse. However, because irinotecan induced ileus in this patient, we chose gemcitabine as third-line chemotherapy. After two cycles of gemcitabine (1000 mg/m2 on days 1, 8 and 15 every 4 wk), a partial tumor response was noted by computed tomography (approximately 68% reduction in tumor size). Our patient survived for 15 mo after diagnosis. This is a rare case of unresectable pancreatic PDEC, which showed a partial response to gemcitabine after the failure of two other regimens. Gemcitabine could be an effective treatment option for pancreatic PDEC that is resistant to other treatments. PMID:20698050

Nakazuru, Shoichi; Yoshio, Toshiyuki; Suemura, Shigeki; Itoh, Mari; Araki, Manabu; Yoshioka, Chiaki; Ohta, Makiyo; Sueyoshi, Yuka; Ohta, Takashi; Hasegawa, Hiroko; Morita, Kaori; Toyama, Takashi; Kuzushita, Noriyoshi; Kodama, Yoshinori; Mano, Masayuki; Mita, Eiji

2010-01-01

274

Analyses of pancreas development by generation of gfp transgenic zebrafish using an exocrine pancreas-specific elastaseA gene promoter  

SciTech Connect

In contrast to what we know on development of endocrine pancreas, the formation of exocrine pancreas remains poorly understood. To create an animal model that allows observation of exocrine cell differentiation, proliferation, and morphogenesis in living animals, we used the zebrafish elastaseA (elaA) regulatory sequence to develop transgenic zebrafish that display highly specific exocrine pancreas expression of GFP in both larvae and adult. By following GFP expression, we found that the pancreas in early development was a relatively compact organ and later extended posterior along the intestine. By transferring the elaA:gfp transgene into slow muscle omitted mutant that is deficient in receiving Hedgehog signals, we further showed that Hedgehog signaling is required for exocrine morphogenesis but not for cell differentiation. We also applied the morpholino knockdown and toxin-mediated cell ablation approaches to this transgenic line. We showed that the development of exocrine pancreas is Islet-1 dependent. Injection of the diphtheria toxin A (DTA) construct under the elastaseA promoter resulted in selective ablation of exocrine cells while the endocrine cells and other endodermal derivatives (liver and intestine) were not affected. Thus, our works demonstrated the new transgenic line provided a useful experimental tool in analyzing exocrine pancreas development.

Wan Haiyan [Department of Biological Sciences, National University of Singapore (Singapore); Korzh, Svitlana [Department of Biological Sciences, National University of Singapore (Singapore); Li Zhen [Department of Biological Sciences, National University of Singapore (Singapore); Mudumana, Sudha Puttur [Department of Biological Sciences, National University of Singapore (Singapore); Korzh, Vladimir [Department of Biological Sciences, National University of Singapore (Singapore); Laboratory of Fish Developmental Biology, Institute of Molecular and Cell Biology (Singapore); Jiang Yunjin [Laboratory of Developmental Signaling and Patterning, Institute of Molecular and Cell Biology (Singapore); Lin Shuo [Department of Molecular, Cell and Developmental Biology, University of California at Los Angeles, CA 90024 (United States); Gong Zhiyuan [Department of Biological Sciences, National University of Singapore (Singapore) and Department of Molecular, Cell and Developmental Biology, University of California at Los Angeles, CA 90024 (United States)]. E-mail: dbsgzy@nus.edu.sg

2006-05-15

275

Inactivation of TIF1c Cooperates with KrasG12D Cystic Tumors of the Pancreas  

E-print Network

Inactivation of TIF1c Cooperates with KrasG12D to Induce Cystic Tumors of the Pancreas David F/lox ), we selectively abrogated Tif1c expression in the pancreas of Pdx1-Cre;Tif1clox/lox mice. We also suppression in the pancreas, brings new insight into the genetics of pancreatic cancer, and constitutes

Paris-Sud XI, Université de

276

Colony-forming cells in the adult mouse pancreas are expandable in Matrigel and form endocrine/acinar  

E-print Network

Colony-forming cells in the adult mouse pancreas are expandable in Matrigel and form endocrine isolated from dissociated adult (2­4 mo old) murine pancreas. We find that a methylcellulose microfluidic expression analysis of single cells and colonies, should also advance study of pancreas

Sander, Maike

277

La "conversione" delle cellule della cute che producono insulina: nuova arma contro diabete e tumore del pancreas  

E-print Network

tumore del pancreas Uno studio dell'Università degli Studi di Milano su PNAS scopre un metodo, sicuro alterarne il DNA. Straordinarie le potenzialità nella terapia del diabete e del tumore al pancreas. La i vari tipi di diabete e per il tumore del pancreas. La ricerca, finanziata da AIRC, MIUR e Regione

De Cindio, Fiorella

278

Identification of differentially expressed mRNA during pancreas regeneration of rat by mRNA differential display  

E-print Network

Identification of differentially expressed mRNA during pancreas regeneration of rat by m was used to isolate genes that show transcriptional changes in pancreas of rat after 90% partial pancreatectomy. Forty-nine candidate pancreas regeneration-associated transcripts were isolated. cDNA sequencing

Park, Jong-Sang

279

Magnetic resonance image-guided photodynamic therapy of xenograft pancreas tumors with verteporfin  

NASA Astrophysics Data System (ADS)

Pancreatic cancer generally has very poor prognosis, with less than 4% survival at 5 years after diagnosis. This dismal survival rate is in part due to the aggressive nature of the adenocarcinoma, leading to a late-stage at diagnosis and exhibits resistance to most therapies. Photodynamic therapy (PDT) is a model cellular and vascular therapy agent, which uses light activation of the delivered drug to photosensitize the local cellular millieu. We suggest that interstitial verteporfin (benzoporphyrin derivative monoacid ring A) PDT has the potential to be an adjuvant therapy to the commonly used Gemcitabine chemotherapy. In the current study, an orthotopic pancreatic cancer model (Panc-1) has undergone interstitial verteporfin PDT (40 J/cm with verteporfin and 40 J/cm without verteporfin). Prior to PDT, magnetic resonance (MR) imaging was used to determine the location and size of the tumor within the pancreas, allowing accurate placement of the diffusing fiber. The success of therapy was monitored in vivo by assessing the total tumor and vascular perfusion volumes 24 hours pre- and 48 hours post-PDT. Total tumor and vascular perfusion volumes were determined using T2 weighted (T2W) and Gd-DTPA difference T1 weighted (T1W) turbo spin echo (TSE) MR imaging sequences, respectively. The validity of the in vivo imaging for therapeutic response was confirmed by ex vivo fluorescence and histological staining of frozen tissue sections. The ex vivo DiOC7(3) fluorescence analysis correlates well with the information provided from the MR images, indicating that MR imaging will be a successful surrogate marker for interstitial PDT.

Samkoe, Kimberley S.; Chen, Alina; Rizvi, Imran; O'Hara, Julia A.; Hoopes, P. Jack; Hasan, Tayyaba; Pogue, Brian W.

2009-02-01

280

Diagnostic value of preoperative serum carcinoembryonic antigen and carbohydrate antigen 19-9 in colorectal cancer  

PubMed Central

Background Since the first introduction of tumour markers, their usefulness for diagnosis has been a challenging question. The aim of the present prospective study was to investigate, in colorectal cancer patients, the relationship between preoperative tumour marker concentrations and various clinical variables. Methods The study prospectively enrolled 131 consecutive patients with a confirmed diagnosis of colorectal carcinoma and 131 age- and sex-matched control subjects with no malignancy. The relationships of the tumour markers carcinoembryonic antigen (cea) and carbohydrate antigen (ca) 19-9 with disease stage, tumour differentiation (grade), mucus production, liver function tests, T stage, N stage, M stage were investigated. Results Serum concentrations of cea were significantly higher in the patient group than in the control group (p = 0.001); they were also significantly higher in stage iii (p = 0.018) and iv disease (p = 0.001) than in stage i. Serum concentrations of cea were significantly elevated in the presence of spread to lymph nodes (p = 0.005) in the patient group. Levels of both tumour markers were significantly elevated in the presence of distant metastasis in the patient group (p = 0.005 for cea; p = 0.004 for ca 19-9). Conclusions Preoperative levels of cea and ca 19-9 might provide an estimate of lymph node invasion and distant metastasis in colorectal cancer patients. PMID:24523606

Polat, E.; Duman, U.; Duman, M.; Atici, A.E.; Reyhan, E.; Dalgic, T.; Bostanci, E.B.; Yol, S.

2014-01-01

281

[Diagnosis and treatment of incidental prostate cancer].  

PubMed

Incidental prostate cancer (IPC)--cancer, identified by morphological evaluation of prostate tissue removed during transurethral resection (TUR) or open prostatectomy, in cases where the results of preoperative prostate biopsy revealed no prostate cancer. Literature review presents the data on the incidence of IPC, features of its diagnosis, prediction of tumor progression, and choice of treatment approaches. Many questions remain unresolved and require additional research. PMID:25211935

Marisov, L V; Vinarov, A Z

2014-01-01

282

Preoperative biliary drainage for pancreatic cancer.  

PubMed

This review is to summarize the current knowledge about preoperative biliary drainage (PBD) in patients with biliary obstruction caused by pancreatic cancer. Most patients with pancreatic carcinoma (85%) will present with obstructive jaundice. The presence of toxic substances as bilirubin and bile salts, impaired liver function and altered nutritional status due to obstructive jaundice have been characterized as factors for development of complications after surgery. Whereas PBD was to yield beneficial effects in the experimental setting, conflicting results have been observed in clinical studies. The meta-analysis from relative older studies as well as more importantly a recent clinical trial showed that PBD should not be performed routinely. PBD for patients with a distal biliary obstruction is leading to more serious complications compared with early surgery. Arguments for PBD have shifted from a potential therapeutic benefit towards a logistic problem such as patients suffering from cholangitis and severe jaundice at admission or patients who need extra diagnostic tests, or delay in surgery due to a referral pattern or waiting list for surgery as well as candidates for neoadjuvant chemo(radio)therapy. If drainage is indicated in these patients it should be performed with a metal stent to reduce complications after the drainage procedure such as stent occlusion and cholangitis. Considering a change towards more neoadjuvant therapy regimes improvement of the quality of the biliary drainage concept is still important. PMID:24727874

Van Heek, N T; Busch, O R; Van Gulik, T M; Gouma, D J

2014-04-01

283

[Preoperative radiotherapy for rectal cancer: target volumes].  

PubMed

Preoperative radiochemotherapy followed by total mesorectal excision is the standard of care for T3-T4-N0 or TxN1 rectal cancer. Defining target volumes relies on the patterns of nodal and locoregional failures. The lower limit of the clinical target volume depends also on the type of surgery. Conformational radiotherapy with or without intensity-modulated radiotherapy implies an accurate definition of volumes and inherent margins in the context of mobile organs such as the upper rectum. Tumoral staging recently improved with newer imaging techniques such as MRI with or without USPIO and FDG-PET-CT. The role of PET-CT remains unclear despite encouraging results and MRI is a helpful tool for a reliable delineation of the gross tumour volume. Co-registration of such modalities with the planning CT may particularly guide radiation oncologists through the gross tumour volume delineation. Acute digestive toxicity can be reduced with intensity modulation radiation therapy. Different guidelines and CT-based atlas regarding the target volumes in rectal cancer give the radiation oncologist a lot of ground for reproducible contours. PMID:24011671

Huertas, A; Marchal, F; Peiffert, D; Créhange, G

2013-10-01

284

Galanin-like immunoreactive endocrine cells in bovine pancreas  

PubMed Central

Pancreata of fetal, neonatal and adult cattle were studied immunohistochemically for galanin. The results revealed galanin-like immunoreactivity both in the endocrine cells and in the neural elements. The galanin-like immunoreactive endocrine cells (Gal-LIEC) were confined to the large islets, and were not observed in the islets of Langerhans and exocrine pancreas. They were first detected at the third prenatal month. Their developmental profile showed an increase from fetal to early neonatal stage with a subsequent decrease towards adulthood. The considerable number of Gal-LIEC from late prepartum to early postpartum stage may imply functional significance of galanin during the perinatal development of cattle. Coexistence of galanin and insulin was also observed which may suggest autocrine interaction between the 2 hormones. PMID:10739025

BALTAZAR, EMMANUEL T.; KITAMURA, NOBUO; HONDO, EIICHI; NARRETO, ERLINDA C.; YAMADA, JUNZO

2000-01-01

285

Targeted agents in treatment of neuroendocrine tumors of pancreas.  

PubMed

Neuroendocrine tumors (NET) of the pancreas are uncommon neoplasms that arise from the pancreatic islet cells. Surgical resections are being tested, as well as multiple chemotherapy agents. Current treatment options for nonresectable disease include somatostatin analogs and chemotherapy. New therapies focus on specific molecular targets such as sunitinib, angiogenesis inhibitor, that target vascular endothelial growth factor receptor (VEGFR) and other growth factor receptors and everolimus, an inhibitor of the mammalian target of rapamycin. Functionally based medical therapies for NET include somatostatin analogs to control symptoms. The 2014 annual meeting of American Society of Clinical Oncology (ASCO) brought us new insights into the management of pancreatic neuroendocrine tumors. The focus of this review will serve to highlight specific Abstracts (#e15160 and #e15161), that shed light on new therapeutic options that help target the unique pathways of this malignancies. PMID:25076341

Karampelas, Ilias N; Syrigos, Kostas N; Saif, Muhammad Wasif

2014-07-01

286

Making ? cells from Adult Cells within the Pancreas  

PubMed Central

Cell therapy is currently considered as a potential therapeutic alternative to traditional treatments of diabetes. Islet and whole pancreas transplantations provided the proof- of-concept of glucose homeostasis restoration after replenishment of the deficiency of ? cells responsible for the disease. Current limitations of these procedures have led to the search for strategies targeting replication of pre-existing ? cells or transdifferentiation of progenitors and adult cells. These investigations revealed an unexpected plasticity towards ? cells of adult cells residing in pancreatic epithelium (e.g. acinar, duct and ? cells). Here we discuss recent developments in ?-cell replication and ?-cell transdifferentiation of adult epithelial pancreatic cells, with an emphasis on techniques with a potential for clinical translation. PMID:23925431

Lysy, Philippe A.; Weir, Gordon C.; Bonner-Weir, Susan

2013-01-01

287

17 beta-hydroxysteroid dehydrogenase activity in canine pancreas  

SciTech Connect

The mitochondrial fraction of the dog pancreas showed NAD(H)-dependent enzyme activity of 17 beta-hydroxysteroid dehydrogenase. The enzyme catalyzes oxidoreduction between androstenedione and testosterone. The apparent Km value of the enzyme for androstenedione was 9.5 +/- 0.9 microM, the apparent Vmax was determined as 0.4 nmol mg-1 min-1, and the optimal pH was 6.5. In phosphate buffer, pH 7.0, maximal rate of androstenedione reduction was observed at 37 degrees C. The oxidation of testosterone by the enzyme proceeded at the same rate as the reduction of the androstenedione at a pH of 6.8-7.0. The apparent Km value and the optimal pH of the enzyme for testosterone were 3.5 +/- 0.5 microM and 7.5, respectively.

Mendoza-Hernandez, G.; Lopez-Solache, I.; Rendon, J.L.; Diaz-Sanchez, V.; Diaz-Zagoya, J.C.

1988-04-15

288

Artificial Pancreas: Model Predictive Control Design from Clinical Experience  

PubMed Central

Background The objective of this research is to develop a new artificial pancreas that takes into account the experience accumulated during more than 5000 h of closed-loop control in several clinical research centers. The main objective is to reduce the mean glucose value without exacerbating hypo phenomena. Controller design and in silico testing were performed on a new virtual population of the University of Virginia/Padova simulator. Methods A new sensor model was developed based on the Comparison of Two Artificial Pancreas Systems for Closed-Loop Blood Glucose Control versus Open-Loop Control in Patients with Type 1 Diabetes trial AP@home data. The Kalman filter incorporated in the controller has been tuned using plasma and pump insulin as well as plasma and continuous glucose monitoring measures collected in clinical research centers. New constraints describing clinical knowledge not incorporated in the simulator but very critical in real patients (e.g., pump shutoff) have been introduced. The proposed model predictive control (MPC) is characterized by a low computational burden and memory requirements, and it is ready for an embedded implementation. Results The new MPC was tested with an intensive simulation study on the University of Virginia/Padova simulator equipped with a new virtual population. It was also used in some preliminary outpatient pilot trials. The obtained results are very promising in terms of mean glucose and number of patients in the critical zone of the control variability grid analysis. Conclusions The proposed MPC improves on the performance of a previous controller already tested in several experiments in the AP@home and JDRF projects. This algorithm complemented with a safety supervision module is a significant step toward deploying artificial pancreases into outpatient environments for extended periods of time. J Diabetes Sci Technol 2013;7(6):1470-1483 PMID:24351173

Toffanin, Chiara; Messori, Mirko; Palma, Federico Di; Nicolao, Giuseppe De; Cobelli, Claudio; Magni, Lalo

2013-01-01

289

Pancreas-specific deletion of mouse Gata4 and Gata6 causes pancreatic agenesis  

PubMed Central

Pancreatic agenesis is a human disorder caused by defects in pancreas development. To date, only a few genes have been linked to pancreatic agenesis in humans, with mutations in pancreatic and duodenal homeobox 1 (PDX1) and pancreas-specific transcription factor 1a (PTF1A) reported in only 5 families with described cases. Recently, mutations in GATA6 have been identified in a large percentage of human cases, and a GATA4 mutant allele has been implicated in a single case. In the mouse, Gata4 and Gata6 are expressed in several endoderm-derived tissues, including the pancreas. To analyze the functions of GATA4 and/or GATA6 during mouse pancreatic development, we generated pancreas-specific deletions of Gata4 and Gata6. Surprisingly, loss of either Gata4 or Gata6 in the pancreas resulted in only mild pancreatic defects, which resolved postnatally. However, simultaneous deletion of both Gata4 and Gata6 in the pancreas caused severe pancreatic agenesis due to disruption of pancreatic progenitor cell proliferation, defects in branching morphogenesis, and a subsequent failure to induce the differentiation of progenitor cells expressing carboxypeptidase A1 (CPA1) and neurogenin 3 (NEUROG3). These studies address the conserved and nonconserved mechanisms underlying GATA4 and GATA6 function during pancreas development and provide a new mouse model to characterize the underlying developmental defects associated with pancreatic agenesis. PMID:23006325

Xuan, Shouhong; Borok, Matthew J.; Decker, Kimberly J.; Battle, Michele A.; Duncan, Stephen A.; Hale, Michael A.; Macdonald, Raymond J.; Sussel, Lori

2012-01-01

290

Carcinomas of the ventral and dorsal pancreas exhibit different patterns of lymphatic spread.  

PubMed

In patients with carcinoma of the head of the pancreas with positive lymph nodes, the extent of an adequate lymph node dissection beyond peripancreatic area has remained controversial. Based on the two anlagens, the ventral or dorsal pancreas, we assessed the lymphatic spread pattern in 58 primary adenocarcinoma of head of the pancreas. Detection of lymph node metastasis was based on microscopic detection of carcinoma in consecutive serial sections of resected specimens including lymph nodes. When the tumor was confined to the ventral pancreas domain (n=20), the lymph node metastases were limited to areas along the superior mesenteric artery (SMA) besides peripancreatic lymph nodes. When the tumor was in the dorsal pancreas domain (n=6), the lymph node metastases were limited to areas along the common hepatic artery (CHA) and the hepatoduodenal ligament besides peripancreatic lymph nodes. When the tumor was extended into both domains (n=32), the lymph node metastases were distributed widely in areas along the SMA, CHA and the hepatoduodenal ligament besides peripancreatic lymph nodes. Based on these findings, the lymphatic spread of carcinomas of the head of the pancreas can be divided into two patterns by tumor location based on the two anlagens of the pancreas. PMID:17981748

Kitagawa, Hirohisa; Ohta, Tetsuo; Makino, Isamu; Tani, Takashi; Tajima, Hidehiro; Nakagawara, Hisatoshi; Ohnishi, Ichiro; Takamura, Hiroyuki; Kayahara, Masato; Watanabe, Hiroyuki; Gabata, Toshifumi; Matsui, Osamu; Zen, Yoh

2008-01-01

291

Technical aspects involved in the harvesting and preservation of the pancreas used for pancreatic islet allotransplantation.  

PubMed

The pancreas procurement from brain-dead donors used for pancreatic islet isolation and transplantation, was analyzed between 2007-2012. The pancreas was transported to the Fundeni Clinical Institute and the islet isolation process was performed in the Cell Therapy Laboratory. There were 20 en bloc pancreas-duodenum-spleen procurement during multiorgan harvesting. Eighteen pancreata were used for islet isolation and two were used for whole pancreas transplantation.One pancreas was used for whole pancreas transplant alone and the other one was used for simultaneous pancreas and kidney transplantation. Donor age ranged between 12 and 61 years, with a median age of 35 years old. The donors were 9 females and 11 males. The causes of death were in 8 cases –brain injury, in 7 cases – aneurism rupture, and in 5 cases stroke. The donors’ blood group was A(II) in 11 cases, O(I) in7 cases, and B(III) in 2 cases. The calculated BMI of the donors ranged between 15.6 and 27.8, with a median value of 24.1. The median calculated Vinkers score for our study group was 11. Cold ischemia time ranged between 1.5 and 8 hours,with a median value of 5 hours. PMID:23790787

Romanescu, D; Gangone, E; Boeti, M P Sirbu; Zamfir, R; Dima, S O; Popescu, I

2013-01-01

292

Place of Culdocentesis in the Diagnosis of Ectopic Pregnancy  

PubMed Central

In developing countries the high incidence of anaemia and pelvic infection often makes the diagnosis of ectopic pregnancy difficult. Culdocentesis has been used in 100 doubtful cases out of 144 consecutive cases of ectopic pregnancy. The preoperative diagnosis was correct in 93 out of the 100 cases. There were three false-negative and four false-positive results; only two unnecessary laparotomies were performed. It is suggested that culdocentesis has an essential place in the early diagnosis of doubtful or atypical ectopic pregnancy. It was simple, safe, and reliable. Owing to earlier diagnosis maternal mortality and morbidity and the duration of stay in hospital have all been reduced. PMID:5412946

Lucas, Cynthia

1970-01-01

293

[Venospondylography in the diagnosis of epidural abscesses in spinal osteomyelitis].  

PubMed

Venospondilography following a modified method in combination with pneumomyelotomography was fulfilled in 1,5 patients with osteomyelitis of spine. Venospondilography was found to be more informative as compared with pneumomyelography and liquor dynamic tests. It can be used among other methods of preoperative diagnosis in patients with spine osteomyelitis complicated by spinal disorders. PMID:6474735

Tikhodeev, S A; Sovetova, N A

1984-07-01

294

Recognition and management of preoperative risk.  

PubMed

Internists are frequently asked to do preoperative consultations and to manage perioperative complications. Realistic goals are to identify patient factors that increase the risk of surgery, to quantify this risk in order to make decisions about the appropriateness of and timing of the surgery, to provide recommendations on how to minimize the risk, to identify and manage coexisting medical conditions and their associated medication requirements, to monitor the patient for perioperative problems, and to make recommendations to deal with these problems when they occur. With few exceptions, nonselective imaging and laboratory screening tests have repeatedly been shown to be of little value when the history and physical do not suggest a problem. The risk associated with the planned surgery can be estimated, with the most common serious complications being cardiac events. Updated versions of Goldman's risk indices are particularly helpful for this. Clinical variables are optimally combined with selective stress testing to discern which patients will benefit from preoperative revascularization. This has been studied best in the setting of vascular surgery. A critical guiding principle is that the value of revascularization must be judged in terms of long term gains rather than just immediate perioperative benefit. Other interventions include the selective use of beta blockers, adequate analgesia for all, control of hypertension, and appropriate volume management, especially in the settings of preexisting CHF or valvular disease. It must also be recognized that perioperative ischemia and CHF often present atypically. An approach that combines aspects of both the ACC/AHA and the ACP guidelines seems optimal. A variety of noncardiac issues must also be addressed. Postoperative pulmonary complications are common, especially with preexisting pulmonary disease, thoracic and upper abdominal surgery, and obesity. PFTs and ABGs are indicated in selected patients. Stopping smoking, incentive spirometry, and selective use of bronchodilators and antibiotics are helpful. Patients with rheumatologic diseases have specific concerns based on systemic manifestations of disease including anemia, thrombocytopenia, pulmonary fibrosis, pericarditis, and hypercoagulability; medication effects particularly from steroids and nonsteroidal anti-inflammatory drugs; and specific joint problems including contractures and atlantoaxial joint instability. Diabetes increases the risk of infection and cardiac complications. Prevention of ketoacidosis and glucose control are necessary and can be achieved through a variety of approaches, depending on whether the patient suffers from Type 1 or Type 2 diabetes. The threshold for transfusion has increased in recent years, as has the use of erythropoietin and autologous blood donation. There is no longer an absolute hemoglobin that requires transfusion, although most require transfusion for hemoglobins less than 8 mg/dL, especially in the setting of cardiac disease and bloody surgery. The elderly require surgery at an increased rate and often do not do as well as younger patients. The primary issues are, however, not their age but their increased frequency of underlying disease and diminished reserve. The latter makes them prone to postoperative delirium, sensitivity to medications, and cardiac and pulmonary problems. Despite the many diseases that patients often have and the stresses of surgery itself, modern anesthetic and surgical techniques allow almost all patients to undergo necessary procedures at acceptable risk. The internist plays a critical role in minimizing this risk even further. PMID:10467630

Nierman, E; Zakrzewski, K

1999-08-01

295

Unique Presentation of Giant Metastatic Microcystic Serous Adenocarcinoma of the Pancreas  

PubMed Central

Tumors of the pancreas that contain substantial cystic components include mainly mucinous cystic neoplasm, intraductal papillary mucinous neoplasm, solid pseudopapillary tumor, and cystadenomas (which encompass microcystic, macrocystic/oligocystic, and rare solid serous adenomas). Microcystic adenoma of the pancreas is a tumor that is benign in nature. Malignant transformation in the tumor with metastases is rare and only about 26 cases have been reported so far. Here we present a giant microcystic adenoma of the pancreas, possibly the largest ever malignant type in this group ever reported in the literature with extensive metastases to the liver and causing extensive compression and encasement on surrounding structures. PMID:24782930

Kalal, Chetan Ramesh; Bihari, Chhagan; Sahney, Amrish; Kumar, KN Chandan; Rastogi, Archana

2014-01-01

296

[Effect of pineal gland peptides on morphofunctional structure of the pancreas in ageing].  

PubMed

A study of pineal gland peptides effect on morphology and functions of the pancreas in the model of premature ageing in rats was performed with respect to the need in methods for premature ageing prevention. Structural, morphological and functional alterations in pancreas tissue, suggesting premature ageing of the gland, were identified by methods of immunohistochemistry and electronic microscopy. There was registered a geroprotective effect of the pineal gland peptides on pancreas tissue, manifested in the resistance of the latter to the impact of stress factors entailing premature ageing. PMID:18306696

Ryzhak, A P; Kostiuchek, I N; Kvetno?, I M

2007-01-01

297

Histopathological effects of intraoperative radiotherapy on pancreas and adjacent tissues: a postmortem analysis  

SciTech Connect

Intraoperative radiotherapy (IORT) has been utilized in the treatment of resectable and unresectable pancreatic carcinoma at the National Cancer Institute. Detailed autopsy analyses of the radiation effects on the pancreas and adjacent tissues were performed on 13 patients dying at various times following therapy. IORT can induce a progressive retroperitoneal fibrosis and fibrosis of the porta hepatis in patients with resectable pancreatic carcinoma. In unresectable pancreatic carcinoma, the major expression of intraoperative irradiation with external beam irradiation is a progressive fibrosis of the pancreas with vascular sclerosis, nerve degeneration, atrophy of acinar cells, and atypical changes in the ducts of the pancreas, as well as degenerative changes of the pancreatic tumor.

Hoekstra, H.J.; Restrepo, C.; Kinsella, T.J.; Sindelar, W.F.

1988-02-01

298

A case of intraductal papillary adenocarcinoma of the pancreas associated with mass forming chronic pancreatitis.  

PubMed

A case of intraductal papillary adenocarcinoma of the pancreas associated with mass forming chronic pancreatitis without calcifications is described. Pancreatolithiasis, or calcified pancreas, is recognized as a high risk factor for pancreatic cancer. However, epidemiologic studies have found that carcinoma of the pancreas associated with chronic pancreatitis was rare. The question is whether chronic pancreatitis without calcifications is actually a precancerous background lesion or not. This case suggests that hyperplasia of the pancreatic ductal epithelium may be a precancerous lesion for pancreatic cancer in some patients with chronic pancreatitis. PMID:1327319

Kadoya, N; Nagakawa, T; Ohta, T; Fukushima, W; Mori, K; Nakano, T; Ueda, N; Kayahara, M; Akiyama, T; Ueno, K

1992-01-01

299

Coronary artery disease in surgical patients. Preoperative evaluation.  

PubMed

Primary care physicians play a major role in the risk stratification of patients with coronary artery disease (CAD) preparing for noncardiac surgery. Preoperative risk assessment takes into account the type and urgency of surgery and the extent of underlying CAD. With this approach, patients can be categorized as being at high, intermediate, or low risk for postoperative cardiac complications. Judicious use of preoperative noninvasive cardiac testing may help identify those patients at particularly high risk for such complications. PMID:1409175

Corapi, M J; Della Ratta, R K

1992-10-01

300

An ICU Preanesthesia Evaluation Form Reduces Missing Preoperative Key Information  

PubMed Central

Background A comprehensive preoperative evaluation is critical for providing anesthetic care for patients from the intensive care unit (ICU). There has been no preoperative evaluation form specific for ICU patients that allows for a rapid and focused evaluation by anesthesia providers, including junior residents. In this study, a specific preoperative form was designed for ICU patients and evaluated to allow residents to perform the most relevant and important preoperative evaluations efficiently. Methods The following steps were utilized for developing the preoperative evaluation form: 1) designed a new preoperative form specific for ICU patients; 2) had the form reviewed by attending physicians and residents, followed by multiple revisions; 3) conducted test releases and revisions; 4) released the final version and conducted a survey; 5) compared data collection from new ICU form with that from a previously used generic form. Each piece of information on the forms was assigned a score, and the score for the total missing information was determined. The score for each form was presented as mean ± standard deviation (SD), and compared by unpaired t test. A P value < 0.05 was considered statistically significant. Results Of 52 anesthesiologists (19 attending physicians, 33 residents) responding to the survey, 90% preferred the final new form; and 56% thought the new form would reduce perioperative risk for ICU patients. Forty percent were unsure whether the form would reduce perioperative risk. Over a three month period, we randomly collected 32 generic forms and 25 new forms. The average score for missing data was 23 ± 10 for the generic form and 8 ± 4 for the new form (P = 2.58E-11). Conclusions A preoperative evaluation form designed specifically for ICU patients is well accepted by anesthesia providers and helped to reduce missing key preoperative information. Such an approach is important for perioperative patient safety. PMID:23853741

Chuy, Katherine; Yan, Zhe; Fleisher, Lee; Liu, Renyu

2013-01-01

301

Preoperative laxity in osteoarthritis patients undergoing total knee arthroplasty  

Microsoft Academic Search

A preoperative quantitative evaluation of soft tissues is helpful for planning total knee arthroplasty, in addition to the\\u000a conventional clinical examinations involved in moving the knee manually. We evaluated preoperative coronal laxity with osteoarthritis\\u000a in patients undergoing total knee arthroplasty by applying a force of 150 N with an arthrometer. We examined a consecutive\\u000a series of 120 knees in 102 patients.

Yoshinori Ishii; Hideo Noguchi; Yoshikazu Matsuda; Hiroshi Kiga; Mitsuhiro Takeda; Shin-ichi Toyabe

2009-01-01

302

Fine needle aspiration biopsy of the islet cell tumor of pancreas: a comparison between computerized axial tomography and endoscopic ultrasound-guided fine needle aspiration biopsy.  

PubMed

The objective of the present study is to compare the cytologic features of islet cell tumor (ICT) of pancreas obtained by endoscopic ultrasound guided fine needle aspiration (EUS-FNA) and computed tomography guided FNA (CT-FNA). We also describe the cytologic features associated with malignant ICT. Eleven cytology samples from 121 CT- FNA and 30 EUS- FNA of the pancreas were obtained from nine patients with ICT. Diff-Quik, Papanicolaou, and immunohistochemical stains to determine neuroendocrine differentiation and the hormonal status were evaluated. Cytologic features and specimen adequacy were compared between the two techniques. Cytologic features noted in both benign and malignant ICT were also compared. Nine patients (5 men, 4 women) ranging in age from 29 to 84 years (mean age, 53.8 years). Diagnoses consisted of benign (4) and malignant (5) ICT. EUS-FNA was superior to CT-FNA in obtaining adequate cells (2/2 v 7/9) for the diagnosis and increased cellularity to perform additional immunohistochemical stains (2/2 v 4/7). Single, plasmacytoid cells with finely granular chromatin distribution characterized ICT on cytology. Mitoses (3/5) and necrosis (1/5) were noted in malignant ICT but not in benign ICT. EUS-FNA is superior to CT- FNA for obtaining cells for the diagnosis of ICT. Detection of mitoses and or necrosis from patients with ICT should initiate a search for metastasis. PMID:12004358

Jhala, Darshana; Eloubeidi, Mohammad; Chhieng, David C; Frost, Andra; Eltoum, Isam A; Roberson, Janie; Jhala, Nirag

2002-04-01

303

Dual diagnosis  

Microsoft Academic Search

Dual diagnosis denotes the co-occurrence of severe mental illness and substance use disorder. This contribution summarizes the literature on dual diagnosis by reviewing epidemiology, phenomenology, clinical correlates, assessment, treatment and current research. Epidemiological data from several countries show that substance abuse or dependence is common (approximately 50%) among persons disabled by severe mental disorders such as schizophrenia, bipolar disorder or

Robert E. Drake

2007-01-01

304

Dual diagnosis  

Microsoft Academic Search

Dual diagnosis in psychiatry and addiction refers to the presence of a substance use disorder coexisting with another major psychiatric disorder. This article reviews the prevalence and timing of occurrence of the various disorders and their combinations. The problems in diagnosis and management associated with these diagnoses are explored both from the point of view of the patient and of

Michael Finbar Sheehan; CAROLINE HAWKINGS

1993-01-01

305

Diagnosis and management of pancreatic cancer.  

PubMed

Pancreatic cancer remains the fourth leading cause of cancer-related deaths in the United States. Risk factors include family history, smoking, chronic pancreatitis, obesity, diabetes mellitus, heavy alcohol use, and possible dietary factors. Because more than two-thirds of adenocarcinomas occur in the head of the pancreas, abdominal pain, jaundice, pruritus, dark urine, and acholic stools may be presenting symptoms. In symptomatic patients, the serum tumor marker cancer antigen 19-9 can be used to confirm the diagnosis and to predict prognosis and recurrence after resection. Pancreas protocol computed tomography is considered standard for the diagnosis and staging of pancreatic cancer. Although surgical resection is the only potentially curative treatment for pancreatic ductal adenocarcinomas, less than 20% of surgical candidates survive five years. The decision on resectability requires multidisciplinary consultation. Pancreatic resections should be performed at institutions that complete at least 15 of the surgeries annually. Postoperatively, use of gemcitabine or fluorouracil/leucovorin as adjuvant chemotherapy improves overall survival by several months. However, more than 80% of patients present with disease that is not surgically resectable. For patients with locally advanced or metastatic disease, chemoradiotherapy with gemcitabine or irinotecan provides clinical benefit and modest survival improvement. Palliation should address pain control, biliary and gastric outlet obstruction, malnutrition, thromboembolic disease, and depression. PMID:24784121

De La Cruz, Maria Syl D; Young, Alisa P; Ruffin, Mack T

2014-04-15

306

Remission and pancreas isograft survival in recent onset diabetic NOD mice after treatment with low-dose anti-CD3 monoclonal antibodies.  

PubMed

Diabetes in NOD mice is an autoimmune disease similar to Type I diabetes in humans. Prior to hypoglycemia, changes in the islet infiltrate led to autoreactive T cell activation and destruction of the insulin-producing beta cells. If T cell activation can be inhibited before beta cell destruction is complete, islet cell rescue and regeneration can occur. Female NOD mice > 100 days old with blood glucose levels > 20 mM/l for less than 7 days were selected as 'recent onset' mice. Untreated, all of these animals would die of diabetes in < 40 days. Mice treated with anti-CD4 (GK1.5) achieved 14.3% permanent remission, while those treated with anti-CD8 (53.6.7) showed 33.3% permanent remission. Mice treated with anti-CD3 (145-2C1) also achieved 33.3% permanent remission, but 14% of these died of first dose syndrome. In mice treated with a low dose of anti-CD3 (10 microg KT3), which did not induce first dose syndrome, 50% remained in remission for > 100 days. This dose of mAb reduced insulitis but did not deplete splenic CD3 cells. When mice in remission were challenged with a vascularized pancreas isograft at 50 days, 9/22 remained normal and 13/22 had recurrent disease in both transplanted and native pancreas. Of the long-surviving isografts 7/9 were in KT3 treated recipients. Histology showed activated T cell infiltration in the native and transplanted pancreases of mice with transient remission. Benign insulitis with macrophages, B cells, CD4 > CD8 T cells and low levels of IL-2R, IL-2, IFN-gamma and IL-4 was seen in islets from the native pancreas and in long surviving pancreas isografts in mice that remained in remission. Thus, using low dose KT3, it was possible to halt the development of diabetes in 50% of animals treated soon after diagnosis, despite significant islet cell destruction at this stage. Of the KT3 treated mice in permanent remission, 70% had re-established tolerance to autoantigen and did not destroy vascularized pancreas isografts. PMID:12182467

Mottram, Patricia L; Murray-Segal, Lisa J; Han, Wenruo; Maguire, Julie; Stein-Oakley, Alicia N

2002-06-01

307

Reporter islets in the eye reveal the plasticity of the endocrine pancreas  

PubMed Central

The islets of Langerhans constitute the endocrine part of the pancreas and are responsible for maintenance of blood glucose homeostasis. They are deeply embedded in the exocrine pancreas, limiting their accessibility for functional studies. Understanding regulation of function and survival and assessing the clinical outcomes of individual treatment strategies for diabetes requires a monitoring system that continuously reports on the endocrine pancreas. We describe the application of a natural body window that successfully reports on the properties of in situ pancreatic islets. As proof of principle, we transplanted “reporter islets” into the anterior chamber of the eye of leptin-deficient mice. These islets displayed obesity-induced growth and vascularization patterns that were reversed by leptin treatment. Hence, reporter islets serve as optically accessible indicators of islet function in the pancreas, and also reflect the efficacy of specific treatment regimens aimed at regulating islet plasticity in vivo. PMID:24248353

Ilegems, Erwin; Dicker, Andrea; Speier, Stephan; Sharma, Aarti; Bahow, Alan; Edlund, Patrick Karlsson; Leibiger, Ingo B.; Berggren, Per-Olof

2013-01-01

308

Revised classification of neuroendocrine tumours of the lung, pancreas and gut  

Microsoft Academic Search

In this article new classifications of the neuroendocrine tumours of the lung, pancreas and gut are proposed. These classifications use a common frame work and attempt to consider the morphological, functional as well as biological features of the tumours.

C. Capella; P. U. Heitz; H. Höfler; E. Solcia; G. Klöppel

1995-01-01

309

Sarcomatoid (spindle cell) carcinoma of the pancreas: A case report and review of the literature  

PubMed Central

Sarcomatoid (spindle cell) carcinoma of the pancreas is a rare, high-grade epithelial malignancy composed predominantly or exclusively of spindle cells demonstrating evidence of epithelial derivation, but no features indicative of a specific line of mesenchymal differentiation. The current study presents the case of an 85-year-old Caucasian male with a tumor mass in the body of the pancreas. The individual subsequently underwent a distal pancreatectomy, splenectomy and partial gastrectomy. Microscopic examination of the 3.3-cm mass located in the body of the pancreas revealed a small, but high-grade, adenocarcinomatous component that blended imperceptibly with malignant spindle cells. No light microscopic or immunohistochemical evidence of specific mesenchymal differentiation was identified, and the spindle cells, as in the case of the carcinoma, were diffusely keratin-positive. Sarcomatoid (spindle cell) carcinoma defined in this way rarely presents in the pancreas, with, to the best of our knowledge, only six cases reported in the English literature. PMID:24348857

KANE, JOSHUA ROBERT; LASKIN, WILLIAM B.; MATKOWSKYJ, KRISTINA A.; VILLA, CELINA; YELDANDI, ANJANA V.

2014-01-01

310

Acute pancreatitis: pancreas divisum with ventral duct intraductal papillary mucinous neoplasms.  

PubMed

Acute recurrent pancreatitis occurs rarely in individuals with pancreas divisum. A 39-year-old woman with no significant history presented with pancreatitis. CT scan and MRI suggested acute on chronic pancreatitis with calcifications and pancreatic divisum. An endoscopic ultrasound demonstrated complete pancreas divisum. A large calcification measuring 12?mm × 6?mm was seen in the head of the pancreas with associated dilation of the ventral pancreatic duct. Fine-needle aspiration of the dilated ventral pancreatic duct showed an amylase level of 36?923?U/L and a carcinoembryonic antigen of 194. A ventral duct intraductal papillary mucinous neoplasm was suspected and a pancreaticoduodenectomy procedure was recommended. After the procedure, pathology demonstrated an intraductal papillary lesion in the main duct with moderate dysplasia. A pancreatic intraepithelial neoplasia, grade 2 was also present. Margins of resection were clear. This case represents the importance of assessing for secondary causes of pancreatitis in pancreas divisum. PMID:25293684

Gurram, Krishna C; Czapla, Agata; Thakkar, Shyam

2014-01-01

311

Shear mechanical properties of the porcine pancreas: experiment and analytical modelling.  

PubMed

We provide the first account of the shear mechanical properties of porcine pancreas using a rheometer both in linear oscillatory tests and in constant strain-rate tests reaching the non-linear sub-failure regime. Our results show that pancreas has a low and weakly frequency-dependent dynamic modulus and experiences a noticeable strain-hardening beyond 20% strain. In both linear and non-linear regime, the viscoelastic behaviour of porcine pancreas follows a four-parameter bi-power model that has been validated on kidney, liver and spleen. Among the four solid organs of the abdomen, pancreas proves to be the most compliant and the most viscous one. PMID:23820244

Nicolle, S; Noguer, L; Palierne, J-F

2013-10-01

312

Chemotherapy Improved Prognosis of Mesenchymal Chondrosarcoma with Rare Metastasis to the Pancreas  

PubMed Central

Extraskeletal mesenchymal chondrosarcoma is rare and metastasis to the pancreas is extremely rare, with only four cases reported in the literature. The therapeutic effectiveness of chemotherapy remains uncertain. We report a 39-year-old man with extraskeletal mesenchymal chondrosarcoma of the buttock, who had metastases to the pancreas, bones, and lung. He underwent distal pancreatectomy, resection of the buttock tumor, and chemotherapy. He had a good response to chemotherapy and survived for about 3 years after surgery. PMID:24716041

Tsukamoto, Shinji; Kido, Akira; Fujii, Hiromasa; Enomoto, Yasunori; Ohbayashi, Chiho; Tanaka, Yasuhito

2014-01-01

313

Pre-existing histological type and developmental mechanism of mucinous noncystic carcinoma of pancreas  

Microsoft Academic Search

Eleven cases with mucinous noncystic carcinoma (MC) of the pancreas were studied by histology and mucin immunohistochemistry,\\u000a to elucidate the mechanism, or route of development, and pre-existing histological type of MC of the pancreas. These MCs were\\u000a observed in close approximation to, or surrounding, intraductal papillary-mucinous carcinomas (IPMCs), and were centrally\\u000a situated among ductal adenocarcinomas (DAs). Hence, the 11 cases

Koichi Suda; Bunsei Nobukawa; Shigetaka Yamasaki; Fujihiko Suzuki; Hideo Shimizu; Masaru Takase

2000-01-01

314

Pax6 is required for differentiation of glucagon-producing alpha-cells in mouse pancreas  

Microsoft Academic Search

The functional unit of the endocrine pancreas is the islet of Langerhans. Islets are nested within the exocrine tissue of the pancreas and are composed of alpha-, beta-, delta- and gamma-cells1. beta-Cells produce insulin and form the core of the islet, whereas alpha-, delta- and gamma-cells are arranged at the periphery of the islet and secrete glucagon, somatostatin and a

Luc St-Onge; Beatriz Sosa-Pineda; Kamal Chowdhury; Ahmed Mansouri; Peter Gruss

1997-01-01

315

Ischemia reperfusion of the pancreas: A new in vivo model for acute pancreatitis in rats  

Microsoft Academic Search

Based on the concept that ischemia is an important factor in the pathogenesis of acute pancreatitis, we developed a new model\\u000a of complete ischemia\\/reperfusion of the pancreas in the rat. The aim of this study was to investigate the microcirculation\\u000a of the pancreas after complete and reversible ischemia at different times after reperfusion by using intravital fluorescence\\u000a microscopy. In addition,

T. F. Hoffmann; R. Leiderer; H. Waldner; S. Arbogast; K. Messmer

1995-01-01

316

Synthesis of guanidinoacetate and creatine from amino acids by rat pancreas.  

PubMed

Creatine is an important molecule involved in cellular energy metabolism. Creatine is spontaneously converted to creatinine at a rate of 1·7% per d; creatinine is lost in the urine. Creatine can be obtained from the diet or synthesised from endogenous amino acids via the enzymes arginine:glycine amidinotransferase (AGAT) and guanidinoacetate N-methyltransferase (GAMT). The liver has high GAMT activity and the kidney has high AGAT activity. Although the pancreas has both AGAT and GAMT activities, its possible role in creatine synthesis has not been characterised. In the present study, we examined the enzymes involved in creatine synthesis in the pancreas as well as the synthesis of guanidinoacetate (GAA) and creatine by isolated pancreatic acini. We found significant AGAT activity and somewhat lower GAMT activity in the pancreas and that pancreatic acini had measurable activities of both AGAT and GAMT and the capacity to synthesise GAA and creatine from amino acids. Creatine supplementation led to a decrease in AGAT activity in the pancreas, though it did not affect its mRNA or protein abundance. This was in contrast with the reduction of AGAT activity and mRNA and protein abundance in the kidney, suggesting that the regulatory mechanisms that control the expression of this enzyme in the pancreas are different from those in the kidney. Dietary creatine increased the concentrations of GAA, creatine and phosphocreatine in the pancreas. Unexpectedly, creatine supplementation decreased the concentrations of S-adenosylmethionine, while those of S-adenosylhomocysteine were not altered significantly. PMID:24103317

da Silva, Robin P; Clow, Kathy; Brosnan, John T; Brosnan, Margaret E

2014-02-01

317

Pancreatitis in patients with pancreas divisum: Imaging features at MRI and MRCP  

PubMed Central

AIM: To determine the magnetic resonance cholangiopancreatography (MRCP) and magnetic resonance imaging (MRI) features of pancreatitis with pancreas divisum (PD) and the differences vs pancreatitis without divisum. METHODS: Institutional review board approval was obtained and the informed consent requirement was waived for this HIPAA-compliant study. During one year period, 1439 consecutive patients underwent successful MRCP without injection of secretin and abdominal MRI studies for a variety of clinical indications using a 1.5 T magnetic resonance scanner. Two experienced radiologists retrospectively reviewed all the studies in consensus. Disputes were resolved via consultation with a third experienced radiologist. The assessment included presence and the imaging findings of PD, pancreatitis, and distribution of abnormalities. The pancreatitis with divisum constituted the study group while the pancreatitis without divisum served as the control group. MRCP and MRI findings were correlated with final diagnosis. Fisher exact tests and Pearson × 2 tests were performed. RESULTS: Pancreatitis was demonstrated at MRCP and MRI in 173 cases (38 cases with and 135 cases without divisum) among the 1439 consecutive cases. The recurrent acute pancreatitis accounted for 55.26% (21 of 38) in pancreatitis patients associated with PD, which was higher than 6.67% (9 of 135) in the control group, whereas the chronic pancreatitis was a dominant type in the control group (85.19%, 115 of 135) when compared to the study group (42.11%, 16 of 38) (?2 = 40.494, P < 0.0001). In cases of pancreatitis with PD, the dorsal pancreatitis accounted for a much higher percentage than that in pancreatitis without PD (17 of 38, 44.74% vs 30 of 135, 22.22%) (?2 = 7.257, P < 0.05). CONCLUSION: MRCP and MRI can depict the features of pancreatitis associated with divisum. Recurrent acute pancreatitis and isolated dorsal involvement are more common in patients with divisum. PMID:23946595

Wang, Deng-Bin; Yu, Jinxing; Fulcher, Ann S; Turner, Mary A

2013-01-01

318

Surgical sentinel lymph node biopsy in early breast cancer. Could it be avoided by performing a preoperative staging procedure? A pilot study  

PubMed Central

Summary Background The aim of this pilot trial was to study the feasibility of sentinel node percutaneous preoperative gamma probe-guided biopsy as a valid preoperative method of assessment of nodal status compared to surgical sentinel lymph node biopsy. Material/Methods This prospective study enrolled 10 consecutive patients without evidence of axillary lymph node metastases at preoperative imaging. All patients underwent sentinel node occult lesion localization (SNOLL) using radiotracer intradermic injection that detected a “hot spot” corresponding to the sentinel node in all cases. Gamma probe over the skin detection with subsequent ultrasonographically guided needle biopsy of the sentinel node were performed. The percutaneous needle core histopathological diagnosis was compared to the results of the surgical biopsy. Results Preoperative sentinel node identification was successful in all patients. Conclusions The combination of preoperative gamma probe sentinel node detection and ultrasound-guided biopsy could represent a valid alternative to intraoperative sentinel node biopsy in clinically and ultrasonographically negative axillary nodes, resulting in shorter duration of surgery and lower intraoperative risks. PMID:22936189

Testori, Alberto; Meroni, Stefano; Moscovici, Oana Codrina; Magnoni, Paola; Malerba, Paolo; Chiti, Arturo; Rahal, Daoud; Travaglini, Roberto; Cariboni, Umberto; Alloisio, Marco; Orefice, Sergio

2012-01-01

319

Organogenesis and functional genomics of the endocrine pancreas  

PubMed Central

Functional genomics, the analysis of the wealth of data produced by genome-wide analyses of gene expression, protein-protein, and protein-DNA interactions, has revolutionized biomedical research. Our ability to determine global gene expression profiles, transcription factor binding sites, and histone modification maps using microarray-based technologies and next generation sequencing applications has greatly enhanced our understanding of gene regulatory networks and the molecular wiring diagrams of cells and tissues. The organogenesis of the endocrine pancreas involves numerous signaling events within the endoderm-derived pancreatic epithelium and the surrounding mesenchyme, as well as complex transcription factor networks. Detailed understanding of the differentiation process from foregut endoderm to mature endocrine cells has enabled the rational design of in vitro differentiation protocols that coax embryonic stem cells into ?-like cells that might enable cell replacement therapy for diabetes in the future. In this review, we summarize the research studies that have utilized genomic tools to elucidate endocrine pancreatic organogenesis. PMID:22241333

Bramswig, Nuria C.; Kaestner, Klaus H.

2012-01-01

320

Impact of simultaneous pancreas-kidney transplantation: patients' perspectives  

PubMed Central

Background: Few qualitative studies of simultaneous pancreas-kidney transplantation (SPK Tx) have been published. The aims of this study were to explore from the perspective of patients, the experience of living with diabetes mellitus type 1 (T1DM), suffering from complications, and undergoing SPK Tx with good outcome; and to determine the impact of SPK Tx on patients and their social and cultural environment. Methods: We performed a focused ethnographic study. Twenty patients were interviewed. Data were analyzed using content analysis and constant comparison following the method proposed by Miles and Huberman. Results: A functioning SPK Tx allowed renal replacement therapy and insulin to be discontinued. To describe their new situation, patients used words and phrases such as “miracle”, “being reborn” or “coming back to life”. Although the complications of T1DM, its surgery and treatment, and associated psychological problems did not disappear after SPK Tx, these were minimized when compared with the pretransplantation situation. Conclusion: For patients, SPK Tx represents a recovery of their health and autonomy despite remaining problems associated with the complications of T1DM and SPK Tx. The understanding of patients’ existential framework and their experience of disease are key factors for planning new intervention and improvement strategies. PMID:22936846

Isla Pera, P; Moncho Vasallo, J; Guasch Andreu, O; Ricart Brulles, MJ; Torras Rabasa, A

2012-01-01

321

A generic telemedicine infrastructure for monitoring an artificial pancreas trial.  

PubMed

Telemedicine systems are seen as a possible solution for the remote monitoring of physiological parameters and can be particularly useful for chronic patients treated at home. Implementing those systems however has always required spending a great effort on the underlying infrastructure instead of focusing on the application cores as perceived by their users. This paper proposes an abstract unifying infrastructure for telemedicine services which is loosely based on the multi-agent paradigm. It provides the capability of transferring to the clinic any remotely acquired information, and possibly sending back updates to the patient. The infrastructure is a layered one, with the bottom layer acting at the data level and implemented in terms of a software library targeting a wide set of hardware devices. On top of this infrastructure several services can be written shaping the functionality of the telemedicine application while at the highest level, adhering to a simple agent model, it is possible to reuse those functional components porting the application to different platforms. The infrastructure has been successfully used for implementing a telemonitoring service for a randomized controlled study aimed at testing the effectiveness of the artificial pancreas as a treatment within the AP@home project funded by the European Union. PMID:23415079

Capozzi, Davide; Lanzola, Giordano

2013-06-01

322

Contrast-enhanced endoscopic ultrasonography improves the preoperative localization of insulinomas.  

PubMed

We report a case in which endoscopic ultrasonography (EUS), intraductal ultrasonography (IDUS) and contrast-enhanced EUS using Levovist helped to localize insulinoma correctly. A 74-year-old woman complained of symptomatic fasting hypoglycemia with relatively high concentration of serum insulin level. Dynamic contrast-enhanced computed tomography revealed a small tumor of 8 mm diameter in the pancreatic head. Insulin secretion was strongly stimulated by calcium injection into the gastroduodenal artery. To clarify the precise localization, we performed EUS, IDUS and contrast-enhanced EUS. The tumor was enhanced clearly by Levovist, and the distance from the main pancreatic duct was more than 3 mm. Therefore, a preoperative decision could be made to use the enucleation method for resection of the tumor. The surgeon could enucleate the tumor in a brief operation according to the preoperative diagnosis, and serum glucose levels returned to normal range after the operation. Contrast-enhanced EUS using Levovist was shown to be a useful diagnostic method for precise localization of small insulinoma. PMID:12402985

Kasono, Keizo; Hyodo, Takafumi; Suminaga, Yoshihisa; Sugiura, Yasuko; Namai, Kazuyuki; Ikoma, Aki; Tamemoto, Hiroyuki; Imawari, Michio; Kawakami, Masanobu; Ishikawa, San-e

2002-08-01

323

The preoperative experience of patients undergoing surgery for colorectal cancer: a phenomenological study.  

PubMed

Colorectal cancer is associated with significant morbidity and mortality; many patients undergo surgical resection following which they are discharged home to await adjuvant therapy. Using a phenomenological approach, patients' experiences during this period were investigated arising from a concern that their needs may be overlooked. However, though post-discharge experience was the primary focus, informants chose first to talk about their preoperative experiences; these are reported here. As this was not the primary focus, we cannot claim that the data is complete though the findings suggest that this area warrants further investigation. Preoperative experiences, characterised by fear, questions, isolation and uncertainty, exerted significant influence on the respondents. Some believed that cancer was 'their problem', no-one could help them with it although support from the Clinical Nurse Specialist was highly valued. Such reactions are not specific to colorectal disease and it was rarely evident that respondents had this form of cancer. Patients exhibited a desire to protect others from their diagnosis. The findings also show considerable variation in the requirement for information indicating that professionals should take their lead from the individual concerned. Patients with cancer are the 'experts' in living with the disease and their experiences can make a significant contribution to the planning and delivery of care. These findings have the potential to impact on the care received by those with colorectal cancer. PMID:18842456

Worster, Barbara; Holmes, Susan

2008-12-01

324

Preoperative Arrhythmias Such as Atrial Fibrillation: Cardiovascular Surgery Risk Factor  

PubMed Central

Atrial fibrillation is still the most common arrhythmia that occurs in heart surgery. However, there is few literature data on the manner in which preoperative atrial fibrillation may influence the postoperative outcome of various heart surgery procedures. The purpose of our research is to assess the effects of preoperative atrial fibrillation on patients having undergone different heart surgery procedures. The results of our research are a review of clinical data which were collected prospectively, over a 10-year period, from all the patients who had undergone heart surgery in our Institute. The study group included 1119 heart surgery patients, who were divided as follows: the preoperative AFib group (n = 226, 20.19%) and the sinus rhythm group (n = 893, 79.80%). Major postoperative complications and hospital mortality rates were analyzed. According to our statistical analysis, preoperative atrial fibrillation significantly increased the mortality risk (P = 0.001), the patients' mechanical ventilation needs (P = 0.022), the rate of occurrence of infectious complications (P < 0.5), the rate of occurrence of complications such as acute kidney failure (P = 0.012), and the time spent by the patients in the intensive care ward (P < 0.01). In conclusion, preoperative atrial fibrillation in heart surgery patients increases the mortality and major complication risk further to heart surgery. PMID:25105131

Anghel, Diana; Anghel, Radu; Corciova, Flavia; Enache, Mihail; Tinica, Grigore

2014-01-01

325

Preoperative cardiac assessment in patients undergoing major vascular surgery.  

PubMed

The aim of this study was to evaluate the effectiveness of a preoperative standardized cardiac assessment in patients undergoing major vascular surgery. From January 2005 to December 2006, 1446 elective interventions for major vascular diseases (carotid stenosis, CS; abdominal aortic aneurysm, AAA; peripheral arterial obstructive disease, PAOD) were performed; 1090 out of these patients underwent preoperative diagnostic assessment on an outpatient basis. Thirty-day results in terms of cardiac mortality and morbidity rates were recorded. Patients suffered from a CS in 578 cases (53%), an AAA in 303 cases (27.8%) and a PAOD in 209 cases (19.2%). Four hundred thirty-two patients (39.6%) underwent further evaluation of cardiac functional capacity with non-invasive stress testing. Sixteen patients were successfully treated prior to vascular surgery. Thirty-day cardiac mortality and morbidity rates were 0.2% and 3.9%, respectively. A positive preoperative non-invasive stress testing did not affect 30-day cardiac outcomes. In conclusion, the use of an accurate preoperative cardiac assessment allowed us to obtain satisfactory perioperative results in patients undergoing major vascular surgery. Routine preoperative evaluation with non-invasive stress testing did not seem to improve perioperative cardiac results. PMID:21742935

Troisi, Nicola; Pulli, Raffaele; Dorigo, Walter; Lo Sapio, Patrizia; Pratesi, Carlo

2011-08-01

326

Data collection variation in preoperative assessment: a literature review.  

PubMed

This study is a systematic literature review to identify data collected in the preoperative assessment. The PubMed and CINAHL databases were searched for articles published from 1997 to 2007. From the included articles, data items that were described as part of the preoperative assessment were extracted. Identified data items were categorized into 13 categories originating from SNOMED CT. Forty-one relevant articles were found. Preoperative assessment was equally performed in outpatient clinics and in-hospitals. The assessment was performed between the day of surgery and 30 days before surgery by anesthesiologists (51%) and/or nurses (39%) and/or other professionals (34%). The included articles described 541 data items. The two largest categories of data were "past history of clinical finding" and "physical examination procedure," with 212 and 75 data items. Only 6 data items "age," "diabetes," "ECG," "cardiovascular diseases," "hypertension," and "cigarette smoking and other use of tobacco" were stated in 50% or more of the articles. This study revealed a high diversity of data being collected during the preoperative assessment. Because of the diversity of patients, one undisputed preoperative assessment data set is hard to define. However, to solve the problem of data exchangeability, professionals should at least use a common core data set. PMID:21270635

Ahmadian, Leila; Cornet, Ronald; Van Klei, Wilton A; DE Keizer, Nicolette F

2011-11-01

327

[A case of intraductal papillary mucinous neoplasm of the pancreas arising from pancreas divisum without ventral pancreatic duct of Wirsung].  

PubMed

Most reported cases of intraductal papillary mucinous neoplasms (IPMNs) originate from Wirsung's duct or their branches. IPMNs arising from Santorini's duct and its branches have rarely been reported. Eight cases of IPMN arising from Santorini's duct have been published worldwide. However, these cases are associated with incomplete type of pancreas divisum. Recently, one report of IPMN with complete absence of Wirsung's duct has been reported. This patient was a 57-year-old woman who was admitted to the hospital due to progressive jaundice. On endoscopic retrograde cholangiopancreatography, there was a severely bulging ampulla of Vater and patulous minor papilla draining mucinous material and a cystic lesion communicating with the dilated Santorini's duct without any communication with Wirsung's duct. A pancreaticoduodenectomy was performed and the pathologic examination of resected specimen showed no evidence of Wirsung's duct, but an IPMN arising from Santorini's duct with peripancreatic lymph node metastasis. Herein, we report a case of invasive IPMN arising from pancreatic head without ventral pancreatic duct with a review of the relevant literatures. PMID:16554676

Kim, Sung Cheol; Kim, Seong Hwan; Myung, Suk Jin; Choi, Jin Woo; Song, Moon Hee; Jo, Yoon Ju; Park, Young Sook; Joo, Jong Eun; Park, Sung Won

2006-03-01

328

Intraductal papillary-mucinous tumors of the pancreas: Clinicopathologic features, outcome, and nomenclature. Members of the Pancreas Clinic, and Pancreatic Surgeons of Mayo Clinic  

Microsoft Academic Search

BACKGROUND & AIMS: Intraductal papillary-mucinous tumor (IPMT) of the pancreatic ducts is increasingly recognized. This study investigated if clinical, imaging, or, histological features predicated outcome, formulated a treatment algorithm, and clarified relationships among IPMT, mucinous cystic neoplasms of the pancreas (MCN), and chronic pancreatitis. METHODS: The medical records, radiographs, and pathological specimens of 15 patients with IPMT (dilated main pancreatic

EV Loftus; BA Olivares-Pakzad; KP Batts; MC Adkins; DH Stephens; MG Sarr; EP DiMagno

1996-01-01

329

[Differential diagnosis of pain in the right lower abdominal quadrant--case reports].  

PubMed

In the submitted case-records the authors present interesting peroperative findings--a coprolith obturing the lumen of the appendix, the torsion of an ovarian cyst and torsion of the omentum during diagnosis of acute appendicitis. The authors discuss the reliability of preoperative sonography for the diagnosis of pathological conditions in the appendical region which despite its falsely negative results are considered by the authors a useful method in the differential diagnosis of pain in the right iliac fossa. PMID:10377778

Smajer, B; Horálek, F; Chvátalová, N

1999-02-01

330

A case of primary jejunal cancer diagnosed by preoperative small intestinal endoscopy.  

PubMed

The patient was a 37-year-old female. She was brought to our hospital by ambulance with nausea and vomiting. Abdominal ultra sound and abdominal enhanced CT scan showed a tumor in left side of the abdominal aorta 6 cm in size, and it showed an expanded stomach and duodenum. Upper gastrointestinal series revealed an apple core sign in upper jejunum near the Treitz' ligament. Small intestinal endoscopy (XSIF-240 endoscope, Olympus Inc.) revealed stenosis related to an epithelially protruding lesion with an irregular surface in the jejunum on the anal side of the horizontal duodenal peduncle. Biopsy suggested a well-differentiated adenocarcinoma. Scintigraphy showed hot spot in left middle abdomen. Under a diagnosis of primary jejunum cancer, Partial resection of the jejunum and partial resection of the transverse colon was performed. Histopathologically, the tumor was well differentiated adenocarcinoma exposed serosal surface. Postoperatively, the stage was evaluated as III (T3, N1, M0). Preoperative diagnosis to use small intestinal endoscopy was effectiveness. We report a patient with primary jejunum cancer in whom a definitive diagnosis was made before surgery. PMID:21318964

Nabeshima, Kazuhito; Machimura, Takao; Wasada, Mitsuru; Takayasu, Hiroyuki; Ogoshi, Kyoji; Makuuchi, Hiroyasu

2008-04-01

331

Assessment of patient satisfaction with the preoperative anesthetic evaluation  

PubMed Central

Background The evaluation of patient satisfaction is a core aspect of the continuous quality improvement in anesthesia service that can be affected by the preoperative anesthetist visit. This visit enables the anesthetist to know about the patient’s general health status and the nature of surgery, to choose the type of anesthesia, and to discuss perioperative complications and their management with the patient. Patients have sometimes complained about the information given during the preoperative anesthetic evaluation in the University of Gondar teaching and referral hospital. The aim of this study was to determine the level of patient satisfaction with the preoperative anesthetist visit. Methods A cross-sectional study was conducted from February 15 to April 15, 2013. All consecutive elective patients who were operated upon under anesthesia during the study period were interviewed 24 hours after operation. A pretested questionnaire and checklists, which were developed based on the hospital’s anesthetic evaluation sheet, were used for data collection. Results A total of 116 elective patients were operated upon under anesthesia during the study period. Of these, 102 patients were included in our study, with a response rate of 87.9%. Anesthetists introduced themselves to ?24% patients; provided information about anesthesia to ?32%, postoperative complications to ?21%, postoperative analgesia to ?18, and postoperative nausea and vomiting to ?21%; and spent adequate time with ?74%. Patients’ questions were answered by the anesthetist in ?65% of cases, and ?65% of patients had reduced anxiety after the anesthetist visit. The patients’ overall satisfaction with the preoperative anesthetist visit was ?65%. Conclusion and recommendation Patient satisfaction with the preoperative anesthetic evaluation was low compared with the Royal College of Anaesthetists standards. Preoperative anesthetic evaluation should be emphasized. PMID:25258564

Gebremedhn, Endale Gebreegziabher; Nagaratnam, Vidhya

2014-01-01

332

Preoperative anemia increases mortality and postoperative morbidity after cardiac surgery  

PubMed Central

Background Anemia is an established adverse risk factor in cardiovascular disease. However, the effect of preoperative anemia is not well defined in heart surgery. This study evaluates the effect of preoperative anemia on early clinical outcomes in patients undergoing cardiac surgery. Methods A retrospective, observational, cohort study of prospectively collected data was undertaken on 7,738 consecutive patients undergoing heart surgery between April 2003 and February 2009. Of these, 1,856 patients with preoperative anemia were compared to 5,882 patients without anemia (control group). According to the World Health Organization, anemia was defined as hemoglobin level?Preoperative anemia was associated with tripling in the risk of death (4.6% vs 1.5%, p??7 days (54% vs 36.7%, p?preoperative anemia was an independent predictor of mortality (odds ratio [OR] 1.44, 95% confidence interval [CI] 1.02 to 2.03), postoperative renal dysfunction (OR 1.73, 95% CI 1.43 to 2.1) and length of hospital stay?>?7 days (OR 1.3, 95% CI 1.15 to 1.47). Conclusion In patients undergoing heart surgery, preoperative anemia is associated with an increased risk of mortality and postoperative morbidity. PMID:25096231

2014-01-01

333

Enigmatic Ectopic Fat: Prevalence of Nonalcoholic Fatty Pancreas Disease and Its Associated Factors in a Chinese Population  

PubMed Central

Background Fatty infiltration of the pancreas is an enigmatic manifestation of ectopic fat deposition in obesity. Studies have shown that pancreatic lipid accumulation interferes with insulin secretion in humans. However, the prevalence of fatty pancreas and its associated factors in the general population remain unclear. The aim of this study was to investigate the prevalence of fatty pancreas and its association with diabetes, nonalcoholic fatty liver disease (NAFLD), and cardiometabolic risk factors in a Chinese population. Methods and Results This was a cross?sectional study. A total of 8097 subjects with or without fatty pancreas (n=1297 and 6800, respectively) were recruited. Each subject was assessed by using abdominal sonography to diagnose NAFLD and fatty pancreas. Clinical and metabolic parameters were compared between groups, and their associations with fatty pancreas were examined. The prevalence of fatty pancreas was 16%. The fatty pancreas group had a significantly greater proportion of subjects with diabetes (12.6% versus 5.2%) and NAFLD (67.2% versus 35.1%) than did the non–fatty pancreas group (P<0.001). In the logistic regression analysis, age (P<0.001), general or central obesity (P<0.001), diabetes (P<0.001), and NAFLD (P<0.001) were independently associated with fatty pancreas after adjustment for sex, lipid profile, alanine transaminase/aspartate transaminase ratio, hypertension, smoking, alcohol drinking, and exercise. Conclusions The prevalence of fatty pancreas is high in the general population. Both diabetes and NAFLD are important associated factors of fatty pancreas, independent of age, sex, adiposity, and other cardiometabolic risk factors. PMID:24572250

Wang, Chih-Yuan; Ou, Horng-Yih; Chen, Ming-Fong; Chang, Tien-Chun; Chang, Chih-Jen

2014-01-01

334

Prognostic significance of preoperative fibrinogen in patients with colon cancer  

PubMed Central

AIM: To investigate the prognostic significance of preoperative fibrinogen levels in colon cancer patients. METHODS: A total of 255 colon cancer patients treated at the Affiliated Tumor Hospital of Xinjiang Medical University from June 1st 2005 to June 1st 2008 were enrolled in the study. All patients received radical surgery as their primary treatment method. Preoperative fibrinogen was detected by the Clauss method, and all patients were followed up after surgery. Preoperative fibrinogen measurements were correlated with a number of clinicopathological parameters using the Student t test and analysis of variance. Survival analyses were performed by the Kaplan-Meier method and Cox regression modeling to measure 5-year disease-free survival (DFS) and overall survival (OS). RESULTS: The mean preoperative fibrinogen concentration of all colon cancer patients was 3.17 ± 0.88 g/L. Statistically significant differences were found between preoperative fibrinogen levels and the clinicopathological parameters of age, smoking status, tumor size, tumor location, tumor-node-metastasis (TNM) stage, modified Glasgow prognostic scores (mGPS), white blood cell (WBC) count, neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), and carcinoembryonic antigen (CEA) levels. Univariate survival analysis showed that TNM stage, tumor cell differentiation grade, vascular invasion, mGPS score, preoperative fibrinogen, WBC, NLR, PLR and CEA all correlated with both OS and DFS. Alpha-fetoprotein (AFP) and body mass index correlated only with OS. Kaplan-Meier analysis revealed that both OS and DFS of the total cohort, as well as of the stage II and III patients, were higher in the hypofibrinogen group compared to the hyperfibrinogen group (all P < 0.05). In contrast, there was no significant difference between OS and DFS in stage?I?patients with low or high fibrinogen levels. Cox regression analysis indicated preoperative fibrinogen levels, TNM stage, mGPS score, CEA, and AFP levels correlated with both OS and DFS. CONCLUSION: Preoperative fibrinogen levels can serve as an independent prognostic marker to evaluate patient response to colon cancer treatment. PMID:25024612

Sun, Zhen-Qiang; Han, Xiao-Na; Wang, Hai-Jiang; Tang, Yong; Zhao, Ze-Liang; Qu, Yan-Li; Xu, Rui-Wei; Liu, Yan-Yan; Yu, Xian-Bo

2014-01-01

335

Conceptualizing and conducting preoperative psychological assessments of cochlear implant candidates.  

PubMed

A review of literature pertaining to psychosocial research on cochlear implantation is embedded in this formulation of how preoperative psychological assessments should be comceptualized and conducted. This article considers various purposes of such assessments, including those relevant to candidate selection, exclusion, and readiness. Particular attention is directed to the conceptualization and operational investigation of candidate readiness, which includes aspects of motivation and informed consent. Assessment in this context is framed as both a data collection and an intervention procedure. The article describes specific methodologies useful in preoperative psychological assessment, including questionnaires, interviews, and psychological tests. PMID:15579809

Pollard, R

1996-01-01

336

The role of N-cadherin and S1P/S1P1 in pancreas development.  

E-print Network

??Organogenesis of epithelial organs requires interaction between epithelial and mesenchymal tissues. During pancreas development, mesenchyme-derived structures induce specification, growth and differentiation of pancreatic epithelial cells.… (more)

Johansson, Jenny

2010-01-01

337

Perfusion-decellularized pancreas as a natural 3D scaffold for pancreatic tissue and whole organ engineering  

PubMed Central

Approximately 285 million people worldwide suffer from diabetes, with insulin supplementation as the most common treatment measure. Regenerative medicine approaches such as a bioengineered pancreas has been proposed as potential therapeutic alternatives. A bioengineered pancreas will benefit from the development of a bioscaffold that supports and enhances cellular function and tissue development. Perfusion-decellularized organs are a likely candidate for use in such scaffolds since they mimic compositional, architectural and biomechanical nature of a native organ. In this study, we investigate perfusion-decellularization of whole pancreas and the feasibility to recellularize the whole pancreas scaffold with pancreatic cell types. Our result demonstrates that perfusion-decellularization of whole pancreas effectively removes cellular and nuclear material while retaining intricate three-dimensional microarchitecture with perfusable vasculature and ductal network and crucial extracellular matrix (ECM) components. To mimic pancreatic cell composition, we recellularized the whole pancreas scaffold with acinar and beta cell lines and cultured up to 5 days. Our result shows successful cellular engraftment within the decellularized pancreas, and the resulting graft gave rise to strong up-regulation of insulin gene expression. These findings support biological utility of whole pancreas ECM as a biomaterials scaffold for supporting and enhancing pancreatic cell functionality and represent a step toward bioengineered pancreas using regenerative medicine approaches. PMID:23787110

Goh, Saik-Kia; Bertera, Suzanne; Olsen, Phillip; Candiello, Joe; Halfter, Willi; Uechi, Guy; Balasubramani, Manimalha; Johnson, Scott; Sicari, Brian; Kollar, Elizabeth; Badylak, Stephen F.; Banerjee, Ipsita

2013-01-01

338

Mechanisms of Action of GLP-1 in the Pancreas  

PubMed Central

Glucagon-like peptide-1 is a hormone that is encoded in the proglucagon gene. It is mainly produced in enteroendocrine L cells of the gut and is secreted into the blood stream when food containing fat, protein hydrolysate and/or glucose enters the duodenum. Its particular effects on insulin and glucagon secretion have generated a flurry of research activity over the past twenty years culminating in a naturally occurring GLP-1 receptor agonist, exendin-4, now being used to treat type 2 diabetes. GLP-1 engages a specific G-protein coupled receptor that is present in tissues other than the pancreas (brain, kidney, lung, heart, major blood vessels). The most widely studied cell activated by GLP-1 is the insulin-secreting beta cell where its defining action is augmentation of glucose-induced insulin secretion. Upon GLP-1 receptor activation, adenylyl cyclase is activated and cAMP generated, leading, in turn, to cAMP-dependent activation of second messenger pathways, such as the PKA and Epac pathways. As well as short-term effects of enhancing glucose-induced insulin secretion, continuous GLP-1 receptor activation also increases insulin synthesis, and beta cell proliferation and neogenesis. Although these latter effects cannot be currently monitored in humans, there are substantial improvements in glucose tolerance and increases in both first phase and plateau phase insulin secretory responses in type 2 diabetic patients treated with exendin-4. This review we will focus on the effects resulting from GLP-1 receptor activation in islets of Langerhans PMID:17306374

Doyle, Maire E.; Egan, Josephine M.

2007-01-01

339

Esophageal cancer: the role of integrated CT-PET in initial staging and response assessment after preoperative therapy.  

PubMed

Esophageal cancer, an uncommon neoplasm, has been increasing in incidence over the past few decades. Optimal management of patients is determined by the stage of disease at presentation, patient performance status, and location of the primary cancer. Recently, there has been increasing use of multimodality therapy in suitable candidates that employs preoperative chemotherapy and/or radiation followed by surgical resection. This evolving treatment strategy together with the substantial morbidity and mortality associated with esophagectomy makes appropriate patient selection critical. Computed tomography (CT) and endoscopy/endoscopic ultrasonography are usually carried out to initially stage patients with esophageal cancer, to determine primary tumor response, and to detect nodal and distant metastases after preoperative therapy. Positron emission tomography (PET) with [18F]-fluoro-2-deoxy-D-glucose and integrated CT-PET are useful in the initial staging of patients with esophageal cancer and in the prediction of pathologic response, disease-free interval, and overall survival after preoperative therapy. Importantly, integrated CT-PET imaging decreases the number of futile attempts at surgical resection, mainly because of the detection of occult distant metastases. The following sections review the use of integrated CT-PET imaging in determining the T, N, and M descriptors of the American Joint Commission on Cancer's 2002 guidelines for pathologic and clinical staging at initial diagnosis and after chemoradiation therapy in those patients being considered for surgical resection. PMID:16770230

Munden, Reginald F; Macapinlac, Homer A; Erasmus, Jeremy J

2006-05-01

340

Preoperative embolization of carotid chemodectoma: a technical challenge that can be customized according to angioarchitecture. Illustrative cases.  

PubMed

Preoperative embolization of carotid paraganglioma is increasingly used to reduce the risk of surgical bleeding obtaining a more precise and extensive tumor resection. Currently the technique can be customized in consideration of the different tumor angioarchitecture, thanks to embolic materials with different vascular penetration: solid particles of polyvinyl-alcohol (PVA), histoacryl glue, and liquid polymer (Onyx(®)). Two cases of swelling dissection with volume progression over time came to our observation. Both patients (45 and 70-year-old women) were studied with neck ultrasound imaging and computed tomography (CT) and/or magnetic resonance (MR). In both cases the radiological investigations confirmed the clinical suspicion of carotid paraganglioma. Both patients were sent for angiography control and preoperative devascularization of the lesion. The treatment was performed under general anesthesia using, depending on the type of tumor vasculature, in case 1 solid particles of PVA and histoacryl glue, and in case 2 Onyx(®) (Covidien, Irvine). The patients successfully underwent excision of the lesion via cervicotomy within a week from the embolization procedure, without any complications. The histological findings confirmed the diagnosis of chemodectoma, and macrophage infiltrates were seen in the regions previously embolized. At one-year follow-up, there was no evidence of recurrent disease. The preoperative embolization of vascular lesions of the neck represents a safe technique that yields the best results when customized over the type of vascularization of the lesion, enabling the use of the most appropriate materials, depending on the case to be treated. PMID:24355187

Faragò, Giuseppe; Castellani, Carlotta; Ponzi, Silvano; Jankovic, Claudio; Saginario, Vittorio; Berardi, Carlo; Pollo, Bianca; Ciceri, Elisa F

2013-12-01

341

[The role of echoendoscopic biopsy in diagnosing tuberculosis of pancreas].  

PubMed

The diagnosis of an abdominal mass using imaging techniques is difficult for clinicians and radiologists. We report a case of an atypical peripancreatic mass, mimicking a carcinoma on abdominal computed tomography and which was only diagnosed after an echoendoscopic biopsy of the mass was performed. It is difficult to differentiate abdominal tuberculosis from a neoplasm, especially if there is no pulmonary tuberculosis. Usually, the diagnosis of abdominal tuberculosis is only confirmed histologically, after surgical resection of the mass. Echoendoscopic biopsy confirmed the infectious nature of the mass and prevented complicated and difficult surgery. PMID:18341981

Coriat, R; Latournerie, M; Galtier, J-B; Michiels, C; Hillon, P; Manfredi, S

2008-01-01

342

The artificial pancreas: current status and future prospects in the management of diabetes.  

PubMed

Recent advances in insulins, insulin pumps, continuous glucose-monitoring systems, and control algorithms have resulted in an acceleration of progress in the development of artificial pancreas devices. This review discusses progress in the development of external systems that are based on subcutaneous drug delivery and subcutaneous continuous glucose monitoring. There are two major system-level approaches to achieving closed-loop control of blood glucose in diabetic individuals. The unihormonal approach uses insulin to reduce blood glucose and relies on complex safety mitigation algorithms to reduce the risk of hypoglycemia. The bihormonal approach uses both insulin to lower blood glucose and glucagon to raise blood glucose, and also relies on complex algorithms to provide for safety of the user. There are several major strategies for the design of control algorithms and supervision control for application to the artificial pancreas: proportional-integral-derivative, model predictive control, fuzzy logic, and safety supervision designs. Advances in artificial pancreas research in the first decade of this century were based on the ongoing computer revolution and miniaturization of electronic technology. The advent of modern smartphones has created the ability to utilize smartphone technology as the engineering centerpiece of an artificial pancreas. With these advances, an artificial or bionic pancreas is within reach. PMID:24725149

Peyser, Thomas; Dassau, Eyal; Breton, Marc; Skyler, Jay S

2014-04-01

343

Smad4 is dispensable for normal pancreas development yet critical in progression and tumor biology of pancreas cancer  

PubMed Central

SMAD4 is inactivated in the majority of pancreatic ductal adenocarcinomas (PDAC) with concurrent mutational inactivation of the INK4A/ARF tumor suppressor locus and activation of the KRAS oncogene. Here, using genetically engineered mice, we determined the impact of SMAD4 deficiency on the development of the pancreas and on the initiation and/or progression of PDAC—alone or in combination with PDAC-relevant mutations. Selective SMAD4 deletion in the pancreatic epithelium had no discernable impact on pancreatic development or physiology. However, when combined with the activated KRASG12D allele, SMAD4 deficiency enabled rapid progression of KRASG12D-initiated neoplasms. While KRASG12D alone elicited premalignant pancreatic intraepithelial neoplasia (PanIN) that progressed slowly to carcinoma, the combination of KRASG12D and SMAD4 deficiency resulted in the rapid development of tumors resembling intraductal papillary mucinous neoplasia (IPMN), a precursor to PDAC in humans. SMAD4 deficiency also accelerated PDAC development of KRASG12D INK4A/ARF heterozygous mice and altered the tumor phenotype; while tumors with intact SMAD4 frequently exhibited epithelial-to-mesenchymal transition (EMT), PDAC null for SMAD4 retained a differentiated histopathology with increased expression of epithelial markers. SMAD4 status in PDAC cell lines was associated with differential responses to transforming growth factor-? (TGF-?) in vitro with a subset of SMAD4 wild-type lines showing prominent TGF-?-induced proliferation and migration. These results provide genetic confirmation that SMAD4 is a PDAC tumor suppressor, functioning to block the progression of KRASG12D-initiated neoplasms, whereas in a subset of advanced tumors, intact SMAD4 facilitates EMT and TGF-?-dependent growth. PMID:17114584

Bardeesy, Nabeel; Cheng, Kuang-hung; Berger, Justin H.; Chu, Gerald C.; Pahler, Jessica; Olson, Peter; Hezel, Aram F.; Horner, James; Lauwers, Gregory Y.; Hanahan, Douglas; DePinho, Ronald A.

2006-01-01

344

Concomitant preoperative radiochemotherapy in operable locally advanced rectal cancer  

Microsoft Academic Search

PURPOSE: The aim of this study was to examine the effectiveness of a combination of preoperative radiotherapy and chemotherapy for operable locally advanced rectal cancer (Stages II and III). METHODS: Chemotherapy and radiotherapy are started jointly on day one of the therapy. 5-Fluorouracil is given in a dosage of 1000 mg\\/ m2\\/day as a continuous 24-hour infusion for 4 days.

Aurelio Picciocchi; Claudio Coco; Paolo Magistrelli; Giuliano Roncolini; Gaetano Netri; Claudio Mattana; Numa Cellini; Vincenzo Valentini; Antonio De Franco; Fabio Maria Vecchio; Renato Cavaliere; Maurizio Cosimelli; Fabrizio Ambesi Impiombato

1994-01-01

345

Minimizing Preoperative Anxiety With Alternative Caring-Healing Therapies  

Microsoft Academic Search

This article reviews holistic caring-healing therapies that may decrease preoperative anxiety for the surgical patient, based on the philosophy and science of caring developed by Jean Watson, RN, PhD, FAAN. Dr Watson reveals a new paradigm emerging in health care that blends the compassion and caring of nursing in harmony with the curative therapies of medicine. Hypnosis, aromatherapy, music, guided

Carol L. Norred

2000-01-01

346

The Role of Preoperative TIPSS to Facilitate Curative Gastric Surgery  

SciTech Connect

The use of TIPSS to facilitate radical curative upper gastrointestinal surgery has not been reported. We describe a case in which curative gastric resection was performed for carcinoma of the stomach after a preoperative TIPSS and embolization of a large gastric varix in a patient with portal hypertension.

Norton, S.A.; Vickers, J. [Bristol Royal Infirmary, Bristol BS2 8HW, University Department of Surgery (United Kingdom); Callaway, M.P. [Bristol Royal Infirmary, Bristol BS2 8HW, Department of ClinicalRadiology (United Kingdom)], E-mail: Mark.Callaway@ubht.swest.nhs.uk; Alderson, D. [Bristol Royal Infirmary, Bristol BS2 8HW, University Department of Surgery (United Kingdom)

2003-08-15

347

Preoperative mechanical preparation of the colon: the patient's experience  

Microsoft Academic Search

BACKGROUND: Preoperative mechanical bowel preparation can be questioned as standard procedure in colon surgery, based on the result from several randomised trials. METHODS: As part of a large multicenter trial, 105 patients planned for elective colon surgery for cancer, adenoma, or diverticulitis in three hospitals were asked to complete a questionnaire regarding perceived health including experience with bowel preparation. There

Barbel Jung; Olof Lannerstad; Lars Påhlman; Malin Arodell; Mitra Unosson; Erik Nilsson

2007-01-01

348

Preoperative planning and training simulation for risk reducing surgery  

E-print Network

need for simulation can be determined for surgery in complex regions of the human body1 Preoperative planning and training simulation for risk reducing surgery Dipl.-Inform. Tobias Salb, such as the cranio-facial or the cardiac area. It is very important that no vital structures of the body are damaged

Weyrich, Tim

349

Preoperative methylene blue staining of galactographically suspicious breast lesions.  

PubMed

Microdochectomy is the standard treatment of galactographically suspicious breast lesions. Precise preoperative marking of the suspicious duct and intraductal lesions facilitates selective minimal-volume microdochectomy. Methylene blue dye staining fulfills this criterion. A retrospective review of our experience of preoperative methylene blue staining in 30 patients with unilateral spontaneous nonlactiferous single duct nipple discharge operated on during 1986-1995 in the Oulu University Hospital for galactographically suspicious breast lesions. Galactography was successful in 29 out of 30 (93.3%) cases. Preoperative methylene blue staining was attempted in all cases on the day of surgery and it was successful in 22 (73.3%) cases making subsequent selective minimal-volume microdochectomy easy to perform. The failure of methylene blue staining led to quadrantectomy in 4 cases and smaller breast resections in the remaining 4 cases. Preoperative methylene blue dye staining crucially facilitates selective minimal-volume microdochectomy. An interval between primary galactography and later methylene blue staining leads to failures in approximately one quarter of the cases. A higher success rate would necessitate scheduling the microdochectomy on the same day as the primary galactography (and the subsequent methylene blue staining in suspicious cases). PMID:9412841

Saarela, A O; Kiviniemi, H O; Rissanen, T J

1997-01-01

350

Pre-operative considerations in aesthetic facial surgery.  

PubMed

This article reviews the common pitfalls in the complex process of pre-operative assessment for facial plastic surgery. Legal guidelines and best practice are discussed, and attention is directed mainly towards the consenting and psychological issues surrounding this area of surgery. PMID:24406082

Veer, V; Jackson, L; Kara, N; Hawthorne, M

2014-01-01

351

Preoperative hair removal: a case report with implications for nursing.  

PubMed

Preoperative hair removal has been a practice since the beginning of this century. Research in the 1970s and 1980s provide support for the contention that the procedure is unnecessary for wound asepsis and may increase the rate of surgical site infections (Seropian & Reynolds, 1971; Hamilton et al., 1977; Cruse & Foord, 1980; Court-Brown, 1981; Alexander et al., 1983; Winfield, 1986; Fairclough et al., 1987). However, some hospitals have continued routine preoperative hair removal long after dissemination of recommendations against it. This begs the question, 'Why is it that so often research findings are not applied in practice'. In Stroud v. General Hospital Corp. and Pollett (1993), a man died of sepsis resulting from cuts he gave himself after he was asked by a nurse, in complete violation of the hospital's preoperative skin preparation protocol, to clip hair from his abdomen. The court held the hospital liable for the nurse's negligent breach of its protocol. The case clearly supports findings in the literature that preoperative hair removal is potentially dangerous. It reinforces the importance of strict adherence to hospital protocols which have been put in place to protect patients' safety. PMID:8696601

Small, S P

1996-03-01

352

Quality Management in Middle Ear Surgery: Controversies Regarding Preoperative Imaging  

Microsoft Academic Search

Today a large variety of different imaging techniques are available for middle ear investigation. However, imaging is not suitable to give essential information in every case on the surgical strategy to be chosen. This article discusses the most frequent indications for preoperative imaging and the relevant techniques. CT scanning, MRI and rotational tomography are taken into consideration as well as

T. Zahnert; C. Offergeld

2010-01-01

353

Congenital Diaphragmatic HerniaOutcome of Preoperative Extracorporeal Membrane Oxygenation  

Microsoft Academic Search

In recent years, increasing numbers of patients with congenital diaphragmatic hernia (CDH) have been offered extracorporeal membrane oxygenation (ECMO) preoperatively if they can not physiologically tolerate early surgical repair. These infants are sicker and more unstable than those repaired pre-ECMO and, in most cases, have not had a \\

Khodayar Rais-Bahrami; Sandra T. Robbins; Vera L. Reed; David M. Powell; Billie L. Short

1995-01-01

354

A prospective multicenter evaluation of preoperative hemostatic screening tests  

Microsoft Academic Search

Background: Several retrospective and four prospective reports have questioned the need for routine preoperative hemostatic screening tests (PHST) in general surgery.Patients and methods: The results of four standard tests (prothrombin time, activated partial thromboplastin time, platelet count, and bleeding time) were prospectively compared with patient history and clinical data in a multicenter study of 3,242 consecutive patients. The patients were

Sidney Houry; Constantin Georgeac; Jean-Marie Hay; Abe Fingerhut; Marie-Jeanne Boudet

1995-01-01

355

Lung cancer: Preoperative pulmonary evaluation of the lung resection candidate  

Microsoft Academic Search

Lung resection provides the best chance of cure for individuals with early stage non-small cell lung cancer. Naturally, lung resection will lead to a decrease in lung function. The population that develops lung cancer often has concomitant lung disease and a reduced ability to tolerate further losses in lung function. The goal of the preoperative pulmonary assessment of individuals with

Peter J. Mazzone; Alejandro C. Arroliga

2005-01-01

356

The Amsterdam Preoperative Anxiety and Information Scale (APAIS)  

PubMed

The purpose of the present study was to assess patients' anxiety level and information requirement in the preoperative phase. During routine preoperative screening, 320 patients were asked to assess their anxiety and information requirement on a six-item questionnaire, the Amsterdam Preoperative Anxiety and Information Scale (APAIS). Two hundred patients also completed Spielberger's State-Trait Anxiety Inventory (STAI-State). Patients were able to complete the questionnaire in less than 2 min. On factor analysis, two factors emerged clearly: anxiety and the need for information. The anxiety scale correlated highly (0.74) with the STAI-State. It emerged that 32% of the patients could be considered as "anxiety cases" and over 80% of patients have a positive attitude toward receiving information. Moreover, results demonstrated that 1) women were more anxious that men; 2) patients with a high information requirement also had a high level of anxiety; 3) patients who had never undergone an operation had a higher information requirement than those who had. The APAIS can provide anesthesiologists with a valid, reliable, and easily applicable instrument for assessing the level of patients' preoperative anxiety and the need for information. PMID:8623940

Moerman, N; van Dam, F S; Muller, M J; Oosting, H

1996-03-01

357

Vascular invasion in pancreatic cancer: Imaging modalities, preoperative diagnosis and surgical management  

PubMed Central

Pancreatic cancer is associated with a poor prognosis, and surgical resection remains the only chance for curative therapy. In the absence of metastatic disease, which would preclude resection, assessment of vascular invasion is an important parameter for determining resectability of pancreatic cancer. A frequent error is to misdiagnose an involved major vessel. Obviously, surgical exploration with pathological examination remains the “gold standard” in terms of evaluation of resectability, especially from the point of view of vascular involvement. However, current imaging modalities have improved and allow detection of vascular invasion with more accuracy. A venous resection in pancreatic cancer is a feasible technique and relatively reliable. Nevertheless, a survival benefit is not achieved by curative resection in patients with pancreatic cancer and vascular invasion. Although the discovery of an arterial invasion during the operation might require an aggressive management, discovery before the operation should be considered as a contraindication. Detection of vascular invasion remains one of the most important challenges in pancreatic surgery. The aim of this article is to provide a complete review of the different imaging modalities in the detection of vascular invasion in pancreatic cancer. PMID:20143460

Buchs, Nicolas C; Chilcott, Michael; Poletti, Pierre-Alexandre; Buhler, Leo H; Morel, Philippe

2010-01-01

358

Preoperative assessment enables early diagnosis and recovery of shoulder function in patients with breast cancer  

Microsoft Academic Search

In order to determine the extent and time course of upper limb impairment and dysfunction in women being treated for breast\\u000a cancer (BC), and followed prospectively, a novel physical therapy surveillance model post-treatment was used. Subjects included\\u000a adult women with newly diagnosed, untreated, unilateral, Stage I to III BC, and normal physiological and biomechanical shoulder\\u000a function. Subjects were excluded if

Barbara A. SpringerEllen; Ellen Levy; Charles McGarvey; Lucinda A. Pfalzer; Nicole L. Stout; Lynn H. Gerber; Peter W. Soballe; Jerome Danoff

2010-01-01

359

Dual Diagnosis  

Microsoft Academic Search

It is estimated that 10 million persons in me United States have at least one mental disorder and at least one substance-related disorder in any given year. Dual disorders are common in psychiatry, but misdiagnosis may be even more common. Drug and alcohol testing should be expanded from routine use in the Olympics and intercollegiate athletics to psychiatric diagnosis of

Mark S. Gold

2005-01-01

360

A case of metaplastic breast cancer that showed a good response to platinum-based preoperative chemotherapy.  

PubMed

Patients with metaplastic breast cancer (MBC) exhibit reduced response to chemotherapy and have poor prognosis. We investigated a case of MBC that showed a positive response to preoperative chemotherapy, resulting in near pathological complete response (pCR). A 59-year-old woman complained of a lump in her right breast. Magnetic resonance imaging (MRI) showed the presence of a solid mass that was 24 mm in diameter. The pathological diagnosis was MBC with cartilaginous differentiation. The clinical stage was T2N0M0, stage IIA according to the International Union against Cancer (UICC) criteria. To observe the response to chemotherapy, we gave her preoperative chemotherapy. The patient was monitored closely, since we realized that failure of chemotherapy carries a risk of tumor progression. Evaluation was carried out using ultrasound, MRI, fluorodeoxyglucose (FDG) positron emission tomography (PET), and a Ki-67 labeling index after the first cycle of chemotherapy, and ultrasound after each additional cycle. FDG-PET showed a positive response after the first cycle of chemotherapy. The patient underwent 4 cycles of docetaxel (75 mg/m(2)) and cisplatin (75 mg/m(2)) followed by 4 cycles of cyclophosphamide (500 mg/m(2)), doxorubicin (50 mg/m(2)), and cisplatin (50 mg/m(2)). Ultrasound showed decreases in tumor size after each cycle of chemotherapy. After chemotherapy, MRI showed nearly complete regression of the tumor. Partial mastectomy was performed. Pathological examination showed few cancer cells remaining, indicating near pCR. We report a case of MBC that responded well to platinum-based preoperative chemotherapy. We propose that preoperative chemotherapy may be an option for treatment of MBC in conjunction with careful monitoring. PMID:21526425

Takuwa, Haruko; Ueno, Takayuki; Ishiguro, Hiroshi; Mikami, Yoshiki; Kanao, Shotaro; Takada, Masahiro; Sugie, Tomoharu; Toi, Masakazu

2014-07-01

361

Improving Surgical Outcomes in Pancreatic Surgery With Preoperative Nutrition  

PubMed Central

The purposes of this study were (1) to describe the relationship between preoperative physical status and postoperative outcomes in patients undergoing Whipple resection, and (2) to determine if the use of specialized immunonutrition with IMPACT Advanced Recovery supplementation improved postoperative outcomes (pancreatic leak rate, length of stay, and postoperative complications) in patients undergoing Whipple resection. The trial was a case-controlled prospective pilot study that took place in an outpatient gastrointestinal surgical oncology office in an urban community hospital in the northeast United States. The study population consisted of nine patients undergoing Whipple surgery. Patients were given IMPACT Advanced Recovery supplementation 4 days prior to Whipple surgery. Prospective data were collected on all patients and then compared to national averages in terms of outcomes. Study approval was obtained from the Fairfield University Institutional Review Board (IRB), though IRB approval was not required by the study facility due to the fact that this was a pilot study. Consent was also not required for retrospective chart review. Patients with lower scores according to the American Society of Anesthesiologists Physical Status Classification System have a shorter operating time in the setting of preoperative nutrition. Patients in this study who received preoperative nutrition with IMPACT Advanced Recovery supplementation had outcomes comparable to the national average. This pilot study suggests that there is a need for a multi-institutional randomized study powered to further evaluate the effectiveness of preoperative nutrition in pancreatic surgery. The literature supports the fact that preoperative nutritional supplementation should be offered to patients undergoing Whipple surgery. Optimization of nutritional status can translate to decreased length of stay and cost savings. PMID:25032044

Ward-Boahen, Dwanna; Wallace-Kazer, Meredith

2014-01-01

362

Improving surgical outcomes in pancreatic surgery with preoperative nutrition.  

PubMed

The purposes of this study were (1) to describe the relationship between preoperative physical status and postoperative outcomes in patients undergoing Whipple resection, and (2) to determine if the use of specialized immunonutrition with IMPACT Advanced Recovery supplementation improved postoperative outcomes (pancreatic leak rate, length of stay, and postoperative complications) in patients undergoing Whipple resection. The trial was a case-controlled prospective pilot study that took place in an outpatient gastrointestinal surgical oncology office in an urban community hospital in the northeast United States. The study population consisted of nine patients undergoing Whipple surgery. Patients were given IMPACT Advanced Recovery supplementation 4 days prior to Whipple surgery. Prospective data were collected on all patients and then compared to national averages in terms of outcomes. Study approval was obtained from the Fairfield University Institutional Review Board (IRB), though IRB approval was not required by the study facility due to the fact that this was a pilot study. Consent was also not required for retrospective chart review. Patients with lower scores according to the American Society of Anesthesiologists Physical Status Classification System have a shorter operating time in the setting of preoperative nutrition. Patients in this study who received preoperative nutrition with IMPACT Advanced Recovery supplementation had outcomes comparable to the national average. This pilot study suggests that there is a need for a multi-institutional randomized study powered to further evaluate the effectiveness of preoperative nutrition in pancreatic surgery. The literature supports the fact that preoperative nutritional supplementation should be offered to patients undergoing Whipple surgery. Optimization of nutritional status can translate to decreased length of stay and cost savings. PMID:25032044

Ward-Boahen, Dwanna; Wallace-Kazer, Meredith

2014-03-01

363

Preoperative cryotherapy use in anterior cruciate ligament reconstruction.  

PubMed

Unrelieved postoperative pain may impair rehabilitation, compromise functional outcomes, and lead to patient dissatisfaction. Preemptive multimodal analgesic techniques may improve outcomes after surgery. We hypothesized that patients using preoperative cryotherapy plus a standardized postoperative treatment plan will have lower pain scores and require less pain medication compared with patients receiving a standardized postoperative treatment plan alone after arthroscopically assisted anterior cruciate ligament reconstruction (ACLR). A total of 53 consecutive patients undergoing arthroscopically assisted ACLR performed by one of seven surgeons were randomly assigned to one of two groups. Group 1 received no preoperative cryotherapy and group 2 received 30 to 90 minutes of preoperative cryotherapy to the operative leg using a commercial noncompressive cryotherapy unit. Visual analog scale pain scores and narcotic use were recorded for the first 4 days postoperatively. Total hours of cold therapy and continuous passive motion (CPM) use and highest degree of flexion achieved were recorded as well. Group 1 consisted of 26 patients (15 allograft Achilles tendon and 11 autograft bone patellar tendon bone [BPTB]), and group 2 consisted of 27 patients (16 allograft Achilles tendon and 11 autograft BPTB). Group 2 patients reported less pain (average 1.3 units, p?preoperative cryotherapy. Our results support the safety and efficacy of preoperative cryotherapy in a multimodal pain regimen for patients undergoing ACL reconstruction. PMID:24488793

Koyonos, Loukas; Owsley, Kevin; Vollmer, Emily; Limpisvasti, Orr; Gambardella, Ralph

2014-12-01

364

Colorectal Stenting: An Effective Therapy for Preoperative and Palliative Treatment  

SciTech Connect

Purpose. To demonstrate the effectiveness of preoperative and palliative colorectal stent placement in acute colonic obstruction. Methods. Sixty-seven consecutive patients (mean age 67.3 years, range 25-93 years) with clinical and radiological signs of colonic obstruction were treated: 45 (67%) preoperatively and 22 (33%) with a palliative intent. In 59 patients (88%) the obstruction was malignant, while in 8 (12%) it was benign. A total of 73 enteric Wallstents were implanted under combined fluoroscopic/endoscopic guidance. Results. Forty-five patients were treated preoperatively with a technical success rate of 84%, a clinical success rate of 83%, and a complication rate of 16%. Of the 38 patients who were successfully stented preoperatively, 36 (95%) underwent surgery 2-22 days (mean 7.2 days) after stent insertion. The improved general condition and adequate bowel cleansing allowed single-stage tumor resection and primary end-to-end anastomosis without complications in 31 cases (86% of all operations), while only 5 patients had colostomies. Stent placement was used as the final palliative treatment in 22 patients. The technical success rate was 95%, the clinical success rate 72%, and the complication rate relatively high at 67%, caused by reocclusion in most cases. After noninvasive secondary interventions (e.g., tube placement, second stenting, balloon dilatation) the secondary patency of stents was 71% and mean reported survival time after stent insertion was 92 days (range 10-285 days). Conclusion. Preoperative stent placement in acute colonic obstruction is minimally invasive and allows an elective one-stage surgery in most cases. Stent placement also proved a valuable alternative to avoid colostomy in palliation.

Jost, Rahel S. [Kantonsspital Winterthur, Department of Surgery (Switzerland)], E-mail: raheljost@dplanet.ch; Jost, Res [Kantonsspital Winterthur, Department of Internal Medicine, Section of Gastroenterology (Switzerland); Schoch, Erich [Kantonsspital Winterthur, Department of Radiology (Switzerland); Brunner, Brigit [Kantonsspital Winterthur, Department of Internal Medicine, Section of Gastroenterology (Switzerland); Decurtins, Marco [Kantonsspital Winterthur, Department of Surgery (Switzerland); Zollikofer, Christoph L. [Kantonsspital Winterthur, Department of Radiology (Switzerland)

2007-06-15

365

Preoperative Planning of Robotics-Assisted Minimally Invasive Cardiac Surgery Under Uncertainty.  

E-print Network

??In this thesis, a computational framework for patient-specific preoperative planning of Robotics-Assisted Minimally Invasive Cardiac Surgery (RAMICS) is developed. It is expected that preoperative planning… (more)

Azimian, Hamidreza

2012-01-01

366

77 FR 71804 - Antiseptic Patient Preoperative Skin Preparation Products; Public Hearing; Request for Comments...  

Federal Register 2010, 2011, 2012, 2013

...Drug Administration [Docket No. FDA-2012-N-1040] Antiseptic Patient Preoperative Skin Preparation Products; Public Hearing...69863). The document announced a public hearing entitled ``Antiseptic Patient Preoperative Skin Preparation Products.'' The...

2012-12-04

367

Successful endovascular treatment for gastroduodenal artery pseudoaneurysm with an arteriovenous fistula after pancreas transplantation.  

PubMed

The aim of this study was to demonstrate the usefulness of endovascular treatment for gastroduodenal artery pseudoaneurysm with an arteriovenous fistula after simultaneous pancreas-kidney transplantation. We describe the case of a 38-year-old man who underwent successful simultaneous pancreas-kidney transplantation. An asymptomatic pseudoaneurysm of the donor gastroduodenal artery with an arteriovenous fistula was incidentally diagnosed by routine color flow Doppler ultrasound (CDU) examination and confirmed by 3-D gadolinium-enhanced magnetic resonance angiography (MRA) 15 days after transplantation. Selective arteriography (via the right femoral artery) confirmed an arteriovenous fistula and a pseudoaneurysm of the donor gastroduodenal artery. The patient underwent successful endovascular embolization. At 11 months of follow-up, normal pancreatic function was reported. Endovascular treatment for gastroduodenal artery pseudoaneurysm with an arteriovenous fistula after pancreas transplantation obviates the need for surgical intervention. PMID:12819860

Orsenigo, Elena; De Cobelli, Francesco; Salvioni, Marco; Cristallo, Marco; Fiorina, Paolo; Del Maschio, Alessandro; Di Carlo, Valerio; Secchi, Antonio

2003-09-01

368

Near-infrared fluorescence imaging of a solitary fibrous tumor of the pancreas using methylene blue  

PubMed Central

A 67-year-old female presented with unexplained abdominal pain. A contrast-enhanced computed tomography scan of the abdomen incidentally revealed a mass in the uncinate process of the pancreas. This mass was resected and based on histopathological findings, diagnosed as a solitary fibrous tumor (SFT) of the pancreas. A SFT is an extremely rare benign mesenchymal tumor that in 65% of cases affects the visceral pleura but can also affect extra-pleural sites. The intraoperative demarcation of pancreatic tumors, such as SFTs, can be challenging. In this report, the first clear intraoperative identification of a SFT of the pancreas in a human was shown using near-infrared fluorescence and methylene blue. PMID:22905287

van der Vorst, Joost R; Vahrmeijer, Alexander L; Hutteman, Merlijn; Bosse, Tjalling; Smit, Vincent THBM; van de Velde, Cornelis JH; Frangioni, John V; Bonsing, Bert A

2012-01-01

369

Evaluation of the degree of pancreas activity in piglets from sows fed enzymatic stimulating complex.  

PubMed

One of the possibilities for estimating pancreas activity is the estimation of zymogene granule content in pancreatic follicular cells. In the present study, the degree of pancreatic activity was measured in piglets from sows receiving enzymatic stimulating complex throughout pregnancy and during the lactation period. The pancreas was collected for ultrastructural examination from 1-day-old and 21-day-old piglets. The enzyme preparation influenced the ultrastructural structure of the piglet pancreas, but the secretory cells in these animals did not confirm a more intensive course of creation and maturation processes. The accumulation of granules in extra-secretory pancreatic cells was observed, with a large volume of these granules and granular crinophagy observed in older piglets. The findings indicate a slow process of granule release, which may be the result of overproduction, lower requirements for enzymes contained in the granules, or both. PMID:20169931

Zielonka, ?; Przewoski, W; Gajecka, M; Jakimiuk, E; Gajecki, M

2009-01-01

370

Elevated preoperative blood pressure predicts the intraoperative loss of SSEP neuromonitoring signals during spinal surgery.  

PubMed

Intraoperative neuromonitoring of somatosensory evoked potentials (SSEPs) can allow identification of evolving neurologic deficit. However, SSEP deterioration is not always associated with postoperative deficit. Transient physiologic changes, including a decrease in blood pressure (BP), can result in signal deterioration, defined as a decrease in waveform amplitude of[50 %seen without neurologic deficit. This study examines the relationship between intraoperative BP decrease and SSEP neuromonitoring to determine whether hypertensive patients are more prone to decreases in BP and if such BP declines are associated with signal loss. We conducted a retrospective review of 43 lumbar laminectomy patients at Mount Sinai. Patients were categorized based on whether they had a previous hypertension diagnosis and if they presented with a first systolic BP of greater than 140 mmHg in the admission area on the morning of surgery, two groups that were not mutually exclusive. We measured BP drop by calculating fractional mean arterial pressure (fMAP, lowest MAP/baseline MAP) and change in BP.We identified patients' SSEP tracings in which signal amplitude decreased[50 %. After dividing patients' recording times into 5-min epochs, we calculated median MAP and whether SSEPs deteriorated in each epoch. We compared the likelihood of signal loss in hypertensives to patients presenting with elevated BP, calculating the odds ratio. Elevated BP prior to surgery is associated with lower fMAP (p = 0.007) and a larger intraoperative decrease in BP (p\\0.001).A diagnosis of hypertension is not associated with lower fMAP orBP drop. Lower epoch fMAPis associated with signal loss (p = 0.0026). While the presence of preoperative elevated BP predicts SSEP abnormality (p = 0.0039), a diagnosis of hypertension does not. Elevated BP, not a hypertension diagnosis, is associated with intraoperative loss of SSEP signals. This effect of elevated BP on SSEPs may be due to the larger associated intraoperative BP decline. PMID:24122076

Kumar, Akash; Chen, Yuangen; Lin, Hung-Mo; Deiner, Stacie

2014-04-01

371

Gravity in mammalian organ development: differentiation of cultured lung and pancreas rudiments during spaceflight  

NASA Technical Reports Server (NTRS)

Organ culture of embryonic mouse lung and pancreas rudiments has been used to investigate development and differentiation, and to assess the effects of microgravity on culture differentiation, during orbital spaceflight of the shuttle Endeavour (mission STS-54). Lung rudiments continue to grow and branch during spaceflight, an initial result that should allow future detailed study of lung morphogenesis in microgravity. Cultured embryonic pancreas undergoes characteristic exocrine acinar tissue and endocrine islet tissue differentiation during spaceflight, and in ground controls. The rudiments developing in the microgravity environment of spaceflight appear to grow larger than their ground counterparts, and they may have differentiated more rapidly than controls, as judged by exocrine zymogen granule presence.

Spooner, B. S.; Hardman, P.; Paulsen, A.

1994-01-01

372

Effect of BioGlue® on the Incidence of Pancreatic Fistula Following Pancreas Resection  

Microsoft Academic Search

Background  Despite numerous modifications of surgical technique, pancreatic fistula remains a serious problem and occurs in about 10%\\u000a of patients following pancreas resection. BioGlue is a new sealant that creates a flexible mechanical seal within minutes\\u000a independent of the body’s clotting mechanism.\\u000a \\u000a \\u000a \\u000a Hypothesis  Application of BioGlue sealant will reduce the incidence of pancreatic fistula following pancreas resection.\\u000a \\u000a \\u000a \\u000a Methods  A retrospective cohort study was

William E. Fisher; Christy Chai; Sally E. Hodges; Meng-Fen Wu; Susan G. Hilsenbeck; F. Charles Brunicardi

2008-01-01

373

Resected Serous Cystic Neoplasms of the Pancreas: A Review of 158 Patients with Recommendations for Treatment  

Microsoft Academic Search

Background  Serous cystic neoplasms of the pancreas are regarded as a benign entity with rare malignant potential. Surgical resection\\u000a is generally considered curative.\\u000a \\u000a \\u000a \\u000a Objective  To perform the largest single institution review of patients who underwent surgical resection for serous cystic neoplasms\\u000a of the pancreas in the hopes of guiding future management.\\u000a \\u000a \\u000a \\u000a Methods  Between June 1988 and January 2005, 158 patients with serous cystic

Charles Galanis; Amir Zamani; John L. Cameron; Kurtis A. Campbell; Keith D. Lillemoe; David Caparrelli; David Chang; Ralph H. Hruban; Charles J. Yeo

2007-01-01

374

[Neuroendocrine complexes in the pancreas of nutria (Myocastor coypus) (an immunohistochemical study)].  

PubMed

With the application of a double immunohistochemical labeling method, several types of neuroendocrine interactions were demonstrated in the pancreas of nutria. Two types of neuroinsular complexes were detected that have the organization typical to the mammals. It was found to be typical of nutria that several pancreatic islets were integrated with nerve cells and nerve fibers. The complexes detected that reflect the interactions between nervous elements and single endocrine cells or their small groups, are species-specific. The data obtained demonstrate the diversity of neuroendocrine interactions in the pancreas and possible influence of the nervous system on B-cell differentiation. PMID:19860332

Krivova, Iu S; Barabanov, V M; savel'eva, E S; Savel'ev, S V

2009-01-01

375

Effects of various hormones and adrenalectomy on the levels of amylase in rat pancreas and parotid gland  

Microsoft Academic Search

Summary Dexamethasone, adrenocorticotropic hormone and thyroxine increased the amylase activities in both the pancreas and the parotid gland of infant rats. After adrenalectomy, the amylase activities of the pancreas and parotid gland were about half the control levels, suggesting that both glucocorticoid and thyroxine are involved in maintaining the amylase activities in these organs.

T. Takeuchi; M. Ogawa; T. Sugimura

1977-01-01

376

Duct to islet-cell differentiation and islet growth in the pancreas of duct-ligated adult rats  

Microsoft Academic Search

Summary  We investigated the growth of islet beta and alpha cells in adult rats which had undergone partial pancreatic duct ligation. Whereas the non-ligated head portion of the pancreas remained unaffected in terms of histology and cell population dynamics, the ligated tail part of the pancreas showed pronounced changes in histology and cell growth. These changes included replacement of exocrine acini

R. N. Wang; G. Klöppel; L. Bouwens

1995-01-01

377

Single-Center, open, prospective, randomized pilot study comparing cyclosporine versus tacrolimus in simultaneous Pancreas-Kidney transplantation  

Microsoft Academic Search

BackgroundAlthough tacrolimus (Prograf) is the calcineurin inhibitor usually employed in simultaneous pancreas-kidney transplantation (SPKTx), no prospective randomized studies have compared its efficacy to cyclosporine (Neoral), when either drug is used in combination with mycophenolate mofetil (MMF) and the pancreas is drained into the portal vein.

U Boggi; F Vistoli; M Del Chiaro; C Croce; L Morelli; L Coletti; S Signori; R Giannarelli; P Marchetti; S Del Prato; G Rizzo; F Mosca

2004-01-01

378

Dipyridamole-thallium scanning in patients undergoing vascular surgery. Optimizing preoperative evaluation of cardiac risk  

Microsoft Academic Search

Dipyridamole-thallium imaging has been suggested as a method of preoperatively assessing cardiac risk in patients undergoing major surgery. To define more clearly its proper role in preoperative assessment, we prospectively evaluated 111 patients undergoing vascular surgery. In the first set of 61 patients, our data confirmed the value of preoperative dipyridamole-thallium scanning in identifying the patients who suffered postoperative ischemic

K. A. Eagle; D. E. Singer; D. C. Brewster; R. C. Darling; A. G. Mulley; C. A. Boucher

1987-01-01

379

Melanoma Diagnosis  

NASA Astrophysics Data System (ADS)

The chapter deals with the diagnosis of the malignant melanoma of the skin. This aggressive type of cancer with steadily growing incidence in white populations can hundred percent be cured if it is detected in an early stage. Imaging techniques, in particular dermoscopy, have contributed significantly to improvement of diagnostic accuracy in clinical settings, achieving sensitivities for melanoma experts of beyond 95% at specificities of 90% and more. Automatic computer analysis of dermoscopy images has, in preliminary studies, achieved classification rates comparable to those of experts. However, the diagnosis of melanoma requires a lot of training and experience, and at the time being, average numbers of lesions excised per histology-proven melanoma are around 30, a number which clearly is too high. Further improvements in computer dermoscopy systems and their competent use in clinical settings certainly have the potential to support efforts of improving this situation. In the chapter, medical basics, current state of melanoma diagnosis, image analysis methods, commercial dermoscopy systems, evaluation of systems, and methods and future directions are presented.

Horsch, Alexander

380

Graft-versus-host disease after simultaneous pancreas-kidney transplantation: a case report and review of the literature.  

PubMed

Graft-versus-host disease (GVHD) after solid organ transplantation is rare and usually fatal. We present, to our knowledge, the second successfully treated case in a simultaneous pancreas-kidney (SPK) transplant recipient. A 29-year-old female with end-stage renal disease from type 1 diabetes mellitus received an SPK transplant from a male donor, with rabbit-antithymocyte globulin induction. Twelve days posttransplant, she was readmitted with abdominal pain, nausea and vomiting. She developed leukopenia, abnormal liver enzymes, fever and a skin rash. Skin biopsy showed interface dermatitis consistent with allergic reaction versus GVHD. Fluorescence in situ hybridization of the skin biopsy showed 28% of cells had a Y chromosome confirming GVHD. Short tandem repeats (STR) enriched for CD3+ cells from peripheral blood showed a mixed chimerism. She was successfully treated with a single plasmapheresis to remove antithymocyte globulin, high-dose steroids, photopheresis and high tacrolimus levels (12-15?ng/mL). Five months after transplantation, she has normal renal function and white blood cell count, normal hemoglobin A1C and no evidence of peripheral blood donor chimerism. In conclusion, early diagnosis of GVHD after SPK transplantation may allow successful treatment. STR enriched for CD3+ may be useful to evaluate the response to therapy. PMID:25219902

Rossi, A P; Bone, B A; Edwards, A R; Parker, M K; Delos Santos, R B; Hagopian, J; Lockwood, C; Musiek, A; Klein, C L; Brennan, D C

2014-11-01

381

[Factors causing damage and destruction of beta-cells of the islets of Langerhans in the pancreas].  

PubMed

Insulin secretion in patients with manifested diabetes mellitus tends to disappear months to decades after the diagnosis, which is a clear sign of a gradual loss of pancreatic islet beta-cells. In our sample of 30 type 2 diabetic patients, whose disease manifested between 30 and 45 years of age, about a half have retained or even increased insulin secretion 30 years later, while the other half exhibit a much diminished or lost insulin secretion. Factors that can damage or destroy beta-cells can be divided into the following groups: Metabolic factors: hyperglycemia and glucotoxicity, lipotoxicity, hypoxia, reactive oxygen species; Pharmacological factors: antimicrobial medication pentamidine, SSRI antidepressants; Factors related to impaired insulin secretion: MODY type diabetes; Environmental toxic factors: rat poison Vacor, streptozotocin, polychlorinated and polybrominated hydrocarbons; Disorders of the exocrine pancreas: tumor infiltration, fibrous infiltration, chronic pancreatitis, cystic fibrosis; Infections, inflammation, autoimmunity, viral factors: Coxsackie viruses, H1N1 influenza, enteroviruses. We are currently working on finding other factors leading to beta-cell damage, studying their effect on apoptosis and necrosis and looking for possible protective factors to prevent this damage. We our increasing knowledge about the mechanisms of beta-cell damage and destruction we come ever closer to suggest measures for their prevention. In this review we offer a brief and simplified summary of some of the findings related to this area.Key words: pancreatic islet beta-cells of Langerhans - factors damaging or destroying beta-cells - insulin secretion. PMID:25294754

And?l, Michal; N?mcová, Vlasta; Pavlíková, Nela; Urbanová, Jana; Cecháková, Marie; Havlová, Andrea; Straková, Radka; Ve?e?ová, Livia; Mandys, Václav; Ková?, Jan; Heneberg, Petr; Trnka, Jan; Polák, Jan

2014-01-01

382

Why were we wrong for so long? The pancreas of type 1 diabetic patients commonly functions for decades.  

PubMed

The type 1 diabetes field has held firm to the dogma that the pancreas is no longer viable, and thus incapable of producing insulin, within 1 to 2 years of diagnosis for the majority of patients. A new study in this issue of Diabetologia (DOI: 10.1007/s00125-013-3067-x ), based on a hypersensitive assay, has found detectable C-peptide, a marker of insulin production, in individuals with long-standing type 1 diabetes. This new study confirms and expands a decades-long track record of research finding intact pancreatic islet cells in advanced disease. Because the evidence, stemming back to 1902, was largely histological in nature, it was dismissed as lacking functional corroboration. This new study in patients with long-term diabetes shows appropriate functioning of pancreatic islet cells after exposure to a mixed-meal stimulus. The weight of evidence now makes it clear that a large fraction of patients with long-standing diabetes have low level, but persistent functioning of pancreatic islet cells enduring more than a decade after disease onset. PMID:24190583

Faustman, Denise L

2014-01-01

383

Diagnosis and management of endocrine gland neoplasms  

SciTech Connect

Functional and nonfunctional neoplasms of the endocrine glands constitute some of the more challenging diagnostic and therapeutic problems in veterinary cancer medicine. The clinical signs are usually the result of an overproduction of hormones that are normally biosynthesized by the neoplastic endocrine gland (orthoendocrine syndromes), as opposed to those that are the result of hormones that are not normally biosynthesized and secreted by those cells that have undergone neoplastic transformation (paraendocrine syndromes, also known as endocrine paraneoplastic syndromes or ectopic hormone syndromes). The biological effects produced by a neoplasm may be out of proportion to the actual size of the tumor. This report focuses on the clinical signs and syndromes associated with neoplasms of the thyroid, adrenal glands and pancreas. Discussion will focus on the mechanisms producing the clinical signs, diagnosis, staging, therapy and prognosis. 2 tabs.

Weller, R.E.

1989-05-01

384

[Pancreatic pseudocyst as a differential diagnosis to dissections aortic aneyrism].  

PubMed

Pancreatic pseudocyst, a common complication of acute or chronic pancreatitis, can be an important differential diagnosis to aorta aneurism. A 46-year-old man under investigation for lung cancer presented with chest pain, dysphagia and dyspnoea. A chest X-ray showed opacity in the mediastinum opposite aorta. A computed tomography revealed a pseudocyst extending from the body of pancreas into the thorax. A mediastinal pseudocyst can cause symptoms due to compression or invasion of surrounding structures. The pseudocyst was successfully treated using endoscopic ultrasound guided transgastric drainage. PMID:23462042

Erikstrup Clausen, Niels; Jacobsen, Villads Bønding

2013-03-01

385

CAD generated mold for preoperative implant fabrication in cranioplasty.  

PubMed

Intraoperative fabrication of acrylic cranial implants may be difficult and will increase operation time. In addition forming implants directly on the defect, intracranial tissues are exposed to heat of polymerization and residual monomer, that occurs, when autopolymerizing methyl methacrylate is used intraoperatively. Furthermore the cosmetical result may be unacceptable. Preoperatively formed acrylic implants may reduce these disadvantages compared to conventional techniques in cranioplasty. We will present methods for preoperative fabrication of cranial implants for a cadaver specimen. Implants were fabricated using a Rapid prototyping (RP) models of the skull built by Fused Deposition Modeling (FDM). In addition a mold of the defect was generated by CAD techniques, that can serve as a template for implant design. PMID:15718807

Wulf, J; Busch, L C; Golz, T; Knopp, U; Giese, A; Ssenyonjo, H; Gottschalk, S; Kramer, K

2005-01-01

386

Preoperative planning and postoperative imaging in shoulder arthroplasty.  

PubMed

The number of shoulder arthroplasties performed in the United States has more than doubled in the last decade. Additionally, there has been a trend toward use of reverse total shoulder arthroplasty and minimally invasive surgical techniques, such as resurfacing humeral head arthroplasty. Thus radiologists will more frequently encounter imaging of shoulder arthroplasty and these new designs. Successful postoperative radiologic evaluation of shoulder reconstructions requires an understanding of their fundamental hardware design, physiologic objective, preoperative imaging assessment, normal postoperative radiologic appearance, and findings and types of complication. This article discusses the designs of prostheses used around the shoulder joint, delineates indications and alternatives for each of the different types of hardware, reviews radiographic and cross-sectional preoperative imaging of shoulder arthroplasty, illustrates normal postoperative imaging findings and measurements, and provides examples of hardware complications. PMID:25184399

Petscavage-Thomas, Jonelle

2014-09-01

387

[Preoperative planning for the placement of a single implant].  

PubMed

Radiography is of primary importance for the preoperative planning of oral implant placement. Depending on the indication, various techniques are available, each with its own merits and drawbacks. In general, it can be stated that the intra-oral radiography using the paralleling technique is the method of choice for a solitary tooth replacement. Panoramic radiography is indicated for implant placement in the symphyseal area of the lower jaw. Cross-sectional imaging is performed when information is needed in the bucco-lingual dimension. Conventional tomography is recommended for preoperative planning of limited edentulous areas. CT-scan imaging is required for rehabilitation of extended edentulous areas or in complex maxillofacial surgery combined with implant placement. Choosing the optimal technique can be performed by weighing the radiation dosage and the diagnostic information required. PMID:11930365

Jacobs, R

1999-05-01

388

[The 'paper-based' preoperative evaluation: sometimes, a suitable alternative].  

PubMed

In the Netherlands, the majority of elective-surgery patients are evaluated by the anaesthesiologist at the preoperative assessment clinic. We believe that this visit can be omitted in selected patients as it has only minimal benefit, whereas its disadvantages can be substantial. Alternatively, the initial screening could be performed by the completion of a questionnaire via the telephone, via internet, by a nurse or by the surgeon. These data can then be evaluated by the anaesthesiologist; this is called the 'paper-based' preoperative evaluation. This method does require the conscientious cooperation between anaesthesiologists and surgeons; it should be clear which patients are eligible, what type of anaesthetic technique should be used, how the patient should be informed and how the informed consent is obtained. In our opinion, this paper-based evaluation combines safety and efficiency with patient-friendliness. It should be anchored in current guidelines to ensure quality. PMID:22805788

Bucx, Martin J L; Wolff, André P; Scheffer, Gert Jan

2012-01-01

389

Latent Subclinical Medullary Thyroid Carcinoma: Diagnosis and Treatment  

Microsoft Academic Search

. Sporadic medullary thyroid carcinoma (SMTC) is usually diagnosed at a clinical stage often associated with lymph\\u000a node involvement. Hence surgical treatment does not result in definitive cure in many patients. Studies have demonstrated\\u000a that routine measurement of serum basal calcitonin (CT) in patients with nodular thyroid disease allows preoperative, early\\u000a diagnosis of unsuspected SMTC. The aim of this work

Jean-François Henry; Anne Denizot; Marco Puccini; Luis Gramatica; Andrey Kvachenyuk; Bernard Conte Devolx; Cathérine De Micco

1998-01-01

390

Measuring preoperative anxiety in patients with breast cancer using the visual analog scale.  

PubMed

Preoperative anxiety is a prevalent concern with deleterious effects in patient recovery and is not routinely assessed in the preoperative screening process. When it is assessed, it may prompt an increase in the use of anesthetic agents, heightened postoperative pain, and prolonged hospitalization. Preoperative women with breast cancer face anxiety as it relates to anesthesia, surgery, and recovery. The preoperative anxiety visual analog scale may identify and quantify anxiety in this population, provide advocacy and support, and improve the preoperative screening process. PMID:25253102

Aviado-Langer, Jennifer

2014-10-01

391

Preoperative portal vein embolization using an amplatzer vascular plug  

Microsoft Academic Search

The purpose was to evaluate the safety and efficacy of preoperative portal vein embolization (PVE) using an Amplatzer vascular\\u000a plug (AVP). Forty-one patients who underwent PVE using gelatin sponge particles and the AVP were enrolled. The right portal\\u000a branches were embolized using gelatin sponges (1–8 mm3) through a 5-F catheter, and the AVP was deployed at the first- or second-order right

Hyunkyung Yoo; Gi-Young Ko; Dong Il Gwon; Jin-Hyoung Kim; Hyun-Ki Yoon; Kyu-Bo Sung; Namguk Kim; Jeongjin Lee

2009-01-01

392

Preoperative pulmonary assessment for patients with hip fracture  

Microsoft Academic Search

Hip fracture is a common injury among the elderly. Although patients who receive hip fracture surgery carry the best functional\\u000a recovery compared to other treatment modalities, the presence of postoperative pulmonary complications, such as atelectasis,\\u000a pneumonia, and pulmonary thromboembolism, may contribute to increased length of hospital stay, perioperative morbidity, and\\u000a mortality. This review aims to provide evidence-based recommendations for preoperative

I.-L. Lo; C.-W. Siu; H.-F. Tse; T.-W. Lau; F. Leung; M. Wong

2010-01-01

393

Comparison of oral lavage methods for preoperative colonic cleansing  

Microsoft Academic Search

Polyethylene glycol electrolyte lavage solution was compared with a 10 percent mannitol solution for preoperative colonic\\u000a cleansing. Eighty patients were prepared randomly with one of these solutions on the afternoon prior to surgery. Colonic cleansing\\u000a was better with polyethylene glycol electrolyte lavage (90 percent optimal cleansingvs. 75 percent). Analysis of hematologic, biochemical, and weight changes before and after the bowel

David E. Beck; Victor W. Fazio; David G. Jagelman

1986-01-01

394

Inflammation to cancer: The molecular biology in the pancreas (Review)  

PubMed Central

Inflammatory responses are known to be correlated with cancer initiation and progression, and exploration of the route from inflammation to cancer makes a great contribution in elucidating the mechanisms underlying cancer development. Pancreatic cancer (PC) is a lethal disease with a low radical-resection rate and a poor prognosis. As chronic pancreatitis is considered to be a significant etiological factor for PC development, the current review aims to describe the molecular pathways from inflammation to pancreatic carcinogenesis, in support of the strategies for the prevention, diagnosis and treatment of PC. PMID:24932227

LING, SUNBIN; FENG, TINGTING; JIA, KAIQI; TIAN, YU; LI, YAN

2014-01-01

395

Utility of Preoperative Anesthesia Clinic Videoendoscopy for Airway Management Planning  

PubMed Central

Introduction: The authors performed videolaryngoscopy during the preoperative anesthesia clinic evaluation of a patient with chronic dyspnea, stridor, and a previous hemilaryngectomy scheduled to undergo a series of orthopedic surgery procedures for an infected knee arthroplasty. The findings proved crucial for determining airway management. Case Presentation: A 68-year-old man presented to the preoperative anesthesia clinic for work-up before anticipated removal of infected total knee arthroplasty hardware, placement of antibiotic spacers, incision and drainage procedures, and revision arthroplasty. The patient had previously undergone a hemilaryngectomy and tracheostomy (now closed) for squamous cell carcinoma of the right true vocal cord. The patient described chronic dyspnea with minimal exertion. Inspiratory and expiratory wheezes and intermittent inspiratory stridor were present. A transnasal videolaryngoscopy examination was performed using topical anesthesia and demonstrated significant supraglottic scarring, a narrowed glottis, and subglottic stenosis. A computed tomography study confirmed the presence of tracheomalacia with subglottic stenosis. A permanent tracheostomy was performed to establish a definitive airway before the knee arthroplasty was removed. Conclusions: The case illustrates that transnasal videolaryngoscopy conducted in the preoperative anesthesia clinic is capable of providing key information to guide airway management in patients with significant upper airway pathology. PMID:25337475

Kallio, Peter J; Cox, Ana E; Pagel, Paul S

2014-01-01

396

Combined effects of protein deficiency and chronic ethanol consumption on rat pancreas  

Microsoft Academic Search

This study was performed in order to delineate the combined effects of protein deficiency and chronic ethanol ingestion on the rat pancreas. Rats fed ethanol in combination with protein-deficient diets developed marked steatosis, whereas alcohol ingestion with nutritionally adequate diets and protein deficiency alone each were associated with a more moderate degree of pancreatic lipid accumulation. On biochemical analysis, it

Jeremy S. Wilson; Mark A. Korsten; Maria A. Leo; Charles S. Lieber

1988-01-01

397

Isolated granulocytic sarcoma of the pancreas: A tricky diagnostic for primary pancreatic extramedullary acute myeloid leukemia  

PubMed Central

We report two clinical cases of primary granulocytic sarcoma of the pancreas that were diagnosed on the surgical specimen. Atypical clinical and morphological presentations may have lead to pretherapeutic biopsies of the pancreatic mass in order to indicate primary chemotherapy. Literature review of this rare clinical presentation may help physicians to anticipate diagnostic and therapeutic strategies. PMID:22248364

2012-01-01

398

Effects of wheat bran on exocrine pancreas secretion in the pig  

E-print Network

was to determine the effect of wheat bran consumption on exocrine pancreas secretion in pigs. Sixteen Large polypeptide (PP)] were measured over an experimental period of 5 days. The results show that wheat bran intake. Introduction. Dietary fiber is known to decrease the availability of food components (Kass et al., 1980 ; Shah

Boyer, Edmond

399

Theoretical analysis and experimental evaluation of laser-induced interstitial thermotherapy in ex vivo porcine pancreas.  

PubMed

Laser-induced interstitial thermotherapy (LITT) has been recently applied to pancreas in animal models for ablation purpose. Assessment of thermal effects due to the laser-pancreatic tissue interaction is a critical factor in validating the procedure feasibility and safety. A mathematical model based on bioheat equation and its experimental assessment was developed. The LITT procedure was performed on 40 ex vivo porcine pancreases, with an Nd:YAG (1064 nm) energy of 1000 J and power from 1.5 up to 10 W conveyed by a quartz optical fiber with 300 ?m diameter. Six fiber Bragg grating sensors have been utilized to measure temperature distribution as a function of time at fixed distances from the applicator tip within pancreas undergoing LITT. Simulations and experiments show temperature variations ? T steeply decreasing with distance from the applicator at higher power values: at 6 W, ?T > 40 °C at 5 mm and ? T is approximately equal to 5 °C at 10 mm. ? T nonlinearly increases with power close to the applicator. Ablated and coagulated tissue volumes have also been measured and experimental results agree with theoretical ones. Despite the absence of data in the current literature on pancreas optical parameters, the model allowed a quite good prediction of thermal effects. The prediction of LITT effects on pancreas is necessary to assess laser dosimetry. PMID:22929361

Saccomandi, Paola; Schena, Emiliano; Caponero, Michele Arturo; Di Matteo, Francesco Maria; Martino, Margareth; Pandolfi, Monica; Silvestri, Sergio

2012-10-01

400

Sonic hedgehog directs specialised mesoderm differentiation in the intestine and pancreas  

Microsoft Academic Search

The generation of the pancreas and small intestine from the embryonic gut depends on intercellular signalling between the endodermal and mesodermal cells of the gut [1–5]. In particular, the differentiation of intestinal mesoderm into smooth muscle has been suggested to depend on signals from adjacent endodermal cells [1–3]. One candidate mediator of endodermally derived signals in the embryonic hindgut is

Åsa Apelqvist; Ulf Ahlgren; Helena Edlund

1997-01-01

401

Carcinoembryonic antigen assay in cancer of the colon and pancreas and other digestive tract disorders  

Microsoft Academic Search

In a study of 279 persons, carcinoembryonic antigen (CEA) was detected in the sera of 32 of 35 patients with carcinoma of the colon, 13 of 13 patients with carcinoma of the pancreas, and 6 of 14 patients with other gastrointestinal cancers, confirming previous work which associated circulating CEA with GI tract malignancies. Six of 8 patients with bronchogenic carcinomas

T. L. Moore; H. Z. Kupchik; N. Marcon; N. Zamcheck

1971-01-01

402

Mucinous cyst exhibiting severe dysplasia in gastric heterotopic pancreas associated withe gastrointestinal stromal tumour  

PubMed Central

Heterotopic pancreatic tissue within the stomach is rare and dysplasia within heterotopic pancreatic tissue is very rare. We present the first report of a patient with concurrent occurrence of heterotopic pancreas in the stomach with a gastrointestinal stromal tumour. PMID:17963310

Kaufman, Antony; Storey, David; Lee, Cheok Soon; Murali, Rajmohan

2007-01-01

403

Accuracy of EUS for detection of intraductal papillary mucinous tumor of the pancreas  

Microsoft Academic Search

Background: Patients with intraductal papillary mucinous tumors of the pancreas (IPMT) present with symptoms similar to those of chronic pancreatitis. This study assessed the accuracy of EUS for detection of IPMT and identified features that discriminate IPMT from chronic pancreatitis. Methods: EUS accuracy for detecting IPMT was determined with characteristic findings by endoscopic retrograde pancreatography as the reference standard. To

Guruprasad P. Aithal; Robert Y. M. Chen; John T. Cunningham; Valerie Durkalski; Eun Y. Kim; Rig S. Patel; Michael B. Wallace; Robert H. Hawes; Brenda J. Hoffman

2002-01-01

404

Secretion from acinar cells of the exocrine pancreas: Role of enteropancreatic reflexes and cholecystokinin  

Microsoft Academic Search

Although the molecular machinery and mechanism of cell secretion in acinar cells of the exocrine pancreas is well documented and clear, only recently has the pharmacophysiology of pancreatic exocrine secretion come to light. Therefore, we focus in this article on the current understanding of the pharmacophysiology of pancreatic exocrine secretion. The pancreatic secretory response to ingestion of a meal is

Manfred V. Singer; Elke Niebergall-Roth

2009-01-01

405

Effect of maternal undernutrition on human foetal pancreas morphology in second trimester of pregnancy  

PubMed Central

Background & objectives: Maternal undernutrition and hyperglycaemia during pregnancy, as well as foetal undernutrition affecting the development of foetal endocrine pancreas structure and function, especially that of ?-cells is well known. This study was undertaken to look into the changes in pancreatic islets morphology of aborted normal human foetuses (16-20 wk old) of undernourished and adequately nourished mothers. Methods: Foetuses were collected over a 24 month period from medically terminated pregnancies of six undernourished mothers (BMI <18.5 kg/m2) and eight adequately nourished mothers (BMI >18.5 kg/m2). The sections were stained with haematoxylin & eosin as well as Masson trichrome for morphometric estimates such as islet count, area, volume, etc. and immunohistochemistry analysis of ?-cells for insulin presence was done. Results: Significant correlations between maternal and foetal parameters were seen. However, there were no statistically significant differences in the number, size or density and beta cell counts of the pancreas among foetal pancreas of mothers with BMI <18.5 and >18.5 kg/m2. Interpretation & conclusions: Our findings indicate that nutritional status of the mother may not have profound influence on the morphology of beta cells of foetal pancreas in second trimester of pregnancy. Further studies need to be done to confirm these findings. PMID:23563373

Kumar, P. Uday; Ramalaxmi, B.A.; Venkiah, K.; Sesikeran, B.

2013-01-01

406

Comparison of Computerized Tomography to Sonography, Applied in Diseases of the Pancreas.  

National Technical Information Service (NTIS)

The examination results of 418 patients whose epigastria had been examined both by computerized tomography and sonography over 1 week in the time from beginning January 1978 until and of July 1979 were compared with regard to the imaging of the pancreas, ...

K. Kluge

1982-01-01

407

Simultaneous pancreas and kidney composite graft transplantation with retroperitoneal systemic-enteric drainage.  

PubMed

Background Simultaneous pancreas and kidney transplantation is the treatment of choice for diabetes mellitus patients with associated end-stage renal disease. Limited vascular access could be encountered in patients with severe atherosclerosis, and/or severe obesity and in re-transplant patients. We describe a modified technique that facilitates simultaneous pancreas and kidney (SPK) composite graft transplantation with retroperitoneal systemic-enteric drainage for patients with limited vascular access. Material and Methods Since April 2012, we performed a modified technique for 2 patients with limited vascular access. SPK composite graft was constructed during the back-table preparation and transplanted in the right retroperitoneal space, finally covered by the ascending colon and its mesocolon. Results The 2 patients achieved good pancreas grafts function with normal blood glucose immediately after the completion of reperfusion. Their kidney grafts have also shown good function. They have not had any rejection episodes or postoperative complications after the SPK composite graft transplantation. Conclusions We propose that simultaneous pancreas and kidney composite graft transplantation with retroperitoneal systemic-enteric drainage can be a viable option for patients with limited vascular access. PMID:25389032

Ono, Shinichiro; Kuroki, Tamotsu; Kitazato, Amane; Ono, Tomohiko; Chen, Yin-Yin; Chen, Shin-Chin; Eguchi, Susumu; Shyr, Yi-Ming; Wang, Shin-E

2014-01-01

408

Embolization of an Insulinoma of the Pancreas with Trisacryl Gelatin Microspheres as Definitive Treatment  

SciTech Connect

Insulinomas are rare, mostly benign neuroendocrine tumors, originating in 99% of cases from the pancreas, that synthesize and secrete insulin, causing symptomatic hypoglycemia. Today the treatment of choice is surgical removal. We present the case of an 84-year-old woman with a symptomatic insulinoma who refused surgery and was treated with arterial embolization using trisacryl gelatin microspheres as definitive treatment.

Rott, Gernot, E-mail: gernot.rott@t-online.de; Biggemann, Martin; Pfohl, Martin [Bethesda-Krankenhaus Duisburg, Medizinische Klinik (Germany)

2008-05-15

409

Antioxidant and pancreas-protective effect of aucubin on rats with streptozotocin-induced diabetes  

Microsoft Academic Search

Oxidative stress has been suggested as a contributory factor in development and complication of diabetes. The aim of the present study was to determine the protective effect of aucubin on lipid peroxidation and activities of antioxidant defense systems and to conduct immunohistochemical evaluation of pancreas in streptozotocin-induced diabetic rats. Lipid peroxidation was determined by assessing the concentration of malondialdehyde and

Lei Jin; Hong-Yu Xue; Li-Ji Jin; Shu-Ying Li; Yong-Ping Xu

2008-01-01

410

AN EMBRYONIC CHICK PANCREAS ORGAN CULTURE MODEL: CHARACTERIZATION AND NEURAL CONTROL OF EXOCRINE RELEASE  

EPA Science Inventory

An embryonic chick (Gallus domesticus) whole-organ pancreas culture system was developed for use as an in vitro model to study cholinergic regulation of exocrine pancreatic function. The culture system was examined for characteristic exocrine function and viability by measuring e...

411

Microencapsulation of Langerhans Islets in Agarose Microbeads and Their Application for a Bioartificial Pancreas  

Microsoft Academic Search

Microencapsulation of islets is considered to be a promising approach to the development of a bioartificial pancreas. In this study agarose was examined as a material to microencapsulate islets. By a low-temperature gelation tech nique, islets can be easily microencapsulated into agarose microbeads without any adverse effect on the functions of islets. Encapsulated islets in agarose microbeads maintained their intact

Hiroo Iwata; Hiroshi Amemiya; Takehisa Matsuda; Hisateru Takano; Tetuzou Akutsu

1988-01-01

412

BASIC--LIVER, PANCREAS, AND BILIARY Development of Nonalcoholic Steatohepatitis in Insulin-Resistant  

E-print Network

BASIC--LIVER, PANCREAS, AND BILIARY TRACT Development of Nonalcoholic Steatohepatitis in Insulin-Resistant Liver-Specific S503A Carcinoembryonic Antigen-Related Cell Adhesion Molecule 1 Mutant Mice SANG JUN LEE Affairs Medical Center, San Francisco, California See editorial on page 1860. Background & Aims: Liver

Brand, Paul H.

413

Genomic alterations link Rho family of GTPases to the highly invasive phenotype of pancreas cancer  

Microsoft Academic Search

Pancreas ductal adenocarcinoma (PDAC) is a highly lethal cancer that typically presents as advanced, unresectable disease. This invasive tendency, coupled with intrinsic resistance to standard therapies and genome instability, are major contributors to poor long-term survival. The genetic elements governing the invasive propensity of PDAC have not been well elucidated. Here, in the course of validating resident genes in highly

Alec C. Kimmelman; Aram F. Hezel; Andrew J. Aguirre; Hongwu Zheng; Ji-Hye Paik; Haoqiang Ying; Gerald C. Chu; Jean X. Zhang; Ergun Sahin; Giminna Yeo; Aditya Ponugoti; Roustem Nabioullin; Scott Deroo; Shenghong Yang; Xiaoxu Wang; John P. McGrath; Marina Protopopova; Elena Ivanova; Jianhua Zhang; Bin Feng; Ming S. Tsao; Mark Redston; Alexei Protopopov; Yonghong Xiao; P. Andrew Futreal; William C. Hahn; David S. Klimstra; Lynda Chin; Ronald A. Depinho

2008-01-01

414

Cancer of the pancreas: Palliative operation, Whipple procedure, or total pancreatectomy  

Microsoft Academic Search

Current reviews of the treatment of cancer of the pancreas, most of which evaluate cases treated in the past one or two decades, continue to present discouraging results. The advantages and disadvantages of performing a resection must be carefully evaluated for each patient. The dilemma of resection should be discussed with the patient before operation and when capable he or

William P. Longmire

1984-01-01

415

Treatment of cancer of the pancreas by intraoperative electron beam therapy: physical and biological aspects  

Microsoft Academic Search

Radiation therapy has had a significant and an expanded role in the management of cancer of the pancreas during the last decade. In particular, for locally advanced disease, radiation therapy has improved the median survival of patients to 1 year. Intraoperative electron beam therapy has been applied to unresectable and resectable pancreatic cancer in an attempt to enhance local control

Farideh R. Bagne; Ralph R. Dobelbower Jr.; Andrew J. Milligan; D. G. Bronn

1989-01-01

416

An Integrated Cell Purification and Genomics Strategy Reveals Multiple Regulators of Pancreas Development  

PubMed Central

The regulatory logic underlying global transcriptional programs controlling development of visceral organs like the pancreas remains undiscovered. Here, we profiled gene expression in 12 purified populations of fetal and adult pancreatic epithelial cells representing crucial progenitor cell subsets, and their endocrine or exocrine progeny. Using probabilistic models to decode the general programs organizing gene expression, we identified co-expressed gene sets in cell subsets that revealed patterns and processes governing progenitor cell development, lineage specification, and endocrine cell maturation. Purification of Neurog3 mutant cells and module network analysis linked established regulators such as Neurog3 to unrecognized gene targets and roles in pancreas development. Iterative module network analysis nominated and prioritized transcriptional regulators, including diabetes risk genes. Functional validation of a subset of candidate regulators with corresponding mutant mice revealed that the transcription factors Etv1, Prdm16, Runx1t1 and Bcl11a are essential for pancreas development. Our integrated approach provides a unique framework for identifying regulatory genes and functional gene sets underlying pancreas development and associated diseases such as diabetes mellitus. PMID:25330008

Benitez, Cecil M.; Qu, Kun; Sugiyama, Takuya; Pauerstein, Philip T.; Liu, Yinghua; Tsai, Jennifer; Gu, Xueying; Ghodasara, Amar; Arda, H. Efsun; Zhang, Jiajing; Dekker, Joseph D.; Tucker, Haley O.; Chang, Howard Y.; Kim, Seung K.

2014-01-01

417

Ontogeny of Neuro-Insular Complexes and Islets Innervation in the Human Pancreas  

PubMed Central

The ontogeny of the neuro-insular complexes (NIC) and the islets innervation in human pancreas has not been studied in detail. Our aim was to describe the developmental dynamics and distribution of the nervous system structures in the endocrine part of human pancreas. We used double-staining with antibodies specific to pan-neural markers [neuron-specific enolase (NSE) and S100 protein] and to hormones of pancreatic endocrine cells. NSE and S100-positive nerves and ganglia were identified in the human fetal pancreas from gestation week (gw) 10 onward. Later the density of S100 and NSE-positive fibers increased. In adults, this network was sparse. The islets innervation started to form from gw 14. NSE-containing endocrine cells were identified from gw 12 onward. Additionally, S100-positive cells were detected both in the periphery and within some of the islets starting at gw 14. The analysis of islets innervation has shown that the fetal pancreas contained NIC and the number of these complexes was reduced in adults. The highest density of NIC is detected during middle and late fetal periods, when the mosaic islets, typical for adults, form. The close integration between the developing pancreatic islets and the nervous system structures may play an important role not only in the hormone secretion, but also in the islets morphogenesis. PMID:24795697

Proshchina, Alexandra E.; Krivova, Yulia S.; Barabanov, Valeriy M.; Saveliev, Sergey V.

2014-01-01

418

Islets of Langerhans Are Protected from Inflammatory Cell Recruitment during Reperfusion of Rat Pancreas Grafts  

Microsoft Academic Search

Background: Ischemia\\/reperfusion (I\\/R) injury plays a pivotal role in the development of graft pancreatitis, with ischemia time representing one of its crucial factors. However, it is unclear, whether exocrine and endocrine tissue experience similar inflammatory responses during pancreas transplantation (PTx). This study evaluated inflammatory susceptibilities of islets of Langerhans (ILH) and exocrine tissue after different preservation periods during early reperfusion.

G. Preissler; S. Massberg; M. E. Eichhorn; H. Waldner; F. Loehe; H. Winter; K. Messmer

2010-01-01

419

Multidisciplinary Management Strategy for Incidental Cystic Lesions of the Pancreas  

PubMed Central

Background At our institution, incidental pancreatic cysts are frequently identified in asymptomatic patients undergoing routine imaging for staging of non-pancreatic malignancies. The management of these patients is unclear since a small but significant number of incidental pancreatic cysts are malignant. Study Design Our institutional database was reviewed for patients with ICD-9 codes for pancreatic cysts from 1980 to 2005. Clinicopathologic factors, including CT and endoscopic ultrasound (EUS) characteristics and management strategies were analyzed. Results Over 25 years, 942 patients were identified with pancreatic cysts. Excluding those with symptoms or pseudocysts, 350 patients remained with incidental pancreatic cysts. Mean overall survival was 41.4 months (mean follow-up 32.7 months). Forty-one patients underwent resection, of whom 38 (92.7%) had premalignant/malignant pathology. On univariate analysis, younger age, size >= 3 cm, nodularity, and presumptive diagnosis based on CT or EUS were all significant predictors of surgical resection. Only young age, EUS- and CT-based diagnoses and size >= 3 cm on CT were independent predictors of resection by multivariate analysis. Univariate analysis of variables predicting pathologic premalignant/malignant diagnosis identified pancreatic neck or body location as significant factors. Conclusions These data suggest that most incidental pancreatic cysts can be managed non-operatively using a selective strategy based on detailed review of CT imaging and EUS findings. PMID:20670858

Bose, Debashish; Tamm, Eric; Liu, Jun; Marcal, Leonardo; Balachandran, Aparna; Bhosale, Priya; Lee, Jeffrey H.; Gomez, Henry; Fleming, Jason B.; Lee, Jeffrey E.; Evans, Douglas B.; Hwang, Rosa F.

2014-01-01

420

Metastatic mixed acinar-neuroendocrine carcinoma of the pancreas to the liver: a cytopathology case report with review of the literature.  

PubMed

A case of metastatic mixed acinar-neuroendocrine carcinoma (MANEC) of the pancreas to the liver is reported. A diagnostic percutaneous US-guided FNA and core biopsy of a liver nodule was performed. The FNA smears were cellular and showed neoplastic cells in clusters with acinar formation, isolated single cells, and scattered naked nuclei. The cytoplasm was finely granular. The nuclei were relatively uniform, some with speckled chromatin and prominent nucleoli. The immunohistochemistry performed on the cell block showed strong positivity for cytokeratin AE1/AE3, chromogranin, and synaptophysin. Furthermore, the tumor cells were weakly positive for ?1-antichymotrypsin. The Ki-67 mitotic index was up to 50%. Based on the morphology and supporting immunohistochemical stains, the final cytopathologic diagnosis rendered was "Positive for malignant cells. Carcinoma with mixed acinar and endocrine features." To our knowledge, this is the first report of a metastatic MANEC to the liver diagnosed based on cytology with confirmatory histology. The difficulties in the cytopathologic diagnosis and differential diagnosis of MANEC are discussed in this article. PMID:22903971

Lee, Lili; Bajor-Dattilo, Ewa B; Das, Kasturi

2013-02-01

421

Localization of lipoprotein lipase and GPIHBP1 in mouse pancreas: effects of diet and leptin deficiency  

PubMed Central

Background Lipoprotein lipase (LPL) hydrolyzes triglycerides in plasma lipoproteins and enables uptake of lipolysis products for energy production or storage in tissues. Our aim was to study the localization of LPL and its endothelial anchoring protein glycosylphosphatidylinositol-anchored high density lipoprotein-binding protein 1 (GPIHBP1) in mouse pancreas, and effects of diet and leptin deficiency on their expression patterns. For this, immunofluorescence microscopy was used on pancreatic tissue from C57BL/6 mouse embryos (E18), adult mice on normal or high-fat diet, and adult ob/ob-mice treated or not with leptin. The distribution of LPL and GPIHBP1 was compared to insulin, glucagon and CD31. Heparin injections were used to discriminate between intracellular and extracellular LPL. Results In the exocrine pancreas LPL was found in capillaries, and was mostly co-localized with GPIHBP1. LPL was releasable by heparin, indicating localization on cell surfaces. Within the islets, most of the LPL was associated with beta cells and could not be released by heparin, indicating that the enzyme remained mostly within cells. Staining for LPL was found also in the glucagon-producing alpha cells, both in embryos (E18) and in adult mice. Only small amounts of LPL were found together with GPIHBP1 within the capillaries of islets. Neither a high fat diet nor fasting/re-feeding markedly altered the distribution pattern of LPL or GPIHBP1 in mouse pancreas. Islets from ob/ob mice appeared completely deficient of LPL in the beta cells, while LPL-staining was normal in alpha cells and in the exocrine pancreas. Leptin treatment of ob/ob mice for 12 days reversed this pattern, so that most of the islets expressed LPL in beta cells. Conclusions We conclude that both LPL and GPIHBP1 are present in mouse pancreas, and that LPL expression in beta cells is dependent on leptin. PMID:23186339

2012-01-01

422

The human GLP-1 analogs liraglutide and semaglutide: absence of histopathological effects on the pancreas in nonhuman primates.  

PubMed

Increased pancreas mass and glucagon-positive adenomas have been suggested to be a risk associated with sitagliptin or exenatide therapy in humans. Novo Nordisk has conducted extensive toxicology studies, including data on pancreas weight and histology, in Cynomolgus monkeys dosed with two different human glucagon-like peptide-1 (GLP-1) receptor agonists. In a 52-week study with liraglutide, a dose-related increase in absolute pancreas weight was observed in female monkeys only. Such dose-related increase was not found in studies of 4, 13, or 87 weeks' duration. No treatment-related histopathological abnormalities were observed in any of the studies. Quantitative histology of the pancreas from the 52-week study showed an increase in the exocrine cell mass in liraglutide-dosed animals, with normal composition of endocrine and exocrine cellular compartments. Proliferation rate of the exocrine tissue was low and comparable between groups. Endocrine cell mass and proliferation rates were unaltered by liraglutide treatment. Semaglutide showed no increase in pancreas weight and no treatment-related histopathological findings in the pancreas after 13 or 52 weeks' dosing. Overall, results in 138 nonhuman primates showed no histopathological changes in the pancreas associated with liraglutide or semaglutide, two structurally different GLP-1 receptor agonists. PMID:24608440

Gotfredsen, Carsten F; Mølck, Anne-Marie; Thorup, Inger; Nyborg, Niels C Berg; Salanti, Zaki; Knudsen, Lotte Bjerre; Larsen, Marianne O

2014-07-01

423

The effect of preoperative symptom severity on functional outcome of total knee replacement—patients with the lowest preoperative scores achieve the lowest marks  

Microsoft Academic Search

To determine if the functional outcome of total knee replacement (TKR) was affected by the level of preoperative symptom severity, the association between preoperative Oxford Knee Scores (OKS), and 2 year OKS, American Knee Society clinical and function scores (AKSS) was assessed. Data were prospectively collected on 45 cases who had single joint osteoarthritis and no other comorbidities. We have

J. T. K. Lim; K. L. Luscombe; P. W. Jones; S. H. White

2006-01-01

424

Preoperative Detection of Small Pancreatic Carcinoma: Value of Adding Diffusion-weighted Imaging to Conventional MR Imaging for Improving Confidence Level.  

PubMed

Purpose To evaluate the benefit of adding diffusion-weighted ( DW diffusion weighted ) imaging to conventional magnetic resonance (MR) imaging in the preoperative detection of small pancreatic adenocarcinoma (?3.0 cm). Materials and Methods The institutional review board approved this retrospective study and waived the requirement for informed consent. This study included 83 patients (56 men, 27 women) with surgically confirmed pancreatic adenocarcinoma of 3.0 cm or smaller and 12 patients (nine men, three women) with histologically proven focal pancreatitis who underwent gadoxetic acid-enhanced MR imaging and DW diffusion weighted imaging at 3.0 T. Two observers reviewed the two image sets, a conventional MR image set and a combined image set including DW diffusion weighted images, to evaluate tumor conspicuity using receiver operating characteristic curve analysis. Contrast ratios between the tumor and proximal or distal pancreas on T1- and T2-weighted images, arterial and portal phase images, and DW diffusion weighted images obtained with a b value of 800 sec/mm(2) were compared by using one-way analysis of variance or Kruskal-Wallis test. Results On DW diffusion weighted images, all tumors but two were delineated as completely (32 of 83, 39%) or partially (49 of 83, 59%) hyperintense. Area under the receiver operating characteristic curve values for the two observers were 0.890 and 0.884 for the conventional image set and 0.976 and 0.978 for the combined image set (P = .01 and P = .04), respectively. In regard to tumor detection, the combined image set (98%, 81 of 83 [observer 1]; 96%, 80 of 83 [observer 2]) yielded better sensitivity than the conventional image set (75%, 62 of 83 [observer 1]; 76%, 63 of 83 [observer 2]) (P < .001). Contrast ratios of tumor to proximal or distal pancreas were significantly higher with DW diffusion weighted images than with other images (P < .001). Conclusion In preoperative evaluation of small pancreatic adenocarcinoma, the addition of DW diffusion weighted imaging to conventional MR imaging improves the sensitivity of cancer detection. © RSNA, 2014 Online supplemental material is available for this article. PMID:24991989

Park, Min Jung; Kim, Young Kon; Choi, Seo-Youn; Rhim, Hyunchul; Lee, Won Jae; Choi, Dongil

2014-11-01

425

Effect of Prenatal Diagnosis on Outcomes in D-Transposition of the Great Arteries  

Microsoft Academic Search

Background. By decreasing preoperative morbidity, prenatal diagnosis could improve neurode- velopmental outcomes in infants with critical congenital heart disease. We explored the impact of prenatal diag- nosis on perinatal and perioperative variables and on outcomes at 1 year of age. Methods. We analyzed a database of children en- rolled in prospective studies on surgical support tech- niques from 1988 to

Jodi M. Bartlett; David Wypij; David C. Bellinger; Leonard A. Rappaport; Linda J. Heffner; Richard A. Jonas; Jane W. Newburger

2010-01-01

426

Preoperative cerebrospinal fluid ?-Amyloid/Tau ratio and postoperative delirium  

PubMed Central

Objective The neuropathogenesis of postoperative delirium remains unknown. Low cerebrospinal fluid (CSF) ?-amyloid protein (A?) and high CSF Tau levels are associated with Alzheimer's disease. We, therefore, assessed whether lower preoperative CSF A?/Tau ratio was associated with higher incidence and greater severity of postoperative delirium. Methods One hundred and fifty-three participants (71 ± 5 years, 53% men) who had total hip/knee replacement under spinal anesthesia were enrolled. CSF was obtained during initiation of spinal anesthesia. The incidence and severity of postoperative delirium were determined by Confusion Assessment Method (CAM) and Memorial Delirium Assessment Scale (MDAS) on postoperative day 1 and 2. A?40, A?42, and Tau levels in the CSF were measured by enzyme-linked immunosorbent assay. The relationships among these variables were determined, adjusting for age and gender. Results Participants in the lowest quartile of preoperative CSF A?40/Tau and A?42/Tau ratio had higher incidence (32% vs. 17%, P = 0.0482) and greater symptom severity of postoperative delirium (A?40/Tau ratio: 4 vs. 3, P = 0.034; A?42/Tau ratio: 4 vs. 3, P = 0.062, the median of the highest MDAS score) as compared to the combination of the rest of the quartiles. The preoperative CSF A?40/Tau or A?42/Tau ratio was inversely associated with MDAS score (A?40/Tau ratio: ?0.12 ± 0.05, P = 0.014, adj. ?0.12 ± 0.05, P = 0.018; A?42/Tau ratio: ?0.65 ± 0.26, P = 0.013, adj. ?0.62 ± 0.27, P = 0.022). Interpretation Lower CSF A?/Tau ratio could be associated with postoperative delirium, pending confirmation of our preliminary results in further studies. These findings suggest potential roles of A? and/or Tau in postoperative delirium neuropathogenesis. PMID:24860840

Xie, Zhongcong; Swain, Celeste A; Ward, Sarah A P; Zheng, Hui; Dong, Yuanlin; Sunder, Neelakantan; Burke, Dennis W; Escobar, Diana; Zhang, Yiying; Marcantonio, Edward R

2014-01-01

427

Does preoperative gabapentin affects the characteristics of post-dural puncture headache in parturients undergoing cesarean section with spinal anesthesia?  

PubMed Central

Background: Gabapentin is effective for treating different types of headache including post-dural puncture headache (PDPH), also used for prophylaxis against migraine. We studied the effect of pre-operative administration of gabapentin on the characteristics of PDPH in parturients undergoing cesarean section (CS) under spinal anesthesia. Materials and Methods: Women undergoing elective cesarean section under spinal anesthesia were randomized to receive preoperative gabapentin 600 mg or placebo. Spinal anesthesia was achieved with 12.5 mg hyperbaric bupivacaine plus 25 ?g